Home Care CareGivers

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Phoenix is known for its heat, but this year is taking a toll everywhere says CareGivers from Care-To-Go.  Weather you are a Scottsdale senior or an elder from Chandler, AZ, caregivers need to be particularly alert to senior hydration.

By:LINDSEY TANNER | AP Medical Writer | 07/19/11 1:38 PM

Healthy, active seniors enduring this week’s heat wave without any trouble are reminded that they need more water to keep the blood flowing and are far more at risk of dehydration and heat stroke.

This week’s heat wave may be uncomfortable, but you’re healthy, active and feel just fine. So what if you’re over 65? Think again. Feeling good doesn’t mean you’re safe.

There are changes in an older person that raise the risk for heat stroke and other problems. An older body contains far less water than a younger one. Older brains can’t sense temperature changes as well, and they don’t recognize thirst as easily.

Blistering summer heat is an underappreciated killer, claiming by some estimates as many as 1,000 U.S. lives each year — more than any other type of weather.

One federal study found 40 percent of heat-related deaths were in people 65 and older. Those numbers could be lower if more heeded heat warnings aimed at seniors. Yet research has shown many people over 65 don’t think the warnings apply to them — because they don’t think they’re "old."

Don Worden is 79 and an avid tennis buff who prefers playing doubles on outdoor courts along Chicago’s lakefront — even in oppressive 90-degree temperatures like those hitting the Midwest this week.

"I don’t pay too much attention to those" warnings, Worden said. "I stay in pretty good shape, and I don’t feel they apply to me."

Worden said he drinks a lot of water and would stop a match if he started feeling effects from the heat, "but that hasn’t happened."

Scott Sheridan, who studies the effects of heat and climate on health at Kent State University, researched how people over 65 view heat warnings. In his 2006 study of more than 900 people, he found about 70 percent knew about advice to drink plenty of water on very hot days, avoid outdoor activities and stay inside with air conditioning. But only about half said they followed the advice.

"People well into their 70s would say old people should watch out but not them," he said. "People just didn’t want to be thought of in that same category."

Dr. David Zich, an emergency medicine specialist at Northwestern Memorial Hospital, said he has colleagues in medicine that age who shun being thought of as "elderly." But those heat warnings apply to them, too.

As Dr. William Dale, geriatrics chief at the University of Chicago Medical Center explains it, "Any older adult has less reserve and is more likely to become dehydrated than others, just because their overall body water goes down with age no matter how healthy you are."

The amount of water in the body declines with aging, from about 80 percent in young adulthood to about 55 to 60 percent for people in their 80s, Dale said.

Temperature sensors in the brain become less sensitive as people age, so the body doesn’t get the same signals to drink water in hot weather, and older people often don’t feel thirsty even when they need to replenish, Dale said.

They also may not feel the typical symptoms of dehydration, such as headache or dizziness. Some complain of just feeling "bad" and think they’re getting sick, he said.

Conditions were ripe for those types of complaints Tuesday as a dense dome of hot air remained parked over much of the nation’s midsection, raising temperatures into the mid- to upper-90s from the Texas Gulf Coast to the Rockies and the northern Plains. Tropical-level humidity raised the heat index in many places to nearly 120 degrees.

In South Dakota, up to 1,500 head of cattle died across the state from the heat. And in eastern Iowa, the scorching sun caused a portion of Interstate 380 to buckle. The weather also sent dozens of people to hospitals, canceled outdoor sporting events and caused sporadic power outages.

In such conditions, dehydration can lead to heat exhaustion and potentially deadly heat stroke. During a heat wave, that can happen in a matter of hours in older people if they over-exert themselves, don’t drink enough water or are frail and don’t get out of un cooled homes, said Dr. Chris Carpenter, an emergency medicine physician at Washington University School of Medicine in St. Louis.

Heat exhaustion can cause muscle cramps, low blood pressure, rapid pulse and nausea. It can be treated at home, by drinking water, getting into an air-conditioned room or sitting in front of a fan and misting the body with cool water.

But affected people should be monitored for mental changes and to make sure their temperature does not rise above 102 because the condition can quickly lead to heat stroke. A medical emergency, heat stroke involves temperatures of 104 or higher and can cause seizures, loss of consciousness and death.

Medicines many older people take also may make them more vulnerable to the heat. These include diuretics for high blood pressure, which increase urination — and make it more important to drink plenty of water, Dale said.

Some types of drugs can interfere with sweating and raise body temperature, including some medicines for insomnia, nausea, prostate conditions, Parkinson’s disease and even Benadryl. Many list "dry mouth" as a side effect — a tip-off to drink more water, Zich said.

There aren’t specific guidelines on how much water older people should drink in a heat wave.

Dale said he generally tells his older patients to drink a quart of water throughout the day, and to drink even if they don’t feel thirsty.

Doctors also advise older patients to avoid alcohol and coffee during extreme heat because they can cause the body to lose fluid and contribute to dehydration.

For more information on home care in Phoenix, Scottsdale, Chandler, Mesa or the East Valley contact Care-To-Go home care. (480) 284-8611

CareGivers providing in home care often are faced with various levels of Alzheimer’s disease. The memory loss found during home care varies in degree and thus requires flexible and sometimes creative caregiving techniques.  The follow is a recap of President Ronald Regan’s battle with Alzheimer’s.  Care-To-Go CareGivers in the Phoenix, Scottsdale, Chandler and Gilbert areas salute his contribution to America.

When Alzheimer’s Waited Outside the Oval Office

By LAWRENCE K. ALTMAN, M.D.

WASHINGTON — Ron Reagan’s new memoir, “My Father at 100,” has touched off sensational headlines with its suggestion that President Ronald Reagan might have begun showing hints of Alzheimer’s disease while still in the White House.

But in two interviews this month, the younger Mr. Reagan said he never meant to suggest that his father had dementia before leaving office in 1989. And he graciously took the blame for not being more explicit in a passage that described a few personal observations along with comments from the former president’s doctors.

A “rather small section of the book has attracted outsize attention,” he said in a telephone interview from Seattle, where he lives.

All he meant, he continued, was that the amyloid plaque characteristic of Alzheimer’s can start forming years before it leads to dementia. The former president’s diagnosis was made in 1993, four years after he left office.

“Given what we know about the disease,” his son told me, “I don’t know how you could say that the disease wasn’t likely present in him during the presidency.”

Had it been stated that way, the assertion about Alzheimer’s would have stirred little if any debate. Still, the issue is important for anyone — including candidates for office — because of the difficulty of distinguishing the initial symptoms of Alzheimer’s from, say, simple forgetfulness.

The disease occurs most frequently after 70, but it can strike younger people. Dr. Alois Alzheimer, a German psychiatrist, diagnosed the first case in a 51-year-old woman. It is now recognized as one of a number of types of dementia. And diagnosing it with certainty requires a brain biopsy, rarely done while a patient is still alive.

Mr. Reagan’s mental state was an issue even before he became the oldest man elected president, at 69, in 1980. Adversaries were fond of attributing his penchant for contradictory statements, forgetting names and general absent-mindedness to Alzheimer’s.

I reported on Mr. Reagan’s health, and he told me that his mother, Nelle, had died of senility — and that if he were to develop it in office he would resign.

As a follow-up to questions about Alzheimer’s, my extensive interviews with his White House doctors, key aides and others, I found no evidence that Mr. Reagan exhibited signs of dementia as president. The interviews did not include family members.

Moreover, until Ron Reagan’s memoir appeared, no other family member — and not Edmund Morris, the official biographer who spent seven years with Mr. Reagan in the White House — publicly hinted that he showed evidence of Alzheimer’s as president.

“My Father at 100” (Viking) is an affectionate, often lighthearted account of a son’s attempt to uncover his father’s character by going back to his early days. It is generally well written, except for portions of the closing chapter about Alzheimer’s — which Ron Reagan acknowledged were flawed because he “relied on memory” without checking facts about when and where the suspicion of his father’s Alzheimer’s was first raised.

He writes, for example, that after the former president fell from a bucking horse in Mexico in 1989, his doctors detected probable signs of Alzheimer’s in removing a blood clot that formed between his skull and brain. But such a procedure does not involve a brain biopsy that doctors would need to diagnose dementia.

Moreover, Mr. Reagan was flown to a military hospital near Tucson — not taken to San Diego, as his son writes — and the blood clot, a subdural hematoma, was removed weeks later at the Mayo Clinic in Rochester, Minn.

In the interviews, Ron Reagan genially acknowledged the errors and said that if he had anticipated the controversy he created, he “would have done more due diligence in terms of pinning down dates.”

When his father was president, Mr. Reagan, then a professional dancer with the Joffrey Ballet, visited him two or three times a year. Now 52, the younger Reagan has been a radio and television talk show host, commentator and magazine writer. In the book, he writes that he did not want his father to run for a second term, partly because of political differences (Ron has long been liberal) and partly because of his concern about Mr. Reagan’s health — not the possibility of Alzheimer’s, but the near-fatal gunshot wound he sustained in a 1981 assassination attempt.

Understandably, the son’s memories about his father’s Alzheimer’s focused on when it first produced symptoms. The anecdotes that he cites are either well known or lack convincing evidence for Alzheimer’s.

For example, he recounts the 1984 re-election campaign, when his father performed dismally as he floundered through his responses and was lost for words in his first debate with his opponent, Walter F. Mondale. But Mr. Reagan performed well in the second debate, 11 days later.

While spending a day in the Oval Office in 1987, the younger Reagan noticed that aides were providing his father with scripted index cards — a technique he often used when giving speeches — for phone calls lasting five minutes at most, implying signs of a failing memory. But in an interview, Mr. Reagan said it was “hard to know what to make of that” — and laughed as he said he was using similar notes in our conversation.

The son noted little things that he could not explain and to which he did not attach a name at the time. Based on knowing his father’s demeanor and cognition over a lifetime, the observations created an impression “that something was amiss.” But, he wrote, he did not want to leave an impression that his “father was catatonic or mumbling incoherently” at any period in the White House.

In his last months, Mr. Reagan held court from a hospital bed in his den, uncomplaining and gently agreeable. By this time he looked younger; his face had lost many of its worry lines and wrinkles. But as he stopped eating and drinking and his kidneys failed, Mr. Reagan lost the decade-long battle with Alzheimer’s and died on June 5, 2004.

Alzheimer’s hereditary patterns are not precisely known. Ron Reagan said he is aware that he is at risk for the disease. But he has not had genetic tests for it, and has not been asked or volunteered to take part in any study of the family history of Alzheimer’s.

Care-To-Go provides home care and caregivers in the Phoenix, Scottsdale, Chandler and Gilbert areas.

By David Lowell, MD

The holidays can be a time of renewal – renewal of friendships through visits and cards, renewal of family relationships through gatherings and shared meals, and renewal of one’s faith. But the holidays also are a time that can be particularly challenging for a family caregiver. It is a time during which the changes in one’s life are highlighted and there are additional demands placed upon on an already stressed life.
The holidays are always a whirlwind and this is especially true for caregivers. During the holidays it is important for caregivers to seek a balance – between caring for someone else and caring for oneself; between celebrating good memories of past holidays while not dwelling on what might have been lost. Here are ideas to keep in mind for both the caregiver and the care receiver as the holiday season arrives:
Ideas for the Caregiver:
1. Don’t try to do it all. In the past you may have prepared Christmas dinner for 20 and created hand-made gifts for all of your relatives. Ask other members of the family to carry on specific family traditions. Dividing the responsibility will help you manage your stress level. 
2. Don’t attempt to travel long distances by car if your loved one is not used to it and tires easily. You will both be exhausted by the time you reach your destination, and you will have a difficult time enjoying yourself. 
3. Ask family or friends to provide respite care. Make time to enjoy holiday decorations or window shopping. Just a few hours of time by yourself or with a friend can be renewing and help combat a sense of isolation. 
4. Avoid comparisons with past holidays. It is often emotionally draining to look upon change as loss. “Life is change” can be a helpful concept to hold onto. 
5. Create new traditions that can be carried on year to year, rather than dwelling on old traditions that your loved one can no longer participate in.
Ideas for Your Loved One:
1. Find a way to have your loved one participate in the holidays, whether its making decorations or counting the days on an Advent calendar
2. Decorate your loved one’s room or living area for the holidays. Incorporate symbols and decorations that are meaningful. 
3. Stimulate all of your loved one’s senses with the sounds, sights, smells and tastes of the holidays. Ideas include holiday music and decorations, a favorite dessert and familiar scents.
4. Familiar holiday foods are a nice way to evoke positive memories.
5. If your loved one is in a care facility, extend traditions to other people in the facility. For example, pass out holiday cards or make a traditional dessert to share.

For families caring for elder loved ones at home, respite care can be a great relief during the holidays. It can be a great relief for the family caregiver as well as the senior. There are two options. First the caregiver can stay with the senior at home while the family members take a break. The other option is to take the senior out for an outing.

For Home Care in the Phoenix area contact Care-To-Go (480) 284-8611 Care-To-Go.com

The old man sat in his gas station on a cold Christmas Eve. He hadn’t been anywhere in years since his wife had passed away. It was just another day to him. He didn’t hate Christmas, just couldn’t find a reason to celebrate. He was sitting there looking at the snow that had been falling for the last hour and wondering what it was all about when the door opened and a homeless man stepped through.
Instead of throwing the man out, Old George as he was known by his customers, told the man to come and sit by the heater and warm up. "Thank you, but I don’t mean to intrude," said the stranger. "I see you’re busy, I’ll just go."
"Not without something hot in your belly." George said.
He turned and opened a wide mouth Thermos and handed it to the stranger. "It ain’t much, but it’s hot and tasty. Stew … Made it myself. When you’re done, there’s coffee and it’s fresh."
Just at that moment he heard the "ding" of the driveway bell. "Excuse me, be right back," George said. There in the driveway was an old ’53 Chevy. Steam was rolling out of the front. The driver was panicked. "Mister can you help me!" said the driver, with a deep Spanish accent. "My wife is with child and my car is broken." George opened the hood. It was bad. The block looked cracked from the cold, the car was dead.
"You ain’t going in this thing," George said as he turned away.
"But Mister, please help …" The door of the office closed behind George as he went inside. He went to the office wall and got the keys to his old truck, and went back outside. He walked around the building, opened the garage, started the truck and drove it around to where the couple was waiting. "Here, take my truck," he said. "She ain’t the best thing you ever looked at, but she runs real good."
George helped put the woman in the truck and watched as it sped off into the night. He turned and walked back inside the office. "Glad I gave ‘em the truck, their tires were shot too. That ‘ol truck has brand new ." George thought he was talking to the stranger, but the man had gone. The Thermos was on the desk, empty, with a used coffee cup beside it. "Well, at least he got something in his belly," George thought.
George went back outside to see if the old Chevy would start. It cranked slowly, but it started. He pulled it into the garage where the truck had been. He thought he would tinker with it for something to do. Christmas Eve meant no customers. He discovered the the block hadn’t cracked, it was just the bottom hose on the radiator. "Well, shoot, I can fix this," he said to
Himself. So he put a new one on.
"Those tires ain’t gonna get ‘em through the winter either." He took the snow treads off of his wife’s old Lincoln. They were like new and he wasn’t going to drive the car anyway.
As he was working, he heard shots being fired. He ran outside and beside a police car an officer lay on the cold ground. Bleeding from the left shoulder, the officer moaned, "Please help me."
George helped the officer inside as he remembered the training he had received in the Army as a medic. He knew the wound needed attention. "Pressure to stop the bleeding," he thought. The uniform company had been there that morning and had left clean shop towels. He used those and duct tape to bind the wound. "Hey, they say duct tape can fix anythin’," he said, trying to make the policeman feel at ease.
"Something for pain," George thought. All he had was the pills he used for his back. "These ought to work." He put some water in a cup and gave the policeman the pills. "You hang in there, I’m going to get you an ambulance."
The phone was dead. "Maybe I can get one of your buddies on that there talk box out in your car." He went out only to find that a bullet had gone into the dashboard destroying the two way radio.
He went back in to find the policeman sitting up. "Thanks," said the officer. "You could have left me there. The guy that shot me is still in the area."
George sat down beside him, "I would never leave an injured man in the Army and I ain’t gonna leave you." George pulled back the bandage to check for bleeding. "Looks worse than what it is. Bullet passed right through ‘ya. Good thing it missed the important stuff though. I think with time your gonna be right as rain."
George got up and poured a cup of coffee. "How do you take it?" he asked.
"None for me," said the officer.
"Oh, yer gonna drink this.  Best in the city. Too bad I ain’t got no donuts." The officer laughed and winced at the same time.
The front door of the office flew open. In burst a young man with a gun. "Give me all your cash! Do it now!" the young man yelled. His hand was shaking and George could tell that he had never done anything like this before.
"That’s the guy that shot me!" exclaimed the officer.
"Son, why are you doing this?" asked George, "You need to put the cannon away. Somebody else might get hurt."
The young man was confused. "Shut up old man, or I’ll shoot you, too. Now give me the cash!"
The cop was reaching for his gun. "Put that thing away," George said to the cop, "we got one too many in here now."
He turned his attention to the young man. "Son, it’s Christmas Eve. If you need money, well then, here. It ain’t much but it’s all I got. Now put that pea shooter away."
George pulled $150 out of his pocket and handed it to the young man, reaching for the barrel of the gun at the same time. The young man released his grip on the gun, fell to his knees and began to cry. "I’m not very good at this am I? All I wanted was to buy something for my wife and son," he went on. "I’ve lost my job, my rent is due, my car got repossessed last week."
George handed the gun to the cop. "Son, we all get in a bit of squeeze now and then. The road gets hard sometimes, but we make it through the best we can."
He got the young man to his feet, and sat him down on a chair across from the cop. "Sometimes we do stupid things." George handed the young man a cup of coffee. "Bein’ stupid is one of the things that makes us human. Comin’ in here with a gun ain’t the answer. Now sit there and get warm and we’ll sort this thing out."
The young man had stopped crying. He looked over to the cop. "Sorry I shot you. It just went off. I’m sorry officer."
"Shut up and drink your coffee " the cop said.
George could hear the sounds of sirens outside. A police car and an ambulance skidded to a halt. Two cops came through the door, guns drawn. "Chuck! You ok?" one of the cops asked the wounded officer.
"Not bad for a guy who took a bullet. How did you find me?"
"GPS locator in the car. Best thing since sliced bread. Who did this?" the other cop asked as he approached the young man.
Chuck answered him, "I don’t know. The guy ran off into the dark. Just dropped his gun and ran."
George and the young man both looked puzzled at each other.
"That guy work here?" the wounded cop continued.
"Yep,"  George said, "just hired him this morning. Boy lost his job."
The paramedics came in and loaded Chuck onto the stretcher. The young man leaned over the wounded cop and whispered, "Why?"
Chuck just said, "Merry Christmas boy … and you too, George, and thanks for everything."
"Well, looks like you got one doozy of a break there. That ought to solve some of your problems."
George went into the back room and came out with a box. He pulled out a ring box. "Here you go, something for the little woman. I don’t think Martha would mind. She said it would come in handy some day."
The young man looked inside to see the biggest diamond ring he ever saw. "I can’t take this," said the young man. "It means something to you."
"And now it means something to you," replied George. "I got my memories. That’s all I need."
George reached into the box again. An airplane, a car and a truck appeared next. They were toys that the oil company had left for him to sell. "Here’s something for that little man of yours."
The young man began to cry again as he handed back the $150 that the old man had handed him earlier.
"And what are you supposed to buy Christmas dinner with? You keep that too," George said. "Now git home to your family."
The young man turned with tears streaming down his face. "I’ll be here in the morning for work, if that job offer is still good."
"Nope. I’m closed Christmas day," George said. "See ya the day after."
George turned around to find that the stranger had returned. "Where’d you come from? I thought you left?"
"I have been here. I have always been here," said the stranger. "You say you don’t celebrate Christmas. Why?"
"Well, after my wife passed away, I just couldn’t see what all the bother was. Puttin’ up a tree and all seemed a waste of a good pine tree. Bakin’ cookies like I used to with Martha just wasn’t the same by myself and besides I was gettin’ a little chubby."
The stranger put his hand on George’s shoulder. "But you do celebrate the holiday, George. You gave me food and drink and warmed me when I was cold and hungry. The woman with child will bear a son and he will become a great doctor.
The policeman you helped will go on to save 19 people from being killed by terrorists. The young man who tried to rob you will make you a rich man and not take any for himself. "That is the spirit of the season and you keep it as good as any man."
George was taken aback by all this stranger had said. "And how do you know all this?" asked the old man.
"Trust me, George. I have the inside track on this sort of thing. And when your days are done you will be with Martha again."
The stranger moved toward the door. "If you will excuse me, George, I have to go now. I have to go home where there is a big celebration planned."
George watched as the old leather jacket and the torn pants that the stranger was wearing turned into a white robe. A golden light began to fill the room.
"You see, George … it’s My birthday. Merry Christmas."
George fell to his knees and replied, "Happy Birthday, Lord Jesus"
Merry Christmas!!
This story is better than any greeting card.

MERRY CHRISTMAS AND GOD BLESS!

What to cook when cancer hits

By Liz Szabo, USA TODAY

Doctors often instruct cancer patients to eat well to keep up their strength.

But for cancer patients, getting through a simple meal can be a challenge. Radiation treatments can burn the throat, making it painful to swallow. Chemotherapy can cause patients to develop mouth sores or leave people nauseated. Other patients find that chemo takes away their sense of smell or alters their sense of taste.

Two books from the American Cancer Society aim to help both patients and their caregivers overcome these hurdles. The Complete Guide to Nutrition for Cancer Survivors ($24.95), published this year, explains how good nutrition can help boost the immune system and fight fatigue.

What to Eat During Cancer Treatment ($19.95), published last year, offers 100 recipes to help patients cope with six major symptoms of treatment. For instance, there’s a brie and apple grilled cheese for patients coping with nausea. Most recipes take only 30 minutes to make.

That’s important, given that cancer patients may not have much energy to spend in the kitchen and caregivers may be pressed for time, says the cancer society’s Colleen Doyle, who edited both books.

The recipes also include foods packed with vitamins and antioxidants, Doyle says. Patients who eat well are often better able to deal with side effects of treatment and may be better able to fight off infections, she says.

"I truly believe food is medicine, and it helps people provide their body with the nutrition they need to heal," say Barbara Grant, a registered dietitian and co-author of Nutrition for Cancer Survivors.

American Cancer Society’s tips for cooking for someone with cancer:

• Ask if the person has any special requests. "Instead of just showing up with chocolate cake, ask, ‘What can I make you? What sounds good?’ " says Grant.

• Ask if you can help with groceries or offer to do the dishes, says the American Cancer Society’s Colleen Doyle, a registered dietitian.

• Offer to put together a "survival kit" in a cooler, filled with snacks and drinks, for times when the cancer patient doesn’t want to get out of bed to go to the kitchen to eat, Doyle says.

• Prepare an "on-the-go" snack mix with nuts, pretzels, dry cereal or crackers for the cancer patient to eat when away from home.

• Instead of making one big casserole, prepare individual servings to freeze and reheat, Doyle says.

• Wash your hands carefully, make sure all meats and eggs are fully cooked, and take care to avoid any kind of contamination, which can be dangerous for people with weakened immune systems.

Recipe: Tuna melt quesadilla

The recipe from the American Cancer Society addresses the common cancer treatment symptoms of unintentional weight loss and taste alterations.

Servings: 3

Prep time: 15 minutes or less

Total time: 15 minutes or less

This twist on a classic gives new life to the tuna melt. A quesadilla is a good choice when a sandwich seems overwhelming. Choose full-fat options if trying to gain weight, reduced-fat if you are watching calories.

Ingredients:

• 1 (5-ounce) can tuna in water, drained

• 1 tablespoon regular or reduced-fat mayonnaise

• 1/2 tablespoon Dijon mustard

• 1 tablespoon finely chopped red onion

• 1 tablespoon pickle relish

• 3 (8-inch) whole wheat or plain tortillas

• 3/4 cup shredded regular or reduced-fat Cheddar or "Mexican style" cheese

Directions:

1. In a bowl, flake the tuna. Add the mayonnaise and mustard and stir to combine. Add the onion and relish.

2. On a microwave-safe plate, place 1 tortilla and spread half with 1/3 of the tuna mixture. Sprinkle the other half with 1/4 cup cheese. Fold the tuna half over the cheese half. Microwave on high for 40 to 50 seconds, or until cheese melts. Repeat twice with the remaining ingredients. Microwaving the quesadilla instead of pan-frying or baking keeps it softer.

Nutritional information:

Per serving (1 quesadilla)

Calories: 360

Total fat: 17 g

Total carbohydrate: 31 g

Dietary fiber: 3 g

Sugars: 3 g

Protein: 21 g

Sodium: 940 mg

For CareGiver Home Care in the Phoenix or Scottsdale area see http://Care-To-Go.com

Caregiver Explains How To Prevent Falls With Better Balance

By John Hanc New York Times

Unintentional falls among those 65 and older are responsible for more than 18,000 deaths and nearly 450,000 hospitalizations annually in the United States, according to the Centers in Atlanta. Most of these falls are caused by a decline in that complex and multidimensional human skill known as balance.

Balance is a critical issue to older people. And more and more, at one-on-one training facilities like Mr. Morea’s or at larger health clubs, whether in yoga and Pilates studios or adult-education exercise classes for older adults, balance training is becoming a priority.

To remain upright and sure-footed, explained Dr. David Thurman, a neurologist with the center and a spokesman for the American Academy of Neurology, “there are several components of the nervous system, as well as motor or movement functions, that need to be intact.” These include the vestibular system of the inner ear, vision and proprioception, the ability to sense where one’s arms, legs or other parts of the body are without looking at them, as well as the strength and flexibility of bones and soft tissue.

“All of these,” Dr. Thurman said, “tend to degrade with age, particularly as people move into their seventh and eighth decades.”

Yet, unlike many effects of aging, balance can be improved, and the age-related declines can be delayed or minimized with proper training.

“The preponderance of evidence,” Dr. Thurman said, “shows fairly convincingly that strength and balance training can reduce the rate of falls by up to about 50 percent.”

Hence, the Department of Health and Human Services in revising its national physical activity guidelines, issued in 2008, added a recommendation for the elderly to include balance exercises as part of their overall physical activity regimen.

The problem, said Michael Rogers, an exercise scientist at Wichita State University, is that while most major public health agencies recommend 30 minutes a day of cardiovascular exercise for the heart and two or three sessions a week of strength training, “there is no real exercise prescription for balance.” So activities that promote balance tend to become integrated into other activities. Mr. Morea does this with older clients like Ms. Luftig in twice-weekly, 30-minute strength-training sessions.

Of course, while it is good to have supervision by a certified fitness professional, not to mention the benefit of a gym full of balance toys (and there are many these days, including wobble boards, balls and cushions), one does not have to work out with a personal trainer to get the benefits of balance training.

“You can do it anytime, anyplace,” said Mr. Rogers, who is research director at Wichita State’s Center for Physical Activity and Aging and teaches exercise classes to older adults. “You don’t have to be involved in a systematic program.”

He added, “You don’t have to be standing on one foot, which is often too difficult for some older people. You can challenge your balance while brushing your teeth.” Simply put one foot in front of the other while you brush, or stand with your feet closer together.

Balance training is often seen as part of a larger trend called functional fitness exercises, which are geared to helping one handle the physical challenges of day-to-day life. Around holiday time, for example, Mr. Rogers tries to prepare the elderly in his class for crowded shopping malls. He has them walk between narrow gaps, occasionally getting brushed by others. This, he said, “helps give them confidence” to face the holiday throngs.

Trainers like Mr. Morea devise balance training drills for their older clients. For example, a woman was having trouble bending down in her kitchen to reach to the back of a floor-level cupboard and retrieve cooking pots. So he developed “pot squat and reach” — a movement that basically imitated what she was doing, except on an unstable surface, so that she could develop the strength, neural connections and balance to confidently perform that movement at home.

One of the nice things about balance training is that the results can be evident fairly quickly.

“The nervous system has considerably more regenerative capacity well into the senior years than we used to think,” said Dr. Thurman. “The capacity for adjustment, compensation and even developing new skills remains there.”

Which is exactly what Ms. Luftig, who lives in Greenwich Village, has found. “I feel more confident,” she said. “In my neighborhood, you have bicycles whizzing by you all the time. You could lose your balance when they come so close. But when that happens now, I feel more stable. I have this ability that I didn’t used to have.”

For assistance in the Phoenix area contact Care-To-Go at 480-284-8611

10 Tips To Avoid Prescription Problems In The Elderly Phoenix AZ

Avoiding Medication Problems

Numerous elders are taking numerous medicines, which increases the

likelihood of prescription problems.  Allow me to share some

excellent tips for seniors to reduce the probability of making a

mistake with their medications:
1.    Check the label when you pick up a prescription to be sure

that you have the right prescription. Read back the prescription to

your doctor and pharmacist.
2.    Keep all prescription in original containers.
3.    Be sure to contact your health care provider or pharmacist

if you have any concerns about missing a dosage.
4.    Always fill all medications at the same pharmacy.
5.    Read the patient information that accompanies the

prescriptions.
6.    Notify the pharmacist right away if there is a change in the

shape, color, size or smell of your medication.
7.    You should not share or take another person’s medication.
8.    If you are in doubt about a prescription you are taking, be

sure to consult your doctor.  Always ask about side effects that you

might experience or expect.
9.    Construct a list of the medications you are taking and share

with your Care Giver and family members. The list ought to include

the following information:
- Your name, social security number and your date of birth.  The

Pharmacy needs this information when someone else is going to refill

the prescriptions without the client present.  Your social security

number and your date of birth should be kept on a separate sheet to

protect against identity theft.
- Prescription name (the drugs being taken, both generic or brand)
- The strength (dosage)
- Instructions for using the prescriptions, including how many times

a day and what time of day medication should be taken
- What liquids or foods are being used to take or should be used to

take with meds, for example, water, juice, apple sauce etc.
- Your allergies to certain medicines as well as foods
- Pharmacy and health care providers names, addresses, contact

numbers
- Family emergency contact information

10.    When you are in skilled nursing or a hospital:
- State your name before taking any medications and always show your

wrist bracelet for identification. Ask the doctor or nurse to

identify each medicine by name before you take it.
- Ask your doctor or nurse why your prescription has not been given

at its normal time during your hospital stay.
If your medication was started in the hospital, watch for new side

effects.  If you experience new side effects or your condition is

not improving as it should, tell your nurse.  From time to time

medications need to be changed when they are not performing

properly.
Be sure to ask your doctor how long a particular prescriptions will

be needed.  Oft times prescriptions are added in the hospital or

skilled nursing facility for a temporary problem, but when you leave

the hospital for skilled nursing or your home, the prescription

remains.  A different doctor may be reluctant to terminate a

prescription from another medical doctor.
- Remind your medical doctor if you have any allergies to certain

meds and food, or if you have a condition that may possibly affect

the use of some medications.
1.    Tell your pharmacist if you are taking any dietary

supplements or over-the-counter meds.
2.    Make sure your CareGiver has an up to date prescription log

listing all prescriptions, Doctor’s name, and Pharmacy.
Make sure to only take medications that you really need and check

with your medical doctor why you are taking it, how long you will

require it, what side effects to watch for, and that it won’t

conflict with any other meds you are taking.

In the Phoenix area Care-To-Go, an in-home care agency can assist

you with your prescription organization.  Care-To-Go also provides

complete in-home care elder services.  Contact Care-To-Go at 

www.Care-To-Go.com and for an Elder Travel Companion CareToGoTravel.com

7 Signs It Is About Time To Fire Your Doctor Reported By Scottsdale CareGiver

What should you do if your doctor isn’t listening to you or the person you’re caring for, or not honoring your desires with regards to treatment and medication choices, or recommending prescriptions or treatment options that seem to be inappropriate for older patients. Listed here are several illustrations.

The relationship with your medical doctor is a special one and has to be taken seriously. Many times senior citizens aren’t receiving enough care from their doctor. Is the medical doctor too busy and overscheduled, or there just may be a personality mismatch. Don’t be afraid to search for a new one if you feel you are not getting the attention you require.

Whenever seniors go to their doctor it’s a great idea to bring along with you, a professional CareGiver or a trusted family member. It will serve you well to have someone else there to be sure you understand what the medical professional is saying and if you need to get more in depth information from the doctor, the advocate can facilitate. Occasionally it is simpler for the other person to ask more inquiring questions.

By way of example a doctor may try to make you feel guilty when you ask to do away with a prescription or a procedure from your regimen. You may have prescriptions from a number of doctors and they may conflict with each other. Your physician may be unwilling to stop or change a prescription prescribed by a different health professional. But sometimes the dilemma doesn’t lie in your control; what is wrong is that the physician isn’t listening to you or not taking your loved one’s age or situation into account when making medication and treatment decisions. In many cases, it’s like a bad relationship; communication has broken down and you, your family member or CareGiver aren’t getting what you need.

7 signs it may be time to fire your doctor:

1. You feel the health professional blames, ignores, or criticizes you, your caregiver or the person in your care

2. The medical doctor does not reply to your feedback, or becomes defensive or unpleasant

3. It seems the physician is not taking your family member’s pain or other symptoms seriously enough

4. You discover treatments that can help that the doctor hasn’t told you about

5. The physician doesn’t explain treatment options clearly, resulting in mistakes

6. The medical doctor prescribes medications without comparing to medications prescribed by another doctor.

7. The doctor is reluctant to organize your medication inventory when it comes from various other physicians.

When you aren’t satisfied, the best thing to do is to change doctors, and change to one you can work with to provide the best care. Doctors often say that if a patient is going to change doctors, they’d appreciate hearing it directly rather than suddenly receiving a sneak request for medical records to be sent to another medical professional. However, it’s your prerogative to find a new doctor and ask the staff to fax over the request for records. You’re not obligated to engage in another confrontation.

Either way, you’ll breathe a sigh of relief once you’re dealing with a medical professional who listens respectfully, answers your questions, accommodates your requests, takes your symptoms seriously, and works with you to develop a treatment plan you can all feel good about.

In the Phoenix, AZ area Care-To-Go offers Elder Home Care services and can assist you with doctor appointments and prescription organization. Contact Care-To-Go at 1-800-818-0407 or Care-To-Go.com  For Elder Travel Companion services see CareToGoTravel.com.

Travel Companion Makes Family Reunion Possible

Phoenix Travel Companion Reunites A Brother And Sister After Years Apart

It was a picturesque spring day in April when Evelyn and her personal Travel Companion and CareGiver headed for the airport shuttle going from Burbank California connecting to John Day Oregon.  This should be a trip to remember.  Evelyn 95 was on her way to reunite with her brother Howard now 93 in Oregon.

Evelyn and Howard are the only ones remaining of five siblings who grew up on a little farm in Missouri then moved to California and Oregon in the mid 1940s.  It had been several years since the two of them had spent time together.

The trip to Boise ID went smoothly because Evelyn’s Travel Companion had scheduled an easy connection and had scheduled a wheel chair and pre-boarding for all the flight segments.  Evelyn’s Travel Companion Pam handled the bags and arranged for transportation from Boise airport to John Day OR, about a 3 hour ride.  Once checked into their hotel in John Day, Pam and Evelyn went to the ranch to reunite with Howard.

Ron, Gary, Brian, along with Donna also come to join in the get-together.  Evelyn and Howard were so excited to see each other and they lost no time in catching up.  Donna, Pam and Ron made dinner “Missouri” style which set the stage for several hours of conversation about the old days. 

During the next three days, The seniors reminisced for endless hours, never running out of stories.  They reminisced, went fishing (Evelyn caught the most fish for the dinner), looked at the scrap books, enjoyed Howard’s birthday celebration and just enjoyed their time all together.

Evelyn’s Travel Companion Pam, not only helped all the way making the trip possible, but she put forth the extra effort insuring that Evelyn was well taken care of and cared for.  Besides the trip, Pam helped with meals, baited hooks for fishing, helped organize scrapbooks and took some family pictures.  Pam roomed with Evelyn in the lodge to be certain she was well cared for and secure.

When it was time for the flight home, Evelyn and her travel companion boarded Southwest flight 405 to Oakland CA to connect to Burbank California.  The standard wheel chair and perboarding were set and the boarding in Boise went fine. 

After 30 minutes in the air, the pilot said that there was a warning light in the cockpit and we needed to return to Boise and have it fixed.  When it was discovered that the delay could be lengthly, the gate agents had everyone to get off and wait for another aircraft.  Evelyn was assisted from the plane and the circumstances was explained to her.  Pam, the Travel Companion continued to handle everything; explaining the circumstances to Evelyn, re-booking the flight connection to Oakland, assuring priority boarding once more, and handling snacks and drinks.  Thankfully the flights home were uneventful and went smoothly.

We are reminded constantly how precious family and friends can be to our well being.  Our seniors regularly let life close in on them because retaining contact with loved ones who live far away becomes too difficult.  Unfortunately, travel is one of the first things that drops out of the life of  an aging senior.  Travel Companions are a way for seniors to keep the lifestyle they love and maintain contact with friends and family.

Evelyn and Howard had a few wonderful days together and they now have more memories to last a life time.  At the last dinner in Oregon, plans were already started to schedule the next family reunion.

One company specializing in Travel Companions is Care-To-Go. For information on scheduling your Travel Companion visit CareToGoTravel.com

Phoenix Home Care Caregiver Explains 19 Home Safety Tips For Seniors

Most accidents occur in the home and especially for our seniors.  Even though our seniors are in their own home and in familiar surroundings, they have a much higher accident rate than the rest of us. When you couple failing eyesight, poor hearing and decreased judgment and balance, the senior has a more difficult time moving around and staying safe. If you make the changes yourself or use a personal CareGiver, you may be able to avoid a major fall and injury to your parent.

What can you do to protect an elderly loved one from getting hurt?  Here are some steps to follow:

1. Keep outdoor steps and walkways in good condition and clear of debris. Be sure the hand rails are clean and in good condition.
   
2. Illuminate all stairways and hallways and provide light switches at both ends. Brighter lights are better.
   
3. Use nightlights or bedside remote controlled switches. Yeah the clapper works too.
   
4. Provide handrails in hallways and stairways.
   
5. Keep a sturdy nightstand next to the bed so glasses and other personal items are within reach.
   
6. Put felt or soft material over sharp edges and corners of furniture such as nightstands, tables and shelves.
   
7. Tack down the edges of carpets and rugs; remove throw rugs that slide or can be tripped on.
   
8. Keep pathways clear of furniture and other objects.
   
9. Provide handrails in the bathroom (especially near the toilet, at the entrance to the shower and in the shower) and use non-skid strips in the shower and bathtubs.
   
10. Use a shower seat and shower hose for those unable to stand in the shower.
    
11. Avoid using bath oils or lotions in the bathtub or shower.
    
12. Use kitchen appliances with thermostats and timers. The elderly find appliances with signal lights and buzzers easier to use.
    
13. Clearly mark the “off” position on stoves and ranges so a person with diminished eyesight can immediately tell if the element is off. Try some nail polish.
    
14. Set water heater thermostats or faucets so water does not scald the skin.
    
15. Install smoke detectors in the kitchen and throughout the rest of the house.
    
16. Keep a fire extinguisher handy and know how to use it.
    
17. Arrange frequently used kitchen items in an easy-to-reach cabinet.
    
18. Install one good lock that can be opened easily from the inside.
19. Keep loose magazines and mail off the floor, seniors tend to accumulate mail clutter.

For a complete home assessment contact Care-To-Go at 480-284-8611 and on the web at http://Care-To-Go.com Are you getting to the point where you need someone to help you shoulder the load taking care of Mom? A Home Care CareGiver will be able to assist your senior with household tasks to be sure they are safe and happy.