Tag Archives: Linda Cronk

Family caregivers provide a vital service: Part 2

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By Linda Cronk, Michigan State University Extension


As it was mentioned in part one of this series about the importance and value of informal family caregiving, caregivers often experience depression as well as physical health challenges. In a Family Caregiver Alliance 2006 report, Caregiver Assessment: Voices and Views from the Field Caring, it says that caring for persons with dementia can impact a person’s immune system for up to three years after their caregiving experience ends, increasing their chances of developing a chronic illness themselves.


In the National Alliance for Caregiving and AARP 2009 report, Caregiving in the U.S., it states that 17 percent of caregivers feel their health in general has gotten worse as a result of their caregiving responsibilities. The report also says that studies have found that 23 percent of family caregivers who have been providing care for five years or more report their health is fair or poor.


Michigan State University Extension says that caregivers need to make their own care their first priority. It isn’t possible to be an effective caregiver for others without taking responsibility to keep their own well-being in mind. But, because of the constant demands of family caregiving, it is often difficult to include self-care in the daily list of responsibilities.


It is important to keep self-care simple. Stick with the basics. According to the National Center of Caregiving at the San Francisco-based Family Caregiver Alliance, it is vital to focus on the following basic self-care practices:

  • Learn and use stress-reduction techniques.
  • Attend to your own healthcare needs.
  • Get proper rest and nutrition.
  • Exercise regularly.
  • Take time off without feeling guilty.
  • Participate in pleasant, nurturing activities.
  • Seek and accept the support of others.
  • Seek supportive counseling when you need it, or talk to a trusted counselor or friend.
  • Identify and acknowledge your feelings.
  • Change the negative ways you view situations.
  • Set goals.

All of these activities are easier to accomplish with the support of family, friends and community resources. Reaching out to others to gather support for your family caregiving efforts can mean the difference between the normal caregiver burden and disastrous caregiver burnout. Contact your local MSU Extension office, your county commission on aging or the regional Area Agency on Aging to locate community resources to support your valiant efforts at family caregiving and self-care.


This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).




Family caregivers provide a vital service — Part 1

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By Linda Cronk, Michigan State University Extension


As the American population ages, family caregiving emerges as a major concern for more and more families. In the National Alliance for Caregiving and AARP 2009 report, Caregiving in the U.S., it was reported that 65.7 million caregivers make up 29 percent of the United States adult population that provide care to someone who is ill, disabled or aged. The report says that caregivers average 20.4 hours per week providing care and caregivers who live with the person they care for spend 39.3 hours per week caregiving.


According to the National Alzheimer’s Association 2011 Alzheimer’s Disease Facts and Figures report, in 2010, 14.9 million families and other unpaid caregivers of people with Alzheimer’s disease and other dementias, provided about 17 billion hours of unpaid care. This represents an average of 21.9 hours of caregiving per week or 1,139 hours of care per caregiver, valued annually at $11.93 per hour—an estimated $202.6 billion in 2010.


Needless to say, the contributions of informal caregivers are very important, valuable and necessary to the well-being of many older adults and a huge contribution to our society. But the challenges and physical, emotional and financial toll of caregiving are also huge.


A Family Caregiver Alliance 2006 report, Caregiver Assessment: Voices and Views from the Field, states several statistics about the emotional and mental health challenges of informal caregiving. Caring for a person with dementia can impact a person’s immune system for up to three years after their caregiving experience ends, increasing their chance of developing a chronic illness themselves.


Also, 40 to 70 percent of family caregivers show symptoms of depression. Caregivers who are caring for someone who has emotional or mental health problems, in result are more likely than others to report a decline in their own health.


There are often physical health challenges for informal caregivers as well. In the National Alliance for Caregiving and AARP 2009 report, Caregiving in the U.S., it says that 17 percent of caregivers feel their health in general has become worse as a result of their caregiving responsibilities. The report also states that studies have found that 23 percent of family caregivers who have been providing care for five years or more, report their health is fair or poor. Twenty-one percent of older caregivers caring for those age 65 and older, report a higher degree of physical strain, compared to 13 percent who are younger caregivers.


The immense challenges of informal caregiving make it very clear that caregivers need to make sure they take good care of themselves. It may seem impossible when responsibilities pile up, but with support and thoughtful planning, self-care for caregivers can make the difference between maintaining good health and becoming someone who needs caregiving. For more information about self-care for caregivers, watch for Family Caregiving – Part 2 coming soon. For more information on caregiving, visit the Michigan State University Extension Caregiving page.


This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).



Helping older adults with substance abuse problems

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By Linda Cronk, Michigan State University Extension


If an older adult were ill or needed help, most people would reach out and help in whatever ways they could. But, if the illness were signs of alcoholism or drug abuse, it’s often really hard for most people to know what to do or say. Often, it’s difficult to tell if what we see are symptoms of substance abuse. In older adults, these signs can seem to mimic other conditions, such as diabetes, dementia or depression.


Is it substance abuse? According to Hazelden, a prominent addiction recovery center, there are two types of alcoholism in older adults. Two-thirds of older adult alcoholics are early-onset – those who have been heavy drinkers most of their adult lives. The other one-third are those who began to drink excess amounts in their older years, often in response to a difficult life situation or transition.


Doctors routinely prescribe tranquilizers for older adults. More tranquilizers are prescribed annually than for all other medications, over 16.9 million prescriptions each year – with the exception of heart medicine.


Some of the challenges that come with prescription drug use by older adults include:

  • Older people often take higher doses than prescribed because they forgot that they already took a pill or because “if one is good, two are better.”
  • It is not unusual for older persons to take their prescription drugs to a friend or spouse — even when the prescription is old, if the drug fits a self-diagnosed ailment.
  • An older person may also become dependent on alcohol or drugs after a major operation or a lengthy hospital stay. This dependency can be life threatening, yet is treatable.

What are possible signs of abuse? Hazelden has identified several warning signs:

  • Drinks in spite of warning labels while on prescription drugs.
  • Always has bottles of tranquilizers on hand and takes them at the slightest sign of disturbance.
  • Is often intoxicated or slightly tipsy, and sometimes has slurred speech.
  • Disposes of large volumes of empty beer and liquor bottles and seems secretive about it.
  • Often has the smell of liquor on his/her breath or mouthwash to disguise it.
  • Is neglecting personal appearance and gaining or losing weight.
  • Complains of constant sleeplessness, loss of appetite or chronic health complaints that seem to have no physical cause.
  • Has unexplained burns or bruises and tries to hide them.
  • Seems more depressed or hostile than usual.
  • Can’t handle routine chores and paperwork without making mistakes.
  • Has irrational and undefined fears, delusions or seems under unusual stress.
  • Seems to be losing his or her memory.

How can we begin to help our loved ones get help for substance abuse problems? Before talking to your older loved one or friend, talk to a professional trained in addiction and older adults. Prepare by gathering information:

  • A list of prescribed and over-the-counter drugs the person is taking.
  • A list of doctors the person is seeing. They may have a general practitioner and a specialist.
  • A brief life history including religious and cultural background and important life events.
  • An idea of the person’s present ability to live alone and take care of themself.
  • How drinking or the misuse of medicines is affecting their health, family and social life, etc.
  • A list of family members and friends who are concerned and would be willing to help, if necessary.

Together, you and the professional should be able to make an informal assessment as to what type of help the older person needs and how to approach the topic with them. You may decide, for example, that it would be better for your friend’s physician to bring up the problem, since many older people trust their doctors. Or perhaps you can ask another close person, such as a minister or an old acquaintance of your friend to sit down for a personal talk. Find out more at www.hazelden.org about how you can help your friend or loved one get help for substance abuse.


If the person is ready to make a change, the first thing to do is listen and be supportive. You may want to urge your friend to see a physician to get a professional assessment of the problem. Depending on the severity, the older person may need hospital care to treat the physical symptoms of alcohol and drug reactions. Many older persons can benefit from inpatient treatment for alcoholism or drug dependency, if their health insurance or other resources will cover the costs.


Alcoholics Anonymous (A.A.) can be a good alternative, along with individual counseling from an addiction professional that is trained to work with older adults. Founded in 1935, A.A. has helped millions of people achieve sobriety. When you talk to an A.A. volunteer, ask for a meeting where an older person could be comfortable. See www.aa.org for more helpful information for friends and families of older adults dealing with substance abuse.


Fortunately, today it is more accepted to seek help for alcohol and drug abuse problems. There are excellent resources in many communities to help loved ones and friends address the issue. Michigan State University Extension staff works with the Geriatric Education Center of Michigan at Michigan State University to bring the latest health information about older adults to health care providers throughout the state. See www.gecm.msu.edu for more information.


For more about older adults and substance abuse read Substance abuse in older adults: Underdiagnosed and undertreated.


This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).



Recognizing depression in older adults

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By Linda Cronk, Michigan State University Extension


According to the Geriatric Education Center of Michigan at Michigan State University, depression in older adults can seriously affect their quality of life and health. Stress, depression and anxiety can contribute to physical ailments including digestive disorders, sleep disturbances and lack of energy. Older adults who are depressed can also have an increased risk of substance abuse, reduced cognition, higher risk of suicide and a higher incidence of heart attacks.


Older adults can experience different reasons and risk factors for depression than younger adults. HelpGuide.org, a research-based website in collaboration with Harvard Medical School, says that common reasons and risk factors for depression in older adults can include:

  • Health problems – Illness and disability, chronic or severe pain, cognitive decline, damage to body image due to surgery or disease.
  • Loneliness and isolation – Living alone; a dwindling social circle due to deaths or relocation; decreased mobility due to illness or loss of driving privileges.
  • Reduced sense of purpose – Feelings of purposelessness or loss of identity due to retirement or physical limitations on activities.
  • Fears – Fear of death or dying; anxiety over financial problems or health issues.
  • Recent bereavements – The death of friends, family members, and pets; the loss of a spouse or partner.

Michigan State University Extension says that ways you can help are to learn about and recognize the signs and symptoms of depression in older adults and the elderly. Common symptoms include sadness, fatigue, abandoning or losing interest in hobbies or other pleasurable pastimes, social withdrawal and isolation (reluctance to be with friends, engage in activities, or leave home), weight loss or loss of appetite, sleep disturbances, loss of self-worth, increased use of alcohol or other drugs, or a fixation on death, suicidal thoughts or attempts.


Is it depression or dementia? According to Harvard Health Publications, here are some signs to watch for:

  • With depression, mental decline can happen quickly, but with dementia, mental decline happens more slowly.
  • When someone is depressed, they still know things like the correct time, date and where they are, but with dementia, they become confused and disoriented and sometimes lost in familiar locations.
  • With depression, people have a hard time concentrating, and they may worry about memory problems. People with dementia have short-term memory loss and don’t notice memory problems or seem to care.
  • When someone is depressed, language and motor skills are slow, but normal, whereas someone with dementia has impaired writing, speaking and motor skills.

There is good news! According to a study published by Harvard Medical School’s Harvard Health Publications, for those who stuck with treatment, depression resolved in seven out of 10 people. Completing a treatment regime can increase positive mood, strengthen personal relationships, increase satisfaction in activities of daily living and help people feel like themselves again.


If you are concerned that your loved one is suffering from depression as an older adult, help them connect to their primary care provider to assess the situation and to identify health and community resources to help them restore their quality of life.


For more information on depression read Depression Symptoms and Warning Signs.


This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).




Is it normal aging or Type 2 diabetes?

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An older adult’s health care provider can help to determine if they’re experiencing normal aging or if Type 2 diabetes is present. (Courtesy Michigan State University Extension)

By Linda Cronk, Michigan State University Extension

According to the Michigan State University Geriatric Education Center of Michigan, Type 2 diabetes continues to increase in the United States population. For adults over the age of 65, diabetes occurs in approximately 27 percent and pre-diabetes occurs in 50 percent of this population. When caregivers think about the overall goals of care for their loved one, it is important to understand how diabetes affects the quality of life for older adults.

The American Geriatrics Society says that older people with diabetes experience higher rates of mental and physical disability and premature death. They are also more prone to develop other illnesses, like high blood pressure, heart disease and stroke. In addition, they also have a greater risk for several conditions associated with the aging process, such as depression, reduced mental function, urinary incontinence, harmful falls, persistent pain and over-medication.

Is it normal aging or is it because of Type 2 diabetes?

In order to figure out how your loved one is affected by Type 2 diabetes, it is important to know how to recognize the difference between normal aging and health problems caused by diabetes. Aging and symptoms of Type 2 diabetes have some similarities: they both can bring on poor eyesight, fatigue, high blood pressure, depression, as well as more frequent urination and higher rates of heart disease and stroke.

Michigan State University Extension says that symptoms can also look similar, but for different reasons. With aging, there may be gait changes because of arthritis and osteoporosis, but gait changes with diabetes may result from neuropathy.

Restlessness and confusion sometimes occurs with normal aging, but with diabetes it results from very high or low blood sugar. Slower reaction time often occurs with normal aging, but for people with diabetes, it can be a result of high or low blood sugar.

These and other symptoms should be signs that our loved one needs to be assessed by your health care provider to determine if they are experiencing normal aging or if Type 2 diabetes is present. Signs of very high blood sugar (hyperglycemia) include increased urination for several days, dehydration, which develops because the person doesn’t drink enough liquids and a change in alertness from generalized fatigue to stupor, coma or seizures. These changes may be mistaken for a stroke or mental illness.

How can your health care provider help?

You will need to work with your older adult’s health care provider to determine plans that are based on the status of your loved one: the high functioning individual, older adults with memory loss and elders at the end of their life. Planning also needs to take into account the living situation of the older adult, how much caregiving and support the older adult needs and how much they actually have.

After a thorough assessment, your health care provider will determine a medicine regime. Insulin will be the quickest way to get a very high blood sugar under control. Then, it will be crucial for you and your loved one to attend diabetes education classes in your community.

The major goal is blood sugar management. Besides medications to resolve high blood sugar, the American Diabetes Association says that it’s also important to help your loved one to improve healthy eating habits and physical activity. Supporting your older loved one to manage their Type 2 diabetes is a real challenge. Reach out to the many community resources available to help you and your family meet the challenge of helping your loved one maintain a high quality life.

This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).

Physical activity helps older adults maintain their health

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By Linda Cronk, Michigan State University Extension 

 

Regular exercise and physical activity are vital at any age, including for older adults. The National Institute on Aging says that being active helps older adults:

  • Keep and improve strength to stay independent
  • Have more energy to do things
  • Improve balance
  • Prevent or delay some diseases like heart disease, diabetes, and osteoporosis
  • Perk up mood and reduce depression

According to Living a Healthy Life with Chronic Conditions, by Dr. Kate Lorig, to get the greatest benefit from physical activity, older adults need to try four types of exercise: endurance, strength, balance and flexibility exercise.

Endurance activity

Many older adults avoid endurance activity, also called aerobic exercise, because they are unsure about how much is safe for older adults. “The most important thing is that some activity is better than none,” Dr. Lorig said. “If you start off doing what is comfortable and increase your efforts gradually, it is likely that you will build a healthy, lifelong habit.” There are three building blocks for a safe, moderate-intensity goal for endurance activity:

  • Frequency means how often you exercise. The Center for Disease Control recommends aerobic physical activity in episode of at least 10 minutes and, if possible, spread it out through the week.
  • Intensity is how much effort you use or how hard you work. Endurance or aerobic exercise is safe at a moderate intensity. You will feel warmer, you breathe deeper and faster, your heart rate will rise moderately and you will still feel like you can continue a while longer.
  • Time is how long you exercise each time you are active. At least 10 minutes is a good starting place. If that is too challenging, start with a smaller amount of time. You can work up from there, with a moderate intensity goal of 150 minutes per week. You can try to attain your 150 minute goal by exercising 30 minutes five days per week.
Strength training

We need to exercise our muscles in order to maintain our physical strength as we get older. Otherwise, our muscles shrink from lack of use. According to the book Living a Healthy Life With Chronic Conditions, moderate-intensity muscle-strengthening exercise of all major muscle groups should be done at least two days per week.

Flexibility exercises

Being flexible means you can move comfortably in your daily life with a minimum of pain and stiffness. A series of gentle stretching exercises done at least three to four days per week can help you improve and maintain flexibility as you get older.

Balance exercises

Falling is one of the most challenging events for older adults. Injury from falls, such as broken bones, is a common experience for those with balance issues. Strong and coordinated muscles in your core and legs are key for good balance. Certain exercises, including qi gong, tai chi, yoga and others are good for improving and maintaining balance.

 

You can find a free user-friendly exercise book and DVD through the National Institute on Aging website called Go4Life.

 

According to Michigan State University Extension, once you start exercising and become more physically active, you will begin to see results quickly. In a few short weeks, you will feel stronger and more energetic, and you will be able to do things easier, faster or longer than before. Your body will get used to a higher level of activity and you can continue to build on those benefits by doing more. Be sure to check with your doctor before you begin an exercise program.

 

This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).

You can prevent or delay complications of type 2 diabetes

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By Linda Cronk, Michigan State University Extension

 

Why is it so important for people with type 2 diabetes to maintain day-to-day normal blood sugar levels? As we have often been told, the complications of diabetes caused by high blood sugar levels can, over time, do permanent damage to many parts of our bodies. According to the book Living a Healthy Life with Chronic Conditions, by Dr. Kate Lorig, et al, the number one complication of diabetes over time is heart disease.

 

Other complications include:

  • nerve damage or neuropathy, which might mean burning, tingling, numbness or loss of feeling in our hands and feet
  • liver and kidney damage
  • vision problems such as cataracts, glaucoma or even blindness
  • infections that persist
  • gum disease
  • skin and foot problems from poor wound healing
  • sexual problems for men and women — erectile dysfunction, yeast infections, vaginal dryness or loss of desire.

What are the best ways to maintain healthy blood sugar levels day-to-day? Michigan State University Extension says that the most basic ways to prevent or delay complications of diabetes are to choose elements of a healthy lifestyle:

  • Keep yourself physically active
  • Pick healthy food options in portion sizes that are right for you
  • Don’t smoke
  • Be proactive to manage your stress levels
  • Take any medications as directed by your health care provider
  • Monitor your blood sugar levels as directed by your health care provider
  • Have regular tests to determine how your health strategies are working and to modify strategies, in consultation with your health care provider, if tests show you need to make changes

What are the tests and procedures that people with diabetes need to determine whether their health strategies are working? If you are not familiar with tests that all people with diabetes need on a regular basis, the book Living a Healthy Life with Chronic Conditions explains:

  • Blood pressure: should be measured at every doctor visit
  • Feet: should be checked for unhealed sores at every visit, and have a complete foot exam at least once a year
  • A1c: should be tested at least twice a year, A1c is a blood test to determine what your average blood glucose level was for the past 2-3 months. Most people should aim for an A1c below 7, or as recommended by your healthcare team
  • Kidney function: should be tested once a year by means of a blood or urine test or both
  • Blood lipids (fats): total cholesterol; LDL, low-density lipoprotein; HDL, high-density lipoprotein; and triglycerides should be tested at least once a yea
  • Eyes: should be tested once a year with a dilated eye exam, in which your eye care professional uses eye drops to dilate the pupils
  • Teeth and gums: should be checked by a dentist twice a year
  • Pneumonia shot: People with diabetes should receive a shot no matter what age. Even if you have had one shot and are over 65, ask your doctor about having another shot
  • Flu shot: recommended once a year for people with diabetes

As with all chronic diseases, active managing of Type 2 diabetes is an ongoing necessity to prevent or delay complications of the disease. Ensuring that your blood sugar levels remain within a healthy range is crucial.

 

Besides the medication management, the other requirements to manage diabetes are very similar to living a healthy lifestyle under all conditions: be physically active, choose a healthy eating plan, manage stress levels, don’t smoke and visit your health care provider regularly. For more information about managing Type 2 diabetes, visit the National Diabetes Education Program website. To find disease prevention programs available in your area please visit the MSU Extension website.

 

To learn more about diabetes self-care strategies, participate in a Michigan State University Extension led diabetes management series.

 

This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).