Malnutrition Among the Elderly

Many of America's elderly are going hungry.

Malnutrition is now being recognized as a major health risk among the elderly.  Studies show that an increasing number of Americans over 65 are not getting the calories, proteins or essential vitamins and minerals necessary for good health.  In fact, according to the National Health and Nutrition Examination Survey, only 17% of the older adult population is actually consuming a quality diet.  Surveys show that 30% of seniors skip at least one meal a day and many are living on less than 1000 calories daily.  An estimated 15 – 20% of the over 65 population suffers from malnourishment.  At a time when the entire country is concerned about obesity and overeating, it sounds amazing that a substantial segment of American’s elderly are going hungry.

There are many reasons why the elderly are not eating the quality or quantity of food they need.

·         Reduction in sensitivity to taste and smell.  A loss of appetite is often related to an older person’s loss of ability to taste and smell foods. 

·        Medications. Side effect of medications or combinations of medications can cause a reduction of appetite, increase instances of nausea and make food taste differently.   

·        Poor dental health. Poorly fitted dentures, jaw pain, mouth sores and missing teeth make chewing difficult and can lead to avoidance of eating protein laden meats.

·        Financial difficulties. Living on a fixed income often means the elderly must decide between purchasing quality foods and paying bills.

·        Inability to shop.  Navigating busy street and crowded shops can be daunting for the elderly, especially in bad weather.  Many forego shopping for fresh produce and try to get by with what is on hand.

·        Physical frailty.  Lack of strength, arthritic pain, dizziness or disabilities can make even simple meal preparation too much of a task.

·        Forgetfulness.  Dementia, Alzheimer’s disease and poor memory can hinder a senior from eating a proper variety of foods on a regular schedule.  It is common among elderly with cognitive challenges to skip meals and not be aware of when they last ate.

·        Depression.  Sadness due to difficulties with health, loss of family and friends or loneliness can affect appetite and cause an elderly person to lose interest in food.

Dangers of malnutrition for the elderly

Malnutrition leaves an elder open to nutrient deficiencies, muscle atrophy, and a weakened immune system. It plays a role in morbidity, mortality, recovery from illness, overcoming functional disabilities and physical complications.  Malnutrition is directly related to increases in infections, imbalances in electrolytes, loss of skin integrity, anemia and overall weakness and fatigue.

Common conditions associated with aging are really due to malnutrition

It is not always easy to recognize if an elderly loved one is suffering from malnutrition.  Weight is not always a good indication. According to Dr. William B. Bateman Jr. of the Montefiore Medical Center in the Bronx, a person can be quite overweight and still be nutritionally starving to death from a protein point of view.  The obvious signs of malnutrition are loss of appetite and an unintentional loss body fat.  Other indicators include dry and dull hair, conjunctive dryness and a receding of the gums. An onset of mental confusion, light-headedness, loss of taste and smell, weakness in motor skills, falls and fractures, and skin sores are all indications that dietary imbalances exist.

The problem is that many of the symptoms of malnutrition among the elderly are commonly thought of as a natural part of the aging process and not seen as signs of a treatable condition.  Even among medical professionals, many older patients with nutrition risks have their symptoms treated without care providers addressing the root of the problem. The fact that elderly experience a physiological decline, grow frail, and become increasingly susceptible to illness had long been accepted as just an unfortunate part of aging.  Yet recent findings show that many of the common conditions associated with aging are largely related to malnutrition.

Gerontologists are now excited about recent evidence that indicates that the illness and disease burden experienced by elderly could be significantly lightened by following a better diet.  According to Dr. Ranjit K. Chandra of the Memorial University of Newfoundland, Canada, it is not impossible for 80- or 90-year-olds to have immune systems similar to that of a 40-year old if their dietary needs are not compromised.  Even those elderly who have suffered from malnutrition can begin to restore their immune systems, improving their resistance to diseases, by correcting dietary deficits. 

Following a proper diet is essential to the health and longevity of seniors and the elderly.  By consuming a nutritionally balanced diet seniors can add years of health to their lives.  To learn more about the specific nutritional needs of the elderly check out the “Elderly Nutrition Handout” available at www.scribd.com.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

 

Sources:

Malnutrition in the Elderly: An Unrecognized Health Issue by Danielle Maher, Student Nurse &Carol Eliadi, EdD, JD, APRN.

Nutrition and the Elderly, by Leanne Beattie and Nicole Nichols, www.sparkpeople.com, retrieved 6/18/12.

Ten Reasons Why Your Aging Parent May Not Be Eating Properly, by Leonard J. Hansen. www.agingcare.com. Retrieved 6/19/12.

Elder Care - When is it Time to Intervene?



Know when to take an active role in making decisions for your loved one.

Take an Active Role

There comes a time when families notice that their aging loved ones have care issues that need to be addressed.  Suggesting the need for extra help coming into the home or introducing the idea of moving into an assisted living situation is a difficult and sensitive subject to raise. Many elderly refuse to face that their health-related challenges or limitations due to aging are serious enough to warrant action.  Fear of treading on their loved one’s privacy and independence often limits families from broaching the subject and taking an active role. 

So how do you know if it is the right time to take action?  There are several areas that family members need to look at when determining if it is the right time to intervene in their elderly loved one’s lives. 

What to look for:

·         Medical Issues – Often a diagnosis of a disease, illness or injury affects the quality of daily life and requires active intervention. 

·         Medication Issues - Difficulties in managing medication dosage and frequency, or confusion in changes in prescriptions can result in pills that are not taken and pose a risk that needs to be addressed.

·         Behavior Issues – Changes in behavior such as excessive anxiety, irritability, or social withdrawal or depression can be the signal that there are underlying cognitive issues, such as Alzheimer’s or Dementia, that should be checked.

·         Nutritional Issues – Lack of healthy, nutritional food in the house, lack of balanced meals, inability to manage grocery shopping, or clean out spoiled food from the fridge all point to the need for help.

·         Mobility Issues – Unexplained dents and scratches on the car can indicate changes in reflexes, vision, and ability to respond to unexpected situations and can be signals that continuing driving poses a great risk. 

·         Hygiene Issues – Noticeable body odors, lack of basic hygienic tasks and grooming, and inability to choose clothing all are common signs that help is necessary.

·         Housekeeping Issues – Daily living tasks such as cleaning, cooking, and laundry plus managing the household finances becomes difficult at some point for the aging.  When these tasks are continuously left undone it is a clear indication that intervention is necessary.

·         Safety Issues – Forgetfulness about keeping house locked and secure, carelessness with lit cigarettes and gas stoves, and lack of safety features in bathroom can all lead to accidents and are issues that require active family intervention.

A Difficult Discussion:

When first raising the subject of getting additional help in the home or the need to move to an assisted living facility, it is important to include your loved one in the conversation.  Involving them in the discussion can alleviate some of their anxiety about making life changes and make choosing a solution less stressful for all involved. Remember the goal is to find a solution that provides the amount of care your loved one needs, while maintaining as much independence as possible.  It takes time and energy to shift through all the options available. That is why it is a good idea to research all the elder care solutions ahead of time. Then when it is time to intervene, you and your loved one can make a smooth transition.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

HomeAid Health Care which provides non-medical home services for the elderly who wish to remain safe and independent at home.  HomeAid is a 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 that meets the needs of the elderly in the Fox Valley of Wisconsin.

What Love Language Does Your Elderly Parent Speak?

Know how to express love so your elderly parent can receive it.

What Love Language does your elderly parent speak?

There has been a lot of talk about understanding different ways of communicating love since Gary Chapman came out with his book, “Five Love Languages.”  Dr. Chapman’s concept is that people generally have a primary and preferred way of expressing and comprehending love.  Knowing how your loved one perceives love is important to getting your love message across so it is actually received. 

Take that idea and apply it to relationships between grown children and their aging parents.  Typically as parents age there tends to be a lot of strain on their relationships with their adult children.  The aging parent may feel embarrassed, depressed or frustrated by having to depend on their children for assistance and care.  Grown children often experience a sense of loss as they see a parent age and become frail.  Caregiving demands coupled with the role reversal of parent and child all cause relationship tension.  It can be very helpful to understand how to communicate love and affection to an elderly parent that transcends even the most trying of circumstances.

What are the 5 Love Languages?

Words of Affirmation - This language uses words to affirm people.  Some elderly parents need to hear the words, “I love you,” as well as other verbal reassurances of appreciation and encouragement.  Seniors who crave words of love will not get the message just through gifts, hugs and time spent together.  They need to actually hear kind and encouraging words.  Verbal cues are important, so negative words, comments or a sharp tone of voice will hurt deeply and need to be avoided.

   

Quality Time - This language is all about giving the other person your undivided and focused attention. An aging parent who prefers this mode of receiving love wants time together, without distractions. Turn off the phone and the TV and spend real time together talking. Maintain eye contact and focus on actively listening. Your loved one will feel truly special and loved.

       

    
                                                            

Receiving Gifts - For some people, what makes them feel most loved is to receive a gift.This does not mean that your loved one is out to gather up material positions, but rather they appreciate the thought behind the gift, whether it is large or small, expensive or free. Gift giving shows you put effort into knowing your loved one’s tastes and desires.  Careful though, missing a birthday or anniversary or giving a thoughtless gift can be disastrous to the one who values this gesture of love.

Acts of Service - For these people actions speak louder than words. Commonly the love language of men and caregivers, this expression of love seeks to please by serving. Aging parents who speak this language of love will understand the dedication and assistance as acts of love and will be especially appreciative for the help. Broken promises or laziness will be interpreted as their desires do not matter.

Physical Touch – For some people, physical touch is how love is expressed. Hugs, pats on the back, holding hands all show concern, care and love. Elderly often suffer from not being touched enough and so respond gratefully to any demonstration of physical tenderness from their grown children. Neglect to touch or rough handling would be considered unforgivable, so gentle hands go a long way in expressing love.

How to recognize your aging parent’s love language: We all use a mix of these love languages in our relationships, but according to Dr. Chapman there is one dominant form of love expression that most will gravitate towards.  To understand your aging parent’s preferred love language, think back to how they related to you during childhood for clues.  If mom was quick with a hug and a kiss, then she may be a speaker of the Love Language of Physical Touch.  If dad rarely said, “I love you,” but spent a lot of time playing ball with you, he might best respond to the Love Language of Quality Time.  Once identified, knowing which love language your aging parent responds to can be used to strengthen your relationship as well as make the sometimes difficult transitions of aging a little easier.  www.homeaidhealthcare.com www.prairiehomeassistedliving.com Sources:  “The 5 Love Languages Explained” Taken from www.thepersonalitycafe.com on 3/21/13. “The 5 Love Languages” by Dr. Gary Chapmen. www.5lovelanguages.com on 3/21/13.

Dealing with the Difficult Elderly

There are bound to be some challenges when providing care for an elderly loved one.

Personal Experience

When my husband’s grandmother moved in I knew there were bound to be some challenges.  She spoke no English and communicating with her in my elementary level Greek was difficult.  Yet I was determined to show compassion, include her in the family and provide whatever care she needed.  Everyone said she had always had a difficult personality, but I was not at all prepared for the ordeal which I had just signed up for.  At 94 she proved to be as wilful, manipulative and mean tempered as a child going through the “terrible twos”.   I had often wished I could give her a time-out or send her to her room. Not knowing why she was acting out or how to handle her caused troubles throughout the household and was devastating to me as her caregiver.  

 

There are times when caring for a difficult elder feels impossible.  Elderly loved ones may feel embarrassed, frustrated and depressed when their physical limitations force them to rely on a grown child or family member for care. Their dependence and sense of helplessness can lead to a feelings of despair and resentment which expresses itself in negative behaviour.  Knowing what can be done to help the situation and what will have to be endured with lots of loving patience, can make a difference in the caregiver’s ability to provide care long term.  

Looking for the cause

When dealing with a grumpy grandma or grandpa it is important to find if there is an underlying reason for their complaints and crankiness.  If anger and negativity are relatively new personality traits there may be external causes which need to be addressed.

·         Medications – Certain medications can cause personality changes.  Antidepressants, anti-seizure medications, blood pressure and anti-inflammatory medications can all cause behavior issues if not matched and adjusted correctly to the individual.  Also a combination of different types of medications can play a role in behavioral problems.  Always have a pharmacist check for interaction problems when dealing with your loved one’s medications.

·         Infections – Bladder infections (UTI) are common among the elderly and can cause trouble physically and behaviorally.  An onset of out of character behavior can often be traced back to a physical infection and should be treated medically.

·         Pain – Chronic pain makes everyone feel a bit cranky and often an elder will try to bear the pain and forego seeing a doctor.  Being stoic about pain isn’t always the same as suffering in silence and often the elder doesn’t see the connection between his pain and a general crabby attitude.  Getting proper medical help for pain management will go a long way in helping with behavioral issues.

·         Dementia – Memory loss is frustrating to those suffering with dementia and can cause unusual behavior.  People with dementia are often unable to mask negative aspect of their personality and will say and do socially unacceptable things. In addition, there are many types of dementia, such as Alzheimer’s disease, Sundowners Syndrome and Pick’s disease, which are marked by dramatic personality changes and rather aggressive behavior.   

 

In some cases, such as with my husband’s grandmother, a life-long habit of being difficult means behavior becomes increasingly impossible as aging issues come into play.  Ingrained difficult behavior that was somewhat kept in check for years, with age cannot be hidden or masked.  Add into the mix a bit of dementia and behavior can become unreasonable, irrational and aggressive.

It is important to recognize that ingrained negative behavior is not likely to change at an advanced age.  According to Jacqueline Marcell, author of “Elder Rage”, in cases where dysfunctional behavior is compounded by age, the best thing a family caregiver can do is to develop an “emotional shield”.   By letting hurtful words and irrational deeds bounce off, caregivers protects themselves from the stress of caring for loved ones who are not behaving in a loving manner.  She also advises getting help from support groups.  Having support from those who going through similar situations can help a caregiver cope and knowing you are not alone can be a source of comfort.

Getting help

Equally important is getting respite.  Caregivers, especially those with difficult elders, need to take break to rest and relax.  There are many community services and home health agencies available to help with providing occasional, temporary or even round the clock respite care.  Often having a professional caregiver come into a difficult situation can break a pattern of negative behavior and is beneficial to everyone involved. 

Providing loving kindness to our elders is the right thing to do, even when behavior issues make it difficult.  Knowing what can be done to help the situation and what, unfortunately, must be tolerated helps caregivers keep things in perspective. 

  

www.homeaidhealthcare.com

 

www.prairiehomeassistedliving.com

 

Sources:

“How to Deal with an Elder Who Complains Too Much” by Carol Bradley Bursack, www.agincare.com. Retrieved 7/9/12.

 “I love My Mother, But I don’t Like Her” by Jacqueline Marcell, www.agingcare.com. Retrieved 7/9/12.

“5 Success Tips with Difficult Aging Parents” by Carolyn Rosenblatt, www.forbes.com. Retrieved 7/9/12.

Aging Fearlessly



Aging gracefully requires a good measure of courage

 

We have all heard the old adage about aging gracefully.  It implies an acceptance of the facts of aging and going gently with the flow of the passing years.  It means forgoing the struggling to appear and behave unrealistically and ridiculously younger than one’s age.  There is a certain beauty about aging gracefully. The ability to live life with poise, dignity and few regrets is an amazing blessing. Yet a passive bow to the passing of time, as graceful as that might be, is not enough.  There is also need for today’s elderly to face the future fearlessly.

Aging is not for sissies.  It is fearful business watching oneself and loved ones succumb to the ravages of time.  Weakness, fatigue and loss of abilities to cope with the little tasks of life are often combined with the fear of becoming dependant and a burden on family and friends. Illness and disability surround the elderly and the awful specter of dementia lurks in the shadows of many elder’s worries. There are no guarantees as we age, and as many older people will attest, life has a way of dealing all of us some difficult blows.  It takes great courage to grow old. To be able to rise above the uncertainties of life and face the future with boldness is fearless aging.

How do the elderly face the future fearlessly? Those with courageous attitudes often know that age isn’t just a number.  Chronological age is based on the number of years since birth and is what most people think of as their age.  Yet as a person ages their focus on the numbers may not be helpful.  Functional age is based on how the body functions and can be a better measure of age if an elder is in good physical condition. Subjective age is the best measure of all, because it can be controlled.  Subjective Age is all about frame of mind and attitude and is the age the fearless focus on.

Looking at how the fearless age, there are some common tips used by the most courageous elderly. 

·         Age with attitude – Abe Lincoln once said, “People are about as happy as they make up their minds to be.”  We cannot change the past or control the future.  We cannot change others but we can choose our attitudes. Attitude plays a major role in how people view their situation and how they feel psychologically and physically.  Choose to be happy and content in today.  A positive point of view affects every aspect of life and empowers the aging with courage.

·         Take care of business – There are a lot of decisions to be made about aging.  Beyond health care and finances, there is the business of settling estates and death to deal with. Take care of each decision ahead of time and reduce the stress of growing older for yourself and your family.  Get all the business of aging organized and let your family know your plans and where to find the paperwork.

·         Get busy – Retired does not mean inactive.  There is a lot of work involved with remaining a healthy elder.  Exercise of the mind and body should become the new employment of the elderly and it needs to be taken as seriously as any career move ever made.  Being actively employed with physical exercise and brain stimulation can make the all the difference in the quality of life for the aging.

·         Invest in the future – Pass on your wisdom and values to the next generation by spending your time and energy with your children and grandchildren.  The legacy of your principles is a gift you pass on to the future which will affect generations to come. 

Aging fearlessly takes a lot of effort and positive mental outlook.  Many times it requires choosing thought patterns and behaviour quite the opposite of how one feels.  Elders who exhibit such courage set the example for all of us and are truly heroic.

www.homeaidhealthcare.com

Sources:

“Aging Gracefully” Retrieved from www.retirementonline.com on 12/15/12.

“Four Ways to Age Fearlessly” by Gay Edelman.  Retrieved from www.thirdage.com on 12/15/12/

"12 Step Plan for Graceful Aging” Retrieved from www.aquidoo.com on 12/15/12.

Quotes by Abraham Lincoln.  Retrieved from www.brainyquote.com on 12/27/12.

 

10 Signs of Alzheimer's Disease

Early diagnosis of Alzheimer's Disease is important.

Early detection matters

We all occationally forget names or appointments, only to remember them later. Typical forgetfulness is not to be confused with the early stages of Alzheimers. Since early diagnosis is so important in the treatment of this disease, it is necessesary to be aware of the signs and symptoms that your loved one may be exhibiting. Once diagnosed, a person with Alzheimer's has better opportunities for treatment and may be able to slow the progression of the disease through medication and cognitive exercises.

1) Memory loss that disrupts daily life

One  common sign in the early stages of Alzheimer's, is the forgetting of recently learned information.  Also forgetting important events or dates could be a sign.  When a loved one requests the same information repeatedly or becomes dependant on memory aids, family or friends to keep track of their information for them, it may be time to consult a physician.

2) Problem solving challenges

Alzheimer's will affect the way a person can solve problems or plan for the future. Often trouble will manifest when working with numbers or trying to develop a plan of action.  For example, following a favorite recipe or keeping on top of household bills often prove to be difficult for those with Alzheimer's.  Also common tasks take far longer and require far more concentration than before.

3) Difficulty completing familiar tasks

Those with early stages of Alzheimer's often find completing routine tasks increasingly difficult.  They may have trouble remembering how to get to familiar places or managing their checking account balance.  Troubles with using familiar items such as a TV remote control or the microwave indicate that it is time to consult a doctor.

4) Confusion about time and places

We all can lose track of time or occationally get confused about the date, but with Alzheimer's time loss is far more severe.  People with early stages of Alzheimer's can lose track of the dates, seasons and even the passage of years.  They can lose track of where they are and how they came to be there. Their concept of time is confused and they may not be able to follow events unless they are happening in the immediate present. 

5) Difficulty with vision and spatial relationships

Problems with eyesight can be a sign of the onset of Alzheimer's.  Early stages of the disease may manifest itself with troubles reading, judging distances or understanding colors.  People with Alzheimer's have trouble with perceptions of people and not even recognize themselves in a mirror. 

6) Troubles with finding words

Those with early stages of Alzheimer's often have difficulties following conversations.  They struggle to find words, often repeating themselves, and may stop in mid-sentence to search for the concept they were speaking about.  They may struggle with vocabulary and use the wrong names for common items. 

7) Misplace items

It is typical for all of us to occasionally misplace things.  Most people are able to retrace their steps and locate the missing item.  Those struggling with Alzheimer's have trouble with this process.  They lack the ability to remember where things were or when they last saw them.  In frustration they may accuse others of stealing.  Often this problem occurs more frequently as the disease progresses.

8) Increase of poor judgement

Changes in a person's ability to make decisions or judgements is another common sign of Alzheimer's.  Poor judgement when dealing with personal finances or trusting disreputable characters are common in the early stages of the disease.  Often less attention is given to personal grooming and hygiene  as perceptions and judgements are affected by the disease.

9) Social withdrawal

Those with Alzheimer's may stop showing interest in their hobbies, interests and social contacts.  They may have trouble following their favorite sport team or remembering how to work on familiar projects.  Those in early stages of Alzheimer's will purposely avoid social interaction out of fear that their cognitive changes are noticeable to friends and family.

10) Mood and personality changes

All people get used to a certain way of doing things and can get irritable when forced to change.  Those with Alzheimer's experience mood and personality changes that go beyond occasional grumpiness. The confusion experienced with this disease causes depression, anxiety as well as  bouts of suspicion and fear.  With a constant feeling of something being wrong, but not able to identify what it is or why, those with Alzheimer's can react completely out of character when anything happens out of their comfort zone.

If your loved one shows any of these warning signs, it is time to consult a physician. With Alzheimer's  it is very important to get an early diagnosis because the best opportunities for treatment take place during the beginning stages of the disease.  

www.homeaidhealthcare.com