Chronic pain is described as any persistent or intermittent pain that lasts more than three months. Depression is described as a psychological state that causes fatigue, appetite changes, sadness, lack of motivation, slowed response times, difficulty sleeping, feelings of helplessness and thoughts of suicide. Studies have revealed that up to 50% of patients suffering from chronic pain are also affected by severe depression.

It can be difficult to assess whether depression has led to chronic pain, or vice versa. Depression can frequently cause unexplained pain, such as back pain and headaches, and people who are experiencing chronic pain can develop increased stress or feelings of guilt and helplessness, often leading to a depressive state. These effects can create a cycle that is difficult to break. Those patients that have chronic pain-induced depression have a poorer prognosis than those suffering from chronic pain without depression. It seems pain and depression create a vicious cycle in which pain worsens the symptoms of depression, and the resulting depression worsens the feelings of pain. Suffering from both conditions tends to promote their own severity.

One of the reasons depression and chronic pain are so intertwined is because of the way stress works on the body. Chronic pain turns on the “fight or flight” stress signals in the brain, preparing the body to fight off whatever is causing the pain. The nervous system is in a high state of alert, and eventually this wears the body down, leaving the person vulnerable to depression. Finding ways to deal with stress and cope with chronic pain can give you an edge in the battle against developing depression.

Chronic pain-induced depression can keep you from enjoying life, such as spending time with your children and grandchildren, engaging in hobbies, exercising and traveling. It can also lead to isolation, exacerbate other health conditions, and can be emotionally draining.  It can quickly lead you in a downward spiral, and without treatment and attention, can gravely affect your quality of life.

ASSEMBLING YOUR TEAM

Those patients suffering from chronic pain-induced depression benefit most when a team of professionals is involved in their care. This team may include a:

Physician: Thorough exams and evaluations are of primary importance in the diagnosis and treatment of pain and depression. Physicians may also include psychiatrists to help manage depression, and pain specialists to help manage the pain. When necessary, both pain and psychiatric medications may be prescribed.

Therapist: Anxious and negative thinking patterns can be alleviated during regular sessions with a trained therapist. Coping skills and behavioral therapy skills can be taught to reduce the symptoms of pain and depression. A therapist can also work with the patient’s family to help them understand this complex disease process.

Physical Therapist: A physical therapist can be invaluable in their instruction on exercise and muscle relaxation techniques to help improve mobility and reduce pain. The added benefit is that regular movement can help improve mood.

Other Health Professionals: Occupational therapists, nutritionists and acupuncturists can also help alleviate the symptoms of chronic pain-induced depression.

TREATMENT

Catching chronic pain and depression in its early stages can help you get your life back. Early treatment of chronic pain and/or depression can help fight this downward spiral.

Medications

Often, when patients present with chronic pain to their physician, they may be prescribed antidepressants, even if the patient’s mood seems fine. While this may seem odd, the use of low dose antidepressants for pain control is well-studied and has been a standard practice for many years. In low doses, antidepressants cause chemical changes in the brain that alter the way pain is perceived. Of course, another reason they are prescribed is that they can stop the cycle that leads to depression prior to it starting.

Standard analgesics are often prescribed to treat chronic pain. For severe chronic pain, opioids are the most effective medications. Several studies have found that opioids may help achieve antidepressant effects by regulating neurotransmitters; however, the use of opioids in chronic pain-induced depression has been controversial due to patients’ dependence and addiction to them. The long-term use of opioids (over 30 days) has actually been shown to increase the risk of depression. Be sure and thoroughly discuss their use and risks with your physician.

Talk Therapy

Also called psychological counseling or psychotherapy, talk therapy can be very effective in treating both depression and chronic pain by changing patterns of thinking and application of coping skills. Look for a therapist who applies Cognitive Behavioral Therapy, which can provide real-life coping skills that are greatly beneficial to patients.

Stress-Reduction Techniques

Many patients suffering from chronic pain and depression find great relief from utilizing stress-reduction techniques. Many of these techniques are taught in therapy sessions, but many more can be learned on your own. Meditation and journaling can both be extremely helpful in coping with chronic pain and depression. Gentle physical activity such as yoga and tai chi are also very healing. Sometimes, just getting out into nature can help those suffering from chronic pain and depression.

Pain Rehabilitation Centers

In these centers, a team approach is provided to treat both the medical and psychiatric aspects of chronic pain-induced depression. These centers offer outpatient or inpatient programs and can provide immediate and long-term support when chronic pain and/or depression is severe. These programs are effective because they involve a combination of treatments. The Comprehensive Pain Rehabilitation Center at the Mayo Clinic is one such program.

Peer Support

Many people suffering from chronic pain and depression find that support groups can be irreplaceable. Peer support groups offer emotional support through caring, encouragement, reassurance and avoidance of criticism. These groups can also offer information support in terms of advice, suggestions, problem-solving and dissemination of facts. The families of patients suffering from chronic pain often have a difficult time relating or understanding, and these groups provide an outlet where the patient is heard without judgment.

The PAINS Project is a great resource for finding more support.

If you are in crisis and need immediate emotional support:

• Call your or your loved one’s health professional
• Call 911 for emergency services
• Go to the nearest hospital emergency room
• 1-800-273-TALK (1-800-273-8255) National Suicide Prevention Hotline
• 1-800-442-HOPE (1-800-442-4673) Kristin Brooks Hope Center National Hotline
• 1-877-Vet2Vet (1-877-838-2838) Veterans peer support line or chat online
• 1-800-SUICIDA (1-800-784-2432) Spanish-speaking suicide hotline
• IMALIVE.org (volunteers are trained and certified in crisis intervention)

If you think you might be suffering from depression in addition to chronic pain, be honest with your health care team and seek the support that will help you regain control over your mind, body and spirit. Nightingale Homecare, top providers of the best home care in Paradise Valley and the surrounding area have to offer, can serve as an invaluable resource to you as well, with a full range of customized skilled and non-medical in-home care services. Contact us for a free in-home consultation at (602) 504-1555to discover how we can help enhance joy, comfort, and overall wellbeing and quality of life.

Learn the importance of proper oral care for the elderly.

The older we get, the more time it seems necessary to spend on maintaining optimum health. Between checkups with primary care physicians, blood work and other lab tests, visits with specialists for chronic conditions, and more, there is one area that many seniors seem to let fall by the wayside: continued, ongoing dental care. While the reasons for this are varied, it is crucial for all of us, regardless of age, to stay on top of oral hygiene needs.

In fact, statistics show that in adults over age 65, as many as 40% suffer from gum infections, 30% struggle with issues related to broken and/or decaying teeth, and nearly a fourth have no teeth at all.

In addition to the pain and discomfort poor oral hygiene causes, the home care team at Nightingale Homecare shares several key risks that can arise:

• Sickness: Infections in the gums can lead to serious infections throughout other parts of the body. Even something as seemingly innocuous as bad breath can indicate the presence of an infection that could travel through the bloodstream to the heart and lungs, resulting in pneumonia or other respiratory illnesses. In fact, gum disease is even linked to the prevalence of cancer, heart disease, and other chronic conditions.
• Eating difficulties: Older adults with dental problems struggle with the ability to chew healthy foods like meat, vegetables, and nuts, opting instead of softer foods that are often low in nutrients and high in salt, fat and sugar. Malnutrition causes additional physical problems such as an increased risk of falls, diabetes, immune deficiencies, heart disease, and more.
• Isolation: The self-consciousness resulting from failing teeth and gums, along with the discomfort experienced in eating can cause older adults with poor oral hygiene to avoid social situations. And we know that a lack of healthy socialization leads to a variety of conditions, both physical and emotional, including depression, anxiety, and cognitive decline.

Help your senior loved ones maintain good oral hygiene to maximize overall health and wellbeing. Nightingale Homecare, top providers of the best Phoenix care at home for seniors, is on hand to keep seniors healthy and well by providing transportation and accompaniment to medical appointments, including visits with the dentist, running errands such as picking up any needed prescriptions and dental care products, and a full range of both medical and non-medical in-home care services. By monitoring a senior’s health ongoing, we can help proactively catch and address any problems early, and avoid serious complications that can arise when needs go unmet.

Contact us any time at (602) 504-1555 to improve quality of life for your senior loved ones!

Improve balance and prevent falls with these tips from our Scottsdale home care experts.

From adulthood onward, all of life can seem like a balancing act. We balance work, family, friends, community, etc. But then there comes a time later in life when, for the sake of our safety and independence, we have to consider our actual balance. As we age, our bodies naturally change, and there are many things that can affect a senior’s balance, including:

• Low vision
• Poor muscle tone
• Medications
• And more

Luckily, there are several simple, common-sense lifestyle changes that can help seniors improve balance and prevent falls.

Exercise

Exercise is an essential part of a healthy lifestyle, and research shows that following a regular exercise routine can help older adults build muscle tone that can improve balance and reduce the risk of falling. Consider working the following types of exercise into your daily routine:

• Tai chi
• Yoga
• Dance
• Water aerobics
• Strength and resistance training

Adjust your diet

Generally, eating a well-balanced diet and avoiding alcohol in excess is key for a healthy lifestyle. However, some seniors may need to make adjustments to their diets in order to get the nutrition needed to improve balance. For example, seniors who have low levels of vitamin D are at an increased risk of having balance problems, falling down, and breaking bones.

Additionally, if the senior has a condition like Meniere’s disease that affects the inner ear, his or her doctor may suggest dietary changes such as:

• Avoiding caffeine as caffeine may make symptoms like tinnitus worse
• Eating six small meals daily rather than three large ones
• Reducing daily salt intake to less than 1,500 mg, to reduce fluid retention
• Avoiding monosodium glutamate (MSG), as it may cause fluid retention

Use corrective devices as needed

Often, poor balance is caused by physical changes in the body, such as reduced vision, hearing or mobility. Hearing aids and prescription eyeglasses can help reduce symptoms of dizziness and disequilibrium, and seniors should get treatment for cataracts, glaucoma, and macular degeneration if needed.

Also, walking aids, such as canes, walkers, and wheelchairs, can help seniors live safely and independently when they are properly used.

If a dizzy spell occurs…

It may not always be possible to prevent a dizzy spell, even if you take all the precautions listed above. In order to prevent loss of balance when feeling dizzy, follow these steps:

• Sit or lie down as soon as you feel dizzy
• Move slowly and try not to change the position of your head
• Rest as much as you can and don’t try to go back to your regular activities before you are ready
• Don’t smoke
• Avoid exposure to things that may cause sinus congestion
• Try to manage your stress and anxiety levels

At Nightingale Homecare, we strive to help seniors stay safe, happy, and healthy in the comfort of home by offering a full range of Scottsdale home care services that can allow them to live the lives they want. To help ensure the home is a safe place, we are always happy to provide a home safety assessment and make recommendations on how to reduce the risk of falls in the home. Additionally, our Paces Fall Prevention Program incorporates the expertise of our professional therapists, dieticians, social workers, home health aides and others to provide a well-rounded fall prevention plan that can be implemented to enhance safety even further.

Contact our Scottsdale home care team today to learn more about how we can help seniors prevent falls in the home.

Are you at risk for infection from antibiotic resistant bacteria?

Antibiotic resistant bacteria, also known as multiple drug resistant organisms (MDROs), are germs that have developed resistance to multiple antibiotics over the years due to overuse of antibiotics – when antibiotics are taken longer than necessary, or taken when they are not needed. These MDROs then develop and can go on to infect others.

New MDROs are constantly developing. They are mainly found in hospitals and long-term care facilities, typically affecting the elderly and patients who are severely ill.

MDROs are commonly spread from patient to patient at the hands of a healthcare worker, or when people come in contact with an infected person, such as touching a draining wound.  These germs can also be spread when a patient comes in contact with an object contaminated with the organism, such as on bedrails or IV poles.

So, are you at risk? The care team at Nightingale Homecare, your local in home senior care experts, identifies the top risk factors of becoming infected with antibiotic resistant bacteria:

• People on long-term use of antibiotics
• People with a severe illness or underlying disease such as diabetes, kidney disease or wounds
• People who have invasive procedures such as dialysis, catheter insertions, drain tube insertions or IV therapy
• People who have had repeated hospitalizations or a long hospital stay
• People who are elderly or immune-suppressed

Serious MDROs have developed from common skin and intestinal organisms which have developed antibiotic resistance:

• Staphylococcus aureus germs, including:
  • MRSA: Methicillin-resistant staph aureus
  • CA-MRSA: Community-acquired MRSA
  • VISA: Vancomycin intermediate-resistant staph aureus (very dangerous, rare)
  • VRSA: Vancomycin resistant staph aureus (very dangerous, rare, most difficult to treat)
• Enterococcus germs, a family of intestinal organisms, including:
  • VRE: Vancomycin resistant enterococcus

All the organisms above can be spread by direct or indirect contact. To avoid the spread, follow these precautions:

• In general, contact precautions should be used when patients have been identified with one of the MDROs listed above
• Full long-sleeved isolation gowns should be worn by all those caring for the infected patient
• You will need to assure that clothes do not come in contact with items that would likely contain a lot of germs (e.g., bathroom, bed linens)
• The most important part of contact precautions is appropriate hand washing and wearing gloves

Contact precautions are indicated as long has the patient has symptoms (e.g. unhealed
infected wound, watery stools several times a day).

MDROs are difficult to treat because they do not respond to many common antibiotics, even the most powerful ones. There are some antibiotics that can help control MDROs in most people, and the doctor will try to find the best antibiotic for the MDRO.

To help lessen the impact of antibiotic resistant bacteria, everyone should advocate for antibiotic best practices and antibiotic stewardship. Only use an antibiotic for a true bacterial infection. A lot of infections are caused by viruses. Antibiotics do not work on viruses, and use of antibiotics in these instances can contribute to the problem of antibiotic resistant organisms.

For more information visit the CDC Antibiotic Resistance website or contact your local in home senior care experts at Nightingale Homecare any time at (602) 504-1555.

If you were at risk for a serious chronic illness like diabetes, chances are you’d know it, right? Turns out, you might not. According to the CDC, one in three Americans has pre-diabetes, and most, 90% in fact, don’t even know it. Because November is National Diabetes Month, our professional Phoenix caregivers want to give you the heads up on how to know if you have pre-diabetes and what you can do about it if you do.

What is pre-diabetes?

Because it often doesn’t present with any symptoms, many people don’t know that pre-diabetes exists or how serious it is to their health. In fact, pre-diabetes frequently goes undetected for years until a person experiences a major health problem caused by elevated blood sugar levels that put the person at increased risk for type 2 diabetes, heart disease and stroke. So, how can you know if you’re at risk for pre-diabetes?

It’s important to talk to your doctor about your risk for pre-diabetes, but certain lifestyle and hereditary factors can increase your risk, including:

• Being overweight or obese
• Being 45 years or older
• Lack of physical activity
• Having a close family member (parent or sibling) with type 2 diabetes
• A previous diagnosis of gestational diabetes (diabetes during pregnancy)
• Being of African American, Hispanic/Latino American, Native American, Pacific Islander, and/or Asian American race

What can you do now to prevent diabetes?

If you have pre-diabetes or are at risk for the disease, there is good news. The steps for prevention are basic, healthy lifestyle choices that you can start making now.

Step 1: Start exercising. A simple thirty minutes a day, five times a week of brisk walking or a similar activity is recommended to help increase your physical activity.

Step 2: Reduce your weight if you are overweight. A modest weight loss of five to seven percent can make a significant difference.

Step 3: Eat better and smarter to help lower blood sugar. Eat a variety of foods—particularly whole grains and fruits and vegetables, limit serving sizes so you don’t overeat and eat regular meals and small snacks.

Step 4: Find support. Making lifestyle changes to support your health, while important, can often feel daunting, so it’s vital to find support to help keep you on the healthy path. Nightingale’s professional Phoenix caregivers can help support your healthy lifestyle changes by shopping for and preparing nutritious meals that meet your unique dietary needs and encouraging and supporting you in exercise programs recommended by your doctor.

Additionally, our Pathlink Chronic Disease Management program is known for improving outcomes and decreasing re-hospitalizations for patients with a wide variety of chronic conditions, including diabetes, through improved health literacy, self-management skills, and more.

If you or a loved one has pre-diabetes, our dedicated Phoenix caregivers can help. Call us at (602) 504-1555, or contact us online to let us know how we can help, and we’ll be in touch with you as soon as possible.