Month: March 2020

Choosing A Good Nursing Home

When making the decision to move a loved one into a nursing home there are many questions and it can become overwhelming! There are some basic questions you can ask and signs to look for to ensure your loved one will be in a safe, friendly, caring environment.

1. How does the food look and taste?

Dining with your parent in the nursing home cafeteria is a great way not only to bolster your parent’s spirits, but also to give you an idea of how well he or she is eating. It is hard to know if your parents are not eating because they have no appetite or if the food is no good unless you are eating it every so often.

2. What sounds do you hear?

Do you hear residents yelling or begging for care, or are there people laughing and enjoying themselves? There will be some residents who have dementia or Alzheimer’s that may act out, which is to be expected, but look for residents that seem cognitive but unhappy. Make sure the staff is addressing the residents by their names, “Good morning Ms. Mary” not “Hey there mamma, or pops”.

3.     What does is smell like?

Unfortunately, as we get older we do not have the control of our bodily functions as we did when we were younger, so walking into a nursing home you may get a whiff here or there of a foul odor, but it is nothing to cause alarm. However, if everywhere you go there is a foul odor, or strong smell of urine it could mean they do not properly clean their facility. 

 4.     Is the staff overworked?

 Talk to the nurses and orderlies; are there a lot of employees working double shifts or overtime? Do they mention they are always looking for staff? Does the staff look tired? Do you hear them complaining about too many residents per staff member?

 5.     How do the residents spend their afternoons?

 Are the residents in their rooms or are they participating in activities? Are they hanging around the nurses station, or sitting together having coffee? Does the nursing home offer entertainment, such as, bingo or old movies played in the rec room? Even the residents that are room bound, does the staff take them games and interact?

 6.     How does the staff interact with each other?

 You can tell a lot about how a facility is run by the interactions of the staff with other staff, and with the heads of departments and of the company. If there is visible tension or very little interaction this is not a good sign. A good sign is when you see people smile at one another and say please and thank you and address each other in kind and respectful tones, and when the boss is around people continue to do the job they were doing and not start acting like they are working.

 7.     Do you see bruising on the residents?

 As we age our skin is not as strong and the medications we take can cause easy bruising, but does the bruise look like a finger or hand? That is when you want to take a closer look. Also bruises on the stomach or back are not typical of a fall, so be skeptical about bruises in those areas.

 8.     How do they handle a slip and fall?

 Even under the best circumstances people sometimes fall, it is sometimes unavoidable. But, how the staff and the facility handle the fall is very important. Do they help the patient up? Do they notify the families immediately? Are they checking on the resident a few hours later to make sure there are no signs of an injury that were not present at the initial fall?

 9.     Are there unexplained bedsores?

 If the resident is bed bound it is easy to get bedsores if they are not properly turned and kept clean and dry, and even then sometimes the paper thin skin breaks apart. If there is a bedsore, is it being addressed and taken care of? If the resident is active and there is a bed sore there needs to be a conversation with the staff as to why the resident is not up and active.

 10.    Are personal care needs being met?

 The residents that are incontinent should be changed at a minimum every two hours. Does this facility have a maximum times number of diapers they will give a resident? If so, that is not a good sign, a person left in an unclean diaper can have skin breakdown and wounds.

 There are a lot of questions to ask and things to think about when placing your loved one in a Nursing Home. Make sure you take the time to look at each place and ask the hard questions to guarantee you find the best fit for your loved one.

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November is National Alzheimer’s Disease Awareness Month

President Ronald Reagan designated November as National Alzheimer’s Disease Awareness Month in 1983. At the time, fewer than 2 million Americans had Alzheimer’s; today, the number of people with the disease has soared to nearly 5.4 million.  Get involved this month, and help raise awareness for Alzheimer’s disease! One great ways to get involved is to join your local Alzheimer’s Association and become a Champion! 

According to the Alzheimer’s Foundation of America, Alzheimer’s disease is a progressive, degenerative disorder that attacks the brain’s nerve cells, or neurons, resulting in loss of memory, thinking and language skills, and behavioral changes. These neurons, which produce the brain chemical, or neurotransmitter, acetylcholine, break connections with other nerve cells and ultimately die. For example, short-term memory fails when Alzheimer’s disease first destroys nerve cells in the hippocampus, and language skills and judgment decline when neurons die in the cerebral cortex.

Two types of abnormal lesions clog the brains of individuals with Alzheimer’s disease: Beta-amyloid plaques—sticky clumps of protein fragments and cellular material that form outside and around neurons; and neurofibrillary tangles—insoluble twisted fibers composed largely of the protein tau that build up inside nerve cells. Although these structures are hallmarks of the disease, scientists are unclear whether they cause it or a byproduct of it.

Here are some signs of Alzheimer’s; memory loss that disrupts daily life, challenges in planning or solving problems, difficulty completing familiar tasks at home, at work or leisure, confusion with time or place, trouble understanding visual images and spatial relationships, new problems with words in speaking or writing, misplace things and losing the ability to retrace steps, decreased or poor judgement, withdrawn from work or social activities, and changes in mood and personality. If a family member or friend displays one or two of these signs, you may want to keep a closer eye on the person, if they display more than two signs, you may want to schedule a doctor’s appointment to have your loved one examined.  

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November is National Hospice Palliative Care Month – This years’ theme is “Hospice Helps Everyone” and that is truly what hospice does, it helps everyone, from the patient to the family, and help every step of the way.

In 1992, the month of November was designated to raise awareness of hospice and palliative care within the community. During the month of November, hospices across the country are reaching out to raise awareness about important care issues for people coping with serious illness.

The National Hospice and Palliative Care Organization defines Palliative care as; patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering patients. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information and choice.

The following features characterize palliative care philosophy and delivery:

Care is provided and services are coordinated by an interdisciplinary team;

Patients, families, palliative and non-palliative health care providers collaborate and communicate about care needs;

Services are available concurrently with or independent of curative or life-prolonging care;

Patient and family hopes for peace and dignity are supported throughout the course of illness, during the dying process, and after death.

There are a few ways that palliative care can help you or your loved ones. First it will provide relief from stress and symptoms of the ailment. Having someone who is an expert at managing pain and other issues will be a huge asset to relieving stress and will teach you how to cope. They will help to coordinator your care, communication is key and a great strength of palliative care providers, and they will ensure you are being taken care of properly.  They will provide support to the family caregivers, allowing them to spend time with their loved one as their loved one and not their caregiver; this is a huge burden that is too often taken for granted and palliative care givers understand and address that issue. They will help support your doctor and keep them informed of any changes to your health, they work in partnership with your doctor as an extra layer of support and comfort for your family. The job of a palliative care giver is to help improve your overall quality of life, if they can help find relief for you from pain, shortness of breath and fatigue then they have done their jobs and they can help you get the strength you need to keep a good quality of life.

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How General Anesthesia Can Affect an Elder’s Mind

As we get older our bodies become weaker or problems arise and more likely than not you will need to have surgery and will require general anesthesia. As we age the way our bodies process drugs changes and our overall metabolic rate is slower.

According to Agingcare.com “General anesthesia does carry a higher risk for the elderly population,” says Damon Raskin, M.D., a board-certified internist and medical director for two skilled nursing facilities. According to Raskin, it takes longer for an older person’s body to rid itself of the chemicals involved in anesthesia, which can in turn prolong the negative effects of the drugs.

When you compound surgery with other health conditions, such as, heart disease and diabetes the problem with anesthesia becomes more complex.

Some people with more complex diseases may have trouble with confusion or hallucinating, and these signs may not appear until days after a surgery. These types of problems can disrupt the post-operative care and must be taken into account when creating a care plan for an elderly patient coming out from under general anesthesia.

Anesthesia, delirium and dementia

With the elderly, the conditions of dementia and delirium can sometimes be confused, and it is important to understand the difference and the signs of each condition.

While these ailments share similar symptoms—confusion, problems with perception, mood swings and decreased cognition—there is one crucial difference that separates them. Delirium refers to abrupt, temporary changes in a person’s mental functioning, whereas dementia describes a more gradual, consistent decline in cognitive capacity.

Delirium is a common cognitive after-effect of general anesthesia, particularly for the elderly. This has led to a flurry of research studies aimed at determining whether being “put under” can cause permanent brain changes, even dementia.

The problem with the studies is the results came back both ways, reports show that anesthesia could increase risk of dementia, and others that show is could not.

Most evidence suggests that receiving general anesthesia during the course of surgery does not increase the likelihood of developing lasting dementia. Yet it is clear something is going on: Recent experiments on animals and human cells show that anesthesia can increase the buildup of the proteins thought to underlie Alzheimer’s disease, especially in high doses.

Avoiding post-op problems

As a caregiver, it can be hard to know what to do when a senior needs surgery.

The link between dementia and general anesthesia remains fuzzy, but there’s no doubt that surgery can cause lingering physical and cognitive issues for older adults.

Post-operative cognitive dysfunction (POCD) isn’t synonymous with Alzheimer’s, or other forms of dementia, but it is a mental condition whose symptoms can mimic those of more permanent forms of cognitive impairment.

When an elderly loved one is preparing for surgery, the best thing you can do for them is insist they participate in a thorough pre-operative evaluation. The pre-operative evaluation will give the surgeons and anesthesiologists information about your conditions and medical background. It will inform them of the medications being taken, any pre-existing conditions that could be detrimental to the surgery, and all supplements being taken, because just like medication, they can have adverse reactions with anesthesia drugs.

The doctor in charge of coordinating your loved one’s surgery should make sure this and any other relevant information is communicated to their surgical team. You and your loved one may also meet with the anesthesiologist in person, prior to the procedure, to go over important medical considerations.

Undergoing general anesthesia carries risks for people of every age, but making sure the surgical team is up-to-date on your loved one’s medical conditions will reduce the risk of potentially adverse mental side effects.

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Medication Management Tips That Could Save Your Life

According to the American Academy of Family Physicians: “The statistics on medication usage among elderly patients in the US are eye-opening: more than one-third of prescriptions drugs used in the US are taken by elderly patients; the ambulatory elderly fill between 9-13 prescriptions a year (including new prescriptions and refills); the average elderly patient is taking more than five prescription medications; the average nursing home patient is taking seven medications.

When caring for the elderly, proper medication management is crucial, mostly because they take so many pills and some are required at different times and days, and if they are mixed up, the results could be life threatening.  Typcially an elderly person is taking prescriptions for more than one aliment, it is important that you have a competent pharmacist that knows your history to avoid a harmful interaction.

 Guidelines for Effective Medication Management

1. Make sure the pharmacy label gives the reason for taking the prescription

This is mainly significant for older adults who are taking multiple medications, to ensure that they know what each medication is for and how to take it properly.

2. Create and maintain an up-to-date medication list

After every doctor’s visit, update the medication list, this way you will always have a current copy. Make sure you give a copy to a family member, or next door neighbor, even keep a copy in your wallet or purse, in the event of an emergency you will have all of the information needed.

3. Bring a medications list – or the medications themselves – to the doctor with you

Letting your doctor see what prescriptions you are taking, allows them to see if something should be adjusted or removed, or even added.

4. Ask your provider if the dosage is age-appropriate

As we age our bodies slow down, it is important to ensure that the prescriptions you are taking are the correct dosage for your age.

5. Talk to the pharmacist and ask questions

Pharmacists are there to answer questions and to give you piece of mind that the prescriptions you are taking will help and not harm you. If you are unsure of anything regarding your prescription, ask the Pharmacist.

6. Get a second opinion if you are uncertain

When you buy a new car, or a television you shop around for the best deal and price, your health care is even more important, so get a second opinion, there is nothing wrong with knowing your options.

7. Be aware of medications deemed unsafe for the elderly

The Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, put together by the American Geriatric Society, is a list of medications that older adults should avoid or use with caution. Some pose a higher risk of side effects or interactions, while others are simply less effective.

8. Know the side effect profile of your medications

Each medication is given to you in a bag with a description of the medication and the side effects make sure you read and understand the side effects of the medication and the interactions with other medications that could be harmful. Again, if you are uncertain, ask your Pharmacists.

9. Tell your provider about any previous adverse drug effects

If you have an adverse drug reaction, make sure you tell your doctor and pharmacist and make a note on your medication list, this will help to ensure you are not given drugs that have adverse effects.

10. Closely monitor medication compliance in the cognitively impaired

If your loved one has been diagnosed with Alzheimer’s, dementia, or other cognitive diseases, make sure they are not responsible for their medication management. These diseases attack the short term memory and therefore they cannot be responsible for making sure they are properly taking their medication.

11. Minimize the number of providers and pharmacists you use

As we age the amount of specialty doctors you need to see increases, however, you can find doctors that specialize in more than one area of expertise. If you can minimize the number of doctors and pharmacists you see you will reduce the chances of problems with your medications.

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Eye Health Risks for Seniors to Know

As we age, certain health issues can become more and more prominent, meaning we have to stay consistent about medical check-ups and taking good care of ourselves. One area in particular that becomes more susceptible to disease and damage as we age is our eyes. There are several eye-related health risks that increase for seniors, and knowing what they are can help you know what signs and symptoms to be on the lookout for.

 Which Eye Health Issues Should Seniors Keep Their Eyes On?

 1.)    Age-related macular degeneration. As the name indicates, age-related macular degeneration is an eye health condition uniquely associating with the aging process. The “degeneration” in question refers to the weakening of the macula, the hub of central vision. As it weakens, certain tasks that require strong central vision, i.e. reading and identifying fine details, can become more challenging.

2.)    Cataracts. Cataracts are an extremely common eye health condition; it is estimated that nearly 22 million Americans who are over the age of 40 suffer from cataracts. The cataracts themselves affect your vision by blocking the lens of the eye, which can make for cloudy vision and a distorted perception of color. Because cataracts are so common, cataracts surgery is a frequently-performed and effective method of treatment.

3.)    Glaucoma. People regardless of age are at risk for developing glaucoma, but seniors do have heightened chances. Glaucoma is a disease that affects the optic nerve, which can lead to moderate to severe vision loss; there is even the risk that glaucoma will lead to blindness if left untreated.

 Though all three of these eye health conditions can have serious consequences for your vision, early detection can help you to avoid them. Make sure to attend check-ups at your eye doctor’s on a regular basis to see what you can do to keep your eyes health for years to come!

 There are things you can do in your daily life to help aid in healthy eyes, one of which is diet. As part of an eye-healthy diet, choose foods rich in antioxidants, like vitamins A and C, such as leafy, green vegetables and fish. Many foods – especially fish – contain essential omega-3 fatty acids that are important to the health of the macula, the part of the eye responsible for central vision.

 An inadequate intake of antioxidants, as well as over consumption of alcohol and saturated fats may create free-radical reactions that can harm the macula. High-fat diets can also cause deposits that constrict blood flow in the arteries. The eyes are especially sensitive to this, given the small size of the blood vessels that feed them.

 Another thing you can do is exercise, our eyes need good blood circulation and oxygen intake, and both are stimulated by regular exercise.

 Quit smoking, Smoking exposes your eyes to high levels of oxidative stress. While the connection has not been clearly identified, it’s a fact that smoking increases your risk of developing a variety of conditions that affect eye health.

 Being outdoors on a sunny day feels wonderful – but it can be tough on your eyes. The solution? Wear sunglasses that block harmful ultraviolet (UV) rays. Also, a hat with a brim will reduce the amount of UV radiation slipping around the side of your sunglasses.

Lori A. Sportelli, O.D., Doctor of Optometry says “We are living longer now than ever before. As we age, our bodies, including our eyes, can “break down” if we don’t take care of ourselves. We can have wonderful quality of life as we age if we adopt a healthy lifestyle and have preventative health exams. There is no reason seniors cannot be active and participate fully in all aspects of life well into their 90’s. Vision is one of our most important senses. Our eyes can change faster in our senior years than any other time in our lives, so it’s of great importance that yearly comprehensive dilated eye exams are a part of our wellness plan. This is even more important if you have a family history of glaucoma or macular degeneration, or if you have diabetes, as this is the leading cause of preventable blindness.”

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How to Prepare to Age Alone

According to a 2012 study in The Gerontologist, about one-third of 45- to 63-year-olds are single, most of who never married or are divorced. That’s a whopping 50 percent increase since 1980, the study found. What’s more, about 15 percent of 40- to 44-year-old women had no children in 2012 — up from about 10 percent in 1980, U.S. Census data shows.

So what do you do when you step back from your work, or just look at your future and realize there is no one to take care of me when I get older? It can be a scary question to face, and as the statistics show, there are many more people today that are in this situation.

In research presented this year at The American Geriatric Society’s annual meeting, found that nearly one-quarter of Americans over age 65 are or may become physically or socially isolated and lack someone like a family member to care for them. The term elder orphans is being used to describe this new group of the elderly.

The consequences are profound, older adults who consider themselves lonely are more likely to have trouble completing daily tasks, experience cognitive decline, develop coronary heart disease and even die. Those who are socially isolated are also at risk for medical complications, mental illness, mobility issues and health care access problems.

But growing older without kids or a partner doesn’t mean you’re doomed — just as aging with kids and a partner doesn’t mean all’s clear. You never know what will happen, life is a game of roulette, you could be married and have seven children, and you could still wind up alone.  Keep in mind that 69 percent of Americans will need long-term care, even though only 37 percent think they will, according to SeniorCare.com.

Here are some ways to help yourself to be prepared for the chance that you could become an elderly orphan.

1. Speak up.

Talk about your choices with your friends and family members, it is a discussion that needs to be had so stop waiting for it to go away, or magically resolve itself. It will not, you will get older and eventually you might be alone and talking about what could happen and having a plan in place is important.

2. Act early.

You need to look inside yourself and know yourself and your family history to determine when you should start planning. Someone with a family history of Alzheimer’s, Parkinson’s’, heart disease, and other serious conditions should start planning much earlier than someone whose family genes are strong.

No matter what type of family tree you have, it is never too early to start planning for long-term care, because just like car insurance, you may never need it, but will be thankful if you do! You can create a long-term care plan by socking away money for medical emergencies, or invest in a long-term care insurance policy that will give you peace of mind that you will be financially taken care of later in life.

3. Make new friends and keep the old.

Your social connections can help with practical health care needs, like driving you to the doctor when you’re unable. But they also do something powerful: keep you alive, research suggests. In a 2012 study of over 2,100 adults age 50 and older, researchers found that the loneliest older adults were nearly twice as likely to die within six years than the least lonely — regardless of their health behaviors or social status.

Connections can also help ward off depression, which affects nearly 20 percent of the 65-and-older population, according the National Alliance on Mental Illness .  The more social activities you have, the more friends, the more things you can do to keep your body and mind active — that’s the best protection you have against mental illness.”

4. Appoint a proxy.

Find that person who you trust most in the world and ask them to be the keeper of your personal information in case of an emergency. They should have your Social Security number, where you keep your insurance card, which medications you take, everything you would need in the event of an emergency. Also, revisit the information with that person every so often to update any new medications or other pertinent information.

Before you start losing any cognitive capacities, consider designating that person as your durable power of attorney for health care, or the person who makes health care decisions for you when you’re no longer able.

If no one comes to mind, hire an attorney who specializes in elder care law by asking around for recommendations or searching online for highly rated professionals. Unlike your friends, they have a license to defend and are well-versed in elder care issues.

5. Live well.

The two biggest things you can do to stay healthy as you age is exercise and eat well. Some of the foods that we eat are really, really bad for the body and that’s one of the major causes of chronic conditions — and not exercising.

Keeping your brain sharp is also critical if you want to be able to make informed decisions about your health care. Participate in activities that challenge you — math problems if numbers trip you up, or crossword puzzles if words aren’t your forte. “The old adage, ‘If you don’t use it, you lose it,’ is 100 percent correct.

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When Assisted Living Isn’t Enough

You and your family may be beyond frustrated and sad about your aging loved one’s situation, and you may think you have no options. However, the truth is that there’s always something that can be done to optimize health and wellbeing when assisted living isn’t enough.

Whether it’s consulting a geriatrician for expert advice and care information, finding a senior care community that specializes in memory care, or exploring Program of All Inclusive Care for the Elderly (PACE); there are services and expertise available to you and your family.

According to the U.S. Census Bureau, the nation’s 65+ demographic, which currently accounts for 13% of the overall population, is expected to more than double by 2050 to more than 89 million – roughly 20% of the population – and 5% accounts for people 80 years and older. It’s no mystery that people are living longer these days, so families have to make tough choices for aging family members on a daily basis.

Discover options that may be available to you, depending on your loved one’s unique situation.

Continuing Care and Memory Care Communities

If your aging family member’s needs have outgrown their family home, senior living community or assisted living community, there are other options available.

Some families know in advance that they want a community that offers different levels of care as their loved one ages, and these communities are known as a continuing care retirement communities (CCRC), or lifetime communities. CCRCs are retirement communities with accommodations for independent living, assisted living and nursing home care, offering residents a continuum of care. Your elderly family member can spend the rest of his or her life in a CCRC, moving between levels of care, as needed. This type of community is often called ‘aging in place’ as the services and accommodations offered evolve as level of care progresses with age. As with any living arrangement, it is important to look at services offered by each community, the possible benefits and disadvantages, the costs, and the contractual obligations of the CCRC.

Memory care communities have become very prevalent these days for people who suffer from dementia or Alzheimer’s. Memory care caters to residents’ specific needs, and the communities are often in a secure assisted living or nursing home setting, usually in a separate floor or wing with layouts to accommodate wandering. Residents may live in semi-private apartments or private rooms and have structured activities delivered by staff members trained specifically on caring for those with memory impairment.

A person who suffers from dementia and Alzheimer’s will eventually require 24-hour supervised care in catered settings, making memory care a preferred choice for many families. But, again, it’s important to do your research and find a community that compliments your loved one’s needs and personality; while also keeping the family budget in mind.

Program of All-Inclusive Care for the Elderly (PACE)

PACE is a Medicare and Medicaid program that helps people meet their health care needs in the community instead of going to a nursing home or other care facility.

If your aging loved one qualifies for PACE, he or she would have a team of health care professionals working with your family to get the care needed for your family member’s specific medical condition.

PACE organizations offer care in the home, community and the PACE center, but there are specific requirements needed to participate in this program, so you’ll need to research whether it’s right for your family. Follow this link to find out more information about the Sutter PACE Program.

Speaking with a Geriatrician

Last, but certainly not least, a geriatrician is always an excellent source of information for families. As a medical doctor who specializes in senior care, a geriatrician is specially trained to meet the unique healthcare needs of older adults, and answer medical questions for both patients and family members. If you are looking for another perspective or second opinion from your loved one’s doctor, a geriatrician is an informed professional who can help answer questions and discuss unique care needs.

Geriatricians are in fairly short supply, as to date relatively few doctors have chosen to specialize in aging adults.

As an added benefit, geriatricians are cross-trained in palliative care, and are experienced in helping families navigate goals of care, difficult symptoms, and other challenges that come up in the last years of life.

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Holidays and Depression

The holiday season is a time of joy, laughter, family gatherings, and wonderful memories, created and remembered. However, not everyone enjoys this time of year, for some it actually causes depression. For many individuals, and most especially seniors, the holidays can be especially sad and depressing. If you are a caregiver or family member of an aging loved one, you may observe a change in their mood or behavior during the holidays. You may notice unusual signs of fatigue or sadness or perhaps limited interest in the holiday season. Sometimes it is not even so much the holidays that is the problem, it is the memory of past holidays, happier times when all of the loved ones were still around that causes the depression. There is a name for the depression it is called Seasonal Affective Disorder (SAD) and it can affect seniors in warm climate as well as cold ones.

What causes depression in the elderly?

Depression can be caused by a minor or serious medical problem; chronic pain or complications of an illness; memory loss; poor diet; loss of a spouse, close friend or companion; a move to a care facility; lack of exercise; change in routine; general frustrations with aging. Symptoms to look for include:

*              Depressed or irritable mood

*              Feelings of worthlessness or sadness

*              Expressions of helplessness

*              Anxiety

*              Loss of interest in daily activities

*              Loss of appetite

*              Weight loss

*              Lack of attention to personal care and hygiene

*              Fatigue

*              Difficulty concentrating

*              Irresponsible behavior

*              Obsessive thoughts about death and suicide

Depression or Dementia?

In depression there is a rapid mental decline, but memory of time, date and awareness of the environment remains. Motor skills are slow, but normal in depression. Concern with concentrating and worry about impaired memory may occur.

On the other hand, dementia symptoms reveal a slow mental decline with confusion and loss of recognizing familiar locations. Writing, speaking and motor skills are impaired and memory loss is not acknowledged as a being problem by the person suffering dementia.

How do you help your elderly loved ones through the Holiday Season?

There are many of activities you can create for your family member to help the combat the depression during this season.

–              Listen and understand when they want to talk, even if the talk is negative. They are likely mourning many of the losses mentioned above. Don’t imply they are whining or that they should snap out of it. They can’t. Your empathy is vital here. Try to put yourself into their place.

–              Remind them how important they are as a part of your own celebration and that of the entire family. Be especially careful not to act like what you do for them is a duty. This can be tough, as your tired body language can show through. However, again, put yourself in their place. They may feel useless and burdensome. Remind them they are loved.

–              Holiday cards often bring bad news, and diminish in quantity. I used to sit with my mom when she opened her cards, because nine out of ten cards brought news of illness or death. She was very aware, too, of the people she didn’t hear from. That was one reason I helped her write her own cards. She needed this connection with life-long friends.

–              If your parent is in an assisted living facility or nursing home, check with the local kindergarten or day care centers to see if they can bring children to visit the elders. The freshness of the small children’s presence can help lighten a day for an elder in physical or emotional pain.

–              Contact their church and find out what they do to help support elderly congregation during the holiday season. These people undergo considerable training that provides them with tools to listen compassionately and creatively. This can go a long way toward helping with depression over the holidays.

–              Decorate their home or room in stages, presenting cherished ornaments for Christmas or a menorah for Chanukah at intervals so there is something to look forward to. By the way, electric menorahs are available if your parents live in a facility where real flames can’t be used.

–              Bring traditional baked goods or treats regularly for your elders and their friends to share.

–              Spend time with them. This is the most important thing you can do. Look at holiday photos or videos with them and leave them photos in a handy place so they can walk down memory lane when they are alone. Play music. Listen to them reminisce.

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