Questions to Ask When Searching for In-home Care

There are certain questions that need to be asked if you are considering care for you or a loved one. It may be difficult to know where to begin; some people find it difficult to even think about this topic. Below are some questions that might help when you are talking with representatives about this kind of service. The answers to these questions may help you focus on which care provider will be the best fit for you and your family members.

Here are a few questions that may help:

• What kind of licenses do you have?
• Are your caregivers insured and experienced?
• What is your screening and hiring process for caregivers?
• What is your process when overseeing your caregivers?
• Is there a contract for services rendered?
• Do you have a minimum number of service hours required?
• Do you provide 24 hour care?
• How flexible are you when it comes to scheduling care for my loved one?
• What are your rates for weekends and after business hours?
• What is your policy if my caregiver doesn't show up or is late?
• What are your fees?
• Are there follow-ups on how care is dispensed?
• How involved are you in the beginning stages of in-home care for me or my loved one?
• Describe the services you offer
• If I have a complaint or question, who can I turn to for help?

If you need more background information on home care before you begin your search for these services, check out these two minute tips.

In-home care can make a big difference when you or a loved one needs extra care or when personal care for those you love becomes too much of a responsibility. Always check out what senior care services an agency offers so that you have an idea of the services that they offer before you go for a visit. 

Travel Tips for Seniors with Dementia

Older couples who enjoy going on trips together face unique challenges when one of the partners develops dementia. Traveling is easier and still possible for a senior who is in the early stages of dementia, according to the Alzheimer's Association.  Planning ahead is crucial for the senior's safe and comfortable travel experience.

Plan and Prepare Ahead 

Be well-prepared when traveling with a senior with dementia. Keep a bag of essentials with you at all times.  You should pack all the senior's medications, a copy of your travel itinerary, a bottle of water, some snacks, activities the senior enjoys (books, puzzles) and a change of comfortable clothes in this bag. Include the senior's medical information with a list of the person's emergency contacts.  Put in copies of key documents such as the birth certificate, passport and medical power of attorney.

Write a detailed travel itinerary with information on each destination you will reach and leave a copy with each emergency contact. As his/her caregiver, carry a copy with you at all times as well. When staying at a hotel, contact the staff before arrival to tell them about your loved one’s special needs so they will be ready to assist both of you.  Seniors with dementia develop a time of day when they function best. Travel during this time frame so the senior is rested and relaxed.

Safe Travel Tips

Other tips for making travel safer include:

• Always allow extra time; don't plan too many activities daily.

• Fly at times when airlines are less busy; fly direct. Sit near restrooms.

• Let the airline/flight attendants know about any special needs. 

• Try short car trips before attempting a long one to trouble shoot for potential problems. 

• Follow the senior's usual routine as much as possible.

• Put identification on the senior, including your cell phone number. 

• Take the senior's photo daily with your cell phone for identification purposes.

When It Is Time to Stay Home

Gradually a senior's dementia progresses and the person will become agitated/ anxious around newcomers and in new environments.  Changes which indicate travel is no longer a safe option for a senior include:

• Great difficulty walking and risk of falling
• Tendency to wander off
• Problems with continence and needing assistance with toileting, bathing, dressing, eating
• Becomes physically and/or verbally abusive
• Serious health issues requiring medical consent to travel

When preparing to travel, your Alzheimer's caregiver can provide an extra hand getting your loved one packed and ready for the trip. When travel is no longer possible, non-medical home care workers can stir the emotional memories that linger longer than factual ones by showing the senior photos of previous trips.

How Volunteering Helps Seniors with Hypertension

Seniors in the United States belong to the portion of the population that has the highest prevalence for high blood pressure, a health condition known as hypertension. This dangerous cardiovascular condition causes the heart to work harder than it should and over time, the high force can damage the kidneys, brains, heart, eyes and other organs in the body. While many individuals rely on their family physician to prescribe medications that will control their blood pressure, studies indicate that one effective way for seniors to control this disorder is by volunteering to help others.

A report appearing in a journal published by the American Psychological Association revealed results from a Carnegie Mellon University study. University researchers found that adults who spent a minimum of 200 hours a year volunteering could lower their risk of developing hypertension by as much as 40%. Individuals can reap the benefits of volunteerism regardless of whether they are tutoring students, serving food at a homeless shelter, walking dogs at an animal shelter or participating in some other activity that is beneficial to others.

Further research is necessary to identify the precise psychological and biological mechanisms affected by volunteering. One theory is that participating in volunteer activities may produce neurohormonal changes that have a positive influence on the cardiovascular system. In addition to improved physical health, seniors experience psychological benefits from volunteering their time to help other people. The opportunity for social interaction allows them to stay engaged and form meaningful relationships.

Interacting with others socially boosts self-esteem and improves overall quality of life. Seniors who live alone are at risk of leading a sedentary lifestyle that can contribute to a variety of health problems. Having a reason to leave the house and participate in a physical activity allows the elderly to maintain a sense of independence, which helps improve self-image. In general, doing something for others promotes a sense of well-being that relieves stress.

Individuals providing home care can assist seniors by reviewing the many local opportunities for volunteering and helping them choose an appropriate activity. Individuals charged with elderly care can also help by providing transportation when necessary.

How Retina Changes May Indicate Alzheimer’s in Seniors

Alzheimer's disease is a progressive brain disorder that affects seniors' memories, thinking and behavior. Although there is no cure, early intervention can slow the progression somewhat. That is why the research presented at a 2013 Neuroscience Conference is being studied so carefully. It indicates that the thickness of certain retinal cell layers in the eye may help doctors determine the presence and advancement of Alzheimer's in a patient. 

The results of research work conducted jointly by The University of Hong Kong and Georgetown University Medical Center have strongly indicated in research laboratory mice that two key layers of their eyes' retinas had lost thickness. Alzheimer's is known to kill the neurons of the brain. In these animals, it also destroyed many of the neurons (up to 49%) in the retinal ganglion cell layer, which sends visual information to the brain through the optic nerve. 

Why is this important and what does it mean for future treatment? A simple scan of the eye may be able to determine if there is significant loss of neurons in the retina, indicating the presence of Alzheimer's disease. Measuring retinal thickness changes can lead to earlier diagnosis, testing of new medications for Alzheimer's treatment and better, more effective treatments overall. 

There is no known way to prevent Alzheimer's, just as there is no known cure. Seniors can work to lessen their risk of getting the disease by living a healthy lifestyle that supports brain and heart health. Some preventative steps include:

• Engage in regular exercise to improve cardiovascular health.
• Eat a heart-healthy diet. It should include plenty of fruit,   whole grains, nuts, vegetables, fish and olive oil.
• Engage in regular social interactions with other people. Have strong interactions with someone during each week. Do not live an isolated life.
• Participate in challenging mental activities daily. Work jigsaw puzzles, play chess, work on puzzle booklets such as fill-ins, crosswords, mazes, or logic puzzles.
• Challenge yourself to learn something new. Take piano lessons. Take an art class. Take Pilates.

The care givers of an In-home care agency are trained to recognize and watch for the symptoms of Alzheimer's disease so the senior's family can be notified to seek a medical screening and treatment as soon as possible. Home care workers can also assist seniors in mentally stimulating activities to keep their brains alert and active.

How Home Care Can Help Seniors with Gout

Many of us have heard of gout but may not understand exactly what it is. Gout is arthritis in one of its most painful and severe manifestations. Gout is the result of uric acid crystallizing in the body and being deposited into a person's joints, leading to inflammatory arthritis in these locations.  This arthritis is partnered with swelling, stiffness and tenderness in these joints.

When a person is afflicted with gout, the body part most commonly affected is one's big toe. The other joints typically prone to gout are the ankles, knees, elbows, hands and wrists. Gout becomes more and more painful as the joint swelling makes the skin above it tighten and become extremely sensitive to the touch. The skin reddens and even turns purple. Often a diagnosis of gout is not made until a patient comes to a doctor for something to help manage his or her pain.

Factors Affecting Seniors' Risk for Gout

Gout can last anywhere from three or four days to several weeks. It may even become severe enough to result in deformities in the affected joints. It is important for the elderly and those who work in senior care to know and understand the key factors that impact whether a person is at risk of developing gout or not. These include:

• a family history of gout
• being overweight, which leads to increased uric acid production
• alcohol consumption which interferes with the body's uric acid removal ability
• prescription medications used in the treatment of Parkinson's Disease such as Levodopa and Cyclosporine and drugs with Salicylate (aspirin, diuretics or Niacin
• increased risk from other health conditions like hypertension (high blood pressure), hypothyroidism,  and renal insufficiency,
• psoriasis and certain forms of cancers

Treatment for Gout and In-Home Care Precautions with the Elderly

The main goal of gout treatment is quick pain relief and prevention of any future attacks. Containment of the damage and avoidance of any long-term complications is also paramount. Kidney damage and deforming joint destruction are both potential hazards of severe gout. It is important for elderly patients to take any medicine prescribed and understand the steps they must take to prevent re-occurring attacks.

For those who have gout, home care can play a significant role in treatment. Seniors and their home care givers should use any recommended hot or cold therapy packs on any affected areas as directed and keep the gouty joint elevated as instructed. It is important that the affected person drink a great deal of water (up to ten glasses per day) and take the recommended doses of over the counter pain medication. Alcohol intake should be limited if not eliminated altogether. 

Seniors Feeling More Confident about Their Looks

In today's world, we're surrounded by "the beautiful people" at every turn: TV shows and endless infomercials telling us how we can "improve" our faces and lose those love handles with the latest and greatest diet, and magazines with every other page featuring a digitally-altered model with a caption telling us why we need to look just like them.  Although we can all have moments of self-doubt, today it's even more understandable than ever for feelings of self-consciousness to surface, considering what's going on in the world around us.  But don't fret.  It doesn't have to be that way; in fact, research shows that the older we get, the better we feel about ourselves.

According to a Gallup survey of 85,000 people, here's what they found out from respondents aged 65 and older:

• 66% responded that they were happy with their appearance
• 64% of males who responded are happy with their looks, while 60% of women have the same feeling

The numbers above are the highest of any age group in this survey: in the 35 to 64 age range, only 54 percent were happy with their looks, and 61 percent in the 18-34 age group.  There are a few reasons why seniors may feel more confident in their appearance:

• Many seniors may be more relaxed in all aspects of their lives---this feeling can also carry over into how they feel about themselves and how they look.  For example, although they still want to look good, the sometimes unseen pressure of keeping up with the latest fashion trends is not the same as when they were younger.
• According to the American Senior Fitness Association, the overall number of seniors who exercise has increased over the years.  Exercise not only builds strength and stamina, but also builds confidence, both inside and out.
• The Gallup organization also surmised that another major reason for confidence expressed by seniors is that as we grow older, the expectations from society changes, leading seniors to feel better about their appearance.

To sum it up, when it comes to our appearance, confidence really does increase with age.  If you are exploring home care options, assisted living placement or in-home care for a loved one, contact us for a selection of options that may be right for you.

Home Care Visits Lessen Need to Be Hospitalized Again

The results of a recent study conducted at North Shore University Hospital clearly indicate that patients who receive follow-up home care from a nurse practitioner following cardiac surgery were less likely to need readmission to the hospital within 30 days of their initial stay, and also achieve a higher survival rate than patients who do not.  In fact, patients who had no assistance at home after their surgery were re-hospitalized at triple the rate (almost 12 percent) of those who do have in-home assistance (almost four percent).

The Advantages of In-Home Care

According to Dr. Michael Hall, who is NSUH's Chief of Adult Cardiac Surgery, the nurse practitioners who cared for the patients in their homes had also cared for them during their hospital stays and so were familiar with their conditions and their particular needs.  The NPs visited their patients at home for the first two weeks following discharge twice weekly.  During these visits, the Nurse Practitioner's job was to:

• Provide the patient with a physical exam
• Provide management of the patient's medication
• Serve as a liaison for the patient with his/her family doctor, cardiologist, pharmacist, others
• Contact social service agencies for future needs, if necessary

The NPs participating in the studies had special smart phones that were encrypted for patient information privacy to allow them to send the surgeons patient data, vital signs and photographs of patients' surgical sites for care instructions. The patients continued to receive the latest in updated care for these weeks following their surgery even though no longer being supervised in a hospital setting but enjoying the comfort of home.

Additional Findings of NSUH Continued Care at Home Study

As summarized by the May 2014 article on this study in The Annals of Thoracic Surgery, Dr. Hall also spoke of some of the problems the NPs dealt with while working with the patients in the study that are indicative of the reasons patients without care at home fare poorly and must return to the hospital for further care. These are:

• Failure to fill new prescriptions due to cost issues
• Substituting their old prescriptions instead to save money because they erroneously believe they are still good or appropriate, when they are not
• Not following up with seeing doctors in the community for lack of transportation

Nurse practitioners were able to help patients with these and various other issues on an individual basis because they could respond within that patient's community to his or her needs once they visited them in their home.