Monday, March 24, 2014

Caregiving in Crises

Family caregivers are reminded to practice four self-care strategies to keep safe during various caregiving crises. Crises in caregiving can be brought on by things like: • Conditions: Broken hip, blindness, stroke, cancer, a rare disease, or chronic illness • Decisions: Take away car keys, move to assisted living, begin hospice, or remove a breathing tube • Conflicts: Doing enough, doing the right thing, or balancing work and caregiving responsibilities Caregiving crises develop when health conditions change, difficult decisions must be made, or conflicts arise. Overwhelming, they disrupt daily routines, demand a response, and can drastically change lives. As the caregiver, you must find ways to live through caregiving crises. It’s impossible to predict exactly how or when they’ll end. But you can count on anxious moments and debates about what to do. Post-crisis, life is different. Sometimes the changes are minor, sometimes significant. Whatever the outcome, there is always relief when the storm has passed. To stay safe in the storm, practice self-care: • Stay calm. Anxiety, fear, and panic block logical decision making. These emotions are contagious and can raise fears in those around you. Calm yourself by breathing slowly and deeply. Affirm your strength and capacity to handle adversity. Envision positive resolutions. Distract your mind from worry by focusing on topics or activities that aren’t related to the crisis. Do what works best to help you relax. • Create a plan. Don’t waste time and energy focusing on things you don’t control. Identify ways to improve your situation: what you can influence, improve, decrease, or eliminate. When making plans, be specific by defining who will do what. Set a time for each action. Make sure actions are achievable, and assignments are reasonable and within people’s abilities. Get agreement with others on the plan. Then take action and follow up to check progress. • Connect with others. It’s awful to feel alone in a storm or crisis; it’s always easier to bear with the support of others. Discuss the situation and how you feel about it. Ask for, and offer, a helping hand or words of encouragement. Seek advice from experts or from others who have had similar experiences. If you are a caregiver, you will at some point be faced with a crisis – I hope these tips help.

Thursday, March 13, 2014

Wellderly Week

Have you ever heard of Wellderly Week? Wellderly is a blend of the words “well” and “elderly”. The third week of March is set aside to celebrate and recognize senior citizens who are young at heart. During the week, I hope you will select your own Wellderly activity and celebrate in style. Here are some great ideas about how to celebrate being young at heart. Take a class – Find a cooking class or some other type of class that you are interested in. Not only is it a great chance to continue to grow and learn, it also gives you the opportunity to meet and engage with new people. The more you branch out of your comfort zone, the more you gain from the experience. Give Back – volunteer. By giving back to your community, not only are you rewarded with the sense of accomplishment and goodwill, but you’re changing the lives of those around you. Nothing puts your world back into perspective than seeing yourself through someone else’s eyes. Exercise – I’m not suggesting you run a marathon (unless that is already your style). What I’m suggesting is to stay active. From gardening to dancing to yoga or Qi Gong , there are a variety of ways t keep your body limber and moving. Whatever you do, don’t stop moving. Go on a date – whether it’s with your longtime spouse or the cutie from the center, take a special night to show how you care. Appreciate all the ways they have helped you feel young. Throw a party – get together with friends. This is a great time to celebrate life. And, add balloons and a cake – just to make it a real party! You may have your own ideas about how to celebrate being well and elderly – just celebrate!

Monday, March 10, 2014

Drug Use and Dementia

Many people are unaware that dozens of painkillers, antihistamines and psychiatric medications — from drugstore staples to popular antidepressants — can adversely affect brain function, mostly in the elderly. Regular use of multiple medications that have this effect has been linked to cognitive impairment and memory loss. The drugs block the action of the chemical messenger in the brain, which is responsible for a range of functions in the body - including memory production and cognitive function. The difficulty for patients is the cumulative affect. Doctors are not always aware of all of the medications their patients take. It’s a particular problem for older patients, who are more vulnerable to the effects of these drugs and who tend to take more medicines over all. New research studies have focused on these types of medicines (called anticholinergic drugs). Researchers found that those taking more than one scored lower on tests of cognitive function than those who were not using any such drugs, and that the death rate for the heavy users during the course of the study was 68 percent higher. “These are very, very common drugs; that’s a scary finding,” according to one of the lead researchers from the study. The researchers go on to say that they suspect these drugs take a toll on bodily organs and systems like the cardiovascular system, although there are no studies confirming this. The same types of drugs have also been implicated in the delirium that intensive-care patients frequently develop in the hospital. “Clinicians don’t think of them nearly as often as they should as a potential cause of cognitive problems,” said another professor who studied the deficits that occur after intensive care hospitalization. Of the 36 million Americans 65 and older, at least 20 percent take at least one medication that affects the chemical messengers in the brain. A study of nearly 4,000 older adults found that those who had been using three or more such drugs consistently for 90 days or longer were nearly three times as likely to receive a diagnosis of mild cognitive impairment as those who had not taken any. “If you were taking one of the drugs we know is definitely an anticholinergic for 60 days, you doubled the odds of developing mild cognitive impairment” compared with a patient taking none” researchers said. The aim of studies like these is to evaluate the magnitude of the effects of different drugs, to determine whether there are safe thresholds for their use and to learn whether the effect is transient and reversible. Studies from large clinics that treat people with memory disorders have shown that up to 25 percent of the patients who seek help have reversible disorders, including those caused by taking a combination of medications. Even so, why do physicians prescribe medications that alter chemical messengers in the brain to elderly people, who may be using them regularly for many years? Not only are doctors often unaware of all the medicines their patients are taking, but the list of drugs is a long one. So what’s a patient to do? If you or an elderly relative take one or more drugs on a regular basis, ask your primary care physician to evaluate the cumulative anticholinergic burden of all them (as well as other potential interactions and side effects). The patient is critical in triggering that kind of discussion. It may not be automatic, but if in fact the patient asks for it, it’s much more likely to be done. Remember to tell your physician about drugs prescribed by other specialists, as well as nonprescription or alternative medicines you take. This review should be done once a year. Do not stop medications on your own without medical supervision.