Caring for the Elderly

Caring for the elderly is one of the most challenging and rewarding jobs in nursing. Demanding a great deal of tact and care, looking after elderly patients is a trying and testing job, although it is one of the most necessary and most sought after positions in modern times. Elderly patients require care for a number of reasons, and these each carry their own complexities and challenges which must be met by the carer.

For some elderly patients, care is a round the clock affair, and this means you also have to be dedicated to patient’s well being. On top of that, patients require genuine attention, which extends beyond the hours of the job. A carer for the elderly must be a genuinely caring person, willing to commit to a career in people. At times it can be a demoralising and depressing job, but at the end of the day, the difference good care can make to quality of life is substantial.

Amongst other things, elderly patients need human company and companionship, and a good carer should have the ability to listen and interact on many different levels. It is a good idea to come with plenty anecdotes, and a good knowledge of current affairs to keep your patients amused whilst you provide them with essential care to improve the quality of their lives. Additionally, it requires patience. Elderly patients can, at times, be set in their ways, and can find it hard to accept help and treatment from someone younger than themselves. However, it is essential to remember that the patients are people too, with their own opinions and dignity. In nursing the elderly, it is a case of striking a balance between offering care and assistance and understanding the mindset of the patient, and this is arguably one of the most difficult things about the job.

Caring for the elderly is not a job for everyone, but it is a job that many would find appealing. Working with the elderly can be very rewarding, and the loyalty and respect you can expect in return for your help is heart-warming. Furthermore, many patients will adopt you and care for you as their own, creating a uniquely bonded two-way relationship. It is this relationship which makes caring a job that is worth far more than any wage, and is something which can provide the real sense of job satisfaction which can’t be found anywhere.

Patients And Caregivers Unprepared For The Mental And Behavioral Changes Associated With Parkinson’s Disease

Parkinson’s disease affects 6.3 million people worldwide. While the disease is recognized for its profound effects on movement, up to 40 percent of Parkinson’s disease patients also develop changes in thought, behavior and judgment.

As Parkinson’s disease progresses, patients may experience what is called ‘Parkinson’s Psychosis,’ in which they experience changes in thought, behavior and judgment. In more advanced stages these symptoms include hallucinations where patients see, hear or feel things that aren’t really there, and paranoid delusions where they become distrustful of even their closest friends and family members. The emergence of these symptoms represents a major turning point in the course of the patient’s disease.

“While the physical manifestations of Parkinson’s disease are difficult to deal with, the changes in thought, behavior and judgment strain the bonds between patients and their caregivers and families,” said Dr. Bernard Ravina, Director of the Movement and Inherited Neurological Disorders Unit at the University of Rochester in New York.

According to an on-line survey recently conducted by MediciGlobal, a global patient recruitment and retention specialty firm, over one-third of Parkinson’s caregivers are unaware that changes in thought, behavior, and judgment can accompany the disease. “As a registered nurse, I was prepared for the physical problems with my husband’s Parkinson’s disease but, despite my job as a RN, I was totally unprepared for the psychiatric issues,” said Carol McLain, a caregiver who took the survey.

According to Dr. Ravina, “It’s the non-physical symptoms of the disease that are often most devastating for both the patient and caregiver. As the patient’s mental health deteriorates, the family often has to make the painful and expensive decision of moving the patient into a nursing home.”

There are currently no FDA-approved treatments for these particular non-physical symptoms of Parkinson’s disease. Nevertheless, doctors often resort to the use of potent antipsychotic drugs to treat these symptoms even though these drugs sometimes have serious side effects, particularly in the elderly, including worsening of motor skills, excessive sleepiness, increased infections, stroke, and sudden death in some patients. As a result, there is a large unmet medical need for new and improved treatment options.

Patient Falls Down, Nursing Home Fined

A Springfield nursing home has been fined by federal officials who say the facility failed to prevent an elderly patient strapped into a wheelchair from tumbling down a flight of stairs.

The U.S. Centers for Medicare and Medicaid Services imposed the $3,500 fine against the Capitol Care Center.

Capitol Care Center administrator Cynthia Schaaf says she did not know whether the facility would dispute the fine.

The fine stems from an incident on Sept. 24. Eighty-six-year-old Alfred “Stan” Catherwood was in a wheel chair when fell down eight stairs, breaking bones in his face and neck.

The state report says the 228-bed facility did not provide adequate supervision or maintain a hazard-free environment.

Home Care Versus Nursing Home Care

Most elders would prefer to stay in their own homes, where they know their neighbors and can associate memories with each piece of furniture and object around them, rather than move to an institution as they age.

Things that can make “aging in place” — the current term for staying in one’s own home as one ages — problematic are tasks such as cooking, cleaning, toileting, shopping, doing laundry, and driving, as well as falls, which for frail elders could initiate a downward spiral.

Support systems

• Help could come from family members, friends, or neighbors, who take care of the specific thing the elder has trouble with — such as doing laundry or shopping.
• Or, some elders turn to their religious community, as often there are volunteers willing to enable a senior to age in place.

• Home care agencies can be hired to provide the extra help needed for the senior to be able to age in place. In some cases, expenses will be reimbursed by Medicare, but seniors will need to check with the home care agency to find out about this possibility.

New technology can help seniors

• Electronic devices are now available to help monitor whether or not a senior has taken his or her medication — and if not, to remind the senior — or to determine whether a senior has opened the refrigerator.
• Emergency buttons can be worn around the neck and pressed if a health or other emergency should occur, in which case a person will speak to the senior through the device, assess the situation, and call for appropriate help.
• Cameras can be installed to track a senior’s movements, allowing adult children to monitor the senior and be assured that he or she is functioning well.
• New devices are constantly being invented, and they can make an enormous difference in a senior’s ability to age in place.

With all of these options available, aging in place is an increasingly viable choice. Seniors and their loved ones need to assess whether this alternative is indeed best, the risk being that the senior may become too socially isolated despite being in familiar neighborhoods and homes.

FREE Elder Talk Audio Release Coming Soon!

Grace Home Care will be releasing an audio compact disc covering the important topics of elderly living and aging.  To receive your FREE copy today, please send email, including your name and mailing address to ttgracehomecare@gmail.com.

The compact disc will be available 12.15.2008. The CD’s  will be going FAST, so reserve your copy TODAY!!

For your In Home Care needs, look to Grace Home Care Services  to provide care that cannot be matched.

Grace Home Care Services

308 22nd Ave. South

Seattle, WA 98144

206.328.6251

ttgracehomecare@gmail.com

Grace Home Care Has Great Care Assistants Available For The Holidays.

If you or a loved one is need  of a great Care Assistant for the holidays or beyond, DO NOT hesitate to give Grace Home Care Services a call. We have qualified Care Assistants available for all shifts. Including day, night, 24 hour, or live-in.

If you need help cooking, cleaning, dressing, doing laundry, running errands, care for pets, or any other household chore call Grace Home care TODAY!!

Phone: 206.328.6251

Antipsychotic Drugs Increase Risk of Death Among Elderly

The FDA has ordered the makers of older, “conventional” antipsychotics to add a “black box warning” to the drugs labels about the risk of early death in elderly dementia patients who take them. This is the strongest warning that can be placed on a medication without pulling it from the market.

This marks the first time that the FDA has used its new authority to mandate stronger warning labels on drugs. Before 2007, the FDA only had the power to request changes to warning labels.

The FDA concluded that conventional antipsychotics pose the same risks to elderly dementia patients as the newer, so-called “atypical” antipsychotics.

“The warning for both classes of drugs will say that clinical studies indicate that antipsychotic drugs of both types are associated with an increased risk of death when used in elderly patients treated for dementia-related psychosis,” the agency said.

In 2005, atypical antipsychotics received a black box warning after studies found that they increased the risks of heart attacks and pneumonia among elderly dementia patients, and that patients who were given the drugs died sooner than those who were not. In one such study cited by the FDA, 50 percent of elderly dementia patients died after ten weeks of treatment with the drugs, compared with only a 2.6 percent death rate among those taking a placebo.

Antipsychotics were designed for the treatment of schizophrenia, and are not approved for the treatment of dementia. Nonetheless, doctors are allowed by law to prescribe according to their own judgment, and antipsychotics are often used to sedate elderly dementia patients who develop psychosis-like symptoms, such as aggression, agitation, hallucinations or delusions.

Many patient advocates have accused many nursing home staff of shortening patients’ lives by giving them drugs that are only designed to sedate, rather than treat them

Holidays and your aging parent. Does Mom or Dad need Home Care Help?

Holiday gatherings are a time when family members reconnect. If it has been awhile since adult children have seen their aging parent, they may be surprised by the changes. Unopened bills strewn across the dining room table or dirty dishes piled up in the sink. Mom seems absentminded and Dad is moody. Clearly help is needed, but what should you do?

First of all, don’t panic. The holidays are a good time for family members to observe changes in older relatives and begin a conversation on the type of assistance they may need. Discussing plans for the future with aging parents is not easy.

As your parent’s potential caregiver, it’s up to you to ask questions regarding their medical, financial, and housing plans and arrangements. Keep in mind that it is easier to have made plans before a crisis — such as a fall or an illness — occurs. Taking action ahead of time will help you avoid scrambling for a solution after the fact. There can be a lengthy application process for long-term-care insurance or waiting lists for some senior communities.

Signs to look for:

• Changes in personal hygiene
• Home in disarray or in need of cleaning
• Changes in weight (check the refrigerator and pantry)
• Failure to manage medications or keep medical appointments
• Increased difficulty with mobility
• Changes in judgment, mood, or overall behavior
• Increased forgetfulness
• Missed bill payments or other financial difficulties
• Decreased social activity

Another difficult aspect of coping with aging parents is dealing with siblings, other family members, or well-meaning friends. Everybody has an opinion or an agenda. Encourage everyone in your family to listen to each other, respond with respect, keep a sense of humor, and stay focused on the goal: providing your parents with the best quality of life.

Use of Bright Lighting May Improve Dementia Symptoms

The use of daytime bright lighting to improve the circadian rhythm of elderly persons was associated with modest improvement in symptoms of dementia, and the addition of the use of melatonin resulted in improved sleep, according to a study in the June 11 issue of JAMA.

“In elderly patients with dementia, cognitive decline is frequently accompanied by disturbances of mood, behavior, sleep, and activities of daily living, which increase caregiver burden and the risk of institutionalization,” the author writes. These symptoms have been associated with disturbances of the circadian rhythm (the regular recurrence, in cycles of about 24 hours, of biological processes or activities). “The circadian timing system is highly sensitive to environmental light and the hormone melatonin and may not function optimally in the absence of their synchronizing effects. In elderly patients with dementia, synchronization may be [diminished] if light exposure and melatonin production are reduced.”

Rixt F. Riemersma-van der Lek, M.D., of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, and colleagues conducted a trial at 12 elderly group care facilities in the Netherlands that evaluated the effects of up to 3.5 years of daily supplementation of bright light and/or melatonin on a number of health outcomes, including symptoms of dementia and sleep disturbances. The study included 189 facility residents, average age 85.8 years; 90 percent were female and 87 percent had dementia.

Six of the facilities had bright lighting installed in ceiling-mounted fixtures. Lights were on daily between approximately 9 a.m. to 6 p.m. Participants were randomized to receive evening melatonin (2.5 mg) or placebo and participated an average of 15 months (maximum period of 3.5 years).

The researchers found that bright light lessened cognitive deterioration by a relative 5 percent, reduced depressive symptoms by a relative 19 percent and diminished the gradual increase in functional limitations by a relative 53 percent.

Melatonin reduced the time to fall asleep by a relative 19 percent and increased total sleep duration by 6 percent, but adversely affected caregiver ratings of withdrawn behavior and mood expressions. The addition of bright light improved the adverse effect on mood. In combination with the bright light, melatonin reduced aggressive behavior by a relative 9 percent.

“In conclusion, the simple measure of increasing the illumination level in group care facilities [improved] symptoms of disturbed cognition, mood, behavior, functional abilities, and sleep. Melatonin improved sleep, but its long-term use by elderly individuals can only be recommended in combination with light to suppress adverse effects on mood. The long-term application of whole-day bright light did not have adverse effects, on the contrary, and could be considered for use in care facilities for elderly individuals with dementia,” the authors write.

Grace Home Care has great Care Assistants available for all shifts.

Grace Home Care has several qualified, loving, and caring Care Assistants available for all shifts. Whether you need assistance for part of the day, the night, or a 24 hour live-in shift, GHCS can provide you with the impeccable care services that you need. We also provide Care Assistants to Nursing Homes, Adult Family Homes, and Hospitals.

So call today for more information.

Telephone: 206.328.6251

E-mail: ttgracehomecare@gmail.com