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S E N I O R Stay safe during COVID-10 Tips for caregivers Eat healthy
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Caregiving & COVID-19 TIPS FOR PEOPLE WITH VULNERABLE FAMILY MEMBERS
COVID-19 has dramatically shifted daily life for many people around the world. Nobody is immune, according to the Centers for Disease Control and Prevention, and older adults and individuals with chronic health conditions are at higher risk of getting very sick from the coronavirus. To protect vulnerable individuals, many nursing homes or assisted living facilities are banning outside visitors temporarily in hopes of limiting residents’ exposure to someone who may be infected with the virus. Additionally, many individuals who need care and are currently living in their own homes are feeling isolated and anxious about how to stay healthy and safe. AARP offers guidance to family caregivers with vulnerable family members, especially those who might be new to caregiving because of coronavirus and its impacts on older populations.
Make it a team effort
While there may be one primary family caregiver, identify other family members, friends and neighbors who can check in or help with shopping and important errands. It’s important that the Caregiving is now taking center stage. With already more than 40 million unpaid family caregivers helping loved ones in the United States, experts expect the coronavirus to increase the number of people providing short-term or long-term care to an older or aging loved one. STOCK PHOTO Living Senior
person you’re caring for doesn’t leave their home and stays out of public places. Create a list with contact information of friends, family and services in your community that can help you perform key caregiving tasks. For example, find out if services such as Meals on Wheels can help deliver meals, or if there are other local services to help with food or medication delivery.
Inventory essential items
It’s important to figure out what you have so you can determine
living S E N I O R
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Safeguard against COVID-19 when grocery shopping Supermarkets and other food merchants are allowed to stay open as “essential” retailers amid the mass shutdowns prompted by the spread of the COVID-19 virus. Along with banks, gas stations and takeout restaurants, supermarkets are among the few places that people are allowed to visit to procure the necessities of everyday life. Even with social distancing and other precautions in place, grocery stores remain high-traffic locations. As a result, many people feel concerned about how to best protect themselves when turning to in-store visits or grocery delivery services to stay stocked on food and other essentials.
Maintain a six-foot distance
As with other locations, shoppers should keep a distance of six feet between themselves and other shoppers. Do not hesitate to move back or ask someone to move away if you feel concerned about proximity. Shopping during “off-peak”
hours may help thin out crowds and make it easier to maintain social distance.
Shop small retailers
It can be beneficial to visit independently owned retailers, like local markets, delis and specialty food stores. Crowds at such stores will likely be smaller than the crowds at large chain stores.
Wipe down products
Data published in The New England Journal of Medicine that tested how long COVID-19 survived on surfaces found the virus was detected up to 72 hours on plastic, 48 hours on stainless steel, four hours on copper, and 24 hours on cardboard. While infection from touch may not be as likely as it is from direct inhalation of COVID-19 from an infected individual, it can be helpful to wipe down surfaces, including non-porous packaging, once items are brought home, as well as counters or tables used to unload packages. Wiping down a shopping cart
handle also may be helpful.
Wash produce
Consumer Reports suggests washing fruits and vegetables in a mild soap-andwater solution to eliminate any possible live virus and pesticides.
Avoid direct contact
Whether items are delivered or purchased in-store, avoid personal contact with cashiers or other store employees. Pick up and pack your own groceries. Opt to pay with a credit card or another digital pay option like Apple Pay instead of handing over cash. Use your own pen to sign receipts. Scan your own frequent shopper card or have the cashier use a scan gun, rather than taking your key ring to hold. Delivery services can place the bags outside of your front door. Tips also can be exchanged electronically for delivery services through an app or online or over the phone.
Some simple shopping strategies can help people prevent the spread of COVID-19. STOCK PHOTO Living Senior
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LIVING SENIOR • SUMMER 2020
(METRO CREATIVE)
As you age, keep nutrition top of mind Getting proper nutrition can be challenging for everyone, but especially as we age for a variety of reasons, including changing tastes, physical or dental conditions, and lack of access to healthy foods. “It’s critical that people of all ages get proper nutrition, but especially seniors, and particularly now with the spread of COVID-19 in the United States,” says Dr. Gina Conflitti, chief medical officer with Cigna’s Medicare Advantage business, which offers Medicare plans in 18 states and the District of Columbia. “Good nutrition helps older adults stay active and vital, and can help them stave off or better manage chronic conditions.” Cigna provides the following nutrition tips:
Make healthy choices
Add plenty of fruits and vegetables to your plate for colorful, nutrient-rich, fiberfilled meals. Add flavor with spices and herbs instead of salt. Stay hydrated with plenty of water. Even light exercise can
stimulate appetite and strengthen bones and muscles.
dental benefits at no extra cost. Check your plan for details.
Consult your doctor
Explore options
If your appetite is changing or you’re losing weight, talk to your primary care physician. There could be an underlying reason for these changes. For instance, your medication might be affecting your appetite. Or maybe you’re dealing with depression. Your doctor can work with you to identify possible causes.
Adapt to changing tastes
There are a number of ways to change your eating habits to improve your nutrition, from eating more frequent, smaller meals to trying new foods and cooking styles. For tips on preparing healthy meals, visit ChooseMyPlate.gov.
See a dentist
A dentist may be able to address any dental problems impacting your ability to enjoy food. If you have a Medicare Advantage plan, you may have access to
If mobility is an issue, look for local organizations offering transportation or meal delivery to older adults. If you have an MA plan, you may have access to home-delivered meals following a hospitalization. One-third of hospital patients are malnourished at admission and poor nutrition increases their risk of having to return to the hospital after being released. Good nutrition helps patients regain their strength and energy faster for better recoveries. Check your plan for details.
Get help
Some older adults with limited resources may qualify for assistance with food purchases through programs such as the Supplemental Nutrition Assistance Program (SNAP). Many older adults See NUTRITION, Page 14
Proper nutrition is essential to overall health. As you age, keep nutrition top of mind and explore new ways to eat well. RAWPIXEL / ISTOCK VIA GETTY IMAGES PLUS Living Senior
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Tips to help family caregivers avoid burnout Family caregivers lead busy and at times, stressful lives, often balancing work, their own kids and spouses, hobbies and more, all while ensuring their loved ones are happy and healthy. In celebration of family caregivers and all that they do, Interim HealthCare Inc. shares tips to help them avoid burnout and provide better care:
Know you’re not alone
Recent data shows an estimated 43.5 million adults in the United States have provided unpaid care to an adult age 50 or older, according to AARP. Of these individuals, around 28 percent have a child or grandchild under the age of 18 living in their household, and six in 10 caregivers report being employed at some point in the past year while caregiving. Online and in-person support groups can be a great way to connect with others who may be in similar situations. These groups can be found through hospitals, Facebook, Meetup.com or organizations like the Alzheimer’s Association or the American Heart Association.
Make life easier
You can simplify daily tasks for your
senior with a few considerations. For example, if utensils are difficult to use, look for opportunities to provide healthy finger foods that help your senior feel more independent. Think sliced frittata, which can be eaten like pizza, versus scrambled eggs. When it comes to getting dressed, opt for Velcro if zippers and buttons have become difficult. Another good trick? Tie loops of string around the ends of zippers so they’re easier to grab.
Don’t be surprised by negative feelings
Caring for someone can be an emotional rollercoaster. Even the calmest person can experience a range of negative emotions. The best way to handle them is to acknowledge that they are a natural reaction to stress. If these feelings persist, reach out to local caregiving support groups, a family physician or therapist for help.
Consider home care as a partner
Professional home care services can complement the care you provide, helping
ease its emotional and physical toll while offering you peace of mind. While selecting senior home care services is something to be proud of, family members often feel guilt over the decision. Conflicted emotions are normal. However, knowing that the decision will make you better equipped to care for everyone can help you move past feelings of guilt. Home healthcare has emerged as a powerful option for families seeking a better way to care for their senior loved ones. Not only does it provide medical and personal care for seniors, it can nurture their independence by allowing them to remain at home, all while providing respite care for family members from the daily routine of caregiving. Be sure to look for care that offers a whole-person approach, such as Interim HealthCare’s HomeLife Enrichment standard of care, where caregivers look beyond a diagnosis so that every patient is treated as an individual with unique needs and desires. To learn more, visit interimhealthcare.com. More caregiving tips can be found at interimhealthcare.com/blog. (STATEPOINT)
Serving as a family caregiver is challenging, but there are ways to make life easier and more fulfilling for both you and your loved one. MANGOSTAR_STUDIO / ISTOCK VIA GETTY IMAGES PLUS Living Senior
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How to help loved ones handle sundowning
A diagnosis of Alzheimer’s disease can catch families off guard. When such a diagnosis is made, patients and their families typically have a host of questions, including how far the disease has progressed and what to expect as it advances. One potential side effect of Alzheimer’s disease that can catch families off guard is sundowning. The National Institute on Aging notes that sundowning refers to the restlessness, agitation, irritability, or confusion that can begin or worsen as daylight begins to fade. Sundowning is difficult for Alzheimer’s sufferers, but also can be especially hard on their caregivers. As day turns to night, people serving as caregivers to Alzheimer’s patients tend to wear down, only to suddenly realize that the people they’re caring for are becoming increasingly difficult to handle. The NIA
notes that sundowning can continue well into the night, compromising patients’ ability to fall asleep and stay in bed. Sundowning will not affect every Alzheimer’s patient, but caregivers should prepare themselves to handle such a situation should it arise. Learning more about sundowning can be part of that preparation.
Why does sundowning occur?
The exact cause of sundowning, which is sometimes referred to as “late-day confusion,” is unknown. However, the Mayo Clinic notes that certain factors may aggravate the feelings of confusion felt by Alzheimer’s patients who experience sundowning. Those factors include: • fatigue; • low lighting; • increased shadows; • disruption of the body’s internal clock; and • the presence of an infection, such as a urinary tract infection. The NIA notes that one theory suggests Alzheimer’s-related changes in the brain can disrupt a person’s internal clock, confusing their sleep-wake cycles as a result. That can confuse Alzheimer’s patients and contribute to the feelings of agitation and irritability that are common among people who experience sundowning.
What can be done to combat sundowning?
The NIA recommends looking for signs of sundowning in late afternoon and early evening and trying to determine what might be causing these behaviors. Try to avoid anything that appears to trigger these behaviors, if possible. Reducing noise, clutter or the number of people in the room when sundowning symptoms typically appear may help reduce the confusion Alzheimer’s patients feel during this time of the day. In addition, scheduling a favorite activity or providing a favorite snack at this time of day can give Alzheimer’s patients something to focus on, potentially cutting off the confusion before it surfaces. The NIA also recommends making early evening a quiet time of day reserved for playing soothing music, reading or going for a walk. Caregivers who also have children to look after can explain the importance of this quiet time to youngsters and ask for their cooperation. Closing curtains or blinds and turning on the lights at dusk can minimize shadows in the house, potentially making this time of day less confusing for Alzheimer’s sufferers. More information about sundowning is available at www.nia.nih.gov. (METRO CREATIVE)
Sundowning is a symptom of Alzheimer’s disease that can be difficult for caregivers to manage. STOCK PHOTO Living Senior
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FLOURISHING IN MULTIPLE DIMENSIONS
How to choose a senior living facility
“Life is a great big canvas, and you should throw all the paint on it you can,” wrote Danny Kaye, beloved Hollywood performer. Kaye’s advice certainly reflected his colorful career. It’s true that the more one expands one’s palette of experiences, the more vibrant life becomes. As you evaluate senior living communities for the next step in your or a loved one’s life journey, look for environments with an array of resources conducive to flourishing. The National Wellness Institute defines Six Dimensions of Wellness – physical, emotional, intellectual, social, spiritual and environmental – which can serve as a guide to enrichment and growth.
Physical
Look for a community fostering physical wellness through excellent health care, nutrition and exercise. Confirm that each resident receives a care plan tailored
to individual needs, and that services such as physical, occupational and speech therapy are available onsite. There should be ample access to state-of-the-art fitness equipment designed for older adults and daily group-led exercise programs. The finest senior living communities offer healthful meals prepared from scratch by professional in-house chefs to meet residents’ dietary needs. Look for a variety of dining venues, from casual bistros to formal restaurants with gourmet cuisine. For example, Anthology of Clayton View boasts chef Adam Shaw, former head chef for Ritz-Carlton. Anthology of The Plaza chef Sam Hudging prepares happy hour appetizers highly enjoyed by residents, and his theme-inspired meals have delighted residents and families alike.
Emotional
Emotional wellness means having a positive sense of self and feeling
connected to others. Consider senior living communities whose staff and environment encourage connectedness. Do compassionate care providers ensure that each care plan promotes independence? Are staff aware of individual care plans, so they have a holistic understanding of each resident? Does the community provide opportunities for emotional development, such as intergenerational art therapy for individuals with memory loss, plus pet therapy and music therapy? Another key to emotional wellness is a sense of fun. At Anthology of Louisville, management and staff lead by example. They turn Kentucky Derby day into a highlight of the year. And when many residents had birthdays the week the COVID-19 crisis hit, they organized a family parade of cars for a motorized See FACILITY, Page 13
With many senior living options available, thoughtful evaluation will help you find a community that provides the enrichment and care needed for a flourishing lifestyle. STOCK PHOTO Living Senior
LIVING SENIOR • SUMMER 2020
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• Vulnerable what you need. Inventory how much food, medication and basic supplies the person you’re caring for has currently. Then make a list of what you need and how often you need to replenish it. Many older individuals often keep minimal extras on hand because they are on a strict budget and are used to regular grocery or medication refills. If possible, help them have a two-week supply of food, water, house cleaning supplies, and medical equipment.
Get medications in order
If you don’t already have one, create a list of medications, medical contacts, and important information like allergies for easy access. If there are upcoming non-emergency, routine medical appointments, reschedule those or, if possible, switch to a virtual visit to receive telemedicine. Ask your pharmacist or health care provider if you’re able to have an extra
(Continued from page 3) 30-day supply of essential medications on hand. Don’t forget to stock up on over-the-counter medications like cough suppressants and fever-reducing drugs like acetaminophen.
Stay connected
With current social distancing recommendations, strict isolation will impact many older individuals. To keep connections strong, set up communication using a variety of technology such as FaceTime or Skype, smart speakers, or simply phone and text. Use these to stay connected with your caregiving team as well as your older or aging family members. If your loved one lives in a longterm care facility, see if they have accommodations for online visits and how they plan to communicate with families. If they can’t support visits via technology, send in cards, letters, magazines, puzzles or other items you know your loved one would be grateful to receive. Talk with your facility management about the safest
way to deliver items.
Maintain personal safety and self-care
In order to help slow the spread of coronavirus, limit physical contact with others, stay in as much as you can and continue to follow guidelines from the CDC. While you are likely very focused on the person you’re caring for, it is essential to also care for yourself. For high-risk individuals, such as those with dementia and underlying health conditions, consider having the primary caregiver self-isolate with the care recipient. Then, have a back-up plan if the primary caregiver becomes ill. It’s best to be proactive and not have to use plan B, rather than being caught off guard without options. For more information about caregiving and important considerations in light of COVID-19, visit aarp.org/ caregiving and aarp.org/coronavirus. (BPT)
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(Continued from page 11)
birthday party.
Intellectual
Intellectual wellness is cultivated through stimulating mental activities and access to opportunities to expand and share knowledge and creativity. Look for a senior living option offering opportunities to expand residents’ minds. Learning experiences like language courses, sewing classes and lectures by guest speakers should be listed in their calendar.
Social
For social wellness, residents need to feel connected to family and community, with opportunities to enhance friendships. This has been severely challenged by the COVID-19 pandemic. Senior living communities nationwide have had to implement strict safety protocols such as in-room isolating, social distancing, use of personal protective equipment, screening and testing. Inquire if the community you are considering acted quickly to put programs in place to help residents maintain connectedness to
loved ones. Despite difficult circumstances, premium senior living communities still provide creative and engaging socially distanced activities to promote residents’ mental and emotional wellness and use technology to help residents connect with loved ones. “Our Socially Distanced Engagement Program provides residents with daily activities that focus on the mind, body and spirit to keep them mentally stimulated and physically active,” says Anthology Senior Living president Benjamin Burke. “We continue to look at the best ways to keep lines of communication open, and we encourage residents and loved ones to stay connected through phone calls, video chats and email. The safety and well-being of our residents and team members is always our true north.”
Spiritual
Spiritual wellness encompasses the need for meaning, as expressed in spiritual beliefs and practices. Look for senior living communities providing opportunities for
spiritual growth, with spiritual gatherings such as non-denominational services, rosary prayer, hymn singing, devotionals and Shabbat celebrations.
Environmental
Our feeling of wellness is profoundly affected by our environment. Look for a beautifully designed community with welcoming indoor and outdoor spaces. Seek sophisticated accommodations with spacious private suites and a variety of floor plans to meet individual preferences. The best-designed communities offer well-appointed public spaces such as meeting rooms, landscaped courtyards and raised planters for resident gardening. Keep these Six Dimensions of Wellness in mind as you research your or your loved ones’ next home. All six dimensions should be interconnected, strengthening residents as individuals and the community as a whole. To learn more about independent living, assisted living and memory care, visit AnthologySeniorLiving.com. (BPT)
Well-designed and attractive living spaces are important to the emotional well-being of assisted living resident. Look for places with a variety of floor plans and spacious private suites. STOCK PHOTO Living Senior
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qualify for this program and don’t know it. One way to verify eligibility is to visit Cigna.BenefitsCheckup.org and enter your information under the “Food & Nutrition” section. If you aren’t eligible for this type of assistance, you can still find ways to save on food bills, including asking for senior discounts, using coupons, having a store discount card and buying store brands. These are just a few resources. Every individual has unique needs. Cigna encourages you to talk with your physician for additional information about your personal nutrition requirements. For videos about senior nutrition and some warning signs of malnutrition, visit wnpt.org/agingmatters/nutrition-aging. (STATEPOINT)
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Being a compassionate caregiver to someone living with dementia Dementia can be devastating for the people who live with it and their family members, and it’s a diagnosis more Americans will face as the U.S. population ages. In the next 20 years, the total number of those living with Alzheimer’s disease or other types of dementia in the U.S. is expected to approximately double from 7.2 million to nearly 13 million, according to the Milken Institute. “As the life a person always knew becomes increasingly unfamiliar, caregivers can play an important role in helping ease anxiety,” says Jennifer Sheets, president and chief executive officer of Interim HealthCare Inc., an inhome healthcare and assistance provider that takes a positive approach to caring for those with dementia. “With the right knowledge, a caregiver can help their loved one cope with the changes they are experiencing.” Here are three practical tips for
compassionate caregiving: Use the hand-under-hand technique Hand-under-Hand is a technique that caregivers can use to reduce anxiety and calm a person with dementia. The base or heal of the hand is a highly sensitive area. Put slight pressure on that area by clasping your loved one’s dominant hand. This technique works best if you put your hand underneath theirs. That gives them a feeling of control as well as calms them. Acknowledge evolving tastes A person living with dementia experiences a range of sensory and cognitive changes that can affect their appetite and food preferences. Indeed, your loved one’s favorite foods may now have a negative smell or taste to them. While maintaining good nutrition is essential, don’t force these foods or argue over them. Instead, offer a variety of balanced
foods: vegetables, fruits, whole grains, low-fat dairy products and lean proteins, in small servings at first until you understand new preferences. Realize these preferences may change again. Carve out time for art and music Once a person is diagnosed with dementia, their ability to act independently greatly diminishes. However, artwork and music allow for freedom of expression, which over time, can be quite impactful in relieving anxiety. Remember, it’s about the creative process, not your loved one’s abilities. So, set aside 30 to 45 minutes weekly for art or music and consider participating alongside them. Interim HealthCare has created a free downloadable guide with more tips and guidance intended to provide the most supportive environment possible at Interimhealthcare.com/dementia-caregiverSTATEPOINT) guide.aspx.
Caring for a person with dementia is a difficult journey. However, a greater understanding of the condition can help caregivers better cope and manage their role with compassion. KALI9 / GETTY IMAGES + INTERIM HEALTHCARE Living Senior
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