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Stroke: Know the Warning Signs!

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“I have met a number of people that have had a stroke. Each one has had different consequences- some severe and some with hardly any visible effects. Are there warning signs and can you discuss the different effects strokes have on individuals?” – G.L. of Reedley

The medical terminology for a stroke is a cerebral vascular accident (CVA). A CVA is caused by the blockage of blood flow by a clot or a rupture of an artery in the brain. This can result in sudden death of brain cells due to lack of oxygen. Strokes can create all sorts of disabilities. Depending on where in the brain the stroke happened you can have trouble speaking, the extremities of one side of your body could be limited or not work at all. Reasoning skills could be hindered, eye sight may be changed, or the muscles for swallowing could be weakened. The list of possible disabilities goes on and on. Damage from a stroke can lead to death. Statistics show strokes are rated 3rd in the leading causes of death.

Transient ischemic attack (TIA) is a small stroke, sometimes referred to as a warning stroke. These strokes have the same symptoms as a (CVA) stroke but there is no lasting damage. The symptoms appear for a short time and then recede and your body goes back to normal.

Each year hundreds of thousands of people have strokes (CVA or TIAs). Both of these types of strokes need immediate attention at a medical facility. There is no way to tell if you are having a TIA or the more damaging CVA. Whether or not you recover from the stroke depends on getting to the hospital quickly. There are clot busting medications now that can eliminate or reduce the damage done by a blood clot in the in brain. The blood clot busting medication can reduce long-term effects if it is administered within three hours of the start of the symptoms.

It is important that everyone recognizes the symptoms of any type of stroke:

  1. Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
  2. Sudden confusion, trouble speaking or understanding
  3. Sudden trouble seeing in one or both eyes
  4. Sudden trouble walking, dizziness, loss of balance or coordination
  5. Sudden, severe headache with no known cause.

If you or someone you are with has one or more of these signs, don’t delay to call 9-1-1. It is best to get an ambulance to the scene rather than take the person to the hospital yourself. The ambulance is equipped with emergency equipment. It is good to check the time when the symptoms started. There is a very small window of time to get the necessary medication to circumvent the effects of the stroke. The brain cells start dying quickly when they are deprived of oxygen.

It is difficult to treat a stroke if there has been a delay in getting to the hospital. Reasons for the delay can be denial “I have got this little problem. If I ignore it I am sure it will go away.” Maybe there is nobody around when the stroke happens. If you live alone or are alone for extended periods of time I encourage you to form a buddy system to check up on each other or get something like Lifeline so you have a way to call for help. Fortunately on a retirement campus like Sierra View Homes neighbors look out for each other and are more aware of symptoms to be alerted for. Another reason for the delay is lack of understanding how important it is to get the victim of the stroke to the hospital quickly. Not calling an ambulance can delay treatment.

Not everybody has full recovery from a stroke. Some strokes are caused by bleeding in the brain. Clot busters do not work on this type of stroke. Some areas of the brain when deprived of oxygen just do not come back to full function.

Rehabilitation therapy for the stroke usually follows a stay in the hospital. Therapists try to reprogram the effected area. The first year following the stroke is the period when it is possible to make the most progress toward prior level of function. Once the first year anniversary is passed progress becomes extremely limited. Sierra View Homes rehab center has had a lot of success in improving residents function in both the outpatient and inpatient programs.

The risk factors for having a stroke are high blood pressure, elevated cholesterol, tobacco abuse, diabetes and aging. Also, heart rhythm disturbances like atrial fibrillation and heart disease can cause strokes. Specialists are studying if there can be an inherited predisposition to strokes.

Strokes can be devastating and change the quality of your life. It is important that you looks at the risks factors, makes adjustments in life style to reduce the risk factors and heed the warning signs if they appear. Get to a medical center quickly if you suspect a stroke. Remember the three hour window. If you live alone make sure you have a system to get help in an emergency. Be alert and aware that someone around you could be in trouble so I encourage you to know the warning signs and assist as needed.

Understanding the Durable Power of Attorney

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Image by Dan Moyle - Creative Commons (https://flic.kr/p/f5j58F)

Durable Power of Attorney for Healthcare and Finances

What happens if you should suddenly have a life-threatening emergency? You are unable to talk and unable to tell the medical professionals what your wishes are. The medical personnel have taken an oath to do everything possible to save you. They may give you medical attention you do not want.

As you look to the future it is important to put safeguards in place to make sure your wishes are carried out through the rest of your life. There are things you can do at any age to put your wishes in writing and designate someone to follow your decisions in case you are unable to do so.

A Durable Power of Attorney for Health Care (DPOA) enables you to designate another person, called the attorney-in-fact (agent), to act on your behalf regarding healthcare issues. It is important you pick an agent who understands what your wishes are, and promises to follow you guidelines. Some people pick family members, others pick a friend. Be sure this person is aware of and agrees to what you are asking them to do. There is a place on the form to designate a second person in case the first one cannot fulfill the responsibility. I feel the second person should be someone younger than you are. I often see DPOAs that list the husband or the wife of the person being admitted to the Sierra View Homes Nursing Care. There are times when that person is too emotionally distraught or unavailable to do the job.

The DPOA not only states who is to be your agent but also states what your wishes are regarding end-of-life issues. Do you want to be kept alive no matter what?

You can state what limitations of treatment you want. Be specific with timelines of treatment procedures and when it is time to discontinue them.

The DPOA can be prepared and is filed away for future use or you can have it be in affect right away. It is important to have this document in your doctor’s office and with the person who will be acting at your agent. Hospitals, nursing homes, assisted living facilities and doctors respect the DPOA for Healthcare.

You can find the form for the DPOA for Healthcare online, in your local nursing homes or you can have a lawyer draft one for you. After you complete the form, two witnesses must watch you sign it. These two witnesses must have no direct interest in how long you live. It should be two friends rather than two family members. Once the signatures are in place the document is legal. If you would prefer, you could have the document signed with a notary. When you use a notary you do not need witnesses. There is a different procedure that must be followed when you are a resident in a nursing home. There is a law that states the DPOA must be completed in the presence of an Ombudsman. The Ombudsman serves as a neutral third party to ensure the resident in the nursing home is making the choices of their own free will.

Durable Power of Attorney for Finances

What happens if you cannot take care of your financial obligations because you have a serious health issue or struggle to understand all the bills? There is a Durable Power of Attorney for Finances to name an attorney-in fact (agent) to act on your behalf. Your agent is given the ability to handle your financial affairs. It is important to state in your document if you want your agent to handle your affairs on an ongoing basis or for a short period of time, immediately, or in the future. You can limit what your agent can do for you. But keep in mind that if you become unable to continue handling your affairs the limitation may cause problems.

It is important you find an agent, who can and wants to handle the task. This person needs to be someone you can trust, who keeps good records and will be around for an extended period of time. Talk to the person you have chosen so that they understand what you expect of them. Be sure they understand what their responsibility will be. The DPOA for finances should be on file where you do business.

At Sierra View Homes Retirement Community, I have seen how difficult it is when the resident has no documentation explaining what his/her end of life wishes are. Often families are emotional or in disagreement with each other when it comes to making difficult but necessary decisions. Residents who have completed a DPOA for Healthcare have already expressed what their wishes are and have designated someone to follow those directions. Some of the guidelines may not be what the family members want but they can follow through knowing this is what my loved one wants.

The fact is, we are all living longer and statistics show that many of us will have some form of disability in the future. I encourage everyone to take steps to ensure your wishes are documented. Talk with someone you trust to determine what your wishes are and who you want to act as your agents. Then get the DPOA for Healthcare completed. Likewise think about your finances and who you would like to help you if you could no longer take care of your own finances. Then get that DPOA done too. Both forms are good until you decide to change them. It gives you peace of mind to have some of those hard decisions determined.

Macular Degeneration

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Image by F Delventhal - Creative Commons

There is something mystical about sight. Vision is so mechanically complex that we all take our eyesight for granted until something goes wrong. As we age there are numerous ways that our eyesight can be compromised. Many of us are familiar with cataracts and understand what they do to blur vision. Cataracts are one of many possible vision problems as we age. Lately, my attention has been drawn to a number of my friends at Sierra View Homes and family members who have been diagnosed with macular degeneration. I realized I did not know much about the disease and became interested in understanding macular degeneration better. 

In a healthy eye, the eye receives and processes light. The retina takes the light and turns it into signals that the brain interprets as visual images. The macula is part of the retina where the detailed central vision happens. Peripheral vision is the side vision and is the less acute vision and is not affected by macular degeneration. 

People 50 years and older can be affected by Adult Related Macular Degeneration (AMD). AMD happens when the macula part of the retina is slowly destroyed, and represents the leading cause of vision loss in older adults. People who have macular degeneration talk about how blurred the central part of their vision is. AMD affects the central vision of one or both eyes by causing blurred vision and shadows that create blind spots. This causes problems with activities such as driving, sewing and reading. b            

There are two forms of AMD: wet and dry. Either version can cause severe vision loss. The dry form is the most common. It has three stages, early, intermediate and advanced. The dry AMD increases slowly as the light-sensitive cells in the macula gradually break down causing the central vision to blur. There are few symptoms in the early stages so you may not be aware things are changing.  AMD is not painful and if you are not getting regular eye exams you may miss the early symptoms. In the later stages, the blurred vision is the most common symptom. AMD usually does not affect both eyes equally. You can have it in one eye, or it can be in both eyes but in different stages. 

The wet AMD is the advanced form of AMD. People who have the dry AMD are at risk of the disease progressing to the wet AMD. Wet AMD happens when new blood vessels under the macula leak blood and fluid causing the macula to break down quickly. Blood and fluid can cause the macula to swell damaging the retina and create scarring of the retina. Wet AMD causes the central vision to become distorted. Straight lines look wavy and blurred. It can also cause a blind spot that is in the center of your vision. The good news for people with wet AMD is that eye care professionals can delay or even stop the progression of the disease. There are several therapies that could be done. None of them are a cure for AMD. It is important that you work closely with an eye care professional to determine what  is the best therapy for you. 

AMD affects older adults. People who are 50 and older should get regular testing done.  As we age our chances of AMD increases. Caucasians are more likely to get AMD than people of other nationalities. If you smoke you double your chances of AMD and if your grandparents or your parents had AMD you are at higher risk. 

Research is telling us to avoid smoking, exercise, maintain normal blood pressure and cholesterol levels, and eat a healthy diet with an abundance of green leafy vegetables and fish to reduce the impact of AMD. Have regular eye exams and follow your eye care professional’s advice to slow down or stop the progression of the disease. 

In my discussions with people with macular degeneration, I sense the frustration of not being able to do the things that once were so easy. It becomes difficult to sing out of the hymnal in church because the eyes can’t focus to read the print of the song. Using the computer becomes more frustrating because there is not enough contrast to see clear enough to work the different functions. Driving becomes difficult when you need to look all directions and have a spot you can’t see through. The central part of our vision is necessary for so many tasks. It would be easy to become depressed. If someone you know has AMD, it is important to stay supportive and to help the person as they work on rearranging their life style to accommodate the vision changes. There is no cure for AMD but with support those affected by AMD can lead a happy healthy lifestyle.

Do You Own a Pet?

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Looks like this kitty enjoyed her visit to Sierra View's nursing care center!

Pets can be good medicine.

Do you own a pet?  Pet lovers are quick to tell you about the immediate joys of pet ownership. At Sierra View, we pride ourselves in our lenient pet policy, which has allowed many independent and assisted living residents to bring their furry loved ones with them. As a result, our campus boasts many non-human residents – from small dogs, cats, birds, and fish to a friendly bunny who hops down the Sierra View hallways on a leash!

A common sight in the halls of The Terraces, Sierra View's independent senior apartment building.

One resident of Sierra View Terraces senior apartments told me she has always had a pet. “When you live on the ranch you must have dogs,” she said. Her small dog lives with her in her Sierra View Terraces apartment, and makes friends with passers-by on daily strolls around the neighborhood. “The companionship is special, and I am so thankful for my dog. He lets me know when someone is walking up to my door, and is a great conversation starter when we meet people on our walks.”

Researchers have been looking at the possibility of health benefits for pet owners.  Studies on the effects of owning and caring for a pet have revealed that pet ownership can bring remarkable results for your health. 

Studies show that pet owners are less likely to suffer from depression. Pet – especially dogs and cats – fulfill the basic human need for touch. They offer unconditional love, attention, and companionship. Caring for a pet can boost your morale and bring pleasure to your days. Pets require regular feeding and exercise so, no matter how depressed, anxious or stressed you are, your pet needs you to care for it. Being needed, and the job of taking care of an animal, can give your life purpose and provide a sense of self-worth. Veteran groups have seen amazing changes in depression with disabled soldiers. Some animals can even sense a person’s mood and purposely try to change it. 

Stroking, holding, cuddling, or otherwise touching a loving animal can have a powerful effect in lowering blood pressure. Touch and movement are two healthy ways to deal with stress. Pets encourage playfulness, laughter, and exercise. Studies show that playing with a pet can elevate levels of serotonin and dopamine, which calm and relax us. Laughing at the antics of a playful pet helps you enjoy life, and adds to your sense of well-being.   

Having a pet can also be heart-healthy. Research shows that heart attack patients who have pets recover more quickly and have longer life spans than non-pet owners. Going for walks with your dog, riding a horse, or chasing a kitten keeps you moving in heart healthy ways. “My dog has to say hello to everyone, and that makes my walks with him take a long time,” mentioned a Sierra View resident. “So I end up getting more exercise!” 

Pets also help us take better care of ourselves. When you have a pet, you have to be there to take care of it. In fact, pet owners over age 65 are less likely to need to visit the doctor with ailments. Pets encourage laughter, playfulness, and exercise. All three boost your immune system and increase your energy. 

A pet does not have to be a cat or a dog. There are many animals to consider. When you decide to get a pet, look at your home environment, your time commitments, how active you are now, and who else lives in your home. Some pets require more time than others, so think about what the pet requires and if that commitment works for you. 

Pets are not for everyone. It is important to weigh the pros and cons when considering a pet. Food, shots and equipment can represent a significant financial investment. Some animals, especially dogs, may need training and ongoing time for walks and outdoor play. The time commitment cannot be shortchanged, so it is necessary to look at the time you can devote to a pet. Additionally, a particular pet’s lifespan and adult size should be considered – for example, some tortoises sold in pet stores can live up to 100 years and grow to weigh hundreds of pounds. 

Throughout our retirement campus, Sierra View Homes Retirement Community has several birds and aquariums for residents to enjoy. Sierra, one of our most popular birds, can often be found on a resident’s shoulder happily taking a break from sitting in her cage.  Recently, three-week-old kittens brought smiles and cuddles to many people in both our Nursing Care Center and Assisted Living. We also have visiting animals, such as a therapy dog that stops by frequently to cheer up anyone who wants a bit of love. 

Owning a pet has many positive attributes. If you (or your parents) are feeling down, stressed out, lonely, or have health issues, consider purchasing a pet. Researchers have found the pet owner feels remarkably better in just a few short months. As we age and our families and friendships change, caring for a pet can give you the lift you need to stay healthy and happy well into the future.

11 Benefits of Living in a Retirement Community

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Wondering if retirement community living is really better than living in a house? It is!

Below is a list of reasons that retirement community living beats living alone in a home every time.

Benefits of Living in a Retirement Community:

  • FriendshipsFriends

    As we age, we often lose roles, spouses, and friends. As a result, living at home can become lonely. Living with peers offers friendship, companionship and a sense of community. Neighbors become traveling companions, friends who share a cup of coffee, and often a fellowship and support group in times of need.

    On the day I arrived and moved into my apartment, I was welcomed by many of my neighbors,” said Mary Lou Martens. “One of my neighbors even brought over some cupcakes to enjoy with my coffee! My doorbell rang quite often during that first week. Though I didn’t know them at the time, they’ve since become good friends. It’s so nice to know that I’ll always have someone to talk to, someone who notices when I’m away, and always someone who will help when it is needed. We look out for each other! One of the best decisions in my life was coming to live at Sierra View Homes Retirement Community.”

  • Safety and Peace of Mind.

    Living in a retirement community can combine the best of both worlds, offering both freedom and safety. Sierra View’s gated community, security cameras, key-card locked building, indoor mail slots, and vigilant neighbors mean that you have more security than you would in a house. Friends check in on each other, noticing when someone is missing from the dinner table. Additionally, in case of some sort of medical event, nursing staff are right across the parking lot. All of this combines to increase the feeling of safety and provide peace of mind.

  • Less Home Maintenance.

    As we age, home maintenance becomes increasingly difficult. Gutters, lawns, and leaky hot water heaters are no respecters of age! This is one of the biggest benefits to life in a retirement coCCRC_Buffetmmunity – the chores of keeping up a house are gone. You do not have to worry about who will water the lawn while you travel, or deal with the financial burdens of home ownership. 

  • Less Cooking.

    Many retirement communities (like Sierra View Homes Retirement Community in Reedley, CA) offer meal plans, where a certain number of meals are provided each day. These meals are tasty, and provide the opportunity to socialize with neighbors.

    We never miss the evening meal,” said one resident. “Not only is it nice not to worry about cooking, it’s also an important time for us to connect with our friends. My husband and I are always busy and out and about, but we plan around meal time with our neighbors and try to make it a priority.”

  • Interesting Activities.

    Retirement communities make social activity a priority, making it easier to keep active as you age. There’s something for everyone! Bingo, movies, exercise classes, swimming, cooking, musical events, shuffle board, pool-playing competitions, bus trips and featured programs  – the busy activities calendar increases the level of social activity and provides entertaining ways to socialize. Living in a retirement community makes it easier to find peers who have similar interests and enjoy similar activities.
    Sierra View Guitar

  • Transportation.

    Most retirement communities offer transportation to surrounding shops and resources, which can be a vital service once driving is no longer an option. Sierra View’s shuttle goes to supermarkets every week, and other locations in the nearby city for special events. Even those who can drive often choose to tag along with their friends on the facility shuttle – why not turn the weekly shopping trip into a chance to chat?

  • Freedom.

    After devoting years to work and family, many seniors have a desire to experience traveling, deepening relationships or simply enjoy doing the things that interest them. There is a sense of freedom when you leave on a trip and know the staff and friends of the retirement community are watching your place. For many people, becoming a resident of a retirement community is a wonderful thing because many of the worries and burdens of life are gone, and in their place come new friendships, traveling companions, and rich experiences.

  • Access to Additional Services/Care Without Relocating.

    Recovering from a fall and need rehabilitation? Need some extra in-home services? Recovering from an illness that needs temporary skilled nursing care? These are situations that would require a complete relocation while still living in a house alone. In a retirement community, stepping up to a higher level of care does not necessitate losing your home, or even leaving it. Retirement communities offer the ability to smoothly move from one level of service to another, and back again, and typically preferred access to higher levels of care is given to those already living in the community.

  • Lower Financial Burden.

    There are often choices for housing in retirement communities, meaning that residents can choose their housing based on their budget. Knowing what your rent will be, and what your extra payments are, can help with budgeting for the future. A move to a retirement community can often lock in rates, or lock them to planned-for increases, which works better for a senior’s fixed income.

  • Respectful Neighbors.

    piano2
    Retirement communities have an age requirement of 55 and older, and as a result they enjoy a level of peace and quiet that cannot be found out in the general community. No loud rap music and frat parties here! 

  • Volunteer Opportunities.

    Retirement communities offer a wealth of opportunities for residents to make a difference, through service projects like gardening to make the community more beautiful, reading to those whose eyesight no longer allows them to, leading support groups, and going out together to make a difference in the Reedley community.

    I thought, what do I have to give? I realized that I can share my music. I have been playing the piano in the lobby for awhile now and I can’t begin to tell you how blessed I feel. There are so many opportunities here for those of us who enjoy volunteering. Sierra View Homes Retirement Community in Reedley, CA is the best place to live as a retiree.”

Make the transition to a retirement community today! The sooner you do, the sooner you’ll be enjoying the benefits that only retirement community living can provide.

Retirement Communities and Eating Habits

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Could moving to a retirement community improve my eating habits and help me eat a healthier diet?   
– D. Mc. of Reedley, California

Yes! Living in a retirement community does encourage better eating habits. Very often, socialization during meals results in an increase in appetite.

Having a healthy diet with proper nutrition has benefits, such as increased mental ability, better mood stability, a strong immune system, more energy and faster recuperation times.

As we age there are factors that cause our eating habits to change, such as the loss of a spouse, a limited budget, metabolism starts to slow down around age 40. Activity levels change due to medical or physical problems. Our sense of taste and smell diminish and various factors can cause appetite changes, such as medication, depression, or an acute or chronic medical condition.

In the aging process we need to continue to exercise.  Statistics show weight more than age determines how much energy we have.  Eating food with fiber keeps the digestive system working well. Taking calcium walking and getting 15 minutes of sunlight daily, helps keep bones strong. Drinking plenty of water promotes regularity, helps our joints, keeps us feeling energetic and much more.  Avoiding foods with high sugar content is important; sugar can suppress the immune system, weaken eye sight, and contribute to obesity, diabetes and other chronic health issues.

Retirement living facilities offer help with maintaining good eating habits. Some independent living facilities have meal plans that can be purchased by the people who live there. There are facilities that offer one meal a day; others offer 2 or more. Some have the meal plan built right into the rental price. There are also assisted living and skilled facilities that serve 3 meals a day.

It should be noted that retirement communities create menu cycles based on the direction of a registered dietitian. For example, SVH has John Varin, RD who verifies diets for proper nutrient content and gives direction to the kitchen supervisor in coordinating food preparation and modified diets. . Retirement communities offer nourishing meals and the socialization encourages better nutrition by continuing to wet the resident’s appetite.

If living in a retirement facility is not an option then try having a potluck frequently with friends. Go to the community center either in Dinuba or Reedley for a noon meal M-F.

Both programs are serving meals very reasonably priced and offer other activities with possibilities to meet new friends and have things to do.

The life span for the average American is increasing. A healthy diet and regular exercise can help us live those extra years with energy, and enjoyment.

This article was co-written with John Varin, R.D. He is the consultant dietician for Sierra Kings Hospital and a number of long term care facilities in the Reedley area.