Tips & Tricks for Daily Tasks When Arthritis is a Problem

Arthritis, whether osteoarthritis or rheumatoid arthritis, is prevalent in older adults. Aches and pains and stiffness seem to be an almost universally accepted consequence of aging. Given that 49.6% of adults aged 65 and older have been diagnosed by a doctor with some form of arthritis, this is perhaps not surprising.1

In our younger years, we can easily take for granted how freely we can do daily tasks without the pain and stiffness that can be caused by arthritis. If you suffer from arthritis pain, you know all too well how present it is in everything you do from the moment you wake up in the morning and your feet hit the floor.

In severe cases, certain tasks can be nearly impossible to accomplish. It’s no wonder, then, that arthritis is the leading cause of disability in adults.2

There are, however, some practical tips and tricks you can use to help you get through your daily activities if arthritis is a problem for you. We’ll take a closer look here.

First, the basics

Common sites for the pain, stiffness, or swelling caused by arthritis are:

  • Hands- impacts grip strength, holding items, and lifting
  • Knees- affects walking, climbing, squatting, and getting in and out of a seated position
  • Hips- interferes with bending and moving
  • Spine- affects twisting, moving, bending, and more

Arthritis can also affect any other joints including ankles, toes, shoulders, and elbows. Of adults diagnosed with arthritis, 44% say their daily activities are limited.3 We’ll discuss each of these problem areas in more detail.

General strategies for managing arthritis

There are a few key self-care approaches you can take to help control your arthritis no matter what part of your body it is affecting. They include:

  • Talk to your doctor- it’s important to see your doctor regularly and discuss your symptoms and how to manage them medically. Anti-inflammatory medications, and in the case of rheumatoid arthritis (RA), immune-modulating drugs, can help to control symptoms and even joint damage. Sometimes cortisone shots can be used to target specific joints. And in severe cases, joint replacement and other surgeries can offer relief.
  • Start an exercise program- the CDC recommends that people with arthritis exercise for either 150 minutes of moderate-intensity aerobic activity weekly, or 75 minutes of vigorous aerobic activity weekly. 4 Regular exercise can help reduce discomfort and improve balance and flexibility. Activities like walking, swimming, and bicycling are easier on joints. Yoga can help with muscle strength, flexibility, and balance. You can talk with your doctor about an exercise program that would be best for your situation.
  • Lose weight- if you are outside of your ideal BMI, the extra weight can put added wear and tear on your joints. Just 10 excess pounds can add 15-50 pounds of pressure on your knees, for example. 5 Also, fat stores in your body can contribute to overall inflammation that increases arthritis symptoms. The exercise discussed above can help you reach a weight loss goal. In addition, a healthier diet not only impacts your weight but your overall health and risk for other medical problems. Your doctor may be able to refer you to a nutritionist that can help you with a healthy diet plan.

If you are actively managing these self-care strategies and still struggling with daily tasks, there are some useful tricks and tools you can incorporate into your daily life. We’ll take a closer look below.

Tips for hand discomfort

Your hands get a lot of use every day, even if you’re not physically active. Gripping a book to read, holding the remote to flip through channels, and even using utensils to eat require mobility in your fingers and wrists. If you find this is challenging due to arthritis, here are some tools you can use:

Buttons, zippers, and otherwise getting dressed

To fasten clothing, your fingers need dexterity. This can become challenging with arthritis. Here are some workarounds:

  • Simplify your wardrobe– buy clothes that you can pull on, like t-shirts and sweaters, and pants with an elastic waist. Sports bras are comfortable and don’t require fastening. Slip-on shoes, or shoes that fasten with velcro, are also arthritis-friendly.
  • Use a zipper hook or button aid- these tools have a large handle for easy grasping and a special hook for grabbing zippers and buttons so you can fasten them.
  • Magnetic button covers are easy to fasten- these change your buttons into magnetized fasteners– no more fumbling required.
  • Keep a shoehorn handy- this makes sliding your foot into a shoe much simpler.

When grasping and twisting is a problem

Jar lids, other containers, doorknobs, and faucets can be difficult to manipulate without grip strength. Try these tricks:

  • Swap containers with small tops for pump tops- lotions, shampoos, and even salad dressings, can all have small, hard-to-open lids. These things can all be poured from their original containers into reusable pump-top bottles instead.
  • Give vacuum-sealed jars a tap- if you hit the edge of the lid of a sealed jar on the counter, the seal will pop and the lid is easy to turn.
  • Use a rubberized gripper- these can help turn lids, doorknobs, and even faucets.
  • Switch to a lever- swapping out doorknobs for door levers, and sink faucet knobs for faucet levers, can make using these items easier.
  • Use a jar opener- various styles use teeth or wrap around the lid with handles to give you leverage for twisting.
  • Try rubber bands- for very small lids, like nail polish or medication bottles, wrapping rubber bands around the lid can increase grip.
  • Switch to a pill organizer- for medications, there are push-button pill organizers that flip open with the touch of a finger. (Just be sure to keep medications away from children.)

Holding small items like utensils and toothbrushes

Managing basics like eating meals and tending to dental hygiene can be difficult with stiff, painful, or swollen fingers. Some easy tricks can help, though:

  • Use large-handled adaptive utensils- these are made with special rubber grips that are easier to handle.
  • Slide a foam tube or bicycle handle over your toothbrush- this works for some utensils, too.
  • A tennis ball is a great gripper- cut a hole in the center, and push a handle through the ball. Now you can hold the ball.
  • Rubber bands to the rescue- they don’t just work for small lids, they’re great wrapped around narrow handles, too.
  • Switch to electric- electric toothbrushes and kitchen knives have larger handles and require less repetitive hand motion.

When reaching, twisting, and turning are a problem

Large, whole-body movements that are difficult due to hip, knee, or spine arthritis can interfere with almost every daily task. Here are some ways to alleviate related problems:

Washing your entire body

This basic care need requires flexibility and balance. If you struggle with it, it can even increase your risk of falls. Take these simple measures to make bathing easier:

  • Use a shower chair- washing while seated means you can reach your lower half more easily, with less risk of losing your balance
  • Add a detachable showerhead- using a showerhead that can be held like a sprayer allows you to reach all the parts of your body with less turning or twisting
  • Long-handled brushes and sponges help with reach- no more painful stretching to reach your back or feet- let the tool do the work!

Reaching far-away items

Tidying up around the house, or retrieving items you’ve dropped, can require both reach and the flexibility to bend and/or squat. Rather than over-extending yourself, try this:

  • Use a grabber tool- the long handle means you can pick something up without bending.
  • Choose long-handled cleaning tools- a duster with an extension handle avoids excessive stretching to clean hard-to-reach areas
  • Change your environment- move your most frequently used clothing items to upper drawers or closet shelves. Swap out shorter hampers and trash cans for taller versions that you can pick up without bending. Hang pans on an eye-level pot rack, instead of inside a lower cabinet. Simple changes can reduce how much you have to bend and reach!

Getting in and out of a chair, bed, or car

Sometimes you just lack the strength to push your stiff joints into a different position. And getting in and out of the car requires a lot of twisting. Here’s how to make these tasks easier:

  • Ask your doctor about physical therapy- physical therapists can help you with exercises that will target muscle groups to increase strength, and change your leverage so you can move more easily. They can also suggest tools that can help.
  • Give yourself extra time- especially when you first wake up, being stiff and sore can get in the way of moving easily. Take some time to stretch, and slowly move in stages.
  • Use a chair lift- special inserts designed to help lift you off of chairs are available, or electric recliners that help give you a boost can be helpful.
  • Use a walker- this gives you something to push off on when standing, and helps your balance.
  • Seat belt hooks help in the car- these are attached to the shoulder belt and reduce the need for twisting to reach to buckle up.

A few final thoughts

Experimenting with the tricks and tools listed above can help you find what works best for you. Each time you are successful with a workaround, it’s a victory!

Remember, too, that asking for help is ok. Sometimes, the only thing standing between you and an extra pair of hands is sharing that you are having difficulty. A weekly meal-prep session, for example, can be a memory-maker and help you with opening containers and cooking food for several days at a time.

For some, having an in-home caregiver can relieve many of the challenges associated with daily self-care activities and chores. A caregiver can help with light housekeeping and meal prep, assist with mobility, and even help with bathing when necessary. If you’d like to explore this option further, you can read more about Caresify’s services here, or call 888-799-5007.

References

  1. https://www.cdc.gov/arthritis/data_statistics/arthritis-related-stats.htm
  2. https://www.arthritis.org/getmedia/e1256607-fa87-4593-aa8a-8db4f291072a/2019-abtn-final-march-2019.pdf
  3. https://www.cdc.gov/arthritis/data_statistics/disabilities-limitations.htm
  4. https://www.cdc.gov/arthritis/basics/physical-activity-overview.html
  5. https://www.arthritis.org/health-wellness/about-arthritis/related-conditions/other-diseases/how-fat-affects-osteoarthritis

How to Choose a Good Professional Caregiver

There’s nothing quite like home. Familiar, comfortable, and uniquely ours, it’s no wonder that as we age, a huge percentage of people- as many as 40%- still live in their own homes 1, even though assisted living facilities offer some built-in perks.

Due to some of the changes that may come along with aging and some chronic health conditions, extra help is sometimes needed to maintain independence at home. Often, this starts with family and friends stepping in as caregivers. If a loved one’s care requires 24/7 help, this can become challenging. If you are in this situation and considering the addition of a paid caregiver to offer either respite or regular assistance in your home, how do you choose the best one?

Step one: what are your needs?

Before you begin your search, it’s important to know what your care needs are so that you can find the perfect match in a caregiver. Some of the daily tasks a caregiver can assist with include:

  • Bathing
  • Toileting
  • Dressing
  • Meal prep
  • Feeding assistance
  • Light housekeeping
  • Ambulation (walking) assistance
  • Running errands/shopping
  • Companionship

It’s easy to see how these activities require different skills. Do you or your loved one require extra assistance with transferring from a wheelchair to the bed? Your caregiver will need to be able to safely lift. If transportation assistance is important, a current driver’s license is a must.

In addition, there may be other specific requirements to consider in a caregiver, such as:

  • Language skills, if speaking in a native tongue other than English would be helpful
  • Gender- if a caregiver will be involved in personal care, does your loved one prefer a male or female?
  • Is a live-in caregiver preferred, or one that will come for scheduled shifts?

If you’re a family member locating a caregiver for a loved one, it’s important to take their needs and preferences into consideration. After all, it’s their home. They may have fears about someone stealing valuables, or be hesitant about a “stranger” in their home. If they would prefer a short trial basis to ease these fears, be sure you discuss this possibility with a caregiver.

Hiring on your own vs. using an agency

You’ll also have to decide whether you want to go through an agency for a caregiver, or if you prefer to find your own.

Some agencies keep caregivers on staff as employees and cover their taxes, insurance, and ongoing training. Others act as an employment agency, leaving you with more responsibilities. You’ll want to ask how they operate.

Consider some differences between the two:

Private Caregiver Agency Caregiver
You are responsible for screening and background checks The agency conducts background checks and other screening
If a caregiver is sick or on vacation, you must secure a replacement Fill-in caregivers are provided by the agency as necessary for caregiver absences
You must decide how to handle taxes, worker’s compensation insurance, and pay Administrative details like taxes, worker’s compensation, and pay is handled by the agency
Cost may be lower Cost may be higher
Search for caregiver with the right skills is your responsibility Caregivers with many different skills may be available through the agency
May not be covered by long term care insurance May be covered by long term care insurance
Coordinating scheduling is your responsibility Scheduling is taken care of by the agency and there are multiple caregivers available to cover shifts

Hiring a private caregiver

If you’ve decided to conduct your own search and hire a caregiver privately, there are some important questions to ask when you interview prospects:

  • Remember to go over your list of needs and make sure they’re able to meet those needs- can they lift someone to transfer them? Are they able to cook meals?
  • What certifications does the caregiver have? Two common certifications are Home Health Aide (HHA) and Certified Nurse Assistant (CNA)
  • Does the caregiver have a current driver’s license and/or transportation of their own for the job? Or would they need to use the client’s car?
  • Can the caregiver provide references?
  • Is the caregiver CPR certified? (this includes training on managing choking emergencies)
  • Is the caregiver bonded and/or insured?

You can also ask some questions about how the caregiver handles interactions. For example:

  • Ask the caregiver to describe a time when they had a conflict with a client, and how they resolved it
  • What experience do they have with clients with memory issues, if applicable?
  • What is their favorite activity to do with their clients?
  • How do they respond to an angry or confused client?
  • What has been their most difficult caregiving task in the past?

After the interview, you’ll want to conduct a background check, contact references provided, and decide how you will handle administrative details. There are several important things to consider related to this.

For example, how will pay be handled? Will it be provided weekly or bi-weekly? Will you withhold taxes? There are new federal regulations affecting how caregivers are classified for tax purposes. You may have a responsibility to pay employment-related taxes for in-home caregivers and file the appropriate paperwork. These IRS rules should be discussed with your professional tax consultant to avoid potential penalties.

Will you be paying for any vacation time? Are meals provided? Will the caregiver be live-in, or will they work scheduled shifts?

When you hire a caregiver, you’ll want to create a contract that spells out your job expectations. These include:

  • Notice required for vacation or sick time
  • Scheduled hours
  • How tardiness will be handled
  • Payment schedule
  • Job duties, such as meal prep, housekeeping, etc. Will the caregiver be expected to help with pets?
  • Transportation arrangements (whether the caregiver will have access to a car, or use their own for helping with errands and outings)
  • Confidentiality expectations
  • How you will handle reimbursement of any expenses the caregiver might incur in their role
  • Is smoking allowed on the property?
  • Notice required for ending employment

To ensure your contract legally protects you, it is advisable to review your contract with an attorney before offering it to any prospective caregivers. For assistance with this, you may find it helpful to contact your local council on aging for recommendations on discounted legal services, or a federal agency called the Administration for Community Living (ACL) offers a Legal Services for Older Americans Program.

Using an agency for caregivers

If you’d rather go through an agency to find a caregiver, you will have some other considerations. Here are some things you can ask:

  • How long has the agency been in business?
  • Is the agency licensed by the state? (not required by all states)
  • Can they provide a fee schedule?
  • Are references available?
  • What certifications do they require of caregivers?
  • What kind of training is offered to caregivers each year?
  • How much notice will they need for schedule changes?
  • How do they handle any potential concerns with caregivers?

Good professional care can improve daily life

Ultimately, the right caregiver can make a big positive impact on both the senior living at home and any involved family. A professional caregiver can provide companionship, reduce the risk of depression, and prevent family caregiver burnout. They can reduce the risk of health complications such as falls. Their relationship can even grow to be like part of the family!

If you’re looking for a professional caregiver through a home care agency and would like to discuss options with Caresify, we can answer any questions you might have and help you find a great fit for your loved one. Read more about our services here, or call 888-799-5007.

 

References

  1. https://www.ncbi.nlm.nih.gov/books/NBK51841/

Remember to Take Your Medication: Tips for Avoiding Missed Doses

Taking medication, especially more than one kind of medication, can be challenging. If you have ever missed doses or stopped taking medication your doctor prescribed, you might be surprised to find out this is very common. According to a review by the Annals of Internal Medicine, 20%-30% of prescriptions are never even filled, and almost 50% of medications for chronic conditions aren’t taken correctly. 1

There are many risks of skipping or reducing doses of medication or stopping medication your doctor has prescribed. Some of them don’t show up right away but can be very serious. In fact, every year this is estimated to cause 125,000 deaths and 10% of hospitalizations. 2

What can be done about this? The reasons that it happens are complex, and there are many possible ways to improve your medication adherence. Let’s take a closer look.

What can I do to avoid missed doses of medication?

We’ve mentioned that missing doses of your medication can have serious consequences. These include:

  • Worsening symptoms of health problems the medication is supposed to treat
  • Worsening of the actual condition the medication is treating
  • New medical problems developing

What are some of the barriers to taking medication correctly and what can you do to help avoid missed doses?

When side effects or costs are barriers

Oftentimes, bothersome side effects from medications discourage people from taking them regularly. Add in high copays– often more than one for multiple medications– and it’s a perfect recipe for cutting doses in half, or just skipping the medication altogether. In one survey, 32% of adults taking 4 or more medications reported difficulty affording medications. 3 Here are some strategies you can try to improve these barriers:

  • Talk to your doctor about side effects- don’t assume you have to put up with them. Sometimes a medication or dose change relieves the problem. Other times side effects improve with time and consistent use, or a medication can be added that relieves the side effect.
  • Ask for a better formulation- is a medication hard to swallow? It might come in liquid form. Is there an extended-release formula so you can take it once a day instead of twice?
  • Keep a current list and review your medications at every doctor visit- are there any medications that could be discontinued? What about medications that could be combined? Some drugs come in a combination form that is two medications in one pill (less to take and only one copay!). Reviewing your list is also helpful to make sure you are taking the doses of all your medications correctly without mistakes.
  • Ask about less expensive options- sometimes brand-name medications become available as generic drugs, which costs less. And some insurance companies offer lower copays for a 3-month supply instead of 1 month.
  • Ask about manufacturer discounts and other coupons- your pharmacist can tell you about any available discounts or drug programs that you can get medications through for a lower cost. Some manufacturers offer programs that pay the entire drug copay, leaving you with $0 out of pocket. There are also companies online that offer prescription discount cards for many common medications.
  • Check to see if your insurance provider offers health coaching- for some conditions or specialty medications, insurers or employers have programs that help you manage your chronic health problems and medications. Nurse case managers keep in contact with you through regular telehealth check-ins. They can troubleshoot side effects and drug interactions, and help with healthy habits and strategies. They can also help you with navigating insurance authorizations and delays and remembering refills.

I can’t remember to take my medications or refill them, what should I do?

Even if you can afford your medications and have managed any side effects, organizing and remembering doses and refills is not always easy. There are some tried and true tricks to help with this, though:

  • Stick to a routine- to take your medications at the same time every day, you can try setting an alarm on your phone. Or if you are especially tech-savvy, some medication apps will remind you as well. This is particularly helpful with medications that are not taken daily, such as some injections. You can use this strategy for refill reminders, too.
  • Use a pill organizer- the same day each week, fill the pill organizer for the week. This helps you to see whether you took a dose or not if you can’t remember. There are also electronic pill keepers that will alarm until opened.
  • Ask your pharmacy for individual packaging- some pharmacies offer daily dose packs with all of your medications pre-sorted for you for the entire month. These can be easier to open for people with arthritis, too. (Always keep medications away from children!)
  • Pair your medication with a routine- think about something you always do without fail. Do you always pour a cup of coffee in the morning? Put your medication right next to the coffeemaker. Or set your toothbrush on top of your pill organizer as a reminder.
  • Use notes and calendars- if you live by your planner or calendar, a note there can remind you to take your medication or refill it. Post-it notes in unusual places– on the cabinet you get your cereal out of, or the bathroom mirror where you comb your hair– can jog your memory.
  • Collaborate with a caregiver- a family member or paid caregiver involved in your daily care can help you remember to take your medications on time.

I missed a dose of my medication, now what?

If you have tried the above tips and tricks and discover that you’ve accidentally missed a dose of medication despite your best efforts, what should you do?

  • Don’t double up on doses- many medications are designed to release slowly. Never take more than the prescribed dose without talking to your doctor.
  • Check the medication information sheet- this is included in the packaging with your prescription from the pharmacy and often has instructions for managing missed doses.
  • Ask your pharmacist or doctor- if all else fails, talk to your pharmacist or doctor about the best way to handle a missed dose. Each medication is different, so it’s important to know the safest way to correct the mistake.

Extra effort with your medications can improve your quality of life

Once you hit your stride with healthy medication habits that work for you, there are many potential benefits to your overall well-being and quality of life. The right medication, taken as prescribed, can help reduce symptoms of chronic health conditions. You’re also less likely to end up in the hospital due to complications from untreated disease.

If you’ve tried one of the strategies discussed here and it didn’t work for you, keep in mind that habits take time to develop. Research shows that it can take as long as an average of 66 days for a new habit to form. 4 You may also find that one of the other strategies might be a better fit for your learning style.

For older adults with chronic health conditions that struggle with memory due to problems like dementia, it is critical that a family member or regular caregiver help with reminders to take medications as prescribed. This can include sorting medications into a pill keeper so one medication isn’t accidentally skipped in a confusing assortment of pill bottles. Or it can be prompting someone that it is time for a dose.

Finally, if you’d like some professional help with medication reminders, Caresify’s team of highly skilled caregivers provides this service along with many others that can help you maintain independence at home longer. You can read more here, or call 888-799-5007.

 

References

  1. https://www.acpjournals.org/doi/full/10.7326/0003-4819-157-11-201212040-00538?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org
  2. https://www.acpjournals.org/doi/full/10.7326/0003-4819-157-11-201212040-00538?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org
  3. https://www.kff.org/health-costs/poll-finding/public-opinion-on-prescription-drugs-and-their-prices/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505409/

Is it an Infection? Common Warning Signs You Should Know

In our lifetimes, we all experience infections of many kinds. These can be as simple as a common cold, or more severe, requiring medical care. For many of us, most if not all infections we might experience are not much of a threat. But for the senior population, it’s a much more serious concern.

For those of us aged 65 years and older, 1/3 of all deaths are due to infection.1 This is partly because an infection can be hard to spot in elderly people. Do you know the warning signs, and what kinds of common infections to watch for? Read on to learn more!

Health problems that increase the risk of infection

As people age, health problems that can increase the risk for infection are more common. If you or a loved one have multiple chronic diseases or experience any of the following conditions, it’s especially important to watch for signs of infection:

  • Type II diabetes
  • A compromised immune system, for example, due to cancer or HIV
  • Autoimmune disease
  • An indwelling urinary catheter
  • Any other tubes or drains in place
  • An implanted port, or PICC line
  • Regular use of steroid medication due to any condition
  • Poor nutrition
  • Incontinence or mobility issues

Where in the body are infections often found?

There are several common sites of infection in the body that you should know to watch for:

  • Respiratory
  • Skin
  • Urinary tract
  • Gastrointestinal (GI)
  • Bloodstream
  • Bone

What kinds of symptoms should I watch for?

As we mentioned earlier, infection can be harder to identify in seniors. One reason for this is that fever may be less likely due to immune system changes as we age. Another is that communication difficulties due to problems like dementia can mean that a person may be unaware of problems or unable to tell a caregiver they don’t feel well.

If you are a caregiver, it is very important to remember that if your loved one has a sudden change in behavior, such as increased confusion or agitation, it could be a warning sign of infection. The same is true for any sudden increase in weakness or sleepiness.

Let’s look closer at symptoms you might notice:

Respiratory symptoms

With the COVID-19 pandemic, we’ve all become familiar with watching for symptoms of respiratory infection. Influenza and pneumonia are also common respiratory infections. In fact, pneumonia is a leading cause of death from infection in seniors.2  Symptoms of respiratory infection include:

  • Fever
  • Runny or stuffy nose
  • Sore throat
  • Cough
  • Shortness of breath
  • Body aches
  • Headache
  • With COVID-19, loss of taste and smell, and GI symptoms such as vomiting and diarrhea can also be common

Skin infection symptoms

Skin infections can happen for many reasons in seniors and are very common. Caring for aging skin and watching closely for problems, especially hidden ones, is extremely important. Incontinence and immobility can especially increase the risk of wounds developing, which can then become infected. Symptoms of skin infection include:

  • Fever
  • Redness, especially when it spreads
  • Swelling
  • Pain
  • Warmth around an area of redness, pain, or swelling
  • Drainage

If any of these symptoms are worsening, or are at the site of a drain or tube, it’s important to let your doctor know right away. Waiting can result in a much more severe infection developing quickly.

Urinary tract infection symptoms

In older adults, it is very common for urinary tract infections to cause confusion, lethargy, or even other behavior changes such as agitation. They may not experience the more obvious symptoms, which include:

  • Burning or pain with urination
  • Blood in the urine
  • Cloudy urine
  • Foul-smelling urine
  • Needing to urinate more frequently (frequency)
  • Having an urgent need to urinate (urgency)
  • Pain or pressure in the pelvis
  • Abdominal pain, side (flank) pain, or lower back pain
  • In more severe UTIs, fever, fatigue, and/or vomiting

As with skin infections, any sign or suspicion of urinary tract infection should be addressed with the help of your doctor right away.

Gastrointestinal (GI) infection symptoms

A GI infection can quickly lead to dehydration, electrolyte imbalances, and other serious problems. This is especially true in older adults with a history of diabetes, underlying problems with proper nutrition, or other medical concerns. Some GI infections can be caused by a virus. Others are caused by bacteria, such as c-difficile or “c-diff”. (This infection is more common after antibiotic use.) Symptoms of GI infection include:

  • Nausea and/or vomiting
  • Abdominal pain
  • Fever
  • Diarrhea
  • Blood in the stool or vomit
  • Dizziness
  • Irregular or rapid heartbeat
  • Weakness
  • Confusion

Any blood in the stool or vomit, or black or tarry-colored stool or vomit, should be reported to your doctor immediately. Because dehydration can cause serious problems quickly, any inability to keep down fluids for more than a few hours is also concerning. Dizziness or rapid/irregular heartbeat should also be addressed by a healthcare professional right away. If you’re not sure, call 911 or go to the emergency room– don’t wait.

Bloodstream infection symptoms

This type of infection results from another infection spreading throughout the bloodstream. For example, it commonly starts with a urinary tract infection that goes untreated.  Although this can happen at any age, it is most common over the age of 65 and has a 12-20% fatality rate.3  Also called sepsis, this is a serious medical emergency.

Signs to watch for include:

  • Fever
  • Chills (sometimes severe)
  • Very low body temperature
  • Discolored or blotchy skin
  • Low blood pressure or dizziness
  • Weakness and fatigue
  • Peeing less
  • Nausea, vomiting, or diarrhea
  • Rapid heartbeat
  • Rapid breathing
  • Sweating, or clammy skin
  • Confusion
  • Severe pain

If you or your loved one have any of the above symptoms, call 911 or go to the nearest emergency room right away.

Bone infection symptoms

Also called osteomyelitis, infection in the bone can happen due to infection spreading from a wound or other skin infection. It can also happen after joint replacements or surgery. People with diabetes are more prone to this kind of infection. Chronic sores such as bedsores (also called pressure ulcers) increase the risk as well. Some symptoms of bone infection include:

  • Swelling around a joint or bone
  • Fever
  • Tenderness, redness, and warmth around a joint or bone
  • Severe back pain
  • Trouble moving a limb or joint

Infections in bone are hard to identify and sometimes challenging to treat. Untreated, they can lead to amputations and bloodstream infections. If you’re concerned that any symptoms you’ve noticed could be a bone infection, it’s important to let your doctor know.

Preventing and treating infection

With any of the above infections, it’s always best to contact your doctor if you have any concerns or questions, or think you have noticed symptoms of infection. Infection can become serious and even life-threatening quickly, especially for an older adult.

To help avoid infection, there are some steps you can take. Staying up to date on vaccines as recommended by your doctor can help prevent respiratory infections. This includes the COVID-19 vaccination, the annual flu vaccine, and pneumonia vaccines. Good nutrition is also important to help your immune system stay healthy. Manage any chronic health conditions by taking your medications as prescribed and with regular doctor visits. And finally, staying mobile and maintaining good hygiene can protect you from wounds, skin infections, and urinary tract infections.

If you need extra help with day-to-day personal care activities and ambulating, a professional in-home caregiver can also help maintain your best health to avoid infection. For more information on these services through Caresify’s expert team of caregivers, you can check out our homepage or call 888-799-5007.

 

References

  1. https://www.aafp.org/afp/2001/0115/p257.html
  2. https://www.atsjournals.org/doi/10.1513/pats.200508-081JS
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871665/

What to Do About Common Dementia Behaviors

It’s easy to think of dementia as simply an issue of poor memory and confusion. However, if you or a loved one have been diagnosed with dementia, you may be surprised to find that new, challenging behaviors and personality changes are also a common part of this condition.

There are some helpful approaches you can try to reduce or better manage these behaviors. Understanding dementia-related behaviors and the ways to manage them offers dignity to loved ones with the diagnosis. It also reduces stress and worry for caregivers.

Understanding the basics and what is behind behaviors

Anywhere from 30%-90% of people diagnosed with dementia experience behavior disturbances.1 A key fact to remember is that dementia is the result of a progressive brain disorder. The behaviors are out of the person’s control and do not reflect any bad feelings or ill intent toward family or caregivers.

We’ll first discuss behaviors that can result from dementia, and then we’ll consider ways to help reduce or improve some of these difficulties. As you read, keep in mind that some of these behaviors can happen not only because of confusion but due to the inability to communicate needs. Is the person hungry, exhausted, or in pain? Looking for patterns and underlying problems can help relieve any discomfort that is contributing to disruptive behaviors.

Behavior difficulties common with dementia

You may recognize several or only a few of the behaviors common to dementia. In the early stages of Alzheimer’s disease, there may be little or no behavior changes. As dementia related to Alzheimer’s or other conditions progresses, however, these behaviors can all be common:

Agitation

Anxiety and restlessness due to confusion, discomfort, fear, medication side effects, and more are very common with dementia. Because of the inability to identify what is upsetting or to communicate needs, the person with dementia can become overwhelmed and irritable.

Aggression & verbal outbursts

Confusion and agitation sometimes lead to escalating anger and aggression. Yelling, cursing, or becoming physically aggressive can happen suddenly at times and without warning.

Repetitive speech

Asking a question over and over again, or repeating a word or statement many times, can happen when a confused person fixates on an idea. While it’s a harmless behavior, it can be very frustrating for caregivers and sometimes escalate to agitation for the person with dementia.

Wandering

Up to 60% of people with dementia wander. 2 Walking around constantly, sometimes even at night, can turn into a safety hazard if the person starts leaving the home to wander. Sometimes it can seem as if the person is looking for something, or going somewhere meaningful. Other times, there is no clear reason for the wandering.

Paranoia or hallucinations

As the brain problems worsen in conditions like Alzheimer’s, people can experience seeing things that are not there (hallucinations). Or, they may believe things that are not true (delusions), leading to suspicion and paranoia of others.

Sleep issues and “sundowning”

With dementia, it is very common for the brain to have trouble regulating sleep. Increased confusion, agitation, and restless behaviors that begin at dusk are called “sundowning” and frequently happen with Alzheimer’s disease. In addition, a person’s circadian rhythm, or internal clock, can be disrupted.

Depression

As many as 41% of people with dementia also suffer from depression. 3 Some of the symptoms of depression– social withdrawal, trouble concentrating, lack of interest in hobbies and activities, and difficulty thinking– can also be early symptoms of dementia, so it’s easy to miss.

Problems with hygiene and dressing

Confusion and forgetfulness can often lead to difficulties with dressing, bathing, and tending to other personal hygiene like brushing teeth. Even simple tasks like choosing the correct outfit can be a challenge. The person may resist important personal hygiene. Incontinence due to confusion about how or when to use the toilet can add to these challenges.

Sexually inappropriate behavior

As shocking or upsetting as sexually inappropriate behaviors may be, this is not unusual when dementia is present. These behaviors can include inappropriate verbal comments, inappropriate physical touch, or public sexual behaviors.

Some practical tips for approaching behavior concerns

As we’ve discussed, some of the behaviors above may be an expression of other underlying problems that the person can’t communicate clearly. Investigating further and offering food or drink, or tending to personal hygiene can sometimes improve behavior.

Sometimes, medications prescribed for other conditions can cause increased confusion, hallucinations, or agitation. So can urinary tract infections. And problems like incontinence and pain can be addressed with medication. It’s good to visit a healthcare provider especially if changes in behavior have been sudden.

Let’s go over some practical suggestions for how to handle these behaviors when they occur:

How to reduce agitation

While it may not be possible to eliminate all agitation, there are ways you can reduce it and de-escalate it once it happens:

  • Express empathy– “I can see you are very frustrated/upset/scared, how can I help?”
  • Offer distractions- food, drink, or a preferred activity can redirect a person.
  • Follow routines- the fewer changes a person with dementia has to face, the less upsetting, confusing, and frustrating things will be. Keep everyday expectations the same, and avoid big changes like moving, or rearranging furniture if possible.
  • Avoid overstimulation- too much noise, activity, or even conversation or multiple visitors, can overwhelm a person with dementia. Keep the environment calm and quiet.
  • Don’t argue- disagreeing, even if you are right, will only escalate frustration and confusion.

Allow extra time- sometimes, a little patience goes a long way in calming an upset person. Often agitation can result from loss of control. Allowing the person time to do things on their own can give them a sense of control over their life.

Reacting to aggression and verbal outbursts

Aggression that becomes physical can lead to injury. Verbal aggression is upsetting and overwhelming for caregivers. The same tips that help with agitation can aid with aggression as well. Here are some additional approaches that can help calm these episodes:

  • Address confusion- re-orient the person to their surroundings with simple reminders and reassurance. “We’re at home and I’m here to help you.”
  • Find sources of frustration- Ask simple questions that call for a yes or no answer. “Are you hungry right now? Is anything hurting?”
  • Try to focus on a happy memory- while short-term memory may be a struggle for someone with dementia, they often retain long-term memories. It is sometimes possible to calm a person who is focused on anger by redirecting them to a conversation about a better time.

How to redirect repetitive speech

This behavior can be a result of anxiety and confusion, or even due to boredom. There are some ways you can “change the subject,” so to speak:

  • Give the person a purposeful activity- redirect them to a task they enjoy doing, go for a walk, put on music, or offer to read a book together. This can occupy their mind with something else.
  • Calm anxiety- offer reassurance with comforting words and hugs or touch, if appropriate.
  • Use visual reminders- if the speech involves questioning a future event constantly, such as when a family member might arrive home, you can help by hanging written signs that remind the person what time to expect something. Having a clock available and showing it to them can help too, depending on how advanced their dementia is.

Tips for wandering

Because wandering is a safety concern, it’s important to address this problem immediately. There are several approaches you can use:

  • Install safety locks on doors- placing these above eye level can stop someone from opening doors. There are different styles available, including hinge locks that easily flip open and closed for fire safety. These are not likely to be opened by a person with dementia. Child safety door knob covers may also work.
  • Install door alarms- simple alarms mounted on the door and frame will alert you to doors being opened.
  • Have your loved one wear ID- a safety alert bracelet or tags sewn into clothes can help them return home safely if they do wander outside of the home. There are also digital trackers with GPS that can be used.
  • Alert neighbors- if the community is aware that seeing your loved one unsupervised means they are likely lost, they can act faster
  • Put away coats, shoes, etc.- sometimes, not being able to find essential items to leave the house will deter wandering outside
  • Use a 24-hour caregiver- supervising wandering that may potentially happen overnight is exhausting. If the above tips are not preventing the person from leaving the house unexpectedly, an overnight professional home caregiver can help.

Managing paranoia and hallucinations

To the person experiencing hallucinations, delusions, and paranoia, their experience is real. Some strategies that help redirect these issues are:

  • Don’t argue- trying to convince the person of reality leads to agitation. Instead, offer solutions, like helping them look for missing items they believe have been stolen, and distracting them with other tasks
  • Visit the doctor- especially if this is a new symptom, sometimes underlying medical problems can trigger it.
  • Reassure the person- hallucinations can be frightening if they involve threats that aren’t real, like seeing bugs crawling. Let your loved one know you are there and will help them.
  • Change the environment- make sure there is enough lighting to reduce shadows that might be seen as something else. Cover mirrors if they are causing the person to believe they are seeing a stranger.

Helping sleep issues and sundowning

Problems with sleeping and settling down in the evening can lead to other issues like agitation, wandering, and sleepless nights for caregivers. Here are some ways to help this concern:

  • Restrict caffeine, alcohol, and sugar- because these substances can disrupt sleep hours after ingestion, limit them to early in the day
  • Encourage activity and reduce naps- staying active and doing things like taking walks can make a person more likely to fall asleep in the evening. It can also discourage napping. Taking too many naps or long naps can further disrupt sleep at night.
  • Establish a routine- make sure bedtime is at the same time every night, and try to follow the same routine for getting ready for bed. Dim lights, comfortable pj’s, soft music, or whatever is calming to the person will serve as a cue that it will be time to go to bed soon.
  • Keep the lights on- both daylight exposure and having indoor lights bright until it’s time for bedtime can help reduce night and day confusion and loss of bedtime routines.

What to do about depression

Because depression can make other dementia symptoms worse, and affect quality of life, it’s important to address it. Here are some things to do if you’re concerned about depression:

  • Talk to your doctor- medications to treat depression can be used by people with dementia. It’s also important for a doctor to diagnose whether depression is truly present.
  • Offer companionship- loneliness due to isolation, and friends pulling away after a dementia diagnosis can lead to depression. Providing social activities or involving a home caregiver for regular visits can help the person feel less isolated.
  • Prioritize fun- what kinds of activities is your loved one happiest doing? Make sure these are offered and encouraged regularly.

Improving challenges in hygiene and dressing

You can make some simple changes that improve these self-care activities for a person with dementia:

  • Choose simple outfits- avoid buttons and zippers and opt for clothes with elastic waistbands that are easy to pull on, for example.
  • Break tasks into steps- just reminding someone to take a bath or get dressed may not help them if they are confused. You may need to tell them each step involved, from getting undressed to washing and then drying off.
  • Offer help- as dementia worsens, hands-on assistance may be necessary for all tasks.
  • Set a routine- regular bathroom breaks can reduce episodes of incontinence, and serve as a reminder to tend to personal hygiene.

Addressing sexually inappropriate behavior

This can be upsetting and embarrassing for family, but it’s important to remember that the person cannot control the behavior. As many as 25% of people with dementia display these inappropriate behaviors.4 There are some ways you can redirect this issue:

  • Reduce boredom- keeping a person occupied in other meaningful ways can reduce sexual behaviors. Snacks, activities, exercise, and social interaction are good distractions.
  • Keep hands busy- this can reduce inappropriate touching. Crafts, folding towels, and other “chores” can help.
  • Ask about medication- although caution must be taken with medications and dementia, your healthcare provider can make recommendations about treatment that could reduce this behavior.

It’s important to be adaptable as dementia progresses

Keep in mind that trying to change or control behaviors is not going to improve the brain condition that is causing them. Over time brain function will worsen– and the behaviors will change, or new behaviors may develop.

Because of this, your approach to behaviors may need to change as well. What works today, may not work tomorrow. You may find it helpful to review this guide from time to time to help you create solutions that ease some of the stress of managing disruptive behaviors.

In addition to the strategies we’ve mentioned, sometimes having professional home care, even for respite visits, can give family caregivers a much-needed break to rest. This helps caregivers to feel better prepared for difficult behaviors that are beyond their loved ones’ control. If you’d like to learn more, or are ready to take the next step to hire a home caregiver, Caresify’s team is available to help. You can read more here, or call 888-799-5007.

 

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181717/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234917/
  3. https://onlinelibrary.wiley.com/doi/10.1002/gps.5556
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980403/

10 Tips for a Good Night’s Sleep

Getting proper, restful sleep is something that has a huge impact on your well-being and health. But what if you simply can’t sleep even though you try? Insomnia and other sleep problems are a common concern for adults over the age of 65. In fact, in one study over half of the participants aged 65 and older reported sleep difficulties. 1

Ignoring sleep problems like insomnia can lead to issues like heart disease, depression, type 2 diabetes, and an increased risk of accidents and injury. 2 There are ways you can address sleep issues and improve them, though. Let’s take a closer look at why sleep problems happen and what you can do to get a good night’s sleep.

Common sleep issues in older adults

Normally, our brain’s sleep-wake cycle runs smoothly and we consistently fall asleep and stay asleep. As we age though, this can change. Older adults often have trouble falling asleep, or they wake up during the night or too early in the morning. Or, they fall asleep earlier than intended and wake up earlier. In some cases, people can experience disruptions during the REM or “dream” cycle of sleep as well.

Illness, pain, medication side effects, and habits like drinking caffeinated beverages or alcohol can also affect sleep. And at any age, sleep apnea, restless leg syndrome, and periodic limb movement disorder can interrupt sleep.

Symptoms to watch for

Here’s a breakdown of the common sleep disorders you might see as an older adult, and their symptoms:

Insomnia

For a diagnosis of insomnia, symptoms have to be present for at least a month. 3 These symptoms include trouble falling asleep, staying asleep, or having poor sleep quality. This happens even though a person has the chance to sleep in a quiet and comfortable environment. Also, these problems can’t be explained by other sleep disorders or medical problems. Insomnia is related to sleep habits and behaviors and how they influence sleep patterns.

When someone has insomnia, it affects their quality of life during the day, causing sleepiness and other problems. Treatment includes improving sleep habits, cognitive behavioral therapy, and sometimes medications.

Circadian Rhythm Sleep Disorders

You can think of your circadian rhythm as your internal clock– your brain’s ability to regulate your sleep patterns behind the scenes. In older adults, it’s common to find this internal clock isn’t functioning quite right. This results in sleepiness early in the evening and very early morning awakenings. It can also cause waking up during the night too many times. Just changing sleep behavior isn’t enough to correct this problem.

Sleep Apnea

This condition causes a person to breathe abnormally while sleeping. There are three types of sleep apnea- obstructive, central, and mixed. Obstructive sleep apnea (OSA) happens when the back of the throat is blocked temporarily during sleep. Central sleep apnea is caused by a problem with the brain regulating breathing during sleep. Mixed is a combination of both.

No matter what type a person has, it causes long pauses in breathing, leading to poor quality sleep as the person’s oxygen levels drop and they partially wake to start breathing again. Many people aren’t even aware they have sleep apnea. Snoring can be a sign that sleep apnea may be a problem, or a spouse may notice breathing pauses in sleep.

Restless Leg Syndrome and Periodic Limb Movement Disorder

If you struggle with an uncontrollable urge to move your legs when you are at rest (some people say their legs feel like they are “buzzing”), you might have restless leg syndrome. Periodic limb movement disorder involves involuntary jerking of the arms and legs during sleep, many times per hour. Both of these neurological problems disturb normal restful sleep.

REM Sleep Behavior Disorder

During REM sleep, people can experience dreams. REM sleep behavior disorder results in dreams being acted on, sometimes with forceful physical movements during sleep. It is more common in elderly men and those with Parkinson’s disease. Because of the risk of injury during these episodes, measures must be taken to increase safety in the sleeping area, such as removing breakable objects or putting the mattress on the floor.

Alzheimer’s Disease and Sleep

The confusion and sleep disturbances that are often a part of Alzheimer’s disease and dementia require special care. Alzheimer’s can often result in people wandering at night, or having difficulty settling down to sleep. This can be dangerous if doors and windows aren’t secured and other home safety measures haven’t been taken. It can also disrupt caregivers’ sleep.

How can I improve my sleep?

For adults over 65, it is recommended to aim for 7-8 hours of sleep per night. 4 If you’re experiencing any of the problems listed above, how can you improve your sleep?

1. Follow the same sleep routine every day

Sometimes the key to good sleep is forming healthy sleep habits, also called sleep hygiene. Go to bed at the same time every night, and get up at the same time every morning. Do this even if other parts of your routine change, such as when traveling. Use your bedroom only for sleeping. Practice relaxation such as meditation before going to sleep. Cognitive behavioral therapy, or CBT, can help you with building better sleep habits.

2. Limit naps to only short rest breaks

If you suffer from disrupted sleep, daytime sleepiness is common. It’s very tempting to take a long nap to catch up. But if you do this, it becomes a vicious cycle, further disrupting your nighttime sleep patterns. If you must nap, take a short nap only, limiting it to 20 or 30 minutes at the most.

3. Talk to your doctor about pain or other health problems

When problems like pain, urinary frequency, sleep apnea, or other health problems interrupt your sleep, they can lead to other health issues too. Be sure you discuss these kinds of concerns with your doctor to get the best treatment and a better night’s sleep.

4. If you can’t fall asleep, get out of bed

Your bed is for sleeping, and if you find yourself staring at the ceiling instead of falling asleep, get back out of bed. Never lie in bed awake for more than a half hour. Find a quiet activity, like reading or listening to quiet music, and then try again after a little while.

5. Exercise daily, even a little bit

Regular exercise has been shown to improve sleep, and better sleep also makes it easier to exercise! 5 This is a win-win for your overall health since exercise improves other health concerns and improves mood as well.

6. Ask your doctor about any medications you’re taking that could interfere with sleep

This is a detail that can easily be overlooked in a quick doctor’s appointment, but if you’re having trouble sleeping, especially after adding a new medication, it’s worth asking your doctor if any changes to your medications could help improve your sleep.

7. Avoid caffeine after lunchtime

Six hours after caffeine consumption, half of it is still in your body, and it can take up to 10 hours to completely leave your system. 6 If you can’t fall asleep, adding caffeine later in the day only worsens the problem.

8. Don’t use alcohol before bed or in the evening

It seems like alcohol would be a good way to relax, unwind, and fall asleep. But alcohol has been shown to decrease sleep quality, by up to as much as 39.2%, and it can make sleep apnea worse. 7

9. Avoid electronics in the bedroom

Phones, tablets, TV, and other electronics emit blue light– the same light spectrum that triggers the brain to stay more alert. In studies, the use of these devices before bedtime disrupts the circadian rhythm, leading to problems falling asleep at night and waking up in the morning. 8

10. Keep your bedroom quiet and at a comfortable temperature

It seems obvious, but creating optimal sleeping conditions can go a long way in being comfortable and relaxed enough to fall asleep. Take a moment to think about any frequent noise disruptions in or near your room, and whether your bedroom temperature is comfortable. Adding a quiet fan, white noise, and dimming lights before bedtime can help you get in a sleepy mindset.

With the right tools, good sleep doesn’t have to be elusive

It’s easy to take good, restful sleep for granted. But sometimes, focusing on proactive ways to improve sleep is necessary. Following the above tips can help you make useful improvements to your sleep habits.

If you’re a caregiver struggling with nighttime behaviors in your loved one that disrupt sleep, it’s important to address these concerns with a doctor. And, when dementia and other neurologic or medical conditions are impacting sleep, having extra help during the nighttime hours can make a big difference in caregivers getting enough rest. Home caregivers can assist with trips to the bathroom, and with safety concerns like wandering. If you’d like to learn more, you can read about Caresify’s professional caregiver services here, or call 888-799-5007.

 

References

  1. https://www.aafp.org/afp/1999/0501/p2551.html#afp19990501p2551-b1
  2. https://www.cdc.gov/sleep/index.html
  3. https://www.aafp.org/afp/1999/0401/p1911.html
  4. https://www.thensf.org/how-many-hours-of-sleep-do-you-really-need/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3844037/
  6. https://my.clevelandclinic.org/health/articles/15496-caffeine-how-to-hack-it-and-how-to-quit-it
  7. https://www.sleepfoundation.org/nutrition/alcohol-and-sleep
  8. https://brighamhealthhub.org/beware-of-blue-light-before-sleep/