Activity Directors - Aging Related Vision Problems - APNCC.org AD Credentialling Center - NAPT Activity Certification Class Starts Feb 2nd 2021 Activitydirector.org

Aging Related Vision Problems There are a number of common aging related eye diseases that may affect visual acuity of our elderly population and thus, make it more challenging for residents to fully participate and engage in facility programs. It is not unusual for residents to be reserved about admitting that they are dealing with visual problems and equally not unusual for visual problems to develop later after the resident has been admitted to the facility. For this reason, the IDT Interdisciplinary Team members will closely monitor new admissions for developing health issues, whether aging related or other health concerns, that may present either prior to or after admission. The director of resident programming (Activity Director) is part of that IDT team keeping watchful eyes over our senior population while delivering individualized resident care plans. For this reason, these professionals need to make it a priority to understand the individualized resident’s needs, desires, and overall health status. Treatment and follow-up for visual difficulties will fall under the clinical team however, as a director of facility programming, you will need to know about visual issues so that you may anticipate and plan for interventions/adaptations to ensure that your resident will not miss out on programs they would otherwise fully enjoy. Common Eye Conditions Age-Related Macular Degeneration (AMD) Floaters Pink Eye Retinal Detachment Refractive Errors Dry Eye Glaucoma Diabetic Retinopathy Cataracts Amblyopia (Lazy Eye) Color Blindness What is AMD – Age-Related Macular Degeneration? Age-related macular degeneration (AMD) is an eye disease that can blur the sharp, central vision needed for activities like reading and driving. “Age-related” means that it often happens in older people. “Macular” means it affects a part of your eye called the macula. AMD is a common condition — it’s a leading cause of vision loss for people age 50 and older. AMD doesn’t cause complete blindness, but losing your central vision can make it harder to see faces, drive, or do close-up work like cooking or regular housekeeping duties. AMD happens very slowly in some people. Even early onset may not cause vision loss for a long time. For other people, AMD progresses faster and can lead to central vision loss in one eye or both eyes.   What are the symptoms of AMD? As AMD progresses, many people see a blurry area near the center of their vision. Over time, this blurry area may get bigger or may present blank spots. Things may also seem less bright than before. Some people may also notice that straight lines start to look wavy. This can be a warning sign for late AMD. Eye doctors can check for AMD as part of a comprehensive dilated eye exam. The exam is simple and painless — some eye drops are given to dilate (widen) pupils to allow for examination for AMD and other eye problems. AMD Risk Factors Early AMD does not consistently present with warning symptoms, so eye exams are crucial to prevent permanent vision loss. Risk for developing AMD will increase with age. Individuals over age 60 are more likely to have AMD. The risk for AMD is also higher for those that: Have a family history of AMD Are Caucasian Smoke What’s the treatment for AMD? There’s currently no treatment for early AMD, the individual will be monitored to keep track of any changes during regular eye exams. Eating healthy, regular exercises, and quitting smoking may somewhat contribute towards preventing progression. Adaptations/Interventions Special tools can help people with low vision to read, write, and manage daily tasks. These tools include large-print reading materials, magnifying aids, closed-circuit televisions, audio tapes, electronic reading machines, and computers with large print and a talking function. Offer the resident with visual deficits to sit closer to the subject of interest. Such as white-boards, television screen, exercise group leaders, and BINGO boards, etc., Other tips that may help: Increase/brighten environmental lighting (diminishes shadowing). Write with bold, black felt-tip markers. Use paper with bold lines to help write in a straight line. Use colored tape on the edge of stairs (often reflective tape) to increase visibility and aide in fall prevention. Install color contrasting switches (dark-colored light switches and electrical outlets against light-colored walls). Use motion lights that turn on when entering a room. Auto-on lights in any room will prevent falls and increase “infection control” prevention because it keeps residents from touching these receptacles throughout the day. Offer large-print items such as books and directional signs as well as cell phones and clocks. Source: https://www.nia.nih.gov/health/aging-and-your-eyes?utm_source=nia-mailchimp&utm_medium=email&utm_campaign=healthyaging-20210118 https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/age-related-macular-degeneration Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org

Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network.

Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2010 US HWY 190 W Ste 120 Livingston, Texas 77351

 

Food Service regs have changed for your Residents? Person-Centered Care at work! by Kathy Hughes, ADC Instructor - ActivityDirector.org

I was recently passed an interesting article from our instructor Kathy Hughes, ADC that I think we can all relate to. Nursing home food is often compared with hospital food and is rarely accused of being appetizing. However, the nationwide push to make care homes more person-centered has extended well beyond care and is now attempting changes in the dietary department. It may be hard for some to believe but prior to November 2016 family members weren’t allowed to bring outside food in. The value of sharing recognizable comfort food with a loved one in the throes of dementia could easily be recognized by the family, but couldn’t be executed until this all important CMS update in 2016 that was over 20 years in the making. According to the article: The new and modified regulations explicitly state that menus at facilities participating in the Medicare and Medicaid programs must now reflect the religious, cultural, and ethnic needs of residents, be updated periodically, and undergo review by a dietician or nutrition professional (who, according to the new regulations, have higher certification requirements than in the previous iteration). Also, for the first time, nursing homes can officially grow their own food or buy it directly from local producers, and allow residents to eat food brought in by friends and family. Finally, meals and snacks can now be served whenever works best for the residents, not just at designated feeding times. The changes these updates are making can be felt already in many homes, perhaps even yours. Rather than regular American staples day in and day out residents are now enjoying more ethnic foods being served right in their dining rooms. The ability to participate in CSA (community supported agriculture) programs opens a whole new way to plan activities for your community as well, providing pathways for field trips, vegetable, fruit and herb education, harvesting and preparation, increased health education and the lists goes on and on. Better food isn’t just about better taste and nostalgia either. Nutrition is critical in determining how one’s life will unfold particularly at this leg of life. Fresh and accessible food, from a variety of trustworthy sources increase intake in general and nutritional levels greatly. The article discusses many advantages to these CMS updates, but its central point remains that the boost in mental well-being received by these residents is really what counts. The ability to feel autonomous and to be reminded of the good times in life go a long way in contributing to joy. A care home should not feel like a jail and access to a variety of food and lifestyle experiences is a basic freedom. The updates are a huge step in the right direction however there is a stark difference between policy change and implementation. Positive effects are being felt as are the negative effects that variety can have on an ever decreasing dietary budget. The article references some worst cases scenario numbers that come in at less than $1 per meal. Think about that. Staffing issues also remain a concern that block many attempts above and beyond the norm of how things have always been. Even still, these changes are good changes and they were a long time coming. It allows residents to remain in contact with food, which is such a cornerstone of all of our lives and interactions therein. It is true progress and I for one was fascinated to read the article. I grew up in an Activity Department because my Mom was an Activity Director and I can remember the food vividly. I really hadn’t realized that food could be or was regulated in that way and that dietary had such restrictive guidelines and budgets (even though I should have because my Mom’s best friend Debbie was the Dietary Manager and she complained about it constantly!). I am glad to see these changes going into place and it gives me great hope about the type of facilities we are all pushing for together. The future is certainly brighter….and tastier. Article Referenced: Nursing home food is getting better. But the journey is far from over. by Jillian D' Onfro Nov. 27, 2017 Read the Article

ENROLL Now Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. Activity Directors are the key to creating environments that we ourselves would be excited to live in. We envision facilities that feel like homes, not institutions. Facilities that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe providing the best education available, with the most talented teachers we can find, is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network.

Copyright © 2019 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2010 US HWY 190 W Ste 120 Livingston, Texas 77351

Dehydration and the Elderly - Activity Planning During a Heat Wave by M. Celeste Chase, AC-BC, ACC, CDP

Dehydration and the Elderly A widespread blanket of increasing rising temperatures is expanding across much of the country. . . . And of course, hot weather always increases the risk of dehydration. Older aging populations are vulnerable to climate change-related health impacts for a number of reasons. The body’s normal aging process causes the body’s systems mechanisms, that are meant to protect us from dehydration, to work less efficiently as we age. The elderly population does not have the same internal thirst signals with age progression and consequently do not take action to reach the necessary liquid consumption. Experts generally recommend that older adults consume at least 57.5 fluid ounces or 7.1 cups within a 24 hour period. (https://link.springer.com/article/10.1007/s12603-009-0023-z) NOTE:  Elderly people should not be encouraged to consume large amounts of fluids at once but rather small amounts throughout the day. Factors that put older adults at risk for dehydration include (includes but not limited to): Chronic problems with urinary continence, which can make older adults reluctant to drink a lot of fluids. Memory problems, which can cause older adults to forget to drink often, or forget to ask others for something to drink - even mild dehydration, can cause noticeable worsening in confusion or thinking skills. Mobility problems associated with aging, such as muscle and bone loss, which can make it harder for older adults to get something to drink. Older adults are more likely to be taking medications that increase the risk of dehydration, such as diuretic medications, which are often prescribed to treat high blood pressure or heart failure. Dehydration can also be brought on by an acute illness. Older adults are also more likely to have a chronic health condition, such as diabetes, that requires medications for treatment. Vomiting, diarrhea, fever, and infection are all problems that can cause people to lose a lot of fluid and become dehydrated. Dehydration also often causes the kidneys to work less well, and in severe cases may even cause acute kidney failure. Additionally, chronic mild dehydration may further exacerbate constipation problems. Physical signs of dehydration may include: high heart rate (usually over 100 beats per minute) low systolic blood pressure dry mouth and/or dry skin in the armpit less frequent urination dark-colored urine delirium (new or worse-than-usual confusion) sunken eyes Caffeine and Dehydration Coffee or Tea please!  We all know only too well how important it is for our seniors to enjoy a nice cup of coffee or tea while gathering in morning socials to shake off those morning cob webs and get ready for the day’s events.  Is there any other way to start the day? Technically caffeine is considered a weak diuretic. By definition, a diuretic is a product that increases the body’s production of urine. Hence water, or any drink consumed in large volumes, is a diuretic. It should be noted that urinating more does not inevitably lead to dehydration (excessive loss of body water). http://theconversation.com/health-check-does-caffeine-cause-dehydration-73965 Current studies suggest that caffeinated coffee or tea is not proven to be particularly dehydrating in people who drink them regularly. Caffeine, however, may worsen overactive bladder symptoms, so there may be other reasons to be careful about fluids containing caffeine for our senior population. Feel free to offer decaffeinated drinks but if an older person particularly loves his/her morning cup of (caffeinated) coffee, there is no reason why they cannot partake unless it is physician ordered to avoid such liquids. Help Them Stay Hydrated Here are some reasonable approaches to help your seniors remain hydrated during current rising temperatures: Identify continence issues that may make the older person reluctant to drink. Consider a toileting schedule, which means helping the older person get to the bathroom on a regular schedule. This can be very helpful for people with memory problems or mobility difficulties. Offer fluids in small amounts throughout the day; consider doing so on a schedule. Ensuring the appeal of the beverages you offer – they will drink more if they enjoy it. Determine if your senior prefers drinking through a straw. Enlist interdisciplinary staff in your efforts. Track in a journal how much the person is drinking; be sure to note when you try something new to improve fluid intake. Offer more fluids when the senior is ill (seek nursing oversight). Reducing Swallowing Problems By Making Liquids Thicker While you focus on actions to prevent dehydration issues be mindful of anyone with a swallowing disorder, often experienced in the elderly.  Normal aging causes reduced muscle tone in the pharynx and esophagus and other changes that affect swallowing. Thickened drinks are normal drinks that have a thickener added to make them thicker. They are often recommended for people who can no longer swallow normal fluids safely, because normal drinks go into their lungs, causing coughing, choking or more serious risks such as chest infections and aspiration pneumonia (seek nursing oversight). More Ways to Keep Seniors Cool in Hot Weather Offer a cooling snack like popsicles (use cupcake liner to catch drips). Place a cool washcloth on the back of the neck and a pan of cool water close by to periodically re-cool the towel. Meals should be cold like chicken or pasta salad instead of heavy hot dishes like pot roast. Encourage clothing that is lightweight and in light colored cotton so it’s easy to adjust to the temperature throughout the day by removing layers of clothing. https://dailycaring.com/10-tips-to-keep-seniors-cool-in-hot-weather/ Calendar Programs Older people can have a tough time dealing with heat and humidity. The temperature inside or outside does not have to reach 100°F (38°C) to put them at risk for a heat-related illness. Be mindful of the temperatures when planning programs. Restrict your events to locations that offer cool environments. For outings; seek senior-friendly places that offer air conditioning (Restaurants, Shopping Mall or Stores, Public Library, Art Museums, Movie Theaters). Senior exercise programs may need to shortened in duration and restricted to easy and simple range of motion programs to prevent over- exhaustion. Don’t forget the hydrating liquids!   Stay Cool!       Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org Introducing a NEW course from Best-Selling Teacher Kathy Hughes, ADC... ENROLL Now Our MEPAP 1&2 Courses   2 Course Formats www.ActivityDirector.org - 1.888.238.0444   Structured Class (16 Weeks) - Begins the First Tuesday of each Month Self Paced Class (13 Weeks-1 Year) - Enroll and Begin Anytime

Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network.

Copyright © 2019 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2010 US HWY 190 W Ste 120 Livingston, Texas 77351