Archive for December, 2009

Posted on December 30, 2009 - by Nurse Virginia

People 65 and Older Fastest Growing Segment of Population not only in the U.S. but around the World

Elderly population literally exploding around the world

This year 2010 is the year of a U.S. census. What we already know is that our elderly population is growing by leaps and bounds. That people 65 and older are the fastest growing segment of our population.  However looking beyond our borders, we see this is a world wide reality. China now has over 106 million people 65 and older. India has reported almost 60 million people 65 and older. The U.S. now has close to 39 million people 65 and over. And we soon will start to welcome the baby boomers into this ever expanding segment of the world population.

Fastest growing portion of aging population are those over 80 years

The fastest growing portion of the U.S. population over 65, is persons 85 and older. Recent reports indicate that while life expectancy is increasing due to improved health care. It is also true that it is more costly to care for the elderly. Because the costs will be coming from diseases associated with aging like diabetes, heart disease, and cancer the need for education focusing on prevention will be critical.

Elderly when 85 years have a 47% chance of Alzheimer’s disease

Alzheimer’s disease is largely a disease of the elderly. Some individuals do have signs of Alzheimer’s disease at a very young age, do to genetic causes. This however is a small portion of the population afflicted with this form of dementia. The much larger percentage is made up of the elderly population 85 and older.

The coming need for care giving information

Education for families on caring for their elderly and increasing social support options will be needed.   Elders will need to make their wishes known to their families. My mother now living in a nursing community always told us she would not live with one of her children. We heard her, but never really questioned why she felt so strongly. But true to her word, when she had her most debilitating stroke, she continued to maintain that living with one of her children would not be an option.

Please see also under “Aging”:

• No Nursing Home for Baby Boomer Nurses   (April 22, 2009)
• Why Blog? When we have a “Silver Tsunami” coming at us and more family members are becoming caregiver, why not blog?  (April 27, 2009)

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire Illinois

Posted on December 21, 2009 - by Nurse Virginia

ALZHEIMER’S DISEASE IS A TERMINAL ILLNESS

Alzheimer’s is a progressive disease

Whether it is called “end stage” or “late stage” the disease will progress until the individual no longer speaks, recognizes friends, family or caregivers and requires total care in all activities of daily living. That will mean a caregiver will have to totally dress the individual, hand feed the individual and keep them clean and dry due to total incontinence.

Few family members understand the possibility of complications when their loved one reaches this end stage of the disease. Communication between the physician and family members to do advance planning and decision making is critical.

Symptoms that signal end of life for a person with Alzheimer’s disease

Typically the individual will begin having eating problems, fevers, infections usually pneumonia.  Due to their loss of ability to swallow they will start to aspirate their food into their lungs. This will cause infections and fever, sometimes these are the first indications that the individual is no longer able to swallow.

So many times the only question that is asked of the family at this time is whether they want to use antibiotics or not to fight the infection. The communication should involve that this is a symptom of end of life for this individual. That their Alzheimer’s has progressed to the point where they are losing the ability to swallow their food.

The end stage Alzheimer patient needs an end of life plan.

When the individual has no plan in place then painful, burdensome solutions may be suggested. Such as putting a feeding tube into the person’s stomach by way of an incision. Many times these decisions are made independently of any over all plan of care. So the involved family is called for one issue after another because no plan is in place.

The healthcare professional who clearly communicates that Alzheimer’s disease is a terminal disease with expected complications, not only helps the family, but is a true patient advocate.

Virginia Garberding, R.N.

Director of Education

The Wealshire, Lincolnshire Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

Posted on December 17, 2009 - by Nurse Virginia

What is- Dementia, Reversible Dementia, Irreversible Dementia, Vascular Dementia, and Alzheimer’s Disease

What is Dementia?

When brain cells are no longer communicating with each other. The cells then die, and the brain can’t replace those cells, so brain function is lost. The loss of these cells can create a decrease in the ability to make decisions, understand the environment, and be able to reason, be socially appropriate, lose language skills and remember.

Dementia is not the disease

Dementia is a symptom of the disease that is affecting the person’s brain. The elderly person has dementia because they have Alzheimer’s disease, Parkinson’s disease, Pick’s disease, Lewy Body disease, Huntington’s disease, Creutzfeldt-Jakob disease or one of many other dementia causing diseases. When the disease attacks the brain and destroys the brain cells the person starts to lose those abilities that indicate they now suffer from dementia.

What are Reversible Dementias?

Because dementia is a symptom, if the cause of the loss of the function of brain cells is corrected the dementia can be reversed. A brain tumor can cause dementia, when removed the dementia is reversed. Metabolic disorders, hypothyroidism untreated can cause some dementia. Head injuries, infection and intoxication can cause problems with memory, language, thinking, reasoning, personality changes and result in abnormal behaviors.

See: Alzheimer’s disease, Dementia and Hypothyroidism in the Elderly

Blogged on – October 19, 2009

What are Irreversible dementias?

The diseases that cause dementia are progressive diseases. The symptoms of dementia go through stages from mild to severe dementia. The person may start with some word finding problem and eventually progress to the loss of all of their words. As those brain cells die because of the disease the person may eventually be completely incapacitated and require total care.

What is Vascular dementia?

A stop in blood flow to the cells of the brain causes a lack of nutrition to those cells and the cells die. This can happen over a period of time with small silent strokes where the person loses their memory and ability to think and reason. The person may experience one large episode or stroke and lead the physician to monitor the blood flow and provide blood thinners which ensure the cells will receive their nutrition.

Most common disease causing dementia -Alzheimer’s disease

The most common cause of dementia affecting more than 5 million people in the United States alone is Alzheimer’s disease. The disease causes plaques and tangles in the brain making the cells unable to communicate and die.

See: When you get the Diagnosis of Alzheimer’s Disease

Blogged on – August 19, 2009

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

Posted on December 15, 2009 - by Nurse Virginia

Caregiver Tips: Call on Friends to Help Take Care of Confused Elder with Alzheimer’s Disease

I’ve had a lot of friends over the years, and I’ve tried to help them any way I could. “That’s what friends are for” I used to say.

I never suspected I would ever need help myself. But I can’t care for him all the time. He wears me out. So I call on my friends.

The first time I called on a church friend. I started apologizing-and she interrupted me. “That’s what friends are for,” she said.

I laughed because I had to listen to my own little speech. I’m glad I did too. Their help takes a load off me. But I’m grateful even more that these people care enough to help lift the load.

My best friend said, “At last I can do something important for you.”

My heavenly Friend, thank you for the friends who care and who show it by all the practical things they do.

Excerpt from: Daily Encouragement – When Someone You Love Has Alzheimer’s

By: Cecil Murphey – Beacon Press of Kansas City

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get to Know Me – Aging with Dignity and Relevance

Posted on December 14, 2009 - by Nurse Virginia

The Best Gifts for Caregivers of the Confused Elderly and Disabled

Best Gifts for Family Caregivers

The best gift I can think of to give yourself, is the gift of more help. The first step is to realize that you need help, and then get comfortable asking for it. A great resource for this is the book Share the Care – How to Organize a group to Care for Someone who is Seriously Ill By: Cappy Capossela and Sheila Warnock, available at B&N, Amazon, and on the web site. This book takes the reader by the hand in a step by step approach to building a support system. Included are all the forms you will need to identify those potential sources of help, how to educate and organize the helpers and record keeping forms.

Time is always the best gift

Give the family caregiver some time off, even if it means taking the confused elder for a respite stay in a nursing community. The time in the nursing community can be an opportunity for the nursing staff to do a complete nursing assessment and have a skilled therapy assessment. Many nursing communities have on staff Dentists, beauticians, Podiatrists, message therapists, as well as many other amenities.

See blog:    Respite Care – July 14^th, 2009

Give yourself some well deserved credit

Take the time to re-evaluate your role as caregiver, and the blessings of the task that you have taken on.

See Blogs:       National Caregiver Month – November 10^th, 2009

Blessings of Being a Caregiver – April 2nd, 2009

Whoever notices the caregiver pushing the wheelchair – June 28, 2009

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

Posted on December 12, 2009 - by Nurse Virginia

Holiday Activities for the Confused Elderly That Prompt Reminiscing

Look at Christmas Lights

This was a big Christmas tradition years ago, when I was growing up. In several neighborhoods in Chicago, the blocks were all set up with holiday themes. Cars would be bumper to bumper crawling around those blocks just to see every house with a lighted candy cane. The whole family would be bundled up, in the car and off to see the lights.

Now almost every homeowner has invested part of their decoration budget into outdoor decorations. No one has to go very far to see amazing Christmas light shows. Some communities also have large displays, where for a modest amount you can once again crawl along bumper to bumper at peak times.

Bundle up Grandma and Grandpa, pick up some hot chocolate, and just go for a drive to see the lights.

Go to the mall and watch the children sit on Santa’s lap

Every mall has a Santa and a line of children waiting to see him. “Children watching” in general is a great activity for the elderly, but especially so at Christmas time. Being in the environment of people shopping, holiday decorations, Christmas music playing and children seeing Santa can help the confused elderly connect to emotional memories.

Being in the mall can have the added benefit of providing a safe place to walk and the so important exercise the elderly need. Make sure you are going at times of lower activity – a crowd is not the place to be for a person unsure of what is going on around them.

Christmas church services and pageants

Find out when all your local churches are having special Christmas services. Being a part of a congregation singing carols is a normalization activity for the confused elderly. When the church is decorated with large trees, lots of lights, Christmas music, the choir singing, all of these things prompt emotional memories.

Many elderly with Alzheimer’s disease who have lost their ability for conversation continue to be able to sing. Especially long remembered carols that are stored in many different areas of the brain are still available to the elder as emotional memories.

(See also: November 30, 2009 -Elderly Christians need their Church)

Look at Christmas Trees

If weather permits, go to a Christmas tree lot and walk around critiquing the trees. Which one looks good on all sides, which one is more of a Charlie Brown tree.

Department stores, home stores even hardware stores all have displays of decorated Christmas trees to see. Trees with different themes and various choices of ornaments and lights. This year they have even brought back the old fashioned large colored ceramic bulbs I grew up with. These are the bulbs I put on my tree this year, we all enjoy the things we remember as children.

Think about your family’s traditions and how you can still bring the spirit of the holiday to your elder. Even if it just sitting together and listening to “The Little Drummer Boy.”

Virginia Garberding, R.N.

Director of Education, The Wealshire

Author: Please Get To Know Me – Aging with Dignity and Relevance

Posted on December 8, 2009 - by Nurse Virginia

Christian Radio – Keeps the Confused Elderly in a Nursing Home in the Season

Holiday music on Christian Radio triggers reminiscing.

Christian radio supports and, most of all triggers the kind of reminiscing that brings joy and comfort to elders. We live much of our lives inside our minds. Memories are stored in many different areas of our brains under different triggers. Mother can’t hear “How Great Thou Art” without thinking of Dad, because that was his favorite hymn.

Listening to the radio keeps her in the season and helps her to pass the long nights when she is unable to sleep. One day when I visited, Mother said she had awakened during the night and the most beautiful music was playing, and she thought, this must be just like heaven. As I stared at the joy on Mother’s face, it made me grateful to the nursing assistant who had turned on the radio that night.

Having the staff know that, when Verona is in her room and going to bed she listens to her radio station, makes a statement to the staff of who Verona is. I believe they can see her Christ-like witness as she faces difficult days and sometimes a difficult life. Hearing Christian radio supports her faith and provides a sense of continuity amid the changes she faces, and gives her peace.

No amount of money, power or prestige could provide the peace, confort, contentment, and pure joy Mother is able to receive every hour of every day from the dedicated Christian speakers and musicians coming from that dear little black box on her nightstand. I wish that every elder in a nursing community could have access to Christian radio, because it has power to inform, comfort, and keep them strong in their faith, until they “take Jesus’ hand.”

Excerpt from: Please Get to Know Me – Aging with Dignity and Relevance

by: Virginia Garberding, R.N. with Cecil Murphey, New York Times best selling author of 90 Minutes in Heaven

Posted on December 2, 2009 - by Nurse Virginia

HELPING THE ELDERLY IN THE NURSING HOME KEEP IN TOUCH WITH THE COMMUNITY – SENDING OUT MOM’S CHRISTMAS CARDS

Dad needed help keeping in touch with family and friends and we didn’t know it.

 So many times, moving into a nursing home can mean for the elder breaking ties to their community. I sadly remember when my Dad no longer could drive and moved into the Assisted Living area, of my Mom’s Nursing Community. That last Christmas, Dad cut up old Christmas cards that he and my Mom had received from previous years. These front flaps of old cards, he signed on the back and sent out that year in the only envelopes he had, letter size. Several family members commented on those cards that year. Saying” Dad seems to be slipping – did you see his Christmas cards?”

 

What I saw was how no one had taken the time to help him – taking him to the store to buy new cards with envelopes. He didn’t have the pretty Christmas stamps that year or nice holiday stickers; he just had his recycled cards, the best he could do.

 

When Dad died, we realized we now had to step in and keep Mom in touch with her community.

 

Keeping the elder in touch through correspondence or telephone.

Many times going into a nursing community means the elder is breaking ties with their long-time friends. That’s when the family can step in and bridge the gap of keeping in touch. They can:

• send cards or make phone calls.
• ask friends or other family members to keep the elder connected by mailing cards and pictures to them
• ask their Church to send the Sunday bulletin and monthly newsletter. If necessary, family members can read it to the elder during visits.

 

Sending out Mom’s Christmas Cards.

So, the day after Thanksgiving there we were my sister and I, writing out Mom’s Christmas cards. She signed the ones she could (when you no longer use your penmanship skills, you lose them). Reminiscing about the friends who were no longer with us, and how the list gets shorter every year. Eating Christmas cookies and visiting with the nursing home staff. We try to make the day a memorable event.

 

We include in the cards personal notes to people to encourage them to come by and visit Mom. And we include a sister’s phone number for them to call to coordinate a visit.  We want to be ready with lunch or a snack for her very welcome visitors.

 

When we are done with the cards and they are on their way in the mail, we think of all the return greetings that will come to her at the Nursing Home. All these cards will say to the staff, that people out in the community haven’t forgotten Mom.

 

Virginia Garberding, R.N.

Director of Education, The Wealshire

Author: Please Get To Know Me – Aging with Dignity and Relevance