Senior Living: A Look at Your Options (Guest Post)

Sometimes seniors and caregivers have to ask the ultimate question: "What form of long-term care is best for our situation?" 

Although aging in place or keeping the elderly at home with a caregiver are considered the most appealing choices for most people, neither option may be possible.

When the time comes to make the decision, you will want to know all of your options. Today's guest post covers just that topic. Below, our guest author will introduce you to the 5 types of aging care, and an overview of what each one can do for you.

Senior Living: A Look at Your Options

Finding the right senior living situation can be a challenge, both for you and your family. There are a variety of housing options available to seniors, and choosing the right one can seem very
overwhelming.


Before you settle, educate yourself on the options available to you, then base your decision on your

C. Diff Infections in Nursing Homes|Who is to Blame? Opinion Post

C. difficile infections are bad news for the elderly. They run rampant in nursing homes, hospitals and other medical facilities, where they  lead to thousands of deaths each year. 

In this post, I will discuss some of the reasons this infection is so hard to contain, then ask YOU to share your opinion on prevention solutions below! 

Are Medical Staff Solely Responsible for Spreading C. Diff?

Last week I was researching information on fecal transplants for an article on elderly health concerns. Mainly, for digestive illnesses caused by C. difficile infections. 

Although still in the experimental phase, several studies have shown the treatment to be extremely safe and effective. Importantly, it could break the cycle of antibiotic dependency that keeps the elderly at risk for repeat infections. 

Because the treatment is still relatively rare, (especially when compared to antibiotic prescriptions), it can be difficult to match eligible donors to needy recipients. At this point, the cost is still out-of-pocket for those needing the treatment. 

I was seeking an answer to the question: 

"Is it worth the cost and effort to obtain this treatment for those who are advanced in age? Even those who may not live another decade?" 

(Of course, there is no definite answer to that question. My opinion is that if a treatment offers relief and possibly improves the quality of life and perhaps the length of life, then yes, it is worthwhile, regardless of individual situations or life expectancies.) 

What I found instead, was a user comment targeted toward long-term care facilities, stating that if staff members were doing their jobs correctly, then C. difficile infections wouldn't even be an issue. (theoretically saving tons of money on the cost of the procedure.)

Even though that comment was over a year old, I felt the need to fashion a response to the suggestion that care providers alone are responsible for the spreading of the C. diff infection. 

What is This Clostridium Difficile Infection, and How Does It Spread?

If you are a caregiver at home, or if your loved one is in a long-term care facility, then you need to be aware of this infection. It is a very real problem that can affect anyone of any age. 


If your aging loved one is a facility or hospital, then you also need to be aware of how this spreads, and how it is impossible for staff members to completely control it. 


Clostridium difficile is a bacterium that can infect the human digestive tract. It is more common in people who take antibiotics, which can upset the balance between "good" and "bad" intestinal bacteria. 

It can cause severe diarrhea, colitis, and even perforation of the colon, which can be fatal. It is transferred from human to human via contact with fecal matter. 

 C. difficile can live for a very long time (up to several weeks, or even months, in favorable conditions) on a variety of surfaces. C. diff bacteria can be present in residual amounts on surfaces such as tubs and commodes, and anything that was touched with contaminated hands. 

A Matter of Dignity?

In one facility where I worked we cared for three residents infected with c. diff.


Precautions were the same for ALL residents. All staff had to use gloves when giving showers, changing bed linens, etc. However, we had complaints from family members that wearing gloves  made the nursing home "too clinical". 


There were a few people who tried to force the facility in eliminating the use of gloves to make the environment seem "homelike and appealing". 


Not only would that have been a danger to ALL residents, including those who were already fighting off the infection, it would have been a risk to staff members and visitors, too.  


We were never officially ordered to stop wearing gloves when performing care tasks, but it was suggested to us that we only use gloves in the presence of family members if we thought we would be coming into contact with bodily fluids. 

We did not comply. We gloved. 

A Matter of Mobility

The three residents who were infected were mobile and independent. That means that they took care of their own toileting and grooming needs, with the exception of showers. 


By policy, aides could not force these residents to wash their hands. You could  suggest it. You could offer to help. 


But you could not MAKE someone wash their hands. You could NOT even tell them that it was to prevent the spread of an illness they were carrying. 


You could not forcibly wash or wipe their hands. You could not make them take a shower or bath if they refused. This was part of the dignity policy. 


MOST residents would agree to be showered every other day. Sometimes, that was the only times their hands would be cleaned. 

So what does that mean? 

Well, in an ideal situation, aides would make certain that everyone's hands were thoroughly washed after every trip to the bathroom. 


In reality, it meant we had three residents carrying a highly infectious disease. Three people who toileted themselves, and possibly did a poor job cleaning themselves. After which, they did not wash their hands. 


They were free to go wherever they pleased. Which meant that over the course of a day, they could touch hundreds of surfaces. 

So What About Keeping Things Sanitized?

According to the CDC, bleaching surfaces contaminated with C. diff is the preferred protocol. It is recommended that people with the infection  have one bathroom solely for their use. Some people even recommend keeping dishes and linens separate too. 


Things don't work that way in a nursing facility. Private rooms may have their own bathrooms, but many residents share bathrooms. Showers and tubs are shared. 


So are recreational supplies, furniture, tables, door knobs, light switches, handrails etc. 


Without putting a resident into complete isolation, there is no way to keep them from spreading c. diff if they are mobile. 


That doesn't mean that cleaning staff aren't doing their jobs. But unless you have one person assigned to follow an infected resident around and bleach each surface as soon as it is touched, then you have a window of opportunity for another resident to touch a contaminated object. 


Scenario: 

Marge uses the toilet without washing her hands. She walks down the hall while holding her walker and the handrail for support. She goes to the lobby and sits down. 

Meanwhile, two other residents walk down the hall touching the handrail. 

Another resident, a visitor or a staff member pushes Marge's walker to the side so that no one will trip on it, touching the contaminated surface. 

When Marge goes to the dining room, another resident sits in the chair. 


Its that easy. 


Residents might make multiple trips around the facility in the course of a day. They might go outdoors, they might ride the bus to church services. 


Completely preventing the spread of C diff by constantly bleaching surfaces was (and is) impossible in a multi-resident facility. You also get complaints from visitors if your facility smells too strongly of bleach or other chemicals. 

Visitors--The Other Factor

C. diff doesn't always come from the healthcare facility, either. Visitors can carry the infection, and if they aren't washing their hands, they can pass it to their loved ones or to other residents. 


This makes sense if you consider some numbers. 


The majority of residents in our facility ranged between 78-95 years of age. 


That put their visiting children in the age groups of mid-50's to mid-70's. 


Siblings and friends would fall in those age groups as well. 


The CDC states that 1 out of every 3 C. difficile infections occurs in patients 65 years or older People who use antibiotics are more likely to become infected. 


You can get it anywhere. Public restrooms, restaurants, the door handle of your grocery store. A younger person with a healthy immune system who is not taking antibiotics stands a good chance of fighting off the infection. 


However, if a person is susceptible, and becomes ill, they may be treated with antibiotics, thus starting a cycle. They may spend time themselves in a hospital where they can become infected. 


If that person visits a loved one in the nursing home, and brings in any contaminated item (dirty hands, clothing, a cup, homemade cookies) then they could possibly start an infection inside the facility. 


Especially if their loved one is on antibiotics or just has a very weak immune system. 


On the other hand, they can also accidentally transfer the infection outside of the facility. This can happen when a family member visits a loved one who has C. diff, and comes in contact with the spores. This can be from simply holding their hand, or using their bathroom, or helping them change soiled clothing. 

They may take an item out of the facility, such as soiled quilt, in order to have it cleaned. Now it is possible that they can continue to pass the infection back and forth with their loved one. 

So, Who Is to Blame for the Spreading of C. Difficile in Nursing Homes? 

Truthfully? Everyone is potentially to blame. It could be a careless staff member. It could be a resident who refuses to wash their hands. 


It could be a family member or a visitor. It could be the fault of a hospital or doctor who sent a resident back to a nursing facility without informing the staff about precautions. 


It can be the fault of the people who make policies. It can be the fault of all the people who say "its mean to make the elderly wash if they don't want to do so."


Really, no individual is to blame. However, maybe our attitude and approach toward elder care might be to blame. 


Here is something that should shake us all awake: 

• In 2012, it was reported that 20,000 Americans die each year from c. diff. 

• Clostridium difficile (C. difficile) caused almost half a million infections among patients one year (in just the US)

• 29,000 of those infected died within a month of being diagnosed. 

• 80% of the deaths were people 65 years or older. 

What is Your Opinion? 

What do you, as a caregiver, think should be done about preventing Clostridium difficile infections? Should healthcare facilities implement  stricter rules about hygiene for patients or residents as well as staff? 


Should staff numbers be increased to keep infections under control? Should people who are infected be kept in isolation until they are no longer contagious, (even if it is your loved one)?


Should health care providers work harder to educate family about being proactive in regards to infection prevention? 


Should we work harder to eliminate the use of un-necessary antibiotics as an act of prevention? Or should we just seek out more efficient treatment options (such as fecal transplants) after the fact?

Share your thoughts in the comments!

(Go here to read CDC information.)

Halloween Boo Bucket For the Elderly

Ready for a fun way to surprise the elderly this Halloween? How about a Halloween Boo Bucket filled with goodies?

Seniors love Halloween too. And almost everyone loves getting a gift basket, treat bucket or bag full of surprises, right? This is a fun, easy, and relatively inexpensive way to let an elderly loved one, neighbor or friend know that you are thinking about them!

The Winter Blues--Protect the Elderly From Seasonal Depression

source: Jayme Kinsey

Are you prepared to help your elderly loved beat the winter blues? As fall hurries by, and the days grow shorter, senior citizens can be at risk for depression.

Autumn leaves are more than just colorful litter in your yard. They are a sign that we are officially kicking off the holiday season.

That means that the upcoming months should be full of warm, pleasant rituals, right? Fireside cuddles, good books, hot cocoa, family and friends, dinners, presents, decorations, snow ball fights?

Rather than a sense of comfort, these winter activities could bring on an increased sense of loneliness in the elderly. What starts out as the winter blues could escalate into a condition known as SAD.

More than 4% of all Americans suffer from

Dementia or Dehydration?

If you care for someone with Alzheimer's or dementia, then you know how frustrating it is when a doctor asks the world's dumbest question; 

"Does she/he ever seem confused?"

Confusion, slurred speech, forgetfulness, and hallucinations can be signs and symptoms of a variety of conditions. However, for those with a dementia, they can be the daily norm. 

Yet, ignoring these signs could allow a silent killer to

Fall Cleaning For the Caregiver

In a previous post, I talked about helping the elderly clean and winterize their homes. Now, its time to talk about cleaning house when you are a full-time caregiver in your own home.

I heard that groan.

I know.

But keeping a clean house really IS important when you have an aging loved one. With weakened immune systems, and decreased sense of smell, taste, and sight, the elderly could be considered

Winterizing the Elderly| Helping Aging Loved Ones Prepare for Bad Weather

Is Your Elderly Loved One Ready For Winter?

Winter can be a dangerous time for the elderly. Not only are they more susceptible to colds and viruses, they have to worry about slippery sidewalks and stoops and not being able to obtain necessities such as medications or food.

Just like everyone else, the elderly need to make preparations for winter. Usually, this blog focuses on advice for people who provide full-time care for a loved one in their own home. But there are many elders out there that don't need full-time care. They are still mostly independent and live alone, but they may need a helping hand when it comes to

Keep Calm, Caregivers

4 Things You Should Tell Someone With Dementia

What can you say to someone who has had their memories stolen? What can you say to someone who may not know your name, or why you are visiting? You can say a lot. You say these things everyday...

Protecting the Elderly From Summer with Cool Zones

Elder Care Issues--Summer and Elder Safety

How hot is it outside right now? The sun beat down on us today, with an actual temperature of 98, and a heat index of 109. That is pretty hot.

In fact, when the temps soar that high, it is hard for air conditioners to keep up. That means that cars and homes can still be stuffy and uncomfortably warm even with the A/C turned down past the recommended energy-saving temperature.

So what does that mean for people with no A/C?

Sure, humans survived for centuries without artificial cooling systems. That doesn't mean that it was safe, or that people didn't die back in the day from heat exhaustion and dehydration. Although the young and healthy, and those accustomed to working outdoors in all sorts of weather conditions, can rough through the hottest days of the year, the elderly are particularly vulnerable to the dangers of summer. 

Last week, my sister-in-law, who is the library director, mentioned that she was taking donations of puzzles and other games. Why? Because the library has been declared a Cool Zone.

What is a Cool Zone?

Cool Zones are exactly what they sound like. They are public places where anyone can come inside to escape from the heat.

Even though most stores and businesses are running their air conditioners, many of these places don't encourage people to loiter indoors if they aren't shopping. The homeless, and those who live in homes without cool air need a place where they can basically "hang out" during the hottest times of the day.

 The library is a great place, because it offers plenty of entertainment. Other local places include the senior center and one old timey drugstore that still has a soda fountain.

As she was talking, my sister-in-law mentioned that one elderly gentleman with dementia comes is brought to the library every day. While there, he works jigsaw puzzles--sometimes assembling 1000 piece puzzles in just a few hours, and then partially taking them apart to leave for the next person to work.

How awesome is that? Not only is this man kept indoors in the cool air, he has something to occupy his time. He has the opportunity to socialize, and he is minimally supervised without having to feel as though he is being babysat.

Every communities needs a Cool Zone. Every community could probably use more than one.

Why Are These Cool Zones So Important?

Last year, dozens of elderly persons were brought to the local hospital with heat -related illnesses. Many were dehydrated. Some had suffered heat strokes.

There are several reasons why the elderly suffer from the summer weather, including:

• Poverty. Many are too impoverished to afford proper cooling systems. Or they may be saving pennies and not running the air conditioners or fans. 
• Water quality. Here, most drinking water is drawn from local lakes. When they turn over in summer, the water can become fetid and discolored, making it unappealing to drink. A person may not be able to afford enough bottled water or filtering systems, and may ration their drinks. 
• Medication. Some medications react with heat or sunlight. Or, when taken in hot weather, may cause queasiness that makes eating and drinking unappealing. 
• Dementia. People with dementia often forget to drink. They may not realize they are too hot.

Those are just a few reasons why the elderly should be protected in during hot weather. Cool Zones however, are for everyone who needs them, a when temperatures reach numbers such as 115 degrees (not uncommon here), anyone can need a break.

Only three weeks ago, their was a motorcycle charity run organized to raise money for an injured child. Although there were frequent stops and cool refreshments, many riders came close to heat exhaustion before the ride was completed. (kudos to the selfless men and women who braved the heat to help a needy family meet their goal though!)

Thankfully, local restaurants, gas stations, and  other businesses always open their doors and welcome riders even when they aren't buying anything. These temporary Cool Zones often hang out banners, signs or flags letting people know they are prepared to help anyone who is at a risk for being overheated.


Does Your Community Have A Cool Zone?

If you have an elderly loved one, or know of any elderly persons that might not have adequate ways to stay cool, check your community for cool zones. These are not just important for people who stay at home, but also for any seniors who may be driving. It should be a matter of safety to know where these areas are located while running errands.

You can help too. Ask around and see if libraries, community or senior centers, churches, etc. need donations of old puzzles, games, books, magazines, etc.  As about donating water or ice, too.

In the meantime, make sure your elderly loved one has access to either an air conditioning system or plenty of fans. Make sure they have clean water and ice. If they can drink it, it is also smart to keep a sport's drink or bottle of Pedialyte on hand in case of dehydration.

Caution elders about wearing sunscreen (yes, it is important at any age!), staying in the shade when out doors, and not working in yards or gardens during heat advisories. Check their medication for any information about heat or sunlight.

If you take your loved ones out for day trips, make sure they get plenty of rest and hydration during outdoor activities.

And most importantly, learn the signs of dehydration (which can  manifest differently in the elderly) and heat exhaustion.