Being your parent’s nursing home advocate

home care omahaWhen an elderly person relocates to a nursing facility, he or she needs an advocate to help make the transition as smooth as possible. If this responsibility falls on your shoulders, there are many things you should be prepared for. For one, prior to the move, it’s vital to research and visit several facilities in your area so you can choose the best option for your loved one. Once your parent is settled in, be sure to get know the staff and make them aware that you’re serving as the advocate.

Still, as the AARP notes in a recent article, problems can arise even if you’ve done your research. That’s why it’s important to know the signs of mistreatment.

Here’s a quick checklist of what to look for (via AARP):

    • Bedsores

 

    • Stiffening muscles

 

    • Physical restraints

 

    • Malnutrition

 

    • Dehydration

 

    • Chemical restraints (such as drugs)

 

What to do if you suspect abuse

If the incident is serious, immediately call an elder abuse hotline, the police or the state department of aging. If the quality of treatment is your main concern, the AARP suggests trying the following:

Talk to the caretaker whom you suspect is involved. Don’t be accusatory, rather be friendly and respectful of their perspective. Make it your goal to find a solution together.

Attend the next meeting when staff and/or families of the clients are invited to address any concerns.

Speak with a supervisor if you feel your issues are not being adequately addressed. Be as detailed as possible with times, dates and other information. Be sure to let the supervisor know of any of your other concerns, such as your complaint resulting in retaliation against your parent.

File a written complaint with the facility if you can’t get through to the staff. You can expect a written response as well, as nursing homes are required to follow a formal grievance process.

If you’re still not getting results you like, contact the long-term care ombudsman in your area via your state agency on aging and/or the National Long Term Care Ombudsman Resource Center. You can also file a complaint with the state survey agency that licenses nursing homes, the AARP notes, often overseen by the state’s department of health.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa ” provides seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system. All Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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The Zen of Caregiving

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No one said caring for your elderly mother would be easy. Even though she’s in her twilight years, she still seems to know how to get under your skin with those perfectly-timed critical remarks, just as she’s been doing since you were a child.

So what should you do? Snap back at your mom like you did as a bratty teenager or just hold it in? Maybe you should take cues from Jennifer Block, purveyor of “contemplative caregiving,” which applies Buddhist principles to the care of your loved one. Block is the founder of the Beyond Measure School for Contemplative Care and former director of education at the Zen Hospice project in San Francisco.

The New York Times’ New Old Age Blog posted a Q&A with Block, giving insight to the instructor’s techniques. Below are some experts from the interview.

On the challenges of caregiving:

People are for the most part unprepared for caregiving. They’re either untrained or unable to trust their own instincts. They lack confidence as well as knowledge. By confidence, I mean understanding and accepting that we don’t know all the answers — what to do, how to fix things.

We live in a fast-paced, demanding world that says don’t sit still — do something. But people receiving care often need most of all for us to spend time with them. When we do that, their mortality and our grief and our helplessness becomes closer to us and more apparent.

On the benefits of contemplative caregiving:

We teach people to cultivate a relationship with aging, sickness and dying. To turn toward it rather than turning away, and to pay close attention. Most people don’t want to do this.

A person needs training to face what is difficult in oneself and in others. There are spiritual muscles we need to develop, just like we develop physical muscles in a gym. Also, the mind needs to be trained to be responsive instead of reactive.

Skills learned via contemplative caregiving:

[One skill] is to become aware of how much we receive as well as give in caregiving. Caregiving can be really gratifying. It’s an expression of our values and identity: the way we want the world to be. So, I try to teach people how this role benefits them. Such as learning what it’s like to be old. Or having a close, intimate relationship with an older parent for the first time in decades. It isn’t necessarily pleasant or easy. But the alternative is missing someone’s final chapter, and that can be a real loss.

On caregiver needs:

I think every caregiver needs to have their own caregiver a therapist or a colleague or a friend, someone who is there for them and with whom they can unburden themselves. I think of caregiving as drawing water from a well. We need to make sure that we have whatever nurtures us, whatever supplies that well. And often, that’s connecting with others.

For more information, the article suggests picking up a copy of The Arts of Contemplative Care: Pioneering Voices in Buddhist Chaplaincy and Pastoral Work.

Physicians Choice Private Dutycurrently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system. All Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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Caffeine and the elderly: Good or bad?

caffeine and elderlyStudies have found caffeine helps muscles produce more force for adults in their prime. But does the same thing apply to the elderly, whose muscles naturally become weaker due to age?

According to Science Daily, the answer is a soft yes. Sports scientists from Coventry University looked at whether age-related changes in muscle altered the effect of caffeine. By studying the performance in two different muscles from mice, they found that caffeine continued to enhance performances, but was less effective in older muscles.

“Despite a reduced effect in the elderly, caffeine may still provide performance-enhancing benefits,” Jason Tallis, the study’s primary author, told Science Daily.

With muscle decline in the elderly a major contributing factor in injuries, maintaining muscle tone is key. And those who do remain physically active likely will receive the most benefits from consuming caffeine, Tallis notes.

Other studies have found that caffeine can reduce the risk of heart disease in elderly people with normal blood pressure levels.

Can caffeine be dangerous?

Like other substances, caffeine is best in moderation. Excessive caffeine intake can lead to a number of health problems, writes LiveStrong.com, including:

    • Reduced bone strength. Too much caffeine can expel calcium from the body. Elderly women are especially at risk for caffeine-related bone problems, according to a 2009 study by the Journal of Bones and Mineral Research, as a lack calcium in a woman’s diet paired with high levels of caffeine intake lead to an increased chance of osteoporosis and bone fractures.

 

    • Increased blood pressure. The Mayo Clinic found that the amount of caffeine in two to three cups of coffee can raise a person’s blood pressure to levels that may be dangerous for people with high blood pressure or heart-related diseases.

 

    • Addiction. As most of us know who’ve gone a morning without our coffee, caffeine can lead to a physical dependence. Roland Griffiths, of John Hopkins School of Medicine, says the basic mechanisms that lead to people becoming dependent upon caffeine are similar to classic drug addiction. Caffeine withdrawal can have rather severe symptoms as well, including headache, lethargy, foggy thinking, depression, nausea and/or vomiting. Naturally, those who consume high amounts of caffeine are at the greatest risk for addiction.

 

If you’re curious or concerned about the effect caffeine is having on your elderly loved, it’s best to consult with a doctor.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system. All Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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Senior Care Chat: The ins and outs of this year’s flu season

encompass omahaThe team at Physicians Choice Private Duty hosts our second Twitter chat today at 3 p.m. EST. We’ve named it Senior Care Chat using the hashtag #srcarechat. Whether you’re a caregiving family member or professional, we invite you to join in on todays conversation, which will focus on the 2012-2013 flu season that is starting to peak and is currently a hot topic for various media channels.

We’ve found that Twitter chats are a great place for caregivers and healthcare professionals from across the world to gather and discuss the issues currently facing the world of elderly care. With so many people sharing their insights and personal experiences, Twitter chats can be a great resource to draw from, helping us all to make the services we provide better and better. We hope you can join us!

Here are todays questions:

1. Why is it important to get vaccinated every year?

2. Besides a vaccination, what else can you to do prevent contracting the flu?

3. As a caregiver, what are the best ways to prevent getting the flu?

4. When should someone go to the hospital if they’re suffering from the flu?

5. Should you get vaccinated even if you’ve already gotten sick?

6. Is it possible to get the flu even if you get vaccinated?

7. Why is it especially important for elderly people to get vaccinated every year?

8. What questions about the flu should you ask if your loved one is in a health care facility?

Feedback is always welcome, please let us know what you think in the comments or on Twitter.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system. All Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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Fighting the flu as a family caregiver

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We’ve already touched on the importance of getting vaccinated for the 2012-2013 flu season, which is already widespread in 47 states. Still, family caregivers especially need to take extra precautions to avoid coming down with the flu, as those receiving the care — likely persons 65 and over and/or with weakened immune systems — are the most at risk to be hospitalized or even die from influenza.

The AARP and the Center for Disease Control (CDC) shared the following seven tips for fighting the flu:

1. Of course, both caregiver and their loved one should get a flu shot. Beyond that, use soap or hand sanitizer to wash your hands and your care recipient’s hands often, especially after sneezing, handling a tissue, etc.

2. Remember, flu shots don’t guarantee you won’t get sick. This year’s vaccine is about 60 percent effective — which is a good first line of defense.

3. If you or your loved one are a cougher or sneezer, use a tissue and toss it into the trash immediately.

4. Until the flu season is over (typically at the end of winter) avoid shaking hands and sharing food and drinks. The AARP notes that the flu outbreak is “so worrisome that the Catholic Archdiocese has asked priests not to share communion wine or touch congregants hands or tongues and for worshippers not to shake hands.”

5. While not very glamorous, if you’ve come down with the flu or a bad cold it’s suggested you wear a drug store doctor’s mask in addition to staying at home for at least 24 hours after your fever has gone. Same thing goes if you’re caring for someone who is sick.

6. Hand wipes can be your best friend. Use them on door handles, banisters, kitchen counters, etc. — anywhere germs tend to congregate.

7. If your loved one is staying in a health care facility, ask the staff what they’re doing to contain the virus and take any necessary precautions.

Are there any other tips you take to avoid the flu? Let us know on Twitter or in the comments.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system. All Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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As flu season peaks, it’s still not too late to get vaccinated

senior care omahaAs a person ages, their immune system weakens, in turn making them more susceptible to illnesses like pneumonia and the flu, according to Flu.gov. With 47 states currently reporting widespread flu, the 2012-2013 flu season is likely nearing its peak. And seniors are at the greatest risk: 90 percent of flu-related deaths and more than half of flu-realted hospitalizations occur in people 65 and older.

The Center for Disease Control (CDC) recommends gettings a flu shot every year and offers the following information on the 2012-2013 flu season.

Get vaccinated

According to the government, this season’s vaccine is a good match for the circulating strains of the flu, being 62 percent effective. The CDC notes that getting a vaccine every year is the first and most important step in protecting against influenza. For the current season, more than 128 million doses of vaccine have been produced as of January 4, 2013. So it’s safe to say local pharmacies and health clinics won’t be running out any time soon.

Defense

Besides getting a flu shot, the CDC recommends regularly washing hands with soap and to avoid touching your eyes, nose and mouth. Also, practice proper cough etiquette and clean and disinfect frequently touched surfaces.

Treatment

Most people who come down with the flu experience mild symptoms that require them to stay home for a day or two and rest. Those with severe symptoms, common with the elderly, should see a doctor to receive antiviral drugs, medications or other treatments to relieve symptoms.

Other notes from the latest CDC report

    • The CDC recommends people get vaccinated even if they’ve already gotten sick with the flu. The main reason for this is that many people who get sick think they have the flu but do not — there are other flu-like illnesses going around this season as well, mainly respiratory viruses. Also, the seasonal flu vaccine generally protects against three types of flu viruses that research suggests will be most common, meaning it will protect you from other strains you haven’t been exposed to yet.

 

    • It’s possible to still get the flu even though you’ve gotten vaccinated.

 

    • Suffering from the flu can lead to other complications, such as pneumonia. That’s why it’s especially important for elderly persons and those with weakened immune systems to get vaccinated every year.

 

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system. All Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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Pneumonia and other elderly lung problems

Lungs have two primary functions: bringing oxygen into the body to provide energy (breathing in) and removing carbon dioxide — the waste produced by the body and expelled by breathing out. As a person ages, the lungs, like other parts of the body, become more frail and in turn are more susceptible to potentially deadly conditions like pneumonia. That’s why being aware of signs and symptoms of common lung conditions is important for elderly persons as well as their caregivers. You never know — catching conditions early could save someone’s life.

Pneumonia

The Center for Disease Control and Prevention (CDC) notes that more people die from pneumonia each year from than from car accidents. Many people over 65 are especially vulnerable because they tend to have weakened immune systems and sometimes have problems clearing secretions from their lungs, making them prone to infection.

Signs (via the Mayo Clinic)

    • Cough (often producing green mucus)

 

    • Fever

 

    • Chills

 

    • Fast, shallow breathing

 

    • Chest pain

 

    • Increased heart rate

 

    • Feeling weak and/or tired

 

    • Nausea

 

    • Vomiting

 

    • Diarrhea

 

    • Treatment

 

Treatment

A doctor can diagnose pneumonia with a blood test and chest X-rays. Depending on whether the pneumonia is bacterial or viral, antibiotics or anti-viral medicine will be prescribed.

Lung cancer

Smoking causes the majority of lung cancer cases, followed by secondhand smoke. It is also the deadliest cancer among men and women in the U.S. Naturally the easiest way to prevent lung cancer is to not smoke and stay away from smoky environments.

Signs (via the Mayo Clinic)

    • Persistent cough

 

    • Developing chronic cough or “smoker’s cough”

 

    • Coughing up blood

 

    • Chest pain

 

    • Wheezing and shortness of breath

 

    • Unusual weight loss

 

    • Bone pain

 

    • Headache

 

Treatment

Surgery, radiation, RF ablation, chemotherapy or a combination of multiple treatments can help battle lung cancer. Surgery is also common. The average person diagnosed with lung cancer is lucky to live more than five years, so early detection is vital.

COPD

Millions of elderly people suffer from Chronic Obstructive Pulmonary Disease (COPD), which is characterized by persistent, limited airflow, apt to inflammatory reactions to noxious particles and gases present in the airways and lungs. Sadly, COPD is a progressive disease with no cure, one that can only be slowed down by treatments and changes in lifestyle.

Signs (via the National Heart Blood and Lung Institute)

    • Constant coughing/smoker’s cough

 

    • Excess sputum (mucus from coughing) production

 

    • Feeling unable to breathe

 

    • Unable to take a deep breath

 

    • Wheezing

 

Treatment

Lifestyle changes go hand-in-hand with treating COPD, including the following:

    • Quitting smoking

 

    • Avoiding secondhand smoke

 

    • Keeping home as dust free as possible

 

    • Avoiding the use of products with strong chemical odors

 

    • Avoiding the use of fragrant sprays and lotions

 

    • Using a humidifier (especially if living in a dry climate)

 

    • Keeping necessities nearby, especially those with less mobility due to COPD

 

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system. All Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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Where can a family caregiver learn how to care?

While someone who takes on the duty of becoming a primary caregiver may be able to do nearly everything that’s required to see that their loved one is properly cared for, certain tasks demand more specialized skills — those learned by health care professionals, such as nurses.

Even though many agencies and organizations provide family caregivers with basic training for tasks like bathing, dressing, eating and using the bathroom, there is little opportunity to learn advanced skills like giving injections and administering I.V.s. A recent article on The New York Times’ New Old Age blog makes clear that such tasks should usually fall on the shoulders of health care professionals. Still, in many instances, doctors and nurses only give brief explanations of complex tasks that will later wind up being the responsibility of the caregiver.

If this sounds like a situation you’re in, the article offers a few tips to help you out.

    • Be assertive. If someone is ready to return home from a stay at a hospital or skilled nursing facility, ask the nurse or care professional to show you what they are doing so you can learn how to do it when you get home.

 

    • Ask for feedback. Whenever you get a chance, show a health care professional what you’ve learned and ask for their feedback.

 

    • Don’t sign the form. When someone is discharged, hospitals are legally obligated to ensure that the discharge is safe. Likewise, pharmacists are required to make sure you’re adequately informed about any medications you’re purchasing. If there’s a sliver of doubt, ask questions until you’re satisfied with the answers.

 

    • Seek out help. If there are tasks you simply can’t handle yourself and/or need help with, there are many caregiving agencies that can send a certified health care professional to your home.

 

 

Are there any other options for a family caregivers that we missed? Let us know on Twitter or in the comments.

Physicians Choice Private Duty  currently serving Omaha, Eastern Nebraska and Western Iowa ” provides seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system. All Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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Symptoms that caregivers of elderly should never ignore

The older a person gets, the aches and pains of aging tend to occur more frequently. But how do you know if certain symptoms are more serious than others? As a caregiver, it can be difficult to tell whether your elderly loved one has a headache brought on by muscle tension or something much more severe, such as a TIA.

The AARP put together a list of symptoms you should never ignore, adapted below. The article notes that symptoms which develop unexpectedly or gives a person a bad gut feeling are cause for alarm.

    • A sudden, intense headache could signal a ruptured aneurysm, cardiac cephalgia, meningitis or temporal arteritis.

 

 

    • Unexplained weight loss is common in 36 percent of cancers in older people, according to the article. Other conditions associated with weight loss include diabetes, IBS, celiac disease and endoctrine disorders.

 

    • Unusual bleeding are often associated with ulcers, colon cancer, hemorrhoids and bladder infections.

 

    • High or persistent fever may indicate a urinary tract infection, pneumonia, endocarditis or a viral infection.

 

    • Shortness of breath is the primary symptom of pulmonary embolisms. It’s also often associated with asthma, bronchitis or pneumonia.

 

    • Sudden confusion is often tied to interactions between medicine and drugs/alcohol. More severely, it can indicate a brain tumor or onset of a stroke.

 

    • Swelling in the legs is tied to many conditions, but heart failure is the one that concerns doctors the most.

 

    • Sudden or severe abdominal pain can signal an aortic aneurysm, perforated viscus, intestinal ischemia and many other conditions.

 

Physicians Choice Private Duty  currently serving Omaha, Eastern Nebraska and Western Iowa ” provides seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system. All Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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Why is hospice care underused in the U.S.?

home care omahaWhile the number of people turning to hospice care may be growing in the United States, people suffering from terminal illness still face many barriers when trying to access end-of-life palliative care. And it’s not just because patients and/or their families are afraid of coming to terms with death. Medical journal Health Affairs conducted a nation-wide survey of nearly 600 hospices, which revealed there are other factors at play as well. The results showed that 78 percent of hospices had “at least one enrollment policy that may restrict access to care for patients with potentially high-cost medical care needs” like chemotherapy and tube feeding, according to Health Affairs.

Dr. Melissa Aldridge Carlson, lead author of the study and a geriatrics and palliative care researcher at Mount Sinai School of Medicine, told The New York Times that the results show there’s a barrier for people who may want hospice care but can’t receive it due to current Medicare requirements. And while this made sense a couple decades ago when Medicare first developed regulations that require patients to stop curative treatments upon entering hospice, advances in medicine have outpaced such regulations and currently blur the line between palliative and curative treatments, according to Aldridge Carlson.

The survey also showed hospices that are small, for-profit and in certain regions of the country consistently reported more limited enrollment policies than non-profit hospices. This is likely due to Medicare regulations, making it too expensive for many operations to care for a terminally ill patient’s high-cost care needs.

In the end, the study suggests Medicare’s hospice requirements be revised to better meet the needs of patients receiving modern medical treatments.

2011 U.S. hospice stats (via nhpco.org)

    • Nearly 1.7 million patients received hospice services.

 

    • The median length of hospice service was 19.1 days.

 

    • 66.4% of patients received hospice care at home.

 

    • Only 21.9% of patients received care in a hospice inpatient facility.

 

    • Currently there are more than 5,300 hospices in operation in the United States, including the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands.

 

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system. All Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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