Both doctor and hospice nurse are responsible for the patient’s health, but while doctors strive to keep patients alive, the hospice nurse focuses on keeping patients comfortable as they die.

The idea of formalized hospice care was accepted into mainstream medical care in the United States only in the past 20 years.

The term “hospice” was first applied to specialized care for dying patients in 1967. States were given the option of including hospice care in their Medicaid programs in 1986; it became a nationally guaranteed benefit in 1993.

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Before you can even begin the process of evaluating assisted living, it’s im- portant to familiarize yourself with all the terms. There are many types of care ranging from skilled nursing to senior living. They all vary based on the level of assistance required by the resident.

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A geriatric screening is a comprehensive assessment designed to optimize an older person’s ability to enjoy good health, improve their overall quality of life, reduce the need for hospitalization and/or institutionalization, and enable them to live independently for as long as possible.

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Has your loved one lost interest in reading, playing cards, or other hobbies where clear vision is required (embroidery or television viewing, for example)?

Are their clothes, shoes or socks frequently mismatched?

If they still drive a car, are they getting lost more often (because they can’t see the street signs)?

Has your loved one started to fall, trip or bump into things more frequently?

Once again, a primary concern here is one of safety. How safe can your loved one be, if they can’t clearly hear or see the world around them? And if they’re driving, it can be catastrophic.

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• How is Your Loved One Feeling Today?

• Regardless of our age, our bodies are in a continuous state of decline. Whether it is reading glasses, arthritis or a doctor’s warning about your lifestyle, our bodies emit warnings about its decline.
• It’s no different with our loved ones, except that while it can be an inconvenience for us, it is a matter of independence for them. Since you are concerned about your loved one, you’ll want to do an assessment.
• An assessment looks at four areas where change may have taken a toll on your loved one’s independence: the physical, perceptual, cognitive and psychological manifestations of aging. We’re going to explore those areas with one overriding premise: ensuring their safety, and the safety of those around them.

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Schedule deliveries around peak times.  Think about when you have the most energy during the day.  In the morning upon awakening, late morning, afternoon or evening?  Really sit down and think about how you feel at various times of the day.  For example, I know I’m a morning person, but  my husband is more efficient accomplishing things late at night when there are less distractions.  Once you figure out your optimal times, schedule your most difficult caregiving duties at those higher energy periods.

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The study, published online in the Journal of Gerontology: Medical Sciences, found that nursing home residents have a fivefold increased risk of falling within two days of a new prescription for or an increased dose of a non-SSRI (selective serotonin reuptake inhibitor) antidepressant such as bupropion or venlafaxine. Researchers said these findings suggest that nursing home staff should closely monitor residents following a prescription change to prevent potential falls.

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Hydration is Key  

The average person needs eight to 12 cups of water daily to help maintain body temperatures and to transport wastes, nutrients and other substances. But as temperatures rise, so does your body’s need for this essential element. With higher mercury readings, perspiration, the body’s way of cooling itself, increases, therefore depleting the body of more of its essential fluids. This is especially true when exercising or taking part in strenuous activities during peak heat hours.   Dehydration is common among the elderly because as the body ages, sweat glands don’t work as well and blood vessels carry less blood to the skin as they once did. So, the body becomes less tolerant to heat.   One way to avoid dehydration is to save activities and exercise for the coolest times of the day — morning and evening. If mid-day outdoor activity is necessary on a hot day, be sure to take frequent breaks in the shade and always have water with or near you. If you feel like you might be starting to overheat, place a cold towel on your wrists, forehead and behind your knees.

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Dr. Martin and two colleagues presented findings from their research on nursing home resident autonomy in the areas of smoking, dysphagia treatments, sexuality, and antipsychotic drugs at the annual conference of the American Society on Aging. They also gave their listeners advice on how to address autonomy vs. safety in these areas.

Smoking

Between 2% and 10% of nursing home residents smoke, Dr. Martin said. She pointed out that, besides its familiar health implications, smoking can accelerate residents’ cognitive decline and risk fires and personal burns.

This article from Internal Medicine News discusses the special challenges of balancing patients autonomy with their safety.

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Introducing the Peacemaker Corps

The Peacemaker Corps concept grew out of the United Nations mission to promote peace, tolerance and conflict resolution. A collaborative effort between the Department of Housing and Urban Development (HUD), Friends of the United Nations (FOTUN) and Simon Youth Foundation (SYF) launched the preliminary Peacemaker Corps trainings in fall of 1999 with the aid of a $ 1MM U.S. Federal Discretionary Grant from HUD. After a successful rollout to 11 cities coast-to-coast and positive feedback obtained in follow-up interviews in the year 2000, the Peacemaker Corps training was incorporated into HUD’s ongoing budgeted programs in 2001, only to be eliminated later due to budget shortfalls.

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