Managing Long-Distance Caregiving

Taking care of ill or elderly relatives is a complicated and stressful situation. That stress is compounded in the case of long-distance caregiving. As more and more adult children care for their elderly parents, this issue is becoming more common.

Health visitor with smartphone and a senior man during home visit. A female nurse or a doctor making a phone call. long-distance caregiving concept

According to a survey conducted by the MetLife Mature Market Institute and the National Alliance for Caregiving, long-distance caregivers experience negative impacts on their time, finances, and work schedules. Despite this, over half of these caregivers see their loved ones at least a few times a month, and over 75% help with basic services such as shopping, cooking, and transportation, spending 22 hours on these aspects of caregiving alone.

If you are managing long-distance care, here are a few things to keep in mind.

 

Recognize the Added Strain

Caregiving can cause major stress. Compounding this stress with the addition of travel, finances, and schedule increases the load for the long-distance caregiver. It is important to ensure that caregivers, as well as the patient, have the support they need.

In order to receive this support, the long-distance caregiver must acknowledge their added stress. Once the problem is recognized, steps can be taken to help relieve the pressure. Consider support groups, in person or online. These meetings can be an important source of comfort. Regular, healthy meals and exercise can also help reduce stress levels.

Remember: you can only care for others if you care for yourself first.

 

Gather Information

When medical emergencies arise, it’s important to have all the information you’ll need. Make copies of insurance documents and medical information, including medications and doctors’ orders and phone numbers. Keep these documents handy, so you don’t have to find them during stressful moments.

One important document to have is a durable medical power of attorney. This is particularly important if there are multiple siblings or you are taking care of an in-law. It is extremely important to clarify your right to make medical decisions if the patient is unable to do so.

DYA has handy publications for organizing you essential documents on our website.

 

Keep Communication Open

When possible, it’s a good idea to attend doctor’s appointments with the patient. They may not remember everything the doctor says or feel comfortable talking about the visit. If you can be there to hear the doctor’s orders and keep notes, it can help you see that the patient is getting what they need.

According to the Mayo Clinic, it’s important to keep lines of communication open. Some of the things they recommend are:

  • Speak with your loved one’s healthcare providers. A release signed by your loved one will allow their doctors to talk to you about their treatment. See if you can set up conference calls or log into their online medical records to stay fully informed.
  • Get support from friends. People who live nearby can check in on your loved one. Having a few people look in periodically can give you insight on how they are doing.
  • Consider hiring help. Someone to help with tasks such as meals and bathing can ease the burden on both of you.
  • Prepare for emergencies. Save time and money in case there is a crisis. Look into the Family and Medical Leave Act, which can provide you with unpaid time off with no threat to your job.

 

Maintain Your Relationship

Finally, remember to spend time visiting. It is easy to become overwhelmed by the tasks of caregiving and forget the relationship. Try to set time aside for sitting and talking, or doing an activity you enjoy together, such as taking a walk. The reason you are doing this monumental task is that you care so much about this person. Remembering that can ease the strain on both of you.

 

There are many difficult choices to make when taking care of a loved one. Living far away complicates those decisions. If David York Agency’s qualified, compassionate caregivers can help you in this process, please 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.

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.

 

Genetics + Environment ≠ Inevitable Health Profile

A new study gives insight into the role of exercise on overall health measures while controlling for genetics and childhood influences. A study out of Finland examined ten sets of identical twins for the effects of exercise on health and brain development while controlling for genetics and childhood influences. One twin was active physically and the other was sedentary.

AA052490Ten sets of identical twins from Finland, who grew up together, obviously sharing the same DNA, were examined. While their pasts were similar, their future exercise habits differed. While past studies of twins with respect to divergent exercise habits focused on their effects on aging, this study focused on factors that measured overall health: endurance capacity, body composition and insulin sensitivity. The sedentary twins exhibited lower endurance capacity, higher body fat percentages and signs of metabolic problems with respect to insulin resistance. The active twin had more grey matter than his sedentary counterpart especially in the areas having to do with motor control and coordination. Interestingly, the twins had similar diets. This led the research team to conclude “that the results strongly imply that the differences in the twins’ exercise habits caused the differences in their bodies.”

On the bright side, genetics and environment don’t equal inevitability. We can make significant changes with respect to exercise regimens that can dramatically impact our overall health and that of our brains.

David York Home Healthcare Agency is always on the lookout for tips on improving our overall health and alleviating the debilitating aspects of aging. However, when home healthcare becomes necessary, we provide certified home health aide services for the elderly. Please call us at (718) 376-7755 or visit us on our website www.davidyorkagency.com to become acquainted with all we offer. We would be happy to discuss your case with you. Please like us on Facebook or follow us on Twitter, Google+ or LinkedIn.

 

Is It A Heart Attack or Something Else?

As we age, our risk for having a heart attack grows. We all should be acquainted with the signs of a heart attack.

  • Chest pain or discomfort like pressure, squeezing, fullness or pain.
  • Upper body discomfort in one or both arms, the back, shoulders, neck, jaw or upper part of the stomach.
  • Shortness of breath either while resting or doing any physical activity.
  • Breaking out in a cold sweat.
  • Feeling unusually tired.
  • Light-headedness or sudden dizziness.

Heart attackThese symptoms vary from one person to another and they can come on slowly or all at once. Diabetics often have mild symptoms or none at all. A second heart attack in the same person doesn’t necessarily occur in the same way. Women are more likely to experience shortness of breath, extreme tiredness and nausea as pre-cursors of their heart attacks.

While we should never take the traditional signs of a heart attack lightly, there could be other explanations for those often frightening signs. The following are 7 alternative underlying causes for a racing heart, chest pains and sweating.

  • Panic Attacks: Arrhythmia (abnormal heart rhythm) can often accompany a panic attack making one believe they are having a heart attack.
  • Caffeine: It can stimulate the central autonomic nervous system which controls the heart rate. This stimulant can cause palpitations, lightheadedness or chest pain.
  • Decongestants: Those sensitive to these drugs can experience arrhythmia.
  • Dehydration: Serious dehydrations can lead to heart palpitations and muscle cramping. The resulting lowering of electrolytes also lowers blood pressure and an abnormal heartbeat.
  • Prescription Medications: Many, including those for asthma and thyroid regulation, can disrupt electrical conduction to the heart. It is important to read side effects for each.
  • Anemia: An iron deficiency means that there are not enough red blood cells to carry oxygen to your cells. A fast beating heart aids the delivery of oxygen, but may feel like a heart attack.
  • Heavy Metals: Long term exposure to mercury or other heavy metals can cause inflammation leading to thrombosis (blood clots), electrolyte imbalance and other heart related problems that cause heart palpitations.

In the event of a heart attack, acting fast makes all the difference. When in doubt, don’t hesitate to call 911 to get an ambulance, the best way to get to the hospital during a heart attack. It is always better to be safe than sorry. The emergency operator might be able to give you advice such as taking an aspirin while you are waiting for emergency service.

David York Agency provides skilled home health aide services for the elderly in their home and is abreast of all the latest guidelines for seniors.  At David York Home Healthcare Agency, we could provide direction as to how to manage the total care of your senior loved one. A nurse is waiting to take your call. Contact us at 718.376.7755 and visit our website. You can also like us on Facebook and follow us on Twitter, Google+ and LinkedIn.

 

 

Overuse of Benzodiazepine in the Elderly

The New York Times recently reported that even after 30 years of warnings regarding the dangers it poses to the elderly, use of benzodiazepine, sedative-hypnotic drugs like Valium, Xanax, Ativan and Klonopin, rises sharply with age. A study in the February 2015 edition of JAMA Psychiatry reports that 9% of those between 65 and 80 years of age take them and the proportion is even higher among women at 11%. These are astounding figures for any class of drug.

The known adverse effects of these drugs include increased risks of falls and fractures, diminished cognition in terms of memory and other neuropsychological measures, as well as an increased risk for car accidents.

497526103Yet, doctors persist in prescribing them. Why?

Doctors like to prescribe them because they work fast for such things as insomnia and nervousness. Doctors encounter resistance to employing alternatives like meditation and talk therapy by their senior patients.

Seniors don’t want to give them up. They are addicted to either the drug or the notion that a magic pill will cure any symptom that ails them. Moreover, the withdrawal process from the drug brings on some of the same symptoms such as insomnia, sweats and nervousness that prompted their use initially and patients don’t want to go through it.

Doctors are afraid to fight with their elderly patients about discontinuing the prescription. They are also under the mistaken notion that the process is too daunting. A Canadian study has shown that even a brochure with a schedule for weaning can have a dramatic effect on those wishing to make the change.

There is plenty of support out there if you want to find it. Doctors and healthcare professionals need to be more motivated identifying potential abusers and heed the long standing warnings of over prescribing these drugs. The elderly need to be fully counseled on the associated dangers and assisted in weaning themselves off these drugs.

David York Home Healthcare Agency is fully acquainted with all factors related to eldercare services and is always available to set up a senior care plan taking the whole patient into account. David York Agency provides skilled home health aide services for the elderly in their home and is abreast of all the latest guidelines for seniors.  Contact us at 718.376.7755 and visit our website. A nurse is waiting to take your call. You can also like us on Facebook and follow us on Twitter, Google+ and LinkedIn.

 

New Blood Test for the Detection of Alzheimer’s Disease

There is exciting news in the field of Alzheimer’s disease (AD) research with the advent of a new blood test which can determine the presence of a key marker, brain amyloidosis, the buildup of amyloid proteins in the brain, as well as other blood proteins known to be associated with AD. Early detection of the disease can have implications in terms of benefitting from any current and new treatments, joining research trials underway and taking advantage earlier of any support services available.

T181985743he blood test can be administered after a clinical examination uncovers symptoms of Alzheimerhttp://www.alz.org/’s disease including cognitive impairment such as dementia. This new blood test is safe, affordable and easy to administer in a variety of settings. Currently, the only definitive tests for the presence of AD either have major drawbacks associated with them or can only be done post mortem. The first method of extracting cerebrospinal fluid requires an invasive spinal tap and carries the risk of nerve damage. The second is a PET scan testing for amyloids in the brain exposes the patient to radiation, is not usually covered by insurance and few centers have the technology. Autopsies can reveal brain beta amyloid proteins in the brain, a hallmark sign of AD, but, obviously, has no benefit to the sufferer at that time.

This new test also has the benefit of reducing the stress of not knowing for the patient and their loved ones. An important byproduct of the test is enhancing the integrity of research by ensuring that only true AD patients are included in any treatment trials which currently have an error rate of about 25% of non-AD patient inclusion.

Receiving a diagnosis of 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. We 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.

 

Prescribed Drugs: Possible Risk to the Elderly

A study out of Brown University finds that doctors in the U.S. are prescribing drugs to the elderly that can have harmful side effects and the problem is even more acute in the south.

122422920Many drugs such as valium are harder for the elderly to metabolize so they stay in their systems a lot longer and this lingering effect can cause lightheadedness in an older person. This compromised physical state can very well lead to falls which we all know can have deadly consequences for the elderly.

Furthermore, a problem now termed as polypharmacy seems to be taking hold as a public health issue. This relates to the fact that the average senior citizen’s treatment plan includes four prescription drugs at the same time opening endless possibilities for harmful interactions which are suspected to be responsible for almost 33% of all hospital admissions.

The elderly and their caretakers need to review their medications regularly to make sure they know all associated risks, possible side effects and negative interactions. This link from Merck can be a handy reference.

David York Home Healthcare Agency provides skilled home health aide services for the elderly in their home and is abreast of all the latest guidelines for seniors.  We would be happy to discuss your case with you.  Please call us at (718) 376-7755 or visit our website.  You can also follow us on FacebookTwitter or LinkedIn.

Getting Important Documents Assembled for the Elderly

So often, when crisis hits, a family can be caught unawares by this emergency situation. Adult children are blindsided by not knowing where to find critical documents necessary for deciding on the care for their elderly parents and they feel handcuffed by not having access to important assets or documents that are needed. However, it is never too early to start that ‘just in case’ file.

While the holidays are a wonderful time for family sharing and bonding, it is also an opportunity for adult children to help organize essential information for their elderly parents. I think that in addition to feasting and spreading joy this holiday season, all of us, whether we be seniors, caregivers or potential caregivers, should take the opportunity to get some ‘ducks in a row’ and organize those all important documents and bits of information. David York Agency has compiled a handy checklist and a small packet of worksheets to assist in this task. Both are accessible through these links or on the Caregiver Resources page of the David York Agency website.

Essential Documents & Emergency Information Worksheets (pdf version)

Essential Documents & Emergency Information Checklist (pdf versionDec newsletter

  • Professionals List – All Contact Information for:
    • Doctors: Primary Care and Specialists
    • Accountant
    • Attorney
    • Financial Advisor
    • Insurance Brokers
  • Important Documents Packet (Originals and/or Copies):
    • Social Security Card
    • Birth Certificate
    • Driver’s License
    • Marriage Certificate
    • Divorce Certificate
    • Passport
    • Medical Information
      • Allergies
      • Medications
      • Treatments
      • Major Operations
      • Immunization Records
    • Medicare/Medicaid/Insurance Card
    • Life Insurance Policies
    • Military Discharge Papers
    • Deeds
    • Titles
    • Tax Returns for last 6 years
    • Instructions on Location of all files
  • Financial Accounts List – All Contact Information and Account Numbers for:
    • Bank Accounts
    • Investment/Brokerage Accounts
      • Stocks
      • Bonds
      • CDs
    • Credit/Debit Cards
  • Financial Assets List:
    • Car Ownership
    • Mortgage Documents
    • Real Estate Holdings
    • Loans Owed or Owed to them
    • Tax Returns
    • Insurance Policies
      • Home
      • Auto
      • Health
      • Long Term Care
      • Life
    • Original Invoices for Important Possessions
    • Partnership Documents
    • Jewelry and Valuables
    • Safe Combination and Directions
    • Location of Safety Deposit Key
  • Sources of Income:
    • Annuities
    • Social Security
    • Pensions
    • Annual Distributions from Retirement Accounts
    • VA Benefits
    • Disability Payments
  • Recurring Bills:
    • Mortgage
    • Loans
    • Utilities
      • Telephone
      • Electric
      • Gas
    • Insurance Premiums (monthly & quarterly)
    • Car Lease
    • Annual Expenses (i.e. home alarm)
    • Deliveries (i.e. newspaper, milk)
  • Computerized Information:
    • Email Accounts and Passwords
    • Password for Computer
    • Recurring Online Billing
  • Estate Planning Documents:
    • Will
    • Special Instructions regarding personal property
    • Durable Power of Attorney
    • Advanced Healthcare Directive/Living Will
    • Healthcare Proxy
    • Do Not Resuscitate (DNR) Order
    • Retirement Plans
    • Disability Plans
    • Governmental Benefits for which they are eligible
  • End of Life Arrangements:
    • Cemetery Plot Ownership
    • Pre-Planned Burial Papers
    • Personal Statement regarding burial services

Most important is that all this information be easily accessible clearly labeled and a trusted person know its location. Also, if you choose to keep this all stored on a computer, make sure a back up is made and a print out is kept in a location known to a close friend or relative. Healthcare decisions are often quite pressing, so knowing where to find medical records and decision makers in time can be crucial. With respect to assets, at times the government takes possession of unclaimed assets and while you might be able to get a hold of something belonging to you that was overlooked, it is not always an easy process. It is best not to get into that situation and have everything organized ahead of time.
When home healthcare becomes necessary, David York Agency provides skilled home health aide services. David York Home Healthcare Agency can satisfy all your questions and would be happy to give you more information and discuss your case with you. Visit our website at David York Agency – providing healthcare professionals to the elderly and infirm, with the highest degree of personal service. Please like us on Facebook or follow us on Twitter, Google+ or LinkedIn.

Watch Out for Pre-Diabetes

If you are over 45, overweight and inactive, you should seriously think about whether you might have diabetes or pre-diabetes.

Diabetes is on the rise worldwide and about to get even higher as a large segment of the population becomes senior citizens. Knowing if you have an elevated blood sugar level which is still in the range of normal, in other words, pre-diabetic, can help you to stave off this latest scourge.

Common complications of diabetes include heart disease, stroke, kidney damage, nerve damage, hearing loss and eye disease including blindness. Some even link it to dementia and Alzheimer’s disease. The concerning thing is about 28% of adults with full blown diabetes and those with pre-diabetes don’t have symptoms.

As we age, the risk of diabetes increases. Insulin is a pancreatic hormone that regulates blood sugar and your body uses the insulin in order to use glucose for energy. Aging causes these cells to wear out in certain individuals triggering diabetes or pre-diabetes.Pre-Diabetes_DavidYorkAgency

In a pre-diabetic stage, you can take the following steps to try to reduce your risk of developing the full blown disease:

  1. Diet: Watch your diet for refined sugars and carbohydrates so there aren’t any spikes in your blood sugar and insulin levels.
  2. Exercise: Even moderate exercise for 30 minutes a day, 5 days a week can make a difference, especially those aimed at reducing belly fat (apple shaped body) since that appears to be a risk factor for developing the disease.
  3. Weight Loss: Losing 7-10% of your starting weight can have an unexpected positive effect.
  4. Smoking: Quit now. In addition to other known ills, smokers have a 50% higher risk of developing diabetes.

More serious measures include:

  1. Daily monitoring of your glucose levels.
  2. Taking medication such as Metformin to keep the blood sugar down.
  3. Having the doctor check the blood level of hemoglobin A1C to make sure it hasn’t risen.
  4. Bariatric surgery for weight loss.

It might be prudent for us all to consider ourselves either pre-diabetic or at risk for it since watching your weight, diet, exercise regimen and not smoking are good steps for any of us to take.

David York Agency is skilled at recognizing the symptoms of various diseases endemic to the elderly. We are licensed by the New York State Department of Health and provide skilled home health aide services for home healthcare and could assist in 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.

Diabetics: Beware of Tuberculosis

478746553 (1)With 382 million people affected with diabetes worldwide in 2013 and that number poised to rise to 592 million by 2035, a warning bell is being sounded with respect to the real possibility of a serious co-infection – tuberculosis (TB). Since diabetes is a disease that weakens the immune system, diabetics are 3 times as likely to develop this lung infection. We have seen this before when the HIV/AIDS epidemic burst on the scene. At that time, we experienced a quadrupling of TB in some African countries.

As our population ages, grows more sedentary and obese, The incidence of type 2 diabetes will rise. Obesity is often linked to adopting a Western diet and countries around the world have been integrating more and more of it into their diets as they have everything Western. The countries most at risk are China and India who are the leading countries for diabetes and TB sufferers respectively.

Clearly a strategy needs to be put in place where there is ‘bi-directional” screening. Diabetics should be carefully monitored for TB and TB sufferers should undergo testing for diabetes and both must be treated properly.

David York Agency is skilled at recognizing the symptoms of various diseases endemic to the elderly. We are licensed by the New York State Department of Health and provide skilled home health aide services for home healthcare and could assist in 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.