Category Archives: Health

Sing a Song for COPD!

COPD

If you know someone with COPD (chronic obstructive pulmonary disease), you are familiar with the ever-present wheezing, coughing, fatigue, and anxiety that come with the disease. It’s difficult to breathe! The lack of oxygen leads to persistent “air hunger,” which can be both frightening and exhausting.

At Senior Life Management, we find that people with COPD are often so tired, they have trouble leaving the house. Such isolation leads to depression in 50% of the cases. Plus it can be very wearing for partners and family caregivers.

Music Therapy

Several studies have recently confirmed that singing and playing light wind instruments, such as penny whistles, can greatly improve lung function, fatigue and even depression.

The Louis Armstrong Center for Music and Medicine

Funded by the foundation of our country’s “Wonderful World” jazz great, Louis Armstrong, a team of music therapists at Mount Sinai Beth Israel is investigating an integrated approach to the management of chronic illnesses. In particular, the focus is on improving quality of life and daily life activities through music and culture.

Sing-a-Lung Choir

Participants in the Music for AIR study engaged in music-assisted relaxation and guided imagery. They also learned greater breath control by playing penny whistles together and singing in the Sing-A-Lung chorus. Study participants got to pick the music from a wide range of styles. Some even wrote tunes for the group to play! The goal was to enhance voice and spirit, as well as breathing ability.

COPD is serious

COPD is the fourth leading cause of death, after heart disease, cancer, and stroke. There is no cure. But this study did shine a light on fun ways to manage the condition and combat the depression, fatigue, and breathlessness.

Learn more in this month’s issue of our newsletter, Kari’s Communication Korner.

If you have questions about ways to juggle the care needs of someone you know with COPD, give us a call at 949-716-1266. We can help. We are the experts in aging well in Orange County.

When Dad Resists a Walker

Walker

For many older adults, use of a walker carries great stigma. It’s a symbol of disability and often of isolation. In actual fact, a walker can be the key to staying actively engaged with favorite activities.

The benefits of a walker

  • It can bear up to 50% of a person’s weight. (A cane holds only 25%.)
  • It supports good posture. A walker keeps a person upright by reinforcing both sides of the body. (A cane steadies only one side.)
  • It is designed for people with moderate to severe balance problems or those with generalized weakness and arthritis. (A cane is best for only minor balance problems or injuries.)
  • It may act as a chair when needed. Many walkers with wheels have a bench. Great for “standing” in line or when your loved one is suddenly tired or dizzy.
  • It can be rather stylish, with modern accessories, such as a smartphone clamp, a coffee cup holder and a basket for carrying things.
  • It stays where you put it! Canes seem to have a mind of their own, scooting out of reach when you least expect it.

If you have had the “walker talk” with no success, make an appointment with the doctor and directly ask, “What’s your experience with patients who fall? How careful should we be?”

Also get the doctor’s input about the type of walker that is best for your loved one. Perhaps he or she will do a mobility assessment. Or make a referral to a physical or occupational therapist to create a plan for safe walking.

Empathize with Dad’s frustration that his body has given out on him in this way. Remind him that with a walker, he can still get around on his own to do what he pleases. It’s often the most effective choice for maintaining independence.

Is mobility a struggle?

As the Orange County experts in family caregiving, we understand. At Senior Life Management we have helped many older adults come to terms with the need for a walker. You don’t have to do this alone. Give us a call at 949-716-1266.

Care of the Feet

care feet

Did you know that our two feet together have 52 bones and 66 joints? And that doesn’t count all the muscles and tendons needed to carry our weight upright and in balance. It’s a lot to ask of two little feet!

Natural changes of the feet

With advancing years, the padding of the feet gets thinner, joints get stiffer, and arches flatten out. These are normal changes of aging. Since the feet are the basis for walking, and problems with the feet contribute greatly to falls, it’s important to be sure that your relative’s feet get the attention they deserve.

At Senior Life Management, we notice that in the hubbub of all the other elder care issues, foot care often goes by the wayside. On the one hand, it’s easy to take feet for granted. On the other, making foot care a weekly routine can be a very tender and caring exchange with your relative.

To maintain foot health,

  • do a weekly soak. Begin by soaking the feet in warm water softened with Epsom salts. Afterward, dry the feet thoroughly. Then massage in skin cream or lotion.
  • inspect for problems. Check for ingrown nails, cuts, hot spots, redness, or swelling once a week. If your relative has diabetes, check daily! Put a hand mirror on the floor to readily check the soles of the feet. Diabetics often lose sensation in their feet and can develop sores and infections without realizing it. These infections can lead to the need for amputation, which is why it’s so critical to check every day.
  • be sure socks and shoes fit well. Be careful that socks don’t bunch up in shoes. Are socks so tight they leave dents in the calf? Have shoe size checked by a podiatrist or in the store. Try new shoes on at the end of the day, when feet are apt to be swollen. There should be a half-inch of space between the longest toe and the end of the shoe’s toe box. Don’t assume new shoes will stretch out.
  • avoid walking barefoot. With the thinning of the foot pads, it’s hard on the bones to walk without shoes. Keep cushy, nonslippery shoes for wearing around the house.
  • seek professional support. Have a podiatrist or other trained healthcare professional evaluate your relative’s feet, especially if there is pain. Treatment may be as simple as a new pair of shoes.

Nails are also a concern

Nails are the archeological record of foot health. And even nutritional health. Check out our article about nail care in this month’s issue of our newsletter for family caregivers.

Not sure what to do?

There’s certainly a lot to do when caring for an aging loved one. As the Orange County experts in aging well, we can help guide you through all the areas that need attention. Give us a call at 949-716-1266. You don’t have to do this alone!

 

Balance exercises to prevent falls

balance exercises

If remaining independent is a goal for your older relative, bringing some balance to his or her life is essential—balance exercise, that is.

All it takes is short but consistent focus for Mom or Dad to significantly reduce the chance of a fall. In one study, two 15-minute sessions of balance exercises over a six-month period was enough to make a difference. That’s only 30 minutes a week. Depending on your situation, this may even be something you can do together.

Routines are simple. Mom won’t be daunted by the balance activities recommended by the National Institute on Aging. Standing on one foot and heal-to-toe walking are easy to do at home.
No muss, no fuss. No special clothing, no special gear, and not even much floor space is needed for balance activities. Dad can even hold on to a table or chair until he feels more stable.
Tai-chi

It turns out the most effective exercise for preventing falls is tai chi. This gentle activity has been practiced in China for centuries. Tai-chi involves slow, graceful movements combined with controlled breathing and awareness of the body’s position.

Research has shown that people who practiced an hour of tai-chi three times a week for three months experienced a 43% reduction in falls. They also had a 50% reduction in injuries from a fall.

Tai chi is best done with a teacher and in a class. But if that’s not an option, there are DVDs that teach tai chi. The local library may even have some to lend out.

Get the doctor’s okay first

There are many reasons a person might have poor balance. Just to be safe, ask for a fall risk assessment before starting an exercise program. You want to be sure your loved one has all the bases covered.

Does your Mom or Dad need help with balance?

The exercises aren’t difficult, but they do take time. And it’s much easier to stick with them if they can be done with others. Let us help you explore the options. As the Orange County experts in aging well, we at Senior Life Management are quite adept at helping older adults become more physical and focus more positively on their bodies. Give us a call at 949-716-1266.

What is MCI?

 

“Senior moments” are a normal part of aging. They happen to everyone. We just don’t process things as quickly as we did in younger years.

Some people develop significant memory and thinking problems. These people are eventually unable to live safely on their own. Typically, they have a stroke or develop Alzheimer’s or Parkinson’s disease.

And some people function at a level in between. They can live independently and lead normal lives. But they just aren’t thinking as well as they used to. These people may have mild cognitive impairment (MCI). About 15%-20% of adults over age 65 have MCI.

Signs of MCI include greater than usual difficulty with

  • remembering recent events or scheduled appointments
  • following the thread of a conversation or movie
  • making decisions or following instructions
  • finding familiar locations
  • making well-reasoned choices

People with MCI are at greater risk for dementia. Every year, 10%-15% of people with MCI will go on to develop dementia as compared with 1%-3% of the entire group of adults over age 65. Some people with MCI simply stay at this mild level of memory and thinking difficulty. Some even improve over time!

If you think your loved one may have MCI, schedule an appointment for a full examination. It may be MCI. Or the explanation could be as simple as a medication side effect or even sleep apnea or alcohol overuse. Follow up every six months to track changes.

If your relative has MCI, there is no treatment. Research shows, however, that strong circulation of blood and ongoing mental stimulation are very supportive of a healthy brain:

  • Manage blood pressure and heart health.
  • Increase physical activity.
  • Increase social and mental activity. People who are socially engaged or who have a hobby tend to keep their mental functions longer. Passive activities, such as watching TV, aren’t as helpful.

Are you concerned about a loved one’s memory changes?

Give us a call at 949-716-1266. As the Orange County experts in family caregiving, we at Senior Life Management can help you get your relative the assistance that is needed.

If Mom is Afraid of Falling Again

Many older adults who have fallen believe it is best to “stay safe” and avoid falling again by restricting their activities. Unfortunately, that’s the worst thing they can do! Inactivity is a path to reduced strength and mobility, which increases the risk of a fall and injury.

One of the most important things you can do is encourage your worried relative to stay up and moving. Here are some tips:

Talk about the fear

Although you don’t want to push, it’s important to talk with your relative about the risks of inactivity. This can pave the way to discussion of how to work with his or her (understandable) fear. Putting things in terms of your own concerns may be helpful. It sounds less blaming or demanding. For example:

“I’m concerned, Mom, that the fall you took in December has made you extra fearful. For sure, no one would want to go through that again! But I’ve done some reading and learned that being inactive actually makes you more likely to fall a second time. What can we do to build your strength and confidence?”

Offer strategies for change

Suggest ways that you can help your relative overcome his or her fear.

  • “Let’s talk with your doctor about what’s worked for other patients in this situation.”
  • “Let’s practice balance exercises together. Take a few laps down the hall. I’ll be here so you don’t have to worry.”
  • “Let’s ask for a referral to a physical therapist. They can give you tips about walking, how to better catch yourself, and how to get up safely if you did fall again.”
  • “Let’s take stock of what’s different now than when you fell. You were sick then.” (Or, “You’re no longer on that medication that made you dizzy.”).

Does fear of falling loom large?

As the Orange County experts in family caregiving, we understand both sides! At Senior Life Management we can help you negotiate a graduated activity program that starts small to boost confidence and then builds upon success. Give us a call at 949-716-1266.

Aging and the self-fulfilling prophecy

self-fulfilling prophecy

“Whether you think you can, or you think you can’t—you’re right.”

—Henry Ford

It turns out this truism applies to the ways we perceive the aging process itself. Research shows that older adults who view aging as a time of continued learning and development are physically more resilient. They seem to weather a setback and regain their mobility and independence more readily. They stay healthier and live longer than their peers who view aging primarily as a time of decline.

As a society we tend to hold aging in a negative light. But studies have found that advanced years do indeed bring many benefits. When compared to younger generations, for instance, older adults generally are more able to

  • focus on the positives
  • tune out the negatives
  • relax and accept who they are

The wisdom of aging may be that older adults recognize life is too short to “sweat the small stuff.” And with accumulated years, they have developed more coping skills for life’s inevitable rough spots.

Get this self-fulfilling prophecy working in your loved one’s favor! Try asking some of these questions to help him or her identify the special strengths of aging:

  • If you were suddenly 20 again, what skills or wisdom would you miss?
  • What has helped you through hard times in the past? Look for ways to emphasize these skills or resources.
  • What people, activities, or situations tend to leave you feeling positive? Consider ways to emphasize these resources. For many older adults, family and social interactions bring the greatest joy.
  • What is the ‘gift’ in your situation right now? With aging, we frequently come to realize that in every situation the good coexists with the bad. Even people with incurable diseases can usually identify something positive they have learned as a result of their condition.

Is the glass looking half empty?

Let our strengths-based approach give everyone a fresh perspective. As the Orange County experts in family caregiving, we at Senior Life Management can help with a realistic picture of the glass-half-full side of the equation. Give us a call at 949-716-1266.

Distraction Techniques

Distraction Techniques

If the person you care for has a problem with memory loss (dementia), you may find that he or she gets agitated about things that don’t make sense. Your long-retired dad, for instance, may wake up in the mornings and insist, “I have to go to work!” It can be confusing for you. And frustrating!

Disregarding these comments will only make your relative more determined. And it’s pointless to try to reason. The disease has robbed that ability. Instead, spend some time connecting with your loved one in “their reality,” and then distract them.

Compose yourself. Your body language, face, and tone of voice speak volumes. People with dementia still perceive respect versus dismissal. If you need time to calm yourself, make an excuse to get something from the car or to go to the bathroom, so you can return refreshed.

Validate their concern. “Gosh, Dad, I see you are ready to go. I wish I had your enthusiasm about work! Is there something special at work today?” By joining in their emotional reality, you are not telling them they are wrong. They feel reassured you understand.

Distract. Engage them in a fond memory of something related. “Remember your first client back when the business was new? What was it they had you do?” As you reminisce, consider walking together into another room to shift their attention. Once in the other room, draw on their forgetfulness and eventually offer an alternative activity: “I’m hungry. Let’s have breakfast” or “Oh look at that messy walkway! Would you sweep it? That would really help.”

Reflect. If your relative obsesses on things that don’t make sense, look for triggers or the underlying meaning. If Dad associates morning with time to go to work, have a task for him to do that addresses that need—in this case, to feel productive.

Does your loved one get agitated often?

It can be very wearing when a relative gets stuck, especially about things that aren’t real to us. We at Senior Life Management have a lot of experience with dementia. As the Orange County experts in family caregiving, we can help you learn validation and distraction techniques. Give us a call at 949-716-1266.

Starting a Safe Walk Routine

Safe Walk Routine

Walking for exercise is recommended for every phase of life! Walking is the easiest physical activity to engage in, and it brings multiple benefits. The ability to get around readily is often the deciding factor in whether an older adult can stay living at home.

Many older adults are hesitant to walk much. If you sense resistance, ask your loved one about concerns. He or she may be afraid of falling, or of the neighborhood. Other common obstacles include foot problems, uncomfortable shoes, depression, or poor eyesight.

Begin by getting the doctor’s approval. Getting the thumbs up from the doctor may help your relative get going. Even short 10-minute walks are beneficial.

Review safe walking practices:

  • What to bring. Dress in layers. Wear loose-fitting, comfortable clothes. Choose flexible shoes that fit well and provide a nonslip sole. Carry a cell phone or other device for emergency help. Bring water. And bring any usual walking aids, such as a cane or walker, properly fitted to your relative’s size.
  • Where to walk. When weather permits, walk outdoors. Choose smooth-surfaced, well-lit, and low-traffic locations. This might be a walking path in the neighborhood or a nearby school or park. In bad weather or overly hot weather, try a shopping mall.
  • How to walk. Focus on deep breathing and good posture. The goal is natural, even strides with arms swinging easily. Eventually the pace should be brisk enough to raise the heart rate yet permit conversation. But in the beginning, you want it to be easy and fun so it will become an enjoyable habit.

Ideally, see if your loved one can find a walking buddy or walking group. Especially for people who are not used to exercise, it’s more fun when it’s part of a social activity.

We at Senior Life Management regularly witness the value of a walking routine. Walking promotes balance and well-being. In addition, it’s a great remedy for social isolation if done with others. As the Orange County experts in family caregiving, supporting walking is one of the best ways you can support your loved one’s independence. To learn more, give us a call at 949-716-1266.

Plan Ahead when Downsizing

downsizing

 

Moving into a smaller living situation is a big decision. More emotionally challenging, however, are the many little decisions your loved one must make about what to keep and what to let go.

  • Possessions, from knickknacks to garden tools, hold many dear memories. Letting go of them is like discarding the people or events they are associated with.
  • When boxing up the possessions of decades, it’s not a big jump to realize that one day—after dying—these possessions will be boxed up and permanently disbursed. Downsizing can feel like a little death, at the least the death of their younger self.

Allow plenty of time

Senior move experts recommend a minimum of three months’ lead time. A less hurried approach will allow your loved one to ease into the project and savor memories before saying goodbye. Consider these steps:

  • Talk with your family member. Approach the topic carefully: “While we have the luxury of time, Mom, let’s begin to plan how things will fit in your new space. Only you know what’s most important to have with you.”
  • Know what space is available. Obtain measurements or, better yet, visit the new residence and measure the floor space (and the closet space!). Create a layout drawn to scale to help your relative visualize what furniture will fit. Likewise, plot space for books, clothing, hobby materials, and other personal items.
  • Be sensitive. That set of books may never have captured your interest, but they may hold beloved memories for Dad. This is your opportunity to learn the history of treasured possessions. Such sharing helps your loved one say goodbye, and it provides a way to “pay last respects” to parts of his or her past. What you hear may also change your mind about what to keep!
  • Take time. Go at your parent’s pace, even if it seems tortoise-slow to you. If you rush, you’re likely to run into resistance or exhaustion.

Is downsizing on your radar?

We at Senior Life Management have helped many families go through the process of moving to a smaller household. Give us a call at 949-716-1266. As the Orange County experts in family caregiving, we can help you support your loved one in making this transition as smoothly and sensitively as possible.

Communicating with Aphasia

If your loved one suddenly developed difficulty with speaking, he or she probably has aphasia, typically from a stroke or traumatic brain injury. Slow or garbled speech can be frustrating for everyone.

Recovery is enhanced by following the advice of speech and occupational therapists. There are even apps to help! Your support is invaluable in terms of bolstering self-worth and confidence.

Try these aphasia communication tips:

  • Remove distractions. Turn off the TV or radio. Move to a room that is quiet.
  • Allow time. It takes more effort to organize thoughts and form words.
  • Let them find the right words. Filling in and guessing what is meant may seem helpful. It actually undermines self-esteem.
  • Listen patiently. Communication is more than an exchange of facts. It’s a way to express personality and competence. As a listener, relate as if you have all the time in the world.
  • Confirm your understanding. Repeat back what you think was said.
  • Keep it simple. Speak in short sentences. Avoid a long string of ideas or requests.
  • Consider apps. There are many mobile- and tablet-based apps for aphasia. Some provide assistance with speech exercises. Others offer symbols your relative can point to instead of speaking. Some even help your loved one stay engaged with others by sending emails and texts based on the symbols!

Create a Communication Card
To help your relative stay engaged and be independent, create a “business card” he or she can pass to waiters, receptionists, merchants, or service providers. Personalize it appropriately:

  • I have aphasia: I have trouble speaking.
  • No need to shout: I am not deaf.
  • I do not have dementia: I think very clearly.
  • Please be patient: Give me time to find my words.

We at Senior Life Management As the Orange County experts in family caregiving, we can help you find optimal strategies. Give us a call at 949-716-1266.

Getting out of the mental spin cycle

Mental Spin Cycle

Do you find yourself in a repetitive cycle of reliving an exchange over and over? Reflecting on experiences gone badly is one way we learn. We think about what happened and look for insights that might promote a positive outcome in a similar situation next time.

But sometimes reflection can be unhealthy. If you find yourself in a memory loop continuously going over a negative experience, it may be more rumination than reflection. Instead of finding a way toward closure, it can be more like picking an emotional scab and not letting the wound heal.

Research suggests that a process of self-distancing can help us gather useful insights without getting stuck in a quagmire of replays. Try this:

  • Describe the event in the third person. Imagine you are an observer of the situation. If you were someone watching the dynamic, what events occurred? Write the “story” from this perspective.
  • Avoid the words “I” and “you.” Instead, use the names of the individuals involved. “Sarah told Bob she thought their dad was not taking all his medicines. Bob, who orders their father’s medicines through the pharmacy, got angry about her comments.”
  • Answer the question “Why?” and list many possible answers. In your description, address why the people did what they did. Then ask yourself, “Do I know for sure that’s the reason?” Think of several alternate explanations. For instance, Bob might find himself exploring whether Sarah brought up the issue because she thinks he’s incompetent, or because she’s noticing something different about their dad’s memory.
  • Describe the event from the future. Project yourself a week or a month down the road. Maybe a year down the road. How are you likely to tell the story? This perspective can reduce the emotional punch of the event and help you distill it down to its salient features.

We at Senior Life Management As the Orange County experts in family caregiving, we can help you find optimal strategies. Give us a call at 949-716-1266.

What is an Occupational Therapy?

Occupational Therapy

Eating, dressing, getting in and out of a chair. In the course of daily life, we use many skills to accomplish even “simple” tasks. Walking or using a fork is surprisingly complex. Nerve signals and muscles have to coordinate in a very specific order. A healthy body is a marvel!

We take these skills for granted until something interrupts our abilities. Arthritis, for instance, can make it hard to grasp a fork. A stroke may require a right-handed person to learn to do things with the left hand. The tremor of Parkinson’s can make dressing a challenge.

Occupational therapy can be used to help your loved one

  • remain at home despite a chronic condition;
  • recover from a surgery or other health event;
  • improve the ability to accomplish specific tasks or activities.

Occupational therapists have special training to help people overcome new challenges with the daily tasks of living. A therapist might show your loved one some exercises for better coordination. They might recommend special equipment or supplies. Maybe all that’s needed is a rearrangement of furniture in the house. Or a slightly different approach to doing the same thing.

Occupational therapy can be provided at home or in an outpatient clinic. It usually starts with a home visit. The therapist will

  • watch your loved one perform various tasks;
  • evaluate the home for safety and convenience;
  • recommend exercises and/or home modifications;
  • consider best options for transportation;
  • develop goals based on your relative’s abilities, interest, and budget.

Participate in the visit if you can. That way you learn what might help your family member live to the fullest in spite of limitations.

Ask the doctor for a referral

If you think your loved one would benefit from knowledgeable guidance, ask the doctor for a referral. Occupational therapy is covered by Medicare. Also by Medicaid and most private insurances.

Does life seem harder than it was?

If you notice your loved one struggling to do things that used to be a simple part of daily life, he or she might benefit from the services of an occupational therapist. As the Orange County expert in family caregiving, we at Senior Life Management have seen firsthand how much a simple device or a change in approach can transform an elder’s self-sufficiency. If you are concerned about a loved one, give us a call at 949-716-1266.