Preventing Falls Among Seniors

5 Star Home Care quality homecare for Seniors – call 404-719-4118. Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

Tips

Falls are not just the result of getting older. Many falls can be prevented. Falls are usually caused by a number of things. By changing some of these things, you can lower your chances of falling.

You can reduce your chances of falling by doing these things:

 1. Begin a regular exercise program.

Exercise is one of the most important ways to reduce your chances of falling. It makes you stronger and helps you feel better. Exercises that improve balance and coordination (like Tai Chi) are the most helpful.

Lack of exercise leads to weakness and increases your chances of falling.

Ask your doctor or health care worker about the best type of exercise program for you.

2. Make your home safer.

About half of all falls happen at home. To make your home safer:

• Remove things you can trip over (such as papers, books, clothes, and shoes) from stairs and places where you walk.
• Remove small throw rugs or use double-sided tape to keep the rugs from slipping.
• Keep items you use often in cabinets you can reach easily without using a step stool.
• Have grab bars put in next to your toilet and in the tub or shower.
• Use non-slip mats in the bathtub and on shower floors.
• Improve the lighting in your home. As you get older, you need brighter lights to see well. Lamp shades or frosted bulbs can reduce glare.
• Have handrails and lights put in on all staircases.
• Wear shoes that give good support and have thin non-slip soles. Avoid wearing slippers and athletic shoes with deep treads.
  

3. Have your health care provider review your medicines.

Have your doctor or pharmacist look at all the medicines you take (including ones that don’t need prescriptions such as cold medicines). As you get older, the way some medicines work in your body can change. Some medicines, or combinations of medicines, can make you drowsy or light-headed which can lead to a fall.

4. Have your vision checked.

 Have your eyes checked by an eye doctor.  You may be wearing the wrong glasses or have a condition such as glaucoma or cataracts that limits your vision.  Poor vision can increase your chances of falling.

Recovery From Back Surgery at Home

5 Star Home Care quality homecare for Seniors – call 404-719-4118. Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

Exercise and Activity

• Do not stay in bed once you get home. Rest when you need to, but move about frequently with your cane or crutches, gradually increasing your activity level. Activity will help your body heal and help you feel better.

• Practice walking every day, first around your home and later outside.

• You should be able to resume most light activities within three to six weeks.

• It’s important to follow the exercise program developed by your physical therapist diligently. This will help your muscles regain mobility and strength, allowing you to walk normally again.

Self Care

• Eat a balanced diet, take any vitamin or iron supplement your doctor recommends and be sure to drink plenty of fluids. Good nutrition will help your tissues heal and your muscles regain strength.

• Keep your incision clean and dry.

• Your staples will be removed about two weeks after surgery.

•  At four to six weeks, your orthopedist will want to take X-rays and discuss which activities you can resume.

Call Your Surgeon If:

• The wound becomes unusually red or hot.

• There is an opening or drainage from the wound.

• Your hip or knee pain is not relieved by rest, ice or elevation.

• You have unusual pain, swelling or redness in your calf.

• You develop a fever over 101 F.

• You develop chest pain or trouble breathing.

What Kind of Care Does a Person with Dementia Need?

5 Star Home Care quality homecare for Seniors – call 404-719-4118.  Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

People with moderate and advanced dementia typically need round-the-clock care and supervision to prevent them from harming themselves or others. They also may need assistance with daily activities such as eating, bathing, and dressing. Meeting these needs takes patience, understanding, and careful thought by the person’s caregivers.

A typical home environment can present many dangers and obstacles to a person with dementia, but simple changes can overcome many of these problems. For example, sharp knives, dangerous chemicals, tools, and other hazards should be removed or locked away. Other safety measures include installing bed and bathroom safety rails, removing locks from bedroom and bathroom doors, and lowering the hot water temperature to 120°F (48. 9°C) or less to reduce the risk of accidental scalding. People with dementia also should wear some form of identification at all times in case they wander away or become lost. Caregivers can help prevent unsupervised wandering by adding locks or alarms to outside doors.

People with dementia often develop behavior problems because of frustration with specific situations. Understanding and modifying or preventing the situations that trigger these behaviors may help to make life more pleasant for the person with dementia as well as his or her caregivers. For instance, the person may be confused or frustrated by the level of activity or noise in the surrounding environment. Reducing unnecessary activity and noise (such as limiting the number of visitors and turning off the television when it’s not in use) may make it easier for the person to understand requests and perform simple tasks. Confusion also may be reduced by simplifying home decorations, removing clutter, keeping familiar objects nearby, and following a predictable routine throughout the day. Calendars and clocks also may help patients orient themselves.

People with dementia should be encouraged to continue their normal leisure activities as long as they are safe and do not cause frustration. Activities such as crafts, games, and music can provide important mental stimulation and improve mood. Some studies have suggested that participating in exercise and intellectually stimulating activities may slow the decline of cognitive function in some people.

Many studies have found that driving is unsafe for people with dementia. They often get lost and they may have problems remembering or following rules of the road. They also may have difficulty processing information quickly and dealing with unexpected circumstances. Even a second of confusion while driving can lead to an accident. Driving with impaired cognitive functions can also endanger others. Some experts have suggested that regular screening for changes in cognition might help to reduce the number of driving accidents among elderly people, and some states now require that doctors report people with AD to their state motor vehicle department. However, in many cases, it is up to the person’s family and friends to ensure that the person does not drive.

The emotional and physical burden of caring for someone with dementia can be overwhelming. Support groups can often help caregivers deal with these demands and they can also offer helpful information about the disease and its treatment. It is important that caregivers occasionally have time off from round-the-clock nursing demands. Some communities provide respite facilities or adult day care centers that will care for dementia patients for a period of time, giving the primary caregivers a break. Eventually, many patients with dementia require the services of a full-time nursing home or 24 hour home care services. For more information on home care services             call  5 Star Home Care at 404-719-4118. 

Urinary Tract Infections In Seniors

5 Star Home Care quality homecare for Seniors – call 404-719-4118.  Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

Urinary tract infections are a serious health problem affecting millions of people each year.

Infections of the urinary tract are common–only respiratory infections occur more often. Each year, urinary tract infections (UTIs) account for about 9.6 million doctor visits. Women are especially prone to UTIs for reasons that are poorly understood. One woman in five develops a UTI during her lifetime. UTIs in men are not so common, but they can be very serious when they do occur.

The urinary system consists of the kidneys, ureters, bladder, and urethra. The key elements in the system are the kidneys, a pair of purplish-brown organs located below the ribs toward the middle of the back. The kidneys remove liquid waste from the blood in the form of urine, keep a stable balance of salts and other substances in the blood, and produce a hormone that aids the formation of red blood cells. Narrow tubes called ureters carry urine from the kidneys to the bladder, a triangle-shaped chamber in the lower abdomen. Urine is stored in the bladder and emptied through the urethra.

The average adult passes about a quart and a half of urine each day. The amount of urine varies, depending on the fluids and foods a person consumes. The volume formed at night is about half that formed in the daytime.

What Are the Causes of UTI?
Normal urine is sterile. It contains fluids, salts, and waste products, but it is free of bacteria, viruses, and fungi. An infection occurs when microorganisms, usually bacteria from the digestive tract, cling to the opening of the urethra and begin to multiply. Most infections arise from one type of bacteria, Escherichia coli (E. coli), which normally live in the colon.

In most cases, bacteria first begin growing in the urethra. An infection limited to the urethra is called urethritis. From there bacteria often move on to the bladder, causing a bladder infection (cystitis). If the infection is not treated promptly, bacteria may then go up the ureters to infect the kidneys (pyelonephritis).

Microorganisms called Chlamydia and Mycoplasma may also cause UTIs in both men and women, but these infections tend to remain limited to the urethra and reproductive system. Unlike E. coli, Chlamydia and Mycoplasma may be sexually transmitted, and infections require treatment of both partners.

The urinary system is structured in a way that helps ward off infection. The ureters and bladder normally prevent urine from backing up toward the kidneys, and the flow of urine from the bladder helps wash bacteria out of the body. In men, the prostate gland produces secretions that slow bacterial growth. In both sexes, immune defenses also prevent infection. Despite these safeguards, though, infections still occur.

Who Is At Risk?
Some people are more prone to getting a UTI than others. Any abnormality of the urinary tract that obstructs the flow of urine (a kidney stone, for example) sets the stage for an infection. An enlarged prostate gland also can slow the flow of urine, thus raising the risk of infection.

A common source of infection is catheters, or tubes, placed in the bladder. A person who cannot void or who is unconscious or critically ill often needs a catheter that stays in place for a long time. Some people, especially the elderly or those with nervous system disorders who lose bladder control, may need a catheter for life. Bacteria on the catheter can infect the bladder, so hospital staff take special care to keep the catheter sterile and remove it as soon as possible.

People with diabetes have a higher risk of a UTI because of changes in the immune system. Any disorder that suppresses the immune system raises the risk of a urinary infection.

UTIs may occur in infants who are born with abnormalities of the urinary tract, which sometimes need to be corrected with surgery. UTIs are rarely seen in boys and young men. In women, though, the rate of UTIs gradually increases with age. Scientists are not sure why women have more urinary infections than men. One factor may be that a woman’s urethra is short, allowing bacteria quick access to the bladder. Also, a woman’s urethral opening is near sources of bacteria from the anus and vagina. For many women, sexual intercourse seems to trigger an infection, although the reasons for this linkage are unclear.

Recovery After Hip Replacement Surgery

5 Star Home Care quality homecare for Seniors – call 404-250-3248.  Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

 

After someone has hip replacement surgery, they will be heavily dependant on others for support and care during their recovery. It can take as long as 2 months or more to recover from hip replacement surgery, until the patient can resume normal activities.

Help with Recovery

1. Step 1

   Create a safe recovery area for someone who has had hip replacement surgery to return to after they are released from hospital. A sleeping area, access to food and a bathroom without any stairs to climb should all be within an easy walking distance. Since the patient will be using a walker or crutches, there shouldn’t be any obstacles in the way either.

2. Step 2

   Talk with the doctor to learn about the recovery process. Learn what your the recovering patient can and cannot do as far as movement is concerned. FInd about the exercises, pain medication schedules, nurse visits and bandage requirements. Someone who has had surgery may be tired and forgetful, so it is important to know all the details.

3. Step 3

   Encourage the patient to perform their exercise routines regularly. This will help them recover faster, as well as reduce the risk of blood clots.

4. Step 4

   Bring the patient to follow up visits with the doctor. Since they will not be able to drive for quite some time, and you may have to serve as temporary driver.

5. Step 5

   Someone who has had hip replacement surgery may be fairly groggy for a week or so following surgery due to the pain medication. If you can arrange to be home with him for this time that would help him recover more safely.

6. Step 6

   Acquire games, books, movies and other items to keep someone who has had surgery occupied during their recovery. It can be discouraging to remain immobile for so long, so keeping busy will help the time pass more quickly. Try to think of some things to do together that would be fun for both of you.

7. Step 7

   Remain compassionate, as this surgery can be quite emotionally taxing for the patient as well.

What is 24 Hour Live In Care?

5 Star Home Care quality homecare for Seniors – call 404-719-4118. Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

Live-in care

A live-in caregiver resides in and provides home care services in the private household where the person being cared for resides. They provide assistance whenever it is needed. However, it is important that the caregiver gets regular rest times and enough uninterrupted sleep at night. If we provide live-in care for 7 days a week, the primary caregiver works for 5 days and then a reliever will take over for the weekend. Live-in care is the most cost effective care option available and ensures continuity of care for your loved one without disruption to the senior’s daily routine. Call us! (404) 719-4118.

Hip Fracture Causes and Prevention

5 Star Home Care quality homecare for Seniors – call 404-719-4118. Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

Causes and Risk Factors of Hip Fracture

The most common cause of hip fracture is injury.

It is estimated that one in four women surviving to the age of 90 years will suffer a hip fracture.

Symptoms of Hip Fracture

A person with a suspected fracture of the pelvis should not move, since this can cause damage to the pelvic organs. A fracture should be suspected if there is pain in the hip, groin, lower back or suprapubic area, especially with movement of the leg. One should observe these precautions:

• Do not move unless absolutely necessary.
• Do not permit any movement of the torso or legs. With a pelvic fracture, this may be achieved by tying the legs together at the ankles and knees and transporting on a firm surface (backboard). With ahip fracture, the leg may appear to be shortened and rotated out.Do not attempt to straighten it.
• Look for signs of shock and treat appropriately.
• Call an ambulance.

Treatment of Hip Fracture

Hip fractures can almost always be repaired with orthopedic surgery. The usual surgery involves opening up the hip joint and placing a pin internally through the neck of the femur into the femoral head. Sometimes other “hardware” is used to keep this pin stable until the fracture is healed. New fixating techniques are being used to securely stabilize fractures, enabling individuals to get out of bed shortly after surgery.

An important aspect of hip surgery is the team concept involving orthopedic specialist, nurses, physical therapists, social workers, family and friends. This helps address and avoid many of the problems that reduced function from a hip fracture can create. Home care programs for the elderly are becoming increasingly popular.

Recovery

Most elderly patients who fracture a hip continue to decline in health one year after discharge from hospital. One study found that most recovery took place within the first six months, and that few patients fully regained their pre-fracture ability to perform the activities of daily living.

Patients were less likely to recover quickly if they were older, cognitively impaired, had longer hospital stays, were rehospitalized or displayed symptoms of depression. Patients who maintained social contacts during their first two months out of the hospital recovered more rapidly than patients without ready access to family and friends.

Prevention of Hip Fracture

Treatment with estrogen, calcium or calcitonins may decrease the risk of a hip fracture in older women. These drugs may help decrease the rate of bone loss in women with osteoporosis, a disorder characterized by loss of bone mass. Research indicates that women taking estrogen, calcium or calcitonin had a significantly lower risk of a hip fracture than those who were not. Women who had been treated longest had the lowest risk. Calcium and calcitonin had a similar effect in older women as in younger women, but estrogen was more effective in preventing hip fractures in younger women.

Physical activity is also a very important method of preventing bone loss. Exercise reduces the risk of bone loss by almost one-half.

Discontinuing smoking women before menopause reduces the risk of hip fracture by 25 percent.

Facts on Fall Prevention for the Elderly

5 Star Home Care quality homecare for Seniors – call 404-719-4118. Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

Quick Facts…

• The risk of falling increases with age and is greater for women than for men.
• Two-thirds of those who experience a fall will fall again within six months.
• A decrease in bone density contributes to falls and resultant injuries.
• Failure to exercise regularly results in poor muscle tone, decreased strength, and loss of bone mass and flexibility.
• At least one-third of all falls in the elderly involve environmental hazards in the home.

Causes and Prevention

The causes of falls are known as risk factors. Although no single risk factor causes all falls, the greater the number of risk factors to which an individual is exposed, the greater the probability of a fall and the more likely the results of the fall will threaten the person’s independence.

Many of these risk factors are preventable. As obvious as it may sound, a lack of knowledge about risk factors and how to prevent them contributes to many falls. Some people believe that falls are a normal part of aging, and as such are not preventable. Lack of knowledge leads to lack of preventive action, resulting in falls.

Discussed below are five key risk factors of falls among older adults. Preventive measures for each factor are briefly listed. No attempt is made to provide a comprehensive description of preventive measures. Refer to the references listed at the end of this fact sheet for more detailed information.

Factor #1: Osteoporosis

Osteoporosis is a condition wherein bones become more porous, less resistant to stress, and more prone to fractures. Caused by hormonal changes, calcium and vitamin D deficiency, and a decrease in physical activity, osteoporosis is a chief cause of fractures in older adults, especially among women.

What is debatable is whether brittle bones break after a fall, or break when stressed and in turn cause a fall. In either event, a decrease in bone density contributes to falls and resultant injuries.

Prevention Tips

• Eat or drink sufficient calcium. Postmenopausal women need 1,500 mg of calcium daily. Calcium-rich foods include milk, yogurt, cheese, fish and shellfish, selected vegetables such as broccoli, soybeans, collards and turnip greens, tofu and almonds.
• Get sufficient vitamin D in order to enhance the absorption of calcium into the bloodstream. Vitamin D is formed naturally in the body after exposure to sunlight, but some older adults may need a supplement.
• Regularly do weight-bearing exercises.

Factor #2: Lack of Physical Activity

Failure to exercise regularly results in poor muscle tone, decreased strength, and loss of bone mass and flexibility. All contribute to falls and the severity of injury due to falls.

Prevention Tips

• Engage regularly (e.g., every other day for about 15 minutes daily) in exercise designed to increase muscle and bone strength, and to improve balance and flexibility. Many people enjoy walking and swimming.
• Undertake daily activities in a safe manner, such as reaching and bending properly, taking time to recover balance when rising from a chair or bed, learning the proper way to fall, and learning how to recover after a fall.
• Wear proper fitting, supportive shoes with low heels or rubber soles.

Factor #3: Impaired Vision

Age-related vision diseases can increase the risk of falling. Cataracts and glaucoma alter older people’s depth perception, visual acuity, peripheral vision and susceptibility to glare. These limitations hinder their ability to safely negotiate their environment, whether it be in their own home or in a shopping mall. Young people use visual cues to perceive an imminent fall and take corrective action. Older adults with visual impairments do not have this advantage to the same extent.

Prevention Tips

• Have regular checkups by an ophthalmologist to discern the extent of age-related eye diseases such as cataracts and glaucoma.
• Use color and contrast to define balance-aiding objects in the home (e.g., grab bars and handrails).
• Add contrasting color strips to first and last steps to identify change of level.
• Clean eye glasses often to improve visibility.

Factor #4: Medications

Sedatives, anti-depressants, and anti-psychotic drugs can contribute to falls by reducing mental alertness, worsening balance and gait, and causing drops in systolic blood pressure while standing. Additionally, people taking multiple medications are at greater risk of falling.

Prevention Tips

• Know the common side effects of all medications taken.
• Talk with your physician or pharmacist about ways to reduce your chances of falling by using the lowest effective dosage, regularly assessing the need for continued medication, and the need for walking aids while taking medications that affect balance.
• Remove all out-of-date medications and those no longer in use.
• Have a physician or pharmacist conduct a “brown bag” medicine review of all current medications.
• Limit intake of alcohol as it may interact with medications.

Factor #5: Environmental Hazards

At least one-third of all falls in the elderly involve environmental hazards in the home. The most common hazard for falls is tripping over objects on the floor. Other factors include poor lighting, loose rugs, lack of grab bars or poorly located/mounted grab bars, and unsturdy furniture.

Prevention Tips

It is useful to conduct a walk-through of your home to identify possible problems that may lead to falling. A home visit by an interior designer or occupational therapist might also be useful in that they are trained to identify risk factors and recommend appropriate actions.

Outdoors

• Repair cracks and abrupt edges of sidewalks and driveways.
• Install handrails on stairs and steps.
• Remove high doorway thresholds Trim shrubbery along the pathway to the home.
• Keep walk areas clear of clutter, rocks and tools.
• Keep walk areas clear of snow and ice.
• Install adequate lighting by doorways and along walkways leading to doors.

All Living Spaces

• Use a change in color to denote changes in surface types or levels.
• Secure rugs with nonskid tape as well as carpet edges.
• Avoid throw rugs.
• Remove oversized furniture and objects.
• Have at least one phone extension in each level of the home and post. emergency numbers at each phone.
• Add electrical outlets.
• Reduce clutter.
• Check lighting for adequate illumination and glare control.
• Maintain nightlights or motion-sensitive lighting throughout home.
• Use contrast in paint, furniture and carpet colors.
• Install electronic emergency response system if needed.

Bathrooms

• Install grab bars on walls around the tub and beside the toilet, strong enough to hold your weight.
• Add nonskid mats or appliques to bathtubs.
• Mount liquid soap dispenser on the bathtub-wall.
• Install a portable, hand-held shower head.
• Add a padded bath or shower seat.
• Install a raised toilet seat if needed.
• Use nonskid mats or carpet on floor surfaces that may get wet.

Kitchen

• Keep commonly used items within easy reach.
• Use a sturdy step stool when you need something from a high shelf.
• Make sure appliance cords are out of the way.
• Avoid using floor polish or wax in order to reduce slick surfaces.

Living, Dining and Family Rooms

• Keep electrical and telephone cords out of the way.
• Arrange furniture so that you can easily move around it (especially low coffee tables).
• Make sure chairs and couches are easy to get in and out of.
• Remove caster wheels from furniture.
• Use television remote control and cordless phone.

Bedroom

• Put in a bedside light with a switch that is easy to turn on and off (or a touch lamp).
• Have a nightlight.
• Locate telephone within reach of bed.
• Adjust height of bed to make it easy to get in and out of.
• Have a firm chair, with arms, to sit and dress.

Stairways, Hallways and Pathways

• Keep free of clutter
• Make sure carpet is secured and get rid of throw rugs.
• Install tightly fastened hand rails running the entire length and along both sides of stairs.
• Handrails should be 34 inches high and have a diameter of about 1.5 inches.
• Apply brightly colored tape to the face of the steps to make them more visible.
• Optimal stair dimensions are 7.2 inch riser heights with either an 11 or 12 inch tread width.
• Have adequate lighting in stairways, hallways and pathways, with light switches placed at each end.

What is dementia?

5 Star Home Care quality homecare for Seniors – call 404-719-4118. Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

Dementia is the loss of mental functions—such as thinking, memory, and reasoning—that is severe enough to interfere with a person’s daily functioning. Dementia is not a disease itself, but rather a group of symptoms that might accompany certain diseases or conditions. Symptoms also might include changes in personality, mood, and behavior. Dementia is irreversible when caused by disease or injury, but might be reversible when caused by drugs, alcohol, hormone or vitamin imbalances, or depression.

Dementia develops when the parts of the brain that are involved with learning, memory, decision-making, and language are affected by any of various infections or diseases. The most common cause of dementia is Alzheimer’s disease, but there are as many as 50 other known causes. Most of these causes are very rare.

Some of the disorders that cause dementia might be reversible, although unfortunately most types of dementia do not respond to treatment. Therefore, it is very important to evaluate dementia symptoms comprehensively, so as not to miss potentially treatable conditions. The frequency of “treatable” causes of dementia is believed to be about 20 percent.

What are some of the other causes of dementia?

There are many causes of dementia, including neurological disorders such as Alzheimer’s disease, blood flow-related (vascular) disorders such as multi-infarct disease, inherited disorders such as Huntington’s disease, and infections such as HIV. The most common causes of dementia include:

• Degenerative neurological diseases, such as Alzheimer’s, dementia with Lewy bodies, Parkinson’s, and Huntington’s
• Vascular disorders, such as multiple-infarct dementia, which is causes by multiple strokes in the brain
• Infections that affect the central nervous system, such as HIV dementia complex and Creutzfeldt-Jakob disease
• Chronic drug use
• Depression
• Certain types of hydrocephalus, an accumulation of fluid in the brain that can result from developmental abnormalities, infections, injury, or brain tumors

Alzheimer’s disease causes 50 percent to 70 percent of all dementia. However, researchers are finding that some of what was previously considered Alzheimer’s disease is really one of two other degenerative diseases: Lewy body disease and Pick’s disease. There also are a number of other important disorders that can lead to dementia. Some of these are potentially reversible, at least partially, and should be considered before a diagnosis of Alzheimer’s disease is made.

How common is dementia?

Although dementia has always been somewhat common, it has become even more common among the elderly in recent history. It is not clear if this increased frequency of dementia reflects a greater awareness of the symptoms, or if people simply are living longer and thus are more likely to develop dementia in their older age.

Dementia caused by neurological degenerative disease, especially Alzheimer’s disease, is increasing in frequency more than most other types of dementia. Some researchers suspect that as many as half of all people over 80 years old develop Alzheimer’s disease. Also, the increased incidence of AIDS dementia complex, which results from HIV infection, helps account for the increased dementia in recent history.

Who gets dementia?

Dementia is considered a late-life disease because it tends to develop mostly in elderly people. About 5 percent to 8 percent of all people over the age of 65 have some form of dementia, and this number doubles every five years above that age. It is estimated that as many as half of people 85 or older suffer from dementia.

What are the types of dementia?

Some doctors and researchers split dementia into two broad categories — the cortical dementias and the subcortical dementias — based on which part of the brain is affected.

• Cortical dementias arise from a disorder affecting the cerebral cortex, the outer layers of the brain that play a critical role in cognitive processes such as memory and language. Alzheimer’s and Creutzfeldt-Jakob disease are two forms of cortical dementia. Cortical dementia patients typically show severe memory impairment and aphasia, the inability to recall words and understand common language.
• Subcortical dementias result from dysfunction in the parts of the brain that are beneath the cortex. Usually, the memory loss and language difficulties that are characteristic of cortical dementias are not present. Rather, people with subcortical dementias, such as Huntington’s disease, Parkinson’s Disease, and AIDS dementia complex, tend to show changes in their personality and attention span, and their thinking slows down.

There are cases, such as with multi-infarct dementia, where both parts of the brain tend to be affected.

Is dementia treatable?

Treatable causes of dementia are reversible disorders that can be cured completely, or at least partially, by treating the underlying disorder. Because some types of dementia are treatable or partially treatable, it is important not to assume that a person who is showing any symptoms of dementia is suffering from Alzheimer’s disease or another incurable disease. For example, dementia caused by any of the following are often at least partially treatable:

• Chronic drug abuse
• Tumors that can be removed
• Subdural hematoma, an accumulation of blood beneath the outer covering of the brain that results from a broken blood vessel, usually as a result of a head injury (which can be minor and even unrecognized)
• Normal pressure hydrocephalus
• Metabolic disorders, such as a vitamin B12 deficiency
• Hypothyroidism, a condition that results from low levels of thyroid secretion
• Hypoglycemia, a condition that results from low blood sugar

Non-treatable causes of dementia include:

• Alzheimer’s disease
• Multi-infarct dementia
• Dementias associated with Parkinson’s disease and similar disorders
• AIDS dementia complex
• Creutzfeldt-Jakob disease (CJD), a quickly progressing and fatal disease that is characterized by dementia and myoclonus — muscle twitching and spasm

How Dementia Can Affect the Elderly’s Indepenence and Safety

5 Star Home Care quality homecare for Seniors – call 404-719-4118.  Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

Dementia in the elderly can produce significant deficits in functional abilities, which can affect their ‘independence’ and ‘safety’ living at home, especially if living alone.

This can include: difficulty tending to basic self-care needs such as hygiene, bathing, dressing, etc.; difficulty with taking medications on schedule everyday; preparing and eating adequate meals; increased risk for falling due to in-coordination, weakness and poor safety awareness; difficulty with communicating skills, etc. Dementia can also cause a change in personality, psychosis and delusional thinking; and a host of other problems, both subtle and obvious.

Although most people are familiar with Alzheimer’s Dementia (AD), there are also other forms of dementia that can affect older adults.

This includes vascular dementia, multi-infarct dementia, Lewey body dementia, and Frontotemporal dementia. People with other primary disorders, such as Parkinson’s or stroke, may also develop some form of dementia at some point.

Dementia is usually classified as mild, moderate or severe. When AD is diagnosed in someone who is younger, say 65 years of age, the progression tends to be quicker and more severe than in someone who is 80 years old and only recently diagnosed with the disorder. A CT scan can often reveal if there are any significant areas of atrophy in the brain, sometimes related to multi-infarct or vascular dementia. It is important to know what type of dementia the person has and if they should be taking any medications for the disorder. Often, older adults at home will not seek out a physician or neurologist to get an accurate diagnosis and receive the proper medication, which can make living at home more difficult; both for the person and the caregiver, if there is one.

One of the hallmarks of AD is the difficulty with language and communication skills. Those with AD may have difficulty expressing themselves and communicating with others. Withdrawal and decreased socialization may occur. They may become depressed due to a recognition that their mental abilities have diminished. Sometimes the physician will prescribe an anti-depressant that may also alleviate some of the symptoms of their dementia.

Some of the cognitive components required to perform functional tasks include: adequate long and short term memory, appropriate insight and safety awareness, sequencing skills, ability to stay focused on a task, sufficient judgment and problem solving abilities, and higher level ‘executive function’ abilities. ‘Executive function’ refers to our ability to plan and execute a series of tasks in order to produce a desired outcome. It is a complex mental ability which integrates the various cognitive skills; which people with dementia have difficulty with. For example, baking a cake requires the ability to preheat the oven, gather and mix all the ingredients in the proper amount, know when the oven is hot enough, know when the cake is done, and safely removing it from the oven at the correct time. Someone with dementia may have difficulty with many of the functional components required to do all of these steps in the correct order to produce the desired outcome.

When mental abilities have diminished, seniors are at a greater risk for declining physical health. Declining physical health related to cognitive deficits can occur due to poor eating habits and malnutrition, poor hygiene and self care skills, a greater risk for falling, not taking prescribed medications daily, not monitoring blood sugar levels – if diabetic, and a host of other health-related problems.

Some basic home adaptations for safety: hand rails on the stairs, well light rooms and stairwells, grab bars in the tub/shower, keeping toxic items out of reach or locked up, no throw rugs, low profile carpeting, no clutter in the walking paths of the home, limit carrying of items up and down stairs – such as laundry, taking away car keys to prevent them from driving if that is an issue (this is often a difficult issue to address for those with dementia), obtaining an ID bracelet if they are prone to wandering, a gate to prevent them from going down into the basement, and other adaptations as needed.

For those with mild to moderate dementia who live at home, here are some tips that may be helpful for the individual and the family / caregiver (the level of care will be dictated by the severity of the dementia):

It is important that the individual receive a proper diagnosis, which can be obtained from a neurologist, and that sufficient medication is provided. It is vital that a caregiver look after them and insure that medications are taken daily. If there is no family who can help, then maybe someone from their church or local senior center can be entrusted to help. Also, the local Agency On Aging can have someone look into their well being if there is no family member who is responsible for them.

Have medications dispensed from a daily pill organizer. This way a caregiver can make sure that each day’s medications are taken. Daily phone calls from someone familiar with the person can then check up on them and remind them, if they live alone.

Have meals-on-wheels provide at least one hot meal each day. This may not always be sufficient, but it can help insure that some nutrition is provided.

A local home care agency can provide a ‘house sitter’ to stay with the person each day and help out with daily chores. They are available for as many hours as needed. This can sometimes be expensive, but a lower rate can sometimes be given when they are employed for a certain amount of hours each week.

If the person is becoming incontinent, have them wear snug fitting disposable briefs with elastic leg bands. This will prevent accidents from ruining clothing. Have them on a toileting schedule of every two to three hours during the day. At night, a wet alarm on the mattress can be used to remind the person to change out of wet clothing.

Provide plenty of physical activities, such as daily walks. This is not only for their physical well being, but it has been shown that daily walks provide mental stimulation as well.

Have the person participate in mentally stimulating activities daily, such as board games, card games, etc.; tasks that require interaction and a bit of problem solving. Watching television is the least stimulating for those with dementia, but sometimes that is all they wish to do. The problem with television is there is no interaction or response required from the viewer, which is the same issue with young children. The person needs to be engaged with the environment in order for it to be sufficient as mental stimulation.

Allow the person to do as much of their own self-care, as possible; such as washing, grooming, etc. Some people with dementia enjoy using their hands and holding items; things that can be manipulated, etc. For a retired mechanic, maybe nuts and bolts could be used, for a housewife who enjoyed sewing or knitting, maybe a ball of yarn could be used. There is no limit to what can be tried; as long as the items are not sharp, could be swallowed easily, breakable, etc.

Be aware that those with moderate dementia often become more agitated in the late afternoon, and they should not be over-stimulated during this time frame. Sometimes a nap will help calm them. Even a change in medication intervals may help keep them calm in late afternoon.

Be aware that medications can affect their level of arousal. Let the physician know about any side affects which are affecting the person’s ability to function. Cognitive medications need to be at a certain level (titrated) in order to be effective. Too little medication will not help them and too much may produce undesired side affects.