Tag Archives: Trillium HomeCare

A Fond Farewell

To all the Trillium HomeCare staff, clients, fellow bloggers, and extended Trillium family, it’s time to say good-bye. After twelve incredible years, Trillium HomeCare will be closing operations. Making this decision has been extremely difficult but I will always be grateful for the many friends I have made along the way and for the wonderful memories I will take with me. To our clients, it has been an honor to serve you. We feel privileged to have been entrusted with your care. To our employees, your hard work and dedication to our clients have always made me proud to represent Trillium HomeCare. Providing our clients with the best care has been central to Trillium’s mission and couldn’t have been accomplished without your dedication to excellence. Take pride in your special calling as caregivers. I thank all of you and wish you the very best for the future.

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SAD and the Elderly

During the winter season, you need to be on the lookout for signs of SAD in your elderly loved ones. SAD is the acronym for “seasonal affective disorder”. This is a form of depression usually seen in the late fall and especially in the winter. It is more common in women and those people who live in colder climates which generally get less sunlight and shorter days. SAD is not that typical let-down feeling you get after all the holiday rushing around is over. It lasts for many weeks and is characterized by a loss of energy, lethargy, sadness, increased sleepiness and an increased desire to eat carbohydrates. Doctors and mental health professionals believe that SAD is caused by the shorter days and longer nights of winter which disturb the body’s natural sleep cycle and result in less exposure to sunlight. In addition, the vitamin D that is produced by our bodies is greatly reduced due to the diminished amount of sunlight in the winter season. Vitamin D deficiency has been linked to both depression and obesity. Decreased sunlight also increases the level of melatonin in our bodies which in turn increases a tendency to sleepiness and to some extent depression. Seniors are more likely to be affected by these factors since they often are housebound and generally less active outdoors during the cold winter weather. In addition, as they age, their bodies become less efficient in producing vitamin D. If your loved one has SAD, the doctor may prescribe antidepressants but there are non-pharmacological things that can be done to greatly improve your senior’s mood. Using a “light box” for 30 to 45 minutes a day decreases the amount of melatonin that circulates in the body. The light box mimics the light spectrum of natural sunlight and makes up for its shortage in the dark winter days. Be sure to keep blinds and curtains open as much as possible to let in what sunlight there is. Set the chairs and furniture your senior uses in a location closer to windows to take advantage of any sunny days. Be sure they eat foods rich in Vitamin D such as fortified milk, tuna, salmon, mushrooms, and eggs. Check with your doctor as to whether a vitamin D supplement is needed. Perhaps the most natural aid for SAD is simply getting more sunlight. If weather conditions permit and your loved one’s mobility can accommodate it, try to get them outside for a period during daylight hours, particularly on sunny days. Both the sunlight and the exercise can help relieve the symptoms of depression. What have you found to be helpful in dealing with SAD? Please share your thoughts below and visit at http://www.trilliumhomecare.com

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Surviving The Holidays

If you are caring for an elderly parent or a relative who can’t live on his or her own, you’ll soon been entering the most stressful time of the year for you. The traditional holiday season between Thanksgiving and New Year simply compounds your already stressful life in a number of ways. You’re already trying to keep the delicate balance between your job, your family life with its demanding schedule, and your efforts to properly care for your loved one. Add to this mix all the holiday preparations, family get togethers, and dicey winter weather, and you’ve got the perfect combination for caregiver stress. With some planning you can increase your chances of surviving or even enjoying the holidays.
Perhaps the best thing you can do is accept the fact that the holidays needn’t follow the same cookie cutter pattern every year. Different is okay. Endless days of cooking and baking followed by hours and hours of gift buying excursions aren’t necessary. Take some short cuts – shop online, order out, and enlist the help of family and friends. You don’t have to accept every holiday invitation you receive nor do you have to invite a massive crowd to family gatherings. Sometimes just dealing with family dynamics during gatherings can be enough to wear you down. There may be those who are long on criticizing what you do as a caregiver but short on actually offering any help. If so, take the opportunity to ask for help and be specific about what would be helpful to you. You may be surprised with a cooperative response. Don’t be shy about getting family members on board.
There are practical things you can do to make the season run more smoothly. Simplify, simplify, simplify. Cut back on how much holiday decorating you’ve traditionally done. Keep gatherings at a smaller, more manageable scale, and suggest potluck meals with everyone bringing a dish. Try to stay organized by keeping a to-do list to help you stay in control of your time. Adjust the time of day gatherings are held to accommodate what works well for your loved one. Don’t neglect yourself. Eat well and get enough sleep. Try to fit in some “me-time” so you can de-stress. Use the resources that are out there whether you call on family and friends or enlist the aid of an in-home agency. Give yourself a break. After all, caregivers deserve a holiday too. Do you have any tips for surviving the holidays? Share below and visit us at http://www.trilliumhomecare.com

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Seniors and Falls

According to the Center for Disease Control (CDC), in seniors over the age of 65, falls are to be blamed most often for non-fatal injuries and hospital admissions. Even worse, two thirds of senior accidental deaths result from injuries sustained from a fall. In hard numbers, that’s almost 20,000 deaths and more than two million emergency room visits at a medical cost of over $28 billion dollars a year. Of fall related injuries, hip fractures are the most common and have the most long term effects with only a quarter of seniors who suffer a hip fracture making a full recovery. Almost half of these seniors will lose their ability to walk and 40% of them will require care in a nursing home. This is definitely a major concern for our rapidly increasing senior population that needs to be addressed.

Preventive measures can be taken once you can identify the major risk factors for falls. Medical issues such as poor vision, heart disease, arthritis, dementia, and diabetic neuropathy can cause mobility and sensory problems that can lead to falls. General inactivity on the part of the senior also leads to muscle weakness and inflexibility and increases fall risks also. Certain behaviors, such as alcohol use and interactions of medications pose a fall risk. Perhaps the most controllable risk is the senior’s environment. This includes hazards in the home and improperly sized walkers and canes.

By reducing these risk factors, falls among seniors can be significantly reduced. Several studies have show that an exercise program such as Tai Chi combined with strength training exercises increases mobility and flexibility while increasing muscle strength. Basically, moving more allows you to not only move more but also to do so with increased safety. Having medications reviewed by the senior’s doctor and pharmacist can identify possible side effects and problematic interactions. If necessary, alternative medications may be prescribed. Taking vitamin D3 supplements has been shown to reduce the risk of sustaining a fracture among women. A comprehensive vision exam can detect the presence of glaucoma, macular degeneration, and other vision issues that can increase the risk of falls. The senior’s home can be modified by adding stair railing, increasing lighting, eliminating clutter, and removing scatter rugs. Adding grab bars in the tub/shower area provide stability for getting in and out of the tub. A combination of these strategies can reduce fall risks on many levels and go a long way toward allowing a senior to remain safely at home. Please share your thoughts below and visit us at http://www.trilliumhomecare.com

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When It’s Time for Home Care

There are a lot of guides available to help you decide if someone you care about has reached the point of needing outside help. If you do a web search for “time for home care”, an incredible list of sites appears with all kinds of signs to look for in your aging parent or loved one that will signal their need for help with daily living. These clues include poor personal hygiene, difficulty managing daily living activities such as housework and grocery shopping, missed appointments, and problems taking medications as prescribed. Although these clues are certainly important when deciding if you should look to professional help for your loved one, a consideration that is often overlooked is YOU.

If you’ve been your loved one’s primary caregiver, you need to assess your own condition also. According to the Family Caregiving Alliance there are over 44 million unpaid caregivers in America and they are definitely paying a price. The effects of being a caregiver are both psychological and physical. The strain of caring for a friend or relative who is frail or elderly causes significant clinical symptoms of depression in 40%-70% of all unpaid caregivers. Take some time to think about yourself. Do you feel stressed all the time? Do you feel frustrated, angry or hopelessly drained at the end of the day? Are you no longer in control of your own life? Are you becoming more isolated and do you continue to maintain social contact with friends and relatives … when did you last have some “me time”? Are all the hours of your day filled with obligations to your job, your family, and your loved one?

How are you doing physically? The stress felt caring for someone long term has been linked to elevated blood pressure, a compromised immune system, and heart disease. Is your blood pressure up? Do you seem to catch every cold or bug that comes your way? Caregivers typically don’t have time to take care of their own health needs. Do you get regular checkups with your doctor and your dentist? Do you take the time to prepare nutritious meals for yourself or to get some exercise? Do you have insomnia or stomach complaints? Do you actually feel guilty if on some rare occasion you take the time to enjoy a former hobby or interest?

Be careful not to miss the signs of needing help, both in your loved one and most importantly in yourself. Don’t wait for a crisis to happen with the one you care for or with yourself. After all, the best way to help your loved one is to make sure you are at your best. It may be time to get some help. How did you know it was time to get professional help? Share below and vist us at http://www.trilliumhomecare.com

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The Caregiver at the Doctor Visit

According to the Census Bureau, there are over 43.1 million persons in the United States that are 65 years of age or older. The elderly population is expected to double to 80 million when all the “baby boomers” have reached their elderly years. Due to advances in medical science these baby boomers will be living longer and that translates into huge numbers of people living with chronic conditions like arthritis, diabetes, osteoporosis, or dementia. A large population of chronically ill older people means that more and more seniors will be dependant on others for help with their activities of daily living – in short, they’ll have a caregiver whether it’s a family member or a professional from an agency.

Caregivers are now and will increasingly in the future be an important component of doctor visits for the elderly. According to a study by Jennifer Wolff, PhD of the Johns Hopkins Bloomberg School of Public Health, doctor visits that include caregivers are an increasing trend that has important benefits. Her study showed that visits that included a caregiver lasted at least 20% longer and resulted in less social conversation between the doctor and the senior and more biomedical information being given to the patient. This is really important because a trip to the doctor is all about communication and the exchange of information. Doctors need information from patients to provide an accurate diagnosis and to provide treatment options. The patient needs to be able to clearly discuss and understand what’s going on. This is where the caregiver’s presence can be very valuable.
A caregiver can help the senior with every aspect of the visit beginning with getting ready for the visit by gathering all the necessary medical history information and making a list of current medications and by preparing a list of symptoms for the doctor along with any questions the senior may have. During the visit, the caregiver can make notes for the senior and can remind them of any symptoms they may have forgotten and can relate to the doctor any changes in the senior’s general health and abilities. In effect, the caregiver is a second set of eyes and ears and can request further clarification about the diagnosis, treatment options, and what can be expected down the line. After the visit, a caregiver can support the senior’s compliance with the doctor’s instructions by encouraging them to follow the prescribed course of treatment along with taking their medications as prescribed and by helping them further understand the doctor’s instructions if necessary. This in turn can help reduce possible hospital readmissions.

According to the study by Dr. Wolff, seniors and loved ones who have been accompanied by a caregiver to a doctor ended up being more satisfied with their overall care and were shown to be more likely to remember important information after their visit to the doctor. Please share your thoughts and experiences below and visit us at http://www.trilliumhomecare.com

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Hiring a Caregiver Privately?

According to the National Alliance for Caregiving, more than 65.7 million Americans provide informal care for a family member or loved one. Most of us come by the role of caregiver gradually. We start by “helping out” when we notice a parent or loved one is having some difficulty taking care of some routine tasks they once managed well. In time our list of responsibilities gets longer and our loved one needs much more help. And then it happens….we see there is so much more to do than we have hours in the day for. Perhaps there’s been a medical crisis or an accident. We realize some outside help is needed.

Once you’ve made the decision to get help, it’s easy to believe all you have to do is hire someone. If you choose to hire someone directly to care for your loved one be sure you know what goes with your new role as employer. This means that now you have switched jobs from “caregiver” to “accountant” because you will now have to take care of payroll and tax requirements since the IRS views you as the caregiver’s employer. According to foxbusiness.com, if the caregiver you hire earns more than $1000 a quarter or over $1900 a year, you’ll have to file payroll taxes including Social Security and Medicare taxes, Federal Unemployment Tax, state unemployment and disability insurance taxes levied on the employer, and advance payments of the earned income credit if your employee is eligible. These thresholds and figures may change yearly so you will need to verify them every year. You also have to know what taxes your employee has to pay and will have to provide a Form W2 to your employee by January 31st of every year. In addition, you’ll need to pay for worker’s compensation and disability insurance in case your caregiver gets hurt while caring for your loved one.

If the caregiver you hire claims to be working as an “independent contractor” and no money should be withheld for any taxes, they are wrong. According to the IRS an independent contractor has total control over their work hours, their responsibilities, and schedules. This does not apply to your employee because the caregiver will be providing the services you want on the schedule and terms you set. Failure on your part to fulfill your accounting duties as the employer of a caregiver will alert the IRS, set you up for an audit, and can even result in compromising your own personal taxes. You’ll have to pay back the unpaid taxes along with interest and possible penalties. Be certain you make the correct decision when hiring a caregiver. Are you prepared to be an accountant in addition to dealing with all the work and responsibility of caring for a loved one? Share below and visit us at http://www.trilliumhomecare.com

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Older Adults and Medication – Part 2

As you get older or someone you care for enters their “senior” years, you have to be very careful about which medications are used. Older adults usually have several chronic medical conditions they are dealing with at any given time so that means they’re probably using a variety of drugs. The more medication you take, the greater are the odds that you can end up dealing with the effects of drug interactions. In addition, seniors are more sensitive to some drugs due to the natural changes in their bodies as they age.

Among the most commonly used and abused drugs are non-steroidal anti-inflammatory drugs (NSAIDS). Long lasting versions include Feldene and Indocin which are available by prescription while shorter acting ones include Motrin, Advil, and Aleve. Because the shorter acting NSAIDS are available over the counter, there’s a misconception that they must be totally safe but keep in mind that they’re mean for short term use only. In fact, all NSAIDS carry a risk of indigestion and ulcers and in the over 75 age group there is a possibility of bleeding in the stomach or colon especially if your senior is taking aspirin or a blood thinner like Coumadin for their heart. In addition, NSAIDS can increase your blood pressure so if you’re taking medication for hypertension which is very common in seniors and you take an NSAID for your arthritis, the medications are fighting each other.

Other medications to use with caution include muscle relaxants and over the counter allergy and cold medications. Muscle relaxants such as Flexeril and diphenhydramine , which is the active ingredient in Benadryl and over the counter sleep aids like Tylenol PM, can cause confusion and grogginess along with blurred vision. This can be particularly troublesome for seniors since it can increase the risk of falling. If your senior takes something to help them sleep and something else because their allergies are bothering them, you can see how easily they could be double-dosing without realizing it!

In light of the fact that there is an endless list of possible drug combinations you or your loved one may be taking, it’s important to keep a CURRENT list of all drugs being used, including any over-the-counter medications and herbal supplements. Take this list with you to every doctor visit and ask lots of questions. If your doctor prescribes a drug, be sure you are clear about what it’s for and how to properly take it. Ask if it will interfere with anything on your list and if any adjustments need to be made. Be sure to get all your prescriptions filled at the same pharmacy so the pharmacist can also keep track of any possible interactions. Using a pill organizer at home can help you keep track of whether you’ve taken the medication as prescribed. If you start noticing a possible side effect to a medication, don’t just stop taking it without contacting your doctor. Follow his advice and be safe. Do you have any tips for managing your senior’s medications? Share below and visit us at http://www.trilliumhomecare.com

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Older Adults and Medications – Part I

When you are younger and in need of medication for an illness or injury, things are pretty simple. You go to the doctor, get a diagnosis, fill your prescription, and a few days later you’re feeling better. If you get a headache or pull a muscle at the gym, you pick up some over-the-counter analgesics and in a bit you’re back to your busy life good as new. It never occurs to you to monitor what you’re taking because you’re not taking a lot of medications with a lot of frequency. That changes as you reach your senior years. As you get older, it’s typical to be dealing with more than one chronic condition resulting in taking multiple medications which are very often prescribed in multiple doses. In fact, the average older person takes at least four prescription medications and at least two over-the-counter drugs on a regular basis. Seniors over 65 are responsible for the purchase of 30% of all prescription drugs and over 40% of all over-the-counter drugs. You can see where this is going. As you get older or someone you care for enters their senior years, it becomes increasingly important to manage medications.

Seniors are particularly vulnerable to problems with medications for a variety of reasons. The more medications are taken, the greater the odds are that they may have an interaction that could be dangerous if not unpleasant. It’s not uncommon for a senior to simply stop taking a medication because of its side effects. Between 40% and 75% of seniors stop taking their medications at the right dosage and the right schedule. This issue is compounded by the fact that older adults are more sensitive to drugs because of their now slower metabolisms and organ functions, thus keeping drugs in their system for longer periods of time. Physical problems such as poor vision or a weak grip due to arthritis can result in dosing errors. Cognitive and memory issues can prevent the older adult from following the doctor’s orders and since so many seniors live alone there’s no one to assist them with nor monitor their use of drugs. Simply forgetting is a major reason medication doses are skipped by the elderly. With an increased number of chronic conditions the typical older adult sees a number of different physicians — the endocrinologist for their thyroid, the cardiologist for their heart problems, and so on. Multiple doctors equal multiple medications that can conflict with each other. You can see why studies have shown that any combination of these factors causes 30% of hospital admissions of older adults. It’s apparent that being able to manage an older adult’s medications is critical to their well being and even their ability to remain independently in their own home. Next time we’ll talk about which medications to be especially cautious about and what action you can take to help keep your senior safe with their medication. Visit us at www.trilliumhomecare.com

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Aging and Sleep

When we’re young we often burn the candle at both ends when it comes to our sleep habits. We stay up late watching TV, socializing with friends, or doing schoolwork and then get up the next morning and go to work or school. Weekends are “catch-up time” with some power sleeping —-or not. Somehow we survive these erratic sleep habits. That all changes as you get into your senior years and sleep becomes much more important. It allows your body to restore its energy levels and it refreshes the immune system so it can help prevent disease as we age. In addition, sleep improves concentration and memory function. As you get older your sleep changes and you can’t bounce back from lack of sleep as you once did. Your body produces less melatonin so you wake up more often at night. In addition, an aging internal clock makes you wake up earlier in the morning while making you sleepier earlier in the evening. You generally need more time to fall asleep and any noises you hear at night may awaken you more readily than when you were younger. The problem is that as you age you still need seven to nine hours of sleep at night, just as you did in your early adult life. According to the National Sleep Foundation, almost half of older adults experience insomnia at least a few nights per week. In the over 65 age group, 13% of men and 36% of women need more than a half hour to fall asleep.

As you get older, there are a lot of factors that can directly affect your sleep. Most seniors are dealing with multiple health issues such as arthritis, heartburn, lung disease, or heart problems and the pain and discomfort they result in can keep you awake at night. These health issues are usually accompanied by a litany of medications and they too can affect the quality of sleep. These medications include anti-depressants, diuretics, decongestants, and high blood pressure medications. Psychological issues like depression and neurological illnesses like dementia are an additional source of sleep problems.

There are steps you can take to ensure a good night’s sleep. Many of them are simple lifestyle changes such as avoiding caffeine and alcohol at least 6 hours before bedtime and not eating heavy meals late in the day. Sticking to a regular schedule for going to bed and getting up in the morning (even on weekends) gets your body into a regular routine. Getting regular exercise reduces stress and according to the Feinberg School of Medicine results in dramatic improvement in the quality of sleep. Limit the amount of liquids you consume for a couple of hours before you go to bed. Getting up to go to the bathroom is the major cause of waking at night for seniors. If you make these changes yet are unsuccessful in getting a good night’s sleep, it’s time to talk to your family doctor. Do you have any good sleep tips to share? Visit us at www.trilliumhomecare.com

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