Tuesday, March 18, 2014

Senior Care & Elder Care in Durham & Chapel Hill: How you see yourself!

How others see you is not important, how you see yourself means everything.

At Comfort Keepers of Durham and Chapel Hill, we understand the stress that aging can have on a family especially if you are providing senior care or elder care at home.  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.

Senior Care & Elder Care in Durham & Chapel Hill: Food Safety for Seniors

Helen Antipov

Providing senior care and eldercare in Chapel Hill and Durham is a rewarding opportunity, but frustrating when we see our seniors get sick from preventable issues such as food safetyThe National Institutes of Health (NIH), Senior Health reports that approximately 76 million Americans get food poisoning, or foodborne illnesses, each year, and of those about 5000 die. Foodborne illnesses are caused by eating foods that are contaminated with bacteria, protozoa, or other microbials and viruses. The real tragedy here is that in most cases these foodborne illnesses are preventable simply by using proper food handling and storage methods. At Comfort Keepers of Durham and Chapel Hill, we are committed to Senior Care & Elder Care in Durham & Chapel Hill and your senior's healthy living and quality care. We can help keep your senior safe and avoid these food safety issues.

Why is this so important? Because food poisoning is especially detrimental to seniors, causing them to be sicker longer with more acute symptoms. As people age, their immune systems slow down and are not as effective in combating illnesses. Older adults’ bodies do not produce as much stomach acid and their digestion slows, both making it difficult to eliminate bacteria that enter the system. Seniors are also more likely to be suffering from chronic illnesses, which affect the body’s ability to ward off disease. Additionally, older people’s abilities to smell and taste are not as acute as when they were younger, making it difficult for them to discern when food has spoiled. This makes them more likely to eat foods that may be contaminated.
For these reasons, it is critical that seniors and their caretakers are able to immediately identify the symptoms of food poisoning and seek proper medical care and treatment. It is equally important, or more so, that they follow safe food preparation and handling methods.

Symptoms and Treatment of Food Poisoning
Symptoms of foodborne illnesses can start hours, days, or even weeks after eating contaminated food. They can range from mild to acute and can include nausea, diarrhea, vomiting, fever, and abdominal cramps that can last for one to ten days. Severe cases usually require hospitalization. 
Seniors or caretakers who suspect a senior under their care is exhibiting symptoms should seek medical attention immediately. If they believe they can identify food has caused the illness, they should wrap it, label it clearly, and freeze it for testing. They should also keep any packaging that the food came in to help doctors identify the cause of the illness. Additionally, they should report the contaminated food to the USDA Meat and Poultry Hotline at (888) 674-6854.

To diagnose food poisoning, doctors will generally want to know how long the symptoms have been present and when the food was eaten. Very often, they will take laboratory samples and cultures, such a blood and stool samples, to help with the diagnosis. In many cases, there may not be a definitive diagnosis of food poisoning, but the physician will treat it as such because the symptoms match.
When the senior does undergo treatment for food poisoning, it is imperative that he or she complete the full prescribing dosage of medication to ensure full recovery. Stopping medicines too soon may allow a recurrence of infection. 

Preventing Foodborne Illnesses in Seniors
Thoroughly washing hands before handling and preparing food can greatly reduce the risk of contamination. Many foodborne illnesses come from oral-fecal transmission when people use the bathroom and do not properly wash their hands before handling food. The Food and Drug Administration (FDA) recommends washing your hands for at least 20 seconds before handling food. 
Aside from hand washing, both the FDA and the Academy of Nutrition and Dietetics list these recommendations for safe food handling, preparation, and storage on their websites:

  • Wash cooking items, such as cutting boards, with hot soapy water between food items.
  • Rinse fresh fruits and vegetables thoroughly.
  • Raw meats and poultry do not need to be washed. Washing can spread bacteria to other foods, surfaces, and utensils. 
  • Separate raw meat, poultry, fish, seafood, and eggs, and their juices, from  ready-to-eat foods. Use one cutting board for fresh fruits and vegetables and a separate one for raw meat, poultry, fish, seafood, and eggs. Do not place cooked food on a plate that held raw meat, poultry, fish, seafood, or eggs unless you first wash the plate with hot, soapy water.
  • Cook meat to recommended internal temperatures to destroy bacteria: beef to 145°F; ground beef, veal and lamb to 160°F; pork to 160°F; poultry to 165°F; fish and seafood to 145°F; eggs to 160°F; and leftovers to 165°F. Check internal temperatures with a food thermometer.
  • Thaw frozen foods in the refrigerator, not at room temperature. Place in a container to prevent juices, which may contain harmful bacteria, from contaminating other food. Food may also be thawed in a microwave and cooked right away.
  • Keep your refrigerator at 40°F or below and your freezer at 0°F or below. Use an appliance thermometer.
  • Never keep refrigerated leftovers more than three or four days, even if they still look and smell fine.
  • Refrigerate food promptly. Never allow meat, poultry, fish, seafood, eggs, or fresh vegetables or fruit to sit at room temperature for more than two hours before storing in the refrigerator or freezer. Reduce this time to one hour when the room temperature is 90 degrees or above.
  • Keep in mind that bacteria grow quickly in the “danger zone” between 40°F and 140°F, so hot food left out for serving should be maintained at an internal temperature of 140°F or above. Likewise, cold foods should be kept below 40°F to prevent bacteria growth.
  • Follow "sell-by" and "use-by" dates on food packaging. Do not buy an item after the "sell-by" date, and throw out food when the “use-by” date passes.
  • Do not take restaurant leftovers home unless you can refrigerate them within two hours of being served (one hour if air temperature is 90°F or above) – or if you can keep them in a cooler with ice or freezer gel packs until you arrive home.

The Academy of Nutrition and Dietetics also recommends that seniors avoid the following foods due to the increased risk of contamination: 

  • Raw, rare or undercooked meats and poultry (rare hamburgers, carpaccio and beef or steak tartare) 
  • Raw fish (including sushi, sashimi, ceviche and carpaccio) 
  • Undercooked and raw shellfish (clams, oysters, mussels and scallops) 
  • Refrigerated smoked seafood unless it's in a cooked dish, such as a casserole. 
  • Unpasteurized dairy products ("raw" milk and cheeses) 
  • Some fresh soft cheeses (Brie, Camembert, blue-veined varieties and Mexican-style queso fresco) unless made with pasteurized milk 
  • Raw or undercooked eggs (soft-cooked, runny or poached) 
  • Food items that contain undercooked eggs (unpasteurized eggnog, Monte Cristo sandwiches, French toast, homemade Caesar salad dressing, Hollandaise sauce, some puddings and custards, chocolate mousse, tiramisu and raw cookie dough or cake batter)
  • Raw sprouts (alfalfa, clover and radish)
  • Deli salads
  • Unpasteurized fruit and vegetable juices
  • Refrigerated pâté or meat spreads

At Comfort Keepers of Durham and Chapel Hill, we understand the stress that aging can have on a family especially if you are providing senior care or elder care at home.  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.

To get a detailed downloadable PDF file on food safety from the FDA click here or visit the FDA’s website.
Academy of Nutrition and Dietetics. (December 2012). Food safety tips for older adults. Retrieved from eatright.org/Public/content.aspx?id=5982.
Mayo Clinic (June 2011). Diseases and conditions: Food poisoning. Retrieved from mayoclinic.org/diseases-conditions/food-poisoning/basics/symptoms/con-20031705.
National Institutes of Health, Senior Health. (n.d.). Eating safely: Keep food safe. Retrieved from nihseniorhealth.gov/eatingsafely/avoidfoodborneillness/01.html
U.S. Food and Drug Administration. (June 2011). Food facts: Safe food handling. (PDF document) Retrieved from fda.gov/downloads/food/foodborneillnesscontaminants/ucm257049.pdf.
U.S. Food and Drug Administration. (March 2013). Safe food handling: What you need to know. Retrieved from fda.gov/Food/FoodborneIllnessContaminants/BuyStoreServeSafeFood/ucm255180.htm.

Tuesday, March 4, 2014

Alzheimer’s Care Chapel Hill and Durham: Nutrition and Its Impact on Alzheimer’s Disease

By Helen Antipov

Many seniors here in Chapel Hill or Durhamare faced with a growing number of health problems as they age. One particularly concerning disease is Alzheimer’s. Alzheimer’s is a progressive, incurable, fatal disease that usually strikes the elderly but can occur in people as young as age 40. This disease is the most common subclass of dementia, which is a term used for any number of diseases that affect memory and intellectual ability to the point of interfering with a person’s everyday activities. Alzheimer’s disease in particular causes memory loss and affects the thinking and behavior of those who suffer from it.  At Comfort Keepers of Durham and Chapel Hill, we are committed to Senior Care & Elder Care in Durham & Chapel Hill, Alzheimer's and Dementia Care and your senior's healthy living and quality care. Here are some great facts...

Currently, Alzheimer’s disease affects more than 5 million Americans, a number that is expected to rise to 7.1 million by 2025. There are a number of risk factors for this disease that the general public is aware of, including head injuries, genetics and a family history. However, one risk factor that does not seem to get as much media attention is the possible link between Alzheimer’s disease and vascular disease.

The human brain is fed nutrients and oxygen by the vascular system. If the vascular system is not functioning well, the brain is also deprived of essential nutrients and oxygen, which can cause disease in the brain, including dementia. Research shows that the same risk factors for vascular disease–diabetes, hypertension, and high cholesterol–are also risk factors for Alzheimer’s. 

Reducing Your Risk of Alzheimer’s Disease
While a person may not have any control over genetics or family history, he or she can take action that may reduce the risk of acquiring Alzheimer’s disease, including following a brain-healthy diet. The Alzheimer’s Association defines a brain-healthy diet as “one that reduces the risk of heart disease and diabetes, encourages good blood flow to the brain, and is low in fat and cholesterol.” They recommend increasing the intake of foods that can protect brain cells, and list the following recommendations on their website:  

  • In general, dark-skinned fruits and vegetables have the highest levels of naturally occurring antioxidant levels. Such vegetables include kale, spinach, brussel sprouts, alfalfa sprouts, broccoli, beets, red bell pepper, onion, corn, and eggplant. Fruits with high antioxidant levels include prunes, raisins, blueberries, blackberries, strawberries, raspberries, plums, oranges, red grapes, and cherries. 
  • Cold-water fish (halibut, mackerel, salmon, trout and tuna) contain beneficial omega-3 fatty acids. 
  • Some nuts can be a useful part of the diet; almonds, pecans and walnuts are a good source of vitamin E, an antioxidant. (Alzheimer’s Association, Adopt a Brain-Healthy Diet)
While studies have not been able to definitively state exactly how much of these brain foods are required to have a noticeable affect on a person’s risk of acquiring Alzheimer’s disease, there are some data that show that older women who eat primarily leafy green and cruciferous vegetables demonstrate mental functioning that is two years younger than their counterparts who do not eat many of these vegetables. Therefore, incorporating as many of these brain-healthy foods into the diet as possible is recommended.

Following a brain-healthy diet, along with being socially and physically active, limiting the intake of alcohol and maintaining a healthy weight, could very well mean the difference between acquiring Alzheimer’s or other forms of dementia or aging gracefully.

Nutrition and the Alzheimer’s Patient
It is also vitally important that seniors who already have Alzheimer’s disease practice healthy nutritional habits to help them stay healthy and independent as long as possible. Foods high in cholesterol, saturated fat, sodium, and refined sugar should be greatly limited or eliminated. They should also eat a good variety of foods to ensure an adequate nutritional balance. 
An additional problem that needs to be accounted for, however, is that Alzheimer’s patients may be faced with additional challenges that interfere with maintaining a healthy diet. As the disease progresses the person may have difficulty with dexterity and may not be able to handle cutlery and utensils easily; the person may not recognize foods or may forget when he or she last ate. Other obstacles to eating well include mouth pain due to poor-fitting dentures or other mouth problems the person is not able to communicate; lack of exercise, which reduces the appetite; a reduced sense of taste and smell; medications that interfere with the appetite; changes in perception that make it difficult for the person to distinguish food from a plate; and distractions that keep the person from eating.
To overcome these obstacles, caretakers can apply a number of approaches to ensure their loved one or client gets the nutrition he or she needs. The Alzheimer’s Association provides a number of excellent tips and strategies on their website for caretakers to use including the following:

Distinguish food from the plate and the plate from the table by using contrasting colors for plates and placemats. This can help the food to stand out and become identifiable to someone whose perceptions are dramatically altered. 

  • Make sure that food and drink are at an edible or drinkable temperature to ensure the person does not burn his or her mouth. Test them before giving them to the Alzheimer’s patient.
  • Make eating easy by providing finger foods that are easy to pick up.
  • Avoid distraction and confusion by only serving two foods at a time.
  • Let the person eat according to his or her preferences. Keep these preferences in mind and serve foods that the person has liked in the past so that the meal is more appetizing to him or her. If the person’s preferences suddenly change, change the foods and do not try to force him or her to eat foods he or she may no longer like.
  • Allow the person as much time to eat as he or she needs. Because of limited abilities, he or she may take an hour or more to finish a meal.
  • Allow the person as much independence as possible, even if he or she makes a mess, and adapt the plates, cups and utensils to accommodate his or her abilities. Bowls may be easier for the person to use than plates, and cups with suction cups on the bottom may aid in preventing spills
  • Make the meals pleasurable by joining the person at mealtime. Engage him or her in conversation to stimulate the brain and appetite. You can also show the person how to eat as necessary through demonstration.
  • If the person forgets when he or she last ate and keeps requesting a meal, break up that meal into several little meals so the person can eat each time he or she wants to without overeating. Portion out the different foods and provide them to the person over the course of the day as he or she asks for them.
For additional tips and information, and some great caregiver guides, visit the Alzheimer’s Association website at www.alz.org.

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. (n.d.). Adopt a Brain-Healthy Diet. Retrieved from alz.org/we_can_help_adopt_a_brain_healthy_diet.asp
Alzheimer’s Association. (n.d.). Alzheimer's Facts and Figures. Retrieved from alz.org/alzheimers_disease_facts_and_figures.asp
Alzheimer’s Association. (n.d.). Food, Eating and Alzheimer's. Retrieved from alz.org/care/alzheimers-food-eating.asphttp://durham-832.comfortkeepers.com/