The Professional Geriatric Care Manager’s Blog

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.

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 at 201-587-5283 to schedule a consultation.

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.

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

A Week in the Life of the Geriatric Care Manager

January 3, 2012 at 10:30 am | Posted in Christine Clark, GCM | Leave a comment
Tags: GCM, Weekly

Happy New Year! It’s hard not to think of ways to make 2012 a better year. The first thought that comes to my mind is that I will exercise more as a way to stay in shape and reap the many physical benefits. But when I recently read an article called “Refresh Your Mind,” memory expert Gary Small, MD said if there was one single change that you could do to make a difference to keep your mind sharp as you age it would be moderate physical exercise. He states that when your heart is really pumping you deliver more nutrients and oxygen to your brain, and that the body secretes protective chemicals during physical activity which are thought to spark the growth of neurons.

Dr. Small also explains that mental exercise is also important and that even driving home via a new route can help. He states that once a task has become repetitive the brainwork involved becomes more rote which means there’s less neural activity going on.

He also talks about a study done in Finland in 2009 that found that subjects who drank 3 to 5 cups of coffee a day has 65% lower risk of dementia and Alzheimer’s. But too much coffee makes it hard to sleep and sleep is important for brain health. Moderation is the key.

When asked if he thought a single change could make a difference, Dr. Small felt that according to his data, if everyone in the United States adopted one additional healthy lifestyle habit, the number of expected Alzheimer’s cases would be reduced by a million in the next five years.

On that note, I’m off to the Gym (via a new route of course)!

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

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

Presentation of Maximizing Your Memory

January 2, 2012 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Education, Help, Memory, Seminar, Tips

Who doesn’t want to maximize their memory! Sophia Heftler, RN, MSN,CALA, CMC, CDP® will be presenting one of her most popular talks, Maximizing Your Memory, at the North Rockland Senior Center at 69 Bridge Street In Garnersville, NY on Wednesday, January 4, 2012 at 11:00AM. If you would like to attend, call Barbara DuVal at 845-429-9027 to let her know you are coming.

Learn what memory is and how your memory works. This seminar will discuss what simple things can be done to improve your memory. Find out what normal memory loss is and what it is not. Discover when memory loss should be investigated further with your physician and become informed about some of the current medications used for memory loss, Alzheimer’s and the various other forms of dementia.

If you would like to attend, call Barbara DuVal at 845-429-9027 to let her know you are coming.

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.

How Much Is Too Much?

December 29, 2011 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Aging, Diet, Health, Holidays, Life, Safety

New Year’s Eve is approaching us very soon. With that, I sometimes think of alcohol and why people consume too much of it on that particular day, or any day for that matter. I have attended educational programs and have learned that drug and alcohol abuse is becoming more common in the elderly population. The fact is, many family members, friends, and health care professionals often overlook their concerns about older adults’ drinking habits. Sometimes trouble with alcohol in older people is mistaken for other conditions that happen with age. Alcohol use deserves special attention, because the aging process affects how the body handles alcohol; the same amount of alcohol can have a greater affect as a person grows older. Over time, someone whose drinking habits have not changed may find that he or she has a problem.

Facts about Alcohol and Aging

It has been shown that as people age they become more sensitive to alcohol’s effects. The same amount of alcohol can have a greater affect on an older person than on someone who is younger.
Some medical risks, such as high blood pressure, ulcers and diabetes can worsen with alcohol use.
Both prescription and over the counter medications can be dangerous or even deadly when mixed with alcohol. This is a worry for older people, because the average person over the age of 65 takes at least two medicines a day. Examples: aspirin can cause bleeding in the stomach and intestines. If you mix with alcohol, the risk of bleeding is much higher. Cold and allergy medicines (antihistamines) often make people sleepy and when combined with alcohol, it can make drowsiness worse and driving even more dangerous. Alcohol used with large doses of acetaminophen (Tylenol) can raise the risk of lever damage. If you are taking any over the counter or prescription medications, ask your doctor of pharmacist if you can safely drink alcohol.

Effects of Alcohol

Even drinking a small amount of alcohol can impair judgment, coordination, and reaction time. It can increase the risk of work and household accidents, including falls and hip fractures. It also adds to the risk of car crashes. Heavy drinking over time also can cause certain cancers, liver cirrhosis, immune system disorders & brain damage.

Alcohol can make some medical concerns hard for doctors to find and treat. For example, alcohol causes changes in the heart and blood vessels. These changes can dull pain that might be a warning sign of a heart attack. Drinking also can make older people forgetful and confused. These symptoms could be mistaken for signs of Alzheimer’s disease.

How to Know if Someone Has a Drinking Problem

There are two types of problem drinkers: early and late onset. Some people have been heavy drinkers for many years. But, as with great Uncle George, over time the same amount of liquor packs a more powerful punch. Other people, like Grandma Betty, develop a drinking problem later in life. Sometimes this is due to major life changes like shifts in employment, failing health, or the death of friends or loved ones. Often these life changes can bring loneliness, boredom, anxiety, and depression.

Not everyone who drinks regularly has a drinking problem, and not all problem drinkers drink every day. You might want to get help if you or a loved one:

Drink to calm your nerves, forget your worries, or reduce depression.
Lose interest in food.
Gulp down drinks.
Frequently have more than three drinks in one day. (A standard drink is one 12-ounce bottle or can of beer or a wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.)
Lie about or try to hide drinking habits.
Drink alone.
Hurt yourself, or someone else, while drinking.
Were drunk more than three or four times last year.
Need more alcohol to get high.
Feel irritable, resentful, or unreasonable when not drinking.
Have medical, social, or financial worries caused by drinking.

Resources for Help

The National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health, recommends that people over age 65 who choose to drink have no more than one drink a day. Drinking at this level usually is not associated with health risks.

National Institute on Alcohol Abuse and Alcoholism (NIAAA)
6000 Executive Boulevard
Bethesda, MD 20892-7003
Phone: 301-443-3860
Website: www.niaaa.nih.gov

National Drug and Treatment Referral Routing Service
National Clearinghouse for Alcohol and Drug Information
Substance Abuse and Mental Health Services Administration
Phone:
Website: http://www.niaaa.nih.gov/Resources/RelatedWebsites/Referral.htm

Alcoholics Anonymous (AA)
Grand Central Station
P.O. Box 459
New York, NY 10163
Phone: 212-870-3400
Website: www.aa.org

National Council on Alcoholism and Drug Dependence, Inc. (NCADD)
20 Exchange Place, Suite 2902 New York, NY 10005

Melatonin Nightmares?

December 28, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Caregiver, Eldercare, Health, Life, Medication

Melatonin has received a lot of press coverage in the last few years, as a supplement which may help improve sleep. It is a natural hormone secreted by the pineal gland in the brain, which regulates other hormones and maintains the body’s circadian rhythm, or “body clock.”

Several of our clients use melatonin supplements (with their doctors’ supervision, of course) to combat insomnia. Recently, the caregiver for one of them reported that our client has been having increasingly frequent vivid nightmares or hallucinations, including the very scary belief that a stranger has entered her home in the middle of the night.

In our weekly case review meeting, our care management team brainstormed possible explanations for this change in her behavior. Is the client struggling with increased anxiety which manifests itself in her dreams? Is this behavior evidence of a new or worsening physical condition such as an infection, or a different form of dementia? Could she be experiencing a drug interaction from the many prescriptions she is on? Could it be simply a side effect of one or more medications she takes? Melatonin is known to produce nightmares in some patients at higher doses.

All of these, and more, are plausible explanations for our client’s change in behavior. These will be explored by her Distinctive Care Geriatric Care Manager, who works closely with her physicians to monitor her care.

If it turns out to be melatonin at fault, discontinuing it or adjusting the dosage should provide prompt relief from the nightmares. And this case illustrates the importance of discussing all supplements with your physician, whether or not they are “all natural” or sold over the counter.

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.

« Previous Page — Next Page »

Blog at WordPress.com. | Theme: Pool by Borja Fernandez.
Entries and comments feeds.

The Professional Geriatric Care Manager’s Blog

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

Drug Reactions in the Elderly

A Week in the Life of the Geriatric Care Manager

Presentation of Maximizing Your Memory

It’s Time to Say Goodbye to Clutter

How Much Is Too Much?

Melatonin Nightmares?

Blogroll

The Team

Tags

Archives

Meta

Distinctive Care on Facebook

Follow “The Professional Geriatric Care Manager's Blog”

Rate this:

Directions

Rate this:

Rate this:

Rate this:

Rate this:

Rate this:

Rate this:

Rate this:

Rate this:

Rate this:

Blogroll

The Team

Tags

Archives

Meta

Follow “The Professional Geriatric Care Manager's Blog”