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Archive for category: Seniors Health

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Put On Your Own Oxygen Mask First

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

In celebration of National Caregivers Month we wanted to re-share one of our popular caregiving posts:

If you have ever traveled by air you are familiar with the drill. Instructions on how to buckle and unbuckle your seatbelt, where the life vest is located, emergency exits, and “should cabin pressure change, an oxygen mask will fall from the overhead compartment…passengers should always put on his or her own mask before assisting children, or a disabled passenger”.

I read a mommy blog the other day that called this the “airplane example” and the writer related this to how moms should approach motherhood. Ultimately the message is this: as a mom, put your own health first because you are useless to your kids and spouse if you ignore your own needs. Really, you can’t help a child with an emergency escape from a crashing plane if you pass out helping them with their mask.

While I do agree that mothers (and fathers for that matter) need to consider their own needs in providing for the family, this is also true of people that provide care to a disabled person. My experience is that often caregivers do not really “elect” that role. They are not trained to be a caregiver, and really just try to do their best with the skills and resources they possess. However, where many fall short is maintaining their own health and well-being in dedicating their physical and emotional time to another person: a person with challenging and multiple needs. The job of a caregiver is often 24 hours, and resources don’t often permit, nor does the government provide, sufficient relief from this responsibility. Caregivers are often sleep deprived, suffer from muscle and joint pain in fulfilling their role, and can become isolated and depressed due to the changes they have made to take on these new responsibilities. Sound familiar? This very closely mimics motherhood (especially for new moms).

The answer? Put on your own oxygen mask first. What can you do to breathe easier? What helps you to feel clear-headed, energetic and optimistic? What gives you that ability to stay positive, appreciate and take on your responsibilities with some enthusiasm? The answers are often different for all of us. In the end, figuring out how to wear your oxygen mask first requires you to be honest about your abilities and skills, to utilize the resources available, and to ultimately ask for help if this is needed.

And for us health care professionals? We need to be very careful of the responsibilities we place on caregivers. This is especially true in the medical community where we repeatedly discharge people into the care of family, without family really knowing what the responsibilities will entail. As health care providers our responsibility is always to the client, yet we need to take that extra time to check in with the caregiver, talk about how they are coping and managing and if needed, offer them an oxygen mask.

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Kitchen Safety – Hidden Hazards

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

I think I spend about three hours a day in my kitchen. Just when I get a meal or snack prepared, served and cleaned-up, it seems to be time to eat again. I guess that is the norm for busy families that are constantly on the go.

Yet, while the kitchen is one of the most lived-in rooms in the house, there are many hazards here that are often overlooked. These hazards can result in illness or injury if not addressed. For example, did you know that the dish cloth or sponge is the most dangerous item in your kitchen? That a child’s shirt can catch on fire while stirring something on a gas stove? That there are all sorts of bacteria (including fecal matter) on the rinds of lemons and limes (but we squeeze these and throw them in our drink!).

My blog today is going to highlight some of the under-estimated hazards in the kitchen, including:

1. Dirty Dish Sponges: Did you know that a dirty dish sponge can harbour and spread disease-causing bacteria? A study completed at the University of Arizona detected salmonella in 15% of sponges that were examined. As we age, it becomes more difficult for our bodies to fight off disease, making it important to be aware of how bacteria spreads and how to prevent it. A simple way to get rid of bacteria on sponges is to wet the sponge and zap it in the microwave for about one minute. Or for dish cloths, rotate and wash these regularly using bleach if available.

2. Cross-contamination of food: Ensure to thoroughly wash your hands, surfaces, and utensils after handling meat, poultry, or seafood to avoid spreading bacteria. Keep two cutting boards – one for meat products, and one for other food items. Purchasing cutting boards in different colours or labelling them can make it easier to discriminate between the two. Considering putting your cutting boards in the dishwasher after use to increase sanitation.

3. Spoiled Food and Storing Leftovers: Never leave raw meat, poultry, seafood or leftovers on the counter for longer than two hours. If defrosting food, defrost in the refrigerator or immerse in cold water. When storing food in the fridge, the temperature should be set to 4° C (40°F) or lower and your freezer at -18°C (0° F) or lower to avoid growth of bacteria. Ensure to keep meat, poultry, and seafood in sealed bags separate from the rest of your food items. The best place for these items is on the bottom shelf, so that juices can’t drip onto other food. If you are storing leftovers, use labels to record when each product was prepared. General guidelines for storing items in the fridge are as follows:

• Bacon: 1 week
• Lunch meat: 3-5 days
• Fresh beef, veal, lamb, and pork: 3-5 days
• Cooked meat, poultry, pizza, stews: 3-4 days
• Fresh poultry, ground meats, or raw sausage: 1-2 days

Go through your fridge weekly to throw out anything outdated or questionable. Always remember – when in doubt, throw it out!

4. Forgetting to Turn-off the Oven or Stovetop: This is extremely dangerous and can lead to fires or burns. To avoid this, stay close to anything cooking and use a timer or alarm. If you worry about forgetting to turn things off, consider using a visual checklist to remind you to check the stove. Place this at the exit to your kitchen, or post it at the door you use to leave your home. If you must leave the kitchen area while cooking for any reason (e.g. to answer the phone or the door), wear an oven mitt or carry a kitchen utensil with you to serve as a visual reminder to return to the kitchen as soon as you can. If using the oven, always wear long sleeved oven mitts to avoid burns. Alternatively, slow cookers are an easy and safe substitute to using the stovetop when preparing meals.

5. Supervise Children. Getting children involved in cooking and baking is a great way to increase their willingness to try new foods, and teaches them valuable life skills. But as with all things involving children, close supervision is mandatory. A child standing on a stool to stir something on the stove can lose their balance falling onto the burners and loose clothing can catch on fire. All knives (dull, sharp, large or small) can be difficult for children’s coordination, and small hands may have a hard time lifting heavier and hot baking pans. Even using a knife to get a piece of toast from a plugged in toaster is dangerous. So, supervise children in the kitchen and teach them the safe and proper way to prepare food and work around kitchen tools and appliances.

Although this is not an exhaustive list of kitchen safety hazards, the above are some of the most common and the easiest to avoid. Of course, there are other kitchen safety hazards that are created when people have physical, cognitive, emotional or behavioral disabilities. But the good news is there are many aids, devices and strategies that can help people to improve their independence and safety during meal tasks. Consider consulting an occupational therapist for suggestions on ways to be successful in the kitchen.

References:
1) http://www.chow.com/food-news/54707/10-kitchen-hazards/
2) http://healthycanadians.gc.ca/eating-nutrition/safety-salubrite/safety_home-maison_salubrite-eng.php#Refridgerator
3) http://www.foodsafety.gov/keep/charts/storagetimes.html

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Community Safety for Alzheimer’s Disease and Cognitive Impairment

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

In recognition of World Alzheimer’s Day, I wanted to touch on the important topic of helping people with Alzheimer’s disease (or cognitive impairment) to be safe in the community.

A few months back I received an email from a friend. She wanted to “pick my brain” about a problem they were encountering with her father who has Alzheimer’s disease. She mentioned that he enjoys spending time in the community on his own, but the family was growing increasingly concerned about his safety. She was wondering if I had any suggestions on how they could monitor his community activities, and be able to locate him should he not return home when expected.

My experience working in brain injury has had me looking for such solutions in the past. Some people, with behavioral or cognitive impairment, are at risk in the community because they become disoriented, confused, lose track of time, or are not attentive to traffic. There is such a loss of independence for people to be told they cannot leave the home alone, and some become agitated or angry when people try to supervise their activities. Yet, even a familiar route can become a problem for people if their cognitive status changes or deteriorates, and what is manageable one day may become problematic the next. Part of my role as an occupational therapist when dealing with cognitive impairment is to problem solve with the client and family the ways we can help them to pursue their goal of independence outside the home, while also ensuring their safety and easing the mind of the care provider. There are several ways to do this, and the list below is not exhaustive by any means.

1. Consider the local Police Departments. These often have programs and ways to track people at risk of wandering. It is also helpful to notify the police about a potential wanderer so this is in their records should their help be needed.

2. The S-911 bracelet has multiple features that allows health care workers and families to GPS locate anyone that may have wandered off, or who is in the community unsupervised. There is a monthly and yearly fee for this device.

3. The Loc8tor is another option and notifies a care giver (or parent of a child for that matter) if the person wearing the device has wandered up to a certain distance away. The Loc8tor is also useful for helping people to find those items that tend to get misplaced – such as keys, wallets and cell phones.

4. Smartphones have GPS detection capabilities such as the “Find my Friends” application for the iPhone. With this, both users can locate the other person, but it does require the person to be carrying the phone, and the phone to be charged and on. This can be a problem for people with cognitive impairment as they may not always remember to take the phone with them when out, may not understand how to turn this on and / or to check and see if it is charged.

5. There are home monitoring systems that can notify family when people are coming or going, or even bed alarms if people leave the bed at night. Motion sensors in the home can also help to notify family if someone is wandering or moving between locations indoors. While these don’t work to locate or ensure someone’s safety outside the home, they are a way to give family members piece of mind to go about business inside the home without always needing to provide the person with cognitive impairment constant supervision.

Remember that Occupational Therapy is about helping people to solve the problems that arise when physical, emotional or cognitive abilities change rendering daily activities to become a struggle. In all cases, because disability is experienced differently by everyone, the solution for one person may not be the solution for another – even when dealing with the same diagnosis. So, consult an OT if you have a functional problem to solve!

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Cheer Up the Lonely Day

Tomorrow, July 11th, is “cheer up the lonely day.” A day to contact those you’ve lost touch with, reach out to someone who is suffering, or give your time to help a complete stranger in need. Many seniors in the community, whether in their own homes or long-term care facilities, are often in need of company and companionship and many local programs help facilitate phone calls or visits for those in need. Big Brothers and Big Sisters associations help to pair disadvantaged children with a caring adult. It has long been known that volunteering is good for your mental health, but recent studies show that giving of yourself is actually beneficial to your physical health and could possibly add years to your life. Check out the following from CTV news and on this “cheer up the lonely day” think of volunteering, reaching out, or helping someone in need.

CTV News:  Volunteering Could Add Years To Your Life

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Use Fats to Feed Both a Growing and Aging Brain

The following from Dr. Sears discusses the importance of proper nutrition to fuel the body, and most importantly the brain. Dr. Sears states “…there are two windows of time in which the brain is especially sensitive to nutrition: the first two years of life for a growing baby and the last couple decades of life for a senior citizen.” The article discusses the best ways to provide this nutrition is through the incorporation DHA and Omega 3 fats. Read this great article here to get the facts on the fats you need for proper brain development and optimal brain function!

Ask Dr. Sears:  Omega-3 and DHA as Brain Food

 

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Say “Bonjour” to a Healthier Mind

Bonjour… Hola…Konnichiwa…Say hello to a great way to boost brain power and help slow the process of aging for your brain. The following from New Scientist discusses recent findings which show that learning a second language may be one of the best ways to help keep your brain fit and strong, and bid adieu to memory loss in the latter years of life.

New Scientist: Learn a second language to slow ageing brain’s decline

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Brain Injury Awareness – The Caregiver

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

We cannot (or should not) discuss brain injury awareness without spending time recognizing the family and friends that take on the caregiving role after someone they love has an injury of this nature. On June 9 I co-facilitated a workshop for caregivers of brain injury survivors. What a great event! Not only was this well attended, but the speakers provided an amazing amount of education, skills and insight into how to both cope, manage, and achieve success as the care provider of someone with a brain injury. I wanted to take a moment to highlight my personal takeaways from this event:

Everyone has a story. As someone who lost a brother-in-law to the effects of a catastrophic brain injury, I understand how telling our story – be it about loss, change, remorse, guilt, fear, or triumph can bring people together and has immense therapeutic benefit. Caregivers benefit from collaborating, talking, sharing, laughing, crying and growing together. Our health system needs to create these opportunities, or caregivers need to find ways to make this happen.

Grieve. In my undergrad I studied grief and loss and even worked in hospice. What I realized at our workshop, however, is that the permanence of death allows people to grieve their loss, achieve acceptance, and eventually move on. When dealing with survival from a traumatic event, however, grief is not always experienced as our loved one is still present, albeit different. Yet, our speakers emphasized the importance of grieving: the life that once was, the life that may never be, and the changes and adjustments that have occurred. Caregivers need to let this grief process happen, or should seek support from a trained professional to experience this important emotion.

Find a new normal. Clients, caregivers, and health care professionals need to always consider that the old “normal” may never return. In that case, we all need to collaboratively look ahead to creating a “new normal”. Different does not always have to be bad, and it requires an open and optimistic mind to think that way. For OT’s that means taking the abilities of the individual, considering their resources, and helping them to create that new life of function, fulfillment, meaning and productivity.

Put on your own oxygen mask first. We spoke extensively about the importance of caregivers taking the time to attend to their own personal needs, to have positive coping mechanisms and sources of support. Then, at break I was speaking with a man whose wife suffered a brain injury. He talked about the “airplane analogy” and how this applies to caregivers – put on your own mask before helping another. I smiled and told him that I wrote a blog on that exact topic, with that exact title last year. As he found that analogy practical and helpful, I thought I would share the contents of that previous blog here, to highlight this important third point:

Posted September 25, 2013

If you have ever travelled by air you are familiar with the drill. Instructions on how to buckle and unbuckle your seatbelt, where the life vest is located, emergency exits, and “should cabin pressure change, an oxygen mask will fall from the overhead compartment…passengers should always put on his or her own mask before assisting children, or a disabled passenger”.

I read a mommy blog the other day that called this the “airplane example” and the writer related this to how moms should approach motherhood. Ultimately the message is this: as a mom, put your own health first because you are useless to your kids and spouse if you ignore your own needs. Really, you can’t help a child with an emergency escape from a crashing plane if you pass out helping them with their mask.

While I do agree that mothers (and fathers for that matter) need to consider their own needs in providing for the family, this is also true of people that provide care to a disabled person. My experience is that often caregivers do not really “elect” that role. They are not trained to be a caregiver, and really just try to do their best with the skills and resources they possess. However, where many fall short is maintaining their own health and wellbeing in dedicating their physical and emotional time to another person: a person with challenging and multiple needs. The job of a caregiver is often 24 hours, and resources don’t often permit, nor does the government provide, sufficient relief from this responsibility. Caregivers are often sleep deprived, suffer from muscle and joint pain in fulfilling their role, and can become isolated and depressed due to the changes they have made to take on these new responsibilities. Sound familiar? This very closely mimics motherhood (especially for new moms).

The answer? Put on your own oxygen mask first. What can you do to breathe easier? What helps you to feel clear-headed, energetic and optimistic? What gives you that ability to stay positive, appreciate and take on your responsibilities with some enthusiasm? The answers are often different for all of us. In the end, figuring out how to wear your oxygen mask first requires you to be honest about your abilities and skills, to utilize the resources available, and to ultimately ask for help if this is needed.

And for us health care professionals? We need to be very careful of the responsibilities we place on caregivers. This is especially true in the medical community where we repeatedly discharge people into the care of family, without family really knowing what the responsibilities will entail. As health care providers our responsibility is always to the client, yet we need to take that extra time to check in with the caregiver, talk about how they are coping and managing and if needed, offer them an oxygen mask.

I hope the caregivers that attended our workshop felt that by spending a day focusing on themselves, expanding their knowledge, and learning the keys to success, that this was one step towards them being able to put their own mask on first. This was highlighted at the end of the day when the caregiver of a survivor, whose loved one was injured 13 years ago gave this advice: “If I could do it again, my priorities would be self, family, then my loved one with a brain injury”. What a great lesson for me to take forward in my practice.

For more posts related to brain injury please visit our Brain Health Archive.

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Give Your Mind a Check Up

Whether you think your memory is failing you, or other people are telling you so, or you just like brain games, the following “test” created by Baycrest Health Sciences provides an easy way for a quick “check up” on your memory functions. Of course, the results are not a medical diagnosis, but see how you score and if you are concerned, speak with a health professional.

Canada News Wire:  Baycrest memory experts launch ‘thermometer’ for the mind

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P is for Prevention

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

In recognition of Brain Injury Awareness month, I thought it would be fitting to start at the very beginning. PREVENTION. Really, it is the best medicine. For now, let’s forget about the symptoms of brain injury and its’ impact on work, home, school, and quality of life. Let’s not talk about how it is assessed and treated. Instead, let’s focus on trying to stop it from happening in the first place.

But even before that, we need to know what we are dealing with. It is well known that brain Injury is the leading cause of death and disability worldwide. In Canada, Traumatic Brain Injury (TBI) is more common than breast cancer, spinal cord injury, HIV/AIDS, and multiple sclerosis (MS) combined. There are approximately 18,000 TBI hospitalizations annually. In the province of Ontario, 25% of the two million people diagnosed with a neurological condition have suffered from a TBI. In 2000-2001 brain injuries accounted for $151.7-million in direct costs to Canadians (1).

By way of distribution, TBI is most common in children (0-19) at 30%, followed by seniors (60+) at 29%. In kids, falls are the most common cause followed by motor vehicle accidents and then sports. In adults, motor vehicle accidents cause the most TBI’s, and in seniors the causes include falls (76%) followed by car accidents (2).

Knowing the causes helps to look at how we can engage in preventative strategies. As an occupational therapist with a background in health promotion, a parent of four, and athlete, here are my thoughts:

Falls

Kids fall all the time, so how can we prevent that? Well, there is a difference between a child falling when walking, running or jumping, versus falling from, say, a shopping cart, off of a playground structure, or from a tree they tried to climb. Falls from bikes, skateboards and scooters are going to happen – and a helmet can mean the difference between a head injury and not. The bottom line is that falls in kids are best prevented by proper adult supervision. Yes, it is that simple.

In seniors, falls take on a different form. They are not from carefree or reckless behavior, but often happen when someone is just trying to go about their day by having a shower, coming down the stairs, or taking a leisurely walk. Seniors need to be attuned to the physical, balance and vision changes they are experiencing as they age, and need to consider the importance of anti-slip mats in the bathroom, removing scatter mats, installing grab bars or railings, and the benefits of a walking stick or cane when outdoors. Seniors need to engage in regular exercise and activity to maintain bone density, mobility and intact balance. They have to be very careful when living with pets or when trying to negotiate places that are cluttered or dark. Awareness of declining abilities is the first key to addressing these properly such that a prevention plan can be developed that will ultimately improve safety and reduce the risks. Note that the services of an occupational therapist can be pivotal in creating this safety plan.

Motor Vehicle Accidents

Like falls, despite our best intentions, these can and do happen. The issue here is trying to minimize the risk and optimize the outcome. Safe drivers are attentive, undistracted, and alert. They travel at safe speeds, approach intersections with caution, stop behind the line, pass when appropriate, and recognize that rushing to get somewhere on time is useless if it means you never get there at all. Safe drivers don’t text or hold a phone to their ear, don’t eat a hamburger and steer with their knees, and don’t drive when tired. If you are one of these drivers you are going to increase your chances of avoiding a collision, and lower your chances of being the cause. Unfortunately, however, not everyone is a safe driver. So, all the rest of us can do is wear our seat belt, buy a car with a good safety rating, make sure everyone in the car is buckled properly, make sure the headrest is at a proper height, put loose belongings in the trunk (I know of a child who got a head injury from a flying jar of pickles that escaped the grocery bag during a collision), and follow the rules for child seats.

Sports

I am an avid athlete and have pretty much played or tried every sport. There are very few sports I dislike and I honestly feel that sports can be the most positive and influential outlet for young people, and one of the most engaging and social outlets for adults. The issue is that sports seem to be becoming more and more competitive, kids and adults are getting bigger and stronger, and the culture of some sports has changed from friendly competition to all-out war. Preventing head injury in sport can include outfitting your kids with proper equipment (many hockey parents spend more on a stick than a helmet), ensuring they are playing at their level, monitoring the coaching influence and team culture to make sure this is appropriate, and my favorite is from the book “The Secrets of Successful Families” and includes that the only job of a parent in organized sport is to “shut up and cheer”. No parent should be on the sidelines encouraging reckless, mean or harmful behavior. The results can be devastating. And if you are concerned about your child’s risk of head injury in sport, know that there are many other sports that reduce the risk but are equally as challenging, competitive, fun and have the same physical, cognitive and developmental benefits.

So, let’s start our recognition of Brain Injury Awareness Month by practicing prevention. It does not have to be easier said than done.

(1) Brain Injury Association of Canada
(2) Canadian Institute of Health Information

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Gardening is Therapeutic—Make it Accessible for Everyone!

Gardening provides a therapeutic outlet mentally, emotionally and physically. It can provide exercise, fresh air and it is well known that spending time outside connecting with nature is good for your soul. Those with disabilities may find the bending, reaching and digging associated with gardening difficult. “Carry On Gardening” in the UK, in association with “Thrive”, is an organization that helps people with a wide range of disabilities to get into the garden. The following from their websites provides tips and guides on how to create and maintain an accessible garden.

Carry On Gardening:  Top Tips for Disabled Gardeners