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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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.

hold hands

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.

Check It Out

I spend more time than I would like to at hospitals and clinics.  I guess it is just part of the job.  But last week I had to go for a visit for my own health.  It was time for my annual mammogram.  Now my tween-age daughter might say this is “TMI” or too much information.  But I think…that this is actually the opposite.  I think it is necessary for us to discuss important health issues at any age.  And being informed and keeping the lines of communication open regarding breast health should be a priority.

According to Harvard’s Women’s Health Watch, half of newly diagnosed women with breast cancer are over 60, and more than a fifth are over 70. Although the risk of being diagnosed with breast cancer increases with age, the chance of dying from it declines steadily. “Women who have lived to an advanced age do very well when treated for breast cancer,” says Dr. Hal Burstein, senior physician and breast cancer specialist at Harvard-affiliated Dana-Farber Cancer Institute.

But the path to early detection and effective treatment isn’t always clear for older women; once you’ve reached 75, there is no hard-and-fast schedule for screening or protocol for treatment. Instead, how often you should get a mammogram or the kind of treatment you undergo for early breast cancer is a decision for you to make with your doctor.

What are the risk factors?

The Mayo Clinic and National Cancer Institute list these primary risk factors:

  • Age
  • Chest radiation as a child
  • Start of menarche before the age of 12
  • Adolescent weight gain
  • No pregnancy or late pregnancy (after 30)
  • Lengthy use of oral contraceptives
  • Post-menopausal weight gain
  • Late menopause (after age of 50)
  • Increased breast tissue density

It is important to keep your appointments for all regular checkups for women and men of all ages.  What may be uncomfortable or inconvenient for a day can save your life.

You can find more information at http://www.cancer.org

 

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.

 

 

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.

Keep It Clean

There are many reasons that family members become concerned that an elderly loved one is not doing well.  One issue that is a cause for concern is bathing or rather the lack thereof.  A parent not bathing is a topic that many families are reluctant to discuss as they may be uncomfortable bringing it up. But be assured that this is an issue that many people face.  It is common…but there may be multiple root causes.  It is important to understand why they are reluctant.  Only when you understand that the underlying reasons can you better approach and address successfully.  Let’s look at some of the more common reasons.

 

  1. Fear of Falling

The bathroom can be a very dangerous place. If you have every slipped in the shower, you can relate. Now you pair the environment with physical issues like foot problems, balance issues, arthritis and more…and you have a recipe for disaster and fear.

 

  1. Depression

Often elderly have issues with depression that can zap their get up and go. When you lack motivation, bathing and concerns for your grooming often go by the wayside.

 

  1. Cognitive Issues

Another reason that is very common are memory issues. If your parent has dementia or other cognitive decline, keeping up with a bathing schedule can be extremely difficult.  Realizing that you haven’t taken a bath is not something they may be able to keep up with easily.

 

While it may be a difficult subject to approach, you must develop a plan. For some simply adding grab bars or safety equipment may help. Some may be able to follow a chart.  But if it is a depression or memory issue, it may be time to consider getting help.  As always discuss your concerns with a doctor.  A physician may want to consider medications to help with depression.  It may be time to enlist the help of a caregiver or look into an assisted living community where your loved one can have daily assistance with their activities of daily life like bathing and grooming.  But don’t avoid the topic because it is messy and uncomfortable.  The health benefits of cleanliness are far too important to ignore.

Shine a Purple Light

I will admit that until I began working in the senior living sector, I knew very little about Alzheimer’s Disease and Dementia.  It was not something I had seen on a personal or family level.  That has changed.  Now I know and care for people affected by Alzheimer’s and dementia.  I understand that they are not all one in the same.  There are even different types of dementia.  I have come to know some of the devastating effects they take on lives.  Since June is Alzheimer’s and Brain Awareness Month, I thought I could help do my part by shining a purple light.

Did you know that according to the Alzheimer’s Association:

  • Alzheimer’s is fatal. It kills more than breast and prostate cancer combined.
  • Alzheimer’s is not normal aging. It’s a progressive brain disease without any cure.
  • Alzheimer’s is more than memory loss. It appears through a variety of signs and symptoms.

Per the website alz.org, “A number of studies indicate that maintaining strong social connections and keeping mentally active as we age might lower the risk of cognitive decline and Alzheimer’s. Experts are not certain about the reason for this association. It may be due to direct mechanisms through which social and mental stimulation strengthen connections between nerve cells in the brain.”

AlzheimersTable

During the month of June, the Alzheimer’s Association asks you to learn more about Alzheimer’s. Share your story and take action.  It may be as simple as bringing awareness via social media.  Alzheimer’s disease awareness is represented by the color purple, and in June, thousands of Americans will turn their Facebook profile purple with an “END ALZ” icon.  If you need help or more information on ways you can raise awareness of the truth about Alzheimer’s, visit alz.org/abam to get started.

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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