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Thursday, January 29, 2015

Heat Stress

As outside temperatures rise, the elderly are more prone to heat stress. Heat stress occurs when the body can't adequately cool itself or maintain a healthy internal body temperature. Normally, we cool ourselves through sweating, but sometimes this just isn't enough and the body's temperature keeps rising. Heat-related illness can range from mild conditions such as rash and cramps to more serious and potentially life threatening conditions like heat stroke. Heat stroke occurs when the body becomes unable to control its temperature, and the body temperature rises to 106F or higher. Heat stroke can happen in as little as 10 minutes and can cause death or permanent disability if emergency treatment is not immediately provided.

Be alert for the following warning signs of overheating or heat stroke:

  • Very high body temperature
  • Dry swollen tongue
  • Nausea
  • Rapid Pulse
  • Red, hot and dry skin
  • Throbbing headache
  • Confusion or strange behavior
How to protect yourself and your loved one:

  • Drink cool, nonalcoholic beverages
  • Rest
  • Take a cool shower or bath
  • Wear lightweight clothing
  • Do not engage in strenuous activities
  • Limit tea and coffee
  • If possible, seek an air-conditioned environment
The elderly require extra vigilance. Not only does the aging body have a harder time regulation its internal temperature, but the elderly often have a decreased thirst awareness. Taking certain medications can reduce the skins ability to sweat and may increases health issues like blood circulation problems which can put an elderly person at higher risk for overheating. If you have an elderly friend or relative who is currently living alone, check on them twice a day. Look for signs of dehydration and heat stress. If you see any of these warning signs of overheating or heat stroke, get help immediately.


Keith Ayers — Executive Director at Pacifica Senior Living Modesto

Connect with us on Facebookwww.pacificaseniorliving.com or at Pacifica Senior Living Blog.

Wednesday, January 28, 2015

Constipation: Cause and Treatment

Constipation is one of the most common disorders in Western societies, and its prevalence increases with age.  Many of the factors that predispose older adults to constipation are not a direct effect of normal aging, but are closely related to it. Fortunately, there are therapies which can improve this distressing condition.

Causes


A majority of people over 65 take one or more medications that effect nerve conduction and smooth muscle function.  Medications such as opioids, NSAIDS, calcium supplements, and various others increase the risk of constipation in older patients.  Other common risks include low-fiber diets, limited fluid intake, impaired mobility, and cognitive disorders.  Studies also show that there are distinct physiological changes which can affect colonic motility in older people. 

Treatment


Treatment should focus on education.  Informing patients about diet, exercise and bowel techniques, including evacuation timing, breathing, and the way they position themselves on the toilet, can be incredibly effective.

Depending upon the type of constipation, a routine that includes taking a fiber supplement mixed with 2 ounces of water every evening, can be a proven therapy. Additionally, adding a morning routine which begins with mild physical activity- just stretching in bed- a hot, preferably caffeinated beverage and possibly a fiber cereal followed by another cup of a hot beverage- all within 45 minutes of waking can increase the possibilities of effective evacuation.

Having a routine and an organized plan will provide patients with an improved quality of life. It offers more than the band-aide of taking a laxative, as laxatives really do not provide a long term solution, nor do they promote health.

Tuesday, January 27, 2015

Have You Had Your Residents Poached?

Few things aggravate me more than a “well-meaning” outside care provider or the like, coming into a community and telling a family or resident that they should be relocated to a different level of care or a different community. This could be skilled nursing, a designated hospice wing, or the classic board and care. I am by no means opposed to their help and services when necessary, but I’m primarily referring to the ill-timed incidences when business appears to be more important than the residents well-being.

Dying Alone

Let me illustrate my point with an experience I had several years ago.  A resident who had been in our community for an extended length of time was approaching the end of his life. He was in the hospital and despite the fact that they knew we could do hospice care in our building, the hospice agency told the family that he should go to their specialized wing as we wouldn’t be able to handle the care of their resident.
It was not even close to the truth.
His daughter, who didn’t know the complexities of the senior healthcare system, went along with the agency’s advice and he went to this “specialized” unit.  When I found out what happened I called his daughter and told her that we could have taken him back and would have loved to have cared for him in his final days. At that point he was far too frail to move again so he stayed there for the remainder of his days. When he left this world, it was alone, without staff that had cared for him for years, fellow residents with whom he had built meaningful relationships, and the familiar surroundings of his room and our community. And it was precipitated by a suggestion from a staff member of an agency who thought they were doing the “right” thing.

Poaching as a Common Practice

I’ve since had experiences in which others have come into the picture and suggested other living arrangements for our residents; as a matter of fact I don’t think I’ve ever worked in a building where it hasn’t happened at least once. But despite that, each time it happens it is no less infuriating. It is so maddening because in most cases, we as the  provider are working hard to ensure our residents are happy; we know not only them, but their families, preferences, and have diligently met their needs from the day they’ve entered our buildings. So when another provider, let’s say a home health or hospice employee, comes in and completely disregards the history, rapport, and well-being of the resident, it makes me feel as though I’ve been betrayed. Yes betrayal is a strong word, but I think it’s an accurate way of describing the experience.
Why do I feel so strongly about this frequent occurrence that happens in nearly all communities?
I can tell you adamantly that is it’s not because of a loss in occupancy or revenue. It is because I firmly believe that as an operator, a large part of my vocation is to ensure that each resident who calls our community home is indeed kept in their home; surrounded by familiar sounds, visual stimuli, people, and routines to which they have become accustomed. To remove someone from that level of comfort when they are dying because we don’t keep a bowel and bladder book is a little silly, isn’t it?

There is Enough to go Around

My point is this; we are all in this business of caring for our seniors together. There is no shortage of people over 65 to care for and thus we need to learn to better communicate and work together instead of against one another.  Finally,  we need to put the needs of our residents ahead of our sales targets and financial goals.
Just to give this a little more perspective here are a couple facts:
  • From 2010 to 2050 the numbers of Americans over 65 will more than double; from 41 to 86 million.
  • By 2050, the number of people age 65 and older with Alzheimer's disease may nearly triple, from 5 million to as many as 16 million.
Based on those two statistics alone it is quite easy to see that we are living in an era where there are an abundance of people who can be classified as seniors. And it is only increasing. Therefore, why not work together with the varied repository of resources to create a strong, unified network of providers who strive to do their best to ensure our elders are given the dignity and respect they deserve?

Calling a Truce

White FlagWe all know that in today’s business climate it’s often easy to see providers pitted against one another in the name of quality care, but I don’t think we should allow that to become our standard of practice.Instead, let’s call a truce. Let’s remember to look at things on more of a macro rather than micro level.
The next time a provider of any type comes to your community or office, or a family from a competitor comes to see you regarding a possible move, I challenge you to ask the following questions before proceeding:
  • Is this suggestion because of a genuine concern for the quality of care of the resident?
  • Do you know the family history and their rapport with the community?
  • If dissatisfaction with another community is involved, can you share with the other competitor to allow them the opportunity to rectify?
  • Is it in this resident’s best interest to be able to return to their current community from an emergent occurrence to prevent as  little upheaval as possible?
  • Is the resident at a significant safety risk or is it simply a preferential suggestion to relocate?
If we can all answer these questions each time our paths intersect with regard to our common residents, I am confident that we will all serve our elder population with greater efficacy and increased camaraderie. After all, we are in this together; let’s act like we mean it when we say that we put our residents first.
 Leslie — Executive Director of The Meridian at Lake San Marcos, a Pacifica Senior Living community. 

Monday, January 26, 2015

AMBROSIA SALAD

Not long ago, I had lunch with a former Executive Director who now owns her own senior referral agency. During the course of our conversation, I asked her if she ever missed that role which she held so many years ago. Her response was one of the best assessments of the job I’ve ever heard, “When it was good, there was nothing better.” 

The Gift of Today

Today wash one of those days for me. After two weeks of holidays, family, sickness and a December full of events and activities galore, I've found it difficult to follow my usual routine, both personally and professionally. Finally this week, things have returned back to normal. One of those routines that I enjoy most is walking through the dining rooms and visiting our memory care neighborhood. This afternoon, I got to spend some time in that special neighborhood, and it was nothing short of magical.
Our activity person was in the kitchen with a couple of memory care residents making Ambrosia salad. A mixture of fruit, mini marshmallows, shredded coconut and cool whip that instantly transports you back to summertime family gatherings and happy memories. As we continued working in the kitchen, more residents came in to see what was happening. One was helping at the sink, washing dishes, another comes in to eat some grapes, and a few more came in just to see what was going on. I grabbed a bag of mini-marshmallows, adding them and a few other ingredients to the mixture. Once everything was mixed together, we all tried a spoonful, uttering praises about the yummy creation before turning the conversation to shoes, babies and other topics.
After leaving the kitchen, I walked across that hall to the activity room, and spoke with a resident that I hadn’t seen in a while. Usually quiet and sometimes even withdrawn, she has recently become animated, talkative, and more engaged than she has ever been before. When I sat next to her she leaned toward me saying, “I haven’t seen you in a while” which warmed my heart in a way that is difficult to describe. While there I met one of our newest residents, greeted three other ladies and watched as our newly acquired community pet walked around and gently interacted with the residents.

What’s So Special?

I know that you are probably thinking, what is so magical about salad making and a dog roaming around a memory care neighborhood? Here’s what’s so special. All of those ladies, plagued with dementia had temporary slipped their bounds and were once again engaged, vibrant women. There weren't wracked with anxiety, worried about what they cannot remember, and weren't experiencing sun-downing behaviors. For this brief window of time, they were simply women enjoying themselves, engaged in the simple practices of everyday life that we often take for granted. They were ALIVE.
As I walked back to the main building, I felt as though I had been given a very valuable gift. I had been able to not only witness, but be part of a small time period in which these ladies were once again like their former selves. We laughed and talked, and I was able to envision what it must have been like before they were stricken with this terrible disease. I felt blessed to have to have been a party to something that was so special and beautiful. And then, I thought about my new friend, the former Executive Director, and how her words couldn’t ring truer for me than today: “When its good, there is nothing better.”
Leslie Quintanar — Executive Director of The Meridian at Lake San Marcos