Beat the Flu

Tried and true flu shot proves to be the 

best defense against influenza this year.

It is that time of year when people of all ages start worrying about the flu season. The concern is real and prevention is important.  The influenza virus can be extremely serious.  Every year thousands of people are hospitalized due to the flu.  Approximately 46,000 people die annually from flu complications.  Each year new strains of the virus circulate making being vaccinated annually very important.

For the past couple of years a nasal vaccine called FluMist was available.  It was used with small children so to avoid the painful poke of the injection.  Unfortunately this type of vaccine has been proven rather ineffective in beating influenza last season.   Recently the AAP (American Academy of Pediatrics) recommended that everyone aged 6 months and older get the tried and true flu shot to ward off getting sick this flu season.  The inactivated influenza vaccine (trivalent or quadrivalent) was proved 63% effective against last season’s flu strains whereas the nasal spray version was only 3%.  This could mean that there will be more demand for the vaccination than normal. 

The AAP encourages everyone to get their flu shot no later than October to be protected against the virus for the entire season.  The length of flu season is unpredictable and outbreaks of flu can occur even in the spring, so healthcare providers are encouraged to provide the vaccine up to June 2017. 

The very young and the very old are at high risk from flu complications.  According to the CDC (Center for Disease Control) getting the flu shore reduces the chances of catching the flu by up to 90%.  Other preventative measures include practicing good hand hygiene, covering the mouth when coughing or sneezing and maintaining a clean living environment.  One especially helpful preventative measure is avoiding exposure to the flu by staying at home during the peak of the season.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Deb Hintz is Assistant to the Director for HomeAid Health Care. HomeAid provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to MedAid Staffing which provides trained Caregivers to serve the staffing needs of local facilities as well as educational training classes for Caregivers. Both companies are associated with Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the three family owned and operated companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

Sources: 

www.cdc.gov/flu

www.medscape.com. Medical News, 9/6/16.

www.mystatesman.com. Nicole Villalpando, 8/20/16.

Strokes: Signs and Symptoms

Strokes cause long-term disability and death. 

Edith suddenly felt odd as she sat at the table for lunch.  The glass in her hand slipped from her fingers and everything looked blurry.  A small trickle of the water she just sipped dribbled from the corner of her mouth. She tried to speak but her words slurred and came out wrong.  Edith was having a stroke.

Fortunately Edith’s family realized something was terribly wrong and got her to the hospital in time. 

Strokes kill close to 800,000 people each year and is the 3^rd leading cause of death in the United States. It is also the leading cause of grave long-term disability. 

What is a Stroke

A stroke takes place when the brain doesn’t get enough blood.  When a Stroke is happening, the blood supply to part of the brain is interrupted or severely reduced, starving the brain tissue of oxygen and nutrients. Within minutes, brain cells begin to whither and die. This happens either due to the blood flow being blocked by a clot or because an artery feeding the brain has burst.  The lack of blood flow to the brain is immediately evident and requires quick intervention to prevent permanent damage or even death.

Risk Factors

Risk for having a Stroke increases with age, but it is also affected by other factors:

• High blood pressure - Having Hypertension increases the risk factor of          experiencing Stroke by 4 to 6 times.
• Diabetes - People with Diabetes often have damaged blood vessels in the brain and so have a 3 times greater risk of having a Stroke.
• Heart Disease - Irregular heartbeat or damaged heart can contribute to having a Stroke.
• Abnormal Cholesterol - Having too much the “bad” LDL cholesterol or too little of HDL “good” cholesterol can also trigger Stroke.
• Obesity - Being overweight can contribute to all the other risk factors making Stroke all the more likely to strike.

Symptoms of Stroke

It is more likely that a bystander will recognize the Stroke than the person experiencing one.  Knowing what the symptoms are and what to do is very important as every second counts when getting treatment.  A Stroke is evident by the victim’s inability to speak, a awkward facial expression and cognitive confusion.  Secondary symptoms may include dizziness, loss of balance and sudden onset of a headache.  Some people experience blurred vision on one or both eyes, a weakness on one side of the body and nausea.  Some people suddenly experience trouble walking.

F.A.S.T.

This acronym can help recognizing a Stroke as it is happening.

• F – FACE  Ask for a smile.  Check if the face is drooping on one side.
• A – ARMS  Ask to raise their arms.  Check if one arm drops down.
• S – SPEECH  Ask to repeat a simple phrase and check for slurred or odd speech.
• T – TIME  If any of the signs are evident, call 911 immediately. 

Getting to the hospital for treatment is important.  The goal is to get a diagnosis within an hour of experiencing a Stroke and treatment within 3 hours so to avoid complications and long-term disabilities.  

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to MedAid Staffing, which supplies trained Caregivers to local facilities, and Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the three companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

 

Common Traits of Longevity

What do the longest living people

in the world have in common?

They say that it is the little things that matter most in life.  That is true especially when talking about the secrets of longevity.  Apparently it is the small details of daily living that add up to a healthier and longer life.  That is what the people at National Geographic discovered when they tried to explore the secrets of longevity among various people and cultures.  While looking for the common traits in lifestyle among the longest living people on the planet, they discovered certain similar practices which could be considered a formula to living a longer life. 

There are areas of the planet where people tend to enjoy longevity.  People there reach the age of 100 at extraordinary rates and reach these ages enjoying   amazing health  and strong cognitive capabilities.  The places have been geographically and demographically defined as the Blue Zones.  Blue Zone places like Greece, Nicaragua and Japan can teach the rest of the planet how to live a long and healthy life.  In the book, “The Blue Zones: Lessons for Living Longer from the People Who’ve Lived the Longest”, Dan Buettner maps out some common traits shared be these groups of people.

Lifestyle of Food

Diet is key to longevity.  Those who live in the Blue Zones share the same foundation in their diets. They all get the bulk of their protein from beans rather than meat.  High consumption of proteins from animal products can increase mortality levels by 70% and greatly increase the risk of getting cancer.  The Blue Zone centenarians eat beans, grains, fresh fruits and vegetables on a daily basis and enjoy small amounts of meat only a couple times a month.  They also drink a little wine daily which brings high levels of polyphenols and antioxidants into their diets. They live much longer than average with just a fraction of the current rate of dementia in their elderly years.

Lifestyle of Motion

People who live to the age of 100 and older are engaged in physical activity throughout their lives.  They don’t actively take part in exercise like per se but their lifestyles are set up so they are constantly in motion either through walking, gardening or doing household chores, mostly without the aid of modern conveniences.  Their daily chores keep them fit because they do them the old fashioned way: walking to the stores instead of driving, kneading bread instead of buying it sliced and packaged, planting, watering and weeding a vegetable garden…. These daily tasks create unconscious physical activity which carried out over a lifetime leads to a fit and healthy body.

                                                                                         

Lifestyle of Purpose

Having a sense of meaning or purpose in your life can add up to 7 years to the average lifespan.  The people living in the Blue Zones focus on family and relationships.  They live with or near their adult aged children and help raise their grandchildren.  They are deeply involved in the daily lives of their family because they all live, work, eat and play together.  Having a deep sense of purpose and involvement with the people you love adds years to a lifespan. 

Lifestyle of Community

Those living in the Blue Zones have a real sense of belonging to their community.  They share a commitment to social network that they have built over a lifetime.  Most live in a village setting with people they grew up with and have known for years.  The concept of being lonely, which can take 8 years off average life expectancy, would be hard for them to understand.  In addition the bulk of the centenarians are involved in a faith based group of some kind. A deep religious faith and connection to other faith based people can add up to a decade in life expectancy.

Taking a lesson from lifestyles found in the Blue Zones and adapting them to our daily lives can be a challenge but is well worth the effort.  Aging cannot be helped but how you live as you age can make an amazing difference in the quantity and quality of the years you enjoy.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

Sources:

“Here are the Secrets to a Long and Healthy Life” by Simon Worrall, National Geographic. April 12, 2015.

“The Blue Zones: Lessons for Living Longer from the People Who’ve Lived the Longest” by Dan Buettner.

National Geographic, 2009.

“Top Lifestyle Changes for Older Adults to Live a Longer, More Enjoyable Life” by Derek Jones, April 4, 2016.

Preparing Your Aging Loved Ones for Tornado Season

Be sure to have an emergency plan

in place for your aging parents.

It was a calm afternoon in early May when the sky suddenly turned dark and ominous.  A thunderstorm was approaching.  The clouds turned green and then yellow and orange and soon began to pile up and converge.  As the sky grew dark and the wind picked up, large hail began to fall.  A tornado was on its way.

Our area will soon be in the severe weather season for tornadoes.  A tornado can occur at any time of the year; however, the peak season for Wisconsin is May through August.  In the northern states the season starts later in June and the southern states are on alert as early as March.  Even if you and your aging loved ones don’t live in states considered to be part of the tornado alley, it is important to have a plan in place in case the weather turns severe.

Warnings

Knowing the difference between the two tornado warnings can help individuals know what steps they need to take to protect themselves. 

A Tornado Watch is an indication that tornadoes are possible in and near the watch area.  During a Tornado Watch, people should remain alert for approaching storms and be prepared to move to safety if a warning is issued.  It is a good idea to know which counties are in the watch area by listening to NOOAA Weather Radio All Hazards or a local radio or TV station.  

A Severe Thunderstorm Watch means that thunderstorms with large hail and damaging winds are possible. With a Severe Thunderstorm Watch, individuals must be prepared to move to a safe place immediately.  

A Tornado Warning is when a tornado has been sighted or indicated by weather radar.  Once a Tornado Warning has been issued it is important to immediately move to a safe place to wait out the storm.  Tuning in to local media to keep informed about the weather is good, but having a plan of action in place in the event of an emergency can mean the difference between life and death.

 

Tornado Myths

In the case of a tornado, it is often wise to know what not to do.  There are many myths surrounding tornadoes which are commonly accepted as fact by elderly and can lead to making poor choices during an emergency. 

Tornadoes don’t come here – It is very common for people to assume that because a tornado hasn’t hit an area before that it cannot happen.  Assuming immunity to tornadoes is a dangerous myth to follow.

I can’t see one – Stepping outside to check the sky after hearing a Tornado Warning may be a natural reaction to the news but don’t assume that just because you cannot see a funnel cloud it isn’t there.  Funnel clouds are often masked in a dropping cloud base and can descend at a moment’s notice.  Rain and hail can be so thick and whipped around by wind that it obscures the tornado itself.   Tornado experts say people should not venture out looking for tornadoes when a Tornado Warning is issued.  At that time the best thing is to immediately seek shelter.

Taking Cover – Contrary to popular belief, the southwest corner of a basement is no safer than any other corner during a tornado.  An interior room in the basement, away from windows with a support structure, like a stairwell, is the best possible place to wait out a storm.  Hiding under a sturdy workbench or heavy table is a good shelter spot. Wearing a bicycle helmet while waiting out the storm is excellent protection from possible flying debris.  If basement shelter is not available, then an interior room on the ground floor, preferably without windows is the next best option.  Taking shelter in a bathtub, covered by a small mattress and blankets, is another option.

Open the windows – Wind blowing the walls in or out is what causes major structural damage during a tornado, not the pressure of the storm on the house.  Taking time to go through the house to open each window instead of immediately getting to a safe shelter space can be dangerous, especially when a Tornado Warning has been issued.

Hide under a highway overpass – When on the road and a Tornado Warning has been issued it is best to stay in the car and driving away from the storm.  Tornadoes generally travel at about 25 mph, but can move up to 60 mph in the spring when storms are more powerful.  Although Tornadoes can change paths, they generally move in the same direction, so outrunning a storm is possible.  If there is no way to avoid a tornado, taking shelter in a low lying ditch is better than getting into a culvert or hiding under a highway overpass.  The wind from the storm can create a tunnel effect and can literally suck people out of their hiding place.

What to do

Prepare for tornado season by making sure your elderly loved one’s home is insured for full replacement value rather than just its market value.  Be sure there is a list of their possessions to prove ownership and value just in case.  It is always wise to have a copy of all important papers safely stowed away in a safe deposit box.  Keeping a list of insurance policies, policy numbers and contact information for the agents is a good idea too. 

Practice what to do in the case of emergency with your elderly loved ones.  Go over the different tornado warnings and review the various alarms used locally to warn people about severe weather.  Show your loved ones where to go and what to do in the event of an actual tornado and have them practice getting to their shelter area if a warning is given.  Set them up with a weather radio and show them how to monitor the weather. 

Review the Acronym D-U-C-K with your aging loved ones. 

D = Get Down to the lowest level in the house.

U = Get Under something. Preferably a stairwell, work bench or heavy table.

C = Cover your head.  Use a bike helmet, a blanket or pillow.

K = Keep in the shelter until the storm has passed.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Deb Hintz is Assistant to the Director for HomeAid Health Care. HomeAid provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

Sources:

http://readywisconsin.wi.gov/tornado/sever_weather_watch.asp
http://shotphotos.com/tornado-with-road-warning-sign/
www.tornadofactandsafety.com

Aging Joints

Joint pain can be one of the most

crippling aspects of living with arthritis.

A sharp burning, ripping pain… a constant pins and needles sting…  a throbbing, traveling ache… the constant echo of hurt … the pain of Arthritis is experienced differently by those who suffer from it.  For some it is stiffness and discomfort when rising in the morning for others it is chronic and disabling pain which travels through the body like a hot fiery poker.

Arthritis literally means “joint inflammation,” but the term really defines more than 100 different conditions which affect joints throughout the body.  Symptoms of arthritis can include swelling, pain, stiffness and a decrease in range of motion as the disease influences the muscles, tissues and the bones associated with joints.  People of all ages, sexes, and races can suffer from arthritis and it is the leading cause of disability in America.  More than 50 million adults and 300,000 children have some type of arthritis.  Arthritis is more common among women and it occurs more frequently as people age. There are two common types of arthritis which are prevalent among the aging, Osteoarthritis and Rheumatoid Arthritis.

Osteoarthritis

Considered a common form of joint disease, OA usually afflicts people over the age of 60.  Although many elderly experience this type of arthritis in some degree or another, it is not considered an inevitable part of aging. Generally those with this disease deal with limitations in their movement and experience pain.  Osteoarthritis usually affects weight-bearing joints and is commonly associated with a deterioration or breakdown of the joint itself. Osteoarthritis destroys the cartilage which acts as a cushion-like connection between the joints.  When everything is working well, the cartilage protects the bones of the joint from rubbing on each other.  When Osteoarthritis attacks the cartilage it begins to die and disintegrate leaving the joint to grind bone on bone, causing pain.  

Carrying extra weight can really add stress to the lower body joints and is a documented factor in the development of Osteoarthritis.  At risk, in particular, are knees and hips.  For every extra pound a person gains, an added 4 pounds of pressure are on the knees and each pound increases the pressure on the hips by a factor of 6.

Another common factor in the onset of OA is injury or overuse of joints.  Former athletes have a higher risk of developing Osteoarthritis as they age due to increased stress or sport related injuries and on their joints when they were young.  Even those who were not athletic their youth can develop problems as they age due to repetitive motion that put stress on their joints. 

Genetics can also play a role in the onset of Osteoarthritis, especially when there is a family history of arthritis in the hands.  Families pass on bone abnormalities which affect the joint shape and causes problems with the cartilage. 

Rheumatoid Arthritis

Considered a chronic autoimmune disease, RA is a systemic inflammatory condition that causes joint destruction. Currently there is little understanding why those with Rheumatoid Arthritis develop an immune system that attacks itself.  The immune system, normally used to fight infection, attacks the joint causing inflammation, swelling, stiffness and pain. Rheumatoid Arthritis causes progressive deterioration of the joints and often often results in permanent joint damage, deformity and disability.

The onset of Rheumatoid Arthritis can be as early as in the mid-twenties and affects people throughout their lives.  RA presents itself with swelling and stiffness in the joints of the shoulders and neck, hands and wrists, hips, knees and feet and is often more noticeable in the mornings or when the body is resting.  Because RA affects the entire body, other symptoms such as fever, weight loss, fatigue and loss of appetite are often associated with RA and the inflammation can affect the body’s glands, blood vessels and the lining of the heart and lungs. 

Managing Arthritis

What can individuals with arthritis do to decrease the pain associate with this disease? 

Exercising is a key component to improving health and can help ease some symptoms of arthritis.  Studies have shown even two minutes of exercise daily is enough to ease pain, improve energy levels, strengthen muscles that support joints, increase joint range of motion, plus lose excess pounds that add stress to painful joints. Pool-walking and water aerobics can be an incredible workout that does not strain joints.  Stretching and building strength in muscles through yoga and Tia chi can also be beneficial for those who suffer with Arthritis pain.  Walking, biking and swimming are other good options.

It is important to balance activity with rest.  Moderate movement with Arthritis is beneficial, but over exercising can cause increase in joint pain. 

Eating a healthy balance diet with an emphasis on food with anti-inflammation properties can make a real difference in levels of arthritic pain.  Focus on consuming lean or low fat source of protein, food rich in calcium and dark green and orange vegetables and foods rich in antioxidants such as fruit. Tart cherries, blueberries and raspberries can help limit inflammation and pain levels in joints.

Along with exercising and diet, there are other options to help manage arthritic pain.  Consult with your family physician about medications that may be of benefit to you such as vitamins, and/or supplements associated with relief from arthritis pain.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

Sources: 

www.arthritisfoundation.com

www.arthritis.org,

www.cdc.gov/arthritis/basics

www.myageingparent.com/health/medical/arthritis-in-the-elderly. Feb. 18, 2015.

www.pharmacytimes.com/publications/issue/2003/2003-12/2003-12-7559,Greta M. Pelegrin, PharmD

The Costs of Aging in Place

Home Health Care allows

the elderly to age in place.

Image abandoning the place you’ve called home for the past 40 years, surrendering all your income and moving into a long-term care facility, a nursing home.  There you must share a room with a stranger, follow the facility’s schedule and spend the majority of your time alone or with nursing staff.  Of course this is a stereotype, many long term care facilities are lovely places, but this lonely scenario is what many older Americans fear to be waiting for them when they are too ill, injured or grow to frail to live independently. The majority of elderly are adamant that they do not want to end up in an institutional setting.  Today, with the rising costs of care, there is an increasing interest in home health care as an alternative to long term facilities.

Age in Place

Home Health Care provides health care and support services that can be received at home and is available for ill or disabled people of all ages.  The main goal of Home Health Care for the elderly and frail is to allow the individual to age in place.    Home Health services allow aging individuals to maintain their independence and remain comfortable in a familiar setting.  With Home Health Care, the aging can avoid moving to institutionalized long term care facilities.  Studies have shown that Home Health Care can actually improve the quality of care received and many times will reduce the need for hospitalization. 

Benefits of Home Health Care

With outcomes often as effective as care received in assisted living, rehabilitation and skilled nursing homes, Home Health Care brings a lot of benefits to those who use it.  Home Health Care providers get to really know their patients and families and can tailor their services to best meet the Client’s health care needs, finances and family preferences.  They can help families navigate the confusing web of health care resources and can effectively advocate the needs of their patients.  Another advantage is family is invited to become more involved and can participate in providing support and hands on care for their loved one.  In addition patient morale is often better at home and people tend to recover faster with less incidents and safety issues in a home setting.  Finally, there can be significant cost savings when using Home Health Care as there are no room and board costs compared to nursing home, rehabilitation centers and other institutional care settings.

Types of Home Health Care

There are two types of Home Health Care options available; Skilled Home Health Care and Non-Medical Home Health Care. 

Skilled Home Health Care is medical in nature and is used to provide skilled care or treatment or rehabilitation services to homebound patients.  This type of care is usually initiated by a physician and provided by a licensed medical professional such as an RN, LPN or Physical, Speech or Occupational Therapists.  Providers must follow specific federal guidelines and criteria regarding patient care.  Skilled Home Health Care providers are usually Medicare certified and can accept 3^rd party billing of health insurance which is great because out of pocket expenses range from $85 - $150/hour.

Non-Medical Home Health Care provided home services which are not considered to be skilled care but help the individual be safe and comfortable at home.  Services are usually initiated by social workers, family members or by the aging person in need.  Care is provided by trained Caregivers and CNAs (Certified Nursing Assistants).  Providers can be licensed by the state but requirements vary state to state.  Non-Medical Home Health is usually an out of pocket expense and ranges from $20 - $30/hour in cost.  Non-Medical Home Health Care can be covered by Medicare if coupled with Skilled Home Health Care.  Long term care insurance policies as well Veterans Aid and Assistance benefits can be used to pay these Non-Medical services.

How they work together

Let’s work through a scenario to see how Skilled and Non-Medical Home Health Care work together.  Margaret is an 83 year old female who was hospitalized due to a fall.  She was released after 3 days in the hospital.  Upon her discharge, the physicians and social workers agreed that Margaret could not be home alone during her recovery even though she was expected to make a full recovery in time.  Margaret elected to use Home Health Care rather than move into an assisted living or stay at a skilled rehabilitation center. 

Skilled Home Health Care was set up to monitor Margaret’s recovery and ensure she would not have to be readmitted to the hospital.  Weekly, 30 minute RN visits were scheduled to check her vitals, medications and general health.  Physical Therapists visited her at home biweekly to work with Margaret on her walking and balance skills to prevent future falls.  Non-Medical Home Health Care was set up to visit Margaret twice a day.  A 4 hour AM and a 2 hour PM shift came daily to help with companionship, medication reminders, assistance with exercise routines, transfers, showering, toileting and dressing as well as household chores and meals.  Within a month Margaret no longer needed the Skilled Home Health Care which was discontinued.  She retained the Non-Medical Home Health Care long term but reduced the hours to only 3 per day.  Margaret’s combined use of the services cost her very little compared to moving into a facility to recover.  The fact that she retained the Non-Medical Home Health Care means that she will be able to remain at home in the future even as her care needs increase. 

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

Living with Urinary Incontinence

The loss of bladder control can be embarrassing

 and is a common problem among the elderly.

Joe tends to avoid company.  His peers think of him a crotchety old man and usually  give him his space.  His demeanor discourages close contact.  But all that is a guise Joe maintains to keep people at a distance.  Joe suffers from urinary incontinence and is embarrassed by his condition. 

A cough, sneeze or just laughing out loud can trigger it.  Urinary incontinence is a common problem for many people, not just the elderly, although it becomes more of an issue with age.  It is a topic which is difficult to talk about with family, friends or even a doctor.  The wetness, odor and the constant need to change clothing can be very embarrassing. 

What is Urinary Incontinence?

Defined as loss of bladder control, the term urinary incontinence covers anything from the occasional leaking of urine to the inability to make it to the toilet in time. These incontinence episodes can occur any time, even when asleep in bed. 

There are five types of urinary incontinence.

• Stress Incontinence – Pressure on the bladder from coughing, sneezing, exercising, or lifting heavy objects.
• Urge Incontinence – an urge to urinate is followed by involuntary loss of urine.  This is often caused by infections or more serious conditions such as neurologic disorders or diabetes.
• Overflow Incontinence – a constant or frequent dribbling of urine due to the bladder not being able to completely empty. 
• Functional Incontinence – a physical impairment, such as limited mobility or severe arthritis, which prevents getting to the toilet in time. Mental impairments, such as inability to recognize the need to get to the toilet are also considered in this category.  
• Mixed Incontinence – a combination of two or more types of insentience.

Factors which increase development of Urinary Incontinence

There are several factors which play a role in developing an incontinence problem.

• Gender – Women are more likely to have Stress Incontinence due to the physical effects of pregnancy, childbirth and the female anatomy.  Men with prostate gland problems have an increased risk for Urge and Overflow Incontinence
• Age – Unfortunately age causes the muscles around the bladder and urethra to lose strength.  With age the bladder reduces the amount it can hold and increases the likelihood of incontinence.
• Being Overweight – Carrying extra pounds can increase the pressure on the bladder.  The muscles surrounding the bladder can weaken and allow the urine to leak when coughing or sneezing.
• Diseases – Neurological disease or diabetes may increase risk of incontinence.  In addition a Urinary Tract Infection (UTI) and constipation can also aggravate the problem. 
• Diet – Temporary incontinence can be caused by certain drinks, foods or medications.  The diuretic stimulants which can increase the volume of urine in the bladder are alcohol, caffeine, decaffeinated coffee or tea, carbonated drinks, artificial sweeteners, corn syrup, foods high in spice, sugar or acid (especially citrus fruits).  Heart and blood pressure medication, sedatives and muscle relaxants also are diuretic stimulants as well as large doses of vitamin B or C.

Complications of Chronic Urinary Incontinence

Incontinence can greatly affect a person’s personal life by its negative influence on social, work and personal relationships.  Skin problems such as a rash, infections and sores can also develop from constantly being wet with urine.  Incontinence also increases the change of repeat UTIs and can aggravate constipation.

Overcoming Urinary Incontinence

It is important to seek medical advice if urinary incontinence is a frequent concern or is having an effect on the quality of life. Before speaking to a physician:

• Start a journal to track symptoms and frequency of incontinence.  Keep notes about what was happening at the time of the incident, i.e. laughing, lifting groceries, or sleeping.
• Make a list of all medications being taken.   Multiple physicians may prescribe medications and there is always a possibility of negative interactions from various pharmaceuticals.   Be sure to including over the counter pills.  The doctor will be able to look at all the medications being taken to see if there if incontinence is a side effect from one or a combination of medications.
• Track the kind of foods being eaten and how much fluid is consumed daily.
• Provide a brief health history and compile a list of questions to ask the physician.  It is sometimes helpful to bring along a friend or family member to take notes and help remember what the physician said.

Giving as much information as possible to the physician helps with getting the correct diagnosis and making a plan of action to correct the problem.

What to expect from the physician

The physician will review the information provided and ask questions to get a complete picture of the problem.  Possible questions that could be asked are:

• How long has urinary incontinence been a problem?
• Are there any issues when trying to empty the bladder?
• When is the problem most noticeable?

The physician will do an examination, order blood work and/or radiology testing and could recommend a specialist called an Urologist.  Those who suffer from urinary incontinence often experience different symptoms and may receive a variety of treatment plans.

For most people simple lifestyle changes combined with some medical treatment can ease the discomfort and stop the problem of incontinence.  It is a difficult topic to speak about but gathering information and taking steps to control the problem can lead to a happier and healthier life.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Deb Hintz is Assistant to the Director for HomeAid Health Care. HomeAid provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

Options of Elder Care

Know when it is time to get extra help 

and which type of care is appropriate 

for your loved one’s needs.

There is an awful lot to be said for an elderly person remaining at home as long as possible [1]. Home is familiar, its the place that holds a lot of treasured memories, and staying at home is key to retaining independence and feeling less like a 'burden' on family members (however inaccurate that feeling may be). However, there may well come a point when home is simply no longer a healthy, safe, or practical option. People who need medically intensive  round the clock care, or are unable to afford the assistance required to keep themselves safe and their homes running efficiently may well be better off if they receive care in a facility setting. This can be a hard decision to make, but there are a few pointers which may make choosing easier.

Struggling With ADLs and IADLs

'ADL' stands for Activities of Daily Living [5]. These activities include ambulation, bathing, continence, dressing and grooming, eating and toileting.  The ability to manage these activities is necessary to live independently.  IADL means Instrumental Activities of Daily Living and they include doing housework and laundry, shopping and preparing meals, managing medications, money and caring for pets, as well as other basic functions which supplement independent living. As people age they lose the ability to perform these activities as they used to.  Inability to perform ADLs and IADLs are usually the sign that assistance is necessary. Most elderly will maintain a degree of function with their ADLs and IADLs and can often still live quite happily in their own homes with a greater or lesser amount of outside assistance. However, when functionality of these activities drop significantly, then it's considered a sign that your loved one should make some changes so their care needs can be met on a more permanent and professional level.

Home Health Care Option

Staying at home for as long as possible is usually a very good idea. Many elderly prefer to stay at home and will refuse to move despite their need for increased daily care with their ADLs and IADLs.  Moving elderly people away from the comfort and familiarity of home can be very distressing, which in turn can affect their health. For such people, home health care is probably the best option. Home Health care can help your ageing loved one maintain their treasured independence and stay safe in the comfort of their own home. 

With home health care medically trained Caregivers come to the home and provide the individualized care that the elderly person needs. Home health care can be very flexible and provide as little as an occasional visit every two weeks to tidy up the house to round the clock care daily care.  In some cases with the help of home health care, it is possible to remain at home long term and receive appropriate care which includes hospice and end of life care.  The home health Caregiver forms a unique bond with their home patients and in many cases, become part of the family. The elderly person receiving care has dependable care that is tailored to their preferences.  Not only does this keep them feeling comfortable and safe at home, but it also allows them to maintain their independence which is indescribably valuable to the elderly.

Assisted Living Option

The hardest part of sending a parent or loved one to a facility setting can be persuading them that it's the right thing to do. Often they just don't want to go, and it's not unusual for distressing scenes to develop [3]. On these occasions, it may be a good idea to look at assisted living options. In most assisted living situations the facility is set up to feel like home.  The buildings have individual rooms which Residents can decorate with personal items from home.  There are common living areas which promote socialization among all the elderly who live there.  It may not be home, but assisted living facilities try to maintain a home-like atmosphere while providing the care that an elderly person needs. 

When looking at assisted living facility, also known as a CBRF, Community Based Residential Facility, it is best to remember that there are many types of facilities which offer different degrees of care.  It is wise to ask about the facility’s state classification to get a clear idea of what degree of care they are allowed to provide.  Some facilities provide limited care and assistance while others can provide full health care on site, including up to end of life care.  Choosing a facility according to its location and decor is often short sighted as your loved one’s care needs will increase and that may mean having to change facilities in the future. 

Nursing Home Option

If your loved one has an acute health condition, a nursing home may be the best option. When an elderly person requires care which isn't feasible to manage at home with home health care, or is beyond the scope of care for an assisted living facility, then a stay in a nursing home might be the best option. Typically a nursing home has a more institutional atmosphere as the focus in health care rather than just assisting with ADLs and IADLs. 

The bottom line is, if your loved one is seriously struggling to manage their ADLs and IADLs in their own home, and their quality of life is declining as a consequence, then it is time to start considering the various options.  Care solutions can be found in many locations, even at home, but matching the type of care to your loved one’s needs requires some thought and planning. Remember the goal is to ensure that your loved one is safe and can enjoy a rewarding quality of life no matter which option is chosen.  

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Mel Higham is a writer and editor with a special interest in mental health and wellness.  As a guest writer for HomeAid Health Care’s Elder Topics, Mel brings her expertise to our audience.

HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999. Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

[1] National Institute On Aging, "There's No Place Like Home - For Growing Old", 

[2] Council On The Ageing, Victoria, "The Voice of older people on Independence", 2009

[3] Carol Bradley Bursack, "Handling a Parent Who Doesn't Want to Live in A Nursing Home",AgingCare.com

[4] KwikMed, "20 Truly Exceptional Elderly Care Sites"

[5] PBS, "Checklist Of Activities Of Daily Living (ADL)"

[6] Alzheimer's Association, "Choosing a Care Facility"