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A new year, fresh start - every year we get a chance to improve our lives with new habits and healthier ways.
Here's to a happy and healthy new year.
I have been taking some time off due to vision problems. Well, with one cataract surgery done, and one to go, I have clear vision in my right eye, and blurry vision in my left. I play a little game with myself called "vision check", when the two eyes aren't working together and annoy me - first I shut my right eye and my vision is blurry on the left. Then I open my right eye and close my left eye. Better! It's alot like having two different views of life - one is cloudy and confusing, the other is clear and sharp edged.
I was younger than the patients at the surgical center by about 10-20 years. I felt sad for some of them as I heard that they hadn't followed pre-op instructions (one lady was hungry and had an entire breakfast before she came in). They had medical issues that had to be addressed before the surgery could begin (elevated heart rates and blood pressure seemed to be a common theme). The nurses kept telling me how "perfect" my vital signs were, etc. and were amazed that I had no "issues". Of course, age makes a big difference. I was born with cataracts and they never bothered me much except for glare at night, until they decided to cloud this fall. I thought I just needed new glasses when my eyes were having trouble adjusting between close work and distance. Glare was becoming a HUGE issue and I stopped driving at night the last month before my eye surgery (headlights were too much). I even thought it was just my right eye that clouded until they removed that cataract and replaced it with an implanted lens. That's when I realized my left eye was pretty cloudy, too - just not as bad in comparison to the right (before surgery).
Okay, beyond the personal update, here's a thought - we all need regular eye checks, no matter what our age. If a parent is having eye problems, it is good to have a support person with them when they go to have it checked. I was fortunate to have no major health issues, understood my instructions for the surgery, followed them, made sure my paperwork was complete, etc. before arriving for surgery. The IV medication relaxed me so much that the surgeon had to remind me to focus on the light during the surgery.
Now, throw in some medical issues (Diabetes, hypertension, etc.), some confusion about the instructions, and the actual procedure (flat on my back for over an hour before the surgery as numerous eye medications were put in my right eye, my face scrubbed before the surgery, then draped with an opening for the operative eye, covering the rest of my face, and the worst part was the clamp thing that held my eye open) and I could see someone without my medical training, alone, confused - it would be difficult, at best. It was difficult for me, and I had researched the procedure and discussed it fully with two doctors before having it done. It was not the worst thing I've ever had done (a closed MRI comes to mind), but, I'm glad I only need it done twice.
So, if you know someone who is having it done - a neighbor, friend, relative, they really do need your support. It made me feel more comfortable knowing my husband was there for me in the waiting area. My youngest daughter watched over me that afternoon as I slept off the aftereffects of the IV med, and I had her to drive me to the first post op appointment the next morning.
Pain wasn't much of an issue - my eye was swollen and sore, but, Tylenol was enough to help me sleep. The eye shield was a pain for the week I had to wear it, but, I didn't poke myself in the eye when I was sleeping. My eye was sensitive to light, so the dark sunglasses helped alot. My one week post op visit, I was 90% healed, had almost 20/20 vision in my right eye, and now, after 2 1/2 weeks, except for the occasional slight irritation, when my eyes are tired, I look forward to the clearer vision in my left eye. It's like the difference between watching a regular, older TV and a HD television - amazing!
Showing posts with label elderly. Show all posts
Showing posts with label elderly. Show all posts
Sunday, January 10, 2010
Monday, August 10, 2009
Why does someone stop eating?
There are many reasons that someone might stop eating. In long term care (aka nursing homes), the interdisciplinary team (all the people involved from all disciplines - nutrition, social services, nursing, infection control, activities, the doctor and anyone else on the team who can add insight) , the Resident (aka patient) and their family needs to be involved. Are they depressed? In pain? Is there a urinary tract infection (or any infection) that is affecting their appetite? Is medication making everything taste "bad" or "funny"? Are they weak? There are so many reasons someone stops eating. Sometimes their disease processes are affecting them in ways no one has realized. With input from everyone (and not everyone will agree on what they see), the doctor can order testing and physically assess the patient.
A sore mouth, ill fitting dentures - the causes are many, and not always easily found. But, with observation, persistence, and the input of many different perspectives, the cause can often be found.
Sadly, sometimes the body systems are failing, and the body is responding by decreasing appetite. It isn't something that can always be fixed - but, sometimes (more often than not) a cause can be determined, and interventions will be effective.
People don't stop eating just because they are getting old. Never accept that as a reason.
A sore mouth, ill fitting dentures - the causes are many, and not always easily found. But, with observation, persistence, and the input of many different perspectives, the cause can often be found.
Sadly, sometimes the body systems are failing, and the body is responding by decreasing appetite. It isn't something that can always be fixed - but, sometimes (more often than not) a cause can be determined, and interventions will be effective.
People don't stop eating just because they are getting old. Never accept that as a reason.
Friday, August 7, 2009
My mother's face in the mirror
The one thing I can guarantee in life - one day (if you live long enough) you will look in the mirror and say to yourself "Who is that? Is that me? That looks like my mother (or father, depending on gender)." It is not so much a "light bulb moment" as one of those "how did that happen?" moments.
Lines suddenly appear where there didn't seem to be any before. Hair grows in interesting places. Hot flashes provide indoor heating to most of us lucky ladies (most men deny any life altering changes like our hormonal joys, but, I tend to think otherwise - picture some of the commercials airing these days).
I'm sure we could have some fun with thoughts along those rife with possibilities topics, but, first let me introduce myself. I am of a mature age (still young enough to be amazed how long ago I graduated from high school, still have a daughter in college). I am also what I like to call a "late bloomer". My first great joy in life was being a mother to three daughters. But, somewhere down that path, I finally figured out what I wanted to be "when I grow up", and that was, and is, a nurse. I have been a nurse for 16+ years, first an LPN and then earning my degree, and becoming an RN.
That's when the journey got really interesting. I thought I would want to work in pediatrics or obstetrics (didn't). What I found I love, in many different forms, is geriatrics. I love working with the elderly. They are interesting and endlessly complicated as a group, and as individuals. Geriatric Psych was a locked Med/Surg unit with IV's, transfusions, and every psychiatric and medical issue you could name. Don't even get me started about the psychiatrists! I was there after working in long term care for a few years (nursing homes).
Then, when I got the itch to try something new (and during the day, so I could see my kids more), I went to work for hospice.
The short story about hospice, is not only the many useful things I learned about pain management, etc., but, that working with the dying was more about life, than death.
That was when I learned that it is the journey, not the destination, that is important, while we are so busy living our lives.
I visited people in their homes, helping them with the day to day struggle of living with a sure knowledge of how short life is. There were many symptoms that people had to deal with, when they are dying. Most of them can make life very unpleasant. But, there are many medications and resources to help control those (it's called symptom management, and with alot of team effort, it usually works). I am sure, somewhere out there are heroic nurses singlehandedly slaying dragons for their patients. Fearless and without support from anyone else. Never met one, although I've heard the stories. My experience is that it takes a team of caring professionals (not all nurses and doctors, either), to successfully manage and support a patient (in any environment). When being on the road 12 hours at a time, day after day, got too much, I went to work at the inpatient unit. I was the only nurse for nine patients, with an aide to help with the physical stuff (it is truly hard to lift someone around in a bed, without any help). I worked all night, because that was the only full time shift available. Interestingly enough, I spent alot of time with patients. It amazes me, still, how long night seems to someone facing their mortality. Somehow, it is safer to sleep when it is light outside. It is truly darkest before the dawn. I've shaved men's faces at 3AM as they told me stories. I've held hands of the dying and the frightened. I've learned the grace that some people live and die with, and how others fight and struggle to the last breath. I learned that there are many facets to the way individuals leave this life, just as there are so many ways to live it. A topic we can pursue, if anyone is interested.
Then I became an RN Unit Manager of a 40 bed nursing home unit that was primarily for dementia patients. While there I learned more about nursing and the many facets of management. I passed meds, did treatments, met with families - I learned alot.
But, four years later, I was burned out, looking for something different. I started working at another nursing home, not as management, but, strictly as a charge nurse/floor nurse. It took me nine months to find my way back to who I wanted to be as a nurse.
Then, refreshed (but, tired of working on my feet all the time), I trained as an RN Assessment Coordinator, including being certified in my specialty (that means extra I had to attend classes, take certification exams - ten-before becoming certified - thus adding more letters onto my signature). I complete the mandatory assessments for the residents on the 62 bed unit I work on (the government requires new assessments every 92 days on everyone in long term care). Medicare has other assessments that are required. The assessments are important, because it is how the facility receives funding (there are 108 line payment items on a full assessment). But, even more important, for the families and residents, is that this is a review of how the resident (the patient) is doing physically, emotionally in all areas of their lives. Every resident has a plan of care that details how their needs are met. That plan of care is reviewed with the resident and their family quarterly (again by regulation). This is also known as Care Plan, or Plan of Care. About two weeks after the MDS (minimum data system) assessment is done, the meeting is held. Residents and their FRP (first responsible party) are invited.
However, much more than just the review is accomplished with this meeting. Family and patient teaching is important to help (you and yours) understand changes, disease processes, and sometimes, just how the system (of the nursing home) works. I always encourage my families to tell us (team members, individually and together) their concerns and worries as they occur. Three months is much too long to wait if there is an issue about care.
The team consists of myself, the social worker, the dietitian, activities aide (one of the most important concerns in the facility, if you are bored!), sometimes the unit manager or a occupational or physical therapist if they are on therapy. Other people who are part of the team, but, who rarely attend, are the infection control nurse, nursing administration, housekeeping, nursing assistants, the hairdresser, the business office,maintenance (there are alot of people on the team). I've always thought that housekeepers, nursing assistants and the hairdresser are a priceless source of information about the residents. Unfortunately, they are very busy people who don't have time to attend the meetings, but, I frequently ask their opinion both before and after care plan meetings.
My favorite role as the RNAC (Registered Nurse Assessment Coordinator - the medical field LOVES acronyms), is family and patient teaching.
My grandmother was a teacher and I'd like to think that my strength in this area comes from her. She was my first and greatest role model.
Which brings me back to the mirror - is it her face I see? My face? Or is it my mother's face in the mirror?
I hope you will join me as we look into life's mysteries and any questions you would like to have a dialog about, relating to the one thing we are all doing - getting older.
I don't proclaim myself an expert in long term care, but, I have alot of knowledge - and I'm willing to share.
As I develop this blog, I will include tips, guidance, etc.
I can also be found on Twitter (lizziebetliz).
My friends call me Cindi.
Lines suddenly appear where there didn't seem to be any before. Hair grows in interesting places. Hot flashes provide indoor heating to most of us lucky ladies (most men deny any life altering changes like our hormonal joys, but, I tend to think otherwise - picture some of the commercials airing these days).
I'm sure we could have some fun with thoughts along those rife with possibilities topics, but, first let me introduce myself. I am of a mature age (still young enough to be amazed how long ago I graduated from high school, still have a daughter in college). I am also what I like to call a "late bloomer". My first great joy in life was being a mother to three daughters. But, somewhere down that path, I finally figured out what I wanted to be "when I grow up", and that was, and is, a nurse. I have been a nurse for 16+ years, first an LPN and then earning my degree, and becoming an RN.
That's when the journey got really interesting. I thought I would want to work in pediatrics or obstetrics (didn't). What I found I love, in many different forms, is geriatrics. I love working with the elderly. They are interesting and endlessly complicated as a group, and as individuals. Geriatric Psych was a locked Med/Surg unit with IV's, transfusions, and every psychiatric and medical issue you could name. Don't even get me started about the psychiatrists! I was there after working in long term care for a few years (nursing homes).
Then, when I got the itch to try something new (and during the day, so I could see my kids more), I went to work for hospice.
The short story about hospice, is not only the many useful things I learned about pain management, etc., but, that working with the dying was more about life, than death.
That was when I learned that it is the journey, not the destination, that is important, while we are so busy living our lives.
I visited people in their homes, helping them with the day to day struggle of living with a sure knowledge of how short life is. There were many symptoms that people had to deal with, when they are dying. Most of them can make life very unpleasant. But, there are many medications and resources to help control those (it's called symptom management, and with alot of team effort, it usually works). I am sure, somewhere out there are heroic nurses singlehandedly slaying dragons for their patients. Fearless and without support from anyone else. Never met one, although I've heard the stories. My experience is that it takes a team of caring professionals (not all nurses and doctors, either), to successfully manage and support a patient (in any environment). When being on the road 12 hours at a time, day after day, got too much, I went to work at the inpatient unit. I was the only nurse for nine patients, with an aide to help with the physical stuff (it is truly hard to lift someone around in a bed, without any help). I worked all night, because that was the only full time shift available. Interestingly enough, I spent alot of time with patients. It amazes me, still, how long night seems to someone facing their mortality. Somehow, it is safer to sleep when it is light outside. It is truly darkest before the dawn. I've shaved men's faces at 3AM as they told me stories. I've held hands of the dying and the frightened. I've learned the grace that some people live and die with, and how others fight and struggle to the last breath. I learned that there are many facets to the way individuals leave this life, just as there are so many ways to live it. A topic we can pursue, if anyone is interested.
Then I became an RN Unit Manager of a 40 bed nursing home unit that was primarily for dementia patients. While there I learned more about nursing and the many facets of management. I passed meds, did treatments, met with families - I learned alot.
But, four years later, I was burned out, looking for something different. I started working at another nursing home, not as management, but, strictly as a charge nurse/floor nurse. It took me nine months to find my way back to who I wanted to be as a nurse.
Then, refreshed (but, tired of working on my feet all the time), I trained as an RN Assessment Coordinator, including being certified in my specialty (that means extra I had to attend classes, take certification exams - ten-before becoming certified - thus adding more letters onto my signature). I complete the mandatory assessments for the residents on the 62 bed unit I work on (the government requires new assessments every 92 days on everyone in long term care). Medicare has other assessments that are required. The assessments are important, because it is how the facility receives funding (there are 108 line payment items on a full assessment). But, even more important, for the families and residents, is that this is a review of how the resident (the patient) is doing physically, emotionally in all areas of their lives. Every resident has a plan of care that details how their needs are met. That plan of care is reviewed with the resident and their family quarterly (again by regulation). This is also known as Care Plan, or Plan of Care. About two weeks after the MDS (minimum data system) assessment is done, the meeting is held. Residents and their FRP (first responsible party) are invited.
However, much more than just the review is accomplished with this meeting. Family and patient teaching is important to help (you and yours) understand changes, disease processes, and sometimes, just how the system (of the nursing home) works. I always encourage my families to tell us (team members, individually and together) their concerns and worries as they occur. Three months is much too long to wait if there is an issue about care.
The team consists of myself, the social worker, the dietitian, activities aide (one of the most important concerns in the facility, if you are bored!), sometimes the unit manager or a occupational or physical therapist if they are on therapy. Other people who are part of the team, but, who rarely attend, are the infection control nurse, nursing administration, housekeeping, nursing assistants, the hairdresser, the business office,maintenance (there are alot of people on the team). I've always thought that housekeepers, nursing assistants and the hairdresser are a priceless source of information about the residents. Unfortunately, they are very busy people who don't have time to attend the meetings, but, I frequently ask their opinion both before and after care plan meetings.
My favorite role as the RNAC (Registered Nurse Assessment Coordinator - the medical field LOVES acronyms), is family and patient teaching.
My grandmother was a teacher and I'd like to think that my strength in this area comes from her. She was my first and greatest role model.
Which brings me back to the mirror - is it her face I see? My face? Or is it my mother's face in the mirror?
I hope you will join me as we look into life's mysteries and any questions you would like to have a dialog about, relating to the one thing we are all doing - getting older.
I don't proclaim myself an expert in long term care, but, I have alot of knowledge - and I'm willing to share.
As I develop this blog, I will include tips, guidance, etc.
I can also be found on Twitter (lizziebetliz).
My friends call me Cindi.
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