The Answer:

Minimizing heavy activity was one of the first things to consider, said Raquel Mullaney, owner of Comfort Keepers, an in-home care service for the elderly with a center in Milford. ‘‘Elderly people feel the heat differently,’’ said Mullaney. ‘‘As the older adult ages, their ability to feel the heat and humidity declines.’’ So when Grandma puts on a cardigan in 80-degree weather, it’s because she really feels a chill.

Mullaney said dehydration is also a big worry because seniors often don’t feel all that thirsty even if they start to get dehydrated. Mullaney suggests that seniors drink plenty of water, dress in lightcolored and lightweight clothing, and stay in shaded places, despite not feeling thirsty or hot.

As if these changes are not enough, other barriers of healthy eating may arise. Taste buds change with age making some foods less desirable. Medication and even some medical conditions seniors experience can cause loss of appetite. Some seniors may feel less apt to prepare healthy meals for themselves. Preparing meals and eating alone can be lonely. They may find cooking for one cumbersome and resort to quick meals with little nutritional value. For these reasons, seniors are at risk for malnutrition as well as subsequent physical and mental complications from lack of calories and nutrients.

Comfort Keepers® leads our industry in caring for the elderly population. Our caregivers know good nutrition is the foundation for seniors trying to achieve the goal of living independent lives at home. Caregivers are able to help seniors achieve this through Interactive Caregiving™ – not merely keeping a watchful eye on seniors they care for, but joining seniors in grocery shopping and meal preparation. Knowing that companionship stimulates appetites, caregivers often dine with clients.

These actions foster a greater sense of wellbeing in seniors, making them feel valued and secure. But, Interactive Caregiving is not just a concept for professional caregivers. Comfort Keepers encourages family caregivers to consider the same techniques when caring for their loved ones. Cooking and eating together can become an activity that is anticipated by both the caregiver and the one being cared for. Encouraging a senior loved one to participate in shopping and dinner preparation is a good way to teach them the value of healthy food choices without seeming overbearing or intrusive.

To help, Comfort Keepers suggests following a food pyramid designed especially with seniors in mind. When followed in conjunction with the advice of a senior’s health care provider, this pyramid ensures seniors know what types of foods they should consume in order to foster the best health possible. The food pyramid can be found by following this link: http://interactivecaregiving.com/senior-nutrition.

The benefits of healthy eating are an important part of overall good health. Healthy, well-balanced diets support physical strength, mental wellbeing, increased immunity, and cardiovascular health. Those who consume regular nutritious meals are less susceptible to fatigue and bouts of depression, and are able to maintain adequate weight control. For seniors, healthy eating becomes imperative in sustaining independent lifestyles within their own homes.
 

While it is never too late to begin protecting your skin from damaging UV rays, experts say sunburns experienced early in life can cause skin cancer in later years. However, damage caused by the sun’s rays is cumulative, spanning a person’s entire lifetime in the sun. Knowing this, it may not be surprising to learn that cases of skin cancer among seniors are more prevalent than in the younger population.

Skin cancer among seniors is a serious matter. In fact, research indicates that over 50% of deaths associated with skin cancer occur in people over the age of 65. Perhaps this is because some older adults, unaware of the sun’s continuous damaging rays, think the danger of skin cancer is not as high as they age. But it is critical that seniors protect their skin from the sun as aging skin loses its ability to protect itself. Additionally, current sun exposure further harms “old” sun damage, and inhibits the skin’s ability to protect it from cancer. It also may become harder to detect clues of cancer on the skin as the skin matures with aging. Wrinkles and decreased elasticity due to aging change the overall appearance of skin. Age spots, dryness and other skin conditions seniors suffer make it harder to detect abnormal cancerous lesions. 

Seniors who develop melanoma are not as likely to have a good prognosis as younger generations may be. Early detection of melanoma can literally mean the difference between life and death. Any signs of moles that are raised, change in shape, have jagged edges, discolorations, or signs of bleeding should be viewed by a doctor immediately. Other skin abnormalities should be checked out with a doctor, as well.

While not all skin cancer lesions are malignant, it is important as a person ages to be proactive in detecting skin cancer. Regular self-examinations of moles and other skin spots are crucial. Yearly appointments with a healthcare professional to examine all moles on the body are essential.

_{^{References
WebMD (2012). Skin conditions and the elderly. Retrieved on April 6, 2012 from http://www.webmd.com/skin-problems-and-treatments/guide/elderly-skin-con….
Lebwohl, Mark. MD (2010). Skin cancer treatment among elderly requires additional caution. Retrieved on April 6, 2012 from http://skin-cancer doctors.com/2010/
11/09/skin-cancer-treatment-elderly/.
Evans, Susan. MD. Skin cancer on the rise among seniors. Retrieved on April 6, 2012 from http://www.doctoroz.com/blog/susan-evans-md/skin-cancer-rise-among-seniors.}}

Healthy eating cultivates good overall health; it potentially helps ward off some medical conditions; and it positively affects other conditions. For instance, those with diabetes are able to maintain better health when they follow the correct diet for that disease. People with high-cholesterol can help improve that condition when following nutritional guidelines that aid in decreasing cholesterol levels.

Healthy eating is beneficial in other ways, both medical and non-medical, including battling fatigue. Knowing this may be of particular interest to the senior population who are prone to experience a lack of energy and increased fatigue due to medical conditions, medications, and the aging process, in general. To make it easy to understand, this analogy may help: your body needs the proper amount of nutrients in order to function best, very much like a car needs gasoline. Without a continual supply of nutrients and sufficient calories needed to perform both physical and mental activities, your body can become sluggish and tired on a daily basis. The subsequent lethargy can leave you feeling much like you have run out of gas.

The good news is – provided your lack of energy is not caused by a medical condition or medication – fatigue can easily be addressed by learning to eat well-balanced meals and snacks that contain enough calories and nutrients to keep your body in optimum health. Even if fatigue is caused by an underlying condition, medication or stress, eating well can help boost energy levels and counteract excessive tiredness.

Simply eating to stave off hunger during the day is not sufficient. Also, keep in mind that if your body out-performs its caloric intake, this can cause increased tiredness. The foods that you choose to eat are essential. However, overeating can also cause fatigue, as it causes the digestive process to work overtime and can contribute to feelings of lethargy. The key to healthy eating is choosing key foods that contain adequate nutrients and consuming these meals or snacks in appropriate portions.

Foods that are nutrient-rich that can help fight fatigue are not hard to find. Opt for plenty of fresh fruits and vegetables. Vegetables should not be overcooked, as doing so causes a loss of nutrients. Red meat and spinach provide needed iron, while fish such as tuna or salmon contain omega-3 fats – all of which are helpful in fighting fatigue. Proteins can also be obtained by consuming fish, lean meat and beans. Nuts offer a protein boost and are a good snack choice. Choose whole grain pasta, rice, bread and cereal to complete a well-balanced, fatigue-fighting diet.

If you suspect your fatigue is due to poor eating habits, changing your diet may be all you need to feel energized daily. However, there are medical conditions that can cause fatigue. It is important to discuss this with your care provider to determine if your fatigue may be due to an underlying health issue. In the meantime, feel free to pursue healthy eating habits because the end result will be a healthier you!

^{References:
Andrews, Jill. Livestrong.org (2011). Food to fight fatigue. Retrieved on March 22, 2012 from http://www.livestrong.com/article/375604-food-to-fight-fatigue/.
Tree.com. Healthy eating: diet and fatigue. Retrieved on March 22, 2012 from http://www.tree.com/health/chronic-fatigue-treatment-diet.aspx.
Psychologytoday.com (2003 / 2011). Fighting fatigue with diet. Retrieved on March 22, 2012 from http://www.psychologytoday.com/articles/200310/fighting-fatigue-diet.}

Part Two of Two

Hardware

• Hand tools – hammer, screwdrivers to use now, shovel and pickax for after the storm
• Power screwdriver
• 4×8-foot sheets of plywood 5/8-inch to 1/2-inch thick to put over windows. Ask for exterior plywood.
• 1/4 machine screw sockets and screws
• Plastic sheeting to cover furniture
• Rope
• Sturdy working gloves
• Duct tape to waterproof items; masking tape isn’t strong enough.
• Canvas tarps
• Nails. There are many kinds, so look over your home now and determine what you will need.

 Medical Needs

• Medic-alert tags
• Insect-repellent sprays and candles
• Feminine hygiene items
• Sunscreen
• Soap
• First-aid kit and first-aid handbook
• A supply of any prescription drugs
• Extra over-the-counter medicine (for colds, allergies, cough)
• Children’s medicines
• Aspirin
• Bandages
• Adhesive tape
• Cotton-tipped swabs
• Antiseptic solution
• Sterile rolls, bandages
• Ear drops
• Thermometer
• Tweezers
• Needles
• Disinfectant

 Baby Needs

• Disposable diapers, wipes
• Formula, baby food
• Diaper rash ointment, petroleum jelly
• Baby medicines (pain, cold, cough)
• Medicine dropper

• Small can with tight lid
• Plastic bags for liners
• Disinfectant or bleach
• Deodorizer

• Plastic to line bathtub to fill with water
• Jugs or containers to store water
• Water purification tablets (usually available only in drug stores), 2 percent tincture of iodine or ordinary household bleach, which contains hypochlorite as its only active ingredient – not bleach with soap, lemon or other additives.
• Manual can opener
• Bottle opener
• Matches
• Pocketknife – preferably Swiss Army style
• Camp stove or other cooking device and plenty of fuel. Use canned fuel, not charcoal or gas
• Disposable dishes
• Ice chests or coolers
• Paper plates, napkins, cutlery, cups

Part One of Two

• Flashlights and extra bulbs
• Battery-operated radio
• Fully charged battery-operated lanterns. Don’t get candles and kerosene lanterns. They are fire hazards.
• Extra batteries (in different sizes)
• Matches (waterproof matches also suggested)
• First aid kit
• Manual can opener
• Clock (wind-up or battery-operated)
• Plastic garbage bags
• Duct tape
• Working fire extinguishers
• Scissors
• Clean change of clothes, rain gear, sturdy swamp boots, heavy gloves
• Extra blankets
• An inexpensive rabbit-ears television antenna to use if cable goes out

• Store loose outdoor items
• Anchor small sheds
• Trim dead branches from trees and shrubs
• Put chorine in pool – protect filter motor
• Tape or board up windows
• Fill gas tank of cars – park in safe place
• Remove valuables (furniture and rugs) from the floor
• Move furniture away from window – cover with plastic
• Put important documents in waterproof container
• Get extra cash (ATMs may lose power)
• Refills and extra supplies of medications
• Keep tuned to Bay News 9 for the latest information

• Bottled water. Figure on a gallon of drinking water per person per day.
• Shelf-package juice and milk boxes
• Canned and powdered milk
• Beverages (powdered or canned, fruit juices, instant coffee, tea)
• Prepared foods (canned soups, beef, spaghetti, tuna, chicken, ham, corned beef hash, fruit cocktail, packaged pudding)
• Canned vegetables and fruits
• Dried fruits
• Snacks (crackers, cookies, hard candy, nuts)
• Snack spreads (peanut butter, cheese spreads, jelly)
• Cereals
• Raw vegetables
• Sugar, salt, pepper
• Bread
• Dry and canned pet food
• Right now, buy all the nonperishable foods you will need, put them in a box and leave them alone, except to rotate stock. Stock up on ice and pack coolers as early as possible. Freezing them ahead of time is less hassle than fighting for them at a store.
• Before the storm, turn your refrigerator and freezer to the coldest setting and drape blankets over them, but keep bottom vents clear. Then move perishables you’ll use first into ice chests to limit opening of refrigerators.
• Designate one cooler you will open regularly; fill that with drinks and less perishable items. Set aside other coolers for more perishable things such as meats and open them only rarely.
• Crank up your ice maker, break out the ice cube trays or fill jugs with water, so you can be making and storing ice in your freezer or coolers around the clock.
• Store cubes or small blocks of ice in sealed bags and containers so you can drink it after it melts.
• Clean your bathtub out, then wash it with bleach. Rinse thoroughly. If possible, line it with plastic. Then fill it and as many clean bottles as you can with drinking water. Fill your toilet tank; you’ll want it to flush after the storm.

However, loneliness sometimes takes on a different role in the lives of seniors. Lack of companionship can become a way of life that can have a negative impact on the overall health of the elderly.  Whether loneliness is caused by the loss of a loved one,  living miles away from family and friends, or because a senior’s social circle is not active – studies show that loneliness in the elderly can raise the potential for certain health risks including depression, high blood pressure and heart disease. 

As seniors grow older, it is important to understand the hazards of becoming isolated and inactive in social life.  Lack of companionship – not having anyone to lean on for emotional support – can cause seniors to internalize negative feelings instead of dealing with issues head-on.  Internalizing these feelings can compound the sense of loneliness and isolation which in turn can increase the risk of death and stroke in the elderly.

There is good news.  Because isolation has been identified as a major risk factor for morbidity and mortality in older adults, extensive research has been conducted to find ways to prevent it.   There are strategies proven to help elevate moods and stave off feelings of isolation and loneliness.  The following are a few ideas that can help seniors combat loneliness by seeking out and forming friendships within their lives.

Develop an active social circle.  Activities include taking on a part-time job or volunteering at a local organization that may offer opportunities to increase feelings of purpose and self-worth.  Joining a garden club or a book club can provide a way for making new friends.

Surf the net.  There are many online sites and chat rooms designed for seniors to cultivate friendships and even dating relationships.  Chatting with people online can be fun and is a good way for connecting with others who have the same interests.  Many seniors enjoy playing games online or even enrolling in classes and educational seminars to keep busy.  If a senior has relatives or friends who live far away, emailing letters and pictures of each other or chatting live via webcams also fosters a sense of connectedness that is important in maintaining a healthy outlook on life.

Get together.  Having a small gathering inside the home can boost the mood of a lonely senior, and can also provide a sense of focus.  Play a board game.  Gossip over coffee or dessert.  Whatever the occasion, having company makes the senior feel less isolated and alone and gives them something to look forward to.

Become a pet owner.  Studies show that the owners of pets can have blood pressure that is lower than that of non-pet owners.  Dogs, cats and even fish are proven to have calming effects on their owners and taking care of a pet is a responsibility that can make seniors feel needed.  The daily routine of caring for a pet not only gives a senior something useful to do, but increases the attachment and affection between pet and owner…a greater sense of companionship that decreases feelings of loneliness.

Dare to fall in love again, no matter what your age.  Encourage seniors to have a special someone. It can lift their mood, increase levels of happiness and can provide a great sense of well-being.  It is hard to feel lonely when one is in a healthy, loving relationship!

As humans, we are social creatures who interact to support and nurture one another.  Companionship fosters positive feelings of self, and as we grow older seeking companionship, whether that of a friend or pet, gives us a sense of value and purpose.  Feeling needed and loved provides a sense of security and happiness that is vital in maintaining both mental and physical health.

But they also are still practicing their trade the time-tested way: Knocking on doors.

Comfort Keepers offers some advice to share with seniors on how to defend against door-to-door scams:

• Don’t let door-to-door salespeople in the house. Some con artists pose as salespeople as they look for burglary targets.
• Refuse to do business with door-to-door salespeople unless confident they are locally-based. Ask contractors to present their license.
• Never sign or buy anything on the spot. At least think about it overnight.  If a door-to-door salesperson says it’s a one-time offer, and can’t wait, it’s time to say, “No thanks.”
• If visited by a home improvement contractor, be sure to get written estimates from other contractors. If the salesperson continues to push, say, “Goodbye.”
• Ask for the salesperson’s credentials. Many communities require door-to-door sales permits. To double check, call the local business permit office to make sure it’s legitimate.
• Insist on references. Check them out on your own time, after the salesperson has left, because scammers often use partners who stand by for “reference” calls.
• Never pay in cash. A check can buy a little time to stop payment if needed. Write checks to businesses, not individuals. Again, don’t buy on the spot.
• If you have any doubts, call the Better Business Bureau (check www.bbb.org for the nearest office) or police department to see if they’ve received any complaints or have any information about the business in question. (But just because they haven’t received complaints doesn’t mean the salesperson is legitimate.)
• Get everything in writing.

Con artists pour on the charm and take advantage of senior citizens’ polite, trusting nature. Advise seniors not to allow a salesperson to make them feel guilty when he appears offended by their cautious approach.  After all, legitimate businesspeople understand they have to earn their customers’ trust. They take caution and skepticism in stride.

Also take note: Under the Federal Trade Commission’s Cooling-Off Rule (http://www.ftc.gov/bcp/edu/pubs/consumer/products/pro03.shtm) , customers can get out of a door-to-door contract of $25 or more within three days of the sale. For details and other consumer protection information, visit the FTC’s Web site, www.ftc.gov.

Malnutrition in seniors is often caused by a combination of physical, social and psychological issues.  Many seniors experience lack of appetite due to the effects of illnesses or medications they take for those illnesses.  Some medications change the effectiveness of taste buds, making food less appealing.  Seniors who live on limited incomes may pay high out-of-pocket costs for medications and do not have funds left over to purchase healthy foods.  In addition, those who have restricted diets because of medical conditions may not find their required bland meals appealing.  Some seniors do not have easy access to grocery stores, or the means to get there to shop. Seniors who live more isolated lives may find cooking for one and eating alone a challenge.  Alcoholism and depression may also be key factors in the lives of some seniors, further inhibiting consumption of necessary amounts of nutritious food.

Whether you are a family member, friend or caregiver of a senior, Comfort Keepers® believes there are ways to recognize whether or not the senior you care for is eating properly and steps you can take to fix the problem and avoid malnutrition.

It may not always be easy to determine whether or not your senior loved one is at risk for malnutrition.  An easy, step-by-step quiz is available at www.InteractiveCaregiving.com ,which provides a nutritional score that can be printed and taken to a doctor to discuss the senior’s nutritional needs.   You can also easily contact a Comfort Keepers office to help seniors who may need assistance from a caregiver.

Here are additional steps you can take to help seniors avoid malnutrition:  

• Visit often and monitor what the senior eats.  If possible, help cook meals and dine together to ensure healthy meals are prepared and consumed.  Doing so also makes mealtime more enjoyable for lonely seniors.
• Offer to take the senior shopping.  Help choose nutritious and easy-to-prepare items that the senior likes.  Foods packed with nutrients such as peanut butter, fresh fruits and vegetables are good choices.  Add cheese to dishes, such as rice, pasta and sandwiches, to make tasty meals.  Top yogurt with wheat germ and add extra egg whites to scrambled eggs.
• Help the senior choose healthy snacks such as peanuts, nutrition-boosting shakes, health food bars, and other nutrient-packed items designed for immediate consumption with no preparation needed.
• Introduce the senior to seasonings, such as lemon juice and herbs, that can make bland meals taste better.
• Monitor alcohol intake and be on the alert for signs of depression that may affect appetites.
• Consult the senior’s doctor regarding changing medications that might suppress the appetite.

The dynamics of a senior living alone pose unique challenges as opposed to those who have other family members living in the household and more interaction on a daily basis.  Good nutrition for seniors is a key factor in maintaining good health necessary to leading active, healthy and independent lives.  Keeping an eye on seniors who live alone is critical to helping them maintain their safety, well-being, and ability to live independently.
 

Difficult behavior by a care recipient can be as simple as refusing to take medicine to as frightening as your loved one wandering during the day and night.   Your loved one may become physically or verbally abusive, or both.  They may refuse to eat or drink, and if suffering from dementia, may become paranoid or exercise random periods of yelling.  Those with depression may cry uncontrollably, and refuse to dress themselves or perform other acts of personal hygiene.

Because of the unique emotional ties between a family caregiver and the care recipient, caregivers are at risk of feeling guilty, angry and overwhelmed when dealing with difficult behaviors.  They often feel the situation is their fault, but this is far from the truth.  In fact, the single-most important thing to know when dealing with difficult behaviors is recipients of care do not act out because they do not appreciate or love the caregiver.  They act out as part of their disease process. 

Whether a care recipient is suffering illness, the effects of a stroke, or simply growing old, caregivers have to adapt to broad spectrums of behavior.  Learning what triggers your loved one’s difficult behavior will help.  It is important to note in some cases, medications can cause difficult behavior, and this possibility must be explored and managed by the health care provider in conjunction with determining other triggers.

Many times, the elderly become agitated when over-stimulated by loud noise, crowds, and over-activity.  People experiencing dementia can become angry or upset when they are forgetful, become lost or realize they cannot do things they used to.  Sometimes, the elderly find themselves in a situation that frightens them, and in turn, become overly aggressive and rebellious. Those suffering from a stroke may have damage in the part of the brain that controls behavior…meaning they can no longer control their actions even if they wanted to.

Help your loved one by identifying triggers of their difficult behavior.  If noise or large crowds make your loved one nervous, play calm music set at low volume, and limit visitors to a few at a time.  Keep happy reminders, such as pictures of family, in plain view and label rooms (such as the bathroom) and cabinets (for cups and plates) if memory is an issue.  When anger rises, speak softly but calmly and try to divert your loved one’s attention, but leave the room if you have to.  In the heat of the moment, do what you can to maintain the safety of yourself and your loved one.

Alleviate the situation by:

• Remaining calm
• Reminding yourself it’s not your fault
• Remembering this moment will pass
• Requesting help from family, friends, and support groups 

Above all, give yourself credit by knowing that you are giving the ultimate gift in order to make the life of your loved one easier in times of need.  The reward may be bittersweet in the moment, but with a proper frame of mind and a bit of help, the benefits are worth it in the long run…for you, and your loved one.