With my elderly father hospitalized due to a fall last week, I have not had time to write for this Florida Senior Living Advisor blog. So I am thankful to Barbara Dunn of haiwatch.com for submitting this guest post on healthcare associated infections. It is particularly timely information for me as my father now goes on his fourth day in the hospital. With his body weak from the fall, I can easily see how he might be susceptible to infection. And the Hand Hygiene guide offers useful information for all of us – young, old, hospitalized or not.

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When someone enters the hospital, he expects to get better of course, not worse. Unfortunately, all too often patients become terribly ill from an infection they didn’t have before entering the hospital. These infections are known as HAIs – healthcare associated infections or hospital acquired infections. With the increase in resistant bacteria, HAIs are on the rise. According to the World Health Organization (WHO), at any point in time, 1.4 million people worldwide are suffering from infections acquired in hospitals.

Unfortunately, hospital or clinic visits are almost unavoidable and usually unplanned. That is one reason it’s even more important for anyone to know the basics of HAI prevention. Surprisingly (or perhaps not surprisingly) the most important methods to prevent HAIs are simple hygiene and sanitation. Cross contamination, also called contact transfer, is the number one cause of HAIs and fortunately, the easiest to tackle. See the following PDF with patient tips:

Patient’sGuide to Hand Hygiene

Two other common HAI types are ventilator-associated Pneumonia (VAP) and Surgical Site Infections (SSIs). There are things both patients and health care professionals can do to prevent HAIs. The ‘Not on My Watch’ Campaign aims to educate both groups about the best ways to prevent infections.  

You can get more information on healthcare associated infections at www.haiwatch.com.

Tags: elderly, Florida Senior Living Advisor, HAI, healthcare associated infections, hospital infection, senior citizen

My elderly father recently underwent cataract surgery, and it has lead to a dramatic improvement in his vision. But the true benefits go far beyond better eyesight. Now that he can see more clearly, he is participating in activities at his Florida continuing care retirement community more. He is spending time in his building’s library, reconnecting with his lifelong love of reading that in recent years had become more of a strain than a joy. And he is spending more time outside going for walks with friends.

By improving his vision, the surgery has ultimately improved the quality of his daily life. And a new study indicates it may also have reduced his chance of developing Alzheimer’s disease, the most common form of dementia.

The  study, from the University of Michigan Health System, reports that elderly people with untreated vision disorders are significantly more likely to develop Alzheimer’s. The study used Medicare data and shows that those with poor vision who visited an ophthalmologist at least once for an examination were 64 percent less likely to develop dementia.

The findings may create a new way of looking at poor vision in the elderly: as predictor of dementia rather than as a symptom after the diagnosis.

For the study, Mary A.M. Rogers, Ph.D., and her colleague Kenneth M. Langa, M.D., Ph.D.,analyzed data from the nationally representative Health and Retirement Study and records from Centers for Medicare and Medicaid Services.

“Our results indicate that it is important for elderly individuals with visual problems to seek medical attention so that the causes of the problems can be identified and treated,” Rogers says. The types of vision treatment that were helpful in lowering the risk of dementia were surgery to correct cataracts and treatments for glaucoma, retinal disorders and other eye-related problems.

Proper vision is a requirement for many of the activities that previously have been found to lower the risk of Alzheimer’s disease. These include reading, playing board games, other mentally stimulating activities, social networking, as well as physical activity such as walking and routine exercising. A visual disorder may interfere with normal mobility and may also hinder a person’s ability to participate in such activities, as it was in my father’s case.

“Many elderly Americans do not have adequate health coverage for vision, and Medicare does not cover preventative vision screenings for most beneficiaries,” Rogers says. “So it’s not unusual that the elderly receive vision treatment only after a problem is severe enough to warrant a visit to the doctor when the problem is more advanced.”

According to a survey conducted by the National Eye Health Education Program, less than 11 percent of respondents understood that there are no early warning signs for eye problems such as glaucoma and diabetic retinopathy. However, vision problems and blindness are among the top 10 disabilities among adults and can result in a greater tendency to experience other health conditions or even to die prematurely.

“While heart disease and cancer death rates are continuing to decline, mortality rates for Alzheimer’s disease are on the rise,” says Rogers. “So if we can delay the onset of dementia, we can save individuals and their families from the stress, cost and burden that are associated with Alzheimer’s disease.”

The study was based on the surveys and medical information from 625 people compiled from 1992-2005. Only 10 percent of Medicare beneficiaries who developed dementia had excellent vision at the beginning of the study, while 30 percent of those who maintained normal cognition had excellent vision at the onset of the study. One in five Americans who are over age 50 report experiencing a visual impairment, according to the U.S. Centers for Disease Control and Prevention. Approximately 5 million Americans have Alzheimer’s disease and the number has doubled since 1980. It is expected to be as high as 13 million by 2050.

Tags: Alzheimer's disease, cataract, dementia, elderly, elderly vision, Florida continuing care retirement community, Florida senior living, Medicare

Love is in the air – again. In my last post, I told you about a contest for love stories sponsored by Emeritus Senior Living. Now I found out about a Florida-based marketing & PR firm that is seeking submissions of senior love stories for a book. The Ehlers Group, a firm that specializes in marketing programs for senior housing communities, is kicking off its “365 Senior Love Stories” quest on Valentine’s Day.

“We are often inspired after meeting residents at our clients’ communities,” said Janis Ehlers. “They often have such rich histories. From their first meeting and courtship to when they married and their early lives, these are wonderful heartfelt stories that need to be written down.”

The idea for the book was sparked during a recent visit to The Carlisle, a retirement community in Naples, Fla. Residents Jim and Winnie Perrill shared the story of their second marriage with Ehlers, who thought the romantic couple’s life sounded like a Lifetime Television movie.

“They are so in love and happy,” said Ehlers. “Everyone enjoys hearing a great love story.”

Entries for 365 Senior Love Stories must be submitted by May 31, 2010. So you have three and a half months to interview mom and dad, or grandma and grandpa, and get it written (400 words is the limit and that’s really not much). What do you get for your effort? For the 365 chosen – the joy of seeing your work in a published book. In my opinion, whether your submission is chosen or not, you may find that the process of writing a small piece of your family’s history will be rewarding on its own.

Additional submission guidelines include:

1. At least one party must be at least 70 years at the time of submission;
2. Both parties be living when the submission is made;
3. The submission may be written by the couple, relatives or third-parties on their behalf;
4. Submissions must be no more than 400 words (include how the couple met, courtship, wedding ceremony, length of marriage, etc.);
5. Submissions must be typewritten and include the full names of the couple, address and telephone contact information for verification;
6. The published story will contain only first names and ages;
7. Submissions without telephone numbers cannot be considered;
8. Submissions may be rewritten, edited and shortened at the discretion of the book authors;
9. Book authors reserve the right to select the love stories for publication and will notify the submitters in advance of the selection;
10. If you would like to submit a photo(s), it could be a wedding photo, a picture of the couple when they met or a recent photo;

Pictures need to include the couples’ names and a photographer’s name if credit is required. Photographs altered in any fashion are not accepted. Pictures can not be returned.  Image requirements: JPEG file format and 300 dpi. Please provide pictures that avoid red-eye, busy backgrounds, etc. Image where the couple’s heads and eyes are on the same level are preferred.

To submit a Love Story, please email SeniorLoveStories@TheEhlersGroup.com. For more information, please call 954-726-9228 or visit 365SeniorLoveStories.blogspot.com.

Tags: 365 Senior Love Stories, Emeritus Senior Living, Florida elderly, Florida senior housing communities, Florida senior living, senior citizens, The Ehlers Group, Valentine's Day

As I’ve watched my father’s relationship with his dear friend Ginny grow closer and closer over the last 20 months, it has demonstrated to me that love really can blossom later in life.  He and Ginny are just one of the many happy couples I see when I visit their Florida continuing care retirement community. So with Valentine’s Day coming up in a week, I wanted to share this contest sponsored by a national senior living provider. Following is the information from their website:

In honor of Valentine’s Day, Emeritus Senior Living, a national provider of assisted living and Alzheimer’s and related dementia care services to seniors, is holding a Facebook contest that encourages fans to share personal and family love stories.

Emeritus’ “Lifetime of Love” contest gives fans the opportunity to share their own love stories, or family love stories that have been passed down from parents and grandparents. Fans are encouraged to post their love stories as comments to the “Valentines Day Contest” tab on the Emeritus Senior Living Facebook page. One grand prize winner will receive a $500 American Express gift card. Twenty additional winners will receive a $100 American Express gift card. All winners will be announced via Facebook on February 15th, 2010.

The inspiration behind the Emeritus “Lifetime of Love” contest comes from sharing the personal stories and journeys of many of the residents who live at its 316 communities across the country. Among the residents who have shared their heartwarming love stories with Emeritus are four Garden Grove, CA couples who are scheduled to renew their wedding vows at Emeritus at Garden Manor community in a group ceremony on February 12th, 2010.

Tags: Alzheimer's, dementia, elderly, Emeritus Senior Living, Facebook, Florida continuing care retirement community, Florida senior living, senior citizen, seniors

It’s common knowledge that high blood pressure can lead to heart attack and heart failure, stroke, kidney failure, and other health consequences. Now new research has found high blood pressure may also make you more prone to dementia as you age.

The research, from the National Institutes of Health, suggests that hypertension – blood pressure readings of 140 over 90 or higher – may cause a kind of scarring that interferes with communication between brain cells. That scarring, known as white matter lesions, has been linked to development of Alzheimer’s and other dementias in the elderly. Researchers have found an increase in white matter lesions with each 20-point jump in systolic pressure above the recommended limit. Systolic pressure is the bigger of the two numbers. Those scars can start building up in middle age, although the resulting memory problems may not appear until decades later.

“If you look … for things that we can prevent that lead to cognitive decline in the elderly, hypertension is at the top of the list,” Dr. Walter Koroshetz, deputy director of NIH’s National Institute of Neurological Disorders and Stroke, told The Associated Press. Age is the biggest risk factor for Alzheimer’s disease and other forms of dementia that affect about one in eight people 65 or older.

This evidence of a link is strong enough that the National Institutes of Health will soon begin enrolling thousands of people with high blood pressure into a major study. The aim will be to see if pushing blood pressure lower than currently recommended might better protect not just hearts, but brains.

Tags: aging, Alzheimer's disease, dementia, elderly, hypertension, NIH

Despite our best efforts to make the holidays a time of pure joy and thankfulness, the fact is for most people I know there is also a fair amount of stress. I can only imagine how that is exacerbated when there is a family member with Alzheimer’s.

The Alzheimer’s Association – Florida Gulf Coast Chapter- has developed 10 Holiday Survival Tips that will help make family gatherings a happy, memorable occasion for all.
 
Tip 1 -  Planning can avoid holiday stress. Individuals who experience the most difficulty with the holiday season are those who have given little thought to the challenges they will encounter. Consider ahead of time what may be expected of you, both socially and emotionally.

• Discuss holiday celebrations with relatives and close friends in advance. 
• Plan to maintain a regular routine while trying to provide a pleasant, meaningful and calm holiday event.
• Celebrate early in the day or have a noon meal rather than a late dinner.

Tip 2 – Take care of yourself (caregiver) Remember, the holidays are opportunities to share time with people you love. Try to make these celebrations easy on yourself and with the person with Alzheimer’s disease so that you may concentrate on enjoying your time together.

• Set limits by telling family and friends that you intend to control stress this holiday season.
• Maintain a positive mental attitude.
• Ask for assistance for you and your loved one.
• Attend an Alzheimer’s Association support group that will allow you discuss ways to overcome holiday stress.
  Prepare to deal with post-holiday letdown. Arrange for in-home care (respite care) so you can enjoy a movie or lunch with a friend and reduce post-holiday stress.

Tip 3 – Prepare the person with Alzheimer’s for the family gathering. Preparing your loved one for the upcoming holiday events can allow both of you to enjoy the warmth of the season.

• Talk about and show photos of family members and friends who will be visiting.
• Have a “quiet” room in case things get too hectic.
• Play familiar music and serve favorite traditional holiday foods.
• Schedule naps, especially if the person usually takes naps.

Tip 4 – Prepare family members and friends. Preparing families and friends with an honest appraisal of the person’s condition can help avoid uncomfortable or harmful situations.

• Familiarize family members and friends with behaviors and condition changes.
• Recommend practical and useful gifts. (See Tip 7)
• Remind family and friends the best way to communicate with a person with dementia. (See Tip 6)

Tip 5 – Involve everyone when selecting activities. Involve everyone in holiday activities including the person with dementia.

• Consider taking walks, icing cookies, telling stories, doing chores, making a memory book or family tree, or keeping a journal.
• To encourage conversation, place magazines, scrapbooks, or photo albums in reach; play music to prompt dancing or other kinds of exercise. 
• Encourage young family members to participate in simple and familiar activities with the person.

Tip 6 – Communicate with success. Alzheimer’s can diminish a person’s ability to communicate. These tips may help you understand each other.

• Be calm and supportive if the person has trouble communicating.
• Speak slowly with a relaxed tone.
• Avoid criticism. For example, when someone forgets a recent conversation, avoid saying, “Don’t you remember?”
• Address the person by name.
• Be patient, flexible, and do not argue with the person with Alzheimer’s

Tip 7 — Smart gift giving.

• Encourage family and friends to give useful, practical gifts for the person such as identification bracelet (available through Medic Alert® + Alzheimer’s Association Safe Return®). Other gifts may include comfortable easy-to-remove clothing, audiotapes of favorite music, videos, and photo albums.
• Advise others not to give gifts such as dangerous tools or instruments, utensils, challenging board games, complicated electronic equipment, or pets.
• If possible, involve the person in giving gifts. For example, someone who once enjoyed cooking may enjoy baking cookies, or buy the gift and allow the person to wrap it.

Tip 8 – Safe environment in the home. Persons with dementia may experience changes in judgment. This behavior may lead to confusion, frustration, or wandering. Consider these tips to reduce the risk of injury and situations that could be confusing to someone with dementia.

• Assign a “buddy” to watch out for the person to ensure their comfort.
• Arrange ample space for walking side-by-side, for wheelchairs, and walkers. Keep walking areas clear.
• Consider seating options so the person with Alzheimer’s can best focus on conversation and be least distracted.
• Don’t serve alcohol, which may lead to inappropriate behavior or interactions with medications.
• Accommodate changes in vision. Place contrasting-color rugs in front of doors or steps.  Avoid dark-colored rugs that may appear to be “holes.”
• Limit access to places where injuries occur, such as a kitchen or stairwell. Check temperature of water and food.  Prevent falls by installing metal grab bars; and secure textured stickers to slippery surfaces.
• Create even level of lighting; avoid blinking lights.
• Keep decorations simple; avoid using candies, artificial fruits/vegetables, or other edibles as decorations.
• Supervise in taking medicine.
• Keep emergency phone numbers and a list of medications handy.

Tip 9 — Travel wisely. The following suggestions may ensure a positive traveling experience:

• Never leave the person alone.
• Use familiar modes of transportation and avoid peak travel times.
• Keep plans simple and maintain daily routines as much as possible.
• Allow extra time to avoid the stress of rushing.
• Advise service and hospitality staff that you are traveling with someone with dementia and about the person’s behaviors and special needs.
• Arrange for services, such as wheelchairs, ahead of time.
• Provide identification items such as a Medic Alert® + Alzheimer’s Association Safe Return®) bracelet and clothing labels.

Tip 10 – Reliable sources of support
Families can call the Alzheimer’s Association (Gulf Coast Chapter) at 727-578-2558 or the 24-hour Helpline at  1-800-772-8672 to answer questions about warning signs and to assist persons with dementia  and caregivers.  The national Helpline is 1-800-272-3900. The Helpline will be open all Christmas day and New Year’s Day, as well as year round.

Tags: Alzheimer's Association, Alzheimer's disease, dementia, elderly, holidays

Thanks to Linda Dunkelberger for submitting this guest blog post to Florida Senior Living Advisor. She provided this post on behalf of Visiting Angels, a nationwide network of  senior home care providers that help seniors with everyday tasks, errands, meals, transportation, just to name a few services.  I think these tips are especially important to keep in mind during the holidays, when we are all busy with jam-packed “to-do lists,” in addition to whatever care we must provide to elderly family members.

Caring for aging parents or loved ones carries a lot of responsibility and a range of emotions.  No matter how much love in your heart, carrying the load of caring for your loved one will leave you drained physically, emotionally and possibly financially.  Coping with the stress of senior home care has to be managed or you will not be able to be an effective caregiver.

Managing the stress of senior home care is all about taking charge.  Take charge of your thoughts, your emotions, your schedule, your environment and the way you deal with problems and unexpected situations.  The ultimate goal of coping with the stress of senior home care is to achieve a balanced life. 

How to reduce, prevent, and cope with the stress of senior home care:

• Senior home care requires organization – Organize your time and your schedule.  Write everything down so that you or another family member has reference to phone numbers, doctors, medications, in-home senior care providers, important insurance and financial numbers.
• Start a personal journal- Share your feelings about the stress of senior home care (either in hard copy or an online blog).  Writing down your thoughts will help you to take charge of your emotions. 
• Prioritize your health and well-being.   Nurturing yourself is a necessity, not a luxury.  Healthy ways to relax and recharge:   
   *Go for a walk 
   *Call a good friend 
   *Sweat out the tension with a good workout 
   *Write in your journal 
   *Curl up with a good book 
   *Take a long bath 
   *Eat healthy and exercise regularly 
   *Play with your pet
   *Work in your garden 
   *Listen to music 
   *Savor a cup of warm coffee or tea
• Give yourself a break – Enlist the help of a professional senior home care provider. Senior home care providers such as Visiting Angels can provide daily or weekly help with everyday chores, errands, hygiene, meals or transportation needs, just to name a few.  Senior home care providers can also provide a respite to you with as little as 15 minute notice to avoid unnecessary stress if your schedule needs help.

Coping with the stress of senior home care is the only possible way to be an effective caregiver to your loved ones.  Your mental and physical health must take priority or you will not be able to manage what needs to be done.  Take advantage of these tips.  Organize yourself, express yourself, nurture yourself and help yourself by arranging for assistance with a senior home care provider.

Tags: caregiver, elderly, senior citizen, senior home care

We celebrated my father’s 85th birthday yesterday.

As I sat there watching him enjoy his dinner and laughing at the antics of his grandchildren, I couldn’t help but smile at how much he has mellowed with age. When I was younger, he was tough. Really tough. Opinionated. Obstinate. Prone to cynicism. As a teenager,  when I would ask for permission to go out with my friends, he would randomly say no. When I would ask why, his response would be, “Because I said so.” End of discussion.  Now I see a softer side to him; he laughs more, even cries occasionally (particularly when my daughters play the violin for him). And he’s definitely much easier on waitresses and other service personnel than he used to be.

So I had to wonder, is there any scientific proof to what I have experienced with him – that personalities can mellow with age. I came across this report from a few years ago from the Journal of Neuroscience. The study suggests that elderly people may be better at perceiving happiness and worse at perceiving fear, which researchers say supports the idea that people do mellow with age.
 
In the study, volunteers were asked to pick out the pictures showing fear and happiness from others showing anger, disgust and sadness. As they viewed these images their brain activity was monitored using functional magnetic  resonance imaging (fMRI). Results indicated that older people more accurately spot happy expressions while teenagers are better at identifying fearful expressions.

An anthropologist from Rutgers University explains that there may be an evolutionary advantage to mellowing with age. Helen Fisher says, “I don’t think it’s just about going to your grave feeling happier about life.” She says our hunter-gatherer ancestors may have benefited from the presence of happier elders with a calm approach to settling disputes within groups. “There would have been a tremendous advantage to have older people in the group with an optimistic view,” she adds.

All I know is that it makes my time with dear old Dad much more enjoyable. Happy Birthday Dad.

Tags: elderly, mellow with age, senior citizen

I suppose I shouldn’t have been surprised by this sentence in a recent report by the Federal Government. The sentence reads, “In addition, the most poorly performing homes tended to be chain affiliated and for-profit and have more beds and residents.”  The report, by the General Accounting Office, is a lengthy document about the quality of our nation’s nursing homes. To see it in print – from the federal government – that “chain affiliated and for-profit” nursing homes tend to be the ones offering the poorest care to residents only reaffirms what I have long suspected, and what I have heard from many of you who write to share your personal experiences of loved ones in senior living facilities. Time and time again, I hear that the best care tends to come from a personal connection between caregiver and resident.

And here is another interesting finding – the most poorly performing homes are distributed UNEVENLY across the states, with eight states having no such homes and ten others have from 21 to 52 such homes. Where do you find the 52 worst nursing homes? According to the GAO, that’s in Indiana. Florida has 16 that make the list, a relatively low number considering there are 664 nursing homes in my Florida Senior Living Advisor database. But we don’t do as well as another popular retirement location – Arizona has just 4 homes on the list.

According to GAO’s estimate, of the 16,000 nursing homes in the US, four percent – or 580 – could be considered the most poorly performing. If you want to understand more about the GAO’s research and conclusions, you can read the summary and recommendations, or even review the entire report. But be patient – it is 57 pages long! (The map showing numbers of poorly performing homes in each state is on page 15.)

Tags: elderly, Florida nursing home, Florida Senior Living Advisor, GAO, nursing home, senior care

In the past year, I’ve seen first-hand how devastating a fall can be to an elderly person. My 84-year-old father has fallen twice in his independent living apartment. The first time, he was on the floor for about 36 hours before he was found; the second time, he was down for about five hours. He has been very lucky – he has recovered fully from both incidents, with no long-term effects. In fact, I think his two artificial hips have actually been a blessing in these  falls – his right hip did dislocate both times, but doctors were able to pop it back into place; had this been his natural hip, it likely would have broken, leading to a much more difficult recovery.

The sad reality is that falls are one of the most common causes of accidental death in the elderly. A series this week in the Minneapolis Star-Tribune aims to raise awareness of the prevalence of falls in Minnesota nursing homes; I have to believe this is a similar problem nationwide, and not just in nursing homes but in assisted living facilities, independent living communities and private homes. In her commentary on the series, Star-Tribune editor and senior vice-president Nancy Barnes writes, “I urge our readers not to look away, despite the distressing nature of these stories. Nothing is more certain in life than death; we can only hope that we will be allowed the gift of dignity. In many of these stories, that is simply not the case.”

The investigative article is long and, at times, difficult to read. But it is important. Worth sharing. As one doctor quoted in the  article states, “”I think if you asked a person on the street, not one of them would know that if you take the frequency of falling and the consequences of falling, it’s as big a problem as heart attacks and strokes.” My father was one of the lucky ones. For many elderly people, a single fall can trigger a rapid decline in health. I hope you will take a few minutes to read this article. And I hope you’ll share your thoughts by leaving a comment.

Tags: elderly, fall, florida assisted living facility, Florida nursing home, Florida senior living facility, Minneapolis Star-Tribune, Nancy Barnes, senior citizen