Wednesday, August 30, 2017

Defeating Malnutrition in Older Adults

by Emily Anderson

I used to read the back of my cereal box every morning as I was groggily getting my day started. At some point, the boxes I was reading transitioned from fun games and puzzles to infographics on good nutrition and balanced diets. We all know that eating right is important for energy and weight management, but it is also an important underlying factor in wellbeing, disease, and recovery from illness.
Nutrition can become more difficult to maintain with age due to medical, social, and psychological factors. As many as 30-60% of older adults qualify as malnourished, and malnourishment worsens with events like surgeries and hospital stays. As a caregiver you may be concerned about keeping your loved one healthy and nourished. Understanding what is going on, what to look for, and what to do can help you keep your loved one on the right track, or healing after a setback.


How Malnutrition Develops

Malnutrition is rarely the result of neglect. More often, it sneaks up on a person and their caregiver due to a combination of medical, social, and psychological causes.
First are medical factors. With age comes some profound changes to the way we taste and digest food. Due to changes in the GI tract and hormones, older adults tend to feel full sooner and are less sensitive to noticing their hunger. Loss of taste buds and medication side effects can make food taste bland or unpleasantly bitter. An older adult, for example, needs eleven times as much salt in a dish in order to sense it. Other common medications—like those for high blood pressure, cholesterol, antibiotics, and heartburn—can reduce appetite, cause nausea or diarrhea, and reduced absorption of nutrients. Only 35% of people over age 75 have all their own teeth, which contributes to dry mouth and difficulty chewing. This particularly leads to a lack of fiber, protein, and the micronutrients often found alongside those first two, like calcium and iron. Finally, particular disease like dementia can create confusion about how to prepare foods, as well as making it more difficult to eat and swallow.
It’s not all medical though. Ever had to cook for just one, and then eat your meal alone too? It certainly doesn’t encourage you to put a lot of effort into the meal. People who live alone are more likely to be malnourished. If your loved one is on a fixed income, they may have difficulty affording high-quality, nutritious food. Older adults experience a lot of loss as well, as friends or family pass away, which can lower appetite. Finally, many older adults experience depression, which often goes unnoticed or untreated, and contributes to a loss of appetite.
Once an older adult becomes malnourished, it takes longer for them to regain good nutrition due to these complications as well. The best approach is to prevent it if possible, and if not, then to notice it as soon as you can and take action.


What to Watch Out For

  • If you go to the doctor with your loved one, write down their height and weight. Use this calculator to figure out your loved one’s Body Mass Index (BMI). Anything under a BMI of 23 is a concern. 
  • Watch your loved one for changes in appetite, and ask if they are experiencing changes.
  • Take note of unintentional rapid weight loss of 5-10lbs over 6 months that leaves their clothes dropping and dangling.
  • Peak in their refrigerator to see what kinds of food they are eating and how much is getting left behind.

What to Do

  • Talk to your loved one about yours concerns. Try to find out if they are having low appetite, or their food tastes bland, or they are getting indigestion.
  • Ask for a consultation with a nutritionist to make a dietary plan. Your primary care doctor may also be able to help you make a plan.
  • Pack your food with flavor! Load up on herbs, vinegars, and ingredients that add flavor without adding salt, sugar, or fat. Read this article for more healthy ideas to pump up the flavor on healthy meals.
  • Encourage your loved on to eat foods high in folic acid, B-12, Vitamin C, Vitamin D, and Omega 3s.
  • Join a congregate meal program. Most senior centers offer lunches that are low cost but filling and nutritious, as well as enjoyable to share in good company.
  • Keep some nutritional shakes on hand, either as a powder you can add to meals or that you can mix up as a drink. Mixes with protein are often sweet, while vitamin-only drinks often come in fruity flavors. Beware of high-sugar drinks like Gatorade though, that offer little nutrition and a lot of diabetes.
  • Use supplements as a last resort. It’s always best to get your nutritional needs from food, but a supplement can help fill in the gaps. If your loved one doesn’t want yet another pill, try gummy or liquid vitamins.

Happy, healthy eating!


Wednesday, August 23, 2017

Back to School: Helping Older Adults Use Technology

by Emily Anderson

Mrs.W was so stiff she could hardly stand, but she could tell endless stories of shoveling coal into her basement to heat her family home and hauling ice blocks inside to chill her home-delivered milk. For her, a microwave was still a "new technology," and one she wasn't too comfortable with. Meanwhile, my grandfather took photos at our last holiday gathering using his light-as-air iPad.

Whether it's a microwave, a TV remote, or a tablet with apps, many older adults don't feel especially comfortable with technology. But as of 2012, more than half of older adults are bravely venturing into the worlds of internet and computerized gadgets.

Technology has the potential to ease and enliven many aspects of aging. Your loved one could enjoy video chatting with grandchildren or seeing pictures of your latest vacation on Facebook. Ridesharing services can help people who no longer have a car remain independent. And watching videos of cats on YouTube can bring a smile to just about anybody's face. Though they may feel tentative at first, you can help your loved one use technology that will enrich their lives.

According to the Pew Research Center, older adults most often point to three main challenges in adopting new technology:
Physical challenges
Skepticism about its benefits and risks
Difficulty learning to use it

Physical challenges includes problems like difficulty seeing small print on a screen or arthritis interfering with their ability to use a mouse pad on a laptop. When choosing a technology to introduce with your loved one, look for models that are easy to hold, hear, see, and handle. A tablet is easier to hold and see than a smartphone, for example, as are remotes with large buttons instead of a million tiny ones.

Skepticism can arise from many different areas, ranging from worries about online security to feeling just fine with the way things are now. Instead of pushing your loved one to adopt your favorite piece of technology, help them explore their own interest, even if it's tentative. Ask questions like "Have you ever thought about trying an e-reader?" or "If you did get a computer, what would you like to do with it?" Share positive stories of your experiences with technology.

The biggest challenge, though, is getting comfortable with the technology and learning to use it. Back when computers were giant machines that you gave instructions to through a punch card, it was easy make the whole thing seize up. Older people often fear that if they touch the wrong button, their technology will be permanently wrecked. Plus, technology comes along with a whole new dictionary, full of uploads and downloads, bytes and cookies (not the chocolate chip kind).

To help your loved one learn to use new technology, first select an appropriate device. It doesn't need to be fancy; straightforward is better. Then, set aside more time than you thought you would need to show them how to use it. Start with just one feature, and walk through the process step by step together several times. Have them try it on their own a time or two, and be encouraging even if they are going slowly. Avoid overwhelming them with too many special features, even if you think they are really fun and cool. Be prepared to show your loved one the whole process over again the next day, but as they get more confident, you can show them new features and uses for their gadget.

Technology can help make caregiving easier for you and your loved one, as it can help you both stay connected, entertained, and engaged.

Wednesday, August 16, 2017

Good News! The Caregivers First Initiative Lives On!

by Emily Anderson

This blog is run by the Familylinks Caregivers First Initiative, an effort to recognize and support caregivers of older adults in our community. Though we are based in Pittsburgh and only provide in-person coaching in Allegheny County, we strive to provide resources that can help caregivers wherever they are.

As a grant-funded program, though, we rely on the benevolent support of our funders. Thanks to the Pittsburgh Foundation, we are happy that we will be able to continue providing support to caregivers far and wide over the next year!

In addition to this blog, find out more about the one-on-one coaching and group workshops we offer by clicking here

Thank you to everyone who has helped us along the way! We're happy to be able to continue serving older adults and caregivers in the coming year!

Wednesday, August 9, 2017

Simple Ways to Support Caregivers

by Emily Anderson

As a caregiver, sometimes people ask you how they can help. In the moment, you might feel stumped. Do they really want to help, or are they just being polite? How much is too much to ask? Will they think you're a "Debbie Downer" if you share how frustrated you are? Even when we are struggling, overwhelmed, and tired, it can be difficult to ask for help.

And yet, it is critically important to get help with your role as a caregiver. The stress of caregiving is related to an increased risk of heart disease and strokes, depression, immune system deficiency, and even death. Sometimes, though, caregivers just aren't sure what to ask friends or family to do. One caregiver told me that she wished she could collect rain checks for favors from friends and family so that later, when she thought of something they could do, she could cash them in. We also hear from friends and family though, who say they want to help their friend, coworker, or employee, but aren't sure what to offer.

Below is a list of simple ways to get or give support. Keep in mind that people offering to help usually truly do want to help. They may be busy, they may have lives and families and work, but they probably still have an hour or two a week that they are happy to give to a friend, neighbor, or loved one. If you are the person offering help, be specific and persistent! Caregivers often feel guilty accepting help, but they will appreciate your efforts.

1. Deliver a meal
When the rest of life gets overwhelming, making a balanced meal can become the last priority. It's easy for a friend to double their own dinner and deliver a delicious heat-and-eat meal and free up time for other important tasks.

2. Listen
Caregivers often feel lonely in their role, but don't want to make anyone uncomfortable by sharing too much. Make it clear that you are ok with listening and letting them vent, or as a caregiver, ask if your friend minds lending you an ear for a while.

3. Visit at home
Getting out of the house can be challenging when your loved one is sick, but that's no reason to be lonely. Ask your friends to meet at the caregiver's house for a brown bag lunch or afternoon tea.

4. Offer a ride
Rather than meeting on location, carpool! Rides can also be helpful if the caregiver is going to a place that has challenging parking, like the downtown area of cities or an airport.

5. Use your special skills
Do you sew? Fix toilets? Mow lawns? Use your special skills to relieve caregivers in your life of work and worry.

6. Give a break
Many caregivers start to feel trapped and smothered by their constant role as a helper. Give them a chance to breath by offering to stay at home with their loved one for a few hours.

7. Send a note or make a call
Knowing that people are thinking of you can be a great lift for lagging spirits. If there is nothing else you can do, it always helps to let caregivers know that you are thinking of them

For more suggestions on ways to offer support to a caregiver, check out this list.

Wednesday, August 2, 2017

Take a Break!

by Emily Anderson

Hey new and loyal readers! We are on vacation this week, and think you should take a break too! Not sure what to do? Try these simple pleasures:

1. Make iced tea or lemonade and go sit outside in the heat for five minutes so you can really enjoy the chill of your summer beverage. 
2. When you're grocery shopping this week, grab some flowers for yourself. Put them in a vase in a central area and smell them every time you go by. 
3. Turn on some lively music and dance--by yourself or with your loved one! Don't worry about how you look, just start jiving however the music moves you. 
4. Set a timer for 5 minutes, lay down, and take nice deep breaths. If you're brain is feeling too hectic, try one of these free guided meditations. 
5. Take off your shoes and put your bare feet in the grass. For bonus points, do this in the morning when you can feel the fresh dew.

A few minutes here and there of a break can do a lot to keep you going day to day. Prioritize yourself and take a break today!