Aging Parent Advisors

05/21/2023

Check out this incredible book based on evidence-based science for living a long, healthy life.

Outlive: The Science and Art of Longevity

01/02/2020

Thank you to everyone who has liked this page so far. I hope you find this information helpful in navigating our confusing health system & I hope to help increase your knowledge about "prevention" strategies for common health conditions. If you find this information helpful please feel free to share this page with friends.

My Next Important Topic: Falls in Older Adults

Did you know that 1 in 4 older adults (65+) experiences a fall each year and every 20 minutes, an older adult dies from a fall in the U.S. 😔

https://www.cdc.gov/steadi/pdf/STEADI_OlderAdultFactSheet-a.pdf

Falling is not a normal part of aging and is preventable. YOU can help prevent falls in older adults. FALLS SCREENING SAVES LIVES 👨‍🦳👩‍🦳🧓🧓🏾

According to the CDC, older adults should be screened using the following questions:
1. Have you fallen in the past year?
2. Do you feel unsteady when standing or walking?
3. Do you worry about falling?

Speak up!! Make sure the older adult you care about discusses this with their doctor. Their P*P-Primary Care Physician- can provide a fall risk screening and refer them for physical therapy to help improve strength and gait. Their doctor can also review their current medications and screen for medications that are known to increase fall risk in older adults. They will also check their Vitamin D levels for bone health.

You may consider conducting a home-safety check:

1. Remove hazards, floors should be clear of debris, not cluttered, and well lit.
2. Remove small area rugs or secure them so they are slip resistant.
3. Install grab bars in the bathroom and throughout the house where necessary.
4. Make sure there is ample lighting throughout the home. This includes night time! Motion sensitive lighting can be installed to ensure those late night bathroom trips do not cause a dangerous fall.

Consider connecting the older adult to an EVIDENCE BASED FALL PREVENTION class within the community. The NCOA, National Council on Aging is a great resource for locating one in your area.

https://www.ncoa.org/healthy-aging/falls-prevention/falls-prevention-programs-for-older-adults-2/

Explore evidence-based programs than have been proven to help older adults reduce their risk of falling.

12/30/2019

This is called Pill Map. It's an amazing tool for patients on multiple medications that are always changing. Multiple medications are REALLY CONFUSING. Take it with you to the hospital and doctor.... Any time your medications change! It has a write on wipe off function that is easy for anyone to add or delete meds. Family caregivers can easily help manage your loved one's medications and keep their pill trays filled. No more missed doses, no more confusing lists!

PillMap is a companion to your traditional weekly pill container. You customize PillMap once and it becomes your trusted visual guide. Medications change? No problem. It's easy to re-customize with the new meds. No guess work - you have a visual sample pill to make sure the meds are correct. Desi...

12/30/2019

One in five Medicare patients (patients 65+) gets readmitted to the hospital within 30 days of a hospital admission, this happens quite often and these folks earn the name among hospital providers as "Frequent Flyers". Unlike the AWESOME perks that come with FF SkyMiles, frequent flyer patients usually end up sicker, weaker and more exposed to some nasty germs in the hospital like hospital-acquired pneumonia (HAP) and Clostridium Difficile (C-Diff), a nasty type of infectious colitis that causes extreme diarrhea and illness in those who are older or with compromised immune systems. Just what an elderly person needs!!

These readmissions are costly for both patient and the health system, but often, these re-admissions are PREVENTABLE. .

Here are some tips to help you and your loved ones and prevent a hospital readmission:

1. If you are in the hospital, make sure your regular doctor knows it. Your primary care physician or P*P, probably doesn't know you or your loved one is in the hospital. Hospitals and community doctors don't communicate all that well. So take the first step, CALL your P*P and schedule a follow-up appointment within two or four days from a hospital discharge. Ask the hospital discharging nurse or doctor to fax your "Discharge Summary"- i.e. the final hospital note from this most recent admission, to your regular P*P before you discharge/leave. This is NOT usually done, you may think it is, but it isn't. They will likely be shocked your navigator/ A game skills to have the fore-thought to request this. BELIEVE ME, THEY WILL BE SO WILLING to do so because they don't want to see you or your family member back in the hospital (in 30 days or less) Good continuity of care benefits everyone- especially the patient!

2. Ask for your discharge paperwork (also called AVS or after visit summary). They usually give you the AVS in a big stack of paperwork. Most people throw into the back seat of their car with all the other stuff they have in their "patient belongings" bag as they race home to: 1. Take A Shower/ Bathe 2. Eat real food not hospital food. The AVS is SUPER IMPORTANT! It spells out what you were admitted for, what new medications you are NOW taking and follow-up instructions. It's important to make sure you understand how to take care of yourself before you leave the hospital. If you are now going to be taking insulin, the nurse who is caring for you in the hospital will be expected to "show you" how to administer insulin and watch you do it. This process is called "Teach Back" and the nurse is documenting they have performed this task in your medical record. My advice is get your monies worth!! During teach back, you listen, then repeat back that you understand or show them you can now draw up insulin and give it to yourself successfully. If you don't know how, don't be afraid to ask them to show you again and again. It takes time to learn and feel comfortable with the ability to perform a new task. That is what your nurse is there for! They may be busy, but most nurses love to educate their patients.

3. Medication problems are a BIG cause for readmissions. This is probably the number one reason for readmission. Often when you go into the hospital, your medications change. Based on your current diagnosis or new diagnosis, the doctor may change a medication or discontinue a medication you were used to taking or add a completely new medication based on a new diagnosis. It can be REALLY confusing and DANGEROUS if you don't understand the new instructions completely. Make sure you review the list of new medications at discharge and understand why you are being prescribed a new or different med. The hospital will give you a new list of medications you are taking at discharge. They will also send the new prescriptions to your pharmacy of record by e-scribe (online prescription). Have a family member or friend review your new list of medications and call the pharmacy to make sure they have received your new prescriptions and have them on-hand/ filled BEFORE YOU LEAVE the hospital. They should be ready and waiting for you when you leave. If you cannot get your medications, let the hospital nurse know. They shouldn't "technically" discharge you and they may need provide a two to three day supply of medications before they can SAFELY discharge you home. I emphasize the word SAFE because it is NOT a safe DISCHARGE to simply send a person home without confirming all systems are GO. This means medication! If you are now on insulin and are sent home and the medication is too costly when you go to the pharmacy, you will end up right back in the hospital. You should also take your new medication list given to you at discharge to the pharmacy. Most important, take this new medication list to your P*P when you follow up with them in office in the next few days. If something is unclear or not working out for you (i.e. it costs too much and you can't afford it) your regular P*P will address it at the hospital follow up visit. Many times they can substitute a generic medication or connect you with pharmaceutical manufacturer grant based programs as a stop-gap measure to ensure your access to medically necessary meds.

I am including a link to an amazing product called a Pill Map. This can be purchased here by clicking the link provided below and I will receive a small commission for promoting it.... or you can search on Amazon yourself for the product. It's same price either way :) You can fill this card with all of your new medications that are provided on the Discharge Med List and write on/ wipe off the new information as needed. This is super helpful when your doses change, frequency changes etc. It can be left as a guide for your loved one when they fill up their pill trays weekly or if there is a caregiver who needs a guide. I met the woman who created this tool and she did so because of her personal experience in caring for her own family and how difficult it was to keep up with their medications after each hospitalization. It's a wonderful tool!

Hope this helps if you or a loved one is admitted to the hospital! 😀🙏

12/25/2019

Today is Christmas✝️🌅🎄, God bless each of you! Be thankful and grateful for the ones you love and are here because life is truly a miracle 🙏. Each day you live is truly a 🎁gift. The older I become and the longer I work in healthcare, the more grateful I am for each new sunrise 🌄.

Today I am grateful for my dad, Larry Murphy, who is 80 years young and who gets to have another Christmas with us ❤️. Last night he attended the candlelight service at church on Christmas Eve (pictured on the left). This past August, my family was praying to bring him home safely from the hospital🏥 with hopes of seeing him turn 80 in November.

I am most grateful for the miracle that he is here with us today and that miracle would not be possible if not for this beautiful angel, his home health nurse Angie; pictured on the right with my dad while in the ICU. She was the nurse who was caring for my dad in the community at the time that he suffered from an acute Heart Failure exacerbation.

Knowing the signs and symptoms of Acute Heart Failure Exacerbation is something nurses are trained for. I will have more to say about that in future posts and why it’s important to understand what Heart Failure is and how to avoid exacerbations❤️ in the first place. If your loved one has been diagnosed with Heart Failure aka CHF aka congestive heart failure, you need to have a crash course in keeping them healthy and out of the hospital.

Because of nurse Angie’s excellent nursing care and quick response (ie she paged his cardiologist who then instructed ER/hospitalization) my dad was admitted to the ICU at his local hospital within hours, something he wasn’t really thrilled about at the time....believe me, he did not want to go🤦‍♀️!!!! And WHO🤔 wants to go to the hospital 🤷‍♀️, fact is he REALLY had no choice if he wanted to live.....WANT and NEED are very different☝️. Because of Angie and her nurse advocacy, she urged my mom to reach out to my brother, the Paramedic. And just like ⚡️lightening ⚡️a plan was set in motion.

My dad was admitted to Manatee Memorial Hospital’s Cardiac ICU (in Bradenton FL) and over the course of a three week admission and another few weeks in a post acute rehab (aka SNF) his life was saved. But...anywhere along that chain of events, it could have all gone south. Many times, people in my dad’s situation will REFUSE hospitalization (like my dad did initially). Persons with heart failure, during a decompensation like the one my dad experienced, aren’t thinking clearly/ rationally because their Oxygen and CO2 levels are waaaaaay off. In this instance they have AMS-altered mental status- and NEED a logical/ rational person to step in and make them seek medical attention, right away, the way Angie did❤️. This is often very DIFFICULT for the spouse, who feels powerless in situations like this. Angie did not take no... and this bought us the time we needed to get to our dad and ensure we would comply with his medical providers recommendations throughout treatment.

My brother and I (both medical) jumped on a plane to get back to Florida ASAP. My bro is in Texas and I am in California, both lifetimes away, but we knew our mom needed us there. She would not understand the medical speak or the in/ outs of the acute hospitalization process and would be lost in trying to advocate for our dad or getting him to agree to care (like wearing a BIPAP mask, because who wants to wear that thing ....especially when you are in a confusing scary environment like the hospital!)

In today’s confusing world of Acute care and care transitions, if you have a life threatening emergency like a Heart Failure exacerbation you MUST align yourself with someone who understands and can help you navigate the hospitalization process to get the best care possible and best outcome possible (i.e safe discharge home)!

My hope is to share some of my knowledge here for you, the non- medical folk, when navigating an Acute admission, what that looks like, how to ask questions and advocate for the ones you love so they can get home 🏡❤️🙏 safely and stay out of the 🏥 hospital for future holidays to come!







Hold your dear ones close! Merry Christmas to everyone. ❤️ your friend the nurse, Sharon “Shari” Gold, RN