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Judith B. Paul Law Blog

Monday, July 6, 2015

Hot Weather Alerts for the Elderly

                                          July has arrived with fireworks and hot weather!  

Introduction 

Warm weather and outdoor activity generally go hand in hand. However, it is important for older people to take action to avoid the severe health problems often caused by hot weather. "Hyperthermia " is the general name given to a variety of heat-related illnesses. The two most common forms of hyperthermia are heat exhaustion and heat stroke. Of the two, heat stroke is especially dangerous and requires immediate medical attention (see Definitions).

Health and Lifestyle Risk Factors

The temperature does not have to hit 100° for a person to be at risk. Both one's general health and/or lifestyle may increase a person's chance of suffering a heat-related illness.

Health factors which may increase risk include:

  • Poor circulation, inefficient sweat glands, and changes in the skin caused by the normal aging process.
  • Heat, lung, and kidney diseases, as well as any illness that causes general weakness or fever.
  • High blood pressure or other conditions that require changes in diet. For example, people on salt restricted diets may increase their risk. However, salt pills should not be used without first asking a doctor.
  • The inability to perspire, caused by medications including diuretics, sedatives and tranquilizers, and certain heart and blood pressure drugs.
  • Taking several drugs for various conditions. It is important, however, to continue to take prescribed medication and discuss possible problems with a physician.
  • Being substantially overweight or underweight.

 

Lifestyle factors that can increase risk include:

Unbearably hot living quarters. People who live in homes without fans or air conditioners should take the following steps to reduce heat discomfort: open windows at night; create cross-ventilation by opening windows on two sides of the building; cover windows when they are exposed to direct sunlight; and keep curtains, shades, or blinds drawn during the hottest part of the day.

Lack of transportation. People without fans or air conditioners often are unable to go to shopping malls, movie houses, and libraries because of illness and/or the lack of transportation. Friends or relatives might be asked to supply transportation on particularly hot days. Many communities, area agencies, religious groups, and senior citizen centers provide such services.

Overdressing. Because they may not feel the heat, older people may not dress appropriately in hot weather. Perhaps a friend or family member can help to select proper clothing. Natural fabrics such as cotton are best.

Visiting overcrowded places. Trips should be scheduled during non-rush hour times and participation in special events should be carefully planned.

Not understanding weather conditions. Older people, particularly those at special risk (see health factors), should stay indoors on especially hot and humid days, particularly when there is an air pollution alert in effect.

Heat Stress occurs when a strain is placed on the body as a result of hot weather.

Heat fatigue is a feeling of weakness brought on by high outdoor temperature. Symptoms include cool, moist skin and a weakened pulse. The person may feel faint.

Heat syncope is sudden dizziness experienced after exercising in the heat. The skin appears pale and sweaty but is generally moist and cool. The pulse may be weakened, and the heart rate is usually rapid. Body temperature is normal.

Heat cramps are painful muscle spasms in the abdomen, arms, or legs following strenuous activity. The skin is usually moist and cool and the pulse is normal or slightly raised. Body temperature is mostly normal. Heat cramps often are caused by a lack of salt in the body, but salt replacement should not be considered without advice from a physician.

Heat exhaustion is a warning that the body is getting too hot. The person may be thirsty, giddy, weak, uncoordinated, nauseous, and sweating profusely. The body temperature is usually normal and the pulse is normal or raised. The skin is cold and clammy. Although heat exhaustion often is caused by the body's loss of water and salt, salt supplements should only be taken with advice from a doctor.

Heat stroke can be LIFE-THREATENING! Victims of heat stroke almost always die so immediate medical attention is essential when problems first begin. A person with heat stroke has a body temperature above 104° F. Other symptoms may include confusion, combativeness, bizarre behavior, faintness, staggering, strong rapid pulse, dry flushed skin, lack of sweating, possible delirium or coma.

How is hyperthermia treated? 

If the victim is exhibiting signs of heat stroke, seek emergency assistance immediately. Without medical attention heat stroke is frequently deadly, especially for older people.

Heat-related illnesses can become serious if preventative steps are not taken. It is important to realize that older people are at particular risk of hyperthermia. Many people die of heat stroke each year; most are over 50 years of age. With good, sound judgment and knowledge of preventive measures the summer can remain safe and enjoyable for everyone. 

 

Information Provided by Medicinenet.com


Friday, June 19, 2015

Are You Still Dating that Guy

As I might have mentioned, my mother has dementia.  She's funny sometimes and I've heard some interesting stories from her that I am well aware never happened, but that's how it is. She makes things up, has serious issues with linear thought and sometimes a vague memory begins a stream of consciousness that makes me laugh.

On a visit some while ago, when she was still speaking in full sentences and knew who I was more than not, she asked me if I was still dating that guy from Canada.  I had to stop and think about that. I never dated a "guy from Canada" and I've been married to my husband for more than 40 years.  He did work in Canada occasionally and I suspect she remembered that even thought at this time it was more than twenty years ago.  

I said, no, we were no longer dating, but we had gotten married. She then wanted to know if we were going to have any children. Rather than inform her that she already had three grandchildren and one great grandchild and that I was in no shape to keep up with a new baby after the age of retirement,  I told her that we were thinking about it to which she replied that I had better hurry up or I'd be too old.  

The staff at her residence thought the whole thing quite humorous and on my next visit presented me with a funny card saying "Heard you were expecting," 

 

 

 


Tuesday, June 16, 2015

Just A Guy

 Interesting Article in USA Today by Paul Singer, Friday June 12, 2015.  He starts out by saying, " For Mother's Day this year I gave my mother the gift of in home care." He continues, " This is the fifth time my wife and I have been down this road with parents/elders, and it is always a shocking reminder of how complex our health care system is and how expensive elder care can be. We also discover each time that we are simply not prepared for it. Every day begins with a new mysterious challenge that we have never before considered.

The biggest problem we face in caring for our elders is that frequently they have no diagnosis other than "getting old." And our medical system isn't built to handle that."

Indeed, each day is a challenge: it can bring frustration beyond belief, more than when the kids were lilttle and dumped chocolate ice cream on the white carpeting or wiped stickty Kool-aid enriched purple fingers on your new suit.  It can bring such joy that you without prior notice, gush tears when Mom or Dad suddently recognizes you for a fraction of a second and says, "Oh, honey, I love you,"  and then the moment is gone and you are a stranger again.  

No matter how many times. like Paul Singer, you have been down this road, it is never the same. Each person is an individual with such different needs that you wonder if THIS time, you're going to be prepared. Not very many people are prepared even going down the road multiple times.  It may seem lonely on this journey to another place with someone who is slowly fading before your eyes, but you are not alone.  According to the National Institute on Aging,  More than five million Americans currently have been diagnosed with Alzheimer's and it is the sixth leading cause of death in the United States, possibley the third leading cause of death among the elderly. With these numbers of individuals affected by this insidious disease, you are not alone.  

The following is a link to the rest of Paul's story. 

 http://www.usatoday.com/story/news/2015/06/11/voices-parent-care/28325051/


Sunday, June 7, 2015

Memory Loss Humor

Memory Loss isn't funny - Alzheimer's and dementia are devastating diseases that destructive and painful for family members to watch.  Although my mother has severe memory loss, it does create some humorous situations for which we are grrateful.

At a visit to the eye doctor where mother repeated her entire life story with multiple embellishments for the umteenth time,  she refused to mention any eye problems although she had complained loudly and constantly that she needed new glasses and couldn't see a thing. The doctor gave her the eye test, the glaucoma test, checked for any eye disease and peered inside, around and outside the eyeball, finding nothing.   He presecribed some eye drops finding these might help her dry eye or teary eye conditions.  

In the parking lot she stopped before getting into the car and said, "That doctor is a phoney baloney!" She turned around to go back inside. "He didn't look at me at all. I'm going back in there to take my clothes off."

"Whoa!  He's an eye doctor, Mom, he doesn't need to see everything. There is no taking off the clothes for an eye doctor."

"An eye doctor?" she says looking astonished. "Well, that explains what he was doing."

 


Saturday, June 6, 2015

Is it time to take the car keys?

My client started off with a question, should I take away the keys?  It could be obvious to other people that this  person should not be driving but as children, we want to give our parents as much independence as possible. So how do we make this decision?   Mom called me one evening which sort of surprised me because she was forgetting things, like telephone numbers and I ususally called her. When I asked her how her day had gone she said it was fine after that nice young policeman helped her get back home.  Of course this raises red flags and carefully I asked her what had happened to need the services of a policeman. Appraently she was taking the dog for a ride to see the sheep and goats (they live in the country) and when she arrived at an intersection she couldn't remember which road she was supposed to take, so she turned off her car engine and sat there. She said it wasn't long before a policeman pulled up behind her and asked her what was wrong and she told explained the problem. She lives in a small town and he knew who she was so he asked her to follow him and he got her to right house. Living some miles away makes things difficulet but I knew the neighbors and called them to probe into this issue. With one exception, a lady who wanted her to continue to drive so she could take this woman to Bingo on Friday nights, the consensus was that she should not be on the road.  I don't know what to do she said. How do I take away my mother's only access to the stores, the bank, the hair salon. She doesn't need a nursing home and if I make her go to an assisted living center she'll hate me! my client wailed, what should I do? 

Taking the car keys is a difficult decision. We discussed this several times before the client was able to take action but she felt guilty and remorseful and her mother was angry for several months. Are the streets safer without mom on the road?  Of course. Is mom safer by not driving? Of course she is.  She hasn't had head on collisions, hit a pedestrian or an animal, forgotten where she parked or left the dog in a hot car. The client arranged for a van to pick her up three days a week to take her shopping or the salon. Every other Saturday a neighbor takes her out to lunch and shopping and other friends show up frequently.  It wasn't easy, but it worked. The client was concerned that this memory loss could be related to dementia which would require more action. She has a network in place to help mom and to call her to keep her informed.


Thursday, June 4, 2015

June is Alzheimer's and Brain Awareness Month

The evidence is mounting...people can reduce their risk of cognitive decline by making key lifestyle changes. That is the conclusion of a new research summary published online in

Alzheimer's and Dementia : The Journal of the Alzheimer's Association. 

1.  Break a sweat! Engage in regular cardiovascular exercise that elevates your heart rate and increases blood flow to the brain and body. 

 2. Hit the books! Formal education in any stage of life will help reduce your risk of cognitive decline or dementia. 

 3. Butt out! Evidence shows that smoking increases risk of cognitive decline. 

 4. Follow your Heart! Risk factors for Cardiovascular disease, obesity, high blood pressure and Diabetes negatively impact your cognitive health.

 5. Heads up! Brain injury can raise your  risk of cognitive decline and dementia. Use a helmet when playing contact sports or riding a bike!

6. Fuel up right! Eat a healthy and balanced diet that is lower in fat and higher in vegetables and fruit to help reduce the risk of cognitive decline.

 7.Catch some Zzz's! Not getting enough sleep due to conditions like insomnia or sleep apnea may result in problems with memory and thinking.

 8. Take care of your mental health! Some studies link a history of depression with increased risk of cognitive decline.

 9. Buddy up! Staying socially engaged may support brain health. Pursue social activities that are meaningful to you.

 10. Stump yourself! Challenge and activate your mind. 

"While the adoption of all of these habits is important in influencing brain health, if it seems overwhelming, start with one or two changes and build on them," said Geiger. "While some changes rnay be challenging, others can be fun. Try to choose activities and foods you enjoy."
  

Saturday, May 30, 2015

Power of Attorney Documents

Every attorney receives a call from a family member at least once in their career requesting a power of attorney for someone else.  Most recently I spoke with a friend who said he had received such a call. 

A Power of Attorney is a legal document that gives powers and authorities to someone else called the agent, on behalf of another person, called the grantor.  This is a serious document, and can be used against the grantor by someone who is not acting in the best interestsof the grantor.

The grantor must have the capacity to execute the document and understand what he or she is signing and what he or she wants to do. It's an unfortunate situation when a power of attorney would be the perfect document to have in that legal arsenal to help an individual but no such thing has been prepared and the person is now not capable of making any decisions.  

When calling on behalf of another person and advising an attorney that you need a power of attorney for someone else, the attorney may be immediately concerned. If possible, discuss the need for a power of attorney with this grantor before such a need arises and speak with an attorney who practices in this area to obtain one that will not be set aside for some failure to properly execute the document.  

If a Power of Attorney is not going to work due to the inability of the gnantor to understand the complexitites of the situation, discuss the possibility of a guardianship with the attorney.


Thursday, April 16, 2015

Welcome

Welcome to my new website, please check back regularly for more information and updated resources.  I'll add information you can use and share some situations I've come across with my own mother who is 98, yup, that's right, two years short of 100. She suffers from severe memory loss and can be difficult, funny, thoughtful, and even insightful.  It's a difficult road for the family of someone with dementia but we take the good with the bad and try to make the best of what we have.

IWatch my blog site for updated information about Medicaid, Estate planning, probate, guardianship, conservatorships, Veterans benefits, trusts and estate planning and pet trusts! 


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