Perhaps you have noticed that Mom or Dad isn’t bathing regularly, or the bills
aren’t being paid, or the house is uncharacteristically messy. Maybe they seem to forget directions from one location to anther, or even worse, they have had a car accident,or re p o rt falling in the home when no one was around to help them. Often, adult children of aging parents notice changes in their loved ones, and when the aging adult is confronted with the facts, they say, “Oh everything is fine, I don’t need any help, don’t worry about me!”
The loss of independence and choice is something none of us want to face. Having our own children tell us what do to or how to live our lives is uncomfortable at best. Many aging adults are also very private about their financial matters, and will not discuss income or assets with adult children. How do you start that conversation with your parents? There is not a one-size-fits-all answer. Below are some tips that might help the process along.
Pick an appropriate time and place. Avoid large family gatherings,holidays, birthdays, and other celebrations. A quiet location, in their home or yours might be more comfortable.
Avoid blaming or accusing. Instead, redirect the conversation by telling your parent how YOU feel. For example, “Mom, I find myself worrying about you a lot these days, and I would like to tell you why I am feeling this way.”
Talk to a geriatric care manager in your area for some good advice on how to approach your parent’s specific needs. That care manager has helped family members have this kind of conversation hundreds of times throughout their career. They are full of helpful hints and tips.
If you decide to seek the services of a geriatric care manager, ask them about their approach when it comes to dealing with difficult clients, or clients who may not perceive a need for services. I often tell adult children that when they approach their parents about setting up an evaluation, they might tell their parents, “I know you don’t want me to worry about you, and I only want the best for you. Having this professional come over and talk to us would really make me feel better. If you would agree to talk with her, we can look at her recommendations together and see if any of them make sense. Is that fair?”
Remember that having a third party, who is not a family member and is completely objective, can help the senior see things from a different point of view. They feel like they are getting some professional advice, as opposed to opinions from their children.
Finally, if the senior is truly not living safely, a geriatric care manager can let the senior know that they need to make some choices about their care or living arrangements NOW, before someone else has to make that decision for them later. Of course, this is done with professionalism, courtesy, compassion, and caring.
Wednesday, January 16, 2008
Monday, January 14, 2008
Making the Most of Doctor Visits
If you go with your parent to see the doctor, here are a few tips that will help you be an ally and advocate:
Bring a prioritized list of questions and take notes on what the doctor recommends. Both can be helpful later, either to give information to the primary caregiver, or to remind your parent what the doctor said.
Before the appointment, ask your parent, the primary caregiver, and your siblings if they have any questions or concerns they would like you to bring up.
Bring a list of ALL medications your parent is taking, both prescription and over-the-counter, and include dosage and schedule (if your parent sees several different doctors one may not necessarily know what another has prescribed).
Tell the doctor about what your loved one used to do, but can no longer do. Sometimes patients come to accept a certain level of disability, particularly if it's the result of a condition that has come on slowly. For example, if she used to garden or knit, but her hands and fingers ache, these are things you should tell the doctor. If you don't share these problems with the doctor, she may miss out on treatments.
When the doctor asks a question, do not answer for your parent unless you have been asked to do so. Always talk to the doctor and to your parent.
Be active during the doctor visit. Take notes and ask questions if you don't agree or don't understand.
Tell the doctor if a treatment or medicine isn't working and ask for something different.
Ask the doctor to discuss other options if he or she saysa test or procedure are needed and you or your parent don't think you it's needed.
Get a second opinion from another doctor if you don't agree with what the doctor is telling you. Find out if your parent's health plan will pay for the cost of getting a second opinion.
• Respect your parent’s privacy, and leave the room when necessary.
• Ask the doctor if she or he can recommend community resources that might be helpful.
Bring a prioritized list of questions and take notes on what the doctor recommends. Both can be helpful later, either to give information to the primary caregiver, or to remind your parent what the doctor said.
Before the appointment, ask your parent, the primary caregiver, and your siblings if they have any questions or concerns they would like you to bring up.
Bring a list of ALL medications your parent is taking, both prescription and over-the-counter, and include dosage and schedule (if your parent sees several different doctors one may not necessarily know what another has prescribed).
Tell the doctor about what your loved one used to do, but can no longer do. Sometimes patients come to accept a certain level of disability, particularly if it's the result of a condition that has come on slowly. For example, if she used to garden or knit, but her hands and fingers ache, these are things you should tell the doctor. If you don't share these problems with the doctor, she may miss out on treatments.
When the doctor asks a question, do not answer for your parent unless you have been asked to do so. Always talk to the doctor and to your parent.
Be active during the doctor visit. Take notes and ask questions if you don't agree or don't understand.
Tell the doctor if a treatment or medicine isn't working and ask for something different.
Ask the doctor to discuss other options if he or she saysa test or procedure are needed and you or your parent don't think you it's needed.
Get a second opinion from another doctor if you don't agree with what the doctor is telling you. Find out if your parent's health plan will pay for the cost of getting a second opinion.
• Respect your parent’s privacy, and leave the room when necessary.
• Ask the doctor if she or he can recommend community resources that might be helpful.
Saturday, January 12, 2008
Staying Warm This Winter: Special Considerations for the Elderly
Cold weather is very risky for older people. Almost everyone knows about winter dangers such as broken bones from falls on ice or breathing problems caused by cold air. But the winter chill can also lower the temperature inside an older body. That can be deadly if not treated quickly. This drop in body temperature, often caused by staying in a cool place for too long, is hypothermia. A body temperature below 96°F may seem like just a couple of degrees below the body’s normal temperature of 98.6°F. It can be dangerous. It may cause an irregular heartbeat leading to heart problems and death.
When you think about being cold, you probably think of shivering. That is one thing the body does when it gets cold. This warms the body. Muscles shiver in response to messages sent by the nerves. Shivering increases muscle cell activity that, in turn, makes heat. But, shivering alone does not mean hypothermia. So, how can you tell if someone has hypothermia? It can be tricky because some older people may not want to complain. They may not even be aware of how cold it is.
Look for the “umbles”—stumbles, mumbles, fumbles, and grumbles—these show that the cold is affecting how well a person’s muscles and nerves work. Watch for:
■ Confusion or sleepiness
■ Slowed, slurred speech or shallow breathing
■ Weak pulse or low blood pressure
■ A change in behavior during cold weather or a change in the way they look; alot of shivering or no shivering; stiffness in the arms or legs
■ Chilly rooms or other signs that they have been in a cold place, or
■ Poor control over body movements or slow reactions.
If you think someone could have hypothermia, take his or her temperature with a thermometer. Make sure you shake the thermometer so it starts below its lowest point. If the temperature doesn’t rise above 96°F, call 911. The only way to tell for sure that someone has hypothermia is to use a special thermometer that can read very low body temperatures. Most hospitals have such thermometers. The person must be seen by a doctor. If possible, the doctor should know about hypothermia and work in a well-equipped hospital emergency room. There, the health care team will warm the person’s body from inside out. For example, they may give the person warm fluids directly into a vein using an I.V. Whether the person gets better depends on how long he or she was exposed to the cold and his or her general health. While you are waiting for help to arrive, keep the person warm and dry. Move him or her t
o a warmer place, if possible. Wrap the person in blankets, towels, coats—whatever is handy. Even your own body warmth will help. Lie close, but be gentle. You may be tempted to rub the person’s arms and legs. This can make the problem worse. The skin of an older person may be thinner and more easily torn than the skin of someone younger.
Some things that put any older person at risk for hypothermia and some things you can do to avoid it include:
■ Changes in the body that come with aging can make it harder to feel when someone is getting cold. It may be harder for his or her body to warm itself. Pay attention to how cold it is where you are.
■ If a person doesn’t eat well, you might have less fat under the skin. Fat can protect the
body. It keeps heat in. Make sure your loved one is eating enough food to keep his or her weight up.
■ Some illnesses may make it harder for the body to stay warm. These include:
➤ Disorders of the body’s hormone system such as low thyroid (hypothyroidism),
➤ Any condition that interferes with the normal flow of blood such as diabetes, and
➤ Some skin problems such as psoriasis that allow the body to lose more heat than normal. Regular doctor visits can keep any illness under control.
■ Other health problems might keep a person from moving to a warmer place or putting on more clothes or a blanket. For example:
➤ Severe arthritis, Parkinson’s disease, or other illnesses that make it harder to move around
➤ Stroke or other illnesses that can leave a person paralyzed and make clear thinking more difficult
➤ Memory disorders or dementia
➤ A fall or other injury.
■ Some medicines often used by older people also increase the risk of accidental hypothermia. These include drugs used to treat anxiety, depression, or nausea. Some over-the-counter cold remedies can also cause problems. Ask the doctor how the medicines your loved one is taking affect body heat.
■ Alcoholic drinks can also make a person lose body heat faster. Encourage your loved one to use alcohol moderately, if at all. He or she should not drink alcohol before bedtime when it gets colder outside—and maybe inside, too.
■ Clothing can make a person colder or help keep warm. Tight clothing can keep the blood from flowing freely. This can lead to loss of body heat. Encourage your loved one to wear several layers of loose clothing when it is cold. The layers will trap warm air between them.
Maybe you already knew that a person's health, age, what they eat or drink, even clothes can make it hard for a person to stay warm enough wherever they are. What you might not realize is that people can also get cold enough inside a building to get very sick. In fact, hypothermia can even happen to someone in a nursing home or group facility if the rooms are not kept warm enough. People living there who are already sick may have special problems keeping warm.
If someone you know is in a group facility, pay attention to the inside temperature there and to whether that person is dressed warmly enough. Homes or apartments that are not heated enough, even with a temperature of 60°F to 65°F, can lead to illness. This is a special problem if they alone because there is no one else to comment on the chilliness of the house or to notice if a person are having symptoms of hypothermia. Set the thermostat for at least 68°F to 70°F. If a power outage leaves him or her without heat, move him or her to stay with family or friend.
Avoid using space heaters if the home seems cold or if they want to keep the thermostat set lower to keep heating costs down. Some types are fire hazards, and others can cause carbon monoxide poisoning. The U.S. Consumer Product Safety Commission has information on the use of space heaters, but here are a few things to remember:
Make sure the space heater has been approved by a recognized testing laboratory.
■ Choose the right size heater for the space being heated.
■ Kee
p substances that can catch fire like paint, pets, clothing, towels, curtains, and papers away from the heating element.
■ Keep the door to the rest of the house open for good air flow.
■ Turn the heater off when unattended such as when leaving the room or going to bed.
■ Make sure smoke alarms are working.
■ Put a carbon monoxide detector near where people sleep.
■ Keep the right type of fire extinguisher nearby.
Don’t forget the need to stay warm when it’s cold outside. Remember that this means knowing if weather forecasts are for very cold temperatures or for windy and cold weather. Your loved one may lose more body heat on a windy day than a calm day. Weather forecasters call this the wind-chill factor. They often suggest, even when the outside temperature itself is not very low, that the wind-chill factor is cold enough for people to stay indoors. If your loved one must go out, they must dress correctly. Be sure to wear a hat and gloves, as well as warm clothes.
Sometimes older people need help making sure their home will keep them warm enough. Some help is available. If the home doesn’t have enough insulation, contact the state or local energy agency or the local power or gas company. They can give information about weatherizing the home. This can help keep the heating bills down. It is also important to think about only heating the rooms in use in the house. For example, shut the heating vents and doors to any bedrooms not being used. Keep the door to the basement closed. If your loved one has a limited income, he or she may qualify for help paying your heating bill. State and local energy agencies or gas and electric companies have special programs that he or she may qualify for. Another possible source of help is the Low Income Home Energy Assistance Program (LIHEAP). This program supports some people with small incomes who need help paying their heating and cooling bills. The Area Agency on Aging has information on programs such as these.
When you think about being cold, you probably think of shivering. That is one thing the body does when it gets cold. This warms the body. Muscles shiver in response to messages sent by the nerves. Shivering increases muscle cell activity that, in turn, makes heat. But, shivering alone does not mean hypothermia. So, how can you tell if someone has hypothermia? It can be tricky because some older people may not want to complain. They may not even be aware of how cold it is.
Look for the “umbles”—stumbles, mumbles, fumbles, and grumbles—these show that the cold is affecting how well a person’s muscles and nerves work. Watch for:
■ Confusion or sleepiness
■ Slowed, slurred speech or shallow breathing
■ Weak pulse or low blood pressure
■ A change in behavior during cold weather or a change in the way they look; alot of shivering or no shivering; stiffness in the arms or legs
■ Chilly rooms or other signs that they have been in a cold place, or
■ Poor control over body movements or slow reactions.
If you think someone could have hypothermia, take his or her temperature with a thermometer. Make sure you shake the thermometer so it starts below its lowest point. If the temperature doesn’t rise above 96°F, call 911. The only way to tell for sure that someone has hypothermia is to use a special thermometer that can read very low body temperatures. Most hospitals have such thermometers. The person must be seen by a doctor. If possible, the doctor should know about hypothermia and work in a well-equipped hospital emergency room. There, the health care team will warm the person’s body from inside out. For example, they may give the person warm fluids directly into a vein using an I.V. Whether the person gets better depends on how long he or she was exposed to the cold and his or her general health. While you are waiting for help to arrive, keep the person warm and dry. Move him or her t
o a warmer place, if possible. Wrap the person in blankets, towels, coats—whatever is handy. Even your own body warmth will help. Lie close, but be gentle. You may be tempted to rub the person’s arms and legs. This can make the problem worse. The skin of an older person may be thinner and more easily torn than the skin of someone younger.Some things that put any older person at risk for hypothermia and some things you can do to avoid it include:
■ Changes in the body that come with aging can make it harder to feel when someone is getting cold. It may be harder for his or her body to warm itself. Pay attention to how cold it is where you are.
■ If a person doesn’t eat well, you might have less fat under the skin. Fat can protect the
body. It keeps heat in. Make sure your loved one is eating enough food to keep his or her weight up.
■ Some illnesses may make it harder for the body to stay warm. These include:
➤ Disorders of the body’s hormone system such as low thyroid (hypothyroidism),
➤ Any condition that interferes with the normal flow of blood such as diabetes, and
➤ Some skin problems such as psoriasis that allow the body to lose more heat than normal. Regular doctor visits can keep any illness under control.
■ Other health problems might keep a person from moving to a warmer place or putting on more clothes or a blanket. For example:
➤ Severe arthritis, Parkinson’s disease, or other illnesses that make it harder to move around
➤ Stroke or other illnesses that can leave a person paralyzed and make clear thinking more difficult
➤ Memory disorders or dementia
➤ A fall or other injury.
■ Some medicines often used by older people also increase the risk of accidental hypothermia. These include drugs used to treat anxiety, depression, or nausea. Some over-the-counter cold remedies can also cause problems. Ask the doctor how the medicines your loved one is taking affect body heat.
■ Alcoholic drinks can also make a person lose body heat faster. Encourage your loved one to use alcohol moderately, if at all. He or she should not drink alcohol before bedtime when it gets colder outside—and maybe inside, too.
■ Clothing can make a person colder or help keep warm. Tight clothing can keep the blood from flowing freely. This can lead to loss of body heat. Encourage your loved one to wear several layers of loose clothing when it is cold. The layers will trap warm air between them.
Maybe you already knew that a person's health, age, what they eat or drink, even clothes can make it hard for a person to stay warm enough wherever they are. What you might not realize is that people can also get cold enough inside a building to get very sick. In fact, hypothermia can even happen to someone in a nursing home or group facility if the rooms are not kept warm enough. People living there who are already sick may have special problems keeping warm.
If someone you know is in a group facility, pay attention to the inside temperature there and to whether that person is dressed warmly enough. Homes or apartments that are not heated enough, even with a temperature of 60°F to 65°F, can lead to illness. This is a special problem if they alone because there is no one else to comment on the chilliness of the house or to notice if a person are having symptoms of hypothermia. Set the thermostat for at least 68°F to 70°F. If a power outage leaves him or her without heat, move him or her to stay with family or friend.
Avoid using space heaters if the home seems cold or if they want to keep the thermostat set lower to keep heating costs down. Some types are fire hazards, and others can cause carbon monoxide poisoning. The U.S. Consumer Product Safety Commission has information on the use of space heaters, but here are a few things to remember:
Make sure the space heater has been approved by a recognized testing laboratory.
■ Choose the right size heater for the space being heated.
■ Kee
p substances that can catch fire like paint, pets, clothing, towels, curtains, and papers away from the heating element.■ Keep the door to the rest of the house open for good air flow.
■ Turn the heater off when unattended such as when leaving the room or going to bed.
■ Make sure smoke alarms are working.
■ Put a carbon monoxide detector near where people sleep.
■ Keep the right type of fire extinguisher nearby.
Don’t forget the need to stay warm when it’s cold outside. Remember that this means knowing if weather forecasts are for very cold temperatures or for windy and cold weather. Your loved one may lose more body heat on a windy day than a calm day. Weather forecasters call this the wind-chill factor. They often suggest, even when the outside temperature itself is not very low, that the wind-chill factor is cold enough for people to stay indoors. If your loved one must go out, they must dress correctly. Be sure to wear a hat and gloves, as well as warm clothes.
Sometimes older people need help making sure their home will keep them warm enough. Some help is available. If the home doesn’t have enough insulation, contact the state or local energy agency or the local power or gas company. They can give information about weatherizing the home. This can help keep the heating bills down. It is also important to think about only heating the rooms in use in the house. For example, shut the heating vents and doors to any bedrooms not being used. Keep the door to the basement closed. If your loved one has a limited income, he or she may qualify for help paying your heating bill. State and local energy agencies or gas and electric companies have special programs that he or she may qualify for. Another possible source of help is the Low Income Home Energy Assistance Program (LIHEAP). This program supports some people with small incomes who need help paying their heating and cooling bills. The Area Agency on Aging has information on programs such as these.
Thursday, January 10, 2008
Advice for New Family Caregivers
When you're starting out as a family caregiver, it's hard to know where to begin. Perhaps you've only recently realized that a loved one needs assistance, and is no longer as self-sufficient as he or she once was. Or perhaps there has been a sudden change in a loved one's health. Now it's time to take action, and take stock of the people, services and information that will help you care for your loved one. The earlier you find support, the better. 
1. Start with a diagnosis. If your loved one is forgetful at times or has gone through a noticeable personality change, take him or her to a neurologist or diagnostic clinic. A thorough evaluation will rule out any reversible causes of dementia symptoms, such as depression, nutritional deficiencies, reactions to medication or infection. An early diagnosis of Alzheimer's disease, or another disease that causes cognitive impairment, has many benefits. First, treatment for Alzheimer's disease is most effective in the earlier stages and can buy more independence for your loved one. Second, knowing your loved one's diagnosis can help you plan ahead realistically.
Learn as much as you can about your family member's condition. This information will confirm that you are not imagining things or exaggerating your loved one's behavior. Especially when you're dealing with dementia, learning about the diagnosis will help you keep in mind that it's the disease that is causing your loved one to gradually lose control over his or her behavior. Many books, videos and classes are available to inform you about what you can expect as your loved one's disease progresses.
2. Talk with your loved one about his or her finances and health care wishes. If your relative is able to complete a Durable Power of Attorney for finances and health care, assist her or him in meeting with an elderlaw specialist to draw up these documents. This planning can help relieve your immediate anxiety and make you better prepared for the future. It can also start important discussions with your family members. If your loved one doesn't have the capacity to execute these documents, you will need further legal advice to learn about your options.
3. At this stage, consider inviting family and close friends to come together and discuss your loved one's care. If possible, your loved one should be included in the meeting. List the tasks that are needed so they can be more easily divided up. Let everyone discuss their concerns, as well as how much and what kind of help each person can offer. As the primary caregiver, it's best for you to focus on accepting what assistance your friends and family are offering, even if it's not exactly what you had in mind.
4. Check into programs such as Meals on Wheels and adult day care programs. These resources are available so that you don't have to do everything yourself'and to give you a brea
k. You can also see if there are caregiver classes and workshops offered in your community by the Area Agency on Aging. These education programs will help you feel more confident and make the time you spend caregiving easier for both you and your loved one.
k. You can also see if there are caregiver classes and workshops offered in your community by the Area Agency on Aging. These education programs will help you feel more confident and make the time you spend caregiving easier for both you and your loved one.5. After all of this planning, don't forget what's most important: finding support for yourself. Caregivers often feel isolated as they take on more responsibility, and as their social lives move into the background. A support group is a good place to meet other family caregivers who have really "been there". You can attend support groups in your community, as well as through the Internet.
Tuesday, January 08, 2008
What Stressors Do You Feel As A Caregiver?
Caring for your older relative or coordinating services for them through community agencies can be overwhelming. Feelings of frustration, depression, anger or guilt are not uncommon. Many caregivers decide to join a support group to provide emotional comfort. These groups allow people to share feelings and information and relieve stress, resentment and anxiety. Others seek help from their clergy or call their local agency on aging for assistance.
The following questionnaire will help you to become more aware of the stresses that you may be under. For each statement, answer for yourself whether each statement describes you or does not describe your situation.
I find I can't get enough rest.
I don't have time for myself.
I feel frustrated or angry.
I feel guilty about my situation.
I don’t get out much anymore.
I argue with the person I am caring for.
I argue with other family members.
I don't feel I know enough to be an effective caregiver.
If the response to one or more of these statements is "describes me," it may be time to begin looking for help with caring for your older relative and help in taking care of yourself.
Signs of Too Much Stress
PHYSICAL: headache, muscle aches, sleeping and eating problems, getting sick frequently.
EMOTIONAL: guilt, anger, loneliness, depression, and anxiety.
MENTAL: forgetfulness, difficulty making decisions, attention wandering.
INTERPERSONAL: withdrawal, blaming, irritability, impatience, and sensitivity to criticism.
SPIRITUAL: feelings of alienation, loss of hope, purpose, and meaning.
What caregivers need most, say professionals, is a clear sense of their own limits as caregivers. This means you may want to try to:
· Talk openly with your aging relative and other family members.
· Assess the problems.
· Figure out where to get help.
· Decide how much help you can realistically supply.
As you begin to assess your own situation keep in mind:
(1) Caring for yourself is a priority.
(2) Know and respect your limits.
(3) Arrange for time for yourself (to be alone).
(4) Arrange for time with a spouse, other family and friends.
(5) Give yourself credit for things you do well.
(6) Caregiving can be a partnership in which you share responsibilities with others.
Fortunately there are some things that you can do to help manage caregiving stresses. The first step is to reflect on how you spend your time each day. Imagine a "typical" day. Ask yourself, "How much time do I spend?" (estimate the number of minutes or hours each day)
EATING _____
SLEEPING _____
GIVING CARE TO AN OLDER PERSON _____
TAKING PART IN FAMILY ACTIVITIES _____
WORKING AT MY JOB _____
ACTIVITIES WITH FRIENDS & NEIGHBORS _____
SPIRITUAL ACTIVITIES _____
BEING ALONE _____
OTHER _____
Total Hours _____
Now that you have sketched out how you spend your time, you can determine how much time you have for yourself and how much time you have with friends or other family members.
Case Study:
Nan Harris felt guilty about asking someone to stay with her father while she did errands but she couldn't find time to go food shopping or keep her own doctors' appointments. Even more troubling, she realized that the only person she was regularly talking to was her sister. Somehow, the challenges of arranging care for dad had taken a priority over keeping up with friends and her own interests. The second step may be to arrange for a substitute caregiver for short periods of time so that you can get some time away from your caregiving responsibilities.
Nan called her Area Agency on Aging for information about eldercare services. She was fortunate because there was a respite program near her which provides trained volunteers to act as substitute caregivers for short (2-4 hours) periods of time once a week. Nan later related that the "time I spent alone revitalized and recharged me."
Listening to music, reading, taking walks and other forms of exercise, can help you to better handle the stresses you may experience during the day. Taking care of personal business also can help you feel more in control of daily pressures. While most caregivers feel that they can, should or must provide all the care to their family member, carrying the total burden is not helpful and probably impossible in the long run.The third step is to ask for other assistance from family, friends, churches, in-home aide services and community agencies.
Before you dismiss the idea of seeking help consider these three points:
1. Additional help allows you to be a more effective caregiver by giving you time away from the person you are caring for.
2. Your spouse or older relative benefits by seeing and being with someone other than you.
3. Community-based services often allow the older family member to postpone using a nursing home by providing the more difficult and/or skilled care that is needed and can be provided in the home.
The following questionnaire will help you to become more aware of the stresses that you may be under. For each statement, answer for yourself whether each statement describes you or does not describe your situation.
I find I can't get enough rest.
I don't have time for myself.
I feel frustrated or angry.
I feel guilty about my situation.
I don’t get out much anymore.
I argue with the person I am caring for.
I argue with other family members.
I don't feel I know enough to be an effective caregiver.
If the response to one or more of these statements is "describes me," it may be time to begin looking for help with caring for your older relative and help in taking care of yourself.
Signs of Too Much Stress
PHYSICAL: headache, muscle aches, sleeping and eating problems, getting sick frequently.
EMOTIONAL: guilt, anger, loneliness, depression, and anxiety.
MENTAL: forgetfulness, difficulty making decisions, attention wandering.
INTERPERSONAL: withdrawal, blaming, irritability, impatience, and sensitivity to criticism.
SPIRITUAL: feelings of alienation, loss of hope, purpose, and meaning.
What caregivers need most, say professionals, is a clear sense of their own limits as caregivers. This means you may want to try to:
· Talk openly with your aging relative and other family members.
· Assess the problems.
· Figure out where to get help.
· Decide how much help you can realistically supply.
As you begin to assess your own situation keep in mind:
(1) Caring for yourself is a priority.
(2) Know and respect your limits.
(3) Arrange for time for yourself (to be alone).
(4) Arrange for time with a spouse, other family and friends.
(5) Give yourself credit for things you do well.
(6) Caregiving can be a partnership in which you share responsibilities with others.
Fortunately there are some things that you can do to help manage caregiving stresses. The first step is to reflect on how you spend your time each day. Imagine a "typical" day. Ask yourself, "How much time do I spend?" (estimate the number of minutes or hours each day)
EATING _____
SLEEPING _____
GIVING CARE TO AN OLDER PERSON _____
TAKING PART IN FAMILY ACTIVITIES _____
WORKING AT MY JOB _____
ACTIVITIES WITH FRIENDS & NEIGHBORS _____
SPIRITUAL ACTIVITIES _____
BEING ALONE _____
OTHER _____
Total Hours _____
Now that you have sketched out how you spend your time, you can determine how much time you have for yourself and how much time you have with friends or other family members.
Case Study:
Nan Harris felt guilty about asking someone to stay with her father while she did errands but she couldn't find time to go food shopping or keep her own doctors' appointments. Even more troubling, she realized that the only person she was regularly talking to was her sister. Somehow, the challenges of arranging care for dad had taken a priority over keeping up with friends and her own interests. The second step may be to arrange for a substitute caregiver for short periods of time so that you can get some time away from your caregiving responsibilities.
Nan called her Area Agency on Aging for information about eldercare services. She was fortunate because there was a respite program near her which provides trained volunteers to act as substitute caregivers for short (2-4 hours) periods of time once a week. Nan later related that the "time I spent alone revitalized and recharged me."
Listening to music, reading, taking walks and other forms of exercise, can help you to better handle the stresses you may experience during the day. Taking care of personal business also can help you feel more in control of daily pressures. While most caregivers feel that they can, should or must provide all the care to their family member, carrying the total burden is not helpful and probably impossible in the long run.The third step is to ask for other assistance from family, friends, churches, in-home aide services and community agencies.
Before you dismiss the idea of seeking help consider these three points:
1. Additional help allows you to be a more effective caregiver by giving you time away from the person you are caring for.
2. Your spouse or older relative benefits by seeing and being with someone other than you.
3. Community-based services often allow the older family member to postpone using a nursing home by providing the more difficult and/or skilled care that is needed and can be provided in the home.
Sunday, January 06, 2008
Osteoporosis: Not Just a Women's Disease
Oseteoporosis is a disease in which the bones become weak and can break easily. Often people don't know that they have osteporosis until a bone actually breaks or fractures. Any bone can be affected by osteoporosis, but the most common bones that break are in the hip, back, and wrist. The condition is quite serious because fractures can lead to pain, hospitalizations, surgery, disability, and even death.
Bones are made up mostly of proteins and minerals. Two minerals that are especially important in bone are calcium and phosphorus. Bones are living tissues and old bone cells are always being replaced by new ones. There are special cells that build up new bone (osteoblasts) while other cells (osteoclasts) break down old bone. As people get older, their bodies don't replace all the
bone that has been broken down, and bones tend to become more porous, weaker and more likely to break.
bone that has been broken down, and bones tend to become more porous, weaker and more likely to break.
Osteoporosis is not just a woman’s disease. Not as many men have it as women do, but men need to worry about it as well. This may be because most men start with more bone density than women and lose it more slowly as they grow older. Millions of Americans have osteoporosis.They are mostly women, but more than 2 million men also have this disease. White and Asian women are most likely to have osteoporosis.
Other women at great risk include those who:
✦ have a family history of the disease,
✦ have broken a bone while an adult,
✦ had surgery to remove their ovaries before their periods stopped,
✦ had early menopause,
✦ have not gotten enough calcium throughout their lives,
✦ had extended bed rest
✦ used certain medicines for a long time, or
✦ have a small body frame
Experts don’t know as much about this disease in men as they do in women. However, many of the things that put men at risk are the same as those for women:
✦ family history
✦ not enough calcium or vitamin D
✦ too little exercise
✦ low levels of testosterone
✦ too much alcohol
✦ taking certain drugs
✦ smoking
It is best to prevent osteoporosis before it starts, and there are many steps that everyone can take to decrease the risk of bone loss. If your loved one is at high risk of osteoporosis or is already experiencing bone loss, talk to the doctor about testing and treatments. The test used to diagnose osteoporosis is called a bone density test. This test is a measure of how strong -- or dense -- bones are and can help your doctor predict risk for having a fracture. Bone density tests are painless, safe, and requires no preparation. Bone density tests compare bone density to the bones of an average healthy young adult. The test result, known as a T-score, tells how strong the bones are, whether a person has osteoporosis or osteopenia -- low bone mass -- and risk for having a fracture. Some people may be unaware that they have already experienced one or more spine fractures. Height loss of one inch or more may be the first sign that someone has experienced spine fractures due to osteoporosis. Multiple spine fractures can cause a curved spine, stooped posture, back pain, and back fatigue.
The goal of treatment is to prevent fractures. A balanced diet rich in calcium, adequate vitamin D, a regular exercise program, and fall prevention are all important for maintaining bone health. There are medications that can slow the rate of bone loss and even help rebuild bone. Several medications are approved by the Food and Drug Administration for the treatment of osteo-porosis. Since all medications have side effects, it is important to talk to the doctor about which medication is right for your loved one.
When bones are weak, a simple fall can cause a broken bone. This can mean a trip to the hospital and maybe surgery. It might also mean being laid up for a long time, especially in the case of a hip fracture. So, it is important to prevent falls.
When bones are weak, a simple fall can cause a broken bone. This can mean a trip to the hospital and maybe surgery. It might also mean being laid up for a long time, especially in the case of a hip fracture. So, it is important to prevent falls.
Some things you can do are:
✦ Make sure your loved one can see and hear well. Encourage them to sse glasses or a hearing aid if needed.
✦ Ask the doctor if any of the drugs he or she is taking can make him or her dizzy or unsteady on their feet.
✦ Encourage your loved one to use a cane or walker if walking is unsteady. A physical therapist can make recommendations for the most appropriate walking device and train your loved one to use it properly.
✦ Wear rubber-soled and lowheeled shoes.
✦ Make sure all the rugs and carpeting in the house are firmly attached to the floor, or don’t use them.
✦ Keep the rooms of the home well lit and the floor free of clutter.
✦ Use nightlights.
✦ Make sure your loved one can see and hear well. Encourage them to sse glasses or a hearing aid if needed.
✦ Ask the doctor if any of the drugs he or she is taking can make him or her dizzy or unsteady on their feet.
✦ Encourage your loved one to use a cane or walker if walking is unsteady. A physical therapist can make recommendations for the most appropriate walking device and train your loved one to use it properly.
✦ Wear rubber-soled and lowheeled shoes.
✦ Make sure all the rugs and carpeting in the house are firmly attached to the floor, or don’t use them.
✦ Keep the rooms of the home well lit and the floor free of clutter.
✦ Use nightlights.
Tuesday, January 01, 2008
Caregiving: A Difficult Role
Being a caregiver for an older adult is a tough job. Caregivers are faced with decisions everyday. Throughout the caregiving ecperience, people second guess themselves about every day care. You may ask yourself "what would my loved one do if were me receiving the care"? You find yourself trying to hang on to anything that might indicate a wrong diagnosis.
Accepting a diagnosis such as cancer, Alzheimer's disease, MS, or Parkinson's disease is very hard to do. As each day passes, there are new challenges. It can be a surreal experience. It takes a team to handle the ever changing situation as you do your best to keep your loved one safe and to keep yourself from becoming burned out.
You must be sure your loved one is safe in their own home. In many cases, movement can deteriorate as a disease progresses, so safety and prevention of falls become a primary concern.
Alzheimer’s disease patients may awaken at night and must be supervised to insure they don't wander away from the home. The job of a caregiver is so taxing that it is best handled by a family team if possible.
Each family member can take on a different role, doing what each are best at. Some may be able to sit by the patient and talk and make the loved one smile. Others can tackle the legal issues and paperwork that seems endless. Everyone can give all that they can and do the best at what they know how. Not everyone is good or comfortable in the same role.
Consider the story of Bettty. She is 58 years old and the sole caregiver to her husband, John, 64 years old, who was diagnosed with primary-progressive multiple sclerosis, three months following his retirement. He is paralyzed from the upper chest downwards-and is losing ground every day. By necessity Betty has learned to use power tools, do plumbing chores, get urine out of the carpet, recognize possible pressure sores and dress a 6’5", 240 pound dead weight.
All the errands, car servicing and driving are her responsibility. She does all the cooking, shopping, cleaning and laundry and has learned to give haircuts because she has found that the outside world really isn’t wheelchair accessible.
She misses the hugs, the snuggling, the hand holding, the love making, the dancing, and the strong shoulder to lean on. Depression, loneliness, hopelessness, and fear (including fear of getting sick herself and not being able to care for her husband and the fear of what will happen to her) – and guilt because she feels those things –are constant companions.
She needs help finding affordable long term care insurance that takes into consideration the fact that MS (and other chronic illness) patients can live decades while totally physically incapacitated. She needs a central clearing house of services available to assist her in caring for her husband and home.
It is important for families to reach out for help. Don’t be embarrassed by the things your loved one may say or do. They are ill and people will understand. Seek the help of friends, your church, social services, and if possible, a geriatric care manager. The job of caregiver is too big for one person regardless age or background. Eventually you will need help and you shouldn’t wait until the disease has taken a physical and mental toll on you along with your loved one. Go to local support groups or support groups on line.
If you live in Berks County, PA and would like a listing of local support services, please contact me at the confidential e-mail link on the right side of this blog page.
Accepting a diagnosis such as cancer, Alzheimer's disease, MS, or Parkinson's disease is very hard to do. As each day passes, there are new challenges. It can be a surreal experience. It takes a team to handle the ever changing situation as you do your best to keep your loved one safe and to keep yourself from becoming burned out.
You must be sure your loved one is safe in their own home. In many cases, movement can deteriorate as a disease progresses, so safety and prevention of falls become a primary concern.
Alzheimer’s disease patients may awaken at night and must be supervised to insure they don't wander away from the home. The job of a caregiver is so taxing that it is best handled by a family team if possible.
Each family member can take on a different role, doing what each are best at. Some may be able to sit by the patient and talk and make the loved one smile. Others can tackle the legal issues and paperwork that seems endless. Everyone can give all that they can and do the best at what they know how. Not everyone is good or comfortable in the same role.
Consider the story of Bettty. She is 58 years old and the sole caregiver to her husband, John, 64 years old, who was diagnosed with primary-progressive multiple sclerosis, three months following his retirement. He is paralyzed from the upper chest downwards-and is losing ground every day. By necessity Betty has learned to use power tools, do plumbing chores, get urine out of the carpet, recognize possible pressure sores and dress a 6’5", 240 pound dead weight.
All the errands, car servicing and driving are her responsibility. She does all the cooking, shopping, cleaning and laundry and has learned to give haircuts because she has found that the outside world really isn’t wheelchair accessible.
She misses the hugs, the snuggling, the hand holding, the love making, the dancing, and the strong shoulder to lean on. Depression, loneliness, hopelessness, and fear (including fear of getting sick herself and not being able to care for her husband and the fear of what will happen to her) – and guilt because she feels those things –are constant companions.
She needs help finding affordable long term care insurance that takes into consideration the fact that MS (and other chronic illness) patients can live decades while totally physically incapacitated. She needs a central clearing house of services available to assist her in caring for her husband and home.
It is important for families to reach out for help. Don’t be embarrassed by the things your loved one may say or do. They are ill and people will understand. Seek the help of friends, your church, social services, and if possible, a geriatric care manager. The job of caregiver is too big for one person regardless age or background. Eventually you will need help and you shouldn’t wait until the disease has taken a physical and mental toll on you along with your loved one. Go to local support groups or support groups on line.
If you live in Berks County, PA and would like a listing of local support services, please contact me at the confidential e-mail link on the right side of this blog page.
Wednesday, December 26, 2007
An Age-specific Food Pyramid Recently Released
Tufts University has updated its food pyramid for over-70 adults, called the Modified MyPyramid for Older Adults, stressing nutrient- and fiber-rich foods over supplements. The modified pyramid emphasizes whole grains, fruits and vegetables. The modified pyramid encourages the use of fiber-rich foods in all food groups and reduced fat intake focusing on low saturated fat and vegetables rich in proteins. The importance of fluid balance is emphasizd.
Older adults need fewer calories because they are not as physically active as they once were and their metabolic rates slow down. However, the aging body still requires the same or higher levels of nutrients for optimal health outcomes. In order to get a nutrient dense diet, the following foods are encouraged:
• Whole, enriched, and fortified grains and cereals such as brown rice and 100% whole wheat bread.
• Bright-colored vegetables such as carrots and broccoli.
• Deep-colored fruit such as berries and melon.
• Low- and non-fat dairy products such as yogurt and low-lactose milk.
• Dry beans and nuts, fish, poultry, lean meat and eggs.
• Liquid vegetable oils and soft spreads low in saturated and trans fat.
• Fluid intake.
Physical activity such as walking, swimming, house work and yard work are emphasized. Regular physical activity is linked to reduced risk of chronic disease and lower body weights.
There are numerous study findings that obesity in adults 70 years and older has been increasing. Physical activity is one way to avoid weight gain in later years and the consequences of sedentary lifestyle.
The Modified MyPyramid for Older Adults stresses the importance of drinking enough fluids by having a row of glasses as its foundation. A common problem associated with aging is the lack of thirst even when the body lacks adequate water intake.
Older adults need fewer calories because they are not as physically active as they once were and their metabolic rates slow down. However, the aging body still requires the same or higher levels of nutrients for optimal health outcomes. In order to get a nutrient dense diet, the following foods are encouraged:
• Whole, enriched, and fortified grains and cereals such as brown rice and 100% whole wheat bread.
• Bright-colored vegetables such as carrots and broccoli.
• Deep-colored fruit such as berries and melon.
• Low- and non-fat dairy products such as yogurt and low-lactose milk.
• Dry beans and nuts, fish, poultry, lean meat and eggs.
• Liquid vegetable oils and soft spreads low in saturated and trans fat.
• Fluid intake.
Physical activity such as walking, swimming, house work and yard work are emphasized. Regular physical activity is linked to reduced risk of chronic disease and lower body weights.
There are numerous study findings that obesity in adults 70 years and older has been increasing. Physical activity is one way to avoid weight gain in later years and the consequences of sedentary lifestyle.
The Modified MyPyramid for Older Adults stresses the importance of drinking enough fluids by having a row of glasses as its foundation. A common problem associated with aging is the lack of thirst even when the body lacks adequate water intake.
Friday, December 21, 2007
Medical Research Findings: Today and Tomorrow Can be Vastly Different
Isn't science a wonderful thing? Because of medical research, our life expectancy has changed dramatically. In 1900, the average life expectancy for a man was 47 years of age! Today it is 77 and getting older as we speak.
Medical research has allowed a death sentence for people diagnosed with HIV in 1982 to now become a chronic illness for the vast majority of those diagnosed since 1995. Cancer of the breast and prostate most often lead to death in in the 1960's. Today, the degree of the cancer determines survival. The lower the degree, better the survival rate.
Yesterday I reported that social, mental and physical activity to counteract loneliness helps to decrease the likelihood of developing dementia. Today, new research indicates that physical activity helps reduce the risk of Vascular dementia, but not Alzheimer's dementia.
These reports can become pretty confusing. You may feel as though your head is spinning. So what are you to believe?
Research reports are as good as the design and execution of the study. It is impossible for lay people to scrutinize every piece of information they hear and determine whether or not it is sound research.
Only time can really tell what will hold water in research results. While learning the results of studies is helpful, looking at the data is important to a physician, nurses, and other allied health professionals. Ask your health care provider to explain things that you hear that are pertinent to you.
Using common sense is helpful along the way. Consider the example of exercise. Does exercise help keep a person healthy? Scientific research is showing that, yes, it does. In years past, people were thinner because they did work that required alot more physical effort compared to most jobs today. Facts show that most adults in previous times did not develop diabetes. Diabetes was seen mostly in children who acquired it from a genetic or immune disorder.
Today, twenty percent of all adults age 60 years and older develop diabetes. Thirty(30%) percent of older adults who are obese have diabetes as compared to 13% of their thinner counterparts.
At least 10 million Americans at high risk for type 2 diabetes can sharply lower their chances of getting the disease with diet and exercise, according to the findings of a major clinical trial at the National Institutes of Health (NIH). All of the people enrolled in this study participated in lifestyle changes with diet and exercise which reduced their risk for developing diabetes. About 15% developed diabetes within 3 years of this study. Not reported in the short report was how many continued with the lifestyle changes.
I reported early in this blog that a new study reported that exercise will help reduce the risk for vascular dementia. So why talk about diabetes? People who exercise less often have a higher risk of developing diabetes. Diabetes causes complications in the blood vessels. Vascular dementia is one of these comlications. Vascular dementia is caused by a change in the blood flow in the vessels of the brain, causing cell death. Cell death in the brain causes dementia.
A tangled web or a domino effect? Lifestyle factors play a huge role. Balance in how many aspects of life impact health overall: stress level, social interaction, sleep, diet, exercise and physical activity level are all predictors of health. This is the overall theme to learn from current medical research findings. What we learn today, the changes in lifestyle made today, can effect our health tomorrow.
Medical research has allowed a death sentence for people diagnosed with HIV in 1982 to now become a chronic illness for the vast majority of those diagnosed since 1995. Cancer of the breast and prostate most often lead to death in in the 1960's. Today, the degree of the cancer determines survival. The lower the degree, better the survival rate.
Yesterday I reported that social, mental and physical activity to counteract loneliness helps to decrease the likelihood of developing dementia. Today, new research indicates that physical activity helps reduce the risk of Vascular dementia, but not Alzheimer's dementia.
These reports can become pretty confusing. You may feel as though your head is spinning. So what are you to believe?
Research reports are as good as the design and execution of the study. It is impossible for lay people to scrutinize every piece of information they hear and determine whether or not it is sound research.
Only time can really tell what will hold water in research results. While learning the results of studies is helpful, looking at the data is important to a physician, nurses, and other allied health professionals. Ask your health care provider to explain things that you hear that are pertinent to you.
Using common sense is helpful along the way. Consider the example of exercise. Does exercise help keep a person healthy? Scientific research is showing that, yes, it does. In years past, people were thinner because they did work that required alot more physical effort compared to most jobs today. Facts show that most adults in previous times did not develop diabetes. Diabetes was seen mostly in children who acquired it from a genetic or immune disorder.
Today, twenty percent of all adults age 60 years and older develop diabetes. Thirty(30%) percent of older adults who are obese have diabetes as compared to 13% of their thinner counterparts.
At least 10 million Americans at high risk for type 2 diabetes can sharply lower their chances of getting the disease with diet and exercise, according to the findings of a major clinical trial at the National Institutes of Health (NIH). All of the people enrolled in this study participated in lifestyle changes with diet and exercise which reduced their risk for developing diabetes. About 15% developed diabetes within 3 years of this study. Not reported in the short report was how many continued with the lifestyle changes.
I reported early in this blog that a new study reported that exercise will help reduce the risk for vascular dementia. So why talk about diabetes? People who exercise less often have a higher risk of developing diabetes. Diabetes causes complications in the blood vessels. Vascular dementia is one of these comlications. Vascular dementia is caused by a change in the blood flow in the vessels of the brain, causing cell death. Cell death in the brain causes dementia.
A tangled web or a domino effect? Lifestyle factors play a huge role. Balance in how many aspects of life impact health overall: stress level, social interaction, sleep, diet, exercise and physical activity level are all predictors of health. This is the overall theme to learn from current medical research findings. What we learn today, the changes in lifestyle made today, can effect our health tomorrow.
Thursday, December 20, 2007
Loneliness Can Increase Dementia Risk
A 4 year study completed at Rush University, Chicago shows that lonely elderly are more than two times likely to develop dementia than those who are not lonely. Older adults with a good social network, who were frequently involved in social activity, and were mentally stimulated demonstrated less risk for dementia.
Loneliness was associated with more rapid decline in overall cognition, memory, perceptual speed and visuospatial ability. Staying mentally and physically active are keys to beating both loneliness and decreasing the risk of dementia. One recent large group study found that staying mentally active reduces the risk of Alzheimer's disease and other forms of dementia by nearly half by building and maintaining a reserve of stimulation.It is a case of "using it, not losing it." Another study found that older people who exercise three or more times a week had a 30 to 40 percent lower risk of developing Alzheimer's and other types of dementia. Even light activity, such as walking, seemed to help.
Many families struggle with the best way to reduce social isolation, loneliness, and mental and physical stagnation for their elderly family members. Environmental barriers can be obstacles to overcoming social isolation. Attending a senior center or becoming involved in a senior club can provide activities such as exercise, meals, games, and trips. Libraries, book stores offering book clubs and quilting groups are just a few of the possible choices that can improve a person's mental and physical health inexpensively.
Elderly family members who are physically unable to participate in a public venue because of decreased function can certainly benefit from visits from church members, adult day centers, and non-medical home care providers. The visits must focus on the interests of the individual. As such, a history of the elderly person's interests and lifelong hobbies is important to putting together a worthwhile and meaningful plan to decrease loneliness and stimulate interest in life's rewards.
Loneliness was associated with more rapid decline in overall cognition, memory, perceptual speed and visuospatial ability. Staying mentally and physically active are keys to beating both loneliness and decreasing the risk of dementia. One recent large group study found that staying mentally active reduces the risk of Alzheimer's disease and other forms of dementia by nearly half by building and maintaining a reserve of stimulation.It is a case of "using it, not losing it." Another study found that older people who exercise three or more times a week had a 30 to 40 percent lower risk of developing Alzheimer's and other types of dementia. Even light activity, such as walking, seemed to help.
Many families struggle with the best way to reduce social isolation, loneliness, and mental and physical stagnation for their elderly family members. Environmental barriers can be obstacles to overcoming social isolation. Attending a senior center or becoming involved in a senior club can provide activities such as exercise, meals, games, and trips. Libraries, book stores offering book clubs and quilting groups are just a few of the possible choices that can improve a person's mental and physical health inexpensively.
Elderly family members who are physically unable to participate in a public venue because of decreased function can certainly benefit from visits from church members, adult day centers, and non-medical home care providers. The visits must focus on the interests of the individual. As such, a history of the elderly person's interests and lifelong hobbies is important to putting together a worthwhile and meaningful plan to decrease loneliness and stimulate interest in life's rewards.
Wednesday, December 19, 2007
Assistance With Aging Skin Changes
Skin changes as the body ages. It becomes thinner. It loses some of its elasticity. It is less able to protect itself from damage, and it heals more slowly from cuts or burns.
Dry skin is a common problem in older adults. To avoid dry skin:
Shower or bathe with warm water
Apply a skin lotion over the whole body, while it is still damp
Always shower and apply lotion immediately after swimming in a chlorinated pool or sitting in a spa
Avoid saunas
Apply lotion to entire skin surface at bedtime
Use only soaps designed for dry skin
Consider using a humidifier on cold, dry winter days.
It helps to be slightly damp when lotion is applied to help lock in moisture. But don't leave the skin too damp, or fungal infections can develop. Women should dry under the breasts, and both men and women should dry their genital areas well after showering or bathing.
Skin tears are very common. They tend to be shallow, involving the outer most layer of the skin. Tears occur from rubbing, pulling or touching on something in the home. For example, bumping counter tops, coffee tables or bedposts can result in a tear. It is important to try to prevent such injuries. Look around the home and remove potential targets. Consider padding bedposts or corners of tables with soft cushiony materials.
Stop the bleeding by applying direct pressure to the wound. If bleeding does not stop within a few minutes, obtain assistance from your health care provider.
Wash the wound with soap and water. If the injury occurred outside and rocks or gravel are inside the wound, they need to be removed.
If the cut or tear is small, you can apply an antibacterial cream and then a bandage. It is usually most helpful to apply a soft roll of gauze, wrapping it around the affected area and applying tape to the gauze instead of directly onto the skin since many people experience more skin tears from the adhesive sticking too well to the skin and tearing as it comes off.
Watch for signs of infection, such as: odor, pain, fever, drainage, redness, red streaks, or warmth in the area. If you notice any of these signs, contact your doctor as soon as possible.
Dry skin is a common problem in older adults. To avoid dry skin:
Shower or bathe with warm water
Apply a skin lotion over the whole body, while it is still damp
Always shower and apply lotion immediately after swimming in a chlorinated pool or sitting in a spa
Avoid saunas
Apply lotion to entire skin surface at bedtime
Use only soaps designed for dry skin
Consider using a humidifier on cold, dry winter days.
It helps to be slightly damp when lotion is applied to help lock in moisture. But don't leave the skin too damp, or fungal infections can develop. Women should dry under the breasts, and both men and women should dry their genital areas well after showering or bathing.
Skin tears are very common. They tend to be shallow, involving the outer most layer of the skin. Tears occur from rubbing, pulling or touching on something in the home. For example, bumping counter tops, coffee tables or bedposts can result in a tear. It is important to try to prevent such injuries. Look around the home and remove potential targets. Consider padding bedposts or corners of tables with soft cushiony materials.
Stop the bleeding by applying direct pressure to the wound. If bleeding does not stop within a few minutes, obtain assistance from your health care provider.
Wash the wound with soap and water. If the injury occurred outside and rocks or gravel are inside the wound, they need to be removed.
If the cut or tear is small, you can apply an antibacterial cream and then a bandage. It is usually most helpful to apply a soft roll of gauze, wrapping it around the affected area and applying tape to the gauze instead of directly onto the skin since many people experience more skin tears from the adhesive sticking too well to the skin and tearing as it comes off.
Watch for signs of infection, such as: odor, pain, fever, drainage, redness, red streaks, or warmth in the area. If you notice any of these signs, contact your doctor as soon as possible.
Monday, December 17, 2007
Alcohol Use and Abuse
Anyone at any age can have a drinking problem. Rachel takes a fifth of whiskey to her mother every 2 weeks. Rachel's mother Mary admits that she drinks a few each evening to help her get to sleep. This is common. Families, friends, and health care professionals often overlook their concerns about older people’s drinking. Sometimes trouble with alcohol in older people is mistaken for other conditions that happen with age.
The aging body does not handle alcohol the same way. The same amount of alcohol can have a greater effect as a person grows older. Some research has shown that as people age they become more sensitive to alcohol’s effects. High blood pressure, ulcers, and diabetes can worsen with alcohol use. Many medicines—both prescription and over-the-counter—can be dangerous or even deadly when mixed with alcohol.
This is a special worry for older people because the average person over age 65 takes at least two medicines a day. Aspirin can cause bleeding in the stomach and intestines. If a person takes aspirin while drinking alcohol, the risk of bleeding is much higher. Cold and allergy medicines (antihistamines) often make people sleepy. When alcohol is combined with those medicines, it can make drowsiness worse and driving even more dangerous. Alcohol used with large doses of the pain killer acetaminophen can raise the risk of liver damage. If your loved one is taking any over-the-counter or prescription medications, ask the doctor or pharmacist if its safe to drink alcohol.
Even drinking a small amount of alcohol can impair judgment, coordination, and reaction time. It can increase the risk of work and household accidents, including falls and hip fractures. It also adds to the risk of car crashes— a special concern because almost 10 percent of this nation’s drivers are over age 65. Heavy drinking over time also can cause certain cancers, liver cirrhosis, immune system disorders, and brain damage.
Alcohol can make some medical concerns hard for doctors to find and treat. For example, alcohol causes changes in the heart and blood vessels. These changes can dull pain that might be a warning sign of a heart attack. Drinking also can make older people forgetful and confused. These symptoms could be mistaken for signs of Alzheimer’s disease. For people with diabetes, drinking affects blood sugar levels. Ulcers also may become worse with alcohol use.
Studies show that older problem drinkers are as able to benefit from treatment as are younger alcohol abusers. To get help, talk to the doctor. He or she can give you advice about your loved one's health, drinking, and treatment options. Your local health department or social services agencies can also help. There are many types of treatments available. Some, such as 12-step help programs, have been around a long time. Others include getting alcohol out of the body (detoxification), taking prescription medicines to help prevent a return to drinking once sober, and individual and/or group counseling. Newer programs teach people with drinking problems to learn which situations or feelings trigger the urge to drink as well as ways to cope without alcohol. Because the support of family members is important, many programs also counsel married couples and family members as part of the treatment process. Programs may also link individuals with important community resources.
The aging body does not handle alcohol the same way. The same amount of alcohol can have a greater effect as a person grows older. Some research has shown that as people age they become more sensitive to alcohol’s effects. High blood pressure, ulcers, and diabetes can worsen with alcohol use. Many medicines—both prescription and over-the-counter—can be dangerous or even deadly when mixed with alcohol.
This is a special worry for older people because the average person over age 65 takes at least two medicines a day. Aspirin can cause bleeding in the stomach and intestines. If a person takes aspirin while drinking alcohol, the risk of bleeding is much higher. Cold and allergy medicines (antihistamines) often make people sleepy. When alcohol is combined with those medicines, it can make drowsiness worse and driving even more dangerous. Alcohol used with large doses of the pain killer acetaminophen can raise the risk of liver damage. If your loved one is taking any over-the-counter or prescription medications, ask the doctor or pharmacist if its safe to drink alcohol.
Even drinking a small amount of alcohol can impair judgment, coordination, and reaction time. It can increase the risk of work and household accidents, including falls and hip fractures. It also adds to the risk of car crashes— a special concern because almost 10 percent of this nation’s drivers are over age 65. Heavy drinking over time also can cause certain cancers, liver cirrhosis, immune system disorders, and brain damage.
Alcohol can make some medical concerns hard for doctors to find and treat. For example, alcohol causes changes in the heart and blood vessels. These changes can dull pain that might be a warning sign of a heart attack. Drinking also can make older people forgetful and confused. These symptoms could be mistaken for signs of Alzheimer’s disease. For people with diabetes, drinking affects blood sugar levels. Ulcers also may become worse with alcohol use.
Studies show that older problem drinkers are as able to benefit from treatment as are younger alcohol abusers. To get help, talk to the doctor. He or she can give you advice about your loved one's health, drinking, and treatment options. Your local health department or social services agencies can also help. There are many types of treatments available. Some, such as 12-step help programs, have been around a long time. Others include getting alcohol out of the body (detoxification), taking prescription medicines to help prevent a return to drinking once sober, and individual and/or group counseling. Newer programs teach people with drinking problems to learn which situations or feelings trigger the urge to drink as well as ways to cope without alcohol. Because the support of family members is important, many programs also counsel married couples and family members as part of the treatment process. Programs may also link individuals with important community resources.
Friday, December 14, 2007
Holiday Blues
Older adults can have an especially hard time with the holidays. There are many causes. The loss of an important person in the last year, or the anniversary of a loss or traumatic event can make memories come back that can dampen spirits. Family misunderstandings and conflicts can intensify — especially if it's all thrust together for several days. Conflicts are bound to arise with so many different personalities, needs and interests. On the other hand, if he or she is facing the holidays without a loved one, he may be especially lonely or sad.
Not being able to do what they used to do in years past can be difficult to handle as an elder may be "stuck" on looking at what they used to do during the holiday season. It can be hard to cope with the reality that a six course dinner for twelve isn't feasible anymore.
For some people, holidays are a source of stress. Falling into the trap of becoming isolated by limitations or leaning on fantasies of how holidays should be can lead to depression and can be avoided.
Elders can anticipate the stressful periods of the holiday by preparing ahead for the people and situations that create stress. Keep in mind that taking care of oneself is a gift to everyone else because everyone ends up having a happier and healthier holiday. Encourage your loved one to take some time this holiday to do a little pampering, give a gift to themself. Treat him or her to a foot bath and massage with nicely scented soap.
Develop new traditions. Space events throughout the holiday season. Take your loved one for a ride to enjoy Christmas lights. Have your parent help wrap presents. Write out Christmas cards together while listening to Christmas music. Watch a favorite Christmas movie together.
While the feeling of the blues may vanish once the holidays are over, it is possible that your loved one is experiencing true depression. Click on the key word "Depression" to go to other posts about depression.
Not being able to do what they used to do in years past can be difficult to handle as an elder may be "stuck" on looking at what they used to do during the holiday season. It can be hard to cope with the reality that a six course dinner for twelve isn't feasible anymore.
For some people, holidays are a source of stress. Falling into the trap of becoming isolated by limitations or leaning on fantasies of how holidays should be can lead to depression and can be avoided.
Elders can anticipate the stressful periods of the holiday by preparing ahead for the people and situations that create stress. Keep in mind that taking care of oneself is a gift to everyone else because everyone ends up having a happier and healthier holiday. Encourage your loved one to take some time this holiday to do a little pampering, give a gift to themself. Treat him or her to a foot bath and massage with nicely scented soap.
Develop new traditions. Space events throughout the holiday season. Take your loved one for a ride to enjoy Christmas lights. Have your parent help wrap presents. Write out Christmas cards together while listening to Christmas music. Watch a favorite Christmas movie together.
While the feeling of the blues may vanish once the holidays are over, it is possible that your loved one is experiencing true depression. Click on the key word "Depression" to go to other posts about depression.
Tuesday, December 11, 2007
High Blood Pressure is Linked to Dementia
According to a recent study, older adults with high blood pressure may be more likely to develop a type of mild cognitive impairment that can lead to vascular dementia. People with high blood pressure had a 40% greater risk of mild cognitive impairment, and a 70% higher risk of cognitive impairment that does not involve memory difficulties.
People with high blood pressure are at risk for vascular disease which can cause changes in the blood flow to the brain and a higher possibility of stroke. Small, frequent changes to the blood flow to the brain may cause small silent strokes. These small areas of stroke over time cause cumulative changes in the cognitive abilities of the brain.
Vascular dementia is different from Alzheimer's dementia. There are differences in the pattern of cognitive changes. Older adults with Alzheimers disease generally hsve a gradual progressive decline in all areas of brain function, whereas an older adult with vascular changes may have step-wise changes associated with the occurrence of each stroke. There are no hard and fast rules as to the type or severity of cognitive changes in vascular dementia because different areas of the brain are responsible for different cognitive functions.
Although not all strokes result in vascular dementia, as many as a third of the people who have a stroke will experience dementia within six months. Vascular dementia also can occur without a complete blockage of an artery. Portions of the brain can be starved for oxygen and food by reduced blood flow from arteries narrowed by vascular disease. Vascular dementia can also be caused by low blood pressure, brain damage caused by brain hemorrhage, blood vessel damage from such disorders as lupus erythematosus or temporal arteritis.
Other risk factors for vascular dementia include high blood pressure and diabetes. There is no treatment to cure vascular dementia. The best medicine is preventive use of blood pressure medicine and medications to reduce blood sugar if a person has known high blood pressure or diabetes. Healthy lifestyle factors are ultimately the best way to prevent vascular dementia, including daily exercise, maintaining a diet low in saturated fat, high in complex carbohydrates and portion control.
Source: Archives of Neurology
People with high blood pressure are at risk for vascular disease which can cause changes in the blood flow to the brain and a higher possibility of stroke. Small, frequent changes to the blood flow to the brain may cause small silent strokes. These small areas of stroke over time cause cumulative changes in the cognitive abilities of the brain.
Vascular dementia is different from Alzheimer's dementia. There are differences in the pattern of cognitive changes. Older adults with Alzheimers disease generally hsve a gradual progressive decline in all areas of brain function, whereas an older adult with vascular changes may have step-wise changes associated with the occurrence of each stroke. There are no hard and fast rules as to the type or severity of cognitive changes in vascular dementia because different areas of the brain are responsible for different cognitive functions.
Although not all strokes result in vascular dementia, as many as a third of the people who have a stroke will experience dementia within six months. Vascular dementia also can occur without a complete blockage of an artery. Portions of the brain can be starved for oxygen and food by reduced blood flow from arteries narrowed by vascular disease. Vascular dementia can also be caused by low blood pressure, brain damage caused by brain hemorrhage, blood vessel damage from such disorders as lupus erythematosus or temporal arteritis.
Other risk factors for vascular dementia include high blood pressure and diabetes. There is no treatment to cure vascular dementia. The best medicine is preventive use of blood pressure medicine and medications to reduce blood sugar if a person has known high blood pressure or diabetes. Healthy lifestyle factors are ultimately the best way to prevent vascular dementia, including daily exercise, maintaining a diet low in saturated fat, high in complex carbohydrates and portion control.
Source: Archives of Neurology
Monday, December 10, 2007
Lung Disease: Reducing the Effects of the Environment on Lung Function
Environmental hygiene, which is reducing air pollution has a strong effect on lung function. Any person with lung disease or at risk for the flu needs to be protected against environmental pollution such as tobacco smoke. Other environmental exposures are also important to control including house dust and pet dander. Indoor environmental exposure increases during the winter months compounding any respiratory illness including the flu.
An approach to lowering the concentrations of indoor air pollutants in your home is to increase the amount of outdoor air coming indoors. Most home heating and cooling systems, including forced air heating systems, do not mechanically bring fresh air into the house. Opening windows and doors, operating window or attic fans, when the weather permits, or running a window air conditioner with the vent control open increases the outdoor ventilation rate. Local bathroom or kitchen fans that exhaust outdoors remove contaminants directly from the room where the fan is located and also increase the outdoor air ventilation rate.
Furnace filters come in many different designs and efficiencies and can be easily installed in your heating system.
Humidifiers can be installed in your heating system to maintain desirable humidity levels, or you can purchase stand-alone units that will serve your needs.
Dehumidifiers also serve a useful purpose. If your basement or other areas of your home have high humidity problems, a dehumidifier can correct these problems and maintain levels between 30 and 50 percent.
Seal off mattress and pillow encasings with zippered casings. Wash bedding frequently in hot water. Remove feather bedding (pillows, down comforters and mattress pads) and replace with products filled with synthetic fibers instead. Use 100% cotton blankets and pillow cases. Wash plush toys in hot water or bag and freeze for 24 hours every couple of days.
Bathe your pet with specialty shampoos at least weekly. Make beds and sofas off limits for animals. Remove carpeting and curtains to prevent dander build up that’s difficult or impossible to remove.
An approach to lowering the concentrations of indoor air pollutants in your home is to increase the amount of outdoor air coming indoors. Most home heating and cooling systems, including forced air heating systems, do not mechanically bring fresh air into the house. Opening windows and doors, operating window or attic fans, when the weather permits, or running a window air conditioner with the vent control open increases the outdoor ventilation rate. Local bathroom or kitchen fans that exhaust outdoors remove contaminants directly from the room where the fan is located and also increase the outdoor air ventilation rate.
Furnace filters come in many different designs and efficiencies and can be easily installed in your heating system.
Humidifiers can be installed in your heating system to maintain desirable humidity levels, or you can purchase stand-alone units that will serve your needs.
Dehumidifiers also serve a useful purpose. If your basement or other areas of your home have high humidity problems, a dehumidifier can correct these problems and maintain levels between 30 and 50 percent.
Seal off mattress and pillow encasings with zippered casings. Wash bedding frequently in hot water. Remove feather bedding (pillows, down comforters and mattress pads) and replace with products filled with synthetic fibers instead. Use 100% cotton blankets and pillow cases. Wash plush toys in hot water or bag and freeze for 24 hours every couple of days.
Bathe your pet with specialty shampoos at least weekly. Make beds and sofas off limits for animals. Remove carpeting and curtains to prevent dander build up that’s difficult or impossible to remove.
Saturday, December 08, 2007
Frailty: Improve Balance
Frailty in your aging parent or loved one can be prevented with regular exercise. If your older relative or friend is reasonably healthy, he or she can begin a regular program of exercise including stretching, weight training, and low impact aerobics, after discussing it with his or her physician. Exercise can help to avoid accidents, improve strength and mobility, lower blood pressure, and help to prevent or control some diseases. If your loved one is frail or ill, you can ask the physician about what exercises may be appropriate.
One of the primary areas of concern in frail older adults is balance. The balance system includes all the senses that tell a person how they are moving, the brain which puts this information together, and the muscles that control movements. People of all ages and abilities need to keep their balance system healthy, and no one is too young or too old to benefit. A healthy balance system helps a person to look and feel good - move freely and confidently, and have more energy and strength. A poor balance system causes a person to move more conservatively and be fearful of normal movement. Decreased mobility leads to more severe balance impairment and more fear of movement. Get the picture?
The complex balance system needs plenty of regular 'practice'. As children we develop good balance by practicing balancing activities - walking along walls, jumping, spinning and climbing. Your older relative or friend may want to begin such an exercise program under a physical therapist’s supervision. Physical therapy, when ordered by a physician, is covered under most health insurance plans. Discuss the potential benefit of phyical therapy with the doctor. The physical therapist can show how to do range of motion, stretching, and strengthening exercises. Over time, these exercises can help to increase strength, balance and ultimately mobility.
One of the primary areas of concern in frail older adults is balance. The balance system includes all the senses that tell a person how they are moving, the brain which puts this information together, and the muscles that control movements. People of all ages and abilities need to keep their balance system healthy, and no one is too young or too old to benefit. A healthy balance system helps a person to look and feel good - move freely and confidently, and have more energy and strength. A poor balance system causes a person to move more conservatively and be fearful of normal movement. Decreased mobility leads to more severe balance impairment and more fear of movement. Get the picture?
The complex balance system needs plenty of regular 'practice'. As children we develop good balance by practicing balancing activities - walking along walls, jumping, spinning and climbing. Your older relative or friend may want to begin such an exercise program under a physical therapist’s supervision. Physical therapy, when ordered by a physician, is covered under most health insurance plans. Discuss the potential benefit of phyical therapy with the doctor. The physical therapist can show how to do range of motion, stretching, and strengthening exercises. Over time, these exercises can help to increase strength, balance and ultimately mobility.
Thursday, December 06, 2007
The Flu Likes It Cold
The flu killed 36,000 older Americans in 2003. Of all age groups, people over 84 are at the highest risk of dying from flu complications. People over 74 face the second highest risk. Older people and people with chronic illnesses are at the greatest risk of getting complications from the flu, such as pneumonia. The elderly have reduced cough and gag reflexes. Their immune systems are also not as strong.
The New York Times reported today that Mount Sinai School of Medicine has found that the flu virus is so prevalent in winter due to environmental conditions. The flu likes the cold weather. It is more stable and stays in the air longer when air is cold and dry. In test animals, the virus was transmitted best at a low humidity of 20%, and not transmitted at all when the humidity reached 80%. The animals also released viruses nearly 2 days longer at 41 degrees than at room temperature of 68 degrees.
The flu usually spreads from person to person in respiratory droplets when people who are infected cough or sneeze. People occasionally may become infected by touching something with influenza virus on it and then touching their mouth, nose or eyes.
Healthy adults may be able to infect others 1 day before getting symptoms and up to 5days after getting sick. Therefore, it is possible to give someone the flu before you know you are sick as well as while you are sick. To decrease the likelihood of passing the flu on this winter, be sure to wash your hands frequently, cover your mouth with a tissue when coughing or sneezing, and discarding tissues immediately after use.
The flu tends to start suddenly and may include the following symptoms:
Fever (usually high)
Headache
Tiredness (can be extreme)
Cough
Sore throat
Runny or stuffy nose
Body aches
Diarrhea and vomiting (more common among children than adults)
Having these symptoms does not always mean that you have the flu. Many different illnesses, including the common cold, can have similar symptoms.
Treatment for the flu:
Rest
Drink plenty of liquids
Ask your doctor or pharmacist before buying a new over-the-counter cold or flu medicine to make sure they won't interfere with prescribed medicine.
Call the doctor if your loved one or you have:
Trouble breathing
Your symptoms don't improve or get worse after 3 to 4 days.
After feeling a little better, you develop signs of a more serious problem. Some of these signs are a sick-to-your-stomach feeling, vomiting, high fever, shaking chills, chest pain, or coughing with thick, yellow-green mucus.
The New York Times reported today that Mount Sinai School of Medicine has found that the flu virus is so prevalent in winter due to environmental conditions. The flu likes the cold weather. It is more stable and stays in the air longer when air is cold and dry. In test animals, the virus was transmitted best at a low humidity of 20%, and not transmitted at all when the humidity reached 80%. The animals also released viruses nearly 2 days longer at 41 degrees than at room temperature of 68 degrees.
The flu usually spreads from person to person in respiratory droplets when people who are infected cough or sneeze. People occasionally may become infected by touching something with influenza virus on it and then touching their mouth, nose or eyes.
Healthy adults may be able to infect others 1 day before getting symptoms and up to 5days after getting sick. Therefore, it is possible to give someone the flu before you know you are sick as well as while you are sick. To decrease the likelihood of passing the flu on this winter, be sure to wash your hands frequently, cover your mouth with a tissue when coughing or sneezing, and discarding tissues immediately after use.
The flu tends to start suddenly and may include the following symptoms:
Fever (usually high)
Headache
Tiredness (can be extreme)
Cough
Sore throat
Runny or stuffy nose
Body aches
Diarrhea and vomiting (more common among children than adults)
Having these symptoms does not always mean that you have the flu. Many different illnesses, including the common cold, can have similar symptoms.
Treatment for the flu:
Rest
Drink plenty of liquids
Ask your doctor or pharmacist before buying a new over-the-counter cold or flu medicine to make sure they won't interfere with prescribed medicine.
Call the doctor if your loved one or you have:
Trouble breathing
Your symptoms don't improve or get worse after 3 to 4 days.
After feeling a little better, you develop signs of a more serious problem. Some of these signs are a sick-to-your-stomach feeling, vomiting, high fever, shaking chills, chest pain, or coughing with thick, yellow-green mucus.
Tuesday, December 04, 2007
What Is Causing Weight Loss?
Elderly patients with unintentional weight loss are at higher risk for infection, depression and death. The leading causes of involuntary weight loss are depression, cancer, heart disorders and digestive diseases.
Medications that may cause nausea and vomiting, difficulty swallowing, and anorexia can also cause unexpected weight loss. Multiple medication use, or polypharmacy, and the reduction of medications used in psychiatric disorders are also causes. Unfortunately, in as many as 25% of those with unintentional weight loss there is no identified cause.
In all cases, a visit to the physician are needed to determine unforeseen causes. The doctor will want to complete blood tests, a phydical exam, obtain a stool and a urine sample.
It is important to play close attention to the environment to determine other factors that may play a role. For example, many older adults lose weight due to disinterest in preparing a meal to eat alone. Others may rely on meals on wheels for the daily meal and ration out the contents for other meals. Addressing these issues are important to get to a possible solution such as sharing meal preparation duties and having congregate meals with neighbors. It is also possible that the older adult may think that they ate a sandwich a few hours earlier but was really yesterday. Short term memory loss or early dementia is a frequent culprit behind weight loss.
Once a cause is identified, treatment will be provided to treat the condition. Protein supplements and meal supplements are abundant on the market in both liquid and nutrition bar forms. Many appreciate supplements that have natural taste appeal including milk shakes made with ice cream, and peanut butter on bananas. Occasionally, if a person expresses a real aversion to food, appetite stimulants may help to improve the appetite.
Medications that may cause nausea and vomiting, difficulty swallowing, and anorexia can also cause unexpected weight loss. Multiple medication use, or polypharmacy, and the reduction of medications used in psychiatric disorders are also causes. Unfortunately, in as many as 25% of those with unintentional weight loss there is no identified cause.
In all cases, a visit to the physician are needed to determine unforeseen causes. The doctor will want to complete blood tests, a phydical exam, obtain a stool and a urine sample.
It is important to play close attention to the environment to determine other factors that may play a role. For example, many older adults lose weight due to disinterest in preparing a meal to eat alone. Others may rely on meals on wheels for the daily meal and ration out the contents for other meals. Addressing these issues are important to get to a possible solution such as sharing meal preparation duties and having congregate meals with neighbors. It is also possible that the older adult may think that they ate a sandwich a few hours earlier but was really yesterday. Short term memory loss or early dementia is a frequent culprit behind weight loss.
Once a cause is identified, treatment will be provided to treat the condition. Protein supplements and meal supplements are abundant on the market in both liquid and nutrition bar forms. Many appreciate supplements that have natural taste appeal including milk shakes made with ice cream, and peanut butter on bananas. Occasionally, if a person expresses a real aversion to food, appetite stimulants may help to improve the appetite.
Monday, December 03, 2007
Making the Holidays Less Stressful and More Enjoyable
When you're caring for a family member, the holidays can change dramatically from what they once were. Though initially difficult and emotional, It helps to change your mindset to plan “new” holiday traditions that will help make the holidays happier, less stressful, and preserve family traditions.
Whether you’re going to your aging loved onesà house or they are coming to yours, the holidays are a wonderful opportunity to open the lines of communication and earn more about your family history.
❖ When the group is gathered (at dinner, for example), encourage each person, even the youngest child and non-family members to share their favorite holiday memories. How did they celebrate the holidays as children? What was their favorite gift and why? What was their favorite holiday memory? What was their favorite holiday food?
❖ Take advantage of any opportunity that arises, such as while preparing dinner or wrapping presents. While these stories are fun and informative for the whole family to hear, don’t force a group activity.
❖ Slow down the day. Ask that only one person (including the children) opens a present at a time. It gives everyone the pleasure of seeing the gifts being opened and reduces the activity level which makes the atmosphere feel more relaxed.
❖If your loved one is coming to your home, keep in mind that too much noise, activity, and hustle and bustle can be overwhelming for the elderly. Set aside a “quiet place” where anyone can go to get away from the ctivity. (But make sure that it isn’t a place that will displace others, such as the room with the television.)
❖ Don’t over schedule the day. “Sharing” flows best during the down time.
❖ Prepare as much as you can in advance so you have longer periods of “calm” time.
❖ Put in those safety aids you’ve been thinking about (such as grab bars in the
bathroom and/or lighting in dark hallways and stairs).
If your loved one is coming to your home from an assisted living community or nursing home, in addition to the above, also:
❖ Confirm holiday meal times with the staff so that you can pick up your loved one before the meal has started and return them in time for the evening meal.
❖ Make sure you have all meds and (extra) supplies your loved one will need.
❖ The elderly get cold more easily so suggest they dress in layers and bring an extra sweater. You may also want to have an extra sweater or blanket on hand at your house.
❖ If your loved one has dementia, it’s important to make the atmosphere as relaxed as possible – too much excitement can make them anxious and agitated.
❖ Talk with your other guests – especially siblings about their needs and expectations and negotiate – in advance – any differences around what’s best for your loved one.
❖ Talk with your kids about your loved one’s situation (for example, they may not remember them or may have physical limitations or issues)and coach them on how to handle it.
❖ If your loved one has an aide, decide in advance whether s/he will be needed for the day and make appropriate arrangements.
❖ Allow family and friends to help you. If you don’t get any offers of help, ask for it. Divide up the caregiving duties, clarify the scope of each, and ask each person which one they’d like to take.
If you’re visiting your loved one at the assisted living community or nursing home:
❖ Unless you’re planning to eat with them (and made arrangements in advance),
confirm holiday meal times so your visit doesn’t conflict.
❖ If possible, arrive an hour or two before mealtime so you have an opportune
time to leave.
❖ Try to coordinate schedules if other family members who will also be visiting. You may want to plan the visits at different times so that your loved one has company throughout the day.
❖ If you visit all at once, keep the atmosphere as calm as possible. Sitting literally lowers the energy level so visit in a location with enough chairs for everyone.
❖ If you bring children, talk with them in advance and coach them on appropriate behavior. Depending on your loved one’s condition, you may decide not to bring very young children.
❖ If your loved one hasn’t gotten gifts for the visiting children, you may want to bring a present “from” your loved one for each of the children that they can play with while there.
❖ Whether the children come or not, encourage them to make cards and gifts that can be hung or placed in the room.
Whether you’re going to your aging loved onesà house or they are coming to yours, the holidays are a wonderful opportunity to open the lines of communication and earn more about your family history.
❖ When the group is gathered (at dinner, for example), encourage each person, even the youngest child and non-family members to share their favorite holiday memories. How did they celebrate the holidays as children? What was their favorite gift and why? What was their favorite holiday memory? What was their favorite holiday food?
❖ Take advantage of any opportunity that arises, such as while preparing dinner or wrapping presents. While these stories are fun and informative for the whole family to hear, don’t force a group activity.
❖ Slow down the day. Ask that only one person (including the children) opens a present at a time. It gives everyone the pleasure of seeing the gifts being opened and reduces the activity level which makes the atmosphere feel more relaxed.
❖If your loved one is coming to your home, keep in mind that too much noise, activity, and hustle and bustle can be overwhelming for the elderly. Set aside a “quiet place” where anyone can go to get away from the ctivity. (But make sure that it isn’t a place that will displace others, such as the room with the television.)
❖ Don’t over schedule the day. “Sharing” flows best during the down time.
❖ Prepare as much as you can in advance so you have longer periods of “calm” time.
❖ Put in those safety aids you’ve been thinking about (such as grab bars in the
bathroom and/or lighting in dark hallways and stairs).
If your loved one is coming to your home from an assisted living community or nursing home, in addition to the above, also:
❖ Confirm holiday meal times with the staff so that you can pick up your loved one before the meal has started and return them in time for the evening meal.
❖ Make sure you have all meds and (extra) supplies your loved one will need.
❖ The elderly get cold more easily so suggest they dress in layers and bring an extra sweater. You may also want to have an extra sweater or blanket on hand at your house.
❖ If your loved one has dementia, it’s important to make the atmosphere as relaxed as possible – too much excitement can make them anxious and agitated.
❖ Talk with your other guests – especially siblings about their needs and expectations and negotiate – in advance – any differences around what’s best for your loved one.
❖ Talk with your kids about your loved one’s situation (for example, they may not remember them or may have physical limitations or issues)and coach them on how to handle it.
❖ If your loved one has an aide, decide in advance whether s/he will be needed for the day and make appropriate arrangements.
❖ Allow family and friends to help you. If you don’t get any offers of help, ask for it. Divide up the caregiving duties, clarify the scope of each, and ask each person which one they’d like to take.
If you’re visiting your loved one at the assisted living community or nursing home:
❖ Unless you’re planning to eat with them (and made arrangements in advance),
confirm holiday meal times so your visit doesn’t conflict.
❖ If possible, arrive an hour or two before mealtime so you have an opportune
time to leave.
❖ Try to coordinate schedules if other family members who will also be visiting. You may want to plan the visits at different times so that your loved one has company throughout the day.
❖ If you visit all at once, keep the atmosphere as calm as possible. Sitting literally lowers the energy level so visit in a location with enough chairs for everyone.
❖ If you bring children, talk with them in advance and coach them on appropriate behavior. Depending on your loved one’s condition, you may decide not to bring very young children.
❖ If your loved one hasn’t gotten gifts for the visiting children, you may want to bring a present “from” your loved one for each of the children that they can play with while there.
❖ Whether the children come or not, encourage them to make cards and gifts that can be hung or placed in the room.
Sunday, December 02, 2007
Is It Elder Abuse?
Elder abuse is the mistreatment of an elderly person. It may include assault, threats of assault, verbal abuse, financial exploitation, physical and/or emotional neglect, or sexual abuse. Elder abuse is one of the most under-reported problems in the country because victims may be ashamed, unable to report it, or fearful of reprisals if they speak up. Abuse is more likely when the stress level of the individual providing the care is heightened as an older person’s condition worsens.
The following symptoms may be as important clues to, but not necessarily signifying, possible abuse:
• Bruises, burns, or cuts
• Dehydrated or malnourished appearance
• Anxiety, confusion, or withdrawal
• Expressions of shame, embarrassment, and fear
• Poor personal hygiene
• Overmedication or oversedation
• Sudden bank account withdrawals or closings
In most places, either Adult Protective Services (APS), the Area Agency on Aging (AAA), or the county Department of Social Services is designated as the agency to investigate allegations of elder abuse. If the investigators find abuse, they make arrangements for services to help protect the victim. Call the National Eldercare Locator at 800-677-1116 and ask for the county Area Agency on Aging telephone number.
In Berks County, the Office of Aging's phone number is (610) 478-6500. Possible elder abuse can be reported anonymously at 1-866-623-2137.
The following symptoms may be as important clues to, but not necessarily signifying, possible abuse:
• Bruises, burns, or cuts
• Dehydrated or malnourished appearance
• Anxiety, confusion, or withdrawal
• Expressions of shame, embarrassment, and fear
• Poor personal hygiene
• Overmedication or oversedation
• Sudden bank account withdrawals or closings
In most places, either Adult Protective Services (APS), the Area Agency on Aging (AAA), or the county Department of Social Services is designated as the agency to investigate allegations of elder abuse. If the investigators find abuse, they make arrangements for services to help protect the victim. Call the National Eldercare Locator at 800-677-1116 and ask for the county Area Agency on Aging telephone number.
In Berks County, the Office of Aging's phone number is (610) 478-6500. Possible elder abuse can be reported anonymously at 1-866-623-2137.
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