Epidemic Proportions

Recently I was helping a young lady prepare an answer for a pageant onstage question.  The question was, “What is a news story that you are following and what is your opinion on the matter?”  After digging into the headlines, I landed on a topic that for me hit a little close to home.  The topic…opioid addiction.  I have typed this out and backspaced and stared at the words more times than I care to admit.  Years ago, I went to great lengths to make sure that absolutely no one knew that opioid addiction was a subject I knew anything about.  But sadly, I know all too well.  Not on a personal level.   But I guess observing the effects of addiction ravage your father’s body and mind are a bit personal.  My Dad died in 2001 at the age of 56 years old.  Now that I am 42 years old…I realize just how young he was when we lost him.  His official cause of death was renal carcinoma (kidney cancer).  But I know that his life was cut short due in part to the large amount of prescription pain killers he took every day.  He was an addict and he knew it.  We all knew it and it wreaked havoc on our lives.  Opioid addiction is an epidemic that affects many different age groups and the elderly are not immune to this problem.

Agingcare.com reports that 40 percent of the prescription drugs sold in the United States are used by the elderly, often for problems such as chronic pain, insomnia, and anxiety. According to the National Clearinghouse for Alcohol and Drug Information, as many as 17 percent of adults age 60 and over abuse prescription drugs. Narcotic painkillers, sleeping pills, and tranquilizers are the most commonly abused medication types.  When drugs come from a doctor’s prescription pad, misuse is harder to identify. We assume that pharmaceutical drugs are only used for treating legitimate medical conditions, and this is typically how seniors begin using these drugs. Doctors often prescribe older patients medications to help them cope with age-related physical and mental changes, such as depression, limited or painful mobility, and shorter, more irregular sleep cycles. Over time, seniors may develop a tolerance to a drug, so achieving the same “coping” effect requires larger and/or more frequent doses. The result is an inadvertent addiction to a specific medication.

Questions to Ask if You Suspect Prescription Misuse or Abuse

  • How much are they taking? If Mom used to take one or two pills a day, but now she is taking four or six, that’s a red flag. Looking at the dosing instructions on the pill bottle or container can give you a clue whether they are abiding by the prescriber’s instructions.
  • Has their behavior or mood changed? Are they argumentative, sullen, withdrawn, secretive or anxious?
  • Are they giving excuses as to why they need their medication?
  • Do they ever express remorse or concern about taking their medicine?
  • Do they have a “purse supply” or “pocket supply” in case of an emergency?
  • Have they recently changed doctors or drug stores?
  • Have they received the same prescription from two or more physicians or pharmacists at approximately the same time?
  • Do they become annoyed or uncomfortable when others talk about their use of medications?
  • Do they ever sneak or hide their meds?

 

How to Help a Loved One Manage Their Prescriptions Responsibly

  • Stay as connected as you can and make sure you know what medications your loved one is taking and why.
  • Check that they are following the prescribed dosage(s).
  • Encourage them to use painkillers and sedatives only when necessary and to taper off as soon as they can.
  • Look for alternative treatments. If a senior has an ongoing problem with pain, for example, a pain management specialist may be able to suggest strategies for controlling it without drugs.
  • Remind them to always avoid alcohol when taking painkillers or sedatives.
  • Encourage them to bring all their medications to their doctor when they go for their annual checkups, so the physician has an up-to-date record of exactly what they are taking.

If you suspect your loved one may be misusing or abusing their medications, consult with their prescribing physician to devise a solution. It may be useful to inquire about psychological tests to check for mood or behavior disorders and research treatment facilities that specialize in programs specifically for seniors. Many insurance plans cover stays at in-patient addiction centers.  It is difficult to face these problems, but the repercussions of sticking your head in the sand is worse for them and you.  Addiction is not something that happens only to the addict.  It affects the entire family.  Don’t just try to sweep problems under the carpet.

Need help???  Get help!!

The Substance Abuse and Mental Health Services Administration (SAMHSA’s) (National Helpline, 1-800-662-HELP (4357),(also known as the Treatment Referral Routing Service) is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.

 

 

 

 

 

 

 

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Tick, Tock…Time to Move that Clock!

Spring forward sounds so chipper.  My last blog detailed the fact that I don’t sleep very well. I’m not so sure how much “pep in my step” I will have when we lose that hour of sleep this coming weekend either.  But it’s not just the grogginess that comes with the time change.  According to statistics, due to the loss of sleep and increased stress from exhaustion, automobile accidents and heart attacks increase dramatically. Scientists have found that on the Monday after Daylight Savings Time begins heart attack rates increase by an astonishing 24 percent.  But take heart! These practical tips can help avoid knocking your natural circadian rhythm completely out of whack.

Tips for adjusting to daylight saving time from agingcare.com

  • Get some sun: Exposure to natural sunlight helps regulate your body’s natural rhythms. Depending on where you live, the weather may be too cold to spend too much time outside, but you can at least pull up the shade and sit in front of the window for a few minutes.
  • Work up a sweat: Engaging in some form of cardiovascular exercise (walking, jogging, biking, swimming) in the late afternoon or early evening may help you fall asleep easier.
  • Develop an appetite for good sleep: Eating and drinking can actually disrupt your sleep. Plan to finish meals and snacks 2 to 3 hours before bedtime because digestion wakes up your body. Alcohol and caffeine are also “sleep interrupters” when consumed before bed. Limit caffeine to the morning and finish your alcohol consumption by early evening. Smoking before bed can also stimulate your body and make it hard to sleep.

It’s important to keep in mind that seniors may need more time to adjust to the transition. What is a minor annoyance for most adults could present a significant obstacle in the routine of older adults, particularly those living with dementia or other cognitive impairments.  Be sure to check on these individuals and make sure that they are getting adequate sleep and seek medical advice if you notice a problem.  Take small steps to prepare for the change for you and your loved ones and enjoy the longer hours of daylight and the warmer days.

 

 

Goodnight, Sleep Tight

I admit it.  I don’t get enough sleep.  Sadly, most people do not.  Sleep is as necessary to our bodies as food and water.  With new devices and monitors that track sleep patterns you can even determine the amount of time you are in deep sleep.  But just keeping tabs on your sleep may not be enough to get you on track for catching up your shut eye deficiency.  Not getting adequate rest can be very serious.  It can be especially serious for seniors who are already a risk for falls and balance issues.  Lack of sleep just increases the opportunity for accidents.   So, what can you do to get a good night’s sleep?

WebMD offers these tips to Sleep Tight:

Stick to a regular bedtime. Go to sleep and get up at the same time each day, even on weekends. Your body will get used to the routine.

Avoid afternoon naps. If you sleep during the day, you’re more likely to stay awake at night.

Drink less fluids at night. Trips to the bathroom break up your sleep.

There are many suggestions and “schools of thought” as to how much sleep is needed.  Most experts still agree that somewhere between 7-8 hours a night is recommended.  But don’t forget to factor in those NAPS!!  Now while a nap sounds heavenly to me.  It can create confusion or longer stretches of night time rest.  I had a resident tell me that he just couldn’t sleep like he used to do.  Upon further discussion, I realized that he had not accounted for his hour and a half morning nap and two hour after lunch nap.  He hadn’t added these napping hours to his sleep bank!  It made more sense that with getting shut eye during the day and his decreased physical activity during the day as to why he wasn’t sleeping for long stretches in the evenings like he had previously.  But by simply getting more exercise and changing his nap schedule his resting at night was improved.

If you are having trouble sleeping, be sure to talk to your doctor.  March is National Sleep Awareness Month and a good time to evaluate your sleep and its relationship to your overall health.

elderly sleep

Benefits of the Blooms

Across the state at our different properties we have communities that have gardens right on property.  We even have some residents (at their choosing) that manage the porch plants at their properties.  As a person that lacks a green thumb, I’m so grateful!  Gardening is good for you, and research confirms that the health benefits are striking for those who have reached the age of AARP eligibility. Routine activity — such as a little bit of gardening every day —promotes a longer, healthier life.  So, what are the benefits?

Some benefits of GARDENING include:

  • Helps mobility and flexibility
  • Encourages use of all motor skills
  • Can improve endurance and strength
  • Helps prevent diseases such as osteoporosis
  • Reduces stress levels
  • While there are many wonderful benefits of gardening, you still must be SAFE and use precautions!

There are a few cautions for senior gardeners.  They should:

  • Wear a hat and protective clothing to protect from damage to the sun
  • Wear sunscreen on all exposed skin and reapply it every two hours
  • Drink plenty of water to avoid dehydration
  • Be careful not to be out in the hottest part of the day

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Preparation for the Situation

When it comes to emergency room visits, I probably have been more times than the average person due to the nature of my job.  But this year with the flu hitting near epidemic levels not only just in Alabama but also nationwide, emergency room visits have been experienced by many.  Trips to the ER can be a scary situation at any age.  The ER can prove particularly challenging for the elderly.  Here are some suggestions to help you keep it cool when you find yourself in the hot seat taking a senior loved one to the ER.

Emergency Files

The first week on the job as a brand-new administrator I found myself headed to the ER following an ambulance with one of my residents who I had obviously just met that week.  Now mind you, I had called their family and notified the proper folks of the situation.  But for a short time, it was just me and this resident (who was experiencing chest pains) in a room in the ER as they were being seen by the doctors and nurses.  I was grateful for a paperwork process that was in place in our community so I had the answers to the questions that were being asked by hospital personnel.   We use what we call an Emergency Red File for each resident in our community for such an occasion.  Inside we keep copies of the residents’ most recent medical exam and plan of care, insurance cards and other ID as well as advance directives and Power of Attorney documentation if they have them.  It is called a red file because well, it’s red in color.  Our local hospital staff has gotten very acclimated to our “red files” and it makes registration and getting medical staff some initial information on the resident so much easier.  It also helps keep the resident calm because they aren’t having to give answers to so many questions.  Our families appreciate this as well. They are usually a barrel of nerves at the call that their loved one is being taken to the ER anyway.  It is a relief for us to go ahead and have all of this information readily available.  Most regulations require assisted living communities to have this as part of the chart and way.  It is so much easier to have this type of file ready to go at a moment’s notice versus stopping to make copies.  We just make sure to secure them in a safe location, update them as appropriate and add the most recent medication list at an emergency occurrence.

Pack like a Pro

In addition to an emergency file, having a small bag packed is a huge help. I have been in situations where family members couldn’t get to the hospital that day due to travel outside the country, illness and more.  I’m typically going to ensure that the resident has someone with them to be there and comfort them and so that I can get the information to pass along to the family.  That is why having a bag packed and ready is a huge help.  Now, this bag doesn’t need to be big and bulky or loaded down and cumbersome.  But there are a few items I would suggest to take to help the resident and you be set up for as smooth “as possible” visit to the ER.  Some things to consider packing include:

  • Depends (pads, etc) for residents that require them
  • Snacks (for both you and the resident)
  • Phone charger
  • Small blanket
  • Water bottle(s)
  • Wipes
  • Ziplock bag

Now I know that most hospitals can provide you with many of these items.  But it doesn’t take much preparation to have these things ready to go. Sure, there are some emergency situations that emotions will be high and some of these items will be the last thing on your mind. But if you make gathering this and your emergency file part of your process, they can make a tough situation a little more bearable.  Remember that these items may be necessary for your resident and you.  So, pack accordingly.  I suffer from migraine headaches.  My triggers for them include multiple things.  But ranking up pretty high include:  stress, dehydration and skipping meals.  I’m no good to anyone else and can’t take care of them if I don’t take care of myself.  I say all of this to say that proper planning can help you be more effective to your residents and their families.

Blog note*

At present date, the Alabama Department Health has made the following recommendations regarding visiting the ER or doctor’s office for FLU RELATED ISSUES:

“For people with mild to moderate flu or flu-like symptoms, please do not go to your doctor’s office without calling first and do not go to the emergency room. Please call your doctor to see if you are eligible for antivirals without an appointment. Many insurance companies now have a “call a provider” service to help with mild to moderate illnesses; please take advantage of this service before going to doctor or hospital.  Mild to moderate cases of the flu usually do not require a hospital visit. Patients who do visit an emergency department or outpatient clinic should be aware of long wait times.” 

As with all emergency situations use your best judgment, especially when it comes to an elderly person who may have a reduced immune system.

 

Realistic and Optimistic

While many have sworn off New Year’s Resolutions, it may not be a bad idea to consider what areas may need improvement in our lives. And improvements apply to all ages!  However, it is important to be realistic in tackling our individual concerns.  I can’t help but think of some of those home improvement shows.  A couple looks at tackling this punch list of things that must be fixed…but when the budget or other “things” complicate the completion…they must settle on what can be accomplished.  So, as you consider your own self renovation project, give yourself a break.  Be realistic and optimistic.  Here are 3 things to consider if you have made a list…or even if you feel like you have jumped ship from the resolutions you started on earlier this week.

Number One

Give Yourself a Break!

Nothing says that just because you may have already stopped what you started on January 1st that you can’t achieve your goal.  Michael Jordan once said, “I can accept failure, everyone fails at something.  But I can’t accept not trying.”  Like the rest of us, Michael Jordan has had his share of failures and mistakes but one way NOT to accomplish a projected goal is to quit or not even make the effort.  Take time out and focus on being realistic with your expectations.

Number Two

Avoid Comparisons

No two people are completely alike.  Even twins have their differences.  Don’t look at a situation and expect your result to be like someone else’s.  Your goal should be just that…YOURS.  Your road to results, may have guidance and perhaps similarity to someone else’s situation, but you want to look at it with realistic eyes.  I remember two ladies discussing their aches and pains one day.  One lady was barely seventy and the other in her nineties.  The seventy-year-old said that knee replacement changed her life!  The next thing I knew I had a ninety-year-old lady calling her daughter wanting to get her knees done!  Set goals that are attainable and healthy.  Take small steps to set yourself up for success.

Number Three

Reward Yourself

One of my favorite phrases that I hear people say is “Treat Yourself!”  I think this especially applies if you are working towards a goal.  Now while this may not mean go and pig out and derail a healthy eating plan once you complete one successful week.  It DOES mean to be sure and give yourself a pat on the back for small steps along the way towards your goal.  Develop a reward system that works for you.

In researching and thinking about the blog this week, I looked back at some of the best advice some of our seniors had to give this past year.  I will close with these thoughts and want to wish you all the best in 2018!

  1. Keep your mind open and don’t stress if you have to start at the bottom to work your way up. You can do it! Learn the value of hard work.
  2. Knowledge is power. Continue your education because that is something that no one can take away from you.
  3. Wake up each day with an open mind and a full heart. Everyone will not always have the same values as you. Stay rooted to what you know while still showing kindness.

HAPPY NEW YEAR FROM GREAT OAKS MANAGEMENT!!

Understanding SADness

Depression is a condition that affects many people of all ages around the world.  Over the years, I have experienced within our community just how difficult and debilitating it can be for some of our elderly in the winter months. Winter SADness…or Seasonal Affect Disorder is not just a bad or sad mood.  It is a real health issue and as with any type of depression, it is important to be aware and seek medical intervention when necessary.  The National Institute of Mental Health gives this explanation and as well as symptoms and treatments:

Seasonal Affective Disorder (SAD) is not considered as a separate disorder. It is a type of depression displaying a recurring seasonal pattern. To be diagnosed with SAD, people must meet full criteria for major depression coinciding with specific seasons (appearing in the winter or summer months) for at least 2 years. Seasonal depressions must be much more frequent than any non-seasonal depressions.

Symptoms of the Winter Pattern of SAD include:

  • Having low energy
  • Hypersomnia
  • Overeating
  • Weight gain
  • Craving for carbohydrates
  • Social withdrawal (feel like “hibernating”)

Treatments and Therapies:

There are four major types of treatment for SAD:

  • Medication
  • Light therapy
  • Psychotherapy
  • Vitamin D

These treatments may be used alone or in combination.  Along with the difficulties that a chronic illness can bring, seniors are also likely to experiences losses in the social networks, which can contribute to the formation of clinical depression.  Not everyone who experiences Seasonal Affect Disorder is clinically depressed, but SAD can increase the effects of those who do live with chronic depression. Families and caregivers should be on the lookout for indicators of SAD in their older loved ones during the winter months.

It is important to talk with your loved ones if you have concerns about their mental health and seek medical attention when necessary.  Be supportive, be loving and help them remain calm as they cope.

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Grateful Gatherings

As we prepare to give thanks and gather around the table…I remember.  I remember that it was just last Thanksgiving that we experienced a “first” in our community. It was the first time that all 16 of our residents were out with family at the EXACT same time.  It was a strange feeling for the folks that were working that day.  I remember them calling to tell me about it.  Oh, there is always plenty to be done and the staff was happy for the residents to be spending quality time with family and loved ones.  It was just a new first for our community.  What about you?  Is this the first year that you will be planning Thanksgiving after having moved a loved one into an assisted living? Are you concerned with all the preparation and worried about the visit?  Here are a few tips to help you stress less and enjoy Thanksgiving with your elderly loved ones.

Schedules and Timing

As much as you don’t want to plan out every little detail, you do want to give it some thought. Remember that if they are residing in an assisted living they may now be accustomed to a more structured routine.  You will want to check with the staff regarding medications and proper protocol.  You want to be sure to keep everything on track.

Food and Options

Our residents live very active and independent lifestyles.  They enjoy making their own choices and directing their care.  But it is important to consider their dietary needs.  Be mindful of food options.  Remember if Mom doesn’t need the extra salt or Dad needs alternative dessert options.

Time Away

One of the most common comments I hear from families is that they are shocked when not long after eating ….the elderly loved one is ready to go back to their community (new home).  Now naturally this makes an administrator very happy that a resident has come to feel comfortable in their community.  But don’t let it make you feel down.  Remember they have gotten on their own time schedule.  They are enjoying your company, but like many people after a gathering may need some rest.

As with all time together…just enjoy.  Make it special but don’t put too much pressure on your family member or yourself (for that matter) to meet unrealistic expectations.  Incorporate them into the conversation.  Maybe call ahead of time and get their special recipe for a favorite dish.  Spend time talking, relating and making treasured memories.  Savor these moments together and you ALL will come away from the gathering feeling grateful.

elderly african american man enjoying coffee with his granddaughter

Fall Factors

One of the top reasons that we get calls or inquiries about assisted living is when families have an elderly loved one who has had a fall.  Falls among seniors are unfortunately very common.  It was recently reported in the news that falls are the number one causes of both fatal and nonfatal injuries among people aged 65 and older.  The U.S. Centers for Disease Control and Prevention reports that every 11 seconds, an older adult is treated in the emergency room for a fall; every 19 minutes, an older adult dies from a fall.  Now, falls can still occur in any environment but knowing what to watch for and having others looking out for you can help avoid potential falls.

 

Here are some key factors from the National Council on Aging to consider regarding falls:

 

  • Balance and gait: As we age, most of us lose some coordination, flexibility, and balance— primarily through inactivity, making it easier to fall.
  • Vision: In the aging eye, less light reaches the retina—making contrasting edges, tripping hazards, and obstacles harder to see.
  • Medications: Some prescriptions and over-the-counter medications can cause dizziness, dehydration or interactions with each other that can lead to a fall.
  • Environment: Most seniors have lived in their homes for a long time and have never thought about simple modifications that might keep it safer as they age.
  • Chronic conditions: More than 80% of older adults have at least one chronic condition like diabetes, stroke, or arthritis. Often, these increase the risk of falling because they result in lost function, inactivity, depression, pain, or multiple medications.

 

Be aware of these factors and keep the dialogue open with your loved ones regarding falls and the issues related to them.  Ask questions and be proactive if you notice changes in health and/or behavior.

Family is Forever

The past two weeks we have been collecting pictures of our residents to do a game of “Guess Who” as a part of our National Assisted Living Week celebrations.  It has been such a joy for families and residents to share their pictures from “way back when”.  It has caused me to pause and reflect on life.  When our residents think of themselves, they may picture that younger self that served in the Army or was a homemaker or helped on the farm.  Their children may envision the Mom or Dad that helped shape their childhood and their memories of growing up.  To the staff at the communities that these folks live in now, we may see them differently.  But it is always wise to stop, look back and remember.  As we all age we may see ourselves in many different lights.  We grow and become many things to many people.  So have our residents.  As we celebrate National Assisted Living Week and the beauty that comes from this environment, I want us all to remember that each of us has a history and we impact so many different people.  The theme of National Assisted Living Week is Family is Forever.  I know for me over the last 8 times that I have celebrated this week that it has seen many different faces and many different memories.  I have helped crown many different Kings and Queens of the Gardens.  But I think that what I realize today that each year…my family has grown.  Sometimes it can be hard to let people into your life with the understanding that they may not be able to stay for long.  But as Garth Brooks once sang, “I could have missed the pain, but then I could have missed the dance.”  Thank you assisted living for what you have meant to me and my family.  I know my family has grown forever and my heart is much more full as a result.

 

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