Elder Care Durham and Chapel Hill: Summer Skin Protection for Seniors

By Helen Antipov

In providing Senior Care and Elder Care in Durham and Chapel Hill, we see various issues with skin. There are obvious cosmetic benefits to taking good care of our skin. More importantly, good skincare plays a big role in our overall health, especially for seniors. Because of the natural changes that occur in skin as we age, the summer season can leave seniors even more vulnerable to its harmful effects. Chief among them are the impacts of being outdoors – the sun, the heat, and the environment. Caregivers can easily help their senior loved ones enjoy the great outdoors and the many fun activities that go along with it by being aware of potential risks and taking some practical yet effective precautions.

Our skin has many important functions. It serves to protect us from the environment, helps us control our body temperature, fluid and electrolyte balance, and through its nerve receptors, allows us to feel sensations like touch, pain, and pressure.

Over time, skin changes occur due to genetic makeup, nutrition, environmental and other factors like smoking, but the greatest single factor is sun exposure. With aging, the outermost layer of our skin thins and the number of cells that contain pigment decrease. The skin’s strength and elasticity also decreases, blood vessels in the middle layer become fragile, and the subcutaneous fat layer that provides padding and insulation reduces. Age also changes our glands. They produce less oil as we age making it more difficult to keep skin moist, and sweat glands produce less sweat making it harder to keep cool.

Wrinkles and sagging skin are among the most visible signs of growing older, but there are other common effects of age-related deterioration as well. Aging skin appears more pale and translucent, is more fragile and tears easily. Skin that has been exposed to the sun frequently and consistently produces a leathery, weather-beaten appearance and large pigmented spots called age spots, liver spots or lentigos, may also appear in sun-exposed areas. Older people bruise easily and may bleed under the skin, a condition known as senile purpura. The dwindling fat layer leaves senior skin at risk of injury and reduces his or her ability to maintain body temperature. The lack of natural insulation can cause hypothermia in air conditioning. Because seniors perspire less, it’s harder for them to keep cool and increases their risk for becoming overheated or developing heat stroke.

More than 90% of all older people have some type of skin disorder, too. Common difficulties include those caused by conditions such as blood vessel diseases like arteriosclerosis, diabetes, heart disease, liver disease, nutritional deficiencies, obesity, reactions to medications, and allergies to plants, or other substances to name a few. The most serious diseases directly related to sun exposure are skin cancers such as basal cell, squamous cell carcinoma, and the deadliest, melanoma which is much more likely to spread to other parts of the body when left untreated.

While the effects of aging can’t be reversed, maintaining proper care means having healthy skin and more importantly, healthy senior people. Here is some helpful advice on how to care for aging skin:

• Opt to shower or bathe every other day to avoid dry skin. Take a sponge bath on alternate days, cleansing gently with moisturizing soap or detergent-free cleansers that do not need to be rinsed. Such cleansers do the job of removing dirt and natural oils but don’t impact the natural acid balance of mature skin.
• Apply moisturizer on a daily basis. Advanced skincare products that nourish the skin from the outside and deliver amino acids, vitamins, antioxidants and ingredients that are gentle and soothing make skin stronger and more resilient.
• Stay out of direct sunlight as much as possible. To protect your senior’s skin from harmful UV rays, the American Cancer Society uses a catch phrase that can help your senior remember some of the key steps to protect him or herself when going out in the sun – “Slip! Slop! Slap! And Wrap!” Meaning, “Slip on a shirt. Slop on Sunscreen. Slap on a hat. And Wrap on sunglasses to protect the eyes and sensitive skin around them.”
• Good nutrition and adequate fluids are especially important for seniors in the hot summer months. Dehydration increases the risk of skin injury.
• Take care to avoid injuries that can cut or tear fragile skin or caustic substances that can disrupt the skin’s protective barrier. Cover small wounds with band aids made for sensitive skin so as not to cause added injury when removing after wounds have healed.
• Remember the special needs of seniors with common diseases like diabetes. Diabetics are more prone to bacterial and fungal infections and itchy skin. Protecting the skin of your senior loved one, especially on extremities, is essential.
• Avoid alcohol-based astringents, strong bacterial soaps and products that are harsh and damaging for older skin. Hand-sanitizers can be especially drying and using a hand moisturizer afterwards can be important.

Cook-outs, trips to the beach, a day at the pool, walks in the park, fishing at the lake, and other outdoor activities are all part of summertime traditions that everyone enjoys, especially seniors. Most involve the potential to soak up the sun. Think ahead and anticipate your senior loved ones’ needs to protect his or her skin beforehand to assure that summer fun is worry-free.

At Comfort Keepers of Durham and Chapel Hill, we understand the stress that caregivers go through and how hard these family decisions can be. We are here to help you and give you the support you need when dealing with a loved one and senior and eldercare issues. Call us at 919-338-2044 or visit us online.

References

‘Aging Changes in Skin,’ from Minaker KL. Common clinical sequelae of aging, published on MedlinePlus (http://www.medline.com)

‘Skin Care Benefits Overall Health For Seniors,” published by ARAcontent on Princeton Online, (http://www.princetononline.com)

‘Sun Safety: Melanoma,’ published by ARAcontent, Princeton Online, (http://www.princetononline.com)

‘Skin Cancer Prevention and Early Detection,’ published by the American Cancer Society online, (http://www.americancancersociety.com)

Senior Care Chapel HIll and Durham: Senior Care is a Family Issue

By Helen Antipov

In dealing with senior care in Durham and Chapel Hill we see that it takes a family working together to choose the most appropriate option for a loved one’s senior care—and to provide a loved one the best care possible.

Why?

For starters, seniors are at a vulnerable stage of life. They often face multiple health concerns and loss of physical and cognitive function. More than ever, seniors need the support and love of family members.

At Comfort Keepers®, we offer suggestions of important areas of family and senior consideration.   Working together, the family can create a great foundation for senior care and support. 

Seniors often have difficulty expressing their needs, desires and preferences, so they need someone to advocate for them. And who is more qualified for that than the people who know them better than anyone else in the world?

Even if your family chooses to involve outside help in providing your loved one’s elder care—an in-home care agency like Comfort Keepers, an assisted living community, or a nursing home—you need to be involved. You can communicate to the professional caregivers your loved one’s likes and dislikes, habits, routines, concerns and all the other things that make them the individual they are. Without your help and involvement, their senior care may fall short of what they deserve.

Today, 80 percent of older Americans prefer to stay at home as they age.  This means families are more directly involved than ever in their loved ones’ senior care.  So, it is more important than ever for families to be involved in the planning stage together, as no single individual can adequately handle the responsibilities of caregiving alone. Certainly not on top of responsibilities at work and with their own families and community involvement.

Granted, in most families, there is usually one sibling who, by desire or default based on proximity to the aging parent, becomes the chief caregiver.  Deciding who that person will be is a good topic for the first conversation with aging parents. Parents, of course, need to be involved in every step of the decision process so they can maintain as much control of their lives as possible.

But no matter who is the chief caregiver, all siblings need to share in the responsibility in some way. This could involve home maintenance, managing bill paying and finances, or taking care of insurance and medical claim issues.

Also, do not forget the importance of frequent visitation. As you brighten your parents’ day, you can monitor their health and mental status and share concerns you have with their professional caregiver. You may find that their elder care plan needs to be modified to address changing circumstances.

Considerations to Make

In choosing the most appropriate care for a parent, there are a number of considerations to make and questions to ask:

• How do I begin talking with my parent about their care needs?
• How will the care be funded?
• What is the safest, most comfortable, most appropriate care option available for my parent?
• Is a family member nearby who can be of assistance at a moment’s notice?
• What types of help does my parent need – for instance, bathing, eating, transportation, medication reminders?
• What about religious affiliation and other personal preferences that are important to my parent as they relate to choosing a care option?
• What types of senior care are available? How do they differ? And how does each one address my parents needs?

To help find the senior care solution most appropriate for your parent, you may consider having their physician conduct an evaluation.

You may also consider options that match your parent's unique traits and temperament. For instance, is your parent typically a thinker or a socializer? Thinkers desire space and privacy and prefer independence, reading, and working quietly alone. On the other hand, socializers are energized by people. They enjoy interactions with others and act lonely without regular interaction.

Also consider your parents past living experiences. Are they accustomed to owning a home where they have acquired many valued items?  If so, they may find it difficult to leave.

Or, are they accustomed to an apartment or condo?  This setting may make it easier to adjust to smaller living areas with others nearby.

At Comfort Keepers of Durham and Chapel Hill, we understand the stress that caregivers go through and how hard these family decisions can be. We are here to help you and give you the support you need when dealing with a loved one and senior and eldercare issues. Call us at 919-338-2044 or visit us online.

Online Resources

The following online resources offer other valuable assistance in making senior care decisions:

• Healthfinder.gov, a resource of the U.S. Department of Health and Human Resources 

Eldercare at Home: A Comprehensive Online Guide for Family Caregivers created by the American Geriatrics Society (AGS) Foundation for Health in Aging

Eldercare in Durham and Chapel Hill: Starting "The Conversation"

By Helen Antipov

Aging happens. There is no getting around it.

Unfortunately, conversations about preparing for our senior years often do not happen. At least not as soon as they should.

In this article, Comfort Keepers of Durham and Chapel Hill offers suggestions for overcoming the discomfort that many times prevents adult children and parents from beginning these important discussions—whether about long-term elder care and finances, health care, end-of-life decisions, driving or safety around the house.

The best advice is to plan carefully and think through such conversations so that they are as positive and productive as possible. Write down what you think needs to be discussed so you don’t forget anything. Remember, Comfort Keepers of Durham and Chapel Hill is here to help.

Also, do not approach this important opportunity as “The Conversation,” but as an ongoing series of conversations. Address one issue at a time rather than trying to resolve everything at once. It is less intimidating that way. If you start small, you are more likely to start.

Following are additional tips for starting the discussions:

• Begin early when your parents health allows them to fully participate and share their wants, needs and preferences. Otherwise, your elder care decisions may be dictated by a life-changing event and may not necessarily reflect your parent's wishes.
• Choose a time and place that makes everyone comfortable. Avoid special family gatherings, like a birthday or holiday celebration. Choose a time that is not hemmed in by other obligations so you can have a relaxed, unhurried conversation, giving your parent plenty of time to share his or her wishes.
• Include other family members, but meet before approaching your parent to make sure everyone’s on the same page to avoid an unproductive, confrontational situation. 
• Make the experience non-threatening by letting your parent know you’re concerned for his or her well-being and want to know how you can help them. Explain that you would like to help them write down their plans to help assure that they are followed. You also can help open the discussion about long-term planning by inquiring whether there are any responsibilities—such as home maintenance, yard work or bill paying—they would like you or someone else to help with to make life easier.
• Use good communication skills. Maintain good eye contact and get close enough to your parent, without invading personal space. Closeness builds trust and allows you to speak—and be heard—in an even, controlled voice.
• Share an experience such as your own retirement or estate planning as a way to gracefully transition into a conversation about your parents' thoughts regarding the future. A friend or relative’s medical emergency could also serve as an opening for dialogue.
• Ask about records and documents. Ask your parent where they keep important documents such as insurance policies, wills, trust documents, investment and banking records, tax returns, living wills and durable powers of attorney. Explain that you want to be prepared to help them when needed. This could also serve as a way of finding out what plans he or she have already made and what needs to be done.
• Ask open-ended questions that encourage your parent to share feelings. Then sit back and carefully listen to learn what is important to him or her.
• Offer options, not advice. Pose questions and offer more than one acceptable solution. Ask your parent which choice they prefer. This involves them in the elder care decision process and enables them to exercise control and independence.
• Speak with respect. Approach the discussion as a partner with your parent. In other words, make sure your parent is an active participant in the conversation. Stop to listen and respect their desire and need to maintain control over their lives. Avoid reversing roles in the discussion, that is, you acting as the parent and your parent as the child. This could cause your parent to resist your attempts to open discussion.
• Keep it simple. As stated earlier, do not try to resolve everything at once. The goal is to open an ongoing, honest dialogue about your parent's future, to share information and to understand your parent's wishes and needs so that decisions can be made.
•  Involve third parties if your parent resists your efforts to begin the discussion. He or she may be more open to the guidance of a respected non-family member, such as a doctor, a member of the clergy, a home care provider, a geriatric care manager (www.caremanager.org), representative of an area agency on aging (www.n4a.org) or trusted friends and neighbors who may have already helped a loved one in a similar elder care situation.

Seniors Can Initiate the Conversation, Too

If you are a senior who is looking ahead and wanting to plan for the future, you do not have to wait for your children to bring up the subject. Often adult children don’t like thinking about their parents getting older and are reluctant to initiate the discussion.

• Take the initiative. If you begin having difficulty with activities of daily living, such as bathing, driving, or managing finances, speak with your physician or other healthcare professional. Also bring up the subject with family and ask for their suggestions and assistance.
•  Share your preferences with family and friends. Do you want to continue living at home but with the help of a caregiver who can assist with certain tasks around the house? Or if you are finding it more difficult to prepare nutritious meals for yourself, would you prefer having meals delivered or having someone prepare meals for you in your home?
• Learn about available services to help you as you age. Physicians, social workers, elder care providers, geriatric care managers and other healthcare professionals can guide you in this, and your local Area Agency or Council on Aging can provide a listing of home care services available in your area.

How to Approach a Parent About Giving Up the Keys

We typically consider driving a significant part of independent living. But the ability to drive safely decreases with age. According to a 2007 report from the U.S. Government Accountability Office, older drivers, based on miles driven, “are more likely to be involved in a fatal crash than all but the youngest drivers.”

So, there comes a time when families are faced with having to talk with an older loved one about giving up driving, for their own safety and that of others. How do you do this and minimize a senior’s feelings of resentment over lost independence?

Comfort Keepers offers these tips:

• Build a case. If you feel safe doing so and have not done so in a long while, ride in the car with your parent at the wheel. Get a sense for whether your intuition is right or not. It may turn out that your parent is a safer driver than you suspected. However, if your hunch bears out, you will have at least one reference point to go to when you talk with your parent.
• Refer to recent headlines—local or national—about accidents caused by elderly drivers. This can help you transition into a discussion about your parents driving.
• Approach the conversation with compassion, making it clear that you are motivated purely by concern for your parents well-being.
• Rely on others’ help when you feel you cannot convince your parent on your own. Many motor vehicle bureaus offer assessment services for elderly drivers. The senior’s physician may also provide an evaluation and a prescription to cease driving due to safety concerns. A friend who has already given up driving can offer the reassuring voice of experience.
• Offer your parent alternatives to driving. For instance, volunteer to take your parent to church or to the grocery—and have other family members and friends help out. Or suggest a professional caregiving service, such as Comfort Keepers, which provides clients incidental transportation to appointments and other needs.

At Comfort Keepers of Durham and Chapel Hill, we understand the stress that caregivers go through and how hard "the conversation" can be. We are here to help you and give you the support you need when dealing with a loved one and Alzheimer's and eldercare issues. Call us at 919-338-2044 or visit us online.

Alzheimer’s Care in Durham and Chapel Hill: Dealing with Difficult Behavior

Helen Antipov

Dealing with Alzheimer’s care in Durham and Chapel Hill, we understand that the disease is perhaps one of the most unpleasant for all concerned. There is no cure but rather, a steady progression of debilitating symptoms which include erratic and difficult behavior that can be hard to manage for even the most seasoned professional.

In order to learn how to deal with difficult behavior that presents in seniors suffering Alzheimer’s disease you must first know and understand the disease. Additionally, learning the different types of behaviors indicative to Alzheimer’s is crucial so caregiving can be administered safely and comfortably for all concerned. Comfort Keepers of Durham and Chapel Hill is here to help.

According to the Alzheimer’s Association^® the following are symptoms or behaviors that sufferers can exhibit:

• Aggression and anger that can appear suddenly with little or no obvious cause.
• Anxiety or agitation in facing or comprehending either new or confusing situations.
• Memory loss and confusion present in the early stages of the disease that worsen with time. Late-stage sufferers may be unable to remember family, friends, or even familiar places. They forget words, become lost within a conversation due to lack of comprehension, and may forget how to use common items such as a brush or eating utensils.
•  Depression that can be hard to detect, due to the challenge of understanding and communicating with those who have Alzheimer’s disease.
•  Hallucinations and delusions which can occur and are difficult to diagnose, as these are also symptoms of other mental disorders. Hallucinations involve the senses such as seeing or smelling something that is not there. Delusions entail thoughts and beliefs of things that are not real, which can cause those with Alzheimer’s to be suspicious of family, friends and others. Seek professional help for proper diagnosis and treatment of these symptoms.
• Changes in sleep patterns. Some sufferers of Alzheimer’s experience “sundowning,” a term used for those who become agitated and restless during the later hours of the day.
• Repetition of words and questions due to brain deterioration as Alzheimer’s progresses, making it even harder for sufferers to comprehend the world around them.
• Wandering and getting lost. The problem can become serious since many with Alzheimer’s disease are unable to remember their names, addresses, or even recognize familiar places.

When dealing with these difficult behaviors it is critical that caregivers, family members and friends learn what the triggers may be, acquire the skill to diffuse and divert uncomfortable situations, and to stay calm during bouts of behavioral outbursts.

Triggers can present when those with Alzheimer’s become over-stimulated, are physically uncomfortable, or exhausted from changes in sleep-wake patterns. Medications can also cause some of these symptoms. Changes in routines can increase irritability and confusion. Triggers vary from person to person so careful observation is required to determine triggers for individuals with Alzheimer’s.

The most important thing caregivers should know is when Alzheimer’s patients act out it is neither the patient’s fault nor the caregiver’s. Try not take things personally. Instead, understand these behavioral patterns are simply a product of the disease. While there is no cure, caregivers can learn calming maneuvers that can help Alzheimer’s sufferers feel safe and secure in times of need and possibly alleviate progression of difficult behavior in the moment. For each person the tactics may be different. However, with a broad understanding of the intricacies of the disease, the caregiver is better able to help Alzheimer’s patients safely navigate difficult times.

At Comfort Keepers of Durham and Chapel Hill, we understand the stress that caregivers go through. We are here to help you and give you the support you need when dealing with a loved one and Alzheimer's. Call us at 919-338-2044 or visit us at online.

^{Alzheimer’s Association.} 

How to respond when dementia causes unpredictable behaviors. 

^{Retrieved on October 10, 2012 from http://www.alz.org/national/
documents/brochure_behaviors.pdf.}


^{Alzheimer’s Association.} 

Difficult behaviors. 

^{Retrieved on October 10, 2012 from http://www.alz.org/care/alzheimers-dementia-stages-behaviors.asp}