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What parent hasn't watched their young child in amazement as they pick up a baby doll, tenderly cradling and stroking it as though the child were mimicking the way their own parent held them? As quintessential as these toys are for young children, research has found that baby dolls are also effective tools in soothing geriatric patients.
At Geisinger Medical Center (GMC), nearly 40 percent of the patient population is considered to be geriatric age 65 or older. These older patients often come to the hospital with complex medical conditions, a long list of medications, and functional and cognitive limitations. They may also struggle with dementia or episodes of delirium upon hospitalization.
To better care for their geriatric patients, GMC nurses affiliated with Nurses Improving Care for Healthsystem Elders (NICHE), a national geriatric initiative to improve the care of older hospitalized adults, began to research the use of alternative treatment methods, namely baby doll therapy.
According to GMC nurses Tami Underhill, R.N., BSN, and Sarah Evans, R.N., this mode of therapy involves the simple act of offering a doll to a patient in need of soothing. The approach may seem fluffy to some, but it works wonders with their patients, according to Underhill.
"It is an effective therapy for improving dementia patients' quality of life," Underhill said. "It is also one of the easier therapies, if not the easiest, to administer."
Research has found that geriatric patients, particularly patients who suffer from dementia, tend to be more active and more focused when they are carrying or handling baby dolls. It also enhances communication, focus, attitude toward other patients and caretakers, while reducing agitation during routine care when they would typically become angry or difficult.
According to a recent study at a United Kingdom university, dolls have healing effects on individuals with dementia, and the Alzheimer's Association reports that this method has become widely used in hospitals, nursing homes and patient homes, as well as during hospice care.
At a nursing facility in Phoenix, Ariz., one nursing supervisor initially objected to a similar therapy, but quickly changed her opinion after seeing how calm a patient became when she rocked, caressed and fed her "baby."
"Not only do we want our patients to be healthy, but we want them to be happy," Underhill said. "The dolls are just a simple means to that end."
The baby doll therapy is just the first of a series of initiatives that will be part of GMC's alternative therapy program. Other tactics coming soon to GMC are the use of age-appropriate music a little Glenn Miller, perhaps? Puzzles, games and playing cards, all of which will be delivered to in-patients units when the need arises.
Underhill and Evans anticipate seeing patients who are more at ease, with minds occupied by activities they find pleasurable.
"Our overall goal is to improve the care of our elderly patients," Underhill said. "We also hope that our nurses will be pleased to have a new array of tools they can use with their patients."
SOURCE: Geisinger Health System, April 28, 2011
With spring comes birds, bees and for some, a wheeze.
More than 24 million Americans have been diagnosed with asthma, but millions more may be at risk for the condition and not know it.
Allergists who are members of the American College of Allergy, Asthma and Immunology (ACAAI) want people to be aware of these five little-known facts about asthma:
1. Sometimes the signs are subtle: Do you cough at night? Get winded while walking up stairs? These can be symptoms of asthma. "The lungs of a person who has asthma are inflamed all the time," said allergist Dr. John Winder, chair of the ACAAI Nationwide Asthma Screening Program. "When a trigger makes the inflammation worse, that's what people think of as an asthma 'attack.' But symptoms are not always like that. You can have asthma and not even know it."
2. Stormy weather can spark trouble: Studies show an increase in asthma-related emergency room visits after a thunderstorm. No one knows the exact reason, but the rupture of pollen grains due to the storm and the wind spreading these grains are thought to be culprits. Allergists advise those with asthma stay inside after a storm.
3. Pollen can be powerful: Many of those with asthma find their symptoms are triggered by allergies. Tree pollen is a common spring allergen, and various parts of the country have seen record-setting levels this year. "It's a good idea to find out if allergies might be triggering your asthma," said Dr. Winder. "Allergy testing can help pinpoint the cause and the right treatment which can include things you can do to avoid pollen."
4. Exercise woes: If you have trouble breathing during or after exercise, you might have Exercise-Induced Bronchoconstriction (EIB). Ten percent of Americans have EIB even though they don't have asthma. Allergists can prescribe inhalers to use before and during exercise. They also recommend sports like swimming, walking, baseball and short track and field events which are likely to cause fewer problems for people with EIB.
5. No age limits: Although it's more common in children, asthma can strike at any age. "The bottom line is that if you are having any trouble breathing, get it checked out," said Dr. Winder. "Testing for asthma is quick and painless."
SOURCE: American College of Allergy, Asthma and Immunology, May 6, 2011
According to a new study, being overweight or obese during middle age may increase the risk of certain dementias. The research is published in the May 3, 2011, print issue of Neurology®, the medical journal of the American Academy of Neurology.
"Currently, 1.6 billion adults are overweight or obese worldwide and over 50 percent of adults in the United States and Europe fit into this category," said study author Weili Xu, MD, PhD, with the Karolinska Institutet in Stockholm, Sweden. "Our results contribute to the growing evidence that controlling body weight or losing weight in middle age could reduce your risk of dementia."
Researchers studied information from the Swedish Twin Registry on 8,534 twins age 65 or older. Of those, 350 were diagnosed with dementia and 114 had possible dementia. Information on participant's height and weight had been taken 30 years earlier.
Participants were grouped according to their body mass index (BMI), a measure of total body fat: underweight, normal weight, overweight and obese. Being overweight was defined as having a body mass index between 25 and 30 and obesity was defined as a body mass index of higher than 30. In the study, 2,541 twins, or nearly 30 percent, were either overweight or obese during middle age.
The study found that people who were overweight or obese at midlife had an 80 percent higher risk of developing dementia, Alzheimer's disease or vascular dementia in late life compared to people with normal BMI. The results remained the same after considering other factors, such as education, diabetes and vascular disease. A total of 26 percent of those with no dementia had been overweight in midlife, compared to 36 percent of those with questionable dementia and 39 percent of those with diagnosed dementia. Three percent of those with no dementia had been obese in midlife, compared to five percent of those with questionable dementia and seven percent of those with diagnosed dementia.
The researchers also analyzed the data in twin pairs where one twin had dementia and one twin did not and found that there was no longer a significant relationship between overweight and obesity and dementia in midlife. "This suggests that early life environmental factors and genetic factors may contribute to the link between midlife overweight and dementia," Xu said.
SOURCE: American Academy of Neurology, May 3, 2011
Watch out for ticks! The Tick is a cartoon, a square-jawed, muscular, bright blue-costumed figure with antennae sticking up from his head, but we are actually talking about the bugs which happen to be the leading cause of lyme disease (LD). LD is a real thing and this month happens to be LD Awareness Month. LD manifests itself as a multisystem inflammatory disease that affects the skin in its early, localized stage, and spreads to the joints, nervous system and, to a lesser extent, other organ systems in its later, disseminated stages. If diagnosed and treated early with antibiotics, LD is almost always readily cured.
The prevalence of LD in the northeast and upper mid-west is due to the presence of large numbers of the deer tick's preferred hosts, white-footed mice and deer, and their proximity to humans. White-footed mice serve as the principal carriers on which many larval and juvenile ticks feed and become infected with the LD spirochete. An infected tick can then transmit infection the next time it feeds on another host, namely...you.
So how can you battle ticks this summer?
Generally, LD in its later stages can also be treated effectively, but because the rate of disease progression and individual response to treatment varies from one patient to the next, some patients may have symptoms that linger for months or even years following treatment. In rare instances, LD causes permanent damage.
Although LD is now the most common arthropod-borne illness in the U.S. (more than 150,000 cases have been reported to the Centers for Disease Control and Prevention [CDC] since 1982), its diagnosis and treatment can be challenging for clinicians due to its diverse manifestations and the limitations of currently available serological (blood) tests.
New tick-borne diseases continue to be discovered. For example, anaplasmosis (Human Granulocytic Ehrlichiosis) was first described in 1994; a Lyme disease-like illness has recently been reported in Missouri that does not test positive on standard Lyme disease serologic tests and is thought to be transmitted by the Lone Star tick; and an encephalitis-like virus was discovered in 1997 in several deer ticks (Ixodes scapularis) in New England. Some researchers suspect that there are even more tick-borne diseases that are still unidentified.
The exponential increase in deer numbers throughout the United States from an estimated 500,000 in 1900 to 30,000,000 today has greatly increased the number of deer ticks throughout the country. Increased outdoor recreation, extended forest cover (especially in the Northeast), reduced hunting in some areas and continued suburban sprawl are some of the factors involved in the rise in reported cases of Lyme disease and other tick-borne infections in humans throughout the United States.
SOURCE: The American Lyme Disease Foundation, May 9, 2011
In the largest study of its kind to establish a link between sleep and diabetes, researchers found that people with diabetes who sleep poorly have higher insulin resistance, and a harder time controlling the disease.
The findings, published in the June issue of Diabetes Care, suggest that poor sleep may contribute to worse outcomes in people with diabetes.
"Poor sleep quality in people with diabetes was associated with worse control of their blood glucose levels," said Kristen Knutson, PhD, assistant professor of medicine and lead author of the study. " People who have a hard time controlling their blood glucose levels have a greater risk of complications. They have a reduced quality of life. And, they have a reduced life expectancy."
People with diabetes generally have poorer sleep than the general population, and poor sleep has been proposed as a risk factor for developing the disease. Sleep disorders, such as obstructive sleep apnea, are more prevalent in people with type 2 diabetes, Knutson said.
For the study, researchers monitored the sleep of 40 people with diabetes for six nights. The subjects also reported if they generally suffered from symptoms of sleep disturbances like insomnia, snoring or sleep apnea. At clinical examinations, they gave blood samples to allow researchers to measure insulin and glucose levels.
The subjects wore activity monitors on their wrists at night, which measure their wrist movements throughout the night. Poor sleep, or insomnia, was determined by both poor sleep quality based on the activity monitors and the subject telling the researchers that they often had a hard time falling asleep or woke up during the night.
Among the diabetics, poor sleepers had 23% higher blood glucose levels in the morning, and 48% higher blood insulin levels. Using these numbers to estimate a person's insulin resistance, the researchers found that poor sleepers with diabetes had 82% higher insulin resistance than normal sleepers with diabetes.
Knutson said the next step for researchers is to see if treating poor sleep can improve long-term outcomes and quality of life for diabetics. "For someone who already has diabetes, adding a sleep treatment intervention, whether it's treating sleep apnea or treating insomnia, may be an additional help for them to control their disease," Knutson said.
In fact, restoring a healthy amount of sleep may be as powerful an intervention as the drugs currently used to treat type 2 diabetes. "This suggests that improving sleep quality in diabetics would have a similar beneficial effect as the most commonly used anti-diabetes drugs," said Eve Van Cauter, PhD, professor of medicine and co-author of the study.
Further investigation into which leads to the other the chronic poor sleep or chronic insulin resistance could improve the quality of life for people with type 2 diabetes. "Anything that we can do to help people improve their ability to control their glucose will help their lives in the long run," Knutson said.
The data was collected as part of the CARDIA study, an ongoing longitudinal study of the heart health. It has tracked thousands of people for over 20 years.
The study, "Cross-sectional associations between measure of sleep and markers of glucose metabolism among persons with and without diabetes" was published online March 16, 2011, in the journal Diabetes Care and is freely available. In addition to Drs. Knutson and Van Cauter, authors include Phyllis Zee and Kiang Liu at Northwestern University, and Diane Lauderdale at the University of Chicago Department of Health Studies.
SOURCE: University of Chicago Medical Center, May 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.
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