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Is Your Loved One at Risk for Elder Abuse?

Sun City home health care

Learn the 7 main types of elder abuse and how to keep seniors safe.

Elder abuse is a serious issue that involves the abuse or neglect of people age 60 and older. The signs of abuse are often not recognized, leading to gross under-reporting of the problem. In fact, the limited research available suggests that only one in 14 cases of abuse are actually reported to the authorities. Sometimes the abuse is a continuation of existing dysfunctional family dynamics. More often, however, the abuse is a result of changes brought about by the stress of illness, dependency and need for increased care.

Adult children and spouses are the most frequent abusers of the elderly, followed by other family members. The National Center on Elder Abuse defines the following seven different types of elder abuse:

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Financial exploitation
  • Neglect
  • Abandonment
  • Self-neglect

Physical Abuse

Physical abuse involves the use of physical force that may result in bodily injury, physical pain, or impairment. Persons who have been physically abused may have bruises, welts, lacerations, rope marks, black eyes, wounds, cuts, or untreated injuries in different stages of healing. Dislocations, sprains, internal injuries, broken eyeglasses or frames, and medication overdosing or under-dosing can also be the result of physical abuse. The elder being physically abused is often withdrawn, anxious, depressed, and fearful around a family member or caregiver. A red flag that physical abuse may be occurring is a caregiver’s refusal to let the patient have visitors without the caregiver being present.

Sexual Abuse

Sexual abuse includes non-consensual sexual contact of any kind with another person. Bruising around the breasts or genital area, sexually transmitted diseases, vaginal or anal bleeding, and torn or bloody undergarments are signs of sexual abuse.

Emotional Abuse

Emotional or psychological abuse involves infliction of anguish, pain, or distress through verbal or non-verbal acts. Emotionally abused persons may appear agitated, upset, withdrawn, non-communicative, or unresponsive. Emotional abuse often accompanies other types of abuse. In the elderly, unusual behavior often attributed to dementia, such as sucking, biting, or rocking behavior, can also be signs of emotional or psychological abuse.

Financial Exploitation

Financial exploitation is a common form of abuse that occurs in the elderly and involves illegal or improper use of an elder’s funds, property, or assets. Financial abuse can include cashing an elder’s checks without permission; forging an elderly person’s signature; stealing money or possessions; coercing or deceiving the elder into signing a contract or will; or improperly using a power of attorney, guardianship, or conservatorship. Other indications of financial abuse include the disappearance of financial papers, checkbooks, and legal documents; a sudden change in banking habits or a change in banking locations; the withdrawal of large sums of money by a person who accompanies the elder; additional names added to an elder’s bank signature card; unauthorized use of an ATM or credit card; the unexplained transfer of assets to a family member or person outside the family; or the unexplained disappearance of funds or possessions.

Additionally, substandard care, even though financial resources are available, can be an indication of financial abuse. Exploitation may also occur in the form of fraud schemes by strangers.

Neglect

Neglect is the most common type of elder abuse. Neglect may be intentional, such as withholding nourishment, or it may be unintentional, resulting from ignorance or from a genuine inability to provide care. Neglect can also take the form of failure to fulfill an obligation, such as failing to pay for necessary home care services or the failure of a caregiver to provide necessary care. Persons who have been neglected may appear dehydrated and malnourished, have untreated bedsores, lice, a flea infestation, a urine or fecal smell, be inadequately clothed, or live in hazardous, unsafe, or unsanitary conditions.

Abandonment

Abandonment is an extreme form of neglect that involves desertion of a person by an individual who has physical custody or by a person who has assumed responsibility for providing care to the individual. An example would be a caregiver who leaves a dependent elderly person alone for several days while traveling.

Self-Neglect

Self-neglect abuse primarily occurs in the elderly and includes behaviors or absence of behaviors that threaten a person’s health or safety. This definition does not apply to a mentally competent person who makes the voluntary decision to engage in behavior that threatens his or her safety and who understands the consequences of that decision. Self-neglect can include behaviors such as:

  • Hoarding
  • Failure to take essential medications or refusal to seek medical treatment for serious illness
  • Leaving a burning stove unattended
  • Poor hygiene
  • Not wearing suitable clothing for the weather
  • Poor living conditions or the inability to attend to housekeeping

Self-neglect accounts for the majority of elder abuse cases reported to adult protective services. Oftentimes, the problem is paired with declining health, isolation, Alzheimer’s disease or dementia, or drug and alcohol dependence. In some of these cases, self-neglecters will be connected to support systems within the community that can assist the person to continue living independently. Conditions like depression and malnutrition may be successfully treated through medical interventions. If the problems are severe enough, a guardian may be appointed or alternate living conditions arranged.

Risk Factors

A combination of individual, relationship, community, and societal factors contribute to the risk of becoming a victim or perpetrator of elder abuse. In many situations, the same risk factors may be shared by both the perpetrator and the victim.

In the elderly population, studies suggest that those at risk are most likely to be female, widowed, frail, cognitively impaired, and chronically ill. Social isolation and mental impairment, such as dementia or Alzheimer’s disease, are two factors that may make an older person more vulnerable to abuse. A history of domestic violence may also make a senior more susceptible to abuse. Particularly in the case of adult children, abusers often are dependent on their victims for financial assistance, housing, and other forms of support. Frequently, these individuals need this support because of personal problems, such as mental illness, alcohol or drug abuse, or other dysfunctional personality characteristics. The risk of elder abuse is particularly high when these adult children live with the elder.

Prevention

Home care clinicians, such as the professional Sun City home health care staff at Nightingale Homecare, are in an ideal position to detect situations for potential abuse and to connect the patient and caregiver with community resources that may prevent escalation of the problem. Stressed caregivers can be put in contact with social organizations and support groups and connected with referrals for adult day care, delivered meals, and respite care. Providing resources for caregiving assistance can be a lifesaver. Clinicians should also teach family caregivers to recognize situations that cause increased stress, as well as appropriate ways to handle difficult patient behaviors like violence, combativeness, and verbal abuse. Identifying actions that can deflate stressful situations is critical to preventing abuse.

Reporting Abuse

Home health providers are mandated to report suspected abuse. Mandated reporters are required by law to report allegations of abuse to law enforcement and regulatory agencies. In most states, Adult Protective Services are the public agencies responsible for investigating reports of elder abuse and for providing victims and families with treatment and protective services. In most situations, the suspicion of abuse is grounds for reporting. Proof is generally not necessary, and the reporter has the option to remain anonymous. Even if a situation has already been investigated, circumstances that seem to be getting worse should continue to be reported and documented by the clinician. If the patient is in immediate danger or a life-threatening situation, it’s important to call 911 or the local emergency authorities.

A trusted home care team, like Nightingale Homecare, is instrumental in reducing the chance for elder abuse and neglect. Contact our Sun City home health care experts to learn how we can help a senior you love stay safe, healthy, and well, in the comfort of home.

Advancing Through the Stages of Alzheimer’s: Tips to Help Manage the Many Changes

dtages of Alzheimers

Find tips to help with the changes that occur through the stages of Alzheimer’s from the Phoenix senior care experts.

When a loved one is diagnosed with Alzheimer’s disease, families are faced with a number of questions and challenges. How will the disease progress? What changes will I see in my loved one? And how am I going to handle them?

It’s important for family caregivers to equip themselves with as much information as possible about the disease, and this includes creating a plan that is proactive enough to address the current needs, while preparing for those yet to come. While each person experiences the stages of Alzheimer’s uniquely, there are some commonalities to keep an eye out for, particularly as it relates to changes in the person’s personality, mood, and the behaviors that stem from those changes:

  • Increased agitation, anxiety, and irritability
  • Loss of interest in once-enjoyed activities
  • Paranoia
  • Depression
  • Pacing and wandering
  • Physical and/or verbal aggressiveness
  • Difficulty understanding the world around them
  • Poor hygiene habits
  • Problems with falling or staying asleep, and differing sleep patterns
  • Physical challenges such as problems with vision and/or hearing
  • And many others

These effects may also come and go as the person progresses from one stage to the next, and new challenges then become apparent. And understandably, trying to help someone who’s experiencing such a wide array of emotions and behaviors can quickly become overwhelming for family caregivers.

Try these tips to bring comfort to a loved one with Alzheimer’s, from the Phoenix senior care experts at Nightingale Homecare:

  • Minimize distractions. Often, confusion and frustration are enhanced for someone with dementia when there’s an overload sensory stimulation, such as the TV or radio playing while others in the room are talking.
  • As much as possible, stick to a daily, predictable routine.
  • Avoid open-ended questions, and instead provide choices; for instance, “Would you like chicken or fish for dinner?” is often more effective than, “What would you like for dinner?”
  • Never correct or argue with the individual.
  • Use statements that reflect the person’s feelings rather than the behaviors that have manifested from those feelings: “It looks like you’re feeling angry today,” rather than, “Why are you banging your fist on the table?”

While it’s natural for family caregivers to feel upset or frustrated themselves when a loved one’s feelings are elevated and behaviors are difficult to handle, it’s also vitally important to maintain a sense of calm, even in the face of distress. The senior will pick up on your agitation, often leading to escalated behaviors. Take a step back, breathe deeply, and count to ten before responding to the senior’s needs.

At Nightingale Homecare, our specialized Connections dementia care program helps those with Alzheimer’s by utilizing a unique, creative, and compassionate approach through qualified Alzheimer’s Whisperers® who are extensively trained in effectively managing the difficult behaviors that often accompany dementia.

We begin by providing an in-depth evaluation, and then create a customized strategic plan to fully meet the person’s needs while empowering him or her to maintain the highest level of functionality at all times.

Partnering with the professional Alzheimer’s care team at Nightingale Homecare helps not just the person with dementia, but his or her family caregivers as well, providing the opportunity for the respite required to maintain a healthy life balance. Contact us at (602) 504-1555 to learn more!

Top Providers of Home Health in Scottsdale Explain the Incredible Impact of Music in Alzheimer’s Disease

home health Scottsdale

Top providers of home health in Scottsdale explain the fascinating connection between music and Alzheimer’s.

Have you ever heard a song playing on the radio and found yourself transported to a time and place from the past? Have you ever had a song stir your deepest emotions – and bring back those memories as if they were happening in the present? Have you been comforted, stimulated, saddened, elated or experienced some other powerful emotion just because of a song? Most of us have had such experiences, and the power of the “remembering” elicited by music can catch us “off guard” when the song evokes emotionally-charged memories.

Music has the same power with individuals diagnosed with Alzheimer’s disease or dementia, and knowing this provides one more tool to help families or caregivers to manage challenging behaviors, to reach someone who appears to be lost in the disease, to calm an agitated individual and encourage cooperation in activities such as bathing that might otherwise be met with resistance. Some research even indicates that music can help restore lost memories and bring those afflicted with the disease back into the present – if only for a short period of time.

These facts about the power of music seem to fly in the face of the progressive loss of memories associated with Alzheimer’s disease – starting with the most recent and steadily erasing long ago memories going back in time. However, it is important to know that the memories of music are “wired” differently in the brain than other memories – it is almost as if the brain is made to contain music. Whereas short-term memories are stored in the hippocampus, music is stored everywhere in the brain, and music with all of its emotional meanings continues to be accessible to people with Alzheimer’s disease, even when they have lost the ability to speak – many can still sing!

What a powerful idea this is! If caregivers fully appreciated the significance of music they would use it all the time and to facilitate many activities of daily living. Caregivers have shared that they engage the person with Alzheimer’s in singing while the individual is bathed and dressed. Nurses sometimes use music while they are performing a painful procedure such as dressing a wound or drawing blood – music can distract, can soothe and can engage the person with Alzheimer’s disease.

Recent research conducted by Brandon Ally, an assistant professor at Boston University, where 32 Alzheimer’s patients participated in a study that examined the power of music, found that these subjects were able to learn more lyrics when the words were set to music than when they were spoken. Ally believes that the results of this study suggest that those with Alzheimer’s could be helped to remember things that are necessary to both their independence and well-being. For instance, creating a short ditty about taking medications or the importance of brushing one’s teeth might be a strategy to help those with Alzheimer’s disease maintain abilities to perform these necessary skills. This was the first study to demonstrate that using music can help people with Alzheimer’s to learn new information.

In the famous YouTube video Man in Nursing Home Reacts To Hearing Music From His Era, we see Henry, a man who was almost totally unresponsive, begin to respond with sound, movement and facial animation when he uses an iPod programmed with “Henry’s music.” After the iPod is removed, Henry is not only quite spirited, but totally involved in the ensuing conversation. He is able to discuss his favorite musician, Cab Calloway, and when asked, “What is your favorite Cab Calloway song?” Henry begins to sing, “I’ll Be Home for Christmas.” Not only is his speech perfectly clear, his face is expressive, he uses his hands in explaining the emotional power of music. The interviewer inquires of Henry, “What does Cab Calloway’s music mean to you?” Henry talks about what music does for him – that the Good Lord changed him through music and made him a “holy man.” The transformation of Henry is nothing short of miraculous and raises questions about why music is not used in every home, in every assisted living facility, and in every skilled nursing home where someone with Alzheimer’s is cared for.

Music should be a routine part of care; not only does it bring joy to the person with this terrible disease, it allows for continuing connections between the caregiver and the person with Alzheimer’s disease. It diminishes the lonely isolation that is part of the disease when the afflicted person appears to be locked in a world that is isolated and isolating to others.

One more story about the power of music: a gentleman named Ben shared this story about his wife who had been diagnosed with Alzheimer’s and was well into the middle stage when he placed her in a facility for care. Ben visited often, and one of the techniques he used to stay connected to his wife and to make the visits pleasant and meaningful for both of them was to draw on his wife’s past history with music. She had sung for many years with the Sweet Adelines and she retained her lovely singing voice despite the ravages of Alzheimer’s disease. Ben loaded music that his wife had sung through her years with the Sweet Adelines. He attached two sets of earphones into an iPod – one for his wife and one for himself, and they would sing together. Music was a powerful connection between them that remained until his wife passed away.

At Nightingale Homecare, providers of the highest quality home health Scottsdale families trust, we are passionate about helping those with Alzheimer’s disease live life to the fullest. Our Connections Dementia Care program incorporates music and a variety of other creative techniques to enhance quality of life. Contact us at (602) 504-1555 for a free in-home consultation to learn more about our specialized dementia care services.

 

About the Author: Verna Benner Carson
P.D., PMHCNS-BC, is president of C&V Senior Care Specialists and Associate Professor of Nursing at Towson University in Baltimore, MD. Dr Carson can be reached at 
vcars10@verizon.net

Occupational Therapy Can Help Alzheimer’s Patients

Scottsdale senior home care

Learn how occupational therapy can enhance the quality of life for those with Alzheimer’s.

Caring for a loved one with Alzheimer’s disease is a constantly evolving process, seemingly changing from day to day or even hour to hour. In the morning, your loved one may be perfectly content to reminisce over family photos and enjoy a walk around the neighborhood; while later in the day, the person may become highly agitated and experience difficulties with sundowning. It can be challenging to know how to most effectively manage the ups and downs of dementia and ensure the senior enjoys the highest possible quality of life.

At Nightingale Homecare, we implement a variety of personalized strategies through our Connections Dementia Care Program, right in the comfort of home, that help those with Alzheimer’s disease live life to the fullest in whatever stage of the disease they happen to be. One of our top recommendations for families is to include an in-home occupational therapist in the care team, something many families haven’t considered. Occupational therapists are trained to adapt the environment of the person with dementia to maximize safety, while focusing activities on the senior’s strengths and interests, leading to a safer and more fulfilling life.

Here are just a few of the challenges that can arise with Alzheimer’s, and how an occupational therapist can help:

Wandering. Wandering is one of the more dangerous problems in dementia, and can be difficult to overcome. An occupational therapist can develop a variety of customized activities that are engaging and enjoyable for the senior that offer the mental stimulation needed to distract and divert away from the urge to wander. Additionally, other methods can be implemented, such as posting stop signs on doors, recommending the most effective types of door locks, and utilizing a GPS monitor to ensure the senior stays safe.

Dependency. A loss of some degree of independence is inherent to Alzheimer’s disease; yet it’s extremely important to help seniors maintain as much freedom and autonomy as possible. An occupational therapist will observe the senior’s strengths and work with those strengths to create adaptations that allow the person to continue to do as much as possible independently.

Memory loss. Preserving memory helps seniors maintain an emotional connection to both those they love and their own life history. Occupational therapy services can help by providing recommendations for memory-prompting activities, particularly in focusing on long-term memory, which is often better preserved than short-term. Occupational therapists can also create strategies for managing the more difficult aspects of memory loss, such as forgetting who family members are.

We’re pleased to offer professional in-home occupational therapists for help in these areas and many others. Contact us at (602) 504-1555 any time to request an in-home evaluation or to learn more about how our full range of home health care services, including occupational therapy, can help older adults with dementia or any other condition of aging live better lives. Our Scottsdale senior home care experts are always here to help!

5 Key Factors That Can Indicate a Need for Senior Home Care

at home care scottsdale caregiver with elderly female gazing out window in wheelchairAccording to a recent study, senior citizens fear moving out of their homes and into a nursing home more than they fear death. The study, “Aging in Place in America,” also found that the adult children of seniors also fear for their parents. Specifically, they express concern about their parents entering a nursing home and suffering a decline in their emotional and physical wellbeing.

Another key finding of the study is that nearly 90% of seniors want to “age in place,” meaning to grow older without having to move from their homes. Sadly, more than half (53%) are not confident about their ability to accomplish this. Although seniors living at home are determined to maintain their independence and stay home, they report that they often do not receive the support they need from their children or other caregivers in order to accomplish this goal safely. In addition, our elder loved ones may hesitate to approach the subject of needing help, specifically because they fear losing independence and don’t want to be the cause of any stress for their adult children. For these reasons, it is important that you be on the lookout for signs, so you know the right time to provide your loved ones with a little extra attention from an agency specializing in elderly home care, like the Phoenix home care specialists at Nightingale Homecare.

If you notice any of the following signs with your loved one, it may be the time to consider home care:

  • Physical Changes. A decline in physical health can increase the risk of your loved one falling or suffering other serious injury. Look for changes, such as difficulty walking, maintaining balance and unsteadiness. If your loved one appears to be in a frail condition, it can be dangerous for him or her to do even the simplest tasks.
  • Inattention to Personal Hygiene. Those individuals who neglect personal hygiene may have a strong body odor, unkempt or unclean hair, obvious inattention to oral care or soiled clothing. While these elderly individuals would like to keep clean, it may have become too difficult to complete the daily tasks to do so. Having in-home care ensures that your loved one can safely maintain a regular hygiene schedule, which improves his or her health and wellbeing.
  • Lack of Nourishment. Your loved one may have lost the ability to regularly prepare food at mealtimes due to lack of energy or other physical conditions. Getting to the grocery store weekly to purchase fresh, healthy foods can be a challenge, meaning the refrigerator and cupboards may not be stocked or there may be many items that have passed their expiration date. Not eating properly can lead to lack of nourishment and dehydration, which causes cognitive issues, depression and other health concerns. A home care agency will provide your loved one with help grocery shopping and preparing meals as well as providing a companion to sit down with at mealtimes, which may make eating more enjoyable.
  • Inability to Manage Medications. Taking the prescribed dosage of medicine is essential to maintaining health, especially for elderly individuals, with chronic or ongoing medical issues. Many times, the elderly are prescribed a number of different medications with different dosage schedules. Prescriptions and dosages can easily become mixed up or forgotten, which can lead to missing or overdosing on medications. When this happens, severe health problems can occur. Professional home care can ensure that your loved one stays on his or her prescribed medication schedule.
  • Lack of Attention to Household Upkeep. When visiting with your loved one, look for things such as stacks of dirty dishes and laundry, overflowing trashcans, and appliances that have been left turned on. If the living spaces are dirty and more cluttered than the person would normally allow, this is a sign that he or she needs some extra help keeping up with the demands of managing a home. Home care assistance will make sure that your loved one lives in a space that is regularly cleaned and clutter-free.

For a trusted, professional partner in care to help your senior loved ones remain safe, comfortable, and healthy at home, contact Nightingale Homecare’s Phoenix home care experts any time at (602) 504-1555.