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Patient Discharge Planning 

Wednesday, June 27, 2012 8:28:00 AM

Many older patients develop health conditions that require hospitalization. Once recovered and ready for discharge from the hospital, these patients often have several more medications and treatments added to the ones they had when they first entered the hospital. Some older patients still need to have daily care after leaving the hospital, which makes it extremely important for family members and caregivers to be prepared and able to provide a smooth transition from hospital to home.

Hospital Discharge Planning
Discharge planning is a crucial step to ensure your loved one receives the proper care after they leave the hospital environment. Medicare defines hospital discharge planning as “a process used to decide what a patient needs for a smooth move from one level of care to another.” This move can include a brief stay at a nursing home, another family member’s home or the patient may be able to return directly to their own home. In any case, discharge planning is needed to develop a plan of action that best suits the patient and their family members. Each treatment option will be evaluated and discussed by the medical team, the patient and their family members. Together, they will decide what is best for the patient.

When an elderly family member is admitted to the hospital, the hospital discharge planner will generally make contact with the family. It is the hospital’s job to make sure your loved one is discharged into a safe and therapeutic environment. For this reason, it is very important to the hospital that they discuss post-care with you and your loved one. The discharge planner can be a nurse, a social worker or they may be identified by different title. No matter what the job title, their goals are the same. They gather information about the patient, their condition, treatment goals, home situation and family involvement, then make recommendations for post-hospitalization care.

Patient Rights
Although the hospital staff and physicians are there to provide your loved one with top-notch medical care, no one knows your relative better than you and your family members. You may notice that something is wrong with your loved one that the medical staff does not recognize. It is a vital part of your loved ones treatment to openly communicate with the hospital staff during the discharge planning process. Every patient has the right to receive quality medical care. Sometimes a patient is simply not ready to be discharged and family members can challenge the timing of release. The New England Journal of Medicine reported that in 2009, one out of every five Medicare patients ended up returning to the hospital within 30 days of their discharge.

Fire Safety for Your Loved Ones 

Tuesday, June 26, 2012 10:04:00 AM

When there is a fire in the home, decreased ability to walk, problems with eyesight or cognitive decline may severely limit a senior’s ability to react quickly and safely escape during the emergency. According to the U.S Fire Administration, people over the age of 65 are twice as likely to obtain injuries or die in fires as compared to the rest of the population-at-large.

If your loved one has Alzheimer’s disease or dementia, has problems walking on their own, or cannot see very well, there are definite precautions that need to be taken in the event that there is a house fire at some point. Using the following tips will help to keep your loved one safe.

If your loved one uses a walking device such as a cane or wheelchair, their normal escape route may no longer be an option for use. So with decreased mobility, you can do the following:

  • Check all exits to make sure that they are wide enough for a wheelchair or walker to easily fit through the doorway. Make any necessary adjustments that are needed to accommodate the medical equipment.
  • Keep a landline phone by the bed of your loved one. This will allow them to make emergency phone calls if they become trapped. It is also a good idea to keep a list of emergency numbers by their bed as well, as this can save valuable time in case of a fire.
  • If your loved one is confined to a wheelchair or the bed, it is a great idea to install a small fire extinguisher made for personal use. Mount it somewhere close to their bed or place it on the wheelchair. Don’t forget to make sure your loved one knows how to use the fire extinguisher properly.
  • If an escape is not possible for your loved one due to being confined to their bed, it is advisable to install a sprinkler system. You can also use fire-resistant blankets and comforters as an extra precaution.

If your loved one has Alzheimer’s or dementia, you must prepare for a fire emergency ahead of time. Purchase a book that explains emergency procedures and has pictures that show a step-by-step process for escape during a fire. It is also vital to practice escape routes with a loved one who is suffering from a decline in cognitive ability. Memory tends to improve and decline at unpredictable times for people suffering from Alzheimer’s or dementia. When you take the time to practice escape routes, and keep doing so on a consistent basis, it is likely to become an instinct which can help to guide the senior out of the home and into safety.

Ordinary Household Items Can Pose Serious Threat to Seniors 

Tuesday, June 26, 2012 9:19:00 AM

Electrical cords, stacks of magazines, dirty floors, bunched area rugs and poor lighting can cause older adults to stumble and fall, leading to injuries ranging from minor cuts to far more serious hip fractures and head trauma. This is especially true for seniors whose balance, vision or cognitive abilities are impaired.

In fact, one in three adults age 65 and older suffers from falls each year, warns Steve Barlam, Chief Professional Officer of LivHOME. Often, these falls lead to emergency room visits, an increased fear of falling and reluctance to take part in healthy physical activities such as walking.

In the latest episode of The Senior Care Podcast by LivHOME, titled Home Safety, Steve Barlam, LivHOME’s Chief Professional Officer, examines home safety, a particularly important issue given that one in three seniors age 65 and older suffers falls each year. He addresses topics including: the most common reasons for falls and ways to avoid them, the importance of home security for seniors, the value of having an emergency supply kit in the home, and home safety issues for seniors suffering from dementia.

Home Safety Needs and Action Plans for Seniors with Dementia 

Wednesday, June 13, 2012 9:22:00 AM

No matter how much you prepare and plan for the safety needs of a family member with dementia, it is inevitable that their needs will change. In order to be successful with their safety, you must remain flexible. When a family member is diagnosed with dementia, you have to start looking at the home environment in a totally different light. You have to recognize hazards that exist and how they can be removed. You have to look for features and ideas that protect your loved one while also promoting their independence. So, where do you begin?

As the disease of dementia progresses, seniors will generally experience changes within the following five key areas:

  • Using proper judgment: for example, if your loved one forgets how to use a general household appliance
  • Perception of time and place: this is generally seen when a loved one gets lost within their own neighborhood or they simply cannot recall what year it currently is
  • Cognitive behavior: this is seen when a loved one becomes very easily confused, angry, suspicious, or fearful
  • Physical activity: loved ones may experience problems keeping their balance or become dependent on a walker/wheelchair for ambulation
  • Use of the five senses: seniors with dementia often experience a decline in vision, hearing, temperature regulation and perception of depth

Naturally, these changes emphasize the reason family members must remain flexible, as some seniors with dementia may experience these changes differently. There is no timeline for how these changes unfold or guideline as to how severe they will be. This uncertainty can make it more difficult to implement safety precautions in the home.

To ensure your family member is able to remain safely in their home, it is important to design an action plan. This is essentially a plan to create a dementia-friendly environment. Following these steps can help to create a safe and secure home:

Look at the home as if you were the patient: Put yourself in the shoes of someone with dementia. What objects could you hurt yourself with? How easy is it for you to get outside? Are the stairs posing a danger?

Emphasize adapting to the environment: You will have more success attempting to teach preventative actions to an elder instead of attempting to re-teach them about their own safety. Focus on showing them tips for identifying possible dangers or risks in the home.

Try to remove any need to rush through activities: Many personal care accidents occur when a senior is rushed for time. Try to break up activities into simple steps and always allow them plenty of time to complete these tasks. Offer to help them with any activities that seem to have become difficult.

Support the needs of the senior: Avoid completing tasks for seniors. You do not want to take away their independence or treat them like a child. Encourage them to be active and participate in activities. The more mobile and independent they are, the better they will feel.

Realize the limitations: You must accept that it is impossible to prevent every accident or to remedy every danger in the home. When you take the necessary steps to make safe changes, follow these tips to create the best home environment for your loved one, keep an eye open for any dangerous objects or activities and rely on common sense so your family is able to successfully support an action plan and take part in its success.

Senior Safety at Home 

Thursday, June 07, 2012 10:09:00 AM

Let’s face it, seniors are more comfortable and definitely happier when they can live in the comfort of their own homes. Since the popularity of in-home care continues to rise, it’s very important to make sure that your loved one is safe. That means being aware of the potential dangers that are present in the home and preparing for them accordingly. Using the following safety tips for your family member or loved one can ensure that they stay as safe as possible.

HOME SAFETY

  • Invest in a medic alert system or set up a type of buddy system
  • Ensure there is a smoke detector on every floor of the home.
  • Practice getting up slowly to ensure they have their balance before beginning to walk.
  • Wear the proper shoes with traction on the bottom and low heels.
  • Do not use scatter rugs since they can slide so easily.
  • Remove telephone cords from areas where they walk often.
  • Do not use wax on floors.
  • Install stable rails for all stairs and showers inside the home.
  • Make sure each staircase has bright lighting with switches that are at the top and bottom.
  • Make sure the steps on the stairs have non-slip surfaces.

OUTDOORS

  • Make sure that all porches have grit on them to prevent slips
  • Inspect all railing for sturdiness and any swings on porch

LIVING ROOMS

  • Take up all extension cords, throw rugs
  • Use light night lights in unlit areas for nighttime bathroom trips.
  • Test batteries in all smoke alarms on a regular basis.

KITCHEN

  • Use electric burners on the stove that turn them off after a certain time has passed.
  • Keep a working fire extinguisher close by in the kitchen.
  • Use very sturdy step stools with handles for reaching.
  • Keep all of the vents free of grease to prevent fires.
  • Always keep the floors clear.
  • Ensure that the appliances are marked ON and OFF clearly and with bright colors.
  • Put all sharp knives in a special knife block.
  • Put heavy pots and pans on a lower cabinet level.
  • Store all hazardous cleaning supplies away from foods.
  • Advise them not to wear long or loose clothing when cooking on the stove.
  • Constantly check the expiration dates of foods.

BATHROOM

  • Use a night light on in the bathroom.
  • Consider installing grab bars on the wall of the toilet for added security.
  • Ensure there is a bath mat inside the tub to increase stability and avoid slips.
  • Turn the water heater to 120 degrees Fahrenheit to ensure they do not burn themselves.
  • Ensure that the faucets are marked HOT and COLD clearly.
  • Ensure the door locks can be opened from both sides.
  • Install each and every shower and tub with tub cutaways.
  • Ensure that each tub has its own grab bars.
  • Consider installing higher toilets to make standing and sitting easier.
  • Use the plastic shower seats that also have portable showerheads.

DRUG SAFETY

  • Check all medications on a regular and frequent basis for expiration dates.
  • Label each medication clearly and in bright colors.
  • Ensure that the area medications are stored in is brightly lit so they can read the labels easily.
  • Promptly throw medications away once the expiration date has gone by.
  • Never advise them to borrow medications from other people.
  • Invest in a pillbox that is clearly labeled and easily accessible.
  • Check with the doctor or pharmacist to ensure that over-the-counter medications are safe to take with prescription medications.

The Progression of Dementia 

Wednesday, May 30, 2012 2:34:00 PM

Dementia progresses in many different ways, often depending on the cause of the disorder. With Alzheimer’s disease, the time between the first symptoms showing through the gradual loss of their mental abilities can range from seven to ten years. Vascular dementia is usually a result of small blood vessels in the brain becoming blocked, but it has a more erratic progression. As dementia progresses, you may notice that your loved one needs more and more care from family and friends.

There are many signs that you should look out for during the progression of dementia. For example, a father who had been a very good driver all his life has recently become lost several times while driving home from the grocery store. He may have even had several minor accidents due to the fact that he can’t keep up with changing traffic patterns or gets confused from all of the turns he must make on the route home. Despite all of these signs, the father demands that he keep driving as usual and gets very defensive when anyone tries to talk to him about the fact that he is no longer a safe driver.

Another example could be a mother who is in the kitchen washing her hands after cooking breakfast. She accidentally leaves the water running and floods the house. Lately, she has completely stopped cooking because she says that she just can’t remember how to cook any of her favorite recipes. These may be recipes that she has cooked for decades and has never had a problem remembering the ingredients before. Earlier, a local supermarket manager, wandering around the produce section for hours, had found her. She had absolutely no memory of how she got there.

If any of these scenarios sound familiar, you are not alone. The problems associated with dementia are often very frustrating for the senior, while they are extremely frightening for their family and friends. The frustration on the part of the senior can boil over into becoming irritable and demanding, especially if they don’t recognize that they have a cognitive problem. They may end up resenting their loved ones for trying to tell them they can’t do activities that they have always done.

Many seniors, despite all the changes that come with dementia, can engage in a lot of usual activities that do not require a difficult level of mental functioning. Some of the appropriate activities may include a family picnic, simple gardening around the home or in the yard, washing dishes or even taking a walk with a family member.

It is imperative to keep an open line of communication with your loved ones when the signs of dementia begin to appear. You will also want to keep the same line of communication open with your family physician as these symptoms progress. Dementia is not an easy disorder to deal with, but if you prepare for the progression, it can be managed more easily for everyone.

Providing Healthy Activities for Seniors Diagnosed with Dementia 

Wednesday, May 23, 2012 2:03:00 PM

Many people who have a loved one suffering from dementia have questions about the kind of activities they should provide for them. Research shows that seniors with dementia need to be provided activities that can help them keep and use the cognitive functions they have. It has also been shown that these types of activities can even slow the progression of dementia. So what kind of activities can you initiate to help keep your loved one’s state of mind in top shape?

- Provide a routine: Dementia has a terrible effect on the way that some seniors feel about their own purpose in life. They can often begin to feel as if they are of no use to others or feel like a complete burden to their own family. You can help your loved one by making them feel needed and important. Start by providing activities that you and your loved one can enjoy doing together. None of these tasks need to be elaborate or physically draining. Try folding the laundry or washing dishes as a team. Did they used to love gardening? Try planting some flowers close to the front door so you can both easily care for them. You may need to simplify each of these activities, but it helps to put them in touch with the things they were passionate about before dementia.

- Offer them social interaction: Even if your elderly loved one has diminished abilities, they still need to experience social interaction with other people. Each one of us needs to have some type of access to socialize with others. Provide your loved one with social activities in order to watch their cognitive function improve. Small things like taking them with you to run errands can become a great activity for the two of you. In addition, signing your loved one up for activities at a local senior center can prove to be a wonderful resource. Schedule social interactions that are calm and free from stress since crowds and noise can often overwhelm people with dementia.

- Provide physical exercise: Just like social interaction, seniors with dementia can also benefit from any type of exercise. Taking short daily walks can help to reduce their anxiety and tension, while also improving cardiac and respiratory health. Another great tool is a stationary exercise bike. These can help to relieve tension and boredom, especially on rainy or cold days when outdoor walks are out of the question. Naturally, you must take into consideration the overall health, level of dementia and general needs of your loved one when developing a plan for physical activities.

These tips can be very successful in helping your loved one to regain some activity in their daily lives. The key is that once you choose an activity for them to participate in, make sure that they are able to continue participating on a regular basis.

Costly Readmission of Seniors To the Hospital Can Often Be Prevented 

Thursday, May 17, 2012 10:20:00 AM

Hospital readmissions have become a serious issue for seniors and their families. The good news is most of these readmissions can be prevented by paying careful attention to aftercare instructions.

Steve Barlam, Chief Professional Officer of LivHOME, discusses the specific steps that families and caregivers can take to avoid preventable post-discharge readmissions in Episode 29 of The Senior Care Podcast by LivHOME. He also looks at the broader implications of readmissions, which have become a significant issue for hospitals, insurers and seniors themselves.

Barlam explains that 1 in 3 seniors are readmitted to the hospital within 90 days of an initial stay. The reasons include confusion about the discharge plan and medications, a lack of follow-up with primary physicians, the absence of home health support and equipment, and insufficient attention to nutritional needs.

Overall, three-quarters of all readmissions are preventable. Avoiding preventable readmissions is important, Barlam says, because the hospital environment is disruptive and not necessarily conducive to health and well-being, with germs and viruses prevalent and privacy and comfort minimal.

Depression in the Elderly Adult 

Thursday, May 17, 2012 9:10:00 AM

Depression affects over 6.5 million Americans who are age 65 and older. Many of these people have already been experiencing symptoms of the illness for several years, while others have only recently experienced its onset. Depression in the elderly is usually associated with the fact that they are being forced to depend on others, or they experiencing a disability that causes several obstacles in their daily living.

Unfortunately, depression in the elderly is an illness that can often go untreated. Too many times, people assume that depression is just a normal part of growing older or a natural reaction to some chronic disease. While it is true that the elderly do face many new challenges as they grow older, depression is not an illness that must simply be tolerated by each senior.

Depression can present itself in many different ways for seniors. Family and friends of the elderly often overlook it because they do not recognize the signs of depression. Other people simply do not know that depression is an illness that can be medically treated by their doctor. Another problem is that depression can easily be mistaken for other illnesses that seniors face, such as dementia, Alzheimer’s disease, cancer, heart disease, Parkinson’s disease or thyroid disorders.

In addition, many elderly people feel too ashamed to admit they are struggling with feelings of depression. They are afraid they will be made fun of if they seek medical help for a mood disorder such as depression, all the while blaming themselves for feeling so glum. Other elderly people may worry that they cannot afford to seek help from a medical professional to treat their depression.

Depression is the highest risk factor for suicide among the elderly. They are more likely to reach out and ask for help when it comes to a physical ailment than they are to seek treatment for depression. While they may initially feel shame when it comes to treating a mood disorder, it is imperative that they receive the proper assistance from a medical professional who is familiar with the illness. With such recent medical breakthroughs in the field of mental health, the treatment prognosis for depression looks good. In fact, once an elderly person is diagnosed with the illness, around 80% of them can successfully be treated using medication, psychotherapy, electroconvulsive therapy or some combination of the three.

University of Virginia Alzheimer’s Team Finds Protein to be Possible Cause of Disease 

Monday, May 14, 2012 10:56:00 AM

A solution to the heinous disease, Alzheimer’s, might finally be within reach, as a University of Virginia Alzheimer’s team found that a special protein triggers a catastrophic reaction in the brain.

In their published study University of Virginia lead scientist Professor George Bloom found that the toxic protein, which has been known to play a key role in Alzheimer's, sticks together in the brains of people with Alzheimer's, and these deposits result in the destruction of key nerve cells. “We've confirmed that it converts more abundant beta-amyloids [proteins] into a form that is up to 100 times more toxic,” said Bloom, “making this a very dangerous killer of brain cells and an attractive target for drug therapy.”

Alzheimer’s disease has long been one of the most painful afflictions that older family members can succumb to, as it is the leading cause of dementia and is currently incurable. In a 2007 study, by Brookmeyer, it was predicted that 1 in 85 of all people globally would become afflicted with Alzheimer’s disease. Probiodrug, based in Halle, has completed phase I safety trials of a drug that suppresses an enzyme involved in the formation of pyroglu beta-amyloid.

Understanding the toxic proteins and learning to suppress them might unlock a treatment that can affectively suppress or eliminate Alzheimer’s. Because of the broad range of senior help, care management, and in-home care that LivHOME provides many elderly people that suffer from severe to mild cases of Alzheimer’s can continue to live in their homes with professional assistance and caregiving.

In many of these instances, non-medical care is the best way to achieve happy living for the family remaining at home. Hopefully, with the help of researchers and scientists working all over the world, Alzheimer’s can be treated and made curable.

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