What to do When Diagnosed with Alzheimer's

When a loved one, family member, neighbor or friend has Alzheimer's disease, there are health care team members who can help families and friends cope with the signs and symptoms of this disease and to start treatment. Here are some of the health care professionals that can help:

• Primary care physician
• Geriatrician—a doctor who specializes in treating the elderly
• Neurologist—a doctor trained to treat diseases of the brain
• Psychiatrist—a doctor who specializes in treating behavioral problems
 
To locate a doctor near you, visit the American Medical Association’s (AMA) website. If you do not have or use a computer you can use the phone to contact directory assistance (dial 411) to locate the AMA’s phone number in your state. There is no cure for Alzheimer's disease. Treatment for Alzheimer's Disease focuses on maintaining quality of life for the person with the disease. Some medications can help improve memory and others can slow the progression of
the disease. Not all treatments will work for everyone. The use of medication is a decision that you and your medical team must decide.

Prevention of Alzheimer's

Since we cannot prevent aging, it is unlikely that we can prevent Alzheimer’s disease. However, to date research has identified some actions that we can take to help reduce our risk for the disease. We know that adults with damaged blood vessels in their brain are more likely to develop Alzheimer’s disease. Blood vessel damage in the brain is more likely to occur in people with high blood pressure, high cholesterol or diabetes. These diseases can be managed through medication, healthy diet and exercise. The more “under control” that these diseases are, the less damage or hardening of the blood vessels.

Seven Warning Signs of Alzheimers

1. Asking the same question over and over again,
2. Repeating the same story, word for word, again and again,
3. Forgetting how to cook, or how to do repairs, or how to play cards— all activities that were previously done with ease and regularity;
4. Losing one’s ability to pay bills or balance one’s checkbook;
5. Getting lost in familiar surroundings, or misplacing household objects;
6. Neglecting to bathe, or wearing the same clothes over and over again while insisting they have taken a bath or that their clothes are sill clean
7. Relying on someone else, such as a spouse, to make decisions or answer questions they previously would have handled themselves without hesitation;
 
When these symptoms are noticed and reported to the doctor, the patient is in a position to obtain treatment that may improve their quality of life. Early treatment in some cases has been shown also to slow the progression of this disease, and importantly, gives time to discuss care options while the diagnosed individual can still take part in decision-making for future treatment and care.

How is Alzheimer’s Recognized?

Family members are often the first to notice changes that could indicate the onset of Alzheimer’s. Family and friends should learn the early warning signs of the disease and be an advocate for the individual who they are concerned about to have an evaluation earlier rather than later, and to seek treatment.

Typical Early Symptoms of Alzheimer’s
• aphasia—or difficulty speaking,
• disorientation---or difficulty remembering place and time, and/or
• disinhibition—difficulty with self-management of behavior such as outbursts of violence without previous history of such.

Developing Alzheimer's Disease

This disease is not transmitted from one person to another, you cannot “catch” Alzheimer’s from someone who has it. You also cannot get it from the food you eat. Scientists are rather looking at a number of complicated causes related to “errors” that occur in our body’s proteins and genetic mutations that cause the disease to consistently appear generation after generation in some families. However, at this point in time we only have a number of theories as to the cause of the disease that may later lead to a definitive reason why people get the disease and when they get it, and hopefully a cure.

History of Alzheimer's

The first Alzheimer’s case was diagnosed more than 100 years ago. Dr. Alois Alzheimer, a German psychiatrist, identified what was to become the first case of Alzheimer’s Disease in a 50 year old woman in 1901. He was able to observe the woman until her death five year’s after her diagnosis. Upon examining the woman’s brain, Dr. Alzheimer identified brain tissue with abnormal clumps and irregular knots of brain cells. Today, these clumps (now called plaques) and knots (now called tangles) are considered the classic hallmarks of Alzheimer's disease.

From that time forward, the diagnosis of Alzheimer’s disease was given to people between the ages of 45 and 65 who had the symptoms of pre-senile dementia. Unfortunately, dementia was considered to be a normal outcome of the aging process for those over age 65 and was thought to be caused by age-related “hardening” of brain arteries. In the 1970s and early 1980s the name Alzheimer’s disease began to be used for all people who were afflicted with dementia
regardless of their age.

Familial Alzheimer's Disease (FAD)

This type of Alzheimer's disease is known to be entirely inherited. In affected families, members of at least two generations have had Alzheimer's disease. FAD is extremely rare, accounting for less than 1% of all cases of Alzheimer's. The disease typically has a much earlier age of onset (often in the 40s).

Late-Onset Alzheimer's

This is the most common form of Alzheimer's disease, accounting for about 90% of cases and usually occurring after age 65. Late-onset Alzheimer's disease is evident in almost half of all people over the age of 85.

Early Onset Alzheimer's

This is a rare form of Alzheimer’s diagnosed among people under age 65. These patients represent less than 10% of all Alzheimer's disease patients. Because these individuals experience premature aging, individuals who are born with Down syndrome are particularly at risk for this

type of Alzheimer’s. Adults with Down syndrome are often in their mid - to late 40s or early 50s when symptoms of Alzheimer’s first appear.

Severe Alzheimer's Disease

People with severe Alzheimer's disease may:
• Have problems with eating-remembering to swallow, how to use a utensil, etc.
• Have problems with speech – sentence structure that does not make sense, incorrect identification of objects, or they may not speak at all
• Not recognize friends or family members
• Not be able to control bowels or urine
• Have problems with walking-generally unsteady on their feet.

Moderate Alzheimer's Disease

People with moderate Alzheimer's disease may:
• experience poor memory of recent events
• Have trouble with completing tasks such as washing dishes or setting the table
• Have difficulty in appropriately dressing for the weather or occasion
• Forget to shave or shower which was a routine repeated task of their daily life
• Argue more often
• Believe things are real when they are not
• Wander, most often at night
• Appear worried or depressed more often than usual, and
• Need close supervision to ensure that they finish tasks or follow through on actions that they start.

“Mild” Alzheimer's Disease

People with “mild” Alzheimer's Disease may:
• experience memory loss,
• Have trouble naming common items,
• Ask or say the same thing over and over,
• Easily get lost,
• Lose interest in things they once liked to do,
• Misplaces things more often than usual
• Exhibits personality changes, not their usual selves with no significant event in their life that might explain the change.

What is Alzheimer’s Disease?

Alzheimer’s is a disease that worsens typically on average over a period of 8 to10 years after diagnosis. Although it affects each person differently, there are some common symptoms as the disease progresses. Categorizing the symptoms and behaviors commonly seen in people who suffer from Alzheimer’s can be helpful. Alzheimer's is broken down into three different categories: Mild, Moderate and Server; and three main diseases: Early Onset, Late-Onset, and Familial Alzheimer's Disease (FAD).

Alzheimer's Disease Awareness Month

Alzheimer’s is a devastating disease that strikes older Americans with increasing frequency. It is the leading cause of dementia or loss of intellectual function in our population, and the eighth leading cause of death in the US. November is Alzheimer’s awareness month, and we will be posting information about how to recognize some of the signs of this disease, and what to do with that information.

Healthy Habits for Aging Adults

Healthy Habits

Smoking and drinking are two big habits that can affect your health and the way you handle aging. Alcohol may be fine in moderation but you must be careful that your consumption is a healthy not harmful habit. Alcohol can contribute to sleep and appetite problems. It’s important to making an effort to change harmful habits. An abundance of medical evidence indicates that smoking is the cause of a variety of illness including cancer, heart disease and lung diseases.

Sleep
Quality sleep becomes more difficult for many people as they get older. On the average people age 50 and over sleep 6 hours per day. Sleeping poorly might be the cause of big changes in life, health issues, medication, stress or anxiety. Exposure to daily sunlight as well as regular exercise contribute to restful sleep.

Mental Activity
Mental stimulation can significantly improve the aging process. Trying to keep active mentally can improve your memory, combat boredom and also help improve sleeping. Simple and fun games and puzzles, reading or changing your route to the store are easy ways to keep your mind active and engaged.

Sure Step: Fall Prevention Program

The odds of falling are about one in three after age 65. You are more likely to fall as you age because of normal, age-related physical changes, certain medical conditions and medications. A fall often damages more than your dignity and many people know others who have been injured or disabled after a fall. But, you do not  need to let the fear of falling rule your life; with some medical management, physical  activity and common sense you can help yourself and others avoid falls and stay independent longer.

Sure Step: Fall Prevention Program
Age-related physical changes affect many of your body systems and can put you more at risk for falling. Changes with your vision or hearing can have an effect on both coordination and balance. Nerves become less able to carry information from your brain to your muscles, which can slow your reaction time and ability to move away from obstacles quickly enough. Normal weakening of muscle strength and joint flexibility can make getting out of chairs, standing up and walking more difficult. The good news is that regular exercise can help to slow this process and help to keep you safe.

In order to avoid falls it is important to keep your body moving. Ask your doctor  for a general exercise program that includes walking or group exercises. Exercises such as water workouts in a pool or tai chi are gentle on the body and are proven effective in reducing the risk of falls. Your doctor may also recommend using a cane or walker to make certain that you are balanced when you are moving. If you are using either of these it is also important to be sure that you are using them correctly. The secret to reducing your risk for falls is moving more and safely, not moving less. You doctor may also advise you to work with a physical therapist to create an individual exercise program for your unique needs. The exercises that your doctor or physical therapist recommend can help to improve balance, strength, coordination and flexibility.

Certain medical conditions can also increase your risk for falls. As you get older, you are more likely to have diseases that affect internal organs, your nervous system and brain. Conditions that can affect the flow of blood, such as diabetes and atherosclerosis can affect eyesight as well as contribute to dizziness and confusion that can lead to falls. Diseases such as Parkinson’s or ALS (Lou Gehrig’s disease), which affect the nervous system, are more common in the older adult and can lead to problems in judging distance or walking without dragging your feet that can lead to falls. Joint diseases such as arthritis can reduce how easily you move around including walking on uneven surfaces or going up and down stairs or getting in and out of cars or getting off buses.

The prescription medication that you take can actually increase your risk of falling. Most often this is related to changes in the way your body reacts to medication, including those that you may have taken for years. Many drugs have side effects that have an impact on your brain function and can cause you to become dizzy or lightheaded affecting your balance

.
Some high-risk medications that can cause these problems are for: high blood  pressure, heart disease, allergies, colds, coughs, sleeping problems, excess stomach acid, depression and diabetes.

Drugs that affect the cardiovascular system (your heart and blood vessels),  including those for high blood pressure and heart disease can lower your heart rate and blood pressure, which reduces blood flow to the brain. This means it is important to rise slowly from a lying or sitting position, this will allow your body to adjust.Medications –those the doctor prescribes or you buy in the store, for allergies or colds or to sleep can contain antihistamines and can cause drowsiness or sleepiness. Sleepiness can interfere with your thinking as well as your balance and coordination.Be careful to plan activities accordingly if you are taking one of these medications; driving, exercising, cooking and bathing –especially taking hot baths, should be avoided while you are feeling the effects of such drugs.

Many prescriptions, including antidepressants and pain pills, also affect your central nervous system or brain. They can cause side effects including dizziness or feeling “drugged”. Again, it is important to safely plan your activities with enough time afterward that you feel alert. Talk to your doctor about taking some of these prescriptions at night so that the strongest side effects occur while you are sleeping and won’t interrupt your plans during the day and to be aware of any symptoms you experience.

Insulin shots and the pills you take to control your blood sugar can actually make your blood sugar lower. This condition, known as hypoglycemia can make you confused, weak or even experience a seizure. Be sure to closely monitor your blood sugar and that you know how to treat the symptoms-ask your doctor if you are not sure what to do immediately.

Combining alcohol with some medications can make you dizzy. Read the labels on the side of your prescription bottles to be sure that you can drink when you take this prescription.

If you are taking four or more medications, especially those that are high-risk medications such as those that we just talked about, it is important to let your doctor know and ask his or her help to reduce your chances of falling. In order to prevent complications it is important for your doctor to know each and every medication you are taking, including vitamins and herbal supplements. The next time that you see your doctor, take in all your medicine or a list.

It is also a good idea to always get your prescriptions at the same drug store or from the same mail order pharmacy (remember most new Plan D’s are mail order and so is AARP the largest pharmacy in the world!). The pharmacist can review ALL the drugs you take for side effects that occur only when taking some drugs together. These can be serious and cause dizziness, sleepiness, and imbalance. Also, be sure your pharmacist reviews the side effects of any new medication with you, including when to take it and what to avoid. If you don’t have a way to talk with your pharmacist, be sure to read the paper that comes with your prescription and look at the side effects. Can the prescription cause dizziness? Does it say not to drive your car?

There are many ways you can reduce your risk of falling and continue to live a healthy and independent life. When you first wake-up, sit on the edge of the bed for a few minutes and make sure you are not dizzy before trying to stand. Eat breakfast every morning as skipping a meal can make you weak and more likely to fall. It is also important to be careful around pets who get under your feet and make you trip or jump on you and could cause you to fall.. Also wear clothes and shoes that fit properly so you don’t trip. Make sure you do not leave items on the floor and that you close drawers and cabinets so you won’t stumble over them. Getting regular eye exams and updating your eyeglasses will also help you prevent falls.

Household safety is of utmost importance when trying to avoid falls. Hazards in each room should be identified and eliminated or modified in order for you to remain safe in your home or apartment. The bathroom is notorious for slips and falls, however, by using simple devices such as non-skid mats, raised toilet seats, shower chairs and grab-bars you will be able to reduce your risk of falling. Many of these items may be eligible for payment under Medicare. Talk to your doctor, physical therapist, nurse or medical equipment company.

Stairs are a constant danger for falls. Remember to never carry any package that obstructs your view of the next step and to keep at least one hand on a handrail. Make sure your living area (where you spend the most time) and bedroom have clear paths and that you have easy access to light switches, preferably switches that turn the lights on before you enter the room.

Have someone help you “tour” your house and find hazards such as cords, wires, unsecured throw rugs and low furniture such as coffee tables. All furniture needs to be sturdy and easy for you to get in and out of. Kitchen safety includes making sure that items are easily accessible; this will help you avoid unnecessary climbing or bending. It is also important to clean up any spills and use non-skid floor wax.

Even after taking precautions, it is still possible for a fall to occur. After you fall, panic is often the first reaction. However, how you react after a fall can actually cause more injuries than the fall itself. If you try to get up too quickly or in the wrong position you may make an injury worse. The following advice on getting up from a fall is from the American Orthopedic Surgeons. Remember to take deep breaths and decide if you are hurt. If you think you are injured do not get up, if you can reach a phone call 911 or press your personal response device or ask for help from a family member. If you feel strong enough to get up, roll over naturally to your knees, turning your head in the direction of the roll. If you can, crawl to strong furniture like a chair, put both hands on the seat and pull yourself up onto your knees. Slowly begin to stand using your stronger knee and leg to push your body up, then carefully twist around and sit in the chair.

It is important to document the times that you have fallen or almost fell. Try to remember what you were doing, where you were, when it was and how you fell. Information about your fall can help you and your doctor identify any risk factors for falling and how to manage them.

Getting Up From a Fall
After you fall, panic is often your first reaction. However, how you react after a fall can cause more injuries than the fall itself. If you try to get up too quickly or in the wrong position you may make an injury worse.

Remember to take several deep breaths, assess the situation and determine if you are hurt. If you believe you are injured, do not attempt to get up. Instead, call 911 or get help from a family member. But, if you feel strong enough to get up, follow these steps provided by the American Academy of Orthopedic Surgeons.

Try to fall on your side or buttocks. Roll over naturally, turning your head in the direction of the roll.

If you can, crawl to strong, stable furniture like a chair, and pull yourself up. Approach the chair from the front and put both hands on the seat.

Slowly, begin to rise. Bend whichever knee is stronger; keep your other knee on the floor.

Slowly twist around and sit in the chair.

Copyright American Academy of Orthopedic Surgeons, used with permission

Click here for more information on Interim HealthCare's Sure Step Program

Benefits of Growing Older

The benefit of growing older is that we have the opportunity to use our wisdom to manage or regain our zest for life. Here are some easy things you can do everyday to make it healthy, safe and fun.

• Stop pressing the snooze button
• Step outside before breakfast to get a dose of sunlight
• Eat to energize
• Save your skin
• Go outside to boost your mood
• Stay hydrated (at least six 8 ounce glasses of liquids every day)
• Try a mental exercise
• Break for coffee or tea with a friend
• Don’t forget your vitamins or meds
• Stretch, exercise with weights or walk for 10 minutes
• Reapply sunscreen
• Eat healthy snacks
• Dim the lights to wind down
• Monitor your alcohol intake
• Turn off the TV

The Importance of Exercise and Aging

Exercise
Keeping your body healthy increases your chances of living a long life. It’s not about how strenuous your exercising is but that it’s consistent. It can help with weight loss and maintenance, combat anxiety and depression, keep bones, muscles and joints working properly relieve symptoms of arthritis and reduce the risk of heart disease, high blood pressure, diabetes and some types of cancer. Exercise is one of the major cornerstones of healthy living.

The following foods contribute to a long and healthy life when they are part of a well balanced diet:
• Good fats such as: avocados, olive oil, sesame seeds and almonds, salmon, mackerel
• Antioxidants such as: pomegranate, blueberries, strawberries, cranberries
• Colorful Produce such as: tomatoes for red lycopene, red bell peppers, carrots, mangoes and sweet potatoes
• Anti inflammations such as: ginger and green and red apples
• Important immune builders such as: low fat yogurt
• Greens such as: asparagus, green tea, broccoli

Weight Loss
Losing weight without trying could be a warning sign of worsening health. Weight loss through diet and exercise is normal. Maintaining a healthy weight is one of the most important things you can do for your health. However, if you have lost weight without trying, make an appointment with your doctor to make sure it’s not a serious illness.

Skin Care
Exercise increases circulation that enhances distribution of nutrients to your skin. As we age skin thins so be sure you moisturize and use at least a SPF 15 or higher.

Early Detection of Problems

Health screenings help to detect chronic diseases early in their course, when the disease is most treatable. Screenings can help save lives.

There are a number of other ways you can confront the aging process and give yourself the best odds for success.

Attitude
Your sense of hope, humor and confidence will determine the tone of your aging experience. Your attitude is one thing you have full control over.

Civic Involvement
Sharing your interests and passions with others and being involved in a cause that is important to you will provide a constant reminder that you have a lot to offer and serves as a tool for putting problems in perspective or maybe even forgetting about them altogether.

Friends and Social Involvement
Contact with others will feed your spirit and can provide purpose and meaning in your life whether it be at work, church, or family get togethers. Interaction with grandchildren and being a volunteer are also very important to keeping ourselves involved verses isolated.

Knowledge of Aging

Growing knowledge and resources about the effects of aging can help you actively take part in your own health and wellness. Taking advantage of these resources can translate into feeling more comfortable, contented and healthy as you age. Keep in mind that reducing your risk of disease is all about making simple changes in your daily routine.

In the past we believed there was little or nothing we could do to change our health and improve our overall wellness. Research has shown that healthy lifestyle behaviors, such as being physically active, eating a healthy diet, and not smoking, are more influential than genetic factors.

Published results in medical research, in-depth studies on women’s and men’s health, and medical and pharmaceutical advances in research have all helped to inform the public and open avenues for better decision making about managing personal health.

Common Myths About Aging

Let’s review some of the common myths about aging and the real statistics.

Myth: To Be Old is to Be Sick
Reality: Older people are in remarkably good health, with fewer illnesses and disabilities; 89% of those age 65-74 report no disability at all.

Myth: You Can’t Teach an Old Dog New Tricks
Reality: Research shows that older people can and do learn new things. Many seniors today are keeping up in a number of ways. 13% of total online users are 55 and over.

Myth: The Horse is Out of the Barn (meaning that the behaviors and habits of our youth and early life have already caused irreversible damage to our health)
Reality: New habits such as healthy eating, regular exercise, mental activity and a strong social life are remarkably effective in combating the byproducts of yesteryear’s bad habits and unhealthy living.

Myth: The Secret to Successful Aging is to Choose Your Parents Wisely
Reality: The MacArthur Foundation conducted a study that showed that lifestyle changes are as important indicators of successful and healthy aging as hereditary is.

Myth: The Lights may be on, But the Voltage is Low
Reality: Mental Acuity and physical ability to an extent decline with age however they are greatly affected by attitude and lifestyle habits.

Myth: The Elderly Don’t Pull their Own
Reality: Seniors play some of the most important roles in society both in formal positions within the community, and informal roles as parents, grandparents, friends and neighbors. Additionally, new opportunities for paid work are blossoming since the traditional retirement age is being
reinvented.

Healthy Aging for Seniors Over Age 65

Getting older brings with it an abundance of emotional, physical and mental challenges. Aging can also bring with it a lot of anxiety. When we are in our 40’s we frequently talk about our parents, aunts and uncles getting older but seldom realize that at the very same time we are also aging.

The unexpected nature of the aging process often makes us feel nervous and scared. One in every eight Americans is over the age of 65. Preventing health problems is one of the few known ways you can remain independent for as long as possible and avoid the debility traditionally associated with aging.

Many organizations, agencies and health care providers are exploring and setting agendas for improvements in health across all life stages in an effort to improve our health and well being as we age.

Interim HealthCare staff are trained to assist you to take care of your body so you can feel more comfortable as you greet the changes that come with aging. Interim HealthCare is committed to assist you with information, education and resources that will help you manage many of the aspects of the aging process and improve your quality of life and help you enjoy yourself.

What the Flu is Costing Your Business.

When employees are sick, your company suffers, one employee sick day can cost your business up to $500 in lost production, replacement and related expenses. Additionally, healthy employees are forced to manage their sick coworker's workload, which leads to distraction and frustration. When sick employees do come to work, they can infect others, multiplying your losses. The Center for Disease Control (CDC) encourages all employees who want protection from the flu to get vaccinated for the seasonal flu.

One way to protect your employees is to set up a Worksite Flu Program. Worksite Flu Programs work by having a nurse or pharmacist come into the office to perform vaccinations at your workers convenience. They will also help organize and promote the program. By having a Worksite Flu Program your employees don't need to spend time out of the office for a doctor's visit and because it is convenient, staff members are likely to take advantage of the vaccination, which in the end means more healthy employees and a more productive company.

In the end Worksite Flu Programs save money by reducing the expense of employee sick days, maintain employee and company productivity, as well as demonstrate your commitment to your employees' well being.

UV Protection

Did you know that exposure to sunlight during the winter months puts you at the same risk as exposure during the summertime? There are a number of things you can do to prevent sun damage in any season. This is a short list of the things you can do to control sun damage to your skin:

1) Seek shade between 10 AM and 4 PM. This is the time of day that the sun’s rays are at their strongest and can do the most damage.

2) Cover up; don’t spend a lot of time in the sun with a bathing suit on. Cover up with towels, tee shirt or robe. Areas of your body that have not seen the sun in a long time are vulnerable to the sun’s damage.

3) Wear wrap-around sunglasses; use the kind that block as close to 100% of UVA rays as possible.

4) Use a hat with a wide brim to shade your face, head, ears and neck. If your hair is thin or you are bald or balding, the uncovered areas of your scalp can sustain a bad burn.

5) Use sunscreen with sun protective factor (SPF) 15 or higher on any skin areas that will “see” the sun.

Sun Damage to the Skin

We often link together a glowing complexion or sun-tanned skin with good health. If you are a “sun worshiper”, damage to your skin from days in the sun or a tanning booth may not become apparent until later in life.

Exposure to the sun causes a variety of conditions to occur; these are:

• Pre-cancerous and cancerous skin lesions caused by the loss of the skin’s ability to fight off disease

• Benign skin tumors

• Discoloration of the skin, including freckles

• Skin lines, including fine and course wrinkles

• Blood vessels that may raise closer to the surface and dilate under the skin

Senior Health & Fitness Day: Healthy Weight Management

Today is Senior Health and Fitness Day and in support we've posted one of our Here's to your Health presentations on Healthy Weight Management.

Obesity has doubled among the population aged 65 and older since 1987. A Task Force of the National Institutes of Health (NIH) estimates that more than 25% of American adults are obese and therefore at risk of heart disease, Type 2 diabetes, high blood pressure, stroke and some forms of cancer.

What is Obesity vs. Being Overweight?

Most people believe that obese is being very overweight, but it is not that simple. In fact, “overweight” is defined as an excess amount of body weight that includes muscle, bone, fat and water. “Obesity” is specifically an excess amount of fat. Bodybuilders, for example, with a lot of muscle can be overweight, but not obese.

A certain amount of body fat is necessary for heat insulation, shock absorption and other body functions. Women as a rule have more body fat than men, and so the proportion of fat considered “healthy” varies by gender. The current standard is that men with body fat more than 25% and women with more than 30% body fat are obese.

Measuring the exact amount of body fat is not easy. The US Preventive Services Task Force recommends using the body mass index (BMI), which is simply weight adjusted for height. As an example, go to the BMI table, and then find your height in the far left-hand column. Then find your weight to the right of your height, and look at your weight group and classification. Are you normal, overweight or obese?

If you are obese, you are more likely to suffer from: gallbladder disease and gallstones; liver disease; osteoarthritis-the result of excess weight on the joints; gout; pulmonary or lung problems-including sleep apnea; and, if a woman, you are at more at risk for cancer of the gallbladder, breast, cervix, uterus and ovaries.

Are You an Apple or a Pear?

Research tells us that not only how much fat a person has is a predictor of risk, but also where that fat is stored on the body. Women typically collect fat in their hip and buttocks, giving them a “pear” shape. Men usually build up fat around their bellies, giving them more of an “apple” shape. Of course men can become more pear-shaped as they age, and some women become more appleshaped after menopause. However, an apple shape is a predictor of heart disease. If you carry fat around your waist you are more likely to develop health problems. Among Asian Americans or persons of Asian descent a waist measurement is a better predictor of disease than using the BMI index.

Measure your waist:

• Women with a waist measurement of > 35 inches,

• Men with a waist measurement of >40 inches are at greater health risk, particularly for heart disease and stroke.

What Causes Obesity and Being Overweight?

Both obesity and being overweight occur when you consume more calories than you burn. However, genetic, environmental, psychological and other factors play a role.

Genetics: Obesity and being overweight does tend to run in families, suggesting a genetic cause. Remember that families do share diet and lifestyle habits that contribute to the problem. Research is beginning to show that heredity can be linked to obesity.

Environment: Lifestyle, such what a person eats and your level of physical activity strongly influences your weight - so genes need not to destine people to lifetimes of obesity. People can change eating habits and levels of activity.

Psychological: Many people respond to negative emotions such as anger, boredom or sadness by eating. Most overweight people have more psychological problems than people of average weight.

Other Causes: Some illnesses also lead to obesity as well as a tendency to gain weight. These include hypothyroidism, Cushing’s syndrome, depression and certain neurological problems. Drugs such as steroids and some antidepressants can also cause weight gain.

Who Should Lose Weight?

The standard in US healthcare is to lose weight if your BMI is 30 or more. If your BMI is between 25 and 29.9, prevention of weight gain is recommended unless your doctor recommends weight loss due to other health factors.

Fortunately, a weight loss of only 5-10% can improve health! The NIHrecommends if you are obese that you lose 10% of your baseline weight (the weight you are now that classifies you as “obese”) at a rate of 1-2 lbs/week. If you are overweight, reduce calories by 300-500/day and you should have a loss of .5 lbs per week.

What Happens 6 Months After You Start Losing Weight?

We now know that in general after 6 months of weight loss, the rate at which weight usually declines does plateau. If you need to lose more weight, it will take intense management and discipline on your part to watch your diet, sustain physical activity and behavior control. This is now the weight
management stage, and you are considered successful if you regain less than 6.6 pounds in the next 2 years and sustain a waist reduction of 1.6 inches from your waist measurement when you started.

Eating for Successful Aging-5 Simple Suggestions:

Loss of weight and sustaining weight is never easy, but the following are 5 suggestions that represent lifestyle changes that help you.

1. Eat plant-based foods: Healthy eating plans includes include foods with whole grains, fresh vegetables, fresh fruit and beans, nuts and seeds.

2. Drink water: Age increases your sense of thirst. By the time you feel thirsty, you are already slightly dehydrated. So drink until you have had enough, and then drink a little more. Although a common guideline says drink 8 glasses a day, a better individualized amount of how much water
you need is to divide your weight in half – this is the approximate amount of fluid ounces you need daily. Remember that drinks with alcohol or caffeine do not count – they only make you urinate more!

3. Watch fat, cholesterol and sodium: This guideline is particularly important for women. Women on average lose more muscle and gain fat more than men do. Therefore, women need to watch the intake of the following fats even more closely:

a. Saturated fat: butter, cheese, whole milk, meat, cream, poultry, chocolate, lard and solid shortening all have saturated fat and raise your cholesterol.

b. Polyunsaturated fat: while vegetable oil lowers polyunsaturated fats, it also promotes oxidation. Oxidation enables cells in your arteries to absorb fat and cholesterol. Over time oxidation builds up plaque, narrowing your arteries.

c. Monounsaturated fat: Olive oil, canola oil and nuts contain this fat that may help lower blood cholesterol. It is a good idea to control all types of fat, but when do you add fat to your diet,
choose monounsaturated fat.

d. Sodium: You need only a small amount of salt in your diet – less than one quarter teaspoon daily to help regulate fluid balance. Controlling sodium can be as easy as limiting processed foods, and carefully watching how much salt you add to foods when cooking and eating.

4. Watch calories: As you age your metabolism slows and fat accounts for a greater proportion of weight. This reduces your need for calories. Don’t forget this fact. On average women gain a pound per year after age 35.

5. Consider supplements: Talk to your doctor about certain vitamin or mineral supplements. Especially important are calcium, Vitamin D, C and E, selenium and co-enzyme Q10-all antioxidants. Do NOT decide on your own about these supplements, as taking too much is dangerous.

These five simple suggestions and making a few adjustments for aging can make the issue of being an apple or a pear a discussion solely for produce section of the grocery store and not your doctor’s office!

References

“Obesity and Other Chronic Conditions Drive Medicare Spending Increases” Diabetes, Obesity and CVD American Diabetes Association November 2006

"Successful Aging" Mayo Clinic Health Information, 2000

"The Practical Guide-The Identification, Evaluation and Treatment of Overweight and Obesity in Adults" National Institutes of Health – National Heart, Lung and Blood Institute North American Association for the Study of Obesity October 2000

“USPSTF Recommends Obesity Screening for all Adults” Medscape Medical News 12/01/03

“Understanding Adult Obesity: Do You Know the Health Risks of Being Overweight?” Briefings on Patient Safety National Institutes of Health 2000

New Commercial for the Month of May

Click here to check out our new commercial that starts airing today on Lifetime and USA!

Tips for Caring for Your Heart and Preventing Heart Disease

February is Heart Health Month, an entire month dedicated to caring for our hearts and preventing heart disease. Heart disease involves any disorder that affects the heart's ability to function normally. The most common cause of heart disease is narrowing or blockage of the coronary arteries, which supply blood to the heart. Other causes of heart disease include problems with the heart valves, abnormal electrical rhythm of the heart and weakening of the heart's pumping. As we age there are many diseases and conditions that affect our hearts and we want you to learn how to recognize if you are having problems with heart disease and how to help control any heart disease you may have. This information is tailored to an older adult who may possibly be living with heart disease, and in sharing this information; we hope to guide you on the path to preventing complications and managing heart disease and to living a happy, healthy life.

Some of the reasons that people get heart disease are not in their control, such as family history, age and race. However, there are many ways you can control the development and seriousness of heart disease. Because the disease is so common (it is the number one cause of death of men and women over 85) many older adults may already have heart disease and not even know it. It is also common not to have any signs while heart disease is developing, so it is extremely important to know your risk factors and ways to manage them. Lifestyle issues such as smoking, obesity (being overweight), high cholesterol, lack of exercise, high blood pressure and uncontrolled diabetes can all lead to problems with your heart. We know that making changes in your lifestyle is not an easy task, but no matter what your age, by making changes you can improve your health and reduce the chance that heart disease occurs or becomes more problematic.

There are many ways you can improve the health of your heart. The first change you will need to make is to quit smoking. Because people who smoke have more than twice the risk for heart attack, this is a powerful way to slow heart disease and reduce symptoms of existing heart disease. Secondly, you may need to improve your cholesterol levels and lower your blood pressure. Because the fat from cholesterol and damage from high blood pressure can lead to heart problems such as coronary artery disease and congestive heart failure, eating a diet low in fat and exercising is extremely important. To lose weight and improve your health you will need to eat foods such as fish, vegetables, fruits and whole grains. You can lower your chances of getting heart disease by carefully choosing the foods you eat. Be sure to speak with your health care professional before beginning any diet program. For a healthy heart eat:

Less Fat
Some fats (saturated) are more likely to cause heart disease.
Eat less of foods containing:
• Animal fats such as meat, milk, cheese and butter
• Palm and coconut oils
Eat more of foods containing polyunsaturated & monounsaturated fats:
• Olive, canola, safflower and corn oil
• Seafood

Less Sodium
This can help to lower some people’s blood pressure as well as reduce the risk of heart disease. Avoid adding salt to foods at the table; many already contain sodium, which was added during preparation.

Fewer Calories
If we eat more calories than our body needs then we gain weight. Being overweight can cause heart disease. In order to lose weight, eat fewer calories.

More Fiber
To lower your chances of getting heart disease eat more foods containing fiber such as:
• Fruits
• Vegetables
Grain

Exercise not only helps you lose weight but also strengthens the heart and improves blood flow. It is safe for most adults over the age of 65 to exercise. Even people with chronic conditions such as heart disease, high blood pressure, diabetes and arthritis can exercise safely; in fact, many of these conditions are improved with exercise. Even leisure-time activities such as gardening, walking and dancing are good for our hearts. If you are not sure if exercise is safe for you, please ask your health care provider. Exercise can be fun and helps to reduce stress, which can be a common problem for people with heart disease. Managing stress can help to reduce heart disease symptoms as well as help prevent feelings of depression, another common complication for those diagnosed with heart disease. Be sure to speak with your healthcare provider if you are experiencing signs of depression such as feeling sad, trouble sleeping, wanting to be alone, or feeling worthless or helpless.

Normally blood flows freely inside your heart’s arteries, which are like hollow tubes. As you grow older, fat and other substances build up along the walls of these tubes, causing narrowing and hardening; this build up is called plaque. Coronary artery disease is the clogging or narrowing of the blood vessels that bring blood to our hearts; if the heart doesn’t get enough blood it becomes starved for oxygen and cannot work properly. Lack of oxygen causes the heart to cramp during activities such as exercise, eating and excitement, when your heart needs extra oxygen. The most common symptom of coronary artery disease and lack of oxygen is angina, which most people say feels like bad heartburn. Angina causes the sensation of pressure in your chest, but it is also common to feel aching, burning, fullness and pain. Angina discomforts may also be felt in the left shoulder, arm, throat and jaw or in your back. If you have angina pain for the first time or if you are already taking medication for angina and it does not relieve your pain, you should seek help immediately.

Another serious condition that can affect your heart is called congestive heart failure. Heart failure is when your heart can no longer pump enough blood to your body, or, when the heart cannot stop blood from “backing up” in your lungs. In most cases heart failure occurs over time and can have many different causes. One of the most common causes of heart failure is an abnormal heartbeat called an arrhythmia. Patients sometimes describe an arrhythmia as their heart beating too fast, fluttering or skipping a beat. Although it is important to see your doctor if you have had any of these symptoms, it is common as you age to have arrhythmias. Other causes of heart failure include: high blood pressure, abnormal heart valves, alcohol or drug abuse, damaged heart muscle or damage to the lungs. Symptoms of heart failure include feeling tired, an irregular heartbeat, loss of appetite, confusion, nausea, coughing or wheezing that doesn’t go away, shortness of breath and swelling of the feet, legs or stomach. Again, it is very important to see your doctor if you experience any of these problems. With congestive heart failure your doctor may recommend limiting your fluid intake in order to reduce the stress on your heart. Weighing yourself daily will also be an important tool in managing congestive heart failure.

One more complication we would like to mention is vascular disease or disease of the blood vessels. Vascular disease is included in the discussion on heart disease because it can eventually lead to heart failure or even a heart attack. There are many different types of vascular disease, each with separate causes and symptoms, but what is important to remember is that any condition that affects your arteries, veins, lymph vessels or blood can affect your heart. Blockage of arteries in your body, abnormal bulges in your vessel walls (aneurysm), certain diseases, varicose veins and blood clots or clotting disorders all place you at a higher risk for heart disease.

After studying the results of your tests your doctor may prescribe medications to help treat or prevent heart disease. There are many different kinds of medications, some are used to lower blood pressure and cholesterol while others rid your body of excess fluids, which put stress on your heart. Each person is unique as is the treatment of his or her heart disease. Although we cannot possibly describe every medication and how it works, we do have some simple suggestions to help you safely use the medications prescribed to you. Keep a list of your medications and how much you are taking with you at all times, this is important in case you experience complications or illness and need to go to the hospital. It is also important to tell your health care team about additional medications you are taking, such as: vitamins, herbals and dietary supplements. If you have allergies to any medications or have had a problem when taking a particular medication in the past, this is also important information to share. If cost is a concern, there may be another medication that costs less, yet works the same. Ask questions about every new prescription medication and be sure to get the answers you need before taking the medication. Know what your edication is for. It is also important that you take your medication when scheduled and at the same time every day. Some medications are more effective when taken at a certain time of day, so scheduling is key. Also, some medications may work better if taken with food and others may react with certain types of foods or with other medications so be sure you follow instructions. Do not skip doses or stop taking your medication unless you speak with your doctor first. Filling a pillbox is a great way to keep medications organized and help you to remember times and dosages. It is also not safe to take over-the-counter or herbal remedies unless approved by your doctor. Before having surgery be sure to let the doctor or dentist know what medications you are taking, because some heart medications may cause excess bleeding. Also, some medications may cause dizziness, so be sure to stand up slowly, especially when getting out of bed. In sharing these tips we hope to help you prevent complications from medication errors, and live a healthier life.

The prevention of infection is of utmost importance to people who have heart disease. By getting vaccinations that protect against flu and pneumonia you can lower your risk of infection related complications that could further damage your heart. Protecting yourself against infections such as the common cold is as simple as washing your hands. Be sure to use soap and warm water and lather up for at least 15 seconds and a great tip for anyone during cold and flu season is to avoid others who appear sick. Knowing the symptoms of the common cold and the flu will allow you to know when there is a problem and when it is time to notify your doctor. A high fever, accompanied by a headache, body aches and pains, fatigue and chest discomfort such as coughing may be the flu. The flu can produce many severe complications, such as pneumonia, so be sure to call your doctor if you experience these symptoms.

The final topic is cardiac emergencies. There are different types of emergencies, but we are going to focus on heart attack. A heart attack occurs when the heart does not get enough oxygen due to blocked arteries; remember that plaque that caused narrowing? Due to the lack of oxygen some of the heart muscle dies, and if too much of the heart is damaged, it can cause sudden death. A heart attack requires immediate attention! For most people symptoms of a heart attack include severe chest pain that may also be felt in the back, jaw, throat or arm. Other symptoms include heartburn-like sensation, sweating, nausea and vomiting, problems with breathing, feeling dizzy, weak or anxious. If you are having chest pain and have been diagnosed with angina, it is important to take your nitroglycerin as prescribed. If you think you are having a heart attack call 911 or emergency services right away. If your heart stops beating, or is quivering instead of beating, you will need to receive defibrillation. Defibrillation assesses your heart rhythm and delivers an electric shock in order to correct it. If a defibrillator or AED device is not available, CPR is another method to help someone whose heart has stopped. CPR does not “restart” the heart, but it helps to deliver oxygen and circulate blood until help arrives. Once you arrive at the emergency room doctors will perform an ECG and do several blood and other tests. Quick treatment is important to save the heart from permanent damage. Treatment may include any of the various medications, procedures, surgeries and/or devices that we have mentioned throughout our discussion and there are also many more options available that we didn’t discuss. If you have already had a heart attack you may be able to prevent having another one; this is where the lifestyle changes we discussed are so important. We at Interim HealthCare are available.

References
Allender, J., & Spradley, B. (2005). Community Health Nursing (6th ed.). Philadelphia:
Lippincott Williams & Wilkins.
American Heart Association. (2005). Diseases and Conditions. Retrieved November 3,
2005, from http://www.americanheart.org
Black, J., Hawks, J., & Keene, A. (2001). Medical-Surgical Nursing (6th ed.).
Philadelphia: W.B. Saunders Company. Allender and Spradley.
Cardiology Channel. Congestive Heart Failure. Retrieved November 8, 2005, from
http://www.cardiologychannel.com
Cass, P., Luckmann, J., Nigro, C., Schlapman, N., & Timby, B. (2002). Content Mastery
Series Registered Nurse Medical-Surgical Review Module (4.1 ed.). United States:
Assessment Technologies, LLC.
Cleveland Clinic. (2005, July). Recovery after heart surgery. Retrieved November 10,
2005, from http://www.clevelandcling.org/heartcenter
Jarvis, C. (2000). Physical Examination and Health Assessment (3rd ed.). Philadelphia:
W.B. Saunders Company.
Porth, C. (2002). Pathophysiology Concepts of Altered Health States (6th ed.).
Philadelphia: Lippincott Williams & Wilkins.
WebMD. (2005, October). Heart Disease: Your Guide to Heart Disease. Retrieved
October 27, 2005, from http://mywebmd.com
MedlinePlus. (2004, February 1). Nitroglycerin Tablets, Capsules, and Sprays. Retrieved
November 10, 2005, from National Institutes of Health Web Site:
http://nlm.nih.gov
Additional resources include JCAHO.org and FDA.gov

The Move Has Started!

The move has started and will be done by the end of the weekend, so we can be fully operational out of the new office starting Monday February 1st, 2010.

Walk and Roll for Disabilities

Interim HealthCare of Omaha is sponsoring KellyLynn for this years Walk and Roll for Disabilities. The walk raises money for the C. Louis Meyer Rehabilitation Foundation, which helps poeple with developmental disabilities, by supporting programs at the Monroe-Meyer Institute.

KellyLynn is this years honorary captain, and those who sign up through Interim will be privileged to walk on her team.

The walk takes place, Sunday, Febuary 21st at 10:30am on the second floor of the Westroads Mall.

Please click on the link below to learn more and make a dontation. All donations are secure and go directly to the C. Louis Meyer Rehabilitation Foundation.

http://firstgiving.com/kellylynnwakehouse

GO TEAM KELLYLYNN!

The Road to Driving Safety: How to survive winter's hazards

from Interim HealthCare's HealthCare Professional Digest

Over the long months of warm weather, we forget how to drive safely when winter rears its sometimes ugly head. Sleet, snow, freezing rain and street ice all pose dangers for even experienced drivers.

And, as a home healthcare professional or hospital staffing nurse, you don't have the luxury of pulling the bed covers over your head and waiting for the mess to thaw. You have patients who need you, regardless of the weather.

So, here are some ways you can keep yourself safe, no matter what winter throws your way.

Before you get behind the wheel

If you haven't already, you should immediately "winterize" your car. Having it prepared for cold weather will help you get your car started -- and keep it safely on the road. So, be sure to:

• Ask your mechanic to check your car's battery, antifreeze, wipers/windshield washer fluid, ignition system, thermostat, lights/hazard lights, exhaust system, heater, brakes, defroster and oil level/weight.
• Inspect your tires for adequate tread.
• Put a windshield scraper and small broom in your trunk for ice and snow removal.
• Put together a car kit including: a flashlight and extra batteries, first aid kit, blankets, newspapers for insulation, matches, warm clothes, small tools, booster cables, brightly colored cloth, canned fruit and nuts, nonelectric can opener and bottled water.
• Put a few bags of sand in your trunk over the rear axle if you have a rear-wheel-drive vehicle. Line them up with the center of your wheels. If you drive a front-wheel-drive car, forget the sandbags.
• Know how your car handles ice and snow. If you're not sure, go to an empty, ice- or snow-covered parking lot and practice. Slam on your brakes, try to turn into the skid and see what happens. And keep on doing this until you know how to regain control of your car.
• Don't go anywhere with less than a half-tank of gas. If you get stuck or stranded, the engine will be your only source of heat. Plus, keeping your tank close to full will prevent warm daytime temperatures from filling empty space in the tank with moisture, which can condense during the cold night and, sooner or later, rust out your tank.

Rolling, rolling, rolling

Once winter comes, there's always the possibility of encountering adverse road conditions. And just like it's not very smart to drive around with the convertible top down during the winter, you have to adjust your driving tactics and techniques if the weather turns nasty.

For instance, in inclement weather, you should:

• Listen to your radio or call the state highway patrol for the latest road conditions.
• Give yourself some extra time.
• Clear snow and ice from all your windows and lights, as well as the hood and roof -- before driving.
• Never warm up your car in an enclosed area (carbon monoxide can quickly build up).
• Always wear your safety belt.
• When snow's on the ground, and the day's very bright, wear sunglasses.
• Start out in the lowest gear recommended by your vehicle's manufacturer.
• Decrease your driving speed and proceed according to road and weather conditions.
• Keep your headlights on. (But never use your high beams since they reflect the snow and make it more difficult for you to see.)
• Leave plenty of room between your car and the one in front of you, and brake early.
• Be extra careful when crossing bridges. They really do ice up first.
• Look farther ahead in traffic. What other drivers do can alert you to problems and give you extra time to react to them.
• Watch electronic highway signs for information
• When it's freezing or below, don't use your cruise control or overdrive. Touching your brakes to deactivate cruise control can cause you to lose control of your vehicle if you're on ice or snow. Overdrive automatically accelerates or downshifts your car when you're on a hill, and that can cause a loss of traction.
• Don't think you're indestructible just because you have four-wheel drive. Four-wheel drive may help you get to your destination quicker, but it won't help you stop any faster if you hit an icy spot.
• Never pump anti-lock brakes. Instead, "stomp and steer."
• Unless it's absolutely necessary, never pass a snowplow or salt/sand spreader.
• If driving conditions worsen, turn on your four-way flashers, get off the highway to a safe area and wait for the visibility and road conditions to improve.

I never thought it'd happen to me

Despite your best efforts, you might find yourself trapped in bad weather. Don't panic. You can get through this, too, if you:

• Stay in your car unless help is visible within 100 yards.
• Hang a brightly colored cloth on your radio antenna, and raise your car's hood.
• Run your car's engine and heater for about 10 minutes each hour. You can also turn on your car's dome light at the same time if you need to.
• Clear snow from the exhaust pipe periodically, and open a downwind window slightly to prevent carbon monoxide poisoning.
• Watch for any signs of frostbite, hypothermia or dehydration.
• To aid in circulation, clap your hands and move your arms and legs from time to time.
• Use newspapers, maps and car mats for added insulation.
• Don't overexert yourself. Shoveling snow from your car or pushing your car can bring on a heart attack if you're not in tip-top shape.
• Always carry a cell phone. If you don't want to sign up for a plan, invest in a pre-paid cell phone. You can get one for $30 or so, and some companies have calling cards you can purchase for as little as $10 for a month's activation. A few even allow you to make 911 calls if you don't have any time left on your card -- as long as you did an initial activation when you purchased the phone and first loaded up time. But make sure you get a card without an activation fee. Once the bad weather is over, you can just put the phone away until winter comes back to town.

By following these tips you should be able to "weather" winter and all its hazards just fine. But if the thought of driving on ice and snow still gives you goose bumps, the Car Talk Guys offer a sure-fire way to get around safely during those months between November and April -- move to Hawaii.

Sources: Washington State Department of Transportation, TDC Marketing and Management Consultation and Car Talk.