Eldercare « 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

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

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.

Healthy Weight in the Geriatric Patient

November 10, 2011 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Diet, Eldercare, Health, Life, Safety

As a Geriatric Care Manager who is a registered nurse and holds a bachelor’s degree in nutrition, I can offer a lot to my individual clients. I try to use preventative medicine through the use of food. I have always felt that a person’s weight can determine the effects on their health. Being overweight can lead to diabetes, heart disease, hypertension and certain cancers. Being underweight can lead to malnutrition, and also a decreased immune system. Recently, one of my clients had been losing weight due to being so cautious of her cholesterol and sodium intake in her diet. We went to her doctor and received a clean bill of health. We were able to problem solve, and found she was mainly eating salads, fish and all low fat dairy products. Her calorie intake was not supporting a healthy weight for her. She looked and felt rather weak. She had been on Ensure Plus three times per day, but was not enjoying the taste and necessary amount that she needed to consume for the extra calories. I knew that we had to change her diet and add more healthy calories from higher fat proteins and dairy into her diet. She was thrilled about eating her taylor ham and whole milk once again.

One of my fellow Geriatric Care Managers from DC spoke to me about a “Magic Milk Shake” with the use of Carnation Instant Breakfast, ice cream, whole milk and what ever else that would taste good(fruit, even a cupcake). Most of these shakes can be up and over 600 calories for 8oz. My client usually has one to two a day and sips it throughout the day. She is eating higher calorie foods and really enjoying the taste and texture of these foods. Her weight has gone up nice and slow, about 1 pound per week. This weight gain has been a very positive one for my client. She has been feeling stronger and able to do more of her daily activities that she was not able to do with her decline in weight.

Always check with your doctor before you make any changes to your diet or medication. You may want to have your doctor check for any underlining reason for recent weight gain or loss.

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.

Dementia and the Hospitalized Patient

October 10, 2011 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Alzheimer's Disease, Dementia, Education, Eldercare, Help, Seminar

Sophia Heftler of Distinctive Care Geriatric Care Management will present a 2.0 CEU course for nurses, social workers, Certified Assisted Living Administrators and Licensed Nursing Home Administrators on Tuesday, October 11, 2011 from 9:00 – 11:00AM at Bergen Regional Medical Center, 230 East Ridgewood A venue, Paramus, NJ. A Continental breakfast and networking will start at 8:30AM. To attend this free course, call (201) 967-4098 or register online at Bergen Regional.

Sophia Heftler, RN, BSN, CMC, CALA, CDP® and founder of Distinctive Care, has specialized in working with older adults for more than 20 years. She has had experience as Director of Nursing Services at local nursing homes, served as executive director at assisted living facilities and is a Certified Geriatric Care Manager and member of the National Association of Professional Geriatric Care Managers. She is also a Director on the Board of the Mental Health Association in New Jersey, Inc., and a Certified Dementia Practitioner (CDP®).

This course covers the different forms of dementia, the stages of Alzheimer’s disease, diagnostics for diagnosis, current pharmacological treatment and non-pharmacological symptom management. The effects of hospitalization on patients with dementia and techniques for dealing with dementia patients, as well as community resources, are also reviewed.

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.

Open Enrollment Begins October 1

September 29, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Eldercare, Family, Medicare, News, Personal, Tips

During the summer, I received a call from the daughter of one of our clients. She wanted to get a jump on reviewing her mother’s Medicare coverage, as she knew that open enrollment (the annual period in which changes in coverage can be made) would be coming up soon.

In fact, this window of opportunity is coming earlier—and ending earlier—this year. Details on coverage options for 2012 will be available on October 1, and changes to existing coverage may be made between October 15 and December 7, 2011.

Even though our client has an existing Medicare plan in place, her daughter is wise to review the plan each year, especially the Part D prescription drug coverage. Changes in her mother’s medications since last year can have a significant impact on out-of-pocket expenses and may warrant a switch to a different Part D plan to minimize drug costs. For some budget-conscious seniors, having good prescription coverage can mean the difference between compliance with doctors’ orders and being unable or unwilling to continue the care they need.

The daughter of our client was feeling somewhat overwhelmed at the prospect of analyzing all of the plans and making the best selection to meet her mother’s needs. I referred her to our Certified Senior Advisor, who is helping her to understand the available options and make an informed decision.

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.

Alzheimer’s Disease and Dementia Care Course

September 26, 2011 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Advocacy, Alzheimer's Disease, Education, Eldercare, Family, Help, Seminar

With a new diagnosis of Alzheimer’s Disease being made every 70 seconds in this country, it is important that our healthcare community know as much as they can about working with older adults who have this disease and other forms of dementia. With that in mind, Sophia Heftler, founder of Distinctive Care, decided to become a Certified Dementia Practitioner and Trainer. She is now able to teach others what she has learned. Distinctive Care is offering an all day course entitled Alzheimer’s Disease and Dementia Care on Wednesday, October 26, 2011 from 8:30am to 5:00pm. It will be offered at Van Dyk Park Place, 644 Goffle Road, an assisted living facility in Hawthorne, NJ.

The course modules will provide an overview of Alzheimer’s Disease and other forms of dementia, as well as diagnosis and treatment. Behaviors which are associated with Alzheimer’s, such as repetition, wandering, hoarding, paranoia and hallucinations, aggression and catastrophic reactions, will be covered. Depression, personal care, sleep disturbances and nutrition will also be covered. In order to offer the best possible care of the patient successful, the course will cover activities, environment, staff and family support, as well as diversity and cultural competencies. Spiritual care and end of life issues will also be discussed.

This course is the first step towards becoming a Certified Dementia Practitioner; further information about this process can be found at www.nccdp.org. Continental breakfast and lunch will be provided and a professional binder filled with important information will be given to each attendee. The course gives 7 CEU credits for activity professionals; 7 CEU credits have been applied for nurses and social workers.

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.

Unique Services for Older Adults

August 1, 2011 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Advocacy, Eldercare, Help, Life, Research, Tips

When someone wants to know more about we do at Distinctive Care Geriatric Care Management, I am the person that gets the first call. I am happy to review what we do and how we do it, and am so glad when our services match a family’s needs. As the Director of Community Relations, I am also the person who is out and about in the community in Bergen, Passaic or Rockland County learning about available services, both old and new.

Although some of the services for older adults are obvious, such as home care, it is always nice to learn the differences between each of them. Some employ people who drive as home health aides, or will provide a bed and bath service of minimum hours while others give their caregivers cooking lessons. It is up to me to make the initial determination as to whether the home health aides that they employ are properly screened, trained and monitored and are possibilities for our referral. It seems as it every agency is trying to set themselves apart from the others in some way that will appeal to the families that need help taking care of their elderly loved ones.

In addition to the obvious, I become familiar with unique services, too. Services which caregivers might not be aware of are agencies that specialize in sponsoring trips for older adults who require dialysis, wheelchairs, or oxygen, and the company that provides dialysis services in the home while people sleep. Distinctive Care is in the forefront of knowledge regarding available services. Whether it is a quality of life issue such as clutter clean-up, money management or transportation or a medical need such as a rehab facility that specializes in cardiac care or one that offers a Transition to Home program, I am always happy to learn about what’s new and exciting in the field of elder care. I hope to share more about these services in future blog entries.

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.

What a Good Read!

July 25, 2011 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Alzheimer's Disease, Caregiver, Eldercare, Life, Memory, News, Research

I read a good book recently, Finding Life in the Land of Alzheimer’s by Lauren Kessler. The author is a journalist who feels that she failed in the role of caregiver for her mother who had Alzheimer’s. So when her mother passed away, she decided to give it another try, but in a different way. She went undercover as an aide in a dementia care facility.

What Lauren found was that aides in dementia care facilities are underpaid and usually living from hand to mouth. Their workload is heavy and their day is challenging both physically and emotionally. In many cases, the job of aide is not the only one that they hold. Their day is repetitive in the tasks they do but not in the challenges that interrupt those tasks. Quite often they are the caregiver that is there when a resident falls or has an accident or has an aggressive episode.

What Lauren also found was that she became attached to these elderly men and women with Alzheimer’s and other forms of dementia. Yes, they experienced behaviors typical to the disease, such as repeatedly asking the same question or experiencing episodes of paranoia, but they also had personality. And each one was an individual in many of the same ways that they had always been an individual before they were diagnosed with Alzheimer’s. They were able to experience emotions like you or I, and although they didn’t have a memory of things that just passed, they were able to enjoy life in the moment.

The statistics for Alzheimer’s are staggering and worth us paying attention to as a nation, and as a world. Today, 5.4 million Americans are living with Alzheimer’s disease. By 2050, as many as 16 million Americans will have the disease. Of Americans aged 65 and over, 1 in 8 has Alzheimer’s and nearly half of people aged 85 and older will have the disease. For more information on this devastating disease, go to Alz.org. Geriatric care managers and other healthcare professionals can help families in caring for a loved one in caring for those with dementia. To find a geriatric care manger in your area, visit CareManager.

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.