Category: Navigation

Dementia Awareness

Blog provided by JaNae Gregg, University of Northern Colorado Student and Covell Care Intern.

In America, one in ten people over the age of sixty five has Alzheimer’s dementia.  Two thirds of these people are women. In 2000, 4 million people in America were diagnosed with dementia.  By 2012, nearly 4.5 million people were diagnosed with this disease. With a rapid increase of people diagnosed with dementia it is important to notice the early signs and receive treatment.

Early signs of dementia include: Increased confusion, memory problems, reduced concentration, personality or behavior changes, apathy, and loss of ability to do everyday tasks. These symptoms can come on suddenly or gradually. Unfortunately, these signs can often be mistaken or overlooked. If you or someone you know is showing any of these signs it is important to seek a doctor and get a medical diagnoses.

If you are caring for a patient of dementia it is important to keep a positive mindset, remember body language and attitude communicate your feelings more than words do! Dementia can be tough for both the patient and the caregiver, so it is important to be clear when relying messages to the patient and to also ask clear and answerable questions.  Conducting activities are easier when performed in steps, this helps instruct the patient with dementia and to avoid frustration for the caregiver.

This being said, frustrations will still occur.  When the going gets tough for the dementia
patient try changing the subject or even the environment.  It is important to remember to connect with the person on a feelings level. This means when making suggestions state what feeling you are sensing from them.  This could be done by saying, “I know you are feeling sad today, maybe a walk would make you feel better?” Doing this will help make a connection and improve communication.  Being diagnosed or having someone you care for be diagnosed with dementia is not easy, catching warning signs early could help with treatment and the caregiving process.

Preventing Falls

Blog provided by JaNae Gregg, University of Northern Colorado Student and Covell Care Intern.

Top 5 Ways to Prevent Falls

Aging into later life can bring many concerns, one of the biggest concerns with aging is falling.  The CDC estimates that 1 in 3 seniors will fall at least once a year. One of the biggest predictors of having a fall is already having a previous fall.  This can be worrisome not only for the person involved, but also the families. To prevent something as serious as a fall from happening the first time, it is important to review 5 steps that have been proven to help prevent falls.

One of the first steps in preventing a fall is reviewing medications, certain medications have been linked to increasing falls in seniors.  Such medications include: sedatives and tranquilizers, antipsychotics, nighttime drugs, over-the-counter medication, medications that cause drowsiness.  If these medications are taken, it is important to review them with a doctor to assess the amount of risk of falling involved.

Checking blood pressure while sitting and standing is the second important step in fall prevention.  A substantial drop in blood pressure when a person stands up or changes position is known as postural.  Drops in blood pressure is common for older adults, especially for those who are taking medicine to lower blood pressure.  Blood pressure treatment has in fact been linked to some of the most serious falls in older adults.

The third step in preventing a fall involves a balance evaluation.  If you or someone who know has noticed difficulty with walking or standing should seek an evaluation by a doctor.  These evaluations are covered by Medicare and can be very useful in preventing a fall from occuring. Strength and balance exercises may be recommended to insure this.  Along with these exercises, taking a daily walk can be very helpful in improving balance.

A home safety assessment may be one of the most important parts to preventing a fall.  A set up of a home and placement of furniture and other household items can easily set a person up for a bad fall.  Having a home healthcare agency to have an Occupational Therapist come and evaluate the home for possible falls is an easy way to prevent something serious from happening.  

The final step in fall prevent consists of getting enough Vitamin D.  Taking 1,000 IU per day will help insure that a person is getting the recommended amount of Vitamin D.  A deficiency in Vitamin D can lead to fragile bones and may cause a fall.

Fort Collins Nurse/Author Releases New Book on Cancer Survivorship Care for Everyone

Working as an oncology nurse in the hospital, Alene Nitzky soon realized her skills and knowledge, as well as her co-workers’, were profoundly underutilized to meet the needs of patients undergoing cancer treatment. From the initial shock of a diagnosis, patients progressed to paralyzing fear around their mortality. Not knowing what to do, when, in what order, or who to rely on for help, patients missed key information that would have helped them go through the cancer patient experience with less distress and anxiety.

Afterward, patients were left to their own devices to recover, with little support or guidance, and few skills to help them restore their quality of life. Outside of the healthcare system, instead of taking a distant, clinical, big data approach, Nitzky describes meeting people where they were, in their homes, communities, and support groups, where she could listen to their everyday concerns- the ones they never had time to discuss in short medical appointments. Given time and active listening, they articulated their needs for practical skills in understanding health information, self-advocacy, and self-care that accommodates their lifestyles, and matches their values and preferences around quality of life.

In three, easy to understand, skill-based education programs aimed at closing gaps in information and understanding about cancer and survivors’ needs, the author calls for active prevention and preparation to reduce the trauma of a cancer diagnosis through C.A.R.E.: creativity, authenticity, resourcefulness, and empathy. Navigating the C will walk you through the steps you need to take to get your needs met in a system that so often fails cancer patients in finding the way back to themselves, and the possibility of emerging better than ever.

Everyone can expect to become empowered by reading this book by a passionate advocate for patients and healthcare workers: Patients, caregivers, and survivors will gain self-advocacy and self-care skills to have more control over their follow-up care experiences, and become more active and confident participants in their own healthcare. Ordinary citizens and those who have never had cancer will learn the simple steps they can take to reduce the trauma around an initial cancer diagnosis for themselves, or support their loved ones. Healthcare professionals will examine their own values around providing cancer treatment and survivorship care.

Finally, those on the fringes of clinical care- the decision-makers and administrators- will gain insight into what really happens to the end-users of cancer services and how their lives are impacted by their experiences in healthcare. Nitzky appeals for the importance of reducing the trauma of a cancer diagnosis, the intrinsic value of community programs, and smaller, individual approaches to cancer survivorship care, where big healthcare and big business miss the mark.

Navigating the C: A Nurse Charts the Course for Cancer Survivorship Care. By Alene Nitzky, Ph.D., RN, OCN. Blue Bayou Press, 2018. 216 pages. $19.95 paperback, $9.99 Kindle. Available on Amazon.

Navigating the C is available on Amazon:   https://a.co/ciTYFWi

Local Signing event at Elevation 5003 on January 28:   https://www.eventbrite.com/e/navigating-the-c-book-signing-meet-the-author-tickets-42151424044

February 12 at Raintree Athletic Club, and February 22 at Hope Lives! For more details, visit https://cancerharbors.com/events 

What to look for with your loved one this holiday season…

The holiday season is a time of gatherings with friends and families, visits to your loved one’s home and hours upon hours of conversation. This is a time when you see a new perspective or maybe even see the truth behind the multiple phone calls or short visits that happen throughout the year.

Go into your holiday season with some insight to better understand your loved ones, their situation and needs. Don’t forget to pack the Aging Life Care Association’s ‘red flag’ list with you when you leave for the holidays.

  1. Scan & take mental notes about your loved one’s environment. Signs of damage in the home, on their vehicle, unopened mail, items placed in unusual areas, decline in cleanliness.
  2. Check out their food. Is there enough food, is it expired, notice any changes in weight (up or down).
  3. Has their mood or behavior changed in any way? Has their social life changed, do they have new friends, are they donating large amounts to organizations, is there an increase in confusion, are they walking differently or change a routine, are they irritable or withdrawn.
  4. Are they keeping up on their personal hygiene? Dressing for the day, showering regularly, do you smell urine or bowels, are their clothes clean, notice any bruising on their skin.

There are many other small pieces you can take away from an encounter with a loved one but here is a start. If you notice any changes and don’t know where to turn contact us for some direction. (970) 204-4331.

Wishing you and your family a happy, safe holiday season!

Why Hire a Private Care Manager

Of all the services Covell Care provides, Geriatric Care Management creates the most questions. Families don’t understand what a private care manager does. People have met care managers in other settings like hospitals and home care agencies and think all care managers do the same thing. Think again.

Geriatric Care Managers (also may be referred to as an Aging Life Care Professional) wear a multitude of hats when working with Covell Care clients. They may sit down with families and review concerns, plans for the future and give expert advice and guidance while breaking it down into tangible steps. Care managers may be tethered to a family throughout their loved one’s life through aging, dementia, disease progression, hospital stays and even hospice. The relationships between families and care managers are deeply personal on both sides. There is very little red tape in hiring a care manager because insurance rules and regulations do not limit all that a care manager can do. It can be incredibly powerful to remember that because insurance doesn’t pay for a service you can still receive it.

As anyone that is involved in the aging process with a loved one knows, the experience can be overwhelming, stressful and possibly the hardest thing a person will experience. There are so many moving parts in the aging process. You may have to tend to a loved one’s medical needs, physical changes and hardships, medication regimes, memory loss, personality changes, pain, recovery from surgery, safety concerns, incontinence, quality of life, adding ramps, grab bars, shower seats to the house, arranging appointments and maybe unexpected trips to the ER. The list can feel endless. On top of all of the moving parts, our current healthcare system is far from simple and navigating the system is harder than ever. A Geriatric Care Manager can co-pilot this process with a family offering emotional support, expert guidance, simplifying the most complex of situations and advocate for a family and their loved one throughout it all.

During a recent personal experience, I was reminded not only of the benefits of working with a care manager but really how imperative it actually can be.

About a month ago my husband and I flew home from vacation in Europe. Upon our return, my husband began to experience severe pain in his lower rib area. Within 24 hours of being home we were in the ER where a radiologist discovered my husband’s lungs contained multiple blood clots–also known as pulmonary embolisms. His pain stemmed from the damage the clots were causing inside the lungs and after multiple medications designed to curb the pain, one finally worked and he could rest. My husband was admitted to the hospital for 4 days. During that time, it was also discovered that he had two blood clots in his right leg. Because of the pain medication, my husband’s thinking was not clear and he relied on me to talk with the docs. As he improved, he continued to wear oxygen during the day and night to support his lungs.

I participated in monitoring the saturation of the oxygen by using the hospital’s pulse oximeter–a machine that simply measures how much oxygen is in your blood (the goal in Colorado should be always over 90%) and how many beats per minute the heart is beating. Throughout the 4 days, my husband could maintain good saturations without the oxygen when he was up and walking around. When he would rest, his lungs would then breathe more shallow and his oxygen saturations would drop below 90%.

Once we were given discharge orders from the hospital we headed home–without oxygen and without an order to receive it. I used my home oxygen monitor and discovered he was continuing to drop as low as 68% once we were home–this is not an acceptable oxygen level for anyone.

What followed next was incredibly stressful. We called his on-call doctor to report the findings. Because the hospital record did not indicate oxygen levels had dropped the doctor would not write orders for home oxygen. The records at the hospital were incorrect and no matter what I explained, the doctor wouldn’t budge. So, I called the hospitalist and received the same information. I called the nurse that took care of my husband in the hospital and she was certainly frustrated that oxygen had not been ordered but her hands were tied. I called the on-call doctor again. I took my husband to the ER and explained he would not drop below 90% unless he fell asleep–and he obviously wouldn’t be sleeping in the ER bed. No oxygen was ordered. I called the oxygen company. Nothing could be done without the doctor’s order. I was frustrated to tears. Because the health care providers were not helping (this all happened over a weekend) I knew we had a doctor’s appointment on Monday so we propped him up on pillows to help elevate the chest and lungs creating a better chance for him to breathe better at night and I woke him up every 1-2 hours. By the time Monday had come, I was as tired as he was.

What would have happened if I didn’t have a health care background? My husband would have continued to sleep every night dropping into those low numbers which can lead to passing out and not being able to wake up, long-term impairments and longer healing time for the lungs and potential other harmful–possibly fatal– issues. Luckily, we knew how to work towards getting a resolution and jumped through hoop after hoop.

These are the types of things a care manager can step in and help with. If I would have had a care manager in place would we have even made it out of the hospital without the order for O2?  More than likely, a care manager would have ensured all the I’s were dotted and T’s crossed and the oxygen would have been ordered without all the headaches (we did receive the home oxygen unit on Monday!). A care manager could have stayed at the hospital with him waiting for the doctor when I had to go to work for a few hours to see clients of my own. I ended up missing the doctor’s visit and my husband had forgotten to ask several of the questions about the medications. Once I returned, the doctor was on to the next patients and didn’t return to repeat the information. That extra, knowledgeable, patient advocate would have really helped! The second night my husband was in the hospital the nurses wanted us to do education about his injectable medication at 10pm. Because of the jet lag, the previous late night and early mornings I was so tired I don’t remember driving home that night. A care manager could have potentially arrived at that 10pm time to participate in the education on my behalf. The list goes on and on. And this is only for a 4 day hospital stay. Can you imagine all the things that can go haywire with longer stays?

I share this experience with you to help frame where the Geriatric Care Manager could potentially fit into your life. Not only in the hospital for more acute issues but in the day-to-day. Hiring a care manager will make things easier and even make things better overall because details won’t get missed or forgotten. The pressure can ease up from you being the one-and-only person to keep it all together. Less stress. Less tears. More sleep. More time. More clarity.

To find out more about what a care manager can do for you and your family call our main line at 970-204-4331.