School bells are ringing and many children are headed back to class. But before they break out those new No. 2 pencils, they probably had to have some health checkups. You are one smart cookie if you know that this is also a good time to get those checkups done for your senior! No not your son or daughter who plays Varsity sports! Rather your elderly parent who is planning a move to an assisted living community.
Now you may already know that part of the process to gain admission to an ALF is to have a physical examination completed by your primary care physician. During this visit the doctor (among other things) will complete the facility paperwork with the potential resident moving to assisted living and in most cases coordinate with the family member to discuss the best care plan to have put into place. This ensures that the assisted living staff knows the diagnoses, that the resident is free from communicable diseases, etc. However, I have seen several family members go a step further to make sure that their loved one is set up for success for the transition to assisted living. And going that extra mile makes a huge difference in most cases.
So what are those extra steps? It’s as simple as ensuring that your loved ones can see and hear as best as possible. It is very important thing to talk with them about the importance of their eyesight and their hearing during this time. As studies show, one half of people age 85 or older have hearing loss. Also when compared to Americans 18 to 44 years of age, Americans 75 years of age and over are nearly three times as likely to report vision loss. Therefore it is of utmost importance that they are regularly checked out. However…you would be surprised how many residents come into assisted living with the same pair of old glasses they were prescribed years ago. And what did you say??? Their hearing hasn’t been checked in ages. Say what?? I said THEIR HEARING HASN’T BEEN CHECKED IN AGES!!! Whew…you get the point. I have seen residents that shy away from the dinner table because they can’t hear well. Why you ask? Well, if your table mates are trying to talk to you and you are having trouble hearing… this can be cause for confusion and (sadly as I have seen this happen before) embarrassment. And the reality is in some cases, hearing can be helped by hearing aids or simple wax removal.
Eyesight is super important in the transition as well. Moving to a new place means maneuvering around a new area. If you can’t see this can be scary and the recipe for a fall! So be sure to have Mom’s eyes checked out to be sure her glasses are still the right prescription. The ALF should care plan any vision issues as to ensure the safest environment as possible.
Sure you are still going to have sight impaired and hearing impaired individuals in assisted living communities. That’s a no brainer! Sometimes there is absolutely nothing that can be done for hearing or sight issues and that is okay! Assisted living staff members are trained on caring for folks with these issues and have ongoing in-services to cater to their needs. But just as you wouldn’t send Johnny off to school without his supplies…be sure your loved one is ready for the transition to their new community and get their eyes and ears checked out! That way they can keep their eyes (and ears) on the prize.
Have you ever felt suddenly dizzy or felt the room spinning or you feel light headed? It is a very scary sensation when it happens. You are not alone; you may be one of 33 million Americans who had a balance problem in the past year. Balance problems are one of the most common reasons senior adults seek medical care each year.
Good balance is important, especially in senior adults as it often leads to falls and more serious injuries. An intact sense of balance allows us to do simple things like walk without staggering, get up from a chair without falling or bend over to pick something up without falling. Often issues with the inner ear create problems with balance, or cause dizziness or feeling light headed.
Weight loss can also contribute to balance issues, especially in senior adult women. Weight loss, even a small amount, can shift our center of gravity and cause balance issues, especially when standing up from a chair. This can often lead of falls in senior adults.
Good balance is important to our ability to get around, stay active and independent. If you are having concerns about dizziness, light headedness or feeling unsteady, especially when rising from a chair, talk to your primary care provider.
Everyone is forgetful from time to time especially when it comes to things like remembering where we put the car keys or forgetting to pick up something at the grocery store. Adults over 65 say they are more forgetful than when they were younger, sometimes having a “senior moment” when they forget something.
Occasional forgetfulness is different than dementia and as our parents age, sometimes we wonderful is the forgetfulness we see is a part of the natural aging process or the beginning of dementia or Alzheimer’s disease. As the child of a senior adult, how will I know the difference?
Research has shown that the early warning signs of dementia or Alzheimer’s disease may begin to occur years before our parents get the diagnosis, sometimes as much as 10-15 years before the diagnosis. That’s why it is important to pay attention to early signs of forgetfulness and consider a trip to the physician for a medical work up if we are concerned about the possibility that our parents may be developing dementia. Forgetting a friends name or missing a lunch date is something that people without dementia do from time to time. Someone with early dementia, though, might repeatedly forget names or plans, and forget all about the incident soon afterward. It may seem strange but while someone with early dementia may forget something that happened the previous evening, they may recall in detail events that happened in the more distant past, last year, say, or during their childhood.
The Alzheimer’s Association has published a list of 10 warning signs of dementia or Alzheimer’s disease. They are:
- Forgetfulness and memory loss
- Lack of concentration and confusion
- Losing things
- Difficulty doing familiar tasks
- Language and speaking problems
- Problems with simple math
- Poor judgment
- Personality changes and mood swings
- Changes in grooming and personal hygiene
- Withdrawing from friends and family
If you are concerned about your parent, make an appointment to see their primary care physician. There are medications available which slow the progression of some forms of dementia, but they work better if they start early in the disease.
Getting that initial diagnosis of Dementia is often such a shock, it may take some time to begin to gather information and formulate a plan with your physician. While the medications available today don’t cure dementia, they can help lessen the symptoms like memory loss or confusion.
The US Food and Drug Administration (FDA) has approved two types of medications cholinesterase inhibitors like Aricept, Exelon and Razadyne and memantine (Namenda) to treat cognitive symptoms of dementia like memory loss, confusion and problems thinking and reasoning. While these medications can’t stop the damage done by dementia, they may help lessen or stabilize symptoms for a limited time by affecting certain chemicals involved in carrying messages in the brain’s nerve cells.
Cholinesterase Inhibitors: Prevent the breakdown of acetylcholine a chemical messenger important for learning and memory. There are three medications in this category:
- Aricept: Approved to treat all stages of Dementia, delays worsening of symptoms for 6-12 months on average.
- Razadyne: Approved to treat mild to moderate Dementia.
- Exelon: Approved to treat mild to moderate stages of dementia. Same type of drug, but comes in a patch.
Memantine: Regulates the activity of glutamate, a different messenger chemical involved in learning and memory. There is one medication in this category.
- Namenda: Approved to treat moderate to severe dementia.
A New combination drug: Namzaric has just become available in 2015. This medication is a combination of Aricept and Namenda for moderate to severe Dementia.
If you or a loved one has gotten a diagnosis of dementia, talk to your doctor about which medication would be the best fit to help lessen the symptoms of the disease. If the doctor prescribes one of these medications, make sure the medication is taken as directed by the doctor and make sure to let the doctor know how the medication is working.
What do Ronald Reagan, Margaret Thatcher, Glen Campbell, Pat Summit, and Perry Como have in common? Your first response might be that they are all famous, successful individuals. You would be right, but the one thing that they all have in common is Alzheimer’s disease. November is Alzheimer’s Awareness Month and now is a good time to learn more about the disease and what to do if you are concerned that a loved one may have memory problems.
Alzheimer’s disease is a brain disease that affects memory, language, thought and eventually, the ability to complete basic activities of daily living. Scientist think as many as 4.5 million American’s have Alzheimer’s disease and the numbers go up beginning at age 60. Scientist estimates that 50% of Americans age 85 and older have the disease. One important point is that Alzheimer’s is not a part of normal aging.
If you have a loved one who is experiencing memory loss, make an appointment to see your primary care provider as soon as possible. There are medications available today which help slow down the progression of the disease if they are started early in the disease process. Delaying getting a diagnosis reduces the ability to slow the disease earlier in the process.
If you have a loved one who has been given a diagnosis of Alzheimer’s disease, get as much information as you can and look for a support group in your area. Explore programs in your area for individuals with memory loss and begin to look at senior living options for when living at home is no longer possible. Don’t forget to take care of yourself. Care giving for an individual with memory problems is challenging and many care givers face health challenges of their own.
Alzheimer’s disease affects individuals regardless of their race, sex, social background or financial class. Getting up to date information will help you find the answers you need.
It is important that you be able to identify each medication that you take and understand what the medication is for. This can be difficult when our pharmacy may substitute different manufacturers with our refills in an effort to get the best price possible with generic versions of medications. Another challenge is if the same medication is taken at different times each day. Here are some simple tips to help identify your medications:
- Let your physician know if you are having trouble identifying your medications. It is important to discuss this with your physician and see if he can identify ways to help you.
- When getting prescriptions filled at the pharmacy, take advantage of the counseling service offered by the pharmacist so you can identify the medication and get information about how to take it and any side effects to watch for.
- Tell you pharmacist you are having trouble identifying your medications and ask if they can add color codes to the labels to help identify your medications.
- Consider using a list of medications by time of dose. This helps us remember especially if we are taking the same medication more than one time of day.
- Ask your physician for a complete list of all your medications and detailed directions about how you are to take them.
- Consider using a pill organizer which is refilled weekly to help with identifying medications. Use the list of all medications and detailed directions to refill the pill organizer each week.
Our healthcare providers prescribe medications to help manage our health. It is important that we take the medication as prescribed in order for the medication to be most effective and to minimize side effects.
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In today’s healthcare climate, we often find the time that our physicians are able to spend with us during our visits are short and can feel rushed. There are things we can do to make the most of our time with our physician and that will help our physician in working with us to plan our care. Below is a list of 5 things to do to prepare for next physician appointment:
- In preparing for our visit, gather any information from visits to other healthcare providers since our last visit with our primary care physician. Any test results, reports or other paperwork is important to share with your primary care physician.
- All prescription medications, in their original bottle should be brought to each physician visit. Point out any new medications that may have been prescribed by another healthcare provider so your physician can add it to your record.
- A list of all over the counter medications, vitamins, herbs or other supplements you are taking.
- A list of any new health problems you are having or questions. We often get into the physician office and completely forget to tell our provider about new health problems.
- Ask questions. If your physician discusses something that isn’t clear or sounds confusing, ask questions or ask for more information.
Our physicians are our partner in helping us improve or maintain our health. It is important that we share information that our physician needs to have a full picture of our needs and any medications or supplements we are taking. Writing down our questions before the visit will help us remember the things we are concerned about and will make sure our physician has a chance to address our questions. Preparing in advance will help make the most of our time with our physician.
How we feel during the day is directly related to how well we sleep at night. If you have trouble getting to sleep each night, there simple things each of us can try to improve our ability to sleep at night. Below are some suggestions:
- Set a regular bed time: Go to bed at the same time each night. Try to stick to this even during the weekends. Choose a time that you would normally feel tired so you won’t toss and turn.
- Wake up at the same time each day. If you are in a good sleep routine, getting up at the same time each day will help keep the routine going.
- Nap to make up for lost sleep. If you need to make up for lost sleep, try to take a nap during the day rather than sleeping late.
- Be smart about napping. While napping can be a great way to recharge, for some, especially older adults, napping may make insomnia worse. If you do nap, do it in the early afternoon and limit to 30 minutes.
- Increase your light exposure during the day. Spend more time outside if possible and let as much light into your house as possible.
- Turn off your TV or computer. Set a specific time each evening to turn off the TV and/or computer and stick with it. Listen to music or read a good book instead.
- Don’t read from a backlit devise just before bed. If using an e-reader that is backlit, turn off the light and use another source of lighting when reading.
- Change the light bulbs in your bedroom. Eliminate bright light bulbs, use a lower wattage and try a bulb with more of a yellow cast rather than a blue cast to the light. This helps your body relax and prepare to sleep.
- Keep your bedroom cool and as dark as possible.
- Cut down on caffeine in the evenings, try to avoid large meals just before bed and limit alcohol intake.
Not every tip above works for every person. The important thing is to try to have a structure and routine to your evenings. Try to begin to relax and prepare for bed, allowing your body time to wind down and begin to get ready for sleep. Keep working at it till you find the right combination that works for you.
None of us like to think that a time may come when we have a medical emergency, but are unable to tell the healthcare team what our wishes are. An Advanced Directive is a document that can speak for us when we are unable to speak for ourselves and tell a healthcare team and our family our wishes.
An Advance Directive describes the kind of treatment you would want depending on how sick you are. For example, the Advanced Directive would describe what kind of care you want if you have an illness that you are unlikely to recover from, or if you are permanently unconscious. Advance Directives usually tell your doctor that you don’t want certain kinds of treatment.
There are several kinds of Advanced Directives. A Living Will is one type of advance directive. It is a written, legal document that describes the kind of medical treatments or life-sustaining treatments you would want if you were seriously or terminally ill. A Living Will doesn’t let you select someone to make decisions for you. A durable power of attorney for health care is another kind of advance directive. A durable power of attorney for healthcare states whom you have chosen to make health care decisions for you. It becomes active any time you are unconscious or unable to make medical decisions. A durable power of attorney for healthcare is generally more useful than a living will, but a durable power of attorney for healthcare may not be a good choice if you don’t have another person you trust to make these decisions for you.
Any time you go for healthcare, your healthcare provider will probably ask if you have an Advanced Directive. If you do execute an Advanced Directive, make sure that your primary healthcare provider has a copy in your record. More importantly, discuss you wishes with your family. It is important that your family understand your wishes and can be supportive of the healthcare decisions you wish. Spelling out our wishes makes it more likely that they will be followed, and it also lessens the likelihood of conflict within the family when difficult decisions need to be made.
The process of finding an assisted living environment for your Mom usually begins when you become concerned that your Mom isn’t safe at home alone. This is often an emotional decision and for many adult children, it’s an area where they have little experience or in many cases, really don’t know where or how to start a search.
One first step is to make a list of the areas where your Mom may need help to stay as independent as possible. Some common areas are help with medications, help bathing or getting dressed, or assistance with ambulation. Perhaps your Mom isn’t as involved in social activities as she used to be. Some of our parents aren’t eating well or are skipping meals.
Once you have your list of areas where your Mom needs extra help, explore what senior living options are available in your area. The Internet is a great place to start and most assisted living communities have websites with information on services offered, apartment sizes and activities and outings offered by the community.
When you see a community that looks like a match for your Mom, call and schedule a visit. When visiting an assisted living community, be keenly aware of your first impressions. Is the staff happy and engaged with the seniors who live there? Are the senior adults happy and engaged in fun social activities? Are the senior adults appropriately groomed and attired? Ask the staff how long they have worked at the community; ask the senior adults how they like living there. Try to schedule your visit during or near meal times. How does the food look? Ask the staff how they handle senior food preferences. Is there assistance with transportation for physician appointments and group outings? What is the visitor policy; can you drop in unannounced at any time you like? Can your Mom bring her pet?
If you initial impression is positive, drop back in unannounced. How do things look when no one knows you are dropping in? It’s often good to do this late in the day and will give you a better picture of what level of staff is available after traditional “business hours”. If this visit is positive, schedule a time for your Mom to come to the community and spend a few hours, perhaps eating a meal with the other senior adults and getting a chance to meet some of her potential new neighbors.
When starting your search, identify what services and supports your Mom needs first and then look for a welcoming, safe community that will meet those needs. Again, your first impressions are important and often key to a successful transition for your Mom.
For more information about assisted living, visit us at GreatOaksManagement.com.