Archive for the ‘Home care’ Category
Phoenix is known for its heat, but this year is taking a toll everywhere says CareGivers from Care-To-Go. Weather you are a Scottsdale senior or an elder from Chandler, AZ, caregivers need to be particularly alert to senior hydration.
By:LINDSEY TANNER | AP Medical Writer | 07/19/11 1:38 PM
Healthy, active seniors enduring this week’s heat wave without any trouble are reminded that they need more water to keep the blood flowing and are far more at risk of dehydration and heat stroke.
This week’s heat wave may be uncomfortable, but you’re healthy, active and feel just fine. So what if you’re over 65? Think again. Feeling good doesn’t mean you’re safe.
There are changes in an older person that raise the risk for heat stroke and other problems. An older body contains far less water than a younger one. Older brains can’t sense temperature changes as well, and they don’t recognize thirst as easily.
Blistering summer heat is an underappreciated killer, claiming by some estimates as many as 1,000 U.S. lives each year — more than any other type of weather.
One federal study found 40 percent of heat-related deaths were in people 65 and older. Those numbers could be lower if more heeded heat warnings aimed at seniors. Yet research has shown many people over 65 don’t think the warnings apply to them — because they don’t think they’re "old."
Don Worden is 79 and an avid tennis buff who prefers playing doubles on outdoor courts along Chicago’s lakefront — even in oppressive 90-degree temperatures like those hitting the Midwest this week.
"I don’t pay too much attention to those" warnings, Worden said. "I stay in pretty good shape, and I don’t feel they apply to me."
Worden said he drinks a lot of water and would stop a match if he started feeling effects from the heat, "but that hasn’t happened."
Scott Sheridan, who studies the effects of heat and climate on health at Kent State University, researched how people over 65 view heat warnings. In his 2006 study of more than 900 people, he found about 70 percent knew about advice to drink plenty of water on very hot days, avoid outdoor activities and stay inside with air conditioning. But only about half said they followed the advice.
"People well into their 70s would say old people should watch out but not them," he said. "People just didn’t want to be thought of in that same category."
Dr. David Zich, an emergency medicine specialist at Northwestern Memorial Hospital, said he has colleagues in medicine that age who shun being thought of as "elderly." But those heat warnings apply to them, too.
As Dr. William Dale, geriatrics chief at the University of Chicago Medical Center explains it, "Any older adult has less reserve and is more likely to become dehydrated than others, just because their overall body water goes down with age no matter how healthy you are."
The amount of water in the body declines with aging, from about 80 percent in young adulthood to about 55 to 60 percent for people in their 80s, Dale said.
Temperature sensors in the brain become less sensitive as people age, so the body doesn’t get the same signals to drink water in hot weather, and older people often don’t feel thirsty even when they need to replenish, Dale said.
They also may not feel the typical symptoms of dehydration, such as headache or dizziness. Some complain of just feeling "bad" and think they’re getting sick, he said.
Conditions were ripe for those types of complaints Tuesday as a dense dome of hot air remained parked over much of the nation’s midsection, raising temperatures into the mid- to upper-90s from the Texas Gulf Coast to the Rockies and the northern Plains. Tropical-level humidity raised the heat index in many places to nearly 120 degrees.
In South Dakota, up to 1,500 head of cattle died across the state from the heat. And in eastern Iowa, the scorching sun caused a portion of Interstate 380 to buckle. The weather also sent dozens of people to hospitals, canceled outdoor sporting events and caused sporadic power outages.
In such conditions, dehydration can lead to heat exhaustion and potentially deadly heat stroke. During a heat wave, that can happen in a matter of hours in older people if they over-exert themselves, don’t drink enough water or are frail and don’t get out of un cooled homes, said Dr. Chris Carpenter, an emergency medicine physician at Washington University School of Medicine in St. Louis.
Heat exhaustion can cause muscle cramps, low blood pressure, rapid pulse and nausea. It can be treated at home, by drinking water, getting into an air-conditioned room or sitting in front of a fan and misting the body with cool water.
But affected people should be monitored for mental changes and to make sure their temperature does not rise above 102 because the condition can quickly lead to heat stroke. A medical emergency, heat stroke involves temperatures of 104 or higher and can cause seizures, loss of consciousness and death.
Medicines many older people take also may make them more vulnerable to the heat. These include diuretics for high blood pressure, which increase urination — and make it more important to drink plenty of water, Dale said.
Some types of drugs can interfere with sweating and raise body temperature, including some medicines for insomnia, nausea, prostate conditions, Parkinson’s disease and even Benadryl. Many list "dry mouth" as a side effect — a tip-off to drink more water, Zich said.
There aren’t specific guidelines on how much water older people should drink in a heat wave.
Dale said he generally tells his older patients to drink a quart of water throughout the day, and to drink even if they don’t feel thirsty.
Doctors also advise older patients to avoid alcohol and coffee during extreme heat because they can cause the body to lose fluid and contribute to dehydration.
CareGivers providing in home care often are faced with various levels of Alzheimer’s disease. The memory loss found during home care varies in degree and thus requires flexible and sometimes creative caregiving techniques. The follow is a recap of President Ronald Regan’s battle with Alzheimer’s. Care-To-Go CareGivers in the Phoenix, Scottsdale, Chandler and Gilbert areas salute his contribution to America.
When Alzheimer’s Waited Outside the Oval Office
By LAWRENCE K. ALTMAN, M.D.
WASHINGTON — Ron Reagan’s new memoir, “My Father at 100,” has touched off sensational headlines with its suggestion that President Ronald Reagan might have begun showing hints of Alzheimer’s disease while still in the White House.
But in two interviews this month, the younger Mr. Reagan said he never meant to suggest that his father had dementia before leaving office in 1989. And he graciously took the blame for not being more explicit in a passage that described a few personal observations along with comments from the former president’s doctors.
A “rather small section of the book has attracted outsize attention,” he said in a telephone interview from Seattle, where he lives.
All he meant, he continued, was that the amyloid plaque characteristic of Alzheimer’s can start forming years before it leads to dementia. The former president’s diagnosis was made in 1993, four years after he left office.
“Given what we know about the disease,” his son told me, “I don’t know how you could say that the disease wasn’t likely present in him during the presidency.”
Had it been stated that way, the assertion about Alzheimer’s would have stirred little if any debate. Still, the issue is important for anyone — including candidates for office — because of the difficulty of distinguishing the initial symptoms of Alzheimer’s from, say, simple forgetfulness.
The disease occurs most frequently after 70, but it can strike younger people. Dr. Alois Alzheimer, a German psychiatrist, diagnosed the first case in a 51-year-old woman. It is now recognized as one of a number of types of dementia. And diagnosing it with certainty requires a brain biopsy, rarely done while a patient is still alive.
Mr. Reagan’s mental state was an issue even before he became the oldest man elected president, at 69, in 1980. Adversaries were fond of attributing his penchant for contradictory statements, forgetting names and general absent-mindedness to Alzheimer’s.
I reported on Mr. Reagan’s health, and he told me that his mother, Nelle, had died of senility — and that if he were to develop it in office he would resign.
As a follow-up to questions about Alzheimer’s, my extensive interviews with his White House doctors, key aides and others, I found no evidence that Mr. Reagan exhibited signs of dementia as president. The interviews did not include family members.
Moreover, until Ron Reagan’s memoir appeared, no other family member — and not Edmund Morris, the official biographer who spent seven years with Mr. Reagan in the White House — publicly hinted that he showed evidence of Alzheimer’s as president.
“My Father at 100” (Viking) is an affectionate, often lighthearted account of a son’s attempt to uncover his father’s character by going back to his early days. It is generally well written, except for portions of the closing chapter about Alzheimer’s — which Ron Reagan acknowledged were flawed because he “relied on memory” without checking facts about when and where the suspicion of his father’s Alzheimer’s was first raised.
He writes, for example, that after the former president fell from a bucking horse in Mexico in 1989, his doctors detected probable signs of Alzheimer’s in removing a blood clot that formed between his skull and brain. But such a procedure does not involve a brain biopsy that doctors would need to diagnose dementia.
Moreover, Mr. Reagan was flown to a military hospital near Tucson — not taken to San Diego, as his son writes — and the blood clot, a subdural hematoma, was removed weeks later at the Mayo Clinic in Rochester, Minn.
In the interviews, Ron Reagan genially acknowledged the errors and said that if he had anticipated the controversy he created, he “would have done more due diligence in terms of pinning down dates.”
When his father was president, Mr. Reagan, then a professional dancer with the Joffrey Ballet, visited him two or three times a year. Now 52, the younger Reagan has been a radio and television talk show host, commentator and magazine writer. In the book, he writes that he did not want his father to run for a second term, partly because of political differences (Ron has long been liberal) and partly because of his concern about Mr. Reagan’s health — not the possibility of Alzheimer’s, but the near-fatal gunshot wound he sustained in a 1981 assassination attempt.
Understandably, the son’s memories about his father’s Alzheimer’s focused on when it first produced symptoms. The anecdotes that he cites are either well known or lack convincing evidence for Alzheimer’s.
For example, he recounts the 1984 re-election campaign, when his father performed dismally as he floundered through his responses and was lost for words in his first debate with his opponent, Walter F. Mondale. But Mr. Reagan performed well in the second debate, 11 days later.
While spending a day in the Oval Office in 1987, the younger Reagan noticed that aides were providing his father with scripted index cards — a technique he often used when giving speeches — for phone calls lasting five minutes at most, implying signs of a failing memory. But in an interview, Mr. Reagan said it was “hard to know what to make of that” — and laughed as he said he was using similar notes in our conversation.
The son noted little things that he could not explain and to which he did not attach a name at the time. Based on knowing his father’s demeanor and cognition over a lifetime, the observations created an impression “that something was amiss.” But, he wrote, he did not want to leave an impression that his “father was catatonic or mumbling incoherently” at any period in the White House.
In his last months, Mr. Reagan held court from a hospital bed in his den, uncomplaining and gently agreeable. By this time he looked younger; his face had lost many of its worry lines and wrinkles. But as he stopped eating and drinking and his kidneys failed, Mr. Reagan lost the decade-long battle with Alzheimer’s and died on June 5, 2004.
Alzheimer’s hereditary patterns are not precisely known. Ron Reagan said he is aware that he is at risk for the disease. But he has not had genetic tests for it, and has not been asked or volunteered to take part in any study of the family history of Alzheimer’s.
Care-To-Go provides home care and caregivers in the Phoenix, Scottsdale, Chandler and Gilbert areas.
What to cook when cancer hits
By Liz Szabo, USA TODAY
Doctors often instruct cancer patients to eat well to keep up their strength.
But for cancer patients, getting through a simple meal can be a challenge. Radiation treatments can burn the throat, making it painful to swallow. Chemotherapy can cause patients to develop mouth sores or leave people nauseated. Other patients find that chemo takes away their sense of smell or alters their sense of taste.
Two books from the American Cancer Society aim to help both patients and their caregivers overcome these hurdles. The Complete Guide to Nutrition for Cancer Survivors ($24.95), published this year, explains how good nutrition can help boost the immune system and fight fatigue.
What to Eat During Cancer Treatment ($19.95), published last year, offers 100 recipes to help patients cope with six major symptoms of treatment. For instance, there’s a brie and apple grilled cheese for patients coping with nausea. Most recipes take only 30 minutes to make.
That’s important, given that cancer patients may not have much energy to spend in the kitchen and caregivers may be pressed for time, says the cancer society’s Colleen Doyle, who edited both books.
The recipes also include foods packed with vitamins and antioxidants, Doyle says. Patients who eat well are often better able to deal with side effects of treatment and may be better able to fight off infections, she says.
"I truly believe food is medicine, and it helps people provide their body with the nutrition they need to heal," say Barbara Grant, a registered dietitian and co-author of Nutrition for Cancer Survivors.
American Cancer Society’s tips for cooking for someone with cancer:
• Ask if the person has any special requests. "Instead of just showing up with chocolate cake, ask, ‘What can I make you? What sounds good?’ " says Grant.
• Ask if you can help with groceries or offer to do the dishes, says the American Cancer Society’s Colleen Doyle, a registered dietitian.
• Offer to put together a "survival kit" in a cooler, filled with snacks and drinks, for times when the cancer patient doesn’t want to get out of bed to go to the kitchen to eat, Doyle says.
• Prepare an "on-the-go" snack mix with nuts, pretzels, dry cereal or crackers for the cancer patient to eat when away from home.
• Instead of making one big casserole, prepare individual servings to freeze and reheat, Doyle says.
• Wash your hands carefully, make sure all meats and eggs are fully cooked, and take care to avoid any kind of contamination, which can be dangerous for people with weakened immune systems.
Recipe: Tuna melt quesadilla
The recipe from the American Cancer Society addresses the common cancer treatment symptoms of unintentional weight loss and taste alterations.
Prep time: 15 minutes or less
Total time: 15 minutes or less
This twist on a classic gives new life to the tuna melt. A quesadilla is a good choice when a sandwich seems overwhelming. Choose full-fat options if trying to gain weight, reduced-fat if you are watching calories.
• 1 (5-ounce) can tuna in water, drained
• 1 tablespoon regular or reduced-fat mayonnaise
• 1/2 tablespoon Dijon mustard
• 1 tablespoon finely chopped red onion
• 1 tablespoon pickle relish
• 3 (8-inch) whole wheat or plain tortillas
• 3/4 cup shredded regular or reduced-fat Cheddar or "Mexican style" cheese
1. In a bowl, flake the tuna. Add the mayonnaise and mustard and stir to combine. Add the onion and relish.
2. On a microwave-safe plate, place 1 tortilla and spread half with 1/3 of the tuna mixture. Sprinkle the other half with 1/4 cup cheese. Fold the tuna half over the cheese half. Microwave on high for 40 to 50 seconds, or until cheese melts. Repeat twice with the remaining ingredients. Microwaving the quesadilla instead of pan-frying or baking keeps it softer.
Per serving (1 quesadilla)
Total fat: 17 g
Total carbohydrate: 31 g
Dietary fiber: 3 g
Sugars: 3 g
Protein: 21 g
Sodium: 940 mg
Caregiver Explains How To Prevent Falls With Better Balance
Unintentional falls among those 65 and older are responsible for more than 18,000 deaths and nearly 450,000 hospitalizations annually in the United States, according to the Centers in Atlanta. Most of these falls are caused by a decline in that complex and multidimensional human skill known as balance.
We all know of someone who “just fell” and broke something, a hip, an arm, an ankle or leg. We usually write it off to just old age, weak muscles, or failing bones. If you ask the senior who fell it was usually someone else’s fault. One lady told me that a cat ran between her legs and tripped her causing an ankle and eye injury.
The debate rages on about calcium and bone density. Did someone fall and break a hip or did the hip just give way and they fell. You can read more about calcium and bone density in our nutrition section at MyNaturalSuppliments.myShaklee.com.
Balance is a function of inner ear sensations transmitted through a series of nerves to the brain and signals sent via more nerves to the muscles of the body. If you sense you are falling, you adjust your torso, legs or arms to maintain in balance.
The old adage of use it or loose it applies here just like most things in life. It does seem to apply more to brain use and muscle use though.
Inactivity in seniors as well as nutritional levels can lead to the loss of use or slowing of brain recognition and nerve transmission, thus the inability to recognize when they are loosing their balance or falling. By the time they realize the need for a readjustment to maintain balance, it is often too late.
In an article by John Hanc of the New York Times the benefits of strength and balance training are explained. Dr. Thurman explains that strength and balance training can reduce the rate of falls by up to about 50 percent.
While most public health agencies recommend 30 minutes a day of cardiovascular exercise and two or three sessions of strength training, there isn’t a recommendation for balance training.
There are a number of good balance exercises to use. The best bet is to go to a gym and use a personal trainer. Many gyms offer low impact stretching and balancing sessions. Gentle yoga would be wonderful for stretching and balance. Those yogis live to 125 you know.
At home one of those big balls to sit on and raise up feet land lets would be a good idea.
Try walking a straight line with both feet hitting the line. Kind of like when the police give a sobriety test on the street. Next try walking the line with arm out to the sides and cross over the line with each step. Put your left foot on the right side of the line and visa versa. This is the model runway walk. Have someone stand behind for safety and stand on one leg with arm out. Just raise one foot up a little. When this becomes easy, reach down and put your palms under the raised foot and balance for 15 to 30 seconds.
Remember safety first. You don’t want to get hurt exercising so you won’t fall. Have someone with you for support.
For assistance in the Phoenix area contact Care-To-Go at 480-284-8611
10 Tips To Dodge Medication Problems In The Elderly Phoenix AZ
Avoiding Prescription Errors
A lot of senior citizens take multiple medications, which may increases the likelihood of prescription mistakes. Here’s a number of terrific recommendations for elders to lessen the chance of making an error with their prescriptions:
1. Check the label when you pick up a medication to confirm that you have the right medicine. Read back the prescription to your doctor and pharmacist.
2. Keep all prescription in original containers.
3. Contact your medical professional or pharmacist if you have any questions about dosage.
4. Be sure to fill your medications at the same pharmacy.
5. Read the patient information sheet that comes with your medication.
6. Call the pharmacist immediately if there is a change in the color, size, shape or smell of your medication.
7. You should not take or share another person’s prescriptions.
8. If you are in doubt about a medication you are taking, consult your doctor and pharmacist. Always ask about side effects that you experience or expect.
9. Construct a list of the medications you are taking and share with your CareGiver and family members. The list ought to include the following information:
- Your full name, social security number and date of birth. The Pharmacy needs this information if the caregiver is going to refill the medication without the client there. Social security number and date of birth should be kept on a different sheet of paper to defend against identity theft.
- Medication name (the drugs being taken, both generic and brand)
- The strength (dosage)
- The directions for taking the medication, including frequency and what time of day medication should be taken
- What liquids or foods are being used to take or should be used to take with meds, for example, water, juice, apple sauce etc.
- Allergies to certain medicines and foods
- Pharmacy and health care providers names, addresses, phone number
- Family contact information
10. When in skilled nursing or a hospital:
- State your name before taking any meds and always show your wrist bracelet for identification. Ask the nurse or doctor to identify each medication by name before you take it.
- Ask your nurse why your medicine has not been given at its customary time during your hospital stay.
If your medication was started in the hospital, watch for new side effects. If you experience new side effects or your condition is not improving as it should, tell your doctor or nurse. From time to time prescriptions need to be changed when they are not performing properly.
Be sure to ask the doctor how long a particular prescriptions will be required. Oft times prescriptions are added in the hospital for a short term problem, but when you leave the hospital for skilled nursing or your home, the prescription remains. Another doctor may be reluctant to change or stop a prescription from another doctor.
- Remind your physician if you have any allergies to certain prescriptions and food, or if you also have a condition that may possibly affect the use of certain meds.
1. Tell your doctor if you are taking any dietary supplements or over-the-counter meds.
2. Make sure your CareGiver has a current medication log listing all prescriptions, Doctor’s name, and Pharmacy.
Make sure to only take prescriptions that you really need and confirm with your doctor why you are taking it, how long you could need it, what side effects to watch for, and that it is not going to conflict with any other meds you are taking.
In the Phoenix area Care-To-Go, an in-home care agency can assist
you with your prescription organization. Care-To-Go also provides
complete in-home care elder services. Contact Care-To-Go at
www.Care-To-Go.com and for an Elder Travel Companion CareToGoTravel.com
7 Signs It Is About Time To Fire A Doctor Reported By A Phoenix CareGiver
What should you if the medical doctor doesn’t listen to you, or not honoring your needs relating to treatment and drug choices, or suggesting medicines or treatments that appear inappropriate for much older patients. Listed here are several examples.
The connection with the medical professional is a vital one and has to be taken seriously. All to often seniors aren’t receiving adequate care and attention from their medical doctor. Is the physician too busy and scheduled to tightly, or there just may be a personality mismatch. In this case don’t be afraid to shop for a different one if you believe you are not receiving the attention and care you deserve.
When the elderly go to their medical professional it truly is a great plan to take along an advocate, a family member or a professional CareGiver. It will serve you well to have someone else there to make sure you understand everything the medical professional is saying and if you need to get more complete information from the doctor, the advocate can facilitate. Now and then it is a lot easier for the someone else to ask in depth questions.
By way of example a medical doctor may try to make you feel guilty when you ask to take away a medicine or a procedure from your regimen. You may have prescriptions from a number of doctors and they may conflict with each other. Doctors may be hesitant to change or stop a prescription prescribed by another physician.
Sometimes the problem doesn’t lie within your power; what is wrong is that the health professional isn’t listening to you or not taking your loved one’s age or situation into account when making medication and treatment decisions. In many cases, it’s like a bad relationship; communication has broken down and you, your family member or CareGiver aren’t getting what you need.
Here are the 7 indicators it may be time to "break up" with your health professional:
1. You feel the medical professional blames, ignores, or criticizes you or the person in your care
2. The health professional doesn’t act in response to your feedback, or becomes unpleasant or defensive
3. It seems the health professional isn’t taking your pain or other symptoms seriously enough
4. You discover treatments that can help that the medical doctor hasn’t told you about
5. The medical doctor doesn’t explain treatment options clearly, resulting in mistakes
6. The medical professional prescribes medications without comparing to medications prescribed by another doctor.
7. The physician is reluctant to organize your prescription inventory when it comes from many different other medical doctors.
When you are dissatisfied, your best bet is to change your doctor, and change to one you can work with to provide the best care. Physicians regularly say that if a patient is going to change doctors, they’d appreciate hearing it directly rather than suddenly receiving a sneak request for medical records to be sent to another health professional. However, it’s your prerogative to find a new doctor and ask the staff to fax over the request for records. You’re not obligated to engage in another confrontation.
Either way, you’ll breathe a sigh of relief once you’re dealing with a health professional who listens respectfully, answers your questions, accommodates your requests, takes your symptoms seriously, and works with you to develop a treatment plan you can all feel good about.
In the Phoenix, AZ area Care-To-Go offers Elder Home Care services and can assist you with doctor appointments and prescription organization. Contact Care-To-Go at 1-800-818-0407 or Care-To.Go.com For Elder Travel Companion services see CareToGoTravel.com.
Most accidents occur in the home and especially for our seniors. Even though our seniors are in their own home and in familiar surroundings, they have a much higher accident rate than the rest of us. When you couple failing eyesight, poor hearing and decreased judgment and balance, the senior has a more difficult time moving around and staying safe. If you make the changes yourself or use a personal CareGiver, you may be able to avoid a major fall and injury to your parent.
What can you do to protect an elderly loved one from getting hurt? Here are some steps to follow:
- Keep outdoor steps and walkways in good condition and clear of debris. Be sure the hand rails are clean and in good condition.
- Illuminate all stairways and hallways and provide light switches at both ends. Brighter lights are better.
- Use nightlights or bedside remote controlled switches. Yeah the clapper works too.
- Provide handrails in hallways and stairways.
- Keep a sturdy nightstand next to the bed so glasses and other personal items are within reach.
- Put felt or soft material over sharp edges and corners of furniture such as nightstands, tables and shelves.
- Tack down the edges of carpets and rugs; remove throw rugs that slide or can be tripped on.
- Keep pathways clear of furniture and other objects.
- Provide handrails in the bathroom (especially near the toilet, at the entrance to the shower and in the shower) and use non-skid strips in the shower and bathtubs.
- Use a shower seat and shower hose for those unable to stand in the shower.
- Avoid using bath oils or lotions in the bathtub or shower.
- Use kitchen appliances with thermostats and timers. The elderly find appliances with signal lights and buzzers easier to use.
- Clearly mark the “off” position on stoves and ranges so a person with diminished eyesight can immediately tell if the element is off. Try some nail polish.
- Set water heater thermostats or faucets so water does not scald the skin.
- Install smoke detectors in the kitchen and throughout the rest of the house.
- Keep a fire extinguisher handy and know how to use it.
- Arrange frequently used kitchen items in an easy-to-reach cabinet.
- Install one good lock that can be opened easily from the inside.
- Keep loose magazines and mail off the floor, seniors tend to accumulate mail clutter.
For a complete home assessment contact Care-To-Go at 480-284-8611 and on the web at http://Care-To-Go.com Are you getting to the point where you need someone to help you shoulder the load taking care of Mom? A Home Care CareGiver will be able to assist your senior with household tasks to be sure they are safe and happy.