Deborah Varisco, GCM « The Professional Geriatric Care Manager’s Blog

The Myth of Multitasking

February 17, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Memory, Personal, Study, Tips

We live in a very hectic environment where everyone wants tasks accomplished quickly. Our lives are busy and we often find ourselves trying to cope by doing several things at the same time. We talk on the phone while driving, we watch the evening news while cooking, or we text or email while walking. These are examples of multitasking, trying to do more than one thing at the same time. We are all guilty of trying to accomplish multiple tasks simultaneously and thinking that we are doing a good job at it. Research states otherwise. When you multitask your brain is shifting attention from one task to another which makes it difficult to focus on either task. We simply cannot focus on more than one thing at a time. One of the reasons for this is that similar tasks compete to use the same part of the brain. Studies have shown that we actually lose time when we try to multitask. Researchers state we go through two stages, goal shifting and rule activation, when we multitask and this uses significant time, particularly if we switch back and forth between tasks many times. You may think you are saving time and being more efficient, but you are actually taking more time in the end to complete a task. There is actually a lag of several tenths of a second each time your brain handles a switch. We overestimate our ability to handle multiple tasks.

New research also shows that multitasking may take a toll on our memory. Individuals who learned something new while multitasking were less likely to recall what they learned later on. This is particularly true of older adults. Studies are showing that multitasking takes a significantly greater toll on the memories of older adults, and they have more difficulty remembering tasks after experiencing a brief interruption.

One of the best things you can do to improve your memory is to pay attention to the things you want to remember. Multitasking causes you to pay less attention to what you are doing or learning, and you do not learn as well as if you had paid attention. While this probably won’t stop any of us from multitasking, remember that if you are trying to learn something new that you definitely want to remember, don’t multitask!

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

Statins for Women

February 10, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Alzheimer's Disease, Gender, Health, Life, Personal, Prevention, Safety, Support

Friday, February 3, 2012 was National Wear Red Day to raise awareness for Women’s Heart Health. Although heart disease is often thought of as a problem for men, more women die of heart disease each year. The rise of heart disease in women increases with age. Heart disease is a leading cause of death in women over 40 years old. This is a result of changes in the walls of blood vessels, making it more likely for plaque and blood clots to form; changes in the level of fats in the blood, where the LDL or bad cholesterol increases and the HDL or good cholesterol decreases; and increases in fibrinogen levels, a substance in the blood that helps blood clot.

Women and their health care providers need to take the risk of heart disease in women seriously and take measures to reduce that risk. In the past the benefit of statins for women to reduce cardiovascular events has been questioned. Recent studies have proved otherwise. Statin therapy has been shown to cut cardiovascular events in both men and women, and statins should be prescribed in appropriate individuals regardless of gender. Individuals at risk taking statin drugs are less likely to have a heart attack or stroke, be hospitalized for chest pain, or require a cardiac procedure to restore blood flow to the heart. Women can reduce their risk for heart disease by quitting smoking; losing weight; exercising; following a diet low in saturated fats, high in fiber, whole grains, legumes, fruits, vegetables and fish; and treating and controlling medical conditions such as high blood pressure and high cholesterol.

Cholesterol lowering statin medications also continue to be studied for their potential preventive or therapeutic effect on Alzheimer’s disease. Lowering cholesterol levels may reduce production of beta-amyloid or improve blood vessel functioning in the brain. Statins also have an anti-inflammatory effect, which may target the brain inflammation associated with Alzheimer’s disease. Several studies have suggested people who take a statin to lower LDL levels have a reduced risk of developing Alzheimer’s disease.

If you are a women with at least one risk factor for heart disease such as age, hypertension, high cholesterol levels or especially a family history, it is important to talk to your doctor about your heart disease risk and start statin therapy to help reduce your risk!

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

The Hidden Disability

February 3, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Education, Eldercare, Health, Life, Tips

Hearing loss is a sudden or gradual decrease in how well you can hear. If you have hearing loss you may not be aware of it. It has been called the hidden disability. An individual with hearing loss will ask others to speak up, repeat what they say, or speak more slowly. Family and friends may notice you have trouble understanding them. It can gradually worsen over time and is easily ignored. As one’s hearing worsens, though, an individual may become increasingly frustrated and socially isolated.

Social isolation has been linked to depression and an increased risk of heart disease. Studies have also shown another major risk associated with hearing problems is dementia. New research suggests that the strain of decoding sounds over the years may overwork the brain of individuals with hearing loss, leaving them more susceptible to dementia. Hearing loss could also lead to dementia by making individuals more socially isolated, a known risk factor for dementia and other cognitive disorders. Individuals who have a hard time hearing can’t follow conversations or respond to questions. They become frustrated and embarrassed, and begin to avoid socializing.

Common causes of hearing loss include noise, age related changes in the inner ear, injury to the ear, an ear infection or an object in the ear. Some common symptoms of hearing loss include muffled hearing, trouble understanding what people say, especially when there is background noise and listening to a television or radio at a higher volume. Noise induced or age related hearing loss can be treated with hearing aids. An audiologist will do tests to find out what kind of hearing loss you have, how severe it is and which part of the ear is affected. To prevent hearing loss, turn down the volume on anything you listen to through headphones, wear hearing protection when working around loud noises, avoid loud noise, avoid putting foreign objects in your ear and treat ear infections as soon as possible.

Individuals do not give hearing loss the same kind of attention they give hypertension or heart disease. Most accept hearing loss as an inevitable part of aging. It is time to take a more serious look at hearing loss. Urge individuals to get their hearing checked and if needed fitted with hearing aids to hear clearly again.

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

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

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.

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

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

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.

Drug Reactions in the Elderly

January 6, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Education, Health, Medication, Prevention, Safety, Tips

There are four medications used alone or together that are felt to be responsible for drug reactions resulting in the most emergency room visits in the elderly. They are Coumadin (Warfarin); aspirin, Plavix (Clopidogrel), or other antiplatelet drugs; Insulin; and oral diabetes drugs. All of these medications or medication groups are commonly prescribed to older adults. In addition, they are difficult to use correctly. Some of them require regular blood testing and dose changes, and the correct therapeutic index is a narrow one.

Every year in the United States, approximately 100,000 individuals 65 years and over are taken to the hospital for adverse reactions to medications. These visits may be a result of an accidental overdose or because the amount of medication prescribed for them was too much and resulted in an adverse reaction. Common factors among the drugs responsible for these visits are they are difficult to use, require blood testing to adjust their doses, and a small dose can have a powerful effect.

Coumadin or Warfarin, a blood thinner, tops the list. It is one of the drugs which requires regular blood monitoring and dose adjustment. Its therapeutic range is narrow and it can interact with many other drugs and foods. Insulin injections are next on the list. Blood sugars are difficult to control in people with diabetes. A diabetic who takes a slightly larger dose of insulin than needed can send themselves into shock. Antiplatelet drugs, such as aspirin and Plavix are next on the list, followed by oral hypoglycemic drugs used to control diabetes. These medications are critical for many older adults, yet none of these drugs are typically listed as “high risk.” The medications usually listed as high risk are the over the counter drug Benadryl and powerful narcotic painkillers such as Demerol. These drugs, though, account for fewer emergency room visits.

When individuals show up at the emergency room as a result of drug misuse or abuse, it provides an opportunity to reach out with counseling or exploring other options that could help prevent it from being repeated or further consequences. Often times this opportunity is missed. Data suggests focusing on safety initiatives on a few medicines that commonly cause serious harm can improve care for many older adults. Individuals need to work with their physicians and their nurses, pharmacies, or a geriatric care manager to make sure they are receiving appropriate testing and taking the correct dose of their medications.

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

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

It’s Time to Say Goodbye to Clutter

December 30, 2011 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Health, Help, Life, Personal, Support, Tips

It’s a new year and many of us make New Year’s resolutions. For many of us, maybe our New Year’s resolution should be to “declutter.” Some of us have drawers and closets stuffed with items. Every nook and cranny of our living space may be piled high with newspapers, magazines, paperwork, canned goods or that one item we are afraid to be without.

Lots of people lead a messy lifestyle and hoard certain objects. These individuals may acquire things that they don’t need, but they are still able to continue to function. Hoarding becomes a problem when an individual may no longer be able to cook meals, live safely in their home or when their hoarding becomes a threat to others. Hoarding can put one’s health and others at risk. Individuals hoard for many reasons. They may hoard because of an intense emotional attachment they have developed to certain objects. Throwing these objects away results in a sense of loss. Others hoard because they feel the item may be useful to them or someone else in the future. We accumulate too much if we are afraid we won’t be able to get more of it when we need it, or that it may be discontinued.

Most people who hoard will not seek help on their own. It is usually a friend or family member who pressures the individual to control their hoarding. Solutions are usually not simple, quick or long-lasting. Extreme hoarders will require professional therapy.

For others dealing with clutter, here are some helpful tips.

Take just one project at a time and stick with it until it is complete. Start with an easy project and gradually move onto more challenging ones.
Schedule time for decluttering.
Make three piles for items being decluttered. Keep, donate, discard. Do not make a fourth pile labeled undecided. Remove the discard and donate piles as soon as possible.
Bring nothing new into your home unless you have a proper place for it.
Sales and bargains may cause you to over buy. Remember that food, over the counter medications and beauty products all have expiration dates and buying too many could be wasteful.

Parting with the objects you have collected can trigger anxiety. If an individual becomes anxious during decluttering, having them sit down and do something fun or relaxing until the feeling passes may be helpful. Hoarders need to realize they may be causing others and their community harm and stress. The goal is to help an individual see their objects in a new light and to change their hoarding behaviors. Pairing a health professional with an organizer can be helpful. Together they can guide the individual toward understanding the benefits of changing their hoarding behavior and setting goals to clean up the mess!

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 at 201-587-5283 to schedule a consultation in our Ramsey or Ridgewood offices.

Boost Your Health with a Dose of Gratitude

December 23, 2011 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Health, Life, Love, Personal, Stress, Tips

The holiday season is upon us. It typically starts with Thanksgiving and lasts through to New Year’s Day. Giving thanks or possessing the “attitude of gratitude” is linked to and celebrated during the holiday season. Studies have shown that a positive emotion such as gratitude can guarantee better health. Gratitude has been linked to better health, sounder sleep, less anxiety and depression, increased satisfaction with life, and kinder behavior towards others. Individuals who perceive gratitude as a permanent trait have been shown to take better care of themselves and engage in more protective health behaviors like regular exercise, a healthy diet, and regular physical examinations.

Stress can make us sick, particularly when we can not deal with it. Stress is linked to several diseases, such as heart disease and cancer. Gratitude can help us better manage stress. Research suggests that feelings of thankfulness have tremendous positive value in helping people cope with daily problems and stress. Grateful people are more optimistic, a trait which may boost the immune system. Optimism has also been shown to have a positive health impact on people with compromised health. Studies of patients preparing to undergo surgery had better health outcomes when they had attitudes of optimism.

Some people always manage to feel grateful, even when challenged by life circumstances. Others are not the grateful sort and sink into despair. If you are not the grateful kind, here are some ways to get into the grateful spirit.

Maintain a grateful journal. Write down things which you feel grateful for once a week. They may include a friend’s generosity, something new they have learned, or a beautiful sunny day. Research discovered that people who kept grateful journals were more optimistic and felt happier. They experienced fewer physical symptoms and felt better about their lives as a whole. They slept better and were more optimistic about the future. Counting blessings worked better than counting sheep.
Create a list of benefits in your life. Many of us take many things for granted. Making a visual list of some of the benefits we have, such as the freedoms we enjoy, will be a reminder.
Try a gratitude visit. Begin with writing a letter to someone who changed your life for the better. Deliver the letter in person and read it to that person.
Share the feeling. Do one small thoughtful or generous thing for a friend or a member of your family. As a result, that person will not only realize how much you matter to them, but are more likely to help someone else.

Trying these simple gratitude-enhancing strategies can improve your health and well-being. Gratitude is the best approach to life!

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 Ridgewood Office at 201-587-5283 to schedule a consultation.

Slowing Cognitive Decline with B12

December 16, 2011 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Diet, Education, Health, Life, Personal, Tips, Vitamins

As we age, our ability to absorb B12 from the foods we eat declines. We also tend to consume less foods rich in B12 as we get older. As a result, an individual can develop a B12 deficiency without warning. A B12 deficiency can lead to an individual having increased symptoms of confusion and possibly being misdiagnosed. These symptoms may even be thought to just be a part of aging.

B12 is an essential vitamin. Having a vitamin B12 deficiency means your body does not have enough of this vitamin. You need B12 for the development and maintenance of a healthy nervous system, the production of DNA, and the formation of red blood cells. Red blood cells carry oxygen throughout your body and not having enough B12 can lead to anemia, where you feel weak and tired. Other symptoms of a B12 deficiency include muscle weakness, fatigue, shakiness, unsteady gait, incontinence, low blood pressure, depression, and cognitive problems like poor memory. An individual with a B12 deficiency may also have pale skin, bleeding gums, weight loss and numbness and tingling of fingers and toes.

The recommended daily amount of vitamin B12 depends on your age. The recommended daily amount of vitamin B12 for individuals 14 years and older is 2.4 mcq daily. This level is obtained by eating a well-balanced diet with foods containing vitamin B12. B12 is found in foods from animal protein, such as meat, seafood, milk products, poultry and eggs. Other foods, like cereals, are fortified with B12.

Plant sources of food are low in B12 and the vitamin is poorly absorbed from them. Vegetarians should consume supplements to get adequate amounts of vitamin B12.

Normally, B12 is absorbed by your digestive system. A deficiency will occur when the digestive system is unable to absorb the vitamin. This can occur with chronic users of acid suppressing drugs, like Prilosec and Nexium; individuals who have had stomach surgery for weight loss; heavy drinkers of alcohol; individuals with digestive diseases, like Crohn’s disease; and older adults, since stomach acid levels decline with age. Older adults may lack sufficient stomach acid to absorb adequate amounts of B12 from natural food sources. In this situation, regular consumption of fortified foods or a B12 supplement is recommended.

A simple blood test can check if your body has enough vitamin B12. If your B12 level is low, you will probably be prescribed a B12 supplement, given by either pills or shots. You can also improve your health and B12 levels by eating a varied diet that includes meat, milk, cheese and eggs, which are all good sources of vitamin B12. Eating plenty of foods that contain folic acid, another type of vitamin B, is also helpful. They include leafy, green vegetables, citrus fruits, and fortified breads and cereals.

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 Ridgewood Office at 201-587-5283 to schedule a consultation.