Advance Directive & DNR Orders

In 1991, The Patient Self-Determination Act (PSDA) was enacted, and enabled people to exercise their right to make decisions about the type and extent of health care they choose to accept or deny when under medical supervision. This applies to care provided in a variety of medical environments including, hospitals, nursing facilities, long-term health institutes and home health agencies that receive Medicare and Medicaid reimbursement. Virginia law recognizes a patient’s right to consent to treatment, and their right to refuse medical treatment. Advance directives and DNR orders are two important components to a patient’s right to make decisions on receiving and denying treatment.

An advance directive permits a person to make decisions and state preferences regarding medical care. It also provides options in the event a person is unable to make these decisions themselves, including the ability to appoint a competent adult to act as a decision maker on their behalf. A durable do-not-resuscitate order (DNR) is a medical order written by a doctor with the patient’s consent. It instructs health care providers to withhold cardiopulmonary resuscitation (CPR) if breathing stops or if the heart stops beating. DNR orders are to be followed by emergency medical services (EMS) or any other licensed health care provider. It is valid until revoked by the ordering doctor.

Aging Well with Diet and Exercise

A well-balanced diet and adequate physical activity are the foundation of a healthy lifestyle for a person of any age. However, for seniors over 60, this is particularly applicable. In order to age well, it’s said that seniors must practice good lifestyle habits, stay active and eat well. Adhering to nutrition, activity and lifestyle guidelines for their age and physical health can greatly impact their ability to remain healthy with a high quality of life well through their senior years.

Every senior is different. Some are fortunate enough to be generally healthy, while others may battle chronic illnesses or mobility challenges. The common misconception is that seniors can’t and shouldn’t exercise. People might say that in their age they should simply “slow down and relax” for fear of overdoing it, falling or injuring themselves. However, research indicates that seniors who exercise regularly are seven times likely to live longer, healthier lives. It’s important to recognize that the definition of “regular exercise” is different for everyone, and before beginning any exercise plan it should be doctor approved.

Benefits of regular exercise include:

  • Weight management/maintenance
  • Increased physical endurance
  • Maintaining bone/muscle health
  • Strengthening heart, lungs and vascular systems
  • Enhances mood
  • Provides restful sleep
  • Reduces fatigue

When talking about diet and nutrition for seniors, it’s important to focus on both quality and quantity. A well-balanced diet should consist of proteins, fruits, vegetables, whole grains and fiber. Vitamins, nutrients and a generous amount of water and other fluids are critical for a healthy lifestyle as well. Quantity is just as important. The changing nature of a senior’s body calls for specific amounts of vitamins and nutrients. It’s recommended to follow suggested intake requirements, and consult with a doctor about what foods to include and/or avoid in conjunction with current health conditions.

Benefits of a well-balanced diet include:

  • Reduces risk of Type 2 diabetes
  • Decreases chance of heart disease, cancer and other chronic conditions
  • Promotes energy
  • Boosts mood
  • Controls weight
  • Improves digestion

Helping Seniors Beat the Winter Blues

If you struggle with the “winter blues” you know how difficult it can be to make it through the holiday season. Although winter brings cheerful, festive holidays, it also means less sunlight, shorter days and colder weather. This can result in a lack of exercise, more sleep, less interest in activities, social withdrawal, unhealthy eating and a general sense of feeling down.

Medically termed seasonal affective disorder (SAD), the condition can happen at the onset of any season. However, winter depression or winter blues are the most common. What happens to a person’s mood when they lack exposure to daylight creates a domino effect. Serotonin and melatonin levels both drop significantly which causes major changes in sleep and mood—two critical components to overall health and wellness.

Seniors are especially vulnerable to winter-onset SAD. Since they are generally less active, capable and independent it can be a particularly challenging time of year to get through. When you add cold winter weather to the mix, it only makes matters worse. The result is a senior that feels lonely, isolated and depressed.

Fortunately, there are activities to help seniors battle the winter blues. Whether you’re a loved one or caregiver, here are some ideas that might help…

Get enough exercise. Cold temperatures and winter weather can sometimes make it challenging to get outside. Shopping malls are a great place to get out of the house and get moving.

Eat healthily. Winter may put us into hibernation mode which causes us to reach for the comfort foods and sweets. Find low-calorie alternatives like soups, stews, vegetables and hot teas.

Maintain social interaction. Make plans with friends and family. Volunteer and try new activities of interest. Social engagement is a health booster for sure, but during this time of year, social activities may help you enjoy the holiday season even more.

AT Home Care offers a variety of companionship services that help seniors fight off the winter blues. In-home visits consist of meal planning, housekeeping and social interaction. Our staff can also arrange social activities outside of the home, or accompany you to appointments and errands. To learn more about senior companions, call AT Home Care today.

Introducing Seniors to New Technology

The healthcare industry is quick to encourage adaptive technologies and assistive devices to help seniors live safely and more independently. With some of these tools and services, it’s amazing to see how a single technology can help empower seniors aging in place. For example, a loved one may have trouble remembering what pills to take each day, so you get them an electronic medication reminder. Or, you might worry about them falling, so you have home monitoring devices installed. Whether a senior has mobility challenges, difficulty communicating, symptoms of dementia, or they simply need a watchful eye, there is likely a technology or device to fit their needs.

However, for a person of any age, learning and accepting something new can elicit mixed emotions. Anxiety, resistance, anticipation, confusion, stress and uncertainty are common feelings when trying to overcome a learning gap. Expecting some baby boomers and especially those from the silent generation to adopt new technologies and devices isn’t always an easy feat. These age groups aren’t as familiar with technology and electronics as younger generations. They tend to stick with what they know and may appear stubborn in their acceptance of new people, places or things.

So what happens when you show a loved one a helpful, new device or technology and you are met with resistance and frustration? Here are some tips to minimize the distress of introducing a new technology to your loved one…

  1. First and foremost, keep things simple. Stick to the motto of minimal technology for maximum quality of life. Once a senior feels overwhelmed with information the less accepting they’ll be as you explain how it works. Think carefully about how you first broach the subject. Once you do always lead with options and choices to give them control.
  2. Next, explain how the technologies or devices you’re proposing work. Keep it basic, but emphasize how these tools will help them stay not only safe, but connected and independent. It’s critical to make sure they know why they’re being asked to give something new a try.
  3. Understand their hesitancies, concerns and try to compromise. For example, a senior may be hesitant to allow cameras in their home for monitoring purposes because it seems invasive. Suggest video chatting as an alternative to check in and stay connected.
  4. If one thing is for sure, younger kids love technology and gadgets. Whether it’s a blood pressure monitor, electronic reminder device or a smartphone app, give the grandkids a shot at explaining it. Seniors love spending time with their grandchildren and this could be the best route to introduce a new technology.

Home health care services offered by certified medical professionals are a wise alternative if you feel your parent or loved one needs attention beyond what a device or technology can provide. There are always outside resources, like those available from AT Home Care, to assist in helping seniors remain independent and live a quality lifestyle. Contact us today to learn more about supporting a parent or loved one who is aging in place.

Helping Seniors Beat Seasonal Allergies

Spring is in the air! We’re finally coming out of a long, unusually cold winter and are getting our first taste of spring. The snow has melted and tree buds are starting to bloom, but the inevitable truth is that the beautiful greenery outside will soon release pollen into the atmosphere. Although warm, sunny seasons have physical and mental benefits, an early spring, or a spring that quickly turns to summer can signify an exceptionally bad allergy season is ahead.

Unfortunately, seasonal allergies don’t spare anyone. Infants, children, middle age adults and seniors are all equally susceptible to allergies. However, for seniors, allergies pose a higher risk than for any other age group. Asthma, COPD, high blood pressure and other chronic diseases may be further complicated by allergies. The challenge is that most of the medications that provide allergy relief contain an antihistamine. This can be a harsh combination with other medications used to treat chronic conditions. It’s for these reasons that seniors have a particularly hard time controlling seasonal allergies.

There are some things that caregivers and family members can do to help seniors be safe and more comfortable this upcoming allergy season. Here are a few tips…

Talk to your doctor before taking over-the-counter medication. Most allergy treatments contain antihistamines, and when paired with other medications can cause dizziness, drowsiness, high blood pressure and other adverse reactions. This can challenge a senior’s health, increase fall risk and the chance of other injuries.

Keep a watchful eye for common allergy symptoms like coughing, runny nose, itchy eyes, sniffling and sneezing. These are traditional signs that allergy season is upon us. For seniors in particular, it’s important to also pinpoint the specific allergy. This is why allergy testing is often recommended. Handling an allergy to a pet is much different than dealing with a pollen allergy.

Check pollen and mold levels before heading outdoors. There are many free services to check local counts. If levels are high and you intend on being outside, wear a hat and sunglasses to keep allergens out of your face and hair.

Make sure outdoor allergens stay outside. Remove clothing and shower if you’ve spent time outside, especially in areas with freshly cut lawns or heavy foliage. Keep windows and doors shut to keep pollen and other allergens from coming into the home. Clean bedding and other linens regularly.

The best way to fight allergies is by determining the culprit(s) and learning how to avoid them. If you’re a caregiver or loved one of a senior who is struggling with allergies, keep their doctor in the know. It’s easy to overlook allergies if the person has multiple health issues.

Skin Care & Health Tips for Seniors

As we age, our skin undergoes many changes. We’re not referring to fine lines and wrinkles, rather changes taking place that make the skin drier, thinner and more fragile. Seniors are more likely to have an increase in itchy, scaly, dry skin as they age as well. These variations can make skin more prone to injuries like bumps, bruises and scrapes that take a considerable amount of time to heal. While these skin changes are common with aging, they also put seniors at risk for skin infections and ulcerations which are very serious conditions. Those who have existing medical conditions like diabetes or kidney disease can experience an even greater degree of skin problems.

It is very important that seniors take care of their skin because they are more susceptible to skin infection and other skin diseases. Here are some tips to help seniors protect their skin, and to make them look and feel better about themselves…

  1. Many seniors suffer from dry skin. This oftentimes occurs on the lower arms and legs as well as the elbows. Taking warm, not hot, baths or showers and the daily use of a moisturizer should improve dryness. There are many ointments, creams and lotions on the market, test several to find what you like best. If your skin is still very dry and itchy, consult with a doctor.
  2. Be mindful of time spent outside. The sun is typically brightest between 10 a.m. and 4 p.m., and some might say to avoid being outside during these times. However, it’s perfectly fine to go outside, just wear sunscreen and protective clothing. Apparel like a wide-brimmed hat, sunglasses and light-colored, loose-fitting clothing that covers the arms and legs will block harmful rays.
  3. Regularly check your skin for changes and abnormalities. Keep an eye out for new moles, ones that have changed in shape, size or color, moles that bleed and other sores that do not heal. These may be warning signs of something more serious, and it’s recommended to consult with a doctor for further examination.
  4. Keep an eye out for bruising. Since there is a gradual loss of fat and connective tissue as we get older, the blood vessels are not supported as well and are more susceptible to injury. The skin is also thinner and more fragile so it’s prone to bruise easily. Seniors typically see an increase in bruises on their arms and legs. Some health conditions and medications can cause bruising, but if bruising occurs on areas always covered by clothing, check with a doctor.

Staying Active this Winter

The start of a new year usually includes goals of eating healthy and staying fit. While the weather doesn’t hinder the eating well portion of your goals, it may affect the ability to stay active. Winter weather can challenge anyone’s desire and discipline towards being physically fit, especially when it’s cold, dreary and unpleasant beyond your home’s comfortable (and heated!) walls.

Dropping temperatures don’t mean you have to abandon your health and fitness routine. Depending on your age and health, your doctor can recommend an appropriate activity level for you. Here are some ideas for staying active this winter…

Check out health clubs and community centers. Most gyms have group classes and instructed activities for people of varying ages and fitness levels. For seniors, your doctor should determine if gyms are a good fit for you. Many community centers offer fitness/wellness classes and activities. This is also a great outlet to remain social and engaged with others in your community.

Keep the same activities in your routine, but change up the location. If your go-to activity is a brisk walk with a friend or neighbor, head over to your local mall. Most malls open their doors early so walkers can get their exercise before shoppers arrive. This is a great alternative in a climate-controlled environment

If you decide to endure the cold temperatures for physical activity, it’s important to take a few precautions. Dress appropriately with the right types of layers and don’t forget to protect your extremities. The body loses 90% of its heat through the head, so make sure to wear a hat. Listen to your body for signals you may want to slow down or move inside.

Staying active doesn’t necessarily mean you have to break a sweat. For seniors in particular, staying active is really more about participating in activities and connecting to the community. Volunteering is a great way to stay active, learn a new skill or nurture a hobby or passion. Libraries, shelters and churches are resources to seek out volunteering opportunities.

Don’t lose sight of the simple truth—every activity counts towards your personal goals for staying active and healthy. Whether you’re doing laps at the mall, participating in a group fitness class or volunteering at a shelter, all of these are helpful to staying active and healthy. Have an open mind to try new things and get creative with friends and family.

What to Expect When a Loved One Suffers a Stroke

Every stroke victim’s experience is different. The type of stroke and severity of damage to the brain are determining factors in how one’s life is affected. Since a stroke changes the body’s ability to function physically, cognitively and emotionally, there are many challenges to getting the body back on track. After experiencing a stroke, most people need help and assistance getting their lives under control.

Many problems that occur after a stroke are temporary, but they take time and patience in healing. People may find they need rehabilitation therapy to overcome some of the effects of a stroke. Since a stroke impacts physical, cognitive and emotional abilities, it’s important to have an understanding the side effects so that you can begin the road to recovery. Listed below are some of the commonly experienced side effects of a stroke. More specific conditions affect some people, but not others. These include shoulder/arm syndrome, learned non-use and spasticity.

Physical changes of a stroke include:

  • Vision loss or perception problems
  • Sleep disturbances
  • Pain and fatigue
  • Problems with balance and coordination
  • Incontinence
  • Seizures
  • Paralysis

Cognitive & emotional changes of a stroke include:

  • Depression and anxiety
  • Short term and long term memory loss
  • Loss of thinking abilities
  • Challenges with communication

A stroke survivor’s family and friends form an important network of support, companionship and assistance. It’s important to understand side effects and how they affect life after a stroke so you can best position yourself as a knowledgeable caregiver and supporter. Many of these symptoms can dramatically change the person long term, and others take months or more to fully recover. Encouraging independence and participation is important, as many stroke survivors are capable of far more than a loved one may expect. Focus time on exercise when the person is up for it. Instilling a good quality of life is one of the most important parts of stroke recovery. For more information on rehabilitation and recovery after a stroke, contact AT Home Care today.

The Benefits of In-Home Speech Therapy

What is speech therapy and who provides it?

Speech therapy is provided for disorders of communication, cognition and swallowing. When speech intervention is necessary it means that one of the most essential human functions is compromised. What could be more important than restoring a means of communication, thinking or eating?

Speech-language pathologists are trained professionals with the ability to improve or restore function in these areas. They must have a Master’s degree and state licensure. Most hold clinical certification (CCC) from the American Speech-Language Hearing Association (ASHA). Their expertise and services include, but are not limited to:

  • Speech Services –
    • Articulation
    • Voice
    • Resonance
  • Language Services –
    • Word-finding
    • Increasing sentence length
    • Comprehension
    • Pragmatics
    • Reading
    • Writing
  • Alternative means of Communication –
    • Tablet/Smartphone
    • Computer
    • Dedicated communication devices
    • Eye gaze/non-hand switches for communication devices
    • Low tech picture communication systems
  • Swallowing Services –
    • Objective swallow studies (Modified Barium Swallow or FEES)
    • Bedside swallow evaluation
    • Postures/positioning for increased swallow function
    • Modified texture diets
    • Thermal/tactile and swallow-related oral motor exercises
    • Electrical stimulation of swallow, such as VitalStim
  • Cognitive-Communicative Services –
    • Memory
    • Problem-solving
    • Planning and initiation
    • Attention

Can effective speech therapy be provided at home?

Whether the need for speech therapy arises from an illness, disease or accident, speech-language pathologists can provide most services at home. Many people in recovery have spent weeks or months in hospitals and are thrilled to return home. Others may not have been hospitalized but do not have a means of transportation to outpatient service facilities. Still others are homebound, receiving all care in their residence. It is still possible to receive high quality, evidence-based speech-language, swallowing or cognitive-communicative therapy. There are actually benefits to receiving therapy at home.

Benefits of in-home speech therapy

People feel most comfortable in their homes and everything they need is nearby. Therapy will be less disruptive for medication, food or bathroom breaks.

Informed Caregivers

In the home, a speech pathologist frequently encounters family members or professional caregivers. They can observe therapy and receive education or counseling about the techniques implemented by the therapist. Continuity of care then improves when the speech pathologist is not present. Family members or professional caregivers are with patients many more hours per week than the visiting therapists. Knowledgeable caregivers can encourage patients to use techniques throughout the week. This extends the therapeutic effect by increasing practice time and intensity. Recent research suggests these parameters improve patient outcomes. Additionally, naturalistic home environments support generalization of techniques to everyday situations, not confining learned behaviors to just the speech pathologist or clinic.

Personally Relevant Materials

Another benefit of in-home speech therapy is that the patient’s own items can be used in therapy. For example, in language or memory therapy family pictures or photo albums can be adapted as stimulus materials. In swallowing therapy, the speech pathologist can use the patient’s actual silverware. This can increase the accuracy of instructions and the safety of the patient during swallowing. A patient’s spoon may be twice the size of a plastic spoon commonly used in outpatient rehabilitation.

Less Stress and Energy Expenditure

Patients experience fatigue with illness or during recovery. In-home speech therapy reduces the burden on the patient for travel time and physical activity, saving energy to put into a meaningful therapy session instead. This improves patient’s stamina and allows a speech-language pathologist to see a patient at his or her best.

There are numerous reasons why people elect to have rehabilitation at home. An experienced speech-language pathologist can provide quality therapy in that environment and actually harness the benefits of in-home speech therapy to enhance a patient’s experience within individual therapy sessions and overall outcomes.

Parkinson’s Disease Care

Parkinson’s is a slow progressing disease that affects the body’s ability to have a full range of motion. This neurodegenerative brain disorder results from a gradual deterioration of the nerve cells in the brain that control regular body movements. The most common symptoms of Parkinson’s disease are tremors, stiff muscles, slow movement or decreased range of motion, and difficulty walking or balancing.

There is no known cure for Parkinson’s disease, but there are ways to slow its progression and better manage symptoms. The type and severity of symptoms range, as does the length of time it takes for symptoms to appear and become noticeable. This can make it difficult to know what to expect and how to act when new symptoms emerge. AT Home Care’s medical team of nurses, aides and therapists can guide patients through the various stages of the disease.

AT Home Care can assist patients with medication and treatment options to help control symptoms. Patients also benefit from physical and occupational therapies. Since those with Parkinson’s disease struggle with physical limitations, their ability to live comfortably in their own home often proves difficult. AT Home Care has a team of therapists that specialize in helping patients overcome physical limitations, as well as the challenges that arise in daily living activities.

Each patient suffering from Parkinson’s needs personalized care and treatment. Whether medications alone are effective, or therapy and in-home assistance are necessary, the AT Home Care team can provide a personalized, comprehensive treatment plan. Our goal is to help those suffering from this debilitating disease to better manage symptoms and maintain freedom, independence and a good quality of life.

Parkinson’s Disease Statistics:

  • Parkinson’s disease is one of the most common nervous system disorders
  • Nearly one million Americans are currently diagnosed with Parkinson’s disease
  • There are 50,000 to 60,000 new cases diagnosed each year