signs to look for

How to prevent pressure sores in seniors

A better understanding of what causes pressure sores helps caregivers take better care of their elderly loved ones. A pressure sore (also known as pressure ulcer and bedsore) is a result of tissue getting compressed between bone and an external surface. Pressure sores affect seniors who are unable to move and change position regularly. Prolonged pressure on the compressed areas leads to reduced blood supply (and eventual death) to the skin and underlying muscle tissues. Skin becomes dry and flaky and can break open which allows bacteria to enter the wound. 

Pressure sores/ulcers are located in areas such as the head and ears, elbows, shoulders, heels, and the sacral region and are graded or staged to classify the degree of tissue damage.

A body indicating the areas of the body where pressure sores may occur

Pressure sores are characterized by four stages dependent on the severity and depth of the lesion

Stage 1:    Pressure sores involve the superficial skin layer. The area has prolonged redness or “non-blanchable redness” (the area is red and does not go back to normal color when the senior is moved). The area can also turn pale or shiny and white.

Stage 2: Pressure sores involve superficial lesions to the top layer of skin. This results in a shallow depression or abrasion causing skin breakdown, blisters, shallow craters, edema, drainage, and possibly infection.

Stage 3: Pressure sores have full skin loss and extension into the subcutaneous tissue causing necrosis, drainage, and localized infection.

Stage 4: Pressure sores have damaged the muscle, fascia, and bone with deep infections, drainage, and death of the tissue (necrosis). Consequently, when a senior enters this stage they will always have a stage 4 ulcer. Although pressure sores may heal on the surface, the sores are deep and usually slow to heal. Due to this, pressure sores re-open easily.

Image showing the 4 stages of pressure sores

In most cases, seniors have special skin care needs because their skin becomes dry and thin as they age. If it becomes too dry, skin is prone to cracking and dermatitis. In addition, this allows for the growth of bacteria which can result in infection. Prevention of and assessment for pressure sores/ulcers and skin tears will avoid discomfort and decreased quality of life for seniors.

Prevent pressure ulcers and skin tears:

  • Relieve pressure by off-loading weight  
  • Prevent shearing and friction with careful transfers
  • Provide good personal care
  • Adequate nutrition and hydration
  • Loose, non-binding clothing

What can you do as a caregiver?

  • Reposition often: seniors need to be turned frequently to avoid pressure-sensitive ulcers.  
  • Check skin and all pressure points frequently
  • Give good skin care: powder which keeps areas clean and dry, lotion which keeps skin hydrated and elastic
  • Give good perineal care—toilet often and clean area well
  • Help the client exercise regularly – whatever the client is capable of doing
  • Make sure bed linens are clean, dry and wrinkle free
  • Give gentle massages to increase blood flow
  • Encourage fluids and good nutrition
  • Use pressure reducing devices: pillows, coccyx cushion, air mattress, barrier cream

What should you report to the doctor, Home Health nurse, or other healthcare providers?

  • Redness that won’t go away
  • Pale, white, shiny area over a bony prominence
  • Red, hot, tender to touch
  • Pressure ulcer that has increased in size or depth
  • Senior reports pain
Aspen Senior Care team photo

Aspen Senior Care has won Provider of Choice for 8 years in a row!

Aspen Senior Care trains our caregivers to follow these guidelines to ensure we provide our clients with the best possible care. We know how important it is to have caregivers our clients can trust. Because of this, we provide monthly in-service training to cover important educational topics. This improves the quality of life for both the caregiver and the senior receiving care.  Click here to learn more about our professional caregivers.


 

Information presented by Amanda Hensler

First Choice Home Health & Hospice

According to The Association for Frontotemporal Degeneration (AFTD), Frontotemporal Dementia (FTD) refers to a progressive disease process which causes a group of brain disorders. These disorders result in cell damage to specific areas of the brain – the frontal lobes and/or the temporal lobes.  The atrophy of these nerve cells interferes with brain activity and causes a loss of function in these regions of the brain.

Frontotemporal Dementia is different from other types of dementia in two important ways:

  • The trademark of FTD is a gradual, progressive decline in behavior and language with memory usually remaining intact. As FTD progresses it gets more difficult for the person to plan or organize activities, interact with others appropriately, and care for themselves.
  • In the majority of cases, FTD occurs earlier in life in people between the ages of 45 to 65, although it has been seen in people as young as 21 and as old as 80.

Frontotemporal Dementia is often misdiagnosed as a psychiatric problem or a movement disorder, such as Parkinson’s Disease. This is because certain symptoms of FTD mimic other diseases and in other cases, individuals are considered “too young” to have dementia.  According to AFTD, Alzheimer’s Disease is another possible misdiagnosis; however, the largest difference is that FTD affects language and behavior, while AD affects memory. 

Brain image of FTD vs Alz: image from medschool.ucsf.edu

Image from medschool.ucsf.edu

FTD makes up about 10%-20% of all dementia cases and the course of FTD ranges from 2 to over 20 years. The average length is about 8 years from the beginning of symptoms. It affects both men and women and, in some cases, can be inherited.

According to HealthLine.com, symptoms of FTD differ depending on the area of the brain affected, but most symptoms fall under behavior or language.

Common Frontotemporal Dementia behavioral issues include:

  • Loss of empathy
  • Inappropriate actions
  • Compulsive behavior
  • Lack of inhibition or restraint
  • Neglect of personal hygiene and care

Common Frontotemporal Dementia language-related symptoms include:

  • Difficulty speaking or understanding words
  • Problems recalling language
  • Loss of reading and writing skills
  • Difficulty with social interactions

Cognitive and Emotional symptoms of FTD include:

  • Difficulty planning, organizing, and/or executing activities
  • Becoming less involved in daily routines
  • Abrupt mood changes
  • Apathy
  • Emotional withdrawal
  • Becoming distracted
  • Reduced initiative

FTD Movement symptoms include:

  • A difference in gait, such as walking with a shuffle
  • Tremors
  • Muscle weakness, or cramps
  • Clumsiness
  • Apraxia (Loss of ability to make motions which are usually common and easy, such as using utensils)

Proper diagnosis is crucial because some medications used to treat other types of dementia may be harmful to a person with FTD. Unfortunately,  AFTD reports no cures at this time. However, research is ongoing and rapidly increasing, and new drugs are beginning to be clinically tested.  

Most importantly, remember that those dealing with any form of dementia are not doing these things on purpose. When providing care, caregivers sometimes trigger behaviors without realizing it. By understanding more about the many different types of dementia, caregivers can begin to improve quality and enjoyment of life at whatever stage of dementia a person happens to be in.

Visit The Association for FrontoTemporal Degeneration

AFTD helpline: 866-507-7222


Learn about different types of dementia in our other blog posts!

Understanding Dementia

Understanding Alzheimer’s Disease

What is Vascular Dementia?

What is Lewy Body Dementia?

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Aspen Senior Care provides in-home care for seniors with all types of health challenges, including all forms of dementia.

Aspen Senior Day Center in Provo provides adult day care services (fun activities and personal care) for seniors with all types of dementia.

Contact Karen Rodgers, Family Caregiver Coach, for a free assessment to help you navigate the challenges of caregiving. You can reach her at 801-224-5910.

Visit aspenseniorcare.com or call our office at 801-224-5910 for more information.

What is it?

Alzheimer’s Disease is the most common form of dementia and makes up about 60% to 80% of dementia cases.  However, many researchers believe this number is too high and that other forms of dementia may be under diagnosed. On average, a person diagnosed with Alzheimer’s will live with the disease for 4-8 years depending on the person’s health and age.  The majority of cases are people aged 65 and older.

In some cases, individuals with this disease aren’t diagnosed until they have had the disease for a few years because the symptoms come on gradually and can be confused with normal aging.

A healthy brain versus a brain affected by Alzheimer’s Disease.

What causes Alzheimer’s Disease?

Although there are ongoing studies, Alzheimer’s Disease is believed to be caused by protein build-up in the brain. These abnormal protein particles are called tangles and plaques and as these tangles and plaques start to attach to nerve cells in the brain, they block communication between the cells and also keep the cells from getting nutrients and oxygen to survive. When a nerve cell dies, that part of the brain shrinks causing the disease to gradually worsen over time. Subsequently, this begins to affect memory, thinking, and behavior as the brain’s “file system” is progressively removed.

Symptoms include:

  • Forgetting how to use common, everyday items
  • Forgetting how to do common activities, such as cooking and driving
  • Misplacing things and not being able to problem solve to find them
  • Becoming fearful or jealous of people
  • Unable to find the right words to speak or write
  • Repeating the same question over and over
  • Poor judgment about appropriate behavior
  • Confusion about time and place
  • Mood and personality changes
We Are People Who Have Alzheimer’s. We Are Not Alzheimer’s.

We Are People Who Have Alzheimer’s. We Are Not Alzheimer’s.

According to the Alzheimer’s Association, there are different stages of the disease which will progressively worsen over time, although the disease will affect each individual differently. Initially, early-stage Alzheimer’s Disease will result in mild memory loss but as it progresses towards late-stage, the disease removes functionality and the ability to make conversation or respond to what is happening around one’s environment.  

Unfortunately, medication does not slow down the progression of Alzheimer’s Disease.  However, there are both drug and non-drug treatments which can help neurons in the brain to fire, aiding in cognitive and behavioral symptoms. 

 

To learn more about Alzheimer’s Disease and other Dementia related topics, visit our blog or the following websites:

Alzheimer’s Association  (24/7 Helpline: 1-800-272-3900 and Find Your Local Chapter)

NIH –  National Institute on Aging

Mayo Clinic

______________________________________________________________________________________________________________________________________

Learn about different types of dementia in our other blog posts!

Understanding Dementia

What is Vascular Dementia?

What is Lewy Body Dementia?

What is Frontotemporal Dementia?

______________________________________________________________________________________________________________________________________

At Aspen Senior Day Center in Provo, we provide adult day care services (fun activities and personal care) for seniors with all types of dementia.

Aspen Senior Care provides in-home care for seniors with all types of health challenges, including all forms of dementia.

Contact Karen Rodgers, Family Caregiver Coach, for a free assessment to help you navigate the challenges of caregiving. You can reach her at 801-224-5910.

Visit aspenseniorcare.com or call our office at 801-224-5910 for more information.

 

 

Preventing Elder and Vulnerable Adult Abuse

This month we had the opportunity to learn about Adult Protective Services and the prevention of abuse for vulnerable and elderly adults.  Debbie Booth from Adult Protective Services taught how we as professional caregivers can prevent abuse, neglect, and exploitation of the seniors in our care.   

Who is considered a Vulnerable Adult?

  • An elder adult, defined as anyone 65 years of age or older.
  • An adult 18 years of age or older who has a mental or physical impairment which substantially affects that person’s ability to:
    • Provide personal protection
    • Provide necessities such as food, shelter, clothing, or mental or other health care
    • Obtain services necessary for health, safety, or welfare
    • Carry out activities of daily living
    • Manage the adult’s resources
    • Comprehend the nature and consequences of remaining in a situation of abuse

What can Adult Protective Services do? 

  • Investigate reports of abuse, neglect, or exploitation
  • Perform needs assessments
  • Coordinate with and refer to community resources for services

What can Adult Protective Services not do?

  • Take custody of an adult.
    • Adults have the right of self-determination unless there is imminent danger of injury or death
  • Under APS authority, place an adult in a nursing home or other facility.
  • Provide any service without the voluntary consent of the alleged victim or their guardian/conservator unless court ordered to do so.

“…Caretakers are our eyes and ears in terms of protecting this very vulnerable population.”

– Debbie Booth

Debbie also taught our team how to spot and report abuse, neglect, and exploitation of vulnerable adults by being aware and watchful of the following signs:

ABUSE

  • Unexplained bruises or welts
  • Multiple bruises in various stages of healing
  • Unexplained fractures, abrasions, and lacerations
  • Multiple injuries
  • Low self-esteem or loss of self-determination
  • Withdrawn, passive, fearful
  • Reports or suspicions of sexual abuse

NEGLECT

  • Dehydration
  • Lack of glasses, dentures, or other aides if usually worn
  • Malnourishment
  • Inappropriate or soiled clothes
  • Over or under medicated
  • Deserted or abandoned
  • Unattended

SELF-NEGLECT

  • Over or under medicated
  • Social isolation
  • Malnourishment or dehydration
  • Unkempt appearance
  • Lack of glasses, dentures, or hearing aides, if needed
  • Failure to keep medical appointments

EXPLOITATION

  • Possessions disappear
  • Forced to sell house or change one’s will
  • Overcharged for home repairs
  • Inadequate living environment
  • Unable to afford social activities
  • Forced to sign over control of finances
  • No money for food or clothes

In the state of Utah, it is the law that any person who has reason to believe that a vulnerable adult is being abused, neglected, or exploited must immediately notify Adult Protective Services intake or the nearest law enforcement office.

 

To Report Elder and Vulnerable Adult Abuse, Please call:

Salt Lake: 801-538-3567

Statewide: 800-371-7897

Click here to learn more about APS
Visit our website at aspenseniorcare.com for more information regarding in-home senior care.

**All information was provided by Debbie Booth from the Division of Aging and Adult Services for the State of Utah Department of Human Services**

 

 

The topic of death and losing a loved one, for many, is a difficult topic to address and understand. Every individual will go through a different process and each caregiver will experience different emotions. There is no right or wrong way to feel when the one you love is reaching the final act of living.

“I truly believe it’s all about the living. We are born and we die and everything in between is living, clear until our last breath.” – Diana Cazier

For our in-service for the month of February, Aspen Senior Care had the wonderful opportunity to have Diana Cazier from Elevation Home Health and Hospice teach our team about the sensitive topic of recognizing the signs to look for when your loved one is in the final act of living. She referred to the booklet by Barbara Karnes, RN, titled, “The Final Act of Living: Reflections of a Long-Time Hospice Nurse”.  

The final act of living is a challenge.  This is a flexible guideline for what caregivers can watch for because no one knows the exact date that someone will pass.

Signs to look for in the Final Act of Living

One to three months before death:

  • Withdrawal from world and people
  • Decreased food intake
  • Increase in sleep
  • Going inside self
  • Less communication

One to two weeks before death:

Mental Changes

  • Disorientation
  • Agitation
  • Talking with the unseen
  • Confusion
  • Picking at clothes

Physical Changes

  • Decreased blood pressure
  • Pulse increase or decrease
  • Skin color changes; pale, bluish
  • Increased perspiration
  • Respiration irregularities
  • Congestion
  • Sleeping but responding
  • Complaints of body tired and heavy
  • Not eating, taking little fluids
  • Body temperature: hot, cold

 

 

Days or hours before death:

  • Intensification of one to two week’s signs
  • Surge of energy
  • Decrease in blood pressure
  • Eyes glassy, tearing, half open
  • Irregular breathing: stop, start
  • Restlessness or no activity
  • Purplish, blotchy knees, feet, hands
  • Pulse weak and hard to find
  • Decreased urine outlet
  • May wet or stool the bed
  • Acetone breath

Minutes before death:

  • “Fish out of water” breathing
  • Cannot be awakened

Through this presentation, we were taught how to be more aware and understanding of the different signs we may observe as one approaches death from disease or old age. We are so grateful to Diana for her presentation as it will continue to help us be more supportive and observant as professional in-home caregivers.

“At Aspen Senior Care, we like to align ourselves with the finest Home Health and Hospice agencies in Utah. We appreciate their willingness to present at our in-service training and reach us about important topics.  We are better because of it.”

Gary Staples, Owner and Administrator

 

If you have any questions, or if you need further support, contact us today at 801-224-5910. You can also refer to “The Final Act of Living: Reflections of a Long-Time Hospice Nurse” by Barbara Karnes, RN.

For more information and topics about in-home care, visit aspenseniorcare.com