Kristen Mauk

About Kristen Mauk

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 |2024-02-01T14:34:29-05:00March 22nd, 2024|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Five tips for Grandparents to stay connected with family

Five Tips to Surviving Your Husband’s Retirement

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I remember when my father retired at the age of 62 from a busy career as a pediatric surgeon. I thought he would be bored, but he had already compiled a notebook full of chores to do around the house, places he wanted to go, and a bucket list of other accomplishments that had been put on hold. Shortly after his retirement, my Mom confided in me that it was a bit of an adjustment having Dad home all the time. Suddenly, Mom said she seemed to no longer be able to cook right after about 40 years of doing this on her own. Dad had a better way to do things, after all. Once I saw Mom trying to wrap a gift and the wrapping paper seemed too small for the size of present. Dad was trying to give her step by step instructions and after snapping at her, Mom let him wrap the gift himself. Now, while I do concede that Dad was able to wrap the gift absolutely perfectly with the allotted paper, Mom and I gave each other a knowing glance and smiled. Ah, retirement.

So, when my own husband announced that he was going to retire and sell his share of the business at the age of 51, I knew I had to take some action to give our marriage the best chance to survive and thrive against this new challenge. After all, when my father-in-law retired, my mother-in-law had to encourage him to get a part-time job so she could have some “peace”. Even she was a bit concerned when my husband decided to take early retirement. Here I offer my short bit of wisdom, gleaned not only from my own experience but also from many wise women who gave me their sage advice to prepare for this season of life: when your husband retires.

Set the ground rules. I had fortunately learned during a brief period when my husband was working from home that there were certain things that would have to be agreed upon before he ever retired if we were to live peaceably. For example, he was not allowed to take over any of my former responsibilities unless I asked him to. Driving the kids around to activities can be helpful, but trying to wash the shrinkable clothes was not. Taking us out to eat after I worked all day was fine, but trying to take over the kitchen was off limits. Helping the kids with business math (not my area of expertise) was great, but trying to be the full-time homeschool Dad was not going to work for any of us.

Have separate work spaces. Jim and I cannot share a computer. I teach partially online and spend lots of time working from home with consulting. We agreed early on that he would set up a separate place in a different part of the house for his computer and desk. This has created much harmony over sharing the work space.

Allow everyone time to adjust to the change. I must admit that it took me several weeks, maybe even months, to realize that my husband was truly going to retire. Once he was home all the time, the reality gradually set in, but I kept reminding myself to give us all an adaptation period as if we were starting a new job orientation, because things were definitely going to change. Our two teenagers were the most leery of Dad being home all the time. For them, the ground rules (i.e. “please just let us do our work and don’t change our routine”) were particularly essential.

Accept your differences. My husband is a problem-solver and savior. He likes a challenge and wants to fix everything for everyone if he can. While I admire this about him, I didn’t want him to fix the nice structure and functionality by which our home was already running. I learned to embrace his strengths and encourage him to accept my weaknesses (like overindulging in carbs and worrying about things I can’t control). He likes to exercise every day, watch sports, and spend time on the landscaping. I would rather take the kids to the movies and go shopping. And that had to be ok.

Embrace the positives. While I was a bit skeptical about how our lives would change with my husband retiring so soon, there are so many things to celebrate that I am daily embracing the wonderful opportunities and blessings that his retirement has brought to our family. We are free to travel more. He accompanies me on business trips, even to China twice! He is much more relaxed and pleasant. It makes our family happy to see him have the time and resources to do what he enjoys. Jim keeps busy all of the time and yet does not have the daily pressure of work-related stress. We spend more time with family and have plans to move nearer to the grandchildren and to a better climate.

For all the women who are warily facing their husband’s retirement, take heart. I can honestly say that with some forward and deliberate planning, my husband’s retirement is one of the best things that has ever happened to us!

By |2024-02-01T14:32:35-05:00March 6th, 2024|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Five Tips to Surviving Your Husband’s Retirement

Tuberculosis (TB)

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Background

Tuberculosis (TB), caused by Mycobacterium tuberculosis, is a contagious infection that involves the lungs but can attack any part of the body. Primary TB is caused by inhalation of air droplets from an infected person through coughing, sneezing, laughing, or other activities in which particles become airborne (NCBI, 2011).

Risk Factors

Older adults and immunocompromised persons are at the greatest risk. According to the CDC’s and Prevention Morbidity and Mortality Weekly Report [MMWR] (2012), the incidence of TB in 2011 has declined by 6.4% since 2010. There are a reported 3.4 cases per 100,000 populations in the United States, which translates to about 10,521 new TB cases in 2011. However, data continues to point to a trend of foreign-born or racial/ethnic minorities being disproportionately affected by TB compared to U.S.- born persons. This gap is continuing to widen despite an overall decreased number of cases in both groups (MMWR, 2012). The AIDS epidemic has contributed to the spread of TB, particularly in less developed countries; this may be due to the suppression of the immune system that is associated with AIDS.
Nursing home residents are considered an at-risk group due to the typically higher rates found in this population. General guidelines from the Advisory Committee for Elimination of Tuberculosis (Centers for Disease Control and Prevention [CDC], 1990) set a concrete strategy for prevention and management of TB in nursing homes to decrease the spread among this institutionalized and vulnerable population. Thus, older adults who may be discharged from acute care facilities to a nursing home will generally undergo TB skin testing prior to discharge.

Warning Signs

The CDC (2013) lists the following signs and symptoms of TB:
• A bad cough that lasts 3 weeks or longer
• Pain in the chest
• Coughing up blood or sputum (phlegm from deep inside the lungs)
• Weakness or fatigue
• Weight loss
• No appetite
• Chills
• Fever
• Sweating at night

A person can be infected with TB and have no symptoms. This means they may have a positive skin test, but cannot spread the disease. Such a person can develop TB later if left untreated. Those with active TB can spread the disease to others and should be treated by a physician or other health care provider.
Screening for TB is simple and can be done at the local health department, clinic, or doctor’s office. A Mantoux test is an intradermal injection that is read for results in 48–72 hours after administration. A result of 11 mm or greater of induration (not redness, but swelling) is considered a positive result. It is recommended that older adults undergo a two-step screening wherein the test is given again, because there are many false results in older adults. A positive TB skin test should be followed up with a chest Xx-ray to rule out active disease.
It must be noted that persons who received a vaccine for TB may have a positive reaction. A TB vaccine is commonly given in many countries outside the United States.

Diagnosis

For older adults born in the United States, a positive skin test may prompt the health care provider to initiate preventative treatment. The medication isoniazid (INH) is generally given to kill the TB bacteria. Treatment with INH often lasts at least 6 months. Few adults have side effects from the medication, but those that are possible include nausea, vomiting, jaundice, fever, abdominal pain, and decreased appetite. Patients taking INH should be cautioned not to drink alcohol while on the medication.

Treatments

Patients with active TB can be cured, but the medication regimen is complex, with several different drugs taken in combination. Caution should be taken to avoid spread of the disease. This generally means isolation for patients in the hospital with active TB. In 1998, the FDA approved a new medication, rifapentine (Priftin), to be used with other drugs for TB. Medications should be strictly taken for the entire period of time (many months) to kill all of the bacteria. Older adults may need assistance with keeping track of these medications; evaluation of medication management should be included in the assessment. The use of a medication box set up by another competent and informed family member to ensure compliance with the medication regimen may be helpful, because it can be overwhelming for some persons. Adequate rest, nutrition, and hydration, as well as breathing exercises, may help with combating the effects of TB. Since over half of all patients with actively diagnosed TB have come to the United States from other countries, language may be a barrier. Education requires understanding and may necessitate an interpreter to ensure understanding of the complex regimens required to eradicate the bacteria.

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. Burlington, MA: Jones and Bartlett Publishers. Used with permission.

 

By |2024-01-29T11:56:00-05:00February 27th, 2024|News Posts|Comments Off on Tuberculosis (TB)

A Mom for all Seasons

I have been fortunate to have a number of mothers in my life – by birth, marriage, or adoption. Each of these women has helped to shape my perspectives and  values in various ways during different seasons of life.  As Mother’s Day approaches, reflecting on the role that mothers play in our lives is a worthy exercise. So, here is my tribute to my mothers.

My first mother is the one who gave me life. I like to think of this as the Spring of my life. Mom Phyllis raised me until the age of 9 years. She tended to the scrapes and cuts, helped to mold my personality, hand-made my clothes, and made life an adventure, all whilst being the wife of a busy doctor who was studying to be a pediatric surgeon. Thank you, Mom, for treasuring my childhood.

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When my parents got divorced, a second mother entered the Summer of my life. Mom Kay took three confused and fragile children under her wings as a young step-mother in her early 20’s. She nurtured us as if we were her own. She helped me navigate the difficult teenage years and transition into young adulthood, listening to countless stories of puppy love, crushed hearts, and future dreams. Mom brought faith and light into a home that had been shattered by divorce. She has given me an example of a loving and faithful wife to my father for 45 years. Thank you, Mom, for preserving my spirit and encouraging my faith in God.

In college, I attended a little Baptist church where they had a program in which families could “adopt” a college student. Through a round-about way, I was adopted by Marvin and Patsy Bell. Grandma Bell, as my children later called her, saw me through my first 17-year  marriage, a painful divorce, and was a second mother to many other young women like me. She has been a faithful friend and mentor for more than 38 years. Ma Bell stood in the place of the mothers who couldn’t be with me during some of the coldest and darkest Winters of life. She attended countless school programs for my kids and never forgets a birthday to this day. Thank you, Ma, for giving me the example of the kind of Grandmother I want to be.

Lastly, when I remarried to my current husband, Jim, I gained a wonderful mother-in-law. Gracie is true to her name. She has a loving and nonjudgmental spirit. She always thinks the best of people and is kind and gentle.  In the Fall of my life, she embraced me as a daughter and is always ready to help in times of need.  Thank you, Mom Mauk, for showing me what unconditional love looks like.

All of us have mothers in our lives that we need to thank. So, this Mother’s Day, purpose to give a special blessing to those women who have so influenced your life. Without them, our days would be less rich and the journey much lonelier. Celebrate those who have traversed the seasons of life with you!

By |2023-10-27T15:36:05-05:00November 22nd, 2023|Dr. Mauk's Boomer Blog, News Posts|Comments Off on A Mom for all Seasons

Total Knee Replacement

 

Background

Similar to hip replacement, knee replacement is done when a person is experiencing decreased range of motion, trouble walking or climbing stairs, and increased degeneration of the joint so as to impair quality of life. This most often occurs as a result of arthritis.

Treatment

Total knee replacement (TKR) surgery involves resurfacing or removing the distal portion of the femur that articulates with the end of the shin bone. The prosthesis consists of metal and plastic or similar materials that are cemented onto the newly resurfaced areas of the articulating bones. Although often done under general anesthetic, this surgery can also be performed under spinal anesthesia. Sometimes blood loss is significant, so patients may be asked to donate their own blood ahead of time to be given back to them in the event it is needed. In addition, a growing trend is toward bilateral knee replacement in those persons requiring both knees to be surgically repaired. The benefits of this are the one-time operative anesthetic and room costs, and many physicians feel recovery from bilateral replacement is similar to single replacement. However, the pain and lack of mobility, as well as the significant increase in the assistance needed after surgery when a bilateral replacement is done, may make this less than ideal for older patients. Surgical procedures for TKR have not evolved quite as rapidly as total hip arthroplasty.

Discomfort after knee surgery is generally severe in the first few days. Complications after surgery may occur, including pain, infection, and blood clots. Patients may use cold packs on the operative area and take pain and sleeping medications as ordered. In addition, alternative therapies such as guided imagery have been shown to help with pain management (Posadzi & Ernst, 2011). Many joint replacement patients feel a loss of control and independence.

Therapy will begin immediately in the acute care hospital. Although weight bearing does not usually occur until 24 hours after surgery, sitting in a chair and using a continuous passive motion machine (CPM) (if ordered), will ease recovery. The use of a CPM is generally based on the surgeon’s preference. There is research to support it, as well as studies indicating that walking soon after surgery has an equal effect and makes the CPM unnecessary. However, in cases of an older person who may not have the mobility skills initially after surgery that a younger person would, a CPM may be beneficial to keep the joint flexible and decrease pain.

Dr. Zann (2005) indicated that “patients undergoing total knee replacement do not achieve their maximum improvement until 2–4 years” (p. 1). This is attributed to the lack of muscular structures that surround and protect the knee and the need for the ligaments and tendons to adapt to the indwelling prosthesis. Recovery times vary and depend upon a number of variables, including the patient’s overall health, age, other preexisting health issues, and motivation. Patients report that the new knee joint never feels normal even years after the surgery, but that they experience an increase in function and generally much less pain than before.

Patients should be educated about signs and symptoms of infection, care of the surgical site (if staples are still present), pain management, and expectations for recovery. A range of motion from 0–90 degrees is the very minimum needed for normal functioning. Normal knee flexion is 140 degrees, but few older persons would get this amount of flexion after surgery, and may not have had full flexion even prior to the operation. After discharge, a walker is usually used in the first few weeks, followed by light activities 6 weeks after surgery. In addition, the patient’s spouse may experience feelings of being overwhelmed due to role transitions that occur after surgery and during the recovery period (Walker, 2012 ). Newer knee prosthetics are still going strong for the majority of patients 15 years after surgery.

 

By |2023-08-25T18:57:34-05:00September 15th, 2023|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Total Knee Replacement
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