Kristen Mauk

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President/CEO - Senior Care Central, LLC

Five tips for Grandparents to stay connected with family

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With the birth of my daughter’s second child, I began to reflect on the important role that grandparents can play in the lives of their grandchildren. Here are five essential tips for older adults who want to have a lasting influence in the lives of their children and grandchildren.

Visit often. For those of us fortunate enough to live near our children and grandchildren, it is easy to see them often. Grandparents may even be the caregivers while parents are working. Visits don’t always have to be planned. Sometimes the best family time is a spontaneous invitation to dinner and a movie. However, sometimes distance can prevent regular visits. Some grandparents make it a goal to see their distant grandchildren once every 6 weeks or every few months. Be sure to take advantage of technology for your time together. Set a regular time to Skype or do Face-time. Don’t miss out on the subtle changes in those early years while babies are growing. Exchanging pictures may help, but they don’t replace the in-person experience. You may even think of relocating to be closer to family. For older grandchildren, be sure to have their cellphone number. Text them often and exchange pictures to stay involved in their lives and let them know you are available to them. Even small connections throughout the week (but without being annoying to teenagers of course) can make a difference in your relationship with your grandchildren.

Offer to help in practical ways. Working parents with young children will need a break at times. Ask how you can best help. Offer to keep the children for an overnight while mom and dad have a special dinner or weekend getaway. Many grandparents like to take their grandchildren on trips without the parents. Places like amusement parks, the zoo, or day trips to the water park or national forest all provide good diversion and quality time with Grandma and Grandpa while giving parents a rest. For even more quality time, take the older grandchildren on a cruise, camping in the mountains, or to a resort without their parents. For the mom with a newborn, take meals to the house (if you live close), do her grocery shopping or laundry, or send her a new bathrobe to show you are thinking of her. A favorite role model of mine sends the grandchildren a “baby shower in a box” with all sorts of goodies when she can’t be present due to distance or health concerns.

Plan special activities. Special activities need not be expensive. This could mean a trip to the park with Grandma or a special morning walk each week with Grandpa. My father used to take every grandson on a bow-hunting trip when they turned 12 years old. This was a rite of passage for every boy in the family. Grandpa would mount their first deer head for them and buy them a special hunting knife to commemorate the occasion. The girls in the family would take a trip to a Disney resort while the men were hunting. Grandchildren remember these events forever.

Attend special events. How fortunate are the kids whose grandparents are able to attend basketball and volleyball games, swimming tournaments, and Grandparent’s Day at school! Take advantage of being able to attend those dance recitals and school plays. If you live far, plan your visits to be able to attend some significant events like graduations, wedding showers, or school performances. This makes lasting memories with your family.

Be a constant in their lives. My parents divorced when I was 9 years old, and my paternal grandparents were the one constant in my life at that time. When a child’s world is jolted by change, grandparents can be that steadying influence that doesn’t change. They provide stability and security in an unsteady world for a child. The most important thing to remember is to be there. You don’t have to be the all-star parent or grandparent, but your children will remember that you were there for them when it counted the most.

By |2022-06-13T12:13:17-05:00June 26th, 2022|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Five tips for Grandparents to stay connected with family

Guest Blog: What is Psoriasis?

Guest Blog: Lindsay Munden, DNP, RN, FNP-BC

Psoriasis

Psoriasis is a lifelong disease that causes scaling and inflammation of the skin. The condition starts beneath the skin’s surface and is triggered by an overactive immune system, which causes skin cells to be over-produced and accumulate on the skin’s surface faster than normal. This process is called cell turnover, and in psoriasis may take a few days instead of weeks. This causes the formation of thick, red, itchy, flaky patches with silvery scales known as plaques. While any part of your body can be affected, psoriasis most often occurs on the elbows, knees, scalp, back, face, palms, and feet.

Risks

According to the American Academy of Dermatology (2015) about 7.5 million people in the United States have psoriasis. Anyone can get the disease, but it occurs more often in adults.

  • Age: Adult men and women are affected equally. The two peak ages at onset are during the late teens to early 20s and in the late 50s to early 60s.
  • Genetics: Psoriasis has a strong genetic influence, with one-third of patients with psoriasis reporting having a family member with the disease.
  • Environmental Factors: Trauma to normal skin, repeated friction, infections, stress, fatigue, warm humid climates, changes in weather that dry the skin, and certain medications may trigger psoriasis flare-ups.

Causes

The primary cause of psoriasis remains unknown. Research has indicated that psoriasis is caused by genetic influences and a dysfunction of the immune system. Although, psoriasis plaques may look contagious, you cannot get the condition from someone that has the disease.

Symptoms

Symptoms can range from mild to severe and are often recurring. Itchy, red, inflamed and dry scaly plaques distributed symmetrically over areas of bony prominences such as the elbows and knees are characteristic of the disease. The joints, nails and scalp may also be affected. As with other chronic conditions, symptoms may flare or worsen for a few months and then subside for a period of time.

Diagnosis

Psoriasis may be hard to diagnose because it can be confused with other skin diseases. Usually your healthcare provider will make a diagnosis based on a thorough skin examination. Biopsy is seldom necessary because the clinical features of psoriasis are so distinctive. Plaque psoriasis is the most common form, but patients typically have one or more types.

Treatment

The goal of therapy is to control the symptoms and clear the plaque lesions.

For mild to moderate psoriasis, topical medications (those applied directly to the skin) and phototherapy (light therapy) are the mainstays of treatment.  For severe psoriasis, systemic treatments are recommended. Sometimes, combining topical, light and systemic treatments leads to the best results.

Topical Medication Options:

  • Topical steroids are widely used because they help reduce inflammation. Generally, a very potent topical corticosteroid preparation is applied two to three times daily for 2 weeks and then decreased to a lesser potency for maintenance therapy long term.
  • Coal tar works by causing the skin to shed dead cells from its top layer and slow down the growth of new skin cells. This effect decreases scaling and dryness. Coal tar is applied once or twice daily and is not well favored due to the potential for staining of the clothes and skin.
  • Anthralin works by slowing down the production of skin cells. This type of medication is applied to the skin for a prescribed period of time and then rinsed away, with increased increments until the skin is healed which may take a couple of weeks.
  • Topical immunomodulators are medications which work by decreasing the body’s immune system to help slow down the growth of the psoriasis plaques.
  • Vitamin D3 derivatives regulate cell growth and decrease lymphocyte (cells which play a role in the regulation of the immune system) activity. The medicine comes in a form of an ointment which is typically applied twice daily.

Phototherapy:

Phototherapy with ultraviolet-B (UVB) light is effective in the treatment of psoriasis lesions. This type of treatment reduces DNA synthesis of skin cells. Phototherapy can produce symptom-free periods of up to 2-4 months. UVB therapy units are often available at dermatologist offices and the use of commercial tanning beds (with both UVA and UVB lights) is not recommended. Dermatologists may recommend consistent light therapy 3-5 days a week for 2 to 3 months.

Systemic Medications:

Systemic therapy is reserved for patients that have severe or incapacitating disease. These medications are prescribed by expert specialists such as dermatologists or rheumatologists because they have a risk for serious side effects.

More Information:

National Psoriasis Foundation   www.psoriasis.org

National Institute of Arthritis and Musculoskeletal and Skin Diseases www.niams.nih.gov

American Academy of Dermatology https://www.aad.org/

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By |2022-06-03T09:32:56-05:00June 9th, 2022|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: What is Psoriasis?

Hypothyroidism Warning Signs and Treatment

 

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Background

Hypothyroidism results from lack of sufficient thyroid hormone being produced by the thyroid gland. Older adults may have subclinical hypothyroidism, in which the TSH (thyroid-stimulating hormone) is elevated and the T4 (thyroxine or thyroid hormone) is normal; 4.3–9.5% of the general population has this problem (Woolever & Beutler, 2007). In this condition, the body is trying to stimulate production of more thyroid hormone. Some older adults with this condition will progress to have primary or overt hypothyroidism. This is when the TSH is elevated and T4 is decreased. Hashimoto’s disease is the most common cause and represents 90% of all patients with hypothyroidism (American Association of Clinical Endocrinologists [AACE], 2005; Woolever & Beutler, 2007), though certain pituitary disorders, medications, and other hormonal imbalances may be causal factors.

Warning Signs

Older adults may present an atypical picture, but the most common presenting complaints are fatigue and weakness.

Diagnosis

Diagnosis should include a thorough history and physical. Bradycardia and heart failure are often associated factors. Lab tests should include thyroid and thyroid antibody levels (common to Hashimoto’s), and lipids, because hyperlipidemia is also associated with this disorder.

Treatment

Treatment centers on returning the thyroid ¬hormone level to normal. This is done through oral thyroid replacement medication, usually L-thyroxine. In older adults with coexisting cardiovascular disease, starting with the usual doses may exacerbate angina and worsen the underlying heart disease, so it is important to start low and go slow. Titration should be done cautiously, with close monitoring of the older adult’s response to the medication. The does should be adjusted on 6- week intervals until normal levels of thyroid hormone are achieved. Once the TSH is within normal limits, then checking the TSH should be done every 6 to 12 months to monitor effectiveness and blood levels, because hyperthyroidism is a side effect of this therapy and can have serious implications on the older person’s health.

Patients need to learn the importance of taking thyroid medication at the same time each day without missing doses. Sometimes older adults have other problems associated with hypothyroidism, such as bowel dysfunction and depression. Any signs of complicating factors should be reported to the physician, and doctors’ appointments for monitoring should be religiously kept. Strategies for managing fatigue and weakness should also be addressed, because some lifestyle modifications may need to be made as treatment is initiated.

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.

For more information on Hypothyroidism, visit the NIH:
http://www.nlm.nih.gov/medlineplus/ency/article/000353.htm

 

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By |2022-06-03T09:32:22-05:00June 5th, 2022|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Hypothyroidism Warning Signs and Treatment

Grandparents Raising Grandchildren: A Growing Trend

A Profile of Older Americans (2012) revealed that over 480,000 grandparents had primary parenting responsibility for their grandchildren who lived with them.  AARP cited that over 2.5 million grandparents are helping with the responsibility of raising their grandchildren, and 7.8 million children live in homes owned by their grandparents. These statistics represent a growing trend in American culture.

I have several friends who have raised or are raising their grandchildren in their own home. Some have formally adopted their grandchildren. Others share parenting responsibilities with one or both parents. All of them share the common feeling that this is a blessing, not a burden, but that raising grandchildren in later life does have its challenges.

Whatever the circumstances that brought grandchildren into the home of their grandparents to be raised, it can come as a shock to the older adults who find themselves in this situation.

Here are some beginning considerations to raising your grandchildren in your own home.

Impact of aging

Older adults who are assuming primary responsibility for children should “cut themselves some slack”. Don’t feel that you have to do everything as if you were a first-time parent in your 20’s. Remember that you may be parenting, but your body knows that you are still a grandparent. You may have to limit the children’s activities because keeping up with the driving and multiple schedules is too difficult. The good news is that many grandparents in this situation are retired, so both Grandma and Grandpa can help with the kids. This teamwork might not have been possible with your own children because one or both of you were working, but now you can share the duties such as driving kids to school or sports practices, helping with homework, and taking them to doctor appointments. If the children are school age, allow yourself extra time to rest and relax during the day so that after school you have the energy required for these new-again activities with the grandkids. If needed, enlist the help of other family members or friends to help by giving you a break on occasion.  Keep in mind that maintaining your own health is especially important if you have young ones depending on you.

Expenses and Education

Many older adults are on a fixed income and may not have planned to care for grandchildren. Your financial plan for retirement might need an overhaul with additional family members in the household. Several organizations have worked cooperatively to compile resources for grandparents in this situation. National and state fact sheets have been developed to link grandparents with key resources in their area. You can find out about resources available to help you at http://www.aarp.org/relationships/friends-family/grandfacts-sheets/ .These helpful fact sheets list local programs, public benefits, key state laws, and contact information for national resources. There may be funding or tax breaks to help with living or educational expenses.

Records and immunizations

It’s important to keep important documents together in one safe place. This includes birth certificates, legal papers, report cards, baptismal papers etc… Keeping a log or journal of important events is also a good strategy, especially when caring for multiple children. There are a number of immunizations for children today that were not available or required when you parented your own children. Immunizations are often free at your county health department, but can be very expensive at the doctor’s office. The health department can tell you what your child needs and when, and will help you by providing an immunization record that will need to be kept up for school. The CDC has a helpful chart of recommended immunizations for birth to 6 years that can be found at http://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdf  A summary of vaccinations for birth to age 18 can be found at http://www.immunize.org/catg.d/p2010.pdf

Enjoy your Grand Family

Despite the obvious challenges of raising grandchildren in your older years, most grandparents describe the many joys that come with this new adventure. Grandparents share a special bond with their grandchildren, and when sharing a home together, that bond can be strengthened. Grandparents can share the wisdom of their experience with this younger generation and have the opportunity to shape their lives for the better. If you are new to this second round of parenting, AARP offers a helpful guide with tips to GrandFamilies, as they call them. These can be found at Grandparents Raising Grandchildren: A Growing Trend

 

 

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By |2022-05-12T11:06:53-05:00May 28th, 2022|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Grandparents Raising Grandchildren: A Growing Trend

The Sandwich Generation: Make it a Triple Decker!

We have all heard of the “sandwich generation” – those middle-aged adults who are still caring for their own children and also an aging parent. Well, here is an emerging trend that I will call the Triple Decker Sandwich generation: Baby Boomers who help care for aging parents, who still have children at home of their own, and who find themselves also taking on full time care of their small grandchildren. Yes, that is a sandwich of an entirely different kind. That is a Triple Decker.

Pew Social Trends (2013) revealed that many adults in their 30s and 40s were caring for ailing older parents and also providing some type of financial support for grown children. This resulted in reports from the sandwich generation in feeling in a hurry, rushed, and not having enough time for all of their expected duties. Now, add to those statistics another emerging trend: grandparents caring for grandchildren. I am not referring to the occasional or even regular hour babysitting or childcare that loving grandparents provide. Instead, this is the 24/7 responsibility for grandchildren who live with them, or whom they have adopted. The 2015 Profile of Older Americans from the Agency on Aging found that “in 2014, about 554,579 grandparents aged 65 or more had the primary responsibility for their grandchildren who lived with them”. Now, please note that this is only those grandparents aged 65 an over. What about all the others in their 50s and early 60s doing the same? I imagine that each person reading this can think of at least one or two grandparents who are raising small grandchildren. The implications of this on the health of aging persons is enormous. So, here are some tips to survive the Triple Decker Sandwich generation.

Pace yourself

If you have this many people in your life to care for, you must pace yourself. Avoid the temptation to give 100% all the time. It isn’t possible. Something in your life will suffer – and often this is your own health. Think of this task of caring for multiple generations as running a marathon. Develop skills, train, get into a good rhythm that you can maintain for the long haul.

Set priorities

You might have been able to juggle 4 kids and a job when you were in your late 20s or early 30s, but maybe now you are in your 50s with aging parents, teenagers, and a grandbaby to care for. Flexibility is a key to success. You just can’t do everything the same way if you are caring for small children again. Decide what is most important. Set reasonable and attainable goals. Make small goals for each day and celebrate those accomplishments.

Accept help

Even if you were used to being able to do it all yourself when you were younger, the amount of care that a Triple Decker generation person takes on requires some help at times. Let your adult children watch that baby to give you a break. Let the teens in the house help with the childcare. It is a good time for them to learn these skills for when they are parents. Tag team with your spouse to share the burden if you have a little one in the home. Church friends are happy to help if you need a night out.

Take time to rejuvenate

Being part of a Triple Decker sandwich is tough. Take time to rejuvenate to avoid burnout. You can’t care for anyone if you become ill or incapacitated yourself. For each person, renewal comes in different forms. For men, this might mean playing a sport or watching games on TV without interruption, or having a quiet private place in the house that is off limits from the noise of the household. For moms, this might be shopping alone or getting a manicure or pedicure. Sometimes talking on the phone, or meeting with friends for lunch provides a needed break. Know what you personally need to recharge and refocus and then allow yourself this (without guilt) on a regular basis. You may not be able to change your circumstances, but you can change how you deal with them.

Don’t expect too much

Chances are, if you find yourself in the Triple Decker mode, you are aging yourself. You can remember how you balanced work, life, kids, and higher education by yourself years ago. Now you wonder how you did it all. Well, you were 20 or 30 years younger then, so cut yourself some slack. Be sure to get enough sleep. Take breaks as needed. Exercise and eat right. Cut out the unnecessary things you did before to fill time and focus on those priorities that you set, without neglecting your own health.

Triple Decker Sandwich persons are tough and resilient. Congratulate yourself that you have been able to make it all work and care for your many loved ones. You sacrifice many things such as an easy and comfortable retirement and the ability to travel. But, you have given a great gift to those you love by sharing your care for them. In the end when you reflect back on your life accomplishments, you might very well find that this was one of the greatest.

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By |2022-05-12T11:05:35-05:00May 18th, 2022|Dr. Mauk's Boomer Blog, News Posts|Comments Off on The Sandwich Generation: Make it a Triple Decker!