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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.
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By |2021-01-07T11:14:43-05:00January 7th, 2021|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: Home Improvements and Modifications for Aging in Place

Guest Blog: Top 6 Things You Need To Work On For An Effective Education

Education is a tool that provides people with knowledge, skills, technique, and information. It enables them to know their rights. Proper and adequate education is essential for all of us. It facilitates quality learning throughout life among people of any age, group, caste, creed, religion, and region. Education is going out to institutes to gain knowledge, but there are online schools like online high school South Africa, which lets us understand without much effort. You can also read books of famous authors for their knowledge power, like Mike Holt books.

So as there are many benefits of education, it must be practical and purposeful. Here are some ways to make teaching effective:

  1. Communication:

To know the art of communicating is very important in education. Information is delivered and received through communication, whether verbal, written, or any route from practical demonstration to artistic interpretation. Anything that gets your point to others is communication. Being a teacher, you need to have excellent communication skills to deliver your knowledge and ideas to the pupils. Simultaneously, the students must develop this ability for their future by joining a debating society or writing in a magazine.

Creativity:

For effective education, you need to be creative, and learning must be creative too. People learn best when something is fun and creative; according to the national standard of education, learning must be fun and exciting. You can take up an artistic hobby pr get used to sharing ideas and brainstorming. Creativity not only helps with a practical education but also enhances your thinking ability.

Patience:

As said, patience is the key to success. Patience is essential in education. You are supposed to do things as many times as it takes. If you are a teacher, you need to teach one thing to students every time they understand it. As for the student, education requires patience; you need to learn things with patience. You might need to try several times to learn something by heart, which needs patience. When you face challenging behavior, you need to stay calm and patient and not lose your temper. You can improve it by practicing before you speak or make patience your goal.

Enthusiasm:

Enthusiasm boosts your aim, and you aim to make education effective. If you have to do something boring, you can turn it into something you are enthusiastic about. You can make a game of data entry or write poems to help you memorize facts. But the most important thing to bring in enthusiasm is to do what you love. It would be best if you opted for the education of something you are passionate about.  This will help you perform effectively in your education field.

Confidence:

One of the essential factors in making education effective is to build confidence in you. Being an education instructor, faith must be the priority. One cannot teach someone if he lacks confidence in himself because there is a vital element to pass to students’ confidence in teaching. A teacher must show spirit, so the students learn its importance and value. And for students, they must know how to gain the confidence required in every field of life. Also, learning involves belief.

Dedication:

Gaining or delivering education can be challenging at times, but you can succeed if you are dedicated. Energy levels are to be at their highest while learning and teaching. At times you will consider yourselves discouraged, but that does not let education have its effects. Instead, it is of no use if you are not dedicated. To make teaching effective, you need to be a dedicated teacher and a dedicated learner.

We need to get a high-level awareness about the importance of knowing more than before. Effective education is essential for each and everyone to improve experience, way of living, and social and economic status throughout life. Getting proper education is the birthrights of everyone restricting, which is a crime. Education is the ultimate way to get victory overall personal and social problems. It is essential to all of us as it plays a crucial role in our life. It transforms us entirely from inside and outside by changing our mind and personality and improving our confidence level. It changes our life completely as it is constructive.

 

 

By |2021-01-05T13:36:05-05:00January 6th, 2021|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: Top 6 Things You Need To Work On For An Effective Education

Guest Blog Self-Care Tips For Caregivers

Self-care is defined as caring for ourselves physically, psychologically, spiritually, and socially. Because when we are focused on those things outside of ourselves it is so easy to overlook our own needs, self-care is a concept that applies to everyone.

For example, imagine that your boss lays a new project in your lap with an impending – and almost impossible – deadline. You put everything aside because the project requires all of your energy. So, you don’t do those stretches that keep your low back pain at bay. You don’t return non-professional emails, texts, or messages. You reschedule every appointment that doesn’t apply to this project.

In the end, the project does get done, but you find yourself completely exhausted, and in serious need of a break. The truth is, any of us can find ourselves in this situation at any time, but especially when we undertake the care of a dependent other.

People who rely on us for their daily living cannot be put on the back burner. Maybe they need help getting dressed, making meals, taking a bath, or just getting out of bed. (In some cases, the care may mean just being turned in bed to avoid developing bedsores.)

For caregivers, the work never ends. Every single day they are a requirement to another person and it is simply not possible to call in sick when someone else depends on you more than you need a day off.

The result is that caregivers are often the worst at self-care. When this happens, they can end up feeling exhausted, irritable, resentful, and hopeless. And the quality of care they can provide suffers. For caregivers, quality care starts and ends with consistent self-care.

Remember The Why

Tony Robbins is famous for always asking for the WHY. The reason for this is because when we have a why, we can find a how. This becomes monumentally more important when what we are doing is hard, long-lasting, and with little gain.

It is these times when it makes the most sense to give up because the energy we put out can seem out of proportion to what we get back. But this is also when it is so important to stop and ask ourselves why we got into this work in the first place. What was it about caring for others who depend on us that attracted us? Why did we choose this profession over others? And why do we keep at it despite the long, exhausting hours?

Answering questions like this will bring us back to the fundamental reasons for our decision to go into caregiving. It will also bring us back to a fundamental human need – which is to have a purpose.

To be content with our lives, we must feel that what we do has meaning. We must feel like we matter in one way or another, and that what we do makes a difference. Whatever our why is, it carries us forward when times get challenging. It reinforces us, stabilizes us, gives us solid ground on which to stand.

Find Something To Be Grateful For

Gratitude is such a powerful emotion that even just keeping a daily gratitude list has been shown to have a dramatic effect on many measures of our lives – from happiness and wellbeing to creativity and productivity.

While gratitude can be described as a “top end” emotion that is most effective when everything else in our life is going well, in many cases, it is just the opposite. It is through being grateful that we find a way to get through things that confound us, challenge us, overwhelm us, and make us want to quit.

For caregivers, gratitude is especially effective because not only is caring for another person inherently hard, when they are dependent, it is without end. It is at these times that our psychological systems most need bolstering, and on a daily basis.

What gratitude effectively does is bring us out of the dreariness of our daily lives and into a new perspective where things look different. And when we begin to see differently, those things we see begin to change. The sunrise looks brighter, the trees greener, the flowers brighter, and the people more kind.

Make Humor A Part Of Your Daily Life

Humor is a wonderful resource that has been associated with feelings of wellbeing, happiness, vitality, creativity, and even cognitive functioning. Humor is something that has also been demonstrated in a variety of species and seems to play a central role in bonding. But perhaps most importantly, humor acts like a tonic for the brain.

Humor allows us to temporarily escape our reality, to transform our situation is a way that brings us levity and lightness. When we can stop to laugh, we can, for the moment, suspend any negative emotions we might otherwise be feeling. We can, momentarily, make our situation and ourselves feel different.

For caregivers, humor is an essential resource because it acts like a reset button. Performed regularly, humor doesn’t just make every day better, it makes the tough ones survivable.

Caring for another person may be one of the most challenging jobs we can choose. But it is also one that is essential. By remembering why we choose to become caregivers, finding things to be grateful for and incorporating humor into our daily lives, we can keep ourselves at our best for ourselves and those who depend on us every day.

By |2021-01-05T13:17:06-05:00January 5th, 2021|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog Self-Care Tips For Caregivers

Parkinson’s Disease

 

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 |2021-01-01T10:54:13-05:00January 5th, 2021|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Parkinson’s Disease

The 6-Step Process of Stroke Recovery

 

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 |2021-01-01T10:53:59-05:00January 4th, 2021|Dr. Mauk's Boomer Blog, News Posts|Comments Off on The 6-Step Process of Stroke Recovery