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Psychotropic Medications: Are They Helping or Harming Seniors?

Scottsdale home care agencyMedications that are capable of affecting the mind, emotions and behaviors are called psychotropic medications. These include commonly used pain medications called opioids as well as medications used to treat depression, anxiety, mood disorders, sleep problems, dementia and other mental illnesses. When given to older adults, psychotropic medications are typically intended to improve quality of life and ability to function. The doctor must assure, however, that the patient is accurately diagnosed, that the dose is correct, that harmful side effects don’t occur and that the psychotropic medication doesn’t interact badly with other medications that the patient is taking.

At Nightingale Homecare, the top Scottsdale home care agency, we want to help seniors and their caregivers better understand the types of psychotropic medications they may be prescribed, how they can help, and the effects they may experience.

Some examples of psychotropic medications include:

  • Depression medications (e.g. Zoloft, Paxil, Elavil, Effexor, Wellbutrin)
  • Anxiety medications (e.g. Valium, Xanax, BuSpar, Ativan, Halcion)
  • Mood stabilizer medications (Depacote, Lithium)
  • Antipsychotics (e.g. Risperdal, Haldol, Zyprexa, Seroquel)
  • Stimulants (e.g. Adderal, Ritalin)
  • Anti-dementia medications (i.e. Aricept, Namenda, Exelon, Cognex)
  • Sleep medications (e.g. Ambien, Sonata, Lunesta, Remeron, Desyrel, Pamelor,)
  • Opioid pain medications (e.g. Percocet, Vicodin, OxyContin, Morphine, Meperidine, Hydromorphone, and Fentanyl)

The use of psychotropic medications and opioids has increased steadily in older adults over the last ten years. In the United States, people over the age of 65 represent just 13 percent of the population, yet this age group takes over one-third of the drugs prescribed in this county. What is even more disturbing is that a recent study found that the number of older Americans who take three or more brain-affecting medications has doubled in the last ten years. For adults age 65-80, nine out of ten have prescriptions for psychotropic medications written by a doctor that is not a psychiatrist.

Although they can be beneficial at times, psychotropic and opioid medications can also be dangerous when taken by older adults, especially when taken long-term. The elderly are more sensitive to the effects of these medications because most drugs are eliminated from the body through the kidneys and liver, both of which may work less efficiently in later years. Another age-related change is an increase in the amount of body fat. Seniors are at high risk for “drug toxicity,” or the result of drugs accumulating in the body because the drugs are often stored in fat. Drug toxicity is very serious and can be fatal.

Even though there is a well-known connection between the use of psychotropic medications in older adults and the potential toxicity from them, health care professionals often do not recognize what is happening. More than likely, they attribute the symptoms of medication toxicity to some sort of new health condition or worsening of an existing health condition.

Side effects from psychotropic drugs are more frequent and severe in older adults, especially feelings of sleepiness or being “out of it.” Memory and movement problems are also very common and can lead to falls, fractures and other accidents.

Most older adults who take psychotropic medications also take other prescribed and over-the-counter medications. Because of this, careful evaluation is needed to make sure that unwanted, uncomfortable or dangerous side effects and interactions are not occurring. Bad medication reactions commonly include: hallucinations, confusion, dizziness, constipation, drowsiness, weakness, slurred speech, lack of balance or coordination, slow and shallow breathing, poor judgement, falls with broken bones, addiction and even death. In addition, a recent study found that use of benzodiazepine (or anti-anxiety medication) results in a higher risk of developing Alzheimer’s disease.

Hospitalization due to bad drug reactions occurs about four times more frequently in older patients than in younger ones – and, these bad reactions could have been prevented in almost 90% of cases!

Due to the risks involved, psychotropic medications should only be prescribed by a senior’s doctor after very careful consideration, and only after trying medications or treatments that pose a lower health risk.

When considering treatment foranxiety, depression, psychological distress, sleep disorders and chronic pain,non-pharmaceutical strategies are often considered preferable to drug options in the elderly. These include:

  • Exercise
  • Meditation
  • Physical therapy
  • Acupuncture
  • Thai chi
  • Cognitive behavioral therapy
  • Yoga
  • Biofeedback
  • Chiropractic therapy
  • Guided imagery
  • Progressive muscle relaxation
  • Hot and cold treatments
  • Deep breathing
  • Relaxation training

When it comes to pain management, there is a perception that opiate pain medications are the best treatment, but studies have determined that there is no advantage to using opioid pain medications for the treatment of chronic pain in older adults when the pain is not caused by cancer. For non-cancer pain, opioids are recommended for a maximumof 3-7 days, and some over-the counter pain medications may actually be more effective.
Nightingale Homecare is committed to keeping seniors safe and well through trusted in-home care services, skilled nursing care, and more. Contact our Scottsdale home care agency at (602) 504-1555 for further information on psychotropic medications or any of other questions related to aging safely at home.

Caring for a Loved One with Cancer

Cancer CareWhen a loved one is diagnosed with cancer, life as we know it can suddenly come to a halt. As difficult as it is for the person receiving the diagnosis, it’s also often challenging and overwhelming for those providing care. Whether your role is providing comfort and emotional support, hands-on assistance with transportation or help around the house, or simply stopping by to visit and lift the person’s spirits, there are a number of steps you can take to make sure you’re providing the very best possible care. The Scottsdale home health care team at Nightingale Homecare offers the following suggestions:

  • Develop a team of support. We’re stronger when we work together and trying to provide care for a loved one with cancer is much more effective when family members, friends, and neighbors band together to utilize their individual strengths. Maybe you’re especially talented in cooking, and can prepare healthy meals for the person, while a family member takes care of mowing the lawn and the neighbors take turns driving the cancer patient to her medical treatments. In sharing responsibilities, no one person experiences burnout, and your loved one’s needs can be fully and cheerfully met.
  • Take time to listen. While it may seem as though the person with cancer would welcome the distractions of talking about anything but the cancer itself, the reverse is often true. Ask if she would like to share her feelings about what she’s going through, and if so, devote as much time as needed to simply listen. It’s also human nature to want to try to come up with solutions for our loved ones, but often all the person really needs is the chance to talk and know that she is heard and loved.
  • Arm yourself with education. Learning as much as possible about your loved one’s particular type of cancer will help you better understand what to expect as she works through a treatment plan, and therefore to provide the best possible assistance. For instance, if she’s undergoing a round of chemotherapy, learn what the potential side effects are, and how to help combat them, such as preparing certain types of meals that will be more tolerable, avoiding the use of metal when cooking to combat the metallic aftertaste experienced by some, and more.
  • Keep in mind who the person was pre-cancer. It’s easy to allow a cancer diagnosis to overshadow everything else, but taking time for normal activities and interests can help the person keep a healthier perspective. Spend time together enjoying the same types of pursuits you did before the diagnosis, or create a modified version if needed, such as taking a slower-paced walk together around the neighborhood instead of a high-intensity aerobics workout at the gym.
  • Nightingale Homecare can help! The Scottsdale home health care professionals at Nightingale Homecare are trained and experienced in cancer care, whether the need is for transportation, maintaining a clean home and preparing meals, assisting with bathing and dressing, skilled nursing care, or chronic disease management services. We are available for as much, or as little assistance as needed, to allow family members the opportunity to spend quality time with their loved one.

We’d love to share more cancer care resources with you, or to arrange for an in-home consultation to learn more about the challenges your loved one with cancer is facing and provide solutions to make life easier and more comfortable. Contact us at (602) 504-1555 any time.

Top Phoenix Home Care Agency Shares Tips to Better Manage Wandering in Alzheimer’s

Top Phoenix home care agency

Providing a comfortable and safe home environment for a loved one with Alzheimer’s or another form of dementia is key to improving the person’s emotional and physical wellbeing. This goal can be challenging, especially for those families who have a loved one who wanders due to dementia. The Phoenix home care agency team at Nightingale Homecare understands firsthand how difficult it can be to effectively manage behaviors such as wandering, and is here to help!

An individual with dementia is likely to wander at some point during the disease – as many as three out of every four patients, according to the Alzheimer’s Association. This is an incredibly stressful behavior for loved ones to deal with because of the safety implications associated with wandering.

The first approach to dealing with wandering is to identify the reason behind the wandering.  There may be a number of causes, including:

  • Medication side effects
  • Stress
  • Confusion related to time
  • Restlessness
  • Agitation
  • Inability to recognize familiar people, places and objects
  • Fear arising from the misinterpretation of sights and sounds
  • Desire to fulfill former obligations, such as going to work or looking after a child

There are some things you can do to reduce wandering in your loved one:

  • Encourage movement and exercise. This tends to reduce anxiety, agitation and restlessness and can have a dramatic effect on wandering.
  • Involve your loved one in productive daily activities such as folding laundry or preparing dinner. This can keep your loved one occupied and provide opportunity for meaningful tasks.
  • Remind your loved one he is in the right place and reassure him if he articulates feelings that he may be lost, abandoned, or disoriented. This kind of reassurance from a trusted loved one or caregiver can be invaluable in calming your loved one and preventing wandering behavior.

If you continue to notice wandering behaviors, there are some things you can do to protect your loved one:

  • Enroll your loved one in the Alzheimer’s Association’s Safe Return program.
  • Notify all your neighbors of your loved one’s condition and keep a list of their names and phone numbers.
  • Keep your home safe and secure by installing deadbolt locks on exterior doors and limiting access to potentially dangerous areas of your home.
  • Be mindful that your loved one may not only wander by foot but also by other modes of transportation, so limit access to cars or other transportation.
  • Be sure and keep a list of emergency phone numbers and addresses of the local police and fire departments, hospitals and poison control as well as the Safe Return help line.

Although it may seem overwhelming to proactively address any potential hazards, in the long run, it’s well worth it to know that your loved one with Alzheimer’s or dementia is safe. And you don’t have to figure it all out alone! The staff of Nightingale Homecare is uniquely qualified to provide Alzheimer’s, dementia and memory loss care through our Connections program, using the unique approach taught by Dr. Verna Benner-Carson through her “Alzheimer’s Whisperer®” methods. Alzheimer’s Whisperers enter the client’s world and manage the challenging behaviors associated with dementia in a way that is gentle, creative and highly effective. These skills are not only practiced and known by our trained caregivers, but also taught to the families of our dementia clients by the clinical staff of Nightingale Homecare.

Contact the Alzheimer’s care experts at the top Phoenix home care agency, Nightingale Homecare, at (602) 504-1555 for more helpful tips to make life safer and more comfortable for your loved one with dementia, or for professional, compassionate, hands-on assistance with all of his or her care needs.

Top Tips for Preventing Diabetic Kidney Disease

kidney diseaseThe Diabetes Council shares that diabetes is the leading cause for kidney failure; in fact, as many as half of all diabetics will be diagnosed with some type of kidney damage in their lifetime. However, there are steps that those with diabetes can take to prevent kidney disease. The Phoenix home health care experts at Nightingale Homecare share the following common questions about diabetes and its connection to kidney disease, and the answers to help keep diabetics healthy:

  • Am I at a greater risk for kidney disease than those without diabetes? There is a link between kidney disease and the glucose control issues inherent in diabetes, but those with high blood pressure, poor diet and genetic history for kidney disease are also at heightened risk.
  • How can I tell if I have kidney disease? Symptoms may not be evident in the early stages of the disease, but as the disease progresses, patients may experience nausea and vomiting, loss of appetite, weight gain, and eventually fluid in the lungs and heart failure. A simple test to detect levels of protein in the urine can indicate kidney disease, so it’s important for those with diabetes to closely follow the physician’s recommendations for ongoing blood work and other tests to monitor for kidney disease and other complications.
  • How can I prevent kidney disease? Carefully and consistently checking blood sugar levels is crucial, as well as adhering to all doctors’ orders and taking medications exactly as prescribed. An in-home care provider, such as the Phoenix home health care team at Nightingale Homecare, can be invaluable in reducing the risk for developing complications such as kidney disease from diabetes.
  • What treatment options are available if I am diagnosed with kidney disease? Certain types of high blood pressure medications have been found to reduce the pressure in the kidneys, helping to stop or delay the progression of kidney disease in those with diabetes. A diet low in protein may also be beneficial. Dialysis or a kidney transplant may be a viable option as well. The physician will be able to recommend the best treatment option for each individual.
  • How can home care help? A professional home care agency can help individuals with diabetes and kidney disease in a number of ways. Specifically, Nightingale Homecare’s Pathlink Chronic Disease Management program uses nationally-recognized standards of care to help seniors actively manage chronic conditions such as diabetes, allowing them to fully understand their diagnosis, improve outcomes, and reduce hospitalizations. Our Pathlink program includes:
    • Education for improved self-management skills
    • Integration of “High-touch” approach to provide frequent contact with those most at risk of re-hospitalization
    • Evidence based interventions built on adult learning principles
    • Health literacy assessment and intervention tools
    • Innovative strategies for working with non-adherent patients
    • Technology for effective patient management and ongoing clinical oversight

Whether enrolling in our comprehensive Pathlink program, or selecting other skilled or home care services, our fully trained and skilled nurses and home health care aides can help in a variety of ways, including:

  • Blood draws
  • Glucose monitoring
  • Education on effective diabetes management techniques
  • Diabetic self-management skills
  • Medication reminders
  • Chronic disease management
  • Transportation to medical appointments and treatments
  • Meal planning and preparation in conjunction with any dietary restrictions
  • Friendly companionship
  • And much, much more

To learn more about how we can help with diabetes management and to keep seniors healthy and thriving, in the comfort of home, contact the in-home care specialists at Nightingale Homecare. Our Phoenix home health care professionals are available any time to answer questions, consult with you and your senior loved one at home, and provide individualized home care services to enhance quality of life and overall health and wellbeing. Contact us at (602) 504-1555 to learn more.

Posted in Blog, Phoenix, Senior Health on March 27th, 2018 · Comments Off on Top Tips for Preventing Diabetic Kidney Disease

Senior Hip Fractures: Risk Factors, Prevention Tactics, and Recovery Tips

senior hip fracturesHip fractures are a serious injury that can lead to a host of complications for older adults, including death. The elderly are especially prone to hip fractures due to several reasons, including bone weakening as one ages, and the increased risk of falls. Additionally, osteoporosis makes bones brittle and more likely to fracture in the event of a fall, and because more women are prone to osteoporosis, they are three times more likely than men to suffer a hip fracture.

Each year, over 300,000 Americans age 65 and older are hospitalized for a hip fracture, and over 95% of those are the result of a fall.

At Nightingale Homecare, the top Carefree home care agency, we’re skilled in both helping seniors recover from hip fractures and enhancing safety to prevent them from occurring. The information below can help keep your senior safe from a hip fracture, and help you understand the healing process if one should occur.

Several risk factors for increased danger of experiencing a fall include:

  • Certain medications causing dizziness
  • Weakened muscles due to inactivity
  • Poor balance
  • Changes in blood pressure, with a drop occurring when getting up from sitting or lying produces dizziness
  • Poor vision
  • Slow reflexes resulting in loss of balance

Surgery is most often recommended within 48 hours of a hip fracture to stabilize the hip. There are risks with surgery, and complications can include:

  • Blood clots in the legs or lung
  • Delirium
  • Bed sores
  • Pneumonia
  • Urinary tract infections
  • Further loss of muscle strength

The loss of muscle strength can lead to increased risk of a secondary hip fracture. Included in the post-operative plan for any patient suffering a hip fracture should be an evaluation of the home and the patient for falls risk.

At Nightingale Homecare, we’re committed to helping seniors stay active while remaining safe from falls. Our fully trained Carefree home care agency staff would love to meet with you and your senior loved one to provide a free in-home assessment and to offer assistance on enhancing quality of life and independence while maintaining optimum safety.

We provide a fully encompassing range of home care and home health care services through our team of professional nurses, medical social workers, dieticians, occupational/ physical/speech therapists, and home health aides – ensuring that the individual needs of each senior client are covered both for today and as needs change in the future. And, our Paces Fall Prevention Program places a concerted focus on further reducing fall risk in seniors.

Contact us to learn more about how our Carefree home care agency can reduce the risk of a fall, and subsequently a hip fracture or other serious injury, by calling us at (602) 504-1555, or by completing our simple online contact form. We’re on hand to answer any questions you may have or to schedule a free in-home consultation.