The SCANS content team headed by Jean Bandos along with the development team announced today that the SCANS Version 1.3 - May release is now available.  SCANS Version 1.3 is a major content release to the SCANS Knowledge Base.

In order to make more real-world tools for eldercare available more quickly, Jean and the team have devised a "rolling release".  For 3 months beginning in May another group of resources, processes, and tools will be made available to geriatric care managers at My Health Care Manager and our affiliates.

The May release contains 57 new and/or revised resources, processes and tools.  Some sample items include: 
 

• Behaviors and Alzheimer's Disease
• Grief Education
• Activities of Daily Living Education
• Depression and Alzheimer's disease
• Early Stages and Impact on Health
• Memory & Cognition Questions
• Memory Care Unit Checklist
• Memory Care Unit Education
• Mild Cognitive Impairment
• Sobriety Programs Resource
• Handyman Resource
• Private Handyman Contractor Checklist
• Smoke & Carbon Monoxide Detectors
• Daily  Money Management Education
• Financial Planning Education
• Trust Education
• Verifying Funeral Arrangements
• Veterans Benefit Information
• Elder Law Resource & Checklist
• Medication Management Procedure
• Medication Reconciliation
• Polypharmacy
• How to Find a Pain Specialist
• Pain Education
• Pain Resources
• Pain Visual Analog Scale
• Arthritis
• Heart Failure
• Hypertension Education
• Family History - Cancer Education
• Family History - Dementia
• Family History - Diabetes Education
• Family History - Heart Education
• Seat Belt Education
• Cataracts Education
• Glaucoma Education
• Hearing Aid Education
• Sensory Changes
• Assistive Devices
• Hospice Education
• Spiritual Connections

Stay tuned; the June release will include resources on incontinence, cognition, supporting services, and more processes.

Be sure to visit Jean's blog, click here.

**The following post is from my guest blogger, Natalie Langley, MSW.  She is a Geriatric Care Research Analyst for SCANS (for more on SCANS, please see Eric Tinsley's blog by clicking here).**

There are several barriers that can impact the older adult’s ability to achieve good nutrition.  The following checklist can help to ensure older adults are getting the proper nutrition. 

Determine if there is a problem that impairs their ability to eat:

1. Have a physician/pharmacist review side effects of medications.
2. Are their teeth/dentures in proper condition?
3. Are there any physical limitations relating to pain and arthritis?
4. Is there a decrease in a sense of smell and taste?
5. Are finances a barrier?
6. Is their eyesight failing?
7. Do they have weakness and are not able to carry grocery bags?
8. Is forgetfulness or dementia present?

As a caregiver or an older adult, make sure to enlist people and programs within the community to help with meal assistance.  One way is to contact your local Area Agency on Aging for meal programs for older adults, such as Meals on Wheels.  This program offers deliverable meals for older adults in their homes.  For a list of local Area Agencies on Aging, you can visit www.n4a.org. 

Another good resource for meal assistance is Seattle Sutton's.  This is an Illinois based company, but they have locations everywhere.  They offer healthy, prepared meals for a reasonable price.  To find a location near you, please visit their website at http://www.seattlesutton.com/.
 

There are many drug-free (non-pharmacological) options that have been proven to help relieve certain types of pain, which could be from arthritis, chronic pain, or another chronic disease. These techniques can help complement the pain management medications prescribed by your doctor.
1. Apply heat or cold to the affected area
2. Ask your geriatrician or health care provider about specific exercises to help with pain
3. Find something that distracts you such as music or a hobby
4. Practice relaxation or deep breathing techniques
5. Massage or vibration can help relax you and may relieve the pain
6. Applying pressure to the area that is in pain
7. Find support groups or someone to talk with
8. Modify your environment so that it is more comfortable for you
9. Plan activities earlier in the day when pain is sometimes not as bad
10. Learn how to manage pain- learn what triggers it, what makes it worse, and what makes it better
11. Consider keeping a journal of when pain occurs and what helps relieve it
 
If you are not sure of how to use these techniques ask your health care provider and/or discuss with your Health Care Manager.  If you're a caregiver, you can discuss these options with your aging loved one and have them work with their health care provider to integrate the techniques into daily life.

In past blogs, I’ve talked about how the holidays are bittersweet for many caregivers, with the increased stress levels and happy memories of the past contrasting with the difficulties of the present.  These extra demands on time and energy can seem overwhelming both to you and your aging parent.

Try to create a balance between rest and activity. In order to keep up with family traditions, take time to assess how important these traditions are and how they affect your responsibilities of caring for your aging parent - especially when your parent has Alzheimer’s or other chronic illnesses such as diabetes, CHF, or arthritis. 

Start early and write down activities that are important to you. As you are making your calendar remember to:

• Keep or adapt family traditions that are important to you
• Include your aging parent as much as possible
• Recognize that things will be different
• Encourage friends and family to visit you this year to limit the number of trips you have to arrange for your aging parent
• If your parent has Alzheimer’s, avoid crowds, changes in routine, and strange surroundings that may cause confusion or agitation 
• Do your best to enjoy yourself
• Try to find time for the holiday things you like to do, even if it means asking a friend or family member to spend time with your aging parent while you are out
• If there are occasions that are large events, try to have a space available where your parent can rest, be alone for awhile, or spend some time with a smaller number of people, if needed.

Most importantly:

• Have realistic expectations about what you can do
• Take care of your needs and keep it as simple as possible!

For more information on caregiving, you may want to visit the National Institute on Aging and explore their available publications.

**The following post is from my guest blogger, Natalie Langley, MSW.  She is a Geriatric Care Research Analyst for SCANS (for more on SCANS, please see Eric Tinsley's blog by clicking here).**

Nutrition and eating right are important components to keeping us all healthy.  But what happens when a chronic illness such as diabetes, congestive heart failure, or cancer is brought into the picture?  Having a chronic illness may mean taking a few more steps to ensure the older adult is getting the appropriate nutrients daily.  Making sure that all the key nutrients are a part of your diet can actually help you stay healthy, fight off infections, and feel stronger.  Even making simple changes such as removing the salt shaker from the dining room table can help reduce the amount of salt you put on food, therefore, reducing the sodium level for someone who has Chronic Obstructive Pulmonary Disease (COPD).  Other nutrition tips can be found on the web resources below for individuals who have chronic illnesses.  If you notice you are losing weight (10 pounds or more) involuntarily over a 6 month period, please check with your primary care provider.  In addition, before making any changes in your diet, always consult with your primary care provider. 

American Heart Association
http://www.americanheart.org/presenter.jhtml?identifier=1444

American Cancer Society – Recipes high in calories and easy to eat
http://www.cancer.org/docroot/MBC/content/MBC_6_1_Recipes.asp

American Lung Association – Eating well with COPD
http://www.lungusa.org/site/c.dvLUK9O0E/b.3529631/#eating 

American Diabetes Association
http://www.diabetes.org 

National Institute of Diabetes and Digestive and Kidney Diseases
http://www2.niddk.nih.gov/ 

National Institute of Arthritis and Musculoskeletal and Skin Diseases
http://www.niams.nih.gov/

In several of my past blogs, I discussed safety concerns and the older adult.  One the main concern is medication safety. Not just the management of medications but how many are actually taken.

It is often reported in the news about a medical error made and the impact it has on individual lives.  Those articles are frequently about hospitals errors.  But have you ever thought about the older adult and how they manage at home...?  The impact our current health system has on managing medications...?  How chronic illnesses such as congestive heart failure, diabetes, and arthritis impact the older adult and his/her caregivers...?  Different providers – prescribing different medication – generic versus brand names.  multiple medications with multiple doses all affect the medication management and the safety of the older adult.

Let’s look at the key safety issue: polypharmacy (multiple medications).  
A caregiver may ask what defines polypharmacy or how many pills or too many?  The answer would have to be that different entities in the current health care system define Polypharmacy differently.  I have seen it defined as low as two or more medications, but in general it deals with using more than three to five medications or herbal supplements for longer than 90 days in a given year.  In my career I have witnessed shoe boxes filled with medications that have numbered over 20 different medications- especially when dealing with multiple chronic diseases, over the counter medications, herbs, and vitamins.

Where should the caregiver and/or older adult start in trying to deal with their medications?
First, realize that the main problem with polypharmacy is that it increases the clients’ risk for drug interactions.  Drug interactions occur when one medication or herbal supplement reacts negatively with another medication when they are taken together. It is important to report any side effects to your physician.
 
The following are some steps you can take to prevent drug interactions:

• Provide a complete list of your medications and herbal supplements to your physician and/or pharmacist
• Discuss how each medication/herbal supplement works inside the body.
• Verify with your physician that you are receiving the recommended dose of each medication/herbal supplement.
• Verify with your physician that you are receiving the recommended form of each medication/herbal supplement you are taking (pill, liquid, tea, extract).
• Determine how many times a day your medications/herbal supplements should be taken.
• Discuss any side effects that might be experienced.
• Discuss the common prescription medication interactions.
• Discuss the common herbal supplement interactions.

If you can not complete a list of medications, take them all into your physician or pharmacist and have a list made for you. 

The National Institute on Aging is a great resource for learning more about medication managements, herbs, vitamins and safety concerns - learn more by clicking here.

The My Health Care Manager's Client Portal serves as a communication platform for families caring for aging parents. It provides easy access to information like:

• Schedule of care events (e.g. medical appointments, therapy, geriatric care visits)
• Medical issues (e.g. Alzheimer's, arthritis, incontinence, congestive heart failure, diabetes, COPD)
• Health provider contact information and specialties
• Medication list including dosage, frequency, prescribing physician, and other specifics
• Recent Hospitalizations
• Client contact information
• Updates on key issues of aging such as Caregiving, Advanced Directives, Living Independently, Family Communications, Depression, and more
• Resources
• and more

It also supports secure, private interactivity with the Health Care Manager providing geriatric care for the family using tools like a discussion board, contact logs documenting visits and phone conversations, and posting of care goals like improving home safety, reducing isolation, improving depression, improving mobility, supporting treatment plans, and so on.

As we entered into spring, the presidential candidates continue the health care debate.  The real issue is that the US has an aging population.  By 2030, the number of adults age 65 and older will nearly double to 70 million. With twenty percent of the Medicare population having at least five chronic conditions (e.g. hypertension, diabetes, arthritis), the question remains: How do we care for these elders? 

Geriatrics is a growing specialty where physicians, nurses, social workers and other health care providers receive special training dedicated to improving the health, independence and quality of life of all older adults.  Geriatricians are physicians who are experts in caring for older persons; they are initially trained in family practice or internal medicine and then complete at least one additional year of fellowship training in geriatrics. They have the expertise to coordinate services among multiple specialty care providers.  For more information on the profession, visit the American Geriatrics Society website at http://www.americangeriatrics.org.

A geriatrician will coordinate a health assessment for older adults with the primary goal of encouraging and promoting wellness and independent function. The health assessment will include an interdisciplinary team approach to the physical, emotional, cognitive, functional, and medication status of the older adult.  If you would like to locate a physician in your area who is sensitive to the special needs of older adults, you can submit your request by completing a form on line located at http://www.healthinaging.org/public_education/physician_referral.php  or contact a geriatric care manager in your area.  To locate a local geriatric care manager, visit http://www.caremanager.org/.  In addition, telephonic geriatric care management services are now offered by My Health Care Manager.  To learn more, visit our website by clicking here.

With the Hollywood writers strike, some of those writers may be treating this time as a much-needed break from the daily grind, as they are only required to work 20 hours a week manning the picket lines.  Unfortunately, as most caregivers know, caring for aging parents is a full-time job.  And this is often on top of the full-time hours put in at a paying full-time job.  It can often be tiring, emotionally and financially draining, and very hard.

 

For family caregivers that are in need of a well-deserved respite, don’t hesitate to ask for help...  Don’t hesitate to take a well-deserved break!  Accept the help that your family and friends offer or hire outside help to give you a few hours (or a few days) of help each week.  Caregiver burnout is real – especially for working caregivers.  Understand that you must first take care of your own health, and that asking for help or accepting help may make you a better caregiver in the long run by reducing your stress levels and allowing you some respite.

 

Providing care for a loved one, organizing their health care and managing appointments, checking on their home safety, spending time with them to prevent isolation, AND doing all of the other duties that come with the territory is extremely time consuming, sometimes confusing, and sometimes stressful.  If you find yourself ‘in over your head’ or just needing some advice, you may consider enlisting the help of a geriatric care manager.  Geriatric care managers can help facilitate communication within your family, give you advice on avoiding caregiver burnout, and offer tips and tricks to help you manage the health conditions of your loved one (whether it be helpful ways to remind your mother with diabetes to check her blood sugar, tips on communicating with a senior suffering from Alzheimer’s, ways to improve your father’s quality of life or help manage your uncle’s arthritis, or a better way to manage the multiple medications prescribed to your grandmother).