Dr. Mauk\'s Boomer Blog

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

Guest Blog: Home Improvements and Modifications for Aging in Place

January 5, 2021 by Julia Weaver

Now more than ever before, we’re seeing more adults choosing to live at home as they grow in years, or what is known as aging in place. Living at home helps aging adults maintain their lifestyle for as long as possible, rather than moving into a nursing home or assisted care center. In fact, three-quarters of adults 50 years and older would prefer to remain in their homes as they age, according to a survey by AARP. Though many of us won’t be able to live independently forever, home modifications will allow your loved ones to continue to live in their home longer by creating a more manageable environment. Whether they’re living in a single-story condo in Dallas, TX or a three-story home in Portland, OR, there are modifications that can be made to every home to help make daily tasks a little easier.

Helpful home modifications

As we grow older our bodies and capabilities change, and not all homes are designed to support this challenge we’ll face. A lot of times doorways are too narrow, bathrooms too small, floors too slippery, and kitchen cabinets too high to reach. For aging adults, a home designed for optimal accessibility, convenience, and safety is imperative to avoid falls or serious injuries.

Optimizing a home for safe and comfortable living while creating a home environment that makes getting around easier is essential for aging in place. That’s why we’ve gathered the most common home modifications, from simple adjustments to larger remodeling projects.

General Home modifications to aid in mobility

Install handrails. For aging in place, add handrails to stairs, hallways, bedrooms, and bathrooms for extra balance.
Upgrade the lighting. Replace existing bulbs with LED bulbs to increase visibility. Consider installing touch-activated lamps, and placing night lights in the bedroom, bathroom, and hallways.
Install lever door handles. Switch out standard round doorknobs for lever-style handles. These do not require the same level of grip.
Install a stairlift. This is a great alternative when walking up stairs becomes more difficult. Install light switches at the top and bottom of the stairs to prevent your loved one from using the stairs in the dark.
Install automated blinds. This style of window treatment allows aging adults to adjust their blinds without having to stand up.
Create an open floor plan. Make wide passageways throughout the home with little obstruction. Widen doorways and hallways if your loved one uses a walker or wheelchair to navigate their home.
Replace hardwood, tile, laminate, or vinyl flooring for carpet. If your loved one doesn’t use a wheelchair, carpet will be most forgiving and provides more floor consistency.

For the living room

Rearrange furniture and remove clutter. To avoid tripping hazards, be sure furniture placement leaves plenty of space to move about the room safely.
Install anti-slip mats. Add strips to the bottom of rugs to increase traction and reduce the chances of tripping.
Replace unsteady furniture. Discard furniture that wobbles to prevent falls, and add plastic bumpers to the sharp edges on furniture pieces.

For the kitchen

Keep daily-use items accessible. Store small appliances, cookware, and tableware between waist and shoulder height to avoid the need to crouch down or use a step stool.
Consider purchasing a stovetop with an automatic shut-off feature. Once the sensors fail to detect motion for an extended period of time, the stove will shut off.
Install a hands-free faucet and anti-scald device. Easily turn the water on and off with the wave of a hand, and install an anti-scald device to avoid the possibility of burns.
Replace kitchen cabinets and adjust counter and sink height. For more convenient storage space, install drawers, open shelving, or pull out shelves. Choose a counter height where it’s easy to prepare meals and wash dishes while sitting.
Adjust the location of major appliances. Place the oven, sink, and refrigerator as close to each other as possible.

For the bathroom

Add adhesive strips to a bath mat in showers and tubs. This can help prevent slipping on wet surfaces.
Install non-skid strips in case the flooring becomes slippery. Try to avoid ceramic tile as this can become slick when it’s wet.
Install a walk-in bathtub or a shower transfer bench. This can greatly reduce the chances of slipping and falling. Climbing in and out of a traditional bathtub or standing for an extended period of time may become more difficult.
Install grab bars or rails in bathtubs and near the toilet. This will improve mobility and help to prevent falls.
Install a raised toilet seat. An elevated toilet seat decreases the distance between standing and sitting.

For the home’s exterior

Create at least one no-step entry into the home. Replace exterior stairs with a removable ramp for a smooth transition into and out of the home.
Add exterior lighting and landscape lighting. To avoid falling or tripping, add outdoor lighting to walkways and stairs.
Install handrails. Add handrails on both sides of walkways for extra support and balance.
Choose low maintenance materials. Opt for vinyl siding, metal roofing, composite decking, and low maintenance landscaping.
Install a security system. A home security system can give your loved one a sense of security and protection.

How to pay for home modifications

While in the end, it’s generally less expensive to age in place as opposed to living in a senior living community, the upfront costs for a remodel can add up. Luckily there are resources and programs available, such as home improvement grants, equipment loans, and low-interest loans.

You should also consider researching programs like Medicare Advantage, Non-Medicaid Government assistance and Medicaid HCBS Waivers, Veterans programs, and non-profit organizations for financial help. As you’re crunching the numbers, it’s important to remember that the cost associated with home modifications has two components: the labor cost and the materials cost. Oftentimes, the cost of labor for installing the equipment will not be covered by insurance.

Create a support system with senior care and services

Forming a support system for your loved one is a big part of aging in place. Besides the support from family members, it’s a good idea to consider senior care and services for your aging parent. There is a network of services available, including meal delivery, nurses, transportation, and house cleaning services.

In-home care services are also offered at various levels depending on the situation. On days when you’re unavailable, an elder companion could spend time with your loved one to prevent social isolation. In-home caregivers can provide help with day-to-day activities like cooking, grooming, or shopping, while also making sure your loved one is safe in their home

Introduce technology into your loved one’s home

Assistive technology solutions, smart home features, and tech gadgets can be used to help simplify everyday tasks, promote independence, and stay safe while aging in place. There are all sorts of devices, like medical alert devices to signal for help, assistive seating devices to lift your loved one into the standing position, and smart bulbs that can be controlled remotely.

Individual results may vary.
This is not intended as a substitute for the services of a licensed and bonded home services professional.

Redfin does not provide medical advice.
All of the material provided on Redfin’s blog, such as text, treatments, dosages, outcomes, charts, patient profiles, graphics, photographs, images, advice, messages, forum postings, and any other material provided on Redfin’s blog are for informational purposes only and are not a substitute for professional medical advice or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have read on Redfin’s blog.

If you think you may have a medical emergency, call your doctor or 911 immediately. Redfin does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on Redfin’s blog. Reliance on any information provided by Redfin’s blog, by persons appearing on Redfin’s blog at the invitation of Redfin’s blog, or by other members is solely at your own risk.

By Jim|2024-04-23T11:16:19-05:00June 10th, 2024|Dr. Mauk's Boomer Blog, News Posts|Comments Off

Background

Parkinson’s disease (PD) is one of the most common neurological diseases, affecting at least 1.5 million people in the United States (American Parkinson Disease Association {APDA}, 2010). The average age of onset is about 59 years of age (APDA, 2010), and the likelihood of developing PD increases with age (National Institute of Neurological Disorders, 2008). It affects both men and women, particularly those over the age of 60 years (American Parkinson Disease Foundation, 2012). Parkinson’s disease was first described by Dr. James Parkinson as the “shaking palsy,” so named to describe the motor tremors witnessed in those experiencing this condition.

Parkinson’s disease is a degenerative, chronic disorder of the central nervous system in which nerve cells in the basal ganglia degenerate. A loss of neurons in the substantia nigra of the brainstem causes a decrease in the production of the neurotransmitter dopamine, which is responsible for fine motor movement. Dopamine is needed for smooth movement and also plays a role in feelings and emotions. One specific pathological marker is called the Lewy body, which under a microscope appears as a round, dying neuron.

Signs and Symptoms

Parkinson’s disease has no known etiology, though several causes are suspected. There is a family history in 15% of cases. Some believe a virus or environmental factors play a significant role in the development of the disease. A higher risk of PD has been noted in teachers, medical workers, loggers, and miners, suggesting the possibility of a respiratory virus being to blame. More recent theories blame herbicides or pesticides. An emerging theory discusses PD as an injury related to an event or exposure to a toxin versus a disease. Interestingly, coffee drinking and cigarettes are thought to have a protective effect in the development of PD (Films for the Humanities and Sciences, 2004).

The signs and symptoms of PD are many; however, there are four cardinal signs: bradykinesia (slowness of movement), rigidity, tremor, and gait changes such as imbalance or incoordination. A typical patient with PD symptoms will have some distinctive movement characteristics with the components of stiffness, shuffling gait, arms at the side when walking, incoordination, and a tendency to fall backward. Not all patients exhibit resting tremor, but most have problems with movement, such as difficulty starting movement, increased stiffness with passive resistance, and rigidity, as well as freezing during motion (NINDS, 2012). Advanced PD may result in Parkinson’s dementia.

Diagnosis

Diagnosis of PD is made primarily on the clinician’s physical examination and thorough history taken from the patient and/or family. Several other conditions may cause symptoms similar to PD, such as the neurological effects of tremor and movement disorders. These may be attributed to the effects of drugs or toxins, Alzheimer’s disease, vascular diseases, or normal pressure hydrocephalus, and not be true PD. There is no one specific test to diagnose PD, and labs or X-rays rarely help with diagnosis.

Treatment

Management of PD is generally done through medications. Levodopa, a synthetic dopamine, is an amino acid that converts to dopamine when it crosses the blood–brain barrier. Levodopa helps lessen most of the serious signs and symptoms of PD. The drug helps at least 75% of persons with PD, mainly with the symptoms of bradykinesia and rigidity (NINDS, 2008). One important side effect to note is hallucinations. A more common treatment, and generally the drug of choice, involves a medication that combines levodopa and carbidopa (Sinemet), resulting in a decrease in the side effect of nausea seen with levodopa therapy alone, but with the same positive control of symptoms, particularly with relation to movement. Patients should not be taken off of Sinemet precipitously, so it is important to report all of a patient’s medications if they are admitted to either acute or long-term care. Dopamine agnoists trick the brain into thinking it is getting dopamine. This class of medications is less effective than Sinemet, but may be beneficial for certain patients. The most commonly prescribed dopamine agonists are pramipexole (Mirapex) and ropinirole (Requip) (Parkinson’s Disease Foundation, 2012). Medications such as Sinemet show a wearing-off effect, generally over a 2-year period. During this time, the person must take larger doses of the medication to achieve the same relief of symptoms that a smaller dose used to bring. For an unknown reason, if the medication is stopped for about a week to 10 days, the body will reset itself and the person will be able to restart the medication at the lower dose again until tolerance is again reached. This time off from the medication is called a “drug holiday” and is a time when the person and family need extra support, because the person’s symptoms will be greatly exacerbated without the medication. The earliest drugs used for PD symptom management were anticholinergics such as Artane and Cogentin, and these medications are still used for tremors and dystonias associated with wearing-off and peak dose effects (Parkinson’s Disease Foundation, 2012).

There are many other treatments for Parkinson’s disease being explored. These include deep brain stimulation (DBS), with electrode-like implants that act much like a pacemaker to control PD tremors and other movement problems. The person using this therapy will still have the disease and generally uses medications in combination with this treatment, but may require lower doses of medication (NINDS, 2012). Thalamotomy, or surgical removal of a group of cells in the thalamus, is used in severe cases of tremor. This will manage the tremors for a period of time, but is a symptomatic treatment, not a cure. Similarly, pallidotomy involves destruction of a group of cells in the internal globus pallidus, an area where information leaves the basal ganglia. In this procedure, nerve cells in the brain are permanently destroyed.

Fetal tissue transplants have been done experimentally in Sweden with mild success in older adults and more success among patients whose PD symptoms were a result of toxins. Stem cell transplant uses primitive nerve cells harvested from a surplus of embryos and fetuses from fertility clinics. This practice, of course, poses an ethical dilemma and has been the source of much controversy and political discussion.

A more recent development includes the use of adult stem cells, a theory that is promising but not yet well researched. Cells may be taken from the back of the eyes of organ donors. These epithelial cells from the retina are micro-carriers of gelatin that may have enough cells in a single retina to treat 10,000 patients (Films for the Humanities and Sciences, 2004). In addition, cells modified from the skin of patients with PD can be engineered to behave like stem cells (NINDS, 2012). Both of these alternatives present a more practical and ethically pleasing source of stem cells than embryos.
Other research includes areas include those related to alternative therapies. For example, Tai Chi has been shown to be effective in improving balance and reducing falls for PD patients (NINDS, 2012). Rehabilitation units have been using Tai Chi for similar benefits in other patients with neurological deficits. Simple interventions such as using Wii games to promote activity and exercise may be explored. The role of caffeine in PD is also being examined. In a small randomized control study of 61 patients with PD, caffeine equivalent to 2–3 cups of coffee per day was given to subjects and compared with a control group of those taking a placebo. Those patients receiving the caffeine intervention showed little improvement in daytime sleepiness, but modest improvement in PD severity scores related to speed of movement and stiffness (Postuma et al., 2012). Further study with larger groups was recommended by the researchers.

Much of the nursing care in PD is related to education. Because PD is a generally chronic and slowly progressing disorder, patients and family members will need much instruction regarding the course of the disease and what to anticipate. Instruction in the areas of medications, safety promotion, prevention of falls, disease progression, mobility, bowel and bladder, potential swallowing problems, sleep promotion, and communication is important. Most of the problems seen as compli¬cations of PD are handled via the physician as an outpatient, but certainly complications such as swal¬lowing disorders as the disease progresses may require periods of hospitalization. When persons suffer related dementia in the final phases of the disease, they are often cared for in long-term care facilities that are equipped to handle the challenges and safety issues related to PD dementia. In ¬addition, access to resources and support groups is essential.

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.

For more information on Parkinson’s Disease, visit the Michael J. Fox Foundation Website:
https://www.michaeljfox.org/

By Kristen Mauk|2024-04-23T11:16:01-05:00June 8th, 2024|Dr. Mauk's Boomer Blog, News Posts|Comments Off

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.

Independent at Its Finest

Successful independent living, country club atmosphere — in case your parents have decided to move into a assisted living Boynton Beach place where they could experience these, consider Courtyard Gardens Senior Living. Give us a call at (561)568-4849 now!

By Jim|2024-04-23T11:15:24-05:00June 6th, 2024|Dr. Mauk's Boomer Blog, News Posts|Comments Off

Guest Blog: Why You Need a Geriatric Nurse Practitioner

It is no surprise that baby boomers are entering the elderhood phase of their lives, which often means seeking medical care or advice for themselves or for their aged parents. The role of the Adult-Gerontology Nurse Practitioner (AGNP) is quickly becoming more relevant as America’s older population is expected to grow from 15% to 24% over the next 30 years. With life expectancy increasing from 68 years old in 1950 to 79 years in 2013, the expertise of the AGNP is more valuable than ever as healthcare faces this “Silver Tsunami.”

AGNPs are trained to provide care across the continuum of adulthood from young adults to the frail elderly as a reflection to changes made to the national certification exams in 2013, which combined the adult and gerontological specialties into one certification. However, many AGNPs and still-certified Gerontological NPs choose to specialize in the elderly population, (those older than 65) with specific focus areas or competencies related to the aging adult.

Nurse practitioners who specialize in adult and gerontological care can further their specialization by choosing a primary care or acute care concentration. No matter the setting, the AGNP provides multi-disciplinary care to treat the entire individual, not just their health concerns. As there are many facets of aging to consider, the AGNP addresses the physical, psychological and social aspects of aging not only to treat conditions, but to educate patients and the community on preserving function and preventing injury or further decline. Depending on the state in which they practice, AGNPs typically work with a supervising physician under standardized procedures in order to assess, diagnose, treat and prescribe medications.

Many studies have shown that patients are very happy to receive care from nurse practitioners in a variety of settings, including palliative care. Education regarding options for end-of-life care is typically managed by AGNPs in the acute care, post-acute care, home care, long-term care and primary care settings. As educating patients and populations is a cornerstone of the nursing profession, advanced-practice nurses such as AGNPs offer expert knowledge to guide patients and their families through the challenging maze of end-of-life planning. The role of the Adult-Gerontological Nurse Practitioner has never been more valid or necessary as the U.S. begins to feel the surge of the silver tsunami.

Catherine Burger, BSN, MSOL, RN is a board-certified nurse executive leader and contributing writer for www.registerednursing.org.

By Jim|2024-04-23T11:15:10-05:00June 4th, 2024|Dr. Mauk's Boomer Blog, News Posts|Comments Off

Guest Blog: 3 Reasons How Counselling Can Be a Life Saver for Many Seniors

Many of us face loads of issues in different aspects of life. It can be heed to our career, studies and personal affairs. However, we all are somehow dependent on a counsellor to sort out our emotional difficulties, overcome our problems and make appropriate changes in our lives. Counselling can help people of any age, but the counselling needs of a teenager are almost going to be a lot different than those of an adult. Ageing includes life changes and transitions like retirement that you may want to talk to someone about. Many famous counselling centers, such as Lakewood senior care, help seniors stay home with custom assistance which works together to create a network of services and support for seniors in a community. They focus on providing a safe, pleasant, home-like environment for their residents. Their goal is to treat every person with respect and the dignity they deserve. They urge us to focus that why counselling plays an essential role in the life of seniors. Hence, this is proven as under.

Stimulate seniors to have a positive mindset:

For most people, retirement is a thrilling time to progress, engage themselves in entertainment, or spend additional time with their loved ones. Others may feel less passionate and admiration what to do with their time. Even if they are excited to retire and have plans for how to spend their time, the adaption can still be a shock to the system. Part of ageing is losing people that you know. For some, that means losing a friend, family, or partner. Counselling can help them work through their grief and thoughts related to ageing, death, and dying. Counsellors provide therapy that changes our thoughts, emotions, and behavior.

Talking to a counsellor can help seniors consider their choices and reflect on their careers. It can also give them a more accurate sense of what they should want to focus on during retirement. This also builds a positive sense of humor in adults, and they start observing things firmly. Better advice and guidance promote positivity in their thinking and professional life.

Address speculative affairs formerly:

A clash from the past would be sorted out when a person reaches seniority in a perfect world. However, many seniors are still getting their hands-on on issues that ensue long ago. A time-honoured family dispute could turn down your loved one’s fretwork of support. Remembrance of a horrifying experience can cause seniors to segregate themselves from the ones left over. Your beloved may not be ready to transverse some of these problems with close family members, but they are likely to open up to a counsellor who can help them take steps towards relief.

Most counselling techniques are based on respect, empathy, and support. It is critical for the profession of geriatric counselling to foster a culture in which mentally healthy older persons are seen as “normal.” Counsellors must convey the concept that old age is not problematic in and of itself and does not necessitate counselling. However, when symptoms exceed an older adult’s capacity to function, counselling should be considered regardless of age. Some therapists and counsellors focus on dealing with seniors. They are informed about the unique challenges that impact you and others your age.

Dealing with medical issues:

Mental health mainly deals with our thinking, feelings and behaviors. From the time we are born through childhood, and adulthood, until old age, we can get stressors in life, leading to changes in thinking, feeling, and behaviors, leading to mental health problems. A counsellor will help the person and guide the person in various ways. One of the ways is counselling, where the person is taught to develop specific coping skills and help them become better at dealing with stress. There are also other methods like medications that help a person recover faster and those who are incredibly suicidal or homicidal very agitated. They may require inpatient management. Positive mental health allows seniors to realize their full potential to cope with destresses in life and work productively.

Counsellors advise people to maintain positive mental health, have a positive connection with others, and get enough periods of sleep. As time passes, you may have health issues that change how you do things. Many circumstances associated with getting aged may alternate your daily routines and capability. Even if you haven’t been treated with a condition, your vision, hearing, memory, and physical strength will likely decline as you get older.

Positive deliberation is not about expecting the best to happen. It’s about accepting that whatever happens, happens for the best.

By Jim|2024-04-23T11:14:54-05:00June 2nd, 2024|Dr. Mauk's Boomer Blog, News Posts|Comments Off

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