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.

 

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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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All in the Family

We are right around the corner from National Assisted Living Week.  Every year this tradition is a very special time for our residents, staff, families and our entire community.  As we busy ourselves with plans and preparation to make this event a success, I wanted to stop and reflect on why this year’s theme means so much to me personally.

 

I started working in assisted living in 2010.  I am truly amazed how quickly time has passed.  Through these last years, I have met some truly amazing people.  I have laughed and I have cried.  I have learned about others and I have learned about myself.  Rick Warren once said, “while it is wise to learn from experience, it is wiser to learn from the experience of others.”  The people that live and work and volunteer in our communities are true blessings.  I have learned many life lessons from so many of these wonderful people.  The wisdom that the residents share is invaluable.  The families of our residents are treasures as well.

 

National Assisted Living Week will be the week of September 10th through the 16th and the theme this year is “Family is Forever”. This year’s theme is inspired by a quote from the poet Maya Angelou: “Family isn’t always blood, it’s the people in your life who want you in theirs: the ones who accept you for who you are, the ones who would do anything to see you smile and who love you no matter what.”

 

I feel this theme truly represents what I see on a daily basis.  It’s in the encouragement of a staff member, the smile of a volunteer or the laughter of a resident.  The people that you will find here truly are family.  Find out more about our communities at the links listed below.  Schedule a tour at one of our properties today.  Find out why we believe Family is Forever!

 

Look Out

Did you get your approved solar glasses earlier this week?  I did not.  For me, I make it a practice not to look directly at the sun.  Millions of people, (per the sales of solar eclipse glasses) have been in tune with recommendations about protecting their vision from the solar eclipse.  Now that the hysteria has passed…there is something that we should all set our sights on that affects us on a regular basis and that is our vision changes.  Since August in National Eye Exam Month, here is a list from the American Optometric Association of age related illnesses that we can look out for that can have a serious impact on your eye health and vision.

Age-related Macular Degeneration (AMD) is an eye disease that affects the macula (the center of the light-sensitive retina at the back of the eye) and causes central vision loss. Although small, the macula is the part of the retina that allows us to see fine detail and colors. Activities like reading, driving, watching TV and recognizing faces all require good central vision provided by the macula. While macular degeneration decreases central vision, peripheral or side vision remains unaffected.

Cataracts are cloudy or opaque areas in the normally clear lens of the eye. Depending upon their size and location, they can interfere with normal vision. Usually cataracts develop in both eyes, but one may be worse than the other. Cataracts can cause blurry vision, decreased contrast sensitivity, dulling of colors and increased sensitivity to glare.

Diabetic Retinopathy is a condition that occurs in people with diabetes. It is the result of progressive damage to the tiny blood vessels that nourish the retina. These damaged blood vessels leak blood and other fluids that cause retinal tissue to swell and cloud vision. The condition usually affects both eyes. The longer a person has diabetes, the greater the risk for developing diabetic retinopathy. In addition, the instability of a person’s glucose measurements over time can impact the development and/or severity of the condition. At its most severe, diabetic retinopathy can cause blindness.

Dry Eye is a condition in which a person produces too few or poor-quality tears. Tears maintain the health of the front surface of the eye and provide clear vision. Dry eye is a common and often chronic problem, particularly in older adults.

Glaucoma is a group of eye diseases characterized by damage to the optic nerve resulting in vision loss. People with a family history of glaucoma, African Americans and older adults have a higher risk of developing the disease. Glaucoma is often painless and can have no symptoms. Over time, it can take away peripheral (side) vision.

Retinal Detachment is a tearing or separation of the retina from the underlying tissue. Retinal detachment most often occurs spontaneously due to changes to the gel-like vitreous fluid that fills the back of the eye. Other causes include trauma to the eye or head, health problems like advanced diabetes, and inflammatory eye disorders. If not treated promptly, it can cause permanent vision loss.

eye test

The American Academy of Ophthalmology recommends that folks 65 years of age and older have a full exam every year or two.  Be sure to contact your doctor if you have concerns so that you can be focused on maintaining good health and vision.

Peachy Keen

Today we are honoring Gardens of Clanton resident Lucille Mims.  Mrs. Lucille is 94 years old and thoroughly enjoys being a resident at our Clanton community.  Most folks when they think of Clanton, immediately think of peaches.  Clanton is famous for their delicious peaches and their water tower in the shape of a peach. August is National Peach Month and in honor of Mrs. Lucille Mims, the Gardens of Clanton and the delicious fruit…we are sharing a delicious recipe for Peach Cobbler. We hope you all enjoy this delicious taste of summer!

clanton peach

Peach Cobbler Recipe

  • 8 fresh peaches – peeled, pitted and sliced into thin wedges
  • 1/4 cup white sugar
  • 1/4 cup brown sugar
  • 1/4 teaspoon ground cinnamon
  • 1/8 teaspoon ground nutmeg
  • 1 teaspoon fresh lemon juice
  • 2 teaspoons cornstarch
  • 1 cup all-purpose flour
  • 1/4 cup white sugar
  • 1/4 cup brown sugar
  • 1 teaspoon baking powder
  • 1/2 teaspoon salt
  • 6 tablespoons unsalted butter, chilled and cut into small pieces
  • 1/4 cup boiling water
  • MIX TOGETHER:
  • 3 tablespoons white sugar
  • 1 teaspoon ground cinnamon

Directions

  1. Preheat oven to 425 degrees F
  2. In a large bowl, combine peaches, 1/4 cup white sugar, 1/4 cup brown sugar, 1/4 teaspoon cinnamon, nutmeg, lemon juice and cornstarch.
  3. Toss to coat evenly, and pour into a 2 quart baking dish. Bake in preheated oven for 10 minutes.
  4. Meanwhile, in a large bowl, combine flour, 1/4 cup white sugar, 1/4 cup brown sugar, baking powder, and salt. Blend in butter with your fingertips until mixture resembles coarse meal. Stir in water until just combined.
  5. Remove peaches from oven, and drop spoonfuls of topping over them. Sprinkle entire cobbler with the sugar and cinnamon mixture. Bake until topping is golden, about 30 minutes.

Mims grand

Pictured is Mrs. Mims and her loving granddaughter

Serving Up Sweetness

Elizabeth Andrew once said that “volunteers do not necessarily have the time…they have the heart.”  With that being said I wanted to shine light on one of our many volunteers that brighten our days at Great Oaks Management.  Ellen Dewberry has been volunteering at the Gardens of Eufaula since 2010.  She brightens the days of our residents and shares the word with Bible Study on Wednesday afternoons.  Mrs. Dewberry is one of our shining stars!  In honor of her sweetness we are going to share her delicious recipe for Turtle Cake!  Thank you Ellen Dewberry for your kindness and your servant’s heart.  We at Great Oaks Management love our volunteers who are always being willing to share!

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Turtle Cake

¾ cup butter

½ cup canned milk (use small can)

1 (1lb) bag caramels

1 cup chocolate chips

1 German chocolate cake mix

 

Mix cake mix according to package directions.  In 9 X 13 inch pan that has been greased and floured, pour ½ batter.  Bake for 15 minutes at 350 degrees.  While this is baking unwrap caramels.  Put in bowl and add the butter and milk.  Microwave one to two minutes until melted.  When cake is done, pour mixture over cake.  Sprinkle chocolate chips on top of that.  Pour rest of batter over this and bake for 20 more minutes.

Recipe Courtesy Ellen Dewberry

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