Practical perspectives on ambulation aids Choosing the best equipment, having it set up for you and being taught how to use it properly will help to keep you mobile and independent. This article explains a lot about mobility aids, however it is really important, especially if you have had a stroke or have some other neurological condition, to have an assessment by a physiotherapist. They will look at your physical capabilities, lifestyle, advise you on the type of equipment to best suit your needs, adjust the equipment and teach you how to use it safely and effectively. Our friendly Physiotherapist can help, just call us at Therapy Professionals Ph: 03 3775280 Email: [email protected] Selecting safe, effective ambulation aids for older adults involves a variety of factors. Guidelines vary with users’ needs and environment Author: Michael Moran PT, DPT, ScD from Aged Care NZ Issue 02 2021 ![]() Older adults may require ambulation aids for a variety of reasons, such as pain or decreased balance, strength, and endurance. Such problems typically result from some sort of degenerative process such as arthritis (eg reduced strength from pain/inactivity). Other factors include injuries (often from a fall) and surgery. An ambulatory aid can increase independence for many older adults with these problems. Practical considerations Typical ambulation aids include canes, crutches, and walkers. Selecting an ambulation aid requires the consideration of several factors, including changes in gait, weight-bearing status, falls risk, the environments that a person must negotiate; lifestyle, sensory (such as vision and hearing), cosmesis (making someone or something look acceptable), and cognition. A general rule of thumb is to select the least restrictive device (eg a cane rather than a walker) that promotes independence to the greatest extent possible. Keep in mind that an aid is of no value if the individual won’t use it. The optimal location for determining the ideal ambulation aid for older adults is in their living environments. In this context, environment means all or almost all of the places older adults typically inhabit in a normal day or week. For instance, it is unwise to select a device that aids mobility on level surfaces but hampers the use of steps. An example is a wide-base quad cane that aids a patient’s mobility in the home but has a base too large for proper use on the steps leading to or from the home. Deciding what ambulation aids best suit older adults’ needs requires an accurate assessment of individuals and their typical environments. Community based assessments often more accurately identify patient-specific issues and problems. While elders may try different ambulation aids in an institutional setting, such as a hospital or a rehabilitation facility, and may even be extensively trained in their uses, carryover to a home or community setting may be impractical or even unsafe. ![]() Typical problems and potential solutions Surfaces (inside and outside): the most common surfaces an older adult needs to negotiate are level, inclined and elevated (steps). Sometimes an ambulation aid isn’t the solution; portable ramps or a wheelchair may offer better options. For instance, if individuals need to traverse a long. level distance, they may not have the necessary endurance. Using a wheelchair could be less stressful and help them avoid exhaustion. Walking isn’t the only concern related to the mobility of older adults. They need to possess the ability to change surface heights and levels safely. Stair glides and seat lift chairs can help previously dependent individuals become independent. Securely mounted handrails can sometimes substitute for ambulation aids for elders who can negotiate steps. It’s important that the railings be secure and installed at a height suitable for the individual requiring assistance. In most situations, having the handrail at the level of the person’s greater trochanter (near the hip) is appropriate. If a landing is adjacent to the set of steps, the railings on the landing should be level rather than on angles as they are on the steps and likewise should be situated at the height of the greater trochanter. Walking speeds: How quickly does the individual need to walk? Many times, a person’s preference determines walking speed. However, some situations, such as crossing a street with the traffic light, require travelling a given distance in a specific period of time. If ambulation aids such as walkers slow down elders so that they are unable to cross streets at a timely pace, it may be essential to consider one of several changes. The situation may require a different aid, retraining with a faster speed, such as taking the arm of another person. Functional needs while using aids: Do individuals conduct all daily activities on one level, or must they also use steps? Elders may benefit from having two of the same ambulation aids – one at the top and one at the bottom of the steps. Handrails then become the aid on the steps, but older adults don't need to carry an extra device while using the steps. Some older adults need to carry items with them as they walk. If they can use both hands, a single-hand aid such as a cane or crutch frees the other hand for carrying tasks. Different strategies are required if an elder uses both hands on ambulation aids (eg a walker or canes or crutches). Fitting ambulation aids Variations in footwear provide the most challenging problem in fitting ambulatory aids. Individuals select and wear different shoes, or sometimes no footwear at all. Slippers, shoes, boots, and other footwear can effectively change a person’s height. Aids fitted when older adults wear sneakers may be too tall for the same individuals who walk to the bathroom at night wearing nothing on their feet. While it’s uncommon, some people use a night cane or one fitted for use without footwear. Another factor to consider when fitting an ambulation aid is a change in posture. A device suited to a person walking in a flexed trunk posture may become too short if the individual can assume a more upright posture. For example, if older adults use an aid to help relieve low back pain and subsequent medical intervention, such as injections in the back, relieves the pain, it’s likely they would assume a more upright posture and the aid would need to be refitted. In some cases, the pain relief eliminates the need for an aid. Unfortunately some patients demonstrate an increased flexion posture (eg from increasing kyphosis associated with spinal osteoporosis and /or compression fractures). In such cases, height adjustment of the aid to accommodate for a shorter individual is usually necessary. ![]() Keeping it practical and effective Needs for ambulation aids can change over time. An older adult recovering from hip replacement surgery may need a walker at first but eventually progress to walking with a cane and, ultimately, with no aid at all. In selecting ambulation aids of any kind, there are many factors to consider. Walkers are multi-legged items that can include wheels of varying heights and widths. Since inappropriate wheels can increase the energy required to move the walker on carpeted or irregular surfaces, wheel selection is critical. Usually wheels are installed on the front legs of a walker. Modification of a walker’s back legs allows some older adults to ambulate better with a wheeled walker. Tennis balls on a walker’s back legs permit them to slide more easily on some surfaces such as tile. However, the drag of the tennis balls on carpets may be more than an older adult can handle. For use on carpet and most surfaces, plastic skis on the back legs can reduce friction. While some walkers are designed for use on steps, experience proves that the added weight and difficulty of use outweigh the benefits. As previously noted, even if a walker can be used on steps in a home, it probably won’t be useful on other types of steps, such as on a bus. Also if handling the weight of a device such as a standard ‘pickup’ walker leads to fatigue, it may increase the risk of a fall. In such cases, adding wheels may allow a patient to walk functionally but avoid excessive fatigue. With some wheeled walkers, brakes may be an appropriate feature. Brakes can be an appropriate feature. Brakes can be operated by exerting downward pressure on a part of the walker or by squeezing a lever-type hand attachment. It’s important for the individual to be capable of functionally using the brakes. An increased tendency to fall may occur if elders use a brake that requires squeezing a device, causing his or hand too loose contact with the support grip. ![]() The most commonly used crutches are axillary crutches or the kind that fit under a person’s upper arm. One problem specific to axillary crutches is that older adults tend to lean on to the part that comes up under the shoulder, especially if the crutches are too long. Placing weight on the top of the crutch this way can lead to discomfort, but a proper crutch height can effectively eliminate the problem. By design, the top of the axillary crutch will come near the individual’s underarm. If clothing is in the way, the top of the crutch may not lie squarely under the axilla and can move forward abruptly during use, possibly leading to a fall. In this case, patient education and adherence to proper technique provide the ideal solution. Another common problem with axillary crutches is that even though the length of the crutch may be correct, the handgrip can be located improperly. While variations depend on specific patient needs, the handgrip is usually placed so that the angle of the elbow is approximately 45 degrees. ![]() Canes vary considerably in both appearance and use. Canes are meant to help individuals with balance, not individuals who have weight-bearing limitations. Canes are typically single-arm items, though an older adult may occasionally need one for each hand. Commonly called straight canes, these aids are in fact rarely straight. The top part of the cane usually has a rounded appearance. The rounded portion may serve as the hand grip, or a moulded grip may be used. Canes may have a single support leg or several, such as a quad cane with four support legs. Designs vary, but quad canes are usually grouped as those having either a narrow or wide base. While more stable than a single-leg cane, quad canes have the possible disadvantage of being too large to fit entirely on a step. One solution is to turn the quad cane sideways, but that changes the function of the hand grip. Lessons learned Over decades of working with community-based older adults, the most frequent problem encountered arises when an older adult uses an ambulation aid that was fitted for another person. While their efforts are well intentioned, local community groups that lend ambulation aids don’t usually have specialists to fit the devices to the older adults who intend to use them. Frequently, the situation may result in an older adult attempting to use an aid that is too short or too tall. Older adults sometimes also take time or money-saving shortcuts when attempting to use an aid fitted for another individual, such as a deceased spouse, or family member. Many older adults use ambulation aids. Properly chosen and fitted aids can reduce dependence and enhance independence. It’s essential for caregivers to remember that an older adult’s needs for ambulatory aids may vary over time. And the type of ambulation aid required may change as an older adult’s condition changes. Professional input can make the difference between safe and unsafe situations. Selecting an ambulation aid is usually best done by a physiotherapist, in the environment, where it will be used. This helps to assess an older adult’s willingness to use an aid and to identify common obstacles not typically seen in a clinician’s office. Author: Michael Moran PT, DPT, ScD from Aged Care NZ Issue 02 2021 Reference Tsai, H. A., Kirby, R. L., MacLeod, D. A., & Graham, M. M. (2003). Aided gait of people with lower-limb amputations: Comparison of 4-footed and 2-wheeled walkers. Archives of Physical Medicine and Rehabilitation, 84(4), 584-591. Turning the tide on diabetes More than one in four Kwis have diabetes, and it’s estimated that another 100,000 are undiagnosed. Diabetes New Zealand represents and supports people with diabetes. They have branches across New Zealand with staff and volunteers who help people to live well with diabetes From: Aged Care New Zealand, Issue 02 2021 Our vision is that the tide will be turned on diabetes, a health condition that threatens to overwhelm New Zealand’s health system both now and in the future. Our mission is to ensure that all people living in New Zealand who are affected by, or at risk of, diabetes have access to the appropriate tools, information and support essential for their health and wellbeing. People aged 40 years or over are at increased risk of developing Type 2 diabetes, but many problems with diabetes can be prevented with early diagnosis and good management. What’s more, you can support older people in the community to take action that may prevent them from ever getting diabetes. Diet, exercise, and looking after themselves both physically and emotionally, all contribute to managing or preventing diabetes. And these tips can be applied to carers too. You are what you eat Older people with diabetes need to eat a balanced diet to help manage their blood glucose levels as well as address any other dietary issues they may have. While managing excess weight is key earlier in life, for those over 70 a little excess weight can actually reduce the risk of poor health. Malnutrition and becoming underweight is an increasing issue for older people. In the case of an older person with diabetes who is also malnourished, they will need both their diabetes medication and their diet reviewed by appropriate members of their health team. With or without diabetes, as one gets older one should drink plenty of water and maintain a good diet of breakfast, lunch and dinner every day. Unless otherwise advised by their health professional, older people should be eating meals that:
It is important to remember that diet for older people with diabetes will often be indivdualised and should always be under the supervision of their health team. Get physical Exercise is especially important for people with diabetes as exercise helps insulin lower blood glucose levels. For older people, regular weight bearing and muscle strenghtening exercise can also help prevent bone loss and, by enhancing balance and flexibility, reduce the likelihood of falling and breaking a bone. Walking is an ideal form of basic physical activity. Firstly, it’s low to medium intensity - people can be encouraged to walk briskly so they elevate their heart rate but aren’t gasping for air. It is easy on the joints, it promotes good blood flow, can be done on a whim at any time of day or night, its free; and there is no complicated equipment required. Active walking promotes good blood flow by increasing heart rate without making it pound out of the chest, and as they become more accomplished walkers they can make it more challlenging. The first and most important step is to get some good shoes to walk in, comfortable and with plenty of padding in the innersole. Support those with diabetes-related foot complications to talk with their podiatrist about shoe and sock recommendations. Although walking is easy, it is still a physical activity and should be treated as such. Remember to also promote stretching after walks, ensure good water intake and encourage getting some rest. ![]() Best foot forward Foot care is crucial for people with diabetes, and problems with feet in old age are one of the main reasons members of your community might struggle with exercise. Fortunately, giving feet some extra care can help a lot.
For those with diabetes, high blood sugar can cause neuropathy (nerve damage) and poor blood circulation over time. It also raises infection risks, as bacteria thrive on sugar. If someone you support has nerve damage or poor cirulation in their feet you will need to take additional precautions; see www.diabetes.org.nz/complications-feet. Get them to see their doctor immediately if they get any sort of cut on their feet. Love your skin and it will love you Health professionals believe people with diabetes can reduce their chances of skin problems by taking good care of their skin and managing their diabetes properly. Here are their top tips
Emotional wellbeing also needs attention The past year has been frightening and stressful for everyone. For those who are especially vulnerable to COVID-19, including those who are older and/or with pre-existing medical conditions such as diabetes, it has been more stressful for most. Diabetes New Zealand undertook new research in October that revealed distress related to COVID-19 had been even more acute for the quarter of a million people living with Diabetes New Zealand. The good news is that the research also showed that practicing self-compassion can help reduce stress, which in turn can help with better diabetes management, improve overall health and wellbeing and also mental health. The simplest way to assist those you support to manifest self-compassion in daily life is to discover how they already care for themselves, and then aid them to do these things when life becomes difficult. Physical – soften the body How would they care for themselves physically? Exercise, massage, warm bath, a cup of tea? Make time for these when things get tough. Mental – reduce agitation How do they care for their minds, especially when they’re under stress? Suggest meditating, reading an inspiring book, or something you know they find reassuring. Emotional – support them to soothe and comfort themselves How do you care for yourself? Pay attention to how people in your care do it for themselves. For example, they might enjoy being outdoors, writing a journal, or cooking. Relationships – connect with others How or when do they relate to others in a way that brings them genuine happiness? Perhaps they could meet with friends, send a birthday card, play a game with the grandchildren Spiritual – respecting and embracing their values What do they do to care for themselves spiritually? Maybe they pray, walk in the bush or on a beach, or take pleasure in helping others. Finding the things that help those you support to feel well helps you to support them better. And who knows – it might help you to care better for yourself too. Diabetes New Zealand Phone: 0800 342 238 Website. www.diabetes.org.nz Reference: Aged Care NZ Issue 02 2021 Caring for Seniors with Autism | Senior Care - Parent Giving Article from American website - www.parent giving.com ![]() When we hear about autism spectrum disorder (ASD), we often think about small children and the challenges they will need to face throughout their lives, but most often than not we forget that these children will grow up and turn into young adults and then seniors. Although autism can’t be cured, there are many approaches that you, as a caregiver – whether you are a beloved family member or a paid professional - can make to facilitate the life of an elderly that has been diagnosed with ASD. Autism Spectrum Disorder can be diagnosed at any stage in life, however, when it is rather later than earlier, it can be a little more challenging - but not impossible - to adjust. If diagnosed at a later stage in life, usually, a series of changes in the daily routine and care needs to be made. If the diagnosis was made in the early years, this is something that you will be more accustomed to and dealing with a senior with Autism could be a little less changeling for the family. We must all agree that one of the most important aspects of our existence is having a good quality of life, and so, with that in mind, here are some great tips on how to take care of seniors with ASD. ![]() Keeping a daily routine In general, individuals with ASD need a healthy daily routine. These simple everyday tasks will be extremely powerful as they will reinforce a feeling of happiness, stability and overall well-being. When these feelings are surfaced and experienced, it will be much easier for them to accept and handle other changes when needed. A great proactive plan is to sit down and make a morning schedule or a to-do list with the ASD senior. The routine must be straightforward and easy to follow. Some examples can include healthy meal times, short walks - if possible, an art class, medication at a specific time of the day, attending a support group, quality family time. Also, keep in mind that a hygiene routine should be included. Reminding the senior with ASD of the good points of their appearance can be a good way of encouraging healthy hygiene habits. A safe environment for everyone
It is imperative to ensure that the environment is prepared according to the difficulties of each individual. For example, if the elderly person has difficulty moving around, it is essential to avoid slippery rugs, floors and cluttered spaces. Another idea is to install wall bars around so they can walk freely when needed. Sociability is a must To improve the individual's quality of life diagnosed with Autism, a key element is social interaction. Whenever possible, seniors should attend a support group. Support groups can be a great place for them to identify with other people that face the same everyday challenges. Always go slow and see how they feel - they don’t like being pushed too hard into doing something they are not 100% comfortable with and sure about. A good idea is to start nice and easy, with an easy topic and then add someone else into the conversation. Since social interaction can be harder for seniors with ASD, support groups could be added to the routine. Family support can be life-changing to ensure good self-esteem and results in individuals with autism in older stages in life, it is important to have a good, caring and healthy family environment. Although it is not always easy to deal with elderly and autistic patients, the family is one of the most important roles in this process. Be kind to their sensitivities People with autism are far more sensitive as their senses are sharper than normal. Music and general noises will sound louder in their ears, lights can appear much brighter for them and smells can feel stronger. With this in mind, try to find out which one of these senses can be a trigger and work towards minimizing it. A lower TV and radio can be more accommodating while dimming the light or using side lamps can do the trick for avoiding distractions and stress. Watch out for the non-spoken language Autism affects the way people communicate, especially seniors, so you will need to be extra sensitive when it comes to understanding what they need and figure out what is going on with them. Simple questions such as “How are you feeling?” should be avoided and replaced with more specific questions such as “Are you happy/sad today?” “Are you feeling leg cramps or stiff joints?” Specific questions are more prompted to result in clear replies. Some ASD seniors may panic one day when they realize that they have lost their hearing or can no longer see, so all eyes should be on them to understand the unspoken words of what is happening. Reference: https://www.parentgiving.com/elder-care/caring-for-seniors-with-autism/ Update from the Ministry for Disabled People Establishment Unit It’s been a busy month at the Ministry for Disabled People Establishment Unit (EU) with just a few weeks to go before the new Ministry goes live on 1 July. The EU team is working hard on ensuring that the disability support services people receive will continue without disruption, that staff are in place for day one as well as all the foundation work required to start a Ministry. Name of the new Ministry The new Ministry will have three names – an English name, a te reo Māori name, and a NZSL name. Thanks to those of you who took part in the consultation for the new Ministry's name. The consultation process has now closed and the EU will provide an update on this soon. Further engagement opportunities Keep an eye on the EU’s engagement platform and Facebook page so you can continue to have your say on a range of topics or give them your ideas on the ideas wall. The EU is also working on other formats for you to connect with them including freepost, 0800, SMS, stakeholder networks and face to face. They‘re also planning to use public spaces (such as libraries) and create informative brochures and posters to help people find out about and connect with the new Ministry. Feel free to contact the EU if you would like copies of this material. Looking to the future From 1 July under the new Chief Executive of the Ministry will:
The exact details under each of these headings will be the role of the new Ministry under the leadership of the new Chief Executive. The appointment of this vital role is being managed by the Public Service Commission and it is understood this has been going well and they will be ready to appoint someone by the time the new Ministry starts in July. The EU encourages all our important community members to give feedback on the future Ministry’s work in whatever format you find easiest. Please see below for all the ways currently available – the EU plans to have further options in the coming weeks.
Reference Disability Directorate of the Ministry of Health. Update https://www.health.govt.nz/our-work/disability-services/disability-publications/disability-directorate-newsletter Autumn is a time for tiding up and getting ready for winter. In the garden we’re cutting things back, raking up leaves and collecting fruit from the trees. Being outside in the garden has the added benefit of exposing your skin to sunlight which help you store vitamin D ready for the winter. It’s also a busy time for preserving all excess fruit and other produce by bottling, freezing or dehydrating ready to be used in the winter. It’s a good time to attend to the things that may cause you to slip and trip around your home like paths that get no winter sun, pavers which are lost or broken, replacing outside light bulbs and cutting back foliage covering your paths. Covid Covid is now well established in the community, and we are all feeling the effects of sickness and isolations. This could be complicated by normal seasonal colds and flus this winter so ensure you have good stocks of food and medicine at home. The Burden of Ageing Relatives If you are worried about an older relative’s living situation, we can help alleviate your concerns by checking how they are managing. After doing so we would either suggest residential care or improve their independence by suggesting equipment, exercise, socialising, assistance with everyday tasks and adapting their environment. For a small fee we could make a difference to the stress in your life. Since 1985 Therapy Professionals has worked with the elderly, providing:
![]() Services for Children who Struggle with Life and Learning Children with major disabilities are well served by Health and Education, however many other children struggle with a range of physical, thinking or sensory problems that cause challenges for learning, social interaction and behaviour. They may:
For many years Therapy Professionals has provided services for children with disabilities, at home and in schools. If you recognise a child with any of these issues a Therapy Professionals therapist may be able to help, contact us today. ![]() Enable Equipment – what will be funded Government funded equipment is available for people who are disabled to assist them to live as independently as possible (the exception is those in Rest Home and Hospital care). To access this equipment, you can go through your GP and get a referral to the Adult Community Therapy Team or come straight to Therapy Professionals who will be faster at doing an application for you however we have to charge for this. Repairs and Maintenance The contractors are: Mobytech Limited 0800 662 983 Email: [email protected] Wheelchair Services Plus 0508 MOBILITY (662 454) 03 366 8815 Email: [email protected] Total Equipment Care Services Limited 03 423 3574 [email protected] Rehab Enterprises 027 230 5974 [email protected] ![]() Returning Enable equipment If you or your client no longer needs the equipment please contact Enable and ask them to collect it. First ensure the equipment is from Enable. Enable equipment has a silver label like this. If the label is different or it has no label the equipment maybe owned by the CDHB or another organisation. They have a free call number 0800 362 253 or 0800171995 ![]() Physiotherapy Assistants – Legal requirements The employer, Physiotherapy Assistant and supervising Physiotherapist need to be very clear on the limitations of the Physiotherapy Assistant role and ensure they are adhered to. Tasks specifically excluded from the Physiotherapy Assistant’s role that could put the employer and employee at risk of legal action are:
Any NZ new graduates and overseas Physiotherapists waiting for NZ registration must be considered Physiotherapy Assistants until their registration is confirmed. Physiotherapy Assistants in residential care facilities must be supervised by a NZ Registered Physiotherapist. ![]() Having trouble finding a gift? Therapy Professionals gift vouchers could be the answer. If you want to give an elderly relative or a child with special needs a little help, and don’t know how? A gift voucher can be a very good way to do this. Choose any amount from $50 or over to go towards Physio, Speech Language, Music and Occupational Therapy and Dietetics. If you’re not sure what these therapists do, check out our website http://www.therapyprofessionals.co.nz Therapy Professionals is a community based private practice of Physio, Speech Language, Music and Occupational Therapists and Dietitians. We work with people of all ages with disabilities, our special interests being ageing, intellectual and physical disabilities.
We can help. We come to you. Phone: 03 377 5280 Email: [email protected] Website: www.therapyprofessionals.co.nz ![]() Tips on storing your fresh food to last longer We’ve all had the experience of going to our fruit bowl, pantry or fridge to find wilted, rotten, or mouldy produce which we throw out! This is a waste of good food and money. With the present inflation rate many of us can’t afford this kind of waste so here are some tips on how to make your produce last longer. The fridge and freezer - These are great inventions for improving the longevity of our perishable produce. Your fridge should be between 4-5 degrees Celsius. The temperature will vary between seasons so check the temperature occasionally. Place your fridge or freezer out of direct sunlight and heat so it doesn’t have to work so hard to keep cool and to keep an even temperature throughout the day. Cover all food in the fridge to prevent cross contamination and tainting. In your fridge store veggies in the bottom with meat, poultry and fish on the shelf above and ready to use in the top shelves. Anything that goes in the freezer should be labelled with what it is and the date frozen. Dehydrators are also a good way of preserving excess produce. Tips for fruit and veg Most fruit and veg can be kept in the fridge either in the veggie drawer or an airtight plastic container with a paper towel. The exceptions being potatoes, kumara, onions, garlic and bananas. Excess fruit and veg can be frozen either by first blanching, stewing or snap freezing, then placed in a plastic airtight container or plastic bag. Bananas - Keep your bananas away from other fruit especially if you like them greenish as the gas released by other fruit will ripen the bananas quickly. Once your bananas are ripe, they will release gas which will ripen other fruit. Freeze uneaten bananas without skins on in an airtight plastic bag or container and use for smoothies, baking or fried banana. Avocado – ripen before putting in the fridge, to speed up their ripening put them under your bananas Managing your fruit bowl – Keep only a day’s supply of fruit in your fruit bowl. As cold fruit is not as flavoursome as warm fruit, take a day’s supply out of your fridge at night so it’s at room temperature the next day ready for eating. Keep your fruit bowl out of the sun and in a coolish place. ![]() Potatoes - store with a little soil still on, in a cool, dark, dry place, such as a pantry or cupboard. Use a storage container that is well-ventilated, such as a crate, a cardboard box with holes punched in it, or any container that will allow any excess moisture to evaporate. Onions – keep in a ventilated space, such as on your bench or pantry, in a paper bag or a wire basket. ![]() Onions and potatoes – do not store next to each other. Onions produce a gas that makes potatoes seed quickly. They can be in the same cupboard if separated with good ventilation. Limp veggies such as lettuce, broccoli, celery and asparagus can be revived by placing the stems in a container of cold water. Pre bought packets of lettuce, salad mixes, spinach, coleslaw, open the bag and put a paper towel down each side or place in a brown paper bag. Meat – should be stored in the fridge. If it’s not going to be eaten by the use by date, store it in the freezer in an airtight well sealed plastic bag. In the fridge store meat in butchers paper tightly wrapped, in Styrofoam container it came in or an airtight container or plastic bag. If Styrofoam container is open or punctured use another method of storing. If freezing, remove from Styrofoam and put in airtight plastic bag or plastic wrap. Dairy produce - needs to be stored in the fridge and milk and cream are fine to be frozen. Cheese – once opened, if in plastic wrapping it is best kept in an airtight container with a paper towel or in a tightly wrapped beeswax cloth. For cheeses that come in paper wrappings, rewrap tightly in the paper they came in and put in an airtight container. ![]() Eggs – will last longer if stored in the fridge, however if you want to do any baking they are best kept out of the fridge in a dark place. Bread – store in the freezer and bring out what you need. If you are going to eat the bread in the next three days and it came in a plastic bag, leave the bag open so the bread doesn’t sweat and go mouldy store in a dry, dark, cool place. Keep the crusts on the ends to help stop the middle of the loaf from drying out. These are just some tips on how to store your perishable food, so it lasts longer. Poorly stored and cared for food can be a source of food poisoning, if you need help keeping your food safe to eat Therapy Professionals Dietitians can help. Is a child you know struggling at home and school? ![]() A child you know may
Physical, thinking or sensory problems may create challenges for learning, social exchanges and behaviour. Some common causes are:
Many children will not have a diagnosis; however, Therapy Professionals friendly therapists may be able to help. Some common issues families and teachers may experience are in the following lists: ![]() Movements
Hand skills
![]() Sound, touch, sight, taste, smell or balance
Thinking
Relating to others
![]() Behaviour
One or more of these problems may indicate a need for help We know when a child is struggling, it affects the whole family and classroom. Our therapists will give support and advice as required by:
Therapy Professionals Therapists
will work with people of all ages who are struggling with physical, thinking, sensory, social and behavioural challenges. We provide services wherever the person/child lives, works, learns or plays. When desirable we will work closely with:
If a child you know needs help, you don’t have to struggle alone, we can help we can come to you. Just contact Therapy Professionals: Ph: 03 377 5280 Email: [email protected] Website: www.therapyprofessionals.co.nz Behind Closed Doors “ Elder abuse has been defined by the World Health Organisation as ‘a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person”. Author: Hanny Naus, Elder Abuse National Educator for Age Concern NZ ![]() Elder abuse can take various forms, including financial, physical, psychological, emotional and sexual abuse, or neglect. No older person should be subjected to any form of abuse. Age concern New Zealand is a charity dedicated to helping older New Zealanders have a good quality of ‘later ‘life, and unfortunately, supporting people who are experiencing elder abuse is significant part of their operation. Hanny Naus, professional educator, elder abuse and neglect (and registered social worker) at Age Concern New Zealand loves her job advocating for people who deserve to be treated well, and with the dignity and respect, and said: “It is great to be part of such a dedicated, caring and expert team but the real reward comes in helping the most vulnerable when they are unable to help themselves. “Elder abuse is a hard issue to raise, and it is often underreported due to the perceived shame that may bring to a family. But we cannot turn a blind eye any longer as in many situations people’s choices are being disregarded, they are not getting the care they need, and their voices are not being listened to”. Hanny is working hard to increase awareness of elder abuse and to get more people asking questions within their families and communities. Hanny says many people think it won’t happen to them or to someone in their family, so it is confronting when it does. However, Age Concern would rather people seek support early, than let it go and have it escalate. “If one suspects something is not right, even have a notion that something doesn’t feel right or have an inkling someone is being abused then ask for help. These are often complex situations because they involve family members so always make sure you talk to a range of people within the family, as they might be worries too,” adds Hanny. Raising Awareness It is horrible that this type of behaviour is taking place in our families, neighbourhoods and communities as everyone has the right to be treated with dignity and respect. The theme for World Elder Abuse Awareness Day in mid-June this year was Elder Abuse Hits close to Home and Age Concern New Zealand highlighted the fact that more than three quarters of alleged abusers are family members. “We see too many adult children and grandchildren taking advantage and manipulating their parents and grandparents,“ adds Hanny. The overall campaign was a success, but Age Concern want to continue to strengthen conversations around elder abuse as they believe and think that bringing the issue out of the shadows will encourage those who are silently suffering to reach out for help. So, what does elder abuse look like in New Zealand? What is Elder Abuse? Elder abuse occurs where an older person is harmed (physically, emotionally or financially) through the actions of another: usually those they trust. No one is immune. It can happen to men and women of every culture, faith, ethnicity, and socio-economic group. It affects those who own a great deal, those who own very little and all those in between who are unable to effectively protect themselves. Elder abuse is a very serious issue. It is estimated that at least 17,000 older people in New Zealand are being abused. Last year Age Concern investigated more than 2400 cases of elder abuse – that is nine referrals each working day. What does elder abuse look like? It is common for several types of abuse occur together. The types of abuse include: Psychological abuse: Actions and words that cause misery, anxiety of fear, For example:
Financial Abuse: Illegal or improper use of money, property, or other assets. For example:
Scams that establish relationship with the older person for exploitation e.g romance scams. Physical Abuse: Infliction of pain, injury or use of force. For example:
Neglect: Not providing for physical, emotional or social needs. For example:
Neglect: Non-consensual sexual acts or exploitive behaviours. For example:
Institutional abuse: A policy or accepted practice within an organisation that does not respect person’s rights or causes them harm or distress. For example:
Why don’t older people seek help when they are abused? Some of the reasons why an older person does not tell anyone about the abuse are:
How can you tell if someone is being abused or neglected? The following signs may indicate an older person is being abused
Whether it is perceived as need or as greed, those who perpetrate elder abuse are disregarding those who trust them. The personal losses associated with abuse can be devastating and include the loss of independence, homes, lifesavings, health, dignity and security. Elder abuse and neglect can also be a significant cause of injury, illness, lost productivity, isolation and despair. Abuse can reduce a person’s independence by undermining their self-esteem and confidence. It also damages family/Whanau relationships, financial security and mental and physical health, increasing dependency on health and support agencies that may result in the need for residential care. It has been established that many older people do not like to reach out for help because their family is sometimes the only support they have. They may also feel embarrassed and ashamed to speak out about what their family is doing to them. If there is concern and one can talk to the older person about the possible abuse, be sure to only do so when they are alone and the potential abuser is not within earshot. Let the older person know you care about them and are worried for them. Giving encouragement and support is an important way people can help an older person to take action. ![]() How you can help: Tips to be kind and prevent abuse
What else can you do? Take a stand against ageism with Age Concern and sign up on www.ageconcern.org.nz as an Age Concern New Zealand Dignity Champion and pledge to:
If you or someone you know has questions about elder abuse, they can get in touch with their local Age Concern for free and confidential advice and support by visiting www.ageconcern.org.nz or Freephone 0800 65 210. If there is a crisis or emergency and someone’s safety is at risk please call emergency services on 111. If you would like more details about being an Age Concern Dignity Champion, please visit www.ageconcern.org.nz. Reference: Author: Hanny Naus, Elder Abuse National Educator for Age Concern NZ Aged Care NZ Issue 02 2021 Hypertension? What does gum health have to do with it? Periodontal bacteria cause damage to the gums and trigger an inflammatory response that can impact the development of systemic disease including hypertension Co-authors: Jeanie Suvan, DipDH, MSc, PhD; Marco Orlandi DDS, PhD; Queralt Miro Catalina, BSc, MSc and Jose Nart, DDS, PhD Article from Aged Care NZ Issue 02 2021 ![]() According to new research, adults with periodontitis, a severe gum infection, may be significantly more likely to have higher blood pressure compared with individuals who had healthy gums. Previous studies have found an association between hypertension and periodontitis; however, research confirming the details of this association is scarce. Periodontitis is an infection of the gum tissues that hold teeth in place can lead to progressive inflammation, bone loss, or tooth loss. Prevention and treatment of periodontitis is cost-effective and can lead to reduction of systemic markers of inflammation as well as improvement in function of the endothelium (thin membrane lining the inside of the heart and blood vessels). “Patients with gum disease often present with elevated blood pressure, especially where there is active gingival inflammation, or bleeding of the gums,” said lead study author Eva Munoz Aguilera, DDS, senior researcher at UC Easterman Dental Institute in London. Elevated blood pressure is usually asymptomatic, and many individuals may be unaware that they are at increased risk of cardiovascular complications; the study aimed to investigate the association between severe periodontitis and high blood pressure in healthy adults without a confirmed diagnosis of hypertension. The study included 250 adults with generalised, severe periodontitis (≥ 50 percent of teeth measured with gum infection) and a control group of 250 adults who did not have severe gum disease, all of whom were otherwise healthy and had no other chronic health conditions. The median age of the participants was 35 years, and 52.6 percent were female. All participants underwent comprehensive periodontal examinations including detailed measures of gum disease severity, such as full mouth plaque, bleeding of the gums, and the depth of the infected gum pockets. Blood pressure assessments were measured three times for each participant to ensure accuracy. Fasting blood samples were also collected and analysed for high levels of white blood cells and high sensitivity C-reactive protein (hsCRP), as both are markers of increased inflammation in the body. Additional information analysed as confounders included family history of cardiovascular disease, age, body mass index, gender, ethnicity, smoking, and physical activity levels. The researchers found that a diagnosis of gum disease was associated with higher odds of hypertension, independent of common cardiovascular risk factors. Individuals with gum disease were twice as likely to have high systolic blood pressure values ≥140 mmHg, compared with people with healthy gums (14 percent and seven percent, respectively). Researchers also found the following:
“This evidence indicates that periodontal bacteria cause damage to the gums and also triggers inflammatory responses that can impact the development of systemic disease including hypertension” said corresponding author Francesco D’Aiuto, DMD, a professor of systemic diseases including hypertension” said corresponding periodontology and head of the periodontology unit of UCL Eastman Dental Institute. “This would mean that the link between gum disease and elevated blood pressure occurs well before a patient develops high blood pressure. Our study also confirms that a worryingly high number of individuals are unaware of a possible diagnosis of hypertension.” The integration of hypertension screening by dental professionals with referrals to primary care professionals and periodontal disease screening by medical professionals with referrals to peridontists could improve detection and treatment of both conditions to improve oral health and reduce the burden of hypertension and its complications. Oral heath strategies such as brushing teeth twice daily are proven to be very effective in managing and preventing the most common oral conditions, and the study’s results indicate they can also be a powerful and affordable tool to help prevent hypertension. This study did not account for other factors that may also impact blood pressure, such as abdominal obesity, salt intake, use of anti-inflammatory medications, hormone treatments or stress, or any other oral health conditions. Aged Care NZ Issue 02 2001
Co-authors: Jeanie Suvan, DipDH, MSc, PhD; Marco Orlandi DDS, PhD; Queralt Miro Catalina, BSc, MSc and Jose Nart, DDS, PhD ![]() Getting children to sleep Following on from our last post "Why Do Children Need Sleep?" - this post is on helping children to sleep. We know sleep is good for all of us, particularly for restoring energy and helping children grow and develop. The question is how do we ensure children get enough sleep? How do you know your child is getting enough sleep? If your child wakes easily in the morning: happy, cheerful and full of energy, they have had enough sleep. If children are hard to wake, are dozy, inattentive, hyperactive and have regular meltdowns they are probably not getting enough sleep. The good thing is children love predictability and knowing what happens next. It makes them feel safe and secure. This means if your child and family have daily and weekly routines, this helps to establish good sleep patterns. Here are a few suggestions on how to establish good sleep routines with children:
- having a quiet time - story or reading time - clean teeth - being tucked in and kissed goodnight quietly We recommend that your approach during this routine be quieter and calmer than your usual interactions and that the general activity around the house be slowed down if possible.
Don't underestimate your children's need for sleep. Here at Therapy Professionals we see some children whose disabilities worsened and others who have been labelled as hyperactive, disobedient, or clumsy when poor sleep has been the significant problem. We all want our children to thrive and one thing we can do for them is establish good sleeping habits. This will help the child and the household. References Healthline Editorial Team (2017) ’10 tips to get your kids to sleep’, Healthline. Ministry of Health (2017) ‘Helping children sleep better’. Macmillan, A, (2015) Sleep tips for kids of all ages’, Webmd.com. Marcu, Shai, The benefits of a goodnight’s sleep – Sleep to remember. Remember to sleep, TED –Ed. Harvard Medical School (Jan 2006), Importance of sleep: six reasons not to scrimp on sleep. American Psychological Association, Why sleep is important. Leech, Joe (June 2017), ‘Ten reasons why good sleep is important’, Healthline. Peterson, SM and Werneburg, BL, Sleep: The foundation for healthy habits, Mayo Clinic |
AuthorShonagh O'Hagan Archives
July 2024
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