Family caregiver serving food to loved one. [Credit: Katarzyna Bialasiewicz] / [Dreamstime]

Dementia touches most everyone, whether they have it or know someone who does.

Dementia is the gradual loss of cognitive functioning (thinking, remembering and reasoning), which eventually interferes with a person’s daily life. Dementia is a set of symptoms, not a disease. Memory loss is a common dementia symptom and Alzheimer’s disease is the most common form of dementia.

As dementia progresses, people cannot manage their lives on their own and depend more on others for help. Their caregivers are often family.

When caring for a loved one with dementia, caregivers should:

  1. Make decisions in advance. Have conversations about finances, health care, transportation and living arrangements, while it is still possible for the loved one to participate in the decision making process.
  2. Research resources. The Alzheimer’s Association is a great place to start—offering a 24-hour hotline and local support groups.
  3. Stay active. Encourage the loved one to remain socially active and continue to pursue activities he/she enjoys.
  4. Play music. Dementia patients often respond to music from an era when they were active, and music is a great way to involve a younger generation in caregiving and connecting with the loved one.
  5. Make safety a priority. Keeping the loved one safe becomes a big issue as dementia progresses. It may be necessary to schedule additional in-home help or move the loved one into a care facility.
  6. Manage medications. Keep a current medication list and seek medical assistance in eliminating drugs that might cause or add to your loved one’s confusion. Use pill boxes to manage medications and seek pharmacies that can prepackage medications in daily doses.
  7. Stay calm. Personality and behavior changes, especially agitation and depression, are all common symptoms of dementia. Try to be agreeable in your conversations and do not argue, unless there is imminent danger.
  8. Keep to a routine. Maintain regular routines in a calm, familiar environment to help reduce the stress and anxiety that often occurs in people with dementia.
  9. Take care of yourself. Caregiving can be extremely stressful and comes at great cost, often including a loss of the relationship with the loved one.

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Woman on scale happy about weight loss. [Credit: Edward J. Bock III] / [Dreamstime]

Woman on scale happy about her weight loss. [Credit: Edward J. Bock III] / [Dreamstime]

Weight loss is one of the top items that appear on New Year’s resolution lists. Unfortunately, only a small percentage of people succeed, while most see it as a reoccurring item for the next new year.

What most people do not realize is that is takes more than just desire to lose weight. It takes commitment and planning, beginning with our step-by-step guide.

Step 1: Make a Commitment
Rather than just committing to losing weight, commit to specifics. Commit yourself to the amount of weight you want to lose, the date by which you want to lose it, diet changes you will make to establish healthy eating habits and your plan for exercising regularly.

The best way to lose weight is to set a reasonable goal and lose it slowly and gradually. An initial weight loss goal of 5 to 7 percent of body weight is realistic for most individuals.

Step 2: Know Your Current State
Speak with your health care provider about the state of your health, specifically asking about weight-related risks. Healthy weight is especially important if you have or have had heart disease; type 2 diabetes; stroke; high blood pressure; high total cholesterol level; cancer of the uterus, gallbladder, kidney, stomach, breast or colon; and arthritis, especially osteoarthritis of the back, knees and hips.

Keep a food diary for a few days to realize what and when you are eating so you become aware of the types of food you eat most often and your mindless eating tendencies. If you find you eat a lot of processed foods, know that those foods tend to be high in trans fats, sugar and sodium or salt, which make it difficult to lose weight.

Also analyze your lifestyle. Identify obstacles that could be a challenge for your weight loss, and think of solutions to overcome those challenges. Recognize opportunities that can support your weight loss (e.g. living near a fitness center) and how to take advantage of those opportunities.

Step 3: Set Milestones
Establish short-term goals for yourself that will act as milestones to getting you to your long-term goal weight. These goals should be specific and realistic. For example, lose 1/2 to 1 pound a week. Achieving your milestones will motivate you to continue making progress.

Your milestones should also be forgiving when you experience occasional setbacks. Rather than criticize yourself and give up, forgive and get back on track as soon as possible. It’s realistic for you to sporadically have setbacks.

Step 4: Take Advantage of Resources and Support
Reach out to family, friends and co-workers who will support you. Perhaps they are trying to lose weight as well, in which case you can support and motivate each other. You are more likely to eat better and exercise more if your friends and family are doing the same.

Also look to local organizations for information and guidance. For example, Howard County General Hospital offers a free Looking to Lose Weight class where a certified nutritionist and registered dietitian discusses the physiology and health challenges that affect weight, and teaches meal plans that taste great, provide a balanced diet and promote health.

Learn to read food labels to make better food choices. Foods like gravy, mayonnaise, sauces and salad dressings often contain hidden fat and lots of calories, and some yogurts may be low in fat, but are high in carbohydrates and sugars. Or, eat foods in their natural state, and you will not have to read labels at all!

Step 5: Monitor Your Progress
Evaluate your progress of the milestones you set in Step 3. Identify areas of your plan that are working well and areas that need adjusting. It may be necessary to rewrite your short-term goals and plan accordingly.

As you are monitoring your progress, you may find you need to focus more on the fit of your clothes and less on reading the scale, especially if you have increased your exercise level. As you increase muscle mass and lose fat, the reading on your bathroom scale may not change much, but the fit of your clothes may be looser. Measure your waistline and compare the results.

Do not forget to reward yourself for your successes, but not with food. If achieving your milestones are coming too easily, consider adding a new, more challenging milestone that will get you to your long-term goal.

Using this step-by-step guide will get you on your way to achieving your New Year’s weight-loss resolution and having a healthier new year.


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Adult children caring for aging parents.

Adult children caring for aging parents. [Credit: Goldenkb] / [Dreamstime.com]

Caregiving for an aging parent can be challenging. Follow these tips to make the process easier.

Prepare for Doctor’s Visits

Older patients often have more health issues to discuss. Create an agenda and questions for the appointment. Attend appointments with your loved one, if you can, or send someone you trust, who can take notes and help remember and understand everything that was said.

Also bring all of their prescription bottles to their appointment. Elderly patients are more susceptible to side effects and interactions between medications and they often see many physicians—so bringing bottles is extremely helpful to the physician.

Organize Daily Medications

Use a pill dispenser with compartments for each day of the week or another reminder system to let your loved one know when to take medications. You can also keep a medication schedule and post it somewhere visible—the refrigerator or medicine cabinet.

Set an alarm on your loved one’s phone, watch or clock to help make taking medications a part of the daily routine.

Make a List of Medications

Maintain a list of medications—with the name of the drug, the dose, how often it is taken and why. Keep a copy somewhere immediately accessible, like your purse or car, in case there is an emergency. Schedule annual medication reviews with your loved one’s primary health care provider. Keep in mind, many common drugs can have interactions with food.

Fill Prescriptions at One Pharmacy

Using one pharmacy makes refilling prescriptions simpler and it helps your pharmacist protect against drug interactions and avoid potential problems. Some pharmacies even deliver.

Take Advantage of Technology

Many health care providers, pharmacies and insurance plans offer apps or websites to manage records. These online tools can help you retrieve and share health care information quickly. If you rely on electronic files, be sure to keep a back-up of logins and passwords. Johns Hopkins MyChart is one example—for more information, visit MyChart.

Discuss Advance Directives

Start the difficult but important conversations about end-of-life care early, when you are not in a crisis, and there is more time to think and make better decisions.

Advance directives identify who will make decisions regarding treatments, such as life support measures, when your loved one is too sick to do so themselves. The designee should have a full understanding of the patient’s wishes.

Know that you are not alone. There are many great resources for caregivers. To start, download a free copy of the Johns Hopkins guide “Take Care: A Guide for Family Caregivers.”

Anirudh Sridharan, M.D., is a board-certified geriatrician on staff at Howard County General Hospital.

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Man and Woman Sleeping [Credit: Monkey Business Images] / [Dreamstime.com]

Most of us love the extra hour we gain when daylight savings time ends in the fall. However, feeling better rested may not result from simply sleeping in an extra hour. Rather, aligning your waking time more with daylight – a physical cue that makes all the difference – is the more likely explanation.

Your biological internal clock, known as circadian rhythm, responds to light and darkness. When your activity does not correspond with sunlight cues, it throws off your circadian rhythm, causing your sleep to be disturbed. The extra hour helps with resetting your body’s exposure to sunlight.

Getting a good night’s sleep is important. If you are wondering how important, consider the risks associated with poor sleep and the benefits of good-quality sleep.

Risks from Poor Sleep

  • Weight gain
  • Heart attack
  • Stroke
  • High blood pressure
  • Diabetes

Benefits from Good-quality Sleep

  • Feeling better
  • Looking younger
  • Experiencing improved memory and concentration
  • Feeling less moody and grouchy

While seven to nine hours is optimal for most adults, you can achieve big improvements in your sleep quality by practicing consistency, which is going to bed and waking up at the same time every day.

If you are not currently doing this, try testing it. Make a point of going to bed and waking up at the same time for a couple of weeks. I did this several years ago. For two weeks, I went to bed at 11 p.m. every night and woke up every morning at 7 a.m. After five days, I felt like the last time I had slept so well was in middle school.

However, if you think you are getting enough good-quality sleep, but are still very tired, that is a signal for getting evaluated. Start by contacting your primary care provider who may be able to treat your sleep condition or recommend someone who can. The good news is that common sleep disorders can be treated.

Rachel Salas, M.D. is the assistant medical director for the Johns Hopkins Center for Sleep at Howard County General Hospital.

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Stroke: What You Need to Know

You’ve most likely heard the term “stroke” and may even know people who suffered from a stroke, but how much do you really know about stroke? Do you know risk factors, warning signs and what to do in the event of a stroke?

Saturday, Oct. 29 is World Stroke Day, and to help you learn about stroke, we’ve included the basics to help you take preventive measures, and understand what to do if you or someone you know is experiencing a stroke.

About Stroke
Stroke occurs when blood flow to the brain is disrupted, either by a blood clot that blocks one of the vital blood vessels in the brain (ischemic stroke) or a blood vessel bursts spilling blood into surrounding tissues (hemorrhagic stroke). Even a brief interruption in blood supply can cause problems as brain cells begin to die after just a few minutes without blood or oxygen.

Risk Factors in Both Women and Men
While some risk factors cannot be changed, like age, others can be changed. Reduce your chances of stroke by improving the factors you can change.

  • Being inactive
  • Older age
  • Previous heart and blood vessel (cardiovascular) disease
  • Being overweight
  • Having an unhealthy diet (e.g. high in fat, cholesterol and sugar; low in fruits, vegetables, grains, nuts and olive oil)
  • Smoking
  • Metabolic syndrome – a group of findings and lab test results that increase the chance of stroke, heart attack and diabetes

Warning Signs and Course of Action
Learn from Eric Aldrich, M.D, medical director of the Stroke Center and director of Inpatient Neurological Services at Howard County General Hospital, on how to use F.A.S.T. to detect warning signs, and what to do if you think you or someone you know is experiencing a stroke.

 


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According to the Centers for Disease Control and Prevention (CDC), the flu is more dangerous than the common cold for children. Children younger than 5 years old typically need medical care, and severe cases are more common in children younger than 2 years old. Children with chronic health problems like asthma, diabetes and brain and nervous system disorders are especially at high risk of developing serious complications from the flu.

The CDC recommends flu vaccinations for children as being the single best way to protect them from the flu. Common vaccination methods have included the nasal mist and shot. However, recent research has found the nasal mist to be ineffective, and because of this the CDC is only recommending the shot as an effective vaccination method.

Convincing children to get the shot is likely to be a hurdle for parents, but parents can make the experience less stressful with these tips from Laura Hagan, Howard County General Hospital Pediatric Emergency Room nurse manager, and her little helpers.

Parents may also find it helpful to try these following tips:

  • Taking slow, deep breaths – Deep breathing can help children relax and concentrate on something other than the shot. For this reason, parents should ask their children to breathe all the way down to their belly.
  • Focusing on something in the room – Parents can distract their children by getting them to concentrate on the details of a poster, picture or sign in the room. For example, if there’s a picture, they can count the number of flowers, animals or other images in the picture. In the case of a sign, they can try to think of new words from the same letters that are in the sign.
  • Coughing – Encouraging children to cough as the needle goes in may help them feel less pain during the process.
  • Relaxing the arm – A tense arm can make a shot hurt more, so parents should try to get their children to relax their arm.

For more information, view Johns Hopkins All Children’s Hospital’s Five Tips for Surviving Shots.


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