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Dehydration

As we head into summer, it is important to remember that the joy of seeing the hot sun can also bring health problems.  One common problem is dehydration.  Dehydration is more common in the elderly.  The elderly have lower water content and decreased capacity to respond to stressors such as fasting, exposure to extreme heat, exercise, and disease.

Causes of dehydration can include: increased heat, decreased fluid intake (sometimes from the desire not to have to use the toilet), fever, hot weather, increased urinary infection, vomiting, or diarrhea.

Early symptoms of dehydration should not be ignored.  They include: thirst; dry,warm skin; increased confusion; dizziness or lightheadedness; hard bowel movements; weakness; and dry mouth or mucous membranes.  Increasing the amount of fluid intake can easily rectify dehydration if caught early.  Dehydration can be prevented by drinking 8 glasses of water a day unless otherwise directed by your doctor.  So remember, as the summer approaches:

             Drink!   Drink!   Drink! 

written by: Carolyn Uzarowski, RN; Health Director, Woods Adult Day Services

Pain

Physical, mental, emotional, or spiritual…. we’ve all experienced pain.  Although generally we know what this means, we can only experience pain as an individual.  For more than 50 million Americans, pain can linger for months and years.  Chronic pain is hard to diagnose.  It can’t be examined under a microscope and can’t be sutured; because of this, patients are sometimes told, “it’s all in your head”, “you’re a chronic complainer”.  This can lead to anxiety, loss of sleep, and depression.  Chronic pain can destroy lives and families.  The adjustment for everyone in the family is a major one.

Baltimore’s American Pain Foundation states that, “most pain is untreated, under treated, or improperly treated”.  Some people despair or decide they’ll just have to tough it out.  What can you do if pain is very real to you, persists, and yet no underlying diagnosis can be made?  Scott Fishman, M.D., chief of pain medicine at the University of California, Davis in Sacramento says, “We can impact pain by impacting the mind…   treating people for comfort, as well as cure, gives us the best health outcomes”.

Dr. Bennet recommends:

    • Become informed.  Become your own advocate.
    • Be open to complementary (holistic) as well as traditional treatments.
    • Check out support groups and the Internet.

 

Some sources are:

 

Woods Adult Day Services is staffed from a whole-person perspective.  Skilled and compassionate nurses, health aides, and recreational activity aides are in attendance anticipating and responding to participants’ needs- especially that of discomfort and pain.

written by: Rose Yapundich, L.S.W.A.; Social Worker, Woods Adult Day Services

 

Vision Loss and Communication

Less than 30% of elderly people by the age of 70 have 20/20 vision. 

Macular degeneration, cataracts, and glaucoma can impact day to day activities.  They can affect the ability to drive, read, maneuver an uneven sidewalk, or recognize friends.

Impaired vision also affects the ability to communicate.  We look for visual clues during conversation.  Some are:

  • Facial cues indicating mood or emotion
  • Hand gestures indicating size or direction
  • Turn-taking cues, such as raised eyebrows
  • Feedback, such as head nodding

Those with poor vision may be lost or misunderstand these types of non-verbal messages.  Imagine not being able to see a person roll his eyes when making a sarcastic remark. 

There are some simple things that you can do when talking to someone who has visual impairments:

  • Identify yourself when approaching.
  • Describe, with words, instead of gestures.
  • Increase the room lighting; make sure the light is not behind you.  Overhead fluorescent lighting causes glare on linoleum and hardwood floors.
  • Reduce background noises.  Hearing is used to make up for limited vision.
  • Offer your arm for support.  Let the person know about upcoming curbs or stairs.

 Following some of these suggestions can keep those with vision impairments involved in conversations and ensure safety at home.

Holiday Traditions

Caregiving and the Holidays

 Family and friends come together on the holidays to celebrate; share memories, laughs, and good cheer.  For those living with Dementia and other disabilities, the holidays can be a difficult time.

Caregiving responsibilities plus keeping up with holiday traditions can take a toll on everyone.  With a little planning and adjusting expectations, celebrations can be filled with joy and moments to cherish forever.

 Change your expectations

  • You cannot maintain every holiday tradition
  • Do only what you can reasonably manage
  • Host a small family gathering instead of a big holiday party
  • Serve pre-cooked items or carry out restaurant meals
  • Start a new tradition

 Involve your loved on in the preparations

  • Wrap gifts
  • Bake together
  • Set the table
  • Prepare simple appetizers
  • Read holiday cards together
  • Reminisce by looking through photo albums
  • Watch a holiday movie
  • Sing carols

 By making just a few changes, your holidays can be a special time again, with just as many great memories.

Nutrition

Eating well is important at any age.  However health issues and physical limitations can make it difficult for some to get the nutrients they need.  Symptoms of malnutrition (weight loss, disorientation, lightheadedness, lethargy, and loss of appetite) can be mistaken for illness or disease.  If you are concerned about the diet of someone you care for, here are some tips to ensure proper nutrition.

  •  Offer nutritionally-dense foods.   Encourage whole, unprocessed foods that are high in calories and nutrients.  Whole grains, fresh fruits and vegetables, and protein-rich beans, meat, and dairy products are some good choices.
  •  Enhance aromas and flavors.  You can intensify flavors with herbs, marinades, dressings, and sauces.  Switching between a variety of foods during one meal can make the meal interesting.  Try combining textures, such as yogurt with granola, to make foods more appetizing.
  •  Eating is a social event.   People often fail to eat if left alone.  Have the family eat together or invite a friend over.  Play soft music, light candles, and talk about the day’s events. 
  •  Be aware of the food available.  Remove outdated and spoiled food and have nutritious snacks in plain sight.
  •  Be aware of dental problems.  Improper oral health can make eating uncomfortable.  Make sure dentures fit properly and any other problems are being managed.
  •  Give reminders.  If poor memory is interfering with good nutrition, plan meals at the same time every day and give visual and verbal reminders when it’s time to eat.
  •  Serve finger foods for those unable to handle utensils. 
  •  Have plenty of fluids available. 
  •  If someone has problems swallowing:
    • Allow plenty of time between bites and check for food in the cheeks
    • Remind the person to swallow
    • Gently stroking the throat will sometimes stimulate swallowing
    •  Alter food textures that cause difficulty.  Liquids can be thickened and solids can be moistened or pureed.

 The best ways to find-out why your loved one isn’t eating well are to pay attention. Look for clues and ask questions.  Encourage him to talk openly and honestly, and reassure him that he is not a burden to you or anyone else.

Medication Errors

Medication administration is an important part of caregiving.  Keeping track of medications can be a nightmare if you’re not organized.  With just a little planning, you can reduce your stress and reduce the chance of an error.  The most common medication errors are administering the wrong drug or the incorrect dose.  Drugs with similar names account for 25% of reported errors.

Here are some tips to help you get organized:

  • Keep pills in original container (unless you place them in a dispenser). 
  • Using a dispenser can be a timesaver and reduce errors.
  • Use one pharmacy for all your prescriptions.  This will reduce the chance that you will obtain conflicting medicines.
  • Ask your pharmacist’s advice before splitting or crushing any pills.  Some pills should only be swallowed whole and may produce dangerous effects if the pill is altered.
  • Discard any medications that are no longer being taken.
  • Keep medicines securely stored.
  • Check with your pharmacist about over-the-counter medications.  They may have risks, especially for those taking several medications.
  • Be alert for side effects.  Check with your doctor of pharmacist if you have any questions or suspect that the medicine may be causing problems.

Make a record of all your loved one’s medications as well as your own.  Include medications prescribed by a physician as well as over-the-counter and dietary supplements.  You should include the name of each medication, what it’s for, the strength, and dosing directions.  Additional information could include when the medication was started and when it was discontinued.  This list should be given to all of your doctors, pharmacist, and other caregivers.  Be sure to keep this list current!

Medication mishaps are most likely to occur when:

  • Taking multiple medications
  • Normal routines are disrupted
  • Starting new medications
  • Traveling
  • In the hospital

Finally, never be afraid to ask questions. If the name of the drug on your prescription looks different than you expected, if the directions appear different than you thought, or if the pills or medication itself looks different, tell your doctor or pharmacist right away. Asking questions if you have any suspicions at all is a free and easy way to ensure that you don’t become the victim of a medication error.