Paranoia in the Elderly

By Faith Protsman, MD, Regional Medical Director, VITAS HealthcareVietnam War veterans face unique obstacles throughout the twilight of advanced illness. For hospice care providers to tailor care to meet the needs of veterans who have served in this theater of war, they must consider the tribulations these patients face as they reach the end of their lives.The Vietnam War era was a very tumultuous time to be a soldier. The United States' prolonged involvement in a war of questionable motivation left society with disdain toward the government and its institutions, especially the military.Coupled with horrific images shown on television, constant controversy was a new reality and negative public opinion formed around this conflict, of which those serving the nation were not spared.Careful consideration is necessary when treating patients facing these traumas.Tours of duty proved to be traumatizing in many ways. Young soldiers, some having just turned 18, were drafted into a war that many of them did not believe in. They were not fighting for love of country and God; rather, they were fighting for survival and out of fear for their lives.Intimate battles in the dense jungle led many to be subjected to the horrors that come with fighting in a foreign land that was only familiar to the elusive guerilla enemy soldiers.Servicemembers did not receive a warm welcome when returning home from Vietnam, often being judged and labeled as cruel and even inhumane.Moral Injury Can Impair Mental HealthThis perfect storm of trauma led to lasting moral injury that plagues many veterans for their entire lives. Veterans returning from the war were marginalized and pushed into isolation, often turning to alcohol and substance abuse, which worsened their anxiety and exacerbated their strife.Questions like Ive never spoken about the war, can I now? Was the war moral or immoral? and Was I a good soldier? come bubbling to the surface later in life as their illnesses intensify and their defenses weaken.Careful consideration is necessary when treating patients facing these traumas.The restlessness that can result from post-traumatic stress disorder (PTSD) is often treated with benzodiazepines. In most cases, these medications can bring relief through calming the patient.Yet, there is a common trend amongst veterans who cope with trauma that results in the opposite effect.Benzodiazepines can lower the walls that Vietnam veterans have built up throughout a lifetime of suppressing trauma and negative memories. This class of medications can exacerbate the symptoms of PTSD as traumatic experiences and feelings of regret resurface. Benzodiazepine-induced inhibition of neurotransmission can even lead to agitated toxic psychosis, increased anxiety, hostility, and rage.1The Value of Compassion Along with Clinical CareRemaining considerate does not end with simply staying mindful during the planning of clinical solutions. Providing care for Vietnam veterans requires a high level of empathy.A key to an empathetic approach is taking the time to listen nonjudgmentally. Though seemingly simple, practicing nonjudgmental, open communication with patients facing trauma from war can help avoid the all-too typical responses of Its okay and You did what you had to do.These patients do not need sympathy, because they have been judged enough throughout their lives. When care teams approach them without judgment, they honor the sacrifices these heroes have made.VITAS hospice care provides compassionate care approaches that are tailored to meet the distinctive needs of Vietnam veterans. With the Veterans Administration (VA) offering hospice care as part of its medical package, VITAS team members can provide empathetic psychosocial support, while utilizing clinical solutions that help manage symptoms.The qualifications for veterans to receive hospice benefits include: A life-limiting illness Treatment goals that focus on comfort, rather than curative treatments A life expectancy of 6 months or less, if their illness runs its normal course Veterans also benefit from the option to receive concurrent care through the VA. The VA can provide curative treatments as the patient simultaneously receives symptom-managing comfort care administered by the hospice care provider of their choosing.Offering solace, while remaining compassionate when patients need it most, is too often overlooked in the busy practice of healthcare. Acknowledging the adversity that Vietnam War veterans have had to face throughout their lifetimes and adapting care approaches to meet their needs is the best way for healthcare providers to give back to those who have sacrificed so much for the preservation of freedom.1Paton, C. (2018, January 2). Benzodiazepines and disinhibition: A review: Psychiatric bulletin. Cambridge Core. Retrieved November 2, 2022, from https://www.cambridge.org/core/journals/psychiatric-bulletin/article/benzodiazepines-and-disinhibition-a-review/421AF197362B55EDF004700452BF3BC6

Maintaining proper nutrition is a crucial aspect of healthy aging, especially for seniors who wish to continue living independently and enjoying their golden years. By stocking your pantry with the right combination of nutrient-dense foods, you can empower yourself to prepare wholesome, energizing meals that support your overall well-being. In this article, well explore the top pantry essentials that should be on every seniors radar.The Importance of a Well-Stocked PantryA thoughtfully curated pantry is the backbone of a balanced diet. When you have a variety of healthy ingredients on hand, it becomes significantly easier to whip up nutritious meals on the fly, without the need for multiple trips to the grocery store. This not only saves you time and money but also helps you avoid the temptation of less-than-ideal food choices that can compromise your health.Pantry Essentials for SeniorsNow, lets delve into the specific pantry items that should be on every seniors radar. These versatile and nutrient-dense foods will serve as the foundation for countless delicious and nourishing meals.Whole GrainsWhole grains, such as brown rice, quinoa, and whole-wheat pasta, are powerhouses of fiber, vitamins, and minerals. These complex carbohydrates provide sustained energy and can help regulate cholesterol levels and blood pressure, reducing the risk of chronic conditions. Oatmeal, a classic breakfast staple, is another excellent whole-grain option that can be easily customized with fresh fruit, nuts, and a touch of honey.Beans and LegumesBeans and legumes are true nutritional superstars, offering a potent combination of protein, fiber, and antioxidants. From kidney and black beans to chickpeas and lentils, these versatile ingredients can be incorporated into soups, stews, and even meatless chili, providing a satisfying and filling base for your meals.Nuts and SeedsNuts and seeds are nutrient-dense snacks that can also be used to enhance the flavor and texture of various dishes. Almonds, pistachios, walnuts, and pumpkin seeds are all excellent sources of healthy fats, protein, and essential minerals. Keep a variety of these on hand for quick and nourishing between-meal bites or to sprinkle on top of salads, oatmeal, and yogurt.Canned GoodsCanned goods, such as tuna, salmon, and a variety of fruits and vegetables, are convenient and cost-effective pantry staples. These items often have a long shelf life, making them ideal for seniors who may not have the time or energy to frequent the grocery store regularly. When selecting canned goods, opt for low-sodium or no-added-salt options to keep your sodium intake in check.Spices and HerbsElevating the flavor of your meals is not only enjoyable but can also encourage healthier eating habits. Spices and herbs, such as garlic, ginger, turmeric, and basil, are not only packed with antioxidants but can also help reduce the need for salt, sugar, and unhealthy fats in your cooking. Experiment with different flavor combinations to keep your taste buds engaged and your meals exciting.Healthy Fats and OilsIncorporating healthy fats into your diet is crucial for maintaining overall health. Olive oil, avocado oil, and coconut oil are excellent choices for cooking, dressings, and marinades. Additionally, consider keeping a bottle of apple cider vinegar on hand, as it can be used to add a tangy twist to a variety of dishes, from salads to stir-fries.Dried Fruits and NutsFor a quick and satisfying snack, keep a selection of dried fruits and nuts in your pantry. Raisins, apricots, and cranberries provide a natural sweetness, while nuts like almonds, walnuts, and cashews offer a crunchy texture and a boost of healthy fats and protein. These shelf-stable items can also be used to add texture and flavor to baked goods, oatmeal, and trail mixes.Honey and Maple SyrupWhen it comes to satisfying your sweet tooth, opt for natural sweeteners like honey and maple syrup. These alternatives to refined sugar can be used in baking, drizzled over yogurt or oatmeal, or even incorporated into marinades and dressings. Not only do they provide a touch of sweetness, but they also offer additional health benefits, such as antioxidants and anti-inflammatory properties.Whole-Wheat Flour and Baking EssentialsFor any of your baking needs, keep a supply of whole-wheat flour, baking soda, baking powder, and spices like cinnamon and nutmeg. These ingredients can be used to create healthier versions of your favorite baked goods, from muffins and breads to cookies and scones. Experiment with natural sweeteners like honey or maple syrup to reduce your intake of refined sugars.Putting It All TogetherBuilding a well-stocked pantry takes time and effort, but the benefits are well worth it. Start by gradually incorporating these essential items into your shopping routine, and dont be afraid to try new recipes and flavor combinations. Remember, healthy eating is a journey, and by embracing these nutrient-dense pantry staples, youre taking a significant step towards nourishing your body and supporting your overall well-being in the golden years!  

In todays fast-paced world, its easy to overlook the importance of a balanced diet. One essential component that often gets neglected is fiber. Fiber plays a crucial role in our overall health, from supporting digestion to reducing the risk of chronic diseases. However, many people fall short of meeting their daily fiber requirements. In this comprehensive guide, we will explore the benefits of fiber and provide practical tips to help you boost your fiber intake and improve your well-being.Why Fiber MattersBefore diving into the ways to increase your fiber intake, its essential to understand why fiber is so important for our health. Fiber is a type of carbohydrate found in plant-based foods that cannot be broken down by our digestive enzymes. There are two types of fiber: soluble and insoluble.Soluble fiber forms a gel-like substance when mixed with water and helps regulate blood sugar levels and lower cholesterol. It can be found in fruits, vegetables, legumes, oats, and barley. On the other hand, insoluble fiber adds bulk to the stool, promoting regular bowel movements and preventing constipation. It can be found in whole grains, nuts, and seeds.A diet rich in fiber offers numerous health benefits. Firstly, it supports digestive health by preventing constipation and promoting regular bowel movements. Secondly, fiber plays a role in maintaining a healthy weight as it promotes satiety, reducing the likelihood of overeating. Additionally, fiber is known to reduce the risk of chronic conditions such as heart disease, type 2 diabetes, and certain types of cancer.Assessing Your Fiber IntakeTo determine whether youre meeting your daily fiber needs, its important to assess your current fiber intake. The recommended daily intake of fiber varies based on age and gender. Generally, adult men should aim for 30-38 grams of fiber per day, while adult women should aim for 21-25 grams.To assess your fiber intake, you can use a food diary or a mobile app to track the fiber content of the foods you consume. By keeping a record of your meals and snacks, you can gain insight into your fiber consumption patterns and identify areas where improvements can be made.Increasing Fiber Intake: Practical TipsNow that we understand the importance of fiber and how to assess our current intake, lets explore some practical tips to increase our fiber consumption. By incorporating these strategies into your daily routine, you can gradually boost your fiber intake and reap the benefits of a fiber-rich diet.Embrace Whole GrainsOne of the simplest ways to increase your fiber intake is to choose whole grains over refined grains. Whole grains, such as brown rice, quinoa, and whole wheat bread, contain the entire grain, including the bran, germ, and endosperm. These components are rich in fiber, vitamins, minerals, and antioxidants.When shopping for grains, look for labels that indicate 100% whole grain or whole wheat. Replace refined grain products like white bread, pasta, and rice with their whole grain counterparts. Start by making small changes, such as swapping white rice for brown rice or choosing whole wheat bread for your sandwiches.Load Up on Fruits and VegetablesFruits and vegetables are not only packed with essential vitamins and minerals but are also excellent sources of fiber. Aim to include a variety of fruits and vegetables in your daily meals and snacks. Each meal should feature at least one serving of fruits or vegetables.To boost your fiber intake, opt for fruits and vegetables with edible skins, such as apples, pears, and cucumbers. These skins are rich in insoluble fiber. Additionally, include high-fiber options like berries, avocados, broccoli, and Brussels sprouts in your diet.Incorporate Legumes and PulsesLegumes and pulses, such as beans, lentils, and chickpeas, are versatile and nutritious sources of both fiber and plant-based protein. These legumes can be added to soups, stews, salads, or used as a meat substitute in various dishes.Try incorporating legumes into your meals at least three times a week. You can make a hearty bean chili, prepare a lentil curry, or add chickpeas to your salads. Experiment with different recipes and seasonings to find combinations that you enjoy.Choose Fiber-Rich SnacksSnacking can be an opportunity to boost your fiber intake, especially if you choose the right snacks. Instead of reaching for processed and low-fiber options, opt for snacks that are naturally high in fiber.Nuts and seeds, such as almonds, chia seeds, and flaxseeds, make excellent fiber-rich snacks. Sprinkle them over yogurt, oatmeal, or salads for added crunch and fiber. Additionally, popcorn, air-popped without excessive butter or salt, is a whole grain snack that provides a satisfying crunch.Make Smart SubstitutionsWhen preparing meals, look for opportunities to make smart substitutions that increase your fiber intake. For example, instead of using refined flour in your baking, try using whole wheat flour or a combination of whole wheat and all-purpose flour.Similarly, replace refined pasta with whole wheat or legume-based pasta options. These alternatives offer more fiber while still allowing you to enjoy your favorite pasta dishes. Gradually incorporate these substitutions into your cooking routine to make them a sustainable habit.Stay HydratedAs you increase your fiber intake, its crucial to stay hydrated. Fiber absorbs water, adding bulk to your stool and promoting regular bowel movements. Without an adequate fluid intake, fiber can lead to constipation and discomfort.Make sure to drink plenty of water throughout the day. Aim for at least eight glasses of water, or about 64 ounces. Additionally, incorporate hydrating foods into your diet, such as watermelon, cucumbers, and soups, to support your hydration goals.Gradual Increase and MonitoringWhen increasing your fiber intake, its important to do so gradually to allow your body to adjust. Suddenly consuming large amounts of fiber can lead to digestive discomfort, including gas, bloating, and cramping.Start by adding small amounts of high-fiber foods to your meals and gradually increase the portions over time. This gradual approach will give your digestive system time to adapt and minimize any potential discomfort.As you increase your fiber intake, pay attention to how your body responds. Everyones tolerance to fiber differs, and certain high-fiber foods may affect individuals differently. Keep a food diary to track your symptoms and identify any triggers or patterns.Mindful EatingIncorporating fiber into your diet is not only about the choices you make but also about how you consume your meals. Practicing mindful eating can help you appreciate the flavors and textures of fiber-rich foods while allowing your body to recognize satiety cues.Take the time to chew your food thoroughly and savor each bite. This mindful approach to eating can enhance your digestion and improve your overall eating experience.Seek Recipe InspirationFinding new and exciting recipes that incorporate fiber-rich ingredients can make your journey to increasing fiber intake more enjoyable. Look for cookbooks, online recipe blogs, or food magazines that focus on wholesome, whole-food based meals.Experiment with new flavors, spices, and cooking techniques to make your meals more appealing. By expanding your culinary repertoire, youll discover a wide range of delicious dishes that are both nutritious and fiber-packed.Support Your Gut HealthFiber plays a vital role in maintaining a healthy gut microbiome. The trillions of bacteria in your gut thrive on fiber, fermenting it to produce beneficial compounds that support overall health. To support your gut health, focus on incorporating a diverse range of fiber-rich foods into your diet.In addition to fruits, vegetables, whole grains, and legumes, consider adding fermented foods to your meals. Foods like yogurt, sauerkraut, kimchi, and kefir are rich in probiotics that contribute to a healthy gut microbiome.  Disclaimer: This article is for informational purposes only and does not provide medical advice. While we at Chefs for Seniors specialize in providing healthy, customizable meals, we are not medical professionals. Always consult with your healthcare provider for medical advice, diagnoses, and treatment plans to fit your specific needs.