With the current waiting lists for Long Term Care and the increase in costs of living in Retirement Communities we are looking for other housing options.
The goal is to provide options that are cost effective and provide choices for Seniors. 
Now a days there are definitely more Senior living options than in the past.  Many depend on what you are willing and able to pay for.  

Home Care

•There are many home care providers that can provide assistance for clients in their homes, retirement homes, long term care and in hospital
•Their services include: personal care, meal preparation, homemaking, companionship and safety supervision, up to and including end of life care
•Costs vary slightly but range from $28.00 to $32.00 hourly depending on the level of care and distance required to travel.

•Retirement Homes

•There are a number of retirement residences available for residents that are still independent and provide self-care
•Meals and housekeeping are provided
•If a resident becomes ill or declines in abilities, they may be asked to move unless they purchase additional support services
•Costs can range from $2500.00 to $6000.00 monthly or more.

•Nursing Home

•There are approximately 650 Nursing Homes in Ontario
•Wait Lists in most communities are around 450 persons, many of whom are in ALC beds in hospitals
•There is a tremendous shortage of LTC beds due the increase in the Senior population
•Once a client is deemed an ALC client, the client is charged $2600.00 monthly for the bed
•Part of the emergency room backup crisis is a result of bed shortages related to ALC bed usage.

•Co-op Housing

•Individuals purchase a share of the building
•Provides ownership
•Shared expenses, shared care, shared household duties•Shared decision making regarding new owners, maintenance decisions,purchases
•Property becomes part of the estate
•Example: SolterraCo-housing

•Shared Housing

•A home owner rents part of their home
•To off set income  
•Help with home maintenance
•Provides socialization and prevents Isolation and Loneliness.

The Eden Project, The Green House Project

•A new concept of care homes where people live in a home-like setting of 8-10 persons
•There is a large common shared kitchen DR area, with family room.
•These homes are situated in neighbourhoodsrather Senior Communities, or institutions
•When asked where people want to live as they age, they say they want to remain in their homes
•This alternative gives a feeling of home.

•Other Alternatives

•Reverse Mortgages- those that need cash can use the equity in their home to enjoy retirement.  You receive up to 50% of the equity in your home.  There are interest charges which you do not pay until your home is sold.
•Sell your home, rent it back, use the cash to invest and use funds to care for yourself or your spouse. Maintenance is looked after by the new owner, with a flexible lease in the event of an illness or death

                                                                                                         Yvonne Griggs

By: Julie Corliss

If you’re confused by the terms used to describe heart attacks, you’re not alone. They’re often described as “mild” or “massive,” or even the ominous-sounding “widow maker.” But these terms are not necessarily helpful, and they may create confusion and anxiety.
The good news: most people who have a heart attack survive. The bad news? “Any heart attack can be fatal, no matter how big, how small, or where it occurs in the heart,” says Dr. James Januzzi, a cardiologist at Harvard-affiliated Massachusetts General Hospital. “Furthermore, there’s a lot of misunderstanding among the general public about what a heart attack actually is,” he says.

The connection between heart attack vs. cardiac arrest
Perhaps the most common source of confusion is the difference between a heart attack and cardiac arrest. A heart attack (what doctors call a myocardial infarction or MI) is defined as damage to part of the heart muscle caused by inadequate blood flow to that area. Most of the time, this happens due to a blockage in one of the heart’s arteries. Known as a type 1 heart attack, such blockages typically occur when cholesterol-laden plaque lining an artery ruptures. A clot forms, obstructing the vessel.
While a heart attack is a plumbing problem, a cardiac arrest is an electrical problem. Cardiac arrest happens when the heart’s electrical system malfunctions, causing it to beat rapidly and chaotically — or to stop beating altogether. Without blood circulating to the brain, lungs, and other organs, the person gasps or stops breathing and becomes unresponsive within seconds.
A heart attack is a common cause of cardiac arrest, but most heart attacks do not lead to cardiac arrest. Other possible causes of cardiac arrest include heart failure, a clot in the lungs, a serious imbalance of potassium, magnesium, or other minerals in the blood, a drug overdose, or a blow to the chest.

Does size matter?
Some heart attacks cause more harm than others. During a heart attack, blood levels of a protein released by damaged muscle (troponin) give some sense of severity. Afterwards, an ultrasound of the heart (echocardiogram) can reveal the extent of the damage. “A large heart attack will significantly reduce the squeezing strength of the heart muscle,” says Dr. Januzzi.
The term “widow maker” refers to a heart attack caused by a blockage near the top of the left anterior descending (LAD) artery, the main artery that supplies blood to the front of the heart. However, heart attacks that involve the LAD are not necessarily fatal, and those involving other arteries can be deadly, too.

What to do
Call 911 right away if you or someone near you has symptoms of a heart attack or cardiac arrest. Common heart attack symptoms include:
•    uncomfortable pressure, squeezing, or pain in the chest
•    pain or other uncomfortable sensations in an arm, the back, neck, jaw, or stomach
•    shortness of breath
•    sudden nausea or vomiting
•    lightheadedness or dizziness
•    unusual fatigue.
Signs of cardiac arrest are a sudden loss of responsiveness and abnormal breathing (either not breathing or only gasping). Give hands-only cardiopulmonary resuscitation (CPR) until help arrives.

​ A 2010 Canadian study of hospitalized, elderly patients identified that there is a huge unmet need, that providing more support for end-of-life conversations and advance care planning will have a large positive impact on improving end-of-life care in Canada.[3]

What is an advance care plan?
An advance care plan describes your wishes at the end of life, in the event that you cannot speak for yourself. Your plan may include information about your values, goals and preferences for procedures that you do or don't want to have as well as other information about your care at the end of life (for example, religious rituals, being able to see a family member, dying at home or in palliative care, etc.). The most important aspects of advance care planning are naming one or more Substitute Decision Makers - someone who will speak on your behalf and make decisions for you when you are not able to do so yourself - and having a conversation with them about your wishes. See: www.advancecareplanning.ca for details.

Who should make an advance care plan?
Every adult should make a plan. You can't predict how or when you will die - so having a plan ensures that others know your wishes and that your voice will be heard if you cannot speak for yourself.

When is an advance care plan used?
You plan is only used if you are unable to make your own health care decisions (e.g. you are in a coma or your illness has impaired your ability to make decisions). Your representative can use it to guide your care and to express wishes on your behalf.

By: Harvard Health
​
Try this exercise for better bone health.
Strength-training exercises create stresses on the bones throughout your body, stimulating extra deposits of calcium and nudging bone-forming cells into action. Try this exercise now and then send for your report to get more!

Bridge — exercises the muscles of the back, backs of the thighs, and buttocks

Lie on your back on a mat with your knees bent and your feet flat on the floor. Put your hands next to your hips with palms flat on the floor. Keep your back straight as you lift your buttocks as high as you can off the mat, using your hands for balance only. Pause. Lower your buttocks without touching the mat, then lift again. Do eight to 12 repetitions. Rest and repeat the set.

Falls Prevention Programs and education help to improve the quality of life of seniors aged 65 years and older and decrease the burden of falls on the health care system.
Falls lead to serious injuries, sometimes death, hospitalization, and are the main reason that seniors are institutionalized in Long Term Care.

Risk Factors can be broken down into six main areas:

1.    Physiological

• Balance deficit
• Gait deficit
• Muscle weakness
• Mobility Issues
• Inappropriate use of assistive devices

2.    Medical

• History of falls
• Addiction to drugs or alcohol
• Cognitive impairment
• Diseases such as Arthritis, Osteoporosis, Coronary Artery Disease, Diabetes, Parkinson disease
• Depression
• Postural Hypertension

3.     Socio-demographic

• Age
• Gender
• Social determinants of health – living in poverty, housing, income, education  

4.    Pharmacological

• Anti-epileptic drugs
• Anti-psychotics
• Incorrect use of pain medications
• Use of multiple drugs – drug interactions
• Psychotropic drugs – sedatives, antidepressants, anti-inflammatory drugs

5.    Behavioural

• Agitation, confusion
• Fear of falling
• Inappropriate footwear
• Haste or poor-judgment
• Risk taking

6.     Environment

• Poor lighting
• Mats that don’t have rubber backing
• Loose carpeting or floor boards, linoleum
• Electrical cords that are placed along walking paths
• Poorly lit staircases
• Clutter and debris
• Outdoor environment: no snow and ice removal
• Cracked walkways
• Unsafe stairs, rails
• Poor outdoor lighting

At Alert Best Nursing we do a free client and environmental assessment for new clients. The home safety check is done for the benefit of our clients and staff, to reduce the risk for falls and other injuries. Often minor issues can be resolved. Problems that require medical assessment or repairs are discussed with the client and family.

For more information on Falls Prevention Programs go to Google and search for SHRTN the Senior Health Research Transfer Network.

Yvonne Griggs

While there are guidelines in place for medical consent, things aren’t as clear when it comes to romantic relationships or sexual consent. There have been cases in the news about dementia patients and their capacity to consent to sex. “When it comes to dementia and sexuality… the aging population has been described in the media as a ‘rape case time-bomb,’” observe Alisa Grigorovich and Pia Kontos.
In their article “A New Way to Think About Dementia and Sex,” Grigorovich, a Postdoctoral Fellow with the Dalla Lane School of Public Health, and Kontos, a Senior Scientist with the Toronto Rehabilitation Institute University Health Network point out that “the sexual rights of persons living with dementia are largely ignored within residential care policy, professional training and clinical guidelines.”
Their article, which claims that “a new ethic of dementia care is urgently needed,” points out that current guidelines for lawmakers and physicians do not address the sexualities of persons living with dementia and that guidelines should in fact be crafted to support sexual expression and facilitate sexual rights.

Senior Living Communities, Consent and Capacity
For administrators of senior care communities, the lack of clear legal or medical guidelines around sexual consent in the case of someone with dementia creates a challenge when it comes to protecting seniors in their care, while also supporting their sexual rights.
From a legal perspective, “consent to have sex is similar to informed consent,” Furman says. “Capacity to consent is complicated by the fact that consent may be necessary for different sexual acts and is act specific,” he says.
Steve Morgan, of the Senior Housing Forum, suggests that senior living providers are on the side of caution while acknowledging that “residents have the right to be sexually active if that is their mutual desire.” Morgan suggests that “while it’s hard to talk to families about their parents or grandparents’ sexual activities, families need to be part of the discussion when they have the legal right to be involved.”

1. You find medications that have not been taken as prescribed
2. Yours family member is unkempt and not dressed appropriately
3. The home is in disarray and not kept as it used to be.
4. Food is past the best before date and rotting in the fridge.
5. Frequent or increased falls leading to minor or substantial injury.
6. A decline in health has left your family member in a weakened state and unable to care for themselves
7. Your loved one is being discharged from hospital and needs to monitored and cared for until admission to a facility.
8. You are spending most of your time worried about and caring for your loved one and it is affecting your work, family and your health.
9. You live in another city or province and providing care and support for you family member is difficult a best.
10. Your family member is opposed to moving out of their home into a residence and you want to support them to stay there.

At Alert Best Nursing we can respond quickly to an emergency.  Are you in crisis because of a discharge from hospital, fall or a new medical diagnosis? We are here to help. Contact us!!

As we age we face many losses including retirement, loss of loved ones, health issues and increased isolation.  These losses are a normal part of aging but can lead to depression.  Depression leads to decreased enjoyment of life, but can also affect your appetite, sleep, energy level, and physical health.  Depression is not a part of aging and can be remedied.
                                                   
Depression is a problem for many older adults
Have you lost interest in former activities that you enjoyed?  Do you feel hopeless?
You are not alone.
 
Depression is a common problem in older adults.
 
The symptoms of depression affect every aspect of your life. Including appetite, energy, sleep, relationships, hobbies and work.
 
Depression is often overlooked in seniors because they either fail to recognize the symptoms of depression or don’t take steps to get the help they need.
Reasons:

1. Depression is a normal part of aging
2. Isolation can lead to depression and there is no one to notice the changes
3. You do not relate your physical symptoms to depression
4. Reluctance to seek help

Depression can happen to anyone at any stage of life.  The challenges of aging don’t have to stop you from enjoying your life.  Whether young or older you don’t have to suffer with depression.  Depression can be treated with medication; the right support and self-help strategies and can lead to a happy and fulfilling life. 

Causes of depression in older adults
 
Many life changes related to aging can lead to depression:

• Health problems- chronic pain, physical limitations, cognitive decline, changes in body image
• Loneliness- smaller social circle due to death or relocation, decreased mobility, loss of drivers license
• Loss of purpose- loss of identity related to retirement
•  Decline in physical abilities and/or mental abilities

 
Medical conditions can psychologically or directly cause depression in the elderly.
Parkinson’s disease,                           Stroke
Diabetes                                              Heart Disease                                                             
Cancer                                                 Thyroid Disorders,
Lupus                                                   Multiple Sclerosis
Arthritis                                                Alzheimer’s disease and Dementia
Seniors often have more multiple chronic illnesses.
 
Prescription Medications can result in depression of the elderly.  It is a common side effect, particularly when multiple medications are taken.
Drugs to treat blood pressure, heart disease, ulcer medications, steroids, sleeping pills, painkillers, cholesterol drugs and tranquilizers all can have a depressive effect.
 
Alcohol can be a coping mechanism to deal with physical and emotional pain.  Alcohol may interact with other medications and impair brain function, sometimes worsening the symptoms of depression.

Is it Grief or Depression?
 
Grief is a normal reaction to loss.  Everyone is different and there is no time limit on grieving.  During this process there are still times that we feel some joy and happiness. 
Depression however leaves one with a constant sense of emptiness, despair and hopelessness.
 
Signs of Depression in the Elderly
 
Despite denial seniors may still have depression.  Signs of depression may include:

• Neglect of personal care such as hygiene, skipping meals, not taking medication, poor housekeeping
• Irritability
• Anxiety and worry
• Lack of motivation, energy
• Unexplained physical symptoms
• Unable to sleep
• Memory Issues
• Loss of interest in socializing

 
​Getting over depression
 
It’s never too late to develop a new skill or hobby.  Keep the brain fit by learning new things and finding new enjoyment.

​

• Exercise has many benefits including lifting mood and gaining physical strength.  Small changes like taking the stairs instead of the elevator or parking your car further from the store can make a difference.
• Join some social clubs such as a seniors club or have someone come in to visit, or connect by phone
• Try some yoga or other breathing techniques to relieve stress.

 
Self Care

• Proper diet with an added vitamin supplement
• Get enough rest and sleep
• Get involved in your community, volunteer or join a church group
• Pursue a new hobby or learn a new skill
• Laugh, it’s good for you and provides a mood boost

 
Getting Help for a Loved one or Friend
 
The nature of depression interferes with a senior person seeking help.  You can help by offering emotional support.  Listen with compassion and patience and offer hope.  You can also ensure that your loved one seeks and gets appropriate treatment.  Attend medical appointments and offer hope and support.

​

If you or someone you know has had a serious accident or debilitating illness, the result can be unsettling and devastating for everyone involved. Loss of mobility, cognition and the ability to provide self-care can leave a person frustrated, confused, and in a crisis situation. Fortunately, there are many nursing and home care companies available to help with a person’s recovery, rehabilitation and ongoing support.
 
Nursing – Private nursing care is available in a variety of care settings such as hospital, long-term care, retirement home, assisted living residence, and in a client’s home. A registered staff person is required when a client requires treatment, which is not within the scope of practice of a support worker. Registered nursing staff generally oversee care attendants, do assessments when there is a change in medical condition, and administer medications and treatments.
 
Support Workers, Caregivers – Theses days, many baby boomers find themselves caught in the middle of caring for aging or ill parents, supporting their children and careers. (This is often referred to as “the sandwich generation.”) Having someone oversee the care and well-being of their parents is often a welcome relief. Home support can involve everything from assisting with the activities of daily living to activation to attending medical appointments to end of life care.
 
Care Attendants – An auto accident, stroke, sports injury or anoxia can cause serious brain and physical limitations. Attendants are specifically trained to care for clients who are quadriplegic or hemiplegic and are also trained in the area of brain injury rehab.
 
Dementia Care – Support workers who work with Alzheimer clients require specialized training for dealing with this type of client. Many home care agencies work with the Alzheimer Society to ensure that their support workers are trained to provide optimal care for Alzheimer and dementia clients.
 
Palliative Care – Whether it’s in a hospital, nursing home, retirement home or one’s home, clients can remain where they are most comfortable at end of life. Nurses and support workers are there to support the client and family, whether it be physical needs, pain relief, emotional or spiritual care. They can be reassured they are not alone at this difficult time.
 
Nursing and home care companies vary in the types of services they deliver. It’s important that health employees are well-trained professionals, insured and have experience in the area of care that is required. The care they provide can ease the burden today and tomorrow.
 
 --
Yvonne Griggs is CEO of Alert Best Nursing & Senior Home Care – a leading provider of staff for private-duty nursing hospitals, long-term care facilities and retirement homes. For more information on their services, call 905.524.5990, email info@abnursing.ca or go to www.abnursing.ca.

Supporting Burlington, Hamilton, Ancaster, Stoney Creek, Dundas Brantford and Oakville.

It's important to know that angry, agitated behavior is the result of unmet needs in people with Alzheimer Disease and those with other types of Dementia. There are numerous possible causes.
 
Physiological or medical causes:
 

• Physical discomfort such as constipation, pain, or illness can be expressed as anger
• Adverse effects of medications such as sedatives or psychotropic drugs
• Sleep deprivation
  
• Impaired vision and/or hearing may cause misunderstanding
  
• Sensory overload – too much activity, too many people, too much noise, over stimulation
  
• Feeling lost, insecure, forgotten. Person may feel abandoned when surrounded by unfamiliar people
  
• Difficulty adjusting from lit to darkened areas and vice versa
• Sudden movements or noise
• Feeling hot or cold in environment

 
Other Causes
 

• Response to caregiver impatience, stress or irritability
• Activity perceived as insulting
• Surprised or frightened by unexpected physical contact
• Person scolded, confronted or contradicted
• Responding to conflict around them
• Change in schedule or routine
• Being asked to respond to multiple questions at once
• Attention span to short for requested task
  
• Instructions unclear or too complicated
  
• Task not broken down into manageable steps
  
• Inability to perform what was once a simple task, e.g. putting on shirt
  

 
Coping Strategies for Caregivers
 

• Medical assessment to rule out physical problems/medication problems
  
• Discuss drug side effects or possible interactions with physician
  
• Have vision and hearing checked
  
• Dental visit, possible tooth decay or poor fitting dentures
  
• Make sure person is comfortable – clothes fit properly, shoes fit properly
  
• Alternate quiet times with active periods
  
• Plan activities when person is rested and plan for periodic rests during activity.
  
• Keep daily routines consistent. For some people with dementia, even a slight change in routine can cause confusion and disorientation.
  
• When a change of routine is necessary try to gradually accustom the person to the change.
  
• Simplify the environment by reducing the number of people, noise, and clutter.
  
• Do not move furniture or familiar items.
  
• Person may lose sense of time. Orientate with calendars and large clocks.
  
• Remove sharp utensils and items from environment to prevent injuries.
  
• Exercise to help reduce stress. Walking or dancing are helpful.
  
• Calm or familiar music, massage, or readings are ways of calming a person.
  
• Using gentle physical touch may be calming, hugging or holding hands may be comforting to some and perceived as restraining by others.
  

 
Communication Strategies
 

• Have the person’s attention before speaking and touching.
  
• Avoid questions that rely on memory.
  
• Try not reason with the person, as they may not be able to think logically. This frequently ends in frustration.
  
• Do not express anger or frustration with physical gestures. Body language is easily sensed and can lead to increased agitation and confusion.
  
• Speak clearly and slowly using simple, short sentences.
  
• Always approach the person from the front. Approaching from behind may startle or frighten the person.
  
• Use repetition. Frequent, clearly stated reminders are needed to reassure persons with dementia.
  

 
 
The Alzheimer Society in your community will provide you with advise, education, support, and information about day programs available in your area. 
Remember to take care of yourself, so that you can take care of them.