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.

 

 

 

 

 

 

 

Advertisements

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.

 

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.

You and the Flu

Last week we had our annual flu shot clinic at our community.  I’ll admit that I never started getting a flu shot until I went to work in the assisted living sector.  I had experience with kidney stones, sinus infections, broken bones, and surgeries.  But no flu.  But the first year I got the flu shot….NO…I didn’t get the flu, but my husband and daughter…both (who did not get their flu shot that year) got the flu and it was rough.   But as rough as it can be on school-aged children and middle-aged adults…it can be much more serious for the elderly or those with compromised immune systems.  Here are a few helpful reminders to consider as we approach flu season.

Get your Flu shots!

In our communities’ we offer flu shots annually to protect our residents and staff.  It is something that we take very seriously as it can be a dangerous situation for an elderly person to get the flu.  Nowadays you have options!  You can get your shot with your family physician or many pharmacies have flu shots available onsite.   Remember that when you get the flu shot, it takes about two weeks for it to begin working.  So, you want to get your shots ahead of the flu season curve.

Sniffles?  See you next time!

What may sound rude, is just smart advice.  If you don’t feel well or you have a child that doesn’t feel good…find another time to visit an assisted living community.  What we can shake off easily may prove a huge obstacle for a senior citizen to bounce back.  The CDC provides this list of flu symptoms to watch for:

  • Fever* or feeling feverish/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue (tiredness)
  • Some people may have vomiting and diarrhea, though this is more common in children than adults.

* It’s important to note that not everyone with flu will have a fever.

If you are experiencing these symptoms, plan to visit another time when you are well.

Clean up Your Act!

The CDC states that:

People with flu can spread it to others up to about 6 feet away. Most experts think that flu viruses are spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth or nose.  That is why hand washing is key!

It also is important to wash hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub. However, use caution with these type sanitizers and children.

So, use good judgment this flu season and do your part to protect yourself and others.  We love to have visitors in our communities.  But if you are sick, we will just plan to see you when you are well!  When you see our healthy visit reminder signs posted at your local Great Oaks Management Communities, just know it is part of our mission for seniors – to be happy and healthy.

 

 

Beat the Heat

As I write I have been watching the rain fall onto the scorching blacktop streets of my neighborhood.   It feels good on the porch in the evenings.  But, the middle of the day is a bit unbearable for me.  Summertime is no joke in Alabama.  I remember moving South the summer of 1985.  July to be exact.  Being that I moved from way up North…it seriously took me two entire weeks for my system to adjust.  Heat is not anything for anyone to play around with. It can be particularly concerning for the elderly.  Here are some tips to help our seniors keep their cool this summer.

Drink Up! The key to staying healthy is to stay hydrated!  Drink eight or more 8-ounce glasses per day of water every day.  Be aware of the signs of dehydration, heat exhaustion and heat stroke. The most common signs of dehydration in the elderly are thirst, confusion, irritability and poor skin elasticity.  So, don’t wait…HYDRATE!

walking man sweat

Block the Rays!  Protect your skin from sun damage by wearing hats, sunglasses and don’t forget the sunscreen!  Use a broad-spectrum sunscreen with sun protection factor (SPF) of 15 or higher.  Remember as we age, our skin becomes more sensitive to the sun.

 

Dress for Sunny Success!  When selecting what to wear go with loose-fitting clothes in light colors that will reflect the sun and heat instead of darker colors that will absorb heat.  This will help you avoid a sunburn and stay cool.

couple biking

It’s important to know that extreme heat can wreak havoc on older adults.  According to healthinaging.org, “Every summer, nearly 200 Americans die of health problems caused by high heat and humidity. Hot weather is more likely to cause health problems for older adults for a variety of reasons. These reasons include aging-related physical changes in the body, chronic health conditions, and even side effects of taking some medications.”  Remember heat and dehydration may make seniors more prone to dizziness and falls and can cause/increase confusion. But the proper precautions can help set them up for success. If the heat is too extreme…stay inside with air conditioning!  Keep you and your elderly loved ones safe this summer and do your part to help them beat the heat.

Medication Matters

June is National Safety Month. For seniors, safety takes on many different shapes. In Assisted Living, we find that some of these safety issues are the primary reasons families will reach out for help for their elderly loved ones.  One of the primary safety concerns is that of medications.

Heads on Meds

If you are worried that your loved one is not taking their medications as prescribed…or too much…or not at all…then it may be time to consider assisted living.  We all know that misuse of medications can cause all sorts of problems, or in some serious cases even death. Assisted Living communities can provide residents with assistance with their daily and as needed medications.  Residents must meet the requirements for admission to a community, including being able to identify your name on your medications. Staff are trained to assist residents in taking their meds using the:

stackedpills

  • The right route.
  • The right time.
  • The right resident.
  • The right documentation.

Medication management also helps prevent against a loved one taking a medication that has expired.. Looking out for the safety of your elderly loved ones in regards to their meds is one way that residing in an assisted living can help families find peace of mind.

hug dad

For more information on one of our assisted living communities visit our website:

www.greatoaksmanagement.com

Insider Information

Not too long ago, I had lunch with a friend of mine that also happened to be a sponsor of one of my residents.  She is also my neighbor, but I digress.  As we sipped sweet tea, I asked her what was one thing that she wished she knew more about before she moved her Dad into assisted living.  Here are a couple useful tips regarding doctor visits that she suggested that will make life easier if you are considering or have made the transition to an assisted living community.

Prep Doctor Visit Steps

Not only do assisted living communities offer scheduling and transportation to appointments for our residents…but we also provide useful tools for communication.   We all know that for every physician on the planet they all typically want us to bring our list of meds with us.  But here are some things that our staff will provide if you (or if we) are taking your family member to the doctor:

Pills

  • A current list of medication for all residents for doctor’s appointments (typically we can make a copy of their medication record from that day that ensures they have the most current info available)
  • Physician Communication Form (this form is an excellent tool where the doctor can detail their findings and diagnosis information as well as prescriptions or requests for follow-ups etc.  This helps provide a written outline of the doctor visit so that the sponsor and resident can communicate fully the needs the resident may require.  This form is typically stapled to the copy of the resident’s medication record and given to the sponsor/staff that will be going with the resident prior to the appointment.  Upon return to the community following the appointment, the sponsor can just give this to the Administrator or designee.  If a staff member took the resident to the appointment, they will then call the sponsor to provide the details from the appointment.  This is another reason that this tool is so useful.)

We also can help assist by providing documented weights and other health information that a physician may request.  Health information is protected per HIPPA guidelines.

older-man-dr-visit-daughter

Hopefully this prep will help make doctor visits less daunting.  As my friend explained, “when you have been the sole caregiver for an aging parent or loved one, you know them probably better than anyone.  But by allowing the staff at the assisted living to join forces with the resident, the sponsor and the physician…we become a team”.  This is an excellent analogy!  This TEAM is always looking out for the resident.  And the vital key is communication.  Another important thing that you need to know is that the medications should be in unit dose packaging if they will require staff assistance.  So just running a prescription to the pharmacy and picking up a bottle is NOT the way to go.  The ADPH rules and regulations are in place to protect.  So be sure to get the prescription to the administrator or contact them if you have any questions.  This will ensure that you or the staff have them filled properly and that the staff have the proper documentation for the resident chart.  Following these simple suggestions can make life easier for you, the staff at the assisted living and most importantly the resident.

I’m Afraid My Parents Are Forgetting To Take Their Medications

As our parents age, we often become concerned that they aren’t able to manage simple things, like remembering to take their medications.  Sometimes remembering to take medications is especially hard if our loved one has chronic health problems like diabetes or high blood pressure and takes several medications each day.  What can we do when we are concerned that our parents are forgetting to take their medications?

An easy first step is a trip to the physician to make sure that the medications our parents have are the ones they need to take.  When going with our parents to see their physician, be sure to take all the medications in their original prescription container for review by the physician.  Ask the physician if all the medications are necessary and also if it’s possible to schedule them to be taken no more than twice per day.  Simplifying how many times each day medications have to be taken will help streamline the process.

After the medications are reviewed and streamlined as much as possible, invest in a medication organizer.  These are inexpensive and available at most drug stores.  Fill the organizer with the medications for the appropriate time of day and familiarize your parents with how to use them.  Using the organizer shows at a glance whether medications have been taken and make keeping up with the correct dose much easier.  When looking for an organizer, make sure to obtain one that your parents can easily open and close and make sure that the dose times correspond to the dose times on the prescriptions.  For the first few days using the organizer, a reminder phone call may also be helpful.

If medication organizers, phone call reminders and other steps have failed, it may be time to consider an assisted living community.  Assisted living communities’ help individuals remember to take their medications at the time and correct dose ordered by their physician.  They also monitor individuals for any problems with medications and notify the physician and family if there is a problem.  This is especially important if the individual has chronic health problems.

 

For more information, visit GreatOaksManagement.com!

Are You Taking Too Much Medication?

Does it seem like everyone you know is taking medication for something?  Since 1 in 5 Americans age 45 and older have some type of chronic medical condition like high blood pressure or diabetes, chances are you have friends who are on long term medication.  Perhaps you are also taking a daily medication for a chronic medical condition.

Unfortunately, this trend gets worse as we get older.  76% of people over age 60 in the United States take at least 2 medications daily.  37% take 5 or more medications daily.  It’s easy to slip into this when we are often seen to specialist for specific health problems.  Before we know it, we may be seeing several specialists in addition to our primary care physician.  How do we know when we are taking too many medications?

All medications have side effects.  Sometimes a medication that is given to help a specific medical problem can make us have side effects that we don’t recognize as being caused by the medication.  The more medications you take, the more likely you are to have side effects, especially if there are interactions between the medications you take.

One way to address this is to do a “Medication Checkup” with your primary care physician.  Make an appointment for this and bring ALL the medications you take including those which are only as needed and any over the counter medications, vitamins or supplements.  You may find you are taking a medication you no longer need, or that switching to a different medication for a chronic medical condition can reduce or eliminate any side effects.

Another way to help prevent side effects caused by medication interaction is to make sure you use only one pharmacy.  Your pharmacist should have a complete list of all medications as well as over the counter medications, vitamins and supplements.  Ask your pharmacist before starting a new over the counter medication to make sure it doesn’t interact with the prescription medications you are currently taking.

Keep an up to date list of all prescriptions, over the counter medications, vitamins and supplements and make sure you update the list with any change.  Double check with your primary care provider at each visit to make sure their list is up to date as well.

When bothered by a new problem like insomnia, consider a non-drug approach to manage the problem. Getting some exercise at least 3 hours before bedtime, sticking to a schedule for going to bed each night, limiting caffeine in the evening and limiting electronic screens just before bed can be a non-medication way to help improve sleep.