caregiver support

November 2011 – Managing Incontinence

By: Diane Keefe, Geriatric Care Manager

You may have noticed a change of logo. We decided to let people know that it was about more than about mothers. Originally I chose the name because of my experience caregiving for my own mother. Many fathers felt left out and we didn’t want that. Now everything will be transitioning over the next year to the new logo in time for my upcoming book, Blueprint for Care, which will be released in 2012.

Managing Incontinence

Urinary Incontinence affects twice as many women as men but it is a life limiting condition when it happens. Many people become afraid to leave their home for fear of an embarrassing accident.

Incontinence is not considered a normal part of aging. . Often, family members may decide that it is too much of an issue for them and move their loved one to a senior residence. However, it is treatable.

Incontinence Is Not A Normal Part of Aging

Incontinence is not considered a normal part of aging and usually has an underlying medical cause. Many older adults are hesitant to tell their physicians unless asked directly. Incontinence can increase the risk of falls.

Studies have been done which indicate that those who have incontinence can be circumvented from having accidents by training to go immediately after eating each meal and upon arising in the morning. If the person finds that they are re-arranging their lives for their incontinence, then it is advised that the doctor be informed so that appropriate tests can be conducted to find the source of the issue.

There are many forms of incontinence. As women age, their pelvic floor muscles weaken. This can cause stress incontinence, where leakage can occur with a sneeze or the urgency may become more acute. This is how falls can occur…when they run to the bathroom and fall in the process. Urge incontinence is caused by bladder contractions which causes the bladder pressure to exceed the urethral pressure which controls the urine loss. Many times it is associated with central nervous system disorders such as Parkinson’s or stroke. Sometimes there is a mix of both types of incontinence. Finally, there is overflow incontinence where the bladder does not contract adequately or there is an obstruction due to enlarged prostate, pelvic organ prolapse or urethral stricture.

If the incontinence is not frequent, it may be controlled by light pads. Your doctor may suggest Kegel exercises which involve tightening the pelvic floor muscles repetitively to increase muscular control. However, if the cause is more difficult to control, there are products available that can be purchased locally or over the internet and delivered to your home. Some products come like an adult diaper; others more like a ‘brief’. There are different sizes and higher absorbency available for night wear. It is important that the person maintain cleanliness; keep dry and wear a cream barrier to keep skin from getting irritated. Some conditions may require surgery and medication. Your doctor will be the best person to advise you of what you require.

Incontinence can cause aggravation and embarrassment but it need not be life limiting. Find out what you can do to minimize the condition by contacting your physician and getting the appropriate tests. Then you will be free to think about what you want to do instead of your incontinence controlling what you are able to do.

Posted in Common Medical Conditions, Newsletters, November 2011 - Managing Incontinence | Tagged caregiver support, eldercare, family caregiver, incontinence | Leave a comment

11Nov

September 2011 – Mobility Issues Concerning Aging Adults

By: Diane Keefe, Geriatric Care Manager

Mobility represents a challenge to an older adult's independence and autonomy. Mobility can be on several levels:

1) How does the older adult ambulate in the home?
2) How does the older adult move around the community?
3) How does the older adult perform when driving?

Several factors can come into play. When people age, it affects them physically, mentally and emotionally. Physically, eyesight may begin to decline especially if they have problems with cataracts, glaucoma or macular degeneration. They may not respond as quickly to braking situations or recovering from a near-fall. How do they walk? Is it slow and lumbering or brisk and sure? Gait is very predictive of longevity. If they are shuffling, it may indicate an impending health condition that needs the attention of a physician. If there is an infection in the body such as a Urinary Tract Infection, it can manifest as if they have dementia. However, once they are treated and the infection is gone, they are back to normal. During the infection, they can experience delirium. This would definitely affect their ability to function behind the wheel of a car.

Many older adults are taking medications. These medications can impact their ability to think and react behind the wheel. Mentally, dementia can cause confusion in a situation which requires a quick response. At 85, 50% of older adults experience some form of dementia. Older adults who have been diagnosed by a physician as having dementia or Alzheimer's should be assessed regarding their ability to drive. Dementia can also impact balance and coordination which puts the individual at higher risk for falls. Emotionally, if they are feeling confused, they will be defensive, paranoid and angry. They feel vulnerable. They need to feel that someone is looking out for them and that they are still valued and in control of their lives. Give them choices when dealing with situations so that they feel more in control.

Women are more likely statistically to stop driving before they became a hazard on the road. Men are more likely to continue driving past the time that they should have stopped. There is a lot of denial in families and the individual about their abilities. They still picture themselves as the robust person they have always been and they are unable to see how the changes are impacting them. It is somewhat like a frog in boiling water. If the frog is placed in the water while it is being heated, he will not realize it is too hot until it is too late. The same is true of dementia. It is the obligation of family and friends to observe and point out the changes because the individual will not recognize that they are taking place.

What can families do to be proactive? Put together a plan to help the individual with their mobility. Do they need medical aids to help them get around? i.e. cane, walker, wheelchair? Do they need to strengthen their muscles through walking, exercise or physical therapy? Do they need someone to drive them around to their appointments? Are there services that are able to deliver to the home? For instance, pharmacies, grocers and many other retailers will deliver for a fee. Some doctors will make home visits as will beauticians, foot doctors, nurses and laundry services. Do they need help with bill paying? Talk about what will make their life continue to function with the proper supports.

You may also want to check if they are able to get in and out of the home on their own in case of emergency. Is someone else able to get into their home if there is a problem? Do they have their emergency contacts, doctors, pharmacy and hospital posted in a prominent place. Would a lockbox be appropriate for enabling someone to enter their home in case they are unable to get to the door? Check into technology that can be used to track medication usage and mobility patterns so that in the event of a fall, emergency services will be called immediately.

Mobility is a huge issue which cannot be addressed completely in a short newsletter. However, to find out more about assessing mobility, go to University of Missouri St. Louis Gerontology Program,meusert@umsl.edu or go to National Association of Professional Geriatric Care Managers, napgcm.org, to find a geriatric care manager in your location to help you to assess mobility and develop a plan.

Visit Caring for Mom Together to find out more about caregiving for an aging adult. Diane Keefe is writingBlueprint for Care to assist caregivers in understanding the issues, services and resources available to them while caregiving for an older adult. Diane is a professional Geriatric Care Manager and is writing this from the experience she had while managing older adult care in her Geriatric Care Management practice.

Posted in Newsletters, September 2011 - Mobility Issues Concerning Aging Adults | Tagged caregiver services, caregiver support, family caregiver, mobility & gait, mobility solutions | Leave a comment

09Oct

Independence Through Technology

By: Diane Keefe, Geriatric Care Manager

With children often spread from one coast to the other, there is often concern that someone needs to physically look after their parent. Now there are aids to help older adults to stay in their home safely and with adequate monitoring to make sure they are taking their medications regularly and there is movement in the home.
Here are some of the exciting new technologies available:

EPill Dispensers:

These pill dispensers make sure the patient takes the pill on time and in the correct dosage. http://www.epill.com/dispenser.html?source=google&gclid=COvKj7S9mqsCFUYEQAodfnLFlg

Phillips Lifeline has a medication alert system that is tied to the seniors phone so that someone is called when the older adult misses a dosage. http://www.lifelinesys.com/content/home

http://www.cioinsight.com/c/a/Health-Care/Electronic-Pill-Box-Proves-to-Be-Good-Medicine/

Monitors to detect motion/falls:

It is estimated that 13.3 million persons 65 and over will fall this year and only half will be able to get up.

The LifeProtekt wrist device comes with a GPS/GSM/and RF personal locator that is worn like a watch, and an iPod-size portable receiver that a caregiver can carry. This will allow the caregiver to set fixed or portable safe zones in and outdoors. If the safe zone is crossed, they are immediately alerted and can use the smart phone or computer to locate the loved one using Google map technology. There’s even a panic button, with built in false-alarm protection, for those who are higher functioning. It’s ideal for: wandering prevention, elderly care, and those who are cognitively impaired. http://www.lifeprotekt.com/category/alzheimers-disease/

Phillips Lifeline has a pendant that allows the wearer to push a button to reach attendants who can summon help. They also offer one with an alert system that can detect falls and automatically summon assistance. http://www.lifelinesys.com/content/home

Active Care offers a Personal Assistant Link that provides emergency services if a fall is detected and has a GPS locator that pinpoints the location of the wearer. http://www.activecare.com/pal

The eNeighbor remote monitoring system uses a series of small, unobtrusive sensors that work together to monitor a resident’s daily routine. http://www.healthsense.com/index.php/products/remote-monitoring

Mulberry Gardens offers a system that utilizes sensors to detect motion and possible falls but while still respecting privacy. http://www.mulberrygardens.org/Content/QuietCare.asp

Video intercoms are the newest solution for the home security system. With a video intercom, a person can see who is at the door before it is opened. http://www.gadgetshack.com/wired-camera-intercom-systems.html

These are only a few of the providers who now have systems that can sense movement and falls. Many more are in the works.

Vital Signs Monitoring:

Honeywell HomMed’s Sentry Telehealth Monitor can quickly collect and securely transmit data on five key vital signs: heart rate, blood pressure, oxygen saturation, temperature, and weight. http://www.hommed.com/products/sentry_telehealth_monitor-total-solution.asp

This home blood pressure monitor allows the elderly to check their blood pressure without tiring trips to the doctors. http://www.gadgetshack.com/blood-pressure-monitors.html

Stair Lifts:

Stair Lifts help seniors who need assistance getting up and down the stairs. http://usa.acornstairlifts.com/? source=google&adg=us&u2=Stairlift_High_Volume_b&gclid=CN3A387MmqsCFSEEQAodvUnFiw

Software:

Skype can be used today to see grandchildren who live far away from grandparents.

Software is being developed to assist in managing chronic diseases and monitoring progress especially after a hospital stay.

Geriatric Care Managers will be using Skype via Caring Bridge to connect with family members.

Adjustable Beds:

These beds help patients who are too frail to get themselves up. It also assists acid reflux persons. http://www.medlift.com/index.cfm?action=b14&id=19353,7257&pgurl=AdjustableBeds

Scooters/Assistive Devices:

Scooters allow older adults to get around their homes and communities when they are mobility challenged.

http://www.thescooterstore.com/mobility/microsite/03/?code=INT806MP5&p=8778547699&LID=39729484

Great Website for Assistive Devices is http://www.parentgiving.com/

Automatic Prescription/Medical Supplies
Delivery:

Technology on the internet allows seniors to have their prescriptions delivered to their home. http://www.aetnarxhomedelivery.com/

Access to internet allows seniors to have their incontinence supplies delivered to their house. http://www.hdis.com/?cid=200052&dest=1&gclid=CODkgp7QmqsCFUYEQAodfnLFlg

The Caregiver Partnership offers medical & personal care supplies and provides resources in many categories. www.caregiverpartnership.com, www.caregiverpartnership.com/resources/categories/

Technology to Increase Balance & Coordination:

This is an article on how studies have shown that even just a few sessions with the Wii has led to improved balance, coordination and strength, and could prevent falls, a serious concern for many seniors. http://www.theatlantic.com/technology/archive/2011/02/physical-video-games-may-help-the-elderly-psychologically/71184/

TZone Vibration system was developed by the Russian space astronauts to maintain their muscular fitness. It can help older adults to maintain muscle tone and coordination. It improves bone density. www.tzonevibrationtech.com/

Wandering Safeguards:

By placing miniaturized 2-way GPS technology in shoes, Andrew Carle who coined the term “Nana” Technologies for describing technology for older adults says the GPS Shoe has the potential to be life saving for those afflicted and their caregivers. They were developed by GTX Corporation and will be distributed by Aetrex Worldwide, Inc.

MailBox Alert:

This mailbox alert system informs the owner when the mail has come each day. This allows the elderly to only make one trip out to the mailbox. http://www.gadgetshack.com/mailbox-alert-mail-letter.html

Future Technology in the Works:

Technology is part of every area of our lives. There are many universities working on products that will assist seniors as they age. Here are just a few of the items under development:

Intel is working on an intelligent phone for persons with dementia that will utilize Caller ID to display a picture of the person, the relationship to the person being called and a little about their last conversation.
Medication Minders are already on the market that can alert the individual at the appropriate time to take medications. There are some systems that are connected to a pharmacy and lets them know when a person has missed a dosage and the history of their compliance with medications.
Walkers are being developed that will come to the person via remote control and can steer around obstacles. Smart canes can detect an impending fall, monitor gait and balance.
Medicine cabinet online is being developed by Accenture, a company in Chicago. It will be able to identify the user; tell them when the wrong medicine is about to be taken and automatically reorder medications. It will also set up doctor’s appointments.
Robotic nurses will be able to carry patients that are too heavy for caregivers or who have fallen and need assistance getting up.
Computer games are being programmed to enhance cognition and monitor changes over time that can predict oncoming dementia.
Tracking systems will be available for someone at risk of wandering. This will aid caregivers as to the location of the person they are monitoring.
Afferent Corporation in Boston is ready to introduce a balance booster that will sense when balance is unsteady and stimulate parts of the foot to help right the individual.

With 20% of the population being 65 and over by the year 2030, technology will continue to assist in caring for elders and helping them remain in the home. Because the number of potential caregivers has shrunk to a 4:1 ratio, it means fewer people will be available to help older adults. Technology will help to fill that void.

Posted in Technology, Topics | Tagged aging at home, aging in place, aging in the home, assistive technology, caregiver support, senior technologies, senior technology | 2 Comments

09Sep

8 Tips for Speaking to Someone with Dementia

By: lauren

Caregivers and family members get frustrated when trying to communicate with a loved one who has dementia. Here are a few pointers from Diane Keefe, Geriatric Care Manager, for talking to your loved one. Click on this link:

Posted in Dementia, Videos | Tagged aging adult, Alzheimer's Dis, caregiver services, caregiver support, dementia, eldercare, family caregiver | Leave a comment

November 2011 – Managing Incontinence

September 2011 – Mobility Issues Concerning Aging Adults

Independence Through Technology

8 Tips for Speaking to Someone with Dementia

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