Page 1

Healthy eating

Angina vs heart attack

Caregiver SOS: Declutter

April 2017

Dealing with the unthinkable:

See page 9

stay social Encouraging your elderly loved one to

AS PEOPLE AGE staying social and involved in the community becomes even more important and seniors are at a higher risk of suffering from loneliness and isolation. Living alone, retirement, losing loved ones and poor health conditions can all prevent seniors from being social. But studies show people who are social are less likely to suffer from depression, live longer, have less stress and better self esteem. Here are some ways you can help your elderly loved one get involved in the community. If your loved one is able, encourage him or her to: Volunteer. Lots of organizations, especially notfor-profits are always looking for extra help. Volunteering is a great way to get involved and give back to the community. Join a club. Take a look at your loved one’s interests and see if you can find a club that caters to their hobbies. Some ideas include a book club, chess club, bridge club, knitting club, etc. Visit local senior centres. There are lots of different fun activities that encourage seniors to learn a new skill and connect with one another.


Home & LongTerm CARE | April 2017

Check out the library. Look for events going on in the community and different workshops posted at the library. This may also be a good way to find a book club. Try out an adult education class. Especially if your loved one likes to learn. Exercise. Exercise is an important part of health, so why not try and find a social way to be active? There are a lot of different fitness classes available that are directed at seniors. Some ideas include aqua fit, yoga, or a walking club. Get spiritual. Churches, synagogues, temples, etc. are all great places to get involved and meet new people. Connect to college/university courses. Taking a class at a local school can help keep your loved one’s mind sharp and get them out of the house and interacting with others. Join a support group. If your loved one is struggling with an issue, a support group can help them connect with others facing similar challenges so that they can share their experiences. LC This article was provided by VHA Home Healthcare

April 2017

9 Oral health

Avoiding fall injuries

2 4 14 22

Cover story: Elder abuse



Healthy eating

Keep moving

Staying social Editor’s Note Angina vs heart attack Caregiver SOS: Decluttering


Life through storytelling



Heart and brain health


Editor’s Note 610 Applewood Crescent, Suite 401 Vaughan Ontario L4K 0E3 905.532.2600 EDITOR






LAUREN REID-SACHS IN ONTARIO there are two million seniors aged 65 and over, or (14.6 per cent of the population). Studies indicate two to 10 per cent of Ontario seniors are abused, (between 40,000 and 200,000 seniors living in Ontario have experienced or are experiencing elder abuse). Abuse can take many forms and is defined by The World Health Organization as “a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person.” The abuse does not have to be physical – it could be withholding a senior’s money (financial abuse), psychological, emotional or simple neglect. It is often unseen and can be very subtle. Victims themselves may not even be aware they are suffering from abuse. This month’s cover story addresses elder abuse and provides resources for seniors and caregivers. If we are to protect seniors from abuse we need to talk about it. We need to raise awareness of abuse and the various ways seniors experience it. If you are a senior and you need help please call 1-866-299-1011.





Home and Long Term Care is published for consumers who are supporting and/ or involved in home care or long term care. It is available free of charge from distribution racks in hospitals across Ontario. The statements, opinions and viewpoints made or expressed by the writers do not necessarily represent the opinions and views of Home and Long Term Care, or the publishers. Home and Long Term Care and Members of the Advisory Board assume no responsibility or liability for claims, statements, opinions or views, written or reported by its contributing writers, including product or service information that is advertised. Changes of address, notices, subscription orders and undeliverable address notifications, and inquiries can be sent to: Subscription rates in Canada for single copies is $35.00 per year.

Kristie Jones Editor Home & Long Term Care


Home & LongTerm CARE | April 2017

Canadian Publications mail sales product agreement number 40065412. From the publishers of Hospital News, reporting on health care news and best practices for over 25 years.

smiling Keep on

LOSING OSING YOUR Y TEETH is not a normal part of aging. Thanks to healthier hi r lifestyles, life lifestyles advances in oral and medical care, and a growing awareness of the importance of dental hygiene, seniors can expect to keep most, if not all, of their teeth as they age.

But keeping those natural teeth healthy can be a challenge. Many medications taken by older adults can cause dry mouth, a condition that can contribute to cavities and other oral health problems. Seniors also develop more cavities on the roots of their teeth than younger adults. Dental hygienists encourage all older adults to brush their teeth twice a day with fluoride toothpaste and clean in between their teeth at least once a day. They also advise anyone with dentures (full or partial) and their caregivers to clean and soak dentures daily, and brush and massage the gums either with a soft toothbrush or a warm, damp cloth. Whether you’re at home or in a long-term care residence, good oral hygiene coupled with professional oral care from a dental hygienist can help to prevent more serious health problems and keep you smiling. LC

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Healthy eating for seniors and older adults By Christine Stewart

A HEALTHY DIET for older adults is an important part of active, healthy aging. However, as caregivers, it can be challenging enough to balance convenience with nutrition for your own meals‌ let alone monitor someone else’s diet! Ensure the older adult you care for is eating a well-balanced diet and preparing meals with all four food groups.


Home & LongTerm CARE | April 2017 has got you covered with these caregivers tips for healthy eating to help you support an older adult’s diet and to help the person in your care independently manage a healthy diet.

Healthy eating meal planning Aging has an affect on nutrition. While our bodies still require the same recommended daily vitamin and mineral intake (if not more), as we age into our golden years we need fewer calories, so we actually eat less food. This means that as a caregiver, you can prepare smaller meals for the older person in your care, but make sure the meals are packed with the proper nutrients to help them thrive. Ensure the older adult you care for is eating a well-balanced diet and preparing meals with all four food groups: 1. Whole grains 2. Fruits and vegetables 3. Low fat dairy products

4. Meat and alternatives (meat, chicken, fish, eggs, dried beans, peas or lentils) It’s important for older adults to continue enjoying a variety of nutritious foods at all three meals and with one to three snacks each day. Caregiver tip: Try preparing something new each week to prevent a meal planning rut. Protein-rich foods such as meat, chicken, fish, eggs and dairy products at each meal are very important for keeping older adults’ muscles and bones healthy. We lose bone mass and muscle strength as we age. Fibre, found in vegetables, fruit, and whole grains such as oatmeal, brown rice, or whole grain wheat, help to prevent constipation and soften stools. Fibre also helps prevent and treat a variety of conditions such as high cholesterol, diabetes and heart disease. Seniors need to drink plenty of fluids throughout the day to stay properly hydrated, and to help the fibre work well. Continued on page 8



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Healthy eating Continued from page 7

Easy healthy meals that require little or no cooking • Yogurt with cheese and crackers, canned peaches • Cottage cheese, fruit salad, banana loaf, and milk or juice • Tuna with melba toast or crackers, pudding cup, and a banana • Whole grain English muffin with melted cheese, strawberries, milk • Bran or oatmeal muffin, boiled egg, applesauce • Pasta with meat sauce, a bag of premade salad, and a glass of milk • Canned beans, whole grain toast, microwaveable frozen vegetables, fruit cocktail, milkshake • Soup with extra beans added (chickpeas, lentils or black beans), ½ cup vegetables, frozen blueberries with pudding • Toast with peanut butter, banana, and a glass of milk

Shopping for a healthy diet • Consider a pre-made meal delivery service (e.g., Meals on Wheels) one or two times a week. The frozen meal option gives you more flexibility, but if independence or mobility are limited, a hot meal delivered by a friendly volunteer may be a good option. • Some communities offer group grocery buying and store trips. • Many grocery stores offer grocery delivery services, or online shopping. • As their caregiver, you can also stock an “emergency shelf” for the elder person in your care, filled with canned beans, tuna, canned fruit, skim milk powder, and nutritional supplements such as Boost or Ensure, in case neither of you can get to the store.

Easy food preparation tips Prepare extras when you are cooking healthy foods and freeze leftovers in smaller portion containers for the senior in your care.

Encourage older adults to divide up and share larger portion meals with neighbours or friends, and for alternate cooking days.

Healthy cooking for one Suggest ideas to an older adult who lives alone for how to cook a little extra and use leftovers creatively! Extra vegetables can be used in a pasta dish, pureed with milk for soup, or added to an omelette or stir fry. Encourage older adults to arrange get togethers with others who also live alone, to create a good environment for healthy eating and socializing.

Coping with taste changes and chewing or swallowing problems Sometimes older adults’ taste buds do not work as well as they used to. Caregiver tip: try a different seasoning or spice to liven up the healthy food they are consuming. Nutritious meals can be prepared with softer, more moist foods if the person has chewing and swallowing difficulties.

Appetite changes in the elderly Older adults do eat less but may also have less appetite due to medical conditions that require changes in eating, such as dietary restrictions. Food preparation and eating can cause fatigue or a feeling of being tired in older adults. Improving cooking and food preparation skills for older adults Basic cooking skills can soon be mastered! Teach the person in your care how to prepare 5-10 basic yet nutritious and versatile healthy meals. For example, vegetable puree soups, quiche, roast chicken, or a one-dish casserole. Many grocery stores offer cooking classes. Attend some together. Help the person in your care shop for easy, ready to eat healthy meals. Be sure to read food labels. Always follow specific dietary instructions provided by a doctor or dietitian. LC

Christine Stewart is a writer for This article was reprinted with permission.


Home & LongTerm CARE | April 2017

Dealing with the unthinkable:

Elder abuse By Susan C. Jenkins

ELDER ABUSE is a serious and growing problem. It is difficult to know how widespread it is, because so many cases go unreported, but in 2014-2015 the National Initiative for the Care of the Elderly conducted a survey to try to determine how many community-dwelling Canadians (those not living in care facilities) were the victims of elder abuse and neglect. The survey revealed that about 7.5 per cent of older adults (75 out of every 1,000) experienced abuse in

the previous year. When neglect is included with other forms of abuse, the figure jumps to 8.2 per cent (82 out of every 1,000 Canadian seniors).

What is elder abuse? Elder abuse – actions that cause harm or the risk of harm – can take many forms. It can be a single incident or a repeated pattern, and it can happen in a senior’s own home, in a hospital, or in a longterm care facility. Continued on page 10

Susan C. Jenkins is a freelance writer and editor specializing in medicine, pharmacy, and healthcare. She can be reached at


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Elder abuse Continued from page 9 Generally, elder abuse is categorized as: • Psychological abuse: Actions or communications that lessen a person’s dignity, sense of identity, or feelings of self-worth • Financial abuse: Improper conduct that results in monetary or personal loss for the older adult or gain for the abuser • Physical abuse: Violence or rough handling that causes discomfort or pain • Sexual abuse: Sexual behaviour directed toward an older person without that person’s knowledge or consent • Neglect: Not meeting the person’s basic needs Psychological abuse is the most common form, affecting 2.7 per cent of older Canadians daily or almost daily. Financial abuse comes in second at 2.6 per cent, followed by physical abuse at 2.2 per cent, sexual abuse at 1.6 per cent, and neglect at 1.2 per cent

Preventing abuse The first step in preventing elder abuse is understanding what makes a person a likely victim. There are several factors to look out for. • Confusion or lack of clear thinking: Alzheimer’s disease and other forms of dementia can make it difficult to communicate and understand what other people are saying. These diseases can also cause behaviours that caregivers find difficult and frustrating. • Dependency: Difficulty with activities of daily life such as preparing meals, bathing, dressing, and toileting make a person dependent on others. • Isolation: Having few family members or social contacts to check on them. • Limited financial resources: People with limited finances may not be in a position to change caregivers or move to another facility if they aren’t receiving proper care. Someone who is experiencing abuse may be ashamed or embarrassed to tell anyone about it, or the person may fear retaliation or punishment if the abuse is made known. 10

Home & LongTerm CARE | April 2017

Look for the potential warning signs of abuse and report your concerns to the police, to the person’s healthcare providers,or to social services. Therefore, it is important to watch for the telltale signs of possible abuse. These include: • Changes in the person’s personality or behaviour • Fear, anxiety, or depression • Being passive in the presence of caregivers • Unexplained injuries such as bruises or broken bones • Repetitive behaviours such as rocking, sucking, or mumbling to one’s self • Dehydration or poor nutrition • Improper medication use • Confusion about new documents such as a new will or mortgage • Sudden reduction in finances • Reluctance to talk about the situation

occurred or may occur shall immediately report the suspicion and the information to the Ministry of Health and Long-Term Care Director. Tel: 1-866-434-0144 (7 days a week, 8:30a.m.-7:00 p.m.)

How you can help

More information can be found at or by phoning 416-916-6728 or emailing LC

Visit and call as often as you can so that a potential abuser will know that mistreatment is likely to be noticed. Look for the potential warning signs of abuse and report your concerns to the police, to the person’s healthcare providers, or to social services.

Retirement Home Regulatory Authority (RHRA) You must report elder abuse immediately to the RHRA if you see or suspect harm or risk of harm to a resident resulting from: Improper or incompetent treatment or care, abuse of a resident by anyone or neglect of a resident by staff of the retirement home, unlawful conduct, or misuse or misappropriation of a resident’s money. Tel: 1-855-ASK-RHRA (1-855-275-7472)

If you are the one who is being abused, neglected, or mistreated, tell at least one person you trust – a friend, family member, doctor, or religious counsellor.

Seniors Safety Line (SSL) The SSL provides contact and referral information for local agencies across the province that can assist in cases of elder abuse. Trained counsellors also provide safety planning and supportive counseling for older adults who are being abused or at-risk of abuse. Family members and service providers can also call for information about community services. Seniors Safety Line: 1-866-299-1011

Long Term Care ACTION Line: If you suspect or have evidence that elder abuse is taking place in a Long-Term Care Home it is mandatory to report it with the exception of residents themselves (who have a choice in the matter). The Long-Term Care Homes Act (s.24) states if a person who has reasonable grounds to suspect abuse has

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The importance of life review through

storytelling By Drew Tapley

REVIEWING LIFE is a natural part of aging that helps bring acceptance and closure at the end of life. When combined with storytelling, it is a potent life review therapy for seniors to examine and share the significance of memories in context to their lives. I have interviewed hundreds of seniors at retirement residences and long-term care communities in Ontario and British Columbia, and written dozens of life stories, some of which are published in magazines and journals. In my experience as a writer in the senior care sector, life review is especially effective with seniors in their eighties and nineties. In contrast, centenarians seem less able or even willing to review life to the same extent, and septuagenarians do not always consider themselves as having arrived at this stage. From a wide cross section, the most cognitive seniors I have interviewed have been physically and mentally active, in regular contact with friends and family, and whom maintain a strong faith or belief system of some kind that they continue to nurture. Caregivers and care providers can help seniors with their life review process by harnessing simple techniques to draw out memorable experiences. Ask open questions to mine for deeper recall, and be mindful to listen and not interrupt, even during moments of prolonged silence when a person is reexperiencing their life in review. They will need time to sit with their thoughts and consider them in the light of immediate reflection. I once asked a resident to sing a song she had performed in musical theatre 50 years ago. In half a 12

Home & LongTerm CARE | April 2017

minute, she was immersed in a memory and able to recall details from that time in her life. We benchmark ourselves by milestones in history, and by introducing an historic theme, event, object, or even a person – it opens a log of memories exclusive to that time. Conversations can begin by simply asking for a person’s earliest memory. Start with topics like childhood, adolescence, parents and grandparents, marriage and children, work, siblings, and the threshold of becoming a grandparent. Show continuous interest by maintaining eye contact, nodding throughout, and repeating segments of their story back to them to demonstrate active listening. Life review should be an informal conversation with prepared questions. Start with easy ones to break the ice, and slowly work up to more sensitive or intrusive ones. If you plan to write something from the conversation, it may prove worthwhile recording it on your phone as audio or video footage. It will provide body language, facial expressions and vocal nuances that add a layer of emotion to your mental or written notes. At times it will be necessary to ask more probing questions that encourage greater introspection. Begin questions with a verb, such as: Describe what… Tell me about… Explain why… Ask them to tell you about where they grew up, their experience of high school, how they spent their summer vacations, and what their family traditions were.

Accept that emotions will be present, and that tears and laughter are often part of this.

senior population are preserved so that their stories live on in us, and through us. LC

If your conversation reaches an hour, schedule another one at a future time to allow them to rest and absorb, and for you to think about the answers and additional questions.

Drew Tapley is a Writer, Marketing & Communications with Sienna Senior Living.

In helping bring together a person’s past and present, it enables them to map their emotional journey and recognize the significance of their accomplishments, their life’s meaning and purpose. The process also clarifies areas that may have become distorted with time, and provides an opportunity to say what needs to be said. When a person can confidently say “This is my life story,” they can quantify and measure the years within it. As a consequence, several seniors I’ve interviewed were writing memoirs and autobiographies to continue a review of their lives on their own. If we are lucky, our legacy is preserved through our progeny and woven into family heritage. But it first needs to be reviewed, explored and shared through the lens of a wisdom and hindsight that can only come with age. As the proverb goes: Life can only be understood backwards; but it has to be lived forwards. Perhaps our purpose at the end of life is to share our story so that others may learn from our experiences and be better equipped to handle their own aging process. Whatever it is, let’s ensure the legacies of our April 2017 | Home & LongTerm CARE 13

Angina vs heart attack – what you need to know

By Melanie Ramos

WHEN SOMEONE EXPERIENCES CHEST PAINS, the first thought that usually comes to mind is that they are having a heart attack. This reaction may be due to what we’ve seen on TV or in the movies, or what someone we know has experienced. However, if the pain goes away after a few minutes, or if it comes and goes at different times of the day – is it a heart attack, and should the person seek help from a health care professional? Yes! Chest pain can happen to anyone and should never be ignored.

What is angina? It is an intense, localized chest pain and is a sign that the heart needs more oxygen. Angina may be an early indicator that the arteries that deliver oxygen to the heart are blocked or nar-

rowing and the person experiencing chest pain is at risk for developing heart disease. Without treatment, the risk for a heart attack increases.

What is the difference between angina and a heart attack? According to the Heart & Stroke Foundation of Canada, “The main difference between angina and a heart attack is that a heart attack causes damage to the heart muscle, and angina does not. Angina can develop into a heart attack.”

What should you do if you or the person in your care experiences angina? As a family caregiver, it’s important to be vigilant about chest pains, not just in the person you are caring for, but also in yourself. Chest pain can happen to anyone and should never be ignored. If you, the person in your care, or someone else, experiences chest pain, stop what you or they are doing, take medications that may have been ordered for angina, and seek medical assistance immediately by calling 9-1-1.

Common angina symptoms Because angina and heart attacks exhibit similar symptoms, people are always advised to call emergency services right away. It’s better to be safe than sorry, especially when someone’s life may be at stake. Typical angina symptoms may include: • Sensation in the chest of tightness, burning, heaviness, or squeezing • Discomfort or localized chest pain that appears to be spreading to the shoulders, left arm and back (mostly), or jaw • Difficulty breathing • Feeling of weakness, dizziness, paleness


Home & LongTerm CARE | April 2017

Note that if the person in your care has diabetes, they may only appear to be having trouble breathing.

Any of these factors may trigger angina: • Physical activity or exercise • Emotional stress • Extreme hot or cold temperatures • Eating a heavy meal • Drinking alcohol or smoking These angina triggers may vary from person to person and can differ between men and women. You, or the person in your care, should always seek immediate advice from a medical professional or dial 9-1-1 as soon as possible if one or both of you are experiencing chest pains.

Heart attack symptoms between men and women Chest pain is the most common sign that someone is having a heart attack. However, men and women experience heart attack symptoms differently.

Male heart attack symptoms may include: • Chest pain that has been described as an elephant sitting on the chest, with a squeezing sensation

• • • •

that may be periodic or remains constant and intense Upper body pain or discomfort in arms, left shoulder, back, neck, jaw, or stomach Shortness of breath even when resting Dizziness or feeling like you’re about to pass out Cold sweats

Female heart attack symptoms According to the Heart & Stroke Foundation, “Chest pain or discomfort is the most common symptom of a heart attack in both men and women.” However, not all women experience the same heart attack symptoms as men. Some women may not have any chest pain, while others may feel only mild chest pain or discomfort. A woman having a heart attack may only have one symptom or a combination of symptoms. Visit the Heart & Stroke Foundation to learn more about heart attack symptoms for men an women. LC Melanie Ramos in an Editor for This article is reprinted with permission.

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fall Injuries By Marguerite Thomas

AS CAREGIVERS, fall prevention is a serious issue for both our loved ones and for us. Spoiler alert: the fall prevention information being shared is from the coordinator of the Fall Prevention Community of Practice (CoP), who also is a senior and was a caregiver for the past ten years. Through the CoP, the goal of this and upcoming articles is to share resources, to promote links to helpful groups and organizations and to provide in-depth information on caregiver specific fall prevention topics. The first and ongoing resource is the Fall Prevention Community of Practice and what it offers at no cost through LooP, the online communication platform www. Caregivers are invited to join Loop and can form private groups and workspaces for specific issues. Added benefits include invitations to the free upcoming webinars as well as access to preview webinars.

The vision of the Fall Prevention CoP is to create supportive communities in Ontario where adults enjoy quality of life and maintain their independence through the prevention of falls. Effective fall prevention practice requires participation of older adults themselves, the general community, and health care workers from many sectors. A Community of Practice is simply a group of people who come together to share a common interest. CoP members make a commitment to support and learn from one another, particularly across the continuum of care, from the healthy older adult to the frail elderly across disciplines and perspectives for improved practice, policy and research. In 2015, a Canadian partnership formed to promote November as Fall Prevention month. The ongoing theme is “It takes a community to prevent a fall – we all have a role to play.”

Marguerite Thomas, RN., BScN., is the Coordinator, Fall Prevention Community of Practice and a Consultant, Ontario Neurotrauma Foundation.


Home & LongTerm CARE | April 2017

The CoP has access to a variety of topic specific experts and links to helpful organizations. The focus is on â&#x20AC;&#x153;allâ&#x20AC;? which could mean a senior, caregiver, health care worker, researcher, decision maker, builder, planner, municipal representative or a building designer. In November 2015, 109 organizations were involved in Fall Prevention Month initiatives which included conferences, presentations, health fairs, webinars, and fitness activities, which targeted older adults and health care practitioners. In 2016, the partnership created the bilingual website Fall prevention resources available in the November 2016 Toolkit included information for older adults and caregivers as well as sections for health care workers including promotion & media; sample activities for November; practitioner resources; ongoing programs and interventions; statistics and infographics; and evaluation. The section for older adults and caregivers also includes links to Finding Balance Canada. This site originated in Alberta and other provinces have joined in, including Finding Balance Ontario. Check out the resources from various provinces at Fall prevention requires multiple strategies and methods of information sharing offered via the Loop communication platform Help is readily available and accessible and comes at no cost. Sponsored by the Ontario Neurotrauma Foundation (ONF), Loop has over 1400 members who connect electronically to work together, share mini-newsletters, webinars and library services. Loop brings together a variety of members from hospital, long term care and the community to provide updates on research, hands-on practices and resources, to identify learning needs, to share success stories, to plan educational events and initiatives and to share effective implementation strategies. While caregivers can benefit from caregiver specific information, there are many generic resources that can be helpful. An example is viewing the archived webinars via the Seniors Health Knowledge Network YouTube videos.

SHKNetwork. Recent topics include Naturopathic Approaches to Fall Prevention; SAIL Fall Prevention Program for First Nations; Substance Use Disorders in Older Adults; and Step Well, Stay on Your Feet. A webinar of special interest is Practical Advice for Caring Safely: The ergonomics of providing care for a frail older adult. When you join Loop, an invitation is sent to your email so that you can participate live from your home computer. Please consider inviting other caregivers to join you. What are your greatest needs as caregiver? The CoP has access to a variety of topic specific experts and links to helpful organizations. Potential subjects could include dementia, vision, resource organizations, bathroom design, footwear and exercises. What would you like to see the CoP present in upcoming columns? For further information, please visit or contact the coordinator LC

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Keep Moving:

Your hand-held device is killing you OUR PHONES AND DEVICES ARE AMAZING. They do pretty much anything and soon will do almost everything. There is an app for every activity we could possibly need. We can track our steps, our exercise and our calories. We can look up a recipe in the spice aisle of the grocery store or book a flight while in the bath. We can text anyone anytime and our friends and family can always reach us. We need never miss the latest political maelstrom or celebrity gossip. Work is always at our fingertips. Hand-held technology has revolutionized our lives and it is amazing. It’s also a nightmare. Look up from your phone! What do we see? Everyone looking down at their phones! In the line at the coffee shop, waiting at the theatre, at lunch, at the doctor’s office – everyone is on the phone. Of course there are lots of ways our ability to communicate instantly to anyone from anywhere makes life easier and better and in some cases is life-saving. But our routine and oftentimes compulsive use of our phones is taking us away from what is happening in the moment. It takes us away from the person sitting beside us and from the world in front of us. We are constantly distracted. Our minds are always kept busy attending to something else.


Home & LongTerm CARE | April 2017

Contrary to what our third-grade teachers told us, staring off into space is a good thing. It allows us to process information, to imagine and to contemplate. If our automatic response to a moment of respite is to look at our phone, we lose those moments of wonder. Here are five easy ways to let go of our phones for a precious few free moments in the day and discover wonder:

1. Delay, delay, delay Often the first thing we do when we break from whatever work or task we are doing is to check our phone. Not only does this contribute to diminished productivity and shortened attention spans, it separates us from our work mates, teammates and friends.

Next time you feel like reaching for your phone, delay. Tell yourself you will wait 10 minutes. Choose to do something else instead.

2. Establish phone-free zones Make mealtimes, whether at home with family or out with friends, phone-free times. Turn off your phone or put it on night mode for a period of time in the evening. Travelling in a car with family or friends is also a good time to be phone-free. And of course never use a hand held device while driving.

3. No texting and walking Like eating and walking, texting and walking is just a bad idea. If the text is that important, stop walking and give it the attention it deserves. Otherwise enjoy the skyline and don’t walk into traffic.

4. No phones during social engagements There is no excuse for being on your phone when you are at a performance, concert, or museum. It’s just rude. Leave the phone in your pocket or purse.

5. Keep your phone out of your bedroom Phone distractions don’t stop when you go to bed. Push notifications and late-night text messages wreak havoc with your sleep. Even if you put your phone to night mode, simply checking the time on your phone in the middle of the night affects your ability to get back to sleep. Get yourself an alarm clock and keep your phone outside your bedroom. Technology is not going away. We love our phones and we can’t imagine life without them. But the connection you seek is often not at the other end of the line. It’s right in front of you. LC

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What does your heart have to do with your

brain health? MORE THAN YOU THINK! Stroke and cardiovascular disease are implicated in at least 50 per cent of dementias, and 30 per cent of people with a stroke go on to develop vascular dementia in the first year after the stroke.

So what is vascular dementia? While the human brain comprises only about two and a half per cent of the body’s weight, it receives almost 15 per cent of the blood flow from the heart, and uses as much as a quarter of the body’s total oxygen consumption. Any reduction or interruption of this flow can cause strokes, which damage brain tissue and can cause or contribute to vascular dementia. WHAT ARE THE RISK FACTORS? Age is the biggest risk factor for dementia as well as for stroke, but both stroke and dementia can occur at any age. Vascular disease is actually on the rise among people in their 40s, 50s, and 60s, which increases their risk of vascular dementia. The good news is that many of the cardiovascular risk factors are modifiable, meaning they can be managed through lifestyle changes. And if that doesn’t work, effective medications are available to lower blood pressure, lower cholesterol, and avoid blocked arteries in your brain.


Home & LongTerm CARE | April 2017

Age is the biggest risk factor for dementia as well as for stroke, but both stroke and dementia can occur at any age.

How can you reduce your risk for dementia? • Being overweight. The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls. Obesity also predisposes you to diabetes, another risk factor. • Using tobacco. Smoking damages the lining of your artery walls. This can cause your arteries to narrow, increasing your blood pressure. Secondhand smoke can also increase your blood pressure. • Having too much salt in your diet. Too much salt can cause fluid retention, which leads to an increase in blood pressure.

• Drinking too much alcohol. Over time, heavy drinking can damage both your heart and your brain. • Not doing enough exercise. As well as missing out on the many benefits of exercise, people who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction and the stronger the force on your arteries. LC Learn more tips on prevention by visiting the Alzheimer Society of Canada’s website and click on the Brain Health section. Link to main portal: Link:

Personalized home care services Personal Care Caregiver Relief Nursing Companionship Meal Preparation Medication Reminders Light Housekeeping Palliative / End of Life Care Physio & Occupational Therapy Hospital Bedside Care

Support is just a phone call away.

1.877.289.3997 April 2017 | Home & LongTerm CARE 21

Caregiver SOS

Take it slow and steady to help seniors

declutter My mom was always fairly neat and clean. Since dad died, her place has become messy and cluttered. Things seem to be piling up and it looks chaotic in her apartment. She seems distressed when I discuss it.

Signed, Concerned daughter


Home & LongTerm CARE | April 2017

This is not an unusual problem for a lot of elderly people. There are many reasons that this could be occurring and the first step is to determine if this is cluttering or hoarding. Cluttering, unlike hoarding, is more apt to be responsive to some support strategies that you can implement. Hoarding, a more serious problem, usually requires the help of trained professionals who are experienced in the root of the behaviour (e.g., obsessive compulsive disorder). Homes of hoarders, unlike cluttered homes, are often unsanitary, hazardous and much of the space is unusable. An alarm bell goes off when I hear that this has started since your dad passed away. It may be worth assessing if this is related to physical and/or cognitive issues? Does mom no longer have the ability to deal with all her belongings (and maybe your dad’s)? Decreased mobility, arthritis and a realm of other medical issues can make it difficult for some elderly to cope with more than their basic needs. Cognitive changes may make it difficult to problemsolve and figure out what needs to be done. As a result, mom may be reluctant or unable to manage change. This may be a sign that more assistance is required and that day-to-day activities need more support. Calling in a professional to help sort this out and point out some of the options for care may be of value. Many individuals are able to admit that they have too much stuff – often much more than they need – but they have a problem letting go of it. The reasons for this are varied but often tied to emotions. Some people identify each item with a period or memory of the past and find relinquishing it painful. Others worry they will forget the past if they don’t have the physical reminder. Don’t make negative comments about things being old, junky or not useful. Commentary like that

often alienates the subject and makes it harder for someone to let go of an item. Some individuals need help with this process and it may take time. Rushing and pushing them to declutter is often counterproductive. A technique that is often helpful is to give the items to family members, or share the items with those who may have need (new immigrants, homeless shelters, etc.). This action can give meaning to the separation and can provide an opportunity to reminisce while the item is handed off. It may help to have family members work together on a plan to help move the items. Techniques like having each member take one item away at each visit can be a starting point. Knowing that family will eventually take the items away may make it less threatening for the hoarder. Carting things away may make some older adults fearful that their family members or caregivers are planning to move them to a “home” without their consent or involvement. An honest discussion about future care needs and how to make things easier may be warranted. If an imminent move is the reason for cleanup, then planning and organizing for the new environment can be the focus. Most retirement homes and nursing rooms welcome personal belongings, but choosing which items to take is difficult. As well, the change of a home can be upsetting. A professional who can help sort this out, and be a support to both your parent and you, can help identify what is really going on and what is needed. Hiring a third party to help can sometimes offer an emotional distance, which makes it easier for others to get the job done. Like many issues with aging parents, it takes a few steps to get things sorted out. But if you do so mindfully, patiently and with compassion, it can be done without too much undue stress on all involved. LC

Nira Rittenberg is an occupational therapist who specializes in geriatrics and dementia care at Baycrest Health Sciences Centre and in private practice. She is co-author of Dementia: A Caregiver’s Guide, available at Email questions to caregivingwithnira@ This article originally appeared in The Star.

April 2017 | Home & LongTerm CARE 23

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Home & LongTerm Care 2017 April Edition  
Home & LongTerm Care 2017 April Edition