What is Personal Care?

Personal care refers to a range of personal daily living tasks that keep a person clean and comfortable. These tasks involve private hygiene such as bathing, toileting, and oral care. Additionally, other activities include dressing, eating, and ensuring medication is taken appropriately. An individual’s personal care requirements can differ depending on their overall health and level of mobility. Some older adults may require assistance with these tasks because they have problems with their joints, and strength, or have other health issues. For example, they may need help getting out of bed and into a chair or assistance with a bath or shower.²

Why is Personal Care so Important?

Personal care is key in promoting the overall well-being of elderly individuals. By engaging in personal care routines, individuals can experience a heightened quality of life empowering them to maintain their independence, health (physically, mentally, emotionally, and socially), and overall happiness.³

• Independence benefits – an individual’s personal care routine can be adapted to their specific needs so that their independence can be maintained in a comfortable and safe environment. Support for physical mobility enables them to continue living in their familiar environment and allows them to move around more safely, reducing the risk of falls and injuries. Assistance with outings ensures that a person can participate in social activities, continue their connections, and enjoy life beyond their home setting. Assisted Living care facilities can offer transportation when needed and senior transportation services are available.
• Physical health benefits – showering, dressing, and grooming are essential for maintaining physical health. Maintaining personal hygiene reduces illnesses and the spread of infection. It can also help certain health issues from worsening or reoccurring, such as skin conditions or urinary tract infections. Oral hygiene, including regular teeth brushing and denture care, prevents dental diseases and promotes overall health. Clean, appropriate clothing contributes to overall comfort. Maintaining a healthy diet, getting proper sleep, and obtaining adequate physical activity all play an important role in a person’s physical well-being.⁴
• Mental and emotional health benefits – by optimizing a personal care routine, a person feels better, looks better, and has more energy. This self-care is linked to enhanced mental health, resulting in greater self-esteem and self-worth, increased optimism, and lower levels of anxiety and depression. A warm bath and the use of scented products at the end of the day can help a person feel relaxed and ready for bed. Proper nutrition and sleep are additional aspects of self-care that contribute to mental well-being.
• Social health benefits – living alone can cause feelings of isolation and have serious health consequences. It is crucial to have a good social life to maintain overall wellness. Provided personal care support, such as what is available through an assisted living facility, offers an opportunity where an individual can form a genuine bond with their caregiver and gain companionship.
• Quality of life – when an older adult is caring for themselves and maintaining their overall health, they’ll be better equipped to live their best life. With proper physical health, the body will run more efficiently. There’s a strong connection between the body and the mind, so when caring for the body, one will think and feel better as well. Health problems, even relatively minor ones like aches, pains, fatigue, and indigestion impact people’s happiness and stress levels. Health problems can also make daily tasks more challenging. Poor health habits can add stress to an individual’s life and interfere with daily living. Therefore, maintaining healthy habits is extremely important for overall health. When daily tasks are managed and a healthy personal care regimen is in place, people can focus on activities they enjoy. Additionally, feeling well-cared-for increases happiness, life satisfaction, and psychological well-being, resulting in a higher quality of life.⁵

While personal care routines can differ for older adults, it’s important to recognize an individual’s specific needs. Prioritizing an appropriate routine is a vital aspect of care for seniors. It empowers them to maintain their independence, overall health, and increased happiness. When ensuring personal care for a senior has become challenging or too costly, or social isolation is a concern, consider the benefits of an assisted living environment and call CarePatrol Baltimore for guidance and recommendations.

References:

¹ Verywell Mind https://www.verywellmind.com/self-care-strategies-overall-stress-reduction-3144729

² National Institute on Aging (NIH) https://www.nia.nih.gov/health/aging-place/aging-place-growing-older-home

³ Psychology Today https://www.psychologytoday.com/us/blog/a-deeper-wellness/202302/understanding-the-mental-health-and-self-care-connection

⁴ Verywell Mind https://www.verywellmind.com/self-care-strategies-overall-stress-reduction-3144729

⁵ Verywell Mind https://www.verywellmind.com/how-to-maintain-a-high-quality-of-life-3144723

As CarePatrol Baltimore marks its 10th anniversary in business, we help families navigate the maze of decision making that comes with placement in independent, assisted living and memory care. We realized we have developed a rich foundation of best practices in our industry. Our leadership is evident. Having placed over 2,000 individuals, CarePatrol Baltimore is committed to the community and the families it serves. CarePatrol Baltimore (CPB) has been recognized for this commitment such as Franchise of the year, MVP, and employee of the year awards for the Northeast, and the Founders Award.   We present here our anniversary-10 Reasons Why CPB is the best option to help you find a safe senior option.

Leadership and Best Practices – Our top 10:

1. Team Experience: Across the CarePatrol Baltimore’s team exists a broad knowledge base of experience in critical areas such as healthcare, finance, and real estate.  The depth of experience we tap into serves our clients throughout the whole process of finding a specialized living community that meets both healthcare needs and financial capabilities.  The depth and breadth of the team’s experience in healthcare allows CarePatrol to help seniors that are medically complex. As a women owned company, with the owner a nurse having over 40 years of experience in all facets of healthcare such as hospital, homecare, and wound care, we are so much more than placement services.
2. Large Inventory of Communities: CPB refers to over 350 communities that have been vetted. We know the prices, amenities, and medical capabilities of each one. CPB visits these communities, and we know real-time information on their current abilities.   We are in and out of the communities all the time, checking staffing changes and capabilities.  It is important for individuals to have this knowledge to make the best decisions. It is also important for families to understand that individuals with medically complex health situations have more options than the nursing home or long-term care. Highly medically complex clients have options too! There are assisted livings that can handle sliding scale insulin, Hoyer lifts, and dementia with aggressive behaviors.  We analyze where the best fit would be once we learn about your situation and connect it with the facility which offers the best fit.
3. Tour Support: CPB team members are local and hands-on. In most cases one of the staff members will accompany you on tours so that you will have all your questions answered and have a good idea of how each community will fit your needs. CPB provides on-staff touring specialists which is very unique in this industry.
4. Financial Resource Knowledge: CPB has knowledge of other financial resources.  Access to this knowledge will help identify programs to assist and potentially pay for assisted living. Programs such as the Baltimore Subsidy Program and Veterans Aid and Attendance are well understood by our Advisors. Our team offers best practices in understanding complicated long-term insurance and can guide clients in the right way to present it to increase the likelihood of approval. You do not need to navigate this alone.
5. Other move and legal resources: CPB has a network of resources that will help you with the move to senior communities such as referrals to reputable moving companies and companies to assist with downsizing, law services, and wills.   We offer a team member who earned a notary certificate to help when documents need to be notarized. Our goal is to help streamline and ease a difficult time and we have a decade of experience finetuning this process and building those relationships.
6. Help You Navigate the Health System:  CPB works closely with social workers in hospitals and rehabs.  With the families’ permission we can obtain medical information that will assist with narrowing down the living options for the family to choose. CPB can communicate with the healthcare personnel, even on weekends and holidays, because health situations don’t follow a calendar or clock. Offering this always-on access is unusual. CPB is prepared to go above and beyond for our clients.
7. Blogs Are Available: CPB has over 40 written blogs that will help you navigate this overwhelming time.  We have articles that can help you identify if this is the time to move.
8. Training Residential Assisted Livings: CPB is committed to helping residential assisted living facilities understand the state rules and best practices for operating an assisted living center.  CPB provides training for new assisted living managers monthly as part of the certification class. CPB wants your experience with the smaller residential communities to be positive.
9.  Excellent Client Satisfaction:  We have excellent client satisfaction with a Google rating of 4.8, and many, many positive shared stories from our clients.
10. State and National Reach:  We can help clients throughout Maryland and throughout the country through our partnership with other CarePatrol locations. Importantly, we can help our clients coming from treatment centers across the country get back to the state or town where they live with the same kinds of service we provide locally. We are a united CarePatrol team.

For all these reasons and more the community counts on CarePatrol Baltimore to help people find the living environment best for their needs. We help families manage and navigate a typically trying and emotional time and we do it with compassion and expertise. Help us celebrate 10 years, and know that if and when you need assistance, CarePatrol Baltimore is here and ready to assist.

Learn More:  https://carepatrol.com/baltimore/

Why Do Older Adults Fall?
The most common causes of falls in the elderly and the risk factors that contribute to a fall are divided into the following categories:^2,3
Physical Risk Factors – impairments, chronic conditions, and medications
Environmental Risk Factors – hazards in and around the home
Behavioral Risk Factors – activities or decisions made by an individual

Physical Risk Factors

• Declines in Physical Fitness: Many adults become less active as they age. Without regular physical activity, one loses muscle strength, balance, coordination, and flexibility. This inactivity leads to instability which increases the risk of falling, and the inability to break the fall effectively. It also increases the chances of a serious injury and a more difficult recovery.
• Impaired Vision: Age-related eye diseases make it difficult, sometimes impossible, to detect fall hazards, such as steps, slippery surfaces, and thresholds. Conditions like glaucoma or cataracts limit vision. Poor vision can increase the chances of falling.
• Chronic Conditions: There are numerous chronic health conditions that can put a senior at risk of falling. Some of the common conditions include:

o   Heart disease – heart failure, low blood pressure, and arrhythmias can lead to fainting.
o   Brain disease – epilepsy, Parkinson’s disease, Alzheimer’s disease, and other cognitive disorders.
o   Diabetes – poorly managed diabetes can lead to visual impairments, leg numbness, and in extreme cases, diabetic coma.
o   Osteoporosis – a disease in which bones become less dense, resulting in weak bones that are more likely to break.
o   Inner ear problems – the most important organ for our sense of balance is in our inner ears; issues with it can cause vertigo.
o   Alcoholism – alcohol abuse, especially when combined with certain medications, can easily cause a fall.

• Medications: A wide variety of medications can increase the risk of a fall. Side effects, such as drowsiness, dizziness, dehydration, and low blood pressure, can all contribute to an accident. Sedatives, antidepressants, antipsychotics, opioids, and some cardiovascular drugs are among the most common, causing these side effects. Additionally, over-the-counter medications and dietary supplements can have powerful side effects and collaborative effects, also.

Environmental Risk Factors

• Unsafe home conditions – obstacles in the home like cables in pathways, poor lighting, clutter, loose carpets, or slick floors.
• Hazardous conditions outside the home, like clutter in the yard, uneven ground, or ice and snow.
• Poor or no personal aid equipment like canes, walkers, or grab bars.
• Uncomfortable or poor shoe ware.

Behavioral Risk Factors

• A person’s fall risk is influenced by the types of activities they engage in, the level of physical demand, and their willingness and ability to adapt their routine for enhanced safety. For example, laundry is a normal activity for many people, but it can require a lot of exertion for a senior, especially if they must carry a heavy basket throughout their home. This task can be risky on its own, but without taking proper precautions such as wearing secure footwear or attempting to navigate stairs with the basket, they put themselves at greater risk. Failing to modify behaviors to adapt to new or challenging activities is a serious contributing factor for falls.
• Rushing to the bathroom, especially at night when not fully awake or when lighting may be inadequate.
• Being distracted by multitasking and failing to notice an environmental hazard, such as a curb or step.

Preventing Falls in Older Adults

Following some simple steps will significantly reduce the risk and consequences of falls in the elderly and help keep seniors happy and independent for as long as possible. If a caregiver is involved, fall prevention must be a team effort.^4,5
Step 1: Get Educated

• Learn about the impact of falls on the elderly and ways to prevent them.
• Read CDC’s Stay Independent brochure. This contains a questionnaire to determine an individual’s level of risk.
• The National Council on Aging (NCOA) leads the National Falls Prevention Resource Center to provide awareness and education on falls and promotes evidence-based falls prevention programs and strategies across the nation. Here you can explore desired topics and find the latest webinars.

Step 2: Speak Up

• Talk openly with your healthcare provider about fall risks and prevention.
• Inform your provider if you fall, worry about falling, or feel unsteady.
• Review all your medical conditions and medications with your provider and discuss any side effects like feeling dizzy or sleepy. Some medicines, even over-the-counter medicines and herbal supplements can increase fall risks. As one ages, the way medicines work in the body can change. Ask your provider about taking vitamin D supplements to improve bone, muscle, and nerve health.
• If you get dizzy or lightheaded when transitioning from seated to standing position, read CDC’s Postural Hypotension brochure, which has information to manage these symptoms.

Step 3: Get Eyes, Ears and Feet Checked Annually

• See your eye doctor to have your eyes examined. Update your eyeglasses as needed and always wear your prescribed glasses. Ensure that you have no eye conditions that can limit vision, like glaucoma or cataracts.
• Have your ears analyzed to eliminate the possibility of any problems with your inner ear that may make you feel dizzy. Wear your hearing aids if you use them.
• Have your healthcare provider check your feet and discuss proper footwear. Ask whether seeing a foot specialist is advised.

Step 4: Exercise to Improve Your Balance and Strength
Exercises that improve balance, coordination and increase muscle strength lower your chances of falling. It also helps one feel better and more confident. Tai Chi is a good mind-body activity which helps with balance and strength. Discuss with your healthcare provider about an exercise program that’s best for you.

Step 5: Make Your Home Safer

• Remove clutter, like clothes or books, from places where you frequently walk.
• Ensure rugs and carpets are secure and use double-sided tape if needed to keep them in place.
• Keep items that you regularly use in places where they can easily be reached.
• Have grab bars in the shower/tub and near the toilet. Consider using a shower chair.
• Use non-slip mats in the bathtub and on shower floors.
• Improve the lighting in your home. As people get older, they need brighter lights to see well. Get lighter window treatments or remove them altogether.
• Have handrails and lights installed on all staircases.
• Wear well-fitting shoes with good support when inside and outside the house.
• Get help when needed: don’t put yourself at risk in challenging situations. Get someone to help instead of climbing ladders and stools yourself.
• Consider positioning fall mats next to the bed, in the bathroom, or other places where falls may be more common so that they can cushion the fall.
• Medical alert systems can benefit and give the elderly peace of mind that help is at the push of a button. Furthermore, automatic alert systems can detect a fall without requiring a button to push.

New Applications Being Studied to Help Prevent Falls and Fall Injuries

• Wearable airbags – a Chinese company has designed a vest to protect the head, shoulders, back, and hips when a fall occurs. On top of accomplishing the necessary materials, they determined an algorithm that predicts whether a sudden movement will result in a fall, promising to deploy the airbags within milliseconds for active protection of the wearer before they reach the ground. The company has spent five years working on this system and it continues to be upgraded. If perfected, it could soon reach the entire globe, helping to save lives and reduce harm among an already vulnerable population.⁶
• Smartphone app – researchers at Binghamton University have developed an app to help study and prevent falls in older adults. The phone can be used not just for evaluation, but for delivering intervention. The study began in June 2022 and set out to investigate the body’s ability to maintain balance while standing and walking. Among the study is a Computerized Dynamic Posturography (CDP) system, which measures “postural sway” by analyzing foot pressure, force, and motor reactions while the user stands in a harness on a locked or moving platform. Using this specialized motion-capture gear, the researchers examined gait speed and balance. Improvements, especially in gait speed, have been shown to reduce the risk of falls. If participants show an improvement after utilizing the smartphone-based program, the intervention could be seen as clinically effective.⁷ 

The Importance of Transitions of Care
The term Transitions of Care (TOC) describes a process of transferring a patient’s care from one setting or level of care to another. Settings of care may include hospitals, long-term care facilities, and rehabilitation facilities. This transition most often involves a patient moving from an acute, inpatient setting to an outpatient care environment. Transitions increase the risk of adverse outcomes due to the potential for miscommunication as care responsibility is given to new parties. Primary care physicians (PCPs) often encounter care gaps that are beyond their control due to factors such as inaccessible patient records, unclear discharge care plans, or limited effort by others to engage the primary care team, the patient, or caregivers. Therefore, it’s crucial to have effective provider communication with patient comprehension of discharge instructions in place for a safe and effective transfer.⁸

Even though there are many things that can cause a fall, there are even more things that one can do to prevent them. Utilizing some simple precautions will greatly prevent falls and injuries. Staying active and alert will lead to a better quality of life and the ability to stay independent for as long as possible.

References:

^1,4 CDC https://www.cdc.gov/injury/features/older-adult-falls/index.html
^2,5 Med Alert Help https://medalerthelp.org/blog/falls-in-the-elderly/#:~:text=Falls%20are%20common%20in%20old%20age%2C,it%E2%80%99s%20only%20one%20of%20the%20reasons.&text=Falls%20are%20common%20in,one%20of%20the%20reasons.&text=common%20in%20old%20age%2C,it%E2%80%99s%20only%20one%20of
³ AgingCare https://www.agingcare.com/Articles/Falls-in-elderly-people-133953.htm
⁶ My Modern Met https://mymodernmet.com/wearable-airbags-elderly-fall-protection/?utm_source=join1440&utm_medium=email&utm_placement=newsletter
⁷ Newswise https://www.newswise.com/articles/smartphone-app-could-help-prevent-falls-in-older-adults?sc=dwhn&user=10053418
⁸ Transitions of Care https://transitionsofcare.org/

Is your parents’ home safe to live in? It may seem like a simple question, but it’s actually quite complicated. There are many factors that indicate if a home is a good fit for an older adult and many red flags if it won’t be a good option long-term.

Keeping your aging loved one safe is a number one priority. Unfortunately, one out of four seniors have a serious fall each year — due to lack of mobility, weakness, imbalance or other problems. And a bad fall can lead to many ongoing health issues, including broken hips and traumatic brain injuries. Seniors are also much more likely to fall again and continue to decline after their first injury.

Worse still, many older adults don’t tell anyone about it. Maybe they are ashamed it happened, or they don’t want anyone to worry. In any case, it’s important to check the homes of your parents or grandparents, and see if it’s safe for them — and create a strategy if it’s not.

If your loved one has a history of falls, or seems to need help getting around, it’s time to plan for their future. More and more seniors want to continue living in the home, a term called aging in place. Doing so successfully usually involves hiring caregivers when the need additional help and completing some home renovations, like installing grab bars, lowering door thresholds and converting the main residence to a single-floor home. Stairs, high door thresholds and slippery surfaces are particularly dangerous and need to addressed.

CarePatrol, who offer free senior housing placement service, and Healthmax 360, an online marketplace for health and wellness products, have partnered to create a free online home safety evaluation that you can complete by doing a “walk-through” of your loved one’s home and answering questions.

The assessment asks questions about stairs, floor surfaces and materials, doorways and walkways, and how your loved one gets around the house. After completing the online evaluation, you will receive the results, along with suggestions and tips on how to decrease falls in your loved one’s home.

For more information, visit www.keepingmomsafe.com.

This information is provided by CarePatrol of Baltimore, a senior housing placement agency that serves the Baltimore city and county areas. If you or your loved one need to find a new home, consider talking to a CarePatrol housing placement specialist. They will sit down with you, assess your needs and financial situation, and offer the best options they can find. They are also available for tours and guidance during your final search. You can contact a specialist at (410) 844-0800, CarePatrolBaltimore@CarePatrol.com or www.carepatrolbaltimore.com. You can also find them on Facebook at www.facebook.com/CarePatrolBaltimore.

As of early 2021, there are 613 licensed residential assisted living facilities with beds ranging from 3 to 18 in each of the communities.  Typically, these residential communities are houses in neighborhoods in Baltimore county and Baltimore city.  To be licensed as a RAL you must follow the Code of Maryland Regulations (COMAR)  http://www.dsd.state.md.us/COMAR/searchall.aspx.  The code provides detailed regulations for procedural, safety and health protocols within the living space, its programs, and staff.

Read about RAL specific regulations in the blog post The Code of Maryland Regulations as applied to Residential Assisted Living Facilities.

We often get asked to describe a residential assisted living (RAL), what is it, how does it work, what differentiates a RAL from other types of living communities?

RALs are houses of all different sizes that may have private and semi-private rooms.  They typically have a shared living room, kitchen and shared bathrooms.   Some bathrooms are large enough for wheelchair access, others are not.  They may have one floor or multiple floors with or without a stair lift.  Many have steps into the house that may or may not have a ramp.  RALs all have 24/7 caregivers with caregivers that are licensed to give medication.  The facility must have a delegating RN that assesses every new resident and will assess residents every 45 days or earlier with any change in resident condition.

Typically, RALs may have better caregiver-to-resident ratios compared to ratios at larger assisted living communities.  Due to the small size of the RAL, the residents feel like they are at home. The residents receive individual care.   Due to the close-knit nature, it is more likely for caregivers to know when a resident they provide care for is not acting themselves and will therefore identify early signs of illness or declining dementia.

Each RAL through their uniform disclosure statement will tell the state what kinds of residents they are comfortable caring for. Can they take care of urostomies, colostomies, internal catheters, sliding scale, Feeding tubes, 2 person lifts and wheelchair bound individuals, and other specific medical needs that a resident might have?

Some RALs will provide activities such as music and art while others will take their residents to a senior center for activities.  Some RALs have transportation and others do not.  CarePatrol knows the care capabilities of the majority of the RALs in our region.  This helps us guide families to the best options for their loved one and saves a tremendous amount of time and energy.

The biggest difference between a RAL and the other types of facilities? The cost. Fees are typically less in an RAL.  On average, in a large, rental assisted living, the cost is $5,000 a month or more.  In residential assisted living, depending upon the care needs of the residents, a Baltimore City fee can start at $1,500 a month and in Baltimore County $2,500 a month. With the family home-like feel, the individualized attention and the cost savings attached to RALs, this becomes a strong choice for families looking for the right place for their loved ones. With over 600 in our region, it is good to have a resource like CarePatrol to help navigate the many nuances within each facility. With our deep intake process and clinical understanding of the needs and goals of the family, we can narrow the search to a manageable list of top recommendations.

Reach out today for a no-cost consultation.

The first step of medication management is talking to your parent’s doctor. Bring them a complete list of all the medications they are taking and ask them about their effectiveness. Many medications are prescribed by specialists, without oversight from a primary physician, and could react negatively when combined. Also ask what each are for, and if they are absolutely necessary. Overprescribing is also a common in health care.

If your loved one is struggling to take the right dosages, explain the situation to the doctor and ask if there is a better system. Can they take them all at once to make it simpler? Or is there another brand that can be taken less often?

For many seniors, the struggle to remain organized with medications is an everyday problem. You’ve probably seen the infamous plastic pill boxes many seniors use. These boxes are a good idea but often fall short for people who are easily confused. Many pill boxes aren’t clearly labeled, and its’ still easy to forget if you’ve already taken a dosage.

One option for effectively managing medications is creating a medication routine. If the pills need to be taken three times a day, suggest your dad take one with breakfast, lunch and dinner. Combining habits is a helpful way to remember. Make sure to check with their doctor first.

You can also do something as simple as marking it on a calendar or logging it on a mobile app. There are also alarms on phones, computers and watches that indicate when it’s time to take medicine. Some apps and watches feature helpful information, including the name of the drug, the amount to take, and the doctor’s name for questions. These may not be good fit for someone who struggles with technology or is frightened by beeping or loud sounds. If it leads to more stress, it’s not a good solution.

One of the more helpful and affordable solutions is asking for medication blister packs. Talk to your pharmacist about the situation and request that your mom’s weekly medicines be sealed in blister packs. You have probably seen these before; they are the metallic-looking packs that antibiotics arrive in. Caregivers can also purchase blister pack kits to sort and pack themselves. The labels are usually clearer, and the empty space of a taken dose is an effective visual it’s already been completed.

If your loved one is still struggling with the usual options, it’s time to get more help. After all, their safety is the goal. A medication reminder service may be a good option for you. MyMedChecks is a program of the senior housing referral company CarePatrol and offers a free 30-day trial. You don’t need to use a credit card to sign up. After the trial, continued use of one call per day costs $19.95 per month. Two calls costs $29.95 per month, and three calls per day costs $39.95 per month. For more information, visit http://mymedchecks.com.

This information is provided by CarePatrol of Baltimore, a senior housing placement agency that serves the Baltimore city and county areas. If you or your loved one need to find a new home, consider talking to a CarePatrol housing placement specialist. They will sit down with you, assess your needs and financial situation, and offer the best options they can find. They are also available for tours and guidance during your final search. You can contact a specialist at (410) 844-0800, CarePatrolBaltimore@CarePatrol.com or www.carepatrolbaltimore.com. You can also find them on Facebook at www.facebook.com/CarePatrolBaltimore.

Here’s the breakdown:

1. Alzheimer’s is the most common form of dementia. Between 60 and 80 percent of all cases, according to the Alzheimer’s Association. Signs and symptoms include memory loss, confusion, depression, or mood changes.  A progressive disorder, Alzheimer’s starts before symptoms are recognizable. As it progresses, killing off brain cells, symptoms become worse. Coordination and difficulty walking may become a problem. Some patients have difficulty swallowing. One of the earliest signs is difficulty in communication, forgetting names and recent activities or places, and disorientation. A high number of patients with Alzheimer’s will wander. There is a genetic component that may influence the likelihood of someone getting Alzheimer’s.
2. Caused by a lack of blood flow to the brain, Vascular Dementia is the next most common form of dementia. Possible causes impacting blood flow to the brain are atherosclerotic disease and stroke, afflictions that increase with age. With Vascular Dementia, patients may experience hallucinations and other vision problems in addition to confusion, disorientation, and concentration problems.  Communities must be equipped to manage the severity of the dementia symptoms and an honest discussion with your senior placement specialist can help in this evaluation.
3. Dementia with Lewy bodies (DLB) or Lewy body dementia involves a chemical interruption of messages to the brain, caused by protein deposits in nerve cells in the cortex (part of the brain). This interruption leads to confusion, disorientation, and causes memory loss. Visual hallucinations, sleep disturbances, and even fainting may be issues for these patients. These protein clumps may also be found in patients with Alzheimer’s and Parkinson’s disease. This is a more common type of progressive dementia. Facilities that are able to secure patients who wake in the night or are at the risk of falling from  fainting AND have the experience dealing with hallucinations is mandatory. Some communities will not take patients with Vascular or Lewy body dementia because of problematic behaviors, sometime sexual in nature, where patients’ confusion and hallucinatory symptoms may cause all sorts of problems. Similar to Alzheimer’s and Parkinson’s, Lewy body patients may have trembling hands, difficulty walking and general weakness.
4. Parkinson’s disease, in its advanced stages, may cause dementia. In this instance, reasoning and judgement are the hallmark symptoms to look out for. This iteration may also cause hallucinations. irritability, paranoia, and depression may develop as the disease progresses. Trouble speaking and forgetting words while in conversation is also common. Caused by abnormal clumps of protein deep in the brain. A degeneration of dopamine producing nerve cells results in involuntary and uncontrollable body movements.  Parkinson’s is progressive, often leading to dementia similar to Alzheimer’s or DLB.
5. Frontotemporal dementia affects the front and side part of the brain. Also known as Pick’s disease, it includes several different types of dementia but all effecting this part of the brain that impacts language and behavior. This part of the brain is associated with personality. Causing compulsive behavior, speech problems, loss of inhibitions, loss of motivation, and difficulty recalling the meaning of common words, Frontotemporal dementia refers to any type of dementia that is caused by problems with this part of the brain. There are some communities that will not accept a resident with this dementia.
6. CDJ or Creutzfeldt-Jacob disease is a rare form of dementia effecting one in 1 million people annually. It is an aggressive and deadly form of dementia, where patients often die within the first year of diagnosis. Depression, agitation confusion and memory loss are common hallmarks. This dementia affects the body and patients may experience twitching and stiffness of muscles.
7. Wernicke’s disease, Wernicke-Korsakoff syndrome, or Wernicke’s encephalopathy are caused by a lack of vitamin B-1. Wernicke, a brain disorder. is a result of bleeding in the lower brain areas. Double vision, loss of muscle control, as physical symptoms of Wernicke’s disease, develop into Korsakoff syndrome when untreated. Korsakoff Syndrome is a memory disorder causing trouble with remembering things, learning new things, and processing information. These two syndromes are often grouped together and classified with dementias although they are not true forms of dementia. The similarities are so similar it makes sense to list it here.
8. Mixed dementia is where someone has more than one type of dementia and is very common. According to Mayo Clinic, autopsy studies in of the brains of dementia patients 80 and older showed many to have a combination of several causes.  Although people may not know they have multiple types. The symptoms are different from person to person. However, with progression, difficulty in speaking and walking is common. Early symptoms might include disorientation, memory loss, behavior and mood changes.
9. NPH or Normal Pressure Hydrocephalus causes excess fluid to build up in the ventricles of the brain. Designed to cushion our brain and spinal cordes, ventricles are filled with fluid. But too much fluid places pressure on the brain that causes damage, and can lead to symptoms of dementia. NPH may be caused by injury or infection that causes bleeding, brain tumors, or brain surgeries that leave fluid or bleeding in the brain. Sometimes the cause is unknown. This type of dementia can sometimes be cured with surgery so it’s important to seek treatment and intervene early!
10. Huntington’s disease, a genetic condition that causes a breakdown in the brain’s and spinal cord’s nerves cells, prematurely wasting away. Juvenile Huntington’s is rarer and adult onset fist shows signs in someone in their 30’s -40’s. The breakdown in nerve cells leads to dementia and impaired movement resulting in difficulty in walking, swallow and with jerking movements.

Dementia is also a result of other diseases such as multiple sclerosis, HIV or other illness or injuries that cause damage to the brain cells. Family history, age, repetitive brain injury (accidents or sports injuries) or infections with high fevers, poisoning, alcohol abuse, or cancers may all cause a form of dementia to manifest.

As with other disease, maintaining a healthy lifestyle, with good diet and exercise, no smoking and moderate to no alcohol use, and other healthy lifestyle measure, may aid in stemming the onset of dementia.

1 https://www.aarp.org/caregiving/basics/info-2019/memory-care-alzheimers-dementia.html
2 https://www.healthline.com/health/types-dementia#huntingtons-disease 
3 https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013

Confusion, delirium, marked sleepiness, disorientation, hallucinations, agitation, aggression, these changes in mental function may be caused by post-operative delirium if they are occurring after a surgery that required anesthesia. Post-operative delirium is one of the most common surgical complications for older adults according to The American Geriatrics Society. It is also preventable 40% of the time.

Because it is so common, and because it is largely preventable, it is important for older adults and their care providers to be informed about the risk factors and best practices for mitigation. Understanding what is normal post-op disorientation and sleepiness and what is the more serious post-operative delirium is important so patients can take protective measures and seek proper treatment to prevent long term problems.

Often mistaken for dementia, a range of cognitive disorders that are irreversible and that impact memory and other cognitive functions, post-operative delirium typically lasts a week or less as a patient recovers from surgery. However certain underlying risk factors can prolong the condition, which can cause complications for a patient such as injury, further hospitalization, and potential long term care requirements. Post-operative delirium may also lead to cognitive and functional decline.

Underlying factors that can cause complications often play the driving role in a patient developing post-operative delirium. Especially at risk are those individuals with existing cognitive issues, patients who are on certain medications, and elderly patients. Even though post-operative delirium can happen at any age, it is most likely to afflict older patients. It is important for elderly patients to have a medical exam and discuss with their doctors any medications prior to surgery.

When diagnosing a patient with post-operative delirium, the care team must map back to its probable underlying causes. These can include disrupted sleep problems, poorly managed pain, an infection, or a reaction to a medication. In addition, the family and other care providers close to the patient can be leaned on for additional support and recovery tactics.

Family members can play a critical role in reducing the incidence of post-operative delirium. Activities such as walking, helping with meals and proper hydration, and playing games or working on cognitive challenges such as crossword puzzles with the patient have been shown to be effective in lessening the chance of post-operative delirium as well as the severity of post-operative delirium in patients who develop it.

Other factors to prepare recovering patients for optimum results include proper access to hearing aids and reading glasses, familiar faces and voices to sooth and calm the patient post-surgery, and a return to a regular even sleep cycle.

The AGS CoCare®: HELP program, formerly known as The Hospital Elder Life Program, originally created by Dr. Sharon Inouye is a well-studied, effective, and innovative model of hospital care designed to prevent both delirium and functional decline for older adult surgical patients. This evidenced based practice is focused on delirium prevention through multi-component intervention. Well documented as effective, it is implemented in over 200 hospitals. Free clinical tools and screenings are available through the American Geriatrics Society CoCare HELP website.

Resources:

https://help.agscocare.org/About_AGS_CoCare_program_help 

With warmer weather finally making its way to us, it’s time to talk about a common but extremely serious topic that affects us all, but especially seniors — dehydration.

The human body is made of approximately 60 percent water, so when your fluid levels are too low, the body naturally suffers. If severely dehydrated, your body won’t have enough water to carry out its normal functions, and you may experience a range of symptoms, including weakness, dry mouth, exhaustion, dry skin, cramping, dizziness, nausea and potentially vomiting.

Increased thirst is the most obvious sign, but it’s not always present. More serious symptoms include low blood pressure, convulsions, bloated stomach, severe cramping, rapid but weak pulse, dry eyes, wrinkled skin with no elasticity and rapid breathing. Generally, dehydration occurs when you’re losing more water than you’re putting in.

Heat can be dangerous for seniors, since it leads to excessive sweating, so it’s best to be extra diligent during warmer weather. Carry a water bottle with you when you’re out, and remind mom and dad to drink on a regular schedule, rather than when they feel thirsty.

Why it’s more common in seniors
Since older adults possess a lower volume of water overall and often have health concerns or conditions like diabetes and medications that often act as diuretics, dehydration is a serious and common concern among the elderly. Aging itself also makes people less aware of thirst, and it becomes more difficult to regulate fluid balance as you get older, since kidneys do not work as efficiently. You simply lose more fluid more quickly.

If you’re younger, be careful not to compare your water levels with your aging loved one to determine if they are dehydrated — your body has more water in it, so you can afford to lose more and be okay.

What to do
If you loved one is suffering from mild dehydration, the answer is simple — get them to consume more fluids. Dehydration is a manageable condition, but it must be consistently monitored. Drinking fluids on a schedule, ensuring they have access to beverages they prefer, and not pushing them to consume a large amount all at once should help.

For more moderate levels of dehydration, water enhanced with electrolytes tends to be more helpful. Gatorade and coconut water are decent options if you’re short on time.

Don’t be afraid to ask your doctor. If dehydration is severe, seek medical assistance immediately— it’s possible they may need fluids intravenously. The most important thing is to not wait to act.

This information is provided by CarePatrol of Baltimore, a senior housing placement agency that serves the Baltimore city and county areas. If you or your loved one need to find a new home, consider talking to a CarePatrol housing placement specialist. They will sit down with you, assess your needs and financial situation, and offer the best options they can find. They are also available for tours and guidance during your final search. You can contact a specialist at (410) 844-0800, CarePatrolBaltimore@CarePatrol.com or www.carepatrolbaltimore.com. You can also find them on Facebook at www.facebook.com/CarePatrolBaltimore.

By CarePatrol of Baltimore

Fraudulent credit card charges are not a new thing. However, thieves are getting more and more clever with posting innocent-looking, somewhat familiar charges, like recurring small amounts from iTunes, Spotify, or Amazon Video, to skate through undetected. And seniors are at a particularly higher risk of being scammed.

These types of fraudulent charges may be a scammer using your credit card to purchase on their account to see if you are paying attention prior to making larger purchases. Or they may be a charge designed to look deceptively familiar that instead goes to a fraudulent company masked as the familiar one. With the thief pocketing the revenue. (1)

They may even be legitimate charges for a service the senior didn’t realize they had signed up for. A borderline practice some companies use to rack up ongoing fees from unsuspecting customers.

Seniors are targets. The FBI cites the existence of nest eggs, an overall more trusting generation, and a fear of reporting as the main reasons seniors are preyed upon. Whether it is pride or worry that relatives may see it as a sign of declining mental capacity, many seniors won’t report these issues, and thieves exploit that tendency.(2)

The most important thing to do to prevent fraudulent charges it to closely monitor your credit card statements or those of your loved one if they will grant you permission. Look for obvious purchases that you know you would never make, like in a state or country you’ve never visited or a product you would never use. Look for recurring charges, charges that end with “.95” or “.99”, or the famous “$9.84” (3), small charges scammers hope won’t get noticed. (4)

If you find a fraudulent charge

Determine if the charge is legitimate if you can. It might be that you just don’t recognize it. Businesses operate under different names than the name that appears on their billing identification appearing on statements. Usually, a phone number will be attached to the item on your statement. Call it to verify it is indeed a purchase you made.

Search online for the merchant name and “fraudulent charges” or “what is the credit-card charge (merchant name) for?” The power of the internet to turn up other consumers’ posts about the topic is enormous. Many times these searches will identify that the charge is either fraudulent or a sneaky recurring charge you didn’t realize you had committed to such as magazine “rewards” for taking a survey or a service from a site you visited.

Call to complain or you can go to your state’s attorney general and the Federal Trade Commission. Cancel the credit-card so no further charges are applied. Make sure you cancel the service as well, if it turned out to be a real one,  so there’s no chance the credit card company passes the recurring charge through to the new card, a common practice to ensure continuity of service in legitimate subscriptions and services. It also prevents the merchant from racking up service fees against you that they could send to collections or report to credit services if left unpaid.(4)

If the charges are fraudulent, you might want to figure out where your account was compromised, somewhere around the last legitimate charge, and call the merchant and report it, and call your local police as well. It could be the result of a skimming device where you ran the card or an untrustworthy employee. Spare the next consumer the same fate and report it.

Anyone who thinks they may be the victim of a credit or debit card scheme should contact local police and the Federal Trade Commission (FTC).

1. Check Your Statements For This Long-Running Scam, Money Tips, https://www.moneytips.com/check-your-statements-for-this-long-running-scam 
2. Protect Elderly Relatives from Credit Card Fraud, ABC News, BEVERLY BLAIR HARZOG https://abcnews.go.com/Business/protect-elderly-relative-credit-card-fraud/story?id=16429891
3. How to Spot and Dispute Fraudulent Credit Card Charges, Nerd Wallet, Lindsay Konsko https://www.nerdwallet.com/blog/credit-cards/dispute-fraudulent-credit-card-charges/
4. Why That $9.84 Charge On Your Card May Be Cause For Alarm, HuffPost https://www.huffpost.com/entry/984-charge-credit-debit-card-fraud_n_4675054

Everyone has a journey. Aging is part of the human experience and we’ve not yet found any loopholes that escape us from this journey. Whether you’re managing your own, or a loved one’s elder transition, the best advice anyone can give to you is to be prepared.

Care Patrol believes in this so much that one franchise gives out copies of “The Elder Care Ready Book” by Stuart Furman, Esq. A practicing elder law attorney, Furman has published a guide to help people navigate the elder care journey in a way that involves planning, foresight, organization and deliberate discussion. Furman’s mantra, preparation relieves anxiety and stress, is something we at CarePatrol can get behind. Due diligence is better for the family, better for the senior, and it’s what our company is all about.  (1)

Furman outlines his case well. The Elder Care Journey must be approached in an organized and logical manner to minimize emotions and smooth the transition into new care-giving environments. Planning includes a range of necessary steps, from financial to legal, personal preferences to belongings and pets. The Elder Care Journey covers the many things a family must consider. This article pulls together the big items.

“Preparing can eliminate much of the uncertainty  that can accompany eldercare responsibilities.” Stuart Furman, Esq.

First and foremost – do it now. Do not procrastinate. Prepare early while your elder is competent and can discuss wishes. Also, make sure you have a complete picture of options. Don’t assume communities or doctors are giving you all available options. Get second opinions from experts, like CarePatrol, when you are in a crisis or when you are researching ahead of time.

Equally important, keep your elder’s information and documentation at hand. Emergencies happen and it doesn’t do good to have documentation locked up in a bank deposit box if the emergency happens to be on a Sunday. Identify medical needs such as a complete list of medications and doses, any implants such as pacemaker or replaced joints, assistive devices like hearing aides or walkers, and a list of all care providers and contact information.

Ask the experts. Consult an elder law attorney to make sure paperwork, like power of attorney and advance directives, is adequate. Oftentimes forms presented online are sorely inadequate. And remember, different states have different rules and regulations. Senior placement agencies also come in all shapes and sizes with some being only national online resource lists with no insight as to what an actual facility is like. A locally-based placement agency, like Care Patrol, that has toured each and every recommended facility, can help navigate the priorities and needs of the elder and the family.  Touring facilities before the need arises allows the elder to weigh in with their wishes, and often brings comfort in knowing that there is a plan.

Plan for emergencies like hurricanes, evacuations, fires, or other acts of God that require one to be prepared! Where will the elder go for temporary housing? Is there enough medication on hand? What valuables need to be accounted for? What happens if something happens to you? What is the chain of responsibility surrounding your elder? Identify ahead of time the hospital of choice, the assisted living community of choice or as a last resort, a nursing home of choice.

The Elder Care Ready Book does a great job of outlining the various things a family needs to be prepared for along the elder journey. Your placement professional can assist you in touring and evaluating assisted living facilities, give recommendations on nursing homes and long-term care facilities, and provide overall recommendations for care ahead of time. Your placement agency can also assist families who are unprepared and need to make quick decisions to meet the needs of an emergency situation.

As preparation is the key to the most successful transitions, the fact that you are reading this post suggests you are ready to get started. Call us today to talk through your concerns and possible needs. We can help you navigate the many moving parts of the elder care journey, starting with a copy of The ElderCare Ready Book. For more information on planning, Stuart Furman, Esq., based in California, also has a website, www.eldercareready.com with worksheets and planning tools for purchase, or contact us at CarePatrol at 866 560-5656.

¹The Elder Care Ready Book, Stuart Furman, Esq., 2017 ElderCare Ready LLC; 9510 Vista Aleta, Valley Center CA, 92082

Now more than ever we need to check on seniors in our communities. We need social connection to thrive—no matter our age. In this time of social distancing and stay-at-home requirements, social isolation is hard to avoid. Recent research shows that the negative health consequences of chronic isolation and loneliness may be especially harmful for older adults¹. As our collective world is driving massive changes to our typical routines, older adults who live alone are especially at risk. And while we can’t invite them over for a cup of coffee,  because of the risks of COVID-19, there are other things we can do to help.

Here’s our top 6 recommendations to help seniors avoid the negative health consequences of isolation and loneliness:

1. Call. Call your mom, your auntie, your neighbor, your former teacher, your friends. Check in on a senior and see if they need anything. It may be they are too afraid to go to the market for groceries and are unsure of how to order online. Offer to pick some things up or provide some coaching for online ordering. Perhaps they simply need to hear a friendly voice.  Who doesn’t like knowing that someone is thinking of them?
2. Go for a walk.  Walking together while practicing safe distancing is an easy way to spend some quality time together while still respecting each other’s space. The exercise, fresh air and social interaction are good for you both.
3. Play an online game. Games  like Chess or Words with Friends are not only social, they help to keep the brain active and engaged as well. Mental stimulation and the anticipation of waiting for the next person’s turn helps people stay connected. Set up competitions, challenges and “prizes” (bragging rights?) to keep it interesting. Set regular “game-time” or play throughout the day.
4. Share book and movie recommendations. We’re all stuck at home, and a virtual movie or book review provides common ground for conversation. Read the book then watch the movie combos are always interesting. From best-seller lists to revisiting the classics, it’s a great time to catch up on the best – and talk about it. Most libraries offer downloadable content with a card. And cards can be applied for right on the website.  Need help getting started? Good Reads has lists, discussion topics, and more. Or go to your local library’s website.
5. Use online Meeting Apps. If your senior has a smartphone, tablet or computer, teach them how to use ZOOM, FaceTime, Google Hangouts or any of the other online meeting applications you might be familiar with. With these apps they can see you and feel connected.  Have weekly calls with all your family online. This is one of the easiest ways to connect.
6. Check in on Medications. Make sure medications are being refilled. Look into setting up home delivery if this is not already in place. Most pharmacies are now offering delivery.

Whether you have a senior in your life that is right next door or 5 states away, there are ways to stay connected and help them avoid isolation and loneliness. You might find you get as much out of it as they do!

• 1 Social isolation, loneliness in older people pose health risks , April 23, 2019, National Institute on Aging, National Institutes of Health, US Department of Health And Human Services,  https://www.nia.nih.gov/news/social-isolation-loneliness-older-people-pose-health-risks