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Home Care Insights

The DASH Diet: How It Helps Improve Health

Dietary Approaches to Stop Hypertension, better known as the DASH diet, is one of the first lines of defense when trying to reduce high blood pressure. Research has shown that following a DASH diet along with a low-sodium diet can significantly lower blood pressure as well as, or even better than, using anti-hypertension medications.

High blood pressure is often called the “silent killer” because there usually are no warning signs. It puts you at risk for heart attack, stroke, disability and a preventable early death.

Because of the growing prevalence of hypertension in America, the National Heart, Lung, and Blood Institute (NHLBI), a division of the National Institute of Health, implemented research in the early 1990’s to come up with dietary interventions for hypertension. The studies proved the DASH diet was extremely effective in treating and preventing high blood pressure. The diet is also very effective in lowering blood cholesterol.

Research has shown that people who follow the DASH diet may be able to reduce their blood pressure by a few points in just two weeks. Over time, their systolic blood pressure (the top number in a blood pressure reading) could drop by as much as eight to 14 points, which significantly reduces the risk of cardiovascular disease.

The DASH diet focuses on consumption of vegetables, fruits, whole grains, low-fat dairy, and lean proteins along with moderate exercise. Doctors often prescribe the DASH diet with or without medications to lower hypertension in patients.

Hypertension, or what we usually refer to as high blood pressure, is considered humans’ most common chronic condition, affecting around 1 billion people worldwide. In addition, hypertension is a major risk factor for heart disease, another serious and common chronic condition.

The positive health effects are even greater when DASH is combined with a low sodium diet. US News and World Report has consistently rated the DASH diet as one of the top diets in the world for the past eleven years. Thus, the DASH diet promotes good health for all who use it, not just for people diagnosed with hypertension!

What IS The DASH Diet?

  • Low in saturated fat, trans fat, and cholesterol.
  • Emphasizes fruits, vegetables, and low-fat dairy foods.
  • Includes whole grains, poultry, fish, lean meats, beans, and nuts.
  • Is rich in potassium, calcium, and magnesium.
  • Is rich in protein and fiber.
  • Combined with a low sodium diet has maximum benefit.
  • Is really not a diet at all: It is a long-term, nutritious way to eat.
  • Avoids: red meat, processed food, alcohol, salt, sugary soft drinks and fried food.

Not only effective against hypertension, the DASH diet is easy to follow, nutritious, safe, and effective for weight loss. It has also been proven to protect against diabetes and heart disease. It is extremely effective when paired with a low sodium diet. Most importantly, unlike most diets that are temporary in nature, the DASH diet is a sustainable, nutritious way to eat for the long-term.

The National Heart, Lung, and Blood Institute (NHLBI) was instrumental in the development of the DASH diet. More information is available online at https://www.nhlbi.nih.gov.

For more information about the National Institutes of Health (NIH) and other programs, visit www.nih.gov.

ALWAYS CHECK WITH YOUR DOCTOR BEFORE STARTING A NEW DIET OR EXERCISE PROGRAM.

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Exercise and the Elderly

No matter your age, all people need regular exercises to remain healthy and physically able. This is especially true for adults over the age of 65. Experts recommend at least 150 minutes per week of exercise (30 minutes per day, 5 days a week) for optimal health benefits. Understandably it can be difficult for some seniors to get that amount of exercise in per week.

Though aging can create obstacles to staying physically fit, remember, it is never too late to start moving more, and the sooner you start, the more your health will improve. Staying active is one of the most important things you can do to stay healthy as you age.

Some people feel that if they can’t do the full amount of recommended exercise per week, then it is no use to even try. This could not be further from the truth! Always check with your doctor before starting a new exercise routine, and then do the amount of physical activities you are able to do. This will still give you mental and physical benefits.

You can integrate more walking, stair climbing, and lifting of small weights (2-5 lbs) to start, things you can do in your own home. These small steps will increase your stamina and keep your heart and lungs more healthy. As you gain stamina, you can increase the length of time you walk, the amount of times you go up and down a flight of stairs, and the amount of reps you can do with your weights, for example.

After age 50, muscle mass and muscle strength start a slow and steady decline. In order to maintain muscle mass and strength, both key to maintaining health and wellness as you age, using resistance training is an important strategy.

If you can’t do walking or stair climbing, there are chair exercises available. These are designed for people who cannot safely exercise on their feet. Consider the many examples of chair exercises available on the internet. A good resource can be found at www.verywellfit.com.

Another option for staying active is SilverSneakers, a health and fitness program for seniors that is covered by some Medicare plans. This program includes the use of gym facilities, fitness classes, online access to workout videos, nutrition tips and other resources.

Key takeaways:

  • Even small amounts of daily exercise (i.e. increases in activity) can benefit you.
  • It is never too late to start increasing your activity level.
  • Physical activity, including resistance training (commonly weights), is critical for increasing muscle mass and muscle strength as you age.
  • If you can not safely exercise on your feet, chair exercises are a good alternative.
  • SilverSneakers is a health and fitness program offered by some Medicare plans.
  • Check with your doctor before starting a new exercise program.

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Home Care Insights

The Case for Designating a Medical Power of Attorney:

What Is a Medical Power of Attorney or a Durable Power of Attorney for Healthcare?

These terms can be used interchangeably to mean a person who is appointed by you (or a court) who specifically oversees your medical concerns when you are unable to do so yourself.

Why would it be important to designate a Medical Power of Attorney?

You might designate a financial power of attorney and wrongly assume they can also handle your medical needs when they arise. The fact is, only a medical power of attorney or durable power of attorney for healthcare is officially appointed to speak to your medical needs when you are incapacitated. You should designate a person who knows your desires regarding medical care and end of life care, and someone willing to follow your wishes.

Even if you have a living will, it will only take effect if you are in a persistent vegetative state and not expected to recover. As you can imagine, there are many situations where you might be incapacitated and need a MPOA to speak on your behalf. Some examples of these situations include: surgery, stroke, dementia, etc.

How do I decide who should be my MPOA? Make sure the designee:

  1. Knows your medical history
  2. Knows how you wish to be cared for in the event you are unable to make decisions for yourself.
  3. Will adhere to your wishes despite religious or moral differences.
  4. Will be available if the need arises to give full attention to your medical decisions.

As a plus, has the designee worked in senior healthcare or with the elderly? If so, he or she has likely garnered extensive knowledge about senior medical needs and welfare, working with medical disciplines across the spectrum of care, and care coordination.

KEY TAKEAWAYS:

  • A living will only takes effect when you are deemed to be in a persistent vegetative state and not expected to improve.
  • Assuming “everyone knows” what you want puts your future health at risk should you become incapacitated. Each person might remember your wishes differently, or not remember them at all.
  • A designated medical power of attorney (NOT financial or other) will be the one person to oversee your medical needs if you are rendered incapable.
  • Make sure your MPOA knows your wishes regarding medical care and end if life care, and is willing to follow your instructions.
  • Having a MPOA will help medical providers know who they can legally talk to and rely on regarding coordinating your care.

I am ready to designate my medical power of attorney. Now what?

There are a few options for getting your MPOA assigned on the proper documents. First, you can look for free on-line forms (making sure they are the forms for your specific state). Second, you can speak to your attorney, or find an attorney to draw up the documents for you.

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Home Care Insights

Covid-19 Vaccine Facts:

If you are over the age of 65, you have already been given the opportunity to have both of your covid-19 vaccinations. States have now made vaccinations available to most people 16 years of age and older. All adult Americans will be eligible to get vaccinated against Covid-19 by April 19, 2021 according to the Biden administration.

People under the age of 65 and women are more likely to report side effects from the vaccines. Remember, according to the CDC, you are still protected by the vaccine (two weeks after your second dose) whether you experience side effects or not. If you do feel any side effects after the first or second dose, the effects should begin one to two days after the injection and only last an average of one or two days. More specifically, Pfizer side effects may start within 8-12 hours of the injection, and Moderna side effects may take day or two to develop.

Approximately 50% of people who take the vaccines will experience some kind of side effects. Side effects are more common following the second dose because your body has developed antibodies from the first dose.

The following information outlines possible side effects and tips to keep in mind when receiving your first and second dose of the Pfizer or Moderna vaccines.

After Your First Dose:

Most people have no symptoms or mild symptoms after receiving the first dose of either Pfizer or Moderna. Mild symptoms mostly involve pain associated with the injection site such as:

  • Pain
  • Redness
  • Swelling

You can treat the site with a cool compress. Remember it helps to move and exercise your arm after vaccination.

These symptoms usually do not disrupt daily activities and tend to go away within one or two days.

After Your Second Dose:

  • Pain, redness, swelling at injection site
  • Tiredness
  • Headache
  • Muscle pain
  • Chills
  • Fever
  • Nausea
  • Dizziness

You can additionally treat these symptoms with Advil or Ibuprofen if recommended by your medical provider.

Like the milder symptoms many experience with the first dose, these side effects tend to go away within one or two days.

*If your symptoms last longer, or get worse, you should call your doctor and seek medical care right away. If symptoms are very severe you should call 911.

Final Takeaways:

Whether you experience none, some, or all of these side effects, remember it is far better than the effects and duration associated with having COVID-19. Only when the majority of Americans are vaccinated, we will breathe a collective sigh of relief.

**Regarding Johnson & Johnson’s Janssen COVID-19 Vaccine: 

The CDC and FDA have recommended a pause in the use of Johnson & Johnson’s Janssen COVID-19 Vaccine in the United States out of an abundance of caution, effective Tuesday, April 13.

People who have received the J&J/Janssen COVID-19 vaccine within the past three weeks who develop severe headache, abdominal pain, leg pain, or shortness of breath should seek medical care right away.

Visit www.cdc.gov for more information.

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Home Care Insights

The Case for LTC Insurance

According to the the United States Health and Human Services Department, 70 percent of all people in the US over the age of 65 will need an average of two years assisted care. As you can see, based on the data, there is a high probability you or your loved one will need some kind of personal assistance as you age.

Personal care services average around $20.00 per hour depending on your region and the companies providing the service. To give you an example, just four hours of personal care services at home, seven days a week, costs around $560.00 a week, or $2,240.00 a month. Assisted living costs an average $4,300 per month.

What Is LTCI?

Long Term Care Insurance is a particular kind of insurance specifically designed to help you pay for personal care services rendered at home, or in a facility. It can mean the difference between being able to have professional long term care, or needing to rely on your family and friends for care. It is important to note that Medicare and health insurance usually do not cover long term care. Purchasing LTCI means you will have choices regarding your independence and dignity as you age.

What Does LTCI Cover?

LTCI is specifically designed to cover activities of daily living. Generally speaking, these are the activities or personal care you need every day (think bathing, dressing, toileting, etc.). At least 2 ADLs are required for most LTCI policies to start to reimburse for care.

Generally, the earlier you get LTC Insurance, the less the premium will cost. The older you are when you buy the policy, assuming you can still get approved by underwriters, the more it will cost. Monthly premiums will vary, but you might expect to pay from $150-$200 per month depending on your health and other factors at the time the policy is purchased.

Who Is Likely To Use LTCI?

People who:

  • Are Aging and need extra assistance with ADLs
  • Live alone or who do not have family or friends able to help
  • Have poor nutrition and who lack physical exercise or fitness
  • Have effects of long-term illness such as stroke, COPD, dementia, Alzheimers, etc.

LTCI and Choices:

There are many Long Term Care Insurance companies offering different plans at different premiums. Researching them BEFORE you need care will save you time and money. To get started, you can visit Long-Term Care Information at: https://www.doi.gov

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Home Care Insights

When Is Help Needed at Home?

It can be difficult to decide if your elderly loved one needs help at home. Usually there is a slow decline, and if your family member is very independent, it can be a long time, if ever, that extra help is accepted. This is the reason it often takes a medical crisis before the individual accepts assistance.

This article will address the more obvious and serious needs that signal when an individual requires extra assistance. An important concept to keep in mind is essential activities of daily living. These activities will help guide you in determining if assistance is in fact needed, and how often it will need to be performed.

Activities of daily Living (ADLs) are all the tasks an individual does for him/herself each day in order to maintain a safe and healthy lifestyle. Unfortunately, these tasks can become overwhelming or impossible for some people of advanced age and/or those exhibiting physical or mental decline. The list can be exhaustive, so the items below concentrate on the instrumental, or most important, ADLs. To live at home safely an individual MUST be able to do all of these essential tasks him/herself, or have someone available and willing to assist.

Can your loved one perform all of the following tasks safely and thoroughly without assistance?

Instrumental ADLs

  • Bathing and Dressing
  • Toileting needs (all)
  • Ambulation (walking in the home with or without an assistive device) and open access to bathroom, bedroom, kitchen etc.
  • Ability to procure all medications and take as prescribed
  • Access and ability get and/or prepare all meals with nutritious food
  • Cognitive ability and access to phone and/or emergency call button for reaching 9-1-1 in an emergency

These instrumental or IADLs are called just that because without the ability to perform them, they can lead to a serious decline in health.

As long as the appropriate assistance can be delivered by a friend or family member, etc., and all IADLs can be met, the individual can remain at home. Keep in mind that tasks relating to food and medication are usually the first IADLs that elderly people need assistance with.

Serious problems arise when the person needing help with IADLs does not have someone willing or able to assist. Sometimes it can be unsafe, unwelcome, or downright exhausting for a loved one to assist with some IADLs (such as bathing or toileting). This is often the crossroads where a home care agency or caregiver is brought in.

In these situations, finding a great caregiver, deciding if home care is truly an option, and knowing how often care is needed, can be difficult. Planning ahead and being prepared when this situation happens will save you and your family headaches and heartaches in the future.

Please call Emily’s Home Care at 336-722-4300 if you would like to get more information regarding home care or other assistance options.

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Check the Pressure

When is the last time your blood pressure was checked? Do you know what the reading was, and if it was in the normal range according to the American Heart Association guidelines? Blood pressure can seem like a mundane and routine metric, which is sometimes simply taken and noted in your chart without much further ado. In fact, most of us don’t give blood pressure much thought, that is until there is a problem! Those who are caught unaware may not have noticed as it was silently creeping up little by little, year after year…until the day it seemed to jump out of nowhere into Hypertension stage 2, or worse!

High blood pressure is hard to detect without a reading. It can become a serious problem because it causes your heart to pump harder to distribute blood around the body. This leads to thickening of the left ventricle which can lead to serious heart problems including heart attacks. In addition to heart damage, high blood pressure (called hypertension) negatively affects your circulatory system and other vital organs all of which can lead to a premature and preventable death.

Importantly, blood pressure readings are noted by a systolic number (the top number) which measures the amount of pressure in arteries during the heart muscle contraction, and a diastolic number (the bottom number) measuring the pressure when the heart muscle is resting between beats. These numbers help tell a story about the health of your heart and arteries, and they can also signal an important call to action as the guidelines below exemplify.

Since 2017 the guidelines for blood pressure are:

  • Normal: <120 (systolic) and <80 (diastolic)
  • Elevated: 120-129 (systolic) and less than 80 (diastolic)
  • High B/P (Hypertension) Stage 1: 130-139 (systolic) or 80-89 (diastolic)
  • High B/P (Hypertension) Stage 2: 140 or higher (systolic) or 90 or higher (diastolic)
  • Hypertensive Crisis, Consult doctor immediately: Higher than 180 (systolic) and/ or higher than 120 (diastolic)

High blood pressure left unchecked can cause systematic damage to your heart, arteries, brain, kidneys and more including but not limited to:

  • enlarged heart/ heart disease/ heart attack
  • blocked and narrowed arteries
  • stroke or mini strokes called TIAs (Transient Ischemic attacks)
  • kidney damage and or failure

Some factors that can contribute to high blood pressure:

  • diet high in fat, salt, and cholesterol
  • smoking
  • genetic factors
  • lack of exercise
  • older age
  • being overweight

Though often there aren’t any, some of the warning signs of hypertension may include:

  • dizziness
  • chest pain
  • severe headaches
  • nosebleeds
  • fatigue
  • vision problems

There are things you can do to combat high blood pressure (whether proactive or reactive):

  • exercise regularly
  • stop smoking/ limit alcohol
  • eat a diet low in fat, sodium, and cholesterol
  • use the DASH (Dietary Approaches to Stop Hypertension) diet and DASH recipes as a guide for what you should be eating
  • check your b/p regularly and notify your doctor of changes

Maintaining a healthy blood pressure:

  1. Know what your current blood pressure reading is, and what it should be. If you are a caregiver, also know this information regarding the person you are caring for.
  2. If you are serious about tracking your blood pressure, there are great monitors available for home use (Omron for example). It is recommended you take the reading once per week and keep a log so you can share the information with your doctor.
  3. In 2017, for the first time in 14 years, the American Heart Association tightened the guidelines for what constitutes normal blood pressure. Normal is now considered less than 120/80 (less than 120 systolic and less than 80 diastolic).
  4. You can lower your blood pressure effectively through diet (DASH) and exercise, and if needed, the use of blood pressure medications (which are many and varied) prescribed by a doctor.

There are often no warning signs exhibited for hypertension, as my doctor said “it’s not called ‘the silent killer‘ for nothing.” If your blood pressure is in any stage of hypertension I urge you to talk to your doctor and work to get it back down into what is your normal range. I hope to raise awareness on this subject because hypertension can easily go unnoticed until it is too late, and in fact high blood pressure is very treatable, and even more importantly, preventable.

Disclaimer: Please check with your doctor before starting any new diet or exercise program. We are NOT doctors, nutritionists or registered dietitians.

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Home Care Insights

Health Care Blog

Dear viewers,

Beginning this week, I will be publishing a blog. The information will be related to home care, elder care, health, and other topics that you may find interesting or helpful. I hope you enjoy the varied subjects!

Kind regards,

Emily