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Preparing for Medical Emergencies at Home

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It is 3:00 a.m. and you suddenly hear a loud noise from just outside your door. As you investigate, you discover that your loved one has fallen on the way to the restroom and needs immediate help. What do you do?

In a moment of panic such as this, it’s difficult to know exactly how to react. That’s why it’s important to anticipate the situations you may encounter as part of caring for an elderly or disabled relative or friend.

Here are some suggestions to keep in mind when preparing for medical emergencies at home.

Keep important information handy. Examples of important information to include:

  • Documents and records: Keep important documents, both personal and financial, in a waterproof portable container. This should include personal ID, insurance cards, your loved one’s MOLST (Medical Orders for Life-Sustaining Treatment), DNR form, and/or advance directives.
  • Medicine list: Keep a current list of medicine that your loved one is taking, pharmacy numbers, and doctors’ names and phone numbers.
  • Contact numbers list: Create and keep a current list of phone numbers of family members, physicians, and other personnel who are involved in the care of your loved one. Contact your local emergency medical services to ensure they have your correct address and your loved one’s medical condition on file to ensure a quicker response time.

If you prefer your documents as physical copies instead of digital ones, keep one copy of each document in your vehicle and another copy in a place where you could quickly access it in the event of an emergency. If you prefer to manage health information digitally, you can use mobile applications. However, you should always have a paper copy handy for others in case you are not present.

Keep an overnight bag with two or three days of supplies. For your loved one, pack some nightclothes, toiletries, books, personal care supplies, and any other items to help them retain routine if they are required to spend the night in the hospital. For yourself, pack some extra clothes, daily hygiene products, medications, snacks, and books to help you pass time while waiting in the hospital.

Educate yourself about emergency response. Take classes for first aid and CPR. Assemble and keep first aid kits handy at home and while you travel, such as inside the vehicle. Some essential items include bandages, scissors, tweezers, gloves, cotton swabs, thermometer, cold compress, hand sanitizer, and a blanket. Talk with your loved one and his or her healthcare provider to determine whether you should have specialty items on hand like a blood sugar monitor, blood pressure monitor, automated external defibrillator, etc.

Discuss medical alert systems with your loved one. Medical alert systems offer your loved one a fast and easy way to seek help during an emergency, especially if you and your loved one do not share a household. They are usually wearable devices such as bracelets, watches, wristbands, or necklaces. If your loved one needs help, he or she can push the button on the device to be connected with a trained dispatcher who will contact emergency help or a loved one as needed. There are a variety of medical alert systems, ranging from in-home (using a landline) to mobile (using GPS technology) devices. Identify your loved one’s needs and habits to determine which device is the right fit.

Plan to alternate caregiving responsibilities. While acting as a caregiver can be a fulfilling responsibility, it can also be personally taxing and time-consuming. Experiencing “caregiver stress”—feeling tired and overwhelmed—is common.

Recharge yourself by alternating caregiving responsibilities with siblings, friends, and neighbors. Practice simple self-care techniques like breathing exercises and meditation to ease your mind from any stress or anxiety. In addition, try finding local or online caregiving support groups to cope with the demands and challenges of long-term care.

Will you be ready?

Medical emergencies can happen at any time. It is important to be prepared to take care of your loved ones and yourself during these unexpected moments. Preparation is the best medicine in the event of medical emergencies.

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Caregiving Success: Guiding Your Loved One Through Care Transitions

1Transitioning from a hospital environment to home care might be met with mixed feelings of relief and anxiety for your loved one. After discharge from a hospital or nursing home, individuals are more likely to experience an adverse health-related event at home. According to research by Institute of Medicine, presently known as National Academy of Medicine, one in five Medicare enrollees is readmitted to the hospital within 30 days of being discharged. Fortunately, quality transitional care can prevent up to 75% of these readmissions.

As a caregiver, you play an essential role in helping your loved one to safely transition from a healthcare facility to the home environment. You will face challenges along with the person for whom you are caring, so it’s important to thoroughly prepare for their arrival at home.

Start early. Start preparing for discharge when your loved one is admitted to the hospital. Work with hospital staff to create a continuous, timely, and high-quality plan of care that includes follow-up doctor visits and homecare visits when needed. While planning, be aware of the obstacles that will likely arise during the transition. Challenges may relate to preventing falls, monitoring symptoms, managing medication and future appointments with health care providers, managing nutrition, and taking care of yourself as a caregiver.

Prevent Falls

Your loved one may be exposed to environmental risk factors which could cause falls, trips, or slips. These factors may include poor lighting, unstable seating, objects in pathways, lose handrails, clutter, wet floors, etc. Prepare the home space before your loved one arrives. Clear the walkways, install handrails in bathrooms, and remove tripping hazards (i.e., rugs, extension cords, etc.) to ensure your loved one can move safely around the house.

Monitor Symptoms

As a caregiver, you are responsible for monitoring the symptoms of your loved one’s health conditions at home.

  • Look for warning signs. Discuss negative symptoms and warning signs with your loved one’s healthcare provider so that you can quickly identify and address concerns before they turn into a medical emergency.
  • Communicate and keep health records. Discuss schedules with relatives or friends so that you may take turns checking in on your loved one and monitoring symptoms. Keep records of symptoms and any changes in his or her health condition. Report changes to the doctor.
  • Develop an action plan for emergencies. Make a list of after-hours care services available near your loved one. Keep his or her healthcare provider’s information on a list on the fridge. In the event of an immediate and serious emergency, call 911.

Manage Health Appointments and Medicines

Medication dosage and timing and other healthcare commitments like future appointments can be difficult for your loved one to manage independently. You can support your loved one by setting up reminders.

  • Send appointment reminders to them and plan on being available if necessary. Your loved one’s compliance with their plan of care is important and missed appointments can increase your loved one’s risk of readmission. When you can, accompany them to their doctor’s appointment.
  • Set up a method for medication intake reminders. Your loved one may be taking multiple prescription drugs which can be challenging to keep track of. These mobile applications and automated pill dispensers may be helpful to ensure routine medication intake to prevent adverse reactions.

Manage Nutrition

It might require some time for your loved one to ease into their daily routines at home. This includes their ability to prepare meals for themselves. Help your loved one maintain a balanced diet by helping them shop for groceries and assist them with meal preparations.

Take Care of You Too

Aside from providing care for your loved one, you need to also take care of yourself as a caregiver. Being a caregiver can be physically and emotionally draining. One of the keys to be a successful caregiver is to attend to your own health by taking breaks, eating well, exercising, and asking peers for additional help.

Being a prepared and knowledgeable caregiver will allow you to guide your loved one through this challenging phase of change. Careful planning and anticipation of probable challenges ahead will help you provide successful care for your loved one and keep him or her from returning to the hospital.

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Buying Groceries While Homebound

Make your life easier by ordering groceries online. You can even opt to have them delivered right to your door! Grocery stores across Maryland, Virginia, and Washington, D.C., offer local delivery or store pick up, allowing you to shop in the comfort of your own home. The items available online are the same items available in the store, but they come without the hassle of walking through aisle after aisle to pick them out. Online ordering is a great way to make sure you still get exactly what you want from the grocery store, including health, beauty, home, and garden items, even if you struggle to walk the aisles or travel there by yourself.

Here’s a list of options that may work for you:

Peapod by Giant Foods: https://www.peapod.com/home

  • How it works: Use an internet-capable device (smart phone, laptop, tablet, or computer) to select your items. Then, schedule them for either home delivery or curb-side pickup. If you choose to have your items delivered when you are not home, they will be left in temperature-controlled bins to a secure area outside.
  • Navigating the site:
    • Visit the Peapod website. Create an account and type in your zip code to find a store nearby. Begin shopping by clicking “browse aisles.”
    • Once you have added a least $60 worth of items to your cart, click on it to checkout. Select how you would like to receive your order (delivery or pick up) and choose your desired order completion date and time.
    • Link your Giant card for rewards (optional). Type in your delivery address. Process your credit card and confirm the order.
  • Delivery: Yes
  • Curb-side pick up: Yes
  • Delivery cost:
Order Size Service Fee
$60-$75 $9.95
$75-$100 $8.95
$100+ $7.95

*Minimum order size: $60

  • Curb-side cost:
Order Size Service Fee
All orders $2.95

*Minimum order size: $60

SAFEWAY: https://www.safeway.com/

  • How it works: Safeway allows you to order groceries online and have them delivered during attended or unattended delivery windows. If you choose a time where you will not be home, your groceries are delivered to your front door. Through Safeway’s “Drive Up & Go” program, customers can also pick up groceries that were ordered online by parking in a designated “Drive Up & Go” parking spot. With this option, an associate comes outside to your car and packs your vehicle with the groceries you ordered.
  • Navigating the site:
    • On Safeway’s homepage, select the service you would like. They offer delivery, “Drive Up & Go,” and rush delivery.
    • Create an account with your email, phone number, and address. If you select delivery, you are directed to enter your zip code to locate your nearest Safeway store.
    • After you have a minimum $30 order size, you can simply checkout by selecting a delivery date and time. Process your payment. Receive confirmation for your order via email.
  • Delivery: Yes
    • Rush shipping to get there in as little as two hours
    • Time slots on regular shipping can be 1, 2, or 4-hour intervals
  • Curb-side pick up: Yes (Drive Up & Go)
  • Cost for delivery:
Order Size Service Fee
$150+ $9.95
$30-$150 $12.95

*Minimum order size: $30

  • Cost for “Drive Up & Go”:
Order Size Service Fee
All orders $4.95

*Minimum order size: $30

Instacart: https://www.instacart.com/

  • How it works: Instacart operates as an independent service company. They search for grocery and convenience stores in your area that offer delivery and provide a list of stores you can order from. Store selection includes Publix, ALDI, Costco, Kroger, Wegmans, and even Petco. Once you select a store, you can then browse the store’s selection and make an order. The cost of service varies on the store that you select, some stores increase their product prices online. Instacart delivers purchased items to your home with an additional 5% service fee.
  • Navigating the site:
    • Enter your zip code to display local stores that offer delivery. Select your store preference from the list provided. Click on your cart to check out, pay with a credit card, and pick your delivery for a time when you will be home. Instacart offers delivery in as little as an hour.
  • Delivery: Yes
  • Curb-side pick up: No
  • Delivery cost:
    • Delivery fees depend on the size of your order and your desired delivery time. The fee for each delivery will be displayed when you select a delivery window during checkout before you place your order. Instacart may apply a “Busy Pricing” fee to your order if your desired delivery time occurs during a time of high demand.
Order Size Service Fee
All orders 5%

*Minimum order size: $30

Meals on Wheels: https://www.mealsonwheelsmd.org/

For individuals who struggle to leave the home and cook meals on their own, Meals on Wheels offers food delivery in many areas across the region. It is a non-profit program primarily caring for seniors who are experiencing declining mobility. Unlike the services above, Meals on Wheels requires that individuals meet certain physical criteria to qualify for meal delivery. To receive this service, a person must be homebound and unable to prepare a meal. There are no  financial requirements and the cost of a meal is generated based on the person’s disposable income.

  • How it works:
  • Locations:
    • Click here to find a location in your community.
    • Meals on Wheels of Central Maryland, 515 S. Haven St., Baltimore, MD  21224
    • Meals on Wheels D.C., 6100 Georgia Ave. NW, Washington, DC 20011
    • Meals on Wheels Arlington, 1550 Crystal Dr., #1004, Arlington, VA 22202
  • Delivery: Yes
    • Meals are delivered Monday through Friday and frozen meals are provided in advance for holidays that fall during the week. Two meals—a hot lunch and a cold supper—are delivered daily by a volunteer between 10:30 a.m. and 1:00 p.m.
  • Cost:
    • Meals on Wheels charges a fee based on a sliding scale that considers individual income and “acceptable” expenses.
    • This service accepts assistance benefits through the Independence Card or credit card for payment.
  • Grocery assistance program:
    • Like the above grocery delivery services, Meals on Wheels volunteers purchase the items on your grocery list and deliver them to your home.
    • There are no additional charges for this service. You can provide a written grocery list or speak on the phone to the volunteer.

 

Featured

New High Blood Pressure Guidelines – What Does This Mean?

For the first time in 14 years, high blood pressure guidelines have changed.  With the American College of Cardiology (ACC) and American Heart Association (AHA) guidelines in place, nearly 46% of the U.S. adult population will find themselves having high blood pressure.

What changed?

Medical experts used to consider someone to have high blood pressure if their systolic blood pressure was 140 and their diastolic blood pressures was 90 (140/90). The new guidelines consider 130/80 or over to be high blood pressure. By lowering the numbers, medical experts hope to motivate individuals to be more proactive toward their health and prevent complications associated with high blood pressure.

What are the new guidelines exactly?

The new categories for different levels of hypertension have eliminated the category of pre-hypertension:

  • Normal: Less than 120/80 mm Hg;
  • Elevated: Systolic between 120-129 and diastolic less than 80;
  • Stage 1: Systolic between 130-139 or diastolic between 80-89;
  • Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
  • Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.

What does this mean?

The big change is that medical providers will end up labeling many more people with hypertension and also recommending drug treatment for many more people. The goal is that more aggressive treatment will reduce life-threatening heart attacks and strokes. People need to make their personal health a greater priority!

In honor of February being American Heart Month, begin your journey towards better heart health by eating a balanced diet.

Monitor your salt intake. Avoid adding extra salt to your meals, as well as limit the amount of processed foods you consume, as they are often high in sodium. You should not consume more than 2,300 mg of salt per day. Adults who already have hypertension should limit their sodium intake to 1,500 mg.

Next time you’re at the grocery store, fill your basket with low-sodium foods like:

  • Fresh, canned or frozen fruits, juices or low sodium canned juices
  • Fresh or frozen vegetables or unsalted canned vegetables
  • Canola, olive, corn, cottonseed, peanut, safflower, soybean or sunflower oil
  • Low-sodium salad dressing or mayonnaise
  • Unsalted margarine or butter
  • Cooked cereals: Corn grits, farina, oatmeal, oat bran, cream of rice, cream of wheat (do not use the instant variety)
  • Flavors and sauces: Unsalted tomato sauce or tomatoes or vinegar
  • Snacks: Graham and animal crackers, fig bars, ginger snaps, melba toast, matzo crackers and popcorn without salt or fat
  • Fresh or frozen fish, chicken, turkey, beef, veal, pork or lamb that is not breaded
  • Dried beans, peas, lentils, unsalted or dry roasted nuts or seeds, unsalted peanut butter and tofu

Stay away from high-sodium foods like:

• Boxed mixes, such as pancake, muffin, pudding, cake or pie mixes
• Buttermilk, canned milk, egg substitute (limit to one half cup/day), eggnog, salted butter or margarine
• Bouillon, canned broth, dry soup mixes and canned soups (even low sodium ones)

• Canned meats, canned fish, cured meats, all types of sausage, sandwich meats, peanut butter and salted nuts
• Pre-seasoned mixes for tacos, spaghetti, chili and coating mixes
• Pre-seasoned convenience foods – ready to heat and eat
• Olives, pickles, pretzels, chips and skins
• Gatorade or athletic drinks

View the full list from MedStar VNA.

Watch what you drink. Limit the amount of alcohol you drink. Avoid drinking caffeine daily and sugar-sweetened beverages.

Other tips:

  • Avoid red meat.
  • Read the labels before buying food/beverage products.
  • Last but not least, exercise! Taking out 30 minutes of your day on a daily basis to participate in physical activities will not only help you maintain a healthy weight, but it will help you manage your stress levels as well. Check out our heart healthy exercises blog!

Additional Resources:

American College of Cardiology American Heart Association Everyday Health

Health Line

 

Featured

How to Prevent Falls

Every 11 seconds, an older adult is treated in the emergency room for a fall, and according to the Centers for Disease Control and Prevention (CDC), every 19 minutes, an older adult dies from a fall.

We can never predict the future, but we can be proactive about the steps to ensure a safe home environment and lifestyle. One of the most common causes of non-fatal injuries and hospital visits for trauma are falls. Fortunately, there are ways to reduce risk and  prevent falling.

Addressing the Myths vs. the Reality about Falls

According to the National Council on Aging, there are three common myths about falling:

Myth 1: Other people fall, but I won’t fall.

Reality: One-quarter of seniors fall every year in the U.S. The belief that “it won’t happen to me” is dangerous, because it can happen to anyone. The good news: there are actions you can take to prevent falls. For example, wearing appropriate shoes or keeping throw rugs and other tripping hazards out of your path, are among the ways you can prevent yourself and your older loved ones from falling. You can find a full list of fall prevention ideas here.

CDC falls startling stats
CDC

Myth 2: As I age, falling is normal.

Reality: Falling has everything to do with safety precautions and nothing to do with your age.  From wearing the proper footwear, to improving strength and balance through exercise, to having your vision checked, all of these actions can reduce your risk of falling.

Falling

Myth 3: Taking medication doesn’t increase my risk of falling.

Reality: There are many medications that have side effects that can actually increase the risk for a fall.  Some medications make you dizzy or sleepy, which greatly increases your risk of falling. Others may make it difficult to think clearly or make you feel light headed or off balance. It’s important to talk to your doctor about the side effects of the medications you’re taking to understand if they may increase your fall risk.

CDC preventable problem
CDC

Preventing Fall Risks at Home

Floors

  • Use non-slip rugs with rubber backing
  • Wrap up lose wires and cords or tape them down to the floor. Keep them out of walkways.
  • Keep pathways clear of excessive furniture
  • Keep floors clear of items that can cause someone to trip like shoes, magazines, pets, etc

Stairs

  • Fix loose or uneven steps
  • Install handrails on both sides.
  • Attach non-slip rubber tread to steps
  • Increase lighting at the top and bottom of stairs and turn them on when using the stairs
  • Do not leave items laying on the steps

Bedroom

  • Ensure lamps are easy to reach
  • Use night lights
  • Store flashlights near your bed where you can easily reach them, in case of a power outage

Kitchen

  • Keep often-used items in easy-to-reach places
  • Never use a chair as a step stool
  • Wipe up spills immediately

Bathroom

  • Add grab bars next to toilets and inside showers
  • Use a non-slip rubber mat or self-adhesive strips on the floor of the tub and shower
  • Add a raised toilet seat to assist with going from sitting to stand or vise versa.
  • Use a shower chair or bench to sit on when taking a shower

For an easy-to-use guide, download this simple home checklist provided by Ohio Health to make sure your home is fall proof.


Additional Resources:

http://www.healthinaging.org/resources/resource:winter-safety-tips-for-older-adults/

Article contributed by:  Jennifer Grant, physical therapist, MedStar Visiting Nurse Association