July/August 2010 Print - Debra Levy Eldercare Associates

Could an adult day program be the answer?

Perhaps you’ve heard of “adult day care.” Although you may be reluctant to consider it for your parent, research shows the benefits are undeniable.

Three basic kinds of adult day programs are offered across the country.

Adult social programs provide activities, meals, and personal care.
Dementia-focused programs are like social programs but are geared for individuals with memory loss.
Adult day health programs provide activities and meals, as well as therapeutic and social work services. They serve individuals with serious medical concerns and/or dementia.

Most programs provide transportation to and from the center. The average cost is $67/day, although you may be eligible for assistance. (If your loved one spends at least 8 hours a day living with you and is financially dependent, you may be eligible for Dependent Care Tax Credits from the IRS.

Day programs create a win:win for you and your parent. Researchers report:

Reduced stress for family caregivers.
Increased quality of life for program attendees.
Fewer dementia-related behavior problems over time.

Concerned that your parent will say “no”? Studies of dementia-focused programs find this is not a common problem. Still, follow these tips for a successful transition:

Start slowly. Have your loved one attend for a few hours at first, then a full day. Build up to several days a week.
If your loved one has dementia, new places and faces may cause anxiety or resistance. Stay with them initially to ease their adjustment.
If your loved one does not have dementia, be sure the program has other non-impaired attendees.
Discuss your concerns with center staff. They are experienced at helping newcomers fit in.

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How diet affects breathing

We’re all aware that diet affects health. But did you know that people with COPD (chronic obstructive pulmonary disease) can help themselves breathe better by making simple changes to their eating habits?

What we eat

The food we eat combines with the oxygen we breathe to create energy and carbon dioxide. Our body needs the energy to function. The carbon dioxide is a waste product we need to dispose of. Too much of it is toxic. But having to exhale a lot can be tiring.

Limit sugar and sugary foods such as candy, cake, and soft drinks. Carbohydrates (sugars and starch) produce more carbon dioxide than fats or proteins. They make more work for the lungs.
Fats produce the least carbon dioxide. The best fats are polyunsaturated fats such as vegetable oils and soft margarine (look for those labeled “zero trans fat”).
Protein is necessary to maintain the respiratory muscles. At least two servings a day is recommended: eggs, dried beans, dairy products, and meats.
Limit foods that produce gas, such as carbonated beverages, dried beans, cauliflower, and broccoli. They cause the stomach to expand which puts pressure on the diaphragm.
Limit salt. It can cause the body to retain fluid, making it harder to breathe. See our January 2010 article on reducing salt.

The way we eat

Consider eating four to six small meals a day and minimizing fluid intake at mealtime. It’s harder to breathe when your stomach is full.
Eat earlier in the day. If energy is generally low by dinnertime, focus on consuming more of the day’s calories in the morning and afternoon.

As always, check with a doctor or dietitian to determine the diet that is right for your loved one. You can search for a registered dietitian near you at www.eatright.org.

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Travel tips when your loved one is disabled

It’s difficult to know what to anticipate when traveling with a frail family member. Here are tips from experienced, disabled travelers to reduce your road-trip stress this summer.

If your travel includes hotel lodging:

Talk directly with the hotel. Many chains have a centralized reservation system. Get a direct, on-site number instead. Then ask to speak with the head of housekeeping or engineering. With their intimate knowledge of the building, you can ask them to describe the disability features: How wide are the doorways? Does the bathroom have grab bars? And don’t forget to ask about access to the hotel from the street!
Reserve the room. Confirm that you are guaranteed an “accessible” room. Reconfirm a few days in advance of your arrival. If your room is not available or not accessible, ask to speak with the manager. It is the hotel’s responsibility to find you suitable alternate lodgings.

You might also consider bringing these items. You’ll find them sold online or at medical supply stores.

A folding ramp. An easy way to eliminate a short flight of stairs.
Safety items for the bathroom. Consider a lightweight toilet seat extender. For bathing, look for a suction-based grab bar, or folding shower bench and slip-on shower hose. Add nightlights to improve visibility after dark.
Chair comfort. Bring a lap blanket and special pillows if your family member will be spending a lot of time sitting. Or a small fan to help with cooling. A swivel seat cushion may help a lot with getting in/out of the car.

To help your loved one join in excursions, consider a wheelchair. A wheelchair can preserve your family member’s energy. All transport chairs fold, but some are made for travel and pack easily in a small bag.

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