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Aging Care Solutions
August 2018 Caregiver eLetter
      Vol. 21, No. 2
     The gauntlet was passed to us and we accepted it.
 Therefore we will cope, and in so doing, set an example 
 for our children, and the generations to follow.
Contact Kay at 972-839-0065 or
www.AgingCareSolutions.com or
kay@AgingCareSolutions.com or kay@kaypaggi.com
   In recent months I've received several calls from people who are caring for beloved parents that are not aging well. I generally refer these callers to a care manager who is in active practice while I am in recovery. After further thought I believe that many people do not need a complete assessment of the parents' circumstances but rather need someone to listen to their particular issues and make a few suggestions for improvement.
   If you need someone who has more than 20 years of experience dealing with caregiving and older adults but do not need a complete assessment, please call me and let's talk. 972-839-0065
In this Issue:
Surgical Recovery - Rehab Patients
Nursing Home Staffing

Mental Aerobics
Elder Humor
     In the fall of 2017 I had surgery to correct several spinal conditions. In the next few  eLetters I will discuss the process of surgical recovery. In last month's eLetter I discussed hospital care and types of rehabilitation hospitals. My goal is to provide information to older adults and their families, not only about spinal surgery, but also recovery from various types of surgeries. Hip and knee replacement surgeries are frequent, as well as falls requiring surgery. Knowing what to expect can be helpful.
   People in inpatient rehab do not want to be there.  Rehab is painful, tedious work, and it is frustrating to not be able to do the things you always have done, such as walk and dress yourself. Some patients are admitted following a scheduled surgery and probably knew they would spend some time in a rehab unit - but they are not happy about it. Others are there following an unexpected event like a fall or other accident. These patients sometimes have only hospital gowns that they were wearing when they came to rehab. Patients with nearby friends or relatives are fortunate to have someone to pick up clothes from their home to wear at rehab. One patient wore hospital gowns until she could get a relative from out of state to go to her home for clothes. Generally, ‘workout’ clothes with loose-fitting pants and soft shirt are best.
   Some patients are not able to wear clothes brought from home because their casts are larger than anticipated or the swelling bigger than expected, so family or friends bring items appropriate for rehab, and hope to get the sizes right. Once admitted, it is too late to go shopping for clothes. Shoes are important, too; non-slip tie-ons are perfect but it’s hard to find the correct size from your rehab bed.  Many rehab patients wear TED hose and socks with ‘grippers’ instead of shoes.
   Most patients at Presbyterian Village North eat their meals in the dining room with other patients, although there is the option of eating alone in their room. Sitting with other patients gives patients the opportunity to share small victories ('I walked 100 feet today!'), opinions about therapists and physicians, as well as setbacks in the therapy process. It is helpful to see fellow patients being discharged after completing their successful therapies. For most patients, interacting with temporary peers is therapeutic.

   In the mornings aides come to patient rooms to assist with dressing. At first, patients are dependent on aides for many things: help with dressing and bathing, getting ready for bed, toileting, help to the wheelchair or walker. Aides bring patients to the dining area for meals, if needed. They change bedsheets and clean patient rooms while patients are in the rehab gym. 
   Therapy begins after breakfast and concludes before dinner. Because patients come and go from rehab, the daily therapy schedule is flexible. Therapists are given a list of patients to see each day, although generally the same therapists see each patient through the course of rehab, just rarely at the same time each day Three hours of daily therapy is the goal but not a requirement. Sometimes a patient’s daily three hours are completed before noon; other days it hasn’t started by noon. This makes it challenging to arrange a visit with family or friends. When you visit, remember that inpatients need someone to listen to their complaints, so don't expect a happy social visit. Bring items from home, if possible, such as plants or bedspreads. Encourage them to talk, bring news from home, and leave. Their mood will improve after discharge.
   Most patients are in bed by 8 pm; therapy is exhausting and they do not always sleep well. Nights are almost as busy as days. Patients have difficulty sleeping with their discomfort or pain, or turning over with a heavy cast. Nurses come in to check regularly, to give night time medications, and in response to the call button; phlebotomists come to draw blood; around 5 a.m. the aides bring fresh ice water. Physicians make rounds before breakfast
   Mental Aerobics is a program of cognitive exercises that I developed in 1994 for use in group settings. It has been studied on three occasions by researchers and found to increase cognition in the participants. These studies have been published in academic journals that are sited on my website. I have posted examples of exercises used in Mental Aerobics, along with the answers, on my website.  http://agingcaresolutions.com/Mental-Aerobics
   I do a one-hour weekly class of Mental Aerobics in various communities. If you have family in a community, or are employed in one, and are interested in having Mental Aerobics in your facility, please contact me. I always offer a free one-hour session before adding Mental Aerobics to a community's calendar, to see if residents will find it interesting.
- Think of phrases or sayings using the word 'one.' For example, World War One or One day at a time. 
I have 50+ on my list. How many can you find without looking at the answers?

 - Look for words that contain the word 'one', such as cone and lone. Several contain six or more letters. See if the words below are on your list!

Fill in the blanks to complete these common words containing ONE.

1. ___   __    _  O N E ___ T
2. ___ ___ O N E ___ R
3. ___ ___ O N E  ___  ___  C
4. ___    ___    ___  ___  O N E ___  ___  E
5. ___    ___    ___  ___  O N E ___  ___  ___  Y

(Answers below)      

As you have suspected, most nursing home have fewer caregiving staff on duty than they reported to the government. Kaiser Health analyzed payroll data supplied to Medicare to find the discrepancies. Previously nursing homes have self-reported, and this less than accurate data has been posted on Medicare.gov. The new report found significant daily fluctuations in staffing and major staffing shortfalls on weekends when on-duty personnel cared for more than twice the number of residents than on days when all staff were working. This can lead to increased time between scheduled medications and pain killers, and more time before turning bedbound patients, resulting in bedsores and hospitalizations.

Read the entire story on New York Times. Thanks to Seasons Seminars for bringing this to my attention.
Answers to Mental Aerobics
at any one time
back to square one
in one ear and out the other
go one better
hole in one
I owe you one
If it's not one thing, it's another
in one piece
look out for # one
one among many
one day at a time

one size fits all
one foot in the grave
one horse town
one horse sleigh
one man show or band
one of these days
one true love
one nation
one-armed bandit
one-hit wonder
one-two punch
public enemy #1

Plus More!
1. Soonest
2. Pioneer
3. Phonetic
4. Marionette
5. Dishonestly

   My client's husband had just died. She and her daughter and grandson went to eat at a crowded restaurant where it was hard to hear, and were seated at a round table. 
   She said, "I just realized I'm a widow."
   Her grandson, who is across the table and can't hear exactly what she said says, "No, you're not."
   Her daughter, sitting right by the widow, says gently to the grandson, "No honey, she is a widow."
   To which the grandson replied, "Well, she's not any more a weirdo than she ever was."  :)

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