The Future of Home Health Care

The nation coming close to a tipping point. The number of people over the age of 65 is growing rapidly, and the number of people over 80 will double by 2050. By the year 2030 their healthcare needs will be more than the infrastructure of our nation can handle. It is clear that something needs to change, but what exactly? There isn’t likely to be more money available or more people jumping into healthcare in the next 15 years.

Home care is the most popular option for those needing just a bit of assistance to get by. People want to stay in their own homes, especially if all they need is a little help with housekeeping or light personal assistance. But home healthcare aides are in short supply, and it’s unlikely that more people will be eager to fill these difficult roles when the salary is only around $20,000 a year.

Companies are working hard to find answers that are both practical and fiscally attainable for seniors. One of the most promising is robots; the University of Illinois is currently working on development of such projects with a $1.5 million grant from the National Science Foundation. Right now there are a number of robotic care aides on the market; smart walkers/canes, emergency call pendants with GPS, and medication tracking aides are already available. While these are extremely useful, they do not solve enough of the problems that push the elderly out of their homes and into assisted living communities.

Technology currently in development is more complex, including robots with sensors, microphones, cameras, and even radar. Drones could do everything from fetching simple items from the fridge (or medicine cabinet) to light cleaning or yard work, to carrying or even bathing a person. Some are made to provide companionship as well.

While such technology may be a practical solution to the healthcare needs of an aging nation, is it a moral one? Is it right to turn the care of our loved ones over to machines? Is it ethical and is it healthy for people to bond with robots instead of actual, caring humans? Caring for people is time consuming, stressful, difficult, and even unpleasant at times. It is also rewarding and fulfilling. By turning over such work to unfeeling machines, we lose part of what bonds us together as a society.

The debate comes down to whether robots and tech are the practical answers to a problem with no other solutions in sight, or another step away from social responsibility. One observer commented that if a robot were her last friend she would be very depressed. But is that more or less depressing than having no friends at all?

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Recognizing Pain in the Nonverbal

Pain drains personal resources. It makes everyday tasks more difficult to face and reduces a person’s ability to cope with other stresses that come along. Most people recognize when something is wrong, get to a doctor, and treat the cause of the discomfort to alleviate it. Getting over the pain and on with life is the goal.

But not everyone can do that. People in later stages of dementia are often confused by the world around them and have difficulty expressing themselves to others, even to a point where they cannot speak. So how are these people, already coping with a great deal of stress due to their mental state, to express that they are in pain and need help? Some can’t even recognize that what they’re feeling is abnormal and should be addressed. It becomes the responsibility of caregivers to recognize the problem and get help for them.

Here are some signs caregivers can watch out for that may indicate their nonverbal charge is in pain:

Grimacing – Wincing, frowning, or a furrowed brow can indicate pain, especially when in reaction to a certain movement or touch.

Rocking – Whether rocking one limb or the whole body, this is a common way to bring comfort from pain. Pacing and moving the head around unusually are other signs to watch for.

Odd movement – Aside from rocking, a person who appears stiff, fights moving a certain way, changes positions frequently or won’t change at all may be in pain.

Moaning – this may seem obvious, but nonverbal patients may make a variety of noises for other reasons; be on the lookout for a different type of vocalization. Similarly, whining, crying, or gasps when touched or move are big indicators of pain.

Sleep changes – Dementia tends to disrupt day/night sleep patterns. Someone who is sleeping a lot more than usual may be escaping from the pain of everyday life. A normally solid sleeper who is suddenly waking more might be disturbed by pain.

Quick breathing – Pain can elevate heart rate, breathing, and blood pressure.

Aggression – A person in pain may be quicker to anger or feel afraid when no harm was intended. They may not know the pain is temporary or can be addressed. Even when a caregiver is offering treatment, to a confused person it’s just more pain. They will fight to make it stop.

One of the many difficulties in caring for a person with dementia, especially those who are non-verbal, is that new behaviors emerge as a person tries to cope with the devastation of their mind. Any number of these signs could be a signal that something else is wrong, not just an indicator of pain. As a caregiver, trust your gut. Relying on just one signal that something is wrong may cause you to miss something. But when the signs pile up and you can tell something is wrong, it’s time for a trip to the doctor. Everyone feels and expresses pain differently. As with so many aspects of caregiving, it’s important to go with your instinct and seek help if you aren’t sure.

Pain is draining, but with dementia it is harder to recognize. Finding and treating the source of the pain will bring relief to everyone, especially the person enduring its touch.

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Social Media Is Booming

It used to be entirely predictable for younger generations jump onto technology bandwagons faster than older generations. In fact, Douglas Adams came up with a set of rules that perfectly describes the phenomenon: Anything that is in the world when you’re born is normal and ordinary and just a natural part of the way the world works. Anything that’s invented when you’re fifteen to thirty-five is new and exciting and revolutionary and you can probably get a career in it. Anything that’s invented after you’re thirty-five is against the natural order of things.

But baby boomers are anything but conventional. They were turning 35 before the technology wave that has dominated the last few decades, and instead of calling it “against the natural order,” they have largely embraced the changes and demanded more. But the newest revolution has not been so well received. Those 65 and older have been slower to adopt the social media trend, more in the spirit of Adam’s axiom that those over 35 find new technologies against the natural order.

Our hyper-connected, social media driven world can be very isolating for those not in on the digital wave. The way our culture operates now, a person who is not “wired in” is definitely left out. Institutions and businesses post information on their social media pages or send out email alerts as if it is a sure way to keep people informed, but it doesn’t reach everyone. We operate as if friends and family all read our feeds and keep up with our photo sharing but many people, especially seniors, are either not interested in digital friendships or are overwhelmed by the constantly changing landscape. Functioning in the world without email and a Facebook account leaves one on the outer fringe of society.

Boomers are not taking this laying down. It is becoming clear that social media is less of a trend and more of a lifestyle shift, so more and more seniors are joining in. Social media usage is now growing faster among seniors than any other age group. Currently, 14.8 million seniors use Facebook (11% of total users), leaving around 36 million yet to sign up. Businesses are springing up to cater to those trying to keep up with the wave, but feeling overwhelmed and lost by the constant changes.

Whether enjoying family photos, keeping in touch with peers, or reconnecting with long lost friends, social media is a great way to combat loneliness in seniors. Relationships breathe life into years when it’s easy to slip into an isolated routine, especially when it is physically harder to go out and spend time with people. And loneliness poses serious health risks as we age, so anything to combat it is a boon. It’s no surprise seniors are flocking to social media when everyone they want to connect with is already there. And what grandma can resist easy access to baby pics and grandkids’ updates?

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Shedding Light on a Cure for Alzheimer’s

Alzheimer’s Disease is on the rise, and there is no cure in sight. But progress retrieving memories lost to amnesia has shed some new light on a possibility.

Part of the problem is researchers aren’t entirely sure what causes Alzheimer’s disease. The leading theories involve proteins in the brain that build up and prevent healthy functioning of transmitters. It is possible that these proteins block nutrients to brain cells, killing them and removing memories stored within. Another theory is that the memories remain intact but are rendered inaccessible due to broken pathways and malfunctioning transmitters. So far, there has been no evidence to prove (or disprove) either theory.

A recent study of amnesia in rats has opened a new door for researchers to explore. In the study, rats injected with a protein synthesis inhibitor became unable to retrieve certain memories (much like an Alzheimer’s or amnesia patient). Scientists were able to identify the cells that contain a specific memory and then use a specialized light to activate them. The rats were then observed to “use” the memory – they reacted fearfully to a situation that had once been frightening but then was forgotten through the false amnesia.

While this study is only a baby step in the investigation of memory retrieval, it is the first time there has been success in showing that a memory can indeed be retrieved after being lost in such a fashion. Of course, memory retrieval is not the ultimate goal, but it could certainly bring some relief to Alzheimer’s sufferers and their families. It could also lead scientists to a better understanding of the disease and perhaps closer to a cure.

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Forty-four Ways Kids Can Engage a Person with Dementia

Elderly dementia patients have a lot in common with children. They can’t always meet all of their own needs. They don’t always get social cues. All they want is time and attention. They need social interaction, but have trouble connecting in a mature way. Often times, the guileless and accepting demeanor of a child is less threatening, and opens the door for a personal connection where adults are shut out.

But it is unreasonable to expect either a child or dementia sufferer to be skilled at beginning a friendship or even a conversation. So here are some engaging activities to aid in beginning a friendship that will be beneficial to both.

Play

It’s important to find the right activity – try to choose something that will engage the interest of both parties and also accounts for their cognitive ability. Board games are one way to connect, and for those (young and old) who are not able to read, there are plenty that do not require reading and still offer a challenge for any age. Try Sequence for Kids, Hi Ho Cheerio, Cooties, Chutes and Ladders, Hoot Owl Hoot, or Busytown. Puzzles of all challenge levels are also a fun activity that both parties can enjoy and participate in.

Physical play is also a good endeavor. For those too advanced to join in, just watching children at play can be engaging and enjoyable. For those with a bit more agility, playing catch, shooting hoops, swinging, going for a nature walk, and dancing are great activities to bond over.

Art

Arts and crafts can be fun for anyone, regardless of skill level, and it can strengthen fine motor skills as well (kids and the elderly need to work to keep those muscles agile). Drawing, coloring, painting, knitting, working with modelling clay, stringing beads, and painting can be done either side by side or together. Finger painting is a great sensory experience for those in more advanced stages of dementia and for very young children. Creating a memory box is a nice way for the pair to reminisce and enjoy connecting as well. Completing a craft together can give both kids and adults a sense of accomplishment, promote socialization, and teach a skill.

Music

Both listening to music and making their own can engage dementia patients and children. They can share their favorites, listen to pieces from their respective eras, play a tune if they have the skill, or just enjoy making noise together (a great way to interact with toddlers if neither partner is irritated by loud sounds). Music also has the ability to reach dementia patients in a way words cannot, especially as the disease progresses – a nice bonus.

Brain Building

Trading stories, doing puzzles like crosswords and Sudoku, trivia, reading the paper and discussing the news…all are great ways to engage people and start a conversation. Take cognitive ability into account, and make sure the younger conversationalist has the maturity to handle whatever confusion or lapses dementia may lead to.  Even learning a new skill can help the pair connect, and that can go in both directions. Children and adults each bring value and skills to the friendship and sharing them is good relationship and brain building.

Help Out

Helping others makes people feel good. Sometimes it’s easy to overlook that a person suffering from dementia still needs to feel valuable and needed. It is also beneficial for children to participate in helping out and to see that at all stages of life people have something to give. Working together to accomplish something meaningful adds a deeper level to the relationship between two people, no matter the age. What they can do will vary depending on age, cognitive and physical ability, and the situation. Some ideas include folding laundry, preparing a meal (or helping a caregiver to do so), organizing toys, watering plants, and taking care of pets.

Having a child (of an appropriate age and maturity) help a person with grooming can be a great bonding experience as well. Simple tasks like brushing and styling hair, painting nails, applying makeup, tying shoes, or doing up buttons on a sweater can make the child feel very needed and it might feel more loving for the person in need of help. Do be certain both parties are comfortable with such close contact, and I would certainly not recommend having a child help with more personal bathing and toileting tasks.

If all else fails, a simple hug or holding hands can be a beneficial experience for a person with dementia. Physical contact is a comfort in many cases.

Every situation is unique, but remember to let each partner participate in activities as they are able and comfortable. Sometimes another functional adult will be needed to guide undertakings and sometimes the child and dementia patient can accomplish things with less supervision. And, of course, consider the safety of both the child and the adult. It can also be helpful to have some conversations with the child beforehand to ease fears and surprises related to the symptoms of dementia. Dementia steals away a person’s memories and social skills, but not their need for people and relationships. Children have a special charm that can break down personal barriers and possibly allow for a meaningful and caring relationship. For those suffering from dementia, that is life changing.

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Three Things You Didn’t Know Were Making You Fat

 

 

Does it ever seem like the scale must be wrong? Like no matter how hard you diet and exercise, your weight just keeps creeping up? Here’s a few things you might be falling victim to, without even realizing there’s a problem.

 

Sleep Deprivation

Unless all those extra hours are spent working out, sleep deprived people burn about the same calories as people getting enough rest. But they eat more – about 300 calories every day. Aside from having more time in the day to snack, the hormones that drive eating and tell the body to stop are off balance when tired. Studies have found that the sleep deprived have more of the “eat” hormone, and less of the “stop” hormone than rested people. Also, tired people have decreased impulse control and poorer higher-level thinking, leading to more comfort food choices than healthy ones. All this is to say we make unhealthy food choices (and more of them) when we are tired.

Dehydration

Next time you feel peckish, try a glass of water instead of food. This is not just to fill your empty belly; it could be that you are really thirsty instead of hungry. When cells are dehydrated they don’t get enough energy and so they send out signals for more, which the brain can interpret as hunger. Also, a thirsty body has trouble burning fat, so instead of getting that energy by using fat stores, it sends the brain signals to eat more. One study found that metabolic rates increased by 30% after drinking 2 cups of water. A thirsty body has a slower metabolism (using less of what we eat), has trouble burning fat, and is hungrier than one that is well hydrated.

Sugar

Yes, obviously too much sugar can lead to extra pounds, but the situation is worse than you’d think. Human bodies love sugar, especially our brains. Eat too much and the brain starts to really like it, to the point where you need more and more to feel good, and go through withdrawal when you cut back. Not only that, but eating too much sugar is actually worse than eating too much fat. The problem with fat is that it’s dense – a little fat has more calories than the same amount ofsugar – and it’s easy to think that makes it worse. However, the difficulty is in how we process it. Human bodies are not designed for the 140 pounds of sugar the average person eats each year. All kinds of so-called healthy foods have added sugar – yogurt, cereals, granola bars, peanut butter, flavored waters, and on and on! But there’s no nutritional value to it, just extra calories. The liver processes all that sugar and turns it into low density lipoprotein particles – the kind of cholesterol that leads to blocked arteries and heart attacks. Fats, especially the right kinds, don’t contribute to high cholesterol nearly as much as excessive sugar. 

Sleep well, drink plenty, and check labels for added sugar and you may find the battle of the bulge tipping a bit more in your favor!

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(Cos)Playing in Retirement

Cosplay, or costume play, has been around for a long time, and not just on Halloween. Dressing up as a beloved character and acting out a role is more than wish fulfillment, it’s fun! For the longest time main stream society has relegated role playing to child’s play and a few special occasions, but with the recent trendiness of “geek culture” cosplay has become more common. So much so that even senior citizens are getting in the act.

Cosplay allows people to step outside their everyday lives, to shed inhibitions and be someone else for a time. For seniors who have spent their whole lives playing out the more mundane roles of worker, parent, or retiree, it is like a respite from themselves. Anyone can enjoy such a respite no matter their age, but it is particularly joyful to see the elderly continuing to branch out and enjoy life, rather than staying in the ruts that got them so far along on their journey.

Checkout some of the awesome styles these seniors have jumped into for a little role playing fun!

Grandma is fast as lightning.

 

Their hearts will go on.

 

 

 

 

 

 

 

 

She knows what you’ve been thinking.

 

 

 

 

 

Got spinach?

 

 

 

 

 

 

 

 

Darth Nana

He found the right castle.

 

 

 

Wait a minute…

 

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Are You Stressed Enough to Develop Dementia?

It’s no surprise that chronic stress is bad for you. It leads to a variety of physical ailments including indigestion, insomnia, and high blood pressure. Evidence also shows that chronic stress damages the hippocampus, a region of the brain where memory and learning are primary functions. And studies are finding a correlation between high levels of ongoing stress, like in PTSD sufferers, and development of Alzheimer’s later in life. So could it be that a stressful lifestyle increases a person’s risk for dementia?

Stress is the way we feel when something is off balance, either physically or mentally; it drives us to correct the balance and live healthier lives. It is necessary to survival, spurring us to do what is needed. It gets us moving a little quicker in dangerous situations by sending a surge of energy in the form of adrenaline. In our caveman days it kept us alert around predators, and now stress pushes us to do what needs doing in order to get by. You may not want to get up and go to work, but you need your income so you can live. Crying babies induce stress in everyone; it’s a built in response to ensure the species survives, even at 3 a.m.

But too much stress – too much imbalance – is harder to recover from and can cause permanent damage. Post-traumatic stress disorder (PTSD) occurs when the brain cannot regain its balance and the traumatic experience continues to bring stress into a person’s life. Veterans experience this in spades. Researchers have studied instances of dementia in elderly veterans and found that those with PTSD are as much as 77% more likely to have dementia.

Study of Alzheimer’s patients has found increased levels of the stress-related hormone cortisol in the bloodstream, the amount of cortisol directly related to the progression of the disease. Cells treated with excesses of cortisol have been found to produce the two proteins known to interrupt proper brain function and lead to dementia. While the connection between stress and dementia is there, prevention and a cure have not been found. Will living a more relaxed and balanced life improve your health? Definitely. Will it keep you safe from dementia? Not entirely. However, avoiding chronic stress and getting treatment for conditions like PTSD does reduce your risk for developing dementia as you age.

So how stressful is your day to day lifestyle?

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Senior Care Exposed: Sunrise Home Care Services

Inspection reports offer a glimpse into the care a prospective resident can expect to receive in a given community. Sometimes, violations are easily fixed and don’t necessarily indicate a dearth of caregiving. Other times, a particularly disturbing picture is painted by the reports, reinforcing the need for thorough research before moving into a facility. Here are some of the incidents we discovered from one of the yearly inspections at Sunrise Home Care Services in Florida.

Incident:

Dining room tables are set with paper and plastic products instead of china and silverware; this is the case for every meal. Residents are not given forks and knives at all, and were observed pulling chicken off the bone with plastic spoons or their fingers. Residents were not offered a choice of meals or drinks; everyone was served the same thing and was not offered other options even though some stated that they did not like or want the meal. Fruits and vegetables are always canned; it is very rare to have fresh produce offered. At snack time staff was observed passing out two foods – a pop tart or bread with peanut butter – and no one was asked their preference. Residents were handed one of the two items without the opportunity to choose. The supervisor stated there are other options for meals (canned ravioli, peanut butter and jelly sandwiches, or canned soup), but residents interviewed were not aware they could get something different. The menu is posted in a location inaccessible to residents.

There is not always enough food prepared to satisfy residents. Those asking for seconds were not always able to get more food, especially of the main dish prepared. Butter or margarine is not provided; residents eat bread dry. The supervisor claimed this is for the health of residents. Salt and pepper is also not provided. Residents complained of getting hungry before the next meal and some were noted as losing weight, though they were not on a documented weight loss plan.

Violations:

  • Facility administrator failed to provide regular meals which meet the needs of residents.
  • Facility failed to meet recommended dietary allowances by failing to allow for a variety of foods adapted to the food habits, preferences, and physical abilities of residents.

Incident:

Residents clear their own tables by bringing dirty dishes to the same counter where food is distributed. Second helpings are also provided at this counter when available, and staff was observed both handling dirty dishes and serving food without changing gloves. In the kitchen dishes are washed with a bleach solution, but the water temperature and the amount of bleach in the water are not measured for sanitation.

Violations:

  • Facility administrator failed to be responsible for total food services and the day to day supervision of food service staff.
  • Facility administrator failed to ensure staff performed duties in a safe and sanitary manner.

Incident:

Residents are often called “baby” and “honey” instead of by name. In one observed instance, a staff member was heard encouraging a resident to go use the potty and to have her diaper changed. This was done in the dining area in hearing range of every other resident at supper.

Violations:

  • Facility failed to ensure residents are treated with respect and with due recognition of personal dignity and individuality.

Incident:

Several residents are owed money from an incident in their previous facility. The facility administrator says he has had their checks “maybe a couple of months;” the residents have not received their money.  The administrator also processes residents’ social security checks, giving residents a portion of their money each month. The administrator was not able to produce documentation of payments or receipts from residents who had received their money.

Some residents do not have residency agreements in place.

Violations:

  • Residents have the right to manage their financial affairs unless otherwise authorized.
  • Facility failed to maintain written business records using generally accepted accounting principles which accurately reflect income from residents.
  • Facility failed to ensure that prior to or at the time of admission each resident executed a contract with the facility.

Incident:

Many incidences of unsanitary and unsafe conditions are noted in the report. Furniture is indicated as worn, torn, and dirty. Bathrooms are not well supplied with towels and soap. A toilet seat is noted with a “dark substance” around the rim, and another toilet was left with feces in the bowl. One room smelled of urine and the supervisor stated that the resident is incontinent and it is hard to get the smell out of the bed. A musty/moldy smell was noted in the facility.

Floor tiles are observed to be in disrepair. Residents share adjoining bathrooms and apartment spaces; it is noted that residents of the opposite sex are able to unlock doors in their rooms and bathrooms to access each other’s rooms. Lighting does not work in all areas and exposed wires hang from the ceiling. One exit door was found to be jammed shut.

The inspector found many areas of the facility to be in general disorder, disrepair, and unpleasant condition.

Violations:

  • Facility failed to ensure every resident had a safe and decent living environment.
  • Facility failed to provide a safe, clean, and hazard free environment for residents.

These egregious violations seriously bring into question the safety and well-being of residents. Reports like these reinforce the need for prospective residents to check inspection records and make a few surprise visits at a facility before choosing an assisted living community to call home.

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Dementia Day Care…At Night

Alzheimer’s sufferers don’t live by the clock the way their caregivers do. Many times they are active for hours at a time when the rest of the family wants (and needs) to be asleep. Caregivers have to be up with them, leading to exhaustion, added stress, and reduced personal capacity due to lack of sleep. In the long run this has ill effects on health. Too many high functioning patients move into nursing homes or assisted living facilities because of the inability for caregivers to function without a decent amount of sleep.

The Hebrew Home at Riverdale offers a unique solution to this problem; one that could benefit millions of Alzheimer’s patients and their caregivers if it caught on nationwide. The program has all the advantages of daytime care, but with the added bonus of operating at night. From 7 p.m. to 7 a.m. patients spend their most active hours singing, dancing, socializing, and participating in a variety of engaging activities. They are given the freedom to sleep as needed, or they may just while away the night engaging in fun, healthful activities. This is a far better experience than sitting in front of the TV or enduring a frazzled caregiver. It is a safe, engaging environment that benefits the health and mental state of participants.

The program is also extremely beneficial for caregivers, who can get a good night’s sleep and wake up truly refreshed, ready to take on the daytime challenges of caregiving. As an added bonus, participants are often returned home tired and fulfilled from an active night, making their daytimes much more pleasant and relaxed.

Hebrew Home has reaped the benefits of the program since 1998. A space that would otherwise be empty at night (the recreational areas of an assisted living community, where residents are all asleep) instead generates revenue. The biggest drawback, as with many health care solutions, is cost. Private payers are charged $215 per night (around $6500 for a month), which is far more expensive than the typical middle class family can afford. Most current participants are enrolled through Medicaid, but qualifying for Medicaid requires losing most everything a person has.

This is currently the only program of its kind nationwide, but it has the potential to spread like wildfire. It is a win-win-win situation. The Hebrew Home adds to their revenue stream. Patients benefit from the expertise of professionals, activities designed for their mental needs, and therapies built to soothe agitated sufferers. Caregivers get sleep – need I say more? The only question left is why aren’t there more of these program springing up around the world?

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