IN THIS UPDATE:
The month of June brings with it picnics, trips to the beach, the park, and a long list of summer fun. The summer sun is meant to be enjoyed but it can be a dangerous threat especially for senior citizens.
Times have changed when it comes to people’s thinking about the sun. That deep, dark tan is no longer viewed as a good thing. Plus, there are plenty of misconceptions about the summer sun. So taking the advice of the Centers for Disease Control and Prevention, we compiled this list of sun safety myths and senior sun safety tips.
Sun Myth #1: Seniors need constant sun to supply vitamin D. Seniors only need about 15 minutes or less of sun exposure two to three times a week on their faces and hands for their bodies to produce an adequate supply of Vitamin D. Vitamin D can also be found in foods and in multivitamins. Seniors should always wear sunscreen, a hat and light clothing that cover their skin when they are in the sun.
Sun Myth #2: Seniors only need to apply sunscreen once a day Sunscreen needs time to work. Seniors should apply it about an hour before going out into the sun and reapply about every two hours. They should reapply more frequently if they are swimming. They should use a broad spectrum sunscreen that blocks both UVA and UVB rays. UVA rays cause tanning and wrinkling while UVB rays cause sunburn, aging, wrinkling and skin cancer. Use sunscreen with a Sun Protection Factor of at least 15. Use SPF 30 or higher if you have a history of skin cancer or have fair skin. The risk for cancer increases as you get older. Seniors should especially pay attention to moles and other skin abnormalities.
Sun Myth #3: Seniors only need sunscreen at the pool or beach Seniors should wear sunscreen everywhere if they go outside longer than 15 minutes. Seniors need to exercise, but to avoid too much sun they can walk in malls, casinos, or museums.
Sun Myth #4: The sun isn’t a problem on cloudy days. The sun doesn’t feel as hot when it’s cloudy but the UVA and UVB rays that tan and burn your skin are still shining down and being absorbed. Seniors’ skin is more sensitive. The sun’s rays are more intense in the summer so even on a cloudy day seniors should still wear sunscreen and sun protection.
Sun Myth #5: There’s nothing seniors can do if they get sunburn The bad news is that’s partially true. The CDC recommends aspirin, acetaminophen or ibuprofen to relieve pain, headache and fever. When seniors are exposed to too much sun they’re at severe risk for dehydration. They should drink six to eight glasses of water a day and eat fresh fruits and vegetables. They can also take a cool bath and use an aloe cream to moisturize skin.
Sun Myth #6: Sunburn is the only sun problem seniors should worry about The sun can also hurt your eyes. The UV rays can cause cataracts, macular degeneration and skin cancer around the eyes. Seniors should always wear sunglasses. Choose brown, gray or green lenses and the darker and larger the lens the better. Seniors should choose glasses that wrap around their eyes and block a high percentage of UV rays.
SOURCE: Aging Matters, May 25, 2011
Researchers studying driving habits and accident rates among the elderly found a majority surveyed supported mandatory retesting of drivers based on age while saying they would hand over the keys if a doctor or loved one said they were no longer fit to drive.
"We are now exploring the idea of an advance directive for driving where someone would be designated to take away your keys at some point," said Emmy Betz, MD, MPH, at the University of Colorado School of Medicine who led the study and presented it in May before the American Society of Geriatrics. "It is a very difficult subject. Children don't want to bring it up, older drivers are afraid to lose their licenses and doctors may feel it is not their job."
The study surveyed 122 elderly people and found 71 percent supported mandatory, age-based driver retesting. It also showed that 68 percent believed family and 53 percent believed doctors should decide whether a license should be revoked. Only 28 percent said the Department of Motor Vehicles and 26 percent said the police should make that decision.
Some 89 percent said they might quit driving if their doctor advised it compared to 75 percent who would agree if it was their family's idea. Twelve percent reported a crash in the last year and 87 percent of current drivers said they had at least one medical diagnosis possibly linked to increased crash risk. The elderly drivers also reported taking a median of seven medications each.
Betz, an associate professor of emergency medicine, said the problem is growing as more and more baby boomers retire. Still, she said, despite sensational stories of the elderly crashing into crowds or running people down, drivers over age 75 are responsible for only four percent of pedestrian fatalities. But older drivers do have high motor vehicle accidents per miles driven with less ability to recover from injuries due to their often frail condition.
"We are trying to develop a screening test to identify higher risk drivers," she said. "The tool is a simple questionnaire with questions like, `Do you get confused by driving? Do people recommend you stop driving?'"
If someone is deemed unsafe to drive, Betz said, the question is who should notify the Department of Motor Vehicles - doctors, family or both?
"This is where the advance driving directive could come in," Betz said. "We would have something in writing that says when the time comes who do you trust to make the decision that you can no longer safely drive?"
Each state has its own method of determining whether elderly drivers are competent, most include a vision test. Betz, who recently received a Merck/American Geriatrics Society Young Investigator award, said there is more to it than that.
"It is not all about vision. There are complications from diabetes that may affect driving, cognitive problems - does a person forget how to make a left turn? - and dementia which may develop in some at age 60 and others at 90," she said. "The drugs they may be taking could also have side-effects that impact driving ability. Ultimately, this is a public health issue that needs to be addressed in a coherent way involving family, doctors and state authorities."
Betz's study was funded by the University of Colorado Hartford/Jahnigen Center of Excellence in Geriatric Medicine, the Emergency Medicine Foundation and the Colorado Injury Control Research Center.
SOURCE: University of Colorado, Denver, May 26, 2011
As little as two minutes of exercise a day can reduce pain and tenderness in adults with neck and shoulder problems, according to research being presented today at the 58th Annual Meeting of the American College of Sports Medicine and 2nd World Congress on Exercise is Medicine®.
In this study, a team at the National Research Center for the Working Environment in Copenhagen, Denmark measured neck and shoulder pain and muscle strength in 198 office workers. Participants were either assigned to groups performing two or 12 minutes of exercise per day, five times per week, or to a control group getting no exercise.
After ten weeks, the two-minutes-per-day exercise group experienced significant reductions of neck and should pain (decreased 1.4 points out of ten) and tenderness (decreased 4.2 points out of 32). The 12-minutes-per-day exercise group had slightly larger reductions in pain and tenderness, an extra .5 and .2 points respectively, but these additional gains were not significant.
"Regular physical activity is the cornerstone of many rehabilitation programs, but many people struggle to adhere to their exercise routines," said Lars Andersen, Ph.D., lead author of this study. "If people can achieve significant benefits in less time, they'll be more likely to start and stick with their exercise regimen."
Muscle strength improved by approximately six percent in both two- and 12-minute exercisers.
"These results are a welcome indication that quality counts over quantity in exercise," said Andersen. "For adults suffering from frequent neck and shoulder pain, as little as two minutes a day of daily progressive resistance exercise can result in clinically relevant pain reductions."
SOURCE: American College of Sports Medicine, June 3, 2011
Currently, one in five elderly patients discharged from a hospital is readmitted within a month. Seeking to address the human and substantial financial burden of revolving door hospital readmissions, the Affordable Care Act proposes a number of initiatives to improve care and health outcomes and reduce costs for the growing population of chronically ill people in the U.S. While transitional care is a central theme in these provisions, there is little information available to guide those responsible for implementing these important opportunities.
To bridge the gap, researchers at the University of Pennsylvania School of Nursing reviewed existing programs in order to determine what works, for whom and for how long. They discovered "a robust body of evidence" that transitional care can improve health outcomes and reduce hospital readmissions. Their paper published in the current edition of Health Affairs, the major public policy journal, highlights a range of solutions to reduce avoidable hospitalizations and health care costs.
Specifically, their review shows that, among the common elements of successful transitional care programs, is the use of nurses, often master's prepared, who work with patients, family caregivers and health teams to prevent medical errors and assure continuity of care as patients navigate a very fragmented care system. "All nine interventions that showed any positive impact on readmissions relied on nurses as the clinical leader of manager care," wrote lead author Mary Naylor, Ph.D, R.N., a professor at the University of Pennsylvania School of Nursing.
Transitional care, short-term services that bridge gaps between hospital and home, focuses on identifying and addressing patients' and family caregivers' goals as well as needs for education and support, such as access to community services, to prevent poor outcomes. "We have identified a number of strategies that result in short term benefits and a few that effectively reduce all-cause hospital readmissions through six or 12 months," Naylor said.
"The good news is that available evidence provides those responsible for implementing community-based care transitions programs, accountable care organizations and other innovative delivery and payment models with a strong foundation upon which to build these programs and achieve better care and better outcomes while reducing costs" Naylor said. "If we capitalize on what we know, the real beneficiaries will be those living with complex chronic conditions and their family caregivers."
Mary Naylor and colleagues Linda Aiken, Ellen Kurtzman, Danielle Olds and Karen Hirschman published their findings in the April issue of Health Affairs. Their paper is based on Penn Nursing research sponsored by The Robert Wood Johnson Foundation's Initiative on the Future of Nursing at the Institute of Medicine.
SOURCE: University of Pennsylvania School of Nursing, June 2, 2011

Extra care should be taken to protect pets in the current hot weather, Defra's Chief Vet Nigel Gibbens said today. In a statement issued jointly with the RSPCA and British Veterinary Association, Mr Gibbens urged the public to think about the effects of hot weather on their pets and to take the right steps to ensure their welfare.
Mr Gibbens said:
"You'd think that everybody would know about the dangers of leaving animals in hot cars, but it was still happening last year when we saw some really tragic cases of dogs dying because they were trapped inside cars in high temperatures. This just shouldn't happen these days.
"As it gets hotter this summer, all pet owners need to think about how they can take simple steps to ensure their pets are happy and healthy during the warm weather."
Mr Gibbens said there were some simple guidelines pet owners should follow:
BVA President Harvey Locke said:
"Dogs should never be left in cars by themselves, even when the day is warm as opposed to hot, it can quickly become very hot inside a vehicle. Leaving the car windows open and a bowl of water is not enough. As a dog can only cool down through its tongue and paw pads, it cannot cool down quickly enough to cope with the rising heat.
"Dogs still have thick coats on when humans are walking around in t-shirts and shorts. I would like owners to remember that a dog won't stop enjoying itself because it is hot, so it is up to the owner to stop the animal before it suffers - something that is particularly important as more and more people jog or run with their dogs."
Jude Clay from the RSPCA said:
"All too often, owners make the mistake of thinking that it is sufficient to leave a bowl of water or a window open for their pet but this is not enough to protect your pet from heatstroke, which can have fatal consequences. The RSPCA's message is: 'Dogs die in hot cars. Don't leave your dog alone in a car."
The temperature inside a car in full sunlight can quickly rise to double the temperature outside the car. Signs that dogs are overheating can include faster and heavier panting, with them being more active with barking or whining. They might produce more saliva that normal, have extreme panting and dark coloured gums. A dogs eyes may become glassy and it may appear unconscious.
Detecting overheating early and treating it promptly is essential to dogs recovering successfully. Dogs should be taken to a cool shaded place, given water to drink, and sprayed with cool water. Dogs can also be cooled down by blowing cool air from a fan over them. Pet owners should get advice from a vet immediately if the dog does not respond promptly.
SOURCE: British Veterinary Association, June 3, 2011
AAA Warman Home Care is a family-owned Residential Service Agency which has been providing in-home health care services to thousands of clients for the past twenty years. Warman specializes in providing the highest quality of private duty, non-medical care and companionship for the elderly, those recuperating after hospitalization / rehabilitation, the terminally ill, disabled, alone or at-risk. It is our goal to assist our clients in living the most independent, healthy and comfortable lives in the privacy of their own homes.
If you have written or find any articles that you would like to contribute to the Warman E-Update, please contact Brenda Head at bhead@warmanhomecare.com or by telephone at (877) 694-4264. If any of your colleagues are not receiving the Warman E-Update, please send his or her e-mail address to bhead@warmanhomecare.com for inclusion.
Warman Home Care
(888) 243-6602
Licensed and Regulated by the Department of Health
and Mental Hygiene in Accordance with State Regulations
Homecare in Maryland, Northern Virginia, Pennsylvania including Philadelphia
