Tips « 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

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

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

Realistic Resolutions 2012

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

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

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

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

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

Too Much Sugar in Our Diet!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

Move Over Rice and Pasta, Here’s Quinoa!

January 12, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Diet, Education, Health, Life, Tips

Last week I had the pleasure of educating a client on healthy food choices. She wants to lose weight and increase the amount of fiber in her diet. She informed me that she eats a lot of pasta and rice in her diet and has heard that white rice and pasta are not all that good for a person. I told her that she was right and then I provided her with a better alternative to her bland, white rice and pasta. We sat in her kitchen, as I explained to her about the benefits of Quinoa (pronounced keen-wah).

Quinoa is technically a seed, but is cooked and eaten like a grain and is related to spinach, chard and beets. It is found and grows best in mountainous regions and thrives in poor soil, thin air and extreme weather. Quinoa stalks are 3 to 6 feet tall, each plant can produce up to a cup of seeds. The seeds are about the same size as sesame seeds, and come in a rainbow of colors. They are red to purple to green to yellow in color, but the quinoa that is most commonly found in stores is an off-white color. I just bought tricolor quinoa at Trader Joe’s. You can also find quinoa in bulk section of natural food stores or in the organic section of your supermarket.

Quinoa is a complete protein, which means that it contains all the amino acids necessary for our nutritional needs. A four ounce serving contains over 22 grams of protein. This is considered enough protein to meet the daily needs for an average size child. It is also high in iron and calcium and is a good source of manganese, magnesium and copper, as well as fiber. Quinoa is naturally gluten-free and is very easily tolerated for people who suffer from celiac disease, crohn’s, or has allergies to wheat flour.

Before cooking with quinoa, you should give it a thorough rinsing; this will remove any remaining saponin, a soapy resin that protects the seeds while they are growing. Saponin can leave a bitter taste if not removed well from rinsing. It is very easy to cook quinoa. You only need to combine one cup rinsed quinoa to two cups water or broth (I use low sodium broth), bring to a boil, then simmer to 10-15 minutes, until the seed become translucent and the germ of the seed uncoils to form a “tail”. Quinoa has a fluffy texture and a light nutty taste. It is great to be added to salads, soups and stews. Here is a very easy recipe that you can try with Quinoa. So delicious.

Original Recipe Yield 4 cups

Ingredients

2 cups water
2 cubes chicken bouillon
1 clove garlic, smashed
1 cup uncooked quinoa
2 large cooked chicken breasts – cut into bite size pieces
1 large red onion, diced
1 large green bell pepper, diced
1/2 cup chopped kalamata olives
1/2 cup crumbled feta cheese
1/4 cup chopped fresh parsley
1/4 cup chopped fresh chives
1/2 teaspoon salt
2/3 cup fresh lemon juice
1 tablespoon balsamic vinegar
1/4 cup olive oil

Directions

Bring the water, bouillon cubes, and garlic to a boil in a saucepan. Stir in the quinoa, reduce heat to medium-low, cover, and simmer until the quinoa is tender and the water has been absorbed, 15 to 20 minutes. Discard the garlic clove and scrape the quinoa into a large bowl.
Gently stir the chicken, onion, bell pepper, olives, feta cheese, parsley, chives, and salt into the quinoa. Drizzle with the lemon juice, balsamic vinegar, and olive oil. Stir until evenly mixed. Serve warm or refrigerate and serve cold.

Enjoy!

Drug Reactions in the Elderly

January 6, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Education, Health, Medication, Prevention, Safety, Tips

There are four medications used alone or together that are felt to be responsible for drug reactions resulting in the most emergency room visits in the elderly. They are Coumadin (Warfarin); aspirin, Plavix (Clopidogrel), or other antiplatelet drugs; Insulin; and oral diabetes drugs. All of these medications or medication groups are commonly prescribed to older adults. In addition, they are difficult to use correctly. Some of them require regular blood testing and dose changes, and the correct therapeutic index is a narrow one.

Every year in the United States, approximately 100,000 individuals 65 years and over are taken to the hospital for adverse reactions to medications. These visits may be a result of an accidental overdose or because the amount of medication prescribed for them was too much and resulted in an adverse reaction. Common factors among the drugs responsible for these visits are they are difficult to use, require blood testing to adjust their doses, and a small dose can have a powerful effect.

Coumadin or Warfarin, a blood thinner, tops the list. It is one of the drugs which requires regular blood monitoring and dose adjustment. Its therapeutic range is narrow and it can interact with many other drugs and foods. Insulin injections are next on the list. Blood sugars are difficult to control in people with diabetes. A diabetic who takes a slightly larger dose of insulin than needed can send themselves into shock. Antiplatelet drugs, such as aspirin and Plavix are next on the list, followed by oral hypoglycemic drugs used to control diabetes. These medications are critical for many older adults, yet none of these drugs are typically listed as “high risk.” The medications usually listed as high risk are the over the counter drug Benadryl and powerful narcotic painkillers such as Demerol. These drugs, though, account for fewer emergency room visits.

When individuals show up at the emergency room as a result of drug misuse or abuse, it provides an opportunity to reach out with counseling or exploring other options that could help prevent it from being repeated or further consequences. Often times this opportunity is missed. Data suggests focusing on safety initiatives on a few medicines that commonly cause serious harm can improve care for many older adults. Individuals need to work with their physicians and their nurses, pharmacies, or a geriatric care manager to make sure they are receiving appropriate testing and taking the correct dose of their medications.

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

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

Presentation of Maximizing Your Memory

January 2, 2012 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Education, Help, Memory, Seminar, Tips

Who doesn’t want to maximize their memory! Sophia Heftler, RN, MSN,CALA, CMC, CDP® will be presenting one of her most popular talks, Maximizing Your Memory, at the North Rockland Senior Center at 69 Bridge Street In Garnersville, NY on Wednesday, January 4, 2012 at 11:00AM. If you would like to attend, call Barbara DuVal at 845-429-9027 to let her know you are coming.

Learn what memory is and how your memory works. This seminar will discuss what simple things can be done to improve your memory. Find out what normal memory loss is and what it is not. Discover when memory loss should be investigated further with your physician and become informed about some of the current medications used for memory loss, Alzheimer’s and the various other forms of dementia.

If you would like to attend, call Barbara DuVal at 845-429-9027 to let her know you are coming.