ComForCare Home Care Serving Somerset & Northern Middlesex Countries

Archive for February, 2019

Falls Can Have Devastating Effects for the Elderly

Monday , February 25 , 2019

Falls Can Have Devastating Effects for the Elderly

Here’s how to prevent them.

When I was eleven years old my grandmother came to visit us. Sitting in the living room one day, she rose to walk across the room at her usual rapid pace. But before she could take a step, she lost her balance for a moment and had to grab the chair arm to steady herself.

I still remember the intense look of frustration and annoyance on her face as she realized her body had betrayed her. Her feet, legs and balance weren’t able to obey what her mind told them to do.

It was decades before I learned both how common and how catastrophic falls can be for seniors.

Dangers of falling

According to a government study, deaths from falls among adults aged 65 and older increased from 18,000 to 30,000 a year between 2007 and 2016. That’s a 31% increase. The same report stated: Deaths from unintentional injuries are the seventh leading cause of death among older adults, and falls account for the largest percentage of those deaths. Approximately one in four U.S. residents aged 65 years (or older) report falling each year.”

Of course, not all falls result in death – but the effects can still be catastrophic. In the US, there are 300,000 hip fractures a year as a result of falls, and half of those people will suffer a major decline in independence. Other smaller issues, such as broken wrists, ribs, or even just contusions and scrapes can lead to infection or impaired mobility.

What causes falls in the elderly?

When an older adult falls, it is typically attributed to a simple slip or trip, but this is rarely the case. In reality, it is often a health issue such as dizziness or poor vision that contributes to falls. Some common contributors include:

  • Side effects from medication
  • Arrhythmias
  • Muscle weakness
  • Dementia
  • Low blood pressure
  • Poor center of gravity
  • Inner ear infection

There really is no one-size-fits-all answer when it comes to falls. A variety of factors can lead to a tumble, and it is highly dependent on each individual and their particular health issues.

What should a doctor check for after a fall?

After your older loved one falls, it’s essential that they get checked out by a doctor. Why? Because as we stated above, any number of issues might have caused the trip, and you always want to rule out anything serious.

Here’s what you should have them look for:

A new underlying illness, such as urinary tract infection or anemia

  • A stroke or mini-stroke
  • Low blood pressure upon standing
  • Side effects from medications
  • Gait and balance
  • Vitamin D level
  • Changes in bloodwork, such as low sodium levels or blood sugar issues
  • Underlying heart or neurological conditions
  • Problems with vision

Best activities to prevent falls

As your loved one ages, it’s important to take measures to help strengthen the body and prevent falls. While not all slips can be avoided, preventative measures can make a huge difference. In fact, according to one article in the New York Times, a large review of studies confirmed that exercise can be a good way to help reduce the frequency of falls in the elderly.

What did the researchers find? Proof that exercise reduces the rate of falls by 23% and the number of people who fall by 15% – a significant difference.

In general, exercises that require standing up rather than sitting down proved to be the most effective. Some examples include:

Simple body weight exercises, such as alternating lunges, slow toe touches, or sit-to-stands

  • Resistance exercises using light hand weights or an exercise band
  • Using an exercise bike or treadmill to strengthen the legs
  • Yoga
  • Tai Chi

Of course, before beginning any exercise program, your loved one should consult with their doctor to make sure it’s safe.

Final thoughts

Even if they are seriously debilitated by illness or inactivity, an older adult’s muscles will always respond to exercise at any age. They shouldn’t assume it isn’t worth the effort to try! Tell us: does the elderly adult in your life still exercise? Have you seen an improvement in balance or mobility?

Posted in: Aging

Leave a Comment (0) →
Aging in Place

Monday , February 18 , 2019

Aging in Place

Recently one of our home health aides called our office to speak to our nursing director about her client Jean. She reported that ever since Jean hurt her leg in a fall, she has been having pain when walking. Her doctor had examined Jean and found no sign of injury, but she was less comfortable, less confident, and less mobile than she had been prior to the fall.

The RN, Theresa, suggested a follow-up visit to the client’s MD, but she also made the following
recommendations to the client’s husband:

  • With her doctor’s agreement, Jean should start both physical and occupational therapy
    to improve her strength and functionality in the home
  • Since the leg pain was making Jean more unsteady, it was now very important to install grab bars in the bathroom
  • In addition, it would be safer to have her sit for her shower, so a shower bench and handheld shower should be installed
  • She might want to switch from a regular walker to a rolling walker with a “seat bench” so she can stop and sit whenever she is feeling weak or unsteady

This is the kind of problem solving we do every day to help our clients achieve their goal of remaining in their homes even as they face the challenges of aging.

It’s called “aging in place,” and the online health and wellness platform ShareCare reports that most seniors say it is a very important goal to them: In fact, according to the American Association of Retired Persons (AARP), 89 percent of people 50+ wish to remain in their own homes indefinitely.

In addition, in their study Aging in Place in America, Clarity and The EAR Foundation found that seniors fear moving into a nursing home and losing their independence more than they fear death: Eighty-nine percent want to age in place but are concerned about their ability to do so.

Aging in place difficulties
Unfortunately, aging in place isn’t always an easy prospect. Many older adults face several issues – such as physical limitations or changing social and emotional needs – that can make staying in one place difficult without the appropriate accommodations.

The key is to start planning as early as possible – in fact, some individuals start making modifications as early as their mid-40s!

While it can be difficult to plan that far in advance (because you never know how your needs might change) there are many adjustments that can be made which are useful in almost all situations.

Here are some changes you can make now to help your loved one remain comfortably in their home well into the future:

Physical modifications
Most older adults will experience some sort of physical limitation eventually: From poorer eyesight to decreased muscle strength, the elderly can face diminished capacities in a number of different ways.

How can we help make their homes safe despite any potential health or safety concerns? There are several modifications which are almost universally useful:

  • Ramps: a ramp at the entrance to the house can help older loved ones avoid trips and falls trying to navigate the steps
  • Grab bars: grab bars are useful in the tub or shower, where slippery floors can become an issue, but they can be installed anywhere there is a change in elevation (like a step down from the house to the garage)
  • Multi-level lighting: as they age, seniors’ eyes don’t adjust to changes in light as quickly and they have a more difficult time seeing low-light environments. Multi-level lighting can help alleviate many of those issues.
  • Toilets: adding “comfort height” toilets can make it easier for elderly adults to use the facilities without having to bend too much
  • Non-skid floors: Non-carpeted floors, such as those in a kitchen or bathroom, can be slippery and slick. Adding non-skid mats can help dangerous slips and falls.

Invest in technology
New technologies come out every day that make aging in place much more feasible. Some of the best innovations include:

  • Sensors: Activity-based sensors around the home can sense a loved one’s movements and let you know what they’re up to (many people also use these to monitor children or pets left home alone). Sensors can be placed around the house in strategic locations and will let you know if a loved one is doing (or not doing) something that they should. For instance, if sensors haven’t detected movement for more than three hours in the middle of the day, a designated caregiver can be alerted, and someone can go to check on your older adult.
  • Fall detection: We all remember the “Help, I’ve fallen and I can’t get up!” commercial from the 90s. Well, emergency pendants have come a long way since then! Today, with just the click of a button, emergency responders can be alerted that a fall has occurred. Many pendants offer two-way communication or even come with “fall detection” technology, so caregivers can be notified even if the senior isn’t able to press a button.
  • Medication reminders: Many solutions exist today to help seniors remember if and when they last took their medication. In addition to reminders, many products also dispense the necessary dose. This can eliminate many dangerous problems such as forgetting to take a medication or, potentially worse, taking it twice.

Set up a support network
Staying in place is always easier when your loved one (and you!) has a support network lined up far in advance. These days, you can get almost any type of help you can think of in your home, from on-call doctors to mobile nail salons. Some of the most common types of help are:

  • Meals: Friends and loved ones, community organizations, church groups, and non-profits like Meals on Wheels can all be called on to deliver hot meals to homebound adults. If your loved one still enjoys cooking, but simply can’t drive to the store, a grocery delivery service might help.
  • Household chores: Many older adults have issues with common household chores such as dusting high shelves and taking the trash to the curb. Get help lined up now in the form of friends and loved ones or a paid house cleaning service (at least for the more strenuous chores).
  • Money Management: Many older adults no longer understand where their money comes from or where it goes and need a trusted advisor to help them make sound financial decisions. In addition, elder financial abuse is a growing problem in the United States and with the prevalence of online banking, it’s only going to get worse.
  • Home health aides: Sometimes, despite the best laid plans, the elderly just can’t be alone all the time. A home health aide can help with everyday tasks and chores that have become too difficult for your loved one, as well as providing some much-needed company.

Final thoughts
With some careful planning (and a great support network!), there is a good chance that your older loved one will be able to age in one place. For more information on what you can do (and how you can do it), see the National Institute on Aging.

Posted in: Aging, Home Care

Leave a Comment (0) →
How Dementia Affects the Ability to Complete Simple Everyday Activities

Monday , February 11 , 2019

How Dementia Affects the Ability to Complete Simple Everyday Activities

I felt a cleaving in my mind
As if my brain had split;
I tried to match it seam by seam,
But could not make it fit.

The thought behind I strove to join
Unto the thought before
But sequence ravelled out of reach
Like balls upon a floor.

I’ve always loved this marvelously precise description by Emily Dickinson of the experience of losing your train of thought. It’s an experience I think we can all immediately relate to, and one that reminds us that our brain is a tremendously complicated machine that sometimes misfires.

Most of the time, of course, the sequence of our daily activities is something we don’t have to give any conscious thought. The socks must go on before the shoes. We have to put water in the kettle before turning on the stove and wait for it to boil before pouring it in the cup.

But for people with dementia, planning out activities that must be done in sequence becomes overwhelming.

Dementia’s impact on executive function

According to the National Institutes of Health, Executive functions (EFs) make it possible to

  • Mentally play with ideas
  • Take the time to think before acting
  • Meet novel, unanticipated challenges
  • Resist temptation
  • And stay focused

In those with dementia, executive capacity is affected at a very early stage. These impairments make it difficult to think out, plan and execute an action, often causing complications with activities of daily living. Sometimes, these problems will show up even before memory difficulties.

It should be noted that since dementia is typically a progressive condition, difficulties with executive function usually worsen over time.

Examples of executive function in dementia

Activities that require several different steps, no matter how routine, can become difficult for those living with dementia. Your loved one may become confused while trying to complete a previously-familiar task, lose track of where they were in the process, or just lose interest altogether and walk away.

Here are some signs of impaired executive function that you should be aware of:

  • The person has trouble preparing meals (even those they used to make on a routine basis)
  • He or she often stops in the middle of projects, failing to complete them
  • The individual is less engaged in a hobby that once absorbed them (gardening, scrapbooking, crosswords)
  • They have lost interest in a talent that they were once proud of (music, painting, quilting)

How to handle impaired executive capacity

With the support of those around them, individuals with dementia can still manage a wide range of activities despite their difficulties. Keep calm, remain patient, and remember the following tips:

  • Even though your loved one may have difficulties with simple tasks, they likely don’t want you to take over, just help
  • Allow as much independence as possible
  • Never scold or make comments about mistakes
  • Give verbal directions one step at a time. For example, “get dressed” may be too vague and overwhelming, while “put on your undershirt” may be just right.
  • Even better? Lead by demonstrating. Try laying out your elderly loved one’s clothes in order (with underpants on top) or show them how you put on your own sock and shoes.
  • Practice the activity using the same exact routine every day
  • Allow extra time to decrease stress
  • Use humor appropriately

Bottom line? It’s ok for your loved on to take a break and try again later if they need to. It’s even ok to completely give up and allow someone else to help! The key is to be supportive and kind, don’t push them into anything they don’t want to (or really can’t) do, and allow mistakes to happen.

Posted in: Aging, Dementia

Leave a Comment (0) →
Page 1 of 2 12