ParentCare » Vol. 9

Caregiving Now!

Finding an “Elder-friendly” Physical Therapist

The APTA (American Physical Therapy Association) website (http://www.apta.org) is a wonderful resource for practitioners, patients, students, and more. It also features a Find a PT section that can easily be customized for finding ~ from a national database of physical therapy APTA members ~ PTs who specialize in geriatric issues such as arthritis, balance problems, and osteoporosis. All physical therapists (PTs) who are members of APTA are bound by the Association’s Code of Ethics and are especially committed to providing competent and compassionate care; they also must be licensed by the state in which they practice. All you have to do is simply type in a zip code, “miles from,” even select an area of expertise, and viola ~ a list of Geriatric Specialist PTs in your area plus one-click links to their addresses and phone numbers.

Brain atrophy in elderly leads to unintended racism, depression and problem gambling

As we age, our brains slowly shrink in volume and weight. This includes significant atrophy within the frontal lobes, the seat of executive functioning. Executive functions include planning, controlling, and inhibiting thought and behavior. In the aging population, an inability to inhibit unwanted thoughts and behavior causes several social behaviors and cognitions to go awry.

In a study appearing Current Directions in Psychological Science, University of Queensland psychologist, Bill von Hippel, reports that decreased inhibitory ability in late adulthood can lead to unintended prejudice, social inappropriateness, depression, and gambling problems.

Regarding prejudice, von Hippel and colleagues found that older white adults showed greater stereotyping toward African Americans than younger white adults did, despite being more motivated to control their prejudices. Von Hippel suggests that “because prejudice toward African Americans conflicts with prevailing egalitarian beliefs, older adults attempt to inhibit their racist feelings, but fail.”

Age-related inhibitory losses have also been implicated in social appropriateness. Von Hippel found that older adults were more likely than younger adults were to inquire about private issues (e.g. weight gain, family problems) in public settings. Furthermore, these age differences emerged even though older and younger adults both agreed that it is inappropriate to inquire about such issues in public settings. The older adults seemed to know the social rules but failed to follow them, which is consistent with diminished frontal lobe functioning.

In late-onset depressed older adults, poor inhibition predicted increased rumination, which in turn predicted increased depression. This finding suggests that people who struggle to control their rumination begin to lose that battle as they age, with the end result being the emergence of depression late in life.

Von Hippel also found that a penchant for gambling can be toxic for older adults, as those with poor executive functioning are particularly likely to have gambling problems. Interestingly, these problems are exacerbated in the afternoon, when older adults are less mentally alert. Older adults were more likely to get into an unnecessary argument and were also more likely to gamble all their money away later rather than earlier in the day. These findings suggest a possible avenue for intervention, by scheduling their important social activities or gambling excursions earlier in the day.

While social changes commonly occur with age, they are widely assumed a function of changes in preferences and values as people get older. Von Hippel argues that there may be more to the story and that some of the changes may be unintended and brought about by losses in executive control.
Source: Association for Psychological Science

Elderly Wheelchair Positioning Aids

Inadequate or inappropriate wheelchair positioning can contribute to elderly pressure ulcers, skin tears, bruising, contractures, discomfort, agitation, inability to self-propel, incontinence, unsafe transfers, falls, and injuries. Caregiverproducts.com has a wonderful selection of positioning aids to customize a standard wheelchair to fit an elder’s needs. Their inventory includes*:

Posey Deluxe Lateral Arm Support ~ Wheelchair arm support prevents lateral leaning.

Posey Comfy Seat for Wheelchairs and GeriChairs ~ Adds seating comfort and helps prevent skin breakdown.

Posey Wheelchair Wing Backs ~ Wheelchair wing backs provide firm upper trunk support.

Posey Wheelchair Side Supports ~ Help provide bilateral upper torso support.

Posey Leg and Foot Hugger ~ Provides proper leg positioning to increase comfort.

Posey Soft Seat and Back ~ Add cushioned seating comfort.

Caregiverproducts.com offers a variety of products for the elderly, all with the aim of facilitating as much independence and safety as possible.

*The website provided much more in-depth descriptions of each product.

Walking Around…on Life Support?

Pulmonologists and biomedical engineers have designed a device that enables patients on life support to leave their beds and walk upright as part of the recovery process. The device is essentially a walker with two alterations: the addition of a rack to hold life support equipment, and a nylon seat to catch and support the patient in case of slipping or weakness.

An intensive care unit (ICU) is home to critically ill patients who often must spend 24/7 in bed hooked up to life support machines and monitors ~ but not anymore. Now, a new device is getting patients out of bed faster than ever.

Gary English is lucky to be up and moving. It was just a few months ago that he came close to death. “I went into kidney failure, and that immediately rushed me to the ICU,” says English.

English spent three long months stuck in bed, in the ICU. “I just wanted to get out of bed really bad,” English says. He did get up and move around, but walking critically ill patients on life support, like English, is a huge task for staff.

“Under the traditional approach to mobilizing a patient on life support from the ICU, it required four people to be involved,” says Dale Needham, M.D., an assistant professor of medicine at Johns Hopkins University. “That’s very labor intensive and difficult to achieve in a busy ICU.”

Now, critical care doctors are demonstrating a new mover aide that requires half the amount of staff help that traditional walkers do. “We needed to make some changes in our equipment in order to make it easier and safer and better for patients, and that’s what had us create this mover aide,” Dr. Needham says.

Behind the patient, a built-in tough, nylon seat replaces a wheelchair. It’s designed to catch a patient if he or she suddenly collapse. Life support equipment is attached to a tower on wheels. This new system needs only two hospital staff members to operate.

English said he believes this new device would have gotten him out of bed ~ and out of the hospital ~ sooner.

The original ICU mover aide was designed and built by Johns Hopkins University biomedical engineering students as part of a design course.

Source: Sciencedaily.com

Lighted Slippers

Featuring non-slip rubber soles and an LED in front to light
approximately 10 feet in front of you, these soft dark navy fleece slippers are like wearing nightlights on your feet. They’re great for late-night trips to the bathroom.
After the slipper is removed, a built-in timer delays LED shut-off to allow time to see your way safely back to bed.

The light only comes on at night, and only when weight is applied to the slipper. Two replaceable lithium batteries are included in each slipper. Head to seniorstore.com for sizes, to order, and to view similar products.

Elder Services of Worcester area, Inc.

Elder Services of Worcester, Inc. (ESWA) , located at 411 Chandler Street in Worcester, is an excellent, proactive organization whose mission is “to help elders and their families obtain essential services so that elders can remain at home with dignity and independence for as long as possible.” One of their primary goals is to eradicate the abuse of elders; however, it is not always clear to the layperson what exactly constitutes abuse, who can be considered guilty of committing it, and who is legally required to report it. The below information, taken verbatim from

http://www.eswa.org/programs/protective/, addresses those issues and offers contact information in the event that you discover that an elder you know is the victim of abuse:

As our population ages, elder abuse is becoming one of the fastest growing crimes in the nation. More than two million elderly Americans are victims of neglect or mistreatment every year. Those are the cases that are reported. Experts estimate that for every case of elder abuse that comes to the attention of professionals, as many as 14 cases go unreported.

What is elder abuse? Elder abuse is an act or omission which results in serious physical or emotional injury or financial exploitation of a person over the age of 60. This includes physical abuse, emotional abuse, sexual abuse, neglect and financial exploitation.

As of July 1, 2004 self- neglecting elders are now served under the Protective Services program. Self-neglect is defined as the inability or resistance of an elder to meet their own physical, psychological or social needs without which the elder would be unable to safely remain in the community. Problems may include:

  • not having enough food, money, shelter, or medical care.
  • substance abuse, depression, confusion or fear.
  • language barriers preventing them from accessing needed assistance.
  • danger of losing housing.
  • no support from family or friends, or reluctance to accept help.

Who reports elder abuse? Anyone can make a report of abuse- neighbors, friends, family, etc. The people listed below are Mandated Reporters and must make a report if they have reasonable cause to believe that an elderly person is suffering from or has died as the result of a reportable condition.

Reasonable cause to believe is a judgment based on specific facts, observed or obtained from reliable sources, that an abusive act probably took place or an abusive condition probably exists.

Mandated Reporters subject to a fine:

Licensed physician

Medical intern

Licensed social worker

Licensed physical therapist

Therapist

Licensed osteopath

Family counselor

Coroner

Licensed psychologist

Licensed dentist

Licensed physician’s assistant

Public employee who meets licensing requirements

Licensed registered nurse

Licensed practical nurse

Licensed occupational therapist

Licensed podiatrist

Probation officer

Police officer

Firefighter

Emergency medical technician

Executive director of a homemaker service agency

Failure to report will result in a fine of not more than $1000.

What is Done? Interventions provided by the Protective Service staff include, but are not limited to, receiving reports of adult abuse, exploitation, or neglect, investigating these reports, case planning, monitoring and evaluation. In addition to casework services, staff may provide or arrange for the provision of medical, social, economic, legal, housing, law enforcement, or other protective, emergency or supportive services.

If you need to report a case of elder abuse then you should call the Protective Services Unit of Elder Services of Worcester Area at 508-852-3205 between 8:00 A.M. and 5:00 P.M., Monday through Friday or statewide 24-hour hotline at 1-800-922-2275. This agency is designated by the Commonwealth of Massachusetts to deal with all complaints of elder abuse. Mandated reporters are required to follow up on all verbal reports with a written report. Elder Services investigates reports of abuse and provides protective services to elders who reside in the Elder Services of Worcester service area.

No mandated reporter is liable in any civil or criminal action by reason of submitting a report. No other person making a report is liable in any civil or criminal action if the report is made in good faith. Anonymity of reporter is protected.

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