Common Types of Arthritis Seen in Elderly Residents

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Arthritis is one of the most common diseases associated with aging. Nearly half of Americans over the age of 65 have been diagnosed with arthritis by their healthcare provider.

Many believe they are fully educated about the signs and symptoms of arthritis, but what you might not realize is that there are more than 100 different types of the disease, and each one has its own causes, symptoms, and treatments.

Some variations of the disease can affect more than just your joints. It’s important to stay informed about the different types of arthritis to provide the best care possible for your residents.

What is Arthritis?

The word arthritis comes from the Greek word athron meaning “joint”. Arthritis is not actually one single disease, but encompasses a host of issues that often present most obviously in the joints. It takes numerous forms and has just as many causes.

Surveys show that arthritis is the most common disability in the United States. Every day more than 50 million Americans have to cope with this degenerative disorder. It limits the ability to walk, climb stairs, bend over, kneel, etc. Over time, arthritis can be restrict the capacity of an individual to participate in every day tasks, which can potentially lead to subsequent emotional health problems.

The Most Common Types of Arthritis

Osteoarthritis

The most common type, osteoarthritis, occurs commonly in the elderly due to the result of years of wear and tear on the joints. Past injuries or excessive physical activity (such as from a physically strenuous job) are often to blame.

To help residents relieve or manage pain from osteoarthritis, alternating hot and cold packs on the affected joints is one non-medicinal way. Hot packs help increase blood flow to relieve joint stiffness whereas cold packs can diminish swelling. Over the counter pain medications can also provide relief, but the attending physician and possibly other members of the team will decide to administer these medications. For chronic pain, a doctor or physical therapist may recommend the use of a brace or splint.

Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is an autoimmune disease and the second most common form of arthritis. Normally our immune systems protects us from viruses, and bacteria. However in those suffering from RA, the immune system goes on the offensive against healthy tissue. The immune system attacks the synovial membrane that lines the joints. The continuous inflammation eventually breaks down the joint beyond repair. Sufferers of RA also cite muscle pain, pain in the skin, chest, bones and ligaments.

Sleep is important for everyone, but for those suffering from RA, it is especially critical. That’s why it’s recommended you ensure your residents have the necessary atmosphere to get proper, uninterrupted sleep at night.

Naps during the day and regular exercise can also help alleviate RA pain, but always verify with the attending physician about any modifications to a resident’s sleep schedule, or exercise routine. In some residents, napping during the day can be enough to disrupt their sleep patterns at night.

Gout

While gout is often associated with middle-age, it is actually the most common inflammatory form of arthritis in the elderly with numbers increasing every year in both men and women. It is caused by a buildup of uric acid crystals within the joint, and often affects one or a few joints such as the ankle or big toe, and causes intense swelling and redness.

Although it’s often seen as mundane, gout can still have a devastating effect. A study of patients over the age of 65 in the United States found that those suffering from gout on average spent as much as $3,000 per year or more on medical costs than the control group. The expenses largely went towards treatment, doctors visits, and pain management.

To help relieve your residents’ gout-related pain, it’s important to ensure they consume plenty of fluids. Dehydration can often lead to an increased build up of uric acid crystals and worsen the affected areas. Avoiding high fat protein sources (such as red meat) can also decrease gout symptoms. The dietician on staff should be looped in to the resident’s medical issues so they can be sure to accommodate their nutritional and dietary needs.

Infectious Arthritis

In some cases, a bacterial, viral, or fungal infection can spread to the joints and trigger inflammation. Some infections that can cause infectious arthritis include salmonella, chlamydia, gonorrhea, and hepatitis C. With this kind of arthritis, receiving timely antibiotic treatment is key to preventing the infection from becoming chronic.

It’s important to make sure you have regular communication with your residents so that problems are addressed quickly to provide the best opportunity for recovery. Additionally, for those who may not be able to express their problems or needs, good observation skills are key to noting physical or behavioral changes that may suggest an underlying problem.

Our number one priority at Assisted Living Education is providing the highest quality education and educational resources for those caring for our senior population. We offer RCFE courses & certification, as well as online courses and continuing education. We believe that experience is critical to success, which is why we only employ instructors with extensive experience in the industry and have a reputation for creating engaging and real-world learning environments. Explore our website, or visit our contact page to learn more!

 

Special Feature: Michael J. Fox and Parkinson’s Disease

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In the 1980s and ‘90s, Michael J. Fox became a household name in the U.S. His success in the TV series “Family Ties,” and cult classics including the Back to the Future series, Teen Wolf, Doc Hollywood and others made him a popular actor; a young guy full of energy and a lifetime of roles ahead of him.

However, it was his Parkinson’s diagnosis and drive to support further research that has really cemented the path toward his legacy.  At the early age of 29, he struggled with his Parkinson’s diagnosis for seven years before he went public with the news in 1998. He began his mission to bring awareness and advance more funding and support for a much-needed area of research.

In assisted living environments, a Parkinson’s diagnosis is not uncommon. Assisted Living Education will review the characteristics of Parkinson’s Disease, as well as developments from Michael J. Fox and The Michael J. Fox Foundation for Parkinson’s Research.

Parkinson’s Disease: Basic Facts

Parkinson’s Disease (PD)  is a neurodegenerative disorder recognized by many from its distinctive features, such as tremoring, slowed movement, changes in posture, speech, and more.  Often times, many people are more familiar with the classic motor symptoms of the disease, but The Michael J. Fox Foundation does a great job of highlighting both the motor and non-motor attributes:

Motor Symptoms:

  • Bradykinesia – a slow-down and loss of spontaneous and voluntary movement.
  • Rigidity – unusual limb stiffness or in other body parts
  • Resting Tremor – an uncontrollable movement affecting a limb when it’s at rest and stops for the duration of voluntary movement.
  • Postural instability – difficulty standing or walking, or impaired balance and coordination
  • Other Physical Symptoms, including gait problems and reduced facial expression

Non-Motor Symptoms

  • Cognitive Impairment – a decline in the ability to multi-task/ concentrate and possible decline in intellectual functioning
  • Mood Disorders – depression and anxiety
  • Sleep Disorders – REM Sleep disorders, in which individuals act out their dreams
  • Low blood pressure when standing
  • Constipation
  • Speech and swallowing difficulties
  • Unexplained pains, drooling, and loss of smell

Prevalence

It’s estimated that about one million Americans live with Parkinson’s Disease, with men being 1.5 times more likely to develop the disease than women. Most diagnoses come later in life, typically between the ages of 60-80, though symptoms can begin appearing around 50 years old.

However, as in the case of Michael J. Fox, there are people who are diagnosed much earlier in life. If diagnosed before the age of 50, it is considered Young-Onset Parkinson’s Diagnosis (YOPD). There are varying estimates as to the incidence of YOPD, but it may be around 10% of all Parkinson’s diagnoses.

Daily Life

Depending on the progression of the disease, therapies, and medicinal treatments are in place, some Parkinson’s symptoms are manageable. However, as the disease progresses, managing the symptoms can require more intensive treatments. 

When Michael J. Fox makes his public appearances, he still appears to have the same vitality as he always has. Obviously, his physical manner have changed with the effects of Parkinson’s and medications he’s on, but his drive and intensity are clearly still present.

Despite this, what strikes many who have PD is the level of fatigue they experience. There are physical and mental roots to this fatigue. The Michael J. Fox Foundation describes this fatigue as existing on a “cellular level” since the body is putting more effort into completing tasks that many other individuals take for granted. Additionally, coping with these changes in an individual’s body is mentally and emotionally taxing.

DYSKINESIA

Some individuals with Parkinson’s develop dyskinesia, which are abnormal, uncontrolled, involuntary movements. The Michael J. Fox organization describes its appearance as fidgeting, writhing, head bobbing, or body swaying.

Dyskinesia does not manifest in all individuals with Parkinson’s. There are a few factors which contribute to its development, which include early-onset PD and complications of Levodopa use, which has been the primary medication used in the treatment and management of Parkinson’s. Parkinson’s develops in part to the loss of dopamine production in the brain.

Levodopa facilitates dopamine production in the brain and helps reduce the motor symptoms commonly associated with the disease. (Side note: Levodopa is also combined with Carbidopa, which helps enhance Levadopa’s effectiveness, in addition to curbing the nausea and vomiting side effects.) However, because the effect only lasts so long, Carbidopa-Levodopa must be taken several times throughout the day to help maintain the dopamine levels. Even so, a fluctuation in dopamine levels still occurs, which is commonly referred to as an “on/off” period; the “on” being when the medication is still working, and “off” when it’s worn off, typically before the next dose is due.

The Future of Parkinson’s Disease

There is no cure for Parkinson’s Disease yet, but Michael J. Fox has truly spearheaded efforts to bring awareness, funding, and more research towards developing new treatments. Since its inception in 2000, the Michael J. Fox Foundation has funded more than $750 million into research to expedite a cure for Parkinson’s Disease.  He’s hosted annual galas with celebrity guests, done numerous interviews, and of course, provides numerous educational tools through the foundation’s website.

In the meantime, much of the research being conducted in the field is producing new results in early intervention and factors in predicting or accurately diagnosing PD, as sometimes the symptoms can resemble other conditions in its early stages.

Assisted Living Education will continue to post developments in newer treatments or therapies involved with Parkinson’s Disease.

Assisted Living Education is a premier provider of classroom-based and online coursework for professionals in assisted living. We offer RCFE licensing, continuing education, and consulting in specific areas like compliance, staff training and licensing. Please visit our contact page to reach us for any inquiries.

 

Diabetic Eye Disease in Elderly Residents

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In the general population, about 9.4% of people have a diabetes diagnosis. Among seniors, that percentage jumps to 25%.  

Along with the concerns for diabetes itself, a closely related issue is diabetic eye disease. There are four conditions that fall under this category, which may be seen in elderly residents. Assisted Living Education discusses diabetic eye disease and the complications associated with it.

Diabetic Eye Disease

Diabetic retinopathy, diabetic macular edema (DME), cataract, and glaucoma are the big four of the eye conditions that fall under diabetic eye disease. Individuals who have diabetes are at risk of developing these conditions, and the risk only increases with age.  Fortunately, early detection, treatment, and careful management of diabetes can prevent or delay the onset of vision loss caused by diabetic eye disease.

The Big Four – Types of Diabetic Eye Disease

Diabetic Retinopathy

Diabetic retinopathy is caused by maintained high blood glucose levels over time which can eventually damage the retina’s blood vessels. These vessels may swell, leak, or bleed and subsequently become blocked, leading to a distortion in vision. The individual may start to see spots floating across their vision. As the condition worsens, irregular blood vessels begin forming on the surface of the retina as a work-around for the blood vessels that are no longer able to transport blood due to swelling and distortion. Left untreated, the irregular blood vessels will continue to proliferate and grow into the vitreous fluid in the center of the eye and leak or bleed. Scar tissue is frequently present at this advanced stage, which poses another risk: retinal detachment. A retinal detachment is an emergency situation; this left untreated can lead to an irreversible loss in vision.

Diabetic macular edema (DME)

DME goes hand-in-hand with diabetic retinopathy; it is the accumulation of fluid in the macula (the center of the retina crucial to our central field of vision) due to diabetic retinopathy. This can occur at any stage of diabetic retinopathy.

As the macula is crucial to our central vision, it is the most sensitive area of the retina. The accumulation of fluid causes swelling and results in blurry vision. Of the individuals who already have diabetic retinopathy, about half of them will experience DME.

Cataract

Many are familiar with this term and may understand its basic meaning; that there is a cloudiness in the lens of the eye. The lens of the eye is clear and composed of mostly water and proteins. In a normal or healthy eye, the proteins do not much get in the way of the light, allowing it to pass through the lens. If an individual has a cataract, this means there is a build-up of those proteins in the lens, making it difficult for light to pass. Cataracts are typically removed with surgery.

In individuals with diabetes, they are two to five times more likely to develop cataracts than individuals without diabetes. Additionally, they are more likely to develop at a younger age for those with diabetes.

Glaucoma

Glaucoma is actually a broad term for a group of diseases that can cause damage to the optic nerve, which sits at the back of the eye and connects to the brain. Increased pressure in the eye is the most prevalent cause of glaucoma. There is a potential for fluid to build up in the eye if it is not able to drain quickly enough. If severe enough, the pressure can cause damage to the optic nerve. Individuals with glaucoma who experience vision loss begin to lose their peripheral vision first. Eventually, they will be left with just their central vision before entire vision loss is present.

Currently, there is no cure for glaucoma, but there are treatments which can slow its progression. Medication, laser treatment, and surgery have been proven to slow the process.

Unfortunately for individuals with diabetes, their risk of developing glaucoma is two times more than a person without diabetes.

Preventing or Delaying Diabetic Eye Disease

As with any medical or health condition, it is important to catch it early and intervene as soon as possible. Individuals with diabetes should also receive a comprehensive eye exam, which includes dilation of the eyes, at least once a year. The comprehensive dilated eye exam allows the doctor to look for changes in the lens or blood vessels to detect possible vulnerabilities, as well as nerve tissue damage, or swelling of the macula. Despite seeming asymptomatic, the early stages of eye disease may be present in an individual, which is why it is important to be seen by a professional.

Any changes in vision, such as blurriness or floating spots warrants an eye exam, especially in elderly residents. Those already diagnosed with diabetic retinopathy should receive eye exams more frequently, depending on the stage of the condition.

Diet is also key in delaying the onset of diabetic eye disease. Keeping blood sugar levels under control and within a normal range, as well as blood pressure and cholesterol can help reduce the risk of diabetic eye disease.

Assisted Living Education is committed to the top care and services for the assisted living community. We are a premier provider in RCFE classes, continuing education, products, licensing, and other services for assisted living. Explore our website for more information, visit our contact page, or give us a call (714) 747-0725 or Toll Free 1-855-200-0188 for immediate assistance.

 

 

Reducing Fall Incidents in Elderly Residents

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For elderly residents, falls are a major concern. Not only are individuals more fragile in general, with reduced bone density and other compromised body defenses, but recovery periods are often longer, more grueling, and a more delicate process in general.

A reported one third of the population 65+ will fall each year, and those 80+ years increase to over half of these incidents – note that these are only the reported facts. Falls commonly result in hip fractures and other injuries. On top of that, approximately half of the adults who experienced a hip fracture from a fall will likely fall again in another 6 months. The concern for elder falls is so great that Congress passed the Elder Fall Prevention Act (H.R. 3513) back in 2003 to support more widespread research, education, and services on this issue.

Assisted Living Education provides some common and typical precautions taken in residential care facilities to prevent falls and injury in elderly residents.

Understanding the Context – What Causes a Fall

For the average person, it seems like an obvious answer: we lose our footing or balance, we trip, and we fall. This is true to an extent, but there are so many more variables to consider with an elderly person as well. Here are some factors that can contribute to the risk of falling in elderly:

Weakened muscle tone, gait problems – Those who are not as active as their peers or have sustained an injury that reduces their activity may experience a decrease in muscle tone. This decrease in strength can cause parts of the body to give out more easily. Arthritis, joint, and other issues can also compromise an individual’s balance.

Blood pressure fluctuation – ‘Postural hypotension,’ or a decrease in blood pressure due to rising too quickly from a sitting or lying position can occur more easily in elderly, sometimes with dizziness. Causes for this may be dehydration, side effects from medication, or another underlying disease like diabetes.

Slowed reflexes – With age comes reduced reflexes and a delay in reaction time. Elders may not physically be able to react quickly enough to prevent a fall.

Sensory issues – Some individuals experience a loss of sensation in the extremities. When this occurs in the feet, it can be difficult to detect changes in the terrain or how you are stepping, leading to a trip or fall.

Poor vision – Vision problems can make it difficult to see a clear (or unclear) pathway, or cause a slower adjustment time to changes in light. Poor depth perception can also cause problems around stairs or unfamiliar environments.

Confusion – Moments of disorientation itself or fear/panic from the confusion can cause a misstep. Also, wheelchair or bed-bound residents may forget that they cannot walk and attempt to get up.

Medications – Some medications can cause dizziness or low blood pressure, causing instability and loss of balance.

Fall and Injury Prevention

Residents in a care facility typically have more compromised health conditions than the ‘outside’ elderly community and can require vigilance to ensure their safety. Familiarity with your residents, their conditions, and risks can help you and your facility think proactively in taking and enforcing preventative measures.

Some common preventative measures often taken in a facility include:

  • Maintain clear pathways
  • Avoid the use of carpeting or rugs to prevent tripping from uneven surfaces. If there is a carpeted surface, commercial-grade is best for the short fibers and extra durability.
  • Use textured adhesives on sloping floors for extra grip
  • Use ramps in place of any steps
  • Install grab bars in shower spaces and bathrooms
  • Use raised toilet seats or commodes
  • Use a shower seat or bench for bathing
  • Lower bed heights for especially at-risk residents
  • Install handrails along the hallways

Also be sure residents’ call buttons are easily accessible, and a timely response also encourages residents to request for assistance.

Individual Concerns & Major Fall Risks

Some residents may use walking aids such as a cane or a walker to help with mobility. Frequent checks that these implements are properly adjusted for the individual helps prevent misuse that could lead to a fall. Ill-fitted clothing can also become a problem, especially with the use of walking aids. If the family is involved, ask them to ensure pants or skirts are properly fitting, or even hemming them slightly can be helpful. Reviewing these types of precautions during the admissions process or a debriefing meeting can help the family become more involved and further assist with the care of their family member.

Residents who repeatedly attempt to get up unassisted can be considered a major fall risk. This can happen in stubborn individuals or those with dementia, especially if they have been bed or wheelchair-bound only a short time. They may forget that they are not supposed to get up unassisted, or are determined to reclaim their independence.

The following are extra preventative measures that can be employed for those who present an elevated fall risk.

Bed or personal alarms – Bed alarms detect when there is a major shift in weight or movement, as in a person attempting to sit up and get out of bed. These alarms help alert a staff member to come quickly and check on the resident. Personal alarms work similarly for use in the wheelchair. One type hangs off the back of the wheelchair and clips on to the back of the resident’s clothing. If the resident leans too far forward in an attempt to rise, the device separates and the alarm is engaged. Another type is a pad which fits on their seat, and when a significant shift/decrease in weight is detected, the alarm will sound.

Room placement – Assigning a high risk fall resident to a room near the nurse’s station can help keep eyes on any independent attempts to get up.

Extremely lowered bed heights – Any time a high risk resident is in bed, adjust their bed height to the lowest setting possible so they are closer to the ground in case of any attempts to get up.

Floor mat – For residents persistent in their attempts, a floor mat placed next to the bed during the night, in addition to the lowered bed height, can also offer added protection.

Hip pads are also an option in an attempts to reduce the impact from elder falls, but they’ve received mixed reviews. Some studies reveal no significant statistical data in their favor. Additionally, many hip fractures can occur not just from an impact, but because of an abnormal movement or rotation of the hip during a fall.

Other Precautions

For residents who have little or no issues with cognitive or memory functions, they may benefit from extra education from an occupational or physical therapist to review safety and fall precautions. Those recovering from a procedure or injury should have already received instruction on how to accommodate their new (i.e. limited) range of movement. If the resident has limited mobility and uses a walker or wheelchair the majority of the time, physical and/or occupational therapy generally covers how to safely and properly transfer from bed to standing position/wheelchair and vice versa, as well as commode and shower seat/bench transfers.

Other residents can benefit from such education as well, but may require frequent prompts and assistance due to difficulty in recalling steps and sequences.

Keeping the residents active as much as possible is not only good for their overall health, but can help keep muscle tone and prevent stiffness or muscle atrophy, which can contribute to a fall. Non-ambulatory residents can still exercise to maintain strength in their arms and hands.

The Big Picture

Looking at the overall health of the resident is crucial to their care. Information from the initial comprehensive health examinations, mental & cognitive evaluations, fall risk assessments, and review of resident’s health or care history all help in designing an individualized care plan. This information can also be useful in planning for future changes or adjustments to the facility itself, for additional precautions or measures throughout the campus.

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Assisted Living Education is committed to providing the best in quality education for assisted living services. Our professional instructors have years of real, hands-on, and practical experience that enrich our already-extensive courses. We offer RCFE classes, licensing, and other products and services for assisted living, plus RN, LVN, and SNF continuing education through our online classes. Explore our website for more information, visit our contact page, or call 1-855-200-0188 for immediate service. We look forward to working with you!

 

Holidays Can Trigger Elderly Depression

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For many, the holidays are the time of year for family get-togethers, traditions, friends and fun. However, for others, the holidays can be an upsetting or difficult time of year, with feelings of sadness, resentment, and can even initiate a depressive episode. For elderly residents in facilities with little or no family who visit, this can be an especially painful time of year for them.

Assisted Living Education reviews symptoms to look for, and also how to help elderly residents cope with depression during the holidays.

Spotting the Signs

The key to any effective individual care plan is in simply knowing your residents. Familiarity with their personalities and ‘baseline’ behaviors, disposition, and temperament are crucial in detecting any kind of change.

The following are typical depressive symptoms presenting in an elderly resident around the holidays:

 

  • Subdued or irritable mood; sadness
  • Fatigue, or difficulty sleeping
  • Anxiety
  • Loss of interest in daily activities
  • Change in appetite
  • Lack of attention to personal care, hygiene

 

Even if your residents already present some of these symptoms, it’s important to note if they become more severe or if additional symptoms arise.

How To Help

With proper planning and program design, it may be possible to shift a resident’s attitude and reaction towards the holidays. Well before the holiday season or particular event arrives, try to make an extra effort to engage with those residents who may be at risk for experiencing a depressive episode. One simple way to start is with a conversation.

Have Meaningful Interactions With Your Residents

Regular, casual engagements with your residents can turn into lasting relationships, with positive benefits for the residents. These relationships can help toward stabilizing emotional highs and lows that may be experienced during particular times of year, like the holidays, where residents can tend to feel more isolated and lonely.

Initiating daily conversations with each and every resident may sound like a daunting and time-consuming task, but even keeping it short and sweet can brighten a resident’s day. It’s not necessary to have a long, sit-down conversation, but try to create an ongoing dialogue whenever you see your resident either in passing, during medications administration, therapy sessions, mealtimes, or other times you may have scheduled contact with them.

Obviously, the first priority is to complete your tasks and serve your residents’ medical needs, but sprinkling questions or encouraging comments to engage them can help them feel more at ease and welcome. A simple wave and a smile or a brief question/answer can carry on to the next positive interaction you can make with them.  

Not every individual will be responsive, for various reasons. They may have a shy personality, trust issues, or they may have a disorder or cognitive issue that makes it difficult for them to openly interact or easily communicate with people.

These individuals may take awhile to warm up to you, or you may need to change your approach. Gauge how the individual reacts to conversation; you may need to back off and take small steps for them to open up. Start simply, maybe compliment them on their appearance, or make general conversation, comments, or make small jokes if appropriate. You may be doing most of the conversing at first, but over time, it may balance out to an even exchange. Start inviting them to group activities or outings. Never push a resident into something they are not interested, but let them know they are welcome to join if they want. These relationships can take longer to develop, but are truly meaningful.

Even for residents who have advanced dementia/Alzheimer’s or other cognitive or verbal limitations, making an effort to reach them can make all the difference. Singing to them, or talking/signing with them helps them feel connected to other people. Their responses may be different, but pay close attention to their behaviors and body language for positive or negative feedback.

These are all important components of trust-building, and can help you with other times in the long-run. As a trusted staff member, the resident may look to you in times of difficulty or even non-compliance, to help keep calm or de-escalate a situation if necessary.

Involve Everyone in the Festivities

Most facilities decorate and have events correlating with the major holidays, which is a great start to creating a warm and festive environment. If possible, find out which holidays in particular your residents like to celebrate throughout the year, and make an effort to have those represented if they aren’t part of the mainstream/regular celebrations. Even decorating a common area or the hall near their room can help bring some cheer. If the resident(s) are able, they can help explain the traditions with which they’re familiar and stories they recall from their past.

The winter holidays are also a great time of year to invite people from the community to interact with residents. Local religious organizations, youth musicians, choirs, a capella or other community groups, and even schools can come sing and/or engage with residents and fill their holiday experience. Youth or children’s groups are often welcome ways to enliven everyone’s spirits. Musicians are most appreciated when they play familiar holiday songs or songs from the era when many of the residents were young.

Reaching out to the community and requesting greeting cards for the residents is a simple way to add a little cheer to the holidays as well.

If possible, outings to local community events, or even driving around looking at holiday lights in the neighborhood are great excursions as well.

Recuperation Time is Important

With all of the activities and bustle of the holiday season, down time or quiet time is just as crucial, if not more so. Even if elderly residents are enjoying themselves with all of the festivities, it is a change from their daily routine, and may be more physically and emotionally demanding on them as well. As we age, it can take us longer to recover from activities, especially those out of our norm, whether we realize it or not. Additionally, a tired or stressed individual can have a lower immune response, and be more susceptible to illnesses, which also run rampant during the holiday season.

Partial or half-day activities, and having ‘regular’ days in between can help with recovery time and the extra stress.

Assisted Living Education & You

Assisted Living Education is an outstanding provider of products and services for assisted living, as well as RCFE classes and licensing. Our instructors draw from years of experience and up-to-date training to provide an engaging and informative learning experience to our students. We also offer online and continuing education courses. Visit our contact page to reach out to us for any inquiries!

 

Be Aware of Seasonal Affective Disorder (SAD) Symptoms

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Seasonal Affective Disorder is a form of depression prompted by the time of year and relative to the amount of light present due to the change in seasons. Many of us may have heard of SAD, but may not fully understand its condition, or its counterpart, Reverse SAD.

ALE discusses both kinds of SAD and also how to help our elderly residents diagnosed with this condition.

What Does SAD Look Like?

Seasonal Affective Disorder type of depression whose onset is triggered by changes in seasons. The most common form of SAD occurs in fall through winter, but there are some cases in which the condition affects an individual in the spring/summer months. This is sometimes referred to as Reverse SAD.

In either form, there are marked changes in mood and disposition, starting out mildly with the initial stages when the season starts, and becomes more severe as the season progresses. The fall/winter manifestation resembles the more classic symptoms of depression, but the spring/summer expression presents more like a manic depressive episode.

Fall/Winter SAD

  • Irritability, trouble getting along with others
  • Fatigue, lethargy, low energy
  • Emotionally hypersensitive
  • Change in appetite, especially craving for high carbohydrate foods
  • Oversleeping

People living in regions with distinct weather changes or with limited sunlight (e.g., further up in latitude) are more likely to develop symptoms SAD. However, even in places such as California where the weather may not change as dramatically, cooler temperatures can reduce frequent visits outside, especially for elderly residents, and therefore less exposure to sunlight.

Does the Amount of Sunlight Really Make a Difference?

The reduced sun exposure can lead result in deficiencies or imbalances in the body. For example, serotonin production drops with a lack of sunlight, and this chemical imbalance causes an individual to feel depressed. The cravings for high carbohydrate foods are the body’s way of attempting to increase serotonin levels. Vitamin D also plays an important role in our health, including supporting bone health, preventatives with certain cancers & conditions, as well as help with incontinence. However, Vitamin D is also found naturally in certain foods and also via dietary supplements. Sleep patterns can also be thrown off as well, since the body’s circadian rhythms depend on regular sun exposure. The disrupted sleep prevents the resident from getting quality rest, which can result in depressive symptoms.

For individuals with Fall/Winter SAD, symptoms persist for more than two weeks.

Spring/Summer SAD (also referred to as ‘Reverse SAD’)

Out of the entire U.S. population, 4%-6% of people are affected by SAD and of that population, about 10% experience a reverse of the winter symptoms.

  • Depression
  • Problems staying asleep, insomnia
  • Poor appetite
  • Agitation
  • Anxiety

The cause of Reverse SAD is unknown but thought to possibly result from the excessive heat, or even too much light. Whereas fall/winter SAD sufferers are more lethargic and depressed, those with spring/summer SAD tend to be more agitated and angry. The manic type of behavior presents as irritability, agitation, and restlessness. Adults with Reverse SAD are more inclined to feel suicidal as a result of the agitated mood.

What Can You do for SAD / Reverse SAD?

During the ‘active period’ when the resident is suffering from SAD symptoms, antidepressants can be helpful, especially if the condition’s pattern is known. The antidepressant regimen can begin prior to the expected onset of either winter or summer SAD to be most effective.

Light therapy is another proven effective and useful strategy for fall/winter SAD, especially for those who dislike taking medications or do not want to add to their medications list. Light therapy is also helpful for elderly or those with limited mobility who are not as able to access the outside or natural light.

For residents with executive cognitive functioning within normal range, Cognitive Behavioral Therapy (CBT) is another possible treatment as well.

Residents suffering from Reverse SAD may also benefit from staying in cooler or air-conditioned environments during the warmer months, as well as avoiding rooms or areas that are too brightly lit. If residents are outside or are in areas that may be too bright, dark sunglasses can help, especially the wrap-around type that can block out light from all angles.

Let the Team Make the Decisions

Don’t forget, any change in a resident’s individual health care plan must be approved by the team or the attending psychiatrist and/or physician before they are put in place. They or the team together will be able to determine the best course of action or treatment with the patient’s medical needs, cognitive capabilities, and other symptoms in mind.

Any care prescribed by one of the resident’s team must be communicated to the rest of the team to maintain consistency and treatment efficacy.

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Assisted Living Education is a premier provider in education, services, and licensing for the assisted living field. We specialize in RCFE education and licensing, continuing education, and other online coursework. Our instructors have years of industry and field experience, and bring their expert knowledge to the classroom with engaging and practical instruction techniques. Learn more by exploring our website or reaching out to us via our contact page. We look forward to hearing from you!

 

Assisted Living Education addresses elderly hoarding and how to cope with residents.

Understanding Elderly Hoarding and How to Cope

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Hoarding has long been documented, but has only been systematically studied just within the last decade. Hoarding Disorder was only added to the most recent DSM update in 2013, when the DSM-V was released. This is the extreme side of hoarding where it interferes with normal daily activities such as cooking, sleeping, moving through spaces, as well as relationships with family, friends, or loved ones. It can even become a health or safety hazard either because of restricted movement or as a result of the items themselves (possible decomposition or attracting critters, etc.).

Self-Neglect

A component that often distinguishes pathological hoarding is self-neglect. Self-neglect can appear as a lack of care in personal hygiene and/or appearance, or the lack of care toward an individual’s personal space, such as their room or their home. The individual may no longer experience shame and not maintain typical grooming practices, brush their teeth, shower regularly, wear torn, old, or dirty clothes, for example. In addition to the excess clutter, their home or space may have dirty dishes, accumulated trash, or serious disrepair (e.g., mold problems, bug infestations, unresolved plumbing issues, etc.).

Sometimes this condition coupled with extreme hoarding is called Diogenes Syndrome and often affects seniors late in life.

Why Does this Happen?

For those who are fortunate enough to make it to old age, it can come with difficult consequence as well. Loss of social interactions is prevalent, either due to deaths of family & friends, or illness/injury making it more difficult to connect with others or participate in regular activity. This can leave an individual feeling lonely or isolated, for which they try to fill other things to satisfy that void. Sometimes this turns into hoarding, and can become such a strong behavior/compulsion that it spirals out of control. A strong compulsion develops in the individual to save something that they “may need for later,” but in reality has little or no value.

A specific traumatic event(s) can also trigger hoarding behavior. It may be an extreme expression of the mind attempting to compensate for a perceived loss of control in the individual.

It is also suggested that compulsive hoarding is associated with anxiety and OCD, with some research indicating that a pre-Alzheimer’s personality can contribute to the development of hoarding disorder.

Why Is it a Problem?

Many people have specific collections, or even numerous material items in their home to the point of clutter. The problem reaches a pathological threshold when the individual is saving things that have no value (junk mail, plastic bags beyond reuse, etc.) and feelings of anxiety and anguish arise at even the thought of throwing away or parting with such items. As mentioned previously, these accumulations of items can prevent ease of movement throughout the home or space, and even become physical or health hazards, yet the individual feels more compelled to hoard than to remedy the situation.

Additionally, as individuals are moved into an assisted living situation, there is literally and figuratively little space for hoarding behaviors. Health code is obviously stricter and does not allow for a collection of excess materials to accumulate, as it presents major health & safety code violations, as well as preventing personnel from safely accessing the residents, health supplies, or perform daily or necessary tasks properly.

Helping Individuals with Strong Hoarding Behaviors

The worst way to deal with another individual’s hoarding behavior is to go through their belongings without permission and throw everything away. Even with permission, deep anxiety can arise in the individual just addressing the thought of parting with their item(s), despite any kind of logic or benefit presented.

A study conducted by Boston University School of Social Work revealed that trust is essential in effectively helping an individual with hoarding behaviors. To clarify, trust isn’t solely based on the length of time an individual knows someone. Many of us even have family members that we love, but may not trust enough or feel entirely comfortable when placed in a vulnerable situation. The same applies to people with hoarding disorders. A strong, genuine rapport must be carefully established; the study indicated that individuals were more receptive to social workers with whom they had developed a trusting relationship.

Obviously, these relationships take time to cultivate and even under the best possible circumstances, mitigating strong hoarding behaviors will continue to be an arduous process.

For the short-term, it might seem too time consuming and even frustrating trying to develop this relationship. However, the long-term benefits in investing in this strong foundation will ultimately help in future problems or crises that may arise, and the resident can feel more secure in knowing they have someone they feel is ‘safe’.  

Avoid the Power Struggle

One important thing to remember is to keep the individual involved in the process. While an outsider may view them as impeding the process with possible setbacks and a slower timeline in remedying a ‘problem space’, this will ultimately help resolve the underlying problem instead of hastily applying a band-aid.

Part of the hoarding disorder is rooted in control; completely taking the situation away and handling it for them can send the individual into distress and further aggravate their symptoms. By including them in the process, their feelings and concerns are validated, which helps build trust and increases the chances of compliance.

Ways to Support Residents with Hoarding Behaviors

Though it will take time to curb the hoarding behavior, there are other ways in which to provide support that may help the discourage the behavior indirectly.

A study from the University of California, San Francisco found that 15% of older adults with depression also exhibited extreme hoarding behaviors, versus 2-5% of the older population exhibiting extreme hoarding without the depression comorbidity.

Because a snowball effect can exacerbate hoarding behaviors (loneliness or loss of independence leading to depression, depression manifesting into hoarding), providing elderly residents with outlets for social interaction, creativity, movement (exercise, dance, etc.), music, and more can ideally replace hoarding as behaviors used to fill a void. These activities or a combination thereof can really help to inspire confidence, engage the resident, and possibly ease them from their extreme compulsion to hoard.

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Assisted Living Education is a premier provider of classroom-based and online courses for professionals in assisted living. We offer RCFE licensing, continuing education, and support in staff training in specific areas, like Alzheimer’s and Dementia. Please visit our contact page to reach us for any inquiries.

The opioid crisis happens with seniors and elderly as well. Learn how assisted living can help prevent residents from becoming addicted.

Why Are There So Many Senior Opioid Addicts?

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Lately, it’s been common to hear on the news about the heroin and opioid epidemics across the nation. Often times, we hear about young or middle-aged victims succumbing to their addictions, but the problem doesn’t just exist there. Seniors are also part of this drug epidemic as well. AARP reports that in 2015, nearly one third of Medicare patients (12 million people), were prescribed opioid painkillers. Also in 2015, 2.7 million Americans over age 50 reportedly abused painkillers.

Misconceptions

One of the problems that unraveled with these painkillers is that they are often prescribed for legitimate reasons but are extremely easy for the body to become dependent on. It is possible within just a week for some individuals to become physiologically dependent on these drugs and experience adverse side effects when stopping their consumption. A common misteaching that pervaded the medical community was that that because opioids were prescribed legitimately (post-surgery, chronic pain), they weren’t considered vices of addiction.

Pharmaceutical Companies Spin “Quality of Life”

Previously, opioids were reserved only for treatment with cancer patients or for short-term relief following an accident or major surgery. However, during the ‘90s, opioids became a popular painkiller especially after the 1995 approval of OxyContin by the FDA. Opioids were lauded as the new go-to for pain relief for a new group of consumers: those suffering from chronic pain. Opioids were heavily marketed to medical professionals by pharmaceutical companies without much regard or research  into the long-term consequences.

The CDC started connecting the dots when a 2006 study was commissioned to explore the link between the exponential number of deaths and the 500% increase in prescriptions written for opioid drugs. Despite their findings, there was an undercurrent of advocates for opioid use and against increased regulation on the drug. One of the main champions for fewer regulations was the University of Wisconsin’s Pain & Policies Study Group.

In 2011, an investigation revealed that this particular group had been a behind-the-scenes force in the explosion of opioid use and opioid advocacy. For about a decade, they had been setting the stage by publishing papers and promoting the use of opioid painkillers under the guise that it was in the patient’s best interest to acquire relief from chronic or debilitating pain (quality of life). Surreptitiously, this group also received $2.5 million from opioid companies during their decade-long campaign. Though their claims were almost never substantiated by extensive research, they managed to gain a stronghold in the collective conscience of the medical community, and the damage has just recently been coming to light.

Perhaps due to these or other forces at work, in 2009, the American Geriatric Society actually encouraged the prescription of opioids for pain relief. Though their stance has since been rescinded, the belief still remains pervasive that seniors/elderly are not affected by addiction.

Opioid Dangers Specific to Seniors

The general public now knows that the opioid crisis is real; these drugs are powerful and addictive. But there are effects of opioids that make the drugs even more dangerous for senior and elderly individuals.

Much of this population is already taking other prescriptions, which can enhance the negative effects or even risk contraindications of opiates. Additionally, as “downers,” opioids can depress the respiratory system, which can be dangerous if taken with other medications that have a sedative-like nature. Because the pharmacodynamics (effects drugs have on the body) and pharmacokinetics (the way the drug moves through the body) are also generally slower in seniors and elderly, dosing these heavier medications can be tricky as well and also contribute to a heightening of the medications’ effects. Additionally, with suppressed body responses and reactions, seniors and elderly can be more likely to fall or injure themselves.

Engaging in Best Practices

Unfortunately, there are some doctors who prefer to prescribe medications over finding the root of the problem, which may be able to be resolved with a non-pharmaceutical approach.

For example, if a resident is complaining of muscle pain, the “easiest” fix can be to give them a pain medication or muscle relaxant. However, a different, more productive & long-term solution may involve stretches, exercise, or physical therapy. This can provide other benefits as well: strengthening the muscles and bones  to prevent from further physical damage, as well as keeping the heart active and healthy.

Of course, it is up to the team to decide what is in the best interest for the resident, and what would be most beneficial and applicable to their individual context. In some cases, medication could be the correct answer, or a combination thereof,  but it is worthwhile to explore all possible avenues.

Countering the Opioid Epidemic in Assisted Living

Assisted Living provides an opportunity to make a concerted effort in reducing the dependency on opioids. With multiple medical professionals working on a team for each individual, it can help serve as a check-and-balance system and work toward unbiased care.

Part of ensuring that the rest of the team is on board with the right mentality begins in part with the hiring process. However, it also continues with support from the facility administration. One of the most important tenets in assisted living is to encourage individualized healthcare plans that focus on the true quality of life of the residents and to avoid employing practices that are merely pacifiers and not long-term solutions. Having the administration set the tone and enforce resident-centered philosophies help keep the team focused and on the right path.

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Assisted Living Education is a premier provider in classroom and online courses, continuing education and RCFE classes and certification for assisted living. Explore our website or contact us directly for more information.

 

Supporting the emotional well-being of a resident is top priority in assisted living.

Supporting the Residents’ Emotional Well-Being in Assisted Living Care

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Many residents are admitted to assisted living because they can no longer live independently and may even need professional care for long-term or chronic conditions and illnesses. There are also those who may be admitted temporarily for professional rehabilitory care after a major surgery, such as knee or hip replacement.

Part of quality assisted living care is establishing an individualized healthcare plan that treats and promotes positive progress for the residents’ medical conditions or diagnoses. These plans attempt to hit all aspects of care, including physical, cognitive, and occupational skills.

In addition to these basic components, it is equally important to consider the emotional foundation as well. It is widely known that having a positive attitude and outlook on life can aid in the body’s physical health and recovery. A University of Pittsburgh revealed that from a sample of 97,000 women, the most cheerful were 30% less likely to die of heart disease, while another 14% were less likely to die from other common diseases.

Assisted Living Education reviews some factors, common therapies, and other activities to consider in supporting the emotional well-being of your residents.

Factors to Fight Against

Many elderly individuals face a lot of challenges as they age: increasing aches and pains, developing or worsening health issues, loss of friends and relatives, and some cognitive issues as well. Some take it in stride but for others, it can severely affect their outlook on life.

Though depression is said to affect 6 million Americans over the age of 65, it is not a normal progression of age. In elderly individuals, depression is often a diagnosed comorbidity with another condition or disease, such as coronary artery disease (CAD) or chronic obstructive pulmonary disease (COPD).

Besides some of the factors we mentioned above, there are additional elements that can also lead to depressive episodes as well.

Loss of Independence

For some residents, especially the long-term ones, it can be frustrating needing to depend on others for help and facing the loss of independence they once had. There may be restrictions on certain activities, foods, and certainly where and when they are able to go places. These frustrations and the loss of independence itself can be triggers for depression in elderly residents.

The loss of independence can also elicit feelings of uselessness, loss of control, and even fear, anger, guilt, and confusion. Many elderly are used to certain routines and have probably had more control in designing their own schedules. Any kind of change can take some time to process, and switching environments and lifestyles is a major change which will likely require an overhaul in their daily norm.

Loneliness

For some, being admitted to an AL facility can seem like an isolating event. In addition to losing their independence, individuals may feel cut off from friends and family in their new environment. For those without close friends or family, it may reinforce or enhance an already lonely situation being removed from their home community.

Be sure to consider these in evaluating an individual and their emotional state; it can help inform what strategies and activities would be most beneficial in promoting their well-being.

New Opportunities

With each new admission, we can take this as an opportunity to help the residents create a new lifestyle or routine that they might enjoy.

The staff at an assisted living facility often become like family to residents, especially for those who have few or even no visitors. Consequently, it is up to those staff members and its administration to encourage a nurturing, community environment for the overall welfare of the residents.

Another important way to help residents is to encourage them to participate in activities to fill their day. Many assisted living facilities do take an “interest inventory” of each new resident to match them with different, desired activities.

The following is a list of activities that prove to be most satisfying and most accessible for elderly residents.

Pet Therapy

Pet Therapy is a favorite among residents and staff alike. A visit from a trained dog, cat, or even guinea pig can bring a smile to anyone’s face. Residents who feel lonely or may have difficulty verbalizing or communicating can find affection and love in a furry friend. The reduced expectation to engage verbally can lower anxiety levels in these kinds of social situations. Additionally, the texture of the animal’s coat can be tactilely pleasing and the appearance can elicit the “cute response,” an instinctive desire to nurture based on certain physical features.  

If the resident is ambulatory, having them walk a dog (with supervision) can also provide a sense of purpose and satisfaction.

Music & Dance

Music is another excellent way to promote social interaction. It’s a way for people to come together and enjoy each other’s company without the pressure of having to verbalize or completely engage in direct interactions.

As we discussed in a previous blog feature on Glen Campbell, music has an almost magical way of revitalizing an individual and bringing them back to a different time and place. This is because music is processed in multiple areas of the brain. Even for those with late-stage dementia, it can still elicit a response from the areas of the brain that have not yet been affected (or affected as severely).

Especially with residents who were musicians or dancers by trade or hobby, music is so ingrained that they are often able to recall the lyrics, the moves, or how to play their favorite instrument.

The famous neurologist, Dr. Oliver Sacks and others have described how music can encourage memory, a faster recovery time, and the ability to regain speech (in certain circumstances) is accomplished quicker.

Everyone can enjoy music – whether you have ambulatory residents able to get up and dance, or even non-ambulatory residents who can just be there and listen or watch the others – it truly is a simple but meaningful social experience.

Art Therapy

Like music, art has a way of enhancing physical and cognitive connections and improving the emotional state of an individual. Even for residents experiencing memory loss, art has proven to strengthen or help sustain cognitive and memory function by necessitating the dexterity to manipulate whatever medium is used.

Residents with advanced memory loss still enjoy participating in art, and may even find it as a way to express themselves when other faculties are deteriorating. Some research has suggested that individuals participating in creative outlets are sometimes able to use it as a way to communicate and connect with their world, thus encouraging a sense of belonging and purpose. Art can be an intrinsically rewarding and confidence-boosting activity.

In the right environment, art therapy can be a relaxing social activity with cognitive and emotional benefits.

Workshops, Classes, & Other Activities

Engaging workshops or classes can also be an enjoyable part of the day or week. As mentioned before, art, music, and dance activities are always popular. Depending on the cognitive abilities and interests of the residents, setting up workshops or classes to learn or enjoy focused time on an activity.

Workshops on technology, such as using an iPad or notebook, a laptop, or smartphone are useful for the residents’ own entertainment or keeping connected with family and friends. Gardening brings much joy, nurturing a plant from seed to bloom. This can be an especially fun and rewarding way to access nature in an assisted living environment. Visits from local youth groups, schools, or other community organizations can bring a positive energy, socialization time, and a sense of companionship for elderly residents.

There are many options to engage residents in a meaningful and productive way. As always, be sure there is team and supervisor approval before introducing a resident to a new activity.

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Assisted Living Education is committed to improving a positive quality of life in assisted living through proper, relevant education and training. We specialize in RCFE certifications, online courses, and continuing education. For more information, explore our website, or visit our contact page to reach us directly.

Respiratory Issues with Age

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On average, we reach our peak lung capacity between 20-25 years old. During this time, our lungs have a maximum limit of six liters. After the age of 35, our lung capacity decreases and as a result, our breathing rate slows and physical activity becomes more difficult. Even healthy individuals with no history of smoking tend to decrease their forced vital capacity by 0.2 liters per decade. While some loss of functionality is inevitable, there are things you can do to help your residents improve their respiratory health and ensure a higher quality of life.

Be sure to consult with the attending physician and/or other specialists before making any changes to a resident’s individual health care plan.

Respiratory Changes As We Age

As we age, changes in our body cause our bones and muscles to become weaker. Bones in our rib cage become thinner and change shape. The diaphragm is the large muscle in our chest responsible for moving air in and out of the lungs. As it gets weaker, our ability to inhale and exhale to full capacity decreases.

There are also changes at the tissue level within our lungs. Muscles that kept airways open lose their elasticity and can close. The alveoli are the small sacs responsible for exchanging oxygen and carbon dioxide with the bloodstream. With age they tend to lose their shape, decreasing the efficiency of the gas exchange.

Changes in brain chemistry may affect how efficiently our nervous system triggers actions in our lungs and chest muscles. This problem is exasperated by dementia or other mental illnesses. When signals aren’t sent as clearly to our lungs, we lose control and often experience delays in otherwise automatic processes. Systems responsible for triggering coughs become less effective. Foreign particles build up in the lungs and can cause further damage to already deteriorating tissue.

The Consequences of Poor Respiratory Health

Respiratory degradation is so common among seniors that the U.S. Centers for Disease Control and Prevention reports that nearly 15% of all middle-aged U.S. adults suffer from lung disorders such as asthma or chronic obstructive pulmonary disease (COPD).

In fact, lung-related illnesses are the third most common cause of death in this country. Pneumonia is one of the major causes of mortality among seniors over the age of 65. The illness can present with symptoms ranging from mild to severe and can be fatal. More people die every year from pneumonia than from automobile accidents.

Pneumonia can be contagious, but most seniors actually develop the illness independently. Bacteria is present in everyone’s throats and noses. Elderly can have difficulty clearing contaminants from their lungs with reduced body function discussed earlier. The result is the bacteria that causes pneumonia is able to proliferate far more easily in an elderly person. Pneumonia can lead to bacterial infections in the blood and fluid in the lungs.

Once infected, it is also harder for elderly to fight off complications caused by pneumonia due to their weakened immune systems. This is why it is so critical to encourage a healthy respiratory system in your residents to prevent an infection from taking hold.

Another form of pneumonia is aspiration pneumonia, which is also common in elderly seniors. This occurs when the epiglottis (the flap that covers the windpipe during swallowing) does not close properly. Food and other particles can make their way into the lungs, causing inflammation or even lower respiratory tract infection. Because residents often have a reduced ability to cough properly (dystussia, or cough impairment), this contributes to the severity of aspiration pneumonia.

In some cases, switching residents to a soft food diet can sometimes help reduce the risk of aspiration pneumonia. Additionally, ensuring that residents are always seated upright while eating is important to encourage proper swallowing function.

How to Promote Good Respiratory Health

Perhaps the number one way to promote good respiratory health is to help your residents maintain their body’s ability to protect itself. Consuming a proper diet full of protein, and nutrients is key to good overall health. It’s also a good idea to cut back on foods high in simple carbohydrates (processed sugars and white bread products). These foods raise our body’’ insulin levels, causing inflammation.

A decrease in exercise routine with age is common as the body doesn’t function as well or as easily as before. However, in these golden years, it’s more important than ever to incorporate regular cardiovascular exercise into our daily lives to fight back against respiratory degradation. Encouraging  residents who are able to engage in daily cardiovascular exercise is critical to ensuring they maintain a healthy lung capacity and foster a higher quality of life. Even simple or modified routines for those who are not as ambulatory can help keep their bodies active and deterring muscle or other atrophy from setting in.

Avoid Toxins and Environmental Pollutants

Cigarette smoke is the primary cause of lung cancer. If you have residents who smoke, be sure a plan is in place to help them curb their habits and eventually quit. Cigar smoke and chewing tobacco are also dangerous; the chemicals in these products are known carcinogens and cause inflammation and swelling in the lungs, as well as increasing the risk for oral and throat cancers.

Maintaining a clean environment for your residents is vital to preventing many respiratory infections. Air pollution can irritate lungs and leave seniors susceptible to illness. Ensure that your residents have clean, dust-free environments to sleep in. Be conscious of water damage around your property and report any areas that could be at risk for developing mold. Residents and others will benefit from a no-smoking guest policy to avoid exposure to the contaminants in second-hand smoke. Washing or frequent changes of work clothes, as well as hand-washing or using gloves can help prevent the spread of germs.

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At Assisted Living Education, our number one priority is providing the highest quality education and educational resources for those who care for our senior population. We offer RCFE courses & certification, as well as online courses and continuing education. We believe that experience is critical to success, which is why we only employ instructors with extensive experience in the industry and have a reputation for creating engaging and real-world learning environments. Explore our website, or visit our contact page to learn more!