Safety « The Professional Geriatric Care Manager’s Blog

New Healthy Information Found Within Apples

February 2, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Health, Life, Research, Safety, Tips

My husband is in the food industry and gets many interesting articles sent to him via email. He also knows that, as a Geriatric Care Manager and a Registered Nurse, I am always looking for interesting topics to blog about; he’s well-informed that I usually blog about good, healthy and helpful food facts for elder adults. So, for this week he sent me a worthy article on the positive compound found within apples.

I once wrote a blog about white fruit, like apples, and the wonderful benefits that they attribute to helping with retaining memory. Now I have just learned and would like to share information that apples could reduce the risk of E.coli 0157:H7 infection and intestinal inflammation. In a study conducted by Dr. Jintae Lee of Yeungnam University, Gyeongsan, Korea and just recently published in The Journal of Infection and Immunology (Dec.2011), he and many researchers were able to show that the anti-oxidant compound from apples had anti-inflammatory properties and a reduced biofilm formation on the top of many cells in the colon that make the dangerous strain of E coli 0157:H7 unreceptive to antibiotics.

The compound is called Phloretin; it suppresses the effects of the bacteria Escherechia Coli(E.coli) 0157:H7 that comes from contaminated food. E coli 0157:H7 can cause hemorrhage in the intestines or the bacteria is so harmful it could even lead to kidney failure if medical treatment is not seeked early enough. There is no treatment for this food-borne bacteria which is resistant to antibiotic therapy. Elderly people and infants are especially susceptible for becoming critically ill from E coli. Jintae Lee also said the study results confirmed that Phloretin in apples has anti-imflammatory properties that the researchers found in the lab and in live colitis models. They stated that Phloretin was even stronger than a drug that is would be used in the treatment of inflammatory bowel disease. I also researched that tomatoes are also linked to having this flavonoid Phloretin, but does not do the same job as the apple.

I now make sure I eat an apple a day to help keep the E.coli away!

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

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

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

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

Signs of Sepsis

November 18, 2011 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Health, Help, Life, Medication, Safety

Sepsis is a condition in which the body is fighting a severe infection that has spread through the body via the bloodstream. The individual will have low blood pressure which will lead to poor circulation and shock. In severe cases one or more organs may fail, such as the lungs, kidneys and liver. The elderly population, especially those with weak immune systems, are at increased risk. Others at risk include the very young, those taking an immunosuppressant and steroids, individuals being treated with chemotherapy, and individuals with long-standing diabetes and AIDS. Many different microbes can cause sepsis. Infections such as pneumonia, urinary tract infections, cellulitis and appendicitis can lead to sepsis.

If an individual is septic, they will probably have a fever. In addition, they may have chills, decreased urination, increased heart rate, rapid breathing, confusion, agitation, dizziness, a possible rash and pain in their joints. One should call a doctor if they have any signs or symptoms of sepsis, particularly if they are being treated with chemotherapy, have had an organ transplant, or have diabetes or AIDS. Sepsis may be diagnosed with blood work, and samples of sputum, urine, spinal fluid or drainage from a wound. If an individual is diagnosed with sepsis, they will be admitted to the hospital and treated with intravenous antibiotics and fluids. Oxygen is also given to maintain normal blood oxygen.

The individual’s prognosis relies on age, health history, health status, how quickly diagnosis was made and the specific type of organism causing the sepsis. The earlier that treatment is started for sepsis, the better the outcome.

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.

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.

Seizures

October 28, 2011 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Education, Health, Help, Life, Safety, Tips

Seizures are a symptom of a brain problem. They occur because of sudden abnormal electrical activity in the brain. Seizures are different from person to person. There are many types of seizures with different symptoms, and not all include convulsions where the body shakes rapidly and uncontrollably. Some have only slight shaking of a hand and one does not lose consciousness. Some briefly lose touch with their surroundings and stare into space. Although awake, the person does not respond normally. After the event, they do not remember the episode. A small number of people will have only one seizure in a lifetime. Most seizures last thirty seconds to two minutes. It is a medical emergency if a seizure lasts longer than five minutes.

Seizures can be a symptom of another health problem. A seizure can be a result of a rapidly increasing fever, an extremely low blood sugar in a diabetic patient, damage to the brain from a stroke or head injury, withdrawal from alcohol and drugs, an infection or a brain tumor. Seizures are divided into two categories, generalized and partial. Generalized seizures are produced by electrical impulses throughout the entire brain, while partial seizures are produced by electrical impulses in a small part of the brain. There are six types of generalized seizures. In the most common type, the Grand-mal seizure, an individual usually loses consciousness and can collapse. Partial seizures are divided into simple and complex.

Seizure symptoms include unconsciousness, convulsions and muscle rigidity. No matter what type of seizure, it is important to protect a person during a seizure. During a seizure, protect the individual from injury by keeping them from falling, guide them to the floor and move objects near them that may cause injury. Do not force anything into their mouth and turn them onto their side. Stay calm and do not hold the person down or try to move them. After the seizure check the individual for injuries and loosen tight clothing. Do not give them anything to eat or drink until they are fully awake and alert. It is best to stay with them until they are familiar with their surroundings, as most can be sleepy or confused after a seizure.

There is no way to prevent all seizures. To help control them always take prescribed medication as instructed, get plenty of sleep, reduce stress, exercise and eat a healthy diet. If you have uncontrolled seizures you should avoid activities such as climbing ladders or other high places, biking, swimming and driving.

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.

Foodborne Illness

September 23, 2011 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Health, Life, Safety, Tips

One in six Americans will have food poisoning this year according to the Center for Disease Control and Prevention. In additionm, 128,000 will be hospitalized and 3,000 people will die as a result. There are thirty-one organisms that are known causes of food poisoning, but 38.4 million will be sickened by unknown pathogens.

Typical symptoms include nausea, vomiting, abdominal cramping, and diarrhea that occur within 48 hours, or as quickly as thirty minutes, after consuming a contaminated food or drink. Fever and chills, bloody stools, dehydration and nervous system damage may follow depending on the pathogen. More than 250 diseases can be transmitted through food. Norovirus and Salmonella are the two most common infectious forms of food borne illness. Salmonella is the cause of most deaths.

Food usually becomes contaminated from poor sanitation or preparation. Food handlers who do not wash their hands after using the bathroom or have an infection themselves can cause contamination. Improperly packaged food stored at the wrong temperature can promote contamination. Mild cases of food poisoning can be safely treated at home. Do not eat solid food while vomiting, but drink plenty of fluids. Small sips of clear liquids are the best way to remain hydrated. Avoid alcohol, caffeinated beverages or sugary drinks. When nausea and vomiting have stopped, begin to slowly reintroduce plain foods in small amounts. You should contact your doctor if the nausea, vomiting, or diarrhea lasts more than two days, if the symptoms are associated with a low-grade fever, you cannot keep any liquids down, cannot take medications due to vomiting, or if you exhibit any symptoms such as slurred speech, muscle weakness, or difficulty swallowing.

To prevent food borne illness, safe measures in handling food, cooking, and storage are essential. Bacteria cannot be seen, smelled, or tasted. Here are some safety guidelines to follow:

Buy cold foods last during your shopping trip and refrigerate as soon as they come home from the store.
Keep raw meat and poultry separate from other foods.
Before preparing food,wash your hands with warm water and soap for twenty seconds.
Sanitize cutting boards and countertops often with a bleach solution.
Never leave food out for more than two hours, as bacteria that can cause food poisoning grows rapidly at room temperature.
Do not consume at any time, food made with raw eggs, undercooked poultry or ground meat, or unpasteurized milk.

The Center for Disease Control and Prevention have strict inspection standards, but are not always able to keep the food supply and public safe. It is important for the public to understand the risks with food and protect themselves. When in doubt, throw it out!

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.

The Most Dangerous Room in the House

September 2, 2011 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Falls, Help, Life, Personal, Prevention, Safety, Tips

As we age, the incidence of sustaining an injury in the home increases, especially after age 85. The higher rate of injury is the result of decreased mobility, decreasing eyesight and decreased strength. Studies show that most of these injuries occur in the bathroom, around the tub or shower, and more than half near the toilet. Many emergency room visits are the result of injuries sustained in the bathroom, and a large percent of these have to be hospitalized.

Women have a higher rate of bathroom injury than men. The most dangerous activity for both men and women, though, is bathing or showering. Injuries can occur either getting out of the bathtub or shower, or getting into the tub or shower. A large percent seem to be suffered while getting out of the shower. Another large percentage of injuries occurring in the bathroom are related to getting on or off the toilet.

Injuries in the bathroom can be the result of slipping, tripping, or fainting. The head and neck make up the greatest percent of bodily injuries, followed by the lower torso, the upper torso, and the leg and foot. The least amount of injuries are to the arm or hand. Injuries in the bathroom can never be totally eliminated, but they can be reduced by the installation of grab bars by the toilet or shower. Other helpful hints to prevent injuries in the bathroom are to place nonslip mats in the bath or shower, to prevent slipping; remove throw rugs in the bathroom, to prevent tripping; and installing a shower chair or bath benches, which assist an individual to get into the tub itself.

There are many agencies which will also come into your home and provide an assessment and offer suggestions on how to make your bathroom and home safer. At Distinctive Care Geriatric Care Management, part of the client’s assessment evaluation involves assessing the individuals living environment and performing a home safety evaluation. The client’s individualized care plan will include suggestions on ways to make their living environment safer. Included in the care plan may also be the recommendation to have an evaluation from a home safety specialist such as Back Home Safely, with Gregg Frank, 973-489-7790. So watch your step while in the bathroom.

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.

Safe Storage of Medications

August 26, 2011 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Health, Prevention, Safety, Tips

Where do you store your medications? Do you know what extreme heat or cold can do to your medications? No drug should be exposed to temperatures greater than 80 degrees or below freezing. Extreme temperatures will affect both over the counter medications and prescription drugs. The pharmaceutical companies recommend most medications be stored at a temperature of 68 to 77 degrees. Medications can physically change, lose their potency, and threaten your health if stored in locations that go over and below these ranges. One should be particularly cautious during heat waves and cold snaps.

Medicine cabinets are probably not the best place to store your medications. The high humidity in a bathroom can damage many medications. It can cause medications to dissolve or degrade. Storing medications over a sink can increase the chance of losing a dose down the drain. The best place to store medications is a cool, dry place like a hallway linen closet, bedroom closet, or even a cabinet in the kitchen which is away from the stove. Make sure all medications, prescription and over the counter, are also out of the reach of children and pets.

If you have a chronic disease, such as diabetes or heart disease, a damaged dose of a crucial medication can be life threatening. Insulin can lose its effectiveness if it freezes. Antibiotics can decay and cause stomach upset and kidney damage. Hydrocortisone cream can separate and become useless if exposed to increased heat. If medications need to be refrigerated, do not place in door of refrigerator as the repeated opening and closing may cause temperature variations. Other medications affected by temperature changes are thyroid medications, birth control, and other hormones. They are protein based and prone to temperature changes.

When traveling, it is best to keep medications in a separate bag and do not leave in a car or allow to be transported in a baggage compartment in an airplane. These compartments can become too hot or freezing cold. Keeping your medications stored properly will keep them in the condition that helps them work the best. Never take medications that have changed color, consistency, smell, or expired. Medications that are stored properly and not expired will work the best for you. If medications are damaged, disposed of them properly. Do not flush them down the toilet, as they can end up in our water supply and harm the environment. To dispense of them properly, mix them with coffee grounds or kitty litter and put them in an empty can or sealed bag before placing them in the trash. Some pharmacies will also collect unused medications and may even replace medications damaged free of charge.

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.