Wound healing foods
August 2017 www.homeandlongtermcare.ca
circle of care See page 8
10 warning signs of
Whether you’re experiencing possible symptoms or are concerned for someone you care about, the Alzheimer Society has developed the following list of signs to look for: 1. Memory loss affecting day-to-day abilities – forgetting things often or struggling to retain new information.
6. Problems with abstract thinking – not understanding what numbers signify on a calculator, for example, or how they’re used.
2. Difficulty performing familiar tasks – forgetting how to do something you’ve been doing your whole life, such as preparing a meal or getting dressed.
7. Misplacing things – putting things in strange places, like an iron in the freezer or a wristwatch in the sugar bowl.
3. Problems with language – forgetting words or substituting words that don’t fit the context. 4. Disorientation in time and space – not knowing what day of the week it is or getting lost in a familiar place. 5. Impaired judgment – not recognizing a medical problem that needs attention or wearing light clothing on a cold day.
Courtesy of the Alzheimer Society of Canada.
Home & LongTerm CARE | August 2017
8. Changes in mood and behaviour – exhibiting severe mood swings from being easy-going to quick-tempered. 9. Changes in personality – behaving out of character such as feeling paranoid or threatened. 10. Loss of initiative – losing interest in friends, family and favourite activities. If you are concerned about any of these signs, talk to your doctor. LC
2 4 22
Cover story: Connecting your circle of care
Twice the reward
10 Alzheimerâ€™s warning signs Editorâ€™s Note Nutrition and wound-healing foods
Mental health program
Eye care for seniors
Editor’s Note 610 Applewood Crescent, Suite 401 Vaughan Ontario L4K 0E3 905.532.2600 www.homeandlongtermcare.ca
IT TAKES A VILLAGE. This statement doesn’t just apply to raising a child. Caring for a loved one can be extremely rewarding and extremely challenging at the same time. It’s not typically a one – person job and is most often a team effort. Your team could include doctors, nurses, pharmacists, PSW’s, home care professionals, therapists etc. This care takes place in a variety of settings - clinic’s, hospitals, the home. It is the family caregiver who is usually at the foundation of the care team. In this month’s cover story: Connecting your circle of care, a caregiver highlights the importance of connecting the caregiving team and forming a circle of care. More specifically, how technology has helped her connect the circle of care for her son. Connecting the care team saves the family caregiver the time of explaining things to several care providers and ensures continuity of care. In this month’s issue you will also find tips on how to communicate effectively with your loved one, foods that heal and what songs you should have on your caregiver playlist!
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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: firstname.lastname@example.org Subscription rates in Canada for single copies is $35.00 per year.
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Communicating more effectively with the person youâ€™re caring for By Vivienne Epstein
IT IS THROUGH OUR COMMUNICATION that we establish relationships. Think about all of the relationships you have and consider all of the different ways you communicate with your spouse or partner, children, family members, friends, healthcare providers, communities, and the person(s) in your care.
Effective communication with a caregiver includes using language as a back and forth dialogue of ideas, thoughts, and needs of the patient. Through our communication with others we share our ideas, thoughts, memories, needs, hopes, wishes, concerns, and fears. It is what makes us human. Continued on page 6
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Communicating more effectively Continued from page 5 As a caregiver, you want to be able to share with others through conversation. Ideally, you know what the person in your care needs and in return, the person in your care trusts you to meet those needs. This is why communication skills are an extremely important aspect of caregiving.
How communication works Think for a moment and reflect on the question: What is communication? Communication is the process through which information is exchanged back and forth between individuals. Think about two people in conversation: One person is the communicator sharing information, while the other is the listener or the “communication partner” receiving the information. 6
Home & LongTerm CARE | August 2017
Over the course of a conversation we switch back and forth between these roles without even thinking. In one moment, you are speaking to the person and in the next moment, you are listening to that person. Do you ever stop to think about the switch in your role? Or how remarkable it is that you are able to express your thoughts through conversation with a person and then, without noticing, you are able to interpret what your “conversation partner” shares with you? So how did you do that? How did you express your thoughts to a person and how did he or she interpret or understand what you said? Communication is indeed one of the most complex human functions. As humans, we have acquired a complicated system called language for the purpose
of communication. Only the human brain has developed such an advanced communication system that gives us the capacity to use language as a means of communication. As infants we naturally start to learn the language that surrounds us. This is the way humans, no matter where we live, in what country, city, or small town, communicate through language. Effective communication with another person includes using language as a back and forth dialogue of ideas, thoughts, and needs.
Caregiver communication skills Now, let us consider how we use language as caregivers. Language has four different components that are used to communicate: Speaking: Saying the words needed to clearly convey your message to the person in your care. Understanding and Listening: Interpreting and understanding what the person in your care is saying. (This is not always an easy process if the person has a speaking difficulty).
Reflecting on our communication skills With a better understanding of how we use the components of language in order to communicate, think about what makes you a good communicator. In what ways could you improve your communication skills? In addition to the use of language, consider other ways that you can communicate. What is the impact of a smile, a hand gesture, or a special photograph? In conclusion, remember that good communication skills will benefit all of your relationships. We have all experienced being successful communicators in some situations and ineffective communicators in other situations. Food for thought: Do you often get your ideas across effectively? Do you fully understand what the person in your care is trying to express to you? LC Vivienne Epstein is a contributor for elizz.com â€“ this article is reprinted with permission.
Writing: Writing out the message you need to communicate. Texting is a good example of written communication. You may need to write instructions to other caregivers or even to the person in your care, whether this is by hand, e-mail, or text message. (This requires that the person in your care is able to read written information). Reading: Understanding a written message. There may be times as a caregiver that you will need to read notes and instructions provided by healthcare professionals or by the person in your care. At other times you may need to do your own research by reading articles related to caregiving or the health condition of the person in your care. You may also provide written information or a brochure to the person in your care. When fully functional, these four components of language enable us to communicate with one another. In most caregiving situations you will likely need to use all four language components to fully understand and address the needs of the person in your care. August 2017 | Home & LongTerm CARE 7
Connecting your circle of care By Donna Thomson
TODAY, MY FAMILY USES TECHNOLOGY to coordinate our sonâ€™s complex care in the community, but it wasnâ€™t always so. Nicholas is 26 years old and resides in a small care home in our neighborhood. He is non-speaking and medically complex, requiring one-to-one nursing care 24/7. For the first 22 years of his life, Nick lived at home with us and I struggled to communicate important messages between home and the multitude of home care workers and medical professionals who were part of his care team.
Home & LongTerm CARE | August 2017
I do not have that struggle anymore. A software program called Tyze Personal Networks now effectively connects everyone who cares for and about Nicholas. Tyze is owned and offered by Saint Elizabeth Health Care, a Canadian not-for-profit organization that has been supporting people at home for more than a century. Tyze is a private and secure online network that was developed to combine the efforts of family members, friends and professional supports in a circle of care. It is free to individuals but becomes more valuable when supported by a healthcare organization.
Each personal Tyze network is password-encoded and not publicly searchable. It has enough data storage to allow for a virtual filing cabinet of medical records and even highly sensitive documents such as wills and end of life directives. Healthcare provider organizations in Canada, the US, and beyond use Tyze to reach out to their clients, inviting them to start their own care networks. Most importantly, Tyze gives organizations the ability to share information with all network owners – for example, education materials, newsletters, videos, updates, and events. Continued on page 10
In 1988, when her son Nicholas was born with severe disabilities, Donna embarked on her second career as a disability activist, author, consultant and writer. She is the Special Advisor for Caregiving at Tyze Personal Networks and is the International Advisor to the PLAN Institute for Caring Citizenship. She is the co-founder of Lifetime Networks Ottawa, a PLAN affiliate and is a member of the Cambridge University Capability Approach Network. Donna is also an instructor at the Advocacy School (Ottawa, Canada), teaching families how to employ best practice political advocacy tools when advocating for care. Donna can be reached at donnathomson.com. For more about Tyze Personal Networks, visit tyze.com.
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Circle of care Continued ffrom page 9
Life be before Tyze Before we were introduced to Tyze, Nicholas had a bedside bedside, hospital-style chart where caregivers recorded both health and personal information. There wa was also a separate drug chart where staff signed fo for medications given. If Nicholas’ morphine do dose changed, I couldn’t be sure that staff would ssee the notation in the bedside charts, so we in installed a white board above Nick’s bed. There, we w wrote important messages in large red lett lettering, hoping that new directives begun b one caregiver would be followed by the by next on one, especially if I was not home to point tthem th em o out at shift change. Too often, a part-time h he alth aide would give the old dose of antihealth sseizure se izure medicine or morphine, assuming that n othin had changed since the previous week. nothing T hey simply s They didn’t see the notes we had left.
Life after Tyze T Today, we still use the bedside charting, but we do not rely on it to communicate messages of change in care protocols or important appointments p coming up in the diary. Tyze Personal Networks shifts the responsibility for N care from an individual model to a network model. A traditional, indivvidual model of care looks like this: A individual model of care assumes An autonomy on the part of an able-bodied patient – someone who is verbal and capable of following through on measures for treatment compliance at home. This was not the case for Nicholas. No single individual could keep Nick alive and healthy – he needed a team. Tyze gave us the communication tool we needed to effectively function as a network of care, which looks more like this: 10
Home & LongTerm CARE | August 2017
The home page of Nicholas’ Tyze site includes all his front-line workers, members of our immediate family, executive staff members at the care home where Nick resides, and his family physician. Staffing agency case coordinators are part of the Tyze network too, and when there are last minute HR issues to be solved, everyone can offer to help and stay in the loop. Tyze has many features that enhance both social opportunities and continuity of care. For example, specialist medical appointments as well as recreational outings are entered into the calendar feature and network members receive timely reminders on their smartphones. Network members report feeling group solidarity because everyone has shared and equal access to information about Nick. Tyze has made it easy to share resources, to ask for help and problem-solve within the group.
Overcoming barriers and achieving success
staff. Everyone began to appreciate the benefits of a single communication tool. Like any tool, Tyze is only helpful if users populate it with pertinent information. When frontline staff members forgot to input appointments, I reviewed all my communications strategies and looked for ways to improve compliance. I realized that posting ‘need to know’ information on Tyze, such as staff shift rotas and holiday schedules would draw people to Tyze. Eventually, Tyze became the go-to site for all Nick-specific information. Now, if Nicholas has an emergency hospital admission, his network members know they have access on their phones to his medications list as well as his care plan. Nicholas does not use Tyze himself, but it is only because he would rather use his laptop and iPad as sources of sports news and social media. Still, Nick reaps the benefits of being cared for by a well-coordinated team of people who love him and share his care. And for that, we are all grateful to Tyze. LC
“How did you persuade medical professionals to be part of a Tyze network?” is a question that many curious friends ask. The answer is not straightforward. In the case of Nick’s GP, he understood immediately that an online tool would help him to manage complex care involving multiple players but he was concerned that he would be bombarded with messages. He was relieved when we assured him that only the head nurse would send him private messages via the Tyze site. Plus, recent changes in allowable physician billing codes mean that our doctor can now be paid for the time he engages with Nick’s Tyze network. The trickier barrier to getting Tyze up and running was compliance on the part of frontline care staff, especially after Nick moved out of our home and into a care facility. Every agency or institution has its own in-house communications linkages such as an intranet. At first, it was necessary to remind staff that their intranet excluded Nick’s family members but, eventually, everyone realized that the corporate knowledge of complex care was better managed as an integrated team with equal access to information shared by family and paid
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The ultimate caregiverâ€™s
playlist By Donna Thomson
MUSIC IS OFTEN THE SOUNDTRACK of our lives. Particular songs evoke memories of personal pain, triumphs, love, commitment and maybe a broken heart. Other tunes just make us happy by prodding us to smile and dance. Caring for another person is a journey full of some of the greatest dramas in our lives, so I asked readers to tell me about their playlists. Donna Thomson is a disability activist, author, consultant and writer.
Home H & LLongTerm T CARE | A August 2017
I was astounded by the response. Everyone wanted to describe how music made caregiving easier... or how the silencing of it was necessary. Bob Harrison blogs for The Caregiver Space about his years caring for his adored wife, Annie. I was so touched when he told me that the day Annie was diagnosed with cancer was the day that for him, the music died. But he has songs of grieving on Annie’s beautiful memorial page. Terena, a member of The Caregivers’ Living Facebook page said this: “I have a “ theme songs” playlist I play when feeling overwhelmed. Moby’s “We are all Stars” and George Michael’s, “Freedom” are two faves. And when I’m really stressed out I play “Tightrope” by Janelle Monae.” Lara cares for her son who requires complex care. She’s got a ‘Battle Playlist’ for days when she’s fighting for services or funding. Songs like Brave by Sara Bareilles, Fight Song by Rachel Platten and I Won’t Back Down by Tom Petty are highlights. And lots of research shows that music aids in healing – in one scene of “Alive Inside” (2014), a
documentary film about care and music, a nursing home care worker offers headphones to a wheelchair-bound man named Henry. When Cab Calloway’s voice wakes Henry, he comes alive. This extraordinary moment from the film is available on YouTube, and has been viewed more than 2 million times to date. So with this potent evidence of music’s power to uplift, heal and speak our emotions, here’s a playlist for natural caregiving that’s on my phone and I’d like to share with you. We need the healing power of music too! 1. 2. 3. 4. 5. 6.
Breakfast Can Wait - Prince I’ll Be There - The Jackson Five God Only Knows - The Beach Boys Lean on Me - Bill Withers You’ve Got a Friend -James Taylor It May be winter outside (but in my heart it’s spring) - Love Unlimited 7. Piece of My Heart - Janis Joplin 8. Roar- Katy Perry 9. I Will Survive - Gloria Gaynor 10. Uptown Funk - Mark Ronson and Bruno Mars LC
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Caregiver mental health program By Jonathan MacIndoe
BAYCREST HEALTH SCIENCES has teamed up with Canadian Mental Health Association (CMHA), Ontario to assess the country’s first multilingual, group program centered on evidence-based, talk therapy principles for older adult caregivers. CMHA Ontario’s Living Life to the Full initiative offers a free, eight-week course to help unpaid caregivers aged 55+ self-manage their stress and cope with challenges in their lives. The program, which is delivered in four languages (English, French, Mandarin and Cantonese) across 36 sites across Toronto, aims to improve the mental well-being of caregivers while providing a cost-effective, scalable treatment option for those in need. Since the program began in 2015, more than 275 caregivers looking after loved ones experiencing health changes due to aging, Alzheimer’s disease, anxiety, depression and physical impairments have participated in one of 27 courses delivered across Toronto. “Older adult caregivers are at an increased risk of developing anxiety and depression, which if left untreated doubles their risk of developing dementia later on,” says Dr. Nasreen Khatri, principal investigator on the study and a clinician scientist with Baycrest’s Rotman Research Institute. “Yet, caregivers are unlikely to seek treatment because they lack the time, resources or feel stigmatized. 14
Home & LongTerm CARE | Augustt 2017
Older adult caregivers are at an increased risk of developing anxiety and depression, which if left untreated doubles their risk of developing dementia later on. This program advocates for caregivers by shining a light on their issues and providing care where they live – in communities across Southern Ontario.” Participants in Living Life to the Full attend eight weekly, 90-minute, interactive group sessions with a trained facilitator. Facilitators use small group activities, discussion, course booklets and worksheets to coach attendees on strategies that will help them manage negative feelings, tackle their problems and achieve their goals. “Life’s challenges can appear immense and difficult to overcome, particularly if you’re responsible for the care and wellbeing of a loved one,” says Camille Quenneville, CEO of CMHA Ontario. “This program has been found to help participants address their own wellbeing as it teaches, using simple methods, skills to overcome worry and hopelessness.”
The program continues to invite all caregivers aged 55+ living in Toronto to participate. For program locations and to find out more, visit www.ontario. cmha.ca/caregivers-toronto or call 416-977-5580 ext. 4135. The Living Life to the Full initiative is supported by the Government of Canada’s New Horizons for Seniors Program, the Association of Ontario Health Centres, Health Nexus, the Older Adult Centres’ Association of Ontario and Toronto Community Housing. Additional funding would allow the program to be offered in additional communities, languages and through remote access technology, such as on-line resources. LC Jonathan MacIndoe is a Senior Communications Advisor at Baycrest Health Sciences.
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How to deal with
‘unwanted advice’ when caring for someone with dementia My dad has dementia. I do my best to care for him but find that when my friends hear my story and they give advice and comments, I feel like some of them are judgmental. Signed, tired of everybody’s advice I don’t know your story, but will take this opportunity to reach out and educate you and your friends about all that free advice, commentary and associated judgments. I hear caregivers talk about this a lot when they are sharing their stories. Most caregivers, like you, are trying to do the best they can in very challenging and adverse conditions. It is not easy caring for someone with dementia and even less easy when people heap on unwanted advice, criticism or possibly negative comments. Your role as a caregiver puts you in an interesting place in relation to these “advisers.” As humans, we make judgments all the time, but some people are more judgmental than others. When we delve into it, the word “judgmental” implies making judgments in an unhelpful way. This is likely not your friends’ intention, but it is clearly coming across that way. When someone is ill, it is not uncommon for others to share their suggestions and ideas. Some of these you may have sought out and agree with, but others from a “friend/adviser” may make you feel like that person just doesn’t get it when it comes to your dementia scenario. 16
Home & LongTerm CARE | August 2017
One reason this often occurs with dementia is that almost everybody knows someone who has been touched by the disease. Dementia is also quite variable in its presentation. It may be different in how specific caregivers are coping, depending on whether the dementia is mild, moderate or in the later stage of the illness. Advice in this area is not “one size fits all!” Remember, the people who advise you may indeed have some good tips to share, but sometimes it derives from their own need to share their story or their own caregiving journey. This of course, can be of help, and is a strategy used in Alzheimer’s support groups; but again, it depends how this advice is shared. To the adviser, I always suggest: Ask first. Does the other person actually want your input? Just because you have gone through caregiving doesn’t mean that others are in an emotional place to hear your wisdom. Just listening is often helpful. Caregivers often comment that a supportive ear is the most helpful gift from friends. Ask first if there is something that you can share, having been a caregiver yourself. But we all know someone who won’t be able to omit sharing their “two cents worth.” One technique is to show gratitude for their desire to help, while setting a limit. For example, say: “I really appreciate the information, but right now I am not ready for this.” That may be enough to stave off unwanted advice. If that doesn’t work, be more forthright, by stating: “I have a lot of input now and feel I can’t
Remember, the people who advise you may indeed have some good tips to share, but sometimes it derives from their own need to share their story or their own caregiving journey.
take in any more. I may come back to you when I am ready.” As a caregiver, you have the right to do what feels right and you can try to do this in a polite – and if necessary, not-so-polite – way.
emotion of the moment, the fatigue of caregiving or the frustration of never “getting it right” is still raw. I have heard many caregivers snap, get annoyed or even break into an argument.
If a friend says something you feel is offensive or not appropriate, a good reply is: “I know you are only trying to help, but I need to figure out what will work for me.”
Take a deep breath and step away if you can. If this is somebody in your social circle, try to reach out when they are not in advising mode and pre-empt them by explaining that you prefer not to discuss this topic for now.
Remember, a lot of people need to hear that they are being helpful and doing well. Reinforce the adviser that he/she did a great job, but now it is your turn. This is not easy to do when the
Part of being a caregiver is managing all the information coming at you. Having a professional to rely on will surely help make you feel more confident to set your boundaries with others. 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 baycrest.org/dacg Email questions to caregivingwithnira@ baycrest.org. This article originally appeared in The Star.
August 2017 | Home & LongTerm CARE 17
Double the effort:
Twice the reward By Pamela Stoikopoulos
BEING THE PARENT of young twins can be a handful at the best of times, but when those children have special needs, it requires extra energy and effort. Caridad Dulig somehow stays on top of it all as full-time caregiver to her super-active, happy, fouryear-old twin boys, Jayren and Shandrei, both of whom have Autism Spectrum Disorder (ASD). Just before Jayren turned two years old, Caridad began noticing that her son had trouble making eye contact and would not look at her even when she’d call his name. He also seemed to be lagging behind in some speech developmental milestones. While Caridad’s concern was focused on Jayren, family members and her employer encouraged her to get Shandrei assessed as well. Both boys were diagnosed with speech delays and ASD. The news hit Caridad hard and, for a brief time, she grieved the diagnosis. But the gentle and quiet mom didn’t mourn for long and quickly got busy getting the support and skills needed to ensure her boys’ progress and success. Caridad’s active engagement in Shandrei and Jayren’s development and her commitment to sticking to therapeutic activities to help the boys are just
Caridad Dulig somehow is a full-time caregiver to her superactive, happy, four-year-old twin boys, Jayren and Shandrei, both of whom have Autism Spectrum Disorder (ASD).
Home & LongTerm CARE | August 2017
two of the reasons Occupational Therapist Allyson Hoch submitted a winning nomination of Caridad for a Heart of Home Care Award. The award, given by VHA Home HealthCare, celebrates unpaid Ontario caregivers who go above and beyond to care for a loved one. At the ceremony, Caridad received a welcome by Toronto’s Mayor, John Tory, and was treated to a lunch with other caregivers and a special performance by R & B singer Jully Black at Toronto’s City Hall. “She is a great advocate for the boys in school. She does her homework, listens to strategies and asks for help,” says her nominator, Allyson. Because of
her dedication, the boysâ€™ development has exceeded expectations. â€œOverall, the family is fantastic. The progress Iâ€™ve seen with the boys is because Caridad has been such a great caregiver in following through,â€? Allyson adds. â€œItâ€™s really hard but I try my best as a mother,â€? says Caridad, who was taken aback by the award and the attention she received for her care. Though their progress has been excellent, Caridad is still nervous about her boysâ€™ path in life. â€œIn the future I want them to study at university so that they can help other people too,â€? she says. Watching the boys giggle and jump on their living room sofa (as four-year-old boys are known to do), itâ€™s clear that â€“ with Caridadâ€™s patient and thoughtful support â€“ the sky is really the limit for Jayren and Shandrei.
Caridadâ€™s Caregiving Tips: Be strong and have determination â€“ Though she found the ASD diagnosis challenging, Caridad
sprung into action and got busy learning as much as she could about how to help her sonsâ€™ progress. Seek out support â€“ Despite the tight budget the family lives on (her husband works night shifts and Caridad currently looks after the kids full time), she has been able to capitalize on programs offered and paid for through municipal and provincial governments. Do the homework â€“ Caridadâ€™s attention to detail and follow-through are the main reasons why Jayrenâ€™s and Shandreiâ€™s progress has been so positive. Kids with ASD really respond to routine so the quicker you can make the exercises (assigned by an Occupational Therapist, for example) part of the routine, the better. Thanks to PACE Consulting and Teak Printing, Flashframe Digital Media, BDO, and Home and Long Term Care Magazine for their generous sponsorship of the 2017 Heart of Home Care Awards. LC Pamela Stoikopoulos is Sr. Communications and PR Manager at VHA Home HealthCare.
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Here’s looking at you, kid:
Eye care for seniors By Susan C. Jenkins
PRESERVING EYE HEALTH and protecting vision play an important part in helping us stay safe and remain as independent as possible as we get older. It is normal to notice some vision changes as we age, and many of these changes can be addressed with glasses, medications or, in some cases, surgery. Regular eye exams can detect eye problems at the early stages when they are most treatable, but some vision changes can be a warning of a more serious problem, so it is important to know what signs to watch for and when to see a doctor. Some of the signs that seniors and their caregivers should watch for include: • Trouble reading small print • Problems seeing contrasts and colours • Loss of depth perception and difficulty judging distances • Greater sensitivity to glare from sunlight or light bulbs • Taking longer for eyes to adjust from light to dark • Eyes that are very dry or very watery If you or someone in your care experiences these changes, it is time to consult a doctor to find out what is causing the problem and what can be done to correct it. Common eye problems that affect seniors include: • Cataracts, a gradual clouding of the lens of the eye that can make it seem like you’re looking at the world through frosted glass 20
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• Diabetic retinopathy, a complication of diabetes that affects the retina (the light-sensing part of the eye) and can lead to vision loss • Floaters, tiny specs that float across your field of vision • Glaucoma, a disease that damages the nerves in the eye and leads to vision loss • Age-related macular degeneration, damage to the part of the eye that is responsible for sharp focus • Presbyopia, commonly called farsightedness, makes it more difficult to see close objects and small print • Temporal arteritis, a blockage or inflammation of the arteries in the temple that can lead to vision loss
Reducing the risk Here are some things people can do to help protect their vision. • Have your eyes examined by an eye specialist regularly. • Report any eye problems to your doctor immediately.
• Don’t smoke. Smoking tobacco raises the risk of developing macular degeneration. • Eat a healthy diet that provides all of the nutrients your eyes need. Nutritious food choices include carrots, melons, citrus fruit, spinach, and kale. • Exercise to increase blood circulation and help improve oxygen levels in the eyes, which helps remove toxins that can lead to vision problems.
Some helpful tips • If you suffer from dry, gritty, itchy, or burning eyes, a humidifier or eye drops may provide some relief. • If your eyes water, it might be because they are especially sensitive to light or wind. Shielding your eyes may help. • Reduce glare as much as possible by wearing sunglasses when you go outdoors and making sure all light bulbs are covered by lamp shades. LC Susan C. Jenkins is a freelance writer and editor specializing in medicine, pharmacy, and healthcare. She can be reached at email@example.com.
A guide to eye care professionals There are a number of health providers who deal with eye care. Here’s a guide to what they do. Ophthalmologists are medical doctors with extra years of specialized training in the diagnosis and treatment of eye diseases. They treat eye problems, perform vision assessments, and prescribe corrective lenses. Optometrists are doctors of optometry who diagnose and treat eye and vision problem, assess vision, and fit and adjust corrective lenses, such as eyeglasses and contact lenses. Opticians: Opticians provide, fit, and adjust corrective lenses on the prescription of an ophthalmologist or optometrist. August 2017 | Home & LongTerm CARE 21
Nutrition and wound-healing foods IF THE PERSON you are caring for has a wound, they will have extra nutritional (dietary) needs which include an increased need for protein, vitamins, and minerals. Good nutrition is the initial building block of wound healing. Think of foods that promote wound healing like the materials needed to rebuild the wall of a house that has been damaged by fire. Think of protein which helps to heal skin and tissue as the bricks. Think of the vitamins, minerals, and carbohydrates as the mortar that helps hold the bricks in place making the wall strong again. It is important to point out that when someone had an open wound that has since healed, it can take up to two years for the tissues to become strong again. The healed tissue has only 80 per cent of its original strength. This makes that area slightly weaker and more prone to injury. 22
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Generally, when a wound is healing, extra proteins are required. The vitamins and minerals that have been identified to be the most beneficial are A, C, E, and Zinc. If the person you are caring for has diabetes, it is important that they have good blood glucose control as this is essential to wound healing.
Wound-healing foods Foods containing protein and the suggested vitamins and minerals needed for wound healing include: • Protein: Meat, fish, eggs, beans, milk, yogurt (particularly Greek), tofu, and soy protein products • Vitamin A: Carrots, orange and dark green leafy vegetables, fortified dairy products, cereals, and liver • Vitamin C: Citrus fruits and juices, tomatoes, peppers, spinach, broccoli, cauliflower, Brussels sprouts, cabbage, and tomato juice • Zinc: fortified cereals, seafood, and red meat
It is important to point out that when someone had an open wound that has since healed, it can take up to two years for the tissues to become strong again. Canada’s food guide is an excellent resource to help you plan balanced meals. It’s important to include an item from the meat and alternatives food group of Canada’s Food Guide at every meal. Below is a sample meal plan for increasing the protein and caloric intake of a person who weighs 150 lbs (68 kg). Use this as a guide and make adjustments to suit the needs of the person in your care who has a wound. Breakfast 2 slices of rye toast (you may substitute with orange juice, broccoli, or cereal) 2 tbsp peanut butter 1 cup milk Lunch ½ can tuna (approximately 90 grams) on a pita with lettuce and tomato Banana 1½ cup yogurt Snack 3 chocolate chip cookies Tea Supper 1 chicken breast 1 baked potato with margarine Coleslaw with light dressing ½ cup cooked carrots ½ cup applesauce In addition to ensuring that meals contain the best balance of nutrients to promote wound healing, there are other factors that can affect food intake: • Can the person reach their food/feed themselves or do they need help? • Do they wear dentures to help with chewing the food? If so, do they fit properly without causing pain or falling out? • Does the food need to be a certain consistency (e.g. soft, pureed, etc.)?
Here are some general nutritional guidelines to consider when preparing meals that promote wound healing for the person in your care: • Offer well-balanced meals from a variety of foods • Include adequate protein to maintain good immune function and lean body mass • Look for nutritious foods that maintain the weight of the person in your care within a healthy range. Every person has different nutritional needs. Aim to maintain the weight of the person in relation to their height as opposed to achieving an “ideal” body mass index (BMI) number. • Include vitamin and mineral-rich foods to stay healthy • Don’t forget fibre and fluid • Food safety is important! • EAT WELL AND LIVE WELL
Pressure ulcers and nutrition Pressure injuries, more commonly known as pressure ulcers or bed sores, develop because of injury to the skin and tissues caused by pressure, friction, or shear (damage caused to tissues when the bone moves one way but the skin does not). Malnutrition has been identified as a risk factor for the development of pressure ulcers. Improving energy and protein intake through the use of oral nutritional supplements (additional 250 kcal per day) is associated with reducing the risk for chair-bound or bedridden older adults who are the most vulnerable for developing pressure ulcers. A Registered Dietitian can provide a valuable, individualized assessment to identify the nutritional status of the person you are caring for and recommend any additional dietary requirements to support wound healing and overall good health. A doctor can also refer the person you are caring for to a Registered Dietitian. LC This article is reprinted with permission from Elizz.com
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ALS CAREGIVER OF THE YEAR AWARD An award in honour of Violet Halstead, who died 15 years ago after battling Amyotrophic Lateral Aclerosis (ALS). Her daughter was so touched by the way the professonal caregivers took care of her mother that she founded this award.
Win a night away for your amazing caregiving support! The winner will stay at the Hilton Hotel, be treated to a service at Fioro Salon and enjoy a meal at Canyon Creek restaurant in Toronto. Nominees must have cared for an ALS patient for at least 3 months and must be a paid professional caregiver (Personal Support Worker, Home Support Worker, etc.) that resides in Ontario. The caregiver must not be a family member. Nominees cannot nominate themselves. When submitting your nomination include: • The name and contact information of the person you are nominating. • Their job title (such as Personal Support Worker or Home Support Worker). /V^[OL`OH]LOLSWLKHUK[OLPTWHJ[[OL`OH]LOHKVU[OVZLHќLJ[LKI`(3: For questions and inquiries, please contact the email below. Submit nominations to
firstname.lastname@example.org by Tuesday, September 5, 2017