Dakota Home Care Blog


UTIs: Symptoms, Causes & Prevention in the Elderly

The basics about UTIs can be found in one of our first blogs, Health Wise – Urinary Tract Infections in the Elderly. Because UTIs continue to be a very common, serious and frequently undiagnosed illness in the elderly, today’s blog provides additional information about UTI symptoms in the elderly, causes and prevention. Symptoms The most common reason UTIs often go undiagnosed in the elderly is because the symptoms don’t mirror typical symptoms of UTIs. What can be an easy cure (antibiotics) might not be administered, because your first thought could be that your elderly loved one has a much more serious condition, like dementia or other permanent behavioral changes. The most commonly recognized symptoms of UTIs are frequent urination, burning pain, cloudy urine, a fever and lower back pain. Because many senior citizens’ immune systems have been weakened by time and are not functioning at optimal levels, they have increased susceptibility to any infection. Their bodies do not recognize or try to fight the infection; thus, no fever, but producing UTI symptoms in the elderly that can be very different: Disorientation, confusion or a delirium-like state Hallucinations: hearing or seeing things that aren’t real Agitation, depression or other behavioral changes Decreased motor skills and/or dizziness that causes frequent falls Why these symptoms frequently are the result of a UTI in an elderly is something of a mystery. However, as all infections can lead to dehydration which, by itself, can produce these types of symptoms, that may be one reason. Dehydration is common in the elderly for a variety of reasons. If any of these symptoms come on suddenly, an immediate visit to the doctor is called for. Make sure it includes a urine test to determine whether or not a UTI is the cause. A urine test can also help

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Caring for Elderly Loved Ones Who Don’t Live Near You

If you live an hour or more away from your aging loved one who needs help, you can probably consider yourself a long-distance caregiver. Even though distance makes it more difficult for you to participate in your loved one’s care, there are resources and tips that can help to make it easier. Even if there is a family member or other caregiver nearby, or your loved one lives in a care facility, there are many things you can do to provide emotional support and even help with care needs via the phone, email or during infrequent visits. What can I do? Too often, family members who live out-of-town assume there is nothing they can do to help, leaving a close-by caregiver to feel overburdened and alone. Because this person might not know what they could delegate to you, taking the initiative yourself and volunteering to do things you know you could do can be a big relief. For example, I have a not-so-nearby sister-in-law who volunteered to make regular visits to Dad in his assisted living apartment, assess his needs for personal products, favorite snacks, medical supplies, comfortable pants and other things she could shop for and bring to him. Not having to worry about whether or not he had enough incontinence products, as well as these other things on hand was a huge help to me. Here are some ideas to get you thinking about what you could do to help, even from a distance:  Ask How You Can Be Most Helpful Be sensitive to the feelings of any caregivers already on the job. Compliment them on what they are already doing, and then ask them and the care recipient how you can be most helpful. Talk to friends and neighbors who know your loved one to see if

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An elderly man is sitting in his living room reading a newspaper. He is smiling at the camera. Horizontally framed shot.

Tips to Make Your Home or Assisted Living Feel Like a New Home to Mom and Dad

Even if a loved one agrees that they can no longer live alone, finding a new home for seniors can be challenging when it comes to welcoming them into that home. The transition to your home or assisted living will probably seem more like a loss than a new adventure—at least at first. It will ease the process if you empathize with their feelings and give them time to mourn their loss, while at the same time doing what you can to make them feel more at home in their new surroundings. Anyone who has to downsize from their home feels like they are leaving behind a lot of their past. If your loved one is able to make informed decisions, allow them to be part of the sorting process and help to choose what to take with them, as space allows to. For things they love but just can’t bring with them, take photos and put them in an album to be looked at frequently and enjoyed vicariously. Offer to store things like some seasonal decorations, clothing, and other things they will use only occasionally. Moving to Your Home Daytime space of their own is important when moving a loved one into your home. Try to provide at least a corner of a room with their favorite chair, a side table and lamp from their home, a TV, and a small book shelf for reading material, photos or other things they will use or look at frequently. If possible, move things around so they have natural light in their corner. Remember, Dad or Mom may have visited your home many times, but until now they’ve never had to consider it their home. In their bedroom, use the bedding they’re used to, unless they want something new. If there is

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Peripheral Neuropathy: The Prevention and Care of Sores on the Feet

Peripheral neuropathy is the term for damage to nerves that carry messages to and from the brain and spinal cord, usually to the hands and feet. It can cause weakness, numbness, and pain or lack of it. Three to four percent of people over the age of 55 are affected. Neuropathy is most common in people with diabetes, but it can also be the result of traumatic injuries, infections, metabolic problems, autoimmune or other diseases, exposure to toxins or some medications. As many as one-third of all neuropathies are from an unknown cause, and are classified as idiopathic. To learn how we can help a loved one affected by peripheral neuropathy stay home safely, contact us online or call us at (877) 691-0015. Signs and symptoms of peripheral neuropathy might include:1 Gradual onset of numbness, prickling or tingling in your feet or hands Sharp, jabbing, throbbing or burning pain Extreme sensitivity to touch Pain during activities that shouldn’t cause pain, such as pain in your feet when putting weight on them or when they’re under a blanket Muscle weakness; lack of coordination and falling Feeling as if you’re wearing gloves or socks when you’re not Seek medical care right away if you or a loved one notices unusual tingling, weakness or pain in the hands or feet. Early diagnosis and treatment offer the best chance for controlling symptoms and preventing further damage to peripheral nerves. Complications People with chronic neuropathy often lose the ability to feel temperature and pain. They can burn themselves or develop open sores that are the result of pressure and friction, as from an ill-fitting shoe. Feet and other areas lacking sensation can become injured without the person knowing it. For example, without pain to signal there’s a problem, people with neuropathy can allow small abrasions

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a stack of elderly parents' finances piling up

How to Manage an Elderly Parents’ Finances

You’ve noticed some telltale signs that your elderly parents are becoming less capable of managing their finances. They may be making mistakes or letting bills pile up. (See last month’s blog, “When to Take Over Finances for Elderly Parents.”) Now comes the biggest challenge—how to help them with money matters or talk them into letting you take over completely. The Best Approach for Your Family Talking about finances can be a touchy subject, and you may find it especially difficult getting the conversation started. Maybe your parents have been open with you about their finances, but maybe they’ve never shared anything about how much money is on hand, coming in or going out. Some ideas to help you get started might be: Share what you have done to get your finances in order. Then ask your parents if they have done similar things. Share a story you’ve heard or read that’s about what another elderly person has done, as things became more difficult for them to handle their finances alone. Ask what you can do to help them. Involve just a few family members. That can be less intimidating than a meeting with the whole family. You don’t want them to feel like you’re ganging up on them. Focus on how helping them will help you to worry less about them. Don’t focus primarily on their physical or mental decline. Make them part of an ongoing conversation. Let them give as much input as they can and make their feelings be known. Get an objective third party involved, like a religious leader, a family attorney or their financial planner. Preserve their dignity. Be aware of their need to be as independent as possible. Keep the conversation respectful and light-hearted. Ways to Transition Slowly If they haven’t already put regular bills,

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When to Take Over Finances for Elderly Parents

The National Council on Aging suggests that planning for the inevitable need to take over your parents’ finances should begin with a family meeting, ideally while they’re in their early 60s. Another watermark can be when they retire. Even if those years have passed, family caregivers should still be on the lookout for signs that “the time has come!” One thing is sure, you mustn’t let any awkwardness you feel prevent you from stepping in to assist, because if you don’t, others will, and they probably don’t have your parents’ best interests in mind. What You Need to Know Even if you currently have no worries about your parents’ physical or mental health, start to familiarize yourself with their finances. The sooner you integrate yourself into that element of their lives, the more comfortable they’ll be including you in important decisions, and the easier it will be to take full control when the time is right. It’s never too soon to gather the information you’ll need, so you will have it when your elderly parents can no longer take care of their finances. This is a list of 10 pretty standard things that all family members should know:  If they have named a durable power of attorney (POA) to manage their finances Where they keep their financial records and how you can access them Their bank account numbers and the names of their financial institutions What their monthly expenses are How they pay their bills: by check, auto pay, online banking, etc. What their annual income is, and where it comes from Who has permission to manage their Medicare, Medicaid or Social Security accounts Do they have medical health insurance in addition to Medicare Do they have long-term care insurance How to contact their accountant, financial planner or attorney Not

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Seniors Who Feel Compelled to Shop

Some seniors have had compulsive shopping or shopaholic tendencies their whole lives. Just because they get older and have less discretionary income doesn’t mean that they will adjust to their new financial situation. Even seniors who weren’t big shoppers previously might spend recklessly in excessive senior shopping in an attempt to relieve feelings of depression, boredom, grief and/or loneliness. Some feel they deserve to splurge, because they’ve been frugal all their lives, and they think that now they should be able to buy whatever they want. If you could use support watching over the shopping activities of a loved one, our compassionate caregivers can help. Contact us online or call us at (701) 663-5373 to learn more. Is It Retail Therapy? As friends, family and abilities dwindle, retail therapy gives many people a short-lived mood boost. Online ordering, television shopping channels and mail-order catalogs make it so seniors don’t even have to leave home to over-use their credit and debit cards. Limited mobility and age-related health issues can make it harder for an older person to manage their behavior and hide the consequences. If a loved one who has previously been responsible with their money and kept their home free of clutter suddenly begins spending frivolously and accumulating purchases and other things, it may indicate a mental health issue, such as depression and/or cognitive decline. Dementia also can play a role in senior excessive shopping. Your mom may actually need a new set of sheets but a memory lapse causes her to repeat the order several times. Deliveries arrive frequently, and unopened packages are strewn throughout the house. Impaired judgement and comprehension can also lead to unusual impulse purchases. If no family members or friends are aware of a senior’s excessive shopping habits, their financial situation can rapidly get out

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Is It Hoarding or a Normal Attachment to “Stuff”?

How to Help Your Elderly Loved One “Clean House” Several people I know have a problem with elderly loved ones who can’t bear to part with all kinds of “stuff.” When their home is no longer a safe or sanitary place to be, or it comes time to move them out of their homes, the elderly person wants to keep everything. Their children often have to make difficult and upsetting decisions for them. If they still have access to credit cards and a computer, many order a lot of stuff that they don’t need. Deliveries arrive frequently, and unopened packages littler the house. Some might call this “hoarding,” but is it? And what can be done to help your loved one keep just the necessities and a few sentimental items, while maintaining a kind and respectful relationship with them? Contact us online or call us at (877) 691-0015 to learn more about how we can help with in home caregiver services. What is Hoarding? True hoarding is a complex disorder that is not yet fully understood by the mental health profession. It can be compulsive shopping or just saving so many things that it leads to health and safety issues in the home. It can put a strain on the person’s and/or the caregiver’s finances. The most common items hoarded are newspapers, magazines, clothing and books. Elderly people might say they acquire and keep all that “stuff” because they believe that an item will be useful or valuable in the future. Or they feel some things are unique, hold sentimental value and are irreplaceable. When compulsive shopping is the problem, the explanation might be finding “deals,” even if the deal is something they don’t need or want.   Signs and Symptoms of Hoarding Hoarding is different from cluttering and collecting. Hoarders

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Support for Personal Caregiver

Tips on How Personal Caregivers Can Take Care of Themselves

I have a single friend who is the sole personal caregiver of her 93-year-old mother. She also works full-time at a very stressful job. Fortunately, her mother can still be alone for most of the time my friend is at work. The only outside help she allows is when I and some other neighbors help her mom with her lunch or take her out for a short walk with her walker. Her sister takes their mom to get her hair done once a week and to routine Dr. visits. My friend uses PTO to take her mom to more important appointments. Just twice this year she asked her sister to help their mom with her dinner and to get ready for bed so that she could have an evening out. Although others have offered to give my friend more help with her mom, she says that no one else knows how to meet her every need. She usually gets less than 6 hours of sleep a night. I’m convinced that my friend is at serious risk of losing her own health because she doesn’t accept help in her role as her mom’s personal caregiver, and that she may do so while her mom is still in need of her constant help. Personal Caregivers, Take a Look at Yourself As family caregivers of a loved one, do you see anything like your own situation in my friend’s story? Are you experiencing health problems? Do you recognize them as being related to the constant stress, lack of sleep, manual labor, financial worries and lack of personal time caused by having to–or thinking you have to–do almost everything yourself to meet your loved one’s needs? Are you convinced that there are no caregiver alternatives that will help you take care of yourself, while

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family caregivers

How Family Caregivers Can Relieve Stress During the Holidays with Respite Care

We’ve written before about Caregiver Burnout and Ten Tips to Help the Elderly and their Caregivers Enjoy the Holidays. But zeroing in on family caregiver stress—what it is and how to cope with it—can be a vital part of self-care and burnout prevention, especially during the busy holiday season. The first step to relieving stress is to recognize when you are feeling it in a negative way, and what is causing those feelings. Stress can be described in a number of different ways: Stress can feel like the inability to cope with a real or imagined threat to your mental and emotional well-being. You could compare the effect on your body to a “fight or flight” response. Stressors can be physiological or emotional events that you perceive to be stressful or out of your comfort zone. What is stressful for one person might not be stressful for another. Stress can have a short-term or a long-term (chronic) negative effect on your mind and body. Stress can occur when the mind-body-spirit connection is out of balance. Negative thoughts can cause a physical response that makes your spirit feel “down” or even makes you physically sick. A person who becomes a family caregiver experiences large and small changes in their life that may continue over time, and make a normally busy time, like the holidays, even more stressful. Identifying stressors that are a result of your role as caregiver, added to the stress of the holidays, can be the first step to relieving your stress. These can be physical, social, emotional or economic. It can be helpful to make a list of what your stressors are. Some of the more common ones include: The loss of time for leisure activities, time for yourself, sleep, healthy eating or exercise Worries about finances: suddenly

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National Home Care and Hospice Month: Keeping Home an Option for Dying Loved Ones

November is National Home Care and Hospice Month. We invite you to join us in honoring the millions of nurses, home care aides, therapists, and social workers who make a remarkable difference for the patients and families they serve. Dakota Home Care is privileged to share the stories of two of our clients for whom home care and hospice made a remarkable difference for them and their dying loved one.  Todd Kuester & His Wife Terry In the fall of 2016, My wife, Terry, was diagnosed with terminal brain cancer. She was given only 18 months to live, but with chemotherapy, radiation, and loving care she was able to live for 29 months. With the help of Dakota Home Care and Hospice, she was able to stay in our home—her dream home—until the day she died. About a year ago, Terry’s cancer, which had been in remission, came back with a vengeance. She became paralyzed on her left side. At that point, we knew we needed help. Terry told me to put her “in a home,” because she didn’t think I could take care of her—it would be too hard. I told her “You live in a home.” I knew she wanted me to take care of her. A doctor at Sanford hospital, gave me some names of home healthcare companies. I called Dakota Home Care (DHC) first. They sent a Registered Nurse (RN) to meet with us and assess our needs. I asked, “What if my wife doesn’t hit it off with the people you send?” The RN immediately replied, “Let us know, and we’ll get someone else!” I was very impressed by that. In January, DHC sent us two very kind and loving CNA caregivers, Viola and Shannon. They were God’s angels on earth. They were very good

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Transport service

Physician & Surgical Appointments—New Advocacy and Senior Transportation Services from Dakota Home Care

In his 90s, my dad always needed someone to take him to a Dr. visit, not only because he couldn’t drive, but because he couldn’t give vital information about himself, describe what was wrong, ask follow-up questions or remember what he had been told and instructed to do. He needed an advocate. Now, I am going with my 79-year-old husband to most of his doctor visits, because even in early-stage Alzheimer’s, he has similar difficulties. But what if you can’t be there to transport your loved ones or advocate for them, whether it be for regular Dr. visits or pre- and post-surgery?  Dakota Home Care now offers senior transportation services for families that can’t always transport or advocate for a loved one who can’t or shouldn’t be expected to do it for themselves. Regular MD Appointments Every elderly, or handicapped person probably has more than the usual number of appointments required to maintain health or to deal with chronic illnesses or pain. Even you might be intimidated during an appointment. You would be relieved to have someone there who knows the pertinent information to give about the patient and the important questions to ask. A Dakota Home Care Nurse has years of experience, will know what to say and will understand what the doctor says, giving you peace of mind and guidance through the whole process. Services: Transportation to and from the doctor’s office Expertly advocating for the patient during the visit Helping describe the purpose of the visit to a medical professional Asking pertinent questions about the patient’s wellbeing Reporting the findings of the visit and care recommendations to the family Having Surgery A diagnosis that requires surgery can be frightening and raise many questions about navigating and getting the best results from the whole process. There will be

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For World Alzheimer’s Month, Let’s Raise Awareness and Challenge the Stigma

World Alzheimer’s Month is the international campaign held every September by Alzheimer’s Disease International (ADI) to raise awareness and challenge the stigma that surrounds dementia. World Alzheimer’s Day is on September 21st. Two out of every three people globally believe there is little or no understanding of dementia in their countries. The impact of World Alzheimer’s Month is growing, but the stigmatization and misinformation that surrounds dementia remains a global problem requiring global action. World Alzheimer’s Month seeks to unite opinion leaders, people with dementia, caregivers and family, medical professionals, researchers and the media from all around the world. More information about the campaign can be found at https://www.worldalzmonth.org/ . Dementia is a collective name for progressive degenerative brain syndromes that affect memory, thinking, behavior and emotion. Alzheimer’s disease is the most common type, affecting up to 90% of people living with dementia. Other types include vascular, Lewy bodies and frontal-temporal dementia. Raising Awareness Dakota Home Care is committed to supporting the goals of World Alzheimer’s Month. We respectfully provide specialized home care assistance for clients with Alzheimer’s and other forms of dementia. We work with the local Alzheimer’s Association for education and training and facilitate home consults with their specialists. We provide in-house, online and hands-on training for caregivers. Through our blog, we also raise awareness about dementia and caring for those who have it. You can learn more about these 10 related topics by clicking on the links: Increase Your Understanding of Alzheimer’s Disease Can Lifestyle Changes Affect the Onset or Progress of Alzheimer’s Disease? Alzheimer’s Progression: Is It Possible to Predict? Diagnosing Dementia—a Personal Story “Why did I do that!?!” Caring for a person with impaired judgment and decision-making ability. How to Make Your Home More Comfortable for a loved One with Dementia Why a Daily Routine Is Important

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End of life signs

Recognizing when Death is Near: Planning for End-of-Life Care

It can be just as difficult to predict the exact time that someone will die as it to predict exactly when a baby will be born. However, there are signs you can watch for that will help you prepare mentally, emotionally and physically for this big change in your family’s life when end-of-life care is needed. As you care for your loved who may be near death, look for normal signs like these: Losing interest in and becoming less responsive to what is going on around them Sleeping or seeming drowsy most of the time Eating and drinking less than usual or not at all Irregular breathing, including noisy or gurgling sounds, sometimes called a “death rattle” Talking to someone who has already died A brief surge of energy and clarity of mind The loved ones of a person who is dying want to know what they can do to make the person more comfortable. Even though a dying person may seem unconscious, many professional caregivers think hearing may still be functional. Continue talking to your loved one. Express your love, hold their hand and reassure them that they can go when they are ready. Take advantage of a brief period of consciousness to say final goodbyes. Even though my father couldn’t talk, we put the phone up to his ear to let out-of-town family members talk to him. He seemed to respond to hearing their voices. Don’t try to force food or water. Going without food or water is not uncomfortable. Swallowing may also be a problem, especially for people with dementia. A conscious decision to give up food can be part of a person’s acceptance that death is near. If the person’s mouth seems dry, just swab it with water and apply lip balm. A “death rattle” may

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Senior resting

End-of-Life Comfort Care

When a patient can no longer benefit from curative treatment, comfort care allows them a better quality of life. Comfort care does not seek to cure or aggressively treat illness or disease. It focuses on relieving symptoms and optimizing comfort as patients near the end of life. Comfort care can be given at home and nursing facilities. Most patients and family members prefer home to hospitals. Hospice care is one source of comfort care delivery. Comfort care is sometimes called palliative care, but the terms “palliative care” and “hospice care” cannot be used interchangeably. Hospice can be provided in the last six months of life. Palliative care can be offered anytime in the course of an illness. Loved ones with a wide range of health conditions can benefit from comfort care. This includes cancer, heart disease, chronic obstructive pulmonary disease, and dementia or Alzheimer’s disease. Sometimes loved ones oppose stopping aggressive treatment for a condition and moving to comfort care. They may feel that there is still hope and not realize how much discomfort the treatment is causing their loved one. It to know and ensure the patient’s needs and wishes are honored. Many people approaching death make their own choice to stop treatments that cause significant side effects, preferring treatments that improve comfort. Your loved one also may prefer to die free from the life-support, such as ventilators and dialysis. Choosing Where to Die In Comfort Your loved one might have preferences for end-of-life care and where to receive it. Try to clarify which type of care your loved one wants. Options might include: Home care — Most people prefer to die at home or in the home of a family member. You can assume the role of caregiver or hire home care services for support. Hospice care — services that help ensure the

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