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Simple Steps to Keep the Deadly C. Diff Infection at Bay

January 22, 2019

The contagious bacterial infection can be more serious for older adults
By Mark Ray

When you were a child, did you worry about monsters hiding under your bed or lurking behind your closet door? It turns out one monster — clostridium difficile, or C. diff — may actually be closer at hand, at least in hospitals and nursing homes.

Transmitted via fecal matter, the C. diff bacterial infection can cause severe diarrhea, nausea, fever, dehydration, abdominal pain, kidney failure and even death. Older adults are more vulnerable to it because of naturally weaker immune systems, more likelihood of underlying health issues and more time spent in health care settings.

  1. diff is resistant to some antibiotics, but there are some shown to work against it. In serious and recurrent C. diff cases, patients may undergo a fecal transplant or surgery to remove a portion of the colon.
  2. diff spores adhere to every imaginable surface, including toilet seats, faucet handles, doorknobs, linens, bedrails, nurse call buttons, chair arms, ceiling vents and even floors. A 2017 study in the United Kingdom detected it in floor corners in 86 percent of hospital rooms that had undergone routine cleaning.

Since its spores resist standard cleaning methods and alcohol-based hand wipes, C. diff is tough to eradicate. “We know those spores can last nine months or more in a room,” says Dr. Kate Mullane, an infectious disease specialist at The University of Chicago Medicine. “It takes a high concentration of bleach to kill the spores: a cup of bleach in a gallon of water.”

And killing the spores is critically important because C. diff itself is a killer. The most common microbial cause of health care-associated infections in the United States today, it causes nearly half a million infections and 15,000 deaths annually — almost as many deaths as drunk driving and HIV/AIDS combined,  according to the U.S. Centers for Disease Control and Prevention (CDC). Eighty percent of C. diff deaths occur among people 65 and older, and one in 11 patients in that age group dies within 30 days of diagnosis.

A two-pronged approach can keep this microscopic, but deadly killer, at bay. Prong one is antibiotic stewardship; prong two is infection control.

Antibiotic Stewardship

You’ve doubtless heard the world uses far too many antibiotics, wasting money and contributing to the growing problem of antimicrobial resistance. The Pew Charitable Trusts reported that 30 percent of outpatient antibiotic prescriptions in the U.S. are unnecessary (antibiotics prescribed for a viral infection, for example).

Doctors are getting more judicious in their use of antibiotics, but Mullane says patients should still talk with their doctors about the drugs they’re prescribing. If you can avoid antibiotics, or at least broad-spectrum antibiotics, you will be less vulnerable to C. diff. This is because, along with the bad bacteria the drugs are after, antibiotics also kill much of the good bacteria in our intestines. This leaves C. diff an opportunity to overwhelm the gut and cause illness.

  1. Diff Infection Control

Given C. diff’s persistence in health care environments, it’s also important to prevent transmission between patients, health care workers and visitors — including people who aren’t symptomatic.

“We know at any one time, about 5 percent of the population is colonized with C. diff,” Mullane says. “They may not be sick with it, but they’re at least carrying it.”

The easiest way to stop transmission is with proper handwashing, according to Anna Barker., a researcher in the medical scientist training program at the University of Wisconsin-Madison. “Even with hospital-grade hand sanitizer, which in many cases is pretty similar to what you would buy out in the community, you do still need to use soap and water,” she says.

“It’s not only the soap and water (that gets rid of the germs), it’s the friction and having your hands under the tap water, which you just don’t get when you use (hand sanitizer) gel,” Barker says. A good rule of thumb to make sure you get rid of the germs: Wash your hands for as long as it takes to sing Happy Birthday to You.

But hand hygiene is just the beginning. In the April 2018 issue of the journal Clinical Infectious Diseases, Barker and two colleagues reported their research on the effectiveness of nine discrete C. diff hospital interventions, including everything from patient hand hygiene to terminal cleaning (deep cleaning of a room after a patient is discharged).

Using computer models, Barker and her colleagues found that daily room cleaning with a sporicidal cleaner plus screening for C. diff at the time of admission reduces hospital-associated infections by roughly 82 percent and asymptomatic colonization by about 91 percent.

“When hospitals try to combat their C. diff rates, they’ll end up doing lots of things at once,” Barker says. “This paper showed you can get a considerable reduction in C. diff with only those two interventions.”

What Patients Can Do

While patients don’t have much control over infection-control practices in a hospital or clinic, they can take two concrete actions.

The first is to ask health care providers if they’ve remembered to wash their hands.

“That’s easier said than done given everything we know about power dynamics and the patient-doctor relationship, but I think that really has a potential to make a big impact,” Barker says.

The other action, perhaps surprisingly, is to reduce the clutter in hospital patient rooms.

“One of the things we hear from the cleaning staff is that it’s very difficult to clean a patient’s room effectively if there are newspapers everywhere or books or food or other items throughout the room,” Barker says. “They can’t, at least at our institution, move the patient’s things for them.”

While decluttering your hospital room may not be quite as simple as switching on the lights to banish an under-bed monster, it can go a long way toward keeping you safe from C. diff.

Mark Ray is a freelance writer who has written for Scouting, Eagles’ Call, Presbyterians Today, Kentucky Homes & Gardens and other publications. He has also written, edited and/or contributed to a dozen books for the Boy Scouts and the Presbyterian and United Methodist churches.

18 Questions to Ask Any Nursing Home

January 14, 2019

How to find a place that wants to be a real home
By Denise Logeland

Part of the Transforming Life as We Age Special Report

What makes a nursing home a good place for you or your parents? While “good” can mean a lot of things, it should include qualities like dignity and self-determination for the people who live there. The Pioneer Network offers tips on how to check for those qualities.

Formed 20 years ago, the nonprofit Pioneer Network is made up of professionals who work in long-term care, people who live in long-term care and families who advocate for them. The network, active nationally and through coalitions in 36 states, belongs to a broad-based movement in long-term care that is sometimes called simply “culture change.” That is a movement away from generic, system-based care and toward more individual, person-directed care. With culture change, residents have a large voice in the care they get and have as many of the freedoms they had in their earlier homes as possible.

You can find out if a nursing home is guided by the principles of culture change by asking specific questions when you visit to take a tour. A few examples:

  • Can residents wake up when they want to in the morning?
  • How do you get to know the people who live here?
  • How do you build a sense of community and give those who live here a voice in how things are done?
  • What is the turnover rate for the direct care workers on your staff?

There are 18 questions in all to ask at nursing homes, and a similar set of 16 to ask when looking at assisted living facilities. You can see the questions and the answers to listen for on the Pioneer Network website, where they are also available as downloads.

Denise Logeland is a writer and editor in Minneapolis who has covered business, health and health care. She is the author of Next Avenue's ebook, 10 Things Every Family Should Know: Aging With Dignity and Independence.

8 Reasons You’re Losing Sleep

January 8, 2019

Avoid these culprits to get a better night's rest
By Sheryl Kraft

E-READERS

As if there weren’t enough things keeping you tossing and turning each night, here’s a new one: Using short-wave, blue light-emitting e-readers, like the iPad, iPhone, Nook Color, Kindle and Kindle Fire before bedtime can make it harder to fall asleep, according to a December 2014 study at Brigham and Women’s Hospital in Boston.

“When blue light hits the optic nerve, it tells the brain to stop producing melatonin,” which is “the key that starts the engine for sleep,” says Michael Breus, diplomate of the American Board of Sleep Medicine and fellow of the American Academy of Sleep Medicine. “This is especially problematic, since as you get older, the ability to produce melatonin becomes even more compromised.”

Fixes: Open up a real book instead. (Remember those?) If giving up your e-reader is impossible, look for screens and glasses that can block the sleep-stealing blue light on websites like Lowbluelights.com.(MORE: 6 Habits That Ruin a Great Night’s Sleep)

BEING OVERWEIGHT

Carry extra pounds, especially in the neck and trunk section, and it’s more likely you’ll suffer from sleep apnea, which causes your airway to become blocked or obstructed during sleep, robbing you of quality deep sleep. The condition affects 90 percent of obese men, though it’s not purely a man’s disease. The Cleveland Clinic reports that after menopause, it’s just as likely to affect women. Even more disturbing, it goes undiagnosed in as many as 80 percent of those who get a lousy night’s sleep.

“Sleep apnea can mask itself as fatigue, trouble with concentration, dry mouth or even depression,” Breus states.

Unfortunately, the relationship between sleep apnea and obesity is a bit of a chicken-egg scenario. Do sufferers have problems because they’re obese, or is their obesity stoked by their compromised sleep? No one knows for sure, but what is known is this: Poor sleep makes people less motivated to increase physical activity, which can lead to more weight gain. Additionally, reduced sleep is associated with elevated levels of the hormone leptin, which helps regulate appetite.

Fixes: Among the various treatments for sleep apnea is a continuous positive airway pressure (CPAP) machine, which delivers air pressure via a mask that sits over your nose or mouth while you sleep. Other treatment options include losing weight, oral appliances (that resemble mouthguards), and Inspire Upper Airway Stimulation (USA) therapy, a new FDA-approved implantable device.(MORE: A Good Night’s Sleep Could Ward Off Alzheimer’s)

MEDICATIONS

Many popular over-the-counter pain medications, like Excedrin and Bayer Back and Body, may contain caffeine, which helps the medication get absorbed more quickly, but can cut into your sleep, according to Breus (who suggests always checking the label first). If you’re feeling under the weather, beware of nasal decongestants and daytime cold or flu medicines, as well, which can contain pseudoephedrine; you’ll feel jittery instead of tired.

Diuretics, water pills for heart disease and high blood pressure, and ADD medications like Adderall and Ritalin can also disrupt sleep, says Dr. Hrayr Attarian, a neurologist at Northwestern Memorial Hospital in Chicago, Ill. Other culprits include steroids and some medications for depression or asthma. “As with any new medication, always check with your doctor first,” Attarian says.

Fixes: If your meds are causing sleep problems, “First, I’d suggest talking to your physician to see if your medication can be changed or the dose adjusted,” Attarian says. “If that doesn’t work, you can go to a sleep clinic to discuss treatment options that may or may not include sleep aids. Taking a sleeping pill is not always the right thing right away, especially if you are taking other medications to manage health conditions.”

(MORE: 6 Foods and Medications That Don’t Mix)

A WARM BATH

Body temperature naturally begins to drop before bedtime, preparing us for sleep. Although a warm bath can relax and calm you, taking one too close to bedtime will not give your body enough of a chance to cool sufficiently to bring on slumber.

Fixes: To reap the full benefits of your bath, the National Sleep Foundation recommends finishing up your soak at least an hour before climbing into bed. While you’re at it, keep your room cool. “We sleep better in cool rooms,” says Dr. Patrick D. Lyden, chairman of the Department of Neurology at Cedars-Sinai Medical Center in Los Angeles, Calif..(MORE: Can’t Sleep at Night? Look at Your Day)

THE WRONG FOODS

If you like to snack before bed, watch what you eat. Loading up on foods that contain excessive salt or fat can stimulate brain waves, bringing on nightmares instead of sweet dreams, says the National Sleep Foundation. Choose foods that contain tryptophan (an amino acid linked to sleep quality), whole-grain carbs (which help boost serotonin production) and certain minerals (like calcium and magnesium, which can have a calming effect). Examples include half a banana and a handful of almonds, whole-grain crackers and peanut butter, a mug of warm milk, or half a turkey sandwich on whole-wheat bread.

Fix: In general, stick to a routine of eating early in the evening and try to avoid sugar at night. “Late meals are more likely to make it harder to sleep; snacking in the middle of the night can worsen insomnia,” says Dr. Andrew J. Westwood, a member of the American Academy of Neurology and American Academy of Sleep Medicine. Additionally, eating too much can make you feel physically uncomfortable when you lie down, and may cause heartburn, contributing to wakefulness.(MORE: 6 Healthy Foods to Put in Your Grocery Cart)

CLUTTER

The ideal bedroom should be simply furnished and decorated, so there’s not much to distract you from the primary reason you’re in there — to sleep. Excess clutter and mess can often cause anxiety, and remind you of all your unfinished business, making it harder to fall — and remain — asleep.

(MORE: Take the 30-Day Declutter Challenge)

EXERCISE

Sure, being physically active can make you tired, promote sleep and improve the quality of your rest, but exercising vigorously too close to bedtime can rev you up instead. “Aerobic exercise can raise your core body temperature long after you’ve finished,” says sleep specialist Rubin Naiman.

Fixes: Naiman suggests completing exercise at least three hours prior to bedtime. However, gentle exercise like yoga, he says, can be helpful to promote relaxation and sleepiness.(MORE: The Best Exercise to Protect Your Bones)

STRESS

When you’re stressed, your body secretes cortisol, a hormone produced by the adrenal gland. This can disrupt the body’s natural rhythm, says Naiman. “Cortisol is naturally produced in the morning. It peaks at around 8 a.m., when it can be helpful to naturally energize us,” he explains. “But at the wrong time—like nighttime—it can make us hyper-aroused and disrupt our sleep.”

Fixes: In addition to yoga for relaxation, a new study in adults over 55 finds that practicing a popular form of meditation known as mindfulness meditation can reap improvements in sleep quality and reduce insomnia and fatigue. Mindfulness meditation can also help reduce stress, according to a 2009 Massachusetts General Hospital study. Visit Mindful.org to learn some basics.(MORE: 6 Health Risks of Poor Sleep)

If meditation is not your thing, there’s always a good old-fashioned belly laugh; laughter actually induces physical changes in your body, says the Mayo Clinic. It cools your stress response and can increase positive thoughts, which, in turn, causes your body to release neuropeptides to help fight stress.

By Sheryl Kraft

Sheryl Kraft is a freelance journalist, essayist and writer of non-fiction based in Fairfield County, Conn. Her writing covers all areas, with a concentration in health, wellness and fitness.@sherylkraft

What Can You Do to Ease a Caregiver’s Burden?

January 4, 2019

Giving thought to what she or he needs makes the help more meaningful
By: Debbie Swanson

When a friend or family member is knee-deep in caring for a loved one, a common gesture is to drop off a casserole, or remind him or her to “let me know what you need.” But as genuine as your intentions may be, they may not be the best ways to ease the caregiver’s load.

“The person who offers help almost has to be a detective to figure out what the caregiver actually wants or needs,” says Marty Schreiber, a former governor of Wisconsin, advocate and caregiver. Once you do break through, he adds, the resulting respite will be truly appreciated.

But just how do you decipher the caregiver’s needs when he or she is hesitant to share – or maybe doesn’t even know – what could help? Here are some tips on how to analyze the situation. Then, combine creativity with common sense to formulate a warm and welcoming suggestion.

What Brings The Caregiver Joy?

Browsing an antique shop, pruning in the garden, hiking with the dog — everyone has those little things they relish doing from time to time. Enabling those activities to happen is one area where you can really make a difference.

If you knew this person pre-caregiving, you can probably think of things he or she has now put on the back burner. Your direct offer to sit with the caregiver’s loved one while the carer goes out to enjoy a specific activity may be met with surprise. It may also be hard to resist, particularly if you offer a gentle reminder, should your first attempt be ignored.

Of course, this can be difficult if you’re unfamiliar with the caregiver’s hobbies or interests. Try taking a cue from the seasons: Suggest he or she go browsing at the local farmers market or help the person “put up, or take down, holiday decorations,” adds Leslie Koc, coach and speaker on spousal caregiving from Bend, Ore.

If the caregiver is reluctant to leave home, find a way for the person to enjoy interests at home. “Share a list of best movies to watch, and help them create a Netflix online list. Schedule a time to watch a movie with them,” Koc says.

How Can You Give a Caregiver a Break

Escape from routine worries or chores can go a long way toward recharging a weary caregiver. However, suggesting leaving the loved one for an entire afternoon or evening may seem overwhelming. Instead, think of ways to add small breaks to the caregiver’s day.

“Bring lunch ‘in a box’ to enjoy indoors or outdoors,” Koc says. “Include everything, so that when the lunch is finished, there are no dishes to wash.” Pack a few extras, enabling the caregiver to enjoy a few days of no-effort lunches over the week.

An indulgence is another type of break. “Deliver a dessert that is made or sliced in portion sizes that can be frozen after the first pieces are eaten,” Koc adds.

Something else that may be welcome, but is less often extended, is arranging to take the care recipient out of the house (provided he or she is physically able). The caregiver may relish a brief interlude of time alone at home.

For the best results, approach this with a specific plan, like this: “I’d like to take Jane out for a walk — do you want me at 1:30 or 2?” Schreiber suggests.

How Can You Fill In?

When couples have been together many years, it’s common that each partner has settled into certain areas of responsibility: One does the shopping and cooking, another does taxes and budgeting. Now, the caregiver may be anxious about those things his or her partner used to take care of, so, if you can help in some way, it could mean a lot.

Here are a couple of examples: “I’m pretty good with technology, if your computer or programmable thermostat gives you grief” or, “I know just the person who would love tending to Joan’s lovely gardens; what day is best for you?”

If you aren’t familiar with the couple or don’t know what the household needs are, try asking family members. Or ask the caregiver: “What doesn’t work or needs attention? Caregivers can make up a list if asked that specific question,” Koc says.

Does The Caregiver Have Someone To Talk To?

Caring for someone else usually leads to a plethora of feelings — worry, resentment, fear, exhaustion. One simple way to help is to just listen. Call or text the caregiver at a time when you think the person might be less busy. Or drop by with coffee or a cool drink and be willing to step inside if invited. If the caregiver begins to talk about his or her problems, try to be non-judgmental and focus on listening rather than offering advice.

I Don’t Know You That Well, But…

When a less-familiar acquaintance or coworker suddenly lands in a caregiving role, it can be harder to figure out the best way to help. Try connecting the person to a resource, perhaps an organization focused on the disease or condition the loved one is dealing with, suggests C. Grace Whiting, president and CEO of the National Alliance for Caregiving in Bethesda, Md.

“Information about patient advocacy groups can be a great way to get them connected to a network of caregivers,” notes Whiting.

Don’t be surprised if the individual doesn’t talk much about the particular caregiving role. “People may not feel comfortable talking about their situation (in the workplace) for fear that it will negatively impact their career,” Whiting says.

One way to help with that concern is to supply the person with some pertinent facts. If you are in a position to do so, “share information about workplace protections with all of your coworkers, rather than singling one out; programs like paid family leave, the federal Family and Medical Leave Act, telework and flextime,” Whiting says.

If you’re part of a group including the caregiver, such as coworkers or members of a club, you could pool your money to provide gift cards for, say, gasoline, food or coffee. Another great way a group can help is by creating a monthly calendar of care, distributing days for meal deliveries, snow or leaf removal, grocery pickup or someone to check in for a list of needed errands.

While it’s nice to come up with the perfect way to help a caregiver catch a break, remember that what matters most is simply stepping up and letting the person know you are there.

Being a caregiver is a challenging role, and one that can easily result in isolation or despair. But being a caring friend can help create a bright spot in what could be a difficult time.

By Debbie Swanson

Debbie Swanson (www.swansonwriting.com) is a freelance writer living north of Boston. She often writes about pet care, senior living and family topics.

One Doctor’s Plea: Consider Palliative Care

January 2, 2019

An oncologist grapples with letting patients suffer when there’s an alternative

By Grace Birnstengel

For some people facing a terminal illness or the end of life, transitioning to palliative care (care given to improve quality of life for patients with life-threatening diseases) can signify quitting. They see it as surrendering to what’s ailing them and giving up the fight. But Dr. Isaac Chan, a medical oncology fellow at Johns Hopkins Hospital, wishes people would look at palliative care differently. It just might provide the blessings of time and peace, he believes.

Chan understands that holding onto every ounce of life is an expected reaction, even if it means enduring more pain and suffering for little or no payoff. In an essay published in The Washington Post, he writes about the difficulty for patients in approaching the decision to continue with treatment or pursue palliative care. He sees that struggle all the time at the hospital.

“I am watching a 68-year-old man fall apart,” Chan writes. “He has been through five different types of chemotherapies, yet his kidney cancer continues to grow and metastasize, spreading to different organs. He now sits hunched in his wheelchair. With his worsening diarrhea, and sores in his mouth, he no longer eats with pleasure. Sleeping a few hours without pain has become a luxury.”

In the patient’s eyes, chemotherapy will help him live longer, and his goal is beating the cancer. When a doctor like Chan knows that’s not realistic, he’s put in a tough spot.

Palliative Care Can Grant Time and Peace

In his empathetic and thought-provoking essay, Chan grapples with balancing having frank conversations with patients, explaining the benefits of palliative care in their situations, with the top priority: respecting a patient’s wishes.

He explains to one patient that concentrating on reducing symptoms instead of treating his cancer would provide relief. And, he adds, studies show he could live longer with palliative care instead of having more chemotherapy.

As we’ve pointed out in previous Next Avenue reporting, palliative care has proven benefits of lowered stress and depression in patients and caregivers; reduced pain and better control of other symptoms and better clinical outcomes.

Though palliative care might seem like the obvious route to doctors like Chan, they have to meet patients where they’re at.

What This Doctor Has Learned About Palliative Care

“If the patients are not ready [for palliative care], instead of feeling relief, they may experience this advice as abandonment,” Chan writes.

Chan has learned that no matter what statistics or studies say about the clear benefits of palliative care in the cases of the terminal illnesses he treats every day, that’s not always going to be appealing or meaningful to patients. You can’t always apply logic or science to things as all-consuming or deep as the end of your life.

“Sometimes what our patients need most is just more time: time to accept the terminal diagnosis and time to grieve and hopefully find peace,” notes Chan.

Though the doctor’s perspective is not the one that truly matters at the end of someone’s life, it’s interesting to hear from Chan about how he views these challenging issues where doctors are assessing not only physical needs, but emotional and spiritual ones as well.

“The biggest lesson I have learned is that our role is to support our patients so that they can have they dignity to make these difficult choices and feel empowered to make their own paths, no matter how frightening the decision may be,” Chan says.

By Grace Birnstengel

Grace Birnstengel is an editor at Next Avenue. Her work has appeared in Minneapolis-St. Paul's alt-weekly City Pages, the St. Paul Pioneer Press, Stereogum.com, The Riveter Magazine, VICE's Live Nation TV, 89.3 The Current and more. She most recently worked as an editor for a B2B magazine in New York City. She holds a degree in journalism and gender, women and sexuality studies from the University of Minnesota–Twin Cities where she was the editor-in-chief of the student magazine, The Wake. Reach her by email at gbirnstengel@nextavenue.org.

Sharing the Load: Teamwork vs. Mother Nature

December 28, 2018

At Presbyterian SeniorCare Network, being person-centered is our culture of welcoming others and embracing individuality by respecting each other’s
differences. We do this by empowering the people we serve to make choices based on their preferences, not ours.

Being person-centered is about sharing our experiences—using our backgrounds, understanding and life skills to create and nurture positive relationships with our residents and with one another.

Read this excerpt from our 2017 Community Report to find out how record breaking snow led to extraordinary teamwork – and stories that our residents and team members will be telling for years!  

It wasn’t in their job descriptions, but team members never hesitated when it came to sharing the workload of keeping residents safe and systems functioning when winter weather wreaked havoc in Erie, Pennsylvania.

Over three days in late 2017, Erie was hit with its biggest single snowstorm on record. On Christmas Day, more than 34 inches of snow had fallen and the area received an additional 24 inches the next day. By December 28, a total of more than 65 inches of snow had fallen, paralyzing the city and closing the Erie airport. The National Weather Service declared a state of emergency and State Highway Patrol issued travel restrictions.

At Manchester Commons, the Presbyterian SeniorCare Network personal care and skilled nursing community, many team members were stranded—either at work from their shift on December 26 or at home trying to get to work. One of those who made it to work was Mary Jones, lead cook on the 11:30 a.m. to 7:30 p.m. shift, which includes lunch and dinner service.

SNOW OR NO SNOW, PEOPLE NEED TO EAT

“On December 26, we had five weather-related call offs in our department,” Mary recalls. “The day cook, who was delayed, called the nighttime relief cook, who was scheduled off. He came in and got breakfast started and stayed to help do the prep work because our prep person had called off.”

Some cooks who were scheduled to work eventually made it in, but nursing and administrative staff members helped serve meals to the residents in both the skilled nursing and personal care communities. One part-time staff member worked a 10-hour shift. “It was really wonderful how everybody worked together,” Mary adds.

Among the staff helping to make meal delivery seamless despite the staff shortage was Kelly Kerr, a social worker for the skilled nursing neighborhood. She got in to work her normal day shift but saw that a lot of staff was unable to get there or leave. “The snow was so deep and so many cars were buried that the plows couldn’t even get into our parking lot,” says Kelly. “I helped serve breakfast and lunch, and other team members jumped in to do whatever needed done—transporting residents to their rooms, getting towels, refilling water pitchers, serving food.”

Nurse Manager Kathy Grable, RN, who was the lead nurse in charge on Christmas night into the next day, made sure there was no interruption in medication distribution to residents in skilled nursing. “Although we were shorthanded, all meals were served and all medications was distributed,” Kathy adds. “We tried to keep it as normal as possible for the residents.”

EVERYBODY WAS DIGGIN’ IT

Outside, Maintenance Director Paul Hart and Maintenance Tech Darrell Hunter were helping employees dig out their cars, so they could go home after their shifts, and freeing cars that were stuck on the township road leading into the parking lot. Pretty soon, the National Guard was dispatched and showed up for several hours to help with the shoveling. Even Manchester Commons Administrator John Ferritto got into the action, helping to push cars out of the parking lot. He was shown digging out from the epic snowstorm on NBC Nightly News’ nationally televised broadcast that evening. “It was people helping people, no matter their titles,” says Darrell.

One person who wasn’t worried about the snowstorm was resident Pat Brogdon, 84, an independent living resident of Manchester Commons. Her husband, Charles, 79, lives in the skilled nursing community in the same building and can get to her apartment using his electric wheelchair. “I wasn’t nervous at all,” says Pat, who was safely nestled in her apartment during the storm. “It was wonderful how everyone stepped in to help.”

BE CAREFUL WHAT YOU WISH FOR

Unfortunately, the couple’s plans for a big Christmas Day celebration with their daughters—one of whom was visiting Erie from Texas—were scuttled because of the weather. Pat and Charles had to wait until December 27 when roads were passable to meet their new granddaughter and celebrate the holiday with their daughters and their families in the Sunroom at Manchester Commons. “The kids were praying for snow on Christmas,” says Pat. “Their prayers were answered, that’s for sure!”

Longwood at Oakmont Memorial Garden Reclaims its Tranquility

December 27, 2018

Longwood at Oakmont residents care deeply about the community in which they live and are remarkably involved in life at Longwood through 40-some active volunteer-led committees. A number of those focus a keen eye on their surroundings to ensure everything stays in top shape through leading beautification projects around campus. When members of the Bench Committee noticed that one of the garden areas, The Memorial Garden, created in 1999 by residents Paul and Elizabeth Lyle, needed tending, they reached out to Paul Peterson, senior director of the campus, for help.

No one guessed that simple request for help would bloom into a wonderful partnership between Longwood residents and the Garden Club of Allegheny County (GCAC), a renowned area garden club.

Teaming Up to Create Tranquil Spaces

Paul asked resident Margot Woodwell to lead the revitalization efforts. Margot, who is also a member of the GCAC, graciously volunteered her time and set forth to reconstitute the memorial garden committee to coordinate the project. All the committee had gardening as a hobby, and some were members of the GCAC. Knowing the revitalization effort would require a special set of skills, as well as the willingness to volunteer time to the design and execution of the project, the group decided to see if the GCAC could lend their time, talent, and resources to collaborate with the committee to revitalize the Memorial Garden. When approached, the GCAC heartily accepted.

Delia Egan, president of the GCAC, explains, “Every year in May, the GCAC participates in a hands-on project in the community as part of our annual meeting. The annual project is completely voluntary and is always planned by our newest members. The need to revitalize the Memorial Garden, paired with the upcoming ‘initiation’ of the new members created the perfect community service project!”

When the Longwood residents and the GCAC first met, it was apparent that their joint passion for gardening would recreate a beautiful space at Longwood. “I had so much fun discussing what plants, shrubs and trees would be appropriate for the garden. The Committee was so enthusiastic and had great suggestions. Everyone had a hand in researching the variety of plants for consideration,” says Delia.

Photo caption: From left to right, the Memorial Garden Committee poses at the entrance of Longwood: Mernie Berger, Margot Woodwell, Alden Read, Peggy Sprowls

Digging in the Dirt!

“Gardening is a creative activity and we saw our plans come to life on planting day,” said Mernie Berger, a member of the Memorial Garden Committee. On planting day, several Longwood at Oakmont residents and 35 members of the GCAC spent almost 3 hours bringing the Memorial Garden design to fruition.

“It was so wonderful to see our GCAC members, gardening gloves and trowels in tow, ready to dig in…pun intended,” laughs Delia. After everything was complete, there was not one face without a smile; everyone was delighted with the result. It is amazing what a group of volunteers can do with a bit of enthusiasm, dedication…and dirt!

Alden Read, who has tended to the Garden since 2012, is so proud of all of the work that has been done in the Garden, she says, “The garden is a beautiful place to sit and reflect. It’s a great gathering place, perfect for events, and even a perfect place to just sit with your lunch and enjoy your surroundings.”

The Future of the Memorial Garden

“Now that the Memorial Garden is back in top shape, I hope that residents and their families will use the garden, and even consider making a contribution to help with the upkeep,” says Margot. The garden will be maintained by the landscaping company that Longwood contracts with, and the Memorial Garden Committee will be keeping a close eye on the plants, ensuring they are blooming for years to come.

Peggy Sprowls, a Master Gardner, Longwood resident, and committee member encourages residents, families and visitors to campus to stop by the garden, no matter what time of year. “The Memorial Garden has four-season interest, which means there is something blooming all year long. The garden is never static, it is always changing.”

Through the volunteer efforts of the Longwood residents and the GCAC, the Memorial Garden has reclaimed Paul and Elizabeth’s original vision: a place where residents could go to remember those who had passed. “The Memorial Garden, fittingly, has a beautifully serene atmosphere about it. I hope everyone is able to take advantage of the setting and occasionally stop and sit in the gazebo and pause to reflect on dear friends who have touched their lives but are no longer present on this earth,” says Delia.

The Personal Sacrifices Family Caregivers Make for Their Loved Ones

December 20, 2018

A recent survey shows many give up health care, money and social time
By Edie Grossfield


Part of the Transforming Life as We Age Special Report

Unpaid family members and friends who care for loved ones want to provide that care, but they sacrifice their own financial, medical and social needs to do it. This is one of the main findings from a recent survey conducted by the Associated Press-NORC Center for Public Affairs Research, with funding from The SCAN Foundation (The SCAN Foundation is a Next Avenue funder).

As part of ongoing research into public attitudes about long-term health care in the U.S., AP-NORC conducted the poll to learn more about the stresses and burdens caregivers experience as they help their disabled loved ones remain living in their homes and communities. In earlier research, AP-NORC learned that about 40 percent of Americans have experience providing long-term care to an older family member or friend.

The survey conducted in June and July polled 1,024 caregivers living throughout the U.S. and found these are some of the ways caregivers sacrifice to care for their loved ones:

  • 25 percent have cut back on their retirement savings
  • 41 percent have dipped into their personal savings
  • 25 percent spend 40 hours per week caregiving
  • 45 percent who have outside jobs use some or all of their vacation time for caregiving

The study also found that caregivers give up fun activities and time with friends and family to take care of loved ones.

“I think people don’t always appreciate how taxing, both physically and emotionally, the job of caregiver can be for individuals,” says Michelle Strollo in a video AP-NORC released with the study findings. Strollo is vice president and associate director of the health care department at NORC at the University of Chicago. “Caregivers sacrifice their many social relationships, including relationships with their spouses, other friends and family members. And that comes at a cost to them emotionally,” she says.

For Family Caregivers, An Unexpected Life Change

After taking on more responsibilities, caregivers experience multiple impacts to their lives as time goes on, says Jennifer Benz, principal research scientist and deputy director at the Associated Press-NORC Center for Public Affairs Research.

“What we know from other data regarding caregiving and long-term care is that a lot of people can find themselves in these caregiving situations very quickly, sort of going from 0 to 60 to becoming a caregiver,” Benz says, adding that once the caregiving starts, it usually extends from short-term to long-term. “And then you have caregivers thinking, ‘Well, I’ll stay up late tonight to help,’ or ‘I’ll get up early tomorrow’ or ‘I’ll put this bill aside this month.’ But as you become a caregiver over an extended period of time, that type of activity just isn’t sustainable.”

Forgoing Health Care to Provide Care

With the added stress of caring for another, especially if you have a full-time job and other responsibilities, your own health can begin to suffer. About one-third of the survey respondents said they have gone without dental care or a routine physical exam, skipped or failed to schedule a medical test or treatment, haven’t gone to the doctor when they were sick or injured or forgot to fill their own prescription.

Thirty-nine percent of respondents indicated they have some kind of physical or mental health condition that impacts their daily lives. And, among those with chronic health conditions, 40 percent said their caregiving role makes it difficult to manage their own health.

Another finding of concern, Benz says, is that just barely half of the people polled indicated they have a plan in place for the people they’re caring for should something happen to the caregivers.

The research also shows that many caregivers don’t discuss these issues with their doctors, even as they make sure their loved ones’ medical needs are met. “Only a quarter of the caregivers have talked to their own doctors about their caregiving responsibilities and how that’s impacting their lives,” Benz says. “So, that certainly seems like an opportunity to have caregivers speak with professionals and at least start the discussion of how they can find support.”

The Financial Impact

In addition to many hours spent caring for loved ones, eight in 10 caregivers pay for expenses associated with that care, and many of them earn modest or low incomes, according to the research findings. The majority of the survey respondents earn less than $50,000 annually and more than 10 percent spend over $500 per month on caregiving costs. About two in 10 took on debt to cover these expenses.

“That can be a pretty significant burden,” Benz says. “To do that, we see there are trade-offs for the caregiver, in terms of having to reduce savings for their own retirement accounts and things like that.”

How Can These Findings Help?

Results of the survey can serve as a needs assessment of caregivers to inform communities, leaders and policymakers as they take stock of what services they have available and what they need. Communities differ widely in care services, which can include home care, transportation, meals, adult day care, information and referrals, case management, legal and financial counseling and support groups.

Family members and friends play an integral role in caring for our nation’s older population, as Dr. Donna Benton, research associate professor of gerontology at the University of Southern California, emphasizes in the AP-NORC video: “Caregivers are the backbone of our long-term care system. If we didn’t have family caregivers with unpaid help, our health care system would pretty much collapse.”

And the recent AP-NORC survey shows these caregivers need more help, Benz adds. “The results indicate that these caregivers are very invested in providing care to their loved ones, but they have a lot of needs themselves. So, I think the research begs the question — who’s providing support for the caregivers?”

 

By Edie Grossfield

Edie has been a journalist for more than 20 years, reporting and editing for newspapers and magazines. She also worked in communications for a large health care organization. She holds a bachelor’s degree in communications and media and a master’s degree in journalism, both from the University of Wisconsin in Madison. Reach her by email at egrossfield@nextavenue.org.

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From Military Service to Civilian Life: Team Member Volunteers to Help

December 20, 2018

When the clock strikes 4:30 p.m. and Katie Guardino leaves her job as a social worker at The Willows, the skilled nursing community at our Oakmont campus, her dedication to being “person-centered” doesn’t end when her day is over. Katie volunteers her time with the organization Operation Strong Mind, which assists veterans, current service members, and families, with transitions from military service to civilian life.

Operation Strong Mind, based in Etna, is a non-profit organization created by (Ret.) Colonel Thomas Stokes, who served as a social worker in the U.S. Army Reserve, and continues to practice as a civilian. The mission of Operation Strong Mind is to take on the challenges faced by veterans and members of today’s
military community once they return home.

Katie and (Ret.) Colonel Stokes met at a local VFW and bonded over their love of social work. From there, she became part of his team and was trained to advocate for and assist those seeking guidance with behavioral concerns. "You may be surprised to hear this, but deploying is actually the easy part. It’s when a
service member gets back to civilian life that it gets tricky," says (Ret.) Colonel Stokes. “They lose their mission, their language [military lingo], diversity and the challenge of being deployed. Life is very different here, than it is abroad. So, to help them get back ‘in the fight,’ we take a look at the whole person and provide a holistic approach to meet them where they are, to help them through whatever it is they are going through. We don’t just look at mental health,
we look at everything.”

Katie (L), with (Ret.) Colonel Thomas Stokes and volunteer Kim Falk at Ross Township Community Day. 

Operation Strong Mind has a very “person-centered philosophy,” much like Presbyterian SeniorCare Network, which is why Katie fits right in! “My background is in socialwork—I just love to help people. Volunteering with Operation Strong Mind has given me the opportunity to use my social work skills in a different way than I do at Presbyterian SeniorCare Network.”

As (Ret.) Colonel Stokes says, “you do not need to be a veteran to talk to a veteran, and Katie has an open mind, is flexible and determined to help others.” Katie wears many hats at Operation Strong Mind. In addition to performing some counseling duties, she serves as the Secretary on their Board of Directors, as well as assists in many marketing efforts including attending local events to raise awareness of the services of Operation Strong Mind, as well as posting updates on social media and maintaining the organization’s website.

When asked why volunteering is important, Katie says, “Volunteering is good for the soul and gives me a sense of purpose. I like to feel useful and I am
passionate about what I am able to contribute to Operation Strong Mind." 

Stand Up to ‘Sitting Disease’

December 18, 2018

Adding movement to your day can boost your health and prevent disease
By Lisa Fields

Not long ago, when I interviewed one of the leading experts on “sitting disease” — the buzzy catch phrase that’s been attached to physical inactivity for the past few years — he walked in place on his treadmill desk while we chatted by phone. The irony wasn’t lost on me: I was sitting idly at my desk while writing an article about the health problems associated with sitting idly at desks. Meanwhile, the expert in the know was staying active, even though he had a desk job.

I recently added a treadmill desk to my office, which I fashioned myself out of a regular treadmill and some supplies from the hardware store. It’s empowering to work while walking at 1.6 miles per hour, knowing that I’m taking care of my health.

Why Sitting Has Become More Routine

Unless you make an effort to get moving, it can be easy to fall into a physically inactive lifestyle. You can accomplish some of the same tasks from a seated position today that required walking just a few years ago: Think online shopping and drive-through everything. And with the widespread popularity of screen time, you’re likely allured into a seated position by your smartphone, laptop or TV for several hours daily. Between your desk job, commute, meals and nightly leisure time on the couch, you probably sit for the bulk of your day.

Unfortunately, an inactive lifestyle can be detrimental to your health. Prolonged sitting is linked to a host of health problems, including heart disease, diabetes, obesity, high blood pressure and cancer.

Luckily, research shows that there are simple ways to combat chronic physical inactivity, but it requires consistent effort; your morning walk won’t help to counteract the effects of a full day of sitting. Finding ways to add more movement all day long is key.

“Moving more frequently throughout the day, even at lower intensities and for shorter duration, has a positive impact on health markers and is just as important as regular exercise,” says Lauren Shroyer, director of product development for the American Council on Exercise.

Sneak Movement Into Your Lifestyle

Think about your daily schedule, then figure out ways to be more active.

“The default in America is to end up on your bottom,” says Dr. James Levine, author of Get Up! Why Your Chair is Killing You and What You Can Do About It and president of Fondation IPSEN, a Paris-based nonprofit medical research foundation. “I want the default to be up and doing something.”

The last time that I spoke with Levine — who is also the former director of obesity solutions for the Mayo Clinic — he was walking on his treadmill desk. Now he says that people can inspire themselves to be more active by mapping out a weekly plan, scheduling one appealing activity each day: Window-shopping downtown, volunteering at the library, wandering the aisles at Walmart or spending the afternoon with grandkids.

“The trick is absolutely to find the stuff that you want to do,” Levine says. “There’s no point in going to weight training if you hate going.”

Get Up Often

The problem with sitting is that once you park yourself at your desk or on the couch, you’re likely to stay seated for hours. But regularly shifting from sitting to standing helps to improve your health and preserve your long-term mobility.

“Losing mobility is probably the Number One cause of all the deteriorating we see with aging,” says Joan Vernikos, author of Sitting Kills, Moving Heals: How Everyday Movement Will Prevent Pain, Illness, and Early Death – and Exercise Alone Won’t, and former director of NASA’s life sciences division. “The most basic motion that you can do is structure your life so you have to change your posture often.”

For this reason, Vernikos advocates standing often, whether you place your water bottle just out of reach to encourage movement or train yourself to get up when commercials come on TV. Her research found that standing for one to two minutes every 20 to 30 minutes helps prevent deterioration caused by physical inactivity.

“Your body needs this on-off stimulation of changing posture,” Vernikos says.

Standing from a seated position seems like the simplest of skills, but as people get older, the inability to do this prevents some from being able to use the bathroom independently, which makes them more likely to end up in a nursing home or assisted-living facility, Vernikos says.

Be More Active at Work and Home

There are ways to counteract the inclination to stay seated all day.

“Most modern companies are offering some variant of active work: Walk-and-talk meetings, active lunchtime programs, walking clubs, running clubs, treadmill desks and standing desks,” Levine says. “There’s a whole range of active work opportunities, many of which cost nothing.”

If you’re retired, you don’t have to sit at home all day, even when you have no plans.

“Pacing the room while on the phone, using your standing work station or putting your laptop on the kitchen counter for 15 minutes are additional ways to work in more muscle activity throughout the day,” Shroyer says.

Do Things the Old-Fashioned Way

Just because there are modern conveniences doesn’t mean you have to use them constantly. Try doing activities the way you would have done them decades ago: Walk into your co-worker’s office to share an idea instead of emailing him. Visit the teller at the bank instead of frequenting the drive-through. Order something online, then pick it up at the store instead of having it shipped to you.

“If you want to improve or restore your mobility, be aware of what you’re not doing that you used to do,” Vernikos says. “Every time you go through the drive-through, you are aging yourself. Even getting out of your car and walking two steps to pick up your drugs at the pharmacy is something.”

By Lisa Fields

Lisa Fields is a writer who covers psychology and health matters as they relate to the workplace. She publishes frequently in WebMD and Reader’s Digest.

 

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