10 Ways to Manage Asthma as You Age

Asthma is a common condition for older adults which can cause serious health problems if not managed well. Find out more about asthma as you age and its long-term management options.

by Emma Lennon

Asthma is sometimes thought of as a condition that mainly affects children. However, asthma can come into your life at any time. Asthma can be a debilitating condition, but with proper management most people with asthma lead rich, fulfilling lives even in later life. Here is everything you need to know about managing asthma as you age. 

What Is Asthma?

Asthma is a common health condition that affects the airways in your lungs. People with asthma have sensitive breathing tubes (airways) that can become inflamed when exposed to certain triggers. Inflammation in the airways causes these tubes to become narrow and constricted, making it difficult to breathe properly. People with asthma often experience symptoms when exposed to their triggers, including wheezing, coughing and shortness of breath.

Sometimes people with asthma experience a flare-up of their symptoms, leading to what is called an asthma attack. Asthma attacks can be frightening experiences where your usual symptoms become more acute and severe. During an asthma attack, breathing can become extremely difficult. Some people with asthma describe the experience as feeling like they breathing through a straw. Asthma flare-ups or attacks can vary in severity but usually require urgent medical attention. Asthma attacks can happen suddenly after exposure to a trigger such as smoke. They can also happen gradually over several hours or days as a result of illness or being otherwise immunocompromised. 

Who Experiences Asthma?

Asthma is common in Australia, affecting around 1 in 9 adults and 1 in 4 children at some stage in their life. You can develop asthma at any time in your life, even if you didn’t have asthma as a child. Some children will stop experiencing asthma symptoms as they enter adulthood, however, asthma is a lifelong disease and not something you grow out of. If you have ever been diagnosed with asthma, you should always have an asthma treatment plan to use in case of a flare-up or attack.

It is not clear why some people develop asthma while others don’t. Children are more likely to have asthma if a close relative is diagnosed with asthma. Children whose mothers smoked during pregnancy, or who were born with low birth weight are also at an elevated risk. Exposure to passive cigarette smoke, mould or air pollution can also increase your risk of asthma symptoms. Even healthy adults can acquire asthma through environmental exposure to triggers, including certain chemical fumes, dust and allergens. 

Asthma in Older Australians

Australian research and interventions for asthma have often focussed on children and young to middle-aged adults. However, asthma is a common chronic disease that affects many older people in Australia. Asthma is estimated to affect about 7-15% of the Australian population aged over 65 years. Despite this, asthma among older Australians is thought to be misunderstood and underdiagnosed. Furthermore, previous interventions to improve asthma outcomes have been less successful among older people than children and younger adults. As the Australian and global population ages, it is important to better understand asthma in older people and how it affects them differently. These insights should then be used to develop more effective strategies to improve health outcomes for older Australians living with asthma. 

6 Barriers to Effective Asthma Management for Older Australians

Ageing brings about a range of physiological changes that can make effective diagnosis and management of conditions like asthma more challenging. Additionally, older Australians may have social, cognitive and environmental barriers to accessing asthma management support. Understanding why asthma outcomes are worse for older Australians is key to improving the health of the thousands of Australians aged over 65 who live with asthma. Whilst further research into this area is required, some of the potential barriers to effectively managing asthma for older adults may include the following.

1. Misunderstood or Missed Symptoms

Recognising abnormal breathing symptoms may be more challenging for older people. Often, shortness of breath can be dismissed as simply being ‘unfit’ or a normal part of ageing. Older adults who have lived with asthma for many years may also be accustomed to their symptoms, so seek less medical advice and attention for them. With age, other health conditions become more prevalent. Some older people may incorrectly assume their breathing symptoms are a result of something else such as bronchitis or a respiratory tract infection. 

2. Lack of Suitable Diagnostic Pathways

Diagnosing asthma is more challenging in older people because their symptoms may be caused by a range of health conditions other than asthma. Furthermore, breathing tests used to diagnose asthma such as spirometry often produce less reliable results among older people. This highlights the need for specialised diagnostic tools and tests to more effectively detect asthma among older people. Even if asthma is successfully diagnosed, older people are less likely to receive an asthma action plan and may be less likely to adhere to their plan when they do receive one. Finding self-management strategies that work for older people is an important way of overcoming this barrier to asthma management.

3. Challenges in Accessing Quality Asthma Care

Asthma can have a detrimental impact on your physical and emotional wellbeing. It can also affect your loved ones, family members and caregivers. Asthma can also be financially challenging when you take into account the various medications, devices and medical appointments involved in managing this chronic illness. Older Australians often experience greater financial disadvantage, which may deter them from seeking treatment when needed.

4. Improper Use of Asthma Medications

Poor adherence to asthma medication is a common issue among older adults. Some older people struggle to correctly use their reliever medication due to cognitive or mobility issues. Others may have concerns about potential side effects of their medications, or experience adverse reactions from a combination of two or more types of medications they take for different illnesses. If you or a loved one lives with asthma, it’s important to regularly review all your medications to ensure they are interacting safely.

5. Comorbidities and Other Health Priorities

Many causes of ill-health become more likely and noticeable as we age. For older people living with asthma, other health priorities might take their attention off managing their asthma. Some comorbid conditions, especially if they affect mobility or cognition, may pose specific barriers to attending medical appointments and undertaking the treatment they need. Asthma management strategies need to be holistic and consider the implications of co-existing diagnoses.

6. Social and Geographical Isolation

Older people can be at greater risk of geographical and social isolation, especially those who live in aged care facilities and/or don’t have relatives who live nearby. Outreach programs and services that improve access to medical facilities can form an important part of effective asthma management for older people. Medical escort or patient transport services are a great way to overcome physical barriers to effective asthma management and care.

10 Ways to Manage Asthma for Older Adults

1. Understand Your Asthma

Knowing how your condition affects you is a crucial first step to taking control of your asthma. Everyone with asthma experiences it differently and may have unique reactions to particular triggers. Keep track of your symptoms, how they impact your ability to engage in your usual activities and any triggers that cause your symptoms to flare. It’s important that you feel confident explaining your asthma to others, including loved ones and medical professionals, so you can always access care when you need it.

2. Maintain A Personalised Asthma Action Plan

If you or a loved one lives with asthma, it’s incredibly important to have a personalised, up-to-date asthma action plan. This plan should provide a comprehensive overview of your condition that is easy to access, read and understand in an emergency situation. People who have an asthma action plan tend to have better control of their symptoms, have fewer asthma attacks requiring hospitalisation, take fewer days off work, miss fewer social events and require reliever medication less frequently. 

Your asthma action plan should include your triggers, medications, dosage, and contact details for your medical team. You can find templates for asthma action plans via the National Asthma Council’s website. Your asthma action plan can be written, or if you prefer you can use the online resource Asthma Buddy for a digital, easily updated plan you can access from your device anywhere. 

3. Know Your Triggers

Everyone with asthma may have slightly different triggers. Knowing the environmental triggers that cause your asthma symptoms to flare is important to stay healthy and in control of your asthma. Keep track of what triggers exacerbate your asthma and include this information in your asthma action plan. Common asthma triggers include cigarette smoke, dust, allergens, exercise, some viral infections, weather changes, stress, some foods and fire smoke. Some medications can also exacerbate asthma symptoms, including beta-blockers and non-steroidal anti-inflammatory drugs (NSAIDs).

4. Use Your Medication Correctly

Adhering to the instructions for using your medication is crucial to effectively manage your asthma. If you have preventative asthma medication, ensure you take it regularly and as prescribed. It is also important to have reliever medication on hand at all times in case you experience a flare-up or an attack. Reliever medication works best when administered using a spacer, so ensure you carry one with you when travelling or away from home.

5. Update Your Knowledge

If you have lived with asthma for many years, there may be new treatment and management options available. Over time, your symptoms and individual triggers may also change. Keep yourself and your loved ones up to date on the latest information about asthma by checking peak body websites, such as the National Asthma Council for helpful, up-to-date resources.

6. Maintain Regular Contact with Your Treatment Team

If you live with asthma, it is important to notify your treating doctor if you experience any change in your condition. Even if it seems minor or insignificant, having a thorough understanding of your condition is important to prevent and address asthma flare-ups and attacks. Put reminders in your calendar to schedule regular medical check-ups to stay on top of any complications that arise so you can address them effectively.

7. Share Your Plan with Loved Ones

If you experience a severe asthma attack, it may be hard to communicate verbally due to shortness of breath. Make sure your family, close friends, caregivers and medical staff know where to find your asthma action plan easily in case of emergency. You can print or photocopy it for them, or provide a digital copy by email so they can always access it using their smartphone if they need it. Asthma attacks can quickly become emergencies, so ensure your loved ones are aware of your asthma action plan and are confident in putting it into action.

8. Take Care of Your Lungs 

Respiratory illnesses and infections can aggravate your asthma symptoms. Prevention is always better than cure, so it is recommended that you get vaccinations for common illnesses like influenza and COVID-19 as recommended by your doctor. Older people are also recommended to get pneumococcal vaccinations to prevent pneumonia.

9. Update Your Plan as Needed

If your circumstances or health status changes, make sure it is reflected in your asthma action plan. Your asthma action plan should always be up-to-date with the latest information about your health and how best to manage your asthma. 

10. Teach Your Asthma First Aid To Your Loved Ones

Asthma attacks can become medical emergencies without timely and effective intervention. Even if you have had asthma for most of your life, it is a frightening experience to have a serious asthma attack. Teach your family, friends and caregivers asthma first aid and do regular refreshers to ensure everyone knows what to do if an asthma attack occurs.

The 4 Steps to

Asthma First Aid 

Step 1: Sit the person upright. Reassure them and do not leave them alone.

Step 2: Immediately give the person four (4) separate puffs of their reliever medication, using a spacer if accessible.

Step 3: Wait four (4) minutes. If there is no improvement, repeat steps 2 and 3.

Step 4: If there is still no improvement, dial triple zero (000) immediately and ask for an ambulance. Continue steps 2 and 3 whilst you wait for the paramedics to arrive.

How Homage Can Help You in Your Asthma Management Journey

Asthma symptoms can make your regular activities difficult, especially during a flare-up. Older people with asthma may struggle to stay on top of household tasks, personal care or attending medical appointments when they are experiencing breathing difficulties. This is where Homage’s team of highly trained, compassionate and dedicated Care Professionals come in. Our professional home nurses can assist with administering medications or put your asthma action plan into practice. Our patient transport service can help you to attend medical check-ups and appointments so that you never have to delay treatment due to a flare-up that prevents you from transporting yourself independently. We can even assist with basic domestic tasks like cleaning, shopping or food preparation, so you and your loved ones can spend less time worrying and more time enjoying each other’s company. Contact us today for an obligation-free consultation with our Care Advisors to find out how we can best support you in your asthma journey today.

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References
  1. Asthma and Allergy Foundation of America. (n.d.). Asthma in Older Adults. Retrieved June 16, 2022, from https://asthmaandallergies.org/asthma-allergies/asthma-in-older-adults/ 
  2. Asthma Australia. (2021). Asthma & Seniors. https://asthma.org.au/wp-content/uploads/2021/09/AASENDL2021-Seniors_DIGITAL_v3.pdf 
  3. Better Health Channel. (2021, March 24). Asthma management. Retrieved June 16, 2022, from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/asthma-management 
  4. Goeman, D. P. (2005, July 4). Understanding asthma in older Australians: a qualitative approach. The Medical Journal of Australia. Retrieved June 16, 2022, from https://www.mja.com.au/journal/2005/183/1/understanding-asthma-older-australians-qualitative-approach 
  5. healthdirect. (2020). Asthma. Retrieved June 16, 2022, from https://www.healthdirect.gov.au/asthma 
  6. Mayo Clinic. (2022, March 5). Asthma – Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653 
  7. Royal Australian College of General Practitioners. (2007, September). The needs of older people with asthma. https://www.racgp.org.au/getattachment/47258f75-3ff0-4efc-8469-af3df6bdac11/attachment.aspx 
  8. The National Asthma Council Australia. (2022a). Asthma action plans. https://www.nationalasthma.org.au/living-with-asthma/asthma-action-plans 
  9. The National Asthma Council Australia. (2022b). What is asthma? Retrieved June 16, 2022, from https://www.nationalasthma.org.au/understanding-asthma/what-is-asthma
About the Writer
Emma Lennon
Emma is a public health professional who is passionate about creating health content that informs and empowers. When she is not writing, you can find her at the gym or curled up on the couch with her rescue greyhounds.
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