As June comes to an end, the heat and humidity of July is imminent.  Once the mercury rises, the medical community goes on high alert.  Rates of dehydration and overheating increase leading to more trips to the emergency room and complicating current health conditions.  People living with diabetes, especially, suffer more from the summer heat. 

Based on a recent study by the Mayo Clinic in Arizona, presented at The Endocrine Society’s 92nd Annual Meeting in San Diego earlier this week, the majority of diabetes patients don’t have the proper knowledge of self-care when the weather gets hot.  If you or someone you know has diabetes, it is important to understand how diabetes and heat are intertwined.

Problems

• Diabetes medications like insulin and oral anti-hyperglycemics have reduced efficacy if they rise above the temperature storage requirements.  This could lead to hyperglycemia (high blood sugar) if the medication is not working properly.
• Damage to sweat glands caused by diabetes makes it harder to control core temperature.  Perspiration is no longer effective at reducing the person’s body temperature.
• The humidity decreases the evaporation of perspiration and can lead to overheating.  Overheating can then lead to loss of consciousness, confusion, seizures and ultimately death

To avoid any complications from your diabetes and to keep your temperature down, the following suggestions may be effective:

• Keep hydrated – drink at least 2L of water every day. Avoid sugary products like juice and soda.  Nothing hydrates better than water.
• Check your blood glucose levels more regularly. 
• Read the storage temperature requirements on the insulin package and keep within temperature range. If you are carrying insulin around with you, try to get a refrigerated cold pack that will keep it cool.
• Keep lotion in the fridge and apply to your feet as the day gets warmer
• Avoid coffee and alcohol.  These can increase your dehydration.
• If you need to go outside or want to exercise, do it early in the morning or later in the evening.  These are the cooler periods of the day.
• Try to stay in air conditioned environments during hotter times of the day.
• Measure your temperature.  Your normal temperature may fluctuate within 1 Fahrenheit degree.  If you notice that your temperature keeps rising try a cool bath or a damp cloth to bring it down.
• Keep a spray bottle to mist yourself with water.
• If you don’t have air conditioning, a nice breeze from a fan can help  

If you start to feel dizzy, nauseous or start to sweat profusely, you may be suffering from heat exhaustion.  Call Info-Santé at 811 or your doctor for more information about what to do. 

When temperatures are high, be vigilant and monitor the signs and symptoms of your body closely.  Above all, being “heat aware” is the most important measure in preventing overheating and dehydration.

Perhaps that’s the question on everyone’s mind after reading about the recent car crash involving an elderly lady in Oakville, Ontario last week.  http://www.montrealgazette.com/health/Dangerous+drivers+Aging+boomers+face+tough+road+ahead/3160745/story.html

With incidences such as this, we are again reminded of the safety concerns surrounding elder driving. But, it’s important to remember that there are always two sides to every story.  What measures are needed to ensure the safety of elderly drivers and others on the road remains a much heated debate. 

Keeping elderly drivers off the road: Accidents involving elderly drivers are likely to arise due to do a decrease in responsive reflexes, diminished physical capabilities like poor vision and hearing as well as cognitive impairments. 

There are warning signs that indicate compromised driving abilities:

• road signs are blurry
• fear of being on busy streets
• forgetting directions that used to be easy to remember
• stopping at lights last minute
• mistaking the gas pedal for the brake pedal

Accident rates increase steadily after the age of 65 and with warning signs like these, it is no wonder that some provinces have imposed age cut-offs for elderly drivers to renew their licenses.  In Quebec, elderly citizens are obligated to renew their license pending medical examination at the ages of 75 and 80 and then every 2 years thereafter.

The SAAQ has come out with a 16-page information brochure for elders called Health in the Driver’s seat.  For family members or elderly drivers concerned about possible and potential driving impairments, this brochure highlights the warning signs and offers valuable resources if you think you or someone you know may present a hazard on the road. http://www.saaq.gouv.qc.ca/publications/prevention/health_driver.pdf

Keeping elderly drivers on the road: Being able to drive represents independence and a sense of pride. By taking seniors off the road, we are taking away more than just their car.  Not all seniors over 65 are dangerous drivers and denying them their ability to be mobile within their community is not something that should be taken lightly.

In Montreal, the automobile remains as the most preferred method of transportation.  Fear of being mugged or falling on ice rank high as reasons why elders don’t want to take public transportation.  While the general public may be willing to cut out elderly driving altogether, more needs to be done to continue to encourage senior independence on the road and/or to promote alternative and safer ways of getting around.

The International Driving School of Montreal specializes in elderly driving.  By focusing on the needs of elderly drivers, we can continue to promote their independence by sharpening skills or identifying any adjustments that may need to be made while on the road.

If driving is no longer viable, various volunteer organizations around Montreal provide driving services for elderly citizens.  The CLSC Rene-Cassin has a driving program to take seniors to their medical appointments.

Whether or not someone is capable of driving is not an easy topic to broach.  Many people take pride in their ability to drive but the fact is that some people should not be on the road. 

Reader feedback: What do you think? Do you agree with the age restriction for re-testing at the age of 75?  Should it be higher or lower? Send us your comments by clicking on the comment link below.

It’s a fact: our population is getting older. As age increases so too does the cancer rate.  According to the Canadian Cancer Society, 61% of cancer deaths will occur among those who are at least 70 years old.  At the moment, cancer is the leading cause of death to Canadians yet, less than 60% of Canadian cancer patients receive appropriate end-of-life care. The paradox is obvious.   Every citizen should have access to qualified and skilled care in their final days, but they just aren’t getting it.
See this recent National Post article for more information. http://www.nationalpost.com/Cancer+Society+report+flags+inadequate+life+care/3048253/story.html

Making the decision to seek palliative care is not an easy one but if you find yourself faced with the judgment call to request extra help, it is important to know what services to look for and what is available to you.  Whether it’s private or public health care, your loved one deserves to live each day with dignity and comfort.    Having access to a skilled team that is ready and willing to go that extra mile for your loved one is crucial to providing the highest quality of care.  They should be trained and experienced in knowing the rights and responsibilities as caregivers in palliative situations.

Ensuring that your loved one is being treated by the highest quality of care possible should be top priority.  By moving palliative care from the hospital to the home, you and your family will have greater influence and control over the patient’s quality of life and nursing care process.  The added benefit of a familiar environment, while encouraging the patient’s independence, will ensure appropriate end-of-life care and greater peace of mind for all involved. 

Types of Home Care Available

The various CLSCs in Montreal offer a wide range of palliative services involving trained volunteers and registered nurses providing medical and non-medical support.  Non-profit organizations, such as the Victorian Order of Nurses, are also available who combine bereavement services and palliative nursing care. Privately, companies like Equinoxe who are ISO accredited and follow stringent guidelines as mandated by the National Association of Professional Geriatric Care Managers can offer a team of highly trained professionals of nurses and social workers to deliver all the necessities of palliative care including pain relief, emotional and physical support as well as respite for you or other family caregivers.

Palliative care should be personalized and detailed according to the patient’s physical, psychological and spiritual needs.  By doing the research, you will be able to choose the most suitable care needed for your loved one.

Not only is elder abuse on the rise, it remains as one of the most under-reported types of abuse in Canada.  With World Elder Abuse Awareness Day just around the corner on June 15, 2010, it is important to encourage awareness of elder abuse and what signs to look for.  We have a duty to protect our aging population and by taking simple, smart steps, you can protect yourselves or your loved ones from suffering from abuse. 

Types of elder abuse

Elder abuse can manifest in many ways:

• physical and emotional maltreatment;
• neglect;
• sexual abuse;
• financial exploitation.

Financial abuse appears to be the most common type of abuse across the country, especially in Quebec. Yet, when Canadians are asked what first comes to mind with elder abuse, the majority immediately suggest physical and/or emotional abuse.  The awareness of financial abuse is much lower.

This general lack of knowledge regarding financial abuse creates an environment in which financial abuse is widely overlooked as a problem and further silences the elderly population from reporting any experiences of it.  Most people are not even aware of what the signs of financial abuse might be.

The National Association of Professional Geriatric Care Managers has identified some red flags for the financial abuse of seniors:

• Someone is responsible for paying  bills,  but  the bills are not paid and nor are there adequate resources to pay them;
• Unexplained money missing from accounts;
• Family member /caregiver / friend withdrawing large amounts of money from accounts;
• Someone taking money under false pretenses;
• Forgery;
• Purchasing expensive items with the older person’s money without the older person’s knowledge or permission;
• Denying the older person access to his or her own funds or home;
• Scams perpetrated by sales people for health-related services, mortgage companies, and financial managers—or even by so-called friends.

Steps to protect elders

• Know the signs of financial abuse
• Educate yourself about financial needs of seniors -  The CLSC Rene Cassin offers a program called “The ABC’s of Fraud” funded by the Bank of Nova Scotia to help elders recognize and prevent fraud in the elderly.  http://www.cssscavendish.qc.ca/en/soins-et-services/services-for-victims-of-abuse/elder-abuse/#c2177
• Care management –  A care manager is aware of the signs of financial abuse and are able to act promptly by:
  • Involving an elder law attorney
  • Acting as a mediator between the senior and the others involved
  • Providing outside resources and support from other financial professionals
  • Protecting the family estate/assets

If you or someone you know has experienced financial abuse and would like to talk to a Care Manager, call Equinoxe at 514-935-2600.

References:

http://canada.justice.gc.ca/eng/pi/fv-vf/facts-info/old-age/pdf/OlderAdultsOverviewPaper.pdf

http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/human_resources_social_development_canada/2008/001-08-e/report.pdf