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 Facebook, www.pacificaseniorliving.com or at Pacifica Senior Living Blog.

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.

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

We 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. 

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

Don't Lose Heart

I once had a conversation with the President of a senior living organization for whom I worked in which he related that he believed that the Executive Director role is by far one of the toughest in the industry. You’re ultimately responsible for driving occupancy, meeting financial targets, cultivation an engaged workplace, over seeing compliance issues, functioning as the community HR representative, and overall quality assurance. Finally, we are expected to have a resident focus and create a setting that will allow each individual to have a quality of life that is vital and relevant. Piece of cake, right?

Sisyphus in Training

Anyone who has been or is currently an Executive Director wholeheartedly resonates with the laundry list of expectations. We’ve put in the longs days, lain awake at night remembering things not completed that day and thinking ahead to the next day’s challenges. And to be honest, sometimes it’s just exhausting. There are days we could very accurately compare our jobs to Greek tales of Sisyphus—always pushing the rock up that hill only to watch it roll back down and being faced with doing it all over again. Ever. Single. Day. So what do we do when we fell as though we cannot push that boulder up the mountain one more time? When we hit the proverbial wall?

And the answer is…

I got the answer last week when I was talking to a dear friend and fellow senior living warrior. We hadn’t spoken in a while, and as we were catching up she told me about a coworker who recently took her to his office, put some headphones on her to listen to some smooth, mellow music, and told her ” Do not lose heart—what you do has meaning, and even though tit is hard it’s worth it in the end.”

An AHA! Moment

I knew as soon as she spoke those precious words that their impact would be far-reaching and a source of strength I could pull out in some of my most difficult moments. It would be a source of reassurance to me that there is purpose, value, and hope in my role in senior living. In the last week as I’ve had to deal with staff changes, a belligerent resident, an unfortunate communtiy event, licensing complications, and numerous other challenges, that phrase has been my mantra.

Here is what I learned:

Do not lose heart—for every resident who is difficult there are other who are quick to tell you that you are special to them and that you’ve changed their lives.

Do not lose heart—for every staffing change that happens, you’ve got the unique opportunity to bring in someone fresh, new perspective and they’ll see things in ways you’ll need for that advancement of you community.

Do not lose heart—for every emergency situation you have to deal with you have the opportunity to prove to your residents that they can indeed trust you and you wil do all you can to ensure that they are safe and secure.

Do not lose heart—when you are exhausted and think that you cannot hear one more problem, you find that one resident who shars with you just how happy they are and how you and your staff have made it possible. I’m sure you are seeing a theme here; as leaders in this industry, we often come home emotionallyu spent, physically tired, and mentally drained.

Yet, ask most of us in this business and you’ll find that we cannot imagine doing anything else. Nothing compars to laying your head on you pilow each night and knowing you’ve helped alleviate a families fears, delivered on promised to create a community that exceed their expectiations, and wholeheartedly poured yourself into the lives of those entrust to you care and oversight. So, if you’ve had a tough week, take a few moments to balance the good with the bad, see the blessings in the challenges, and don’t forget to give yourself this piece of advice. Do not lose heart. Leslie

Organizational Culture and 7-Minute Phone Call.

The other day I was surprised to listen to a voice mail on my cell phone from the owner of our company. It’s not every day that the owner calls to inquire about who is working over the weekend as he could be bringing some folks for lunch.

After listening to the message, I called him back as requested. He was pleasant and friendly, asked me about the community, challenges, updates on occupancy, and even complimented me that though I expressed there is a lot to the job, he has heard that I am up to the task. It was a nice conversation.

He let me know he’d confirm the lunch and tour with me the next day. Saturday evening I got another VM from him saying they wouldn't be coming the following day after all as their plans had changed. He also passed along that he hoped I was feeling better (I mentioned the previous day that I had a cold).

Mission and Values

I share this personal illustration because it’s a great example of company culture in action. I've worked for a few other senior living companies and other organizations that serve the senior populace, and they all have a mission and core values. I’m happy to report that in most of my experiences, those companies were, by and large, seeking to exemplify that mission and put those values into practice.

But in at least one of my experiences, that couldn't have been further from the truth. Senior management would espouse core values at every opportunity, but in practice, especially the further down the management chain things went, it was virtually unrecognizable.

The Ripple Effect

What do a couple of voice mails and short conversation have to do with all this? A lot. As the owner of the company, he could have very easily given a directive and had someone else handle the task. He could have sent an email or called the office, but instead he took the time to call my cell phone and personally connect with me. This from a man who presides over a company with more than 50 senior living properties and nearly as many hotels. The fact that he took time out of his day to do so speaks volumes.

It was encouraging to me, but it also left me with a renewed appreciation for what Jen Shirkani refers to as a leaders downstream impact. In her book “Ego vs. EQ,” she explores the fact that as leaders we often lose sight of just how much our behavior is being watched by others and also how our actions have a ripple effect. My owner’s call was a perfect example of that to me. It was a very ordinary call, but the fact that it was made by the owner of our company made it extraordinary.

A Little Introspection

That same surprise call from the owner of our company got me thinking about my own leadership. If I was so impacted by a simple phone call, how am I impacting those I lead? Am I using my influence for good, or is it lacking?

I asked myself the following questions:

• Am I making an effort to connect with my employees? Not just business   conversation, but to really get to know them?
• Am I striving to be consistent with our companies mission and core values?
• Am I seeking to be consistent in my daily practices and subsequent interactions?
• Am I alert to potential blind spots and seeking to grow in those areas?

By asking those questions I’m seeking to ferret out areas where I am not as effective as I could be at leading others. In turn, this gives me the ability to have a greater impact within my sphere of influence. The greater my impact, the greater my opportunity at multiplication: that is, grooming and mentoring new leaders to take up the challenge of leading a successful community. This ultimately has the greatest impact upon the most important people of all; our residents.

Passion Isn’t Enough

Many of us got into senior living because we have a passion for the older population. However, most of us probably figured out just as quickly that simply being passionate about seniors isn't enough. You have to know how to lead people and effectively work through others. If you don’t, the results can be disastrous.

That’s why it’s refreshing and inspiring to have a very easily delegated task of a phone call reveal that a leader recognizes the power of a personal connection with his employees. It made me want to follow suit and examine my own leadership practices to find areas where I can continue to mature.

I encourage you to take a few minutes to mull over the questions above and be really honest with yourself. If you find yourself answering unfavorably to even one of them, take it as an opportunity to grow.

Seek ways to improve your emotional intelligence, which will arm you with the tools to be a more effective leader. And who knows, you just may impact one of your employees with a 7-minute phone call along the way.

Leslie

Executive Director of The Meridian at Lake San Marcos

Pacifica Senior Living

Make a Difference

by Rebekah Martin

How many of you have seen the challenge on the Alz Assn’s website “Do a little BIG thing”?

I took care of my Mother for an entire year and after she passed away, I called our local hospital to provide a change of address as I was still paying down her medical bills.  The account manager in their billing dept stated she remembered me from when she set up the payment plan and asked how my Mother was…  She wanted to know if everything ended as well as it could or if it was rough.

When I hung up the phone that day, I thought to myself “What a huge difference you can make in a small place”

Do a little BIG thing made me think…

The Walk to END Alzheimer’s is a small part of life that gives more back to you than you invest.  For example, when you walk, run, cycle or do other activities, you receive the gift of discovering courage, tenacity and the inner strength you possess

It isn’t what you do that makes you an athlete.  It isn’t how fast or how far you go or haw many personal bests you have.  Its waking up every day knowing that you will take on whatever life has for you that day.  You embrace the challenges – physical, emotional and spiritual – because you know it’s the challenges that make you stronger.

Through your journey you realize you have gained the strength to face it all – the best days and the worst – for what they are: Days, Moments, Experiences

As you set out to walk this morning, remember, Every finish line is a gift.

And because of what you’re doing today, you can expect BIG things!

Walk on, friends.

Contributing Author Rebekah Martin is the Community Relations Director at Pacifica Senior Living in Modesto, CA.