Featured Article:
Persons With Dementia Have
Higher Rate of Hospitalizations.

Avoid Hospitalization!

Among older persons with dementia, hospitalizations or ER stays place them at an increased risk of delirium, functional decline, and iatrogenic (hospital or physician caused) complications during an inpatient stay. Emergency hospitalization of older people, particularly those with dementia, is not a trivial event. A recent study by Dr Phelan and her colleagues at University of Washington clearly demonstrates this.

Elizabeth A. Phelan, M.D., M.S., of the University of Washington, Seattle, and colleagues conducted a study to determine whether (JAMA. 2012; 307[2]: 165-172. www.jamamedia.org)

Among study participants with dementia, the average annual admission rate was more than twice that of those without dementia.    

Three diseases: bacterial pneumonia, congestive heart failure, and urinary tract infection, accounted for two-thirds of all potentially preventable admissions, and admission rates among those with dementia were significantly higher for all 3 conditions.

Admission rates for dehydration and duodenal ulcer, though low overall, were also significantly higher among those with dementia.  

Early detection and outpatient management for these conditions among patients with dementia may very well minimize the need for hospitalization.

The frightening bottom line here is that persons with dementia end up in the hospital far more often than those without dementia.  

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"It isn't the  great big pleasures that
count the most; it's making a great deal
out of the little ones."

~ Jean Webster     

Protecting Elderly Folks From Adverse Winter Weather Conditions 

It is crucial for older adults to exercise extra caution during the winter months to protect themselves from adverse weather conditions, says the February 2011 issue of the UCLA Division of Geriatrics' Healthy / Years.

Winter can be a dangerous time for older adults and the health letter offers the following winter hazards that the elderly must protect themselves from:

Hypothermia - This winter hazard may result from:

1. Our internal thermostat doesn't work as effectively, as we age, so we may be unaware that we are becoming so cold that we are at risk from hypothermia.
2. We generate less compensatory body heat because we move less.
3. Older adults actually can shiver less and, in any case, shivering decreases as your body temperature drops, so don't rely on it as a guide, according to Michelle Eslami, M.D., professor of geriatric medicine at UCLA Health System.

According to figures from the Centers for Disease Control and Prevention, hypothermia, which causes the core body temperature to fall to unhealthy levels, kills about 300 Americans age 65 and older each year.

• Frostbite - This is also a big risk, especially if you have heart disease, diabetes or other circulatory problems, and/or take beta blockers, which decrease the flow of blood to the skin.
• Back injuries - Shoveling snow puts individuals at risk for back injuries. Also, the ice that often accompanies wintry conditions increases the chances of a fall, which can result in serious complications.
• High blood pressure - Research suggests that the cold may raise an individual's blood pressure, increasing the risk of heart attack, stroke and kidney problems. Shoveling snow can further overload the heart, warns the letter.
• Increased stress and strain on the body - According to Dr. Eslami, older adults have less "physiologic reserve," which operates as a sort of "buffer zone" that helps us cope with, and recover from, stress and strain on the body, such as that presented by cold. That reserve naturally decreases with age, making us less able to handle the stress cold temperatures placed on the body. This may be exacerbated by chronic diseases, such as diabetes and by medications (including over-the-counter cold medications) that make an older adult even more susceptible to temperature extremes.
• Indoor hazards - Tracking snow or mud across the floor can result in puddles and wet patches that can cause you to slip.
• Carbon monoxide poisoning - This risk may arise from a malfunctioning water heater or furnace, or if you use an unvented gas space heater. Those with heart or lung disease are particularly vulnerable.

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Paths clear for those  

who know where they're going and  

are determined to get there.

Why Palliative Care and
Hospice is the Ultimate Gift  

Our colleagues in hospice agencies frequently refer to us for supportive personal care to their clients nearing the end of life. We are honored to provide this care, but it is always our hope that in the future, clients and families will be referred to hospice earlier in their disease process. This article explains well why this is so very important.

Dear Doctors:

I am writing no less than 45 days after my mother died from a GI bleed from ovarian cancer.  Not once did my mother's team of doctors mention palliative care.  It was not until days and even hours before her death that hospice was discussed and implemented. Our family was blind sided by this.

While no one likes to talk about the topic of death it is important to remember that this is a natural cycle of life. Doctors are always on the cutting edge of medicine and talking about the possibility of death seems like failure.  In reality not talking about the services available to family is the ultimate failure.

Here are the top 5 reasons why:

1. Pain.  Patients may get to a point where pain is not manageable with the regular visits to the office.  To know that there are potential solutions from a team that understands the full situation and can target medicine toward avoiding suffering is key.  It can make a huge difference in quality of life and the person's overall attitude toward the options available.  It puts the patient in the driver's seat.
2. Quality of life.  Running from doctor to doctor, balancing prescriptions at the pharmacy and not tending to one's overall quality of life can be draining.  If more attention were paid by doctors to palliative care during serious illness the patient would feel a sense of relief that there is a friend on the sidelines ready to work with the entire team to manage symptoms and if need be start discussing hospice.
3. Hospice gives the patient comfort at a time of great stress.  Hospice should not be a last-minute option.  It should be done with great thought and care with the patient's needs in mind at all times.  To be able to stop all treatments and procedures and focus on the remaining days ahead without pain and suffering is often a relief.

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KUDOS from Kelly

 By Kelly McNamara     

Stephen Berko

Stephen is a relatively new employee and has already been a wonderful and valued caregiver to A E during the night and a support to his wife H E. His care of A E and his assistance with meals, and other housekeeping chores have made it possible for this lovely couple to remain in their home safely. It's great to have him as part of our team.

Antoinette Khalia

Antoinette excelled at a very special assignment for us. My grandmother JF has a live in caregiver who needed to take several weeks off over the holidays. Antoinette graciously stepped in and did a wonderful job. Her patience, her enthusiasm, her competence, and her genuine joy in her work combined to make her a wonderful caregiver for my grandmother. She kept J safe, comfortable and busy with three times a week trips to the local Activity Center. She quickly became an honorary member of our family.

Bridget Ackeifi

Again a fairly recent hire, an ambitious and immensely competent young CNA and BSN nursing student, Bridgette was the lead caregiver with V D in Jerome Home. She was a wonderful help to V D and her family as the client made the transition to Jerome Home from Arbor Rose. Her skills and attentiveness insured the client remained safe and comfortable.

Akousa Mensah, and Patience Merisma

Love looks through a telescope; envy, through a microscope.

~ Josh Billings  

Providers We Love   

We are privileged to have received referrals from and be able to coordinate care with many Assisted Living facilities, rehab facilities, and Medicare Home Care and Hospice agencies. Our growth is in large part due to the trust the staff in these organizations have put in our caregivers. We are likewise impressed with them and we are committed to referring to them on a regular basis.

Arbor Rose, Assisted Living, New Britain

Long a favorite facility of ours, Arbor Rose boasts a wonderful and caring group of staff, activity folks who keep life interesting for residents and a very welcoming environment for our pet therapy program. Our caregivers who are providing service for some residents at Arbor Rose have determined that Arbor Rose serves the best food and has the friendliest and most attentive dining staff of any facility in which they've worked. High praise indeed! Arbor Rose is the perfect environment for those who want to age in place gracefully and well cared for. Thanks to our colleagues at Arbor Rose for their continued support and trust in our caregivers. It is always a pleasure to work with all of you!

Vitas Hospice, Waterbury, Fairfield, Hartford

We are always proud to refer our clients to Vitas Hospice. Their beautiful new acute care inpatient unit at St Mary's is just another reason to refer folks there who are struggling with their family members café under hospice. Vitas has distinguished itself on its response time, its amazing and unique Veterans program and its commitment to providing continuous care (24 hour care by Vitas staff LPNs or CNAs at Medicare's expense). Continuous Care is provided by Vitas when clients are actively dying or need short-term symptom management. The vast majority of people have expressed their desire to end their lives at home in peace and comfort. Vitas excels in this area. We are proud to be
a referral partner.

Seabury Active Living Retirement
Community, Bloomfield

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