Cold and snowy winter weather can cause health and safety concerns for seniors and their caregivers. If you worry about your loved one being alone, homebound or going out in the cold, here are 10 risks family members and home health aides should watch out for, and related tips for prevention.
- Falls outdoors. Many seniors have difficulty walking due to arthritis, results of a stroke or other illnesses. A single fall can cause a life-threatening injury. To help avoid falls, seniors should wear appropriate shoes outdoors. Make surfaces less slippery by putting road salt, sand or kitty litter on sidewalks and driveways. Whenever possible, get help with chores that involve being outdoors.
- Hypothermia. An elderly person who goes outside in winter without proper clothing can quickly fall victim to frostbite or hypothermia (body temperature below 95 degrees [35° C] and can’t produce enough energy to stay warm.) Inadequate indoor heat also can cause hypothermia. Keep home temperatures above 65 degrees and dress the person in layers. Do not rely on shivering alone as a warning sign, since seniors tend to shiver less or not at all as their body temperature drops. Call 911 if you think someone has hypothermia.
- Frostbite can cause damage to the skin and even to the bone. It usually affects the nose, ears, cheeks, chin, fingers, and toes, and can even result in loss of limbs. Seniors with heart disease and other circulation problems are especially at risk. Prevention includes covering up all parts of the body when going outside. If skin turns red, dark or starts to hurt, go inside right away. If frostbite occurs, place frostbitten parts of the body in warm (not hot) water, and call for medical help.
- Carbon monoxide poisoning. If your loved one’s home is heated with a fireplace, gas furnace or gas-powered space heater, invest in carbon monoxide detectors. They can be purchased at a home improvement store for as little as $30. Carbon monoxide in the air can displace the oxygen in the blood stream and cause headache, dizziness, nausea, convulsions and even death within two hours. The effects can be even faster for people with heart or respiratory illnesses.
- High blood pressure and heart attacks. Cold weather causes blood vessels to constrict, which increases the risk of heart attack for people with heart disease or other conditions that strain the heart’s ability to pump blood. The heart has to work harder to maintain body heat, while falling temperatures may cause an unhealthy rise in high blood pressure, especially in seniors. This is another reason to keep the elderly inside and warm.
- Influenza can more easily result in pneumonia in seniors. Flu and pneumonia vaccines, while not 100% effective in preventing those illnesses, can reduce the severity of the symptoms and protect against complications. Vaccines are strongly recommended for persons 65+ years old and those who suffer from chronic health problems such as heart disease, respiratory problems, renal disease, diabetes, anemia, or any disease that weakens the body’s immune system. Because the influenza vaccine is only effective for one year and viruses vary annually, it is necessary to get a flu shot every year. It takes about two weeks to develop full immunity.
- Painful joints. While many people with arthritis say their joints become more painful and stiff when the weather changes, there is no evidence that cold weather causes joint damage. Mild daily exercise can help. For example, indoor swimming is easy on the joints. Staying indoors doesn’t have to mean being inactive. Keep your senior in shape by walking in place, using a stationary bike or working out with a fitness video. Daily stretching exercises can help maintain flexibility. Check with your physician before beginning any exercise program.
- Vitamin D deficiency. Being indoors and out of the sun most of the time eliminates a source of vitamin D. Encourage eating foods high in Vitamin D, such as milk, grains and seafood, or ask your doctor about a vitamin D supplement.
- Seasonal Affective Disorder (SAD) & depression. A lack of natural light can cause depression in both young and old alike. As the elderly are more likely to stay indoors, keep lights on, open curtains and blinds to let in natural light, and encourage the person to sit close to a window. The winter months and bad weather also can lead to social isolation. Help your senior to spend more time with family, friends and neighbors, and when weather makes visiting difficult, call them for a chat.
- Dry skin. Heated air can be drying. Because dry skin can lead to other skin complications especially in diabetics, it’s important to monitor carefully. Shower with warm, not hot water. Limit showers to 5-10 minutes. Gently pat skin dry. Use a gentle cleanser and a thicker moisturizer that will help skin retain its moisture. Run a cool mist humidifier in the bedroom.
Winter poses challenges for seniors, but with awareness and planning, they can stay healthy and be ready for spring. Dakota Travel Nurse Home Care can help aging adults maintain health and independence by providing companionship, meal preparation and personal care. For more information, call 701.663.5373.
Alcoholism is a disease. Like any disease, it needs to be treated. Alcohol addiction complicates being a caregiver and makes the role much harder and more stressful than caregiving already is. It increases the clients’ needs, comprises their health and complicates medical conditions. Alcoholism can be the cause of a need for care in the first place. Because the aging process affects how the body handles alcohol, the same amount of alcohol can have a greater effect as a person grows older. Caregivers have to address all the stresses and added health problems of continuing alcoholism, as well as dealing with alcoholics who can be irrational, unreasonable and often dishonest about their addiction.
Talk About It
Dealing with an aging parent who has an alcohol addiction problem isn’t quite like any other challenge. You have to cope day after day with someone who can be kind and communicative one moment and raging and incoherent the next. You have to try to keep a family member safe who could stumble and fall when drinking alone or pass out in an alcoholic stupor.
Since most alcoholics don’t admit they have a problem, it can feel like trying to help someone who refuses to be helped – or who doesn’t acknowledge needing help in the first place. Sometimes all you can do is to connect with others in groups like Al-Anon who have been there, and learn and receive comfort from their shared experiences. It may be difficult to speak openly about a loved one’s alcoholism and the challenges of trying to keep them safe, but it can be very comforting to learn you are not alone and that you are not responsible for curing the addiction.
Judgment and preaching do not help when caring for an addicted elder. Try to find a physician who views addiction as a medical condition and will treat the person with compassion and likely, medication. Don’t be ashamed to tell a doctor that your elderly parent has a substance abuse problem. People can die from untreated withdrawal, e.g., during hospitalization, when medical intervention could have made them comfortable, or even saved them.
Ask your doctor or pharmacist if drugs are safe when combined with alcohol. Many medicines—prescription, over-the-counter, or herbal remedies—can be dangerous or even deadly when mixed with alcohol. They can increase the negative effects of alcohol consumption.
Taking Care of Parents Who Didn’t Take Care of You, a book by Eleanor Cade, addresses the dilemma of adult children of abusive, neglectful or absent parents who have made the choice to care for their elderly parents. “The challenge,” says Cade, “is for caregivers to make sure they are responding to the situation, not their emotions. It is important to be flexible enough to recognize that negative thoughts and positive actions can co-exist. Being flexible also means adapting and changing our caregiver role as needs be, understanding that good caregiving requires diplomacy, outside support, and a practical network of assistance.”
Take good care of yourself. Caregivers need to exercise, eat nutritious meals, abstain from using tobacco, alcohol, and drugs, get enough sleep and make time for partners, children, and friends in order to keep their lives in healthy balance.
Establish boundaries with elderly alcoholic parents, other family members, and yourself. For example, this could mean limiting visits, not taking phone calls after a certain time, and deciding for oneself what is reasonable or possible as you go about caring for this person. Many elders will tell you that alcohol is their “only pleasure.” And for some it is. Don’t let this affect the care you know they need to have. Just remember that compassion in treating the symptoms, or controlling the alcohol or drug amounts to keep them from falling, are often the only choices you have.
If you need help in caring for an elderly parent, contact Dakota Travel Nurse Home Care at 701.663.5373 for a free evaluation.
- Family Caregiver Alliance Web site at http://www.caregiver.org/.
- Caregiving.Com at http://www.caregiving.com/
As the medical power of attorney for my 97-year-old father, I am often asked if I want to switch him from In-Home Care to Hospice or Palliative Care. I have had to weigh the differences and try to decide what is best for him as he ages and goes through various health crises.
Dad currently lives in an assisted living center that provides a high level of care for its elderly residents, but we outsource his oxygen provider, and we have a Home Care Agency that handles his diabetic care and comes in three times a week to shower and shave him. These services are paid for by Medicare. My primary dilemma has been over his diabetic care, which is not included with hospice and strictly palliative care. In Utah, he could switch to hospice care at any time and stay where he is, but that varies from state to state.
Perhaps you or a loved one will be put in the position of having to make a decision similar to mine. When that time comes, the more information you have about each type of care, the easier your decision could be regarding what will provide the services you will benefit from the most. There are many resources you can turn to for information, including DTN Home Care, but here is a brief overview to get you started.
What are hospice and palliative care?
Hospice care provides medical services, emotional support, and spiritual resources for people who are in the last stages (six months or less to live) of a serious illness, such as Alzheimer’s, cancer or heart failure. Hospice care also provides support for family members that help them manage the practical details and emotional challenges of caring for a dying loved one. Hospice and palliative care both focus on addressing issues causing physical or emotional pain, or suffering. The goal is to keep you comfortable, and to improve your quality of life vs. continuing with treatment to prolong your life.
Some hospice providers offer palliative care as a separate program or service, which can be very confusing to patients and families. Click on this link to access a list of questions that includes answers to common questions about the difference between hospice and palliative care.
What services are provided under hospice care?
Common hospice services include:
- Basic medical care, with a focus on pain control and providing comfort measures.
- Access to a member of your hospice team 24/7.
- Medical supplies and equipment that are needed for comfort but not curative care.
- Counseling and social support to help with psychological, emotional, and spiritual issues.
- A break (respite care) for caregivers, family, and others who regularly provide care.
- Volunteer support, such as preparing meals and running errands.
- Counseling and support for family members after a loved one dies.
Why choose hospice care?
During the last stages of a serious illness, many patients and caregivers feel that they have lost control over their lives and over what will happen to them or their loved ones. Hospice care can provide options that could give you more control. It can help you to make decisions related to end-of-life care that are important to you. It can help the dying to be more comfortable and also provide comfort, emotional and even spiritual help. However, it is important to know and understand the services your hospice provider offers, as they are not all exactly the same.
Who is on a hospice care team?
In addition to a doctor and nurses, hospice teams usually include:
- Social workers.
- Medicine specialists.
- Spiritual advisers.
- Nursing assistants.
- Trained volunteers.
Some hospice teams may also include respiratory, music, physical and occupational therapists; pharmacists; psychologists and psychiatrists. Some people worry that they will lose the care of their regular, trusted doctor. But he or she can work with the others on your team and stay involved in your care.
Who is eligible for hospice services?
Usually, these two things must be true in order to be eligible:
- You or your loved one has a terminal illness that cannot be cured.
- Your doctor expects you to live six months or less, if your illness runs its normal course.
People who live longer than six months can be re-evaluated for eligibility to continue with hospice care. If the illness gets better, patients may no longer qualify for it. Hospice care is generally paid for by Medicare, Medicaid, and private insurance. Care also may be available to those unable to pay.
Where is hospice and palliative care available?
Hospice care can be provided in your home. Family members or loved ones may provide much of the daily care that is needed. The hospice team will work with them to help give the best care possible. A member of your hospice team may visit you for an hour or so once a week or more, as needed. Hospice programs also may offer services in a hospice center, nursing homes, long-term care and assisted living facilities, or hospitals. The choice of locations may vary from state to state.
For more information on where you can obtain hospice and palliative care, contact DTN Home Care or a local hospice provider.
by Marti Lythgoe, DTN Home Care Writer/Editor
This blog is not intended to be medical advice. Please contact your own team of specialists.
Holidays can be both a joyful and a stressful time for all of us, no matter what stage of life we’re in. But as a family member ages, it can become more and more difficult to continue the family traditions everyone expects, and at the same time ensure that our elderly loved one’s physical and emotional needs are taken into account. Caregivers often struggle with how to juggle events that can be highly stressful, confusing and even depressing for an elderly family member with the needs and expectations of others.
Situations will vary based on the health issues and mobility of your elderly family member, but these 10 tips could help all families and the elderly person they care for find more joy in the holiday season:
- Simplify your holiday. Caregivers of an elderly family member with younger families of their own have a lot on their plates during the holidays. Over-the-top expectations and an “I want to do it all” attitude can bring on a lot of stress. Simplify routines and modify traditions to reduce stress by making a list of all of your chores and then eliminating those that aren’t truly necessary. Figure out how to continue traditions but perhaps in slightly new ways.
- Plan ahead. If older family members tire easily or are vulnerable to over-stimulation, limit the number of activities they are involved in or the length of time they are included. The noise and confusion of a large family gathering can lead to irritability or exhaustion, so consider designating a “quiet room” and schedule time for a nap, if necessary.
- Modify festivities to accommodate individual limitations. Be conscious of potential difficulties with an event or holiday plans for someone with physical or other limitations
- Ask your loved one about their memories. Holidays often bring back memories. Older people whose memories are impaired may have difficulty remembering recent events, but they are often able to share stories and observations from the past. Use picture albums, family videos and music to help stimulate memories and encourage seniors to share their stories and experiences.
- Create new memories. In addition to familiar traditions, seniors need new things to anticipate. Add something new to this year’s holiday celebration. Enjoy activities that are free, such as taking a drive to look at holiday decorations, or window-shopping at the mall or along a festive downtown street.
- Plan how you will pass along holiday traditions. Use the time together for new ways of storytelling and recording family traditions. Step back from simply celebrating the holidays, and think of new ways to record the stories and memories that your parents hold dear.
- Find ways to celebrate long-distance holidays. Circumstances may prevent you from being with your aging parents for the holidays. Be creative and use your imagination for celebrating holidays with elderly parents. For example, hold a “virtual get-together” using Skype, com or FreeConferenceCall.com.Give everyone a chance to talk or even sing together. Reaching out to older relatives who are alone is something all of us can do.
- Acknowledge feelings of grief. Your parents might have new stories about long-time friends that have died. You may have feelings of sadness because they are aging and things are slowing down. If this is the first holiday after one of your parents has died, grief will be very real for everyone. Get a sense of where everyone is emotionally, and what they fear, dread or look forward to about the holidays. Don’t expect immediate agreement about what should be done. Grieving is personal and takes different forms for everyone.
- Avoid embarrassing moments. Try to avoid making comments that could embarrass an older family member who may be experiencing short-term memory problems. If an older person forgets a recent conversation, for example, don’t make it worse by saying, “Don’t you remember?” Just repeat what was said and go on.
- Monitor medications and alcohol. Help seniors adhere to their regular schedule of medications during the chaos of the holidays. Also, pay attention to their alcohol consumption during holiday parties and family gatherings. Alcohol can illicit inappropriate behavior or interfere with medications.
If you need extra help with your loved one during the holidays, give DTN Home Care a call at 701.663.5373. We have staff who can help.
If you’ve been a parent, you’ve surely heard “I’m bored!” countless times. Children often have difficulty thinking of something to do or initiating an activity or a get-together with a friend. The responsibility often falls to parents to suggest the obvious activity or call another parent to arrange a “play date.” If you are the caregiver of an elderly parent or spouse, you may have experienced the same thing. Boredom that leads to depression is a major factor in many homes, senior health care facilities and assisted living homes. The responsibility now may fall on you to keep your loved one busy and involved with other people. Aging is a process, but boredom can be a danger to seniors.
When my husband was first diagnosed as being in the early stages of Alzheimer’s disease, I was told to expect that something with which he would gradually have more difficulty was planning and initiating a healthy variety of activities. I was also told that it would help his emotional health and mental abilities to interact with other people. Knowing this has helped me to take the initiative when it comes to suggesting and planning things we can do together, and also to suggest opportunities for him to call or do things with friends and acquaintances.
Why does keeping seniors busy and social matter?
No one likes to be bored, at any age. Senior citizens are no different, but when they reach their later years, they begin to experience some significant changes in their physical and mental health that tend to limit their activity. We may think of difficulty with memory as the first mental symptom to appear, but often the first noticeable changes are more related to cognitive abilities—the ability to make plans and carry them out, the ability to follow directions, the ability to use language as effectively—all changes that affect a person’s ability to participate in stimulating activities. This means that they need support in more ways than just help with remembering words and upcoming events. Meaningful activities and opportunities to socialize are vital in helping seniors maintain their ability to live independently and even live longer, happier lives, no matter what their physical problems may be.
Community help for seniors and caregivers
As long as a senior’s physical health doesn’t limit their mobility to the point of keeping them homebound, helping them to get involved in community-based programs that promote social interaction and physical activities can be a win/win for both senior and caregiver. Your community may have a Senior Center that offers free exercise programs, various classes geared to older learners, or other skill-building activities like art and music that allow seniors to interact with others, at the same time as filling their days with something other than boredom. Activities and interactions like these can lead to better cognitive, mental and physical health, as well as less anxiety and depression and an increase in happiness and sense of self-worth. A social network and a sense of community with other seniors helps to prevent a feeling of isolation and not fitting in.
In July of 2016, DTN Home Care began a unique collaboration with Proximal 50, a comprehensive wellness center committed to making positive changes in health and quality of life for clients. They provide customizable health and wellness services, including physical therapy in the home for DTN Home Care clients who are homebound. They are our exclusive, recommended provider of in-home physical therapy. You can find more information about our partnership in our blog here.
Alleviating feelings of isolation
My 97-year-old father lives in a very nice assisted living center that plans many activities for its residents, and yet he often reports feeling lonely. Research reveals that nearly 20 percent of seniors feel isolated. The causes for feelings of loneliness and isolation can vary widely, but there are some we can be aware of and help to alleviate. Not having access to transportation may prevent traveling to activities outside the home. For as long as your loved one is able to move about, arranging for or providing transportation to activities in the community or church may be all he or she needs to become involved. Even a short scenic drive can be a big boost to morale. Many organizations can use senior volunteers to perform tasks that are neither too mentally nor physically taxing.
When a person’s physical health limits their mobility and makes it difficult to leave their home, arranging regular visits from family, friends or even professional in-home aides who will read, play games, do puzzles or simply visit and reminisce can be a big boost to mental health. Reminding a senior resident of in-facility activities may be all it takes for them to get involved. Research has also discovered that men tend to have fewer social networks than women and are more likely to experience isolation. Men might need more encouragement and ideas of how to keep busy and be social than women do.
Senior isolation is a social and health issue that affects everyone
Healthy seniors can contribute to communities by bringing a sense of energy, wisdom and experience, and by lending a hand in a variety of meaningful ways. Preventing feelings of boredom and isolation should be a major concern of health care providers and caregivers to the elderly – as high on the list of importance as adequate medical care and supervision. Boredom leads to multiple physical and emotional issues, including:
- Feeling worthless
- Feeling that life is no longer worth living
- Feeling intense restlessness
- Feeling unloved or uncared about
- Feeling suicidal
The National Institute of Aging has identified regular stimulation as a major factor in quality of life between groups of seniors. Those who are mentally stimulated and enjoy social interaction are less likely to suffer from chronic illness and physical limitations. The fight against boredom and depression should be at the top of your senior’s treatment plan.
PRESS RELEASE: Dakota Travel Nurse Home Care is pleased to announce we recently hired Nicole (Nikki) Kinn, Registered Occupational Therapist, to do Home Safety Assessments and give recommendations that will help “Keep Home an Option” for you or your loved one.
During a Home Safety Assessment, Nikki will assess and provide recommendations for issues such as:
- Fall risks and hazards
- Kitchen and cooking safety
- Medication management
- Safe bathing/showering techniques and equipment
- Dressing made easier
- Transfer status throughout living space
- Mobility and related adaptive equipment
- Front-wheeled walker
- Four-wheeled walker
- Grab bars
- Toilet frame
Nikki is a registered occupational therapist and is licensed to practice in the state of North Dakota. She has worked with the geriatric population for the past 10 years. Her primary focus is increasing her clients’ quality of life and the safety in their home environment.
Nikki completed the Masters Program in Occupational Therapy at the University of Mary and has had additional training in accident and fall prevention, interventions for the cognitively impaired and maintaining good nutrition in the elderly population.
If you or your loved one wants to schedule an in-home safety assessment, please call our office at 701-663-5373. We will be happy to answer any questions you have regarding the scope and benefits of this service.
Dakota Travel Nurse Home Care is licensed by the North Dakota Department of Health to provide in home healthcare services. We are locally owned and operated in Mandan, ND. We provide in home nursing care, home health aide care and at home companion care. Call (701) 663-5373 today for a free consultation!
My best friend’s father (Bob) died about three weeks ago, just 10 days after his 95th birthday. He left behind three sons, two daughters and his 91-year-old wife. His memory and his ability to walk had been failing gradually for several years, but a few months ago a stroke left him wheelchair-bound and unable to carry on a coherent conversation. Because his wife and my single friend who lives with her parents could no longer care for him, he spent the remainder of his days in a VA care center. Because of their belief in a better life after death, the family considered his death a blessing, but still it is not hard to see that they are each grieving in different ways.
My friend and her mom were Bob’s primary caregivers. Judy Tatelbaum, MSW, says in an article titled After Caregiving Ends, “There is a natural sense of loss when the need for our caregiving is over. We must often face the double sorrow of losing a loved one and our purpose or role in their lives. The aftermath can be a very difficult time that leaves us feeling lost, lonely, and useless…..It is possible that we’ll feel relief that we don’t have to work so hard any longer, and then feel a sense of guilt for feeling such relief…. All of these are natural reactions. It is important to express our sadness, anger, loneliness, regret, and whatever else we may feel. It is also important that we listen to ourselves and appreciate what we feel as we go through the mourning process.” (We will cover the topic of Caregiver Grief more completely in a future blog.)
Stages of Grief
In 1969, psychiatrist Elisabeth Kübler-Ross wrote about the “five stages of grief.”
- Denial:“This can’t be happening to me.”
- Anger:“Why is this happening? Who is to blame?”
- Bargaining:“Make this not happen, and in return I will ____.”
- Depression:“I’m too sad to do anything.”
- Acceptance:“I’m at peace with what happened.”
Authors Melinda Smith and Jeanne Segal said in an article titled, Coping with Grief and Loss, “Contrary to popular belief, you do not have to go through each stage in order to heal. And if you do go through these stages of grief, you probably won’t experience them in a neat, sequential order, so don’t worry about what you ‘should’ be feeling or which stage you’re supposed to be in…. Kübler-Ross, herself, said of the five stages of grief: ‘They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss, as there is no typical loss. Our grieving is as individual as our lives.’”
Help for Coping with Grief
Because Grief is made up of many different emotions that can be different for each individual, meaningful advice on how to cope with grief is difficult to give. If you or a loved one is grieving, you will have to pick and choose between a myriad of suggestions. The important thing is to Do Something that helps you. As my friend’s mom wisely said, “I’m trying not to wallow in it.” Here are some widely accepted ideas from a variety of sources. (See Resources below.)
- Acknowledge your pain and actively grieve and mourn. Trying to avoid feelings of sadness and loss only prolongs the grieving process and can lead to depression, anxiety and other problems.
- Look to and accept the support of loved ones and others. Now is the time to lean on the people who care about you, even if you take pride in being strong and self-sufficient.
- Don’t make major decisions while grieving. Don’t decide to do things like move, change your profession, make major purchases or give up possessions until you are more emotionally stable.
- Take care of your physical and emotional needs. If you feel good physically, you’ll also feel better emotionally. Combat stress and fatigue by getting enough sleep, eating right, and exercising.
- Draw comfort from your faith. If you’re questioning your faith in the wake of the loss, talk to a clergy member or others in your religious community.
- Write about your loss in a journal or a letter saying the things you never got to say. Make a scrapbook or photo album celebrating the person’s life.
- Your grief is your own. Don’t let anyone else tell you when it’s time to “move on” or “get over it.” It’s okay to be angry, to cry or not to cry. It’s also okay to laugh and to find moments of joy.
- Plan ahead for grief “triggers.”Anniversaries, holidays, and milestones can be painful. Be prepared for an emotional wallop, and know that it’s completely normal.
- Contact a grief counselor or professional therapist if you:
- Feel like life isn’t worth living
- Wish you had died with your loved one
- Blame yourself for the loss or for failing to prevent it
- Feel numb and disconnected from others for more than a few weeks
- Are having difficulty trusting others since your loss
- Are unable to perform your normal daily activities
Many different aspects of losing a loved one can cause one to experience grief. My friend is grieving for the loss of her father and her role as his caregiver, for her mother as she struggles to cope with the loss of her husband, for the “new normal” of caregiving she and her mother have to work out together, and for the losses that are making change necessary in both of their lives. Your grief also may be coming from a variety of sources. Even though others have not experienced exactly what you are going through, now is the time to put pride aside and reach out for support and comfort from any source that is available.
My 97-year-old dad has lived in a very nice assisted/senior-living center apartment for nearly two years. Now, when we drive up to it together, he says, “There’s my home!” But he also says, “This is a lovely place, but I’m very lonely.” He has outlived two wives. He married a third time when he was 86 because, he said, “I don’t like living alone.” His current wife is 9 years younger than Dad and doesn’t want to leave her home to live with him. She comes to visit him for a couple of hours four days a week. We make sure that at least one of his children also is there for a visit every day of the week. We often wonder what else we can do!
The center offers several activities each day, and they are good to remind him to participate, but his dementia has kept him from developing any satisfying friendships. Because he aspirates food and chokes if he tries to talk and eat at the same time, mealtime conversations are difficult. I’ve encouraged my four siblings who live out of town to call or write. Sometimes they do, but often Dad doesn’t answer the phone, and when he does, it’s hard for them to know what to say to him. They wonder if a call or a visit is worthwhile, especially when after an hour or two, he can’t remember it even took place. I try to encourage them by saying that even if he doesn’t remember it later, at least for the time he is on the phone or with a visitor, he is happy. Keeping Dad active and trying to prevent him from feeling lonely takes a lot of effort.
A Health Risk of Epidemic-Proportion
Loneliness is said to be an “invisible epidemic” that affects 60 million Americans. A recent New York Times article states, “Researchers have found mounting evidence linking loneliness to physical illness and to functional and cognitive decline. As a predictor of early death, loneliness eclipses obesity.” Dr. Carla M. Perissinotto, a geriatrician at the U. of CA, San Francisco, adds, “The profound effects of loneliness on health and independence are a critical public health problem. It is no longer medically or ethically acceptable to ignore older adults who feel lonely and marginalized.” During 6 years of follow-up, the lonely adults she studied had significantly higher rates of declining mobility, difficulty in performing routine daily activities and death.
John T. Cacioppo, professor of psychology at the U. of Chicago and director of the university’s Center for Cognitive and Social Neuroscience, has been studying loneliness since the 1990s. His research has shown that chronic loneliness can raise blood pressure and decrease blood flow to vital organs. “Loneliness doesn’t just make people feel unhappy, it actually makes them feel unsafe — mentally and physically.” It also affects the production of white blood cells, which can decrease the immune system’s ability to fight infection. An article by Dr. Sanjay Gupta in Everyday Health explains why you should treat loneliness as a chronic illness. It goes on to say, “On the other hand, people who have strong ties to family and friends are as much as 50 percent less at risk of dying over any given period of time than those with fewer social connections.”
What to Do for Yourself or Your Loved One
If you, a loved one or someone you care for is lonely, here are some suggestions that may help, depending on current health and mobility:
- Don’t text. Use the phone and talk to someone.
- If you leave a message and don’t get a return call, call back.
- Plan a low-key activity with someone, like a walk.
- Practice simple acts of social interaction, like saying “hello” to everyone.
- Make the effort to meet new people.
- Check out the resources at your local senior center.
- Contact a friend with whom you’ve lost touch and meet for lunch.
- Volunteer to help others as much as you can.
- Take up a new hobby that fits your current abilities.
- Adopt a pet, if you have the ability to care for one.
- Provide transportation for a short excursion or just a drive.
If You or Your Loved One Is Homebound
Being social can be difficult if you are homebound. Area agencies on aging, places of worship or providers like Dakota Travel Nurse Home Care may be able to offer home-visitation services, companionship or respite care. Help prevent illness by lessening loneliness. Call DTN Home care today for a personal consultation on how we can help. 701.663.5373
Maintaining good oral and dental health can get more and more complicated as your loved one ages. At the same time, it becomes more and more important, and caregivers must assume more responsibility. It should not be neglected, because oral health is necessary for good overall health.
At first, regular trips to the dentist and simple reminders to brush twice a day and to floss daily might suffice. Other tips include drinking tap water that contains fluoride and making smart choices about diet. As dementia or other diseases such as arthritis, Parkinson’s, and movement problems progress, it becomes more difficult physically and mentally for an elderly person to take care of their mouth and teeth on their own. Tasks that were once simple to do become challenging or impossible, and help from a caregiver is required.
Several lifestyle changes also can make it more difficult to keep teeth healthy. As the number of medications increase, so can the side-effect of dry mouth, which can be damaging to tooth enamel. Teeth can become less sensitive to pain, making it more difficult for the elderly person to detect cavities and other mouth problems. When you’re caring for someone with a number of health problems, it’s easy to overlook oral health. This can be dangerous, because bacteria from the mouth can be inhaled into the lungs and cause pneumonia.
Medications, Dry Mouth and Cavities
As we age, we become more cavity prone. A frequent cause of cavities in older adults is dry mouth. Dry mouth is not a given in aging. However, it can be a side-effect for more than 500 medications, including those for allergies or asthma, high blood pressure, high cholesterol, pain, anxiety or depression, Parkinson’s and Alzheimer’s. Tell the dentist about any medications your loved one is taking. These are some common recommendations dentists make to help relieve dry mouth and prevent cavities:
- Consult with a physician on whether to change a medication or dosage.
- Drink more water. Have water nearby, and don’t wait until you’re thirsty to drink. (The elderly may have trouble recognizing that they are thirsty.) Your mouth needs constant lubrication.
- Use sugar-free gum or lozenges to stimulate saliva production.
- Get a humidifier to help keep moisture in the air.
- Avoid foods and beverages that irritate dry mouths, like coffee, alcohol, soft drinks, fruit juices.
- Ask the dentist about applying a fluoride gel or varnish to protect teeth from cavities.
Many elderly adults develop gum, or periodontal disease, caused by the bacteria in plaque. Gum disease can be painless until the advanced stages. If untreated, gums pull away from the teeth and form pockets where food particles and more plaque collect. Advanced gum disease will eventually destroy the gums, bone and ligaments that support teeth, leading to tooth loss. With regular dental visits, gum disease can be treated or prevented.
People with diabetes are twice as likely to develop gum disease. When blood sugars aren’t well controlled, it is harder to fight infections, including infections in the mouth and gums. Infected gums make it harder to control blood sugar. Oral health, blood sugar control and the ability to fight infections are closely related.
Dementia and Dental Care
In the early stages of dementia, focus on regular care and preventing the need for extensive procedures later on. During the middle and late stages of dementia, oral health becomes more challenging. The person may forget what to do with toothpaste or how to rinse, or may be resistant to help from others. Try these tips from the Alzheimer’s Association:
- Provide short, simple instructions. Explain dental care by breaking directions into steps. “Brush your teeth” by itself may be too vague. Instead, walk the person through the process. Say: “Hold your toothbrush.” “Put paste on the brush.” Then, “Brush your teeth.”
- Use a “watch me” technique. Hold a toothbrush and show the person how to brush his or her teeth. Or, put your hand over the person’s hand, gently guiding the brush. If the person is agitated or uncooperative, postpone brushing until later.
- Keep the teeth and mouth clean. Brush the person’s teeth at least twice a day, with the last brushing after the evening meal and any nighttime liquid medication. Gently place the toothbrush in the person’s mouth at a 45 degree angle so you massage gum tissue as you clean the teeth.
- Try different types of toothbrushes. You may find that a soft bristled children’s toothbrush works better than a hard bristled adult’s brush. Or that a long handled or angled brush is easier to use than a standard toothbrush. Experiment until you find the best choice. Be aware that electric dental appliances may confuse a person with Alzheimer’s.
If the person you are caring for wears dentures, check with the dentist for specific instructions as to their care. Be aware of any signs of mouth discomfort during mealtime. Refusing to eat or pained facial expressions while eating may indicate mouth pain or dentures that don’t fit properly.
This blog is not intended to be medical advice, only to make you aware of the importance of good oral and dental health in yourself and your loved ones. Always consult a dentist or oral specialist if you suspect problems or encounter difficulties with maintaining good oral hygiene.
The assisted living center where my dad lives provides each resident with an emergency alert button that they can push when they need help. It also senses when the person wearing it falls and alerts a staff member to come running. At first, Dad had trouble remembering that he could push the button when he needed help, but after a while he got the hang of it. Now the only problem is he has no sense of how much time has passed since he pushed it, so he’s either unhappy that it “took so long” for help to come, or he forgets why he pushed it in the first place. When he still lived at home, we rented a similar button for him, but neither he nor his wife would push it to summon help! You will have to determine whether the following types of devices, jewelry and related services could be a help to your elderly loved one.
A DTN Home Care client recently purchased a MedicAlert bracelet for her mom through the MedicAlert Foundation featured on the Alzheimer’s Association website. In the event that her mom gets lost, which happened recently, there is an 800 number on the back that the person who finds her can call. The emergency response personnel then calls from a list of loved ones to notify the family.
In partnership with the Alzheimer’s Association, MedicAlert has created a specialized program to provide 24/7 wandering protection and emergency response services for individuals living with Alzheimer’s or other types of dementia, who are at risk for wandering and becoming lost or having a medical emergency. If an individual with dementia wanders and doesn’t return, caregivers can call the 24-hour emergency response line to report it. A community support network is activated to help find the person who wandered and return them to the caregiver. The service also provides emergency responders with complete medical information. You can learn more about this jewelry and related services here.
If you want to compare providers and services, a list of the 2016 Best Medical Alert Companies can be found here.
Medical ID Bracelets
Another option is an engravable medical ID bracelet with no services included. The person’s name, a phone number and medical condition—for example, diabetes, asthma, hemophilia, dementia—can be engraved on the back. You can search online for “Medical ID Bracelets.” One example can be found here. (DTN Home Care does not recommend a specific provider.)
Emergency Alert Systems
In an article on agingcare.com entitled How to choose an emergency alert system, author Marlo Sollitto informs us, “More than 33 percent of accidents and falls involving people over age 65 occur at home, according to the CDC….There are many devices available that will instantly summon help in the event of an emergency. Sometimes called Personal Emergency Response System, Medical Alert, or Medical Emergency Response Systems, all systems work in essentially the same way: When emergency help (medical, fire, or police) is needed, the senior presses the transmitter’s button. The elderly person wears the transmitter around their neck, on their wrist, belt buckle or wheelchair. In case of emergency, the senior calls for help by simply pressing the alert button, without needing to reach the telephone.”
What to Look for in an Emergency Response System
An article titled “Home Alone” (Nov 2005, Good Housekeeping magazine) lists tips to help you shop for an emergency response system:
- Price: Compare pricing, features and servicing of each system. ask if the price will increase.
- Hidden Costs: The system should be included in the monthly fee with no up-front costs.
- Contracts: Don’t sign a long-term contract.
- Experience: How long has the company been in business?
- Portability: Can the system be used when away from home?
- Ease of Use: Try out the system and make sure it is easy to use and easy to see.
- Waterproof: Can emergency button can be worn in the bath or shower?
- Trained Operators: In an emergency, you need qualified specialists to assist your parent.
- Hours: Make sure the monitoring center is available 24/7 and also has 24/7 customer support.
- Testing: Ask what procedures the center uses to test systems in your home.
- Repairs: Your system should include repair and replacement service.
What Is the Best Option for Your Loved One?
Before you purchase a wearable safety device &/or bracelet, you will have to consider the special needs of your elderly loved one, including whether or not they will remember to wear it and how to use it. Be sure that your service provider allows a trial period, and that you or your loved one’s caregiver will give the user some time to get used to wearing the jewelry or button and to learn how and when to use it. Once that has been accomplished, you will have more peace of mind that your loved one will be cared for when lost or alone.