As the saying goes, you cannot fully understand what another person’s life is like until you “walk a mile in their shoes.” That’s the point behind an innovative training program designed to help caregivers truly appreciate what life is like for their loved ones with dementia. According to an article on GoErie.com, a division of the Pennsylvania newspaper the Erie Times-News:

“You don’t know what they go through until you do this test yourself,” said [Patty Gregory, a certified nursing assistant at Saint Mary's Home of Erie]. “I took care of my father for 12 years, and now I truly know what he went through.”

In order to give caregivers a taste of what what an elderly person with dementia experiences, this is what they go through:

• Kernels of uncooked popcorn are put in their shoes to make walking more difficult;
• Kernels of popcorn are dropped into rubber gloves before sliding them onto the caregivers’ hands;
• Some fingers of the gloves were taped together to make it more difficult to grab and hold objects;
• They wore goggles with dark circles taped to the middle of each lens to approximate what macular degeneration does to vision;
• A CD played loud static and other distracting sounds through headphones;
• Strobe lights flickered.

The caregivers were then escorted to an empty patient room and told to perform five simple tasks—such as pouring half a glass of water and folding towels—but they had to listen to instructions through the static and noise, or read a list in which the words were scrambled. It was a difficult chore. According to the article:

“Where’s the water, where’s the water, where’s the water?” nursing assistant Alice Flemings said after entering the training room. “Oh my, oh my. Where am I going?”

“Take your time and calm down,” said DeAndra Jackson, a Saint Mary’s Home employee whose job during training was to ensure the nursing assistant did not walk into a door or otherwise hurt themselves.

Some nursing assistants were able to complete most of their tasks, while others struggled to finish even one.

One nursing assistant, who asked not to be identified, was so visibly aggravated when she walked out of the simulation room that Jackson jokingly called her a “noncompliant patient.”

The exercise helped caregivers to understand that it takes more patience to work with people with dementia and physical impairments, and that hurrying them along may only serve to make them agitated.

“My love for people has never changed and never will change,” Gregory said. “But until you walk in that room, you will never know the deep impact a disease like dementia can have.”

Such a fascinating program. It seems that this type of training should be required for anyone who works in a nursing home.

To read the full article, click here:  Erie nursing home shows aides what dementia is like

If your loved one has become bedridden due to illness or infirmity, it is important to take steps to prevent bedsores, also known as “pressure ulcers,” which are areas of broken skin caused by the pressure of lying in one spot too long without moving. Bedsores themselves cause pain, but worse than that, if left untreated bedsores are prone to becoming infected. In severe cases, the infection spreads from the skin to the blood, and even the bone.

In extreme circumstances, bedsores can be deadly. According to an article on the British news site The Daily Mail, bedsores kill almost as many hospital patients as the “super bug” called MRSA (methicillin-resistant Staphylococcus aureus).

According to the Mayo Clinic, bedsores can move through four stages of development very quickly:

• Stage 1:  Closed wound. The skin appears red (on fair skin), or ashen, bluish, or purple in people with darker skin. The site may be painful, and may be either warmer or cooler than the surrounding skin.
• Stage 2: Open wound. The outer layer of skin is damaged, making the ulcer look like a shallow divot, or like a large intact or ruptured blister.
• Stage 3: Deep wound. The ulcer starts looking like a crater, possibly with some yellowish dead tissue.
• Stage 4: Large-scale loss of tissue. The would exposes muscle, bone, and/or tendons. The bottom of the wound may look dark with crusty dead tissue.

Treating bedsores can be difficult, which is why prevention is so important. Whether your loved one is at home, or in a nursing home or hospital, here are some steps you can take to prevent problems before they start, from Dr. Anthony Komaroff (AskDrK.com) and the Lake County News-Sun:

• Relieve pressure on vulnerable areas. Move your loved one every 2 to 4 hours—from lying on the back, to one side, then the other side, then the back again. According to Dr. Komaroff: “When she is on her side, she should be only partly on her side (about a 30-degree tilt); if she is completely on her side, her hip bone will push down hard on her skin.”
• Use pillows to keep vulnerable areas from pressing into the mattress.
• Reduce irritation. You know how a tiny pebble in your shoe can feel like a jagged piece of glass after walking on it for awhile? To the skin of a bedridden person, tiny irritations can cause big pain. Keep sheets smooth and not bunched… don’t allow books or other objects to remain in the bed when not in use… make sure crumbs are caught or cleaned after eating.
• Inspect sore-prone areas at least once a day.
• Get prompt medical care if you see suspicious areas of skin irritation.
• Encourage good nutrition. If you have any doubts or questions, talk with a nutritionist to make sure your loved one gets enough calories, protein, fats, vitamins and minerals.
• Encourage movement or exercise. Even stretches or simple arm or leg lifts can help the blood circulate, which can keep the skin healthy.
• Keep skin clean and dry. Wash with plain water and very gentle soap (when in doubt, ask a nurse for recommendations). If sweating is a problem, use absorbent pads to keep moisture off the skin.
• Communicate with nursing home staff about your bedsore observations. If your loved one lives in a nursing facility, ask what steps they take to prevent bedsores. Let them know if you discover early signs of problems. Ask if they have any recommendations about items you could purchase that might make your loved one more comfortable. If you work as a team, your loved one has a better chance of staying healthy!

To read the full article from the News-Sun, click here: Measures to prevent sores in the bedridden elderly

To read more about bedsores from the Mayo Clinic, click here:  Mayo Clinic Bedsores

The U.S. government’s 5-Star ratings of the nations nursing homes are in!

While these results are not as glamorous as the Oscars or the Grammys… okay, they are not glamorous at all, but they are significantly more meaningful than entertainment awards, and they affect more of us much more directly. Currently, about 7.5% of Americans currently live in nursing homes. With the current trends in costs of care, health concerns, and the number of aging Baby Boomers, it has been estimated that about 11 million people will be likely to require assistance in old age within the next 10 to 20 years. That makes it essential that we understand what makes a “good” nursing home or a “bad” nursing home, and how to find the good ones.

Every year the Centers for Medicare and Medicaid Services (CMS) publish the results of their 5-Star Quality Ratings of nursing homes. The Five-Star Quality Rating System was created to help consumers, their families, and caregivers compare nursing homes more easily, and help identify areas about which you may want to ask questions. Nursing home ratings are taken from three sources of data:

• Health Inspections. Onsite visits by a team of trained inspectors who check on the quality of care, inspect medical records, and talk with residents about their care. Inspectors also make sure that the nursing home meets federal quality processes.
• Staffing. This rating looks at the overall number of staff compared to the number of residents…as well as how many of the staff are trained nurses.
• Quality Measures. This measure rates how well a nursing home performs on 10 important aspects of care, such as how well the nursing home prevents and treats skin ulcers, and how well residents are helped in eating and dressing. While this sounds like a valuable measure, the data for Quality Measures are self-reported by the nursing home staff. This makes it the least objective measure, and the most likely to be inappropriately high.

Each of these areas is individually rated, and then these three ratings are combined to calculate an Overall Rating.

The lowest overall rating is awarded to homes “much below average” compared with others in their state, according to CMS. Among problems that can drop a rating: consistently dirty equipment and linens, mistreatment and unlicensed caregivers or specialists.

How to Choose a Good Nursing Home

USA TODAY Analyzes Ratings

The CMS Nursing Home Compare data only list the most recent star ratings, but it doesn’t provide a history for consumers. Now, USA TODAY prices an analysis of the ratings for more than 15,000 nursing homes over the past 3 years. Among their findings:

• Quality improved. There was a 5% decrease in the number of nursing homes with 1- or 2-star ratings; and there was a 5% increase in the number of 4- and 5-star rated facilities.
• Some of the worst stay bad. 564 nursing homes received 1-star ratings in each of the rating periods during the past three years.
• Two-thirds of these low-performing facilities are for-profit organizations.

Here’s how to see specific nursing home ratings from the past three years:

• Go to the USA TODAY ratings page here:  USA TODAY Nursing Home Ratings
• On the upper right corner of the chart at the top of the page, enter the state you would like to search.
• On the lower right side of the chart, you can narrow your search by entering a specific term, which can include a city name, part of the name of the nursing home, a street name, etc.
• To see a comparison of all three years’ ratings, click the “+” sign to the left of the nursing home name and address.

ADDITIONAL RESOURCES

USA TODAY article: Fewer seniors live in nursing homes

To see the full reports AND to search for specific nursing homes by name or location, see the Nursing Home Compare page here: Nursing Home Compare

To see the HensonFuerst video about how to choose a good nursing home, click here: How to Choose a Good Nursing Home (and Avoid the Bad Ones)

BINGO is a fun activity for many people, but especially those in nursing homes and assisted living facilities.  Now, researchers have discovered that BINGO has benefits that go way beyond passing the time: Bingo seems to boost thinking and playing skills, especially among people with Alzheimer’s disease and Parkinson’s disease.

According to an article on ScienceDaily, as people age, they begin to lose sensitivity to perceive contrasts…and this problem is worse in people with dementia. The researchers tested different types of specially-made bingo cards, and discovered that improving contrast and increasing the size of the cards improved the players’ skills. In fact, increasing contrast in the environment made living easier for the seniors, too.

For example, putting a black sofa in a white room would improve the contrast of the room and make it easier for individuals to move about. Additionally, they found that individuals with dementia actually eat more if they use a white plate and tableware on a dark tablecloth or are served food that contrasts the color of the plate.

These types of simple interventions could help people with dementia remain independent longer, and give them greater enjoyment of life overall.

To read the full article on ScienceDaily, click here:  BINGO!