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Good Advice for Families In Need of Long Term Care for Older Adults

How does one know what to choose?

As western Pennsylvania’s largest provider of care and services to older adults, Presbyterian SeniorCare encourages individuals of families in need of long-term care to visit the various care communities and to ask questions. “It is difficult enough to accept that a family member needs to have additional care, and sorting through the different options often adds to the emotions,” said Pat Kornick, spokeswoman for Presbyterian SeniorCare. “People certainly can and should obtain general information by visiting a web site or calling the care community, but nothing replaces a personal visit. A personal visit not only will enable them to see the overall appearance of a care community, but get a feel for how engaged residents are and how the staff interacts with residents and families.”

When visiting, Kornick suggests individuals ask the following:

• Does the staff show an interest and address residents by name?
• Are staff members respectful toward residents, as well as one another?
• How much choice do the residents have in planning their day?
• What happens if a resident’s financial resources are depleted?
• What recreational services are available?
• Are there social workers and pastoral care representatives on staff?
• Is visitation restricted?
• Are pets allowed?
• What is the staff-to-resident ratio?
• As care needs increase, can they be addressed on site or will residents have to
go elsewhere?
• Is there a volunteer program?
• What accreditation and certifications does the care community have?

“Presbyterian SeniorCare has been providing care and services for more than 82 years,” Kornick said. “Based on our experience, those are some of the basic questions that can at least assist individuals.” Kornick adds that Presbyterian SeniorCare also offers a variety of complimentary presentations for social, civic and business groups.

For additional information, visit www.SrCare.org or call 412-826-6083.

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Helpful Hints to Convince a Loved One to Receive Home Care

Many times it is obvious to a caregiver when a loved one needs extra help in their home to remain safe and independent. Unfortunately, the person needing help does not always feel the same way. Following are some helpful hints and informative steps to convince a loved one to consider the option of home care, allowing them to stay in the comfort of their own home when they may otherwise need to move into an assisted or extended care facility, or even require hospitalization.
• If a couple is living together, align yourself with the more independent partner. Make suggestions to them, explaining their spouse would benefit from home health services or outside assistance even though they both might. If they think this will help their spouse, they are more likely to consider assistance.
• Suggest hiring someone to handle household chores and not necessarily personal assistance. This seems less threatening, then as time progresses, they may be more apt to accept more help.
• If your loved one is living alone or with you, focus the attention on you as the one who needs assistance, not your loved one. If they know you are the one who would benefit from outside help, their concern for you will make having someone help a much easier decision to make.
• Involve people in your loved one’s lives who could help to influence their decision. If they trust this person and their judgement, your loved one might be more willing to accept their advice. It might be their physician or a trusted friend or neighbor, but it might just be the right person to help them make the right choice.
There are many options for caring for people in the comfort of their own homes that can assist in keeping them out of the hospital or a nursing home. It may not always be easy to convince a loved one they need assistance, but once they have it, they begin to appreciate the help.

For more information, contact VNA of Western Pennsylvania at 1-877-862-6659 or visit www.vna.com.

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Elder Care – From Whence it Comes!

A comedienne at The Improv whined to his audience the other night about the distinct possibility that neither Social Security nor Medicare benefits would be available to him when he grows old. Why? His slightly off-colored explanation was that, “Old people don’t die when they are supposed to anymore.” Of course, at the comedy club, this statement got a laugh from the listeners, but the uncomfortable reality of his skit is not quite as amusing. We all know that many of us are living longer. Some of us may live longer well; others may not be as fortunate.
The fastest growing group of our population is the “over 65 age group” and experts predict that by the year 2020, almost 20% of America’s population will fall into this category. Accompanying this age group growth-spurt, a multitude of issues has fueled a shift in the needs and expectations of Americans for their healthcare. This has contributed to the development of an entire specialty industry known as ElderCare. Elder Care is defined by Wikipedia as “the fulfillment of the special needs and requirements that are unique to senior citizens. This broad term encompasses such services as assisted living, adult day care, long term care, nursing homes, hospice care, and In-Home care;” in addition to “wellness” and estate planning.
If financial instability and illness could be the exception rather than the norm to growing old, we could all better enjoy our golden years. Sadly and all too often, our parents, if they live long enough, can become our children again. Many parents are dependant on their own children to transport them to appointments; cook, clean, care for them and to manage a second household…that of the aging parent.
Fortunately, the eldercare industry is abundant with professionals with years of experience in helping families with elder care matters, including: Elder Law and Estate Planning Attorneys, Geriatric Care Managers, Insurance Professionals, Reverse Mortgage Specialists, Seniors Real Estate Specialists, Home Care Agencies, and many other elder care experts with long and successful careers helping seniors and their families. There is an unparalleled amount of information both in print and on the Web available to Boomers and members of the Sandwich Generation new to the task of caring for their frail and aging parents; none more meaningful than first-person accounts from caregivers who have already navigated this period in their lives.
As the New Year approaches, Liken Home Care would like to extend our warmest regards to all caregivers and their families. Liken has been in the “eldercare” business for over 35 years. We remain in the business of assisting families to make the right choices for their medical and non-medical needs whether in home or facility.

If you would like more information about eldercare, contact Sue Janosko, CM, and Director of Private Duty Operations at Liken Home Care, at (412) 816-0113 or visit www.likenservices.com.

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Emergency Help Always at Hand

By Hank Walshak

Patients admitted to a hospital for surgery, disabling infections, chronic conditions, or falls often neglect to consider post-hospital convalescence. Yet, within their continuum of care, the getting-better part after discharge at home or in a nursing facility can be fraught with safety concerns.
“Post-op recovery can leave one frail and susceptible to accidents and recurrences,” said Vince

Medical Emergency Alert System
Emergency Help Always at Hand

By Hank Walshak

Patients admitted to a hospital for surgery, disabling infections, chronic conditions, or falls often neglect to consider post-hospital convalescence. Yet, within their continuum of care, the getting-better part after discharge at home or in a nursing facility can be fraught with safety concerns.
“Post-op recovery can leave one frail and susceptible to accidents and recurrences,” said Vince Nigrelli, President of Automated Security Alert, Inc. in Munhall. “Infections under control at a hospital can return. And patients with chronic conditions can take a turn for the worst. At times like these, people need access to an emergency-response system,” he said.
Years ago, hospitals supplied such a service. But as time went on, many discontinued their emergency-response operations. Today, only a few hospitals continue to offer the service.
To fill the gap, Automated Security Alert has, since 1988, provided a wireless, 24/7, monitored, emergency-alert system to seniors, recovering patients, people with disabilities and the elderly.
“The key lies in the medical-alert pendant that service subscribers wear around the neck or wrist. In an emergency, the person in need presses the Help Button on the pendant. This activates a medical alarm and opens transmission for the person with our emergency call center and an experienced operator,” said Nigrelli.
The operator arranges on-the-spot assistance by a family member, a nearby neighbor, an ambulance, and a fire department or police department. Just as important, the operator at Automated Security Alert dispatches assistance immediately even if the person is unable to respond verbally.

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ELDERCARE Healthy Aging

Eldercare 101:
Enhancing Quality of Life Through
Effective Caregiving that Nurtures
the Mind, Body & Spirit
By Bryna Smith

Part 1: Promoting skin integrity in the elderly
A major aspect of eldercare is in the maintenance of healthy skin. Healthy skin is indispensable for human life. Major functions of the body’s largest organ, the skin, include:
• Protection from UV light, disease, and injuries.
• Promotion of bone health
• Temperature and fluid regulation
Age-related changes affect the skin’s ability to function efficiently.
Warning! The elderly are at an increased risk for skin breakdown, pressure ulcer development, and prolonged wound healing.
Pressure ulcers negatively impact quality of life, causing limitations to mobility, activity, and clothing choices. They are painful, ugly, messy, and expensive. To achieve optimum health, skin must be kept intact and pressure ulcers prevented.

Promoting Skin Integrity Through Non-medical Care
Conscientious skincare is essential.
• Carefully examine the skin daily. Report open or reddened areas to doctor
immediately.
• Keep skin clean and dry (especially if incontinent). Use soft washcloths and towels.
Pat dry do not rub!
• Avoid drying out the skin; use lanolin-based products. Do not use alcohol-based or
perfumed products, or harsh detergents or soaps.
• Decrease the number of full baths weekly in winter. Avoid over-soaking.
• Use sunscreen and wear hats, and light protective clothing outdoors.
• Avoid pressure, friction and shear; they cause open areas that are susceptible to
infection. Pressure is a destructive force when applied over time. It is the primary
cause of pressure ulcers. Bony areas with little padding (hipbones, tailbone, elbows,
knees) are especially vulnerable.
• Every two hours: Turn and reposition non-ambulatory seniors and encourage
ambulatory seniors to walk around or change seats.
• Protect skin over bony areas! Use pressure relieving foam, air, or gel devices,
pillows and wedges as props, and to keep vulnerable areas from touching the bed
and each other.
• Place a pillow or rolled up towel under ankles to suspend the heels, which can
breakdown rapidly.
• Avoid dragging motions, constrictive clothing, and massaging bony areas.
• Break in new shoes gradually.

Nutrition is key in the maintenance of healthy skin. Adequate protein and calories are required.
• Consult a healthcare professional regarding diet.
• Strive to achieve in-range blood sugars. High glucose levels hinder wound healing.
The promotion of skin integrity is an integral part of eldercare that greatly enhances quality of life.

For more eldercare tips, visit www.mayihelpyouinc.net
To reach Bryna Smith, Owner, May I Help You, Inc., call (412) 853-0125.

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Alzheimer’s Disease
What we know 100 years after its discovery
By Andrea L. Zrimsek

HEAD-HEART CONNECTION
Some of the strongest research links brain health to heart health. The brain is nourished by one of the body’s richest networks of blood vessels. Every heartbeat pumps about 20 to 25 percent of your blood to your head, where brain cells use at least 20 percent of the food and oxygen your blood carries.
The risk of developing Alzheimer’s or vascular dementia appears to be increased by many conditions that damage the heart or blood vessels. These include high blood pressure, heart disease, stroke, diabetes and high cholesterol. Living an active lifestyle and eating a healthy diet can reduce your risks of both heart problems and brain problems.
Keeping your brain active can also contribute to prevention of Alzheimer’s, though there are no guarantees. The one thing about Alzheimer’s that is difficult for many to grasp is that it does not respect anyone. Much as a marathon runner in peak physical condition can die of a sudden heart attack, a healthy, active, mentally engaged adult can be stricken with Alzheimer’s.
Sadly, DeKosky says, many people do not get to a doctor for an Alzheimer’s evaluation because they don’t want to receive the diagnosis. Yet that same patient would more often than not seek out an expert opinion if they were having chest pains or joint problems.

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For a person who is about to leave their home of possibly 30 or more years, it may seem all the same – adapting to a new environment. But when an individual or an individual’s family decides that it’s time to increase the level of care that an older adult receives, be careful to pay attention to the details.
There are two primary options for older adults who need to change their current living arrangements - Assisted Living Facilities (ALF) and Skilled Nursing Facilities (SNF). The level of care needed often determines which type of facility is most appropriate for that individual.
ALFs are for people needing assistance with aspects of daily living, but wishing to live as independently as possible - for as long as possible. Assisted living serves to bridge the gap between independent living and SNFs. Residents in ALFs are not able to live by themselves, but do not require constant care either. ALFs offer help with activities such as eating, bathing, dressing, and assistance with medications, yet do not offer care as extensive as those individuals in SNFs. The idea is that the help is there if needed, yet independence is encouraged. The key to understanding assisted living is that it is not an alternative to SNFs, but an intermediate level of care.
In many instances, ALFs team with outside healthcare organizations, such as Celtic Healthcare, to provide integrated care services. Through Medicare and insurance-covered home healthcare services, these healthcare organizations enhance ALF residents’ health and well-being significantly by bringing their expertise in geriatric care. Together, the ALF and healthcare provider create a service plan for each individual resident upon admission. The service plan details the personalized services guaranteed by the facility. The plan is updated regularly to assure that the resident receives the appropriate care as his or her condition changes.
The explanation of an ALF already introduced some of the characteristics of a SNF. SNFs, also known as nursing homes, provide a living option where 24-hour medical care is available. In addition to long-term care, residents may be there temporarily for rehabilitation before returning to either an assisted living facility or their independent living. Skilled nursing facilities are regulated by the state, which defines the services that an SNF must provide.

For more information about the differences between ALFs and SNFs and/or Celtic Healthcare, please visit www.celtichealthcare.com
call 800-355-8894 or e-mail info@celtichealthcare.com.

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SENIOR MATTERS:
Marveling…
By Jim Mooney

I sometimes regard these “Golden Years” as a time for marveling. I don’t mean simply marveling at the fact that after all this time I’m still here to marvel. I mean that sometimes at night when sleep is slow to come, I find myself marveling over all the changes that have occurred during my lifetime. All I have to do is pick a category and think a bit.
Transportation: I remember, as a kid, standing on the running board of our family car helping my sister fasten in place the isinglass curtains-the windows-because it was threatening rain, or watching my father with the hand crank trying to start the engine. Today I sit in my air conditioned, push-button-operated auto complaining only of the traffic and gasoline prices. And I remember playing ball on the street as a kid and having the game interrupted when one of the boys stopped, pointed skyward and shouted, “Airplane! Airplane!” Today, I look up on a crisp fall morning and see the blue sky scarred with contrails crisscrossing in all directions.
Communications: I remember listening on the radio to the Pirates playing in St. Louis and Rosey Rosewell broadcasting the game from Pittsburgh. I could hear the clacking of the telegraph as the plays were relayed in to him by wire. Today, thanks to television, I go “live” to the World Series, the Super Bowl, the Olympics, or a concert in Vienna, a theater in London, anything imaginable. I can picture my grandmother turning the hand crank on the telephone mounted on the kitchen wall and shouting because it was long distance. I compare that memory to the teenagers I see in the Mall today, each equipped with a cell phone that seemingly puts them in touch with every other teenager in the world-or better still an iPod that does everything but brush their teeth.
Medicine: I still have a scar on my neck from “a poultice of hot oatmeal” tied round my neck when I was a kid as a treatment for “swollen glands.” So as I sit here today with a heart that must resemble Medusa’s head with its profusion of grafts from bypass surgery, I know I wouldn’t be here to be writing this if it weren’t for the miracles of modern medicine.
Word Processing: The first “mechanical” device I used in writing was my sister’s primitive portable typewriter. What I lacked in technique I made up for in powerful strike-overs or paper-destroying erasures. By the time I’d finished college, I’d learned the keyboard, so when I began working for a large corporation after WWII, I was ready to attack my Remington standard with vigor, if not improved accuracy. Although I was hired as a writer-photographer-or perhaps a “photojournalist”- I didn’t get to use a computer, a PC, until I retired. Now I have instant “erasures”, spell check, grammar check, etc.
Photography: I got my first camera when I was six that took out of focus, underexposed pictures. I had graduated to a 35 mm camera by high school. I had my own darkroom at home. I was unhappy at leaving the darkroom behind when we moved to the retirement community at Sherwood Oaks. True, I now have a digital camera, but what would I do with all the slides and negatives I’d accumulated? Today, beside my computer, sits a flatbed scanner that can do almost everything my darkroom could and do it better. With that “darkroom in a box,” I can make prints from b&w or color negatives, color slides, photographs.
This rundown only scratches the surface of the things I marvel at, but I stop at the mention of computers. I can’t even begin to imagine all the ways in which computers have affected my life. It’s too vast a Pandora’s Box to open when I’m lying there trying to get to sleep.

Jim Mooney is a resident of Sherwood Oaks Retirement Community in Cranberry, PA.
This article appeared in the September 2007 issue of North Hills Monthly Magazine.

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For more articles, download the Winter '10 issue (PDF)