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Depression and COVID: 4 Tips for Managing Emotions

Depression doesn’t end with December, and it’s important to be aware of the potential complications that 2020 brought with it. Whether your loved one has been previously diagnosed with Seasonal Depression, or is showing signs for the first time, handling the blues has become more complicated than ever before. Here is everything you need to know about seasonal depression as well as the effects of Covid-19 on mental health, and four helpful tips on managing emotions during this time.

Seasonal Depression

First, what is holiday depression, seasonal depression, or the winter blues? Seasonal Affective Disorder, or SAD, is a type of depression that usually occurs in the fall and winter, and can easily last until March.

“Some theories suggest that previously happy holiday memories become troubling as loved ones pass away, making the holidays a time of mourning rather than celebration.”

While the real cause of this disorder is unknown, as weather gets colder and the days get darker, a normal sunny disposition can become pessimistic, lethargic, and despondent. While there is a “summer pattern” form of SAD, it is more common in the colder months. The disorder often dissipates as the weather gets warmer and the days get longer in summer and spring.

Image: Sad woman looking through window

Women are more likely to have SAD than men, but at-risk groups include:

  • Those who live further north, in colder, darker climates
  • Those who already suffer from depression or mood disorders
  • Those with anxiety, panic disorders, or attention/hyperactivity disorders

Some theories suggest that previously happy holiday memories become troubling as loved ones pass away, making the holidays a time of mourning rather than celebration. There also seems to be correlation between the disorder and serotonin levels, which can be affected as a person ages, diet changes, and medications are added to a person’s daily life. Symptoms include:

  • Feeling down or depressed throughout the day, and regularly every week
  • Losing interest in hobbies, or holiday traditions that usually bring joy
  • Loss or increase in appetite
  • Weight gain/weight loss
  • Irregular sleep schedules
  • Oversleeping
  • Fatigued
  • Irritable
  • A sense of hopelessness/worthlessness
  • Thoughts of suicide/death
  • Self-isolating, or avoiding social interactions (even in covid-19 safe circumstances)

“The prevalence of depression symptoms in the US was higher in every category during COVID-19 than before COVID-19.”

Covid-19 Influence on Seasonal Depression

According to this study done on depression during Covid, “prevalence of depression symptoms in the US was higher in every category during COVID-19 than before COVID-19.”

Image: Dark cloud of sadness

While it will take more time to have definitive results on the true mental health consequences of the pandemic, early studies are already showing that global depression has only gotten worse during 2020. SAD is not as often associated with suicide, as it usually has a clear trigger, beginning, and end, and is therefore easier to diagnose and treat. However, combined with the increased emotional stress, there are heightened conditions for suicidal ideation. Here are a few ways Covid has increased symptoms and severity of depression worldwide:

  • Isolation and self-quarantining
  • Changes in schedule
  • Lack of activity/stimulation
  • (For the elderly) Push towards unfamiliar/difficult technology to stay informed/connected
  • Sickness/death of loved ones

Managing Emotions

While there is no cure for any type of depression, there are proven methods to help anyone struggle with changes in mood and emotional distress, here are 4 ways to help you or a loved one:

1. Vitamin D

In general, studies have shown that lack of light, and therefore vitamin deficiency, is connected to SAD. Most professionals recommend both taking vitamin D supplements and getting quality time in the light. This can be accomplished safely on a porch, roof, or safe outdoor activity, or by using light therapy, which uses a light box. Fulfilling this need has proven to affect mood in a positive direction.

2. Regulate, Don’t Repress

The worst thing you can do is repress how you feel, even if you can’t rationalize or explain it to others. Validating your feelings is the path to healing. By intentionally and regularly processing emotions, whether ‘rational’ or not, you decrease the chance of being overwhelmed or exploding from internalized pressure. Choose one or two people who are trustworthy, and good listeners, and talk with them regularly throughout the week. Shame-free conversation is vital to normalize otherwise debilitating emotions.

3. Pause

While it might be tempting to react immediately based on the intensity of the emotions you are feeling, it is important to pause before responding. The difference between reacting and responding can mean everything in a relationship, and determine whether your mood will be escalated or deescalated. When feeling a sudden, strong emotion, do your best to remove yourself from the situation. Don’t be afraid to tell those around you that you are not in a place to talk, and that you need space to process. Next, do something that will allow your body to process and regulate the emotions that are raging inside you, like the ‘fight or flight’ response. Whether you play an instrument, do a puzzle, or watch a few YouTube videos. Once you feel your emotions are back to normal, ask yourself, “What about that situation sparked such a strong response?” Next, decide if this realization is worth communicating to others, or if it’s more valuable for you to keep it to yourself and learn for the future. Whenever you’re ready, you can end the “pause” and return to life.

4. Medication

There is no shame in receiving additional help through antidepressants or other medications. Hormones are complex, and difficult to directly change without using medication, but they are also the most clear influence on depression. If you or a loved one is having difficulty managing moods/emotions, talk with your care team about getting medicinal help.

Adora Midtown Park Assisted Living

At Adora Midtown, we are always looking for new ways to support our community. Whether you’re a family trying to make difficult decisions, looking for skilled nursing resources, or the right assisted living facility for the senior in your care, we’re ready to help connect you with the resources you need. Contact us to find out more about who we are, what we do, and the services we offer, including meal programs, senior centers, therapy programs, companion care, and more.

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A COVID Christmas — tips for a merry holiday season

It’s the most wonderful time of the year — but it’s also one of the most stressful! Do you get stressed-out around the holidays? Here are seven easy steps to stay stress-free this holiday season.

Acknowledge all your emotions.

The holidays can bring up difficult emotions for us at the best of times. As we celebrate this year during a pandemic, it makes sense that some of those feelings might be amplified. Give yourself permission to feel sadness and stress, as well as grief for the holiday experience you’d prefer to be having and remind your senior loved ones that they should do so, too. Have an honest conversation about the parts of the holiday season you feel like you’re missing. We can all practice gratitude and feel optimistic about giving each other long-overdue hugs in the new year while still making space for our disappointments.

Go all-out with your holiday cards.

If you traditionally send holiday cards, you might want to embellish them a bit more this year. Rather than standard season’s greetings, consider including a few details about what your family’s been up to this year, some extra warm wishes, and even some pictures!

If you have children, handmade cards from them will likely bring a smile to your senior loved ones’ faces.

If you don’t normally send cards, doing so this year is one way to connect with loved ones you’re not able to see over the holidays. Your cards don’t need to be expensive or elaborate – homemade cards are great, too! What matters most is the message inside. If postage fees or postal delays are a concern, e-cards are also an option.

Include those who are absent in your celebrations.

Just because your loved ones aren’t physically present, that doesn’t mean you can’t include them in your holiday activities. Make your great-aunt’s famous sugar cookies and be sure to take pictures of the finished product. Give your children gifts from their grandparents and film the presents being opened, or do it live over Zoom or FaceTime. Create a musical production of one of your parent’s favorite seasonal songs with the other members of your household. Snap a photo of the family heirloom ornaments on your tree and share it with loved ones. By doing activities like these, you’re communicating to your parent, grandparent, or other senior loved one(s) that they’ve influenced the way you celebrate the winter holidays, and that your celebrations aren’t complete without them.

Just because your loved ones aren’t physically present, that doesn’t mean you can’t include them in your holiday activities.

Take advantage of technology.

Since many holiday traditions are going virtual this year, why not include your whole extended family? Invite everyone to a Zoom call so you can all celebrate together. Be mindful that a well-attended Zoom call might be a bit overwhelming for your senior loved one(s), so try not to talk over one another. You might even wish to decide on a group activity beforehand, like singing a holiday song together, offering a prayer as a family, or letting the grandkids show off what Santa brought them one by one.

Send gifts early.

While presents aren’t the most important part of the holidays, having a little something to open can make the holiday feel particularly festive. If you have senior loved ones who you can’t see over the holidays, send gifts their way as soon as possible, so that they’ll reach your loved ones on time despite shipping delays caused by the pandemic. Looking for a simple and thoughtful gift idea? Try something cozy, like a throw blanket or a pair of slippers with good treads on their soles.

Or pick something personalized, like a book you think your loved one will like (large print may be preferable for your senior loved ones), or a mug with a design your loved one will enjoy for all their warm beverages during the colder months. Or maybe you’d like to give your loved one something that will help keep them entertained as we continue to practice social distancing, like a tablet, some new music to listen to, an adult coloring book, or a puzzle with less than 100 pieces.

Perhaps give your loved one something that will help keep them entertained as we continue to practice social distancing, like a tablet, some new music to listen to, an adult coloring book, or a puzzle with less than 100 pieces.

Worship together even when you’re apart.

If your family is religious, look for an online service that you can all attend, just as you might if you were spending the season together. Remember to discuss how to access the service with your senior loved one(s) ahead of time, in order to try and avoid technological difficulties on the day. Alternatively, use technology to gather your whole family for a private moment of worship. If your senior loved one is up to it, you can even ask them to guide the family in prayer.

Stay connected after the holidays.

At one time or another, most of us have probably experienced a bit of melancholy at the end of the holiday season. We wait for weeks to celebrate with our friends and family, and it’s a bit sad when the festivities come to an end. This year make a concerted effort to keep your senior loved one(s) from experiencing this feeling by maintaining consistent contact with them after the holidays are over. If you gather for a big family Zoom call on Christmas Day, for example, give your loved one a call on the twenty-sixth, too, even if it’s just for a brief chat. Plan to get in touch again soon after – you might even want to set up a phone call/video call schedule. It’s wonderful to put effort into connecting with loved ones over the holidays, but with all of us experiencing more loneliness thanks to the physical distancing necessitated by the coronavirus, this year it’s more important than ever to continue to foster those connections after the holidays, too.

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Pandemic Caregiver Fatigue

What is Pandemic Fatigue for Senior Caregivers?

Caring for our loved ones as they age is never easy. There are tons of factors that can make it taxing physically, mentally, financially, and more for both the caregiver and the one receiving care. This has always been the case, but with the emergence of COVID-19, things have only gotten more difficult. Many of us, especially caregivers for older adults, are feeling a real sense of burnout due to Coronavirus, also referred to as pandemic fatigue. Today we will be covering pandemic fatigue in more detail, recommending coping strategies, and discussing care options.

One group of people that are hit especially hard by Coronavirus spikes are caregivers of older adults, as they risk their lives, and the lives of their aging loved ones, every time they have to leave the home while COVID-19 rages on.

What is Pandemic Fatigue?

When we began seeing increased COVID-19 rates in the United States back in March, many people stayed home as much as possible to slow the spread and protect those they live with, especially those in vulnerable populations like older adults. Seven months later, it often feels less urgent to stay home, despite higher rates of COVID-19 than ever in the U.S. People are coping with the loss of their loved ones, jobs, or housing, and many live in a constant state of anxiety about getting sick.

One group of people that are hit especially hard by Coronavirus spikes are caregivers of older adults, as they risk their lives, and the lives of their aging loved ones, every time they have to leave the home while COVID-19 rages on. Many of these caregivers still have to go to work to support their own kids, and relief has been hard to come by in recent months.

The combination of all of these fears, frustrations, and losses contribute to what we now refer to as pandemic fatigue. Pandemic fatigue can also be thought of as burnout from being pulled in all different directions while also feeling isolated from the outside world. Pandemic fatigue can put our mental and physical health at risk, affecting the quality of our work, caregiving, and lifestyle.

How Can I Cope with Pandemic Fatigue?

Fortunately, there are steps you can take to overcome pandemic fatigue, empowering you to stay as relaxed, calm, and collected as possible.

Stay Connected

One major reason why pandemic fatigue has grabbed a hold of so many of us is the lingering feeling of isolation and loneliness. We may not be able to host or attend gatherings like many of us used to, but that doesn’t mean we cannot stay connected with friends and family members.

Staying connected not only helps us preserve our mental health, talking to friends and family can help us express built up feelings and work through our struggles. Even if you don’t explicitly talk about your problems, feeling connected and supported is just as important too.

Try the following to get in touch with friends and family during the pandemic:

  • Going for a socially distanced hike or nature walk with a loved one
  • Setting up recurring virtual hangouts or dates
  • Writing letters or sending cards to people to tell them you’re thinking of them
  • Hosting a socially distant outdoor get together, like a bonfire or takeout meal

If you don’t feel that you have anyone you can talk to, give Crisis Text Line a try. Text HOME to 741741 to get in touch with a trained crisis counselor 24/7. Their counselors will listen to your struggles, walk you through coping strategies, and provide relevant resources if applicable. It’s free, and their goal is to help people go from “a hot moment to a cool calm.”

If the time has come to look into outside help with caregiving itself, there are options.

Take Care of Yourself

When we put so much time and effort into taking care of others or simply trying to make ends meet, it can feel impossible to take care of ourselves and our needs, too. Setting aside just a few minutes of the day to dedicate to yourself can make a huge difference in your mental state. If you’re feeling burned out, it will only make it harder to provide quality care to your loved one or maintain a household.

Try incorporating more of the following to take care of yourself:

  • Ensuring you get eight hours of sleep whenever possible
  • Exercising regularly or taking small, frequent physical activity breaks throughout the day
  • Consuming a balanced diet with enough fruits, vegetables, and whole grains
  • Sitting in intentional silence for a few minutes or utilizing a meditation app
  • Listening to your favorite music while doing chores or when you feel overwhelmed
  • Limiting your social media intake by deleting addictive apps, setting a social media timer, or logging out after each visit

Most caregivers go through their entire days without rest or doing things they enjoy, and this can lead to burnout faster than anything else. Self-care can look a bit different for everyone but doing enough of it pays off when it comes to your physical and mental health, as well as your caregiving ability.

Get Help

Many are feeling stuck and overwhelmed to the point where they feel like they are drowning in their responsibilities as a caregiver, especially with pandemic fatigue thrown in the mix. If you feel this way, see if you can find a local or virtual support group or if you have access to counseling through your workplace or insurance.

Check out directories like Aunt Bertha that can help you find low-cost mental healthcare, support groups, or other local resources in your area. You don’t have to handle the stressors of caregiving and pandemic fatigue on your own, and you deserve to be supported during these tough times.

If the time has come to look into outside help with caregiving itself, here are a few options:

  • Respite care – short-term relief for caregivers in the form of in-home visits or trips to day care centers or healthcare facilities
  • Assisted living – live-in facilities that provide help with some activities of daily living and nursing care
  • Long-term care – live-in facilities that provide more advanced services and care for those who need more help than assisted living can give.

How We Can Help

Adora Midtown/StoneGate Senior Living offers a wide range of care options that can help alleviate some of the stress, anxiety, and fatigue that come with caregiving on one’s own. We understand that taking care of aging loved ones can progress from slightly challenging to completely overwhelming in a matter of days, but we are here to support your family every step of the way. StoneGate Senior Living has independent living, assisted living, skilled nursing, and memory care options, and we will work with you to determine what is right for you and your loved ones.

If you would like to learn more about who we are and how we can help, please contact us today.


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Supportive Dining: Taking a Fresh Approach

For people living with dementia, dining can serve up a host of challenges. Many memory care residents in skilled nursing facilities (SNFs) and other senior living communities are finicky eaters, and food preferences often turn on a dime. Some have difficulty discerning colors, temperatures, and plate boundaries. Chewing and swallowing may eventually be compromised, along with the ability to hold a glass or handle utensils. Any interruption or change in routine can disrupt the desire to eat.

Industry-leading senior care communities, including Adora Midtown Park, are finding new ways to reduce stress and deliver a safe, enjoyable, and nutritious experience for residents living with dementia.

Preserving identity and choice

“Supportive dining is, first, about providing healthy meals and, second, about safeguarding a sense of self,” says Antoinette Holford, a registered dietitian and StoneGate’s education and training manager. “A predictable dining experience helps residents feel in control and stay connected to who they are at the core.

“We assess each resident’s stage in the dementia journey and build dining services around their individual needs.”

Antoinette Holford, StoneGate Registered Dietitian

“We make every effort to create and maintain a familiar routine. For senior care residents living with dementia – whether in a nursing home, SNF, assisted living, or rehabilitation center – regular mealtimes provide consistency, and that’s important to their dining success. If the routine is altered, confusion can set in, affecting their mood for hours.”

Extra care is taken to make each meal flavorful and visually appealing. Heart-healthy selections use herbs and spices as primary seasonings. Nutritious, eye-pleasing pureed foods are prepared for those with swallowing challenges.

Residents in senior living communities who are living with dementia may also experience changes in depth perception. Colors, once vivid, may eventually appear as shades of grey. “We use bold, solid-colored dishware. High contrast makes it easier to distinguish food items and beverages from the containers that hold them.”

Providing ample choice is essential, and Accel at Longmont dining offers a variety of meal options. Printed menus are available for those who can read. For those who no longer have the ability to read, plates of food are displayed for resident selection. Along with regular mealtimes in the dining room, room service is available at any time.

Personalizing the experience

Key to successful supportive dining is a person-centered approach. “We assess each resident’s stage in the dementia journey and build dining services around their individual needs,” Holford says.

“Food aromas, sights, and sounds evoke memories that are hidden away in the brain….Food can be a mood changer, in the best of ways.”

— Adore Midtown Park Administrator

For example, a person with dementia may not be able to verbalize why the aroma of roast beef and gravy is comforting to them. But we can see by their response that it is. Food can be a mood changer, in the best of ways.”

Families are closely involved in food decisions. Staff explore with family members their loved one’s dining history. What was their mealtime routine? What type of food do they delight in?

Holford tells the story of a resident who enjoyed fast food. Day after day, his family brought him a hamburger and French fries. When the family took an extended vacation, the nutrition services manager noticed the resident stopped eating. “She asked area fast-food restaurants for some take-out containers with their logo. Each night, the staff prepared his meal and served it to him in a takeout box. His routine was restored, and his interest in eating returned!”

Promoting staff skills

The best supportive dining service in senior care communities hinges on carefully trained frontline staff. “These are the ones who sit with residents while they eat,” Holford says. “They’re the first to observe how needs may change. They see how much a resident is eating, what they are eating, and how they are interacting with their surroundings – and can recommend new approaches to food and ambiance.”

Holford provides training updates to caregiver teams, focusing on such topics as food presentation, mealtime atmosphere, and behavior management. “It’s important for staff to observe resident behavior closely, because foods once customary can readily change as the resident’s journey takes a new turn. Someone whose favorite nightly treat was ice cream may now respond with disinterest. Someone who used to avoid a certain food for ethnic or religious reasons – pork, for example – may suddenly be reaching for the ham and bacon. Previous boundaries have blurred.”

Providing the right environment

“We like to mimic the family table and set the stage for interaction,” Holford says. For example, a bowl of salad and a basket of bread are put on the table to pass around family style. “Sometimes it works, and sometimes it doesn’t. Something that happened four or five hours or maybe even a day earlier may affect the resident’s mood and response to meal participation, though they may not be able to define it. We strive to respond to changing behaviors with patience, flexibility, and encouragement.”

“Mealtime is typically a social event. Our goal is not only to provide nutritious meals but also to create a sense of connection and belonging.”

Every effort is made to create a calm and relaxing experience. Diners are typically seated at tables of four to six. “They can sit wherever they like, but often choose the same seat and table. Sitting in the same place enables residents to have control,” Holford explains. “They’re in their spot, and they entirely own it. We also use square edges as opposed to round, because square lines clearly define space.”

Mealtime is typically a social event. “If the resident can’t verbally participate in a conversation, just being at the table can evoke a feel-good response. The experience of being in the presence of others is stimulating in the best of ways. Our goal is not only to provide nutritious meals but also to create a sense of connection and belonging.”


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Diabetes: Helping Seniors Take Control

For today’s seniors, diabetes has rapidly become an epidemic. About one in four people over 60 in the U.S. has diabetes, a condition in which the body does not properly process food for use as energy. If diabetes is not adequately managed, it can lead to serious health problems, from stroke and heart disease to kidney failure, hearing loss, blindness, nerve damage, and amputation. The American Diabetes Association reports that diabetes is the nation’s seventh-leading cause of death.

While there is not yet a known cure for diabetes, through close management – from carefully monitoring medications to adjusting diet, exercising often, and regularly testing blood glucose – most diabetics can take control of their symptoms and avoid further complications.

Meeting the challenges

Leading senior living communities are making a dedicated effort to educate and support senior residents who are living with diabetes. StoneGate Senior Living, for example, a provider of rehabilitation, skilled nursing, assisted living, and memory care services, recently partnered with ARKRAY USA and the Diabetes Store, two leaders in diabetes care. The goal was to expand StoneGate’s diabetes management program to 41 facilities throughout Texas, Oklahoma, and Colorado – providing patient education and guidance in self-management to improve residents’ quality of life.

“While diabetes can have dire consequences for adults of all ages, seniors are at particularly high risk from diabetic complications,” says Angela Norris, Senior Vice President of Business Development at StoneGate. “The body’s ability to heal wanes with age, while the presence of age-related conditions, such as impaired vision, decreased skin elasticity, reduced mobility, and a less-active lifestyle, can work against effective disease management. Also, many seniors with diabetes are struggling with memory issues. Their insulin and medications need to be closely monitored.”

Managing the disease

“Our goal is to provide a personalized diabetes wellness plan for each resident living with diabetes,” Norris says. “Our staff is trained to help residents – short term and long term alike – to monitor food intake, engage in daily exercise, regularly check blood sugar levels, and closely manage medications. We also make sure our diabetic residents have regular eye exams, skin assessments, and podiatrist visits to help prevent complications.

“Partnering with ARKRAY and the Diabetes Store has amplified our efforts to educate residents – and give them the tools to better control blood sugar, avoid the side effects of the disease, and live healthy, active lives,” Norris notes.

Maximizing nutrition

Key to managing diabetes is a healthy-eating plan that helps control blood sugar – one naturally rich in nutrients, low in fat and calories, and abundant with fruits, vegetables, and whole grains.

“We conduct a nutrition evaluation and provide support to help our diabetic residents get the daily nutrients they need,” Norris says. “We also provide diabetes management classes that help them track eating patterns and determine what foods may or may not be the best choices. Our registered dieticians help plan menus and educate our residents on making healthy food choices. Meals can be prepared in accordance with a prescribed diet.”

Making time for exercise

According to the Centers for Disease Control and Prevention, adults over the age of 65 need at least 150 minutes of moderate-intensity exercise a week, such as brisk walking, and at least two days per week of strength training that works all the muscle groups. Exercise is particularly critical for diabetic seniors to improve their ability to use glucose.

“StoneGate offers the LifeWorks Senior Wellness program, featuring purpose-driven exercise that helps diabetic seniors stay active and lower their blood glucose levels,” Norris says. “Fitness classes are designed to help maintain and improve strength, balance, and flexibility.”

Maintaining optimum health

“As baby boomers age, we can expect a continued spike in the rate of diabetes,” Norris says. “While untreated diabetes presents significant risks of a range of serious health problems, these risks can be vastly improved by appropriate medical and lifestyle interventions. Our goal is to help diabetic residents take control of their disease and – through education, lifestyle modification, and continued vigilance – stay healthy.”

CONTACT US to learn more about our services to support seniors who are living with diabetes. 

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Senior Physical Fitness: Using It, Not Losing It

“Use it or lose it,” the saying goes. These words of wisdom are true in many areas of life, but particularly for our bodies as we age. Staying fit helps to lower blood pressure, decrease the risk of falls and injuries, and slow the body’s loss of muscle tone and bone mass.

The Centers for Disease Control and Prevention recommends two types of exercise each week to improve health: aerobics and muscle strengthening. Surveys show, however, that less than one-third of Americans over the age of 65 are following this guideline.

Facing the challenges of senior fitness

“As we age, it’s important to stay focused on overall wellness,” says Stephen Chee, director of employee wellness at Lifetime Wellness. “Physical activity, regular exercise, and good nutrition are keys to staying healthy. It’s a lot like routine repairs and maintenance on an automobile. Our bodies are our vehicles for life. We need to keep them well conditioned, so they stay in top working order.”

Lifetime Wellness – in business since 2005 – is a pioneer in delivering wellness and recreation services to skilled nursing, assisted living, rehabilitation, and memory care facilities throughout Texas and Oklahoma. The company is a partner organization with StoneGate Senior Living, a leading provider of senior living services. With wellness programs in most of its 44 facilities, StoneGate offers a full selection of body-enhancing activities, from fitness and health education programs to nature walks and strength-building classes. Physical activities are complemented by spiritual, emotional, social, vocational, and intellectual wellness programs.

Myths about fitness abound,” says Chee. “Our staff strives to separate the myths from the facts – and help residents understand the role of exercise not only in maintaining stronger bodies but also in elevating mood, improving memory, and protecting the brain from age-related mental decline.”

Forming bonds through group activity

Group exercise can be a powerful antidote to loneliness, a feeling experienced regularly by more than 40 percent of seniors, studies find. “From my experience, fitness has a strong psychological component,” Chee says. “As humans, we’re designed for companionship, but as we age, many of us lose our sense of social connectedness. At StoneGate, we provide many opportunities for group exercise, which not only boost fitness but also build community.”

StoneGate’s wellness programs promote participation in physical activity groups to help improve and maintain cardiovascular endurance, as well as balance, flexibility, and muscular strength. Programs include:

  • Body Works and Fitness for Life: exercises for residents of all physical abilities
  • Sport Fitness: activities that span the sports spectrum, from kickball and volleyball to baseball and basketball
  • Music & Movement: relaxing, low-impact exercises accompanied by music
  • Sensory Shape-Up: activities that strengthen the body while engaging the senses through aromas and essential oils

Many StoneGate facilities also offer a weekly rehab fitness group for patients in transitional care who are recovering from an injury or surgery.

Fighting inflammation

Researchers have found low fitness is associated with a larger waist size and a higher degree of inflammation. “Inflammation is the body’s natural way of protecting itself when we’re injured or sick, but as we age, our cells change and can cause the immune system to continuously activate the inflammatory process,” Chee explains. “This chronic inflammation can be harmful to our bodies, and it is often linked to diseases prevalent in seniors – such as heart disease and diabetes. Increased fitness can lower inflammation and improve metabolic health overall.”

Finding the mental benefits in physical activity  

Studies suggest that aerobic exercise – any activity that raises the heart rate and facilitates movement for a sustained time – has significant benefits for the brain. “Aerobic activities release endorphins,” Chee says. “These are the body’s natural painkillers that create a natural euphoric feeling and help ward off depression.”

A popular activity among seniors is “chair yoga” – yoga exercises that can be done without getting on the floor. “Yoga stimulates the flow of internal energy throughout the body, providing healing and preventing further damage from inflammation,” Chee says. “It combines physical exercise with focused breathing, helping manage stress, improving flexibility, and enhancing mental health.”

Focusing on relationships                                                                                                         

Although education is the foundation of StoneGate wellness programs – teaching residents the facts of staying fit and providing the tools to develop healthy behaviors – the deeper principle is nurturing relationships.

“Our staff’s first focus is on making sure those we serve know how much we care,” Chee says. “We hope this knowledge, coupled with our unified engagement as a team, builds trust, sows compassion, and changes lives.”

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Senior Dining: Turning the Tables

Historically, meal service in the senior living industry has fallen short. Fresh, great-tasting, made-from-scratch cuisine – coupled with a five-star resident dining experience – has been the exception, not the rule.

But today paints a different picture. An industry transformation is in the works, with a focus on offering maximum nutrition, mealtime flexibility, and a memorable social experience.

Changing the dining culture 

Senior living communities are taking a new view of dining. It’s no longer a sidebar to the resident experience. It’s at the core – a key ingredient for health, vitality, and quality of life.

A community at the forefront of the personalized mealtime trend is StoneGate Senior Living, a leading provider of senior living services in Texas, Oklahoma, and Colorado. StoneGate revitalized its dining experience in 2007. Cheryl Korbuly, a registered dietitian nutritionist, licensed dietitian, and vice president of nutrition services at StoneGate, describes mealtime as “a premier experience built on resident choice, restaurant-style dining, and stellar customer service.

“Our goal is to meet each resident’s personal food choices and tastes while providing a pleasurable dining ambiance. Diners choose their selections from a full menu of well-balanced options. Meal orders are taken tableside and delivered in courses.”

Catering to choice 

Key to the improved dining experience is choice. Flexible times for breakfast, lunch, and dinner give residents the freedom to adopt a mealtime that meets their unique preferences.

Choice extends also to a variety of nutritious, freshly prepared, and visually appealing food options. At StoneGate communities, for example, the base menu is “Heart Healthy,” featuring meals with less fat and sodium. Selections range from abundant fruits and vegetables, including always-available fresh salads, to reduced-fat dairy options and whole-grain breads, cereals, and side dishes.

“Along with heart-healthy selections, our residents can select their favorite traditional dishes, many of which have a tie to their past,” Korbuly notes.

Popular menu items range from eggs to order for breakfast to homestyle meatloaf for lunch and grilled salmon for dinner.  Communities with large ethnic populations offer menu options that follow cultural traditions. Nutrition Services team members talk regularly with residents to discuss and incorporate menu enhancements, along with favorite recipes and special requests.

Caring for residents with dietary restrictions

When planning meals for seniors, considerations such as altered taste, difficulty chewing and/or swallowing, medication side effects, and nutrient requirements are key. Another factor is providing special diets to help manage chronic illnesses, such as diabetes, heart disease, and high blood pressure, which affect four out of five older adults. Heart Healthy meals, featuring herbs and spices as primary seasonings, are staples for therapeutic diets.

“Diets modified in texture don’t sacrifice on flavor – or fun,” Korbuly says. “For example, seniors who have difficulty chewing or swallowing may require foods that are modified in texture. StoneGate communities accommodate this need by providing pureed foods that look good, taste great, and maximize nutrients.  “Beyond Puree™” was created to enhance the quality of life for residents requiring the puree food texture, because we all eat with our eyes.”

Considering additional options

Along with enjoying meals in the dining room, residents also have the choice of eating in the leisure of their room. “The in-room dining experience offers flexible dining times, choice of menu items, and the opportunity to receive personalized service while dining in-room,” Korbuly explains. A hot mobile food cart travels from room to room, ensuring food is served fresh and at a palatable temperature. For in-between-meal cravings, snack service is offered three times daily.

Residents in memory care facilities are engaged in family-style dining, where bowls and platters of food are passed around the table. “Our goal for those with memory challenges is to recreate familiar smells and sounds, along with a welcoming ambiance that creates a sense of belonging,” Korbuly says. “We evaluate each resident’s needs and custom-tailor the experience to help them feel at home.”

Creating a recipe for success

Central to the resident dining experience is instilling a shared mindset among Nutrition Services staff. “We continuously educate our Nutrition Services team on how to be proactive in providing a ‘WOW!’ experience for everyone we serve – at the table and beyond,” Korbuly says. “Our residents deserve nothing but the best.”

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Infectious Disease: Partnering for Control and Prevention

Infectious disease can be deadly, especially for seniors. From the flu to bacterial pneumonia, these diseases account for 40 percent of deaths in older adults. They are caused by microorganisms, such as viruses, bacteria, fungi, or parasites, and can rapidly spread from person to person. Some infections, such as MRSA – the so-called “superbug” – are resistant to many antibiotics, further complicating control and prevention.

An infection often makes an underlying chronic condition worse and can lead to hospitalization and additional costs. To win the war on infectious disease outbreaks, many senior living communities are escalating their infection control and prevention initiatives and partnering with hospital-based infection prevention programs to share best practices.

Pinpointing the challenges

One organization taking a proactive stance against infectious disease is StoneGate Senior Living, a leading provider of senior living services in Texas, Oklahoma, and Colorado. “Skilled nursing and rehabilitation facilities encounter many challenges in effectively implementing and maintaining infection prevention programs,” says Rhonda Abercrombie, StoneGate’s corporate director of quality and infection control.

“Unlike patients in hospital rooms, residents in senior living communities typically frequent common spaces, from dining rooms to rehabilitation areas – and spend a lot of time breathing the same air. This can increase the risk of transmitting pathogens. We have stringent disinfection procedures because the many shared areas where our residents congregate can be breeding grounds for disease.

“If a resident tests positive for an infection, we proactively treat other residents who have similar symptoms, even if they haven’t yet been diagnosed. We want to nip any infections in the bud because they can spread so fast from person to person.”

Preparing for government mandates

Post-acute care facilities have traditionally lacked the specialized infection control training of hospitals, a challenge the Centers for Medicare & Medicaid Services (CMS) is addressing through new rules on infection control for long-term care facilities. “StoneGate communities, along with our industry colleagues nationwide, are working to comply with recent mandates from the federal government,” says Dianne Sullivan-Slazyk, StoneGate’s chief clinical officer. “These directives are designed to lower overall healthcare-associated infection rates, prevent harm to residents and healthcare providers, and reduce overall cost burdens to care delivery.”

To participate in the Medicare and Medicaid programs, CMS has mandated that long-term care facilities have a trained, certified, dedicated infection preventionist on staff by November 2019. Infection preventionists are experts in preventing and controlling the spread of infectious diseases among patients, staff, and visitors. They are responsible for developing, enforcing, and evaluating the effectiveness of infection control policies and procedures; investigating disease outbreaks; and training staff members in prevention.

An earlier CMS requirement mandated that facilities have a formal program in place for “antimicrobial stewardship” – a coordinated plan designed to optimize treatment of infections and promote appropriate use of antibiotics. StoneGate’s program was launched in 2017.

“A major concern with antibiotics is that they may not be effective in treating the specific infection a resident is fighting,” Abercrombie explains. “Or, the antibiotics given may be unnecessary. This can lead to increased risk of contracting Clostridium difficile, or ‘C. diff.,’ a bacterial infection that can spread rapidly. Antimicrobial stewardship helps ensure the right antibiotic is used at the right time – and only when it’s truly needed.”

Paving the way for a safety-first future

“An integrated healthcare delivery system is a prime opportunity for acute and post-acute care to collaborate in reducing infectious disease,” Abercrombie says. “We’re seeing many positive results from this combined effort nationwide.”

A notable success is the Veterans Health Administration (VHA), the nation’s largest integrated healthcare delivery system. The VHA implemented a systemwide MRSA prevention initiative within its hospitals, spinal-cord injury units, and nursing facilities that has significantly reduced MRSA rates across care settings.

Collaboration is particularly critical in preventing sepsis, a serious bloodstream infection that can quickly become life threatening. “Many post-acute care facilities are joining forces with acute care partners to promote early sepsis detection,” Sullivan-Slazyk explains. “For example, StoneGate has partnered with Methodist Charlton Medical Center in Dallas, TX, and Southwestern Medical Center in Lawton, OK, to educate healthcare teams through a “Suspect Sepsis, Save Lives” campaign. The goal is to increase staff awareness of sepsis signs and symptoms for immediate intervention.

“Heightened collaboration across the delivery system – coupled with the government’s focus on improving infection control in all healthcare settings – bodes well for the future of patient care. Together, we’re creating a continuing care network that delivers quality care, contains the spread of disease, and puts patient safety first.”

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After a Stroke: Recovering, Relearning, and Regaining Independence

Each year, more than 700,000 people in the U.S. suffer a stroke, and about one-third of that number lose their lives. Strokes are the fifth-leading cause of death in the nation and the third-leading cause of disability.

Also known as “brain attacks,” strokes occur when the blood to the brain becomes blocked. Brain cells begin to die, and abilities controlled by the affected part of the brain – from movement to memory – are lost.

Although strokes can afflict people at any age, those over age 65 experience nearly three-quarters of all strokes.

Racing against time

How a patient is affected depends on where the stroke occurs in the brain and how much the brain is damaged. The earlier the stroke is identified, the better the patient’s outcome.

The American Stroke Association has offered an effective way to recognize warning signs of a stroke in progress. It’s called the FAST technique:

  • Face drooping
  • Arm weakness
  • Speech difficulty
  • Time to call 9-1-1

Thanks to increased public awareness, more patients are getting help within the first critical hour after a stroke.

“Immediate treatment is critical to minimize damage,” says Tori Owens, chief executive officer at Accel Rehabilitation Hospital of Plano. “After the patient’s medical condition has stabilized, the next step is a stroke rehabilitation program. A focused, comprehensive program – delivered by a stroke rehabilitation team – can help patients relearn lost skills, regain independence, and restore the quality of their lives.”

Certified by the Joint Commission for stroke rehabilitation, Accel has consistently shown strong results for medically complex patients in their improved ability to perform everyday tasks. “Essential to patient progress is motivation,” says Anh Nguyen, MD, the facility’s medical director. “It can make the difference between successful recovery and a lifetime of physical challenges. By understanding what motivates each patient, our multidisciplinary teams provide the inspiration to work harder in achieving individual goals.”

Recovering physically, mentally, and emotionally

Research has found that patients who participate in stroke rehabilitation programs typically perform better than those who don’t participate. “Rehabilitation helps stroke patients relearn skills that are lost when part of the brain is damaged,” Nguyen says. “These skills can include coordinating leg movements to enable walking or mastering the steps involved in any complex activity. Patients learn new ways to complete tasks, such as dressing using one hand or communicating differently if their ability to use language has been impaired.”

Rehabilitation also addresses mental challenges. A new study finds more than half of the individuals who have had a stroke have difficulty with such skills as planning, organizing, and social interaction. Comprehensive stroke treatment plans include speech and occupational therapy to help patients regain lost cognitive, communication, and social abilities.

An estimated 30 percent of stroke patients develop depression, yet as many as two-thirds of those patients do not receive treatment for it. “Psychological evaluation is as important as physical assessment,” Nguyen says. “At Accel, we take a holistic approach to treating stroke patients, addressing their emotional as well as physical needs to reawaken a sense of empowerment – and hope.”

Regaining abilities through advanced therapies and technologies

Promising new therapies are extending the window of treatment following a stroke. New medications are being tested to slow the degeneration of nerve cells deprived of oxygen. Medical devices are being developed to reach stroke-causing blood clots and restore blood flow in minutes. Biological therapies, such as stem cells, are being evaluated to replace stroke-damaged brain cells.

Along with therapy innovations, rehabilitation technologies are helping stroke patients regain their strength and function. For example, robotic technology enables earlier mobility, retraining impaired arms and legs through repetitive motions. Functional electrical stimulation applies electricity to weakened muscles and can restore voluntary motor functions, from walking to reaching. Wireless technology, such as biosensors for the arms, legs, and chest, helps monitor stroke patients’ progress in recovery. Video games and other computer-based therapies can improve mobility in a simulated environment.

“With these advances in therapies and technologies, the future for stroke survivors is brighter and brighter,” Owens says. “Whatever tomorrow may bring, state-of-the-art rehabilitation programs will continue to be key to recovery – helping patients gain back the life they once knew and move forward, one step at a time.”

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Alzheimer’s disease and the family caregiver: Deciding when to make a move

Elderly father adult son and grandson out for a walk in the park.

Consider the statistics. Every 65 seconds, someone develops Alzheimer’s disease, an irreversible, progressive brain disease that slowly destroys memory and thinking skills. Today, 5.7 million Americans are living with Alzheimer’s. By 2050, this number is projected to more than double, rising to nearly 14 million.

Much of the responsibility of caring for people with Alzheimer’s falls on the shoulders of family members. A total 16.1 million Americans provide unpaid care for people with Alzheimer’s. Family caretakers can face a cascade of challenges – emotional, physical, and financial.

Coping with the stress  

“Alzheimer’s caregivers typically experience a range of emotions,” says Marie Webster, director of nursing at Williamsburg Village Healthcare Complex, a skilled nursing center in DeSoto, Texas, and one of seven memory care communities operated by StoneGate Senior Living. “Along with stress and depression, they may feel anger with their loved one and then guilt for being angry.

“The result is often burnout, or what we call compassion fatigue. This is when the caregiver is so preoccupied with the suffering of the person they’re helping that they experience their own trauma. It’s not uncommon for caregivers to develop issues with their health, from insomnia to a weakened immune system. They can also face financial challenges if, for example, they need to modify their home significantly to accommodate their loved one’s changing needs, hire in-home help, or leave their job to provide full-time care.”

Connecting with respite care

One antidote to compassion fatigue is respite care. This program gives caregivers a short-term break while professionals trained to care for the person with Alzheimer’s take on the caregiving role. Respite care can be provided in the home, at special daycare centers, or in a skilled nursing or assisted living facility that offers overnight stays. 

“You can’t care for anyone else well if you’re not caring for yourself,” Webster says. “Taking time to relax and rejuvenate can provided a renewed perspective in your caretaking role.”

Considering a move to a care community

Family caregivers of a loved one with Alzheimer’s often realize they can’t provide the level of care required at home. The strain, risks, and responsibilities may have become too much, prompting the difficult decision to move a loved one to a memory care facility.

“As a person’s Alzheimer’s progresses, they need to be in a safe environment, where care is available 24 hours a day,” Webster says. “If you’re considering a memory care facility, it’s important to gather information ahead of time and start the search early on. If you wait too long, your loved one’s memory may be so impaired that their new residence will never feel like home.

“Take time to tour potential communities. Ask questions of staff. Visit with other families whose loved one resides at the facility. Observe how the residents appear. In determining if a community is the right fit for your loved one, there are so many considerations beyond cost.”

Confirming your choice

Webster offers 10 guidelines for evaluating residential community options for a loved one with Alzheimer’s:

  1. What level of care and personal assistance is provided?
  2. How do staff ensure the stability of a routine while maximizing resident autonomy?
  3. How does the physical structure of the facility support residents with memory loss and physical limitations? How is the community secured?
  4. What is the ratio of staff to residents?
  5. What type of specialized training and continuing education have the staff received?
  6. How do staff assess and monitor disease progression?
  7. How will staff communicate with you about your loved one’s care?
  8. What is the meal experience like? Are special dietary needs accommodated, such as pureed food for those with swallowing challenges?
  9. What activities are offered to keep your loved one physically, mentally, and socially active?
  10. Does the facility take a person-centered, strength-based approach to Alzheimer’s?

“When your loved one moves into a memory care community, you’ll likely find their quality of life improves and yours does, too,” Webster says. “With the assurance that your loved one is well taken care of, you can focus on spending time with them – not as a full-time caretaker, but as a devoted family member whose main job is providing comfort, companionship, and love.”

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