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Pain and Fall Risk: The Dangerous Link You Need to Be Aware of

Fall Risk

Discover the dangerous link between pain and fall risk for seniors.

Studies show that individuals who experience chronic pain are more likely to have fallen in the last 12 months, and are more likely to fall again in the future. Some studies have shown that the use of pain medication and other treatments can provide some protection against falls in patients with chronic pain, and therefore, pain appears to be a “modifiable risk factor” for falls. The reduction of pain appears to not only improve people’s quality of life, but also reduces their risk of falls.

Several factors that account for the risk of falls among chronic pain patients, include:

  • Loss of movement and reflexes
  • Medication side effects
  • Osteoporosis
  • Age-related changes
  • Sensory losses

The Reality of Pain

  • All pain is real: Pain is not imaginary. It is whatever the person in pain is experiencing.
  • Chronic pain is complex: Ongoing pain can affect all aspects of your life, including your relationships with others. Pain itself can be affected by many things, such as hunger, activity, sleep, mood, and stress.
  • Chronic pain is common: Diabetes is one of the more common medical conditions, but estimates are that five times more people suffer from pain than from diabetes.

Pain Management

As you know, the management of chronic pain and reduction of fall risk can feel like a balancing act! Effective pain management aims to reduce your level of pain while increasing your quality of life, without increasing your fall risk.

Pain management at home has several general aspects: 

  • Assessment: Your home health care team will gather information on your pain and other conditions that may affect it. The team will also help you evaluate your home and lifestyle for safety risks to limit the potential for a fall.
  • Management plan: You, your physician and your home health care team will work together to create a plan based on your goals. Staying safe and accident-free will be a top priority.
  • Follow-up: Your home health care team will evaluate the plan and see how well interventions and strategies are working for you, then work with your physician to make changes as needed.
  • Self-help activities: Effective pain management often involves your willingness to help yourself. It’s very important that you take an active approach to managing your pain.
  • Persistence: Chronic pain management requires your persistence to work to find the right approach for you. It will mean learning new skills and relying on inner strength that you may not have realized you have! Your home health care team will be with you all the way!

Combining Techniques and Approaches

Studies show that the most effective pain management with fall risk safety as an equal priority comes from combining multiple techniques and approaches. You will need to take into account your whole person – mind, body and spirit – when looking at the approach that is best for you. Chronic pain can take all sorts of turns, and the approach that works one day may not work the next, so it’s good to regularly evaluate what works and what doesn’t work. Effective pain management includes the following three areas.

  • Medical treatments: These include: injections, tens unit, medication and physical therapy.
  • Self-care: This is probably the most important component of pain management, because often it makes other treatments more effective. Self-care techniques are often free and you can do them on your own. Examples include stretching, reading, exercise and stress reduction.
  • The mind-body connection: Examples include meditation and counseling.

Tracking Your Pain

Pain can be affected by many things in your life, and it’s different for everyone. Your home health care team records a pain snapshot at each visit, but only you can track it day by day to discover patterns and help you identify what works and what doesn’t. Tracking your pain can also help you identify what triggers your pain. Once you have that information, you can avoid the triggers, change them, or plan ahead for them if they’re unavoidable. Tracking your pain will also provide insight into which self-care activities are the best pain relievers. Your home health care team can get you started with a pain journal that will help you record your pain, the measures you have taken to reduce the pain, and the results.

If pain and fall risk have made you inactive and your life feels restricted, try these tips: 

  • Ask your physician or physical therapist to evaluate your mobility and suggest an activity plan. You may be surprised. Some activities you’re nervous about may be just fine for you! Your physical and occupational therapist can help you perform the activities safely. The home health care team can also recommend assistive devices to increase your activity and independence.
  • Start gradually and stretch yourself a bit.
  • Choose one or two activities you’d like to be able to do and make that your goal. For example, taking a walk, sitting at a desk to work for a period of time, or completing some housework or cooking.
  • Decide how long you can do the activity: You might only be able to walk for 10 minutes to start.
  • Do your activity both on good and bad days.
  • Add a bit more time each week. For example, the next week, walk for 12 minutes daily.
  • Find new ways to be active: If an activity you used to enjoy is no longer possible, find an alternative. A gym workout may no longer be suitable for you, but you can try gentle movements in a swimming pool or a tai chi class. These activities can help improve your balance, while reducing your fall risk.
  • Give yourself rewards. Find healthy ways to reward yourself when you meet your goals.
  • Remember to rest. It can help to schedule periods of rest and downtime into your day. Treat them as appointments so you don’t overlook rest.

For more helpful tips, or to schedule a free in-home consultation to see how our in-home care in Paradise Valley, AZ and the surrounding area can help improve health and quality of life for yourself or a senior you love, contact Nightingale Homecare at (602) 504-1555.

Vision Changes & Fall Risk: Scottsdale Respite Care Experts Share Tips

Vision Changes

Most seniors experience vision change, making them twice as likely to experience multiple falls as those with normal vision.

People with vision loss are almost twice as likely to experience multiple falls as those with normal vision. For those with vision loss, everyday tasks such as grocery shopping or navigating crowded spaces can be a source of anxiety. Limited vision also may mean risking a fall away from home, leading many to become homebound and isolated.

Changes in Vision as We Age

Most seniors experience the following normal vision changes that are associated with the aging process. In addition, there are age-related eye conditions that will result in vision impairment.

  • Increased need for light:
    • This is a result of a smaller pupil and aging lens. A senior requires four to ten times more light than a younger person.
  • Reduced visual acuity:
    • After age 60, our ability to see clearly declines. This makes it hard to see steps, or you may not be able discern a curb at the end of a sidewalk. If you have reduced visual acuity, you may be more sensitive to glare.
  • Increased sensitivity to glare:
    • Even though you may need a brighter light source than a younger person, your vision can be reduced by glare. Examples include sunlight shining through a window then reflecting off shiny surfaces, glass tables, waxed floors, or bright light from unshielded bulbs.
  • Difficulty adapting to light and dark:
    • You may not be able to adjust to different light levels, especially in low light. This makes walking to the bathroom at night a significant fall risk.
  • Reduced contrast sensitivity:
    • A loss of sensitivity to detect contrast effects your ability to recognize objects or faces, textures and patterns.
  • Decreased depth perception:
    • You may find it difficult to determine how close or how far away an object is. This makes the detection of how high or low a step is very difficult. You may have trouble estimating the height of a step and misplace your foot, leading to a trip or fall. You may think that carpet is uneven and alter your balance and walking to accommodate the misperception. It also makes it difficult to perceive objects in areas of shadows, low light or bright lights.
  • Seeing spots that block central vision due to age-related macular degeneration:
    • This makes it hard to detect obstacles in your path, and difficult to walk across streets or a parking lot.
  • Decreased visual field due to glaucoma:
    • Your peripheral vision is very important to driving or walking. If you have peripheral field loss and are looking straight ahead, your lack of peripheral vision will not alert you to dangers coming at you. People with peripheral vision loss also experience night blindness, meaning vision might okay during day but impaired at night.
  • Visual changes due to medications:
    • Evaluate all medications with your health care team when you notice changes in vision. Even medications you have been on long-term may be affecting your vision.

Ways to Reduce Your Risk of Falls Due to Vision Changes

You want to be able to move about confidently and safely and to detect dangerous obstacles such as tripping hazards, stairs, curbs, moving vehicles, or people in enough time to react safely.

View Falls as Controllable

For those with vision loss, falling may be inevitable. Knowing this keeps many feeling like it’s too risky to leave the house. Learning how to recover from a fall unassisted can help alleviate fear and regain the confidence to leave the house again.

The Scottsdale respite care experts at Nightingale Homecare suggest the following:

Correct Visual Problems

  • Get an annual eye exam.
  • Correct problems with new glasses and keep them clean at all times.

Optimize Lighting

  • Optimal lighting conditions include more than one light source in a room and higher wattage light bulbs.
  • Use even lighting throughout home.
  • Install night lights to navigate in dark rooms and hallways.
  • Use natural light from windows.
  • Give yourself extra time to adjust when going from a well-lit to a dimly-lit room. 

Reduce Glare

  • Pause to adjust to the change between dark to bright environments.
  • Do not wax your floors.
  • Wear sunglasses outdoors.
  • Avoid directly facing the sun.
  • Cover bulbs with a shade.

Improve Contrast

  • Stairs: Use bright, non-skid paint or tape to contrast the edge of each step.
  • Floors: Use colored tape across thresholds when floors are of different heights.
  • Furniture and Carpeting: Remove clutter and keep pathways clear. Selecting contrasting colors or patterns in furniture and flooring can help. 

Improve Bathroom Safety

  • Install grab bars.
  • Use brightly colored rugs that are secure on the floor with rubber non-skid backings. 

Low Vision Rehabilitation Evaluation

Studies show that people start losing independence when their corrected visual acuity drops to 20/60 or worse. Most health insurances cover low vision rehabilitation examinations. A low vision specialist can evaluate the degree and type of vision loss you have, prescribe appropriate low vision aids, recommend non-optical adaptive devices, and help you learn how to use them.

Finding a Low Vision Specialist

To find a low vision specialist near you, go to www.whatislowvision.org and click on “find a low vision specialist.”

If You Do Not Have Insurance Coverage

EyeCare America, a public service foundation of the American Academy of Ophthalmology (AAO), has several programs designed to meet the needs of those who don’t have vision insurance. To find out more about EyeCare America’s programs, call (877) 887-6327. If you are eligible, you will receive the name of a volunteer eye doctor in your community, along with instructions for making an appointment.

Contact Nightingale Homecare for additional resources related to vision changes and aging, or to schedule a free in-home consultation to discover more ways we can help!

Strike a Pose! Try These Types of Yoga for Elderly Adults to Help Seniors Thrive

September is National Yoga Awareness Month, and the benefits of yoga, regardless of a person’s age, are phenomenal. Yoga for elderly adults, when combined with other healthy lifestyle habits such as diet and exercise, has been shown to minimize hypertension, strengthen bones, and help with weight loss. It may even reverse heart disease, according to one study.

Yoga for elderly

Yoga for elderly adults can be extremely beneficial.

At Nightingale Homecare, providers of the highest quality senior care Phoenix, AZ and the surrounding area have to offer, we love helping the older adults in our care engage in ability-appropriate yoga. In addition to enhanced physical health, yoga for elderly adults can also improve memory, boost the senior’s mood and outlook, and reduce anxiety.

Here are a few great senior-friendly yoga exercises to try at home with your loved one (after receiving approval from his or her doctor):

  • Half Chair at the Wall: Stand about 12” from a wall, with the back touching the wall. Lift the arms forward and up over the head, facing the palms toward each other, and then slowly bend the knees and squat towards the floor, until a seated position is achieved about halfway to the floor. Hold while taking five breaths, and then stand and repeat.
  • Warrior: Stand and place feet hip-width apart, while the right foot is held still, bend the right knee to a right angle, and shift the left foot back about 3 feet, pointing the left toes out to the side. Raise the arms straight up near the ears and look up. Hold for three breaths, return to standing straight on both legs, and repeat.
  • Cobbler’s Pose: From a seated position with legs spread out and the spine straight, bend the knees and bring the feet up toward the pelvis area, with soles touching. Press the elbows against the thighs, coaxing them closer to the floor (without causing any discomfort or pain).
  • Alternate-Nostril Breathing: Place the tips of the right index and middle fingers between the eyebrows, and then place the thumb on the right nostril and the ring and pinky fingers on the left nostril. While pressing the thumb against the right nostril, breathe in through the left nostril. Alternate for the next breath, and repeat for five minutes.

Let Nightingale Homecare help the seniors in your life maximize health and quality of life! Our care team is always available to provide the encouragement and motivation for older adults to engage in yoga and other exercise programs, along with a wide range of personalized medical and non-medical in-home care services. To learn more about our services in senior care in Phoenix, AZ and the surrounding areas, call us at (602) 504-1555 at any time!

Home Care Paradise Valley: Learn to Safely Reposition Your Bed or Chair-Bound Loved One

home care paradise valley - Bed-Bound Seniors

Learn tips to reposition bed-bound seniors safely and correctly.

As providers of the most trusted Phoenix senior care the area has to offer, we know working with bed-bound seniors and chair-bound seniors requires much care and attention, and one of the most critical components is repositioning. The primary purpose of repositioning is to improve circulation to the skin and other organs, relieving pressure and preventing skin breakdown. Repositioning also helps in providing comfort to your loved one and ensures movement of the joints and muscles. Although many bed-bound patients often resist turning and will tell you they just want to be left alone, turning will improve comfort over the course of the day and night, and will also give you opportunity to inspect the skin.

Your Loved One’s Individual Repositioning Schedule

Although the current accepted “guideline for care” is to reposition your loved one every two hours, there is much more involved in finding the right solution for your individual loved one. The frequency of turns/repositioning should be individualized to your loved one based on such factors as:

  • Tissue tolerance
  • General medical condition
  • Level of activity and mobility
  • Overall treatment objectives
  • Comfort
  • Skin condition

To test your loved one’s “tissue tolerance” you must observe and document the time it takes the skin to redden over bony prominences (hips, ankles, shoulders). You must gradually increase the amount of time the person is left in the same position until redness is detected. Once the threshold has been established, you must set the turn frequency to 30 minutes less than the time interval, with no more than 2-hour intervals maximum. Repositioning a chair-bound loved one should occur even more frequently.

In addition to determining tissue tolerance and the frequency of repositioning, you will need to move your loved one using proper techniques. Keep these points in mind when repositioning:

  • Make sure the pressure is relieved or redistributed.
  • Avoid positioning over bony prominences that redden easily.
  • Do not drag or pull your loved one while repositioning, which can damage the skin.
  • Alternate between the back, right side and left side on the schedule determined for your loved one, but at least every two hours.

Necessary Equipment for Your Bed/Chair-Bound Loved One

Depending upon your loved one’s condition and activity orders, the use of equipment can make all the difference for a person who is bed/chair-bound. You should talk to your loved one’s physician and health care team about necessary equipment to aid your loved one in repositioning and preventing skin breakdown and other complications.

Some equipment to consider:

  • A hospital bed with bedrails
  • A trapeze, if your loved one has upper body strength to help reposition
  • A Hoyer lift
  • Drawsheets and bedpads
  • Slide sheets
  • Wedges and pillows
  • Low air-loss mattress
  • Wheelchair cushion
  • Geri-chair
  • Heel and elbow protectors
  • Contracture rolls

Always Use a Drawsheet!

Using a drawsheet under your loved one makes it much easier to position the person, and also reduces the possibility of your loved one developing a skin injury/breakdown. If you don’t have one, you can make one by folding a twin-sided top sheet in half. To place the sheet correctly under your loved one, follow these steps:

  • If your loved one has a hospital bed, raise the bed to a level that reduces the strain on your back, and make the bed flat.
  • Roll your loved one to one side and place the half rolled up sheet on top of the fitted bottom sheet so that the top and bottom of the drawsheet go across the bed (perpendicular to the bed). Position the drawsheet so that it will be between the person’s head and knees.
  • Roll your loved one onto the sheet and unroll the sheet out flat under the person.
  • Tuck in the drawsheet tightly on both sides. Smooth out any wrinkles to reduce possible skin irritation.

Basic Repositioning Rules for a Bed/Chair-Bound Person 

  • Never lift more than you can manage.
  • Get help when needed.
  • Explain to your loved one the steps involved, and how the person can help.
  • Raise the bed to safe working height and ensure that brakes are applied.
  • Never lift your loved one.
  • Never pull the person by the arms.
  • Never attempt to pull your loved one without a drawsheet; the risk of giving your loved one a skin injury or injuring yourself is very high without one!

Moving Your Loved One Up in Bed

There are several methods for moving a person up in bed. If your loved one has some upper body strength or is able to use his/her bent legs to push up in bed, this can be helpful. Aids such as trapeze bars, side rails and “slide sheets” can be useful tools when you are moving your loved one without additional help. The goal to moving your loved one up in bed is to not lift, but pull the person up in bed using a drawsheet. Do not slide your loved one up in bed without a drawsheet, as you can create friction or shear skin injury. These are instructions for using a drawsheet and two-person assist for moving a person up in bed:

  • Lay your loved one on his or her back; place the pillow at the head of the bed and against the headboard.
  • Stand between the shoulders and hips of your loved one, with your feet shoulder-width apart. Weight will be shifted from back foot to front foot.
  • Fan-fold the drawsheet toward your loved one and grab the drawsheet at the person’s upper back and hips.
  • Ask your loved one to tilt his/her head toward the chest to protect the neck, and to fold the arms across the chest, bending knees to assist with the movement. Let your loved one know when the move will happen.
  • Tighten your gluteal and abdominal muscles, bend slightly at your knees, and keep your back straight and neutral.
  • On the count of three, gently slide (not lift) your loved one up the bed, shifting your weight from the back foot to the front, keeping your back straight with your knees slightly bent.
  • You may need to do this more than once to get your loved one in the right position.
  • Replace the pillow under the person’s head, and position the person in bed.
  • If your loved one is going to remain on his/her back, raise the foot of the bed enough to bend the knees. In addition, you can place a pillow under the knees to prop the person up to prevent sliding down in bed. This will help reduce friction and shear skin injury as well.

Turning and Positioning Your Loved One in Bed

Repositioning bed-bound seniors is easier to accomplish with help. If you don’t have help, it can be done but will require more steps to accomplish. Here are the steps to repositioning a person in bed without help from experienced providers of home care Paradise Valley families depend on.

  • Move the person to the center of the bed so the person is not at risk of rolling out of the bed.
  • Ask your loved one to look towards you. Position the arm nearest you stretched toward you and the arm farthest from you across his/her chest.
  • Position a pillow next to the person on the opposite side of the bed.
  • Reach over the person and grab the drawsheet on the opposite side, gently pulling the drawsheet toward you.
  • Gently pull the person’s hip and shoulder towards you with the drawsheet as you place the pillow under the drawsheet to prevent your loved one from rolling back.
  • Go around the other side and get your hands, palms up, under the person’s hips to pull him/her back into position.
  • Position the pillow or a foam wedge under the drawsheet at the person’s back. Push the pillow close against the back to help prop the person on his/her side.
  • Make sure the arm under your loved one is pulled out from under him/her, resting more on the shoulders for comfort.
  • Make sure your loved one‘s ankles, knees, and elbows are not resting on top of each other to prevent skin problems.
  • Make sure his/her head and neck are in line with the spine, not stretched forward, back, or to the side.
  • Place a pillow under the top arm of your loved one.
  • Place another pillow or a specially designed foam leg wedge between the person’s knees. This extra bit of support will add comfort by keeping the spine in alignment and by easing pressure on the bony areas of the knees and ankles.
  • Return the bed to a comfortable position with the side rails up. Check with your loved one to make sure he/she is comfortable.

Repositioning Your Seated Loved One

Repositioning chair-bound persons is just part of the care to prevent the development of skin problems, and each person will present different needs. Seated people need to be repositioned more frequently than bed-bound people. Instruct your chair-bound loved one to shift his/her weight every 15 minutes. If your loved one is unable to reposition, you will need to physically move him/her at least every hour. To do this, you will need to use a drawsheet or sling under your loved one’s buttocks and hips to gently pull from side to side. In addition, your loved one who is chair-bound should always use a pressure redistribution cushion, which will distribute the weight of the body without impeding function or increasing the risk of skin damage.

Other factors, such as your loved one’s nutrition, medical condition, skin condition, and tissue tolerance will also determine repositioning needs. Ask your loved one’s health care team what their recommendations are for repositioning. Use of a Hoyer lift, geri-chair and a seated positioning system may be necessary for your loved one who is unable to reposition independently in a chair.

To ensure your loved one is safe from injury – as well as yourself! – call on Nightingale Homecare, providers of the most trusted Phoenix senior care the area has to offer. We can assist with a full range of both skilled and non-medical services for seniors in the home, based on each person’s individual needs. Call us at (602) 504-1555 to learn more.

Posted in Aging Issues, Senior Safety on September 6th, 2019 · Comments Off on Home Care Paradise Valley: Learn to Safely Reposition Your Bed or Chair-Bound Loved One

Seniors and Shingles: Is Your Loved One at Risk?

Shingles

Learn everything you need to know to protect seniors from shingles.

Back in the day, getting chickenpox as a child was a rite of passage. Parents would often even throw “chickenpox parties” – inviting the neighborhood kids over when one was contagious with the disease! The thinking was that since everyone was going to catch it anyway, why not get it over with?

Thankfully, we now have effective vaccines that allow for the prevention of chickenpox. But for those who were stricken with the disease at some point, the lingering effects can manifest later in life as shingles – a condition that can lead to significant pain and discomfort that can last for weeks. There are also a number of serious complications that can arise in older adults who develop shingles, including:

  • Blindness
  • Infection
  • Neuralgia (nerve pain)
  • Hearing loss
  • Encephalitis
  • Facial paralysis
  • And more

Although contagious, it’s important to note that it is the chickenpox virus that will be passed on from the person infected with shingles – not shingles itself.

Shingles typically displays as a rash of blisters that wrap around one side or the other of the upper body, with pain, burning, tingling, or numbness, sensitivity when touched, itching, and sometimes fatigue, headache, fever, and light sensitivity.

Additional risk factors, over and above being a senior, include taking certain prescription medications (prolonged use of steroids, for instance, as well as medications taken to ensure transplanted organs are not rejected), diseases such as HIV/AIDS and cancer, and any other condition or treatment that leads to a weakened immune system.

There is a silver lining in all of this, however! Two types of shingles vaccines are available and recommended for everyone age 60 and older: Zostavax and Shingrix. Talk with a doctor to determine which is right for your senior loved one, but the basic differences include:

  • Zostavax: A live vaccine that provides protection for five years, given as a single injection.
  • Shingrix: Often preferred over Zostavax, Shingrix is a nonliving vaccine that provides protection beyond the five-year mark. Shingrix requires two injections given six months apart.

Although neither vaccine provides 100% protection, the risk of contracting the disease is reduced, and if a vaccinated senior does develop shingles, it’s typically less severe and of a shorter duration, with fewer complications.

For more information about shingles or any other concerns of aging, contact the experts in elderly care Scottsdale at Nightingale Homecare. Our nursing team is always on hand to help provide the resources seniors and their families need to optimize health and wellbeing, and our customized in-home care services ensure that older adults are living life to the fullest, each and every day.

Contact us at (602) 504-1555 to chat with our team in elderly care Scottsdale or to schedule a complimentary in-home consultation and discover a better quality of life for a senior you love!