Today Show: Should seniors take extra precautions against COVID-19 this fall? Experts weigh in.

https://www.today.com/health/should-seniors-take-extra-precautions-against-covid-19-fall-experts-t191800

By Kerry Breen

As the coronavirus pandemic continues and flu season begins, leading to concerns of a “twindemic” in the United States, health experts are urging those who are high-risk for either or both illnesses to limit their social bubbles to stay healthy.

Dr. Anthony Fauci, the top infectious disease expert in the country, said on Sept. 10 that people needed to prepare to “hunker down and get through this fall and winter.”

“We’ve been through this before,” Fauci said. “Don’t ever, ever underestimate the potential of the pandemic. And don’t try and look at the rosy side of things.”……….

Coronavirus concerns show increased need, demand for home care, experts say

By Daniella Silva

For people recovering from COVID-19, home care can be both essential and elaborate, involving a health care professional who provides additional oxygen, monitors vital signs, administers medication and helps with daily tasks such as eating, bathing and getting in and out of bed.

Home care professionals and nurses said the coronavirus pandemic shows how crucial the industry is. It provides life-saving services to people who are vulnerable while keeping them safe in their own homes.

“It’s been quite a dramatic challenge for all of us and certainly the public health challenge of our lifetime,” said Dr. Steven Landers, president and CEO of the Visiting Nurse Association Health Group, which serves New Jersey and Ohio.

“Nurses, therapists, home health aides, they have really shown up to help fragile, medically vulnerable people stay home and also help people come home from hospitals and nursing homes, which have been under incredible stress,” he said.

Landers said his organization has helped more than 500 patients in New Jersey with home services get out of hospitals and emergency rooms. The workers have adapted to the pandemic, learning new protocols and infection control regimens and wearing new types of protective equipment, he said…….

Read the entire article at NBCNews:

https://www.nbcnews.com/news/us-news/coronavirus-concerns-show-increased-need-demand-home-care-experts-say-n1211261?fbclid=IwAR06lorxuc68essEn0HKuo2aFa5qzWgefdhIC_T_mhWSehMcM3CvuXcdxZM

Driving Safely as We Age

Driving is one of the first things that we equate with our independence. It’s only natural that we want to hold on to our ability to drive for as long as possible. But, as we age, our driving abilities begin to change. Everyone ages differently, so there is no arbitrary cutoff as to when we should stop driving, and assessing a person’s driving ability should never be based on age alone. By reducing risk factors and incorporating safe driving practices, many of us can continue driving safely long into our senior years. However, we should pay attention to warning signs that age is interfering with driving safely.

Many studies have shown that older adults are more likely to receive traffic citations and get into accidents than younger drivers. In fact, fatal crash rates rise sharply after a driver has reached the age of 70. What causes this increase? As we age, factors such as decreased vision, impaired hearing, slowed motor reflexes, and chronic diseases that affect our physical health, may become a problem.

Aging tends to result in a reduction of strength, coordination and flexibility, which can have a major impact on the ability to safely control a vehicle. For example:

  • Pain or stiffness in the neck can make it harder to look over your shoulder to change lanes or back up, or look left and right at intersections to check for other traffic or pedestrians
  • Leg, hip and back pain can make it difficult to move your foot from the gas to the brake pedal
  • Diminished arm strength can make it hard to turn the steering wheel quickly and effectively
  • As reaction times slow with age, you may be slower to spot vehicles emerging from side streets and driveways, or to realize that a vehicle in front of you has slowed or stopped
  • Maintaining focus becomes increasingly difficult as you lose the ability to effectively divide your attention between multiple activities (signs, signals, other traffic, pedestrians)

If you find yourself in the position of talking to an older family member or friend about their driving, remember the following:

  • Be respectful. For many seniors, driving is an integral part of independence. Many older adults have fond memories of getting a driver’s license. At the same time, don’t be intimidated or back down if you have a true concern.
  • Give specific examples. It’s easier to tune out generalizations like “You just can’t drive safely anymore.” Outline concerns that you have noticed, such as “You have a harder time turning your head than you used to,” or “You braked suddenly at stop signs three times the last time we drove.”
  • Find strength in numbers. If more than one family member or close friend has noticed, it’s less likely to be taken as nagging. A loved one may also listen to a more impartial party, such as a doctor or minister.

There are many self-assessments available to you and your loved one to help evaluate driving capabilities. The Caregivers Library has a driving assessment checklist to help you determine if it is safe for you or a loved one to continue driving. AAA has a useful website that provides information about senior driving, written and interactive driving assessments, choosing the right car, and access to senior driving refresher courses. Just visit http://seniordriving.aaa.com/. The National Highway Traffic Safety Administration has produced an e-book, Driving Safely While Aging Gracefully, which provides information that can help you recognize physical changes that may pose safety problems, as well as recommendations for alternative forms of transportation.

Sometimes an older driver has to be stopped from driving over their objections. It might feel very difficult for you to make this call, especially if the senior is a parent or close friend. However, their safety and the safety of others must come first. An unsafe driver can seriously injure or kill themselves and others.

When you speak with a loved one about their driving, it is helpful to have a list of alternative transportation modes for them to access. Having these resources available can help them feel more in control of their independence and help them overcome the fear of being isolated. Transportation services, such as those provided by Lifeline Homecare, can be a great alternative for loved ones who are still able to shop, go to church, and visit friends, but who just need help with transportation.

If no amount of rational discussion has convinced your loved one to hand over their car keys, then you may make an anonymous report to your state’s Department of Motor Vehicles or talk to the person’s physician about your concerns. In some cases, there is a need to take further actions such as taking away the car keys, selling or disabling the car, enlisting local law enforcement to explain the importance of driving safely and the legal implications of unsafe driving.

For more information about how Lifeline Homecare can help care for you or a loved one, and for a free in-home assessment, call us 1-844-LIFELINE (1-844-543-3545) or email care@lifelinehomecare.org.

Helping Older Adults Stay Hydrated

As we enter the hot months of summer, much attention will be given to the topic of staying hydrated. Unfortunately, many older adults fail to drink enough fluids and are not aware that many health conditions can increase the risk of dehydration.

Studies show that as many a 1 in 3 older adults may not be getting enough fluid. A person’s total body water decreases with age (from 60 to 52 percent in men, and from 52 to 46 percent in women), and so they have less water to lose before becoming dehydrated. What they don’t realize is that dehydration can be dangerous and even fatal.

Fluid helps to carry oxygen and energy to the body and take away waste products. Without these fluids and electrolytes, the body has difficulty functioning normally. Our bodies cannot store fluid, so it has to be replaced every day. Getting enough fluids can be challenging for older adults who often have a decreased thirst sensation and may not recognize that they are thirsty.

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There are many other reasons why dehydration tends to be more common in older adults. In addition to a decreased thirst sensation, kidneys may also function less efficiently. Changes in physical condition that affects walking, reaching for a glass and feeding themselves also make it challenging to get enough fluids. Cognitive decline – confusion and deteriorating memory – can also make it hard to get enough fluids.

The environment, medications and physical activity also play a role. People perspire more in a hot or humid environment or when they walk, weight lift or garden. Sometimes medications, especially diuretics, can result in fluid loss. Diuretics are used to treat heart failure and hypertension, which are common ailments in older adults. Diuretics will cause individuals to go to the bathroom with greater frequency. The use of laxatives will also cause the loss of fluids.

As people age, it’s not uncommon to have weakened pelvic muscles that create a fear of having ‘accidents’, especially at night. Helping older adults feel comfortable will make drinking enough fluids a less stressful and potentially embarrassing process. Ensuring that the bulk of liquids are consumed earlier in the day, emphasizing the importance of using the bathroom before bed, and using incontinence-friendly undergarments are all ways to safeguard against accidents and help prevent dehydration.

Knowing the signs and symptoms of dehydration can aid older adults in getting the fluids they need. Weight loss, increased heart rate and low blood pressure are three symptoms of dehydration. Decreased skin firmness is another. The skin of a dehydrated person lacks its normal elasticity and sags back into position slowly when pinched up into a fold. Normally, the skin springs back into position.

Other signs are dry mouth and tongue, decreased urination, constipation or fecal impaction, nausea, anorexia, sunken eyeballs and decreased functional ability. In some cases, dehydration can cause weakness, trembling, lethargy or confusion.

The amount of fluid a person needs depends on their body size and health conditions. A registered dietician can help determine the optimum fluid requirement.

Milk, juice, coffee, tea and water all count as fluids. Keep in mind that caffeinated coffee and tea act like diuretics and increase the need to go to the bathroom. Milk provides protein, calcium and vitamin D. Juice does not have the same nutritional value as whole fruit, but can add significant calories that may not be needed.

Individuals who eat well can also get the equivalent of two to three 8-ounce glasses of water from the fluids found in the foods they eat. Fruits and vegetables have high water content. So do soups, gelatin and pudding. Dry foods such as snack foods, cookies and cheeses have low water content. If a person is not eating well, they may need additional fluids to make up for the fluids they are not consuming.

Caregivers and family members can help older adults by making sure that fluids are received at every meal and at set times between them. Establishing this routine will ensure that an individual isn’t relying on thirst to indicate that they need fluids.

Some things to try at home include:

  • Having a beverage with each meal and snack
  • Keeping fluids handy – a pitcher of water with lemon slice in the refrigerator can be very appealing
  • Enjoying a beverage when watching TV or reading
  • Drinking more water than necessary to swallow medications
  • Pouring a half-gallon of water in a pitcher every morning. Use it for any beverage needs throughout the day until empty
  • Eating the recommended 5 to 9 servings of fruits and vegetables each day for essential nutrients and fluids
  • Making a healthy soup meal – with low sodium
  • Taking a bottle of water on outings

For more information about how Lifeline Homecare can help care for you or a loved one, and for a free in-home assessment, call us 1-844-LIFELINE (1-844-543-3545) or email care@lifelinehomecare.org.

Cancer Diagnosis and Home Care

Almost 11 million Americans alive today have faced a diagnosis of cancer. Some of them have just been diagnosed or are going through treatment, while others no longer have active symptoms of cancer or are thought to be cured. Advances in cancer treatment and changes in the health care system have led to shorter hospital stays and an increase in the number of people seeking treatment at home.

Receiving a diagnosis of cancer causes a flood of emotions: worry, anger, panic, frustration and grief. The last thing you may want to think about is long-term care for you or a loved one. And, there’s a lot of information out there that can be confusing and overwhelming when it comes to long-term care. Knowing about your options, including non-medical home care, can help you worry less and get the care needed after receiving a cancer diagnosis and starting treatment.

Many people living with cancer often feel more secure receiving care at home in familiar and comfortable surroundings with their family and friends nearby. In-home care can often reduce the amount of time spent in the hospital during recovery. Care in the home often involves a team approach that includes doctors, nurses, social workers, case managers, physical therapists, family members and others.

Services provided by home care agencies may include access to medical equipment; visits from registered nurses, physical therapists and social workers; help with running errands, meal preparation, and personal hygiene; and delivery of medication.

Lifeline Homecare provides non-medical home care that includes assistance with the activities of daily living such as: walking, meal planning and preparation, bathing, toileting, personal hygiene and grooming, transportation services, medication reminders and respite care. Lifeline Homecare does not provide direct medical care, but we often work in tandem with skilled healthcare providers and medical professionals to provide a holistic approach to caring for those living with or recovering from cancer.

There are several ways that you can pay for non-medical homecare. Government funding through the Older Americans Act provides federal funds for state and local social service programs that help frail and disabled people age 60 and older remain independent. This funding covers home care aide, personal care, meal delivery, escort and shopping services. Local Area Agencies on Aging (AAA) typically administer these funds on a local level.  Lifeline Homecare has been a partner over the years with AAA agencies, and has provided services through these agencies. The Eldercare site provides information about AAAs and other assistance for older people.

Veterans may also be eligible for home care services from the Veterans Administration.  Lifeline Homecare’s Veterans Coordinator can provide more information on these benefits and put you in touch with a VA Representative.

Private health insurance policies may cover some home care or hospice services, but benefits vary from plan to plan. Contact your insurance company to find out which home care services are offered. If insurance coverage is not available or doesn’t cover all the care that you need, you and your family can hire caregivers and pay for the services out-of-pocket.

Lifeline Homecare can offer you the highest in quality non-medical home care. We help with the activities of daily living so that recovery occurs in familiar surroundings providing comfort and peace of mind. Our trained caregivers provide care that is designed to meet your specific needs and support them throughout the recovery process.

For more information about how Lifeline Homecare can help, and for a free in-home assessment, call us 1-844-LIFELINE (1-844-543-3545) or email care@lifelinehomecare.org.

The National Cancer Institute’s website also has useful information that may help you plan for your long-term care.

Chronic Disease and Long-Term Care

Worldwide, chronic diseases have overtaken infectious diseases as the leading cause of death and disability. Chronic diseases like COPD, cardiovascular disease (heart disease and stroke), cancer, arthritis, back problems, asthma, diabetes and chronic depression are becoming more prevalent in aging populations. In fact, more than half of Americans suffer from one or more chronic diseases and Kentucky has some of the highest rates of chronic disease of any state in the U.S.

The number of chronic conditions increases with age. According to the Centers for Disease Control, more than two-thirds of Medicare beneficiaries age 65 and older suffer from two or more chronic diseases, and more than 15% have six or more.

Chronic conditions may significantly impair every day physical and mental functions and reduce an individual’s ability to perform activities of daily living. Physical limitations, which are associated with insufficient physical activity, being overweight, and the consequences of chronic conditions, decrease quality of life, increase the need for costly long-term care, and make challenging demands on family members and other caregivers.

According to the Partnership to Fight Chronic Disease, nearly two-thirds of Americans over the age of 65 are estimated to be candidates for long-term care facility placement. However, alternatives to long-term care facility placement exist, and recent studies have shown that many elderly individuals would prefer to receive care in their home when possible. What’s more, in-home care is usually less costly than placement in a long-term care facility.

Lifeline Homecare provides non-medical, in-home care that enables older adults with MCC to live independently and helps prevent unplanned hospitalizations and emergency room visits. Results of a research study by Health Quality Ontario show that there is a significant beneficial effect of in-home care on unplanned hospitalizations and emergency room visits. The same study also found a significant beneficial effect of in-home care on activities of daily living in persons with MCC.

To learn more about how Lifeline Homecare can help you or a loved one live independently at home, click here to read about our services and request a free in-home assessment.

The National Association of City and County Health Officials has created a toolkit that can be used by public health officials, nonprofit health organizations, and members of the public to raise awareness and improve education about chronic disease prevention. The toolkit contains case studies, presentations, fact sheets, drills, evaluations protocols, templates, reports and training materials. Click here to access the toolkit.

Type 2 Diabetes in Older Adults

According to the American Diabetes Association, one out of four Americans who are 60 or older have Type 2 diabetes. Of the 30 million adults in the U.S. who have diabetes, 90-95% of them have Type 2 diabetes. Type 2 diabetes is a condition characterized by high blood glucose levels caused by either a lack of insulin or the body’s inability to use insulin efficiently. Serious complications such as hearing loss, vision problems, cognitive impairment, and mobility difficulties are especially apparent in seniors whose diabetes isn’t properly managed.

The following are some of the most common complications seniors with diabetes face and what can be done to prevent them or slow their progress.

Vision Problems

Prolonged high blood sugar can damage the blood vessels of the retina, causing them to break and leak blood into the eye which can cloud or obscure vision. High blood pressure, which affects about 60 percent of diabetic patients, is another risk factor.

This condition, known as diabetic retinopathy, is a leading cause of blindness in American adults. According to the National Eye Institute, between 40-45 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy.

Symptoms of diabetic retinopathy include:

  • Blurred or double vision
  • Flashing lights, which can indicate a retinal detachment
  • A veil, cloud, or streaks of red in the field of vision, or dark or floating spots in one or both eyes, which can indicate bleeding
  • Blind or blank spots in the field of vison

If you have diabetic retinopathy, your doctor can recommend treatment to help prevent its progression. If caught early enough, it may be treatable with laser surgery that seals leaky blood vessels and discourages new leaks from forming. The surgery is not a cure-all, however, as retinopathy can reoccur, especially if you don’t control your blood sugar levels.

Since it can take years for high blood sugar to trigger diabetic retinopathy, having regular eye exams are important, as they can detect signs of the condition before symptoms surface.

Hearing Loss

The National Institute of Health has concluded that hearing loss is twice as prevalent among older adults with diabetes. In the estimated 79 million adults with pre-diabetes, the rate of hearing loss is 30 percent higher than in those with normal blood glucose.

High glucose levels over time can damage small blood vessels and nerves inside the ear. Older adults account for the majority of the patients with diabetes-related hearing loss, but anyone who doesn’t control their diabetes or who has had the disease for a long time is at risk.

Signs of hearing loss include:

  • Frequently asking others to repeat themselves
  • Trouble following conversations that involve more than two people
  • Thinking that others are mumbling
  • Problems hearing in noisy places such as busy restaurants
  • Trouble hearing the voices of women and small children
  • Turning up the TV or radio volume too loud for others who are nearby

If you suspect a hearing loss, be sure to tell your doctor and get a full hearing exam. Hearing loss is typically irreversible, but it may be managed with the use of a hearing aid.

Cognitive Impairment

According to a 2013 study published in the New England Journal of Medicine, higher blood sugar levels may have “deleterious effects on the aging of the brain” and increase a person’s risk for dementia.

A December 2014 study by Johns Hopkins  Bloomberg School of Public Health found that people diagnosed with diabetes in midlife are more likely to experience significant memory and cognitive problems during the next 20 years than those with healthy blood sugar levels.

“The lesson is that to have a healthy brain when you’re 70, you need to eat right and exercise when you’re 50,” says study leader Elizabeth Selvin, PhD, MPH, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. “There is a substantial cognitive decline associated with diabetes, pre-diabetes and poor glucose control in people with diabetes. And we know how to prevent or delay the diabetes associated with this decline.”

Screening older diabetic patients for cognitive impairment, regardless of the underlying cause, is critical because it can interfere with their ability to manage the disease. Recording blood sugar levels, managing diet, and taking medication on time can become an issue, as well as coordinating doctor’s appointments. Caregivers can help ensure that older adults are properly managing their disease.

Mobility Difficulties

Arthritis and other bone or joint issues can make getting around difficult for many older adults, but diabetes can exacerbate the problem if a patient develops neuropathy, or nerve damage, in their feet. According to the Mayo Clinic, at least half of all people with diabetes develop neuropathy.

The symptoms of neuropathy are wide-ranging and depend entirely on the form of neuropathy present, and which nerves are being affected. People with neuropathy typically feel numbness or a reduced ability to feel pain in their feet and toes, as well as tingling or burning sensations and pain that increases while walking or sleeping. These sensations can interfere with routine activities, including dressing and basic mobility.

As a result of decreased sensitivity from diabetic neuropathy, many people with diabetes don’t notice when they develop foot ulcers. “If a person doesn’t have full sensation in the bottom of the feet, sometimes they’ll develop wounds from stepping on something or getting something in their shoe, and they don’t feel it, and then it will take months and months to heal,” said Yael Reich, a diabetes clinical specialist with Partners in Care.

Remaining active is important because exercise can reduce the pain while helping lower blood sugar levels. Reich also recommends checking your feet daily to spot and treat wounds or ulcers as soon as possible. Untreated wounds can become infected and lead to gangrene, or tissue death, and amputation.

“We are able to decrease the likelihood of terrible complications that can cause blindness, loss of limbs and more by controlling glucose and A1C level,” said Betul Hatipoglu, MD, and endocrinologist at the Cleveland Clinic. Doctors are paying attention to these things, but the patients and even caregivers need to know as well to prevent these things from happening.”

If you have already been diagnosed with diabetes, the following American Diabetes Association guide, Living Healthy with Diabetes, may help.

If you are a caregiver of a loved one with Type 2 diabetes, check out some of these useful tips on caring for an older adult with diabetes from Care.com.

Contact Lifeline Homecare to find out more about how we can help provide non-medical homecare for loved ones with Type 2 diabetes: care@lifelinehomecare.org