Comparing Assisted Living and Senior Home Care Services

   If you are satisfied with the clinicians at your primary care office, cherish those relationships.  For many reasons, it is getting more difficult to find primary care clinicians who go the extra mile for you and your loved ones.  If you are not content with your primary care team, I offer the following suggestions.    First, find a clinician (physician, nurse practitioner, or physician assistant) who enjoys listening to you and your stories.  The art of medicine is mostly about the art of listening.and believing what you share.  Listening and understanding build trust, essential for any good relationship.  Every city and small town in our country has such clinicians.     Second, appreciate that young nurse practitioners and physician assistants can listen to you and help sort out your problems every bit as well as a seasoned physician who is overworked and/or approaching retirement.  In my 40 + year career, Ive had the opportunity to train hundreds of NPs and PAs.  They gain the knowledge, expertise, and confidence to become great providers within 9-12 months of graduating from professional schools.  Often, they have more technical skills than older physicians.  This works to your advantage in the following ways.  Assume you have an unusual combination of symptoms.  They know how to explore the Internet and rely on specialists to find the best plan of care for you.  Now assume you need a steroid injection in a joint.  Many NPs and PAs can provide procedures that overworked physicians never learned.     Third, see the entire practice as your primary care provider.  A good practice has all members working together as a team.  The members include front office staff who greet you for in-person visits, medical assistants and nurses who answer your phone calls, and the clinicians who care for you in person or with tele-health visits.  If you find that any team member isnt respectful, you should feel free to discuss this with the office manager.  All good practices should welcome feedback.      Fourth, if you have the means and value extra attention, consider a concierge practice.  Unfortunately, concierge physicians are beyond the reach of the vast majority of seniors in our country.  Further, we are seeing a shortage of these physicians just as we are seeing a shortage of all primary care physicians.  This brings us back to my key message: you can find trust and comfort with a dedicated NP or PA.  When we consider the evolution of geriatric practice over the last 4 decades, we understand that it is NPs and PAs providing the vast majority of visits in nursing homes, assisted living facilities, and in-home visits.Finally, it is important to understand the pressure and demands on your primary care office.  The advent of the electronic health records in the 1990s added a massive burden to all practices.  The hope (and the myth) was that EHRs would lead to higher quality medical care.  The reality is that EHRs havent improved true quality.  EHRs are the main reason so many good clinicians are feeling burned out.  The clinicians feel they have to pay more attention to the EHR (and quality metrics) than to the patient in front of them.  When you express your understanding of this dilemma to your clinical team, they greatly appreciate this.  Again, building understanding and trust leads to the best quality of care and beneficial outcomes. The article was written by Dr. Don Murphy, Geriatrician and Hospice Physician who plans to run for Governor of Colorado, on behalf of. He can be reached at murphdoc@comcast.net, his cell, 720-490-6757, or his main YouTube channel, TheCrazyMurphys5560. 

The greatest challenge for all who practice geriatrics is reducing polypharmacy, the addition of medications that either provide no benefit or cause harm to seniors.  Millions of seniors end up on many medications that are not helping them and could be causing side effects.  Geriatricians are the experts in what we call de-prescription, cutting down on unnecessary medications.        The key reasons seniors end up on too many medications are the following.  First, all physicians, including young geriatricians (as I was 30 years ago), have hope that newer medications will actually benefit our seniors.  The four medications we have used to treat dementia turn out to provide no benefit at all.  We cant appreciate this until we have been in practice for decades and know how to review all of the studies that suggest there might be some marginal benefit.  Also, one must practice for many years to understand how all medications, including over-the-counter medications, can cause difficult to diagnose side effects.  For the dementia medications, we had hoped that they either alleviated symptoms, delayed the onset of dementia, or slowed the progression of dementia.  It takes years of practice and experience to realize that these medications fail to help our seniors.      Second, many primary care clinicians (say, family medicine physicians) and specialists (say, cardiologists) tend to overvalue medical benefit for medications used for the most common conditions.  The best example would be blood pressure medications.  All geriatricians know that we approach frail seniors differently than we approach a robust 70-year-old or a healthy 45-year-old.  Many clinicians will treat everyone the same, such as trying to keep the systolic blood pressure around 120 and the diastolic pressure around 80.  Often, these pressures are simply too low for frail seniors and even for some robust seniors.  The medications can cause lightheadedness, falls, and fractures (to name just a few side effects).      Third, clinicians in traditional medicine often fail to appreciate the value of alternative healing and the value of the placebo effect.  Lets return to medications for dementia.  In recent years, we havent seen any commercials for the four medications I referred to above.  Weve seen many advertisements for Prevagen and Neuriva.  These medications have not been studied extensively like the four that required many studies and FDA approval.  If seniors feel more comfortable on these OTC medications, its probably from the placebo effect.  That is, they feel that they are at least doing something to counter the onset or progression of dementia.  The cost is affordable, and these individuals dont need a prescription from their doctor.  If the individual thinks Prevagen isnt helping, or may be causing side effects, he or she can stop it at any time.  They dont need permission from their physician.        Fourth, the pharmaceutical industry has specialized in direct-to-consumer advertising.  These are entertaining and convincing ads.  It doesnt matter what disease condition we are considering.  Every expert in marketing knows that these creative, subliminal messages get through.and result in more prescriptions.        Before sharing my suggestions for cutting down on your medications, let me share a story about Elsie, a 90-year-old woman I took care of in 1992.  She was feisty and funny.  She was on the 6 medications our team had prescribed for her.  Benign positional vertigo was one of her conditions.  One of my most memorable clinic visits was the one when Elsie reported that she followed that Harvard newsletter you gave me, Dr. Murphy, and it worked.  She did this complex maneuver all on her own, and it eliminated her dizziness.  Then she added, oh, and by the way, doctor, I threw all those doggone pills in the garbage.and I feel great now. So be it.  This approach worked well for Elsie, but I dont recommend it for others.  Here is what I suggest.       First, find the courage to question your clinicians.  Its not easy when you have put so much trust in your doctors recommendations.  Try the soft approach.  For example, you could say, Doctor, Im on a lot of medications and I worry that one of them might be causing some problems. You could mention a symptom youve been wondering about.  Then you ask, could I cut down on the dose of one of these medicines to see how I do?  If your physician agrees with this trial of dose reduction, you could ask which medication he or she would select to reduce the dose.        Second, you continue with the honest communication you have established.  You dont need to let your doctor know how you are doing a week or two later.  However, you should report that you are doing fine by calling the office staff that can document your success with the dose reduction.  Believe it or not, you are educating your primary care office about the value of dose reductions.        Third, when you have more confidence in the dose reduction approach, you can specify which medication(s) you would eventually like to discontinue.  You can share feedback youve received from family members and friends or from the research you or they have done.         Ever since the 1950s we have been moving from a paternalistic approach to health care (i.e., the doctor decides everything for your health) to a more patient-centered approach to health care.  This makes sense.  You know whats best for your overall health, including physical, psychological, social, spiritual, and any other dimensions of health.  Your clinicians job is to reflect your preferences.  Dose reductions of useless or harmful medications is just part of this evolution in health care.     Dr. Don Murphy, MD, FACP The article was written by Dr. Don Murphy, Geriatrician and Hospice Physician who plans to run for Governor of Colorado. He can be reached at murphdoc@comcast.net, or calling 720-490-6757, or his main YouTube channel, TheCrazyMurphys5560.  

Are you looking to breathe new life into your senior living space? Theres no better time than now to refresh your surroundings and create a comfortable, inviting, and functional environment. Here are ten decor ideas that will help you transform your space and make it a reflection of your personality and preferences.Idea 1: Color TherapyChoose the Right Colors - Color plays a significant role in setting the mood of a room. When selecting colors for your senior living space, consider the psychological impact they can have. Soft, muted tones like blues, greens, and lavender can create a calming atmosphere, while warm colors such as yellows, oranges, and reds evoke feelings of energy and happiness.Idea 2: FurnitureComfortable Seating - Your seating should be comfortable and supportive, allowing for relaxation and socialization. Consider chairs with lumbar support, padded armrests, and adjustable heights to accommodate various preferences and mobility levels.Multi-functional Furniture - Choose furniture that serves multiple purposes, like a lift-top coffee table or an ottoman with built-in storage. These pieces can help you save space and keep your living area tidy.Idea 3: LightingNatural Light - Maximize natural light by keeping window treatments light and sheer. Natural light can elevate your mood and make your space feel more open and invitingLayered LightingIncorporate different lighting sources such as ambient, task, and accent lighting. This approach allows you to create various moods while ensuring adequate illumination for daily activities.Idea 4: Wall DecorArtwork - Showcase your favorite artwork or prints to add personality and visual interest to your walls. Opt for pieces that evoke positive emotions and memories.Family Photos - Display family photos in coordinating frames to create a sense of connection and warmth. Group them together for a gallery wall effect or scatter them throughout the room.Mirrors - Mirrors can make a room feel larger and brighter by reflecting light. Place mirrors opposite windows or light sources to maximize their impact.Idea 5: TextilesRugs - A well-chosen rug can anchor your room and provide warmth and comfort underfoot. Look for rugs with non-slip backing and low pile for easier mobility and maintenance.Curtains - Choose curtains that complement your color scheme and provide privacy without blocking natural light. For a cozy feel, opt for heavier fabrics; for a light and airy atmosphere, select sheer or lightweight materials. Throw Pillows - Throw pillows can instantly add color, texture, and comfort to your space. Mix and match patterns and textures to create visual interest and a personalized touch.Idea 6: Indoor PlantsAir-purifying Plants - Introduce air-purifying plants like spider plants, snake plants, or peace lilies to your senior living space. They help remove toxins from the air and create a fresher, healthier environmentEasy-to-care Plants - Choose low-maintenance plants like succulents and pothos, which require minimal watering and care. They add a touch of greenery without demanding too much of your time and energy.Idea 7: Memory WallPersonal MemorabiliaDedicate a wall or section of your living space to showcase personal memorabilia such as travel souvenirs, awards, or keepsakes. This can serve as a reminder of your accomplishments and cherished memories. Shared ExperiencesInclude items that represent shared experiences with friends and family, such as group photos or mementos from special events. This can foster a sense of belonging and strengthen relationships with loved ones.Idea 8: Accessible DesignUniversal Design PrinciplesIncorporate universal design principles like wider doorways, lever-style door handles, and non-slip flooring to make your space more accessible and functional for everyone, regardless of age or mobility level.Aging in PlaceConsider implementing aging-in-place design features, such as grab bars in the bathroom, adjustable countertops, and proper lighting. These adjustments can help ensure your space remains comfortable and safe as your needs change over time.Idea 9: OrganizationDecluttering - Take time to declutter and remove unnecessary items from your living space. This can create a more open, peaceful, and manageable environment.Storage Solutions - Incorporate storage solutions like shelves, cabinets, or decorative storage boxes to keep your belongings organized and easily accessible.Idea 10: Personal TouchesHobbies and Interests - Display items that reflect your hobbies and interests, such as a collection of books, musical instruments, or sports memorabilia. This personal touch can make your space feel more like home.Cultural ElementsIncorporate elements of your cultural background into your decor, like traditional artwork, textiles, or pottery. This can provide a sense of connection to your roots and make your space feel more authentic.Dont worry, refreshing your senior living space is easier than you might think! With these ten decor ideas, you can create a cozy, functional, and personalized environment that truly feels like home. By adding your personal touch and incorporating elements that reflect your unique personality and preferences, you can enjoy the many benefits of a refreshed and revitalized living space. So why wait? Get started today and let your creativity shine!Integracare Senior Living CommunitiesAt Integracare, we know that finding the right care is important for you or your loved ones. Our communities all maintain the same high standards of care, and were always happy to help you find the perfect fit. Creating a comfortable and inviting space is essential for your well-being, and we hope that these ten decor ideas have inspired you to transform your senior living space into a reflection of your unique personality and preferences. If you have any questions or want to learn more about our communities, please dont hesitate to get in touch with us. Were here to help!