How Dementia Tampers With Taste Buds

Posted on August 13, 2012

Many people with dementia change their eating habits after they get the disease — and researchers are trying to discover why. But caregivers can help their loved ones get proper nutrition with a few simple tricks.

Medically reviewed by Lindsey Marcellin, MD, MPH

People with dementia experience many big and small changes as a result of their symptoms. One surprising change is in a dementia patient’s taste buds. Because they don’t experience flavor the way they once did, people with dementia often change their eating habits and adopt entirely new food preferences.

One study looked at patients with a specific kind of dementia characterized by changes in food preferences and eating behaviors along with the more typical dementia symptoms. The researchers found that these dementia patients had trouble identifying flavors and appeared to have lost the ability to remember tastes, leading to the theory that the dementia caused the patients to lose their knowledge of flavors, which in turn can lead to changes in eating behaviors.

At the same time, taste tends to diminish as we age, so dementia patients may crave heavy foods or heavily flavored foods like sweets, says Jillian Ball, RD, of Jillian Ball & Associates Nutrition Consulting in Springfield, Mo. Ball likens it to when you have a cold and can’t taste food as well as usual. She once worked with a 100-year-old dementia patient who only wanted a strong broth and heavy buttermilk for her meals.

Adapting to a Dementia Patient’s Changing Taste Buds

Problems faced by dementia patients vary — they may experience weight loss from a smaller appetite or weight gain from eating high-calorie foods such as desserts, Ball says. For a caregiver, packing enough nutrients into a loved one’s meals can be a challenge, but there are ways to do it, for example:

  • Focus on protein. Try to find good sources of protein that your loved one will eat, Ball says. People can’t chew meat as well when they are older (especially if they have dentures) and their stomachs don’t break down protein as well, but protein (along with vitamins and minerals) is vital for healing and staying healthy.
    Try offering custard (which is made with eggs), pudding (which contains milk), or liquid supplements such as Ensure or Glucerna, suggests Ball. You can also find therapeutic ice creams, such as Magic Cup, that have added protein, vitamins, and minerals, at some drug stores or medical suppliers.
    Another option is to add protein powder, available at medical supply stores. Put a scoop in mashed potatoes or shakes — your loved one won’t even know it’s there.
  • Sneak in vegetables. Feeding dementia patients vegetables is definitely a struggle, Ball says. She recommends pureeing vegetables so that they’re easier to eat — or drink when added to a shake. Taking vitamin and mineral supplements is also very important.
  • Make meals a social event. We all like to eat socially, including people who have dementia, Ball says. You’ll probably have more success at getting your loved one to eat a healthy meal if she doesn’t eat alone.
  • At the end of life, give in without worry. If your loved one is in the end-of-life stage, it’s probably okay to let him eat sweets or any other foods he wants. “Food is one of the last things people can enjoy when they’re sick,” Ball says.
    On the other hand, if your loved one still has years ahead of him, you’ll have to take more care to ensure that he’s getting proper nutrition, she says. And if he has diabetes, watching blood sugar will be important.

Changing tastes can be a challenge for the patient and the caregiver alike. But try to make meals special times you enjoy with your loved one — even if his tastes have changed.

Submitted by Gabriela F. Brown, CSA
Owner/Operator
Constant Companions Home Care

Here’s the Skin(ny)—The Importance of Skin Integrity As We Age

Posted on August 12, 2012

No, I am not talking about weight; I am talking about the largest organ on your body, your skin. As we age, the skin, like every other organ in our body, begins to decline. While we don’t have any way to reverse this aging process there are things that we can do to boost it functioning and help to prevent skin integrity issues, a major complication in many seniors.

What does skin do for us?
• Helps maintain proper body temperature
• Wards off infections
• Waterproof barrier that keeps moisture in and moisture out.
• Provides sensory information about our environment and injury

As the body ages, the layer of fat under the skin starts to disappear as well as the blood vessels feeding the skin with lots of oxygen. As a result the skin becomes looser, unable to insulate us well, and thinner. The most visible evidence of this is wrinkling and sagging of the skin. As our skin becomes thinner, it becomes vulnerable to tears and pressure sores. Open skin is an invitation to infection and discomfort.

Risks Factors:

• Diabetes – it is under-diagnosed and under-treated, so make sure you are checking for it regularly with your health care provider. Diabetes causes decreased blood flow to the skin and extremities, encouraging the formation of wounds where there may be pressure points. To make matters worse, it makes the body less efficient in healing wounds, once they have developed.

• Immobility—Any condition that requires someone to be in bed or confined to a wheelchair for long periods of every day will increase the need to be especially vigilant for skin problems. Daily skin checks for tears and sores are essential. Also, making sure that skin is kept clean and dry is essential. If moisture is a problem, check with your health care provider about the use of barrier creams.

• Hip fracture—In otherwise health and active people, hip fractures can cause long periods of immobility during the healing and rehabilitation process. This immobility can increase chances of developing a bed sores.

• Dementia—Dementia can contribute to problems with overall skin integrity due to nutritional factors. Not remembering to eat or prepare balanced meals can cause a drop in weight and nutrients essential to the maintenance of the skin. Additionally, inadequate nutrition can contribute to a higher incidence of falls (weakness from low blood sugar and not enough calories) which can open the skin and lead to infection.

• Rapid weight loss— The lack of ‘padding’, coupled with the underlying cause for weight loss, i.e. poor nutrition or disease, can be problematic for skin integrity.

• Cancer— During treatment, immunity is compromised, appetite may decline, and chemotherapy can directly affect the condition of the skin. Special care should be taken to avoid a skin tear and to try to make sure that food and liquid intake is maintained as much as can be tolerated.

• Smoking or history of smoking—Decreases blood supply to the skin.

• Neurological damage—This can decrease ability to sense discomfort at pressure points that would otherwise prompt one to shift positions.

What you can do NOW

Nutrition is one of the best defenses against skin break-down. No matter what your current health status, making an appointment with a dietician is a great way to make sure you are getting the adequate nutrition you need to provide your skin the opportunity to keep working for you, not against you.

Nutritional factors that can help maintain skin integrity:
• Stay hydrated
• Eat a balance diet that includes protein
• Include healthy fats in your diet
• Make sure you are getting enough Vitamin A, C, E, K and minerals zinc, iron and copper

While there is no cure for what age does to our skin, there are things that we can do to keep it in the best possible condition to help protect us when we are our most vulnerable.

Written by Gabriela F. Brown, CSA
Constant Companions Home Care
http://www.constantcompanions.net
888.883.8393

“Elderspeak” Can Negatively Affect Health of Older People

Posted on August 9, 2012

By: Reuben Chow

It is quite common that many of us speak to older folks in a different manner and with a different tone. “Elderspeak” bears many traits which are similar to “baby talk”, and these include simplified grammar and vocabulary, as well as overly intimate terms of endearment. And recent research has shown that such a communication style may not only be exasperating and insulting to many of the elderly, it can even negatively affect their health.

About Elderspeak

What is elderspeak? Broadly speaking, it is a style which is assumed to accommodate the perceived communication needs of elderly people. It involves speaking slowly, restrictions on vocabulary, simplified syntax, as well as exaggerated prosody.

The fundamental assumption behind elderspeak is that the elderly are cognitively impaired, and thus need some “help”. It can be said to be patronizing and disrespectful to the older adult.

Researchers have also defined elderspeak as overly caring, controlling and infantilizing communication.

Findings from Studies

In a study led by Becca Levy, a professor at the Yale School of Public Health, it was found that elderly folks who were exposed to negative stereotypes commonly associated with ageing, enforced by condescending phrases and attitudes, performed significantly worse when tested for memory and balance.

In one particular town in Ohio, her study team found that those who were above 50 and held positive perceptions about ageing went on to live 7.5 years longer than their peers who did not. This was after other health-affecting factors were already accounted for.

Those attitudes were affected even by apparently harmless words and phrases and, profoundly, they supposedly had a greater impact than important factors such as smoking and exercise.

Elsewhere, Kristine Williams, R.N., Ph.D., an associate professor at Kansas University, studied the effect of elderspeak on Alzheimer’s patients with dementia. The interaction between staff and 20 residents of a nursing home, aged between 69 and 97 years and having moderate levels of dementia, were videotaped.

The study found that the patients were more likely to resist care after they were spoken to using elderspeak, instead of the usual adult-to-adult form of communication. When resisting care, they would carry out actions such as saying no or crying out, turning away, grabbing onto someone or something, pulling their limbs tightly toward the body, or hitting and kicking.

“There’s the suggestion that these people are unable to communicate that their needs aren’t being met. And because they can’t communicate verbally, they may respond in these other nonverbal ways,” Dr Williams said. And, according to her, the need in question could just be the wish to be treated as an adult who is worthy of respect.

And, perhaps somewhat ironically, the biggest culprits of elderspeak are often healthcare workers, including doctors and nursing staff.

The Problem with Elderspeak

The problem with elderspeak, is that it hurts the self-esteem of those to whom it is used on. Worse, it can literally grind them down and send them on a self-fueling downward spiral toward ill health and even premature death. That, after all, is what we get when we communicate to people that they are weak, a liability, incompetent or even useless – they often prove us right!

“Elderspeak is indicative of general negative stereotypes of the elderly. It is another example of how people are treated differently based on their age in healthcare, in the workforce and in everyday life. And we have found a clear connection between how the elderly are treated and their health and functioning,” said Dr Levy.

The Bottomline

“Daily we are witness to, or even unwitting participants in, cruel imagery, jokes, languages and attitudes directed at older people,” said Dr Robert Butler, president of the International Longevity Centre-USA, who first coined the term “ageism” some 40 years ago.

With populations ageing in the US and in many developed nations, the need to avoid elderspeak becomes all the more significant. In the US, the 85-and-above age group is the fastest-growing one.

Ms Elaine Smith, a 78 year old retired Chicago schoolteacher, who was subject to elderspeak when she was hospitalized for two months after suffering a fall, said that people can become quite indignant when she tells them she is offended by such a communication style. And she has an interesting viewpoint regarding elderspeak.

“But I believe that the people who heap these endearments upon us are reacting to their own fears of ageing in a youth-oriented culture,” she said. Her advice? Get over it.

So, the next time we want to use terms such as “dear”, “good girl” and “sweetie” on the elderly, or speak very slowly and in overly simplified language to them, we better think again.

Main Source

Talking down to the elderly is bad for their health, medical study finds (http://www.telegraph.co.uk/health/article3256340.ece)

Posted by Gabriela Brown
Constant Companions Home Care
http://www.constantcompanions.net

 

Is Your Elderly Parent Moving In? It Might Cost You

Posted on August 9, 2012

By Suzanna de Baca

Decisions about providing care for an aging parent are by no means easy — or cheap. Make it easier by asking some key questions and discussing them with your parents ahead of time

Many people my age struggle with the best way to care for their aging parents — and my husband and I are no exception. My friends, colleagues and I all agonize as we debate whether our parent(s) should move in with us or enter an assisted-living facility or nursing home. These are complex decisions that have emotional, physical and financial costs — and no easy answers.

My mother is healthy now, but one fact is clear: if she moves into our three-story home someday, we’ll need to make some changes to our house. And while we would welcome her company, making our home easy for her to get around in could be very expensive.

Recently, my husband and I decided to speak candidly with my mom about her own plans for the future. We were motivated to broach the issue after talking to my friend Victoria, who went through a similar experience with her mother. Victoria’s elderly mom moved in with her after her father’s death, but in order to care for her — Victoria’s mom was wheelchair bound and needed assistance with some daily activities — Victoria had to remodel her home.

(MORE: When Dementia Derails Your Parent’s Finances)

Victoria made the smart decision to do some advance planning together with her parents, talking about options and putting a plan in place, even before her father died. That made the financial aspects of remodeling her home and caring for her mother a lot easier. After Victoria’s father died, she and her mom sold her parents’ home as they had decided. They then used the proceeds to add a bedroom and a bathroom to the main floor of Victoria’s house.

Victoria’s mother lived with her family for six years before she passed away, and they treasure the experience. Victoria reflects that “one of the nicest things we could offer our son was to have time with his grandmother — and it was a joy to her.” She says remodeling their home to make a room for her mother was one of the best decisions they made.

But it wasn’t always easy. The amount of care Victoria’s mother needed increased over time and proved challenging. Chasing after her toddler consumed much of Victoria’s energy, and caring for her mother was often just as exhausting. Navigating Medicare and understanding her mother’s medical needs was complicated and taxing. But as she watched her other friends make tough decisions for their elderly parents, Victoria was grateful for the preparations her family had made in advance.

(MORE: Alternatives to the Nursing Home for Aging or Ailing Parents)

Victoria’s experience inspired me to ask more questions about what my husband and I — and all families in similar situations — might need to consider. Here are some of the essentials:

What are my parent’s plans and desires?
It can be tough to talk to our “silent generation” parents about money. But if we’re going to care for them in the future, having an idea of their financial situation and desires for medical care will save time and headaches. Victoria’s parents had good insurance and some assets in place, which made her circumstance easier. But even better, she and her parents made many decisions together, and she knew she was carrying out their wishes — which was important to everyone.

Do I need to add on, remodel or just renovate?
If a parent is going to move into your home, it’s crucial to consider these three things: privacy, care and safety issues. Ask yourself if you need a major overhaul, or if minor changes will suffice. Is there outside access to your parent’s room? Is it wheelchair accessible? Do the bathrooms have handicapped-accessible toilets, showers and tubs with grab bars? Research the costs well in advance so you won’t be reeling with sticker shock if your parent needs to move in on short notice.

What kind of insurance coverage do my parents have?
In addition to understanding your parent’s financial reality, it’s critical that you talk to your parents about their insurance coverage. Do they have long-term care insurance? What’s covered? What Medicare or Medicaid coverage do they have in place? Determine how your parent’s medical costs will be paid, and speak with them about where the funds might come from if extra costs accrue beyond what insurance covers.

What will this cost me?
It’s imperative to do some research before helping your parent decide what may be the best living arrangement physically, emotionally and financially. If your parent wants to stay in their own home, recognize what the long-term cost might be of hiring an in-home caregiver. It can vary greatly depending on where you live. The amount paid by insurance for different arrangements also varies depending on the type and amount of coverage.

Don’t assume that the lowest cost option will be providing care yourself. A recent survey by AgingCare.com indicated that an estimated 34 million Americans are personally providing care for older family members, and that 34% of those caregivers are spending $300 or more a month of their own money. Consider how this may affect your financial obligations and goals, and plan accordingly.

(MORE: Kids and Money: Is It O.K. to Play Financial Favorites?)

As for my own mother, she said she would like to stay in her own home and live independently as long as possible. But we’re all feeling more prepared to face whatever the future may bring because we’ve had — and continue to have — these discussions. If you’ve faced a similar situation, what tips or advice would you offer others? Tell us in the comments below.

De Baca is vice president of wealth strategies at Ameriprise Financial. See more of her health and money columns here.

Boomers: Big-Impact Health Activites You Can Do in 15 Minutes or Less

Posted on August 9, 2012

elderly couple running The American baby boomer generation isn’t content sitting still – they live full lives working, traveling and pursuing their favorite hobbies. Age is only a number for this determined group whose population is pushing an estimated 78 million. If you are one of the many active baby boomers, you understand your health is a priority, but that doesn’t mean you want to spend long hours each day making sure you stay well. Luckily some of the best things you can do for yourself only take a matter of minutes each day.

Dr. Wendy Bazilian (wendybazilian.com), a doctor of public health, registered dietitian and author of “The SuperFoodsRx Diet: Lose Weight with the Power of SuperNutrients,” knows the importance of optimizing health for baby boomers. Simple healthy activities, when done on a daily basis, can have a huge cumulative effect on health and wellness. Here are four big-impact health activities from Dr. Bazilian that you can do in 15 minutes or less:

1. Be flexible with gentle stretches
Stretching might seem like a basic physical activity, but its positive effects can be substantial. Especially for boomers, stretching for five to 15 minutes each day can help keep muscles and joints flexible, and help increase overall body health. Plus as you age, stretching can help maintain your mobility levels and decrease the risks of falls. Try gentle stretches to get your blood flowing in the morning or before you take a walk. Want to try something different? Yoga blends stretching and strength for a wonderful workout for people of all ages.
Time requirement: 15 minutes or less

2. Get an oil change – in your kitchen
The right kind of oils can benefit your health and wellness, and the wrong ones can put you at risk for high cholesterol, heart disease and even cancer. Cooking healthy means stocking your pantry with the right kinds of oils so you can enjoy the foods you love the right way. Two to keep on hand are extra virgin olive oil and organic grape seed oil. Olive oil contains monounsaturated fats which can help boost healthy HDL cholesterol while at the same time help to reduce unhealthy LDL cholesterol levels. Lower cooking temperatures or cool/room temperature usage is best. Organic grape seed oil has a more neutral flavor and a high smoke point, allowing for higher temperature cooking while using a lighter hand in measures with this healthier cooking oil.
Time requirement: five minutes or less

3. Consider taking an omega-3 fish oil supplement
Recently, there’s been a lot of talk about omega-3 essential fatty acids and their ability to prevent common disease as well as benefit brain and overall health. Because you can only get these essential fats through what you eat, Americans often don’t get as much as they need. Include food sources like wild salmon and sardines, as well as plant sources like walnuts and flax-seeds. Luckily, you can fill a nutritional gap by incorporating a high-quality fish oil supplement into your daily routine. A high-quality supplement can mean more benefit to your health; Ultimate Omega-D3 from Nordic Naturals is a good example and great option.
Time requirement: two minutes or less

4. Eat more fresh fruits and veggies each day
Few foods can provide the high levels of nutrients your body needs than fresh produce, yet more than 80 percent of us are not getting enough. It’s important to aim to make half your plate fruits and vegetables at meals every day. And try to incorporate fresh fruits and veggies daily, and don’t forget about frozen and dried options without added sugars or preservatives. They’re super nutrient-rich, too. The tasty options are endless – from berries, apples, bananas, and cherries to broccoli, tomatoes, carrots, cabbage, and kale. Be adventurous and try a new recipe that features a veggie you’ve never had before. Or, taste local flavors by visiting your neighborhood farmers market. Whether for a snack or with a meal, fresh produce is great for any baby boomer’s diet.
Time requirement: five minutes or less

Taken from: http://www.senior.com/food/boomers-big-impact-health-activites-you-can-do-in-15-minutes-or-less/
Provided by: ARA

Posted by Gabriela F. Brown
Constant Companions Home Care
http://www.constantcompanions.net

 

 

Severe, Chronic Pain in Multiple Areas Found to Increase Risk of Falls in Senior Citizens

Posted on August 2, 2012

Courtesy of http://seniorjournal.com

 

‘Controlled trial is needed to determine whether improved pain control could reduce risk for falls among older patients with chronic pain’

Senior citizens who reported chronic musculoskeletal pain in two or more locations, higher levels of severe pain, or pain that interfered with daily activities were more likely to experience a fall than older adults who did not reports these types of pain, according to a study in the November 25 issue of the Journal of the American Medical Association (JAMA).

“Falls rank among the 10 leading causes of death in older adults in the United States, resulting in more than $19 billion in health care costs annually. Despite a growing body of scientific evidence supporting associations between a number of risk factors and falls, efforts to translate these findings into effective fall prevention strategies have been limited,” according to the study report.

Few reports have examined chronic pain as a risk for falls in older adults, the authors note. “Pain contributes to functional decline and muscle weakness and is associated with mobility limitations that could predispose to falls.”

Suzanne G. Leveille, Ph.D., R.N., of Beth Israel Deaconess Medical Center and the University of Massachusetts-Boston, and colleagues conducted a study to determine whether chronic musculoskeletal pain is associated with an increased occurrence of falls in older adults.

The study included 749 adults, age 70 years and older, who were enrolled in the study from September 2005 through January 2008. Pain was assessed via questionnaires. Participants recorded falls on monthly calendar postcards mailed to the study center during an 18-month period.

At the beginning of the study, 40 percent of participants reported chronic pain in more than one joint area and 24 percent reported chronic pain in only one joint area.

A total of 1,029 falls were reported by the 749 participants during and up to 18 months of follow-up.

Four hundred five participants (55 percent) fell at least once during the follow-up.

Analysis indicated that compared with participants who reported no pain, or those in the lowest groups of pain scores, participants who reported two or more sites of pain had an increased risk for falls. Those reporting the highest levels of pain severity also had an increased rate of falls. Pain interference with activities was also associated with a greater occurrence of falls.

The researchers write that they observed a strong graded relationship in the short term between pain severity ratings each month with risk for falls in the subsequent month.

“For example, among persons who reported severe or very severe pain for any given month on their calendar postcard, there was a 77 percent increased likelihood for a fall in the subsequent month compared with those who reported no pain.” Persons reporting even very mild pain also had an elevated odds of falling in any given month.

The authors suggest there may be several possible mechanisms for the pain-falls relationship, including neuromuscular effects of pain, which could lead to leg muscle weakness or slowed neuromuscular responses to an impending fall.

“Another factor may be gait alterations or adaptations to chronic pain that lead to instability and subsequent balance impairments. Chronic pain may serve as a distractor or, in some way, interfere with cognitive activity needed to prevent a fall. Successful avoidance or interruptions of a fall typically requires a cognitively mediated physical maneuver.”

“The findings provide evidence suggesting that the common complaint of the aches and pains of old age is related to a greater hazard than previously thought. Daily discomfort may accompany not only difficulties in performing daily activities but equally as important may be a risk for falls and possibly fall-related injuries in the older population.

“The significance of this work is in the identification of chronic pain as an overlooked and potentially important risk factor for falls in older adults. A randomized controlled trial is needed to determine whether improved pain control could reduce risk for falls among older patients with chronic pain,” the researchers conclude.

Submitted by Constant Companions Home Care