Education « The Professional Geriatric Care Manager’s Blog

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.

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

Realistic Resolutions 2012

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

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

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

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

Too Much Sugar in Our Diet!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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!

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

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.

Maximizing Your Memory – From Community Presentation to CEU

December 19, 2011 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: CEU, Education, Health, Memory, Research, Seminar

Sophia Heftler, RN, MSN, CALA, CMC, CDP® has given our free community presentation, Maximizing Your Memory, numerous times in the past year. Why is that? What I have been told is that it is an upbeat topic that is pro-active and offers ways to improve quality of life. The program covers what memory is and how memory works, as well as what is normal memory loss and what is not. It offers tips on avoiding memory loss. It touches on when memory loss should be investigated further, and covers current medications used for memory loss, Alzheimer’s and the various other forms of dementia.

When I present the list of topics for someone to choose, the topic of Maximizing Your Memory has been chosen most often. And each time it is presented, it gets improved upon. So much so, that there is now enough information gathered on memory that is has been submitted for approval as a 2.0 credit continuing education unit (CEU) course for nurses and soon will be submitted for social worker approval.

When approved, we hope to offer this course to nurses and social workers who are working in hospitals, assisted living facilities, nursing homes, and wherever nurses and social workers may work with older adults in Bergen and Passaic Counties in New Jersey and Rockland County in New York. At Distinctive Care Geriatric Care Management, we think it is an important topic and the information should be available to everyone, both seniors and those working with them.

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.

Seasonal Affective Disorder

December 9, 2011 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Education, Health, Life, Personal, Support

Some people experience a serious mood disorder when the seasons change. They may sleep too much, have little energy and crave sweet and starchy foods. They may also feel depressed. Though symptoms can be severe, they usually resolve. This condition is known as Seasonal Affective Disorder. It occurs most often in the winter. It is believed that a lack of sunshine during the winter, when the days are shorter, may be the cause.

Light therapy, where individuals expose themselves to a special type of light for thirty minutes everyday, sometimes helps. Light therapy uses a special lamp with a bright fluorescent light that mimics light from the sun. Light therapy works well for most people with Seasonal Affective Disorder and it is easy to use. You will start to feel better within a week after you start therapy. You need to stick with it though, and use it every day until the season changes or your depression could come back.

Other treatments include medicines, such as antidepressants; counseling; changes in diet; taking long walks during the daylight hours and getting exercise; keeping active socially; or going to a sunny climate during the cold months. The disorder may begin during the teen years or in early adulthood. It occurs more often in women than men. Symptoms include increased weight gain; increased sleep and daytime sleepiness; less energy and the ability to concentrate; loss of interest in work or other activities; slow, sluggish lethargic movements; social withdrawal; and unhappiness and irritability.

There is no test for Seasonal Affective Disorder. It is often hard to tell the difference between Seasonal Affective Disorder and unseasonal depression, because many of the symptoms are the same. To diagnose Seasonal Affective Disorder the doctor will ask if you have been depressed during the same season and have gotten better when the season changed for at least two years in a row. Sometimes family and friends are not sure how to help someone who is experiencing symptoms of Seasonal Affective Disorder. Some suggestions to help are to spend time with the individual even if they are withdrawn or quiet, remind them they will feel better with treatment and time, offer to help with daily tasks that are temporarily too difficult for them to do alone, take a walk or involve the individual in some type of exercise or activity, and help them to stick with the prescribed treatment plan.

If you have concerns about the individual, talk with a health professional. If you choose to try light therapy, first consult with a health care provider before starting treatment to rule out other medical conditions and to help with monitoring the therapy. Try to get out as much as possible during the brightest time of the day and if you can not get outside sit near a window during the day to try to get more natural light to help with seasonal mood changes.

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.

Fish is the New Brain Food!

December 8, 2011 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Education, Health, Life, Memory, Personal, Research, Study

I just finished reading an interesting article that was sent to me a few days ago from Emaxhealth. The title of the article was “Baked Fish, Not Fried May Reduce Alzheimer’s Risk.” We have known for many years that fish contains omega-3 fatty acid which has been very helpful for lowering cholesterol levels. According to a new study presented by the Radiological Society of North America annual meeting, at least one serving of baked or broiled fish per week helps preserve gray matter of the brain, strengthening the area of the brain deemed critical to memory and cognition. This is particularly important for people with dementia or leading to Alzheimer’s disease.

A study took place at the University of Pittsburgh Medical Center, Mercy Hospital. They found study participants that ate baked and broiled fish (not fried) had larger brains. They had larger brain cells in areas of the brain most responsible for memory and learning. This area is known as the gray matter. It was noted that these brain areas are at higher risk for Alzheimer’s disease. After five years of following the effects seen with eating fish one to four times a week, the study showed mild cognitive impairment went down significantly in these participants. It is easy as including broiled or baked fish at least once a week into your diet that may help reduce your risk of developing Alzheimer’s disease.

I had my weekly dose of fish tonight. Baked Salmon, delicious!

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.