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

Older Americans Month

May 18, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Health, Help, Life, News, Support

Each May we celebrate the contributions and achievements of older Americans. The 2012 theme for Older Americans Month is, “Never Too Old to Play.” This theme encourages older Americans to stay engaged, active, and involved in their own lives and in their communities. Older Americans are living longer and are more active. Since 1963, communities have celebrated Older Americans Month organized by the Administration of Aging through the Department of Health and Human Services. While there is a vast network of programs for older Americans, many still struggle everyday to stay healthy and make ends meet. Many seniors cope with multiple health conditions and find it difficult to pay for food, utilities and other basic necessities on a fixed income.

To maintain good health, it is important to do something active each day. Older Americans should select activities that they enjoy but also maintain their strength, balance, flexibility and heart health. Activity helps older Americans maintain a healthy weight, prevent or control illness, sleep better, reduce stress and depression, improve balance and feel their best. Being active has also been shown to improve memory.

The theme, “Never Too Old to Play,” is the perfect opportunity for people of all ages to play games together. Younger children or teens can play games with older relatives, neighbors and friends or they can volunteer to play games at area nursing homes. Games can include card games, such as Uno or War and board games, like Monopoly, Clue and Scrabble. Other activities they can participate in are trivia games, video games such as Wii games, bowling, cooking, swimming, going to the movies or a concert, or taking a walk.

Older Americans Month is a great opportunity to show your appreciation for older adults and to thank them for their contributions to our communities. Interactions with older Americans enrich the lives of everyone involved. As part of Older Americans Month, get involved with at least one senior and enjoy an interaction which will ultimately benefit both of 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.

National Nurses Week

May 11, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Advocacy, Life, Love, Nurse's Week, nurses, Personal

National Nurses Week is celebrated each year from May 6, known as National Nurses Day, through May 12, the birthday of Florence Nightingale the founder of modern nursing. National Nurses Day was first observed in 1954. The year marked the 100th anniversary of the nursing profession pioneer Florence Nightingale’s mission to treat soldiers during the Crimean War. It wasn’t until the early 1990′s that the recognition of nurses’ contributions was expanded to a week-long event each year.

The 2012 theme of National Nurses Week is “Nurses: Advocating, Leading, Caring.” Nursing is a profession encompassing dedicated individuals with varied interests, strengths and passions. Nursing offers many opportunities. Nurses work in emergency rooms, schools, clinics, doctors offices, rehabilitation centers and home settings. Nurses have many roles. They care for the sick, they are advocates for their patients and they are educators. Nurses work to make a difference everyday to countless patients, their families and their community. They are dedicated, compassionate and professional.

Nurses have been ranked the most trusted and respected profession in America since 2001. Nursing is the largest of the health care professions and continues to grow. The education level of nurses has increased significantly over the past three decades and the work force has become more racially and ethnically diverse. More men also are choosing nursing as a career. To celebrate nurses week hold a special celebration or reception to recognize nurses in your community, place an article in your local newspaper about National Nurses Week and the value of nurses, sponsor a community event such as a coloring or writing contest for school children where they acknowledge their favorite nurse, send a greeting card, or just say “thanks.” National Nurses Week is an opportunity to acknowledge and thank a nurse who made a difference in your life. In addition, as nurses we should take the time to celebrate all the good we accomplish as nurses and celebrate our profession!

Please contact us in our Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

Caregiver Burnout

May 4, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Caregiver, Caregiver Burnout, Health, Help, Life, Love, Personal, Prevention

Caregiver burnout is a state of physical, emotional and mental exhaustion. Caregiver burnout can occur when caregivers do not get the help they need or if they try to do more than they are able. Caregivers who are burned out may experience fatigue, stress, anxiety and depression. Symptoms of caregiver burn out include withdrawal from friends, family and loved ones; loss of interest in activities; irritability; changes in appetite and weight; changes in sleep patterns and emotional and physical exhaustion. A caregiver will face disruption in work and social life, sleep habits, exercise routines, household management and financial situations.

Some have described the caregiver role as a “roller coaster ride from hell.” Each day brings new challenges, demands and adjustments. Caregivers are often so busy caring for another that they neglect their own needs. They may place unreasonable demands on themselves and may even become sick themselves. Many individuals are confused when they are forced to take on the role of caregivers. It can be difficult for one to separate their role as a caregiver from their role as a spouse or child. Many are additionally frustrated by a lack of money, resources and skills.

To prevent caregiver burnout:

Find someone you trust and talk about your feelings and frustrations.
Set realistic goals. Accept you may need help with caregiving.
Be realistic about your loved one’s disease, especially if it is a progressive disease such as Alzheimer’s disease.
Do not forget about yourself because you are too busy caring for someone else.
Stay healthy by eating right, getting enough exercise and sleep.
Talk to a professional such as a therapist, social worker or clergy member.
Take advantage of respite care services.
Educate yourself. The more you know about the illness, the more effective you will be in caring for the person.
Join a caregiver support group.
Accept your feelings. It is normal to have negative feelings, such as frustration and anger.

Remember you need to balance your caregiver role and personal life. Prevent burnout by recognizing problems you may encounter. Reward yourself for the positive differences you make in your loved one’s life. Do not stress over the things you did not get done, or can not change. Focus on the good things you do and acknowledge the reality that being a caregiver is filled with stress and anxiety. The best way to be an effective caregiver is to take care of yourself.

Please contact us in our Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

An Aspirin a Day

April 20, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Eldercare, Health, Life, Medication, Personal, Prevention, Safety

Aspirin is used to reduce fever, relieve mild to moderate pain from muscle aches, headaches or toothaches, and reduce pain and swelling in those with arthritis. Doctors prescribe aspirin therapy to prevent blood clots, which reduces the risk of stroke and heart attack. Nearly a third of middle-aged Americans take aspirin daily, mainly in the hope of preventing a heart attack or stroke. More recently individuals have begun to take aspirin to lower their risk of cancer. New studies suggest that aspirin therapy can decrease one’s risk of many cancers, including colon, esophageal, breast and prostate cancer.

Other research studies, though, demonstrate aspirin is not for everyone and sometimes does more harm than good, particularly in the elderly. Aspirin is a medication and all medications have side effects. Aspirin may cause nausea, vomiting, stomach pain and heartburn. More serious side effects of aspirin include hives, rash, swelling of the eyes, tongue or throat, difficulty breathing, bloody vomit, bright red blood in stools or black, tarry stools.

It has been demonstrated that there exists a potential for life-threatening bleeding in people over the age of 70 years who take aspirin daily, which may be greater than the heart disease protection it may offer. The benefit of aspirin therapy in individuals with heart disease is clear, however, and those taking it under a physician’s supervision should not stop.

The benefits of aspirin in older individuals without heart disease is uncertain.

Age is a strong predictor of cardiovascular risk, with the thinking that the benefits of aspirin would be greater in the elderly than those in other age categories. The elderly, though, also have an increased risk of bleeding from aspirin use. Even low dose aspirin can increase the risk of bleeding in the gastrointestinal tract.

So daily aspirin might not be for everyone. Many individuals decide on their own to take an aspirin a day. Aspirin therapy should be prescribed case by case depending on the individual’s risk factors and family history. Consult with your doctor to decide if the benefits of aspirin therapy outweigh the risks and if you should be one of those taking an aspirin a day.

Please contact us in our Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

Being Honest

April 13, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Diagnosis, doctors, Health, Honesty, Patients, Safety, Truth

Should physicians withhold the truth about a diagnosis in order to relieve a patient’s fears and anxieties?

Honesty matters in the medical profession, but some degree of dishonesty may be excusable in order to avoid more serious patient harm. Doctors and nurses in some cultures believe it is wrong to lie about a bad diagnosis or prognosis. A number of studies have shown that the majority of patients generally want to know the truth about their diagnosis, prognosis and therapy. Individuals need the truth even when it tells them about their death. Without knowing the truth, an individual can be subjected to aggressive treatments, futile interventions and more suffering. To prevent harm from telling the truth, a doctor needs to tell the truth in a certain way and time.

Truth telling must be sensitive and take into account the individual’s personality and history. An individual needs an explanation of their illness. It should be understandable and convincing so they can cooperate in their treatment and be relieved of any fears. Communicating with a patient and being honest is a important way for physicians to foster trust and show respect for their patient. Giving individuals truthful information helps them to become informed participants in their care and in their decision-making.

Many times families will ask a physician to withhold a diagnosis from a patient. The family usually wants to spare the individual the potentially painful experience of learning the truth. If the disclosure is done sensitively, these fears are unfounded. In rare situations though, family members may make the physician aware of something about the patient that causes the physician to worry that the truth may actually cause harm and be justified in withholding the truth. A recent study in the medical journal “Health Affair” found that more than ten percent of doctors admit to not telling their patients the complete truth about their medical conditions.

So what is right? Physicians must strike a balance between respecting an individual’s autonomy and acting in their best interest. What do you think?

Please contact us in our Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

The Social Connection

April 6, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Family, Health, Life, Love

Recent studies have demonstrated that those individuals in loving relationships with spouses, family members or friends were healthier and lived longer than those lacking these connections. Even those with unhealthy lifestyles but close social connections lived longer than individuals with poor relationships and healthier lifestyles. Those with both close social ties and healthy lifestyles lived the longest. As we age we all hope to live a long life that is rewarding and worthwhile with family and friends. No one wants to live with ill-health or alone. Happiness , a sense of meaning and peace of mind are important attributes possessed by individuals who live long lives, and having good relationships is one of the best predictors for longevity. Just as we need food, water and shelter, we need others in our lives.

The MacArthur Study of Successful Aging talked to individuals between 70 and 79 years old and asked them how useful they felt to family and friends. Years later they found that those individuals who had rated their usefulness to loved ones as high had higher survival rates and a lower incidence of chronic illness. Maintain a sense of purpose and stay involved in activities that have meaning. Give your time to others by joining a cause or volunteering. It has also been shown that having a greater sense of purpose is linked to a reduced risk of Alzheimer’s disease. Close loving relationships have many advantages. When we have others looking out for us they are there to give us advice, assistance and emergency aid if needed. In addition, when we are feeling needed and loved it causes a biochemical change in the body that lowers stress, increases energy, strengths the immune system and extends your lifespan.

Social connections give us something to live for as we age. There are few things that can give us more than happy, loving relationships and good social relationships can increase our longevity and improve our health. Be grateful for your friends, they will help you live longer!

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

Gastrointestinal Infections on the Rise

March 30, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Health, Life, Personal, Prevention, Safety, Tips

The majority of gastrointestinal infections typically involve diarrhea, vomiting, and abdominal cramps and those infected make a full recovery after a few days. Increasingly, gastrointestinal infections are responsible for more deaths in the United States, particularly in the elderly.

The Centers for Disease Control and Prevention reported that deaths from gastrointestinal infections more than doubled from 1999 to 2007. The majority of those deaths were due to the bacterium, Clostridium difficile. The second leading cause of death from gastrointestinal infections was due to the norovirus. Individuals most often contract Clostridium difficile in hospitals and nursing homes, and in most cases occur primarily among those taking an antibiotic. C. difficile bacterium has two forms, an active infectious form that cannot survive in the environment for prolonged periods and a nonactive form that can survive in the environment for weeks and even months. This form cannot cause infection directly, but when ingested can transform into the active infectious form. The spores can be found on bedpans, toilet seats, furniture, linens, telephones, stethoscopes and floors. It takes bleach or other strong disinfectant to kill the spores. The disease is spread by the fecal-oral route, which makes hand washing after using the toilet so important.

Since healthcare settings are responsible for so many cases of C. difficile, it is important for surfaces to be cleansed with bleach and for healthcare workers to wear gloves and gowns when dealing with infected patients to prevent spreading germs to others.

Individuals with C. difficile can have a high fever, severe diarrhea and abdominal pain which can lead to dehydration and disturbances in the electrolytes in the body. Increasingly, C. difficile has become virulent and drug resistant. Since the overuse of antibiotics can cause C. difficile, all antibiotics should be used prudently. Using antibiotics without an accurate diagnosis or proper reason should be discouraged.

The norovirus causes a highly contagious infection. It is sometimes called the winter vomiting illness and spreads rapidly on cruise ships, prisons, dormitories, hospitals and nursing homes. Symptoms include vomiting, watery diarrhea, fever, stomach pain, tiredness, headache and muscle aches. Symptoms may be more severe in elderly patients. Individuals with the norovirus who are unable to replace their fluids and develop signs of dehydration will need medical care. As with C. difficile, norovirus infections can be prevented using good hand hygiene.

In the past few years, researchers have found deaths from gastrointestinal infections have leveled off. Doctors, nurses, other healthcare workers, hospitals and nursing homes need to continue to take responsibility for preventing gastrointestinal infections as the majority of all gastrointestinal infections occur in healthcare settings.

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

Sleeping Pill Alert

March 23, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Health, Medication, Safety

In some cases doctors will prescribe medications for the treatment of insomnia. Sleeping pills will not treat the underlying cause of one’s sleeping problems, but may help one get some much-needed rest. Prescription sleeping pills are available to help you fall asleep, stay asleep longer, or help with both. Today’s sleeping pills do not carry the same level of risk of dependence of the past, but risks still remain. Recent studies found that individuals taking prescription sleeping pills on a regular basis were nearly five times more likely than non-users to die over a period of two and a half years, and be more likely diagnosed with cancer. The study, though, did not prove that sleeping pills caused death, but that there may be a link between the two. Many individuals using sleeping pills are usually sicker than those not using them.

Insomnia also causes additional health problems. Those individuals taking sleeping pills may be at a higher risk because of health conditions that may have brought on the sleeping problems. Many chronic conditions, such as cancer, are linked with insomnia and mortality. Sleep disorders can be a symptom of an underlying mental or physical condition. Many who get prescriptions for sleeping pills have higher rates of heart disease, diabetes and other conditions which contribute to sleeplessness. Sleeping pills can be helpful in many situations, but are not without side effects including drowsiness, impaired judgement, depression and heart problems. The elderly should particularly use caution with sleeping medications.

The nonbenzodiazepine sedative hypnotics including Ambien, Lunesta and Sonata are believed to be safer and less likely to be abused. They are recommended for short-term or occasional use, but some individuals take them for years. Side effects of the nonbenzodiazepine’s include dry mouth, dizziness, headaches, nausea, diarrhea and abdominal pain. In addition, severe allergic reactions, breathing problems and depression may result. They can contribute to confusion, affect judgement and behavior, and have resulted in falls that may be fatal for older adults.

If you suffer from insomnia then, what should you do? An individual needs to weigh the risks versus the benefits as with many other medications. If there are ways to help you sleep, other than taking pills, that’s a better solution. Practice good sleep habits such as a set bedtime and start a pre-sleep ritual, like reading. Try not to nap during the day and do not watch television or use the computer before trying to sleep. Avoid exercise, nicotine, alcohol, caffeine and spicy foods several hours before bedtime. In addition, block out light and noise from the bedroom to get a good night sleep.

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 Benefits of Vitamin D

March 16, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Diet, Education, Health, Life, Personal, Tips, Vitamins

Vitamin D is a fat soluble essential vitamin. It has been used to treat weak bones or osteoporosis and for preventing falls and fractures in people at risk for osteoporosis. Vitamin D is also used for conditions of the heart and blood vessels, including high blood pressure and high cholesterol.

Research has shown that increasing blood levels of vitamin D may additionally protect an individual from chronic or life-threatening diseases, such as diabetes, obesity, muscle weakness, multiple sclerosis, rheumatoid arthritis, chronic obstructive pulmonary disease, asthma, bronchitis and tooth and gum disease. It is also used for boosting the immune system, preventing autoimmune diseases and cancer. In addition, deficiencies of vitamin D may be responsible for neuropsychological disorders including depression and memory loss.

Sun exposure is an easy way for individuals to get vitamin D. The necessary exposure time varies with age, skin type, season and time of day. Ten to fifteen minutes of sunshine three times a week is enough to produce the body’s requirement of vitamin D. The sun needs to shine on the skin of your face, arms, back and legs.

Vitamin D deficiency is common. Individuals stay indoors more, cover up when outside or use sunscreen to reduce skin cancer risk. The elderly are particularly at risk for vitamin D deficiency. They are less likely to spend time in the sun, have fewer receptors in their skin that convert sunlight to vitamin D and may not get enough vitamin D in their diet.

It is difficult to get enough vitamin D from food sources alone. Very few foods naturally have vitamin D. Vitamin D can be found in small amounts in a few foods including fatty fish such as herring, mackerel, sardines and tuna, beef liver, cheese, egg yolks and mushrooms. Vitamin D has been added to most dairy products, some juices, cereals and soy beverages. Some individuals may have to take a vitamin D supplement in order to boost their level. The Recommended Dietary allowance for vitamin D for those age 9 to 70 is 600 IU daily. Adults over age 70 should take 800 IU daily.

The best measure of an individual’s vitamin D status is a blood level. Levels below 30 ng/mL are too low for bone or overall health and require a supplement. Vitamin D is important to the body in a number of ways. As with all medications and supplements, speak to your doctor, pharmacist, or other healthcare provider about starting a vitamin D supplement. Vitamin D may interact or interfere with one’s prescription or over-the-counter medications and how your body absorbs or uses them.

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

Aging Eyes

March 2, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Eldercare, Health, Help, Life, Personal, Prevention, Tips

Your circadian rhythm is a biological clock that regulates many of the systems of your body, such as the sleep-wake cycle, the temperature regulation system and the endocrine system. Circadian rhythms are responsible for rallying the body in the morning and slowing it down at night so the body will rest and rejuvenate. The malfunction of an individual’s circadian rhythm causes circadian rhythm disorders leading to insomnia, heart disease and cancer.

Most of the time your biological clock or circadian rhythm is in sync with the 24 hour day-night. In some individuals, the circadian rhythm is out of sync due to several reasons, which include travel, shift work or neurological diseases such as Alzheimer’s. Symptoms found in individuals with circadian rhythm disorders include difficulty initiating sleep, difficulty maintaining sleep, daytime sleepiness, poor concentration, decrease in cognitive skills, headaches, gastrointestinal distress and poor psychomotor coordination.

Recently researchers have been studying the effect of the aging of the eyes as one of the reasons for some of the health problems that come with age. As we age there is a gradual yellowing of the lens of the eye and a narrowing of the pupil, which results in less sunlight getting through the lens and reaching key cells in the retina, which regulate the body’s circadian rhythm. Studies indicate that by age 45 the photoreceptors, cells in the retina that absorb sunlight and transmit messages to the part of the brain which governs our internal clock, receive only 50 percent of the light needed to stimulate the circadian system. By age 55, it is only 37 percent, and only 17 percent by the age of 75. Due to these changes it is felt that as an individual ages they should make an increased effort to expose themselves to bright sunlight or bright indoor lighting when they cannot get outside. Often older adults spend more time indoors and put themselves at increased risk.

The eye’s role in maintaining good health is becoming increasingly evident. In order to decrease some of the conditions that occur with age, such as depression, slower reaction time, memory loss and insomnia, it is important that the eyes get the proper light exposure they require to maintain one’s circadian rhythm.

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