What is “Polypharmacy”?

Written by: Jessica Moreau RN

Polypharmacy, defined as the simultaneous use of medications to treat the same ailment, is plaguing our older adult population. It is estimated that 30-40% of seniors take 5 or more medications. When it comes to complex illnesses, such as cancer, heart disease and hypertension, it is common that multiple medications are used to manage symptoms.

A contributing factor to polypharmacy is that patients are often seeing multiple physicans, such as visiting their primary physician, specialists and occasionally a physician in urgent care or the emergency department.

One of the main risks of polypharmacy is drug to drug interactions. If an adverse effect occurs, it can be very difficult to figure out which of the many drugs is the cause, and the correct treatment for the adverse effect. Harmful effects of taking multiple medicines can include:

  • Falls and fractures (due to dizziness/grogginess)
  • Memory problems
  • Hospitalization
  • Higher risk of death

Multiple medications increase the risks of inappropriate medication use, non-adherence, and adverse effects. Another unwanted effect could be that physicians may hesitate to prescribe a new essential medication to a patient already on five or more. Thus, ironically, polypharmacy can lead to under-treatment. Regular medication reviews should happen to ensure that a patient is only taking what is needed. Here are some helpful questions to ask a doctor or pharmacist:

  • Do I still need to take all of my medicines?
  • Are all my medicines still helping me to stay well?
  • Could any of my medicines be causing ________?
  • Could any of my medicines be affecting the others?
  • Is there anything I can stop taking safely?

Deprescribing is what occurs when a medical professional reviews the medication list of a patient and begins discontinuing medications. It involves patients, their family and/or caregiver, doctors and pharmacists who together:

  1. Review all medicines a person is taking and why
  2. Identify how likely each medicine will cause problems
  3. Identify if each medicine is still right for the person or could be stopped
  4. If medicines can be stopped, prioritize which should be stopped first
  5. Agree on a management plan
  6. Stop medicines carefully, one by one
  7. Meet frequently to see if the plan works or the patient is experiencing problems.

Polypharmacy puts seniors living alone at risk for various problems, but knowing your medications and consulting with your health care team is paramount to keeping yourself or your loved ones safe.

About the author:
Jessica is a Registered Nurse Psychotherapist and Intake Specialist at Freiheit Care Inc. She has been with Freiheit Care Inc since its inception. She has experience in community nursing and palliative care. Jess sees customers for psychotherapy sessions & initial intake assessments.

Cooking for One

Written by: Jessica Moreau RN

If you live with a partner, friends or family, chances are good that you have an idea of what will be on the table at every meal. Couples and families have multiple helpers for meal planning, grocery shopping, cooking and clean-up. Meal time is also family time, which provides added motivation to create healthy, enjoyable meals. But what about people who live alone?

Too often, healthy eating or smarter choices can seem troublesome for people on their own – especially if they don’t have much experience with meal planning and preparation. Health problems and disabilities can make these tasks even more difficult.

Unfortunately, this is the situation facing many older adults, many of whom are on their own for the first time in years. It’s not uncommon for seniors to eat poorly.

Planning healthy meals for one

Eating well when eating alone takes effort, but with planning and practice, it can become a daily routine. Consulting with the new Canada Food Guide can be a great starting point to get some ideas. Its advice includes: have plenty of vegetables and fruits; choose whole grain foods; cook more often; limit foods high in sodium, sugars or saturated fat; make water your drink of choice; and read food labels.

If you have specific health concerns, such as weight management or diabetes, talk to your physician or a dietitian. If oral health problems are making it difficult for you to eat properly, see a dentist as soon as you can.

Trying new recipes is an enjoyable way to add variety and nutrition to your lifestyle. Look for cookbooks and cooking magazines at your local library, or go online. Be mindful that what you choose fits within your diet and is healthy.

More ways to improve eating habits

Healthy meals start with healthy ingredients. You can stretch your grocery dollars by buying fruits and veggies that are in season, or frozen. Buy in bulk the items you use frequently. Check store labels for unit pricing to compare costs and ensure you’re getting the best value. Shopping at Costco may give you better value for your dollar.

Explore what resources are available in your community. For example, does your local seniors’ centre or community centre offer workshops about meal planning or cooking? Does your community have a meal delivery service for seniors? Would friends or neighbours join you for monthly potluck dinners? Eating with others offers opportunities to socialize and to share foods from different cultures. It also encourages people to eat more slowly and enjoy their meals, rather than seeing food as fuel.

Plan your meals. You are more likely to eat well when you know exactly what is required of you for the meal. How long will it take? What ingredients do you already have, and what do you need to buy? There is nothing more frustrating than making a meal but realizing you don’t have the right stuff. It can be easy to resort to easier, less time consuming meals if you aren’t prepared.

About the author:
Jessica is a Registered Nurse Psychotherapist and Intake Specialist at Freiheit Care Inc. She has been with Freiheit Care Inc since its inception. She has experience in community nursing and palliative care. She sees customers for psychotherapy sessions & initial intake assessments.

Sun Safety for Seniors

Written by: Jessica Moreau RN

As we age, our skin changes. Our skin becomes more susceptible to damage from the harmful UV rays from the sun. The skin will begin to lose its turgor and wrinkles emerge. Individuals with thinner skin are more likely to develop sun-related skin problems, such as irritations, sun spots, and in some cases, benign or malignant skin lesions.

It’s important for seniors to get out and enjoy the sun, but they need to exercise extra caution when it comes to sun exposure. So how can seniors keep their skin safe while soaking up the Vitamin D?

HOW SENIORS CAN ENJOY THE SUN WHILE STAYING SAFE

Stay hydrated

When you’re in the sun, it can be easy to get dehydrated. In fact, you might not even notice you’re thirsty until you’re already dehydrated. Make sure to always have water on hand when you’re outside or in the car. You don’t have to drink it all at once – just be sure to sip throughout the day. If you tend to sweat more, consider an electrolyte replacement drinks (with salt and potassium) to replenish your sweat. Be mindful of the sugar content, however!

Cover up

If your skin isn’t exposed to the sun, it won’t burn. Covering up also provides protection from the harmful UV rays. Look for fabrics that will help to block the sun and keep you cool. Just make sure you’re dressed to handle the heat, but still keep your skin safe. You don’t want to be too hot, so it’s a good idea to dress in layers. If you don’t already, consider wearing a hat whenever you’re out in the sun; it will help protect your scalp and face from sunburns.

Use sunscreen

It’s easy to forget to put on sunscreen before you go out, but it’s a vital step in keeping your skin safe from skin cancer. Make it a habit to apply sunscreen whenever you step outside, even if it’s just for a short time. It’s also a good idea to carry it with you in your bag, so you can reapply if you’ve been out for a while. When you choose a sunscreen, SPF 30 rating is the minimum you should use, especially for prolonged exposure. If you are worried about chemicals in sunscreens, look for natural formulas. Here are some recommended ones!

Protect your eyes

Sunglasses are another important part of sun protection! The eyes can be extra sensitive for many seniors, especially those with vision problems. Wearing sunglasses can help shield your eyes from damaging rays. Make sure you choose sunglasses with 100% UV protection, or UV 400 rating, as these are the types of lenses that will actually protect your eyes from the damaging rays of the sun. If you wear prescription glasses, chat with your optometrist to see if you would benefit from prescription sun glasses – pun intended.

Keep cool

It’s easy for seniors to get overheated on hot days. Try to find a shady spot to sit when you’re outside and stay out of direct sunlight. On extra hot days, try to limit your time outside and take breaks indoors when you can. You can also try to stay out of the sun during the peak hours of 10am to 4pm when penetration of harmful rays is at its highest. If your home doesn’t have central air, consider investing in a portable air conditioner unit, or purchase some fans. It is easy to become overheated indoors when it is 30 degrees Celsius or higher outside.

Look for skin changes

Just one bad sunburn early in life can potentially double the risk of skin cancer as a senior. This is why it’s especially important to watch for changes in the skin for seniors. If you notice any changes, tell your doctor right away. What should you look for? A handy way to remember it is to look for the ABCDEs: look for moles that are Asymmetrical, have irregular Borders, have a strange Colour, have a Diameter larger than a pencil eraser, or that have Evolved or changed in any way. If you are unsure about a spot on your skin, make sure you contact your GP or dermatologist so they can have a look!

In the mean time, cover up, stay cool and wear the sunscreen! Enjoy the sunny weather.

About the author:
Jessica is a Registered Nurse Psychotherapist and Intake Specialist at Freiheit Care Inc. She has been with Freiheit Care Inc since its inception. She has experience in community nursing and palliative care. Jess sees customers for psychotherapy sessions & initial intake assessments.

Glossary of Home Care Terms

Written by: Jessica Moreau RN

It is a known fact that medical terminology can be a bit daunting, especially so to the untrained eye. Terms such as “respite care”, “palliative care” and “gerontology” can be intimidating if you’re seeing them for the first time and aren’t clear on their meaning. We at Freiheit Care Inc have compiled a list of terms that are often misunderstood or are unknown, which we hope will simplify an already challenging time.

Glossary of Teams

Activities of Daily Living (ADL): things that happen every day and are part of personal care, such as bathing, dressing, hair care, nail care, brushing teeth, etc. Our companions and personal support workers are trained to assist or supervise our customers with personal care.

Family Caregivers: a family member or loved one of a senior who provides care to them in the home. In Canada, there are upwards of 8 million caregivers providing care to family members. Family caregivers are especially susceptible to caregiver guilt and burnout.

Gerontology: the study of social, cultural, psychological, cognitive and biological aspects of aging.

Palliative Care: there is a tainted reputation surrounding “palliative care” and what it means. Palliative care has coined the nickname “end of life care” over time, and while this is true in some cases, even those who are not approaching the immediate end of life can receive palliative care. “Palliative care” is a blanket term used to describe comfort measures and symptom management of disease. This includes (but is not limited to): pain management, symptom management (such as oxygen therapy), psychosocial support and caregiver support.

Professional Caregivers: professional caregivers are trained and certified individuals who will enter the home to provide care. Freiheit Care employs three classifications of professional caregivers:

Personal Support Workers: assist in the home with tasks such as hygiene, meal preparation, light housekeeping.

Registered Practical Nurse & Registered Nurse: administer treatments in the home, such as medications, wound care, foot care.

Respite Care: often offered temporarily in the home, respite care can provide family caregivers with a much needed break from the caregiving process. Our trained professional caregivers are available 24/7 to provide relief to you and your loved ones.

These are only a few of the common terms used in home care. At Freiheit Care, we are happy to help explain what our services and definitions are. We don’t want there to be any confusion, because the longer you spend trying to figure things out, the less you will be free to live your life to its fullest. So, call us today and we’d be happy to define any terminology for you that is unfamiliar or seems daunting! Just another way we help you to be free to live.

About the author:
Jessica is a Registered Nurse Psychotherapist and Intake Specialist at Freiheit Care Inc. She has been with Freiheit Care Inc since its inception. She has experience in community nursing and palliative care. She sees customers for psychotherapy sessions & initial intake assessments.