This New Year’s Make a Resolution to Have Better Communication and Joyful Conversations with Your Loved One in Assisted Living!

It can often be challenging for us—family and caregivers—to carry a conversation with a loved one who has dementia, Alzheimer’s Disease or other cognitive disorders. Beyond the “It’s so nice to see you today.” and “Isn’t the weather just beautiful” and “I like your shirt. Nice color.” What do we say?

 Sometimes we stumble upon a good conversation and everyone is delighted. I saw one such magical moment the other day. The daughter mentioned she was going to have a date night with her husband and go to the movies. Then her Mom asked if they were going to see The Wizard of OZ. That turned into a great conversation about the magic of the film, the great storyline and the characters, how they love watching it every year and eating home-made popcorn.

 Wouldn’t you like to stumble on that type of conversation more often? One of the ways to create a more meaningful conversation is to “go back in time” and focus in on the small moments. Little things like how Mom got you up in the morning, the routine for going to bed, or licking cake batter from a spoon. How about the time you crashed on your bicycle and dad bandaged your leg with toilet paper?  Think of those stories that always get a laugh.

 You probably can think of a dozen little stories as you read this blog! Sounds like it’s time for you to make a “Memory Jar” (or Box). It’s easy to do and it makes a great, useful gift too!

 1. Start      by jotting down all your favorite memories and little details. Example, “I      remember on Thanksgiving I always loved your Pumpkin Pie.” Or “You love The      Laurence Welk Show.” Keep the memories to a single sentence. Break up      complex ideas. You can have three or four memories from each holiday listed individually.

 2. Next, type      up the memories in a large font, like a 16. Put a couple blank spaces      between each memory and then print it all out. You’ll want it to be      several pages worth!  

 3.   After      printing, (if you choose, laminate the pages so they are more durable), cut      out the memories into paper strips and place them in a jar with a lid or a      pretty box. An inexpensive jewelry box works well too. Decorate it or put      their name on it. 

4. Make a      second jar/box so you can have one, filled with memories.

5. Share the little memories together! This keepsake will be a wonderful gift to read over throughout the year. It will provide both of you with great, positive affirmations of love and your family traditions. We have Residents that read through them on their own and Caregivers use the jars to start conversations. 

So, why not help your loved one reconnect to special memories and give yourself the gift of easy conversation starters?!

Could you use more ideas on how to be conversational with someone who has memory care needs? Sunshine Care also has the following tried and true conversation starters posted in all our houses…

 Conversation Starters:

• This weekend we went to…
• The weather today is…
• I talked with your sister/brother/friend the other day and she said….
• At church this week the pastor talked about…
• I have a dog named _______ and he is…
• Someday you will have to meet my daughter, she is…
• You are such a good mom/dad because…
• You know when I was a kid we used to…
• I heard you can fix just about anything.
• I heard you have a green thumb, do you like  roses?
• I heard you love to dance. What about the waltz?

Things to reminisce about:

• Hide & seek at dusk
• Sitting on the porch
• Hot bread and butter
• Penny candy in a brown bag
• Hopscotch, kickball and Jump Rope
• Cowboys and Indians
• Being tickled to death
• Climbing trees
• Building forts
• Laughing so hard it hurts
• Licking the beaters when mom made a cake
• Walking on the Beach
• Long Car Trips
• Songs around the fire or piano
• Popcorn at the Movies
• Summer Vacation
• What was your very first car ?
• Sewing your own clothes
• Man Walking on the Moon
• Shoe Shopping
• Favorite TV Shows: I Love Lucy, Lawrence Welk, Johnny Carson
• Candlelight Dinner
• Santa, the Tooth Fairy, the Easter Bunny
• Holding a child’s hand
• Playing Cards, Monopoly or Shooting Pool
• First Job,  Last Job before Retiring
• Favorite Pets /Animals
• Arranging Flowers in a Vase
• Getting a Bear Hug

P.S.: The Memory Jar is also a great thing to send to a student that is away at college!!

Assisted Living Visiting Guide for Families

Fall and the winter holiday season mark the busiest time of the year in Assisted Living. Everyone comes to visit! From Girl Scout carolers to church youth groups to grandchildren and great-grandchildren, to the out-of-state son who came into town for a holiday and hasn’t seen Mom since last year.

It’s the grandchildren and son that likely could use a little support and ideas on how to make the visit most successful. So here are Sunshine Care Assisted Living Home’s tried and true tips for Holiday visiting:

1. Consider calling ahead and letting staff know you are coming in with extended family. They will take a few minutes to help your Mom touch-up her hair, put on some lipstick, change her into a fresher or dressy shirt. At Sunshine Care we will set a private alcove with afternoon tea or hot chocolate and cookies if given a little notice.

2.  If family has never been  to visit, or it has been a few months, try to give them an honest and simple overview of how Mom is doing. And then give them some tips, “Mom is using a walker now. She sometimes repeats herself and she sometimes says she lives at the house we grew up in. Try using statements instead of questions. ‘Mom, it is so nice to see you today.’ versus ‘How are you?’”

3.  Take a minute to talk about the assisted living setting with young children. What types of things might we see? Walkers, wheelchairs, people who have trouble walking or talking. Maybe people who don’t have teeth. People who would love you to say hello and shake their hand or give them a gentle high-five. It is guaranteed when you go visit a family member you will visit and say hi to other residents.

4. Bring something you can share. Keep it simple– some family photos, a magazine with great pictures. Have the grandkids bring their favorite stuffed animals to introduce or make and bring homemade greeting cards. Bring a t-shirt you all have signed or put your handprints on or one that says “Happy Thanksgiving” or “Merry Christmas”. Something you can easily talk and laugh about.

5. Skip the cookies, candies and living plants! Sweets should be in moderation — bring three or four cookies, not two dozen. It’s a fact of life, living plants will die and it is especially likely when they are kept indoors. Unless you firmly believe Mom can water it herself, don’t waste your money. Even consider skipping cut flowers. Bring something that is inexpensive but will last and brighten her day each day of the season. A small fiber optic Christmas tree or plastic wreath for her room is perfect. Or a poster with pictures and notes from all the family. A seasonal themed necklace or bracelet that is from Target not Tiffany’s, so it’s no big deal if she loses it.

6.  Pay attention to your body language and pace. Remember silence is okay too. No matter what level of care needs a person has and no matter how much they can or cannot communicate, the one skill that is never lost is what we call ”emotional communication”. Mom might not know what she had for breakfast, but she can sense when things are not okay. You and your family need to provide a feeling of love, calm and joy. Be prepared to slow  down, move at her pace, sit down and smile. Sometimes, after ten minutes, you run out of things to say. Try just sitting together holding her hand or massage some lotion into her hands and arms. Touch is very healing and speaks volumes.

7. Take pictures together. Ask the staff to snap some with your camera. Those multi-generational family photos are real treasures.

8. Keep the visit short, not more than one hour. Consider not more than 30 minutes with young children.

9. Keep your goodbyes simple. Keep Mom in mind and her comfort when saying goodbye, “Mom, it was great visiting with you. The kids and I have to go grocery shopping so we’ll see you later.”  It is recommended that you don’t give a return time. Keep it casual, as if you see each other all the time. Try your best, and encourage family, to avoid long drawn-out emotional goodbyes, “Goodbye Mom, I’ll miss you so much. I’ll see you next Christmas okay?” These prolonged goodbyes trigger fear, anxiety, confusion and frustration for Mom.  She is suddenly uncertain when she will ever see you again. Not a good way to leave her feeling. If you need support or Mom asks to go home with you, get a staff person to help with redirection when it is time to leave.

10. Debrief. Take a few minutes to talk about the visit with your family. Allow family that hasn’t seen her in some time to talk about the changes they noticed and their fears.  

We hope these ten steps will make visits more enjoyable for both you and your loved one in Assisted Living. They certainly have come in handy for us!

America’s Best Intergenerational Communities–From Generations United

Just this week, Sunshine Care had the pleasure of being honored as the North County Inland star partner in the recognition of San Diego County –Our County has been named as one of America’s Best Intergenerational Communities! And that’s good for everyone’s health— that we continue our focus on building a community for all ages.

The write up from Generations United (gu.org) states the following:

“Think of San Diego and you probably focus on its physical beauty: the sandy beaches and imposing canyons, the charming historic area, and, of course, the lovely weather. But if you concentrated solely on the physical attributes, you‘d miss out on one of San Diego‘s most appealing traits: its commitment to making life better for all generations.

With three million residents strong, the County of San Diego believes in the need to support intergenerational connections. In 2001, it backed up that belief with serious funding by adding a fulltime staff position of Intergenerational Coordinator at the county‘s department of Aging & Independence Services (AIS). That investment has paid big returns: through intergenerational programs it has employed residents‘ strengths to expand services and address serious challenges. Residents benefit by having the opportunity use their talents and creativity to contribute to the county‘s well-being and vibrancy.

Over the past 11 years, the county‘s commitment to intergenerational programs has only strengthened as the economy has weakened. By sharing sites and resources, it has maximized financial resources. It has also challenged traditional ways of funding. For example, AIS allocates funding from the Older Americans Act to support intergenerational program development. It also requests and receives funds from other county agencies to support intergenerational programs.

Recently, a $16.1 million dollar Centers for Disease Control Healthy Works grant included an intergenerational thread that supported Safe Routes to School, Breakfast in the Classroom, Community gardens, and Community Engagement.

 In San Diego today, all types of county services and programs have an intergenerational aspect. Libraries and Parks and Recreation offer intergenerational art, math, reading and jazz programs. Older adults take part in a Workforce Academy for Youth, mentoring foster youth for six months as they get ready to leave the foster system and join the work world. Young people have the opportunity to join the Legacy Corps Program where they serve caregivers and learn about the aging process. The county also works with providers that serve older adults and youth to sponsor Resident and Youth Leadership Academies. These academies train older adults and youth in leadership, and primarily focus on community planning principles and environmental prevention strategies. The list goes on.

 This June, county agencies, non-profit organizations, for-profit agencies and faith communities will conduct a summit: Live Well, San Diego! Building a Healthy Community for All Ages. Speakers and activities will focus on how to make healthy choices and create living environments that encourage safe, active lifestyles. The event will take place in five locations to ensure all San Diegans have access to the information and activities. San Diego‘s efforts have resonated well with residents of all ages. As retired volunteer and community gardener Rich Rogers noted, community gardening ―has turned into a labor of love. Gardening is as ―grass roots‖ as you can get and teaching and mentoring kids of all ages increases my desire to be a positive influence and asset in my community.

 And for Alexis Wilson, a college student, her labor of love is to volunteer to meet with an older adult who has Parkinson‘s disease. As she describes it, ―Phil‘s wife recently told me he sometimes forgets I‘m not part of the family. Spending time with Phil reminds me I‘m not going to be young forever. I would want the same help when I am that age.”

Lowering Fall Risk

Prevention of Falls

Set-up of the environment and reminders can really help prevent falls for many seniors. Here are some safety tips from the National Institute of Health for preventing falls–both outside and around house. But the biggest prevention of falls comes from maintaining a regular 15 -20 mintue daily exercise program that includes balance exercises. This is not anything too advanced or complicated, take for example the low-impact chair exercises offered daily at Sunshine Care Assisted Living Homes. www.sunshinecare.com

Safety first to prevent falls: At any age, people can change their environments to reduce their risk of falling and breaking a bone.

Outdoor safety tips:

• In nasty weather, use a walker or cane for added stability.
• Wear warm boots with rubber soles for added traction.
• Look carefully at floor surfaces in public buildings. Many floors are made of highly polished marble or tile that can be very slippery. If floors have plastic or carpet runners in place, stay on them whenever possible.
• Identify community services that can provide assistance, such as 24-hour pharmacies and grocery stores that take orders over the phone and deliver. It is especially important to use these services in bad weather.
• Use a shoulder bag, fanny pack, or backpack to leave hands free.
• Stop at curbs and check their height before stepping up or down. Be cautious at curbs that have been cut away to allow access for bikes or wheelchairs. The incline up or down may lead to a fall.

Indoor safety tips:

• Keep all rooms free from clutter, especially the floors.
• Keep floor surfaces smooth but not slippery. When entering rooms, be aware of differences in floor levels and thresholds.
• Wear supportive, low-heeled shoes, even at home. Avoid walking around in socks, stockings, or floppy, backless slippers.
• Check that all carpets and area rugs have skid-proof backing or are tacked to the floor, including carpeting on stairs.
• Keep electrical and telephone cords and wires out of walkways.
• Be sure that all stairwells are adequately lit and that stairs have handrails on both sides. Consider placing fluorescent tape on the edges of the top and bottom steps.
• For optimal safety, install grab bars on bathroom walls beside tubs, showers, and toilets. If you are unstable on your feet, consider using a plastic chair with a back and nonskid leg tips in the shower.
• Use a rubber bath mat in the shower or tub.
• Keep a flashlight with fresh batteries beside your bed.
• Add ceiling fixtures to rooms lit by lamps only, or install lamps that can be turned on by a switch near the entry point into the room. Another option is to install voice- or sound-activated lamps.
• Use bright light bulbs in your home.
• If you must use a step-stool for hard-to-reach areas, use a sturdy one with a handrail and wide steps. A better option is to reorganize work and storage areas to minimize the need for stooping or excessive reaching.
• Consider purchasing a portable phone that you can take with you from room to room. It provides security because you can answer the phone without rushing for it and you can call for help should an accident occur.
• Don’t let prescriptions run low. Always keep at least 1 week’s worth of medications on hand at home. Check prescriptions with your doctor and pharmacist to see if they may be increasing your risk of falling. If you take multiple medications, check with your doctor and pharmacist about possible interactions between the different medications.
• Arrange with a family member or friend for daily contact. Try to have at least one person who knows where you are.
• If you live alone, you may wish to contract with a monitoring company that will respond to your call 24 hours a day.
• Watch yourself in a mirror. Does your body lean or sway back and forth or side to side? People with decreased ability to balance often have a high degree of body sway and are more likely to fall.

Medications That May Increase the Risk of Falling:

• Blood pressure pills
• Heart medicines
• Diuretics or water pills
• Muscle relaxers or tranquilizers

 

Brain Health

When people think about staying fit, they generally think from the neck down. But the health of your brain plays a critical role in almost everything you do: thinking, feeling, remembering, working, and playing — even sleeping.

 The good news is Sunshine Care Assisted Living Homes has a partnership with the Alzheimer’s Association and they tell us, there’s a lot you can do to help keep your brain healthy as you age.

 The Alzheimer’s Association has launched a Maintain Your Brain^® campaign designed to help all Americans understand steps they can take now to make brain health part of their overall goals for healthy aging. A few simple lifestyle changes can help keep you fit mentally and physically for years to come, and might also reduce your risk of Alzheimer’s disease and other dementias.

 Several of the 10 Ways to Maintain Your Brain form the core of how and why we design our daily activities at Sunshine Care Assisted Living Homes.

 10 ways to Maintain Your Brain^®

 1. Head first

Good health starts with your brain. It’s one of the most vital body organs, and it needs care and maintenance.

 2. Take brain health to heart

What’s good for the heart is good for the brain. Do something every day to prevent heart disease, high blood pressure, diabetes and stroke — all of which can increase your risk of Alzheimer’s.

 3. Your numbers count

Keep your body weight, blood pressure, cholesterol and blood sugar levels within recommended ranges.

 4. Feed your brain

Research suggests that a diet rich in dark vegetables and fruits may help protect brain cells. Eat less fat and more antioxidant-rich foods.

 5. Work your body

Physical exercise keeps the blood flowing to the brain and may encourage new brain cells. Walking just 30 minutes a day can help keep both body and mind active.

 6. Jog your mind

Keeping your brain active and engaged strengthens brain cells and the connections between them, and may even trigger growth of new cells. Read, write, play games, learn new things, do crossword puzzles.

 7. Connect with others

Leisure activities that combine physical, mental and social elements may be most likely to prevent dementia. Be social, converse, volunteer, join a club or take a class.

 8. Heads up! Protect your brain

Take precautions against head injuries. Always wear a seat belt; unclutter your house to avoid falls; and wear a helmet when cycling.

 9. Use your head

Avoid unhealthy habits. Don’t smoke, drink excessive alcohol or use street drugs.

 10. Think ahead – start today!

You can do something today to protect your tomorrow.

 The science behind these recommendations

While there is strong evidence pointing to ways to support brain health and possibly reduce risk of dementia, it’s important to understand that there is no way to predict what will happen to any particular person. Sunshine Care Assisted Living Homes, The Alzheimer’s Association and Maintain Your Braindo not guarantee individual health outcomes.

 More information

To learn more about Maintain Your Brain^®, visit http://www.alz.org/maintainyourbrain.

Urinary Tract Infection & the Elderly: Signs & Symptoms

If a 30-year-old woman experiences painful burning when she urinates, it’s almost certain she has a urinary tract infection. But an elderly urinary tract infection rarely causes such clear symptoms and might not involve pain or discomfort at all. “As you get older your immune response changes; it’s part of normal aging,” says Anna Treinkman, a nurse practitioner at the Rush Alzheimer’s Disease Center in Chicago and president of the National Conference of Gerontological Nurse Practitioners. In fact, a sudden change in behavior is one of the best indicators of a urinary tract infection in older adults. Some common warning signs might include the onset of elderly urinary incontinence, confusion, or not being able to do tasks the patient could easily do a day or two before. “Anytime there’s a change in an older adult… if one day they’re able to dress themselves or feed themselves and then there’s a sudden change, a red flag should go up in a caregiver’s mind,” Treinkman says.

Half of all women will develop a urinary tract infection (UTI) in their lifetimes. Ranking as the body’s second-most common infection type, UTIs in women—and less often in men—account for about 8.3 million doctor visits each year, according to the National Center for Health Statistics. Typically, UTIs, also known as bladder infections, are easy to cure. But if left untreated, the infection can spread and develop into far more serious conditions. UTIs, for instance, are a leading cause of sepsis, a potentially life-threatening infection of the bloodstream.

“A bladder infection places stress on the body,” says Dr. Mary Ann Forciea, an associate clinical professor for the University of Pennsylvania Health System. That stress can result in confusion and abrupt changes in behavior in older adults with an elderly urinary tract infection. And for people suffering from Parkinson’s disease, Alzheimer’s disease, or other dementia, “any kind of stress, physical or emotional, will often make dementia temporarily worse,” Forciea says.

Causes and Symptoms

The kidneys, ureters, bladder, and urethra work together to rid the body of urine: the kidneys remove extra liquid and waste from the blood in the form of urine, the ureters carry the urine from the kidneys to the bladder, and the bladder stores the urine until it is emptied through the urethra.

An infection can occur when bacteria cling to the opening of the urethra and begin to multiply. UTIs are thought to be much more common in women because the urethra is shorter in women than in men, giving bacteria—which live in the rectal area and also on a person’s skin—an easier route into the body.

The most common diagnosis is cystitis, the infection and inflammation of the bladder, which causes frequent and painful urination. However, other parts of the lower and upper urinary tract system can become infected. As a general rule of thumb: the higher up the infection in the urinary tract system, the worse it is.

Burning urination is often the result of urethritis, the infection of the urethra. In men, urethritis can also cause penile discharge. Pyelonephritis occurs when a bladder infection spreads to the kidneys. It can cause upper back and flank pain, shaking, chills, nausea and vomiting. UTIs in men can lead to prostatitis, or enlargement of the prostate gland, the male organ that produces semen, which is located just below the bladder.

Forciea says it’s helpful to think of the prostate as shaped like a doughnut. Urine comes out of the prostate’s center. As the prostate swells, the opening for urine shrinks, making it more difficult to urinate. Some swelling of the bladder wall can block the exit path of urine, resulting in a bladder outlet obstruction. A key indicator that the outlet is beginning to close, Forciea says, is if the patient starts to urinate more frequently. If his usual tendency is to void every two hours and now he’s urinating every thirty minutes, that’s a sign that the outlet is beginning to close and only small amounts of urine are passing through.

Other symptoms of a UTI include: general discomfort, a feeling of being over-tired, blood in the urine, and pain even when not urinating. Men might feel fullness in the rectum. Back and side pain can indicate the infection has reached the kidneys. An elderly person will rarely get a fever, but if an older patient has one it is considered an emergency. “It shouldn’t be taken lightly,” Treinkman says. “If they do have a fever, it’s a serious infection.”

Stroke Awareness: Act F.A.S.T to Prevent Irreversible Damage from Stroke

Act F.A.S.T to Prevent Irreversible Damage from Stroke

Despite the fact that stroke is the third leading cause of death inAmerica and the number one cause of adult disability, many remain uneducated as to its causes and methods for prevention.

Even more alarming is the fact that many individuals fail to recognize a stroke when experiencing symptoms or seeing someone else with the symptoms. Sunshine Care Homes understands the importance of Stroke Education. We encourage you and your loved ones to become more aware about stroke risk factors, methods for prevention and symptom recognition. Sunshine Care Homes knows that acting F.A.S.T is the key to reducing the side effects of a stroke.

Here are signs to look for:

Face- Ask the person to smile. Does one side of his face droop?

Arms- Ask the person to raise both arms. Does one arm drift downward?

Speech- Ask the person to repeat a simple sentence. Can he repeat the sentence correctly? Are his words slurred?

**If any of these answers are YES then…

Time is of essence! Call 911 right away or get to a hospital as quickly as possible!

More on strokes and care management next week. www.sunsinhineacare.com