New Trend in Nursing Homes: The Rise of Younger Residents

There’s an interesting new trend in nursing home care.  The number of younger residents in nursing homes has increased in the last few years.  The number of nursing home residents under the age of 65 has jumped 22%.  This means about one in every seven residents is under 65 years of age, some even in their twenties and thirties.  

What’s causing this growing phenomenon in medical care?  The Washington Post reported that it’s due to 1) medical advances that help individuals survive traumatic illnesses and injuries, and 2) the closing of mental health facilities.  Many of these younger residents have suffered severe injuries. Others have neuromuscular diseases such as multiple sclerosis, or have suffered a stroke. 

This trend has proven a challenge for caregivers and residents, because while the younger residents may have some of the same physical demands as older residents, their social and psychological needs are much different.  

While many facilities try to separate the older from the younger generations, this isn’t always possible because of the still small number of younger residents.  This can cause tensions between the generations.  The older residents complain about loud music and young visitors.  On the other hand, the younger residents don’t want to room with someone with dementia, they don’t want to be forced to eat food specifically with the elderly in mind, and hate that the only social activity is bingo.  

Living in these facilities can also cause the younger residents to become depressed not only because of their disabilities or illnesses, but because they’re constantly surrounded by the elderly and dying, and quite simply, they’re lonely.

Some homes have already accommodated these younger guests by giving them their own wing, offering poker instead of bingo, pizza and pop instead of meatloaf and tea.  They even take them out on outings. If this trend continues, the nursing home industry will have to adapt in order to not only give the elderly comfortable quality care, but also the young who suffer from debilitating injuries and illnesses.

Sources: 

Nursing Home Abuse Blog

 

Time Healthland

McKnight's Long Term Health Care News

Tis the Season...

Although it’s the-season-to-be-jolly, it’s definitely not the season-to-stay-healthy for many.  The holidays can be a stressful, depressing time for some, not to mention the inevitable weight gain most of us pack on this time of year.  

 

Depression

For some, the holidays are not a joyous time; for some they’re difficult and painful to get through.  This could be because of the loss of a loved one, divorce, or anxiety of the upcoming year.  It can also be a time of introspection, loneliness, and reflection which can bring on feelings of despair. 

 Here are some tips for fighting holiday depression:

• Are your traditions working for you?  If not, get rid of them and create new ones. 
• Go outside, get some fresh air and exercise. 
• If you suffer from SAD (Seasonal Affective Disorder) take vitamin D supplements, or use phototherapy to relieve depressive symptoms.
• Don’t compare the current holiday to holidays past, just enjoy it and make new memories to cherish.
• Do something for someone else. Try volunteering some time or donating needed items to charitable organizations in your area.
• Remember, alcohol is a depressant and may add to your holiday melancholy.
• Spend time with supportive and caring people.  Try to make new friends or reach out to ones you haven’t talked to in awhile.

Loss 

If your depression is caused by the loss of a loved one, have a family discussion about what each member wants to do for the holidays and how much they think they can handle.   

•  If you live alone, invite a friend for dinner, go to a movie, or start a new book.  
•  Alleviate yourself of some holiday pressures.  Limit gift buying and giving, and decorate as much as you are ready for. Let someone else host and cook. Be sure to take care of your own needs and get adequate rest and exercise.
• If you’re up to it, acknowledge the absence of your loved one, toast in their honor, or visit the cemetery or memorial site.  Cry, smile, and laugh, if you need to and enjoy creating new memories and new traditions with family and friends. 

Don't Forget the Elderly

Holidays can be very lonely and stressful for the elderly. Remember to include them in your family gatherings.  The passing on of traditions, becoming the guest instead of the host, deaths of spouses or siblings are all things you might not think about, but can add to their feelings of loss and sadness.   If they’re able, try to involve them in the holiday preparation, let them help decorate or cook.  Make them feel important.

Destressing 

• Try to set realistic goals and pace yourself. Make a list and prioritize the important activities. Be realistic about what you can and cannot do. Don’t spread yourself too thin, you don’t have to attend every party to which you’ve been invited.

• If you're in charge of preparing the holiday meals, start cooking early so you can enjoy the holidays. Create sauces, jams, cookies, and other items that will keep until the guests arrive in advance.
• Simplify. Bake only one type of cookie instead of a dozen.   
• If you get tired, take a break.  The wrapping, baking, and shopping will be there when you’re rejuvenated.
• Don’t go into the red.  Give gifts of your time or services, or pull names for gift exchanges. Enjoy free activities, such as driving around to look at holiday decorations; window shop, build a snow man, go caroling.
• Return Gifts Later.  The day after Christmas is not the time to return unwanted gifts. Wait until after the New Year when shopping crowds have diminished.

Holiday Weight Gain

The holiday season brings festive family get-togethers, office parties and other traditional activities. What common thread do these activities have? Food, food and more food (with a side of alcohol). The average American gains 5 to 7 pounds over the holidays. 

• When we spend an entire day shopping, we usually end up making poor meal choices by eating fast food, which is high in fat and calories and low in nutritional content. Keep it as healthy as you can.  Avoid "super-sizing", limit fried foods, and avoiding high fat condiments such as dressings, mayonnaise, sauces and cheese. Instead, slather that burger with mustard, ketchup or fat-free dressing or order a salad. 
•  Don't skip meals or eat very little most of the day to save up so that you can eat more at a party or dinner. Eat at your regular times, with perhaps a little lower fat or smaller portions in general. If your meal will be later than usual, have a snack to curb your appetite so that you are not too hungry when you get there.
•  Looking for healthy holiday entertaining ideas? Instead of a traditional holiday cookie exchange, invite friends over for a light meal that includes vegetable soups, fresh breads, fruits and lettuce salads. Plan the event so that food is not the main focus.  Plan activities such as games and a gift exchange.   
•   If you’re traveling during the holiday and staying where there is no gym, bring an exercise band or DVD so you can get your physical activity in. 
•  Modify your recipes to make them lighter.  The sugar and fat content in most holiday recipes can be altered without a noticeable difference in taste. Use low-calorie substitutes for butter, shortening, and sugar, and cook with skim milk.   Strong-flavored cheeses, such as gorgonzola or aged parmesan, add more "oomph" per ounce and have less fat than easy melters such as cheddar.  
• Don't forget the roasted vegetables -- squash, sweet potatoes, parsnips or tomatoes. These vegetables require little if any fat to prevent sticking, and roasting them with your turkey, ham, or prime rib is an ideal cooking method.
•  Watch out for hidden calories in your holiday beverages.  Alcohol is high in calories and some mixed drinks contain up to 450 calories per glass. Soda, fruit punch, and eggnog can be loaded with sugar and calories.  By drinking water and diet sodas you stay calorie free. 
•  Moderation is key; whether we’re talking red meat, alcohol, or cookies, try to balance intake of these items with fruits and vegetables, lean meats and other healthy choices. 
•  Make the season one of sharing. If you are given sweets or other special foods, then share them with family and friends or take them to work.

Eat Out Fear-Free

1. Cocktails: Order your food first. It’s the first thing you’re offered when you walk into a restaurant. But after just one drink, you’re more likely to order the 2,400-calorie Bloomin’ Onion rather than a green salad to start. Until you’re placed your food order, stick with water. 
2. Ordering: Choose before you go. Check out the menu online or call and ask the restaurant to email or fax it to you. Decide what to order in advance and stick with it.
3. Waiting: Don’t go in on an empty stomach. Have a small low-calorie snack before you eat out so you’re not tempted to munch while you wait for a table or your food. Turn down bread or ask that it be placed out of reach.  
4. Portions: Less is more. Most restaurants give you far more food than you need or can eat. Beat the system by ordering two appetizers instead of an entrée, sharing a meal with a friend, or asking for a take-out container when you order so you can put half your meal aside before you eat. 
5. Cooking styles: Steer clear of fats. Beware of anything cooked with cream, such as sauces or soups, also, butter, oil, gravy, au gratin, breaded, Alfredo, blackened, battered, or fried. Stick with poached, baked, broiled or steamed.  Or ask if your meal can be cooked “light” and ask for sauces and salad dressings (plain oil and vinegar is best) on the side.

Party Time 

• Once again, keep alcohol intake down. Drinking sparkling water instead of alcohol will keep your brain from forgetting to watch what you eat. Not to mention that alcohol itself contains 7 calories per gram. That’s twice as much as sugar!
• As with eating out, enjoy a pre-party snack. Arriving hungry to a party makes us more likely to overeat. Plan and prepare to combat this by eating before a party.
• Move away from the buffet. Find a room that’s not full of food. You’ll be less tempted to eat if you can’t see what you’re missing.
• Bring a party platter of sliced veggies and yogurt dip, or another healthy appetizer.  Then you’ll know there will be at least one healthful choice to nibble on. 
• Avoid recreational eating by setting a one plate rule. At parties and holiday dinners we tend to eat beyond our body’s physical hunger simply because food is there and eating is a social activity.  Also, try to eat slowly and possibly on a smaller plate.
• If you overindulge at a holiday gathering, don't just decide that you have blown it and that you won't try to keep a healthy diet until after the New Year. An occasional lapse does not cause excessive weight gain but several weeks of over-eating may.  Instead of giving up, learn from your mistakes and plan better for the next time.

The Gift of Health

Looking for fitness and exercise gift ideas, here you go:

• Yoga mat 
• Exercise Ball 
• Weights
• Personal Training Session 
• Workout Video 
• Fitness Video Game 
• Jump Rope 
• Fitness Fashion

1. Sneakers
2. running pants
3. bicycle shorts
4. sweats
5. swim goggles
6. towel
7. gym bag
8. outdoor gear for outdoor sports, such as, wool socks, gloves, long underwear, hat

• MP3Player, of if that is out of your budget, a new set headphones and a gift certificate for downloadable workout tunes.
• Gym Membership 
• A gift certificate for indoor sports such as bowling or mini golf.  

Have a healthy and happy holiday from MBC

Sources:
Bangor Daily News
Associated Content
Kaiser Permanante
Nurse Tips
Wellness Corporate Solutions
California Progress Report

Snowmobile safety.

Just yesterday there was a snowmobile fatality in Minnesota, the same day a Wisconsin man was sentenced in a deadly snowmobile accident from last New Year’s Eve.  While yesterday’s accident is still being investigated, alcohol and excessive speed were factors in last year’s. The twenty-seven year old Wisconsin man ran over a friend after he’d fallen from his own snowmobile.

75% of snowmobile fatalities occur off trails.  74% involve alcohol and 37% involve excessive speed.  Most snowmobiling injuries and deaths fall on males, aged twenty to thirty-four.

How do you stay safe out there on the trails?  Well the obvious would be to stay on designated trails, keep speeds at a reasonable rate, and avoid using drugs and alcohol if you’re planning on snowmobiling. 

Here are some more tips to follow in order to help you remain alert and ensure your safety on the trails:

1. Always let someone know where you going and when you will return.
2. Never ride alone.
3. Watch your fuel supply.  Head out only to a point where the fuel gauge is showing no less than one half, then follow your track back.
4. Be sure to have reflective trim somewhere on your snowmobile for night time visibility.

Be on the watch for:

• Obstacles hidden in the snow.
• Trees and branches on the trail.
• Slow maintenance equipment.
• Other snowmobiles, sleds, skiers, walkers, and wildlife.
• Wash outs and flooding.
• Snow banks and moguls.
• Road and railway crossings.
• Unexpected corners, intersections, and stops.
• Bridges, open water, and unsafe ice.
• Logging operations.

  Avalanches:  They’re not just in the movies.  They are a real, life-threatening winter hazard.  Here are a few tips on how to avoid an avalanche:

• Avoid areas in which avalanches are known to occur
• Spend as little time as possible on open, steep slopes
• Avoid crossing steep sided hills.  If you must cross, stay on the side where the wind blows.       
• Stay out of narrow, steep canyons
• It’s safer to snowmobile in areas where snow tends to be compacted and fixed, such as timbered areas, along ridges, and rock outcrops.

If you get caught in an avalanche:

• Remain calm.
• Call out to others so they can 
• find your course.
• Move away from your machine     and equipment.
• “Swim” with the avalanche.
• Before coming to a stop, place your hands over your face to form an air pocket.  If the snow is soft you may be able to dig yourself out.  
• Be sure to dig your way up.  If you have been able to create a pocket, use gravity to determine up from down.  
• Don’t waste your strength and oxygen yelling.  Sound doesn’t broadcast well out of snow.

If you get out of the avalanche:

• Don’t leave your party behind.  You may be their only chance at survival. 
• Search for victims by probing with a pole directly downhill from the point they were last seen.

 Be sure to dress right when snowmobiling. 

• Bottom layer should be polypropylene and thermals, fabrics that release moisture while retaining heat. Then add another heat retentive layer on top of that.
• Avoid cottons and sweat shirts.  They keep the moisture in and will make you cold and clammy which could lead to hypothermia.
• Find snowsuits that are water and wind proof.
• If riding across ice, consider wearing a buoyant snowmobile suit.  If the ice happens to break, the suit will keep you afloat and help protect you against hypothermia.  It’s best however, to avoid riding over ice if possible.
• Always carry extra clothing, socks, boot liners, and mittens.

 

Hypothermia is the greatest threat for winter riders.  When you have hypothermia your body loses heat faster than it can produce it, causing a dangerously low body temperature.   When your body temperature drops, your heart, nervous system and other organs don’t work properly.

Left untreated, hypothermia eventually leads to complete failure of your heart and respiratory system and to death.

Here are the causes of hypothermia:

• Not dressing properly for weather conditions.
• Staying out in the cold too long.
• Unable to get out of wet clothes or move to a warm, dry location.
• Accidental falls in water.

Signs and symptoms of hypothermia include: 

• Shivering.
• Clumsiness or lack of coordination.
• Slurred speech or mumbling.
• Stumbling.
• Confusion or difficulty thinking.
• Poor decision making, such as trying to remove warm clothes.
• Drowsiness or very low energy.
• Apathy, or lack of concern about one's condition.
• Progressive loss of consciousness.
• Weak pulse.
• Shallow breathing.

A person suffering from hypothermia usually isn't aware of his or her condition.  The symptoms often begin gradually and one of the symptoms, confusion, prevents self-awareness. 

If you fear someone is suffering from hypothermia, here’s what you should do:

• Handle them with care.  Limit movements to only those that are necessary. Don't massage or rub the person. Too much movement could trigger heart failure.
• Move the person to a warm, dry location if possible. If you're unable to move the person out of the cold, try to shield him or her from the cold and wind.
• If the person is wearing wet clothing, remove it. Cut away clothing if necessary to avoid excessive movement.
• Use layers of dry blankets or coats to warm the person. Cover the person's head, leaving only the face exposed.
• To warm the person's body, remove your clothing and lie next to the person, making skin-to-skin contact. Then cover both of your bodies with blankets.
• If they stop breathing or their breath seems dangerously low, begin CPR if you’re trained to do so.
• If the affected person is conscious, give them something warm to drink.  No alcohol or caffeine. 
• Get medical help as soon as possible.

 Follow the above guidelines and snowmobiling can be an exciting, yet safe activity in which to engage this season.  Also keep in mind courtesy and protection of the environment when hitting the trails. Take pleasure in the winter wonderland around you and enjoy the ride!

Sources:
The Mayo Clinic
KARE 11
WSAU Newstalk
Clallam County, Washington

To learn more about  snowmobiling in Washington state visit Washington State Parks, the WSSA, and the WSSA Safety Program.

To find snowmobile associations in your state click here.

Highway Design Defects

By John L. Messina 

Every year over 45,000 Americans are killed on the nation’s streets and highways and countless thousands are seriously injured.  Often these tragedies are due to bad driving.  However, the design of the roadway may sometimes be a contributing factor.  

The law requires all public entities, cities, counties, and the state, to keep our roadways safe. If a government entity’s failure to design and build a safe road contributed to the collision, victims may seek damages.  Careful research and thorough discovery, often involving highway safety experts, is essential to establish the public entity’s responsibility for a dangerous condition.

We at MBC are proud of our record in this area of the law.  We have successfully handled cases involving dangerous rail crossings, negligent signing or striping, failing to install necessary guardrails, negligent placement of poles, signs or other hazards too close to the roadway and many others.  Our first case, a trial in 1978 involving a power pole too close to the roadway, resulted in a record-setting verdict. 

The statute of limitations on government claims is three years from the date of the injury, However, unlike private cases, you can bring a suit against a branch of government only if you file an administrative claim against it first.  Then, you must wait 60 days before you can file suit.

The moral to this story is not to be discouraged if a serious injury seems to be due solely to bad driving or there is not enough insurance to cover the claim.  When the injuries are great, contact a law firm that handles highway design cases to find out if  the roadway may have  contributed to the collision.  Such consultations are free and are a stone worth turning over.  We at MBC stand ready to help and advise.