Tag: Alzheimer’s care Philadelphia

Home Care or Nursing Home?

There comes a point in every person’s life when they are not physically able to care for themselves anymore. The decision of what to do next can be a difficult one. If you have a loved one who is approaching old age and seems to need care, the responsibility of choosing a care plan may fall on you. How do you know what’s right for the senior in your life? By knowing your options and weighing them carefully. Home Care and Nursing Homes are two viable options for providing care. Understanding the benefits of both can help you make a better decision.

Home Care

Of the two, home care is a more private option and allows your loved one to remain in their own home. Home care is often the first choice for individuals with Alzheimer’s or dementia as it is less disruptive to their current lifestyle. Home care allows for a more personal, one-on-one relationship with the caregiver and ensures that your loved one’s needs are being met all while keeping them in a setting that is comfortable and familiar to them. With home care seniors can remain as independent as possible, rather than needing to turn over basic tasks to the daily staff at a facility. This is especially important for individuals with dementia, as they often find a sense of stability and purpose in the small tasks, they are still able to perform for themselves.

Who you hire for in-home care matters! Your in-home care team needs to be friendly, professional, and patient. NursePartners provides quality certified nursing assistants that specialize in geriatric care. They have at least one-year experience and are managed by registered nurses and certified dementia practitioners. We want to make sure the proper support is in place.

Nursing Home

In some cases care is needed at all times of the day; and for these individuals nursing homes may be a good option. Nursing homes are typically staffed with a variety of medical professionals. These professionals can care for your loved one around the clock and can perform medical and non-medical functions when needed. Though they are all inclusive, nursing homes may remove an individual’s independence and leading to depression. Nursing homes can be noisy and feel unfamiliar for a time before feeling like “home,” which can be a difficult adjustment for some seniors.

 

False choice?

The choice between a nursing home and home care is up to each individual and their family. Sometimes it is a very personal decision, and sometimes it is a logistical one. It also does not need to be one or the other. Many families use home care services to transition a loved one to a facility or supplement care.

As a dementia progresses, many assisted living communities will require that the resident move to a nursing home. This comes at a steep premium. By using home care services at the facility, you can devise a creative solution. You also have two groups of advocates monitoring your loved one and another.

 

Learn more: 610-323-9800.

Call us to learn more about what makes NursePartners different. We are an independent coming, caring exclusively for older adults since 2002. We are locally owned and run by a registered nurse and certified dementia practitioner, Angela Geiger. We would love the opportunity to learn more about how we can support you.

 

hospice care Philadelphia, home care Philadelphia

What is the difference between Dementia and Alzheimer’s Disease?

Dementia and Alzheimer’s disease are often used interchangeably even though they mean different things. Put simply, dementia is a broad term we use to describe a collection of symptoms associated with the decline of neurological function. Dementia can be present in a patient for many reasons, although Alzheimer’s disease accounts for roughly 75% of known dementia cases.

Other types of dementia include vascular, Lewy Body, Frontotemporal, and mixed. There are also ‘reversible dementias’ which can be remediated when the root cause is addressed such as severe urinary tract infection, vitamin deficiency, sleep deprivation, and severe depression.

Different forms of dementia have different early symptoms. But there are common early signs across many types. These include:

  • Short-term memory loss
  • Decreased concentration
  • Disorientation
  • Mood changes
  • Judgement lapses

And while some forms of dementia share similar symptoms, others can be identified by their unique effects on patients. For example, someone with Lewy Body dementia might experience visual hallucinations, stiffness and slowness of movement, tremors, night terrors, or may even be observed acting out their dreams. In the case of Alzheimer’s disease, one of the first things to be affected in patients is their short-term memory. In brain scans of patients with Alzheimer’s disease a deterioration of the brain’s regions associated with short-term memory functions can be observed. While Alzheimer’s disease is much more commonly diagnosed than Lewy body dementia, it is important to understand that both are only types of dementia.

There is no test to definitively confirm the presence of Alzheimer’s or other types of dementia, while the person is alive.  However once symptoms begin to appear, physicians can examine the person to determine potential causes. If a neurodegenerative disease such as Alzheimer’s disease is present, early identification allows for the best possible intervention and treatment. This allows you to better structure your relationship, complete future planning with the input of the diagnosed person and try pharmacological remedies.

NursePartners prides itself on our commitment to clients, and their families, who are living with dementia. Are you living in the Philadelphia metro and are looking for support? Give our team a call at 610-323-9800.

Dementia during the Holidays: Diamonds

Brain Change Model

This is the continuation of our series about connecting with a loved one, living with dementia, during the holiday season.

In the previous article about Sapphires, we discussed someone exhibiting signs of dementia, but not actually suffering from the disease. Depression, as well as other possible culprits, are mostly curable. Dementia is different.

What is Dementia?

In this article, we will discuss the first stage of dementia: Diamond.

If you are looking for a three-minute explanation of dementia, here is a great video.

Here are a few important statements to keep in mind:

  1. Dementia is progressive, without a known cure, and leads to death. However, medications and engagement can slow the progression of the disease.
  2. There are over 80 known types of dementia, and sometimes some can exhibit multiple types. The most common type of dementia is Alzheimer’s disease.
  3. Many people are only officially diagnosed further in the disease progression, if at all. (There are many Diamonds that do not know they have the disease, nor do their family members.)
  4. A person living with dementia will loose various skills and abilities as the disease progresses, not just their cognitive capacity.

Diamond

The first stage of dementia is a Diamond because this gem is “clear and sharp”. Diagnosis is tricky because sometimes picking up on changes requires a long visit.

Diamonds can be successful at established habits and routines. They can engage in small talk and appear pleasant. This is because the first skill to be compromised, in Alzheimer’s type dementia, is short-term memory. In other types of dementia, such as frontotemporal, the person loses the ability to control their impulses.

Established habits and social mannerisms continue, because they were usually adopted at a younger age. These memories and skills are preserved are stored differently in the brain.

Interactions become more difficult as they become more substantive. During conversation difficulties can arise if you reference recently learned information. The person living with dementia becomes less flexible at changing habits and behaviors in response to new information. In conversation, the person will begin to appear overly rigid and are prone to snap if they cannot follow the conversation.

Recommendations for engaging with Diamonds

For those living with dementia and are operating as a Diamond, here are some recommendations:

  • Throw out the phrase “Do you remember?” and anything similar. They do not remember and you quizzing them will leave no one feeling better. Instead, try to focus on what they remember, resorting to more distant memories.
  • Involve them in the process as much as possible. They will feel frustrated by being unable to accomplish certain tasks, but your job is to find out the ones they still can do with you or on their own. If they can participate, they will feel competent and valued. Best activities will vary depending on physical abilities and past hobbies, but here are some ideas:
    • Ask them to help you sort or organize, preferably a task that you are not highly prioritizing, but would be nice if complete.
    • Have them paint or color certain objects.
    • Request they tell you a favorite childhood story.
    • Enlist their help watching a pet dog or cat.
    • Try a simpler version of a task they used to enjoy. For example, if they used to complete 1,000-piece puzzles, try a 100-piece puzzle.
  • Do not rationalize or try to occupy the moral high ground. Meet them where they are in their moment. If you seek to stop or prevent a certain activity, offer them an alternative. Substitute, then subtract.

GEM levels can fluctuate based on the person’s energy level, stress, and nutrition. For example, a fatigued or sick Diamond, can operate more like an Emerald for periods of time, before the Emerald stage become their modus operandi. Learn when and how your loved one operates best and use these moments to maximize a connection. Remember, always connect before providing care.

Build your team

It is important to build your care team at this stage before you reach a state of desperation. As the disease progresses, the person will become increasingly dependent on the people who are currently fulfilling the role as caregiver. If this person is you, it will be more difficult to introduce outside help effectively. Your loved one living with dementia may develop abnormal sleep patterns and become less considerate of your needs until theirs are met.

Providing hands on care is more effective after a connection is established. It is recommended that you introduce care early, on a regular weekly schedule, to get the person comfortable with the idea of help before someone needs to actively assist with hygiene and other more private care needs. In this way, you can gradually build your team and establish coverage with a reputable care provider.

Let’s talk

NursePartners is happy to complete a wellness assessment, at no cost, if referencing this article. All assessments are completed by a registered nurse and certified dementia practitioner. Your call is answered by a member of the admin team, at any time around the clock: 610-323-9800.

Personalizing care techniques can reduce behavioral and psychological symptoms of dementia

The most effective care begins with forming a connection, which includes meeting clients where they are in the disease process.

The Tailored Activities Program (“TAP”) aims to reduce behavioral and psychological symptoms of dementia (“BPSD”). This is often what we struggle with as family members and caregivers. How do we engage the person with just enough activity to make them feel loved and needed?

Unchecked challenging behaviors can lead to increased healthcare costs, caregiver burden, and care recipient placement into facilities. There the person living with dementia usually faces pharmacological intervention, which may exacerbate these challenging behaviors or worse.

An Australian trial randomized 180 participants living with dementia by placing them into two groups. One group received 8 home care visits using the training from TAP to train the caregiver and engage with the person living with dementia. The control group received three phone calls with the caregiver about basic dementia related materials from a book, and did not involve the care recipient. Follow up continued four and eight months after the home care visits and phone calls.

The trial was done with individuals living at home or with relatives, outside of formal care facilities.

The results of the TAP pilot trial:

The TAP pilot trial showed overall reductions of incidences of challenging behaviors or BPSD. There were also reductions in other specific behavioral categories as defined by the study:

BPSD overall: F(1,41) = 7.58, p = 0.009, Cohen’s d = 0.72,

Shadowing: F(1,4) = 58.9, p = 0.003, Cohen’s d = 3.10, agitation, Wald X2(1) = 6.0, p = 0.014, Cohen’s d = 0.75

Repetitive Questioning: F(1,22) = 5.94, p = 0.023, Cohen’s d = 1.22

Argumentation: Wald X2(1) = 6.6, p = 0.010, Cohen’s d = 0.77 ()

To read more about the study, click here.

In many ways, TAP is like the Positive Physical Approach to Care as pioneered by Teepa Snow. NursePartners has embraced this methodology since the inception of our GEM division in 2015. It builds on the intuitive notion to engage with people living with dementia according to their life experiences and interests. By appealing to their sense of self-worth, we can prevent or mitigate some of the most challenging behaviors.

 

NursePartners trains all carepartners in the GEM methodology as perfected by Teepa Snow.

All carepartners are trained to engage with clients, focusing on what they still can do and letting go of what they cannot. Even at the most advanced stage of dementia, you can find new ways to say hello and make the person feel valued and with purpose.

To learn more about how we can engage your loved one living with Alzheimer’s disease, Frontotemporal dementia, or another form of dementia, call us at 610-323-9800.

Philadelphia dementia care, Philadelphia home care, Philadelphia caregiver

 

Pride month may be over, but our LGBT sensitivity training continues!

NursePartners offers a LGBT sensitivity training in additional to our base dementia (“GEM”) training.

Why is the LGBT sensitivity training important?

According to SAGE, there are 3,000,000 people in the U.S., aged 55 and older, that openly identify as LGBT. When providing care to this community, there is a distinct set of challenges and way to connect before providing care. It is important that the employees providing the caregiving not only understand basic terminology, but listen and understand needs, said and unsaid.

Based on a SAGE survey of 1,857 LGBT older adults, here are some of our key considerations when caring for those in this community.

  • 40% of LGBT older adults, ages 60 to 75 report that their healthcare providers do not know their sexual orientation.
  • 40% of this same group report that their support networks have shrunk compared to 27% of non-LGBT people.
  • 34% are concerned about “being lonely and growing old alone”, compared to 19% of their non-LGBT counterparts.
  • 34% live alone, compared to 21% of their non-LGBT counterparts.

In Philadelphia, we commit ourselves to LGBT older adults through board membership and activism via the LGBT Elder Initiative of Philadelphia. Many of the SAGE findings have also been reported by the LGBT Elder Initiative here. (The LGBT Elder Initiative also offers great programming… if you were not already aware.)

So, what can a potential client that identifies as LGBT expect from NursePartners before the initiation of services?

  • An in-person assessment by a registered nurse, dementia practitioner, and a SAGE-certified employee. Subsequent LGBT sensitivity training has been done internally.
  • The development of a plan of care that not only outlines physical care needs but paints a picture of that individual’s life up until this point. This allows the care team to find ways to relate to the client before they even meet.
  • Given that the client commits to a regular schedule, they can expect a regular care team with whom they can establish trusting relationships. We take our commitment to HIPAA seriously, and this includes issues particular to LGBT older adults.
  • All carepartners are trained in the Positive Physical Approach to Care, as outlined by dementia care revolutionary, Teepa Snow. Many of these care approaches directly translate to individuals who are not living with dementia. It emphasizes connecting, patience, and “joining the client’s world”.
  • Carepartners working with LGBT older adults will also have received a LGBT sensitivity training provided by us.
  • A continuous relationship with NursePartners admin throughout the entirety of their time with us. We are an open book, with 24/7 effective hours of operation. Yes, we in admin sleep, but never all at the same time!
  • We are locally owned and have been hard at work since 2002. Since then, we have developed a network of providers that have also earned our trust. We are happy to share these resources with you if they are needed.

Want to learn more about NursePartners?  Why not give us a call at 610-323-9800?

Vision Changes for those Living with Alzheimer’s disease or another form of dementia

Our field of vision changes as we age, but the changes are drastic for a person living with dementia.  Eventually the field of vision becomes so restricted that sight becomes a main obstacle in carepartners connecting before providing care.  The results could worsen anxiety, hallucinations, mood swings, aggression, and other behavioral issues. 
Visual deterioration progresses in the following order:
  1. 45* peripheral (This is the normal range of vision for an older adult 75 years young.)
  2. Tunnel vision (The width is about a yard in diameter.  Loss of sight occurs in all directions: left, right, up, and down.)
  3. Binocular vision (Cup your hands around your eyes or use a pair of binoculars to experience this for yourself.)
  4. Restricted binocular (Cup your hands tighter around each eye, until they are just loose enough to fit a pencil through each opening.)
  5. Monocular (The brain shuts off vision to one eye.  This is because the brain is prioritizing other bodily functions such as digestion, respiration, and blood circulation.)
NursePartners practices the positive physical approach to care.  We emphasize the importance of recognizing these changes in order to build meaningful and successful relationships.  Admin includes dementia practitioners and coaches that train our carepartners in dementia care before placing them to work with our clients.  
Want to learn more about our dementia training?  Think these approaches can enhance the quality of life for your loved one? 

Call us to learn more about how we can help: 610-323-9800.

Philadelphia demenia care, Philadelphia home care, Philadelphia Alzheimer's disease“Ambers”, or clients living in a middle stage of dementia, experience the world with binocular vision.
If you want to learn more about reducing challenging behaviors, check out this article from Pines Education.
 

NursePartners looks for carepartners at local career fair

NursePartners was proud to participate in the career fair hosted by the Philadelphia Regional Library system.  Our two delegates were Lakeya Dula, Senior Recruiter and Dementia Coach, and Nafeesah Mays, Certified Nursing Assistant (“CarePartner”).  Philladelphia dementia care, Philadelphia best home care, Philadelphia dementia careNursePartners is looking for CNAs, LPNs, and RNs who specialize in geriatric care.  We are always growing our team and want dependable CarePartners to work in consistent care teams.  We offer assignments (not “shifts”) in three company divisions: traditional home care, GEM (dementia care), and staffing at our partner facilities.  Carepartners receive the detailed plan of care and report before arriving for a first assignment with a new client.

If you are interested in joining our team, please complete an application online for the desired position: https://www.nursepartners.org/about/employment/

Lakeya Dula executes the entire hiring process, beginning with a screen, personality assessment, interview at the Philadelphia Office, executive huddle, background and drug screen tests, orientation, dementia workshop, and additional dementia training.  She seeks personable and dependable CNAs for all three company divisions.  NursePartners is looking for carepartners that want to make a difference in the lives of older adults.  As an executive team, we proceed with each hire only after asking ourselves: “Would we want this CarePartner to care for an older adult in our family”?  If so, we are confident to place them in the homes of our clients. 

Nafeesah Mays has made an exceptional impression on seven of our clients.  As a CarePartner with more than 16 years of working experience in home care and long-term care and assisted living communities, we are happy to have her as part of the team.   As part of the orientation process, Nafeesah participated in an orientation that included a dementia workshop.  During the workshop, dementia coaches role play difficult scenarios with carepartners to see how they might respond with our clients.  Role plays are filmed and played back to the CarePartner so that they can see themselves from the eyes of the client.  Nafeesah is in the process of completing additional dementia training.

Tips for the Holidays – a collaborative piece from the National Aging in Place Council

NursePartners is proud to be a co-founder of the National Aging in Place Council of Philadelphia.  Monthly we meet with other vetted service providers to determine how we can best support older adults as they age in place.

National Aging in Place Councils from across the country have collaborated to prioritize five tips we can offer families during the holiday season.  The original post below has been supplemented by additional tips from NursePartners.

seniors during the holiday, senior care in Philadelphia,

Tips for the Holidays from NAIPC

      As the holiday season approaches, NAIPC members would like to offer seniors, caregivers and family members some health and safety tips for enjoying the holidays with loved ones.NAIPC members compiled a list of the five most common things that normally concern seniors, caregivers and their families.  We recommend that all stakeholders remain vigilant to minimize the risks and effects of the issues below:

  1. Isolation

  2. Safety

  3. Nutrition/Health

  4. Finances

  5. Transportation

      1. Isolation. Many older adults who have raised families, or been a central figure in their community, are now at a place where those roles are no longer part of everyday life. This leaves them searching for where they fit in the bigger picture and this is especially true during the holidays. It’s important for them to feel their participation is valuable and meaningful. Here are some ways you can mitigate isolationism:

  • Social visits include busy and quiet environments.  If your loved one is living with dementia, consider minimizing excessive noise and chaotic environments.  Try driving around your neighborhood to look at the holiday lights.
  • In they are unable to stand in the kitchen, have them sit and decorate cookies. You are involving them in the process, but also preventing the activity from being exhausting or overwhelming.
  • Reduce lengthy travel for older adults during the holidays.  Try suggesting that younger family members reunite in the home of the older adult.  If not, plan a virtual visit.
  • Older adults have rich stories of past holidays; incorporate these into your traditions and watch how they feel honored and valued.
  • Decorate as an intergenerational affair. From the youngest to the oldest, memories will be built when everyone can participate.

      2. Safety is a big concern, whether it be safety from the elements or safety from the unknown.

      For those aging in place, whether living alone or with the assistance of a caregiver, winter weather can be treacherous. It’s important to ensure that walkways and driveways are cleared of snow and ice before venturing out.  Hire someone to shovel pathways and salt sidewalks. Additionally, it is wise to keep a supply of candles, matches, food, extra blankets and medications at the ready.  If the older adult is living with dementia, consider having someone stay with them during snow storms.  Arrange for a groceries to be delivered before the storm, either online or by a relative or friend.
      Only use flame-resistant decorations and keep power cords away from heavily trafficked areas. Do not leave lights unattended and always assist the older adult while they are decorating.

      3. Nutrition/Health. It is always important to manage a sensible diet, but especially over the holiday season with the rich foods and drinks, that could potentially be detrimental to anyone with a risk of diabetes, heart disease or worse. Encourage those at risk to limit consumption, by taking smaller portions and balancing their diet, or avoid holiday treats altogether.

      4. Finances. We all cope with the financial pressures that our society imposes on us as we approach the holiday season.  We need presents, trees, decorations, festive meals, and constant entertainment.  This can certainly deplete the funds for someone living on a budget.

  • Consider going to another relative’s house rather than cooking a meal yourself.  If this is not an option, consider ordering a meal from somewhere like Boston Market.
  • Minimize holiday decorations by purchasing a table top tree.  This would be more manageable and easier to dispose.  Use holiday decorations that you already own.
  • Shop online for the best holiday deals to save on gifts for family members.  Assist an older adult with this process!
      Beware of charitable fraud.  Checking the IRS website for legitimate charities could be a lifesaver.

      5. Transportation. Whether it be local or long-distance travel, transportation becomes a larger issue around the holidays. Either it’s the inaccessibility of running errands or it’s waiting in long lines, navigating airports and security, claiming baggage and meeting up with relatives.  Don’t subject an older adult to these inconveniences.   Instead, celebrate your holidays by traveling to them.

The holidays are supposed to be full of joy, love and family. So, keep your family safe and happy this year.

      HAPPY HOLIDAYS from all of us at NAIPC!