Things To Know

Things to Know: Alzheimer’s Disease

“Alzheimer’s disease is a progressive, degenerative disorder that attacks the brain’s nerve cells, or neurons, resulting in loss of memory, thinking and language skills, and behavioral changes.” This is the definition according to the Alzheimer’s Foundation of America. We have several residents with this diagnosis at CCRC and no two residents are alike. The signs and symptoms of the disease do not have a specific age or gender, it does not affect each person in the same way, and the stages of the disease do not begin at a certain point. Some people may stay in one stage for many years, while another may go through several stages very quickly. It is also important to note that Alzheimer’s is NOT a normal stage of aging. One of the best known symptoms of Alzheimer’s is memory loss. This includes short-term loss, which means you might not be able to remember what you had for lunch or even if you had lunch. Then there is long-term memory loss which includes your long ago memories. Short-term memories are the first to be lost.

A description that best illustrates these occurrences is to do the following:

1. Place your memories on a large black-board in order starting with earliest memories first.
2. Keep writing until you get to the latest memories you have.
3. Make sure to include all your best holidays and memorable experiences.
4. Take an eraser and take big swatches through the center of the memories.

Things to Know: The Importance of Movement 9/30/16

Movements are an important part of good mental and physical health at any age. Movement and Activity can range from taking a walk, to simply getting up out of bed for a while. Keeping active promotes independence and reduces drastic decline in functions and mobility.
The Benefits of Physical Activity
• Reduces the risk of developing chronic diseases
• Aids in the management of active problems such as high blood pressure, diabetes, obesity and high cholesterol
• Improves the ability to function and stay independent
• Reduces symptoms of depression and pain
• Improves balance and help prevent falls
Engaging in healthy movement helps stimulate the brain and assists in staying independent. We encourage simple healthy movements.

Things to Know About Heart Failure 9/10/16
What is heart failure?
Heart failure is a serious medical condition. It is one of the most common reasons people over the age of 65 are hospitalized.  The heart muscle slowly weakens and loses its ability to pump blood. The heart is unable to pump strongly enough and your body can’t get the blood and oxygen to meet the body’s needs. It can get worse over time and can even lead to death.  The good news is that there are medicines available that are proven to help manage it. One out of every 5 people will develop heart failure over the course of their lifetime.

Diseases that damage the heart can increase your risk of developing heart failure. Among them:
•Coronary heart disease
•Heart attacks
•High blood pressure

Certain behaviors can also increase your risk of developing heart failure, such as:
•Eating foods that are high in salt, fat, and cholesterol
•Not getting enough physical activity
•Being overweight

What are symptoms to look for?
•Shortness of breath
•Swelling in legs, feet, and ankles
•A dry hacking cough that doesn’t go away
•Feeling light-headed or fatigued
•Trouble sleeping when you lie flat
•Rapid weight gain (3 or more pounds in a day)

Foot Care 5/24/16

Foot problems are sometimes the first sign of more serious medical conditions such as arthritis, diabetes, and nerve or circulatory disorders.

Caring for Your Feet: Take a look at your feet often; use a mirror to look at the bottoms of your feet. Look for cutes, blisters, and ingrown toenails. If you have diabetes, be sure to check your feet every day. Remember to put your feet up when you are sitting down to help circulation in your feet. Where shoes when you’re outside, and if you cross your legs, be sure to reverse or uncross them often. Don’t smoke.

Make Sure the Shoes Fit: Wearing comfortable shoes that fit well can prevent many foot problems.

  • Most of us have one foot that is larger than the other. Make sure your shoes fit your larger foot.
  • Soles should give solid footing and not slip.
  • Low-heeled shoes are more comfortable, safer, and less damaging than high-heeled shoes.

To Prevent Infections:

  • Keep your feet clean and dry. Dry the area between your toes.
  • Change your shoes, socks, and stockings often to help your feet dry.
  • Don’t buy tight shoes.
  • Dry skin: use small amounts of cream or lotion on your legs and feet every day.

Common Problems:

  • Corns and Calluses: These are caused when the bony parts of your feet rub against your shoes. Corns usually appear on the tops or sides of toes while calluses form on the soles of feet.
  • Bunions: These are swollen, tender joints that can develop at the base of your big toes. They tend to run in families. They can be caused by shoes that are too small or have pointed toes.
  • Ingrown toenails: They are caused by a piece of the nail piercing the skin. This can happen if you don’t cut your toenails straight across so the corner of the nail can be seen above the skin.
  • Swollen Feet: This may happen when you have been standing for a long time. Both diabetes and peripheral artery disease can cause poor blood flow to the feet, which can cause scrapes or bruises to become infected more easily. This makes good foot care very important. Make sure to check with your nurse if you develop a sore on your foot that does not heal.

Good foot care and regular foot checks are an important part of your health care. 

Know Your Diet 4/11/16

At CCRC we observe and serve Liberalized Geriatric diets. Our diets consist of the following:

Regular diet: this diet is nutritionally adequate according to her Recommended Dietary Allowances (approximately 2200 to 2400 calories, 5-6 grams of sodium, and 80-90 grams of protein per day). No foods are restricted.

No Added Salt (NAS) diet: this diet is a regular diet served without an additional salt packet.

Consistent Carbohydrate (CCHO) diet: Regular diet with three meals with consistent amounts of CHO and a bedtime snack is encouraged. Foods sweetened with sugar are usually given once a day. To serve a stricter CCHO diet, fruit for dessert can be given at both lunch and dinner meals. At CCRC we have chosen to serve a ½ portion of the regular dessert at both lunch and dinner meals.

We also serve texture modifications of each of the above diets: the modifications include:

Mechanical soft: meats are ground with gravy to add moisture. Vegetables are usually fork tender.

Puree: all foods are placed in a commercial food processor and blended to a smooth consistency.

Thickened Liquids are also considered a mechanically altered diet. Liquid consistencies are as follows:

Nectar- like consistency, Honey-like consistency, or Pudding-like consistency. When on thickened liquids, items like ice cream, sherbet, frozen yogurt, gelatin, etc are not permitted, unless ordered by the Speech Therapist or physician.

Should you have any questions about your diet or diet modification, you can speak to our Dietary Director, when you visit or you may call and speak to her at any time.

Preventing Pressure Ulcers 1/22/16

Pressure ulcers…also called bedsores…cause discomfort, pain and can impact your quality of life. Preventing pressure ulcers can usually be prevented by diligent care and following simple procedures.

  • If you are immobile and sitting in a chair it is important to reposition often
  • Everyone needs to reposition at least every 2-4 hours
  • It is good to set up a reminder system to prompt you to reposition
  • Keeping your skin dry and clean is important to preventing pressure sores
  • Residents who are immobile, those who have diabetes and other conditions which make them vulnerable need to have their skin checked daily as they are at risk for pressure ulcers. Be sure checking skin is part of your daily care. If you see any signs of red skin or sores, report them to your nurse immediately
  • Be mindful not to drag skin across sheets as dragging can cause tears in delicate skin and cause a pressure ulcer
  • Use recommended supports to keep bony areas up off the mattress. Pressure relieving devices may include wedges, pillows and special mattresses
  • Good nutrition has been proven to help prevent and also to heal pressure ulcers.

Early prevention and treatment is a must to maintaining healthy skin.

Depression 12/30/15

According to The Merck Manual of Health and Aging, “depression is extraordinary sadness that interferes with the ability to function.” This sadness can be like a shroud of emotional emptiness, a deep sense of hopelessness or worthlessness. We know that depression affects 1 out of 6 elders. Even though some may have had depression in their earlier life, some develop depression during old age. Following are some of these types of depression identified by doctors: Major depression, Psychotic depression, Seasonal Affective disorder, Dysthymic disorder and Bipolar disorder. The cause of depression is unknown however it can be brought on by emotionally stressful life-changing events such as death of a loved one, ending of a significant relationship, or moving away from familiar surroundings. Placement in a nursing home can be one of the most stressful events of a lifetime. This is a time when independence is lost, familiar surroundings disappear and the patient can be at their most physically vulnerable. Physical activity, involvement in surroundings, feeling useful and believing there is still purpose gives us ways to combat the effects of depression in elders. Getting correct diagnosis and medical interventions are pivotal as well. As caregivers and family we must listen and observe for signs and symptoms of depression such as withdrawing from usual activities, crying or seeming hopeless. For more information call Belinda Skidmore or Pam Jackson 615-893-2624.

Antibiotics 11/22/15

When you feel sick, you want to feel better fast. But antibiotics aren’t the answer for every illness. What’s the harm in taking antibiotics anytime? Using antibiotics when they are not needed causes some bacteria to become resistant to the antibiotic. These resistant bacteria are stronger and harder to kill. They can stay in your body and can cause severe illnesses that cannot be cured with antibiotics. A cure for resistant bacteria may require stronger treatment and possibly a stay in the hospital. Most illnesses are caused by two kinds of germs: bacteria or viruses. Antibiotics can cure bacterial infections – not viral infections. Bacteria cause strep throat, some pneumonia and sinus infections. Antibiotics can work. Viruses cause the common cold, most coughs and the flu. Antibiotics don’t work. Talk to your healthcare provider or visit the Centers for Disease Control and Prevention website at for more information.

Physical Restraints 10/26/15

What is physical restraint?

A physical restraint is items used to restrict or restrain a resident from movement. Residents can’t remove restraints easily. Examples include vest and waist restraints, chairs and foam pillows that prevent getting up, bed rails and hand mitts.

What do residents and families need to know?

  • Residents, family members or guardians should help plan care to avoid restraints.
  • In most cases, restraints should not be used to keep residents from wandering.
  • Family and guardians don’t have the right to force nursing homes to restrain a relative.
  • Restraints can be harmful if used inappropriately.

Why can restraint use be harmful?

  • Restraining residents for long periods can lead to poor circulation, constipation, incontinence, weak muscles and bones, pressure sores, poor appetite and infections.
  • Restrained residents enjoy life less.
  • Restraints can cause agitation, less ability to do daily activities, less social contact, withdrawal, depression and poor sleep.
  • Injury or death can occur from strangulation on a restraint.

What does restraint mean to a resident?

  • Many restrained residents feel like they are being punished.
  • Imagine being in a chair with a tray table that prevents you from rising. You cannot move or stand by yourself, or independently get a drink of water, lie down, or get to the bathroom.

How can residents and family help plan care to avoid or reduce restraint use?

  • Ask about and attend care plan meetings.
  • Share with staff what things make a good day for residents.
  • Share with staff things that upset residents like early awakening, hunger, thirst or pain.
  • Work with staff to plan care that keeps residents strong, busy and able to move around the home safely.
  • Ask to have the same caregivers four days out of five. Residents are calmer with the same caregiver.

If you would like to discuss this important issue further, arrange a time to meet or call a Social Worker or MDS Nurse?


 Diabetes is a disease that affects the way your body uses food. When you have diabetes, your body either doesn’t make enough insulin or it can’t use the insulin that it makes. This causes you to have high blood sugar.

There are two types of diabetes, Type 1 and Type 2. In Type 1 the body doesn’t make insulin. In Type 2 the body still makes insulin but the cells can’t use it.

The cause of diabetes isn’t known, but you are more likely to have diabetes if someone else in your family does.

Your health care provider can check for certain symptoms and perform certain test to check you for diabetes.

Diet and exercise can help keep your blood sugar at a normal level and prevent other complications. Your healthcare provider may prescribe medicine and have you check your blood glucose level at home. Untreated or poorly controlled diabetes can cause major health problems. It is very important that you follow your healthcare provider recommendation when treating diabetes.

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