Bergen County Geriatric Care Manager
March 27, 2009 at 11:09 am | Posted in Megan Milchman, GCM | Leave a CommentTags: GCM, Life, Weekly
Monday: Visit with M, I take her for her blood work, basic labs are done to check for normal values. She is very anxious because they always have trouble finding her vein and getting her blood. This time is no problem though, they found her vein first try and she was very happy about this.
Visit with A, she has a breakdown under her breast, the doctor was called and ordered them to put neosporin and vasoline on it. I advise not to wear a bra because it can cause further irritation, until it is clear. It all started becasue she scratched a small scab.
Tuesday: I am in a seminar regarding Caregivers and Alzheimers Disease, and how to help the caregiver cope with the issues the are going to face with their loved one.
Wednesday: Visit with Ma, filled her medications and went over her medications with her Aide who has just returned from vacation and doesn’t know the new medications.
Visit with Mr. A who has the owner of a home health aide company come and talk to him about having a companion. We had to get firm with him, because he doesn’t realize that his dementia is progressing quickly and that it is unsafe for him to be alone all the time. At this point in time he forgets to take his medications and we are unsure if he is eating. Everyone is very concerned for him.
Thursday: Visit with P, everything is the same, nothing has changed. She is doing well and is happy that she will be getting a new television soon.
Visit with B, a new client who was just transferred from a hospital to a rehab facility. Her family was concerned because she was disoriented and hallucinating when she was transferred, I told them that, that is normal and when I saw her today she was fine. She was alert and oriented. Her PT and OT stated that they had just completed their evaluation and feel that she is in good shape. Her doctor and the people in the facility will be working their hardest so that she can return to her home. As a Geriatric Care Manager in Bergen County, NJ, I would like to see that as well. People are the happiest when they are in their own home and that is what we strive for.
Dr. G, he is doing very well in his new facility, but he did bring up wanting to go home for the first time today. I explained to him that his home was unsafe, but he had a hard time understanding that, and kept telling me that his home is fine.
All families were contacted shortly after the visit with their loved ones. We strive to keep everyine informed who needs to be informed.
Alzheimer’s Medications
March 25, 2009 at 7:58 am | Posted in Sophia Heftler, GCM | Leave a CommentTags: Alzheimer's Disease, GCM, Medication, Support
There are currently four medications that are FDA approved for the treatment of Alzheimer’s Disease. These drugs are:
Aricept, Exelon, Namenda, and Razadyne.
The first question that may come to mind when considering the use of one of these medications is, “Which works best?” The American College of Physicians advises that there is little evidence that one of these drugs works better than the others. They point out that the real differences between these medications include cost, possible adverse reactions, and how easy it is for the medication to be taken. If the drug needs to be taken several times a day it may be to complicated or difficult to manage; particulary if the person with the disease has a difficult time taking medications.
So instead of asking, “Which works best”, the care managers at Distinctive Care recommend that the following questions be asked when discussing a medication regime with the physician:
- Which medication will be the safest when taken with the other medications my loved one is taking?
- Which medication has the lowest risks of side effects based on my loved one’s medical status?
- What adverse reactions should I look for at home, what should I notify you about and when should I notify you?
- What form does the medication come in (pill, liquid or skin patch)? How often shoulf the medication be taken? When should the medication be taken? Are there any special instructions I will need to remember, for example should it be taken with food or on an empty stomach?
- How long will it take to know if the medication is working? If the medication does work might there be a time when it will stop working and it will become necessary to stop taking the medication?
- How much do these medications cost? Will it be covered by our insurance? And do not be afraid to ask for samples to see if the medication is effective for your loved one before spending the money to have the prescription filled!
After reviewing these questions with your loved one’s physician you will be better prepared to make a collaborative decision with the physician that is in the best interest of your loved one.
If you would like to find out more about what to ask at a doctor appointment contact us in our Ridgewood, NJ office at 201-587-5283.
A Surprising Off-Label Use for Botox?
March 17, 2009 at 10:22 am | Posted in Mark Heftler, Admin | Leave a CommentTags: Botox, News, Stroke
Botulinum toxin is kind of a scary thing – as the most toxic protein known to man, it’s used as a medication for a number of purposes, ranging from the cosmetic application to the prevention of muscular spasms.
These days, however, it looks like Botox is claiming another procedure for its repertoire of successes: freeing up muscles of stroke victims. Though not yet approved by the Food and Drug Administration, the off-label use of Botox on stroke victims has been widely accepted by Medicare as a reimbursable procedure.
For this, the patient is injected deep into the muscle tissue with Botox. Though Botox cannot restore the use of muscles when stroke has destroyed the brain region that controls them, it can help patients look and feel better and often find it easier to dress, hold objects and bathe themselves.
Second Quarter Newsletter
March 16, 2009 at 8:46 am | Posted in Mark Heftler, Admin | Leave a CommentTags: News, Support
The first quarter is quickly ending, and that means a busy time for Distinctive Care. Beside the typical paperwork and accounting, important number tracking and things of that nature, we’re very excited to be wrapping up our second newsletter. We’ve received a great deal of positive feedback from our first newsletter, which went out the beginning of January, and we’re hoping to keep our friends and contacts equally as happy and informed as we’ve done in the past.
If you’re interested in signing up for the newsletter, I encourage you to head over to our website. Just drop your information in the sign-up box, and we’ll get our Medicare guide right out to you, along with our quarterly newsletters and anything else we find newsworthy and important.
This week as a GCM in Bergen County
March 13, 2009 at 4:02 pm | Posted in Megan Milchman, GCM | Leave a CommentTags: GCM, Life
Monday: Visit with M, her blood pressure is much lower than it was, but she is still using salt, so it is still too high. A is not feeling well again, so I will check up on her tomorrow.
Tuesday: Call to check in on A, she is feeling better but is refusing medication, because it different than normal. After talking with her and telling her that it is correct the way it is, she still refuses. The owner of Distinctive Care, Sophia, goes to her house and explains that the doctor changed the order of the medications.
Wednesday: Mr. A goes to see his neurologist, where he learns that his condition is much worse than he realized. We discussed the possibility of him having someone come and live with him, but he doesn’t want to change anything just yet. Distinctive Care’s Geriatric Counselor will discuss this further with him, and try to get him to realize that he does need the help.
Thursday: A visit to Ma, she has been feeling really tired lately, but will be seeing her doctor next week, she asked me to leave so she can go back to her nap.
A Geriatric Care Managers Week
March 7, 2009 at 11:28 am | Posted in Mark Heftler, Admin | Leave a CommentTags: GCM
Monday: Snow storm outside, so I spent the time calling all my clients I was supposed to visit to see how they were doing, and to make sure everything was well. I also made some phone calls to doctors to get test results and called my clients with their results. Caught up on emails
Tuesday: Making up for lost time, visiting Monday’s clients and Tuesday’s clients. First visit with Mr. A, he lives alone so he has a tendency to get bored and lonely, he is very happy when I arrive and his personality changes. I check on his medications, which he hasn’t really taken and I spend the time telling him the importance of taken his medications. Last week went on a little trip to visit an Assisted Living facility, he says at this time he is not ready but will let me know when he is. We talked about this for a little while, he is showing signs of depression and it is sad to see the decline that he has had in the recent months.
Visiting M today, her UTI is gone and she is feeling much better, but her Blood Pressure is still high. I advise her live-in to take her blood pressure only after she has rested. I will check in tomorrow and if her blood pressure is still high, I will take her to the doctor tomorrow.
Mr. T, I see every couple weeks, he lives in long term care facility in Bergen County, NJ and suffers from Alzheimers. I do a chart check and not to much has changed, he did suffer from a UTI but seems to be doing much better. I check in to see him while he is eating lunch and he still has a hearty appetite. Even though he doesn’t remember me, I can see that he is grateful for the visit.
Wednesday: I visit with Ma to do her medications and to see how she is doing with all the changes she has gone through. Moving back home and having a live in can be a big deal to some people. She seems to be handling everything great though. She is happy with her live-in and she gets out daily.
There is an IDCP meeting for G today, since she just moved into a new facility and I go to give her family support and make sure that everything is being taken care of. There has been a big changed in G since the move. She doesn’t speak, but you can tell that she is very happy where she is. She is walking using a merry walker, where in the other facility she was belted into the wheelchair and left alone all day. Here in the new facility, she participates in all the activities and is very social. What a change in personality a move can do.
Since I am there I visit with P who is in the same facility as G in Bergen County. Everything is the same with her, there is nothing new added to her charts. The only complaint that she had for me was that they forgot to tell her that the monthly birthday party was today, so she was unable to attend.
I called M and her blood pressure was still high, so off to the doctor we went, where another blood pressure medication was added and she was told that she had to cut salt out of her diet completely.
Thursday: We having our weekly meeting today, since there was a storm on Monday and we couldn’t get together any earlier. We go over all the clients we have and everyone seems to be doing well.
I visit Mr. A for the 2nd time this week, just to help with his loneliness and he talks about his wife some more, and his life in Cuba. I check is medication and he still hasn’t taken them. He then brings up the subject of Assisted Living and says that he has been thinking about it a lot lately. We see what happens.
A visit with A. I fill her medi-minders and call in refills to the pharmacy. We had a short discussion, but she was just waking from her nap and her physical therapist was coming, so I decided that she needed to rest some before he came, since it can be exhausting.
After each visit with the client I contact their loved one, to let them know how everything is and what has been going on.
Mall Walkers Talk on Benefits of Exercise for Dementia
March 7, 2009 at 8:00 am | Posted in Pat Linard, PR | Leave a CommentTags: alzheimer's, bergen county, exercise, mall walkers, paramus park
Sophia Heftler, founder of Distinctive Care, will be speaking to the Mall Walkers at Paramus Park Mall in Paramus, NJ on Wednesday, March 25 at 8:00AM. The topic is Benefits of Exercise in Preventing and Slowing Dementia. Breakfast will be provided for this event. I have a feeling the mall walkers are already on their way to good health with their regular mall walking!
Vitamin D – and Dementia?
March 2, 2009 at 10:54 am | Posted in Mark Heftler, Admin | Leave a CommentTags: Dementia, Study, Vitamins
In a recent British study, a link between low blood levels of Vitamin D and increased risk for Dementia has been discovered.
1,766 individuals over the age of 65 were sampled for the study. 12% were cognitively impaired, and the lower the individual’s Vitamin D level, the more likely they were to be in that grouping. By comparison to those in the highest 25% of Vitamin D intake, those in the lowest were 2.3 times more likely to be impaired.
The doctor’s who ran the study were quick to note that Vitamin D deficiency is not the cause for Dementia – instead, “while further research is needed, vitamin D supplementation is cheap, safe and convenient, and may therefore play an important role in prevention.”
So, be sure to take your Vitamin D!
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