Home Care is a very flexible and cost-effective way to provide a safety net in your parents’ home

Great Expectations

Home Care is a very flexible and cost-effective way to provide a safety net in your parents’ home requiring a minimal adjustment for them in the rhythm of their daily lives.

Even though home care creates a minimal change in lifestyle for your parents, it is has a strong undercurrent of emotion and expectations for the entire family. Home care is a life transition. Having a virtual stranger coming into your home to help manage the most basic aspect of living can trigger feelings of loss and deep emotional responses.

For the senior in need of care, loss of autonomy, independence and privacy are very real. This may be piled on top of other recent losses in health and relationships. No one, in my experience, has EVER welcomed the need for home care as it is usually follows some sort of loss or series of losses.

For the family, namely, the adult children, guilt, fear and inadequacy are feelings that are very relevant and real as well. Many, if not most, adult children wish that they had the time or lived close enough to provide the care they feel their parents deserve. Fear enters in with the control and direction they lose when hiring someone to provide the care. Feelings of inadequacy can surface, especially if they had attempted to provide the care themselves and it became overwhelming.

Rest assured that these emotions are all very natural and if your are feeling any of these things it is best to acknowledge the emotions as they come to the surface. Often, it is the act of hiring outside help that brings these feelings to the forefront. If these feelings are left unaddressed they can have detrimental effects on the success of home care assistance.

Often when people are not aware of or do not want to acknowledge these intense emotions, there is a tendency to place great expectations on the caregiver placed in the home to help. No matter how hard the caregiver works, they will never be a replacement for the adult child. The caregiver is an individual with their own history and personality. They will not immediately understand every nuance and preference of your parent.

Clearly defining tasks and reviewing skill is vital to beginning this professional relationship, which most reputable home care agencies will do with an in-home assessment and a plan of care. Once the expectations are established, they should remain constant as the caregiver establishes a rapport with the family. This takes time and can be a source of anxiety for both the adult children and the parents.

The focus of the caregiver should always be on the safety and well-being of the client. Housekeeping duties can be included, but shouldn’t be at the expense of quality care.  Obvious adjustments should be made if they are not appropriate or working out as anticipated. Clearly, if a caregiver is just NOT the right personality, that should be addressed as soon as possible, but not before careful consideration. If the caregiver is competent and professional, it may help to wait a little while rather than rush into a change. Learning the temperament and rhythms of a new client takes some time. After a while, the caregiver will develop a regular routine based on these daily rhythms and will increasingly be able to anticipate situations and changes and how best to deal with them.  

In short, no one can care for your parents like you can. However, if your situation requires outside assistance, do your best to understand the limits of the professional home care relationship and guard against placing unrealistic expectations. If the home care professional provided is caring and competent, provide space and flexibility for the relationship to develop. In the end this will help both the adult child and the parent ease into this life transition with minimal discomfort.

 

“Elderspeak” Can Negatively Affect Health of Older People

(NaturalNews) It is quite common that many of us speak to older folks in a different manner and with a different tone. "Elderspeak" bears many traits which are similar to "baby talk", and these include simplified grammar and vocabulary, as well as overly intimate terms of endearment. And recent research has shown that such a communication style may not only be exasperating and insulting to many of the elderly, it can even negatively affect their health.

About Elderspeak

What is elderspeak? Broadly speaking, it is a style which is assumed to accommodate the perceived communication needs of elderly people. It involves speaking slowly, restrictions on vocabulary, simplified syntax, as well as exaggerated prosody.

The fundamental assumption behind elderspeak is that the elderly are cognitively impaired, and thus need some "help". It can be said to be patronizing and disrespectful to the older adult.

Researchers have also defined elderspeak as overly caring, controlling and infantilizing communication.

Findings from Studies

In a study led by Becca Levy, a professor at the Yale School of Public Health, it was found that elderly folks who were exposed to negative stereotypes commonly associated with ageing, enforced by condescending phrases and attitudes, performed significantly worse when tested for memory and balance.

In one particular town in Ohio, her study team found that those who were above 50 and held positive perceptions about ageing went on to live 7.5 years longer than their peers who did not. This was after other health-affecting factors were already accounted for.

Those attitudes were affected even by apparently harmless words and phrases and, profoundly, they supposedly had a greater impact than important factors such as smoking and exercise.

Elsewhere, Kristine Williams, R.N., Ph.D., an associate professor at Kansas University, studied the effect of elderspeak on Alzheimer's patients with dementia. The interaction between staff and 20 residents of a nursing home, aged between 69 and 97 years and having moderate levels of dementia, were videotaped.

The study found that the patients were more likely to resist care after they were spoken to using elderspeak, instead of the usual adult-to-adult form of communication. When resisting care, they would carry out actions such as saying no or crying out, turning away, grabbing onto someone or something, pulling their limbs tightly toward the body, or hitting and kicking.

"There's the suggestion that these people are unable to communicate that their needs aren't being met. And because they can't communicate verbally, they may respond in these other nonverbal ways," Dr Williams said. And, according to her, the need in question could just be the wish to be treated as an adult who is worthy of respect.

And, perhaps somewhat ironically, the biggest culprits of elderspeak are often healthcare workers, including doctors and nursing staff.

The Problem with Elderspeak

The problem with elderspeak, is that it hurts the self-esteem of those to whom it is used on. Worse, it can literally grind them down and send them on a self-fueling downward spiral toward ill health and even premature death. That, after all, is what we get when we communicate to people that they are weak, a liability, incompetent or even useless – they often prove us right!

"Elderspeak is indicative of general negative stereotypes of the elderly. It is another example of how people are treated differently based on their age in healthcare, in the workforce and in everyday life. And we have found a clear connection between how the elderly are treated and their health and functioning," said Dr Levy.

The Bottomline

"Daily we are witness to, or even unwitting participants in, cruel imagery, jokes, languages and attitudes directed at older people," said Dr Robert Butler, president of the International Longevity Centre-USA, who first coined the term "ageism" some 40 years ago.

With populations ageing in the US and in many developed nations, the need to avoid elderspeak becomes all the more significant. In the US, the 85-and-above age group is the fastest-growing one.

Ms Elaine Smith, a 78 year old retired Chicago schoolteacher, who was subject to elderspeak when she was hospitalized for two months after suffering a fall, said that people can become quite indignant when she tells them she is offended by such a communication style. And she has an interesting viewpoint regarding elderspeak.

"But I believe that the people who heap these endearments upon us are reacting to their own fears of ageing in a youth-oriented culture," she said. Her advice? Get over it.

So, the next time we want to use terms such as "dear", "good girl" and "sweetie" on the elderly, or speak very slowly and in overly simplified language to them, we better think again.

Main Source

Talking down to the elderly is bad for their health, medical study finds (http://www.telegraph.co.uk/health/article3256340.ece)

About the author

Reuben Chow has a keen interest in natural health and healing as well as personal growth. His website, All 4 Natural Health, offers a basic guide on natural health information. It details simple, effective and natural ways, such as the use of nutrition, various herbs, herb remedies, supplements and other natural remedies, to deal with various health conditions as well as to attain good health. His other websites also cover topics such as depression help, omega 3 fatty acids, as well as cancer research and information.

 
Located and submitted by Gabriela F. Brown, CSA, Constant Companions Home Care http://www.constantcompanions.net

Putting It All On The Table - Senior Nutrition

By 2030, Americans over the age of 65 will reach 71 million, approximately 20% of our population. Further, almost 90% of Americans over the age of 65 have one or more degenerative disorders. These conditions were once thought to be a natural consequence of aging but there is now evidence that many conditions like heart disease, cancer, osteoporosis, arthritis, diabetes can be either prevented or lessened by ongoing good nutrition and exercise.

There are increasing obstacles to proper nutrition as we age: Chronic illness, recent hospitalizations, depression, mal absorption, medications, dental problems, diminished taste and smell, restricted diets, limited income, loneliness and isolation. However, it is important to realize that without the proper mix of fuel and nutrients, symptoms of malnutrition can appear and increase the symptoms and debilitation of any of the above listed conditions. In essence it is a vicious cycle that can only be broken by a commitment to learn and apply better eating habits.

Malnutrition can be seen as increased forgetfulness, dehydration, frailty, delayed wound healing and decreased muscle mass that can lead to falls and fractures. Indirectly, malnutrition could be a significant factor in many hospital stays and lengthy rehabilitations. Additionally, it can make worse any chronic conditions.

Some seniors may be at a healthy or even heavy weight, but still experience malnutrition. Because metabolism can decline by as much as 30% in people over 50, it is important to eat fewer calories. With fewer calories, we run the risk of fewer nutrients, so the foods must be packed with nutrients. A good start is to limit overly processed high-carb, high-fat, nutrient deficient foods and increasing nutrient rich foods like vegetables, fruits, whole grains breads and pastas and to add supplement drinks if necessary. A multivitamin will also go a long way to maintain your stores if your nutrient intake varies day to day.

To help a senior that you suspect of being malnourished, approach the situation delicately. As mentioned above there may be many reasons to not eat properly and you don’t want that person to become defensive and clam up. Eat with them, observe. Is there plenty of protein, fiber and healthy fats in each meal? Are vegetables and fruit included in each meal? Are most meals cooked at home, from scratch and healthy sources? If so, then they are on their way to good nutrition. Next, find out if they are supplementing their diet with a multivitamin or nutrition shake. This can be done by placing the items in the home and periodically checking to see if they have been used. See how much they eat at every meal. A good measure for amount is the size of their fist. If it less than that, try to determine if they are eating more frequently. Many seniors cannot eat 3 large meals and choose to eat more often with smaller portions. As long as the smaller portions and snacks equal 5 a day, throughout the day, all is well.

If a senior is malnourished there are several things that you can do with and for them to encourage healthier/sufficient eating:
Enrich! Add healthy proteins and health fats, like cheese, nuts and nutbutters. Cheese can be mixed in to a wide variety of otherwise bland and calorie deficient foods. Nutbutters are great on crackers and a slice of bread, add a little fruit spread if the diet permits, to moisten and make it easier to swallow. Nuts are great for snacks. Over the day these calories can add up and they are providing rich and healthy oils for the body.

Spice it up! Add some herbs, lemon, seasonings, as tolerated and enjoyed to make the food more flavorful and enjoyable. Make sure you check sodium levels. An adult should take in no more than 1500mg per day. 

Socialize! Get them out or invite yourself over. Eating is a social behavior. We all eat much more when we are in the company of others. This has the dual benefit of providing an anticipated event and the eventual company, which can help to alleviate mild depression.

Get Moving! Exercise gets everything in the body working more efficiently. Encourage walking, biking, chair exercises, swimming, WHATEVER that is possible to do safely and comfortably. The idea is to move the body every day. Metabolism will increase, mood will lighten, appetite will increase. Again, if you are at a loss for options, contact your health care provider for resources.

Supplement! Take a daily vitamin to cover any gaps in nutrition. 

Hydrate! As we age we lose the ability to sense thirst. Aim to get 8 glasses of water per day. Other sources of water such soups, water-rich foods like melons and decaffeinated teas and coffees may be a more palatable way of getting enough fluids every day.

Call the Doctor! If you suspect depression or lack of appetite due to medications or ANY other underlying issues, call the doctor. Many times they will be able to do an overview of health and medications to discover or eliminate possible reasons for a lack of appetite.

This article is meant as general advice. It is not medical advice. I encourage anyone who suspects that they or someone they love is malnourished to see their health care practitioner as soon as possible in order to establish an individualized plan that will put you back on track to better health.

 

By: Gabriela F. Brown, CSA

Article Directory: http://www.articledashboard.com

 

Submitted by Gabriela F. Brown, CSA and Owner of Constant Companions Home Care,www.constantcompanions.net in San Diego and S. Riverside, CA. Contact Info: gbrown@constantcompanions.net

Dementia Care - Constant Companions 360 approach

Dementia Care

Dementia is a broad term that describes the process of a decline in cognitive abilities that interferes with activities of daily living. The most recognized and prevalent form of dementia is Alzheimer’s
Disease which accounts for 50-70 percent of all dementias. There are, however, other causes of dementia:

  • Depression
  • Vascular disorders, such as multiple strokes in the brain
  • Infections that affect the central nervous system, such as HIV dementia complex and Creutzfeldt-Jakob disease
  • Chronic drug/alcohol use
  • Hydrocephalus – Accumulation of fluid in the brain that can result from developmental abnormalities, infections, injury, or brain tumors
  • Degenerative neurological diseases, such as Alzheimer’s, dementia with Lewy bodies, Parkinson’s, and Huntington’s

See More information on Dementia

Our 360 approach:

By the time our office receives a call to provide dementia care to a senior the family has usually been very involved for an extended period of time, providing most of the daily care. The call comes because the family is in need of support and guidance. Our 360 approach is just that, an all-encompassing circle of support for the entire family. During our extensive intake process, we identify where the home care worker can provide support for family members as well as the senior themselves.

We don’t aim to replace the family, we are there to support and only take over the duties that prevent family members from enjoying their time together, due to caregiver fatigue. If you are in need of a helping hand, call us. At Constant Companions,

“It is our mission to enrich the lives of each of our clients by providing the best in compassionate care, second only to family.”

Hearing Loss – Bringing Seniors Back into the Conversation


 

Nearly one-third of people over the age of 65 are hard-of-hearing while nearly 50% of people over the age of 85 suffer from some form of hearing loss. Because hearing loss is usually a gradual process that begins in one's forties, it is commonly not recognized until it is significant. It is important to be able to recognize signs of hearing loss, have it diagnosed and treated.

Symptoms of hearing loss:

• Have trouble hearing over the telephone

• Find it hard to follow conversations when two or more people are talking,

• Need to turn up the TV volume so loud that others complain,

• Have a problem hearing because of background noise,

• Sense that others seem to mumble, or

• Can't understand when women and children speak to you.

Hearing loss in seniors can lead to others mistakenly thinking that seniors are confused, difficult or apathetic. Additionally, the senior may be embarrassed by the loss and resist seeking out medical help. The inability to fully communicate can lead to frustration and isolation. The key here is communication and enlisting the following strategies to bring these seniors back into the conversation:

• Make sure that you are looking at the listener and you are in a well-lit area.

• Don't shout, this can often create increased sound distortion.

• If there are 2 or more people present, make sure that only one person is speaking at a time.

• Address them directly by saying their name before starting a conversation so they have time to focus.

• Many people with hearing loss rely on lip-reading. Keep your hands away from your mouth and avoid smoking, chewing gum or eating while talking.

• Slow down a little but not too much. A natural and unhurried rate of speech allows the hearing impaired person to capture more words, read lips and facial expressions.

• If one ear is better than the other, make sure you are directing your speech to the better ear.

• Hearing loss can include certain sound distortions. They may hear your voice but not be able to decipher certain words or pitches.


• Minimize extra noise in the environment when have a discussion, like turning the TV or dishwasher off.

• If possible, avoid having discussions in settings that may have sudden loud sounds like busy streets, near construction areas or near airports.

• Depending on the level and type of hearing loss, certain words are almost impossible to understand, try rephrasing the sentence or find a different word. Don't repeat the word or sentence over and over again.

• Avoid sudden changes of topic. When the subject is changed clearly state the new topic and look for acknowledgement before proceeding.

• Write specific information, such as appointments, directions and schedules down, if you are talking over the phone, have them repeat the information back as many words and numbers sound similar.

• Understand that illness or tiredness may affect any person's ability to follow a conversation.

• If the listener looks confused, clarify that they understood what you were saying.

The best course of action to take if you suspect hearing loss is to see a doctor as soon as possible to determine the cause and treatments available. If you suspect hearing loss in a senior that you are caring for or that you care about, remember to be compassionate about discussing the possibility of hearing loss. It is important to be supportive regarding the options and opportunity for treatment. Motivation for the decision to seek treatment should be to increase their quality of life by providing the ability to participate in all social interactions to the best of their ability.


The Facts About Senior Health Insurance Plans

Medicare may not be enough to cover your health care needs as you age. But how do you know what kind of health plan will work for you?

By Dennis Thompson, Jr.
Medically reviewed by Pat F. Bass III, MD, MPH

Choosing among senior health insurance plans can be a daunting task. There are government plans and private plans, HMOs, PPOs, and POSs, deductibles, and co-pays. Knowing more about what these terms mean can help you pick the plan that's right for you and your family.

Preparing for Your Senior Health Plan Search

Before you begin looking for a senior health insurance plan, ask yourself these questions:

  • How much money can I spend on health care? Knowing this will give you an idea of how much you can pay in premiums, deductibles, and co-pays for your senior health plan.
  • What pre-existing conditions do I have? Certain health problems might make it harder for you to get an individual senior health insurance plan.
  • If I'm over 65, do I want more than Medicare? Even if you qualify for Medicare, the federal senior health plan that helps pay for hospital bills and medical treatment, you may want to consider a supplemental plan to help with non-covered expenses.
  • Do I belong to an organization or work at a business that offers health insurance? Group insurance often is much cheaper than getting a senior health plan on your own, and you can get sometimes it through membership organizations like AARP.

Types of Senior Health Plans and Providers

More than half of the people covered by health insurance in the United States belong to managed care plans. With these plans, you face lower co-payments if you use in-network providers — doctors or hospitals that are part of the plan. Managed care plans include:

  • Health maintenance organizations (HMOs). These types of plans require you to receive all of your medical care from providers in the HMO's network, except in medical emergencies.
  • Preferred provider organizations (PPOs). These plans allow you to choose doctors and hospitals outside of your network, but you pay more for your care due to higher deductibles and larger co-payments.
  • Point-of-service organizations (POS). In this type of plan, your primary care physician manages your care. You are allowed to choose doctors and hospitals outside your network, but you'll pay more for their services.

As you assess your senior health plan options, consider the following:

  • How much will you pay in premiums each month?
  • How much of your doctor and hospital bills will the plan cover?
  • How much will you be expected to pay in co-payments and deductibles?
  • How restricted will your choice of doctors and hospitals be?
  • What happens when you need a doctor after business hours or have to go to an emergency room?
  • Are there any limits on the medical conditions covered by the plan, or on what the plan will pay for certain illnesses?

If you're eligible for Medicare, you can get supplemental health insurance, commonly referred to as MediGap, that helps pay for medical treatment not covered under the government plan. The National Association of Insurance Commissioners has made it easy for seniors to choose between MediGap plans by creating 12 standardized plans. Different insurance companies may offer the plans, but each of the 12 plans will be the same no matter which company you choose.

Senior Health Plan Terminology You Should Know

Health insurance terms can be confusing. It’s important that you fully understand what payments you’re responsible for and what the insurance will cover. Here are some examples:

  • Co-payment. This is the fixed amount a plan requires you to pay for certain services. For example, you might need to pay $10 or more for a visit to a doctor.
  • Deductible. This fixed amount of money is what you have to pay for medical services before the plan kicks in. For example, you might have to pay the first $200 for a hospital visit before the insurance company starts paying.
  • Maximum plan dollar limit. This is the most a plan will pay out during a year's worth of coverage. Also be aware of a plan’s lifetime limit, the maximum amount it will pay over the course of your life, often set at $1 million, though some plans offer higher coverage.
  • Premium. The premium is the annual amount you pay upfront (or monthly) to have health insurance.

Additional Senior Health Insurance Resources

For more information or for help finding legitimate health plans, you can contact any of these resources:

Most state governments also have insurance commissioners or agencies dedicated to regulating the insurance industry. You can find a list of state insurance offices through the National Association of Insurance Commissioners.

Get more information in the Senior Health Center.