Communicating despite COVID-19 restrictions

Physical distancing in the time of COVID-19 disease is making alternative means of communication even more important, especially for senior living residents.

At The Lutheran Home at Topton, a Diakon Senior Living Community in Berks County, Pennsylvania, we are now making approximately 80 FaceTime or Skype calls every week.

Those calls can be challenging, however, when a loved one has hearing impairments or a cognitive issue, so here are some tips to try when making a “virtual visit”:

Make the call brief, and expect to do most of the talking yourself. Share with the loved one what you are doing or seeing where you are. Reassure the person that his or her extended family is doing okay.

Remember that sound coming from a computer or mobile device might be more difficult to hear. Be prepared with some homemade signs in large print to say the important stuff: “We love you.” “We miss you.” And “I will visit you as soon as I can.”

Many people with cognitive illness have difficulty grasping the concept of video conferencing. They may see the screen as a photograph or television and not realize they can have a conversation. It may help to have a person sitting near your loved one talk back and forth a few times as a model, so that the loved one can see how it works.

An effective way to answer the question “Why aren’t you visiting me?” is by connecting to a long-ago memory. Many older folks can recall the time when measles or polio was in full swing. “Remember when you had the measles and everyone had to stay in the house and no one could visit? Right now there’s a virus going around, and we all have to stay in our houses and are not allowed to visit.”

When in doubt, mention governmental guidelines. Adults from the Greatest Generation respect and honor our national leaders. “Right now, the president, the governor and other leaders say we all have to stay put right where we are. When they say it’s okay to visit, then we will come to see you in person. For now, we can only see each other this way.”

Above all, stay positive and upbeat. As Debra Gogno, the executive director of The Lutheran Home at Topton, frequently reminds us: “Every storm runs out of rain eventually.”

—The Rev. Dr. Colleen G. Kristula
Chaplain, The Lutheran Home at Topton

Insights on fad diets

From keto to gluten-free to vegan and more, fad diet options abound. But are these eating plans a healthy choice for older adults?

And the question has become especially important, as more people eat in and cook at home as they shelter-in-place related to the current pandemic from the SARS-CoV-2 virus.

Two registered dietitians with Morrison Community Living, Diakon’s culinary services partner, Samantha Griffith, RD, LDN, the nutrition care manager at Ohesson in Lewistown, Pennsylvania, and Connor Forlini, MS, RDN, LDN, nutrition care manager at Cumberland Crossings near Carlisle, Pennsylvania, provide insights. As in most cases, if you have specific questions about your own diet, please consult your health-care professional.

One common theme among many fad diets is that something must be eliminated for the diet to be successful: cut carbs or eliminate wheat or eat virtually no fats.

“That’s the first red flag,” says Griffith. “As dietitians, we promote the idea that everything is okay in moderation. People don’t like to hear that, though. They think it’s easier to cut just one thing and magically lose weight.”

Take the ketogenic, or “keto,” diet, for example. According to Griffith, the diet calls for reducing carbs so drastically that you are tricking your body into starvation mode and producing ketones from fat to create energy.

“The problem is that it’s awful for your metabolism; you start to feel fatigued and it’s just not sustainable for the long-term,” she says.

Or the gluten-free diet. Unless you have celiac disease, Griffith says, there’s no advantage to cutting out gluten.

“Gluten is a protein in wheat, rye and barley with no caloric value,” she says. “If you can’t tolerate it, gluten can create serious digestive issues. But a lot of people follow the diet and cut out grains. If you do that, you cut out an important source of B vitamins, fiber and other nutrients. Grains also often are fortified with iron, which a lot of older adults struggle to get enough of. Getting iron from dietary sources, including fortified grains, helps you avoid taking iron pills.”

Griffith’s advice is to instead modify your diet to reduce your carbs overall, but not completely. Not all carbs are bad.

Forlini adds that carbs are often misunderstood. Older adults may just need more education on them, he says.

“Your doctor may tell you to limit your carb intake,” he says. “That really means empty carbs, like sugar. And it doesn’t mean you can’t ever have a sweet dessert. Just have a smaller piece,” although that advice may vary for people with diabetes, who should follow physician recommendations on carb-intake.

Because many older adults deal with health issues such as heart disease and high blood pressure, Forlini notes that culinary services at Diakon vary menus, with less red meat and meatless options. Most foods are prepared in-house from scratch, he explains, and use low-sodium products or are made only with naturally occurring salt and no added sodium.

“We learn about residents’ diet history, their medical history, what foods and drinks they like,” he says. “We don’t tell them they can’t have this or that food. We always offer alternatives.”

Griffith and Forlini agree that fad diets aren’t the answer if you’re trying to eat healthier. Here are five suggestions they make for greater success:

Forget the word “diet.” Think lifestyle changes, Griffith says. “You are changing habits versus cutting things out.”

Make small changes, gradually. You are more likely to stick with the diet than if you overhaul your entire way of eating all at once.

Don’t cut out complete food groups. If you’ve read that fruits are high in sugar, that doesn’t mean you stop eating them altogether. “Many fruits are good sources of minerals, fiber and anti-oxidants,” Forlini says.

Have pizza or a slice of your friend’s birthday cake—just don’t do it every day and pay attention to the carb count if you are diabetic. Good nutrition is not made or broken in one day, Griffith says. “I call those kinds of food good for the soul; we all need those.”

Think of the foods you eat as helping you fight disease. “The American health-care system is more reactive, treating people after they get sick,” Forlini says. “Dietitians and nutritionists are “pro-active,” using food to prevent or reduce the disease state.”

If you’re looking for a tried-and-true approach to healthy eating, Griffith and Forlini recommend the Mediterranean food plan. It focuses on eating smaller portions of meat, more seafood, plenty of vegetables, healthy fats and whole grains.

A promise amidst the “panxiety”

Corona virus.

COVID-19.

Pandemic.

We take all necessary precautions. Buy the items we need. Practice self-isolation and social distancing.

We’ve done all we can. Or have we?

We all seem to have a list of things about which we’re anxious. Pandemic leads to what I might call “panxiety.”

It’s everywhere. We all see it, experience it, feel it. Yet in the midst of panxiety also comes a recollection, a feeling, a memory, a belief, of promise.

And for me, St. Paul’s words from Romans provided that promise: “For I am convinced that neither death, nor life, nor angels, nor rulers, nor things present, nor things to come, nor powers, nor height, nor depth, nor anything else in all creation, will separate us from the love of God in Christ Jesus, our Lord” (Romans 8:38-39).

Nothing can separate us from God’s love.

Not pandemic.

Not panxiety.

By Rev. Mark A. Wimmer, MBA

Vice President, Church Relations and Community Partnerships

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Care that makes you feel at home

In my new role, I am now associated with a number of Diakon senior living communities and if there is one consistent factor I see, it’s the fact that our staff members recognize that no two people are alike.

That means we have to develop specialized care and an individualized approach to meet each person’s needs and preferences. Our goal always is to provide care in just the manner you or your loved one prefers.

In fact, that’s the secret to successful long-term care: Making our residents, their families and our staff teams feel part of a family.

The attributes of this type of care also offer a guide for you as you consider a long-term care community:

• Warm-hearted care. The care team should offer 24-hour nursing support in an inviting, welcoming environment. They should always listen to you and your loved one’s concerns, needs and desires to provide the most personalized service.

A resident-focused approach. No matter what your loved one’s needs are, staff members should strive to provide choice, purpose and meaning in life each day. By keeping you and your loved one at the center of care planning and involving you in the decision-making process, care-team members not only build relationships, but also create a plan that meets individual needs and preferences. Whether you have a concern, idea or simply want to talk, staff should listen to you, allowing them to better serve your loved one while adapting to changing needs. 

You can read more important attributes to look for by clicking here.

Recognizing and treating anxiety in children

A 16-year-old client of Diakon Family Life Services experienced persistent symptoms of anxiety, including difficulties in sleeping and excessive worry about school and interactions at school. Before long, he was using drugs to cope with the situation.

Through work with a Diakon Family Life Services therapist, the young man was able to learn new ways to reduce his stress and, in turn, was able to conquer his anxiety. Skills he learned included deep breathing to assist with anxiety-reduction, positive self-talk, how to “work” with pressure instead of against it and agenda-creation to manage school work. That step helped to reduce stress associated with homework and related projects.

And, of course, he is not alone.

A 13-year-old girl requested counseling services for high anxiety and an inability to concentrate in school. After four months of therapy, however, she reports her anxiety to be at an all-time low. She can now engage in more social activities without anxiety, increasing her number of friends and gaining renewed interest in artistic endeavors. She benefitted significantly from talking through her anxiety, learning thought-stopping techniques, and engaging in calming skills such as mindfulness.

Do you have a child or teen about whom you are concerned? If so, Diakon Family Life Services staff members answer the following questions they often hear from parents and guardians. Of course, no article such as this is a substitute for professional therapy and if you believe your child might benefit from that, we urge you to contact us or another therapist for guidance.

Q. What is a common trigger for stress that most parents are surprised their child or teen is experiencing?

A. Unfortunately, parents are often surprised by how much their own stress affects the level of stress their child is experiencing. Plus, children and adolescents are often struggling to manage their own stress, which just becomes compounded by stress within the family itself. In fact, many parents are unaware how much their children worry about adult matters that they hear their parents discuss. Among key factors causing stress for young people are relationship issues, things they see in social media or on the internet, bullying, parental friction, school and peer relationships, parental expectations and the concerns and stresses friends are experiencing.

Q. What behaviors should parents or caregivers watch for to determine if children are struggling with anxiety?

A. There are a number of behavioral changes for which parents should stay alert. Among them are:

• Being nervous, appearing worried, easily distracted; withdrawing from family and friends

• A tendency to isolate, avoid, be panicked or secretive; hesitant about social interactions; paranoid about life events

• Angry or easily irritated

• Changes in sleep patterns such as falling or staying asleep or unexpected mood swings, such as crying

• Cell-phone attachment

• Avoidance of certain activities, appearing stressed

• Gastrointestinal issues

• Restrictive or over-eating; hair-pulling and self-harm (in extreme cases)

• Reports of physical symptoms such as headache or stomachache

• Not wanting to attend school

• Excessive video-game use, drug or alcohol use

• Not spending as much time with friends as usual

• Lack of motivation

Q. What can parents do in their own lives to make children and youths less anxious?

A. One of the more important actions is to provide a safe home environment and keep your own anxiousness in check. Parents also can help structure their children’s lives so they have a more predictable schedule, responsibilities and bedtimes. Further, parents need to be aware of their use or overuse of substances; reduce preoccupation with electronics and cell phones, along with social media. Spend one-on-one time with each child.

Beyond that, you can model healthy habits and positive coping skills, as well as ways to handle stressful situations. Discuss your availability and willingness to listen to children, expressing hope that any negative situations will change and always talking in a calm and loving manner. Certainly, keep open communication, give children and youths their “space” and avoid telling young people about problems that do not concern them, such as relationship issues, finances or family drama. Be sure to provide children with a safe place to express themselves without judgment.

Other suggestions include limiting screen time and social-media use, having realistic boundaries, increasing time for family talk and routinely asking children about any concerns.

Q. What’s the difference between having “normal” anxiety and an anxiety disorder?

A. While no definition fits every situation, an anxiety disorder is more severe, with the anxiety causing great distress and interfering with the activities of daily life. In fact, it will tend to make normal tasks a struggle. Regular anxiety is situational, whereas an anxiety disorder will occupy thoughts for more days than not over a longer period of time; it typically involves chronic anxious thinking patterns.

As overall information, anxiety is the body’s reaction to a “trigger” and is generally a short-term experience, being a response to a situation such as getting married, a birth or even taking a driver’s test. In some cases, this type of stress can have a positive effect by generating motivation. An anxiety disorder is a sustained mental health disorder that can be triggered by stress and impedes your ability to carry out your normal daily activities; often, it is a response to a real or imagined threat.  

It’s important to remember that everyone experiences anxiety and can typically cope with it. Coping becomes much more difficult when it involves, for example, excessive and perpetual worrying that interferes with life; such a diagnosable anxiety disorder would need further attention by professionals.

Need a snow plow? Nah …

Karen watched the snow pile up in the driveway. Soon, she and her husband would no longer have to worry about shoveling or paying someone to do it.

And yet their move would soon be upon them. How would they manage with the weather being so unpredictable?

But Karen quickly dismissed her concern, because she had a number of tips to follow to make their move to senior living accommodations as smooth as possible.

Although moving typically comes with both hassles and stress, relocating during the winter can be rewarding, if you follow some helpful tips to make the process one of warmth and joy rather than icy challenges.

And if you’re still on the fence, here are some of the reasons residents make the choice to move to senior living:

●    Freedom from home maintenance. Winter is one of the hardest times to maintain a home. From snow removal to winterizing your home and ensuring your steps, mailbox and sidewalks are cleared, winter can be downright treacherous. In senior living accommodations, home maintenance is included, so you don’t need to worry about braving the cold or injuring yourself with a fall.

●    Care is on site. Need to go to the doctor in bad weather? In a senior living community, you often can have your care needs met right on campus.

●    An enriching lifestyle is just outside your door. Isolation and depression can increase during the winter, but in a senior living community, there are endless opportunities to engage with others and participate in an array of programs and activities.

●    No fear of high heating bills. In a senior living community, you can leave those worries behind because everything is included in your fees.

If you do decide to make the move now, click here for tips and tricks to ensure the safest move possible.

Keeping their best interests at heart

Her 90-something father, the friend said, had been told he could no longer drive.

He hadn’t been driving much anyway, but the first thing he did upon hearing of his loss of driving-privileges was to steal away in a family vehicle and drive to a grocery store and, later, to a pizza shop.

The account reminded me of my grandfather, who many decades ago rolled his wheelchair to the end of a hall in his residence, unlatched the door and proceeded apace across the parking lot.

When people found him in his overturned wheelchair, he was laughing.

Such stories strike terror in the hearts of health care providers and family members—and rightly so—because both tales could have had vastly different and perhaps terrible conclusions.

Yet, their authors’ escapades also remind us that in any care situation, we are dealing with individuals—individuals with unique personalities and pasts, with, yes, occasional stubborn streaks and often-captivating humor.

And at Diakon we recognize and love that fact!

As an organization that has been successfully serving people of all ages since 1868, we wouldn’t have it any other way. We take time to know each resident and client on the individual level.

Indeed, we must do that—because it’s the only way we can truly uphold a core value of our mission: That “all people are unique gifts of God to be valued.”

Valuing them—according them the dignity they deserve—means we care for our residents and clients as we would care for ourselves, keeping their best interests always at heart, helping to make their worlds whole again to the extent possible and, yes certainly, keeping them safe!

So no unauthorized car excursions and certainly no wheelchair elopements but, yes, acknowledgement and honor of the traits and experiences that underscore each unique lives.

William Swanger, MA, APR, Fellow PRSA
Senior Vice President, Corporate Communications

Creating a safe environment for a loved one with Alzheimer’s

I have a friend whose husband developed a form of cognitive illness in his mid-70s. From caring for him to making sure he took his medications, got to physician appointments and ate adequately, she had her hands full.

And evening, which sometimes precipitates what is called sundowning (or “late-day confusion”), brings its own challenges.

Her situation is precisely why creating a safe environment for a loved one with Alzheimer’s disease or similar cognitive illness is absolutely necessary, especially as care needs and disease progress.

The changes that cognitive illnesses precipitate can greatly affect the safety of those with the disease, notes the Alzheimer’s Association. These changes are often seen most in judgment, sense of time and place, behavior, physical ability and senses.

If a loved one is beginning to spend money foolishly or forgets daily tasks; gets lost on a familiar street; is easily confused, suspicious or fearful; or is experiencing changes in vision or hearing, you may need to add safety to your list of things to manage.

Here are several tips to help ensure safety:

Consider the environment. Is the garage easy for your loved one with Alzheimer’s to access? Can the person get into the basement or other workspace where you place cleaners and other chemicals? These are among the most dangerous for those with Alzheimer’s because use of tools and cleaners requires close and careful supervision. In addition, be sure to watch your loved one closely outdoors, as wandering can become common.

Click here to read more helpful tips to ensure safety.

43 years? Today, more like 43 months …

In a little more than two months, I will begin my 43rd year with this organization.

Tell that to young people today and their eyes grow wide. Very few people work for an organization that long any longer.

In fact, as just one example, my son-in-law, 31, is in his third corporate position—he’s an expert in UX (user experience; that is, how we interact with and use software), a role entirely unheard of when I began my career. I suspect other positions will eventually follow.

That’s simply the way of the world now.

While that change can present stellar opportunities for employees, it brings challenges to employers.

Diakon is fortunate that we have a number of longer-term employees. You might suspect that with an organization that is more than 150 years old, with long-established locations.

And yet we face the same concerns most health-care providers are experiencing: an increasing need for nursing staff and lots of competition for those potential staff members.

Addressing those concerns requires creative solutions. Diakon has adopted a number of them, including new-employee bonuses, referral bonuses, flexible scheduling, a comprehensive range of benefits and such concepts as “Stay Interviews.”

Recently, the organization has made two additional changes. The first is the provision of certain Day 1 benefits such as paid health-care insurance. No longer do you need to wait through a probationary period to receive this important coverage.

The second is a new, tiered approach to tuition assistance, with increased financial assistance for Diakon staff members interested in furthering their education in nursing.

TAP is a great benefit—I used it myself some years ago to gain my master’s degree in strategic communication—and, in fact, was not one offered when I joined a predecessor of Diakon decades ago, one more example of how organizations adapt to changing times.

—William Swanger, MA, APR, Fellow PRSA
Senior Vice President, Corporate Communications