Live Life On Your Own Terms ®

What a DNR order really means (and what it doesn’t)

dnr optThe way too many people think about DNR orders, it’s as if the initials stood for “Deny Needed Remedies” instead of “Do Not Resuscitate.”

As one hospital Registered Nurse wrote anonymously, “Do Not Resuscitate does not mean that we will not provide care if you become critical” (emphasis in the original). It does not mean the patient wants no care at all and does not want to prevented from catastrophic decline, she added, noting that most hospitals do not treat DNR patients any differently than patients that are Full Code, with regard to transferring to ICU if necessary and providing aggressive treatment…The code simply means that if one stops breathing or one’s heart stops beating we will go in one of two predetermined directions: either CPR or not.

In other words, a Do Not Resuscitate order is really an Allow Natural Death order, and many in the healthcare profession are pushing to start calling it that instead.

But regardless of terminology, chances of successful resuscitation are very low – between 11 and 30 percent, depending on comorbidities and the hospital itself.

And as the patient’s age goes up, the chances of surviving CPR, living to be discharged and having the same quality of life as before go way down. For example, as you age your bones thin. CPR applies enough force to break ribs and leave bone fragments that can puncture lungs, even in younger, stronger-boned adults.

So while nobody wants to spend time thinking about the scariest of all possible “what if?” scenarios, it’s really important do sit down with a blank Advance Directive form and let it help guide you through the thought process.

In addition to thinking about it, talk it over with your family and your clergy member – and with a good elder law attorney, to go over your options and make sure you’ve taken all the factors and possibilities into consideration. (If you don’t know of one, we’ll gladly refer you.) Even after you complete the form, sign it, and have it notarized, you can always make changes if your priorities change; it’s not permanent.

No two people have the exact same needs, priorities and values. And just as we put every client’s priorities first, you should take this opportunity to spell out yours, so that your family doesn’t have to guess about them. It’s the ultimate way to live better with better care.

What happens when Gen X and Y caregivers are less healthy than their parents?

gen x y 500No one ever said that unpaid family caregivers have it easy.

Some 34.2 million spend almost 26 hours a week helping with dressing and undressing, personal hygiene, meals and other activities of daily living  (40.5 hours a week if they and the senior they care for live under the same roof.

It can be hard work that calls for stamina and good health, and a national study shows they may be coming up short.

Statistical researchers led by Ohio State University sociology professor Hui Zheng crunched data from two surveys of a total of 688,054 Gen Xers (born 1965-80) and Gen Yers (born 1981-99) for eight markers of metabolic syndrome – a collection of risk factors for heart and kidney disease, diabetes, and stroke. Some of those markers are waist size, blood pressure, cholesterol level, body mass index, chronic inflammation, and renal function.

What they found was that members of Generations X and Y were in poorer health than their parents’ generation was at the same age, in spite of decades of health and medical progress.

In fact, said Prof. Zheng, “[t]he worsening health profiles we found in Gen X and Gen Y is [sic] alarming.”

There were increases in metabolic syndrome, chronic inflammation, and obesity. Along with those was increased “physical dysregulation,” a precursor to chronic diseases that combines high blood pressure and cholesterol, excess belly fat, and substances in the blood that suggest chronic body-wide inflammation.

“The declining health trends in recent generations is a shocking finding,” Prof. Zheng concludes. “It suggests we may have a challenging health prospect in coming years.”

And it’s their parents’ generation, the Baby Boomers, who stand to be hardest hit.

This year, the oldest Boomers are 75 years old, approaching or having reached the age when they’ll need caregiving help – and when their children may need help in providing it.

So while every good senior care agency pays attention to their clients’ needs, that may not be enough.

It’s becoming increasingly important to pay attention to their family caregivers’ needs as well. This is something we’ve been doing ever since Senior Insights first opened its doors.

The thorough three-part needs assessment that’s the basis of our individualized senior care management plans that cover not only our clients’ health, safety, and emotional needs, but those of their family caregivers as well.

So please contact us to learn more about holistic, coordinated senior care that’s good for caregivers and care receivers alike. 

You may already own the latest telemedicine diagnostic device.

telemedicine device500It’s a smartphone with either FaceTime or Google Duo.

By eliminating travel time to and from doctors’ offices, along with time-wasting inefficiencies once patients get there, telemedicine has been a great convenience for seniors during the pandemic. And, as I wrote earlier, it will continue to be for many years to come.

Its one drawback has been its inability to measure blood pressure, temperature, pulse and heart and respiration rates – all important diagnostic data – remotely.

But now there’s an app for that.

University of Washington researchers have developed a way for smartphone or computer cameras to measure pulse and respiration rate from real-time video images of a patient’s face.

Using machine learning, the system seeks out areas in a video frame with physiological features that indicate changing blood flow and adjusts for different skin tones, lighting conditions, and backgrounds. By doing this over time, it can focus on that area and keep a record of pulse and respiration rate.

And because the system records the data on the device instead of storing it in the Cloud, it protects patient privacy.

The system “provides new opportunities for remote patient care and telemedicine,” says Professor Shewak Patel. “This could include self-care, follow-up care or triage, particularly when someone doesn’t have convenient access to a clinic.”

“Every person is different,” lead researcher Xin Liu noted, “ so this system needs to be able to quickly adapt to each person’s unique physiological signature.”

We at Senior Insights couldn’t agree more.

While many senior care agencies base their care recommendations strictly on the capabilities they offer, we base ours on the fact that every person is different.

So before we recommend any kind of coordinated care management plan, we diagnose. Our thorough three-part needs assessment goes beyond each client’s physiological signature to determine their mental, functional, cognitive, and social signatures as well. It also includes ascertaining what clients’ and family caregivers’ specific values, needs and desires are, so we can honor those as well.

And our monthly Registered Nurse assessments go way beyond just taking vital signs and are more like mini-needs assessments.

Please contact us to learn more about senior care that continually adapts to your unique needs, however they may change over time.

Telehealth is here to stay

telehealth500During the pandemic, the growth of telehealth has been, if you’ll pardon the pun, contagious. So much so that telemed, as it’s also known, will still be with us long after coronavirus becomes just a memory.

In Massachusetts, for example, Blue Cross Blue Shield has seen telemed grow from only about 200 claims a day before Covid-19, to about 30,000 a day this year. And in the year starting March, 2020, they processed some 7.5 million.

The yearlong lockdown let telehealth demonstrate that it’s particularly good for two demographic groups – primary car providers and their older patients.

A totally unexpected way to get a better night’s sleep

sleep optGetting seven to nine hours of sleep a night is important for maintaining good health. The average American gets less than seven. Given the way averages are computed, as many Americans are below that average as above it.

For seniors, getting a good night’s sleep can be even harder, thanks to such things as medication side effects, snoring, apnea, acid reflux, restless leg syndrome, and, for men, enlarged prostates.

But, based on recent Korean research, the Sleep Foundation suggests a totally unexpected and amazingly simple way to fall asleep sooner and sleep longer:

Wearing socks to bed.