Physical Aspects of Aging -- Part 3 of 4

Vision

Even though changes to the eye take place as a person ages, many older people have good-to-adequate vision. Nevertheless, beginning in the late 30s and early 40s, an individual may begin to notice some changes. She or he may have to hold the paper farther away to read it due to changes in the ability of the lens to change its shape to accommodate to distance.

With aging, peripheral vision is reduced. A person may need to turn her or his head to see to the sides. The flexibility of the eye decreases and it takes an older person more time to accommodate to changes in light. Adaptations in lifestyle and behaviors must be made to cope with this change. An individual might give up driving at night. Placing more lights evenly around the room so that the entire room is lit is also helpful.
Degeneration of eye muscles and clouding of the lens are associated with aging. Several changes in vision result from this. Older people tend to have trouble focusing on near objects, but eyeglasses may correct this problem. In addition, the ability to see colors changes with age as the lens yellows. Red, yellow, and orange are easier to see than blue and green. This is why fabrics in warmer shades may be more appealing to the older person.

Serious vision impairments such as cataracts, glaucoma, and blindness affect between 7% and 15% of older adults. If someone you know must learn to cope with blindness or near blindness, you can play a critical role in helping them maintain their independence.

To help a person with any visual impairment, or to make your own life brighter:

• Light the room brightly and use more than one non-glare light in a room.
• Use blinds or shades to reduce glare.
• Keep a night light on in the bedroom, hallway, and bathroom to maintain an equal level of light.
• Increase lighting on stairwells and steps.
• Use concentrated light for sewing and reading.
• Turn lighting away from the television to avoid glare.
• Provide printed materials with high contrast between the background and lettering.
• Use contrasting colors in the home, such as colors between the doors and walls, and between the dishes and table coverings.
• Mark the edge of steps with a brightly colored tape or different colored paint, and paint the handrails.
• Provide audiotaped books and music for the elder's cognitive stimulation, entertainment, and relaxation.
• Wear a hat with a wide brim and sunglasses while outside. This will protect the eyes against too much sunlight, which can lead to cataracts.
• Know the warning signals of possible vision problems, including pain in or around the eyes, excessive tearing or discharge, double vision, dimness or distortion of vision, flashes of light, halos or floating spots, swelling of the eyelids or a protruding eye, changes in eye color, and changes in vision or movement of one eye.
• Make sure the older person has regular eye exams, including a glaucoma screening, at least once every 1-2 years.

Unfortunately, people who experience vision problems may avoid activities that require good vision and become isolated. Work with a professional to explore ways to help the older person maintain a normal lifestyle. With today's technologies and medical care, individuals don't have to accept limitations from declining vision as an inevitable part of aging.

Taste and Smell

Some loss in taste sensitivity takes place with aging. However, the loss is minor and does not seem to occur in most people until well after 70. There is also a loss of smell, but this is not severe.

Nevertheless, older people often complain that their meals are tasteless or that they no longer like their favorite foods. Most experts feel that these complaints are caused by a sense of loneliness at meals, or an unwillingness or inability to cook. Also, older persons may not buy more enjoyable foods when they have difficulty chewing due to poor dentures or dental problems, or are stretching their food dollars due to a limited budget.

To help the older person enjoy mealtime:

• Offer familiar, well-liked foods.
• Invite or encourage the elder to share meals with friends and family, in his or her home or at congregate meal sites.
• Experiment with different seasonings and flavorings.
• Prepare a variety of foods each day.
• Make the table colorful and inviting with bright napkins, mats, and flowers.
• Encourage exercise, when possible, which stimulates the appetite. 

Learn more in our Restorative Aide course!  Click here for more info

Physical Aspects of Aging -- Part 2 of 4

Touch

The skin serves a protective function by buffering us from the environment. Skin changes leave the older person vulnerable to discomfort and harm. Due to reduced sensitivity, heat sources such as heating pads, hot water bottles, and pot handles can hurt the skin before the elder realizes that damage is occurring.

An older person may develop a greater sensitivity to cool temperatures and drafts. This is caused by a decline in sweat gland activity, a decrease in the ability to maintain a normal body temperature due to poorer circulation, and a thinning of the skin. Wrinkling, drying, and scaling also occur. The skin tears and breaks more easily, increasing the chance of injury and infection.

To cope with these changes, the older person should:

• Avoid extreme exposure to sun and wind, which speed up the aging of the skin.
• Avoid daily baths or showers, as these tend to dry out the skin.
• Moisturize the skin with body oil after a bath, gently patted on with a washcloth.
• After bathing, pat the skin dry.
• Drink one to two quarts of fluid daily to maintain normal body temperature and functioning.

The sensation of touch connects us with others no matter what our age. Thus, touch is important in maintaining the elder's emotional well-being. Use touch to communicate that you are there for support and that you care.

Changes in Bones and Muscles

Aging adults, especially the very old, are vulnerable to broken bones. In addition, joints stiffen and connecting ligaments between bones lose their elasticity. Hand and foot pain may result.
Although there is no known way to prevent sometimes painful changes in aging muscles, bones, and ligaments, regular exercise helps to assure continuing mobility in old age. Most physicians feel that walking, along with adequate rest and a nutritious diet, are tremendously valuable for maintaining mobility and fitness in the later years.
Health professionals advise middle-aged and older adults to:

• Eat a well-balanced diet with the proper amount of calcium and other essential nutrients.
• With a physician's guidance, start or continue a regular exercise program.

It is very important to prevent falls. Due to changes in bone mass and strength, falls often result in injury, hospitalization, and continued declines in health.

The suggestions covered under vision and hearing, as well as those listed below, will help the older person take the necessary precautions to prevent falls.

• A no-slip bath mat and grasp rails are installed in the shower or tub.
• A seat is placed in the shower if standing is difficult.
• If scatter rugs are used, they should have no-slip backing or mats underneath.
• Chairs are sturdy and do not wobble, break, or tip over.
• A safe, sturdy step stool is available to reach high places.
• The telephone is placed in a convenient location.
• Chairs and sofas are at a height that permits easy sitting.
• Floors and stairs have non-skid surfaces.
• Railings line all staircases.
• Staircases and walkways are uncluttered.
• Front and back steps, and inside flooring and carpeting are in good condition.
• Instructions for the proper use of medications are followed carefully, as improper types or dosages often cause falls.

You can find this and other great information in our Restorative Aide class!  Click here for more info

An Excerpt From Our Social Service Designee Course

Elisabeth Kubler-Ross

Understanding Death and Dying

Preparing for death often means finishing a life's work, setting things right with family and friends, and making peace with the inevitable. Spiritual and religious issues are important to many dying people and their families. Members of the clergy are part of the care team in some hospice and hospital facilities, and professional caregivers can help people and their families find appropriate spiritual assistance if they do not have a relationship with a minister or other spiritual leader.

Grieving is a normal process that usually begins before an anticipated death. According to Elisabeth Kubler-Ross, a pioneer in death and dying, the dying person typically experiences five emotional stages, often in the following order: denial, anger, bargaining, depression, and acceptance. A person in denial may act as if, talk as if, or think that he is not dying. Denial is caused by fears about loss of control, separation from loved ones, an uncertain future, and suffering. Talking to a doctor or other health care member can help the dying person understand that he can remain in control and that his pain and other symptoms will be controlled. Anger may be expressed as a sense of injustice: "Why me?". Bargaining can be a sign of reasoning with death, that is, seeking more time. When the person realizes that bargaining and other strategies are not working, depression may develop. Acceptance, sometimes described as facing the inevitable, may come after discussions with family, friends, and care providers.

Preparing for death is hard work, with many emotional ups and downs. However, for most people, it is a time of new understanding and growth. By dealing with past hurts and mending relationships, a dying person and family members can achieve a profound sense of peace.

Preparing for approaching death can be terrifying if you have no idea what to expect both physically and emotionally. As the dying process enters its final stages there are two different dynamics at work.

The physical aspect concerns the body as it begins its final process of shutting down; this ends the physical systems' functioning.

The other dynamic is the emotional/mental and spiritual area which is a different process. This is where the spirit of the dying individual begins to slip away from its immediate environment and attachments. This release tends to follow its own priorities when it comes to letting go; of family members, unfinished business of a personal nature and/or unreconciled problems. You have all heard people tell how someone on their death bed refused to let go until a certain member of the family was able to get there. Even when the body is trying to shut down the spirit hangs on until a resolution is reached. It is as though the dying person needs permission to go; needs to feel that he has achieved the support and acceptance of his fate by those he leaves behind. This way he can slip into the next dimension of life with grace and dignity.

Acceptance is coming to terms with reality. It is accepting that the world will still go on without you. Death is after all, just a part of life.

The EKR Foundation: Click Here

Elisabeth Kübler-Ross: Click Here

As a Social Service Designee, you may spend one on one time with dying residents. You may just want to read aloud or hold their hands. Some residents enjoy reading a passages from the Bible (or their preferred holy book) that are comforting (Psalm 23, in particular). Know your residents’ likes and dislikes. This will help you to know what residents would want you to do during this time. You can also get information from family members.

20 Things Nurses Wish They Never Had to Say

The title---borrowed from a nurses' desk calendar---is self-explanatory. The situations that give rise to these sayings, however, are not.

OK, I'll have to admit that I got the idea for this piece from a desk calendar my sister gave me for Christmas last year. It's 365 pages of nursing funnies, some of which really aren't, but the rest of them range from the mildly amusing to rolling-on-the-floor-with-tears-squirting-out-of-your-eyes HILARIOUS. And after having the kind of Hell Week I just went through, I needed the comic relief of "How in the world did THAT get in THERE??!"

Here, for your enjoyment, are twenty more things nurses wish they never had to say:

1) To the CNA: "Uh-oh........it looks like Mrs. Chambers hasn't had a BM in nine days."
2) To the patient with Munchausen's Syndrome: "No, I can't give you any more pain medicine," when what you'd really like is to swack him up with enough Dilaudid to shut him up about his manufactured miseries for a few hours.
3) To co-workers, upon seeing a frequent flyer coming up in the elevator: "Oh, Lordy......look at what the cat dragged in."
4) To the MD: "You want me to do WHAT?"
5) To your best friend's 10-year-old: "No, Eric, you're not a dork. Everybody gets their big toe stuck in the bathtub faucet at least once."

Read the rest...

How Nurse Aide Beat the Odds to Head Up Department

“A very important member of staff,” is how Dr Denis Ogolla, the managing director of Nairobi’s Avenue Healthcare, describes Irene Kaberere. She is the head of support services at the hospital.

Over the years, she earned trust due to her dedication to work which saw her rise through the ranks.

On her way up, she maintained a close relationship with both staff and patients.

“She is the sort of person that all staff members want to talk to, not only regarding official matters but also personal issues,” said Dr Ogolla.

“She spreads that motherly feeling to all of us at the hospital.” Ms Kaberere was employed at Avenue Healthcare in 1978, two years after the hospital was established. She is among the hospital’s eldest employees.

She served as a nurse-aide, assisting senior nurses and doctors with duties in the wards, a task she performed for four years.

Read the rest of the article here:   http://www.businessdailyafrica.com/How+nurse+aide+beat+the+odds+to+head+department/-/539444/1212236/-/ki2ygez/-/

What to Expect Working as a Nurse Aide

The increasing elderly population combined with advances in technology in the medical field is increasing the demand for nurse aides. In fact the U.S. Bureau of Labor Statistics predicts a 28 percent growth in nurse aide positions between 2006 and 2016. People looking for an entry-level position in the healthcare field may find this is the right position for them once they learn about a nurse's aide information and salary.

Job Responsibilities
The main function of a nurse aide is to provide personal care to residents in a medical facility, and this can include assisting them with bathing, eating, dressing or going to the bathroom. They also transport patients to different departments by aiding them in walking through a medical facility or pushing them in a wheelchair. Since the job of a nurse aide is considered entry-level in the healthcare field, people in this position assist nursing staff, who serve as their supervisors, with setting up equipment and obtaining supplies.

Working Environment
Nurse aides can work in any medical facility where there is a need for assistance, but they are most commonly found in nursing homes, assisted living centers and hospitals. These facilities house patients with the greatest need for assistance and personal care services. Since care is needed for patients 24/7, nurse aides may work in the evenings, at night or on weekends to meet the demands of the facility.

Read more here:   http://www.infobarrel.com/What_to_Expect_Working_as_a_Nurse_Aide

New Font Could Help Dyslexic Readers

It might not be pretty, but a Dutch graphic designer believes that a new font he's developed can help people with dyslexia read more easily.

Graphic designer Christian Boer developed the typeface, called Dyslexie, back in 2008. And while it isn't the first font created specifically to help dyslectics, it may be the first backed up by some scientific evidence that suggests it works.

A recent study by researchers at the University of Twente in the Netherlands found the font helped to decrease the number of errors dyslectics made when reading.

Millions of people worldwide are affected by dyslexia, a language-based learning disability that causes problems in reading, spelling, writing and even pronouncing words.

There is no consensus on how many people have the condition, but estimates range from 10 to 20 per cent of the population.

Many people mistakenly believe that those with dyslexia read words backwards. In fact, what they are more likely to do is mix up and switch letters, especially ones that look similar.

For the average dyslectic, many of the letters in the Latin-based alphabet look frustratingly alike. At least eight letters, for example, are based on the letter "o" with various "tails." The letters "b," "d," "p," "q," "g," "a," and even "c" and "e" can be easily mixed up by someone with this learning disability.

Read the rest here:  http://www.ctv.ca/CTVNews/TopStories/20110729/new-typeface-font-dyslexic-readers-110730/

Move To Improve Residents' Quality of Life a Welcome Development

As growing numbers of Americans age and need extended care, long-term care organizations have sought to better meet both the healthcare and social needs of their residents. Those who reach the point in life where nursing home care is necessary do not want to live in an environment that feels like a hospital instead of a home.

Over the past several years, alternatives to institutional environments such as the Green House Project, the Pioneer Network and the Eden Alternative have all aimed to encourage genuine homes for the disabled elderly. And, with the Centers for Medicare & Medicaid Services' recent call for a culture change in nursing homes, the focus on resident-centered care places a priority on residents' rights.

CMS' new rules will encourage long-term care organizations to improve the quality of residents' lives by moving away from the institutional environment. For example, a resident's preferences for a daily schedule should be respected. Also, institutional overhead paging systems, alarms and large nursing stations, and meals served on institutional trays, should be eliminated..

Read more here:  http://www.mcknights.com/move-to-improve-residents-quality-of-life-a-welcome-development/article/141159/

Will music improve MDS 3.0 scores?

Neuroscience research during the past 10 years has made great strides in documenting the relationship between music and the brain. The New York Academy of Sciences Music, Science and Medicine conference recently brought together leading researchers to share what we now know about music and its impact on Alzheimer's disease, pain, Parkinson's, coma and autism.

Optimally, every long-term care facility would benefit from the expertise of a music therapist. Short of that level of expertise, long-term care facilities have an inexpensive tool that can have a positive impact on resident quality of life, which, in turn, should be reflected in an important subset of MDS 3.0 scores.

Using iPods to reconnect residents with their favorite music is a simple intervention with great upside potential and no side effects. According to the New York State Department of Health, individualized music reduces dementia-related agitation by up to 80%. Feedback from hundreds of residents (and staff) is that behavior and mood improves, and residents are more cooperative, attentive and engaged.

Why this works for long-term care:

It breaks through the group activities hurdle

Just think about the top five ways we like to spend our own free time. How many of those are group activities? The answer is typically very few. We tend to think nothing of our anytime access to music. Yet we provide all manner of group activities while we look for ways to be more person-centered. Little is more personally meaningful than our own music.

Read more here:   http://www.mcknights.com/will-music-improve-mds-30-scores/article/205919/

My Twinkling Star

As the social services and activity director in a 92-bed skilled nursing facility, I am fortunate to share in a precious season of residents' lives. For most of them, this is the final "home" that they will have this side of heaven. It is our motto that they don't come here to die but to live.

As social service / activity staff, we have the opportunity to catch a unique glimpse of the individual because we assess their likes, preferences and learn about their backgrounds. We are entrusted with them. The residents share their histories and life lessons with us — if we are quiet enough to listen and observe.

Read more here:   http://www.mcknights.com/my-twinkling-star/article/208031/

A Little Humor

AARP Finds Toll On Family Caregivers Is 'Huge'

A new study by the AARP estimates that for the more than 40 million Americans caring for an elderly or disabled loved one, the value of their work is $450 billion a year.

That's a good deal for society. But for the family members doing the work, the study finds they need a lot more help.

Take Cymando Henley, 36, whose mother was diagnosed with multiple sclerosis when he was starting college. She now must use a wheelchair, and Henley has been taking care of her for nearly two decades.

Henley does have help. Montgomery County, Maryland, where they live, and the MS Society pay for a combined 35 hours of home health aides each week — though that's threatened by budget cuts.

But every day, Henley must help his mom in and out of bed and onto the toilet. He even rolls her over in the middle of the night if she becomes uncomfortable.

Read the rest...

Ten Highest Paying Nursing Specialties

Nurses make up the largest number of healthcare professions -- there are over 2.6 million registered nurses in the US. Here are the ten nursing specialties that earn the highest pay.

Read More Here...

Post Job Interview Strategy

Ever feel awkward about leaving your job interview and what to do next?  Here's some good advice on how to leave your prospective employer with a good impression.

The way in which you follow up after a job interview can be as important to your job search success as the interview itself. After a job interview, it is critical that you make it known to your potential employer that you are enthusiastic about the job for which you interviewed and the company itself.

Leaving the Interview

Before you exit your interview, ask the interviewer what the typical protocol is for hiring--ask what the next steps are in the hiring process and when you might expect to hear from them. Also be sure to get a business card from every person you meet during the course of the interview process. You will need this contact information later on to complete your follow-up.
Thank You Note--Timing

Write a thank you note as soon as you can after your interview. Both email and regular mail are acceptable. If you choose to send an email, wait at least an hour or two before you send it--sending an email too soon after an interview (10 minutes later from your phone, for example) can make you appear somewhat desperate and your thanks will not come across as being completely genuine....Read more: Post Job Interview Strategy

Health Unit Coordinator Responsibilities and Duties

Creating a resume to apply for your Health Unit Coordinator position can be a little tricky.  One of the important parts of the resume is listing what you can or have done as a Health Unit Coordinator.  

Get to know about the Roles, Tasks, Duties and Responsibilities of Health Unit Coordinator. Below is a generic list of the HUC's Responsibilities and Duties that you might consider listing on your resume.

• Transcribe and communicate health physician orders on time.
• Manage unit communication to promptly answer telephones and activating paging system and unit mail.
• Document and manage medical records as per policy.
• Support physicians by transcribing orders and managing patient charts.
• Incorporate vision, values, missions and critical goals into job performance.
• Manage Hospital standards by engaging in health committees and in-services.
• Precept new associates as assigned by department manager.
• Prioritize work and manage multiple emergent demands by working independently.
• Tabulate data log sheets, receive payment, make receipt and follow billing procedures.
• Prioritize and transcribe written doctor’s order under RN supervision.
• Manage patient medical records as per hospital and unit policy.
• Develop and achieve unit goals on health, safety, cost and quality. 
• Attain customer service excellence by satisfying customer needs.
• Transcribe health physician order under RN’s directions.
• Handle patient activities on and off nursing unit such facility transfers. 

See more about Great Resumes - Click Here

Interview with an Health Unit Coordinator

Information regarding certification with NAHUC

More information about certification

Take an online HUC class to prep you for the HUC Exam!

Working Women's Wardrobe Guide

Understanding the rules and etiquette that applies to business attire can be the difference between success in a job interview or job placement and failure. Women's business attire should be understated, good quality, body-appropriate and comfortable. Tight-fitting, translucent, bright and worn-looking clothes are not acceptable business attire and will translate badly in a business environment.

Suits for all Seasons

Suits are the staple of proper business attire. The Pasadena Independent School District business etiquette website states that for women, wool suits are the best choice in winter, fall and spring. Summer suits can be made from cotton or linen. Proper fitting is essential for business attire, so suits should be professionally fitted, if possible--this will give the most professional look to business attire and will also provide optimum comfort. Avoid tight suits, bright colors and bold patterns that may be too distracting--black, gray, navy, taupe, dark green and burgundy are colors that work in a business environment. Pinstripe and, to a lesser degree, houndstooth patterns are acceptable.

Read more: Working Women's Wardrobe Guide | eHow.com http://www.ehow.com/list_6331441_women_s-business-attire_-rules-etiquette.html#ixzz1QgP7L6pa

What Is A Social Service Designee?

The Social Service Designee usually works in a Long Term Care environment. They work under a Social Worker. Social Service Designees are the voice of the resident when the resident has lost the capacity to speak for his or herself.

An SSD should:

• Express a philosophy of person-centered, long-term care based on individual resident needs, preferences and choices.
• Demonstrate a basic knowledge of the aging process, including misconceptions, physical changes and psychosocial aspects.
• Demonstrate knowledge of applicable state and federal regulations.
• Show understanding of the rights of individuals who reside in long-term care facilities.
• Demonstrate knowledge of the admission and discharge process.
• Demonstrate an understanding of the principles of documentation.
• Demonstrate ability in basic performance skills, such as teamwork, communication skills and working with administrative staff and other disciplines.
• Discuss issues involved in the management of internal support staff, budgeting, supplies, and outside resources.
• Show understanding of methods of identifying resident interests and needs and the use of assessment in care plan development.
• Evaluate a care plan for effectiveness.

Sign up for We Care Online's Social Service Designee class - Click Here!

Acing the Interview Once You Have the Training

Interviewing for that job you really want can be both exciting and nerve-wracking. However, there are some tricks to keep your nerves from getting the best of you during an interview and make that first impression a memorable one. A job interview can result in the elusive job offer so it is crucial to head into every interview feeling confident and well prepared.  Read the rest of the blog - click here.

Read more: The Most Important Job Interviewing Skills | eHow.com http://www.ehow.com/list_6504113_important-job-interviewing-skills.html#ixzz1Q9CdIM6G

Helping Others: Residents Like It Too

"Excuse me," I said to the lady sitting across from the nursing station.  "We've been saying hello for a while.  I'm Dr. Barbera, the psychologist.  You're Ms. Patel, right?"

"Yes, that's right."  She looked up at me from her wheelchair and smiled.  "Nice to meet you."

"You too.  Listen, I wanted to ask you a favor.  It's perfectly okay if you say no, because not everyone is comfortable with this, but I'm trying to find a place to meet in private with a neighbor of yours and her roommate is in her room.  I was wondering if I might be able to sit and chat with her for a few minutes in your room, since you're out here.  We wouldn't touch anything, we'd just sit and talk."


Read more at My Better Nursing Home - Click Here

Ever Wondered About the How's and Why's of Scrubs??

See what Wikipedia says about the history of scrubs.  Interesting!

"Scrubs are the shirts and trousers or gowns worn by nurses, surgeons, and other operating room personnel when "scrubbing in" for surgery. In the United Kingdom, they are sometimes known as Theatre Blues. They are designed to be simple with minimal places for dirt to hide, easy to launder, and cheap to replace if damaged or stained irreparably. The wearing of scrubs has been extended outside of surgery in many hospitals. Originally issued as replacement clothing if street clothing was contaminated, scrubs are now worn by any hospital personnel in any clean environment. The spread of Methicillin-resistant Staphylococcus aureus (MRSA) has increased the use of scrubs but can give wearers a false sense of security that they are 'clean' when in fact are as easily contaminated as any other clothing.^[1] They have also been mandated in some American prisons as a prison uniform.^{[citation needed]} The television show Scrubs is named for the medical garments worn by hospital personnel." 

Read the rest of Wikipedia's information:  Click Here