Ageism, Elderspeak, and Long-Term Care

Wouldn’t you be confused if a near-stranger patted your head and called you “sweetie”, or if a nurse shouted instructions despite your excellent hearing? These behaviors are confusing and elicit irritation, but, for seniors, they are becoming more and more common. Ageism, elderspeak, and bias are an unfortunate reality for many seniors in long-term care. Seniors everywhere are struggling against the presumptions that demean them as well as the negative toll on their personal lives.

a care worker or medical professional with a senior client at her home . She is discussing the senior woman’s options on her digital tablet.

Ageism in Medicine

Ageism refers to negative stereotypes about older people that lead others to treat seniors differently from younger people. In medicine, extensive clinical evidence shows that older adults do not receive the same level of preventive care, diagnostic care or treatment as other age groups.

By speaking to residents in certain ways, long-term care workers perpetuate stereotypes about seniors. In turn, older adults may shut down or become angry at staff, which reduces their willingness to ask for help or to talk about their health concerns.

What is Elderspeak?

Elderspeak refers to a communication approach towards seniors that is based on the assumption that older people are incompetent, fragile or impaired. To some, elderspeak is unavoidable because many elders suffer from hearing loss or cognitive decline. But most seniors view elderspeak as a type of bullying that belittles their age. Elements of elderspeak include the following:

  • Speaking in a sing-song voice
  • Using baby talk
  • Talking too slowly
  • Interrupting frequently
  • Speaking loudly when it is unnecessary
  • Saying “we” instead of “you”
  • Using overly familiar endearments (“dearie,” “sweetie”) towards unfamiliar seniors
  • Using overly familiar signs of affection (hair-tousling, back-patting) towards unfamiliar seniors

Elderspeak and Dementia

Research suggests that elderspeak may be distressing to older adults, and may lead nursing home residents with dementia to act out negatively (e.g., disregard instructions, act aggressively) or to withdraw from social interactions altogether. This throws into sharp relief that even in the face of cognitive decline elderspeak has a negative impact on seniors.

Challenging Elderspeak

Several approaches can reduce the frequency of elderspeak. These include:

  • Self-awareness. Most nursing home staff do not realize that they sometimes use elderspeak to communicate with residents. This form of speech may occur among caregivers who genuinely want what is best for the people in their care. When caregivers become aware of their speech behaviors towards seniors, ageist assumptions are challenged.
  • Clear, respectful speech. Nursing staff should learn to speak to seniors in a normal, conversational way, including the use of humor when appropriate. A simple educational lecture is all the difference necessary to raise awareness among caregivers.
  • Encourage assertiveness. Not every senior will take offense at all elderspeak practices. Some seniors find nicknames such as “sweetie” or “honey”, endearing. However, when seniors are annoyed or hurt by certain utterances they can be encouraged to speak out, for example, to say, “You don’t need to yell, I have a hearing aid” or “My name is Lori, can you call me that?” By using calm, clear wording, seniors can advocate for themselves and challenge the inaccurate perceptions of others.

David York Agency provides exceptional in-home care for seniors. If you have further questions about ageism, please contact us.

For more information about David York Agency’s qualified, compassionate caregivers, contact us at 718.376.7755. A free phone consultation can help you decide what services might be best to provide you and your loved one with the assistance they need. If you’d like to hear more from us, please like us on Facebook or follow us on TwitterGoogle+, or LinkedIn.

Exercise Can Delay Dementia

What is Dementia?

Dementia is a type of cognitive decline characterized by memory loss, communication difficulties, and impaired thinking. Dementia is a growing concern for aging populations. According to the World Health Organization (WHO), 47 million people have dementia worldwide. WHO also estimates 75 million people will be affected by dementia by 2030. According to the Alzheimer’s Association, an estimated 60 to 80 percent of patients suffering from dementia also have Alzheimer’s disease.

Dementia is not a normal part of the aging process, and signals damage to the brain. Doctors have long advocated a healthy lifestyle to reduce the risk of dementia. A new study finds that exercise may also play a vital role in helping to delay dementia.

Group Of Seniors Enjoying Dancing Club Together

 

Study Results

Results of this ground-breaking study were published in the September 2017 issue of Scientific Reports. The study found that mice who ran on a wheel for one week had more new neurons in their brains than those of mice who did not run. Neurons are brain cells that transmit information to other parts of the body and provide direction.

Since dementia patients have damaged neurons, the creation of healthy neurons through exercise is a fantastic find. Researchers surmise that exercise can help change brain cells in humans, protecting them from the onset of dementia as well as ensuring a higher quality of life.

 

Exercising to Delay Dementia

Though the study focused on running, there are many other ways for seniors to stay active and keep their brains healthy. Here are four types of exercise to help seniors stay mentally and physically active:

  • Aerobic exercise, or cardio, gets the heart pumping. Some examples of easy aerobic exercises for seniors include jogging, brisk walking, or dancing. Chair-based aerobic programs are also available.
  • Flexibility exercises help seniors maintain good posture and normal a range of movement. Examples of flexibility exercises include stretching and yoga.
  • Strength exercises benefit seniors’ muscles and bones. Examples of strength exercises for seniors include lifting light weights or using resistance bands.
  • Balance exercises can help seniors stay steady on their feet and prevent falls. Tai chi as well as yoga are a popular balance exercises among seniors.

When starting any exercise routine, it’s important for seniors to start out slowly and listen to their bodies. Seniors with medical conditions should also consult a doctor before beginning any type of exercise regimen. Be sure to find trainers that are specially trained to work with the elderly.

Have your trainer lay out a safe exercise plan and have it approved by your healthcare practitioners. David York Agency has a handy workbook that can help.

Exercise is an important part of a healthy lifestyle and it can help seniors maintain a healthy body and a healthy mind.

 

For more information about David York Agency’s qualified, compassionate caregivers, contact us at 718.376.7755. A free phone consultation can help you decide what services might be best to provide your loved one with the care and assistance they need. If you’d like to hear more from us, please like us on Facebook or follow us on TwitterGoogle+, or LinkedIn.

Senior Care: Art, Creativity & Dementia

art therapy

Dementia affects millions of Americans each year, but doctors have yet to find a way to prevent the onset of this disease. However, studies have shown that the use of art and creativity often provide solace to seniors and caregivers alike. Maybe it’s time to consider art therapy. 

Art Therapy

Art therapy benefits seniors tremendously. Creative activities, such as painting, craft making, or collaging, provide a positive creative outlet to seniors living with dementia. They often recall pleasant memories from their past and feel joy in those moments. And, since loneliness and depression are common emotions for seniors both with and without dementia, the joy derived from a creative endeavor can be a powerful force for positivity in their lives.

Collaging

One of the best artistic activities for seniors is collage-making. Collages often expose parts of someone’s world and their perspective. Magazines contain images that can evoke emotions and memories. When one chooses an image to use in a collage, it reflects inner machinations of his or her world, inside and out. Consciously or unconsciously, seniors create more than a collage. They create both a window to their world – past, present and future – and a safe haven for themselves.

Naturally, assistance will be necessary for this activity. Seniors may have difficulty using supplies such as glue and scissors. But materials that stimulate sight and touch prove therapeutically beneficial to participants, so it is worth it to help with this activity.

It is highly recommended that caregivers be part of the creative process with their loved ones. It proves rewarding for everybody involved. When you create art with the special person in your life who has dementia, you not only help them create something new, you give them a way to connect to their past. When that happens, you can be on the spot to catch a glimpse. This will help you build a stronger bond with them and memories of your own for years to come.

Getting Help

At David York Agency, we understand the fears and challenges that dementia can bring, not just for the person diagnosed, but for everyone in their life. We provide families with the support and care they need during this particularly difficult time.

For more information about David York Agency’s qualified, compassionate caregivers, contact us at 718.376.7755. A free consultation can help you decide what services might be best to provide you and your loved one with the assistance they need.

If you’d like to hear more from us, please like us on Facebook or follow us on Twitter, Google+, or LinkedIn.

Understanding a Lewy Body Dementia Diagnosis

lewy-body-dementia

Lewy Body Dementia (LBD) affects 1.4 million people in the United States and is the second leading cause of dementia, according to the Lewy Body Dementia Association. LBD is a combination of two distinct diagnoses, Parkinson’s disease dementia and dementia with Lewy bodies.

Lewy bodies are clumps of abnormal proteins in the outer layer of the brain, the cerebral cortex and are associated with both forms of dementia. When dementia develops after the established motor disorder, it is called Parkinson’s disease with dementia (PDD). When dementia occurs at the same time as the motor disorder, it is called dementia with Lewy bodies (DLB). They are both on the continuum of the same disease. These two conditions can cause the same underlying biological changes in the brain. In the later stages, the two diagnoses exhibit similar behavioral, cognitive, physical, and sleep symptoms. Sufferers also frequently experience hallucinations and bouts of ongoing depression.

Getting the Right Diagnosis

Despite being widespread, health care professionals frequently underdiagnose and misdiagnose LBD. It can resemble other causes of dementia such as Alzheimer’s disease. James E. Galvin, MD at Florida Atlantic University has developed a way to assess and diagnose LBD. The Lewy Body Composite Risk Score (LBCRS) is the system they developed.

The LBCRS system of diagnosis is based on a rating scale. The assessment is one page long and features six questions that quickly outline whether the patient suffers from six non-motor symptoms that are distinct to LBD, but not other forms of dementia. By asking a few questions, the physician can quickly determine if the person suffers from the disease. Tell-tale signs are rest tremors, rigidity, bradykinesia, or postural instability.

Getting the Help You Need

A clear diagnosis of LBD is imperative. This way, patients will avoid being misdiagnosed and, therefore, misprescribed. In fact, taking the wrong medication could possibly have serious adverse consequences and will not help to treat LBD.

A definitive and prompt diagnosis of LBD gives physicians the chance to quickly begin medical therapies that may help or improve the quality of life for the LBD sufferer. Usually, professionals use a combination of the Lewy Body Composite Risk Score System, PET scans, CSF biomarkers, high-density EEG, and MRI tests to arrive at a clear diagnosis of LBD.

Facing a Lewy Body Dementia diagnosis can be frightening for both the patient and their loved ones. If you need extra help caring for a loved one who suffers from LBD, our in-home health care services can help. We are available to offer you additional support on either a full or part time basis.

For more information about David York Agency’s qualified, compassionate caregivers, contact us at 718.376.7755. A free consultation can help you decide what services might be best. Our aim is to provide you and your loved one with the assistance they need.

If you’d like to hear more from us, please like us on Facebook or follow us on Twitter, Google+, or LinkedIn. For more information on discharge planning, contact us.

A Toolkit for Promoting Positive Behavior in Dementia Patients

Toolkit for dealing with dementia

High Risk of Institutionalization

About 5 million Americans have Alzheimer’s Disease and 90% of those are abusive.  This is important because this situation puts these patients at higher risk for institutionalization, greater functional decline, and domestic abuse.  Up to this point, the preferred method for managing the Behavioral and Psychological Symptoms of Dementia (BPSD) has been to prescribe medication to control it.  However, this adds to the already hefty arsenal of drugs currently taken by most senior citizens. Obviously, we should not enter into this lightly since they are often accompanied by significant and dangerous side effects.  Clearly, we need better mechanisms for handling these dementia patients.

Toolkit with Best Practices

An article in January/February 2014 issue of Geriatric Nursing entitled “Promoting Positive Behavioral Health:  A Non-Pharmacological Toolkit for Senior Living Communities” unearths a great find:  a toolkit which was peer reviewed and endorsed by experts and designed to centralize the most up to date best practices for handling these challenging situations.  A team of clinicians assembled data on how to deal with BPSD. They went beyond the parameters of the antipsychotic medications normally prescribed.

The goal is for these methods to be the first course of action in treating dementia.  The toolkit can be accessed at http://www.nursinghometoolkit.com/ and you can navigate through the tabs on top and get to an area of interest.  Searching through the site will yield a plethora of information including non-pharmacological approaches to dealing with dementia.

A helpful graph of approaches can be found in a document entitled “Review of Non-pharmacological Approaches for Treating Behavioral and Psychological Symptoms of Dementia“.

Additional Approaches

This effort meshes with a program which began in March 2012 by the Centers for Medicare and Medicaid Services (CMS), the “Initiative to Improve Behavioral Health and Reduce Antipsychotic Use in Nursing Homes” where it partnered with associations such as the American Medical Directors Association (AMDA)  for a comprehensive approach for limiting the use of dementia controlling medications in this population as part of their overall “Partnership to Improve Dementia Care in Nursing Homes”. Please click on these links to explore their work.

As with everything, we need to be advocates for our loved ones. Take time to investigate the latest best practices for dementia patients. This can yield a better quality of life for both the dementia patients. Consequently, those around them will benefit as well. We owe it to our seniors and their loved ones/caregivers to explore any adjunct or replacement treatments. As always, the end goal is to alleviate the often devastating symptoms of Alzheimer’s and dementia.  This handy tool is worth a look.

David York Agency

Every nurse and administrator on our team reflects our agency’s 33 years of experienced care. For more information about David York Agency’s qualified, compassionate caregivers, please contact us at 718.376.7755. If you’d like to hear more from us, please like us on Facebook or follow us on TwitterGoogle+, or LinkedIn.

Recognizing the Signs of Dementia & Alzheimer’s Disease

It is important to recognize the signs of dementia and Alzheimer’s disease as early as possible. It affords family members plenty of time for planning, ensures that a safe living arrangement is set in place and enables the elderly to take advantage of all current and cutting edge treatments available. Unfortunately, both the elderly and their loved ones are ignorant of the signs and can be in a state of denial.

It’s easy to try to deny signs of dementia in oneself and a loved one. It is terrifying for the former and painful for the latter. Often denials sound like this:

  1. Getting confused is just part of getting older.
  2. The irrationality is just part of a mid-life crisis.
  3. Stress and sleep deprivation is causing the forgetfulness.
  4. Everyone forgets things.
  5. Depression is causing the lack of focus.

Then again, you could be experiencing early signs of dementia and/or Alzheimer’s disease. The Alzheimer’s Association is a great resource and has compiled the following list:

10 Early Signs and Symptoms of Alzheimer’s

  1. Memory loss that disrupts daily life.
  2. Challenges in planning or solving problems.
  3. Difficulty completing familiar tasks at home, at work or at leisure
  4. Confusion with time or place.
  5. Trouble understanding visual images and spatial relationships.
  6. New problems with words in speaking or writing.
  7. Misplacing things and losing the ability to retrace steps.
  8. Decreased or poor judgment.
  9. Withdrawal from work or social activities.
  10. Changes in mood and personality.

If you have a suspicion that the forgetfulness is something more serious, it is time to go see a doctor. The best to find out if any of these signs and symptoms is indicative of dementia or Alzheimer’s disease is to get a complete medical evaluation.

Receiving a diagnosis of dementia or Alzheimer’s disease is naturally extremely stressful to all concerned. Anticipating and planning for the eventual outcome of the disease is not easy, but David York Home Healthcare Agency can help. When home healthcare becomes necessary, David York Agency provides skilled home health aide services for the elderly and infirm in their home. A nurse is always standing by and would be happy to discuss your case with you. Please call us at (718) 376-7755 or visit our website. Please like us on Facebook or follow us on Twitter, Google+ or LinkedIn.

 

Senior Social Media Training for Senior Health

A new study out of England and Italy finds that when the elderly are trained in the use of social media as well as Skype and email, they perform better cognitively and experience improved health.

During a two year period, 120 seniors in the UK and Italy aged 65 and above were given specially designed computer training and were compared against a control group that did not received any. Among those that used these tools, the mental and physical capacity improved as opposed to a steady decline experienced in the control group.

Hypotheses asThinkstockPhotos-453532787 to why this occurred include: “Human beings are social animals,” as stated by Thomas Morton who led the study out of the University of Exeter’s psychology department. It is amazing how satisfying our basic social needs can have synergistic effects for our overall health. One woman reported feeling “invigorated” rather than “slipping into a slower pace” and caring more about her appearance and losing weight. Three quarters of the test group with computer training found email and Skype useful, but fewer than half liked Facebook as much.

The Office for National Statistics in the UK reports that the elderly over 65 have increased their internet use from 9% in 2006 to an astounding 37% in 2013. With the elderly population in Europe set to grow from 17% to 30% by 2060, marrying their well being with this ever growing usage of technology can have dramatic effects on their quality of life.

Those in the eldercare field feel that the computer, and even the use of that word, could be a barrier to entry for many of the elderly. Shifting the focus of technology adoption from the computers to tablets might be more effective since tablets tend to be more user-friendly.

Being that a major problem of the elderly is a devastating feeling of loneliness and isolation, encouraging new technology adoption as an avenue for its alleviation is a winning solution. Keeping in touch with old friends and relatives as well as keeping current with the events of the day could help the elderly remain feeling vital. The counter intuitive marriage of the elderly with technology might be the perfect antidote to what ails them.

David York Home Healthcare Agency is very sensitive to the potential of feeling isolated and makes every effort to send caring and compassionate home health aides into the client’s home. David York Home Agency (DYA) is well versed in the problems of the elderly and all factors related to eldercare services. DYA provides certified home health aide services for the elderly in their home and is abreast of all the latest guidelines and trends for seniors.  We would be happy to discuss your case with you.  Please call for a free consultation today at (718) 376-7755 or visit our website.  You can also follow us on FacebookTwitter, or LinkedIn.

 

Is It Hypoglycemia or Dementia?

With diabetes on the rise in the U.S. and its accompanying concern regarding hyperglycemia (high blood sugar), hypoglycemia (low blood sugar) seems to be given short shrift. In an article entitled “Hypoglycemia Rising in Older People With Diabetes”, the New York Times gives it some of the attention it deserves.

177008288Hypoglycemia is a serious condition especially in older segments of the population 75 and older. Impaired kidney function and adverse reactions from drugs prescribed along side their diabetic medication are two of several things that make hypoglycemia much more of a concern for seniors. Hypoglycemia can cause a host of symptoms such as intermittent dementia, shakiness, sweats, dizziness, overall weakness, blurry vision and intense hunger.

Senior caregivers must be attuned to these symptoms of hypoglycemia before it causes a misdiagnosis of dementia or, worse, results in a loss of consciousness or even death.

It is something that we can no longer ignore. According to studies published in JAMA Internal Medicine, hospital admissions for this condition jumped 11.7% between the years 1999 and 2011 for hypoglycemia while they decreased by 38.6% for hyperglycemia. One study remarked, “Hospital admissions rates for hypoglycemia now exceed those for hyperglycemia.” In fact, hypoglycemia was the third most common complication for the 70 and over population segment.

David York Agency is skilled at recognizing the symptoms of various diseases endemic to the elderly. We provide skilled home health aide services for home healthcare and could assist you in mapping out and managing the total care of your senior loved one. Please call us at (718) 376-7755 or visit us on our website www.davidyorkagency.com to become acquainted with all we offer. Please like us on Facebook or follow us on Twitter or LinkedIn.

MediSafe Project: Never Forget to take Medications

Managing medication compliance keeps getting easier. At David York Agency, we are excited about the MediSafe Project, one of the latest technological innovations to help ensure that you and your loved ones never skip or take the wrong dose of a prescribed medication or supplement. MediSafe is a user friendly app that you can download for free at their website and use to set alerts to remind you to take your various medications or supplements. This new award winning mobile pillbox technology is also a way for supportive families, friends and caregivers to identify when patients have taken medication and be alerted when they did not.

mediSafeFor those who don’t have smartphones, caregivers and relatives can download the app and track the medication compliance for the patient. Also, beginning in 2015, the system will become accessible to people without smartphones via an automated phone system and text messaging. Patients will be able to record medication doses via touchtone and caretakers will be able to receive alerts via incoming, automated calls.

Medication non-adherence is a pervasive and costly problem in terms of time, money and health. This problem tremendously impacts health outcomes and even causes fatalities. Whether they are elderly, diabetic, or suffering from another illness, adherence is critical to patient health. In fact, the National Community Pharmacists Association estimates that it adds $290 billion to healthcare spending annually.

In the elderly, impediments to adherence include dementia and lack of adequate support from caregivers. Though a child, spouse, or senior caregiver is usually taking some level of responsibility for their daily routine, it’s hard for everyone to remember every medication on time.

MediSafe’s mission is to solve the problem of medication non-adherence and increase the power of family & friends to achieve positive, healthy outcomes for each other on a daily basis by delivering personalized medication reminder notifications specific to each patient & medication. It tells you when it’s time to take a medication; then you enter that you have taken it so the software can record that for you. It is the first-of-its-kind cloud-synced mobile medication database management system with an iOS and Android mobile app. Here is a quick video to show you how it works.

David York Agency is expert at the care and management of various diseases endemic to the elderly. Our home health aides are fully aware of the problem of missed medication doses and most of them have smartphones that could be utilized for MediSafe if the family desires.

David York Home Healthcare Agency provides skilled home health aide services for home healthcare and could assist you in mapping out and managing the total care of your senior loved one. Please call us at (718) 376-7755 or visit us on our website  www.davidyorkagency.com to become acquainted with all we offer.
Please like us on  Facebook or follow us on Twitter or LinkedIn.

 

Signs of Normal Memory Loss

They’re quips we hear often enough—when a companion forgets a well-known name, for instance, or when you’ve forgotten where you left your keys: “I’m having a senior moment,” or, “My Alzheimer’s is setting in!” The lapse in memory in itself may be disquieting—no one likes to forget things, after all—but while jests of this nature can be rooted in truth, memory loss ranges from what’s perfectly normal to an underlying condition that may indicate a more serious concern.

normal memory lossOver the past several years, scientists have come to more fully understand which types of memory loss are normal and which may be a warning bell. Age plays a normal role in contributing to memory loss.  As we age, the body changes, including the composition of the brain. We know that children learn at an incredibly fast rate; conversely, adults learn more slowly and do not remember information as well, and the elderly are often prone to mild forgetfulness which does not necessarily indicate serious memory problems.

According to the National Institutes of Health (NIH), older adults may find they don't do as well as younger people on complex memory or learning tests. Given enough time, however, studies show that healthy older people can do as well as younger people do on these tests. In fact, as they age, healthy adults usually improve in areas of mental ability such as vocabulary.

Memory problems may be related to treatable health issues. Chronic alcoholism, thyroid, kidney, or liver disorders, tumors, infections, or blood clots in the brain may cause memory loss or dementia. Additionally, side effects from medication can be a cause, as can certain vitamin deficiencies. Emotional problems like stress, anxiety, or depression, can leave a person feeling distracted, making them appear more forgetful. This confusion and forgetfulness caused by emotions is usually temporary.

For some older people, memory problems are a sign of a more serious problem, such as amnestic mild cognitive impairment (MCI), dementia, Alzheimer’s disease, or vascular dementia. For those whose memory loss seems excessive, it’s important to consult a doctor, as conducting a thorough health evaluation—including review of medical history, prescription and over-the-counter medicines, diet, past medical problems, and general health—is necessary to getting to the root of the problem.

When memory problems make daily living too challenging or unsafe, David York Agency can assist you with senior care planning.  Contact us at 718-376-7755, or visit us online at davidyorkhomehealthcare.com. Please like us on Facebook or follow us on Twitter or LinkedIn.