Posts

Final Stages of Nutrition Therapy Development for Dementia Residents

What is Nutrition Therapy and who can benefit from it?

Eating and enjoying a meal is part of our everyday life and important to everybody, not least to people living with dementia. A healthy diet and nutrition is fundamental to well being at any stage of life and to helping to combat other life-threatening diseases. We believe it plays as important a role in relation to dementia progression, and a resident’s quality of life. Under-nutrition is common among older people generally, particularly common among people with dementia. Under nutrition tends to be progressive, with weight loss often preceding the onset of dementia and then increasing in pace as the disease progresses. The mechanisms underlying weight loss and under nutrition in dementia are complex, multi factorial, and unique to each person. Common reasons include reduced appetite, increased activity, the need for a modified diet and, decreased nutrient absorption. For some forms of dementia, it may be that central regulation of appetite and metabolism is disturbed as an inherent feature of the disease. Although we can’t avoid these symptoms which lead to malnutrition and under nutrition, we can manage them with a variety of Nutrition Therapy Options. Orchard at Tucker’s Nutrition Therapy Program is designed to help combat under nutrition and bring back the joy of eating to those who have lost it.

We are in the Final Testing Stages..

After many months of work with our team and partnering dieticians, Orchard Senior Living is in the Final Testing Stage of our 4 Part Nutrition Therapy Program.  Today’s enriched smoothies were a huge hit. These enriched smoothies are designed to help those in the moderate to severe stage of dementia, who have lost significant weight in the last 6 months, and for whom all other care and environmental modifications have failed.  Each 4 oz pretty glass delivered 240 calories, 9 grams of Organic Protein, and so much more. Most importantly each glass looked and tasted amazing!picc (2)

Orchard at Tucker’s Nutrition Therapy Program Coming in nt22018..

Elevated Emotions Even Without Memory while Living with Dementia

Which last longer for those with Dementia or Alzheimer’s Disease? Memories or Emotion?

Have you seen long lasting emotions in a loved one with Dementia or Alzheimer’s after the memory causing the feelings have faded? I have on many occasions. Although I have seen it live on so many occasions, there is now science behind it. It’s no surprise that people with Alzheimer’00000s have trouble recalling memories. It is, after all, the hallmark symptom of the disease. However, a new study has found that events can have a longer term and profound effect on how they feel even if they do not remember the particular event.

The Study..

A new University of Iowa study further supports an inescapable message: caregivers have a profound influence—good or bad—on the emotional state of individuals with Alzheimer’s disease. They may not remember a recent visit by a loved one or having been neglected by a loved one, but those actions can have a lasting impact on how they feel. University of Iowa researchers also showed individuals with Alzheimer’s disease clips of sad and happy movies. The patients experienced sustained states of sadness and happiness despite not being able to remember the movies.

The Emotional Life of those with Dementia and Alzheimer’s Disease….

These studies confirm that the emotional life of those with dementia and Alzheimer’s disease last far beyond the tangible memory of an event, regardless if the event was good or bad. “This confirms that the emotional life of an Alzheimer’s patient is alive and well,” says lead author Edmarie Guzmán-Vélez, a doctoral student in clinical psychology, a Dean’s Graduate Research Fellow, and a National Science Foundation Graduate Research Fellow.

The Take Away…

Despite the considerable amount of research aimed at finding new treatments for Alzheimer’s, no drug has succeeded at either preventing or substantially influencing the disease’s progression. Against this foreboding backdrop, the results of this study highlight the need to implement new care giving techniques and care models aimed at improving the well-being and minimizing the suffering for the millions of individuals afflicted with Alzheimer’s. These studies prove that traditional thinking about the emotional life of someone with Dementia and Alzheimer’s Disease is lacking immensely. Traditional thinking still tries to convince people that if they don’t remember it does not matter. At the Orchard at Tucker, we feel it Not Only Matters, but it Matters More. Although these studies are wonderful, we see the importance of emotion based care each and everyday by watching our residents.

cesarepavese1

The Biggest Misconception about the Dementia Brain in Dementia Care

Why is our brain so important?

The brain is the most important organ in the human body. It controls and coordinates actions and reactions, allows us to think and feel, and enables us to have memories and feelings.  Furthermore the brain runs everything. It is the guiding, maintenance, and managing system for hundreds of a human beings needed abilities.

When does dementia occur? The quick answer…

Dementia occurs when the brain is damaged by disease. Sometimes it is one part of the brain, sometimes it is multiple parts.

To understand dementia, we must first understand the brain…

The brain can be divided into different parts: the brain stem and cerebellum, the limbic system, and the cerebral hemispheres.  Each part has different functions.

Brain stem and cerebellum…

The brain stem is at the base of the brain. It controls basic bodily functions such as heartbeat and breathing. The cerebellum
controls balance and posture. Breathing and staying upright are things that we normally do automatically.

The limbic system…

The limbic system is deep inside the brain. It links the brain stem and the cerebral hemispheres. The limbic system includes structures with key roles in memory (the hippocampus) and emotions (the amygdala). The limbic system is the first part of the brain to develop and is sometim6bb16d242f0a68490dfe0106d79a5168es referred to as our “primal brain” and manages many of our survival reflexes. It includes the amygdala which is in charge of the “flight, fright, fight response.

Cerebral hemispheres

The tissue that makes up three-quarters of the brain is called the cerebrum. It is responsible for consciousness, memory, reasoning, language and social skills. A deep groove that runs from the front to the back of the cerebrum divides it into left and right halves: the two cerebral hemispheres.
The left and right cerebral hemispheres have different functions. For example, language is usually dealt wit
h mainly by the left hemisphere. In contrast, awareness of where things are around us is usually dealt with mainly by the right hemisphere.

The lobes….

The four lobes are: occipital, temporal, parietal and frontal lobes. Each lobe does different things, though they also work closely together.The lobes are responsible for our senses. There are 5 ways human beings take in information (data) about the world through their nervous system.. WhatPrint you see, hear, touch/feel, smell, and taste.

The lobes are some of the first areas effected by Dementia..

Dementia diseases often impact abilities in the occipital lobe of the brain which affect a person’s visual field.  Dementia commonly affect the temporal lobes asymmetrically; typically attacking left temporal lobes before the right. This means more loss in language stored on the left, and more preserved skills for much longer. In dementia, different forms of damage to the lobes in the brain can cause someone to become either over-emotional or lacking in feelings. This is one of the reasons that a person with dementia exhibits changes in behavior along with memory loss. Sometimes the changes in behavior may be more pronounced than the memory loss. In these cases, many times dementia gets misdiagnosed since common thinking is, that dementia causes just memory loss.

What is the biggest misconception about the dementia brain  and those with dementia?

Emotional memory is stored in the hippocampal area and is commonly a  preserved skill.  Persons living with dementia may not remember the details of what happened, but will almost always remember how an experience made them feel. Traditional thinking is if someone does not remember what they did specifically shortly after they did it, their day has less relevance, their life should be less purposeful. This is the biggest misconception in traditional dementia care. Those with dementia may get to a point that they don’t remember going to a great concert the next day, or helping to bake and delivering cookies to a police department, but they remember till almost the very end how much they enjoyed the concert, and how good they felt delivering those cookies over to those officers.

The Take Away…..

Orchard Senior Living is determined to bring a new type of dementia care to those inflicted with dementia. It is an engagement focused cognitive care model, where we focus on activities that will be stored in our residents’ emotional memories which they will have with them till they take their last breath.

cesarepavese1

The Subtle Signs of Swallowing Problems for Those with Dementia and Other Diseases

How does swallowing actually occur?

The oral phase of swallowing requires a complex interplay of chewing, food bolus formation, and push of the bolus to the back of the throat for the process of swallowing and movement to the esophagus and stomach. Multiple facial and oral muscles, such as the tongue, are responsible for this phase. Once the food bolus is to the back of the throat a series of muscular contractions occur to move the bolus into the esophagus and away from the airway. The airway is temporarily closed as the food bolus is pushed past the tracheal opening and into the esophagus. The food bolus then makes its way to the stomach through another series of coordinated muscular contractions within the esophagus.

Sounds Complicated Right? It is and lots can go wrong..

Due to the complexity of the swallow mechanism, a multitude of problems that can arise. The most common cause of oral dysphagia (swallowing trouble) is stroke, with up to 45 percent of stroke patients develop swallowing problems following the stroke. Other neurological diseases such as Parkinson’s disease, Multiple Sclerosis, Dementia, and Alzheimer’s disease are known to cause swallowing difficulties. Lesions, re flux conditions, and cancer have also caused swallowing troubles but to a lesser extent.

There are obvious and less obvious signs of swallowing difficulties…

Everyone knows that if a person coughs up food or gags while eating, they likely have swallowing troubles. However there are other more subtle signs that can go easily unnoticed such as long breaks between bites, being horse, drooling, frequent heartburn,  and acid re-flux.

What can happen if these subtle signs are ignored?

If subtle signs are ignored they can result in choking, where food partially or fully obstructs a person’s airway, aspiration or inhalation of food or liquids, oral secretions or gastric secretions into the airway and lungs. Also gastric secretions may be inhaled without bacteria causing aspiration pneumonia. A person may aspirate not only food or fluids that are introduced into the mouth but also their own saliva or any gastric secretions, which may be re-fluxed into the airway.

What can be done?

In a community setting, all care partners must be trained to carefully observe each resident for not blatant signs such as chocking, but for the subtle signs such as drooling, and long pauses and usually get confused for something other than swallowing challenges. When a person lives alone, the signs of swallowing trouble usually go ignored until they end up in the hospital. In many setting, little attention is paid to dining room observation. Orchard at Tucker understands the importance of monitoring these subtle symptoms and finding the problem while it is minor,Nutella-Stuffed-French-Toast-with-Strawberries and before it causes a resident irreversible harm.

Transition Care Giving is Essential in Dementia Care

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.

Dementia Care Combined with Comprehensive Nutrition Care

What is Comprehensive Nutrition Care?

Comprehensive Nutrition Care is a creative and comprehensive way to provide care. It takes a complete approach to nutrition care with the purpose of supporting individuals with chronic or life-threatening disease, and healthcare providers who support them, to better manage their health through optimal nutrition.

Why is Nutrition Care Needed for Dementia Care?

Eating and enjoying a meal is part of our everyday life and important to everybody, not least to people living with dementia. A healthy diet and nutrition is fundamental to well being at any stage of life and to helping to combat other life-threatening diseases. We believe it plays as important a role in relation to dementia progression, and a resident’s quality of life. Under nutrition is common among older people generally, particularly common among people with dementia. Under nutrition tends to be progressive, with weight loss often preceding the onset of dementia and then increasing in pace as the disease progresses.

In what ways are the elderly susceptible?

  1. Age related changes in the gastrointestinal tract combined with changes in diet and immune system reactivity affect the composition of gut microbiota, leading to increased numbers of bad bacteria, decreased number of beneficial bacteria such as anaerobic lactobacilli and bifidobacteria.
  2. Osteoporosis is a disease which is characterized by decreasing bone density and increasing fragility of bones due to microexps21585_THCA153054D10_15_4b-architectural deterioration which increases the risk of fracture. Osteoporosis is exacerbated by malnutrition, low weight, poor intake of vitamin D and calcium, and in women, low levels of sex hormones.
  3. Older people need higher quantities of some nutrients, for example, calcium, vitamin D and vitamin B12 due to dementia and other physiological changes making absorption of nutrients more difficult. Studies show that calcium, vitamin D, folate, iron and vitamin B12 are the most important micro nutrients in which deficiencies commonly occur in older people.
  4. Physiological changes to the digestive system affect appetite which can affect nutrient intake. Protein energy malnutrition is common among older people with estimates that 1 in 10 people over 65 living in the community are malnourished. These numbers triple for the elderly with dementia.

     

How to Prevent Malnutrition in the Elderly with Dementia?

In order to prevent malnutrition in an elderly person with dementia, functional foods need to be added to their diet. Due to the age related changes that can make it more difficult for older people to obtain the nutrients they need from their diet, functional foods can have a role to play in improving nutrient intake.

What is a Functional Food?

Functional food is a conventional food product modified in some way to give a health benefit above and beyond basic nutrition. Functional foods can also be designed to fight a certain health condition. Functional foods are generally considered to be those food products which provide a specific health benefit over and above their basic/traditional nutritional value. Examples of functional foods are breakfast cereals with folic acid, yogurt with additional probiotic, vitamin D and calcium fortified orange juice are just a few examples.

The Takeaway..

An elderly person with dementia that has lost weight and is exhibiting symptoms of malnutrition, needs abundant additional assistance to get out of the malnutrition danger zone. Because of the chemical and physical changes, nutrition therapy may be the only option to help them stay healthy and thrive. Nutrition Therapy is a daily ongoing person centered care program that can change lives.

 

Tips for Foot Health and Why It’s Important

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!

5 Activities for Seniors with Dementia

help concept, special toned photo f/x, focus point selective

Connecting with others is an essential part of being human – and that remains the same when a person has dementia. We’re often asked, “What are good activities for dementia patients?”. There are still many ways you can continue to form connections and strengthen bonds with your loved one during this time.

People with dementia turn to long-term memories of their childhood. Their minds seem to only recall their younger years, and this is often where connections can be made. The next time you visit with your loved one, try one or more of the following activities to create a connection with them:

Look Through Photo Albums
Find up photo albums with pictures from your loved one’s childhood or young adulthood to connect with old memories. Past periodicals are another good option, particularly those that include many photos such as Life or Time magazines.

Make a Playlist
Download songs or set up a radio on Pandora that streams music from their teenage years. Many internet radio stations include everything from classic rock to big band sounds, their favorite music should be easy to find.

Go Through Old Cookbooks
In the past, women spent a great deal of their teenage years learning to cook and young adult years cooking for their families. Ask about the origins and different variations used in old family recipes. For even bettr results cook with those old family recipes and reap the rewards with your loved ones.

Enjoy Favorite Treats
Buy some candy or other treats that were common when your loved one was young. Many companies specialize in nostalgic candy where you can buy old favorites.

Visit and Connect with Animals
People who grew up on farms may enjoy an outing to a petting zoo or family farm where they can touch and talk to horses and other farm animals. Ask questions about animals, old pets, or what it was like for them to grow up on a farm. This is a great activity to involve grandchildren in.

Your loved one may seem different than the person you’ve always known, but they still deserve connection and companionship with you. You can strengthen that connection by applying these activities to enhance both of your lives. If your loved one needs help and you need assistance to make sure they are living a happy and productive life, contact us here. We can give you the Orchard difference.

Reasons to Move to an Assisted Living Community

laughing-on-porch-retirement

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.