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Understanding Restless Legs Syndrome

As the name suggests, restless legs syndrome (RLS) is a condition that makes your legs feel extremely uncomfortable. It can begin at any age and grows progressively worse as you age. For most people, the legs are at their worst in the evenings, particularly while sitting or lying in bed. The “restless” feelings associated with the condition make most people get up and walk around. Moving is the one activity that offers temporary relief of RLS symptoms.

In many cases, there is no known cause for RLS. Modern researchers tend to believe the condition is brought on by an imbalance of dopamine, a neurotransmitter chemical found in the brain. Other cases, however, can be traced back to a specific cause. Those include:
  • Heredity
  • Pregnancy
  • Related Medical Conditions

Dual Diagnosis
RLS is sometimes diagnosed with additional conditions, such as:
  • Peripheral neuropathy: Nerve damage in the hands and feet can be caused by chronic diseases like diabetes and alcoholism.
  • Iron deficiency: When the body is deprived of enough iron, the resulting iron deficiency can cause or worsen RLS.
  • Kidney failure: Iron deficiency and kidney failure often go hand-in-hand. When the kidneys are unable to function properly, iron in the blood decreases. The resulting changes in body chemistry can cause or worsen the symptoms of RLS.

Commonly Described Sensations
What does restless legs syndrome feel like? Most people describe the symptoms as abnormal, unpleasant sensations that are localized to the calf muscles. Other descriptive RLS sensations include:
  • Crawling
  • Creeping
  • Pulling
  • Throbbing
  • Itching
  • Pain
  • Tugging
  • Gnawing
  • Burning

Commonly Reported Patterns
Common RLS indicators are:
  • Triggers: Onset of uncomfortable sensations begins after periods of inactivity, such as sitting in a car or traveling by airplane.
  • Timing: During the day, leg symptoms are either non-existent or extremely mild. At night, however, symptoms and discomfort peaks.
  • Secondary conditions: The presence of another associated condition called periodic limb movement disorder (PLMD) is fairly common among RLS patients. PLMD causes the legs to involuntarily flex and contract, then extend and retract. All this movement goes on while you are sleeping. Many seniors experience hundreds of twitching and kicking movements throughout the night. PLMD is common in older adults, even without RLS, and doesn’t always disrupt sleep.

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Sometimes You Have To Find The Funny

Being a caregiver is definitely not for the weak at heart. I’ve been a caregiver to my legally blind mom for almost five years, and my sister, who has been developmentally disabled since 2008.

When you’re a caregiver, everyone wants to give you advice on how you should best handle your situation. But, I find that most of the people offering advice have never had the opportunity to take care of a loved one while managing a life, career, family, and caregiving responsibilities. It’s those moments where I find that you have to live by one of my mottos, finding the funny.

You have to learn how to “find the funny” in every situation. It’s not obvious most of the time. It always appears at an unexpected moment, and that’s what makes it wonderful. You can be at a point where insanity is making a dash toward you because you have just realized that you have to go pickup your sister from work at 7:30 pm; after rushing across town to make dinner for your mom, after leaving your downtown office that you’ve been at since that morning. In that one moment you have gone from breadwinner, cook, and chauffer all in the span of two hours.

The humor reminds me that all of the stresses of the day mean little compared to these moments. Those moments are rare and these memories will last a lifetime. It’s funny when you’re a caregiver, you feel like this is the most permanent decision of your life. But, in reality it’s temporary. Remember, nothing lasts forever.

When you find the funny, you create a memory that will last past this situation. You forget about the stress, and remember the things that make you want to give up your life for this person. That’s what sustains me. Of course, I get frustrated, and want to give up. We all do. But, when I do, I remember that beautiful glint in her eyes and everything is right in my world. Make it a point to find the funny. It will free you, and give you laughs and a lifetime of memories.

About the Author
Pamela Davis is one of the “2 Chicks” of “2Chicks and 1 Old Lady”. “2 Chicks and 1 Old Lady,” is a blog that Pamela started to share the adventures that she and her developmentally disabled sister are experiencing on their quest to live life and find love while taking care of their legally blind mother. Her blog can be enjoyed at www.2chicksand1oldlady.com

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5 Steps to Help Seniors Develop an Emergency Response Plan

In honor of disaster education and awareness month, why not take the time to sit down and formulate a plan for emergency preparedness? Friends, family members and senior caregivers can help tailor an age-appropriate response, keeping in mind that, as people age, their needs and physical capabilities change.

Ready to develop a plan with your senior loved one? Here’s how you can get started:

1. Identify risks that are specific to your area
Common natural disasters to consider will mainly depend on a senior’s location. Find out if the region is known for hurricanes, earthquakes, tornadoes, blizzards, floods, forest fires or other natural disasters. The type of disaster will dictate the reaction and response.

2. Come up with a plan
Make the planning process super simple. Utilize the free family emergency plan form on Ready.gov to record contact information, Social Security numbers, medications, health conditions and health insurance information.

3. Decide who’s in the network
For seniors with special needs or those requiring in-home eldercare, a solid support network is vital. Great ideas include family, friends, neighbors, doctors, organizations or place of worship. Be sure to include contacts that are both local and out-of-town residents.

4. Have an emergency kit on hand at all times
Remember the saying “better safe than sorry”? This is one adage that certainly rings true during an emergency or natural disaster. Seniors and their caregivers should pack the kit with:

  • Three days of water and non-perishable food items
  • A one week supply of daily medications
  • Batteries for hearing aids
  • Hard copies of identifying documents, including birth certificates, Medicare cards, Social Security cards and banking information

  • 5. Store adequate survival items safely within the home
    When storing survival supplies, try to put everything in containers that are easy to reach and easy to transport. For seniors, it’s a good idea to store survival items in containers that come with rolling wheels. Remember to label each bag or container, thoroughly documenting what’s inside each one. It’s also a good idea to label durable medical equipment, including the senior’s name, address and phone number.

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    3 Sure-Fire Ways to Keep Seniors Socially Healthy

    Having a life full of loving family members and loyal friends is a blessing for most seniors. Frequent social contact is the best way to prevent depression and loneliness. Studies show that socialization even has a positive effect on seniors and their cognitive abilities, helping to fight off Alzheimer’s disease and other forms of dementia.

    Let’s take a look at three actions that are sure to keep seniors feeling upbeat and mentally sharp.

    Joining Community Programs
    Local community centers are often the best places for seniors to take part in age-appropriate social clubs. They commonly offer free (or inexpensive) classes, activities and day trips. The centers offer a wide variety of services. Some even offer transportation to and from the center; the complementary commute ensures that homebound seniors have an opportunity to socialize with their peers.

    Giving back to the community not only creates a sense of pride among seniors, it’s also a great way to meet new people and make positive changes. A few of the most common volunteer opportunities for older adults are:

    • Working for local literacy programs to help children improve reading levels
    • Joining foster grandparent programs and serving as a source of inspiration for at-risk youth
    • Helping in the local soup kitchen
    • Donating or working at community thrift shops
    • For seniors looking to broaden their horizons, consider joining the Peace Corps – a group that welcomes retirees

    Live it Up
    Post-retirement, most seniors have a lot of free time. Why not spend it by taking up a new hobby or diving back into a previously enjoyed activity? Thousands of older adults spend their time scrapbooking, painting or pursuing photography.

    Retirement is also the perfect time for seniors to get out and see the world. By conducting some research, older adults will find Elderhostel programs that offer travel and educational opportunities. Cruise lines offer hundreds of packages that give seniors a hefty discount. RV owners can hit the road with communities of like-minded seniors, crossing the country at a leisurely pace and taking in the sights.

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    July is Eye Injury Prevention Month

    Though July is normally associated with Independence Day, the month is also designated as Eye Injury Prevention Month. For older adults, poor eyesight is often a problem that requires prescription glasses and an eye injury has the potential to cause serious, life-altering trauma. In honor of Eye Injury Prevention Month, let’s spend some time focusing on protection and prevention.

    Every day, an estimated 2,000 Americans suffer eye injuries. According to the Bureau of Labor Statistics (BLS), almost 70% of those eye injuries are caused by falling or flying objects, or foreign objects striking the eye.

    Protection is Key
    The best way to prevent eye injury is to practice prevention and use protection. Some of the best protection tips for seniors are:

    Invest in Protective Eyewear
    Protective eye goggles or glasses are the single most effective tool to help seniors avoid eye injury. Though adults over the age of 65 are likely retired from the workplace, protective eyewear is just as important around the house. Mowing the lawn, for example, is a household chore that requires eye protection. Sticks, rocks and other lawn debris are commonly flung from underneath the lawnmower and straight into the eyes of an operator.

    Shield Harmful UV Light
    Did you know that the human eye can suffer sunburn? The sun’s UV rays are extremely harmful to the eyes. If the eyes are sunburned, seniors suffer an increased risk of developing cataracts or, in extreme cases, blindness can occur. In order to protect the eyes, seniors should always wear sunglasses that are made to provide UV protection.

    In the Event of an Eye Injury
    For older adults or senior caregivers, time is of the essence when dealing with an eye injury. Should an eye (or both eyes) become injured, seek immediate medical attention.

    Symptoms of a serious eye injury include:

    • Isolated pain and/or vision problems
    • A visible cut on the eyelid
    • One eye no longer moves like the other
    • One eye protrudes or sticks out further than the other
    • Pupil shape and/or size is abnormal
    • Specks of blood seen in the whites of the eye
    • A foreign body can be seen imbedded in the eye
    • A foreign body under the eyelid that cannot be wiped away or flushed out

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    The Need to Alter Our Communication Techniques

    By Karen Love

    communicationDid you know that spoken words only account for 7% of communication?  The remaining 93% of communication is conveyed through body language, vocal tone and pitch.  If you are surprised by this information you are in good company – most people don’t realize this.  Human brains process communication in milliseconds so we aren’t aware this process is even occurring.

    Communication style becomes especially important when there is someone in your life that is living with dementia.  Communication often becomes one of the most challenging aspects because we try to use the same communication technique with someone living with dementia as for those who don’t have this brain impairment.  Understanding a few basic elements of communication can make a positive difference.

    1. Remember that 93% of communication is non-verbal.  Use this dynamic effectively to help the person with dementia be better able to process what you are saying.  Here are some tips:
    • Stand at eye level in front of them so they benefit from seeing your body language and facial expressions.  People likely don’t realize how often they speak behind or besides someone.  If that person has dementia the lack of visual cues hampers their ability to process information.
    • Slow your speech down because their brains process information more slowly.
    • Phone calls are especially challenging for someone who has dementia because the only communication cues they receive are words (7%) and vocal tone and pitch (38%).  Limit phone conversations to a minute or so and say something positive like, “I was thinking of you and just wanted to call and say hello.”  The expectation of being able to have a meaningful two-way phone conversation is not realistic.
    • Consider using Skype or another one of the visual software methods on a computer, tablet or iPad to communicate.  This provides the opportunity to see the person speaking, which greatly enhances their ability to process what is being communicated.
    1. Take time to listen to the person’s response giving them enough time to respond.  Don’t interrupt them while they are speaking.  If they are especially stuck on a word, kindly supply the word and see how the individual reacts.  If they don’t appear to want the help, let them manage on their own.
    1. Ask one question at a time and ask questions that require simple or yes or no answers.   For instance, “Do you want scrambled or fried eggs this morning?” instead of “How would you like your eggs this morning?”
    1. Where possible, give visual cues about what you are communicating about.
    1. Use touch as a way to communicate.  Touch is a powerful communicator.  When used positively touch can convey caring and warm feelings.  It only takes a moment for a light touch or pat on the shoulder, a kiss on top of the head of someone sitting, or a gentle hand squeeze.
    1. Smile often, not only because it conveys warmth and caring, but also because smiling can make you feel better too.
    1. Spend time together in companionable silence.  It can be exhausting for someone living with dementia to continually process communication.  Sit across from the person or at 90 degrees so they can easily see you.
    1. Lastly, the most important action you can take is to be aware of how you are communicating and whether it is having desirable results such as smiles, nodding, and looking contented, happy, or relaxed.   If not, review how you were communicating to see if you should adjust an aspect of your technique.

    Karen Love is a former speech therapist and long-term care administrator with more than 30 years of experience advancing person-centered practices in long-term service and support settings.  She has been a co-investigator of numerous research projects funded by the National Institute on Aging and the U.S. Administration on Aging. She is the Co-Founder of FIT Interactive, which researched and developed FIT Kits. FIT Kits are engagement kits that help family and care partners improve the quality of life of people living with dementia. For more information please go to their website www.fitkits.org

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    Sunscreen 101: A Focus on Senior Skincare

    While it’s great for seniors to get outside on a warm sunny day, taking proper skincare precautions is of the utmost importance. As we age, our skin becomes more delicate and prone to damage. For adults over the age of 65, protection from the elements is essential. Sun damaged skin is weaker, leathery and easily bruised.

    Before going outside to bask in the warm rays of the sun, take the time to choose the appropriate sunscreen. With multiple types, brands and strengths of sunscreen available, picking the right combination can quickly become confusing. Luckily, the Environmental Working Group puts out an updated list of safest and most effective sunscreens each year.

    The highest scores are awarded to sunscreens that provide excellent UV (ultraviolet) protection and are made from nontoxic ingredients. For 2014, the following sunscreens made the Environmental Working Group’s “top 10” list:

    • All Terrain AquaSport Lotion, SPF 30
    • Alba Botanica Very Emollient Sport Mineral Sunscreen, SPF 45
    • Aubrey Organics Natural Sun Sunscreen, Unscented, SPF 45
    • Badger Sport Sunscreen Cream, Unscented, SPF 35
    • Blue Lizard Australian Sunscreen, Sensitive, SPF 30+
    • Caribbean Solutions SolGuard Sunscreen, SPF 25
    • DeVita Skin Care Solar Body Moisturizer, SPF 30+
    • Nature’s Gate Sport Sunscreen Lotion, SPF 50
    • Safe Harbor Natural Suncare Sensitive Lotion Mineral Sunscreen, SPF 30
    • Thinksport Livestrong Sunscreen, SPF 50+

    Sunscreen Tips
    When going outside for more than 15 minutes, seniors should apply sunscreen first. Remember to apply the lotion or cream liberally. Experts suggest using at least two tablespoons of sunscreen for areas of the body that are normally exposed and a nickel-sized portion just for the face.

    Older adults or senior caregivers should apply sunscreen about an hour before heading outside and into the sunshine. Additionally, it’s important to reapply the product every two hours, even sooner if the hot weather is causing the senior to sweat.

    In-home caregivers should either purchase a new tube of sunscreen each spring or check to make sure the existing tube of sunscreen has not expired. Past the listed expiration date, sunscreen is ineffective and has the potential to cause serious skin irritation.

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    Keep it Moving this Summer: Ideas for Keeping the Elderly Active

    Summer offers seniors a perfect excuse to get out of the house and spend some time outdoors. The sun is shining, the birds are chirping and the whole world seems to exude life. Instead of taking these beautiful summer days for granted, why not encourage seniors to take advantage of them and boost their health at the same time?

    With ageing bones and muscles, vigorous workouts are no longer an option for most older adults. However, some physical activity on a regular basis will help seniors stay healthy, fit and happy. Here’s a look at some age-appropriate summer activities:

    • Take a dive: For seniors, swimming and water aerobics are an excellent option. Caregivers should call local recreation centers and ask about classes and options provided to the area’s older population. Many offer swimming and/or aerobics classes for free or at an extremely discounted rate.
    • Just start walking: Though it may not feel like it, walking at a normal pace for 20 to 30 minutes at a time is a wonderful way for seniors to boost health. Be mindful of the terrain, however. With summer temperatures climbing into the 90s, older adults should not overheat or become dehydrated. Try to choose a route that does not include steep inclines or hills; sticking to a level grade is the best idea. Many senior centers organize group walks and offer the added benefit of socialization.
    • Get serious with a personal trainer: Believe it or not, there are plenty of personal trainers out there who specialize in training seniors. And there’s no reason to go to the gym to work with one of these exercise gurus – most will happily come to a client’s home and develop a targeted workout routine that is safe, effective and fun. What’s more, most of the exercises that personal trainers recommend for older clients don’t require special equipment or tools.
    • Soaking up some culture: Another fun and effective way for seniors to keep it moving this summer is by visiting outdoor cultural events or festivals. Not only do these events provide older adults with some beneficial socialization and quality time with friends and family members, they also encourage lots of movement. Walking through a large outdoor festival, moving from one vendor to the next, most people don’t even realize how many steps they’re taking in the span of two or three hours.

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    The Use of Heat Versus Cold for Treatment

    PT Sue LogoThe use of heat and cold for treatment of injuries has been around for years. Heat and cold come in many different forms and they are relatively inexpensive, easily accessible, portable, and easily administered.

    Regardless of the form of ice for treatment, the principle of cold is to: promote vasoconstriction of the blood vessels to decrease the peripheral blood flow within the first 15 to 20 minutes of application; decrease metabolic rate; and provide topical relief from muscle spasms. Cold is very effective in reducing inflammation after an injury. Compression with the cold at the injury site helps to increase the relief of the vascular congestion. The treatment rule is: RICE—rest, ice, compression, elevation. The resulting vasoconstriction of the blood flow in the injured area puts a demand on the deeper blood flow to dilate and carry away the excess fluid from the involved area.

    In using cold, it is best to place a cold damp cloth over the ice pack against the affected area in order to maximize the effect of the cold to reduce the skin temperature. An ice pack, or ice cubes, is better than chemical cold since it is more effective in absorbing the heat generated by the injured tissue. Chemical cooling agents may numb the tissue but they are not as effective in reducing tissue and skin temperature.

    Heat, in any form, is used to promote vasodilation of the peripheral blood vessels, thereby increasing blood flow; increasing the metabolic rate; and triggering relaxation of the muscle spasms, pain relief, and increased elasticity of the connective tissue. Moist heat appears to be more effective in raising skin and tissue temperature by increasing circulation. The effectiveness of the hot pack is influenced by the amount of subcutaneous fat below the skin of the area being treated. The fat can block, or slow down, the transmission of the heat into the deep muscular tissue, requiring a longer use time.

    One needs to use caution, or actually avoid, combining topical agents with traditional hot and cold packs, which when combined, may cause extreme pain and/or burning of the skin. The standard amount of time for the application of heat or cold pack to an affected area is 20 minutes. The use of heat and cold, alternately, called contrast baths, is very effective to act as a pump to flush out the excess fluid and is best accomplished with two pans of water, one hot and one cold. Start and end the entire session with the hot water. The “hot” water should be comfortably warm; the “cold” water should be anywhere from cold tap water to cold tap water with ice cubes. The “hot” or “cold” should not produce pain. Consider: 5 to 8 minutes in the “hot” water pan, and 3 to 5 minutes in the “cold” pan of water and repeat at least 3 complete cycle (one “hot” and one “cold” treatment constitutes one cycle).

    Use ice after an acute injury, especially while there is swelling in the tissue. Continue the ice treatment three to four times a day for 24 to 72 hours and longer if you are responding well to the cold. Heat is used more for chronic pain where there is no swelling and the purpose is to increase circulation to the tissue. Both heat and cold are helpful in abating symptoms. It is important for you to know which works best for your body.

    Please feel free to contact me if you have any questions at my web site, ptsue.com; my office (951)369-6507; or my email, askptsue@gmail.com. My goal is to help seniors keep healthy and moving. I welcome all questions and/or comments.

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    Summer Vacation Tips: Traveling with an Elderly Loved One

    Senior citizens enjoy a wealth of free time post-retirement. For many, it’s a golden opportunity to travel, seeing all the places they’ve put on the perpetual backburner. Let’s take a look at some of the best summer vacation tips and how they can put people on the road to stress-free summer.

    Planning a Trip
    For loved ones, traveling with a senior can present its own unique challenges, planning the trip ahead of time is vital. Where do you want to go? When is the best time to go? How much do you feel comfortable spending? Think about each aspect of the trip, then share what you’ve learned from friends and family members.

    Suitable Options
    Each time seniors travel, discounts are available. Log on to sites like AAA, AARP, travel clubs for seniors and Internet deals. Figure out which option offers the best deal, meets the goals and sticks to a budget.

    Money, Money, Money
    Before getting the last suitcase packed, it’s important to plan ahead and decide how travelers will pay for the trip. Is it best to use cash or credit cards? Knowing how much money the group is willing to spend.

    Traveling with Prescriptions
    Don’t forget to bring along your daily medications, storing them in the original containers. Seniors may also be required to carry a certification when traveling with certain medications. It’s also a good idea to review the side effects of each drug.

    It’s All About the Details
    A week or more prior to departure, sit down with everyone and go over the trip. Make a “to-do” list, checking off tasks as they are completed. Continue to review the plan, right up to the day of departure. Preparation is the best way to avoid mistakes.

    Take it Nice and Slow
    Your elderly loved one may not be able to keep up during certain activities; that’s why rest, relaxation, and downtime make for the perfect trip. For example, you wouldn’t want to walk the streets at a break-neck pace; seniors could never keep up. Set aside a specific chunk of time each day and make note of your efforts for next year’s trip.

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