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When pain gets bad it can interfere with both one’s physical and mental health.  It can affect one’s sleep and appetite thereby aggravating any other physical issues. Pain is a signal that something is wrong and needs attention.  It should be addressed at the onset of the first symptoms, when it is most likely to respond to medication or holistic treatment.  The elderly may not voice their concerns about their pain with their homecare nurse or doctor because they  assume that their health-care provider understands how they are feeling and that any hurt is “par for the course”.  Communication is the key to the best pain management.   Never keep pain to yourself.

Learning to Talk About Your Pain

There are many different types of pain, and knowing some words to describe how you are feeling to your doctor or home health care provider are important. It is helpful to write down how you are feeling and how the pain may be changing. Some key words are: sharp, aching, dull, shooting, pounding, burning, deep, constant, on-and-off.  You can, also, help others understand by rating your pain on a scale of 0-10. It is also helpful to note whether your pain increases at certain times of the day or when your body is in specific positions. Continue to keep your home health nurse or doctor informed by writing down any descriptions or changes in pain throughout the day.

Drug Alternatives

The good news is that there are more options to alleviating pain than medication these days.  More homeopathic remedies include relaxation techniques such as meditation, hypnosis and progressive muscle relaxation; warm compresses or massage to relieve stress.  Acupuncture is another remedy in which tiny needles are inserted into the skin at specific points.  According to some experts, acupuncture works by stimulating the body’s pain control system or by blocking the flow of pain. In extreme circumstances, Transcutaneous electrical nerve stimulation is used.  A small battery powered box that can be worn with a belt clip sends a mild electrical current along the skin, locking pain sensations. Consulting with your home care nurse, doctor or hospice organization is recommended before you change your medication or care plan. Remember that it is important to speak up about pain.Osteoporosis is the most common type of bone disease. It occurs when the body fails to form enough new bone, or when too much existing bone is reabsorbed by the body. Some osteoporosis sufferers experience both. These problems weaken their existing bone mass, and increase their susceptibility to bone fractures or collapses. Oftentimes osteoporosis is referred to as a silent disease because symptoms can go unnoticed for quite some time. Some of the most noticeable symptoms include back pain, loss of height, stooped posture and other spinal deformities. Medications to stop or slow bone loss are a common treatment method for osteoporosis. Nutrition is critical to helping build strong and healthy bones. Exercise is another important component to those living with osteoporosis. A doctor-approved weight-bearing exercise routine can increase bone strength, as well as improve balance, posture and coordination.

Home Treatment Plans

AT Home Care understands that osteoporosis is a painful disease that affects quality of life. Many patients are overwhelmed by the amount of physical challenges they face as the disease progresses. Our team of health aides, nurses and therapists specialize in treatment plans for those suffering from osteoporosis. Our in-home treatment plans include medication recommendations, physical therapy, assistance with ADL’s and help with modifying the home to create a safer environment. Osteoporosis Statistics: Osteoporosis, a disease characterized by porous bones, threatens the quality of life of millions of older Americans. As it advances, bones weaken and become brittle, sometimes fracturing from minor falls or even just coughing or sneezing. Who is at risk? Most at risk are slim, small females of Caucasian, Asian or Hispanic descent-and the incidence is increasing most rapidly among Hispanic women. A family history of the disease increases the likelihood of developing osteoporosis. Other contributing factors include poor diet, early menopause, excessive alcohol consumption, tobacco smoke and a sedentary lifestyle. Long-term use of steroid medications and certain illnesses, like thyroid disease or anorexia, add to the risk, too.  Although males develop osteoporosis too, it is four times more common in women than men. Ten million Americans have the disease and another 34 million have low bone density, putting them at risk of developing osteoporosis. Bones continually break down and rebuild, but the rate at which this remodeling proceeds slows with age, making osteoporosis a major public threat for Americans 50 or older. In 2005, it was responsible for more than 2 million fractures. While not curable, osteoporosis is preventable if bone loss is detected early. Once diagnosed, it is treatable.  Left untreated, however, it can impede mobility and hasten death. Women start out with lower bone mass than men and lose more after menopause because of decreased estrogen production, putting them at risk of osteoporosis earlier than men. Men are most at risk after age 75. Prevention Osteoporosis advances symptom-free. Most people don’t know they have it until they suffer a fracture, most commonly of the hip, spine or wrist, although any bone can be affected. Other signs include severe back pain, loss of height due to vertebral fractures, and spinal deformity, such as a “dowager’s hump.”  Hip fractures, the most feared, usually require surgery or hospitalization and often cause long-term or permanent disability or even death. Osteoporosis prevention can begin in adolesence. Regular weight-bearing exercise and adequate consumption of calcium and Vitamin D, which is necessary for the body to absorb calcium, are essential for forming strong bones. By age 18, girls have 90 percent of their adult bone mass; boys, by age 20. Peak bone mass occurs at about age 30, after which bone growth slows. In the five to seven years after menopause, bone loss accelerates rapidly, and women can lose 20 percent of their bone mass in that time period. Because of this, doctors recommend that women with risk factors for osteoporosis consult their doctor well before menopause about possible tests, treatments or necessary lifestyle adjustments. At any age, it is possible to build bone mass. Diagnosis  A bone mineral density test is the common method to detect osteoporosis or osteopenia, which is mild bone loss that increases the risk of developing osteoporosis. Doctors review a patient’s risk factors and medical history in determining whether a bone density test is needed. Repeated at intervals of a year or more, these quick, painless tests can track bone loss and help predict the likelihood of fractures. Bone density scans aren’t perfect. While tests like DEXA are the gold standard for detecting the bone-thinning disease osteoporosis, they can sometimes miss fracture-prone skeletons and can deliver false alarms that lead to unneeded prescriptions for bone-bolstering drugs. A better check is here. Just ask your doctor to enter your bone density score—along with about nine other key risk factors for broken bones—into a new fracture assessment calculator called FRAX. Developed by the World Health Organization, FRAX was made available in the United States in the spring of 2008. The online calculator makes adjustments to account for bone differences between women and men and among people from four different racial and ethnic groups: African-American, Asian, Caucasian, and Latino. It also takes risk factors into account, including your age, weight, height, personal and family fracture history, alcohol and steroid use, and whether you have rheumatoid arthritis. The result: You get a personalized 10-year-risk score, which can help your doctor decide whether you need an osteoporosis drug, says Bess Dawson-Hughes, MD, director of the Bone Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. If your doctor doesn’t offer to run your personal data through FRAX, ask her to do so by logging on to http://www.shef.ac.uk/frax. Bone density tests are recommended for all postmenopausal women with one or more risk factors or postmenopausal women who are not taking hormone therapy; men aged 50 to 70 with one or more risk factors; all women 65 or older and men 70 or older. Depending on the test results, your doctor may recommend a treatment plan that includes medication, exercise and diet.It’s undeniable that a well-balanced diet goes hand in hand with a healthy lifestyle. What you choose to eat, and what you choose not to eat, are factors in warding off many leading chronic illnesses and diseases. Food choices make a huge impact on how you feel today, tomorrow and what the future holds in terms of promoting and maintaining good health. The right diet can help fight conditions and illnesses like heart disease, diabetes, osteoporosis, cancer and obesity among many others. Obesity: The scary truth is that obesity is becoming very prevalent in adolescents. Dietary habits that are established in childhood more often than not carry over into adulthood. This is why it’s critical to instill good diet and nutrition practices in today’s youth. Making sure children have the correct amount of nutrients and foods from major food groups is key to preventing obesity. Heart Disease: Keeping blood pressure, cholesterol and weight under control are main components to preventing heart disease. Healthy eating habits are a way to keep these numbers balanced. Focusing a diet on whole grains, fruits, veggies, and proteins, as well as limiting sodium and foods that are high in calories are good rules of thumb. Diabetes: The best way to prevent type 2 diabetes is to eat a low-fat, well-balanced diet. Other diet tips include decreasing fat consumption to less than 30 percent of calories and saturated fat consumption to less than 10 percent of calories. Adding high-fiber foods to a diet regimen is also important to preventing this lifelong condition. Cancer: Obesity increases the odds of developing cancer, and luckily there are many foods that can aide in prevention. Leafy greens, cruciferous vegetables, berries, whole grains and even green and black tea all help protect against various types of cancer. While no single food is a sure way to prevent cancer, the appropriate combination of vitamins and minerals along with a well-balanced diet can provide solid protection. Osteoporosis: A diet lacking vitamin D and calcium can contribute to osteoporosis. In order to keep bones healthy and strong, a diet containing specific types of foods is recommended. This includes low fat versions of foods that are high in calcium, and those fortified with vitamin D. Calcium fortified products, like orange juice, cereals and soy-based foods are a good way to increase calcium in a diet.Multiple sclerosis is a disease that disrupts the function of the nervous system, interfering with the ability of the brain to communicate with other parts of the body. The symptoms and severity of MS can differ greatly among those dealing with this disease. Currently, there is no cure for MS, although the symptoms and disabilities associated with the disease can be managed with varying degrees of success. In-home care is an excellent option. With the assistance of certified home health aide Virginia professionals, those living with multiple sclerosis can continue to enjoy the familiar, comfortable surroundings of home.

Steady Increase

There are more than 400,000 people suffering from this disease in the United States today, according to the Multiple Sclerosis Association of America. With 200 more people being diagnosed each week, that number is steadily increasing. Fortunately, the number of health care professionals experienced with multiple sclerosis in-home care is also rising. That means more home health aide Virginia options for people to choose from and a better chance of being able to manage this debilitating disease successfully in the home, rather than having to trade independence for residential rehabilitation or an assisted living facility.

In-Home MS Management

There are a variety of ways that an in-home care team can assist in the management of multiple sclerosis. Because of the wide range of symptoms and varying degrees of severity, each MS management plan is highly individualized, encompassing such elements as rehabilitation, assistive care, and pain management strategies. Assistance with specialized therapies, such as cognitive, occupational and speech therapies, also make up a portion of the typical multiple sclerosis management plan. A home health aide can be a vital part of the nutritional support so important for those dealing with MS, helping to ensure a healthy daily diet. Quality care can help slow the progression of MS.

Advantages To At Home Care

While many people do go to a rehabilitation facility for physical therapy and occupational therapy, there are many advantages to doing those sorts of therapies at home. After all, it is the home that a person needs to learn to navigate with new skill sets or abilities that have changed. It just makes sense that the home should be the site of that learning when possible. It is natural for a person to feel more at ease and less stressed at home, which can help that person to get more out of therapy sessions. At home care is often the most cost effective option, an important consideration for many families struggling with multiple sclerosis.

Quality Of Care Matters

Facility care has an entirely different energy than at home care does, though the best facilities do try hard to model the personal, caring assistance a home health aide professional can provide. Health care facilities can be very busy, active places and health care staff have to meet the often competing needs of multiple people. In-home care means one-on-one care, which is often better quality care. And, with a complex, challenging disease like multiple sclerosis, the quality of care can make a real difference in both day-to-day quality of life and overall outcome.If you or a loved one has recently been diagnosed with multiple sclerosis, there is understandably a great deal of emotion and concern, as well as unanswered questions. Amidst the feelings of confusion, anxiety and fear there is an overwhelming sense of worry over what lies ahead and how to continue living an independent, quality life. Knowing next steps is critical, as is gaining a solid support system and asking healthcare providers the right questions. These are the keys to understanding the disease and being prepared with the necessary information to face a future with multiple sclerosis. Coping with multiple sclerosis symptoms and the progression of the disease is an ongoing process, and it’s never too early to discover new treatment options and symptom management tactics. Understanding treatment methods and symptom management techniques is one of the first things a person will need to know. Luckily, there are many resources available, support groups, and of course, the guidance of healthcare providers. To start, it’s recommended to meet with your neurologist to discuss appropriate care, and begin treatment as early as possible. It’s easy to feel alone and overwhelmed with a multiple sclerosis diagnosis. Don’t wait too long to talk about it with caring and encouraging family members and friends. These are the people that will be part of a lifelong support system. Allow time for yourself and those closest to you to digest the news before thinking about the next people to tell. Take your time in disclosing the information. Remember that multiple sclerosis is only one aspect of your overall health. One can quickly become so overwhelmed with the disease that they neglect all other facets of their life and their health. Continue to take care of yourself and put an emphasis on being healthy and fit through diet and exercise. Think about how to eliminate stresses that regularly occur in your life, and consider developing a stress management plan. These may be stresses at work, problems with friends or daily occurrences at home that are a constant source of stress. Seek recommendations from your neurologist on how to deal with daily stresses, and be honest about what you’re facing. A doctor can provide the best stress-coping mechanisms that will be beneficial to your health. These are just several of many strategies that when joined together can create the best possible approach to managing the disease. Medications, treatments, rehabilitation, support groups and companionship from friends and loved ones all play an equally important role in living with multiple sclerosis. For more information on in-home care plans for managing multiple sclerosis, contact AT Home Care.Hospice care is medical treatment and support for those with life-threatening, terminal illnesses. Care is provided by a team of professionals including doctors, nurses, health aides and therapists. Hospice is typically available to those with a life expectancy of 6 months or less. The hospice philosophy emphasizes control of pain and the provision of services that allow a terminally ill patient to remain comfortable at home for as long as possible. The primary goal of hospice care is to provide those that are dying or near death with peace, comfort and dignity as they progress towards the end of life. Since home hospice care is provided outside of a licensed medical facility, and by a combination of medical professionals and family members, there are numerous guidelines that pertain to this type of care. The Virginia Department of Health has stated specific rules and regulations regarding in-home hospice care. Every person involved as part of the unit of care, including the patient themselves, should be aware of these guidelines. Included are procedures regarding provision of care and services, indemnity coverage, criminal record checks and emergency preparedness. For a list of frequently asked questions, visit our Hospice FAQ.The body’s internal clock is what signals to us that it’s either time to wake or time to sleep. However, as we age, our bodies go through hormonal and other natural changes that have a direct affect on the internal clock. We oftentimes hear about older adults, seniors in particular, being dissatisfied with their sleep. This includes fragmentation of sleep, the inability to settle down to rest and a lack of feeling relaxed and refreshed upon waking. In addition to being a natural part of aging, there are a variety of factors that affect the ability to get restful sleep. Arthritis, Alzheimer’s, enlarged prostate, sleep apnea and restless leg syndrome are just several of many health conditions that can challenge sleep. Medications for these types of diseases and conditions are major contributors to sleep difficulty as well. Life changes like loss of a loved one, disability, and retirement play a role, too. It’s important to talk with your doctor about health conditions, medications, lifestyle habits and major life-changing events that could be adversely affecting sleep cycles. There are several ways seniors can improve sleep on their own with a few tips.

Home health care provides a caregiver the opportunity to monitor and treat poor sleeping cycles in the elderly

Elderly patients are especially vulnerable to insomnia:  sleep cycle changes, medical and emotional disorders, and multiple medications are a few factors contributing to sleep disruption in elderly patients. Insomnia occurs more frequently in persons over the age of 60 who sleep an average of 6.5 hours compared to the eight that most adults sleep.  Changes in the sleep cycle that occur with age are one cause.  Disturbed sleep also may be a symptom that reflects a serious underlying medical problem; or it may accompany physical and emotional abnormalities that are correctable or that subside with time. Generally, elderly persons have sleep that is less restful and not as deep as it was when they were younger.  Their first sleep cycle is shorter than that of children and young adults, and they have more stage 2, and less of stages 3 and 4 sleep.  Sleep progresses in four deepening stages, plus rapid eye movement (REM) sleep.  Stage 1 is a transitional “drowsy” phase that precedes deeper, more restorative stages.  Stage 3 and 4 are called Delta sleep and are the deepest and most refreshing parts of sleep.  Stage 1, the lightest sleep, increases with age. One must first assess if the insomnia is short (less than 3 weeks) or long-term (more than 3 weeks).  Long term is often referred to as chronic insomnia.  It may be caused by alcohol and substance abuse, depression anxiety, chronic pain, along with many medical disorders.  Anxiety is the most common cause of insomnia and results in difficulty falling asleep.  Depression, on the other hand, usually manifests itself in early awakening.  Some of the medical causes could be congestive heart failure, hyperthyroidism, rheumatologic diseases, dementia, Parkinson’s disease, asthma and others.  The good news is that most of these problems can be treated resulting in the alleviation of the insomnia. Home health care is a growing segment of medical care for the elderly and provides the caregiver a window into the sleep and living habits of an individual who may not realize that he is able to improve his quality of sleep.  Home health care providers see a patient in his own living environment and are able to view his activities of daily living along with his diet, all of which may hamper sleep patterns.  It is the duty of the home care nurse to address harmful habits and educate the patient on improvements that could minimize the patient’s sleep problems.  Nurses who administer medication are able to anticipate problems with sleep and relay that concern to other home health aides who may be present during the evening/night when insomnia occurs. The cornerstone of insomnia management, however, is the use of natural remedies.  This includes establishment of a bed time routine, and instructing the patient to avoid napping and to engage in exercise.  Diet restrictions such as caffeine alcohol and smoking should be avoided.  Stress therapy may be helpful, too.  Many herbal remedies are available, such as valerian root, chamomile and melatonin but they remain unproven in most medical circles. There are a host of medications with sedative qualities that are used to treat various types of insomnia.  But one must remember that medications often have side effects and are only recommended for short periods of time.  By coordinating medication, exercise and nutrition, the home heath care nurse can achieve a balance that will optimize their patient’s sleep.

Home Health Care can be Ground Zero for Help with Incontinency

Incontinency is not a disease, rather a symptom of other associated problems

People receiving home health care are fortunate to be in the comfort and stress free surroundings that their home provides. They perform their activities of daily living in full view of their care providers, thereby giving the home health nurse the unique opportunity to observe and asses many functions of their patient in their normal daily routine. During this home care period, clinicians are able to address the problem of incontinency that may not be apparent in a hospital setting, or with out the home health evaluation. The elderly make up 86% of home bound patients, and, 80% of the elderly over age 65 deal with the problem of incontinence. The inability to control the passage of urine is not a disease in and of itself, but often a symptom of other associated problems. Home health professionals have the advantage of a thorough knowledge of their patients and must be diligent in addressing this problem because incontinence may give clues to more significant problems such as spinal injuries, stress, depression or even prostrate cancer. Home care nurses hold the key to gaining further insight to the elderly patient’s health which opens opportunities for a healthier and more independent lifestyle. Home health care was the fastest growing category of spending between 2004 and 2007 as more and more elderly prefer care in the comfortable surroundings of their home, and costs of hospitals and nursing homes escalated. Eldercare is the majority of a home health care provider’s service. They not only have the opportunity, but the responsibility to investigate incontinency when evaluating their patients. Incontinence is not the inevitable result of aging and in fact, 86% of those with incontinence issues who seek medical intervention can not only see improvement, but may also completely restore their ability of control. Treatment varies depending on the specific cause, and could be significantly improved in elderly patients by things as simple as a change in diet or exercise. There are Six Types of Incontinence:
  1. Stress – increase of pressure prompted by an activity or movement (exercise, laughing, sneezing, or coughing)
  2. Urge which occurs when the bladder contracts when it shouldn’t
  3. Mixed incontinence – involves both stress and urge.
  4. Overflow – when the quantity of urine produced exceeds the bladder’s holding capacity
  5. Reflex – when the person is unaware of the need to urinate which may be caused by a abnormal opening between the bladder and another structure.
  6. Surgeries which may destroy pertinent nerves or muscles.
While the impact of disorders of incontinence on men and women vary significantly, the causes are often the same. Home health care involving elderly care is on the rise and gives clinicians the opportunity to address and treat a problem that has plagued so many people who never knew there may be a cure. Not only can the immediate problem be solved, but also, the patients’ chance of infection or related complications will be reduced which will result in an improvement of the patient’s independence.

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