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There is Such a Thing as Being Too Thin…

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Improved Nutrition outcomes are within reach for those living with Dementia and other chronic illnesses.

A popular saying says, “We are what we eat.” A good diet is vital to everyone’s health, well-being, and quality of life.  A person needs carbohydrates, protein, fat, fiber, minerals, vitamins, electrolytes, and water to survive. Obtaining the correct balance and quantities of these nutrients is essential.  Insufficient nutrition and hydration can lead to deterioration of overall health, including mental health, as well as weight loss, dehydration, dizziness, increased risk of falls, prolonged recovery after surgery, change of mood, frequent colds, reduced strength, reduced mobility, reduced communication abilities, difficulty keeping warm, infections, as well as prolonged healing.  Cognitive deficits such as Dementia, have a direct effect on a person’s nutrition. Malnutrition or under nutrition may occur at any stage of dementia. It is important to detect it and try to remedy this as early as possible.

Did you know? Up to 45 per cent of people living with dementia experience clinically significant weight loss over one year, and up to half of people with moderate or severe dementia have an inadequate food and nutritional intake. Some experience very quick weight loss, dropping to a withering 70-90 lbs. in a span of several months.  As dementia advances, it’s difficult to ensure that those living with dementia are eating and drinking enough. Eating difficulties are also very common in those living with Alzheimer’s Disease. These challenges increase the risk for malnutrition and can worsen other health conditions a person may already have. There are numerous reasons for poor appetite to develop, including depression, communication problems, sensory impairments, change in taste and smell, pain, tiredness, medication side effects, physical inactivity, and constipation.  Some people with dementia may lose their ability to concentrate, so they become distracted while eating and stop eating as a result. Other people may have trouble using utensils or raising a glass. It may also be challenging to bring the food from the plate to their mouth. Some people may need to be reminded to open their mouths to put food in it or even to chew. Another common problem in more severe dementia cases is dysphagia, which is difficulty swallowing. Dysphagia can lead to weight loss, malnutrition, or dehydration. Over time you may find that your loved one’s appetite declines or the taste of food doesn’t appeal to them. Sensory changes in sight and smell can impact their ability to enjoy food and mealtimes. Their likes and dislikes for food and drink may be quite dramatic and different from the ones they held for many years. They may also find it difficult to tell you what they want to eat.

Dementia and Alzheimer’s Disease are not the chronic conditions that often cause malnutrition or under nutrition. Other chronic conditions often impact a person’s nutrition. Many illnesses cause what is called disease-related malnutrition. Many people living with Parkinson’s disease, suffer from muscle weakness or tremors, which can make eating very challenging. Other diseases that often cause nutrition deficiencies are cancer, liver disease, COPD, and CHF to name a few.

In many of these cases, the malnutrition and under nutrition are severe, and all conventional methods have failed. Orchard’s State of the Art Nutrition Therapy Program offers hope for this group, a group that has not responded to traditional nutrition methods. Orchard has partnered with Gordon Foods and their team of experts and dieticians, as well as with dementia specialists to bring this revolutionary nutrition therapy to the community.

Join us on February 27th 4 pm-6 pm as we unveil our Nutrition Therapy Program to area professionals who are interested in helping our community battle this difficult problem. This event will be held at; Orchard at Tucker, 2060 Idlewood Rd, Tucker GA 30084. For questions or to RSVP for the event please email marketing@orchardseniorliving.com. 

Improved Nutrition outcomes are within reach for those living with Dementia and other chronic illnesses.

Improved Nutrition outcomes are within reach for those living with Dementia and other chronic illnesses.

Are Patients with Dementia Smarter than their Primary Care Practitioners?

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Are Patients with Dementia Smarter than their Primary Care Practitioners?

The answer is not necessarily, however patients with dementia work much harder to mask and hide their dementia from the PCP, than their PCP works to diagnose their patients’ dementia.

How Has the Role of a Primary Care Practitioner Evolved?

Due to the increasing numbers of people living with Dementia and Alzheimer’s Disease, primary care practitioners, are seeing their patient loads be filled with more and more dementia patients. Primary Care Practitioners are usually the first health professionals that either patients or their families contact if concerned about memory decline. However only 60% of the people who meet the diagnostic criteria receive a formal diagnosis of dementia. Failure/Misdiagnosis rates have been estimated between 50% and 80% for moderate-to-severe dementia and up to 90% for mild cases. PCPs are usually the ones who have a long relationship with patients as well as their families, so patients and their families usually turn to the PCPs for sensitive matters such as memory loss or other signs of dementia.

Why is there such as high rate of Failure and Misdiagnosis? The Too Simple of an Answer…

Most primary care practitioners do not specialize in dementia and therefore symptoms get missed. Most PCPs rush through the appointments and do not take the time to notice dementia symptoms.  Another too simple of an answer, PCPs treat dementia like they do other chronic illnesses by prescribing medications and sending the patient home. Although there is some truth in all these answers, the real answer is much more complicated.

The Real-Life Reason there such as high rate of Failure and Misdiagnosis?

Although there is some truth in the simple answers, they don’t paint the entire picture. Understanding and diagnosing dementia takes more than just being familiar with the typical dementia symptoms and being able to recognize them.  There are many symptoms of Alzheimer’s and Dementia that a person exhibits before significant memory loss. Many people and their families discount these symptoms as just general senility or some other problem. These symptoms include personality changes. A warm, friendly person may turn into a bit of a grouch, at first occasionally, and then increasingly. They may start neglecting some of their grooming habits slowly. A person developing dementia may start telling inappropriate jokes in wrong settings. Another symptom is developing a problem with executive functions, such as difficulty with familiar, tasks such as cooking.  A person will start having difficulty doing something that involves multiple steps, or following instructions. Word retrieval and getting out the right words can become a problem, and it may be a while before friends and family notice the more common communication problem of repeating stories or questions.  Problems with depth perception or visual-spatial coordination can also precede memory problems. Usually these difficulties get blamed on vision problems and not dementia. Apathy and social withdrawal are also common with dementia. All these symptoms often precede memory loss, yet can easily be justified as being caused by something else other than dementia. Until a certain point, these symptoms do not significantly impact a person’s life, and therefore get ignored, and ultimately dementia is not diagnosed. One of the largest culprits of a missed diagnosis is masking by the person that has dementia. People with dementia usually notice something is wrong and they do everything they can to hide it. So even if a PCP asks their patient about one of the above symptoms, the patient easily comes up with a pliable excuse, such as they are tired and don’t 111214_TECH_doctorpatient.jpg.CROP.rectangle3-largewant to do a hobby, the weather is bad, they are stressed, they need new glasses, they are not sleeping well and therefore their mind is foggy, and on and on. If a person with dementia misses their appointment, they are likely to blame it on the doctor’s office, or someone else, and even avoid making future appointments all together, due to the fear of missing the next appointment. It is very difficult, if not impossible for a PCP that treats a spectrum of patients including those with dementia and without to be able to pick up on these subtle symptoms. They are not focusing on these subtle symptoms, and because many of their patients do not have dementia, dementia and its symptoms are not in the fore front.

Why We Rarely See a Person with Mild Dementia Move to Assisted Living?

Since upwards to 90% of people with mild dementia get misdiagnosed or missed, most people do not realize something is wrong until there are blatant symptoms that usually harm a person in some way. Most people do not notice or get alarmed with a few missed medication doses, until a person either takes to many pills, or takes too few, gets dizzy, and falls. Even in those cases, they go to the hospital and the fall is at the forefront, and not the dementia that caused a person to forget their medications and fall. Rarely do families notice that their loved one is not eating, until there is a significant and visual weight loss. Families usually do not notice that their loved one is neglecting their grooming until they look obviously disheveled. They don’t notice personality changes, until something out of character and usually embarrassing occurs in public, very often in church. Most people with dementia improve their masking abilities over time, and their dementia is not addressed until they are not able to mask anymore, which is usually in the Early Moderate Stage of Dementia. By that time in many cases, substantial damage has been done, such as substantial weight loss, a broken bone due to an avoidable fall, and so much more.

The Take Away….

The solution to the huge percentages of failure/misdiagnosis of dementia, and the damage caused by these misses, is multi-faceted. There is a need for Comprehensive Dementia Education, Dementia Sensitive Primary Care Clinics and Doctors, and Cognitive Care Communities specializing in all levels of dementia from Mild to Severe. To find out more about the importance of a cognitive care community visit; http://orchardseniorliving.com/the-importance-of-a-cognitive-care-community-for-dementia-care/.
The next several posts will detail ideas and solutions to combating dementia caused crisis, and decrease the failure/misdiagnosis rates. Visit http://stage-osl.daveminotti.com/category/blog/

 

 

 

 

Transition Care Giving is Essential in Dementia Care

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Transition and change in general is hard on everyone…

Have you ever moved into a new house? Started a new job? If you answered yes than you can recall your first week.  Do you recall how stressed out you were with the change? Change of location, change of routine is hard on everyone, however having Dementia and Alzheimer’s makes change about 10 times harder.

Transitioning While Having Dementia? About as Hard as Sky Diving While Being Afraid of Heights..

Dealing with an aging loved one that has dementia or Alzheimer’s can be very stressful, especially when it is time to move that senior into an Assisted Living or Memory Care Community. Many families see how important a familiar environment is to their loved one. Being in a familiar place with a familiar daily routine is something that many with Dementia come to rely on. Families worry about the stress that can happen with their loved one during the transition. Stress is escalated in seniors whose cognitive capacity is limited by their Dementia or Alzheimer’s disease. This is a very real fear. Depending on the progression of disease, changes can be very upsetting and disruptive to the patient. Seniors suffering with progressive degenerative brain disease cannot frame their fears and anxiety with logic, as the rest of us can.  A change in environment can often cause tremendous stress for the senior.

What is Transitional Care?

A private duty caregiver meets the senior prior to the move into a community and accompanies them to the community. The caregiver than spends between 4-12 hours each day for 3-14 days with the senior. They accompany them to activities and trips. The caregiver helps a senior learn their new environment. The caregiver stays with the resident for the scheduled hours. The caregiver is there at arm’s length if a senior gets anxious, confused, or stressed out. The amount of hours and days of transitional care depends on the seniors’ cognitive level,  as well as their stress and anxiety threshold.

Why is Transitional Care Important?

Many seniors whose cognitive abilities are hampered by Dementia and Alzheimer’s, have heightened levels of anxiety. They also experience higher levels of stress in many situations. They also retain less new information, which makes change this much harder. The transitional care giver is there to help lessen the stress of transition by being there with the senior to guide them one on one. Once the senior is settled in their new home, the caregiver remains a part of their care plan until they have become accustomed to their new surroundings.  A transitional care taker may start out by spending 12 hours with the senior for the first 3 days. After the 3 days, they spend 8 hours for the next 4 days. After the first 7 days, the hours go to 4 hours for the next 3 days. After that the hours go to 4 hours a week. Each senior is different, however it is recommended that transitional care giver hours get cut slowly based on the seniors’ needs. It usually takes about 30 days to get adjusted to a new community and getting a transitional caregiver involved softens that blow.

Do Communities Offer Transitional Care?

Some corporate giants like Brookdale do have their own agencies. Most smaller companies partner with an agency so that transitional care is provided by a caregiver that is not employed by the company. Orchard Senior Living now has a sister company Peach Home Care which provides transitional caregivers and private duty caregivers to residents.

Tips for Foot Health and Why It’s Important

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Mobility is a vital ingredient to self-sufficiency, making the foot ailments that often trouble seniors particularly worrisome. While it may not come to mind as a major health concern, poor foot health can severely impact a person’s ability to live alone, work and engage in social activities.

Observing preventive foot health care has many benefits. At the top of the list is that it can increase comfort, limit the possibility of additional medical problems, and reduce the chances of hospitalization because of infection.

Here are some tips for keeping feet healthy:

Wear Shoes That Fit Properly
Many people don’t wear shoes that properly fit them or support their feet. Shop for shoes in the afternoon so you can avoid choosing shoes that are too small for your feet that swell during the day.

Regularly Take Walks
This is ultimately the best exercise for your feet.

Wear Seam-Free Socks
This will help with preventing any skin irritations from developing on your skin.

Have Corns & Calluses Professionally Treated
Never cut corns and calluses with a razor, pocket knife. Only use over-the-counter foot products with the advice of a podiatrist.

Bathe & Inspect Feet Daily
Apply lukewarm water and mild soap to keep your feet free of any dirt on a daily basis. If you notice any redness, swelling, cracks in your skin consult your podiatrist.

If you or your loved one needs assistance with foot care or any additional health care and support, contact The Orchard here. We provide 24/7 assistance that will keep your loved one happy and healthy!

Reasons to Move to an Assisted Living Community

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Thinking about making the move to an assisted living community in Decatur? Here are our reasons why moving to the Orchard might be right for you or your loved one.

No More Home Maintenance Troubles
Say goodbye to the days of calling a handyman or plumber that leave you with an expensive bill. No more raking leaves in the fall or watering outdoor plants and grass in the summer. Home maintenance can become a sizable and costly burden that’s all lifted once moved to an assisted living community.

Chauffeured Around Town
You may not get a private chauffeur, but you do get transportation to and from your important appointments like doctor or dental visits. Transportation is also provided to group activities outside of the community including restaurants and local events.

Activities Galore
Some can compare it to being on a cruise because activities play a large part in daily life at Orchard assisted living community. Seniors can enjoy staying active doing those activities that interest them most. Activities can include movie nights, arts and crafts, exercise classes and more.

Safety First
It’s nice to know that help is available 24/7 at the Orchard. We are equipped with safety bars, ramps, emergency alert systems and staff trained in emergency response. You can take comfort in knowing that the appropriate precautions have been taken to reduce the risk of dangerous falls and to keep your loved one as safe as possible.

If you or your loved one is considering a move to a senior living community, such as an assisted living facility contact The Orchard here.

Caring Tips for Sundowners Syndrome

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Sleeping problems occur in almost all people with mental disorders, including those with Alzheimer’s or dementia. Sleep determines our ability to do daily functions and maintain our physical/mental health. Many people believe that a difficulty sleeping is the center of the problem.

Sundowners describes an increase in behavior problems usually in the late afternoon and early evening. People may show signs of increased confusion, anxiety, straying, hallucinations and general disorientation. For those living with or caring for someone exhibiting “sundowning” symptoms, it can be frustrating to experience.

Once a routine is in place, life becomes easier when caring for someone with Sundowners Syndrome. Not all of these ideas will work for everyone; through experimentation, you may find the right one for your circumstance.

Care Tips for Sundowners Syndrome:

  • Allow for light in the morning to help establish an internal clock.
  • Daytime napping should be minimized to help regulate their sleeping cycle.
  • Encourage exercise to help expend excess energy.
  • Limit caffeine intake in the afternoon.
  • Create a private place just for decompressing.
  • Music or sounds like waves or birds can be soothing.
  • Consider purchasing a bedside commode frequently getting up and down can make it hard to get back to sleep.
  • Keep a comfortable temperature in the bedroom to avoid disruption during sleep.

Frustration for family members and caregivers is not uncommon when dealing with loved ones experiencing episodes of Sundowners. Outbursts and odd demands are not unusual, requiring absolute patience on the part of family members and caregivers to make it through this. Following these tips above may bring comfort back into your life. If you need additional assistance, contact us to experience the Orchard difference. 

Meet and Greet with Tucker City Council Candidate Corbett Jordan at Orchard at Tucker Assisted Living and Memory Care

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