In this Edition:

Nutrition, Hydration and Hurricanes
Summer Time and the Living is - Easy?
Florida Home Care Hero
Follow Up - "Generation to Generation"
Hurricane Preparedness Program: Register Early to Save

Nutrition, Hydration and Hurricanes
By: Sandy Dunlap R.N., L.C.S.W., Director of Nursing

Everyone is anxious and nervous when there is news of a hurricane coming. The security of our homes is in jeopardy and the safety of our loved ones and ourselves is of major concern. We all are focused on the weather reports and hoping that the storm will skip us and our area. We have been taught by all of the newscasters to be prepared with varied items including non- perishable foods and water. The extent of this need for supplies is often underestimated. This is especially true for the elderly who are at greater risk for health problems.

It is estimated that 30% to 50% of the elderly living in retirement homes or who are homebound are malnourished and 5% to 10% of those elderly living in the community are malnourished. The elderly may be at risk due to poor dentition or missing teeth, decreased ability to smell, drug interactions, physiological changes, economic and psychological or social factors, such as depression and eating alone, and the inability to shop or cook. Acute and chronic diseases may alter the bodies’ ability to metabolize and utilize nutrients. The above can affect the nutritional status without any storm threat. During and after a disaster, the threat of dehydration and malnourishment increases dramatically.

Those who do not live in our area and have not experienced the effects of a hurricane cannot understand the trauma. Although we may be safe and our homes secure, we are unable to go out due to curfews, loss of traffic signals, debris in the streets, no gas availability, and stores are closed. These factors make it impossible for anyone to obtain supplies. Due to loss of electricity there is no refrigeration and lack of ability to cook, and no air conditioning. The risk of dehydration and malnutrition becomes greater for the frail elderly.

Dehydration is one of the most frequent cases of hospitalization for those over age 65. The signs and symptoms of dehydration can mimic dementia. Other symptoms include persistent fatigue, muscle weakness or cramps, nausea, increased heart rate, and rapid breathing. There may also be decreased urinary output, skin turgor loss (skin pinched into a fold sags back into position very slowly), sunken eyes, and dry mucous membranes. Dehydration can become a very severe medical problem.

The importance of prevention can not be overemphasized. Preparing for a disaster early is the best prevention in order to protect our loved ones not only from the winds and rain but also from the health effects that the aftermath of a storm can bring.

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Summer Time and the Living is - Easy?

• Drink plenty of water before, during and after any activities.
• Avoid alcohol and caffeine which are dehydrating.
• Choose light colored clothes made of breathable materials that allow your skin to breathe.
• Where sunglasses with UV protection to limit sun damage to your eyes, especially if you already have any vision changes.
• Where a wide brim hat to protect your face and neck from too much sun exposure. Skin cancer is the most common type of cancer in the United States. Although curable, skin cancers can often be prevented.
• Use sunscreen everyday on all exposed parts of your body.
• Do errands and other physical activity in the early morning or late afternoon to avoid the full effects of the midday sun.
• Check with your physician about how your medications might make you more susceptible to the heat. People who take diuretics, psychotropics and some cancer medications can be negatively affected by the heat.
• Seek out air conditioned environments. While a fan will make you feel cooler it may not help with preventing heat exhaustion or heat stroke.
• If you feel dizzy, have a rapid pulse, feel nauseous or get a headache cool yourself down with cool water, loosen clothing and sip liquids. If the symptoms continue seek medical help.

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Florida Home Care Hero - Jean Duncan

Jean Duncan (a caregiver from Rona Bartelstone Care Management & Home Healthcare) was nominated for and selected as the recipient of the White Rabbit Award as a Home Healthcare Hero for non-skilled care at the 2007 Annual Conference and Trade Show of the Associated Home Health Industry of Florida (AHHIF). The Conference was held on June 19-22, 2007 at the Omni Orlando Resort at Chanpionsgate. The overall theme of the Conference was "Through the Looking-Glass: A Fresh Perspective on Home Health Care.


Excerpts from a letter received from a patient’s family describe Jean’s work and attributes and are quoted with permission.

“I can remember the first day Jean came to my parent’s house, my father was about to have laser surgery on his brain (for metastatic brain cancer). My father, nervous, my mother overwhelmed, and I sat in the car with Jean trying to get to know her as we drove. When we arrived, she immediately stepped to the plate and helped my father fill out the medical forms and she also comforted my mother and made sure she had something to eat while we waited.

When we went home, everyone was exhausted, but Jean with her now familiar, comforting smile and reassurance helped us all to settle down. After that, it was a growing relationship between my father and Jean as he became sicker and less independent. Jean drove my father to his appointments and helped him in his daily routine, going to the tennis courts to watch his friends play tennis, as he was receiving chemotherapy, until his condition worsened and his sense of balance was deteriorating. Jean was there to take my father to have ‘tea with the boys’ after tennis, a daily ritual that allowed my father to continue his relationships with his best friends. All the while he was slowly withering away. My father would get up early and wait by the door for his beloved Jean who made him feel safe and secure. When my father went into the hospital for the final time, it was Jean he wanted by his side to be soothed and comforted. The morning of his death Jean was there with him talking to him and holding his hand.

This is only half the story. After my father died, my mother, who has mild cognitive impairment, needed some help. Jean is there as my mother goes through the grieving process always supporting and motivating her to join classes and call the few friends that remain. My mother, feeling abandoned by her friends is encouraged to open up to new friends. If it were not for Jean my mother would not be enjoying the quality of life that she seems to muster up at this time.

Jean is a most gracious, modest, and hard working individual, a church going lady who knows deep down what it is to be a very good person. Saying “thank you” will never be enough to express the gratitude my sister, mother, and I have for her presence in our lives. The impact of such a person can be measured by looking at the quality of life and independence a person gets from such a relationship. I wish I could give Jean some of what she has given to our family.”


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Follow Up from Last Month - "Generation to Generation"

In a follow-up to last month’s “Generation to Generation” article, we wanted to share a few pictures detailing the success of our new service.  

Rona Bartelstone Introduces a New Multi-Generational Program

In an effort to offer additional creative and valuable services to our clients, we have recently introduced a new program called “From Generation to Generation”.  Clients who choose to participate in this program can have a middle school child come and meet with them in their home for about an hour and reminisce about their life and important lessons they have learned “along the way”.  After going through a training orientation, the children typically have an informal conversation with a client and try to learn more about them. 

Usually, a Rona Bartelstone Care Manager is present to help guide the conversation and support the communication.  In addition to offering companionship and joy, the children are trying to create a “living legacy” that can be passed from one generation to the next.  They would like to create a “lesson library” that will be a resource for generations to come.  Initial feedback from both the children and our clients is very positive.  If you would like more information on this program, or would like to participate in it, please contact us at info@rbacare.com.  We will continue to explore additional ways we can meet the needs of our clients!

Below are a few pictures we wanted to share detailing the success of the our new service.

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Hurricane Preparedness Program: Register Early to Save

We have recently introduced a new Hurricane Preparedness Program that can help you and your family be prepared this hurricane season. Click here for more information on our dynamic program.