Did you know that in this country 795,000 people have a stroke every year? Every 4 minutes, someone dies from a stroke, the number 4 killer in this country.  What can you do personally to decrease your stroke risk?

If you want to avoid having a stroke, the American Heart Association says to do these seven things:

1.  be active
2. control cholesterol
3. eat a healthy diet
4. manage blood pressure
5. maintain a healthy weight
6. control blood sugar
7. don’t smoke

The American Heart Association’s journal Stroke has published a new study that shows small changes can make a big difference.  Dr. Mary Cushman, professor of medicine at the University of Vermont in Burlington says that a small difference in health status is associated with a large reduction in stroke risk. The researchers used an assessment tool and divided the scores into three categories: 0 to 4 points for inadequate, 5 to 9 points for average, and 10 to 14 points for optimum health. What they discovered about the scores was surprising:

•  For every point toward a better score, the stroke risk lowered 8 percent.
• Optimum scores were compared with inadequate scores. Those with optimum scores had a 48 percent lower risk of stroke, and those with average scores had a 27 percent lower risk of stroke than those with an inadequate score.
• Risk was not affected by color of skin; both whites and blacks showed increased risk in association with the factors above.

What is the number one thing that a person can to to lower their stroke risk?  Statistically, it would be to reduce your blood pressure.  The study showed that those who had ideal blood pressure had a 60 percent lower stroke risk than those with poor blood pressure.

Do these statistics motivate you to take hold of your risk factors?  You can visit the online site for the American Heart Association’s Simple Seven Steps.  Join the over 400,000 Americans who have already visited www.mylifecheck.org and check your health status.

View the Story on our blog: Take Simple Steps to Reduce Your Stroke Risk .

It’s Garden Fest Time!

We all know that summer has arrived in Baton Rouge, whether or not the calendar agrees. If you are a home caregiver, it’s time to get out of your house and enjoy a morning at LSU’s Garden Fest. If your loved ones are in good enough health, it’s the perfect opportunity to take them out for a sensory extravaganza.  Together you can enjoy an engaging morning of sights, sounds and tastes.

The event begins bright and early at 7:30 a.m. Saturday the 15th. It will be great to get there promptly, since the Louisiana Department of Agriculture and Forestry and the Louisiana Egg Commission will treat you to fresh omelets from 7:30 to 9:30.  Delicious buttery omelets are always a treat, and even better when you don’t have to prepare them!

There will be two culinary competitions, one to find the best cocktail, and another for the best homegrown tomatoes.  The public is invited to bring their homegrown tomatoes and enter them in the competition.

After you’ve entered or examined the entrants at the tomato contest, enjoy some music later that morning at 10.  Take a seat and relax while listening to local music competition “Red Stick Idol”.  The competition is sponsored by Baton Rouge Music Studios and Visit Baton Rouge.

You can take tours of the gardens, hop on a hayride, and learn about the latest research conducted by the LSU AgCenter. Delight your taste buds with local tomatoes, peppers, watermelons, and other fruit crops. Sample Bloody Marys by Mason’s Grill, and try other local cocktails.

Taking a break as a home caregiver is so important, and a change of pace is so welcome for your loved ones too. What a delightful morning you’ll have! Adult admission is only $10, and children get in for $5. Check out the Botanic Gardens’ website for more details.

 Botanic Gardens at Burden

4560 Essen Lane
Baton Rouge

(225) 763-3990

View the Story on our blog: Home Caregivers, It’s Time For a Morning Out! .

Your loved one may not have to live with incontinence.

In our last article, we talked about possible causes of incontinence in the elderly.  For whatever reason, if protective undergarments are becoming part of daily life for your loved one, it’s time to schedule an appointment for them to see a health care professional. At the appointment, you can expect the following to take place:

• urinalysis, which will determine if there is blood or infection in the urine
• blood test, which will check kidney function, calcium and glucose levels
• discussion of medical history
• physical exam, including rectal/ pelvic/ urological exam.

It’s a good idea to start keeping a bladder diary before the appointment. Make a note of liquid intake, times of urination, how much urine is eliminated for each trip to the restroom, and description of any and all accidents. Make sure the health care provider reviews the diary at the appointment.

There are tests that can be ordered if your provider feels follow-up is needed to obtain a diagnosis. These include the following:

• Post-void residual: An ultrasound is performed after urination to see if any urine remains in the bladder.
• Urodynamic testing: A catheter fills the bladder with water and the test measure the pressure in the bladder when it is a rest, as it fills, and when it empties.
• Cystogram: dye is injected into the bladder through a catheter, and an x-ray is taken while the patient urinates.
• Cystoscopy: a small scope is inserted into the bladder. The doctor can check for bladder capacity, any tumors, stones, or possible cancer.

Once a diagnosis has been made by a qualified professional, there are many options for treatment and management.

Behavioral therapy is one treatment that often helps. This treatment includes bladder training, scheduled bathroom trips, pelvic floor muscle exercises, and fluid/diet management.

Medications can also be beneficial, especially in combination with behavioral therapies. These medications can and will vary, depending on the cause of the incontinence. Antispasmodic drugs, hormone replacement, antibiotics or even muscle relaxant can assist, depending on the cause.

It’s important to remember to keep up with stringent personal care while dealing with incontinence. Remember to use a mild soap for washing. Use a skin protectant such as cocoa butter or petroleum jelly, and remember to pat the skin completely dry after urinating. If your loved one is often rushing to the restroom, be alert to safety hazards as well.

Finally, it’s good to remember that incontinence in the elderly, though inconvenient and frustrating, is not the individual’s fault.  Ensure your loved one that they can still keep their dignity while they deal with the situation, and that you view them as important and valuable, in spite of their difficulties.

View the Story on our blog: Incontinence in the Elderly: What Can Be Done? .

Bathroom issues come in many variations.

If your loved one is having trouble with successful bathroom trips, it’s probably causing you a great deal of stress and trouble. Did you know that there are several types of Incontinence in the elderly? Some people may leak urine only occasionally, others may have a constant inability to hold their urine, still others may not have any bladder or bowel control at all. We discuss the different types of incontinence in the elderly below, and later will talk about options you may have as a caregiver.

Surge Incontinence

This is the most common type of incontinence in the elderly. It is described as being an urgent need to urinate, which results in a loss of control before one arrives at the toilet. Physicians believe urge incontinence is caused by involuntary contractions of the bladder. It can be caused by strokes, dementia, Alzheimer’s disease, MS, Parkinson’s, pelvic floor atrophy, or prostate enlargement.

Stress Incontinence

When an increase in abdominal pressure overcomes the contracting pressure of the bladder, stress incontinence occurs. Abdominal pressure may be caused by coughing, sneezing, laughing, climbing stairs, or lifting. In the elderly, something as simple as rising from a chair may be enough pressure to cause an accident. Stress incontinence is more common among women who have been pregnant in the past, or men with an enlarged prostate gland.

Overflow Incontinence

Physicians estimate that only 2 percent of patients with incontinence suffer from overflow incontinence. Since the patient’s bladder never completely empties, he or she feels the need to go and will often leak small amounts of urine. Overflow incontinence is often caused by an obstruction in the urinary tract or by a weak bladder.

Functional Incontinence

Sometimes incontinence isn’t caused by a bladder malfunction at all; functional incontinence is caused by the body’s inability to make it to the bathroom in time. Arthritic hands may make un-zipping pants time-consuming; a bad hip or knee may make the trip to the bathroom take longer than anticipated. Even neurological disorders can be the culprit: the patient may still feel the urge to eliminate, but his or her mind cannot translate the urge into planning a bathroom trip.

Happily, there is often something that can be done about incontinence. In our next post, we’ll share options that you may be able to discuss at your loved one’s next medical appointment.

View the Story on our blog: What Causes Incontinence in the Elderly? .

It’s easy to become frustrated as a caregiver.

It’s been a long day.

I feel like I say that every day of my life.

Am I frustrated? Am I exhausted? Am I pessimistic?

You bet.

You see, I’m caring for my mother, who has a slow-paced disease that will for the most part strip her of her memories, her sparkling personality, her kindness, and her love for me. There is absolutely nothing I can do about it. I feel helpless. The only thing I CAN do is stay by her side and be the best caregiver I can be.

The struggles of a caregiver are heartbreaking. If you are in a caregiving role, you can probably identify with the above feelings. How can you cope with the frustration that is so common among caregivers? The Family Caregiver Alliance shares helpful information.

Since we know that those with dementia cannot change their behavior, we need to learn to cope; in other words, we must change ourselves. The first step in this change is to recognize frustration as it surfaces.

Common warning signs of frustration are:

• shortness of breath
• knot in the throat
• stomach cramps
• chest pains
• headache
• compulsive eating
• excessive alcohol consumption
• increased smoking
• lack of patience
• desire to strike out

When you feel the signs of frustration creeping in upon you, it’s time for intervention. Choose an activity to help you calm down. While you are calming your emotions, you will have time to look at the situation in a more objective and controlled way.

If the struggles of a caregiver are becoming too much, here are a few ways to calm your frustration:

•  Count from one to ten slowly while taking deep breaths.
• Leave the room, either to take a walk, or just to step away from the situation.
• Call a friend
• Pray or meditate
• Sing or listen to music
• Soak in a bath

You know your own temperament, so choose an activity that will work best for you, or if you know of another safe and healthy idea that will calm you – by all means, go with it.

Since frustration is a daily part of life while being a home caregiver, it’s a great idea to prepare for frustrating circumstances.

The FCA recommends practicing this relaxation technique at least ten minutes daily:

“Sit in a comfortable position in a quiet place. Take slow, deep breaths and relax the tension in your body. While you continue to take slow, deep breaths, you may want to imagine a safe and restful place and repeat a calming word or phrase.”

Are you a caregiver having struggles of your own? How do you deal with frustration? We would love to hear your thoughts in the comments section below.

View the Story on our blog: How To Cope With Caregiver Frustration .

Crossword puzzles may be a familiar activity for your loved one.

We who are in good health often take the daily activities we perform for granted. But for someone with Alzheimer’s disease, activities can be the defining factor that makes them feel confident, needed and loved.  In the February/March issue of Caring Magazine, Dr. Verna Benner Carson shares some insightful ways that activities can benefit those with Alzheimer’s disease.  She encourages home health workers and family caregivers to work together using these ideas to benefit their Alzheimer’s patient.

Remember the following when introducing new activities to Alzheimer’s patients:

•  Remember that a person with Alzheimer’s cannot change their behavior. You are the one who can and must change.
•  Difficult though it may be, you have the ability to enter their reality. They are not able to enter our reality anymore.
•  Not everything will work. Don’t give up if some suggestions don’t work for your loved one. Be prepared to be flexible.
•  Celebrate the process, not the result. If they are trying, engaging, participating, they are succeeding.
•  The goal is to create a routine that they can perform daily. It should be simple, enjoyable, and familiar.

 What are some daily activities you can introduce?

 Morning

• wash face
• brush teeth
• prepare breakfast
• chat about news stories
• browse photo albums and reminisce

 Afternoon

• prepare lunch
• read mail
• wash dishes
• crossword puzzle
• listen to music favorites
• take a walk

 Evening

• prepare dinner
• play cards
• television or movie
• read a book

 Outside activities

• maintain birdbath/ feeder
• sit in the shade and read poetry
• reminisce about playing outside as a child
• water plants together
• examine rocks, leaves, flowers; talking about differences in sensation from each one

Hopefully these ideas have inspired you, whether you care as a family member or a health worker. What activities are you going to try to work into the daily routine? Do you have other activity ideas to share with our readers? We’d love to hear your thoughts in the comments section below.

View the Story on our blog: Daily Activities Make a Difference .

I knelt down so we could have better eye contact.

My feet move steadily along the stone path that leads to your home.  I know you aren’t expecting me, and I hope that my arrival does not come as an unpleasant surprise.

I’m nervous. I always am when I meet a new friend.

In the ancient tree next to your cozy ranch, a black-capped chickadee whistles a noisy greeting. I take a deep breath and exhale. Then I ring the doorbell.

Your son comes to the door, pleasant and welcoming. I can tell he’s grateful that I’m here to watch over you. I can see how tired his eyes are; he has needed relief from a senior caregiver for some time. We speak briefly about our caregiving schedule today, and then he leads me down the portrait-lined hallway to your bedroom.

“Mom,” your son says to you in slow and elevated tones, “Mom… you have a visitor.”

You look away from the noisy game show on television and regard me with eyes that would be confused if they weren’t so lost to begin with. My heart breaks a little.

I decide to step forward. “Hi Madeline,” I say warmly, looking you in the eye, “My name is Adele. I’m so pleased to meet you.”

You reply with a weak hello, and your son reaches for the remote to turn the volume down on the TV. I want to make you feel comfortable, so I crouch down at your level and set my hand next to yours. “Madeline. I’ve been told that you love mysteries, especially Agatha Christie’s books. Is this true?”

At the mention of Agatha Christie, your eyes dart in my direction. “You know, my favorite Christie novel is ‘The Mysterious Affair at Styles.’” Up until this point, your eyes drifted aimlessly around the room as I spoke. Now, they settled comfortably upon me. I smile wryly at you and winked. “I don’t suppose I could read it to you today, could I?”

And wouldn’t you know, you smiled back at me.

I knew we were going to be friends.

I am a senior caregiver, and yes, this is my job. This is how I make my living, but know this: I put my whole heart into my position. I know that tomorrow, even if you can’t remember me, I’ll be glad to be here, and I’m happy to take care of you.

Aging is very difficult. You’re surrounded by family and friends that adore you, but in this busy world, they can’t always be at your side. They need someone they can trust to care for you in their absence, and you’ll need someone to rely upon.  I promise:  I’ll be that person.

View the Story on our blog: My First Day as a Senior Caregiver .

Of course you need help. You’re a caregiver.

We’re going to take a few moments today and envision a scenario.

A friend or relative or colleague is conversing with you about your life as a caregiver.  You talk about dementia care and see they are sincere in their interest, so you let them in on a few details of your struggles.  They listen attentively and appreciatively, then sigh and say, “Well, I have to hand it to you.  It sounds like you’re doing an amazing job.”

At this point, you’ll probably say something self-deprecating like, “I’m sure I”m not.”  Maybe you make a little joke.  ”I don’t know about amazing – I’m no superhero.  But I’m trying my best.”

“Well,” he or she says, “If there’s ever anything I can do to help you out, let me know.”

You smile just a bit and say thanks, all the while thinking to yourself, “They probably don’t really mean that.”

STOP.

From here on out, dear caregiver, here’s what you’re going to say:

“Wow!  Thank you so much for offering.  There is a little something coming up this week that I could really use some help with.”

It may be difficult to think about accepting offers of help, but do you know what else is difficult?  Caring for a person with dementia… and you need a break.

Think ahead and write down ways (from seemingly insignificant errands to huge favors) that other people can assist you.

Here are a few ideas to get you started, but you’ll no doubt want to customize the list:

• return library books
• drop off dinner one night
• pick up a prescription
• stop in for a social call
• read to your loved one for a while so you can rest
• take your loved one to the doctor
• doing a little yard work

Nobody likes to have to ask for help.  But if a person offers to help you as you provide dementia care, say a thankful and enthusiastic “yes!”  If it feels awkward, just remember: the more help you receive from willing volunteers, the less likely you’ll be in the cringing, desperate position of asking for help.

What are some ways, big or small, that you need help?  Go grab your smartphone or a notepad and jot down a few ideas.  Then share them with me in the comments below.

View the Story on our blog: You Can Make Dementia Care a Little Easier .

Caregiving: fulfilling yet taxing

If you are a home caregiver and are a woman, you’ll find the following statistics eye-opening.

• The average caregiver is a female, aged 46, according to the National Alliance for Caregiving.
• The percentage of female home caregivers is 59 to 75 percent.
• Middle-aged women with depression are twice as likely to have a stroke than those not suffering from the illness.

The last statistic has been published in Stroke: Journal of the American Heart Association.  The study was well established.  It was conducted over 12 years on 10,547 women aged 47-52. Depressed women had a 2.4 times greater risk of stroke when compared to women who did not suffer from depression. Even after other stroke risk factors were eliminated, the ratio was still 1.9 times more likely.

The level of stress and emotional burden often leaves home caregivers suffering from depression.  Our goal here is not to diagnose or predict diseases or illness.  Still, we know the tremendous burden that home caregivers bear, and that depression often becomes an issue for them.

The Signs and Symptoms of Depression Include:

• Persistent sad, anxious, or “empty” feelings
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Irritability, restlessness
• Loss of interest in activities or hobbies once pleasurable
• Fatigue and decreased energy
• Difficulty concentrating, remembering details, and making decisions
• Insomnia, early-morning wakefulness, or excessive sleeping
• Overeating, or appetite loss
• Thoughts of suicide, suicide attempts

The National Institute of Mental Health says, “Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness… Do not wait too long to get evaluated or treated. There is research showing the longer one waits, the greater the impairment can be down the road. Try to see a professional as soon as possible.”

View the Story on our blog: Depression in Female Home Caregivers Leads to Stroke Risk .

Realize that you need a break.

I talked to an old friend on the phone the other day.  It had been a long time since we had talked, and I wanted to hear how her family was doing.  Everyone seemed to be doing great; then the conversation turned to her mother, Donna.  ”Mom has been taking care of Nana now for three years,” she said.  ”She’s having a really hard time.”

I expressed my concern for her and asked if she was taking advantage of respite care.

“No, she won’t let anyone else help since she thinks it’s her responsibility.”

This kind of self-sacrifice worries me.  Everyone needs a break, especially Donna.  She’s the kind of lady with non-stop energy, laughter and silliness.  She thrives on social interaction and new experiences.  Caregiving for someone who is practically bed-ridden is sure to be a tremendous drain on her spirit.

Her next comments support my theory.  ”Mom is really down right now.  She cries a lot and tells me that she feels like she’s losing her mind.”

I can believe it.  Three years without a significant break?  As much as I felt bad for Donna, I know the theme is common.  I couldn’t help but think “Why do so many caregivers have the need to be martyrs?”

I so appreciate the words of Kate Murphy, a registered nurse and author of the article  Respite: Enjoy a Guilt-Free Time Out.  She says, “As a caregiver it is important that we recognize that it is OK to take a break from our caregiving duties. It is OK to feel tired, and want to have a break from caregiving! Not only is it OK, it is your right! You are allowed to stay healthy both physically and emotionally. Actually, by not doing this you are helping to create a potential problem down the road. No one can keep going day after day without a break, sooner or later it is going to catch up with you, and not only will you suffer, but also your loved will as well.”

While it takes courage to walk away from responsibility for a time, experts repeatedly tell us that respite care is a necessity.  Whether it’s a family member, friend, or a competent paid caregiver, find someone to fill your shoes so you can take the break you need.  And yes, you DO need it.

Have you felt guilty about getting away from your caregiving duties?  What helped you to take a break?  I’d love to hear your comments below.

View the Story on our blog: Guilt vs. Respite Care: The Winner Is… .