Thursday, December 19, 2013

Happy Holidays!

Wishing each of you a very happy holiday season as we close out the year. May the New year bring you renewed spirit and ways to accomplish new goals.

As caregivers remember to take time for YOU so that you can continue to be the caregiver. Reflect on how you have made a difference and know that things are better because you care. Noting is ever going to be perfect so don't become paralyzed trying to make it be.

Enjoy the beauty of all the decorations around us whether or not they are your culture. Warm glowing lights can help to lift all of our spirits. Take time to enjoy the aromas of the season. Close your eyes, breath them in and take a mini vacation.

Take time to make new memories with family and friends. Capture them on film, and in your mind. 

Set measurable and reasonable goals for the New Year and examine them often to be sure you are on path and reward your accomplishments along the way.

photo: http://www.flickr.com/photos/paulbrigham/

Thursday, October 24, 2013

The Art and Struggles of Caregiving

Caregiving is an art, and it's not something any of us comes to naturally. Not even nurses. It's something we learn over the course of time and through a variety of classes or experiences. We bring to each patient or loved one our own set of standards, beliefs and abilities as well as a desire to help others. We have the best of intentions and hope for the best possible outcomes.

We struggle to hold on to our own identity and to provide the very best care we can under whatever the circumstances present to us. Caregiving is never easy, and often you must reap your own rewards of knowing you made a difference. We can come to this role once or many times in our lives as children, parents, other relative or health care professional. The basic rule is to give it your best shot and to do no harm to anyone.

I received an email quite some time ago from a young man who has cared for his wife who is now a cancer survivor. He blogs about his experiences and he his bluntly honest about his feelings, emotions and everyday occurrences. I share this with you because there is always something to learn from someone else's journey and struggles. I hope you can gain some insight and find some tips to help you survive your own journey with your aging parents and loved ones.

View the video about their journey: http://www.mesothelioma.com/heather/

Thursday, July 11, 2013

Challenges of Aging in Place

"Aging in place" is a trend or buzz word phrase you may or may not have heard about. The basic idea is to allow older people to remain in their own home, community and environment and maintain as much independence as they safely can for as long as they can. It's not as simple as all that however.

As a member of the Baby Boom generation, I haven't yet hit 65, but I'm getting there. Perhaps not welcoming the fact, but kicking and screaming as I go along. Years back I had a discussion with a friend about considering moving to a single story home before the knees give out. And every day that I climb up and down those stairs I think about it more and more. Yes, it's good exercise, but some days it can be a very painful and unpleasant experience as well.

My mother has complained for years that we don't have a railing for our 2 front steps up to our porch. So we hold her hand and assist her up and down when she visits. But of late, I'm beginning to REALLY understand her concerns. When my knees want to act up, it's not so easy to get up and down those 2 short steps, and sometimes I don't feel all that safe anymore.

Another friend just remodeled her bathroom and her contractor talked her in to adding in some aging/safety considerations. She fought him on it at first and then conceded it would be economically sound to add them in now so that she can indeed age in place in her own home. SO she now has a beautiful walk in shower. Now it's not a gorgeous one like you see on HGTV, but it has all the amenities she can choose to use now and enjoy as she begins to need them way down the road.

Chances are good that when your home and the homes of your aging loved ones were built, there wasn't even a thought by the builder that an old person might live there someday. Picking up throw rugs and installing a hand-held shower device and a few well-placed grab bars may be relatively painless to do, but what about walk-in bathtubs and showers? Are your hallways and doorways wide enough to accommodate a 4-wheeled walker much less a scooter chair or wheel chair? Is there any place in your kitchen where you can sit and rest while preparing a meal or waiting for the microwave to finish heating? Can you rest anywhere while you move laundry from the washer to the dryer in short frequent steps? And on that subject, how far is it to the laundry area from where you hang and house your clothes? Energy conservation is a great tool to learn, but if you don't have the space to make it work well, it's not going to be an easy solution to shortness of breath, lack of energy and just plain feeling too old to do that today!

Even the housing in 55+ communities and assisted living facilities don't meet all of the challenges our aging populations presents today. They don't have the latest and best devices installed. They may not even have adequate ramps or elevators. As a result, some of these places are beginning to take a stance against aging in place. Many have always had specific guidelines as set by state laws, but now they are really enforcing them. For instance, residents have to be independent. They may be allowed to use a walker, but not the newer ones with the wheels and a seat that resemble a light weight wheelchair. These can be quite useful for those who can walk, but tire easily or who need to transport an oxygen tank with them. These are considerations you need to take into account if you're planning to move mom and dad. They may not be able to stay in that place the rest of their lives; opening up multiple challenges and scenarios you may not have ever considered as they age.

If for example, dad has a stroke and needs assistance with his activities of daily living you might have to place him somewhere else with a higher level of care. This leaves mom in one place and dad in another. The rent just doubled and now you have to get mom over to see dad on a regular basis. Transportation time and costs! Then if dad eventually needs hospice, the place you thought was excellent may not be able to let him stay there and you'll find yourself hunting for another place to move him.

Staying in their own home and having help may be the most economical factor of all, but some communities especially condominium and townhouse associations are balking at having people age in place in their communities. They don't want to deal with all of the changes needed such as ramps and railings that may degrade the property values if they stick out from the decor. Dealing with the annoyance of having emergency responders called at all hours of the day and night because dad slipped out of bed and needs assistance to get off the ground. Yes, this is age discrimination. But that's a whole issue unto itself. When you're faced with a situation where mom and dad need their situation handled right now, dealing with the politics of how wrong this is isn't a battle you can deal with and win in record time.

Be aware, and make informed decisions. Know that there will be obstacles even as you age as well. Take a deep breath and when your contractor suggests some aging in place modifications, be grateful you have the time and opportunity to be proactive.





Thursday, May 9, 2013

Grapefruit Interactions with Many Drugs Should NOT be Ignored


 “DO NOT TAKE WITH GRAPEFRUIT”  This or similar grapefruit warnings on medication labels can be a common sight, but how often are these warnings actually heeded? Are you or your aging parents at risk for not heeding the warnings? You can be at serious risk.

According to a recent article in the May issue of Nursing 2013, a recent study found that there are over 85 prescription and over -the-counter medications that interact with grapefruit. Of those, 43 can have serious adverse reactions such as GI (intestinal tract) bleeding, or can be toxic to the kidneys (nephrotoxocity).

from morguefile.com

Serious Consequences
Grapefruit interactions can also have serious cardiac affects such as torsades de pointes which is a type of ventricular tachcardia (very rapid heart rate) with dangerous potential for fatal consequences. Another potential interaction can result in rhabdomyolysis which is the rapid destruction of skeletal muscles.

Only a small amount of grapefruit is required to cause these interactions. Just 2 segments of a grapefruit or one cup of grapefruit juice is sufficient to cause effects. It is important to read the labels on foods and juices or sodas as they can contain grapefruit and should be avoided. Grapefruit is a healthy and nutritious fruit, but must be avoided by those taking medications that can interact.

Actions Altered by Grapefruit
Medication actions can be significantly altered by the grapefruit by increasing or decreasing the absorption of the medication or even delaying the action of the drugs.

One of the most common clasification of drugs that can interact with grapefruit is the statins which are cholesterol lowering drugs. Look for the warning label on these if you or your parents are on thses drugs. If in doubt, ask the pharmacist.

Some other common drugs that can be affected by grapefruit include oxycodone (i.e. Percocet, Oxycontin)  cyclosporin (immunosuppresant drugs used in Crohn's diseases or after organ transplant),  buspirone (Buspar),  nifedipine (Lisinopril), clopidogrel (Plavix) and fexofenadine (Allegra).

Anticancer agents, Erythromycin, Quinidine, and amyodorone (i.e. Nextarone or Cordarone) can have the tosades de pointes effect with potential fatal heart rate issues.

Always ask your pharmacist about food and drug interactions.  If possible, use one pharmacy so all of your medications and history can be overseen by a pharmacist. Be safe!

For further reading:
http://www.fda.gov/Drugs/ResourcesForYou/SpecialFeatures/ucm341437.htm