The Professional Geriatric Care Manager’s Blog

Shingles

January 27, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Eldercare, Health, Life, Medication, Prevention, Tips

It can start out with burning or shooting pain, tingling, or itching on one side of the body or face. The pain can be mild or severe. Blisters then form and can last one to 14 days. It’s shingles, a disease caused by the varicella-zoster virus, the same virus that causes chickenpox. Once one has had chickenpox, the virus stays in your body, and can cause shingles many years later. Other symptoms of shingles include fever, headache, chills and upset stomach. Sometimes a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation or death. The pain of shingles may last for weeks, months or even years after the blisters have healed.

You cannot catch shingles from another person with shingles. A person who has never had chickenpox, though, can get chickenpox from someone with shingles. Shingles is far more common in people 50 years of age and older. It is also more common in people whose immune systems are weakened because of a disease such as cancer, or drugs, such as steroids, or chemotherapy. There is no cure for shingles. Early treatment with antiviral drugs, such as Zovirax or Valtrex, that fight the virus may help. Medication may also help prevent any lingering pain. Taking a cool bath or using cool, wet compresses on your blisters may relieve the itching and pain.

Two vaccines may help prevent shingles. The chicken pox vaccine has become a routine childhood immunization to prevent chickenpox. The vaccine is also recommended for adults who have never had chickenpox. In 2006, a vaccine was approved for the treatment of shingles. It is recommended for adults 60 years and older. It does not guarantee you will not get shingles, but will reduce the course and severity of the disease if you do. A person should not get the shingles vaccine who has had a life threatening allergic reaction to gelatin, the antibiotic neomycin or any component of the shingles vaccine, a weakened immune system, or is pregnant. Minor problems associated with the shingles vaccine have included redness, soreness, swelling and itching at the site of the injection and headache. At least one million people a year in the United States get shingles. The shingle vaccine is used only as a prevention strategy. It cannot be used to treat people who currently have the disease. Speak to your doctor or other healthcare provider to learn more and if the shingles vaccine is for you.

Distinctive Care Geriatric Care Management serves Bergen, Passaic, Rockland and Orange County with nurses licensed in New Jersey and New York. We help families dealing with various issues related to their elderly loved ones and would be happy to discuss any concerns you may have related to long term care.

Please contact us in our Ramsey or Ridgewood Office to schedule a consultation.

201-587-5283.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ 07446

45 N. Broad St., Suite 503, Ridgewood, NJ 07450

A Week in the Life of a Geriatric Care Manager

January 24, 2012 at 10:30 am | Posted in Christine Clark, GCM | Leave a comment
Tags: GCM, Weekly

Ms. S. has had a long standing relationship with her Geriatrician. She was diagnosed with dementia several years ago. There are many types of dementia, and no cure. Recently, it has become apparent that Ms. S. is having even more difficulty with her motor skills. It has been just over a year since she moved into the Assisted Living Facility’s Memory Unit. She has done remarkably well, but at this point, now that she is wheelchair bound, it is difficult to take her out for routine check ups with her Geriatrician.

As her Geriatric Care Manager, and her advocate, I decided to call her doctor and ask if he would be willing to visit her at the Assisted Living Facility. He happily agreed and will see Ms. S next week. He was glad that, instead of Ms. S. being assigned to the facility’s physician, we are able to continue the longstanding, trusting, wonderful relationship that they have built.

Please contact us in our Ramsey or Ridgewood Office to schedule a consultation.

201-587-5283.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ 07446

45 N. Broad St., Suite 503, Ridgewood, NJ 07450

Realistic Resolutions 2012

January 23, 2012 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Education, Health, Life, Personal, Seminar, Tips

After many months of preparing for Realistic Resolutions 2012, previously billed as the Ridgewood Health Fair, I can sit back and relax. The event was a hit! There were lots of vendors offering many services: blood pressure screening, chiropractic screenings, body mass index analysis, Reiki, chair massage, and lots of up-to-date information on all kinds of timely topics, such as wealth planning and elder law, sugar consumption and organic cosmetics. Distinctive Care Geriatric Care Management had their nurse care managers on hand to offer advice on Seasonal Affective Disorder (SAD) and demonstrated a light box. There were healthy snacks, such as green vegetable smoothies, and not so healthy snacks, like fresh from the oven chocolate chip cookies. We can all indulge in moderation sometimes! Representatives from assisted living facilities and nursing homes were on hand, as well as home health agencies and hospitals, fitness and exercise centers.

Our guest speaker, Amanda Arlauskas, Runner-up from NBC’s Season 8 The Biggest Loser gave a very motivating presentation on the her diet and fitness regime. You would hardly believe that she once weighed 270 pounds! She was an inspiration to us all. Hopefully she will enable a few attendees to keep their New Year’s Resolution, too.

We’re already planning for next year. It’s nice to have a speaker from Bergen County – Amanda hailed from Butler, NJ. We’re open for ideas if anyone has them.

Oral Care for the Elderly

January 20, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Eldercare, Health, Life, Safety, Tips

Dental disease can lead to cardiovascular disease, diabetes, oral cancer and respiratory problems. The elderly are more susceptible to oral disease, and this can lead to further medical complications and complaints. Oral disease is closely linked to overall health. Current research states providing the elderly with proper dental care can help avoid illness and discomfort.

As we age it is important to continue with daily mouth care and regular dental checkups. As with other activities of daily living, one should encourage the older adult to do as much of the brushing and flossing as possible. The elderly usually have less saliva, and certain medications decrease saliva output. This decrease in saliva output can change the taste of toothpaste and mouthwash. You may have to switch toothpaste to find one that is acceptable. The same is true for mouthwashes. Try switching brands or diluting the mouthwash if it causes irritation.

To maintain independence in the oral care regime, the toothbrush may have to be adapted. If an individual has difficulty holding a toothbrush, a sponge or rubber ball can be attached to the end of the toothbrush. Sometimes using an electric toothbrush is easier and speeds up the brushing process. If an individual has dentures, it is important to brush the gums and roof of the mouth prior to setting the dentures into place. The dentures should be cleaned once a day and if they break they need to be given to a dentist to repair. Elderly individuals need to watch for any signs of gum bleeding, severe weight loss, loose or chipped teeth, red and swollen gums, change in tooth fit or increased bad breath and loss of taste. These symptoms could all be signs of periodontitis, or gum disease.

Gum disease left untreated will result in tooth loss and other medical complaints. Risk factors which increase periodontitis include older age, poor nutrition, certain medications, tobacco, poor oral care habits and diabetes. Preventing gum disease involves daily brushing, flossing, and regular visits to the dentist for professional cleaning. If the individual has a problem with mobility and is unable to visit a dentist, many dentists now will make visits to the home or a facility, such as nursing homes. The aging process does not mean teeth should be neglected and regular dental care will ensure the elderly have a full set of healthy teeth.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ 07446

45 N. Broad St., Suite 503, Ridgewood, NJ 07450

Too Much Sugar in Our Diet!

January 19, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Diet, Education, Health, Life, Personal, Tips

At first I was not sure what I wanted to blog about for this week, but then I went to a great event last night and it hit me there. I went with my fellow co-workers from Distinctive Care to a wonderful health fair over at the Ridgewood YMCA/YWCA. The keynote speaker was Amanda Arlauskas from NBC’S Biggest Loser Season 8. She did an amazing job speaking about her weight loss venture as a participant on the trendiest show on TV today. She said that she had to make huge changes in her diet and behavior in order to lose her weight and regain her health. She said the hardest part was in the very beginning when she needed to give up some of her favorite foods. She said it was a shock to her body to give up the junk food, which mainly consisted of high amounts of sugar. I thought that would be a great topic of interest for some of my elder clients.

Since many of my clients tend to have high sugar or high simple carbohydrates in their diets, I have been working with clients in the home, assisted living and skilled nursing facilities. I observe what they eat and what they crave most. It is the high sugar foods that many of them really want. We have one gentleman that goes through at least one bag of candy per day. Another client would refuse to eat any of her protein or vegetables from her tray and would just rather eat her dessert first and then would not touch anything else afterwards.

I can only think that the reason so many older adults prefer and like sweets is that much of their taste is altered from the medications that they take. But, maybe they just like the comfort of the refined sugar or sweets they just know and love over the many years? Most older adults need to be careful of developing Type 2 Diabetes, elevated triglyceride levels which leads to coronary artery disease and risk of stroke.

It is recommended that on a 1,600-2,000 a day calorie diet, that one should only be consuming 5-8 teaspoons of sugar per day, or no more than 50 grams of carbohydrate in the form of sugar (one teaspoon of sugar provides 4 grams of carbohydrates). The United States Department of Agriculture (USDA) recommends limiting sugar to 6 to 10% of calories from sugar. This is based on weight maintenance and not for weight loss. To give you an example of how much sugar we consume, I will provide you with a list of high sugar foods/beverages and their sugar content;

12oz can of Coca Cola= 39 grams (10 teaspoons of sugar) 140 calories

2 Fig Newton’s = 12 grams (3 teaspoons of sugar) 90 calories

½ c. of Vanilla Ice Cream=21 grams of sugar (5 ½ teaspoons of sugar) 270 calories

8oz. Cranberry Juice Cocktail=30 grams (7 teaspoons of sugar) 120 calorie

1 Piece of Hard Candy=3.8 grams(1 teaspoon) 24 calories

If you want to learn more about sugar content of some of your favorite foods, take a look at this site, but after you review this website you they might not be your favorites anymore!

After completing some of this research and learning about sugar content on some of these foods, it really gave me a wakeup call. No matter if we are young or old, we need to be aware of what we are putting into our body at all times.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ 07446

45 N. Broad St., Suite 503, Ridgewood, NJ 07450

A Week in the Life of a Geriatric Care Manager

January 17, 2012 at 10:30 am | Posted in Christine Clark, GCM | Leave a comment
Tags: GCM, Weekly

This week was our follow-up visit with Ms. B’s primary care physician. Last week she had noted that her heart rate was faster than it should be and blood work, urine sample, chest x-ray and EKG were normal. We were so grateful that an infection was ruled out and that her heart rate returned to baseline during the appointment with the doctor. This week, her doctor wanted to make sure that her vital signs remained stable. I reviewed with the doctor that Ms. B is feeling well, eating well, sleeping well and taking her medications correctly. The doctor took her vital signs and ran another EKG just to make sure that the heart rate and rhythm were normal. Ms. B passed with flying colors!

As her Geriatric Care Manger, my weekly assessments and medication management are essential tools which assist me to determine the course of action before a serious medical condition develops.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ 07446

45 N. Broad St., Suite 503, Ridgewood, NJ 07450

The Sodium-Potassium Connection

January 13, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Diet, Health, Life, Prevention, Tips

We have all been told that a diet high in sodium increases our risk of developing hypertension. Hypertension can lead to heart disease and stroke. With age, the risk of high blood pressure increases. Studies have now shown that, while a diet high in sodium puts one at risk, even more important is the ratio of sodium to potassium in one’s diet. High levels of sodium in one’s diet raises blood pressure by stiffening arteries and blocking nitric oxide, which relaxes arteries. Potassium activates nitric oxide, thereby reducing pressure in the arteries and lowering blood pressure and the risk of hypertension.

We only require 220 milligrams of sodium a day. Current dietary guidelines recommend a maximum of 2,300 milligrams, about a teaspoon of salt, for anyone over the age of two. Adults at high risk, such as those currently with hypertension, diabetes, or chronic kidney disease, should only have 1,500 milligrams daily. Ninety percent of the sodium in the American diet comes from salt and the majority of that is found in processed and restaurant foods. When tomatoes and potatoes are processed, not only do they have more sodium, but the amount of natural potassium declines, worsening the sodium-potassium ratio. There has been a national effort to convince food producers and restaurants to reduce the amount of salt in their foods and products. Those companies that have made a commitment to reduce sodium in their products are Kraft, Subway and Target. Until more restaurants and food producers participate in this effort and limit the amount of sodium they use in preparing their food, it is recommended that you eat fewer processed foods. Instead of processed foods, eat more fresh fruits and vegetables and dairy products low in sodium. In addition, increase the amount of potassium in your diet by eating more cantaloupe, bananas, oranges, grapes, grapefruit, blackberries, yogurt, dried beans, leafy greens, white potatoes and sweet potatoes.

Other ways to limit the amount of sodium in your diet is to avoid fast-food restaurants; when ordering in a restaurant ask that your food be prepared without added salt, request salad dressing and sauces be served on the side and read all labels when shopping. We are all susceptible to the adverse health effects of too much sodium and not enough potassium.

Move Over Rice and Pasta, Here’s Quinoa!

January 12, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Diet, Education, Health, Life, Tips

Last week I had the pleasure of educating a client on healthy food choices. She wants to lose weight and increase the amount of fiber in her diet. She informed me that she eats a lot of pasta and rice in her diet and has heard that white rice and pasta are not all that good for a person. I told her that she was right and then I provided her with a better alternative to her bland, white rice and pasta. We sat in her kitchen, as I explained to her about the benefits of Quinoa (pronounced keen-wah).

Quinoa is technically a seed, but is cooked and eaten like a grain and is related to spinach, chard and beets. It is found and grows best in mountainous regions and thrives in poor soil, thin air and extreme weather. Quinoa stalks are 3 to 6 feet tall, each plant can produce up to a cup of seeds. The seeds are about the same size as sesame seeds, and come in a rainbow of colors. They are red to purple to green to yellow in color, but the quinoa that is most commonly found in stores is an off-white color. I just bought tricolor quinoa at Trader Joe’s. You can also find quinoa in bulk section of natural food stores or in the organic section of your supermarket.

Quinoa is a complete protein, which means that it contains all the amino acids necessary for our nutritional needs. A four ounce serving contains over 22 grams of protein. This is considered enough protein to meet the daily needs for an average size child. It is also high in iron and calcium and is a good source of manganese, magnesium and copper, as well as fiber. Quinoa is naturally gluten-free and is very easily tolerated for people who suffer from celiac disease, crohn’s, or has allergies to wheat flour.

Before cooking with quinoa, you should give it a thorough rinsing; this will remove any remaining saponin, a soapy resin that protects the seeds while they are growing. Saponin can leave a bitter taste if not removed well from rinsing. It is very easy to cook quinoa. You only need to combine one cup rinsed quinoa to two cups water or broth (I use low sodium broth), bring to a boil, then simmer to 10-15 minutes, until the seed become translucent and the germ of the seed uncoils to form a “tail”. Quinoa has a fluffy texture and a light nutty taste. It is great to be added to salads, soups and stews. Here is a very easy recipe that you can try with Quinoa. So delicious.

Original Recipe Yield 4 cups

Ingredients

2 cups water
2 cubes chicken bouillon
1 clove garlic, smashed
1 cup uncooked quinoa
2 large cooked chicken breasts – cut into bite size pieces
1 large red onion, diced
1 large green bell pepper, diced
1/2 cup chopped kalamata olives
1/2 cup crumbled feta cheese
1/4 cup chopped fresh parsley
1/4 cup chopped fresh chives
1/2 teaspoon salt
2/3 cup fresh lemon juice
1 tablespoon balsamic vinegar
1/4 cup olive oil

Directions

Bring the water, bouillon cubes, and garlic to a boil in a saucepan. Stir in the quinoa, reduce heat to medium-low, cover, and simmer until the quinoa is tender and the water has been absorbed, 15 to 20 minutes. Discard the garlic clove and scrape the quinoa into a large bowl.
Gently stir the chicken, onion, bell pepper, olives, feta cheese, parsley, chives, and salt into the quinoa. Drizzle with the lemon juice, balsamic vinegar, and olive oil. Stir until evenly mixed. Serve warm or refrigerate and serve cold.

Enjoy!

A Week in the Life of a Geriatric Care Manager

January 10, 2012 at 10:30 am | Posted in Christine Clark, GCM | Leave a comment
Tags: GCM, Weekly

Each week I have the pleasure of visiting Ms. B. As her Geriatric Care Manager and Registered Nurse, I am well versed in her medical issues and needs. During my weekly visits I take her vital signs, perform a physical assessment and also set up her weekly medication reminders.

This past week, although Ms. B said that she felt well, I noticed that her heart rate was elevated. I quickly checked her for signs of dehydration and made sure that she was taking her medications correctly. At 90 years old and with Dementia, her caregivers play a crucial role in her care and well-being. I reviewed my concerns with her home health aide and asked if there had been any changes to Ms. B’s level of confusion. I stayed with Ms. B as I called her primary care physician. I reviewed my findings with him and asked that we bring her to the office immediately. We both agreed that a visit to the emergency room was unnecessary at this point, as Ms. B was not in distress and did not have any complaints of shortness of breath, dizziness, chest pain or weakness and a trip to the hospital could add unnecessary stress.

We arrived at the doctor’s office a few minutes later. We were taken in immediately and blood and urine samples were obtained. A chest x-ray was done as well as an EKG. Within a short while, an infection was ruled out and the heart rate was back to normal.

We were all so grateful that Ms. B’s physician assessed her so quickly. Ms. B remains stable but we have a follow-up appointment with her physician in one week to ensure that she remain healthy.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ 07446

45 N. Broad St., Suite 503, Ridgewood, NJ 07450

Come to the Ridgewood Health Fair

January 9, 2012 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Health, Help, Life, News, Personal

It’s hard to believe that the health fair that I have been so busily involved in is almost here. I’ve been very involved as co-chair of the committee and I think it will be a real success! I am hoping lots of people will take advantage of all that is being offered by so many in the community. Distinctive Care Geriatric Care Management has always had a policy of giving back to the community and volunteer activities like this are all part of our Distinctive Touch program.

The former Ridgewood Health Fair, now called Realistic Resolutions 2012, is being held on Thursday, January 19 from 5 to 8PM at the YMCA/YWCA of Bergen County at 112 Oak St. in Ridgewood. Amanda Arlauskas, runner-up from Season 8 of NBC’s The Biggest Loser will be the Keynote Speaker. Amanda will also be on hand to sign books and planners. I have heard Amanda speak before and I know how inspiring she can be. Maybe I too will be inspired to lose those couple of pounds that are making my pants tight!

This is a free event and will feature other happenings such as food demos and samplings from Whole Foods, chair massages, health screenings such as blood pressure, body fat analysis, reflexology and more from more than 40 exhibitors. Door prizes and giveaways will be abundant.

Of the many screenings that are being offered, Distinctive Care wanted to offer something that would be of real service to the attendees. Being in the middle of winter and knowing how many people suffer from depression, we thought it would be a good idea to offer screenings and advice for Seasonal Affective Disorder. We have written many blogs about this and now we are able to work directly with individuals to help them through what is a difficult time for many older adults and people of all ages. Two of our nurse care managers will be on hand to do this timely screening.

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The Professional Geriatric Care Manager’s Blog

Shingles

A Week in the Life of a Geriatric Care Manager

Realistic Resolutions 2012

Oral Care for the Elderly

Too Much Sugar in Our Diet!

A Week in the Life of a Geriatric Care Manager

The Sodium-Potassium Connection

Move Over Rice and Pasta, Here’s Quinoa!

Directions

A Week in the Life of a Geriatric Care Manager

Come to the Ridgewood Health Fair

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