Asthma in the older person

• Asthma can affect people at any age although it more commonly starts in childhood.
• Adults might have asthma as a child, then it appears to ‘go away’ and reoccurs later in life.
• It is not known why some people get asthma for the first time when they are older.
• Sometimes it is triggered by sensitivity to certain medicines or by allergies.
• It is thought than many more older people have asthma than have been diagnosed as it may be mistaken for other conditions.

• You should keep as active as possible. It is important for your general health and for your lungs.
• The treatments that you have been given should help your asthma symptoms when you exert yourself. Make sure you use your ‘reliever’ (often your blue) inhaler before and, if needed, during any activity that brings on your asthma symptoms.
• You may need to pace yourself and take rests/breaks when you need to do so. You may find that being outside in cold air, for example, is harder than doing an activity indoors. Find out what exercise or activity suits you best and also what you enjoy and try to do this regularly when you are feeling well enough.
• However, if you have another condition like a heart condition, arthritis or COPD too you may need further advice before exercising. Ask your doctor or nurse.

• There are many different types of inhalers and your healthcare professional will help you find one that you can manage and show you how to use it properly. See the section on A practical guide to Inhalers for more information.
• Some inhalers are better for people who find it difficult to manage fiddly things, due to conditions like arthritis or poor eyesight.
• Some inhalers are better if you find it hard to breathe in deeply and then hold your breath in for a short while. A spacer with a standard aerosol inhaler is good for this, and for using when you need several puffs of reliever during an asthma attack or flare-up. Ask your doctor or nurse about having one of these ‘spacers’.
• Very few people need to use a nebuliser at home.

Asthma can be dangerous but if it is treated properly it reduces the chance of an asthma attack. Asthma varies from person to person. Some people have never had an asthma attack, but it is important that you get clear advice on how to recognise that your asthma is getting worse and what to do during an asthma attack, in case it happens to you.

Talk to your doctor or nurse about a personal action plan. Everyone with asthma should have one that is regularly reviewed. This tells you what symptoms to look out for, how to increase your inhalers, and when and whom to contact for advice during surgery opening hours and when your surgery is closed.

Make sure you discuss any concerns so you can be prepared for any change in your asthma

• Treatments for asthma are available to control your symptoms and prevent you getting worse. The aims of your treatment is to keep you as free from symptoms and flare-ups as possible. Take your treatment as prescribed and use your inhalers correctly.
• Things that trigger your asthma, especially smoking, will make you worse. Try to avoid these ‘triggers’ if possible. Stress, anxiety and depression can trigger asthma too. You can get help in managing these things visit Moodcafe by NHS Fife. Steps for Stress a website from the Scottish Government.
• Gaining weight can make you feel more breathless and make your asthma worse. Likewise, losing weight and being more active can help improve your symptoms.
• Some medicines can make your asthma worse. Make sure you tell your pharmacist you have asthma if you are buying medicines.
  Try to avoid chest infections, colds and flu. Get your flu jag!

‘Chronic’ means your condition is longstanding and won’t go away. It doesn’t always mean your condition is ‘bad’ but it is a label sometimes given to asthma when your breathing tubes are permanently tighter than normal for your age, especially when you have had asthma for many years. It might mean you will always be out of breath doing some activities, and your ‘chronic asthma’ may cause some limitations even when you follow your treatment plan carefully.

Follow the advice in the Causes of Asthma section to avoid triggers especially smoking and chest infections, and keep as active as you are able.

• Everybody with asthma should have the opportunity to have an asthma review at least once a year.
• Ask for plenty of notice when your review is due so you can try to make arrangements for a relative or friend to take you there. Make sure you take your inhalers and use your action plan.
• If you are unable to go to the surgery, let your doctor/nurse know.
• Ask if there is the possibility of a ‘home visit’ to review your asthma. Some surgeries offer this service.
• If you can’t have a face to face review, ask if you can discuss your asthma over the phone.

A diagnosis of asthma can be distressing and quite a shock. Find out as much information about your condition and how it is treated.

• Make sure you know how to use your inhalers properly. See the section on A practical guide to Inhalers for more information.
• Make sure you know how to recognise if your asthma is getting worse and what to do.
• Think about your ‘triggers’ and which ones you can avoid. See the section on Causes of asthma for more information.
• Use your ‘asthma review’ to discuss your concerns and ask questions.
• Make sure you avoid smoking, have a flu jag annually and also a jag to prevent pneumonia (Pneumovax). See the section on Vaccinations for adults with asthma for more information.
• Keep as healthy as possible.
• Think about joining a local support group such as Breathe Easy

A. Always check with your GP before changing medication. It may be possible to reduce the amount of the medication you take if your asthma is well controlled.

You should always continue to use your preventer inhalers.