Seniors and Proper Nutrition

Our Los Angeles Alzheimer care facilities offer healthy meal options.While eating healthy is vital for any person, regardless of age, the senior population tends to be especially susceptible to poor nutrition or malnutrition. Studies have revealed that a whopping 15 – 50 percent of elderly people in the US suffer from malnutrition, but detection has sometimes proved difficult. Symptoms such as lethargy, light-headedness and loss of appetite are often mistaken for other illnesses. However, as a caregiver, you can help to combat this challenge. Often more important than attempting to alleviate the nutritional deficiency, getting to the root of why your aging loved one is not eating (or eating well) is essential. Some common causes for poor nutrition in seniors includes the following:
  • Medication. The side effects of certain drugs can lead to nausea, poor appetite, and altered taste buds. It doesn’t matter whether the medication is prescription or over-the-counter – feeling bad often leads to reduced food intake.
  • Poor Dental Health. Some seniors have difficulty with their dentures, broken or missing teeth, or pain in the jaw area that can make the consumption of some foods exceptionally difficult.
  • Lack of Transportation. Ours is no longer a society which harvests its own food, so we depend heavily on routine trips to the grocery store or market to get healthy, fresh foods. Seniors have often scaled back on driving due to the hassle of heavy traffic or other challenges; some have stopped driving altogether. This can make getting the foods you need difficult or nearly impossible.
  • Cognitive Decline. Memory loss (caused by dementia, Alzheimer’s, or other diseases) can disrupt the very idea of maintaining a routine of any sort. The brain’s reaction to these diseases can sometimes make a senior forget very simple things you take for granted (such as when they ate their last meal). Further, some seniors suffering with cognitive decline will buy large amounts of the same items (which can, and often does, reduce their intake of certain nutrients).
  • Depression. A person suffering from depression will often simply feel too “blue” to concern themselves with their diet. Depression tends to take a toll on an individual’s appetite, as feelings of loneliness and/or unhappiness mount. While depression is manageable, this shouldn’t be left untreated.
  • Health Challenges: Some health challenges can make simple kitchen tasks unbearable. Arthritis, vertigo, joint or other pains, and overall weakness can lead seniors to settle for something quick and easy, but less healthy.
The best way to pinpoint signs that these challenges may be leading to nutritional deficiency is to simply observe and have open conversations with your loved one, especially when or if you suspect that he or she isn’t eating enough or enough of the right things. Speaking of right things, the types of foods taken in is important. Whole grains, fresh fruits and vegetables, protein-rich beans or other legumes, and lean meat and dairy should be the norm in a senior’s diet. The combination of these items helps assure that seniors are getting essential vitamins, minerals, and other nutrients. Other ways to encourage your senior to get better nutrition include: dining as a group, especially with other seniors (to introduce the social factor); maintaining food storage for them; grocery shopping with them; and addressing contributing health concerns that are obstacles to eating well.  
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How to Dispute Health Insurance Errors

Board care for elderly can cause medical bills to pile up.

Photo used under Creative Commons from attercop311.

With the possibility of multiple bills being generated from a single visit – along with discrepancies in the diagnosis and treatment necessary – there’s no wonder that medical bills sometimes have errors. In fact, a recent study conducted by the American Medical Association revealed that even with the recent improvements in billing accuracy, a full 10% of bills paid by private insurance companies do, indeed, have errors. Added to that is the fact that next year, in 2014, a much greater number of Americans will have health insurance coverage under the Affordable Care Act, thereby increasing the possibility of errors. There are ways consumers can dispute any health insurance billing errors they find. The following are just a few suggestions to set things right and possibly save yourself quite a bit of out-of-pocket expense in the process. First, make sure your insurance provider has the most accurate and up-to-date information about you. Though it sounds entirely too simple, such discrepancies as your date of birth, the spelling of your name or whether or not you regularly utilize your middle initial on your paperwork can create problems. A great example of how this can happen is when a person is admitted to the hospital. A hospital patient can be seen and tested in a number of different departments, and unfortunately, all the departments create separate billing for the work performed. Thus, it can be tricky to keep up with all of this and to remember it all at the time your bill is actually received. It is always best if you have a friend, family member or other patient advocate available to double-check the information while you’re being seen at the hospital. Second, review your bill. Generally, your bills come with an explanation of benefits – read them over and be sure you understand them fully. This statement will indicate what services are being paid for by your insurer and which ones are not. This is a great way to get a clear, concise explanation if your insurer doesn’t cover a particular service. Third, be sure you have a good understanding of your insurance benefits. Have a working knowledge of your deductible and your co-pays. If you have to be referred to a doctor outside the network, understand what percentages are covered for these types of visits. In the case of pricey specialists, you should know that insurance companies often work with average “industry standard” costs for certain services and often will not bend if your specialist charges significantly more than the average. Fourth, after reviewing your bill and truly understanding your benefits, don’t be afraid to ask questions if you do not understand. Challenge the charges if you deem it necessary. Be sure you keep detailed records of who you spoke with and their responses. Keep a copy of anything you fax, mail or email to your insurer. Fifth, check the medical coding information. Much of the medical billing information you receive works off of specific coding from your doctor’s office, submitted directly to the insurance company. In certain cases, you may need to go back to the doctor’s office to request a “run-down” of the medical codes associated with your visit. Compare this information to your bill. If there is, indeed, a discrepancy, you can go back to the doctor’s office and ask that the information be corrected and resubmitted. A simple error in coding the diagnosis can make a huge difference in the payment of services associated with that visit. Sixth, get agreements in writing. Promises are no good without written confirmation, preferably via email. Finally, if the dispute process seems entirely too consuming, you may consider getting a medical billing advocate to help. A growing number of consumer advocate services and software programs are now available to assist in detecting and disputing medical billing errors.  
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Coping with Dementia Behavior

Los Angeles Demetia care understands, we can help.Of all the diseases that can affect our loved ones, dementia is one of the most difficult. Your loved one may have been an intelligent individual who you enjoyed interacting with, but the effects of the disease on the brain may cause that person to become an almost distant stranger you barely know. People facing the early stages of dementia generally understand that something is awry. They may become forgetful, have difficulty remembering names or performing ordinary tasks. Initially, your loved one may attempt to hide the challenges they face by offering a myriad of excuses. Eventually, though, as the disease progresses, your loved one’s frustration is likely to mount as he or she realizes things are getting worse and not better. The loss of independence and often the lack of understanding about what is actually happening becomes very frightening. Anger is sometimes an expression of fear, and as the closest individual to your loved one, you may bear the brunt of the angry outbursts often associated with dementia patients. It is also important for family caregivers to recognize that dementia patients often lose the ability to reason, so what makes perfect sense to them can seem outrageous to others. Sometimes wanting to prove their abilities to maintain their own independence, a dementia patient can, and will sometimes, defy the instructions given by family and physicians. In these moments, it’s important to remember that your loved one does not have the full control or understanding of their actions that they did ten or twenty years ago. So how do you, as a family caregiver, maintain a peaceful, positive relationship with your loved one? First, patience. Yes, mom or dad may ask the same question 25 times a day. Yes, they may tell stories so off-base you’re tempted to lose it. Don’t. Your loved one sees the world through an entirely different filter, and losing your temper benefits no one. So, answer the questions repeatedly. Change the subject. Refocus your loved one on the flowers or animals in the backyard or on music. If those tactics are ineffective, remove yourself temporarily by taking a 10 minute walk or enjoying a calming cup of tea. Praying or venting with a friend (far away from your loved one, of course) can also help reel you back in and shift your perspective. Second, do your best to avoid arguments. Your loved one’s stories may be driving you crazy, but arguments fuel tension at a time when your loved one needs reassurance that you will actually be there for them. Further, dementia patients can be quite stubborn, so they are less likely to back down in the face of conflict. Third, do not take things personally. Dementia patients often lash out at the very loved ones who are attempting to help. Harsh statements can be hurtful coming from anyone, but absolutely devastating when said by your loved one. This is when it is critical to understand the effects of the disease on a person’s behavior and memory. Blame it on the disease, not the person, to reduce your stress and enable you to maximize your time with your loved one. Fourth, get help. Your parent’s doctor can often prescribe medication to reduce their anxiety, so discuss the challenging behavior with them. They may have solutions you are not yet aware of. Also, your emotional and physical health is vital, too, so join a support group to connect with others going through similar experiences. Take care of yourself and see your doctor regularly.
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Preventing Problems with Medication

Los Angeles Alzheimer care facilities prevent problems with medicine.If the healthcare industry actually tallied the numbers and assigned a price tag to medication-related illness, the numbers would place it fourth-highest among “diseases” – behind cancer, Alzheimer’s and cardiovascular disease. A recent study published in the Journal of the American Medical Association, entitled: “Use of Prescription and Over-the-counter Medications and Dietary Supplements Among Older Adults in the United States,” revealed that 91% of adults over the age of 57 are taking some type of medication on a regular basis, with 81% taking a prescription medication regularly. Prescription medication was only one type of medication studied. The researchers also looked at over-the-counter medication, herbal supplements, and vitamins and minerals. The JAMA study concluded that at least half of the survey respondents were utilizing at least 5 medications regularly, which translates to a lot of chemical and natural compounds entering the body routinely. While medications are designed to assist the body in dealing with particular challenges, certain compounds react with others in a manner that can, and does, create harmful interactions. These harmful drug interactions account for an average of 175,000 trips to the emergency room each year for seniors. It is important to take into account age-related differences in the body which may affect the way a medicine reacts for a senior versus younger adults. Older adults tend to lose muscle and store more fat, and the fat balance can alter the effects of medication in the body. The health and overall functioning of the person’s eliminative organs (i.e., the liver and kidneys) has a tremendous effect on how well the medication is removed from the body. Poor elimination can spike the presence of the medication in the blood levels. Hydration (or lack thereof) can be a huge issue that seniors must guard against, since it definitely affects the way the stomach absorbs a particular substance. And what we eat, the effects of certain foods and liquids on our absorption, side effects, etc. are critical. To prevent medication-related challenges, all your healthcare professionals should be aware of every medication you are currently taking. This is not simply related to prescription medications, but should include all compounds you take on a regular basis, even the seemingly innocent ones. Antacids, aspirin regimens, vitamins, minerals, herbal supplements – if you take it regularly, every person who contributes to your healthcare in any manner should be aware of it. Ask your healthcare professionals questions. In addition to problematic drug interactions, certain combinations can deplete important nutrients from the body, so it is best to be aware of the possibilities. Your pharmacist is also your secret weapon in the fight for the prevention of medication-related challenges; he or she is often able to research the various medications you take for possible interactions. Be sure you contact them at a slower time of day so you can get the focused attention you will need. Because the needs of seniors are different, there is a specialized field of pharmacists called “Senior Care Pharmacists” which may be of particular benefit. Find one utilizing the website of the American Society of Consultant Pharmacists. Finally, you can conduct your own research by browsing through the “Beer’s List” of potentially inappropriate medications for senior adults.
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Tips for Getting Cozy in Assisted Living

Our assisted living facilities in California make like comfortable.While many of us dislike change, for an elderly person, change can be especially difficult. Dealing with changes in their body, family dynamics and the like is already a tough process, but the notion of leaving home – their home – is probably amongst the toughest transitions an elderly person may face. As the adult child of an elderly person, you may feel strongly that a move to assisted living is in the best interest of your loved one. For example, safety may have become an issue. However, your opinion may not be readily shared. Your loved one may be leaving a home where they’ve lived for decades – the birthplace of countless years of memories. Moving away is a significant loss, and even if health and safety concerns necessitate the change, it is best to remain sensitive to the emotions that come along with it. So, how can you create the best possible transition? The following are a few tips that may help make the assisted living facility feel a bit more like home. First, take an inventory of the personal effects your loved one feels strongly about. While this could include any number of items, from bed linens to a comfortable chair or a painting, having the comforts of home always makes a person feel better. If you are questioning the items you should take, simply ask your loved one which items they feel strongest about. Their answer can, sometimes, truly surprise you. In the midst of these conversations, you may learn about the significance of certain items they cherish (i.e., could be a family heirloom, an item received in their “courting” days, etc.). In any event, it is important you do not simply assume, but that you truly get this part right. The only way to know is to ask. Second, spruce up their new home with colors, treasures and other items that make the space feel like their own. Photo albums, pictures on the walls, window dressings, etc. are all inexpensive upgrades that can make a world of difference. If your loved one enjoys hosting others at home, sometimes the very simplest gestures (like a candy bowl or other treats) can make this new space feel more like the home they left behind. Third, begin calling the assisted living center their home. If the place feels like, and is referred to as, a temporary dwelling, your loved one may resist getting comfortable there. You don’t want the assisted living center to feel like a hotel or worse, a hospital – you want your loved one to embrace this new community and to enjoy being in thier new space. Fourth, speak with the staff about your loved one’s unique personality and how to engage them in this new community. This conversation may actually turn into a brainstorming session, but this will give the staff a better feel for your loved one and what resonates with them. Just like your parents did when you were younger, help them find a peer group with which they can relate. For example, if your parent has relatively little trouble moving around, make sure they meet others who don’t have major mobility issues. Positive social connections are important, and you are his or her best advocate for that. Finally, nurture and encourage – don’t force. Give your loved one a chance to adjust, but be careful that the transition isn’t taking too long or met with excessive resistance. Watch also for signs of depression, and take the appropriate steps to get help if he or she seems to be falling into a depressed state.  
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What to Do When Your Parent Refuses to See the Doctor

Los Angeles Alzheimer care has healthy options.Among the challenges you may face as a caregiver for an aging parent is the refusal to see a doctor. Most people assume a person who has the financial means to get medical care will do so  – just simple scheduling, right? Not always. So what do you do? First, go for backup. While it may sound silly, if you have been a caregiver (or in contact with other caregivers) for any length of time, you understand that family dynamics can often come into play in these situations. Your parent took you to the doctor as a child, and in your adulthood has been offering you advice over the years. Having those tables begin to turn – even if it is ever so slightly – can cause some resistance. As their loved one, the caregiver often thinks their advice is first to be considered, but the nature of family dynamics sometimes proves otherwise. Often, you can enlist the help of an objective third party, such as a doctor or nurse. Preferably, this person is already known to and trusted by your parent. He or she is likely to be viewed very differently since they’ll be seen as a professional and not subject to the parent-child power struggle. If possible, a geriatric physician is even better, because he or she deals with patients in their age range every day and can often hint at possibilities that others (loved ones or not) may miss. They can often be your best advocate. Second, if the objective third party doesn’t work, or if you cannot secure one easily, getting one of your parent’s friends on board may work wonders. The friend may have already seen a geriatric physician or know someone who has similar symptoms who sought medical attention. Cast your net to include relatives (perhaps your parent’s sibling) to weigh in on the subject as well. Though the friend or sibling definitely has an interest in the matter, they also have more life experience and can relate to your parent on an entirely different level. Third, create a positive reward. As a person ages, the “stuff” of life becomes less important than the experiences of life. So, perhaps the two of you can have breakfast or lunch at their favorite diner after the appointment. It becomes a positive memory for your parent and it creates a convenient focal point should another doctor’s visit be necessary. Fourth, be aware of the time span between appointments. Often, when we are scheduling appointments at the front desk, the scheduler may offer you the very first appointment available. If there is no medical emergency, some time between appointments may make the experience seem less invasive and unpleasant. As a caregiver, you will often need to gain a greater level of perspective in order to relieve frustration. For example, your parent may give you what you deem an absolutely ridiculous reason for not wanting to go to the doctor. For some people, aging brings with it a fear (albeit sometimes irrational) of doctors or hospitals. It may create a very unpleasant association – for example: it may conjure up memories of time spent with their loved ones following an illness or it may bring to the surface fears of hearing that he or she may need to have a surgical procedure. For an elderly person who has been relatively healthy and independent all their lives, the thought of losing that independence can be extremely bothersome. Though younger generations have embraced pharmaceuticals, many older adults have relied heavily on the home remedies and tinctures their mothers and grandmothers used on them. Certainly, a level of distrust can exist toward these “newer” treatment options (and their side effects). Either way, try to assure the discussion (and the trip) is as pleasant as possible… but do schedule that appointment at the first sign of an okay…. okay?
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Financial Mistakes to Watch for in Retirement

Board care for elderly can lead to financial mistakes during retirement.

Photo used under Creative Commons from bradipo.

While some people work and save for years so they can have a very comfortable lifestyle during their retirement years, others find  keeping their retirement nest egg intact to be a challenge. A 2010 survey conducted by Wells Fargo Bank revealed that more than a quarter of the American population has concerns about their finances for retirement. Thus, we’ve put together a short list of common financial blunders to avoid when you’re working to protect your valuable assets. Have a Clear Understanding of Medicare and Medicaid: While Medicare is a very valuable healthcare management program, many retirees do not have the best handle on what is – and is not – covered by Medicare. One of the most financially devastating challenges to your financial health in retirement years is the need to enter an assisted living facility. While Medicare does, in most instances, cover a short-term stay in a rehabilitation center, Medicare will not cover a long stay in assisted living since assisted living is not medical care. Unlike Medicare, the federally funded Medicaid program will cover long term care, but Medicaid is a program designed for seniors who have exhausted all their assets (for a considerable period of time) and is generally considered an absolute last resort option. Many assisted living facilities do not accept Medicaid. Make no mistake – just one serious health challenge faced in the absence of a long term care plan can wipe out years of financial planning. It can also leave you with little options should you face a second, or third, health challenge. If you do not have a long-term care plan, or if yours is not comprehensive enough, start planning for that rainy day now. Beware of Con Men: Today’s seniors grew up in a world that was more trusting and more caring. However, that innocence, along with the availability of funds and assets, makes them a huge target for the unscrupulous (to the tune of $2.6 billion annually). A good rule of thumb: if it sounds too good to be true, it is. Estate Planning 101: Most individuals recognize the importance of having a will in place to leave their assets to the beneficiaries they hold dear. However, wills are not a set-it-and-forget-it type of document, and depending on when the will was initially drafted, it may have to be amended more than once. Pay attention to major life changes you experience, such as divorce, the death of a beneficiary, a birth in your family, or adoption. Note: if your will’s executor passes away, run (don’t walk) to have a new one appointed. The general rule of thumb is to review and update your estate plan portfolio at least once a year (with, of course, revisions done in between when there’s a major change). Doing so will help you notice when your documents have become outdated. Enlist the Help of Professional Estate Planners: While most family members mean well, the fact is that retirement planning is a specialized field best handled by professionals. Unless you have a family member who is both trained and experienced in this field, not just dibble-dabbling and reading market trends, it is best to maintain a relationship with a trusted advisor. Having the input from family members is fine, but before acting on their opinions, be sure your financial planner agrees.
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How to Talk with Someone Who Has Alzheimer’s

Our assisted living facility in California has items to comfort.

Photo used under Creative Commons from Karen Roe.

As human beings, we are created for meaningful relationship with one another. Healthy communication is a vital part of remaining connected in any relationship – even when the person you’re communicating with has been diagnosed with Alzheimer’s disease. While cognitive decline puts a tremendous toll on your loved one’s ability to remember significant people, places, and things, it can also severely impact your ability to communicate with them. There are, however, a few important tips to bear in mind as you are working to maintain healthy communication with your loved one. It is also vitally important that you remember no matter what stage your loved one is in, human connection is essential to his or her overall well-being. That said, the following are some suggestions to make this challenge a bit easier for the both of you.
  • Create A Distraction-Free Zone: Background noises can distract anyone – even those with no cognitive challenges at all. But for a loved one suffering from Alzheimer’s disease, the television, radio, or other device can easily compete with your conversation. Give your loved one’s conversation your full – and undivided – attention in a peaceful environment.
  • One-On-One Conversation: While it may sound silly, having multiple individuals gathered together for conversation can create an overwhelming and highly confusing environment for your loved one. After all, the more individuals who are present, the more apt each party is to contribute to the conversation. It can prove to be extremely agitating to your loved one, whose brain may still be trying to process what has been said as well as who has offered the input. Keep the conversations simple – one person at a time.
  • Simple, Lighthearted Conversation: There’s always something to be said for small talk, but especially so when your loved one is experiencing cognitive decline. Most of us are taught to converse with others using open-ended questions to spark conversation. However, for an Alzheimer’s patient, this leaves entirely too many choices. Remember, your loved one may not remember the significance of certain titles, such as “nurse.” Therefore, he or she may ask questions like, “What’s a nurse?” Combat these challenges by simply referring to your loved one by name, and referring to yourself (or another person) by name. It helps the Alzheimer’s patient to orient themselves. If you’re speaking to your loved one about an animal, address the animal either by name (if it’s a pet) or by species (for example, “cat”) instead of saying “it.” Again, it helps your loved one keep track within the conversation.
  • Be Patient and Non-Combative: It is easy to understand how difficult it becomes for you, as the loved one of a person suffering from such a debilitating disease, to repeat yourself or explain the who-what-and-where’s of very familiar things. But engaging in arguments will most likely end in one result – agitation for yourself and your loved one. Stay calm and repeat yourself if necessary. If your loved one seems to be having difficulty in making a request, do your best to state the question you feel he or she is attempting to ask. For example, if your loved one is fumbling around for something on a table nearby, you may say, “Are you looking for a tissue? Are you looking for your glasses?”
  • Watch Yourself! Everyone understands that non-verbal communication is as important as, if not more than, verbal cues. Cognitive decline, especially as it progresses, will undermine a person’s confidence as simple, routine tasks become increasingly more difficult. Thus, your loved one is likely to be highly sensitive to everything you say and do. The tone of your voice and your body language is important. Expressing your acceptance with friendly eye contact and kind facial expressions is important. After all, the goal is to maintain positive communication with your loved one and to minimize feelings of confusion or distress which may lead to negative, hostile reactions or to your loved one “shutting down” due to feelings of isolation.
 
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