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Wednesday, May 17, 2017

MyGrief.ca – Understanding and working through grief and loss


“I am at the epicentre of this earthquake.”  This is how Bonnie describes her grief when Ray, her husband of 41 years, died in 2013. She is one of 12 men and women from different cultural perspectives who share their very personal stories of grief, loss and healing after the death of a spouse, partner, child, parent or sibling.

MyGrief.ca is a free online resource to help people work through their grief from the comfort of their own home, at their own pace. It was developed by family members who’ve “been there,” and grief experts to complement existing community resources and help address the lack of grief services particularly in rural and remote areas. It is also an education tool for health providers.

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This online tool consists of 9 sections that people can navigate through easily to find the information they need. It covers a variety of topics including: 
  • Recognizing how grief affects you before and after death
  • Facing emotions such as sadness, loneliness, anger, fear and guilt
  • Managing situations that trigger grief
  • Managing family dynamics
  • Dealing with unhelpful comments and unwanted advice
  • Recognizing if you are stuck in grief; and re-engaging with life after a death
MyGrief.ca was produced by the Canadian Virtual Hospice in collaboration with a team of families, grief experts and partners. Dr. Robert Neimeyer, renowned international grief expert was a member of the development team. Funding was provided by the Canadian Partnership Against Cancer. For more information, contact Marissa@virtualhospice.ca 

Wednesday, May 10, 2017

New Canadian Guideline and App for Opioid Therapy & for Chronic Non-Cancer Pain

Approximately 15 to 19% of Canadians live with chronic, non-cancer pain, which is defined as pain that lasts for more than 3 months and that interferes with daily activities.

In a new clinical practice guideline released this week, doctors are being advised to reduce their prescribing of opioid medication to patients with chronic non-cancer pain.Canadians are the second highest users per capita of opioids in the world and the rates of opioid prescriptions and opioid-related hospital visits and deaths have steadily increased in recent years.

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Some recommendations include:

  • Non-drug and non-opioid pharmacotherapy should be considered first and optimized for patients with chronic non-cancer pain 
  • A trial of opioids for patients who have not responded to non-opioid treatment if patient does not have a current or past substance abuse problem or other psychiatric disorder
  • For patients starting opioids, a dose of less than 50 mg morphine equivalents a day is recommended and it is strongly recommended that the total daily dose is under 90 mg a day (this is a change from the previous 2010 guideline which suggested that the max dose be 200 mg/day)
  • A trial period of opioids to the lowest effective dose, potentially to none, for patients who are currently on 90 mg morphine equivalents a day or more, recognizing there are some patients who may need this tapering paused or abandoned 
Led by the renowned Michael G. DeGroote National Pain Centre at McMaster University and funded by Heath Canada and CIHI, this guideline has been developed by an international team of clinicians, researchers and patients. The full guideline is available at: http://bit.ly/2prq3Si

In addition to the guideline, an app has also been created to help doctors and patients work together to find a solution to manage their pain. The app is available at: http://bit.ly/2qhywLU

Note: This guideline does not include recommendations on opioid use for acute pain, patients with cancer-related pain, those in palliative care, or those currently undergoing treatment for opioid use disorder or opioid addiction

References:

Forum for Science, Industry and Business. (n.d.). Retrieved May 08, 2017, from http://www.innovations-report.com/html/reports/medicine-health/new-canadian-clinical-guideline-for-physicians-tapers-down-use-of-opioids.html?_scpsug=crawled_2564611_2092f900-33f0-11e7-cbab-00221934899c#_scpsug=crawled_2564611_2092f900-33f0-11e7-cbab-00221934899c





Wednesday, May 03, 2017

Life Story Work helps people with dementia review past events and build a personal biography

Due to problems with memory loss and communication, people with dementia often need help communicating important aspects of their identity – such as background, interests, and who and what is important to them.
Life Story work is an activity in which people with dementia gather together and review events in their past and build a personal biography with the help of staff and family members. This activity is beneficial as it can help the person with dementia better understand past experiences and see how they have coped with events in their life.
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Some other benefits of Life Story work include:
  • It can help people with dementia share their stories and enhance their sense of identity
  • It can encourage better communication and an understanding of the person's needs and wishes (person-centred care)
  • It can help the person develop closer relationships with family carers and staff

For more information and to view a template from Dementia UK, click on the following link: http://bit.ly/2qoXrwx 
References:
Thomson, R. (2011). Using life story work to enhance care. Nursing Older People 23(8): 16-21. 



Friday, April 28, 2017

Breaking the stereotype: Male family caregivers


In North America, family caregivers are often the ones who deliver supportive services for individuals with chronic, disabling, or other serious health conditions. They identify and schedule services, provide emotional support, accompany their family or friend to doctors appointments, administer medications, and assist with personal care (such as bathing, dressing, and feeding), pay bills, and figure out health insurance. Such help allows individuals to remain in their homes for as long as possible. However, with an increasingly aging population, longer life expectancies,  and shrinking household sizes, the supply of family caregivers is dwindling and likely won't be able to keep up with future demand.

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While traditionally women have taken on the role of caregiver, a recent report shows that more men are rising to the challenge. According to the Caregiving in the U.S. 2015 survey there are over 16 million male family caregivers in the United States meaning that roughly 40% of family caregivers are men. Some other notable statistics include:

  • The average age for a male family caregiver is 48 years old
  • Nearly half of all male caregivers (48%) have a high school diploma, or a diploma plus some college education, compared to only 37% with a college or graduate degree
  • More than 44% of all male family caregivers have household incomes of under $50,000/yr
  • Over half (56%) of male caregivers are married, while a quarter (26%) are single and have never married
  • Similarly to females, nearly half (49%) of all male caregivers felt that they had little choice but to provide care, especially those caring for a spouse or partner
  • More than half (52%) of current male caregivers expect to be caring for someone in the next 5 years, namely an aging parent or in-law 
Drawing on data from the Caregiving in the U.S. 2015 survey, a new AARP report titled Breaking Stereotypes: Spotlight on Male Family Caregivers highlights male family caregivers and provides current information about the experiences and challenges that male caregivers face today.

To read the report, click on the following link: http://bit.ly/2oFzSvm









Wednesday, April 26, 2017

New study looks at Oral Health and Nutrition among Nursing Home Residents

Oral health among nursing home residents is often poor due to age and limited access to dental care, which may be a symptom and cause of poor overall health and nutritional status. [1 However, oral health care support in nursing homes is often limited resulting in poor oral hygiene and oral health [2, 3]. A Canadian study notes that in their most recent shift, 59 % of the care aides surveyed felt rushed when doing mouth care and 19 % left mouth care undone [4]. And many long-term care residents are unable to practice good oral hygiene themselves due to physical impairments or cognitive disabilities.

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With these concerns in mind, a new study was performed to assess oral and nutritional status of nursing home residents in Germany. The aim was to show potential associations between oral status, other factors (dementia, age, smoking) and the risk for malnutrition in this population.

The results of the study showed that dementia was a strong predictor for risk of malnutrition in nursing home residents. Further studies are needed in order to determine the possible role of oral health as co-factor for malnutrition in dementia [5].

To read the full study, click on the following link: http://bit.ly/2oYt1jx

References:
[1] Saunders, M.J., Stattmiller, S.P., Kirk, K.M. Oral health issues in the nutrition of institutionalized elders. J Nutr Elder. 2007; 26: 39-58. 
[3] De Visschere, L., Grooten, L., Theuniers, G., Vanobbergen, J.N. Oral hygiene of elderly people in longterm care institutions- a cross sectional study. Gerodontology 2006; 23: 195-204. 
[4] Knopp-Sihota, J.A., Niehaus, L., Squires, J.E., Norton, P.G., Estabrooks, C.A. Factors associated with rushed and missed resident care in western Canadian nursing homes: A cross-sectional survey of health care aides. J. Clin. Nurs. 2015; 24: 2815-25. 
[5] Ziebolz, D., Werner, C., Schmalz, G., Nitschke, I., Haak, R., Mausberg, R.F., Chenot, J.F. Oral health and nutritional status in nursing home residents- Results of an explorative cross-sectional pilot study. BMC Geriatrics 2017; 17(1): 39. 


Wednesday, April 19, 2017

Strategies for bringing wellness to people with cognitive decline

Changes in cognitive processes are a normal part of aging. However, when cognitive changes become sufficiently severe and interfere with the ability to perform activities of daily living, then individuals may be beginning the journey along the stages of cognitive decline and dementia.
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To address such concerns, the International Council on Aging on Active Aging has released a new blueprint that lists 14 strategies with the aim of providing the most positive experiences for people with mild-to-moderate dementias. Both family members and and colleagues are considered within these implementation tactics, which include suggestions for programs and services, staffing, and physical environment.

The resource can be accessed here: http://bit.ly/2oLsod0


Monday, April 17, 2017

The Dementia Learning and Development Framework

The Dementia Learning and Development Framework was set in motion following an extensive regional scoping exercise which collated information on the type and volume of training currently available to staff in the region (North of Ireland). The exercise included an examination of the cost and accessibility of training programmes and existing levels of accreditation.

This Framework was also informed by best practice guidance and literature reviews, reviews of other frameworks and a programme of consultation and engagement with key stakeholders from June 2015 until January 2016. This included people living with a dementia, carers, professionals, academics and regulators who represented a range of agencies and professions.

To view the Framework, click here: http://bit.ly/2p9Rq6W