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The 6-Step Process of Stroke Recovery

Caring For Husband

 

According to the CDC, nearly 800,000 persons in the United States have a stroke each year. This is about one every 4 minutes, resulting in over 130,000 deaths annually. Stroke is simply defined as an interruption to the blood supply to the brain and is caused by a clot or hemorrhage. It can be a devastating problem for survivors, resulting in changes in mobility, cognition, speech, swallowing, bowel and bladder, self-care, and general functioning to varying degrees.  Some people recover completely after a stroke, but others experience lifelong challenges.

The good news is that there is hope and quality of life after stroke. In my research with stroke survivors, I discovered 6 phases that survivors reported as they made the journey through rehabilitation towards recovery. These steps can be used to see where a person is in the recovery process, help us understand how they may be feeling, and help guide the way we interact with them.

Agonizing:  In this first phase of the process, stroke survivors are in shock over what has happened to them. They can’t believe it, and may even deny the warning signs of stroke. The important task during this time is survival from the stroke itself.  Call 911 if you see the warning signs of facial droop, arm weakness, or speech difficulties.

Fantasizing:  In the second phase of the stroke process, the survivor may believe that the symptoms will all go away. Life will return to normal, and there is a sense of the problem being unreal. Time takes on a different meaning. The way to help is to gently help them recognize reality, and without taking away hope for recovery.

Realizing: This is the most important phase that signals a turn in the recovery process. This is when the survivor realizes that he/she may not fully recover from the effects of the stroke and that there is work to be done to rehabilitate and reclaim life. Common feelings during this phase of realizing are anger and depression. The way to help is to encourage the person to actively engage in rehabilitation. The real work of recovery is just beginning.

Blending: These last 3 phases in the process of stroke recovery may be occurring at much the same time. This is where the real work of adaptation to life after stroke begins. The survivor begins to blend his “old life” before stroke with his new life as a stroke survivor. He/she may start to engage in former activities even if it requires adaptations to be made. He/she will be actively engaged in therapy and finding new ways to do things. The way to help is to promote education. This is a time when survivors are most ready to learn how to adjust to life after stroke. Listen to your rehab nurses, therapists, and physician. Be active in the recovery process.

Framing: During this phase, the individual wants to know what caused the stroke. Whereas in the Agonizing phase they were asking “why me?”, now they need to the answer to “what was the cause?”  Stroke can be a recurring disorder, so to stop a subsequent stroke, it is important to know the cause. Interestingly, if the physician has not given the survivor a cause for the first stroke, patients often make up a cause that may not be accurate. Help the survivor to learn from the health care provider what the cause of his/her own stroke was. Then steps can be taken to control those risk factors.

Owning:  In this final phase of stroke recovery, the survivor has achieved positive adaptation to the stroke event and aftermath. The survivor has accomplished the needed grief work over the losses resulting from the stroke. He/she has realized that the effects may not go away and has made positive adjustments to his/her life in order to go on. Survivors in this phase have blended their old life with the new life after stroke and feel better about their quality of life. While they still may revisit the emotions of the prior phases at times, they have accepted life as a survivor of stroke and made good adjustments to any changes that resulted. They feel that they have a more positive outlook on life. At this point, survivors can use their experience to help others cope with life after stroke.

For more information about stroke recovery, visit www.seniorcarecentral.net and view Dr. Mauk’s model for stroke recovery.

By | 2017-06-28T09:42:09+00:00 June 28th, 2017|Dr. Mauk's Boomer Blog, News Posts|Comments Off on The 6-Step Process of Stroke Recovery

Seniors and Pet Ownership: Tips in Caring for Our Four-Legged Companions

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Whether you enjoy the company of dogs, cats, or even iguanas, pets have been proven to benefit seniors in plenty of ways. For many, they have become an integral part of the family. In fact, assisted-living facilities have adopted a few animals from shelters to keep residents company and uplift their spirits. Pet ownership has helped so many seniors by keeping them physically active, providing emotional support, and even improving cardiovascular health.

 

However, keeping up with your pet’s needs may not be as easy as it was when you were younger. Elderly individuals may be at a disadvantage when matched with highly-energetic pets. The costs of pet care are also a big consideration in this situation, especially when you have your own care costs to contend with.

To keep all the hassles and stresses at bay, we have listed a few tips in living a happy life with your beloved pets.

  1. Care providers who include pets

Many care providers include pet care in their list of services. This may consist of dog walking, pet sitting, boarding, grooming, and even training. So check with your care providers if they can also accommodate your pets.

  1. Maintain a regular schedule for feeding and walking

Schedules and routines do not just benefit the animals; these also can help you maintain a good quality of life. Create a schedule for you and your pets to eliminate surprises and memory lapses that could possibly come with old age.

  1. Set a spending limit and sticking to it

Though pets undeniably cost money, these expenses can be cut down to affordable amounts. Many veterinarians offer senior discounts, so check if yours provides any for special rates.

There are also various pet-care support programs, like selected Meals on Wheels, which help seniors in providing food for their pets. Low-cost clinics are also a great option for individuals on a budget.

  1. Create an emergency plan

Individuals get affected by emergencies, which is why they plan and prepare for it. This is also true for our pets. As their caretakers, it is your duty to ensure their safety before, during, and after an unforeseen incident.

Using Ready.gov’s list of steps to take, you will be able to safeguard and care for your pets through pet and animal emergency planning. Through this, you get to rest soundly knowing that they are protected even when you are not present.

ALTCP.org provides free long term care information, resources, long term care insurance quotes and expert planning advice for seniors and adults. Our mission is to raise awareness and promote self-education on the need to plan for long term care and buy long term care insurance.

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By | 2017-06-25T18:04:33+00:00 June 26th, 2017|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Seniors and Pet Ownership: Tips in Caring for Our Four-Legged Companions

Bladder Cancer Risk Factors and Treatment

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Background

This type of cancer occurs mainly in older adults, with an average age at diagnosis of 73 years, with 9 out of 10 cases of bladder cancer diagnosed in persons over age 55. The American Cancer Society (ACS)(2012) reported that over 73,000 cases were diagnosed in 2012 and that this diagnosis rate has been relatively stable over the last 20 years. Men are three times as likely to get cancer of the bladder as women (American Foundation for Urologic Disease, 2008) and the incidence increases with age.

Risk Factors

Risk factors include chronic bladder irritation and cigarette smoking, the latter contributing to over half of cases. Male gender and age are also risk factors.

Warning signs

The classic symptom of bladder cancer is painless hematuria (blood in the urine). Older adults may attribute the bleeding to hemorrhoids or other causes and feel that because there is no pain, it must not be serious.

Diagnosis

Assessment begins with a thorough history and physical. Diagnosis may involve several tests including an intravenous pyelogram (IVP), urinalysis, and cystoscopy (in which the physician visualizes the bladder structures through a flexible fiber-optic scope). This is a highly treatable type of cancer when caught early. In fact, the ACS (2012a ) estimates that there were more than 500,000 survivors of this cancer in 2012.

Treatment

Once diagnosed, treatment depends on the invasiveness of the cancer. Treatments for bladder cancer include surgery, radiation therapy, immunotherapy, and chemotherapy (ACS, 2012). Specifically, a transurethral resection (TUR) may involve burning superficial lesions through a scope. Bladder cancer may be slow to spread, and less invasive treatments may continue for years before the cancer becomes invasive or metastatic, if ever. Certainly chemotherapy, radiation, and immune (biological) therapy are other treatment options, depending on the extent of the cancer.

Immune/biological therapy includes Bacillus Calmette-Guérin (BCG) wash, an immune stimulant that triggers the body to inhibit tumor growth. BCG treatment can also be done after TUR to inhibit cancer cells from re-growing. Treatments are administered by a physician directly into the bladder through a catheter for 2 hours once per week for 6 or more weeks (Mayo Clinic, 2012a). The patient may be asked to lay on his/her stomach, back, and or sides throughout the procedure. The patient should drink plenty of fluids after the procedure and be sure to empty the bladder frequently. In addition, because the BCG contains live bacteria, the patient should be taught that any urine passed in the first six 6 hours after treatment needs to be treated with bleach: One cup of undiluted bleach should be placed into the toilet with the urine and allowed to sit for 15 minutes before flushing (Mayo Clinic, 2012a).

If the cancer begins to invade the bladder muscle, then removal of the bladder (cystectomy) is indicated to prevent the cancer from spreading. Additional diagnostic tests will be performed if this is suspected, including CT scan or MRI. Chemotherapy and/or radiation may be used in combination with surgery. When the cancerous bladder is removed, the person will have a urostomy, a stoma from which urine drains into a collection bag on the outside of the body, much like a colostomy does. Bleeding and infection are two major complications after surgery, regardless of type, whether a TUR or cystectomy is performed. Significant education of the patient related to intake/output, ostomy care, appliances, and the like is also indicated.

For more information on Bladder Cancer, visit National Cancer Institute at:
http://www.cancer.gov/cancertopics/wyntk/bladder/

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 | 2017-06-22T09:10:02+00:00 June 22nd, 2017|News Posts|Comments Off on Bladder Cancer Risk Factors and Treatment
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