In-Home Care: Cerebral Palsy

Posted in Articles, In-home Care: Diseases and Conditions on January 31st, 2012 | Comments Off

What is Cerebral Palsy?

Cerebral Palsy is a disorder of the central nervous system. Cerebral Palsy is characterized as a group of disorders affecting one’s ability to coordinate their muscle movements. This chronic condition occurs because of abnormalities in brain development. This condition affects the parts of the brain that control body movement. Cerebral Palsy can develop before birth or during the early stages of a child’s brain development. Typically, a child will be diagnosed with Cerebral Palsy before the age of 3.

Cerebral Palsy is a chronic disorder meaning the patient will most likely suffer from the condition for their entire life. This condition is non-progressive meaning it will not worsen over time. Cerebral Palsy is non-contagious and is not considered a disease.

The four most common types of Cerebral Palsy are Spastic Cerebral Palsy, Athetoid Cerebral Palsy, Ataxic Cerebral Palsy, and Mixed Cerebral Palsy. Spastic Cerebral Palsy is the most common form of Cerebral Palsy and is characterized by tightness and stiffness in the patient’s muscles. Patients with Spastic Cerebral Palsy often have difficulties relaxing their muscles. Athetoid Cerebral Palsy patients do not typically have  learning disabilities. They have a difficult time controlling their muscles and are often unable to balance. Their motions are involuntary and uncoordinated. Ataxic Cerebral Palsy is characterized by unsteady and shaky muscle movements. Patients will often experience muscle tremors and have difficulties performing precise motor tasks, such as holding a pencil or tying their shoes. Mixed Cerebral Palsy is any combination of Spastic Cerebral Palsy, Athetoid Cerebral Palsy, and Ataxic Cerebral Palsy.

At this moment, a cure for Cerebral Palsy does not exist. There are medications that will provide relief from certain symptoms, but the medications will not eliminate the condition altogether. Although there is no cure for Cerebral Palsy, there are various treatment options that will help a patient maintain their independence and live a productive and enjoyable life.

What are the symptoms of Cerebral Palsy?

  • Hearing, vision, and speech problems
  • Seizures
  • Problems swallowing, eating, digesting, and breathing
  • Dental problems
  • Incontinence, vomiting, and constipation
  • Spasticity: muscle stiffness and abnormal reflexes
  • Irregular muscle tone
  • Tremors
  • Difficulties with body movement and precise motor tasks
  • Difficulties with walking, balancing, and muscle coordination
  • Learning disabilities/ mental retardation
  • Pain

What type of care does a Cerebral Palsy patient need?

Symptoms vary from patient to patient. If the symptoms are mild, a Cerebral Palsy patient may only require help from family members and friends. When the symptoms are more severe, a live-in caregiver will become necessary. Some patients may experience all of the symptoms at once, while others may suffer from a select few. A caregiver’s duties will vary depending on the situation and the patient’s symptoms. Parkinson’s patients may require part-time care, full-time care, or round-the-clock care.

In-Home Care: Chronic Obstructive Pulmonary Disease (COPD)

Posted in Articles, In-home Care: Diseases and Conditions on January 11th, 2010 | 12,388 Comments

What is COPD?

Chronic Obstructive Pulmonary Disease (COPD) is a debilitating respiratory illness that affects 16 million Americans, making it the 4th leading cause of death in the U.S.A. The term COPD refers mainly to emphysema and chronic bronchitis. Each disease causes damage to the lungs resulting in obstructed airways. Emphysema destroys the cells that support the air sacs of the lungs, enlarging the alveoli and in turn collapsing the bronchioles. The result is permanent airflow obstruction. Chronic Bronchitis is an inflammatory illness that produces spasms, excess mucus, and difficulty breathing. Large airways of the lungs are lined with glands, which when infected become enlarged and mucus secretion is increased. Airflow becomes blocked by the secretions as well as muscle spasms caused by the inflamed bronchioles. It is referred to as Chronic Obstructive Bronchitis if airflow obstruction is present. COPD can lead to arrhythmias and smokers have a higher risk of developing lung cancer.

Around 80%-90% of COPD cases are a result of long-term smoking. The disease typically takes hold after 10 years of steady smoking, and the symptoms are hardly noticeable. By age 60 the patient’s quality of life has deteriorated significantly, and the symptoms are greatly increased. At this stage of life humans are more susceptible to illness, and as a result, 95% of COPD deaths are patients over the age of 55. Men are more likely than women to get it, as well as whites over non-whites. Blue-collar workers are more susceptible than their white-collar counterparts because they are more likely to be around harsh chemicals and airborne debris. It is not proven whether or not COPD is hereditary, but some studies show that the disease occurs more often in some families.

Unfortunately, the damage caused by emphysema is irreversible, but muscle spasms, inflammation and increased secretions could possibly be treated. There is no cure at this point in time, but since some symptoms can be controlled it is possible to maintain a balance in the patient’s health.

What are the symptoms of COPD?

  • Chronic cough
  • Chest tightness
  • Difficulty breathing
  • Shortness of breath
  • Frequent throat clearing
  • Susceptible to lung infections
  • Increased production of mucus/sputum
  • Severe weight loss
  • Possibility of coughing up blood
  • Swelling of the legs
  • Morning headaches

Symptoms could worsen, possibly leading to acute respiratory failure.

What type of care does a COPD patient need?

Symptoms will be different for each COPD patient, but it is guaranteed that they will have breathing problems, making it harder to do simple daily activities. This means they will need one or more dedicated caregivers in order to function comfortably from day-to-day. Depending on the severity of the situation, a live-in caregiver may be needed. If no one in the patient’s family can do this, then a caregiver will need to be hired.

Quitting Smoking:

The first job as caretaker may be to help the patient quit smoking. Since cigarettes are the biggest cause of COPD, it is wise to cut them out of the patient’s life altogether. There are many treatments that will facilitate this process, and it is best to use several treatments at once to get maximum results. As always, a medical professional should be involved in the decision of what medicines or treatments to take. Some examples:

  • Nicotine Replacement Therapy – gum, inhalers, tablets, patches, and nasal spray. These help reduce cravings, allowing the patient to quit
  • Antidepressant Therapy – used alone or w/ nicotine replacement therapy. Wellbutrin for example, may help quitting
  • Clonidine – used mainly to treat high blood pressure. In this case it may be helpful in treating nicotine withdrawal symptoms

There are several mood-changing practices to help quit smoking as well. The problem can potentially be treated physically (by suppressing the body’s need for nicotine) or psychologically (by reducing the need to smoke by changing behavioral patterns). Giving up this habit will be hard for the patient, so it is best to eliminate any desire to smoke. The caregiver should preferably not smoke, but if they do steps should be taken to keep any temptation away from the patient. They should not take cigarette breaks while providing care and shouldn’t smoke on the way to the job. They should always wear clean clothes that do not have the smell of cigarette smoke in the fabric.

Quitting smoking will bring about a new batch of symptoms. These can include insomnia, anxiety, poor concentration, weight gain or depression. These are common problems for the patient to be facing at this time, but should be monitored closely to see if symptoms get worse. Depression may persist well after the quitting stage, and it should be treated to avoid complications and improve the patient’s quality of life.

Comfort:

The caregiver should ensure the patient’s home environment is comfortable. The patient may wish to remain on the main floor of their house to avoid using stairs or to wear shoes without laces so they don’t have to bend over to tie them. Simply reaching for something stored in a high place may cause unnecessary strain for the patient. Because of this, any objects that are used frequently should be lowered from high shelves to allow for easier access. The caregiver should help with daily activities such as preparing food, helping the patient dress, and any chores, errands or housekeeping. When preparing food, the caregiver should make several small meals a day instead of a large lunch or dinner. Smaller meals are easier to digest, allowing the patient to use less effort. Foods that cause heartburn or gas are to be avoided, as these make it harder for a person to breathe.

Record Keeping for Medical Help:

An organized system should be established to keep things on a schedule and to keep the disease in check. The caregiver must manage medications, coordinate physician visits, maintain fluid intake (to help break down secretions), and moderate simple exercise for the patient. Consult a doctor about which exercise is appropriate for the patient’s condition to ensure they are not overworking themselves. Exercise may improve heart and lung function, so it is not something to be overlooked. Keep routine medications and doctor prescribed oxygen tanks in constant supply.

It is highly recommended that a log be kept of all things relating to the illness. Keep track of all medications taken, including what time of day they are administered and what quantity given. If any side effects are felt, these should be entered into the log and brought up at the next doctor visit. Daily assessments should be made about:

  • Breathing – the level of difficulty/coughing
  • Medications – what is being taken and when
  • Diet and activities
  • Whatever problems/complications arise

This log should also have a section where the most important phone numbers are kept. This can include doctors, hospitals, specialists or anyone else who may need to be contacted in the event of an emergency. The log should be brought to every doctor visit to ensure the proper issues are being addressed. Be sure to ask the doctor lots of questions about how to improve the current situation and what to expect in the future.

Additional Medications:

The doctor will put the COPD patient on any number of medicines or treatments they feel will help the current symptoms. This could include anything from oxygen therapy to medications that cut down on inflammation, reduce muscle spasms and help loosen and expel mucus. Flu and pneumonia shots are a necessity for COPD patients because they are more at risk of contracting these diseases. Since their lungs are not in good shape to begin with, catching either disease could prove life threatening.

Here’s a quick list of some medications/treatments the doctor may recommend:

  • Antibiotics when infection sets in: if prescribed antibiotics, don’t quit taking them if your symptoms get better. Continue to take them until the prescription has run out to avoid a relapse.
  • Bronchodilators – relax the airway wall muscles to allow you to breathe better
  • Corticosteroids: manages COPD when taken orally by improving lung function, decrease possibility of early relapse
  • Aerosol Therapy – a Nebulizer that dispenses medication as a vapor. Primarily uses bronchodilators, relieves spasms in lungs, decreases swelling, makes secretions easier to cough up
  • Pulmonary Rehabilitation: This is for serious cases for people with debilitating symptoms that affect their daily activities. This will be accomplished by a team of medical professionals who treat all aspects of the disease

In-Home Care: Multiple Sclerosis (MS)

Posted in Articles, In-home Care: Diseases and Conditions on January 11th, 2010 | Comments Off

In-Home Care: Multiple Sclerosis (MS)

What is MS?

Multiple Sclerosis is one of the most common chronic neurological diseases, inflicting damage to the central nervous system, brain and spinal cord. 400,000 people are affected nationwide, and when viewed globally is somewhere above the 2.5 million mark. It could potentially strike any person of any age, but the onset is more likely to occur between ages 20 and 50. Genetics play a role in determining who gets the disease, but it’s not known to what extent. If someone has a sibling or parent with MS, chances are significantly higher that they will contract the disease. MS is more likely to develop in people who live in colder climates, and women are twice as likely as men to be diagnosed. While studies are still being conducted, it is not certain what is the specific cause of the disease. What is known is that it is a defect within a person’s immune system.

When a person has a functional immune system, certain infection fighting cells will attack foreign bodies to prevent illness. When MS develops, these cells begin to attack healthy nerve cells in the person’s body as through they were an infection. Nerve cells work in a chain-like fashion. When a person touches something hot, the nerves send a signal that travels from one nerve to the next all the way to the brain where the information is processed and returned to the nerves with instructions on how the body should react to this particular stimulus. MS is detrimental because it breaks the connections in the nerves, resulting in “faulty wiring”. Some people compare the effects of MS to a flickering light bulb due to bad circuitry. In the case of MS, the circuitry problem occurs because the infection fighting cells destroy the fatty layer that surrounds the nerve cells, called the myelin. This layer creates a buffer between each nerve cell, allowing for signals to be transmitted throughout the nervous system. With this layer destroyed, the signals are interrupted. This nerve loss is referred to as demyelination. People who loose this type of nerve function typically experience it in many locations throughout their central nervous system. This is the “multiple” part of the disease’s title. “Sclerosis” refers to the scar tissue that blocks messages and signals between nerves and muscles. Unfortunately at this time there is no cure, so treatment focuses on remission and stopping the attacks from occurring.

What are the symptoms of MS?

  • Visual: The Optic Nerve is a common area for inflation. Haziness, blurred vision, serious visual impairment are results. Visual symptoms often lessen or disappear after a period of weeks. Blindness in MS is rare.
  • Movement: Difficulty controlling the strength and precision of movements. Holding things is a problem and balance and coordination my be impaired (ataxia)
  • Sensory problems: Numbness, tingling and sensitivity to heat and cold
  • Bladder/Bowel function: Problems with control, urinary tract infections
  • Cognition issues: May cause problems with memory loss and concentration. Mood swings ranging from depression to euphoria are common. Affects 50% of patients with MS
  • Fatigue: Mild to severe fatigue and weakness

Additionally, patients may experience tremors and slurred speech as a result of blockages.

What type of care does a MS patient need?

Symptoms are different for the varying types of the disease, therefore care practices will depend on the patient’s condition. The three most common types are:

Relapsing Remitting MS: Clearly defined flare-ups (relapses) with some amount of recovery between. Affects 80% of MS patients.

Secondary Progressive MS: Flare-ups and remissions are quite common. More continuous loss of physical and cognitive functions takes over, flare-ups become less common. 50% of people with Relapsing Remitting MS develop this within 10 yrs of diagnosis.

Primary Progressive MS: No flare-ups, but over years there is gradual loss of physical and cognitive functions. 10% of MS patients have this.

Depending on the severity of the situation, a live-in caregiver may be needed. If no one in the patient’s family can do this, then one or more caregivers will need to be hired.

For people with MS, caregivers are very important because they can notice new symptoms or recognize when existing symptoms become worse. Several medications help to reduce the symptoms of MS, so a doctor visit is in order if a relapse has occurred. The caregiver should be sure to ask the doctor which medicines are best for the patient’s symptoms. Medical treatment should begin immediately upon diagnosis because this is when the medicines will benefit the patient the most. There will probably be several doctor trips, so it is a good idea for the caregiver to keep a medical log in order to keep events, lists of medicines taken and treatments in order. This should be brought to every doctor visit to ensure that the patient’s needs are being met.

Most medicines that treat MS must be injected. This can be daunting for both caregiver and patient, so treatments should be discussed with all involved. If the caregiver is not comfortable administering an injection or the patient is squeamish about needles, these problems need to be addressed to the doctor.

In-Home Care: Alzheimer’s Disease

Posted in Articles, In-home Care: Diseases and Conditions on January 6th, 2010 | 11,686 Comments

What is Alzheimer’s disease?

Alzheimer’s disease is the most common form of dementia. It is a brain disorder that is characterized by memory loss and cognitive changes. Protein fragments called amyloid plaques and neurofibrillary tangles begin to build up in the brain causing the destruction of nerve cells. The plaques and tangles continue to accumulate and the nerve cells in the brain have a difficult time functioning efficiently and often do not survive.

The exact cause of Alzheimer’s disease is currently unknown. Alzheimer’s disease tends to affect people over the age of 65 and becomes more widespread amongst the elderly population. The most common risk for acquiring Alzheimer’s disease is aging. Alzheimer’s disease is a chronic and progressive disorder meaning it is both long-lasting and will worsen over time.

At this moment, a cure for Alzheimer’s disease does not exist. There are medications that will provide relief from certain symptoms, but the medications will not prevent the disease from worsening. Although there is no cure for Alzheimer’s disease, there are various treatment options that will better a patient’s mental and emotional state of being. Medical treatment for Alzheimer’s disease will help a patient maintain their independence for a longer duration. It is important for the patient to develop a treatment schedule with a doctor and maintain healthy eating and exercising habits. It is also valuable for an Alzheimer’s patient to participate in social interactions. Being in a healthy and positive environment will help a patient cope with the stresses of Alzheimer’s disease.

What are the symptoms of Alzheimer’s disease?

  • Memory loss
  • Language difficulties
  • Disorientation
  • Loss of muscle coordination and balance
  • Changes in mood/personality
  • Depression
  • Difficulty performing familiar tasks
  • Anxiety
  • Sleeplessness
  • Social withdrawal
  • Loss of judgment
  • Confusion
  • Problems with abstract thinking

What type of care does an Alzheimer’s patient need?

The type of care needed will depend on the stage of the disease. Because the disease is progressive, there are more complications as the disease matures. As the disease develops and symptoms worsen, more care will be needed. A caregiver’s duties will vary depending on the situation. Alzheimer’s patients may require part-time care, full-time care, or round-the-clock care.

Symptoms vary from patient to patient. If the symptoms are mild, an Alzheimer’s patient may only require help from family members and friends. When the symptoms are more severe, a live-in caregiver will become necessary. Some patients may experience all of the symptoms at once, while others may suffer from a select few. The rate at which symptoms worsen also differs depending on the patient’s situation. One patient may find that their ability to remember things gets worse every day, while another patient may not experience extreme cognitive changes for many years.

Early Stage:

It is often difficult to determine whether a person has developed Alzheimer’s disease or if they are simply experiencing normal characteristics of the aging process. It is normal for the elderly to occasionally forget what day of the week it is or what time it is, but when the forgetfulness occurs on a regular basis, it may be a symptom of early stage Alzheimer’s disease. It is common for elders to have a hard time recalling memories from the distant past, but Alzheimer’s patients typically lose their short-term memory as well as their long-term memory. Alzheimer’s patients often have difficulties remembering the names of new friends or recalling what happened earlier during the same day.

Often times, Alzheimer’s patients will forget how to do things that they are normally used to doing. They may have difficulties managing their checkbooks, paying bills, or following directions. It is common for elders to forget where they placed their car keys or a recipe, but Alzheimer’s patients will place their keys in strange locations and forget how to follow recipes all together. Those who suffer from Alzheimer’s will often forget having complete conversations and have a hard time recalling events that have taken place recently.

Alzheimer’s patients will begin to experience personality changes. An early sign of Alzheimer’s disease is when a person begins to withdraw from social situations and interactions. Patients become uninterested in things that would otherwise interest them. It is common for Alzheimer’s patients to experience mood swings, feel depressed, or become irritable. Increased restlessness and irritability tend to occur during the later hours of the day. Sundowning is a term used to characterize the evening mood swings that Alzheimer’s patients experience.

If family members and friends are around to help care for the Alzheimer’s patient, hiring a caregiver may not be absolutely necessary. Part-time care will be needed if there is not anyone living nearby to help out. As the disease progresses, however, more care will be needed.
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Middle Stage:

During the middle stage of Alzheimer’s disease, a patient will acquire new symptoms in addition to the symptoms acquired in the earlier stage. A patient’s symptoms in the earlier stage will worsen in the middle stage. Patients will become more confused as to what the time it is, what day it is, where things are, and how to complete routine activities. A patient’s short-term memory will diminish as well as their long-term memory. Mood swings will become more intense. Changes in personality become extreme and patients will often experience intense depression and apathy. It will be difficult to determine how the patient is feeling because their emotions become more and more unpredictable.

Patients will also begin to experience difficulties with communication and language. They will often have problems with reading, writing, finding the right words as they speak, and understanding things that people say.

In earlier stages of Alzheimer’s, patients tend to only experience cognitive disruptions. In the middle stages, however, patients begin to feel physical changes. Patients experience difficulties with mobility and begin to lose their muscle coordination. The simple tasks of daily living become strenuous on the patient’s body.

During the middle stage of Alzheimer’s, a patient’s safety is often put at risk. Patients begin to wander away from their homes and have difficulties finding their way back. Patients forget necessary safety techniques, such as calling 911 or staying out of busy streets. Getting lost is common for patients in this stage of Alzheimer’s, so it is important that someone else is always around to ensure their safety.

Full-time or round-the-clock care will be needed during this stage of the disease. If family members or friends are not around to help, the patient will require round-the-clock care. Often times, patients in the middle stages of Alzheimer’s disease will be placed in a nursing facility.

One of the most important things to remember when caring for a person with Alzheimer’s disease is to make sure they have a consistent daily schedule. Patients often become stressed when they have difficulties remembering familiar things. Creating a daily routine will reassure the patient and relieve some of the confusion and stress. The more a patient is surrounded by familiar environments and situations, the better they will be able to cope with their disease.

It is important that caregivers establish a way to communicate effectively with the patient. Caregivers must be patient and expect that communicating with an Alzheimer’s patient will be a difficult task. Caregivers should acknowledge a patient’s request and find a way to accommodate to their needs. Caregivers should try to maintain a positive attitude; this will prove beneficial for both the caregiver and the patient.

Caregivers must expect that an Alzheimer’s patient will forget things. The patient’s safety is often jeopardized because of this, so it is important that family members, friends, or caregivers pay close attention to safety hazards. For example, patients may forget how to lock their door, turn off the stove, or escape a fire. Having someone constantly around is essential for the patient’s safety. Caregivers, family members, and friends should make sure the patient’s house is as safe as possible. Patients should be surrounded by a safe, loving, and familiar environment.

Late Stage:

Patients suffering from Alzheimer’s disease do not typically survive beyond the middle stage. The late stage is often characterized as the “end-stage” of the disease. Cognitive functions and physical capabilities deteriorate. Patients will no longer be able to recognize people, places, or things. Their memory loss becomes so extreme that they will not recognize their family members or even themselves. Patients will be unable to communicate properly. They will often confuse the past with the present. They will no longer be able to function physically. Patients will experience difficulties swallowing, eating, and breathing. They will experience incontinence and will suffer from dramatic weight loss.

Patients will be unable to care for themselves. They will need round-the-clock care and are typically cared for in a nursing facility. Patients in this stage should be treated with much compassion. It is important that the caregiver allows the patient to enjoy the rest of their life as much as possible.