Simple Tips for Healthy Dementia Care

Healthy Dementia Care Strategies

Dementia is a difficult condition to live with, but it also affects caregivers. Caring for patients with dementia leaves many caregivers overwhelmed and exhausted. Hard to understand and often invisible to the eye, dementia makes it hard to determine whether care is effective. But, if you practice healthy dementia care, you can reduce or overcome the intrinsic challenges and provide necessary care to the patient.

Senior woman with her home caregiver. Healthy Dementia Care concept

Use Smart Communication

Communicating with dementia patients requires simple, straightforward methods. Use easy-to-understand words and suggestions, and don’t overload your loved one with a string of questions or commands. Give them time to process your words so they don’t become overwhelmed or agitated. Simple yes or no questions or one-step directions are far more helpful than complex queries or multiple-step demands.

 

Play Music

Music has a profound effect on many people with dementia, particularly if that music is familiar. Music can soothe agitation, improve mood, and reduce stress. Even people with advanced Alzheimer’s have responded to music therapy when nothing else has worked, indicating that musical memories outlast other kinds of memories.

 

Practice Self-Care

Although people with dementia are not deliberately trying to test your patience, they often end up doing so. Caring for a person with dementia requires patience, compassion, and energy. Therefore, those who care for people with dementia must take the time and effort to preserve their own health.

It’s easy to let regular exercise and proper nutrition slide, but maintaining these habits is vital. The healthier the caregiver, the healthier the patient. People with dementia need a reliable, healthy person to depend on, so don’t forget to take care of yourself.

 

Understand Aggression

Dementia can often drive sufferers to respond aggressively. Unfortunately, this aggression is often directed at those who are trying to help. In these moments, it’s important not to take the person’s anger personally. Remember, though you can’t see it, the patient is in pain. Aggression is often a result of physical discomfort, confusion, poor communication, time of day, and environmental factors.

Never respond in kind and do not ignore the aggressive behavior. Instead, try to determine the cause of the aggression. Is the person in physical discomfort? Does the aggression always happen at a certain time of day or within a certain environment? If so, is there a way to relieve pain and discomfort, alter the environment, or plan ahead by scheduling naps or eating patterns to reduce sundowning?

 

Get Help from Professional Caregivers

Caring for a person with dementia is challenging, but it does not need to be overwhelming. Keeping a few of the above tips in mind can help you face the task with confidence and help you provide the support, and the quality care your loved one needs. If you find you still have questions or would prefer to work with a professional caregiver, David York Agency is here to help.

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. We aim 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.

Ride-Sharing For Seniors: Motivator For Technology Adoption

One of the sad facts of aging is that people lose the ability to safely operate a motor vehicle. This is largely due to deteriorating vision along with other health-related issues. Telling an aging loved one that he or she can no longer drive can be painful for all concerned (see our previous post Don’t Take Away My Car Keys, Yet!). Though it is a matter of safety it is also a matter of freedom. But ride-sharing for seniors offers freedom and safety at the touch of a button.

An elderly woman is smiling as she enters through the front passenger door of a car. Uber ride-sharing for seniors concept

Ride-Sharing For Seniors

The loss of mobility has been an unavoidable part of aging since the dawn of the automobile. Until recently, many elderly people depended on rides from friends, relatives 0r other community organizations (see our previous post No More Car for Dad or Mom, Now What?). However, technology is changing this old expectation. Ride-sharing services are now available in many communities, offering a cheap, easy, and reliable option for local travel. Offered by companies such as Uber and Lyft, ride-sharing is a convenient way for seniors to get around.

Ride-sharing for seniors ensures that your loved ones are not completely homebound or dependent upon others for rides. This option can also help lessen the blow of having to take away your loved one’s car keys. Thanks to ride-sharing services, the elderly no longer have to endure the loss of mobility that comes with age.

 

Teaching the Technology

Teaching your loved ones to use ride-sharing apps may be a necessary step to ensure their independence. Luckily, these applications they are simple enough for anyone to pick up with a few lessons. Also, they have the added benefit of concretely introducing technology to seniors and act as motivators for their adoption. Both libraries and senior centers offer technology classes to seniors, providing an excellent resource in this area. Additionally, home healthcare workers can help guide seniors through the ins and outs of the technology. With a little time and patience, you can get your elderly parent on the road in safety.

 

David York Can Help

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.

Eldercare Planning: Your Parents & Home Healthcare

Many adult children start to worry about their aging parents. They see them struggling as they get on in years and believe they would be better off with help. Eldercare planning is a difficult subject to broach (especially with seniors who are resistant to such discussions see our post on the subject), but it’s also a necessary conversation for seniors who are experiencing a decline in health or finding it hard to care for themselves.

 

Eldercare Planning for Parents

Approaching Eldercare Planning with Your Parents

Conversations about diminished capacity can be very difficult to have with your parents. They may get offended that you are worried about them and they may have no interest in hearing your viewpoint. It can be frustrating for you to make your concerns clear. However, it doesn’t have to be that way!

Here are some tips to help you through this discussion.

  • Choose the right time. Don’t think that you are going to talk to your parents when you both have five minutes. This conversation cannot be rushed. Instead, find some time that you are all free to sit down and talk.
  • If possible, include all of the children. It can be helpful if all of the children are on the same page. Otherwise, it might look like you are ganging up on your parents.
  • Be prepared with the options. It is important that you are ready to have the talk. Write down the different options that are available to your parents. Prepare a list of pros and cons, as well as the costs associated with each of them.
  • If it gets heated, take a break. The conversation may get heated, and it may be better to take a break before things get said that can’t be taken back. Leave the list of options, pros, and cons, and plan on coming back in a day or two (after your parents have had time to think).

Difficult Now, Helpful When Necessary

Talking to your aging parents about getting help can be quite difficult. However, if you find the right time and come prepared, it is more likely to go well. If not, take a break and revisit the issue once everyone has settled down. David York Agency has a Checklist and Workbook to help guide you through the discussion. Please check them out on our website.

Remember, though this discussion is difficult now, it could lead to a better future for your parents. Decide on small changes that can be implemented now and others that will be helpful down the road.

 

If eldercare planning is a concern for you and your loved ones, please consider the David York Agency. Our qualified, compassionate caregivers are ready to help. Contact us online or by phone at 718.376.7755. A free phone consultation can help you decide how to provide your loved ones 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.

Managing Long-Distance Caregiving

If you live an hour or more away from a parent or relative who relies on you for some form of care, you are considered a long-distance caregiver. Managing long-distance caregiving is no easy task.  It is stressful and time-consuming and difficult to accomplish without additional help. Being far from your loved one when they need assistance can be draining and, as this role-reversal presents itself, you are thrust into a realm of new responsibilities.

There is no one right method to approach your new role. Every situation is different. But the task of managing long-distance caregiving doesn’t have to be daunting with these helpful tips.

managing long-distance caregiving

How will I know help is needed?

Regrettably, if your parents need care, they probably won’t tell you when they need help. The last thing they want is to become a burden to their children. Typically, a person will experience a health crisis or a “wake-up call,” triggering the awareness that they need assistance. Barring a sudden health event, difficulties and changes in performing ADLs (activities of daily living) will be a telltale sign that help is needed. Routine ADLs include:

  • Bathing and showering
  • Personal hygiene and grooming
  • Dressing
  • Toileting
  • Transferring (for example, moving from a chair to the bed)
  • Self-feeding

 

What is my role?

As a long-distance caregiver, you will play the role of information gatherer as well as coordinator of assistance.

As the information gatherer, you can use websites and other resources to locate local community services that specialize in care for older persons or the disabled. You will also gather relevant data pertaining to your loved one. This information will be your go-to resource in the event of an emergency. David York Agency provides an excellent resource in the form of our Essential Documents and Emergency Information Workbook.

As the coordinator of assistance, you will make arrangements for care as well as set appointments. Consult with your loved one to determine their needs in the following areas:

  • Meal delivery
  • In-home care
  • Medical devices
  • Transportation
  • Help with Medicare/Medicaid claims
  • Support groups
  • Telephone check-ins
  • Financial Assistance

 

Additionally, David York Agency publishes a handy Essential Documents and Emergency Information Checklist to make your new role more manageable. This checklist provides a place to record pertinent information that will help you determine what your loved one can and can’t do. The AARP also offers a Caregiver’s Checklist that may be of use as well.

 

Evolving Care

It is never too early to start thinking about the future needs of your loved ones and how you will handle the evolving nature of your caregiving journey. Once you have completed the caregiver’s checklist and determined the wishes and needs of your loved ones, it will be time to speak to professionals in the caregiving industry. Check references and do whatever you can to make things as straightforward as possible for the caregiver. In-home caregivers help with a variety of household and personal tasks and will be in a good position to update you on day-to-day progress.

Remember that you are not alone.  An estimated 43.5 million Americans provide care, advocacy, and healthcare navigation for a relative or friend 50+ years or older.

 

For more information about David York Agency‘s qualified, compassionate caregivers, contact us online or by phone at 718.376.7755. A free phone consultation can help you decide how to provide your loved ones 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.

Determine What Type of In-Home Healthcare is Right for You

Determine What Type of In-Home Healthcare is Right for YouIf you are responsible for caring for an elderly loved one, you probably could use some help to lighten the load. But without experience in the medical industry, it’s hard to know what level of caregiver you need? In-home healthcare needs can be easily met with a little bit of research and the help of an experienced homecare professional.

Here is an easy-to-understand summary in-home healthcare roles that will help you determine your needs.

  1. A Personal Care Aide (PCA)

    provides general support but does not address any medical needs. They often assist with daily chores, bathing, preparing meals, cleaning, or just being a companion to someone who needs a friendly face to come visit on a regular basis.

  2. A Home Health Aide (HHA)

    is the next level up, and can do all of the above, and more. They take care of extra tasks like checking vital signs, or changing medical dressings. Home Health Aides have training and certification.

  3. A Licensed Practical Nurse (LPN)

    has a higher level of education and provides basic medical and nursing care. They check blood pressure as well as insert catheters. An LPN also ensures the comfort of patients by assisting them to bathe or dress. They discuss health care issues, and report the status of patients to registered nurses and doctors.

  4. A Registered Nurse (RN)

    is the highest level of medical professionals typically available for home care.  They usually oversee the treatment plan and administration of medication. An RN can keep an eye on medical test results and handle most of the higher-level medical needs of a patient.

While the terms can be confusing, an experienced agency can work with you to determine your needs. With a consultation, an expert in patient services can ask questions and get to know your situation so the right recommendation is made for both the patient and the family members in need of support. Questions such as procedures, fees, and insurance payments are also covered during this initial discussion.

If you have a loved one in the New York City area who is in need of in-home nursing care, contact us. We can help determine the best course of action and provide any of the above support staff to help your loved one age in place.

 

Ageism in Medicine: Lack of Geriatric Specialists Creates Medical Ageism

The number of geriatric medical health caregivers is not keeping pace with the increasing number of older Americans. In addition, there is a lack of adequate training in the field of geriatric medicine as well as an insufficient amount of hands-on clinical experience. While physicians may have experience dealing with senior patients in their practice, they don’t have the same broad base of knowledge specific to the elderly as physicians who specialize in geriatric medicine. Unfortunately, this all adds up to a lack of geriatric specialists and ageism in senior medicine.

 

Lack of geriatric specialists

Focusing on Geriatric Problems

According to the AARP, specialists in fields such as oncology, urology, and neurology focus on these specific fields, but neglect to study the particulars of accumulated diseases in the elderly. Seniors accumulate medical issues over a lifetime, and these problems require a different medical approach. Geriatric healthcare professionals also understand the necessity of high-level compassion and communication when handling older patients. As it stands, doctors often discuss their senior patients’ prognosis or treatment with family members, bypassing the patient altogether. This creates a feeling of invisibility and lack of respect.

Geriatric Specializations: The Facts

Research conducted by the National Center for Biotechnology Information (NCBI) shows that most existing medical training does not cover the scope of the special needs and diverse conditions of older patients. In addition, medical students are not choosing geriatrics as a specialty. The following data demonstrates this problem:

  • fewer than 8,000 physicians are certified in geriatrics
  • less than 1 percent of pharmacists have geriatric certification
  • less than 1 percent of registered nurses specialize in geriatrics
  • fewer than 2,000 doctors specialize in geriatric psychiatry

Changing the System

Geriatric specializations need to be taken more seriously. First, there need to be more programs that offer this specialty. Next, – what with the rising population of elderly patients –  it should be made a more established path into medicine. We must see geriatric focus in healthcare programs for primary care doctors and offered as a specialty by more educational facilities. Above all, medical institutions should make geriatric medicine more attractive to those choosing a specialty.

Seniors benefit in many ways from seeing geriatric specialists; not only is their overall healthcare and quality of life better, but they are hospitalized less often and can lead more independent lives. This, in turn, lowers overall medical costs and creates a healthier generation of Americans. Ageism in medicine is an unfortunate reality. However, the right information can lead to improvement.

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When you need home healthcare for a senior in your family, contact us. Our licensed practical nurses (LPN), registered nurses (RN), certified personal care aides (PCA) and certified home health aides (HHA) are ready to help. We employ professionals trained in the care and needs of geriatric patients. Let us can help your loved one live a more independent, fulfilled life.

5 Qualities That Separate the “Best from the Rest” in the Eldercare Service Industry

 

qualities eldercare industryCaregivers who consistently go above and beyond the call of duty possess the traits that most people might expect. They demonstrate patience, compassion, and responsibility on a daily basis. However, they also possess five lesser-known caregiver qualities that are instrumental to their success in eldercare. These qualities include stamina, vibrancy, tolerance, strength, and composure.

Stamina: The Key to Enduring Support

Providing eldercare service requires a person to be supportive every minute of the day. Being in constant support mode is physically and emotionally draining. The most skilled caregivers possess a high degree of stamina.

Vibrancy: Inspiring Happiness and Optimism in Others

Effective caregivers exhibit vibrancy throughout each day. They display energy, passion and excitement even when they are in the midst of a bleak situation. By exhibiting vibrancy, caregivers can inspire senior citizens to find happiness and optimism in their own lives.

Tolerance: Combining Patience and Empathy on a Daily Basis

The most effective caregivers have higher-than-average tolerance levels for just about everything that comes their way. From their ability to look past a childish remark to their efforts to try to understand how the people for whom they are caring may feel, the best caregivers will react only after assessing the full situation, and generally will let many things roll of their shoulders.

Strength: An Illustration of Physical and Mental Fortitude

Sometimes it is easier to maintain physical strength than it is to display mental fortitude. The best caregivers display both physical and mental strength on the job. They are just as adept at handling an emotionally draining situation as they are helping to lift a person for whom they are caring.

Composure: Helping to Instill Serenity in Senior Citizens

When people enter the later chapters of their lives, they are often comforted by serenity. When caregivers effectively maintain their composure in the face of a difficult situation, they help instill a sense of serenity in the senior citizens for whom they care.

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.

 

 

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.

Eldercare Conversation With A Resistant Senior by Anita Kamiel, R.N., M.P.S.

couple having serious talking in home interior

Awkward Discussion

We talk a lot about how important it is to have those serious end-of-life discussions with your elderly loved ones as they enter their golden years. It’s so important to hash out their preferences for care while they are still fully cognizant, before any decline in mental capacity. We also know that under the best of circumstances this can be awkward and, when emotions kick in, even painful to the family to face these issues head-on.

Lack of Cooperation

All this can feel downright impossible if the senior is not cooperative. This intractability can be the result of their age accompanied by lessened patience, a personality shift due to an underlying disease condition, or it may just be an extension of a lifelong contrariness.

While we usually dismiss their resistance as “a phase,” we must understand that the elderly have much to lose. Their diminished physical capacity leaves them vulnerable to many losses, especially the loss of their independence as the captains of their fate. They fear these conversations may mean yielding their housing, financial, and day-to-day decisions to third parties they don’t necessarily fully trust or respect. Understandably, they don’t want to deal with that. This is only exacerbated when relationships with potential caregivers have been rocky in the past.

How to Start

So, how do we get the critical conversation going? How do we get recalcitrant seniors to engage? Each case is unique. I don’t pretend that my suggestions will work in every case. These are just pointers I have picked up from years of studying and dealing with the elderly.

First and foremost, I always find it best to approach the elderly with the respect they deserve. They need to know their opinions matter the most here. You must make it perfectly clear that they have a voice and your desire is to comply with their wishes. I cannot stress how crucial real and deep listening is in this situation.

Threats and scare tactics are unduly harsh and totally counterproductive. See your role as one of facilitator with agenda questions. You should be hearing their voice much more than your own.

Ask how they would like you to handle any hospital stay and follow-up care. What kind of insurance do they have in place to cover all this? The David York Agency website has an excellent checklist on our resources page that can be used as a guide for end-of-life planning.

Gently broach the subject of what they would like you to do if they are suddenly ill. I would back away immediately if there is any resistance. It may take a few tries to get through this conversation, but that is OK. These get them to start thinking. The failed attempts are warmups to the successful one.

Perhaps A Family Meeting

In certain cases, you might want or need a family meeting with the senior included. On the other hand, you may not want to make a “federal case” out of the whole thing by calling a potentially intimidating meeting. If you call a meeting, make sure not to muddy the process by holding it during a holiday. Holiday time doesn’t lend itself to the focus required to get this task done and may just end up ruining everyone’s celebration.

Perhaps a Facilitator

In some instances, a third-party facilitator such as a geriatric care manager or another geriatric professional might be quite useful. This is true whether you have solid family relationships or not. These neutral advisers help to keep fears and emotions in check, everyone on track, and the atmosphere non-threatening.

Trust Is Key

These conversations must be predicated on trust and there is no place for any ill will. Be fair and evenhanded. You will gain a lot more trust if you are honest about the pros and cons of every type of available care and residence option. People are much less likely to get defensive if they feel you are not trying to manipulate them.

It may take some time to build that trust—even months—which is why planning is so important here. However, I realize that in many situations time is of the essence, so if you missed out on this lead time, you can still make it up in the end game.

Emotional stroking can help a resistant senior be coaxed into engaging. Remind them how much you love them. Moreover, tell them how caring for them would be your pleasure as compensation for all they have done for you all these years.

Be Patient & Listen

You need to be patient. The world they mastered as they grew from scared child to adult can seem like a scary place again. Emphasize how you are not going to abandon them and will be there for them always.

Again—really listen! Repeat their wishes aloud for clarity and so they can confirm what you said. It will calm seniors to know you understand them. Also, it will build the bridge to ease subsequent conversations that may be necessary.

I suggest ending with a big group hug. It wipes away any mistakes made during the discussion—and even in years past. Let me know if I can help!

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Anita Kamiel, RN, MPS, is the founder and owner of David York Home Healthcare Agency, licensed by the State of New York. She holds a master’s degree in gerontological administration and is fully acquainted with all factors related to eldercare services and the latest guidelines for seniors. Thirty years ago, she realized the need for affordable, quality home health aide services provided and supervised by caring individuals. You can contact her at 718-376-7755 or at www.davidyorkagency.com. David York Agency is also on Facebook, Twitter, Google+, and LinkedIn.

5 Tips for Serving as a Caregiver for a Loved One

Caring for a loved one can be an emotionally challenging task. Not only is it often a 24/7 job, but it can be especially difficult to find a balance between providing and caring for your loved one and maintaining your own physical and emotional well-being.

21829794_sHere are five practical tips that will help you in your role as a caretaker.

  1. Keep records.

Keeping track of your loved one’s doctor visits, medications, symptoms, and eating habits will help you better manage their care. These records make consultations with healthcare providers more focused on getting the specific care your loved one needs and also give you a more holistic view of their medical history. Strong record keeping is especially essential if you share care responsibilities with another family member or professional caregiver.

  1. Educate yourself.

The best way to support your loved one is to understand their specific medical needs, including any chronic conditions or diseases, and the nature of their treatment. This will help you anticipate potential problems or side effects and prepare for unforeseen challenges in your role as a caregiver.

  1. Understand the insurance.

Know the limitations and allowances of your loved one’s health insurance. This will help you navigate difficult topics such as reimbursement, specialist co-pays, and respite care. By knowing what they are entitled to from their insurance provider, you can advocate for their best possible care.

  1. Plan ahead.

Talk with your loved one about his or her final wishes. Do they have a will or special instructions regarding their estate? Do they have specific wishes for their burial services? These are difficult conversations to have, but both you and your loved one will appreciate the peace of mind, knowing that plans for their future are in place.

  1. Take care of yourself.

Providing care for someone can have a substantial effect on your own personal well-being. If you’re finding that your quality of life is diminished as a result of your duties, consider enlisting the help of a certified home health aide or professional caregiver. This will allow you time to recharge, both physically and emotionally. You want to be there for your loved one, but in order to do that, you need to care for yourself as well.

We understand that taking care of a loved one is difficult. If you need additional support, please call David York Home Healthcare Agency today at (718) 376-7755. David York Agency has provided the highest quality care for the elderly and infirm for over 30 years. We would be happy to give you more information and discuss your case with you. To hear more from us, please like us on Facebook or follow us on Twitter, Google+ or LinkedIn. If you would like to learn more about how our certified home health aides can help provide you the additional support your loved one needs, contact us.