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The Silent Killers

By 24th July, 2014 Medical Comments Off

We know our loved ones better than anyone else but often illness comes in a blink of an eye.  Our loved ones may have subtle changes that occur and most often go unnoticed.  Unfortunately, our loved ones may not complain of any discomfort or make us aware that there is something going on.     And in the majority of the cases the elderly will not have the signs and symptoms commonly seen in the adult and younger population.  So what are the silent killers I’m talking about?  Pneumonia and Urinary Tract Infections.

According to an article “Common Infections in Older Adults” by American Family Physicianinfectious diseases account for one third of all deaths in 65 years and older.  Further stated in the article is the importance of early detection and monitoring for subtle changes.

“Early detection is more difficult in the elderly because the typical signs and symptoms such as fever and leukocytosis, are frequently absent.  A change in mental status or decline in function may be the only presenting problem in an older patient with an infection.  An estimated 90 percent of deaths resulting from pneumonia occur in people 65 years and older.  Urinary tract infections are the most common cause of Bacteremia in older adults.”

The reality is that as our loved ones become more difficult to take care of we may have to make the decision to place them in some kind of care facility such as a nursing home.  As many know Medicare and government funded monies are putting a strain on nursing homes.  This has a domino effect as nursing homes attempt to adapt by increasing the ratio of residents to nursing staff.

Nursing homes furthermore determine the number of nursing staff based on the census (total number of residents in the building).  In other words they look at the number not the level of care needed to ensure residents are well cared for.  It is not unheard for a nurse to have 30 residents and 2 CNA’s (Certified Nursing Assistants) to assist with their care.  Yes, that means each CNA has 15 residents.  The high resident to nursing ratio makes it difficult to “watch for those subtle changes”.  Also, with the shortage of nursing staff you have a lot of “PRN” (On Call or as needed staff) nursing staff which adds to the complication because they do not know the residents.  They are not there every day.  Furthermore, you have “burn out” nursing staff there for the simple reason of collecting a paycheck.  Their heart is no longer in it and this is heart-breaking because often times the staff is the only advocate for the resident.  Some residents have family members or people in charge of their care known as POA (power of attorney) who reside in another state or are unable to visit on a regular basis.

So how do we fight this?  It is crucial that if you are taking care of your loved one at home you pay close attention to any changes in behavior or changes in their functional ability.  Sometimes the only clue is confusion or weakness.  If your loved one is requiring 24 hour care then it is vital that you choose a place that the staff has the time and the ability to watch for these signs as well and take action when needed. Like any sickness catching these infections early on and treating them quickly will give your elder loved one the best chance at a longer and healthier life.  This is the reason why many people are now turning to Assisted Living Carehomes, because in these small settings with low caregiver to resident ratios it is much easier to catch these changes early on.