Proper oral care is crucial for those with Alzheimer’s disease. Learn tips here.

Maintaining good oral health is essential to everyone’s wellbeing. For a person struggling with Alzheimer’s disease or dementia, daily attention to oral health can prevent problems like painful cavities, infections, digestive problems and eating difficulties. Your loved one may not be able to express the pain of a toothache or gum problems, and without proper attention, this can lead to tooth decay, untreated lesions, possible abscess and serious health complications.

When a person suffers from Alzheimer’s disease or another type of dementia, attention to oral care often gets overlooked. As the disease progresses, those with memory challenges need varying levels of support to keep up with their oral hygiene routine. In the early stages of the disease, your loved one may just need reminders on how to brush and why it is important; however, as the disease progresses, your hands-on attention to this important daily routine is critical in maintaining your loved one’s oral health and overall wellbeing.

Try these tips to help ensure your loved one with Alzheimer’s disease maintains healthy teeth and gums, courtesy of the professionals in in-home care Paradise Valley, AZ seniors need and trust at Nightingale Homecare:

Keep the teeth and mouth clean. Very gently brush the person’s teeth, gums, tongue and roof of the mouth at least twice a day, with the last brushing after the evening meal (see below for instructions).

Try different types of toothbrushes. Experiment until you find the right choice for your loved one. You may find that a children’s toothbrush works best, as the head is smaller and the bristles are softer. You may also want to try a long handled or angled brush, which can be easier to use than a standard toothbrush. Be cautious with using an electric toothbrush on a person with Alzheimer’s disease, as this can create fear and agitation.

Floss regularly. Take the time to floss daily. Flossing can be distressing to a person with Alzheimer’s, so try using a “proxabrush” to clean between teeth. A Waterpic is another option, if the person can tolerate it, which is gentler on the gums and much easier than trying to manipulate string floss. As when using an electric toothbrush, remember to proceed slowly and calmly, letting your loved one know what you are going to do next. Monitor the water temperature, pressure setting and the angle of the nozzle while working. Instead of using only water in the reservoir of the appliance, add a small amount of anti-cavity mouthwash.

Be aware of potential mouth pain. Investigate any signs of mouth discomfort during mealtime. Refusing to eat or strained facial expressions while eating may indicate mouth pain or dentures that don’t fit properly.

Monitor sugar intake. As we know, sugar can cause tooth decay, especially when it’s frequently eaten. If your loved one with dementia is in need of a snack, try to avoid giving too many sugary foods. Tooth-friendly foods and snacks include:

• Vegetables
• Fresh fruit
• Yogurt
• Bread with sugar-free spreads
• Crackers and cheese
• Pita bread with hummus
• Rice cakes

Keep your loved one hydrated. Proper hydration helps keep the mouth moist and inhibits bacterial growth. Saliva is meant to serve this purpose, but may older adults suffer from dry mouth caused by a wide range of medications. There are several over-the-counter mouth rinses specifically for dry mouth that aid in keeping the mouth moist. The last step to any meal should be using water to wash everything away.

Timing foods for oral care. Offering fruit at the end of each meal can go a long way in helping break down the sugar and starch from a meal. Crunchy fruits and veggies help remove plaque from the teeth.

Brushing Your Loved One’s Teeth

Everyone should have their mouth cleaned twice a day, so make sure your loved one continues to keep up this routine, and provide assistance when needed. You may find that some days you can just direct the steps, and other days you may have to actually perform the care. Keep these pointers in mind as you accomplish the task of brushing.

• Provide short, simple and clear instructions, broken into steps, such as, “Hold your toothbrush. Now put toothpaste on the brush.”
• Use a “watch me” technique. Hold a toothbrush and demonstrate to your loved one what to do.
• You may need to guide by putting your hand over the person’s hand, gently guiding the brush.
• If your loved one seems agitated or uncooperative, postpone brushing until later in the day.
• Observe your loved one for signs of discomfort: grimacing, bleeding gums or sensitivity to hot or cold. These are signs your loved one may need to see the dentist.

If you need to brush your loved one’s teeth:

• Support the person’s jaw to keep the teeth together to help clean the outer surfaces of the teeth.
• Encourage the senior to open wide to help you clean the inside and biting surfaces of the teeth.
• Use a pea-sized amount of toothpaste.
• Use gentle, circular movements, paying extra attention to the area where the tooth meets the gum.
• Encourage your loved one to spit out the toothpaste rather than rinse it out. The fluoride in the toothpaste will continue to protect their teeth.
• Clean the teeth from the outer surfaces to the biting surfaces and finally to the inner surfaces.
• Replace the toothbrush when it begins to show wear, or every three months.
• If you notice your loved one’s gums are bleeding, this means there is some residual plaque in the mouth, which is irritating the gums. Continue to brush the person’s teeth, but if the bleeding continues more than a week, make an appointment with a dentist.

Dealing with Dentures

Many people living with Alzheimer’s disease have dentures, and it’s important to ensure they are cleaned daily and replaced when necessary. Follow these tips to ensure your loved one’s dentures are cared for:

• Rinse dentures with plain water after meals and brush them daily to remove food particles.
• Clean dentures with a special denture brush and denture paste or non-perfumed liquid soap and water to remove all food and plaque deposits.
• Each night, remove the dentures and soak in a denture cleanser or mouthwash.
• Ensure your loved one cleans remaining teeth and/or gums before going to bed. Use a soft-bristled brush or moistened gauze if there are no natural teeth.

Dental Appointments

Most dental insurance plans cover a teeth cleaning (prophylaxis) every six months. Since it can be extremely difficult getting a person living with Alzheimer’s disease to comply with brushing and flossing twice a day, you may want to consider increasing dental visits to every three months. This can help combat plaque and tartar buildup on the teeth. Additional cleanings also help to prevent serious gum conditions like gingivitis and periodontitis, which contribute to decay and tooth loss.

As the disease progresses, those with Alzheimer’s/dementia may become increasingly agitated and noncompliant during cleanings. Finding the right dentist with experience working with the elderly and persons with dementia is critical. Difficult dementia behaviors and diminishing capacity will eventually make regular cleanings too traumatic for your loved one. At that point, assisting your loved one with flossing, brushing and rinsing as often as possible is the best way to maintain oral health.

If providing oral care for someone with Alzheimer’s disease (or meeting any other care needs) is overwhelming, please know that you always have a trusted partner in care with Nightingale Homecare. As the top provider of in-home care Paradise Valley, AZ and the surrounding area has to offer, we can provide a full range of professional Alzheimer’s care services through our specialized Connections Dementia Care program. Call us at (602) 504-1555 to learn more.

Help your older loved ones with surgery recovery at home.

When an older adult is facing a surgical procedure, and the subsequent surgery recovery, it can be a time of stress and anxiety, both for the senior herself and her loved ones. The best course of action to ensure peace of mind and as comfortable an experience as possible is through taking proactive measures before the operation, eliminating a post-op rush to get the home in order.

The Phoenix, AZ home care team at Nightingale Homecare suggest the following steps family caregivers can take now to ease surgery recovery when the time comes:

1. Learn about hospital delirium. Some degree of confusion is quite common in older adults following surgery, and can be quite unsettling for family members who are unaware of this condition. Post-operative delirium occurs most frequently in seniors who have been heavily sedated and/or on a ventilator, and can last for months, causing memory and cognitive problems and hallucinations. Talk with your senior loved one’s surgeon before surgery about this possibility, and how to prevent it.
2. Make a list, and check it twice. Ask a member of the senior’s medical team if any medical equipment or assistive devices will be necessary or simply helpful during the surgery recovery process, and make arrangements to have those items ready in the senior’s home. This might include a wheelchair or walker, a hospital bed, a bedside commode, and more. You can also find out if it’s possible to pick up any medications the senior will need before the surgery.
3. Prepare the home. Take a walk through the senior’s home to address any safety concerns, such as ensuring there are clear pathways in the areas the senior will be ambulating, ensuring there are grab bars near the toilet and shower/tub, removing throw rugs and other fall hazards, and arranging helpful items where the senior will be able to easily access them, such as a phone, TV remote control, reading materials, etc. Fill the fridge and pantry with nutritious food choices, and if possible, prepare some meals in advance to store in the freezer for easy reheating.
4. Reach out to others. Caring for a senior loved one post-surgery is often more than one person can handle alone. Enlist other family members, friends, and neighbors to take shifts in caring for the senior, to help with housework and laundry, to run errands, or simply to provide friendly companionship.

Nightingale Homecare offers a wide range of in-home care services to help seniors with surgery recovery, from non-medical needs such as help around the home and with meals, to highly skilled medical care from our team of registered nurses, and so much more. Allow our Phoenix, AZ home care experts to make surgery recovery a smoother process for your senior loved one by calling us at (602) 504-1555.

Common foot issues of aging are outlined here, with tips to help.

Our feet certainly take a beating! For years they’ve enabled us to walk, run, hop, jump, kick, balance, and more, and as we grow older, all of that activity begins to take a toll, leaving our feet vulnerable to a number of problems. As one of the highest rated providers of home care in Paradise Valley and the surrounding area, the care team at Nightingale Homecare has the information you need to address these concerns and help improve senior foot health:

• Edema: Poor circulation can cause fluid to build up in the feet and ankles, resulting in swelling (edema). This is particularly common in those with congestive heart failure, diabetes, and liver or kidney disease.
  • Try: Drink plenty of water, elevate the legs as often as possible, soak feet in cool water, and ask the doctor to recommend foot and leg exercises.
• Osteoarthritis: Most commonly affecting joints in the ankles and feet, osteoarthritis is diagnosed in as many as 16 out of every 100 seniors. Risk factors include previous injury to the foot or ankle, obesity, bunions, and hammertoe.
  • Try: Physical therapy, canes or braces that provide support to the joints, customized shoes or shoe inserts, or medications/steroid injections at the direction of the doctor.
• Flat feet: The ligaments in the feet often stretch as we grow older, resulting in pain and swelling. Flat feet can cause problems with balance and mobility, as well as an enhanced risk of sprains to the foot or ankle.
  • Try: Proper fitting shoes and/or shoe inserts to relieve pressure on the arch of the foot.
• Thickening of the toenails: As hormone production decreases, keratin production also decreases, leading nails to thicken and become more brittle.
  • Try: Have toenails cut regularly and keep them clean and dry. The doctor may also prescribe a cream or ointment to help.
• Seborrheic keratosis: Although they mimic warts, these lesions can appear on the top (never the soles) of the feet, and may itch or cause irritation when shoes are worn.
  • Try: See the doctor to have the lesions tested to ensure they aren’t cancerous, and then depending upon the level of irritation, the doctor may opt to remove them.
• Shortened Achilles tendon: Water loss in the tendons through aging can cause the Achilles tendon (which connects the heel bone to the calf muscle) to shorten, impacting gait and flexibility.
  • Try: Some stretching exercises may help; check with the doctor for specific recommendations.

Nightingale Homecare’s full range of skilled nursing, non-medical care, and orthopedic rehabilitation services can all help those struggling with issues related to foot problems. Working in conjunction with a senior’s medical team, we can provide the care and resources needed to optimize health, right in the comfort of home.

To learn more about how Nightingale Homecare, the top providers of home care in Paradise Valley and the surrounding area, can help, and to request a free in-home consultation to learn more, call us any time at (602) 504-1555.

Learn to be a more empathetic family caregiver with these tips.

If you ask parents, educators and researchers what are the most important traits to encourage in a child’s development, you would undoubtedly receive a variety of responses, but two of the top responses would likely be kindness and empathy. Yet one study reported that less than 2% of our interactions include a “sincere acknowledgement of the other.”

One of the more heartbreaking calls we receive at Nightingale Homecare is when a caregiver calls to request our service, stating that he or she is failing to feel empathy toward a loved one in need – often the result of “caregiver burnout.”

Empathy is an especially important skill for caregivers. Studies have shown that caregiver empathy plays a critical role in forging a strong patient-caregiver relationship while developing a deep level of rapport and trust. Practiced empathy also plays an important role in increasing patient treatment adherence and reducing accidents. Improving your empathy and kindness can also have huge positive effects on every other relationship!

Empathy Defined

Most people would define empathy as the ability to have a sense of understanding and compassion for another person, while being able to sense what the other person is experiencing; i.e., “putting yourself in someone else’s shoes.” According to author Daniel Goleman, who wrote the book Emotional Intelligence, empathy is:

1. Understanding the emotional makeup of a person, and
2. Treating that person according to his or her emotional reactions

Treating people with empathy and responding to their emotions includes high levels of compassion and tolerance. Fortunately, there are tools for practicing this response towards others.

Active Listening

One of the key elements to conveying empathy and compassion toward another human being is to actively listen.

The steps are as follows:

• Concentrate on not speaking while the other person is speaking
• Pay attention to the words and emotion
• Look directly into the person’s eyes while he or she is speaking
• Listen, do not be thinking of preparing a reply
• Pay attention to the person’s behaviors and body language
• Let the person know you are listening; for example, shaking your head or squeezing his or her hand in reassurance
• When the person stops speaking, try to paraphrase or translate what you heard and reflect on this
• Try to recognize the individual’s feelings; for example, “You sound upset and frustrated”

Some other key elements to keep in mind while actively listening are:

• Do not interrupt
• Do not change the subject
• Do not voice disapproval

Controlling the Urge to Help

During active listening, it’s important to control your urge to jump in and help or offer advice while the person is expressing feelings and emotions. Simply be present in the conversation. It is a difficult urge to control, as most of us responding to an upset person give advice, words of encouragement or comfort. While well-intentioned, these responses interfere with the person talking because our verbalizations result from our thinking about how to help and what the person’s words mean to us, rather than thinking about what the person’s words mean to him or her.

Controlling the Urge to Talk

Research on conversations has found that the person not talking usually starts talking about nine-tenths of a second after the other person stops. Developing the ability to wait, listen, and encourage the other to talk without interrupting is a critical skill. It can be developed by intentional awareness and with practice. Being more aware of opportunities to switch from talking to listening expands your consciousness and choice, which will help increase your flexibility and ease in using empathy effectively.

Can Empathy Be Faked?

It may be necessary while you are caregiving to act empathetically to achieve a positive outcome, even when you feel apathetic toward a loved one. When caring for a difficult loved one, you will still need to act empathetic in order to establish the rapport necessary to encourage the delivery of care. What is interesting with this approach is that often you will begin to feel true empathy toward a difficult loved one as a result of “acting” empathetic. The old adage “fake it till you make it” rings true.

Random Acts of Kindness

In the meantime, along with your empathy practice, throw in some random acts of kindness. This will help develop your empathy skills and you will begin to notice the world is a little better because of it, and the people around you will begin to model your kindness. It’s infectious!

Here are some fun activities that you can do to celebrate kindness:

• Compliment the first three people you talk to
• Write a hand-written note to a friend
• Say good morning to the person next to you on the elevator(bus/subway/street)
• Spend 10 minutes picking up litter in a park or your neighborhood
• Place uplifting notes in library books, on restroom mirrors, on someone’s locker or computer screen
• Hold up inspiring signs during rush hour
• Leave a generous tip
• Send flowers to a friend

If you run out of kindness ideas, The Random Acts of Kindness Foundation has lots of them on their website.

Empathy is one of the primary building blocks of social intelligence. Often, stress, self-absorption, lack of time and caregiver burnout can kill efforts to practice empathy. Knowing what your barriers are to showing empathy and exploring ways to overcome them can help you develop this much-needed skill that is vital to caring for a loved one in need.

And know that Nightingale Homecare’s compassionate and highly skilled providers of home care in Paradise Valley and the surrounding area are always on hand to help with the professional respite care that allows family members to take as much or as little time as desired for self-care – enabling you to return to caring for your loved one refreshed and renewed. Call us at (602) 504-1555 to learn more!

Learn the differences in heart disease symptoms between men and women.

With the CDC reporting that heart disease is the leading cause of death for both women and men, it’s important for all of us to understand how to recognize and prevent the condition – and surprisingly, this can vary widely between the two genders. The heart itself is, in fact, physically different based on gender, with women’s hearts comprised of thinner walls and smaller interior chambers, pumping blood faster and yet with less blood per pump than the hearts of men.

As a result, women’s heart disease risk factors differ from men’s in the following ways:

Heart Disease Risk Factors Specific to Women:

• Endometriosis
• Diabetes
• High blood pressure developed during pregnancy
• Polycystic ovary disease

Heart Disease Risk Factors for Both Men and Women:

• Elevated blood pressure, cholesterol, and/or blood sugar levels
• Obesity
• Smoking
• Family history

Women’s experience with heart disease and treatment/recovery differ as well. For instance, because heart disease in women often effects the smaller arteries, diagnosis through the typical means (angiogram) is less effective, as it shows blockages in the larger arteries only. In fact, it’s recommended that women who receive clear angiogram results but are still experiencing symptoms of heart disease see a cardiologist with a specialty in women’s heart health.

Heart attacks also differ between men and women. Consider the following:

• A first heart attack usually occurs at a later age for women than men (on average, 70 for women and 66 for men)
• A woman’s heart attack can include the additional symptoms of:
  • Sweating
  • Extreme fatigue
  • Pain in the back, neck or jaw
  • Shortness of breath
• Women typically struggle with a more difficult recovery following a heart attack than men, requiring a longer hospital stay
• Women are more likely to experience a subsequent heart attack

One thing that applies to both genders when it comes to heart health is prevention. Reduce your risk of heart disease and a heart attack by making the following lifestyle changes:

• Quit (or never start) smoking
• Ensure your diet includes plenty of whole grains, fresh fruits and vegetables, and less processed foods, simple carbs, and animal products
• Ensure that your blood pressure, blood lipid, blood sugar and weight are all within healthy levels
• Exercise for at least 30 minutes each day

For more heart health tips, call on Nightingale Homecare, providers of the highest quality at home care Scottsdale and the surrounding area has to offer. We can help with planning and preparing heart-healthy meals, encouraging an active lifestyle, ensuring medications are taken exactly as prescribed, and much more. Contact us any time at (602) 504-1555 and take the first step in improving heart health for yourself and the seniors you love!