Monthly Archives: May 2016

Protecting Yourself and Loved Ones from Elder Abuse

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Stop Elder Abuse Sign

Stop Elder Abuse Sign, An American road stop sign with words Elder Abuse with stormy sky background

World Elder Abuse Awareness Day is June 15th and according to the World Health Organization elder abuse is a violation of human rights and a significant cause of illness, injury, loss of productivity, isolation, and despair. It touches people across all socioeconomic groups, cultures, and races. But only about one in five cases is ever reported. People with dementia are particularly vulnerable because they are unable to recognize that they are being abused or to report it.

My friend’s mother lived in Florida where she had round-the-clock nursing care in her own home. At the end of her life she suffered from dementia and was frail and bed-ridden. When Cheryl (name has been changed) went for a visit, she discovered that her mother had been cruelly beaten, and even though her two caregivers were women, it was apparent there she had been sexually abused. The poor woman’s genital area was swollen and bruised.

Physical abuse is not the only type of abuse targeted at the elderly. I know of two families who lost their inheritance because of financial fraud and theft. In one family the elderly father was cared for by a young woman who convinced him to marry her in order to be the beneficiary of his estate. The man’s family was unable to get a penny or access to the family home they had grown up in. Another elderly man assigned a trustee to overlook his financial affairs. The trustee stole his money and even though one of his adult children is a lawyer, the family was unable to recover a penny of their inheritance.

We’ve all heard of telephone scams in which a caller claims he is a jailed grandson who pleads with his grandparents to send bail money, or the IRS scam where the caller threatens severe consequences if the senior doesn’t pay tardy taxes.

These types of occurrences are all too common, especially in under staffed, under funded nursing homes.

Report abuse

Abuse can occur anywhere: at home, in nursing homes, and memory care homes. If you suspect abuse don’t hesitate to report it. You do not have to prove anything. It is up to the professional staff to investigate your suspicions, and put the proper safety measures in place.

Types of abuse

  • Physical–causing pain or injury
  • Neglect–failure to provide food, shelter, clothing, medical and other necessities required to provide a safe, nurturing environment
  • Emotional and Psychological—Verbal assaults, harassment, threats, intimidation
  • Confinement –restraining or isolating the person
  • Financial—Scams, misuse or withholding of the person’s financial resources to the disadvantage of the elderly person, and to the advantage of another person.
  • Deprivation—Denying the person medication, medical care, food, shelter or physical assistance
  • Sexual abuse –Any sexual activity, including fondling, when the person is unable to understand, unwilling to consent, or threatened or physically forced

Signs of abuse

  • Bruises, pressure marks, broken bones, abrasions and burns
  • Bruises around the breasts and genital area could indicate sexual abuse
  • Poor hygiene, bed sores, unattended medical needs, unusual weight loss
  • Sudden withdrawal from normal activities, unexpected depression, and a sudden change in alertness can be an indicator of emotional abuse. However, these symptoms can be the result of a progression of dementia or other disease.
  • Sudden changes in financial situation can be a result of exploitation.
  • Aggressive behavior from a caregiver or from the person being cared for can result in verbal or emotional abuse on either end.

Caregivers also are the recipients of abuse from the person they care for. If a caregiver feels physically threatened it’s important to get help in providing safe care for the person being cared for, possibly in a facility.

What can you do to protect yourself and your loved ones?

Report suspected mistreatment to your community’s Human Services Adult Protection agency and/or law enforcement office. Even if a situation has already been investigated, if you believe circumstances are getting worse, continue to speak out.

If you or others experience abuse or neglect in a community setting:

Adult Protective Services (APS) is there to help. The APS mission is to ensure the safety and well-being of elders and dependent adults. Unfortunately, it is estimated that millions of U.S. elders, from all walks of life, face abuse and neglect every year. Anyone can be victimized. However, there are things you can do to help protect yourself from abuse and neglect…

Human Services provides help with:

  • In-home assessment for abuse, neglect, and/or exploitation
  • Crisis intervention
  • Monthly visits by a case worker, if risk continues
  • Assistance with housing and/or placement to alternative housing
  • Assistance with obtaining benefits
  • Money management
  1. To report suspected abuse in a nursing home or long-term care facility, contact your local Long-Term Care Ombudsman. Each licensed long-term care facility is required to display a poster with the facility’s assigned ombudsman’s name and contact information. If you are a resident or family member of a resident in a facility, call the ombudsman listed on the poster. To learn more about the ombudsman program visit: Long-term care ombudsmen are advocates for residents of nursing homes, board and care homes and assisted living facilities. http://www.ltcombudsman.org
  2. Caregivers (both family and professionals) are most often the abusers of the elderly. Stress and feelings of being overwhelmed may provoke unintentional belligerent feelings. If you feel overwhelmed or frustrated as a caregiver, talk to someone for support.
  3. To speak with an Alzheimer’s Association Care Consultant call: 1-800-272-3900
  4. To find a support group in your area visit http://www.alz.org/apps/findus.asp
  5. To receive support from other caregivers visit https://www.alzconnected.org/
  6. To report an incident or concern of abuse or neglect, call the Alzheimer’s Association (1.800.272.3900) or Eldercare Locator (1.800.677.1116). You’ll be connected to your state or local adult protective services division or to a long-term care ombudsman. You do not need to prove that abuse is occurring — it is up to the professionals to investigate suspicions.
  7. Read more: http://www.alz.org/care/alzheimers-dementia-elder-abuse.asp#ixzz2W9DhCbSL
  8. Keep in contact. Talk with your older friends, neighbors, and relatives. Maintaining communication will help decrease isolation, a risk factor for mistreatment. It will also provide a chance to talk about any problems they may be experiencing.
  9. Join Ageless Alliance, a national, non-profit grassroots organization working to to promote aging with dignity and eliminate elder abuse, neglect and exploitation through Awareness, Advocacy and Action. Based at the Center of Excellence on Elder Abuse and Neglect at the University of California, Irvine, Ageless Alliance is a grassroots campaign to give a voice to those who have been affected by elder abuse and abuse of adults with disabilities.
  10. Plan ahead to protect against financial exploitation. Download a handout on ways to protect yourself or a loved one. http://www.ncea.aoa.gov/Resources/Publication/docs/NCEA_ProtectYourself_web508.pdf
  11. Be aware of the possibility of abuse. Look around and take note of what may be happening with your older neighbors and acquaintances. Do they seem lately to be withdrawn, nervous, fearful, sad, or anxious, especially around certain people, when they have not seemed so in the past?
  12. Contact your local Area Agency on Aging (AAA) office to identify local programs and sources of support, such as Meals on Wheels. These programs help elders to maintain health, well-being, and independence—a good defense against abuse. See the Eldercare Locator, www.eldercare.gov Welcome to the Eldercare Locator, a public service of the U.S. Administration on Aging connecting you to services for older adults and their families.You can also reach us at 1-800-677-1116.

When the Patient has Trouble Eating

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99f56ed5-402e-4a79-87fc-038e8b868a49

Three delicious and nutritous protein shakes

Find more food and nutrition tips in my new book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia”–available wherever books are sold.

Elderly people, people who are ill, and especially people with dementia, sometimes have eating difficulties, which can arise for a number of reasons.

  • Some medications affect taste and decrease appetite.
  • Eating might be one of the few things that a person with Alzheimer’s or dementia still has control over. The memory loss individual might refuse food simply because it’s a way of exerting personal power.
  • A new diet that is introduced due to a health concern such as diabetes, or the introduction of pureed food might cause an individual to refuse food.
  • Depression can result in a lack of interest in food.
  • The sense of taste is the last one to go, but it might be diminished along with the sense of smell.
  • Inactivity can cause loss of appetite, so try to engage the memory loss person in some sort of physical activity. Even a stroll around the block helps.

End-stage Alzheimer’s patients almost always have trouble eating, and ultimately most have trouble swallowing. But if the person you are caring for is losing weight for no particular reason and is still mobile, it is a concern that needs to be addressed. Please consult with your physician when there is any question about weight loss and refusal to eat.

12 Tips for Getting Someone to Eat

  1. Finger foods might be easier to manage than a fork and knife.
  2. Eliminate foods that present a choking risk (hotdogs, chicken or fish that contain bones, etc.)
  3. Provide several small meals throughout the day instead of three large meals.
  4. Make the food tasty by including salt, herbs and spices.
  5. Dementia patients love ice cream. If cholesterol is an issue, substitute a dairy ice cream with a non-dairy frozen dessert such as Rice Dream®, Coconut Bliss or Soy Dream.
  6. Offer healthy snacks throughout the day, such as cheese and apple slices, nut butter on apple slices, smoothies, and diced fresh fruit.
  7. Create a soothing ambience by placing flowers and candles on the table, and playing soft classical music.
  8. Make sure to keep the patient hydrated, especially during the hot summer months.
  9. Provide a comfortable place to eat. If the patient has a bad back, it might be necessary to put a cushion on the chair.
  10. Do a happy, engaging activity before mealtime. Have the memory loss person help set the table or peel vegetables, if possible. Painting, listening to music, playing an instrument, or going for a walk might be all it takes to work up an appetite.
  11. It might be hard for the person to differentiate foods on a plate, especially if they are the same color. Use contrasting colors. For example, serve beets and carrots on white instead of white mashed potatoes on a white plate.
  12. Aromatherapy
  • Bergamot is the flavoring used in Earl Grey Tea. If your patient likes to drink tea, this might be an easy solution. Or, have the person smell bergamot oil, which is used for depression.
  • Citrus oils such as orange, lemon and lime along with ylang-ylang can help alleviate depression.
  • Peppermint and Spearmint are energizing and might stimulate appetite.

 

Protein shake recipes

Protein shakes are nutritious, filling, and nourishing. Use ingredients of your choice without relying on the sugary nutrition drinks that are generously handed out in institutions.

My favorite delicious and easy-to-make shakes

Banana Berry Shake

  • 1 frozen banana
  • ¼ cup sliced strawberries
  • 8 ounces of milk or non-dairy drink such as soy, almond, or coconut milk
  • 1 scoop of whey protein powder
  • Blend together until smooth.

Berry Sunrise Shake

  • 1/3 cup frozen blueberries
  • 3 medium strawberries
  • 8 ounces of orange juice
  • 1 scoop of whey protein powder
  • Blend together until smooth.

Chocolate, Banana, Peanut Butter Protein Shake

  • 1 banana
  • 2 Tablespoons peanut butter
  • 1-cup almond, soy or coconut milk
  • 1 scoop chocolate protein powder
  • 3-5 ice cubes
  • Blend together until smooth

Enjoy!

Is it really important to eat a good breakfast?

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For more information on the importance of good nutrition to prevent caregiver burn-out, including recipes, read my new book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia”—available June 1, 2016 where all books are sold.

Yes! It is absolutely important to eat a good breakfast, and here’s why. This is true for everyone, but especially important for caregivers. It’s recommended that we eat within one hour after waking to stabilize our blood sugar—which has dropped during sleep—so that your mood stays even and you can perform at your best.  If not, you’ll be more apt to reach for a bagel or doughnut or another cup of coffee. After loading up on carbs and empty calories (lacking in nutrition), it’s typical to feel hungry again within a couple hours. And every time our blood sugar crashes, it’s a signal to the body to store calories. The same goes for a hungry body. If you don’t eat breakfast, your blood sugar will be low, and this too is a signal to the body to store calories, which adds fat around your middle.

One of the most critical things you can do for your health and your mood is to keep your glucose levels stable. And that means it’s important to include a healthy protein with breakfast. 

Low blood sugar impairs your concentration and judgment, leaves you tired and fuzzy-headed, and sometimes makes you irritable. These symptoms often disappear after you eat something and your blood sugar rises. Part of the solution is emphasizing a diet rich in protein and non-starchy, high-fiber vegetables. Both protein and fiber help stabilize blood-sugar and insulin levels, which helps to prevent mood swings.

Some things to be aware of

What if you feel hungrier after breakfast? Your body has adapted to not eating breakfast or to eating a poor breakfast. Try eating less at night, or if you eat breakfast at 8am and get hungry at 10am, have a snack that contains protein, such as a protein shake, a small handful of nuts, yoghurt and fruit, or cottage cheese and fruit. You don’t want to get ravenous before lunch and then make a poor food choice.

What if you’re nauseous in the morning but you’re not pregnant? This might be an indication that your blood sugar is too low, and it’s important that you eat!

I need my caffeine fix! Is that bad? Studies show that those who drink the most coffee often suffer from chronic depression because caffeine depletes the body of B vitamins—crucial for dealing with the stress of caregiving —, vitamin C, calcium, potassium and zinc. Caffeine increases thirst because it dehydrates the body, and it overstimulates and weakens the kidneys, pancreas, liver, nervous system, stomach and intestines.

According to the Mayo Clinic, 2-3 cups of coffee can spike systolic pressure up to 13 points and diastolic pressure up to 14 points. If you have high blood pressure, limit your coffee intake to 3 cups a day, and avoid drinking it before exercise or physical labor, which both naturally raise blood pressure.

On the other hand, studies have show that caffeine can delay Alzheimer’s disease in people who are at risk. A study published in the Journal of Alzheimer’s Disease (2012) found that people older than 65 who had higher blood levels of caffeine developed Alzheimer’s disease 2-4 years later than people with lower caffeine levels. The study included 124 people who had mild cognitive impairment (MCI). Typically, 15% of people with MCI will go on to develop full-blown Alzheimer’s disease each year.

The study participants who had less than 1,2000 ng/ml of caffeine levels in their blood developed Alzheimer’s. This is equivalent to drinking several cups of coffee a few hours before their blood was taken. The people whose memory loss did not progress to full-blown Alzheimer’s had higher levels of caffeine in their blood. Coffee appeared to be the only source of caffeine for the participants in the study.

So monitor how you feel after you drink coffee. A safer choice might be a cup of chai or green tea, which has numerous heath benefits, including antioxidant protection.

Breakfasts of Champions

Instead of eating a bowl of cornflakes with a banana and low-fat milk, have a 2-egg omelet, slice of whole grain toast, a cup of fresh fruit and a cup of steamed greens such as kale. Then notice the difference in how you feel. You’ll have more stamina, less anxiety and depression, and will able to get through the whole day more easily.

Other ideas

  • Whole-grain mini-quiche with 1/2 cup berries
  • Oatmeal with prunes or raisins, walnuts or almonds, and cinnamon, whole milk
  • Multigrain hot cereal, Greek yoghurt and fresh fruit, almonds
  • Eggs with beans, salsa, and a side of greens
  • Bagel with hummus, tomato and goat cheese
  • Smoothie with greens, fruit, protein and flax

Recipe for Gluten-free Flax Meal Muffins

  •  ¾ cup brown rice flour
  • ¾ cup buckwheat flour
  • ½ cup ground flaxseed
  • ½ cup date sugar (or sweetener of your choice)
  • 1 tsp baking soda
  • ½ tsp ground cinnamon
  • ¼ tsp ground nutmeg
  • ¼ tsp salt
  • ½ cup raisins
  • 2 eggs
  • ¼ cup oil of your choice (I used grape seed oil)
  • 1/2 cup unsweetened applesauce
  • 1 cup buttermilk or coconut milk

Preheat oven to 375º. Line a 12-cup muffin tin with unbleached paper liners and set aside. In a large bowl, whisk together brown rice flour, buckwheat flour, flaxseed, sweetener, baking soda, cinnamon, nutmeg, salt and raisins.

In a second large bowl, whisk together eggs, oil, applesauce and buttermilk. Add flour mixture to buttermilk mixture and stir until just combined.

Spoon batter into prepared muffin tins and bake until golden brown and a toothpick inserted in the center of a muffin comes out clean, about 30 minutes. Cool muffins in pan for 5 minutes before transferring to a wire rack to finish cooling.

Recipe for overnight oatmeal made in a slow cooker

  • 2 cups old fashioned rolled oats –do not use the instant oats. (serves 4)
  • 1 3/4 cups water

or

  • 1 cup steel cut oats (serves2)
  • 4 cups water
  • Mix oats and water in slow cooker and set for 8-9 hours. These recipes work in a 1 1/2 – 2 1/2 quart capacity slow cooker.

The possibilities of things to add are endless. Some ideas: maple syrup, honey, butter, milk, coconut milk, brown sugar, raisins, dried apricots, prunes, dried cherries, dried coconut, fresh fruit, cinnamon, ginger, almond butter, apple butter, chia seeds, chopped walnuts or almonds, flax meal, etc.

Try some of these recipe and let me know how you feel. Have a great breakfast, and a great day!