Prevention « The Professional Geriatric Care Manager’s Blog

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.

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.

The Goodness of Red Wine

May 3, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Dementia, Diet, Health, Prevention, Red Wine, Reservatol, Study, Tips

A few years ago there were many publications on research studies on the active ingredient in red wine known as resveratrol. Scientists discovered that red wine could help protect people at high risk from heart disease and diabetes.

Researchers discovered that an antioxidant found in red grapes can lower blood sugar levels and reduce blood pressure. Resveratrol is a phytochemical, which is found in the skins of red grapes, peanuts, blueberries and blackberries is now also being studied for assisting in preventing dementia and as well as decreasing progression of dementia.

A 2007 study of elderly Italians showed that drinking alcohol in moderation may slow the progression to dementia in elderly people who already have mild mental declines. Defined in the study as less than one drink a day, low to moderate drinking was associated with a significantly slower progression to dementia among people with mild age-related cognitive declines, this was compared with non-drinkers.

Resveratrol acts to slow the progression of dementia, as it is explained by a study published in the 2004 “Journal of Neural Transmission.” Researchers explain that memory deficits can be decreased by antioxidants, like reseveratrol, as they are able to do so by decreasing inflammation and oxidative damage to brain cells.

Cornell University neuroscientists published a report in 2009, with direct evidence on how resveratrol produces a neuroprotective effect in Alzheimer’s patients. Cornell’s research group studied mice given an experimental effect in Alzheimer’s patients. The mice were given resveratrol for a period of 45 days. Their brains were evaluated to see if they were suffering damaging inflammatory plaques normally found in Alzheimer’s patients. It was found that the plaque formations had been reduced by 48% to 90%. Accompanying these changes were also increases in brain antioxidant molecules. They felt that this was a successful study that leads to the conclusion that dementia or Alzheimer’s could be delayed or reduced.

I had just completed an article about the Mediterranean diet and how people in that part of the world tend to consume red wine on a regular basis and they live about 10 years longer than any another population. Studies have shown that Alzheimer’s disease is less common in populations that consume moderate amounts of red wine. I heard a Neurologist speak last week about this topic and he believes very strongly of the positive benefits from red wine and resveratrol. He recommends that all his patients drink a glass of red wine every day, as long as they are not on any medications that would be affected by the consumption of alcohol.

Ever since his presentation last week, I have been trying to drink more red wine with dinner. I’ve started to like wine a little more after researching for today’s blog.

Before you go running to the store and purchasing bottles of red wine, please speak to with your medical doctor and make sure it is safe for you consume red wine.

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.

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

Hepatitis A In The Elderly

March 15, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Aging, Health, Life, Personal, Prevention, Tips

Today I went to see one of my long term clients who happens to be 80 years old. She has been living in a skilled nursing facility for over a year now and has been doing very well. She loves everything about the facility, except for the food. She really misses her own home cooked foods that she loves and is part of her ethnic background, which she is so familiar with. She is a beautiful Japanese woman who really misses her Sushi and Sashimi.

As her Geriatric Care Manager, I explained to her that the facility does not offer Sushi to their residents and that I also needed to speak with the Dietician on staff about the safety perspective of bringing food in from the outside, and also needed to consider her medical history and what foods she may be restricted from.

The Dietician educated me that eating raw fish or oysters can contribute to food poisoning. Food poisoning occurs when you consume toxins, bacteria or viruses from water or food that contains harmful substances. Symptoms of food poisoning include nausea, diarrhea, abdominal cramps, headache, weakness and nausea and vomiting.

Sushi lovers are at high risk for Hepatitis A virus infection. Hepatitis A, or HAV, is an acute viral infection of the liver. Symptoms of liver infection are similar to food poisoning; nausea, vomiting, diarrhea, exhaustion, jaundice and pain in the right upper abdomen. HAV is caused by the transmission and ingestion of microscopic contaminated feces that can be found on or within fruit, raw vegetables, drinking water or exposure to an infected person who showed lack of hand washing.

You need to be extremely careful of what restaurants you choose to dine in and the safety that is necessary during your own home preparation of food. Stay with what you know best. According to the Centers for Disease Control, most healthy people recover from HAV infection without complications and could even develop immunity again re-infection. But, HAV exposure in older adults my cause severe and serious symptoms, with risk of both morbidity and mortality and this could increase with age. There are vaccinations available to you for both Hepatitis A and B for its prevention. People that do a lot of traveling to many countries are encouraged to get the Hepatitis A vaccination. Please ask your own physician about the Hepatitis A vaccination and see if they feel it is right 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

The “Good Bacteria” Found in Yogurt

March 8, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Health, Life, Personal, Prevention, Tips

I remember, as a little girl, the TV commercial for Dannon Yogurt. The commercial starts off with a choir of Russian men singing and dancing. Then the camera closes in on one particular man. Then the voice-over talks about how great Dannon Yogurt is and that the older man agrees with this because he has been eating the yogurt for 105 years.

The history of yogurt and other fermented milk products have primarily been accidental discoveries, as a result of milk being stored by primitive methods in warm climates. Historians attribute yogurt being developed by the people of Central Asia around 6000B.C.. Herdsmen began the practice of milking their animal, and the natural enzymes in the carrying containers curdled the milk, essentially making yogurt. The milk then kept longer and it was thought that people preferred the taste, so they continued the practice of making yogurt, which then just evolved over centuries into our commercial yogurt making. We have the Turkish immigrants to thank for bringing yogurt over to North America in the 1700s.

Yogurt is so popular today, it seems as if a new frozen yogurt shop opens every month. Yogurt is so important, it’s been found, because of the positive benefits from Probiotics, which are the “good bacteria” that we receive from eating foods like our so loved yogurt and kefirs or can also be found in pill-formed dietary supplements. “By definition, a probiotic is any substance containing live-active organisms that, when ingested, have a beneficial effect on the host by altering the body’s intestinal micro flora,” says physician Robynne Chutkan, Associated Professor of Medicine at Georgetown University Medical Center in Washington, D.C. The theory is that certain strains of these live organisms are good bacteria and can then override the effects of all the bad bacteria in the stomach.

As a geriatric care manager, I have seen many physicians prescribe or recommend probiotics when they place their patient on an antibiotic. Antibiotics wipe the intestines of the bad and the good micro flora, which can be harmful to the person by decreasing their immune system, leading them at risk for other infections. The following information will provide you with more knowledge about the great benefits from yogurt and probiotics.

Fights against inflammation.
Reduces the risk of digestive disorders, colon cancers, inflammatory bowel diseases and infections caused by Helicobacter pylori- bacteria that causes infections on the upper and lower digestive tract.
Enhances the function of the immune system.
Reduces the risks of high blood pressures.
Reduces cholesterol levels.
Promotes healthy bone development.
Decreases and heals the chances of having arthritis.
Prevents vaginal infections.
Prevents diarrhea.
Heals symptoms of lactose intolerance.
Helps alleviate constipation.

Not only does yogurt contain live-active cultures of probiotics, it also contains calcium, riboflavin, vitamin B6, and vitamin B12. I encourage my family and my clients to eat yogurt with active cultures on a daily basis. It would be so wonderful if we all could live a long and healthy 105 years, just like the man I saw on that Dannon commercial.

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

Statins for Women

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

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

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

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

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

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

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

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

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

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.