• May 30, 2017 /  Miscelleaneous

    How Seniors Can Get Better Sleep
    As we age we often experience normal changes in our sleeping patterns, such as becoming sleepy earlier, waking up earlier, or enjoying less deep sleep. However, disturbed sleep, waking up tired every day, and other symptoms of insomnia are not a normal part of aging. Sleep is just as important to our physical and emotional health as it was when we were younger.

    In fact, a good night’s sleep is especially important to older adults because it helps improve concentration and memory formation, allows your body to repair any cell damage that occurred during the day, and refreshes your immune system, which in turn helps to prevent disease. If you’re struggling in this area, but are unsure of what to do, here’s some advice to help you cope.

    Identify the Underlying Problems

    Many cases of insomnia are caused by underlying but very treatable causes.  By identifying all possible causes, you can tailor treatment accordingly. These are some common issues:

    • Poor sleep habits and sleep environment.These include irregular sleep hours, consumption of alcohol before bedtime, and falling asleep with the TV on. Make sure your room is comfortable, dark and quiet, and your bedtime rituals conducive to sleep.
    • Pain or medical conditions.Health conditions such as a frequent need to urinate, pain, arthritis, asthma, diabetes, osteoporosis, nighttime heartburn, and Alzheimer’s can interfere with sleep. Talk to your doctor to address these issues directly.
    • Menopause and post menopause. During menopause, many women find that hot flashes and night sweats can interrupt sleep. Even post menopause, sleep problems can continue. Improving your daytime habits, especially diet and exercise, can help.
    • Older adults tend to take more medications than younger people and the combination of drugs, as well as their side effects, can impair sleep. Your doctor may be able to make changes to your medications to improve sleep. Never make these changes on your own, however.
    • Lack of exercise.If you are too sedentary, you may never feel sleepy or feel sleepy all the time. Regular aerobic exercise during the day can promote good sleep.
    • Significant life changes like the death of a loved one or moving from a family home can cause stress. Nothing improves your mood better than finding someone you can talk to face-to-face.
    • Lack of social engagement.Social activities, family, and work can keep your activity level up and prepare your body for a good night’s sleep. If you’re retired, try volunteering, joining a seniors’ group, or taking an adult education class.
    • Sleep disorders.Restless Legs Syndrome (RLS) and sleep-disordered breathing—such as snoring and sleep apnea – occur more frequently in older adults.
    • Lack of sunlight. Bright sunlight helps regulate melatonin and your sleep-wake cycles. Try to get at least two hours of sunlight a day. Keep shades open during the day or use a light therapy box, which are usually fairly inexpensive.

    How to Encourage Better Sleep

    • Naturally boost your melatonin levels.Artificial lights at night can suppress your body’s production of melatonin, the hormone that makes you sleepy. Use low-wattage bulbs where safe to do so, and turn off the TV and computer at least one hour before bed.
    • Don’t read from a backlit device at night (such as an iPad).If you use a portable electronic device to read, use an eReader that is not backlit, i.e. one that requires an additional light source. And when possible, a good old-fashioned book is the best way to read!
    • Make sure your bedroom is quiet, dark, and cool,and your bed is comfortable. Noise, light, and heat can cause sleep problems. Try using a sleep mask to help block out light.
    • Move bedroom clocks out of view.The light can disrupt your sleep and anxiously watching the minutes tick by is a surefire recipe for insomnia.

    Improve Sleep Through Exercise

    Exercise—especially aerobic activity—releases chemicals in your body that promote more restful sleep.

    There are countless activities you can do to prepare yourself for a good night’s sleep at the end of the day. But always consult your doctor before embarking on any new fitness program!

    • Water exercises– Swimming laps is a gentle way to build up fitness and is great for sore joints or weak muscles. Many community and YMCA pools have swim programs just for older adults, as well as water-based exercise classes.
    • Dance– If you love to move to music, go dancing or take a dance class. Dance classes are also a great way to extend your social network.
    • Golf– Golf is another exercise that doesn’t require vigorous movement. Walking adds an aerobic bonus and spending time on the course with friends can improve your mood, not to mention the melatonin boost from the sunlight.
    • Cycle or run– If you are in good shape, you can run and cycle until late in life. Both can be done outdoors or on a stationary bike or treadmill.

    If your own attempts to solve your sleep problems are unsuccessful, talk to your doctor. Keep a sleep diary and bring it with you. Write down when you use alcohol, caffeine, and nicotine, and keep track of your medications, exercise, lifestyle changes, and recent stresses. Your doctor may then refer you to a sleep specialist or cognitive behavioral therapist for further treatment. You can get better sleep by taking control and being aware of what your body and mind need!

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  • September 26, 2013 /  Dementia

    Urinary Tract Infections and DisorientationUrinary tract infections (UTI) can cause serious health problems. A urinary tract infection is caused when bacteria in the bladder or kidney multiplies in the urine. Left untreated, a urinary tract infection can lead to acute or chronic kidney infections, which could permanently damage the kidneys and even lead to kidney failure. UTIs are also a leading cause of sepsis, a potentially life-threatening infection of the bloodstream.

    According to the National Institutes of Health (NIH), the population most likely to experience UTIs is the elderly. Elderly people are more vulnerable to UTIs for many reasons, including their overall susceptibility to infections due to the suppressed immune system that comes with age and certain age-related conditions.

    The normal symptoms of UTI’s are urine that appears cloudy or bloody, a strong or foul smelling odor, the frequent need to urinate, painful urination, or low grade fever. A UTI in the elderly can be mistaken for disorientation, confusion, a delirium like state, agitation, or hallucinations.

    I have found that there is a high likelihood that if these symptoms develop suddenly that there may be a UTI involved. I also look for a UTI to develop if there has been a recent surgery, especially on the hips.

    This was true of a case I took on where my client had been declared by the attending doctor to be without capacity, had lost her appetite and the staff was recommending palliative care. I spoke with a couple of people who knew her for a long time and noted that she seemed to have lost her memory and reasoning functions rather rapidly. She had just had a major surgery (hip), and been in a skilled nursing community for a month. As her newly appointed agent for her medical power of attorney, I asked for her records and determined that they had not completed a urine test on her so I ordered one. The next day they reported she had a bladder infection (part of the UTI) and put her on antibiotics. After a full week of medication the UTI was gone and she had significantly recovered memory and reasoning abilities. The doctor completed a reassessment (he used the mini-mental exam) and she passed thus “regaining” capacity.

    Not everything is this easy nor do I always have such a wonderful outcome but it is worth evaluating the patient/family member/friend starting with the simplest things (UTI and/or major surgery) before going to the more complicated treatments.

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  • May 3, 2013 /  Basics
    water for the caregiverWhat you know is that water is the basic component of life. What you may not know is that it is also one of the basic “tools” for your care kit. Here are some benefits to drinking more water during these times of giving care:
    1. It helps relieve stress. This is a common word of instruction from many who help others through times of stress like the Placer County Law Enforcement Chaplaincy. If you want to read more from a medical perspective go to

    2. It helps get rid of the toxins in your system. There is a lot of information on the internet regarding toxins not only from stress but also our environment.
    3. It may give you more energy especially for the afternoon. I find that when I am drinking water I am less tired in the afternoon (if I have been consistent in drinking water throughout the day). Of course, if I have been running ragged a glass of water (I like the small ones as I’m not much of a water drinker but can handle it in small doses) and a nap always cure my afternoon slump.
    When do you know when it’s time for water? Signs of dehydration (lack or low level of water) are thirst (I know this seems silly to say but how often are you running around doing chores while you are thirsty but keep on running around without stopping for a drink of water and a small bit of rest?) and if your pee is a dark or pungent.
    How much should you drink? The Mayo clinic states that it depends on your body but a general rule would be 13 cups for men or 9 for women. That’s a lot of water! They also say the 8 glasses of 8 ounces a day also works although that is less than their initial recommendation. Check out what they say on this site: http://www.mayoclinic.com/health/water/NU00283
    4. The final benefit is that you’ll get more exercise. How did I figure that? Easy, the more liquid I intake, the more liquid I need to get rid of which means I need to get out of my chair more often. Don’t underestimate that form of exercise!
    Until next time have some water!

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  • April 18, 2013 /  Basics

    respite care basics

    The following information comes directly from HelpGuide.org.

    It is difficult caring for an elderly, chronically ill, or disabled family member in addition to living daily life. It is a demanding job and very few, if anyone, are equipped or trained to do it alone. Respite care provides short-term breaks that can relieve stress, restore energy, and promote balance in your life. Even if working with family members is difficult, there are many other respite care options available to support you and your loved one.

    Respite care basics

    Seeking support and maintaining your own health are key to managing your role as a caregiver. Using respite care before you become exhausted, isolated, or overwhelmed is ideal, but just anticipating regular relief can become a lifesaver.

    Respite care can take many forms, but boils down to two basic ideas: sharing the responsibility for caregiving and getting support for yourself. Finding the right balance requires persistence, patience, and preparation.

    Planning your relief

    Planning starts with analyzing needs, both yours and your loved ones. Assessing your needs for the type, skills, frequency, and location of respite services is critical to ensure you receive appropriate respite. As a caregiver, is support what you need most? Or is it some regular free time? Or maybe help with transportation? Keep track of your daily activities and then make a list of the areas and times when you most need help.

    Identifying your loved one’s requirements, abilities, and preferences will also help you find the right match. Are social activities primary? Do they require assistance with walking, eating or medications? Do they need mental stimulation? Or exercise? Answering these questions will help you determine which respite options to pursue.

    Learn more about an organization called Helpguide.org started by Robert and Jeanne Segal. It is a non-profit site dedicated to helping the caregiver.

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