Dementia is a term
used to describe the gradual loss of cognitive function that can occur as a
result of neurological changes to the brain. A number of different diseases can
cause dementia such as Alzheimer’s disease, Parkinson’s disease, and cardiovascular
disease. Dementia is characterized by
the decline of a person’s ability to think, reason, and remember, and tends to
get worse with the passage of time. Eventually, these symptoms become severe
enough to interfere with daily function.
Indicators of Dementia
Here are several early-stage indicators or signs of dementia
to watch for in yourself or those for whom you provide care:
Memory Loss: One of the most common
symptoms of dementia is difficulty recalling information that has been recently
acquired, such as instructions, upcoming events, and dates. It is important to
note that occasionally forgetting and then remembering things is normal and not
due to dementia.
Difficulty with Everyday Tasks: If it
becomes harder to complete routine tasks, this could be an early sign of
dementia. Examples include having trouble making a cup of tea, paying bills, or
navigating to the grocery store.
Time and Location Confusion: Judging
the passage of time may prove difficult, as can remembering where a person is
at any given moment. Dates in the future and past can become mixed up.
Losing Track of Things: It can become
more difficult to remember where things are kept, such as car keys, remote
controls, documents, etc.
Struggling with Writing or Speaking: Engaging
in conversations can be difficult because it is hard to track what has already
been said. Writing, grammar, and spelling may become harder.
Other Signs of Dementia
Other indicators can signal early signs of dementia, such as
challenges with planning and problem solving, poor decision-making or judgment,
and difficulty with visual perception. It is also common for people who are
experiencing dementia to become disinterested in social activities. They may
stop participating in hobbies or sports that involve others and may isolate
themselves at home.
Although dementia is not an inevitable part of aging, age is
the primary risk factor. If you are caring for a loved one who may be
experiencing dementia and you are looking for local resources and support,
contact our team at Windward Life Care. The help you seek is just a phone call
Getting older is an
unavoidable part of life. However, age doesn’t mean you have to lose your good
health. Many age-related health concerns can be avoided with proper self-care.
Take dental health as an example. It’s widely known that as we move into our later
years, many people encounter more cavities and dental challenges.
Medications and Oral
Older adults tend to take more prescription and over-the-counter medications than younger adults. These medications often cause side effects, including dry mouth symptoms. Dry mouth means less cleansing and protective saliva flow, which contribute to oral health decline. Some of the more common oral health problems include gum disease, cavity and tooth decay, tooth loss, and oral cancer.
You can avoid many
of these problems by taking the time to visit your dentist regularly. Be sure
to tell your dentist what medications you are taking, if any. They will be able
to make specific recommendations to help you protect your teeth and gums, such
well hydrated, even if you are not thirsty. Carry a bottle with you everywhere
your doctor about changing medications or dose instructions
beverages that aggravate a dry mouth such as coffee, alcohol, acidic fruit
drinks, and carbonation
spray or mouthwash moisturizers
your mouth to produce more saliva by chewing sugar-free gum
often begin to experience oral health deterioration sometime after retirement.
Medicare does not provide for routine dental care, so many people see their
dentist much less frequently than they did when they were employed with health
Fortunately, there are things you can do to prepare for dental care as you age. First, begin planning and saving for dental expenses long before you retire. Second, look for supplemental dental insurance with senior organizations such as AARP. You can also join a dental discount network for services at a reduced cost.
At Windward Life
Care, our goal is to help San Diegans to age gracefully. We do that by helping
individuals find the professional support they need. Call us for a conversation
World Suicide Prevention Day is September 10, an opportunity to highlight the ways in which older adults are at risk for self-harm. Suicide is a more common problem among older adults than you might realize. Figures recently released from the U.S. Centers for Disease Control show that the highest rate of suicides in America is among people age 45 to 64. Knowing this, how can we identify and provide the support to aging adults who may be at risk?
Suicide Risk Factors for Older Adults
First, we need to understand what motivates suicide among older adults. If family members, friends and care providers are more aware of the risk factors, they can more effectively intervene to save lives. The precursors of suicide tend to aggregate around one or more risk factors, including:
Physical pain or illness
Chronic health conditions
Depression or poor mental health
Financial or legal Issues
Prior attempts at suicide
If a person is suffering from one or more of these conditions, they are more likely to consider ending their life. Older adults are more likely to die from a suicide attempt than people in other age groups. This is due to their overall frailty, as well as being socially isolated and less likely to be rescued. Older adults may have more access to lethal methods than others. Men are more likely to die from suicide than women.
Protecting Against Suicide Risk
If you are a caregiver for an aging parent, or a friend of an adult who is experiencing any of the above risk factors, you can help that person build up their strengths or “protective factors.” While some protective factors like resiliency are thought of as more innate, there are others that you can take action to address such as cultivating a sense of purpose, and connecting with others. Older adults who are engaged in social, educational, religious and volunteer activities may feel more connected to others and that their lives are more meaningful.
Depression is one of the most important issues to confront. If you see signs of depression in your loved one, seek the support of a qualified care professional to mitigate this risk factor. Other physical or mental health concerns such as chronic pain and anxiety should also be evaluated and treated.
It is a common misconception that talking to someone about their suicide risk may lead them to consider the idea. In fact, talking to someone you care about and asking them about their mood is one of the best things you can do to support someone. You may experience hesitation when encouraging an older adult to seek outside help. Try to be understanding and look for supportive resources and activities that are of interest to the individual. At Windward Life Care, our experienced team is here to assist you in finding these local resources to support your health and well-being. For more information about available services, call us today.
Windward Life Care’s professional Aging Life Care Managers provide an array of services that benefit clients and their families. One particularly important function is assisting clients and their support systems in managing medical conditions and related problems. This includes helping clients and their families navigate through often stressful and confusing hospital visits, whether the visits are routine or urgent. Care managers like Windward’s Terry Ehlke, RN, BSN, CMC, serve as the client’s primary advocate to facilitate the entire process. Terry took some time out of her busy schedule to answer questions about some of the essential services a care manager provides at such critical moments in a client’s care.
How can Aging Life Care Managers help when an older or disabled adult is hospitalized?
Care managers function as patient advocates, making sure the client is cared for properly during hospitalization all the way through discharge. Care managers work closely with the client and hospital team to ensure everyone understands the history and special needs of the client, any unnecessary trips back are avoided (such as for tests that can be handled during the current visit), the client is safely discharged, and adequate discharge instructions are provided to the client and caregiver. A care manager can also step in with any appeals to pause or slow down the discharge process if need be. Often clients don’t realize they can say “no,” so they just go along. The ultimate goal is for clients to experience the safest and most effective and efficient hospital stay possible.
What are the risks when the hospital says it’s time for a patient to be discharged?
Unfortunately, the discharge process can often be too fast and disorganized. Without any standard of care for hospital discharge in place, every hospital does their own thing. Hospital staff are under great time pressure and can rely on “cookie cutter” discharge plans that don’t account for the client’s unique circumstances. The very real situation at the client’s home is often overlooked, so failures stemming from not considering certain bigger-picture issues are common. Elderly clients especially are very medically fragile. In addition, communication and referral delays can lead to unsafe situations at home and treatment delays. Instructions to the patient regarding follow-up care, if even provided, can be rushed and inadequate. This is particularly dangerous in the case of a new diagnosis for diabetes or congestive heart failure. There is a significant risk that problems that could have been easily prevented through a better discharge process will lead to readmission.
Why is preventing readmission such a big deal?
I recently read a study that revealed up to 27% of rehospitalizations were preventable. While it’s true that many readmissions are simply not avoidable, medical issues that are not resolved prior to discharge or failures in the transition to home can often result in an otherwise unnecessary return to the hospital or emergency department. Readmission has a huge impact on the client’s quality of life and safety. Each hospital visit poses that much more exposure to potentially lethal complications (medication errors, hospital-acquired infections, blood clots, etc.) while putting added stress on the client who is once again away from the comforts of home in an unfamiliar environment. Worsening cognition, including delirium, can result from being in the hospital environment. Ultimately, readmission delays recovery, possibly introducing new complications.
Who is most at risk for recurring hospitalizations/readmission?
There are myriad factors that increase the risk of repeat hospitalizations. These include taking certain medications, such as antibiotics, glucocorticoids, anticoagulants, narcotics, antipsychotics, and antidepressants to name a few, as well as certain chronic health conditions, like advanced chronic obstructive pulmonary disease, diabetes, heart disease, stroke, cancer, and depression, among many others. Prior recent hospitalizations and premature discharges also increase risk, as does low health literacy, a limited social network, and low socioeconomic status.
A key advantage of working with a care manager is that we have detailed knowledge of a client’s daily life, health, diet, medication regimen, and other circumstances that can impact his or her health and well-being when it comes to hospital readmission.
Medications can be confusing and the risks of taking them incorrectly are high. What can families do to help reduce errors and complications in this area upon hospital discharge?
The client and/or family caregiver must be clear on all medication instructions. Families and caregivers need to determine who will set up and manage the medications, as the client may not be the best person to do this for him- or herself. All medications, including pre- and post-hospital meds and over-the-counter meds, should be reconciled. Be sure to update and consult with the primary care physician as soon as possible following a hospital discharge. Due to the complexity of managing the administration of multiple medications at multiple times of day, enlisting the services of a home health nurse may be the best option. Pharmacists can also be an invaluable resource.
What are some of the issues where multiple healthcare providers are involved?
There are often many providers involved after a discharge. Inadequate hand-offs and communication problems between them are major impediments to a smooth transition to home. Home health providers, including nurses and therapists, may get incomplete information from the discharge planner’s referral. Equipment is ordered (or maybe not) and does not arrive on time. Home care aides are often not provided with basic information prior to working with a new client. There’s the potential for no one to follow up on hospital lab results after discharge if the discharge papers didn’t indicate any were pending. Pharmacies are also known to transcribe orders incorrectly, or not know some medications were discontinued or changed at the hospital, and then they don’t fill them correctly or at all.
Do doctors ever talk to each other about their shared patients?
Hospital doctors, or hospitalists, do not talk to primary care doctors as a general rule. This often comes as a surprise to our older clients who were used to a different system for most of their lives. Doctors may share computer records, but those are sometimes incomplete. Up to 50% of patients do not see their primary MD following a hospital stay, though this is essential to the success of ongoing care and is usually included in the “to do” list in discharge instructions. The hospital discharge planner typically does not make this appointment for the client. Referrals are mostly made to specialists, but if the client does not follow up to make an appointment, the specialist may never see the client.
What steps does a care manager take to ensure a smooth transition to home when a client is leaving the hospital?
This is often the time when we first get involved with a new client because the family or involved professional realizes they need an advocate. The Aging Life Care Manager conducts a full assessment that starts with a review of the discharge instructions. Particular attention is paid to any signs that require medical attention, medication changes, any restrictions on physical activity and diet, and any treatments that are needed. The care manager also follows up with the primary care physician and specialty providers while making sure the client and family have a complete understanding of all of the above and consults with them regarding possible needs for home healthcare assistance.
The care manager also discusses with the client and family meal preparation, physical and social activities, transportation needs, financial resources, and client preferences, because a care plan that does not align with the client’s preferences cannot be effective.
The care manager then develops a customized care plan based on this thorough and holistic assessment of the client. The plan addresses both immediate needs and long-term care goals, and it clearly identifies who is responsible for each service. The care manager communicates the completed plan with the client, family, caregivers, and other professionals who may be involved in the client’s care. The care manager then supervises the plan’s implementation.
Terry Ehlke recently presented on the topic of hospital discharge planning best practices at the San Diego Regional Home Care Council Spring Symposium in May 2019. Terry was recently promoted to the position of RN Clinical Services Manager at Windward Life Care and is available for assessments and consultation.
With all the recent news headlines about measles outbreaks and vaccinations, it’s a good reminder for people of all ages to evaluate their immunization schedule. Are you up-to-date on the immunizations required to strengthen your immune system against avoidable diseases?
Often, older adults assume that they don’t need to worry about this topic because of the vaccines that were given in childhood. The truth is that the CDC recommends a few key vaccines for seniors, helping you maintain optimal health in the later years of your life.
Recommended Adult Vaccines
The first step is to evaluate your immunization history with the recommended CDC adult immunization schedule. Your doctor can help you identify the vaccines that should be administered. Health professionals have found that protection from childhood vaccines can wear off with time.
These are some of the guidelines that should be considered to prevent the contraction and spread of serious diseases:
Seasonal Flu: The flu strain changes each year, which means that all adults should receive a seasonal flu vaccine. This immunization is most important for older adults, people with chronic health conditions, and pregnant women.
Measles: Outbreaks have been reported across the country, making it more important than ever to stay current with your measles vaccination. The CDC recommends that people born between 1957 – 1967 should be revaccinated now.
Tdap: If you did not receive a Tdap as an adolescent, then this vaccine is suggested to avoid the risk of whooping cough. Also, a Td booster is recommended every 10 years.
Shingles: Older adults have a higher risk of shingles contraction, which is why it is a good idea to have a shingles vaccine.
Pneumonia: This vaccine is recommended for adults 65 years or older, as well as children younger than 2 years old. People between these ages with specific medical conditions might also benefit from the pneumonia vaccine.
While illness and disease are a part of life, there are things that you can do to protect your health and avoid serious health concerns. Staying current with your vaccinations can be an important step in your overall health plan. Do you need assistance in designing a personalized healthcare plan or finding the right health care providers in the area? Windward Life Care is here to help. Call to learn about the available services.
Hearing loss is surprisingly common among older adults, with an estimated 33% of people between the ages of 65 and 74 suffering from this problem. Aging can contribute to these issues, as well as genetics, noise, and disease.
Hearing Problems Faced by Older Adults
Poor hearing in older adults isn’t only an inconvenience, but it can have a ripple effect on many aspects of life. When someone is experiencing hearing loss, they find it hard to hold conversations with family and friends. Additionally, hearing loss can increase the risk of depression, isolation, and even dementia.
Sometimes, a person suffering from poor hearing feels embarrassed or frustrated because they can’t understand what other people are saying. Friends and family might mistakenly think that the person is uncooperative, unresponsive, or confused when really the problem is with the person’s hearing.
Is it Time to Get Your Hearing Checked?
When hearing problems are ignored or left untreated, the issues will get worse with time. If you suspect that you have a hearing problem, then it is essential to visit a doctor for expert advice and treatments.
Signs of hearing loss include:
Difficulty hearing when talking on the telephone
It is hard to follow conversations when two or more people are participating
There is often a need to ask people to repeat their comments
Turning up the TV or radio to a point where other people complain about the noise
Unable to hear due to background noise
The perception that other people are mumbling
Technologies to Help with Hearing
The recommended treatment plan will vary depending on the severity and type of hearing loss that you are experiencing. Some treatments will work better than others. Available treatment options include:
Hearing Aids: Small, electronic devices worn behind or in your ear, helping to amplify sounds.
Assisted Listening Devices: Certain devices can be used to amplify the sounds coming through a cell phone or tablet. Additionally, closed circuit systems can be used in public locations, such as auditoriums, theaters, and more.
Cochlear Implants: These implants are placed in the inner ear and are often used when the hearing loss is severe.
Other treatment options include lip-reading training or even medications in some cases. If you need help finding the right medical support for your hearing loss, then our team is here to assist. Contact us at Windward Life Care.