Dr. Mauk’s Boomer Blog

/Dr. Mauk's Boomer Blog

Each week, Dr. Mauk shares thoughts relevant to Baby Boomers that are aimed to educate and amuse.

Aging in Place: Home Preparations and Modifications for Alzheimer’s Patients

 

According to the Alzheimer’s Association, the disease affects five million Americans. However, this number doesn’t reflect the many more Americans that are affected by Alzheimer’s indirectly. This includes family and friends that take on the great responsibility of caring for a loved one with the disease. Many of these caregivers have numerous considerations to keep in mind, and one of these is altering and modifying the home to provide better comfort and safety.

Let’s look at some home preparations and modifications you can make if you need to accommodate a loved one with Alzheimer’s.

 

Safety and Comfort.

The first consideration should be thinking about is how you can reduce the risk of your loved one tripping, falling, or becoming confused or disoriented.

● Remove objects that can be obstructive in high-traffic areas. Avoid having stuff on the floor or low tables and furniture that can be easy to miss.
● Lock cabinets that might contain hazardous chemicals and materials.
● Keep dark corners of the house well-lit and illuminated. This includes stairwells and basements.
● Check your smoke alarms and carbon monoxide detectors.
● Ensure your loved ones don’t have easy exits where they can wander out.

Functionality and Design

Making your house function better for Alzheimer’s patients means helping them avoid unnecessary disorientation, fear, or depression. The following are some tips:

● Remove clutter or scattered objects that might overstimulate. For example, instead of having five pairs of shoes for your loved one to choose from, leave only one pair. This might eliminate an unnecessary episode of confusion when getting dressed.
● Rearrange furniture in a simple and straightforward way. The way the furniture is arranged can dictate the atmosphere of the room. For example, if the only chair is facing the television, you might have them constantly sitting in front of the TV.
● The Huffington Post suggests that creating a personalized space with familiar objects and smells can be a great way to keep an Alzheimer’s patient comfortable. At the same time, you should avoid having busy patterns on furniture or curtains, confusing colors, or rugs that can cause tripping.

Stimulation and Socialization

It’s important for your loved one to get plenty of socialization and interaction with others. In a typical household, people are working or living their own lives as they juggle the responsibility of caregiving. Living at home without much visitation can often lead to patients becoming isolated and withdrawn. Try to arrange frequent visits by friends and family members. Consider taking loved ones with you if you have to run errands, going for short walks, or involving them in everyday activities.

How to Modify or Renovate Your Home

In order to maintain safety or functionality, it’s often important to do modifications to your home. One of the most common home alterations is improving or renovating bathrooms and kitchens. This is because these are two areas of the house that can be most hazardous and require a little more navigation.

For Bathrooms

Renovations for bathrooms cost an average of about $8,820 depending on the work to be done. Some common and important improvements for Alzheimer’s-friendly bathrooms include installing grab bars and handrails, swapping out a bathtub for a shower, and adding lighting and non-slip flooring.

For Kitchens

You might consider a kitchen modification as well. It will vary in complexity depending on your current setup. When restructuring your kitchen for a loved one with Alzheimer’s, consider faucets, accessibility of appliances, kitchen counter height, mobility, and difficulty of navigation.

Caring for loved ones with Alzheimer’s is a great responsibility. Ensuring their safety and comfort at home will not only make their lives better, but it will make yours easier and remove unnecessary hazards and stress. Having confidence that your loved one is comfortable and at ease will take a big weight off your shoulders. Your loved one will be happy to be living at home. The Boston Globe reported that Alzheimer’s patients that remain at home live longer and better lives.

Photo Credit: Pixabay

By |2019-08-29T14:37:51-05:00September 19th, 2019|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Aging in Place: Home Preparations and Modifications for Alzheimer’s Patients

Guest Blog: Bringing the family support together – Crucial steps in elder care planning


As a devoted caregiver for an aging parent, you have to be ready to face a wealth of new responsibilities. Some of them will be intimidating, whereas others will be unfamiliar and unforeseen. Every now and then, you may feel alone and overwhelmed. However, in spite of all these challenges, caring for an aging parent comes with plenty of rewards too. There are many guidelines you should consider to make the process run smoother. Here are some steps to consider.

Bring the whole family together decide on a caregiving plan 

Before making any decisions, you should set up a family meeting and decide with your siblings what’s best for your parent. Should you hire a home care assistant for your parent, or would it be better to put them in respite care home? If your parents are mentally stable but are having difficulties remembering things, or heading out to shop for groceries, you and your siblings may be able to be their caregivers. Split tasks equally by making a weekly plan. This way, your parents get the chance to see their kids, and you won’t have to get angry that nobody else but you in the family is looking after the parents.

Split responsibilities equally

Proper elder care takes a lot of time and effort. Careful planning is fundamental for your parents to live happy and not feel like a burden. Always remember that providing care for a loved one is an act of love, loyalty, and kindness. Thanks to advanced technology, it is now easier than ever to keep in touch with aging parents. Medical treatments are improving, life expectancy’s are increasing, and seniors are living well into their 70s. If you know little about caregiving, follow the tips below to provide the best care for your elder parent:

  • Learn everything there is to know about their disability or illness. This will help you be prepared in case something unexpectedly happens.
  • Look for professional help from certified caregivers.
  • Go with your gut, and listen carefully to a doctor’s advice. If they tell you that an assisted living facility is better for your loved one, then they’re probably right.

Elder parents will do anything to preserve their independence, even if it means living on their own with a chronic illness or disability. Don’t allow them to struggle and try to make their lives more comfortable by caring for their well being.

 

 

By |2019-08-29T14:37:34-05:00September 18th, 2019|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: Bringing the family support together – Crucial steps in elder care planning

The Role of the Rehabilitation Nurse

kris2
 

You may have heard of rehabilitation nursing, but are you familiar with what rehabilitation nurses do and their essential role in health care? According to the Association of Rehabilitation Nurses (ARN), there are four major domains within the new competency model for professional rehabilitation nursing (ARN, 2016) that can help us understand what rehabilitation nurses do.  In this blog, we will look at the ARN model from a layperson’s viewpoint to help explain the role of the rehabilitation nurse. Rehabilitation nurses:

Promote successful living

Rehabilitation nurses do not only care for people, but they promote health and prevent disability. This means that rehab nurses engage in activities that help patients, families and communities stay healthy. Proactively, you might see rehab nurses helping with bike safety (such as promoting the wearing of helmets), car seat fairs (to keep children safe from injury), or stroke prevention through community screenings and teaching about managing risk factors. As rehab nurses, we also help patients towards self-management of existing chronic illness or disability, teaching them how to be co-managers with their health providers so they can maintain independence and have a good quality of life. Another key activity is facilitating safe care transitions. This means that rehabilitation nurses have a special skill set to know which setting of care is best for the patient to move to next and how to make this happen smoothly. For example, if Mrs. Smith has had a stroke and finished her time in acute rehabilitation in the hospital, but she lives alone and is not quite ready to go home, what is the best care setting or services for her to receive the help she needs?  Many errors, such as those with medications, happen when patients go from one place to another in the health system. Rehabilitation nurses can help persons successfully navigate these complexities and be sure that clients get the continuity of care they need and deserve.

Give quality care

The interventions or care that rehabilitation nurses provide to patients and families is based on the best scientific evidence available. Part of being a rehab nurse is staying current on the latest technology, strategies for care, and best practices. This is to ensure that all patients receive the highest standard of care possible. We stay current in many ways, including reading journal articles, attending conferences, obtaining continuing education, and maintaining certification in rehabilitation. Research shows that having more certified rehabilitation nurses on a unit decreases length of stay in the hospital. In addition, all of rehab care focuses on the patient and family as the center of the interdisciplinary team. To this end, rehabilitation nurses teach patients and families about their chronic illness or disability across many different areas including: how to take medications; managing bowel and bladder issues; preventing skin breakdown; dealing with behavioral issues that might be present with problems such as brain injury or dementia; coping with changes from a disabling condition; sexuality; working with equipment at home; and ways to manage pain.

Collaborate with a team of experts

Rehabilitation nurses are part of an interprofessional team of physicians, therapists, psychologists, nutritionists, and many others who work together for the best patient outcomes. For persons who have experienced a catastrophic injury or illness, the work of this team of experts sharing common goals will provide the best care, and rehab nurses are the ones who are with the patient 24/7 to coordinate this process. Through effective collaboration, excellent assessment skills, and communication with the rest of the team members, rehab nurses ensure that patient and families are getting well-coordinated care throughout the rehabilitation process. Remember that rehabilitation takes place in many settings, whether on the acute rehab unit, in skilled care, long-term care, or the home. The nurse’s role is to be sure that the holistic plan of care is followed by all staff and that the physicians overseeing medical care are continually informed of patient progress for the best decision-making possible.

Act as leaders in rehabilitation

 Not only do rehabilitation nurses provide direct patient care, they are also leaders in the rehabilitation arena. You might be surprised to learn that rehabilitation nurses advocate at the highest level for legislation surrounding funding and policy for those with disabilities and chronic illness, talking with Senators and Congressmen about key issues. ARN has professional lobbyists that continually watch health policy movement in Washington and keep rehab nurses informed. Rehab nurses help patients to advocate for themselves in holding government and communities accountable for needed care services. Lastly, rehab nurses share their knowledge with others. This is done in a variety of ways through conducting and publishing research, presenting at conferences, serving on local and national committees, and serving in public office. All of the leadership activities done by nurses in rehabilitation are to promote the best quality of care for patients with chronic illness and disability.

 

 

 

 

 

 

 

 

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By |2019-08-29T14:36:23-05:00September 14th, 2019|Dr. Mauk's Boomer Blog, News Posts|Comments Off on The Role of the Rehabilitation Nurse

Guest Blog: The 5 Most Important Vitamins for Seniors

No matter what your age may be, you’ll need to stay healthy by eating right and staying fit. However, as your body gets older, it’s more challenging to hit your target quotas for certain vitamins and minerals because of hormonal changes. Check out the 5 most important vitamins for seniors:

1. Vitamin A

While you may be familiar with vitamin A’s importance for your vision, reproduction, and immune system, you’re probably not aware that it also helps many of your organs to function properly. You can get preformed vitamin A from meat and poultry including salmon and dairy products. On the other hand, you can get provitamin A (such as beta-carotene) from fruits that include apricots, cantaloupe, mangoes, green leafy vegetables, broccoli, squash, and carrots. You can also find vitamin A in your fortified breakfast cereals.

It’s important to note that Vitamin A supplements may interact with Orlistat, which is a weight-loss drug. Also, you shouldn’t take supplements at the time you’re taking prescription medicines that use synthetic forms of vitamin A in them.

2. Vitamin B-12

Vitamin B-12 will further enhance your metabolism, brain processes, and your body’s creation of new red blood cells. Furthermore, it’s also important for repairing genetic material. The best sources for vitamin B-12 are fish, meat, eggs, and dairy products.

However, as your body ages, your stomach doesn’t make as much hydrochloric acid that helps break away this vitamin from animal foods. Without this stomach acid, unabsorbed vitamin B-12 just passes through your digestive tract. Therefore, seniors are advised to get vitamin B-12 from supplements rather than whole food sources.

3. Vitamin D

Although bone loss can’t be prevented as you get older, you can slow it down by taking more vitamin D. With regular intake of a vitamin D supplement, your body’s absorption of calcium will significantly improve. The result would be stronger bones with fewer chances of getting fractures. Good sources of vitamin D include whole eggs, cod liver oil, salmon, and fortified dairy foods, fortified orange juice, and fortified breakfast cereals.

When you were younger, some vitamin D was made as you exposed yourself in direct sunlight. However, this process isn’t as efficient as it used to be when you’re in your senior years. In fact, by the time you turn 50, your body will require 600 international units of vitamin D every day. This increases to 800 IUs per day when you hit 70.

4. Vitamin K

You’ll need vitamin K to make your blood clot. When you injure yourself or fall, this vitamin helps promote proper wound healing. Furthermore, it also prevents bone loss to seniors who suffer osteoporosis. Aside from your daily multivitamin with a huge portion of your vitamin K requirement, you’ll need to ear more spinach, broccoli, Brussels sprouts, cauliflower, cabbage, kale, and Swiss chard, liver, fish, meat, eggs, and cereals. if you want to your vitamin K levels to be elevated even more.

5. Vitamin C

Vitamin C is an antioxidant that wards of the free radicals that destroy your body’s healthy cells. Aside from this, it also protects your eyes, reduces your chances of developing heart disease, and boosts your immune system. You can get your supply of vitamin C from fruits and vegetables such as strawberries, oranges, broccoli, and red peppers. However, it’s best to take vitamin C supplements to meet your daily requirement of 90 milligrams (for women) and 75 milligrams (for men).

Stay on Top of Your Game

It would’ve been ideal if you could get all of the nutrients you need from fruits, vegetables, and other unprocessed whole foods. Unfortunately, science can’t perfectly recreate all that nature has to offer into whole foods. This means that if you want to stay on top of your game, you’ll need to supplement your diet with these 5 most important vitamins for seniors.

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By |2019-09-13T08:49:22-05:00September 13th, 2019|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: The 5 Most Important Vitamins for Seniors

Alzheimer’s Disease

Elderly woman with medications

Alzheimer’s disease (AD) is the most common type of dementia seen in older adults. An estimated 5.4 million Americans of all ages had Alzheimer’s disease in 2012. Nearly half (45%) of people over the age of 85 have AD. By 2050, the number of individuals age 65 and over with Alzheimer’s could range from 11 million to 16 million unless science finds a way to prevent or effectively treat the disease. One in eight older adults has AD, and it is the sixth leading cause of death in the United States (Alzheimer’s Association, 2012). Those affected with AD may live from 3–20 years or more after diagnosis, making the life span with this disease highly variable.

Risk factors

Advanced age is the single most significant risk factor for AD (Alzheimer’s Association, 2012). More women than men have AD, but this is because women live longer than men, not because gender is a risk factor. Family history and heredity are also identified risk factors for AD, as are head trauma and poor cardiac health.

Warning Signs

Alzheimer’s disease is characterized by progressive memory loss. The person affected by AD is gradually less able to remember new information and memory lapses begin to affect daily function. It is a terminal disease that over its course will eventually leave a person completely dependent upon others for care.

Diagnosis

Initially, the clinical progression of the disease is slow with mild decline; however, deterioration increases the longer the person lives, with an average life span of 8 years after diagnosis (Cotter, 2002; Fletcher, Rapp, & Reichman, 2007). The underlying pathology is not clear, but a growth of plaques and fibrillary tangles, loss of synapses, and neuronal cell loss are key hallmarks of AD that interfere with normal cell growth and the ability of the brain to function. Absolutely definitive diagnosis is still through autopsy, although clinical guidelines make diagnosis easier than decades ago when less was known about the disease. Primary care physicians generally make the diagnosis through a thorough history, physical exam, cognitive testing, and labs. New criteria for diagnosis include staging the disorder and biomarkers (beta amyloid and tau in the cerebrospinal fluid and blood) (Alzheimer’s Association, 2012b). An MRI of the brain may be ordered to rule out other causes of symptoms.

The clinical course of AD is divided into several stages, depending on the source consulted. In the early course of AD, the person may demonstrate a loss of short-term memory. This involves more than common memory loss, such as where the keys were put, and may involve safety concerns such as forgetting where one is going while driving. The inability to perform math calculations and to think abstractly may also be evident. In the middle or moderate phase, many bodily systems begin to decline. The person may become confused as to date, time, and place. Communication skills become impaired and personality changes may occur. As cognitive decline worsens, the person may forget the names of loved ones, even their spouse. Wandering behavior as well as emotional changes, screaming, delusions, hallucinations, suspiciousness, and depression are common. The person with AD is less able to care for her- or himself and personal hygiene suffers. In the most severe and final phase, the person becomes completely dependent upon others, experiences a severe decline in physical and functional health, loses communication skills, and is unable to control voluntary functions. Death eventually results from body systems shutting down and may be accompanied by an infectious process. Although there is no single test, and the diagnosis may be one of exclusion, early diagnosis is important to maximize function and quality of life for as long as possible. Persons experiencing recurring and progressing memory problems or difficulties with daily activities should seek professional assistance from their physician.

Treatment

Treatment for AD is difficult. There are several medications (such as Aricept, Namenda, Razadyne, and Exelon) that may help symptoms (such as memory), but they do not slow the course of the disease. There is currently no cure; however, research continues to occur in pharmacology, nonpharmacology, and the use of stem cells to manage symptoms and perhaps one day eradicate the disease.

Treatment will focus on symptom management, particularly in the areas of behavior, safety, nutrition, and hygiene. Behavioral issues such as wandering and outbursts pose a constant challenge. Many long-term care facilities have special “memory care” units to care for Alzheimer’s patients from the early to late stages of the disease. These units provide great benefits such as consistent and educated caregivers with whom the patient or resident will be familiar, a safe and controlled environment, modified surroundings to accommodate wandering behaviors, and nursing care 24 hours a day. Additionally, nurses are present to manage medications and document outcomes of therapies. However, many family members wish to care for their loved ones at home for as long as possible.

Thus, another important aspect of care in AD is care for the caregivers. Howcroft (2004) suggested that “support from carers is a key factor in the community care of people with dementia, but the role of the caregiver can be detrimental to the physical, mental, and financial health of a carer” (p. 31). She goes on to say that the caregivers of persons with AD would benefit from training in how to cope with behaviors that arise in these patients and how to cope with practical and legal issues that may occur.

Research has shown that ongoing skills are needed by family caregivers to deal with the progressive decline caused by AD. In fact, “a 63% greater risk of mortality was found among unpaid caregivers who characterized themselves as being emotionally or mentally strained by their role versus noncaregivers” (National Conference of Gerontological Nursing Practitioners & National Gerontological Nursing Association, 2008b, p. 4). Adapting to stress, working on time management, maximizing resources, and managing changing behavior were all skills caregivers needed to develop in order to successfully manage home care of their loved ones. When interventions and resources were not used by caregivers in the early stages of the care recipient’s AD, the risk of a healthy patient being institutionalized due to caregiver burden was higher (Miller, Rosenheck & Schneider, 2012). Caregivers needed not only to acquire knowledge and skills, but also to make emotional adjustments themselves to the ever-changing situation.

Such findings suggest that nurses should focus a good deal of time on educating caregivers of persons with AD to cope with, as Nancy Reagan put it, “the long good-bye.” Scientists continue to explore the causes of AD and hope in the near future to be able to isolate the gene that causes it. In the meantime, results from a fascinating longitudinal study (called the Nun study) on aging and AD, which used a group of nuns who donated their brains to be examined and autopsied after death, has suggested that there is a connection between early “idea density” and the emergence of AD in later life. That is, essays the nuns wrote upon entry to the convent were analyzed and correlated with those who developed AD. It was found that those with lower idea density (verbal and linguistic skills) in early life had a significantly greater chance of developing AD (Grossi, Buscema, Snowdon, & Antuono, 2007; Snowdon, 2004). The nun study has allowed researchers to examine hundreds of brains so far in nuns who died between 75 and 107 years of age and discover other important facts such as a relationship between stroke and the development of AD in certain individuals, and the role of folic acid in protecting against development of AD (Snowdon, 2004). Scientists from a number of fields continue to research the causes and possible treatments for AD and the Nun study project is continuing at the University of Minnesota. Snowdon’s research suggests that early education, particularly in verbal and cognitive skills, may protect persons from AD in later life.

For more information on Alzheimer’s disease, visit the Alzheimer’s Association website at: http://www.alz.org/

 

Adapted from Mauk, K. L., Hanson, P., & Hain, D. (2014). Review of the management of common illnesses, diseases, or health conditions. In K. L.
Mauk’s (Ed.) Gerontological Nursing: Competencies for Care. Sudbury, MA: Jones and Bartlett Publishers. Used with permission.

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By |2019-08-29T14:36:06-05:00September 13th, 2019|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Alzheimer’s Disease