Safety « The Professional Geriatric Care Manager’s Blog

National Women’s Health Week

May 17, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Advocacy, Health, Life, News, Personal, Safety, Tips

May 13^th-19^th is National Women’s Health Week. It is a very important week that women really need to look deep into, taking some personal time and care for one’s self. This week-long health observance was coordinated by the U.S. Department of Health and Human Services’ Office on Women’s Health. It brings together communities, businesses, government, health organizations, and other groups in an effort to promote women’s health. The theme for 2012 is “It’s Your Time.” National Women’s Health Week promotes women making their health a top priority. It will also encourage women to take the following steps to improve their mental and physical health and lower their risks of certain diseases. Women need to:

Visit a health care professional to receive regular checkups and preventive screenings: mammograms and pap tests, a colonoscopy, and cardiac testing.
Get active and start a regular exercise program. Regular activity can help prevent unhealthy weight gain and also help with weight loss.
Eat Healthy: eat lots of fresh fruit and vegetables, fat-free or low-fat versions of milk, cheese, yogurt and other mild products. Incorporate of fish, skinless poultry, lean red meats, beans, eggs and nuts. Avoid saturated fats and Trans fats. Low sodium and no added sugar are very important to follow in a women’s diet.
Pay attention to mental health, including getting enough sleep and managing stress.
Avoid unhealthy behaviors, such as smoking and not wearing a seatbelt or helmet when riding a bicycle.

With National Women’s Health Week, we remind women everywhere that they need to visit the doctor, make sure their screenings are up to date, and just take time to think about their own health.

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.

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.

National Prescription Drug Take-Back Day April 28, 2012

April 19, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: DEA, Environment, Government, Prescription Drug Take Back Day, Prescription Medication, Safety

The Drug Enforcement Administration (DEA) has scheduled another National Prescription Drug Take-Back Day, which will take place on Saturday, April 28, 2012, from 10:00 to 2:00pm. With over 377,086 pounds(188.5 tons) of unwanted or expired medications deposited for safe and proper disposal at the over 5,327 take-back collection sites that were available in all 50 states and U.S. territories, the DEA had an unprecedented number of participants in the third National Prescription Drug Take-Back Day on October 29, 2011.

The actual results of the three prior Take-Back Days all combined, the DEA, along with the state and local law-enforcement and community partners have removed 995,185 pounds (498.5 tons) of medication from circulations in the past 13 months.

Here are some reasons why it is so important to dispose of drugs in a safe and proper method;

Drugs that are flushed are not removed in sewage treatment facilities and septic tank systems; they enter the soil, surface water and groundwater.
Drug resistant bacteria and microbes can result from contaminated water.
Animals, adults and children are poisoned by drugs they find on the ground or surrounding trash containers.
Increase in drug abuse is seen.
Pollution prevention, the elimination or minimization of pollution source can help clean up the environment.

“With the continued support and hard work of more than 3,945 state, local and tribal law enforcement and community partners, these three events have dramatically reduced the risk of prescription drug diversion and abuse and increased awareness of this critical public health issue,” said DEA Administrator Michele M. Leonhart.

So please join in on this very important day on April 28^th, 2012. Help improve our environment and save your community. Please refer to this link and find a collection site near you.

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

Being Honest

April 13, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Diagnosis, doctors, Health, Honesty, Patients, Safety, Truth

Should physicians withhold the truth about a diagnosis in order to relieve a patient’s fears and anxieties?

Honesty matters in the medical profession, but some degree of dishonesty may be excusable in order to avoid more serious patient harm. Doctors and nurses in some cultures believe it is wrong to lie about a bad diagnosis or prognosis. A number of studies have shown that the majority of patients generally want to know the truth about their diagnosis, prognosis and therapy. Individuals need the truth even when it tells them about their death. Without knowing the truth, an individual can be subjected to aggressive treatments, futile interventions and more suffering. To prevent harm from telling the truth, a doctor needs to tell the truth in a certain way and time.

Truth telling must be sensitive and take into account the individual’s personality and history. An individual needs an explanation of their illness. It should be understandable and convincing so they can cooperate in their treatment and be relieved of any fears. Communicating with a patient and being honest is a important way for physicians to foster trust and show respect for their patient. Giving individuals truthful information helps them to become informed participants in their care and in their decision-making.

Many times families will ask a physician to withhold a diagnosis from a patient. The family usually wants to spare the individual the potentially painful experience of learning the truth. If the disclosure is done sensitively, these fears are unfounded. In rare situations though, family members may make the physician aware of something about the patient that causes the physician to worry that the truth may actually cause harm and be justified in withholding the truth. A recent study in the medical journal “Health Affair” found that more than ten percent of doctors admit to not telling their patients the complete truth about their medical conditions.

So what is right? Physicians must strike a balance between respecting an individual’s autonomy and acting in their best interest. What do you think?

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

Sleeping Pill Alert

March 23, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Health, Medication, Safety

In some cases doctors will prescribe medications for the treatment of insomnia. Sleeping pills will not treat the underlying cause of one’s sleeping problems, but may help one get some much-needed rest. Prescription sleeping pills are available to help you fall asleep, stay asleep longer, or help with both. Today’s sleeping pills do not carry the same level of risk of dependence of the past, but risks still remain. Recent studies found that individuals taking prescription sleeping pills on a regular basis were nearly five times more likely than non-users to die over a period of two and a half years, and be more likely diagnosed with cancer. The study, though, did not prove that sleeping pills caused death, but that there may be a link between the two. Many individuals using sleeping pills are usually sicker than those not using them.

Insomnia also causes additional health problems. Those individuals taking sleeping pills may be at a higher risk because of health conditions that may have brought on the sleeping problems. Many chronic conditions, such as cancer, are linked with insomnia and mortality. Sleep disorders can be a symptom of an underlying mental or physical condition. Many who get prescriptions for sleeping pills have higher rates of heart disease, diabetes and other conditions which contribute to sleeplessness. Sleeping pills can be helpful in many situations, but are not without side effects including drowsiness, impaired judgement, depression and heart problems. The elderly should particularly use caution with sleeping medications.

The nonbenzodiazepine sedative hypnotics including Ambien, Lunesta and Sonata are believed to be safer and less likely to be abused. They are recommended for short-term or occasional use, but some individuals take them for years. Side effects of the nonbenzodiazepine’s include dry mouth, dizziness, headaches, nausea, diarrhea and abdominal pain. In addition, severe allergic reactions, breathing problems and depression may result. They can contribute to confusion, affect judgement and behavior, and have resulted in falls that may be fatal for older adults.

If you suffer from insomnia then, what should you do? An individual needs to weigh the risks versus the benefits as with many other medications. If there are ways to help you sleep, other than taking pills, that’s a better solution. Practice good sleep habits such as a set bedtime and start a pre-sleep ritual, like reading. Try not to nap during the day and do not watch television or use the computer before trying to sleep. Avoid exercise, nicotine, alcohol, caffeine and spicy foods several hours before bedtime. In addition, block out light and noise from the bedroom to get a good night sleep.

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

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!

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