Preventing Wandering in Alzheimer's Patients

Patty McKinney, OTR

Alzheimer's Disease causes a number of changes in the brain and body that may affect safety. Depending on the stage of the disease, these can include changes in judgment, abstract thinking, sense of time and place, and behavior.  As the disease progresses the person's abilities will change, so situations that are not a concern today may become potential safety issues in the future.

One danger to be aware of is wandering in Alzheimer's patients. According to the Alzheimer's Association, about 60 percent of the nation's 5 million Alzheimer's patients will wander. If you are caring for a loved one who suffers from Alzheimer's, these are things to keep in mind to minimize risk and keep your loved one safe.

Wandering is more likely in certain situations, like when someone with dementia is in unfamiliar surroundings. People with Alzheimer's and other forms of dementia often leave clues that they're about to wander. If your loved one says, "It's time to go to work," she might truly be headed out the door in a few minutes. "I want to go home" might mean he's about to go in search of his childhood home, and you have to stop him.

Learn to distract them. Avoid saying, "Dad, you haven't worked in 30 years." Reasoning is not effective, but distracting is a good strategy. For example, if they say they want to go to work, encourage them to go and find their shoes, or to have breakfast first. The distraction is usually sufficient to take their mind off of going to work.

Block or disguise the exits. For safety reasons, never lock a person with dementia in a home alone. Doors can be blocked if a caregiver is with them. Other ideas include placing a mirror or a stop sign on the door.

Another strategy to prevent wandering is to label your rooms. Sometimes people with dementia will go wandering off in search of the bathroom or a glass of water, get distracted and actually leave the house. The Mayo Clinic suggests putting a picture of a toilet on the door to the bathroom or food on the door to the kitchen, so they can more easily find what they need.

Alzheimer's patients sometimes wander out of boredom, or because they are not receiving attention. Engage your loved one in activities to whatever degree you can. For example, washing dishes or folding clothes together. 

Have your loved one take a walk or exercise with you. The physical effort is usually calming. Even if they're not tired afterward, the social engagement of the walk might be enough to keep them from wandering in search of company.

Consider technology as a help in your safety precautions. You can attach a Global Positioning System (GPS) device to your loved one on a bracelet or shoe. If he or she wanders, you can go online to find them on a map. Some devices alert you if a door is open in the house. The Alzheimer's Association has an overview of electronic devices that can help keep track of Alzheimer's patients. 

Finally, many families aren't sure they can safely keep their loved one with dementia at home. The Alzheimer's Association has a guide to determining what kind of care a person needs, and a guide for finding professional assisted living facilities or other long-term care options. Check http://www.alz.org for additional information and resources.

Patty McKinney, Occupational Therapist, is the owner and operator of Glenwood Springs Harmony House, an assisted living facility with peaceful accommodations and professional, qualified personal caregivers.

www.glenwoodspringsharmonyhouse.com

970-404-0551

Seniors and Safe Driving

Older Driver Awareness Week, recognized by the American Occupational Therapy Association December 5-9, helps bring attention to older driver safety

Patty McKinney, OTR

It's a fact of life that people grow older every day. And with increasing age come changes in physical, emotional, mental and sensory abilities that can challenge a person’s continued ability to drive safely. These changes occur individually and at different times.

Age alone is not a good predictor of driving safety or ability. But safety research shows that declines in our physical, emotional, and mental abilities may increase crash risk or unsafe driving. One key to safety is knowing when we or another driver are at increased risk. Visit the National Highway Traffic Safety Administration's web page, Driving Safely While Aging Gracefully, or download AAA's Older and Wiser Driver to read more about the changes that can affect safe driving and the signs that indicate the need to take a closer look at a person's driving.

The American Occupational Therapy Association (AOTA) believes that occupational therapy practitioners have the skills to evaluate a person’s overall ability to operate a vehicle safely and provide rehabilitation, if necessary. Occupational therapy practitioners work with older adults as well as their families and caregivers, offering individualized assessment. They can identify individuals’ unique challenges and find strategies that will help them live life to its fullest by keeping them healthy and safe in their communities, including behind the wheel.

It is the mission of the AOTA to make sure older adults remain active in the community—shopping, working or volunteering—with the confidence that transportation will not be the barrier to strand them at home. The goal of occupational therapy intervention is to explore ways for individuals to drive safely for as long as safely possible, according to a defined plan created jointly by the individual and the therapist. Occupational therapy practitioners can provide basic assessments and suggest solutions, including adaptive equipment such as a wide-angle mirror, seat cushions, left-foot gas pedal, or hand controls.

For most of us, it's difficult to change from the convenience and independence of driving ourselves to relying on some other means to get around, but thankfully, there are alternatives for seniors who can no longer drive safely. Many prefer to ask family and friends to help them. And most communities around the country, Garfield County and Glenwood Springs included, have other choices ranging from public transportation to specialized programs for people with identified needs. 

Check www.garfield-county.com for information on The Traveler transportation program. The Traveler's mission is to serve as a specialized transit organization linking seniors and the disabled with independent lifestyles through mobility. The City of Glenwood Springs provides ADA-compliant transportation around the community with its free Ride Glenwood transit system. Find out more at www.cogs.us.

Patty McKinney, Occupational Therapist, is the owner and operator of Glenwood Springs Harmony House, an assisted living facility with peaceful accommodations and professional, qualified personal caregivers.

www.glenwoodspringsharmonyhouse.com

970-404-0551

Depression in Older Adults and the Role of Occupational Therapy Treatment

Patty McKinney, OTR

The job of the occupational therapist (OTR) is to help people of all ages and stages of life participate in the things they want and need to do. Through the therapeutic use of everyday activities, known as "occupations" in this context, the work of an occupational therapist helps lead to measurable gains in quality of life for the patients they treat. Because of their work helping people achieve and maintain quality of life, treating depression is an emerging niche in occupational therapy practice. Often, an OTR works with a senior population, and OTRs can be especially effective in both identifying, and mitigating, depression in seniors through the work that they do.

Recent data suggests that about 20 million Americans suffer from depression, but not all seek treatment. Treatment can include medications, counseling, and increasingly, occupational therapy. Occupational therapy can assist people in restructuring their daily lives. People with depression, and especially aging adults, can benefit from the support and problem solving that occupational therapy brings to their care. Often, occupational therapy helps people access and be successful with  those day-to-day things that they value, and the net result is a happier and more fulfilled individual. In addition, OTRs are trained in identifying the differences between depression in older adults and the early signs of dementia, which can look very similar.

Depression isn’t always easy to spot. It may be expressed through behavioral changes, emotional changes, physical changes, or a combination of these things. Older adults who are depressed are often experiencing a culmination of losses—not just loved ones, but sometimes their health. Many housebound seniors suffer from Seasonal Affective Disorder (SAD), which is characterized by the onset of depression during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but not all individuals with SAD get better with light therapy alone.

People with depressive illnesses do not all experience the same symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his or her particular illness.

Some signs and symptoms of depression include: 

• Persistent sad, anxious, or "empty" feelings
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Irritability, restlessness
• Loss of interest in activities or hobbies once pleasurable
• Fatigue and decreased energy
• Difficulty concentrating, remembering details, and making decisions
• Insomnia, early-morning wakefulness, or excessive sleeping 
•  Overeating or appetite loss
• Thoughts of suicide, suicide attempts 
• Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.  

If you or an aging loved one may be suffering from depression, please seek treatment. Your primary care physician, counselor, and possibly an occupational therapist, are there to help.

Patty McKinney, Occupational Therapist, is the owner and operator of Glenwood Springs Harmony House, an assisted living facility with peaceful accommodations and professional, qualified personal caregivers.

www.glenwoodspringsharmonyhouse.com

970-404-0551

Helping Your Loved Ones Preserve Independence in Later Years

Patty McKinney, OTR

As we age, the simple fact is that managing daily tasks becomes more difficult. If you have an aging parent, relative or friend living alone, you may be seeing these changes and be concerned about his or her health and safety.

Often, certain daily activities have become too difficult because of physical or mental changes in aging individuals. If bills are going unpaid or your loved one is neglecting grooming, skipping meals, or his or her home appears unkempt, it may be time to intervene. As abilities and strength diminish, families and other caregivers must often help the older person obtain the assistance needed to maintain independence. It can be sensitive and difficult for the older adult to accept these life changes, and to accept help and assistance from others, so thoughtful communication and timing are important.

Caregivers and family members sometimes investigate and suggest outside resources for seniors as part of a strategy to help maintain independent living. Bill paying services, "meals on wheels," lawn care, house cleaning, and other services may be welcome. Very often, elders will prefer professional help over dependence upon family members.

Consider offering assistance with finances and financial decisions. Many older people are highly concerned about conserving resources for future needs for themselves or their spouses. Others have limited experience with current costs and may be anxious about being overcharged for materials and services. If adaptations or repairs are needed around the home, like adding railings on stairways, offer to help the individual make choices and deal with contractors.

Introduce the idea of change through small, minimally intrusive modifications, by offering gifts or services when you notice a need. For example, while replacing hard-to-reach light bulbs, upgrade the wattage for improved visibility. Try building suggestions for change around "I" messages. "I worry about you falling on those dark basement stairs. As a birthday gift, we are going to make sure your stairs are safe and well-lighted."

Many aging people face limitations on continued independent living in their homes only because the design and arrangement of furniture and living spaces no longer meet their needs. Consider calling on an occupational therapist to help you identify ways to improve safety in the home and to modify the environment to compensate for the disabilities your aging loved one is experiencing. Occupational therapists are specialists who help people deal with the effects of aging, illness and injury on their ability to manage daily life; an occupational therapist can assess and adapt a home environment to meet changing physical needs, and introduce these adaptations in ways that help the aging individual maintain dignity, self-sufficiency and self-esteem.

Patty McKinney, Occupational Therapist, is the owner and operator of Glenwood Springs Harmony House, an assisted living facility with peaceful accommodations and professional, qualified personal caregivers.

www.glenwoodspringsharmonyhouse.com

970-404-0551

Falls Prevention Awareness Day

Patty McKinney, OTR

Falls Prevention Awareness Day will be celebrated on September 23 this year. This national initiative reminds us of the importance of making our homes and surroundings hazard-free, a particularly important consideration for people with disabilities and older adults. Occupational therapy practitioners make the most of this annual observance to educate the public about the role of occupational therapy in falls prevention, and to increase public awareness about how to prevent and reduce falls. Slips, trips, and falls in and around the home are frequently the cause of injuries to older adults, particularly fractures to hips, shoulders, ankles, wrists, and hands. One out of three Americans over the age of 65 sustain a fall each year, and falls are the leading cause of injury and accidental death for adults in this age category. However, implementing a few prevention practices can decrease a person's risk of an unnecessary fall.

Some of the simple, but often overlooked, fall prevention tips and strategies taught by occupational therapists include:

• Do not walk and talk at the same time. Concentrate on the task of walking and continue the conversation after you've reached a safe place.
• Wear appropriate footwear. When walking long distances or in unfamiliar areas, wear flat, nonslip shoes. Also wear shoes that are comfortable and fit well.
• Arrange furniture so that it creates plenty of room to walk freely. If you use a walking aid, ensure that doorways and hallways are large enough to get through with any devices you may use.
• Install railings in hallways, and grab bars in the bathroom and shower to prevent slipping.
• Be certain to have adequate lighting throughout your home.
• Install nonslip strips or a rubber mat on the floor of the tub or shower.
• Remove throw rugs entirely, or secure them firmly to the floor.
• Use extra caution when carrying items while walking.
• Use a nightlight when getting out of bed at night.
• Stay active to maintain overall strength and endurance.
• Know your limitations. If there is a task you cannot complete with ease, do not risk a fall by trying to.

Fear of falling can be both a risk factor for falls and a consequence of falling. Occupational therapy practitioners assist older adults to assess whether their fear is based on reality. Based on the assessment, specific precautionary measures, environmental modifications and adaptive equipment may be recommended. Sometimes, fear of falling may be based on lack of confidence and other psychological and social factors. In these situations, occupational therapy practitioners assist older adults to recognize and overcome their fears and problem-solve about how to keep from falling while staying active. Fear of falling can lead to self-limitation in performing activities and tasks that people need to do to remain as independent as possible. This can bring about a cycle where weakness and decreased stamina develop as individuals restrict their participation in activities, leading to further restriction of their engagement in normal daily life.

Staying active and safe are goals that older adults want for themselves: occupational therapists specialize in empowering older adults to do just that. Preventing falls and alleviating the fear of falling are cost effective interventions that promote the safety and well-being of older adults. The profession of occupational therapy focuses on a person’s ability to participate in desired daily life activities or “occupations.” Aging can affect the ability to manage as we continue to live in familiar surroundings or transition to new ones. As people age, occupational therapy practitioners use their expertise to help them to prepare for and perform important activities and to fulfill their roles as community members, family members, friends, workers, leisure devotees, or volunteers.

Patty McKinney, Occupational Therapist, is the owner and operator of Glenwood Springs Harmony House, an assisted living facility with peaceful accommodations and professional, qualified personal caregivers.

www.glenwoodspringsharmonyhouse.com
970-404-0551

Occupational Therapy Helps Life Satisfaction in Seniors

Patty McKinney, OTR

Occupational therapists help people of all ages and stages of life participate in the things they want and need to do. Through the therapeutic use of everyday activities, known as "occupations" in this context, the work of an occupational therapist helps lead to measurable gains in quality of life for the patients they treat. Common occupational therapy interventions include helping children with disabilities to participate fully in school and social situations, helping people recovering from injury to regain skills, and providing supports for older adults experiencing physical and cognitive changes. Occupational therapy services typically include evaluation, goal setting, customized intervention, and an outcome plan. Always, the occupational therapist has a bias for encouraging as much independent activity as possible.

For seniors and an aging population, occupational therapy closely aligns with the national trends in health and wellness: the focus is on preventing illness and disability, as opposed to treating issues once they have already begun to negatively impact health. Research has conclusively shown that as we age, it is critical that we continue to be engaged in life through a mix of productive social, physical, and spiritual activities. This goal of prevention and wellness is really a key to health care reform, and results in a cost savings to society simply due to more health and less disease.

As you age, or care for those around you who are aging, some of the recent research findings of occupational therapy are worth noting:

•  Small, healthy lifestyle changes-- coupled with involvement in meaningful activities--  are critical to healthy aging and maintaining independence. Lifestyle changes and engagement in meaningful activities are proven to lessen body pain, improve vitality, social function, mental health and overall life satisfaction in senior populations.

•  Seniors who make changes in their routines (such as visiting a museum with a friend once a week) that lead to measurable gains in quality of life, are less prone to depression and are more satisfied with life. Quality of life can be measured using a variety of indicators, including physical health, mental health and social well-being.

• Occupational therapy intervention is proven to improve health and reduce body pain and depression in senior populations, and helps individuals re-discover meaningful and social activities.

Bottom line, as we all live longer, it is important to also live better. Occupational therapy can help provide a bridge to regular, sustainable, engaging experiences in the world for seniors.

Patty McKinney, Occupational Therapist, is the owner and operator of Glenwood Springs Harmony House, an assisted living facility with peaceful accommodations and professional, qualified personal caregivers. 

www.glenwoodspringsharmonyhouse.com

Welcome to The Harmony House Health Herald

Patty McKinney, OTR

Patty McKinney, OTR, is the owner/operator of the Glenwood Springs Harmony House assisted living facility. As an Occupational Therapist for nearly two decades, and an expert on aging and health care for the elderly, she will contribute regular articles to her new blog: The Harmony House Health Herald.

Thanks for reading!