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November 27, 1998     Cape Gazette
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November 27, 1998
 

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When choosing anursing home, homework pays off Putting a relative or loved one in a nursing home can be an ago- nizing decision fraught with con- flict and guilt. The temptation can be to hurry and get it over with. But when choosing a nursing home, it pays to do your homework, says Rad- ford University nursing professor and nursing home consultant Mar- celia Griggs. Some nursing homes are de- signed to meet specific needs such as the needs of Alzheimer's pa- tients or those who require reha- bilitation. Others are mostly designed for those who need help with dally ac- tivities, such as people with ongo- ing disabilities or illnesses. "Nursing homes have "almost become what acute care hospitals were 20 years ago," said Griggs. "Hospitals no longer keep people for extended periods O f time." The burden of caring for a chronically ill person while also caring for children or holding down a job can be overwhelming, said Griggs. "It can reach the point where it's unrealistic to try and care for a person at home, es- pecially if it's so draining that the strain is taking a toll on the care- giver's health. How you work through the guilt is very impor- tant. "Be clear on why you're putting the person in a nursing'home ver- sus other options such as adult I Screenings Continued from page 39 common form of cancer in the United States, affecting both men and women with about 140,000 new cases each year. It also has the second highest mortality rate of all cancers, causing nearly 55,000 deaths per year. Risk factors for colon cancer include a family history of colon cancer or precancerous type polyps, known as adenomatous polyps; a history of long-standing ulcerative colitis; an individual history of having an adenomatous polyp; and a diet high in fat and low in fiber. Early identification and treatment of colon cancer may greatly improve long-term sur- vival. Also, many colon cancers start as a precancerous polyp; an adenomatous polyp can be identi- fied and remoyed, and cancer can actually be prevented. The main screening tests for colon cancer and precancerous polyps include the digital rectal exam, checking stool for micro- scopic blood, flexible sigmoi- doscopy, barium enema, and oc- casionally, colonscopy. A colonoscopy is the most accurate test that is available and allows for the evaluation of the entire colon as well as biopsy of any abnormal areas and removal of most polyps. However, it is a more involved ex- am that is generally performed by a gastroenterologist or a surgeon. Colonoscopies usually reserved day-care or home care. Profes- sional counseling or a support group may be very helpful?' When deciding on a nursing home, Griggs advises checking out the facility in person and find- ing answers to the following ques- tions: Programs - Does the facility have programs geared toward the individual's needs? For example, if the patient is battling mental de- terioration, are there programs de- signed for mental stimulation? Al- so, if the person tends to wander, is the facility secure? Location, location, location. Is the facility close enough so that friends or relatives can visit? Patient Rights - Does the facil- ity acknowledge that patients have rights, such. as the right to choose a doctor or refuse treatment? Are they allowed to individually ex- press themselves, for example, by decorating their homes with per- sonal objects such as rocking chairs, as long as the personal ob- jects aren't safety hazards? The ability to personalize a room can make a difference psy- chologically. "One person who spent a lot oftime with horses had a poster of horses put on the wall and it made a big difference," Griggs said. "The patient spent hours staring at that poster. It's important to make a connection with who they are and their past experiences." for patients with significant risk factors such as a family history of colon cancer, or for patients who have had an abnormal flexible sig- moidoscopy, an abnormal barium enema, or microscopic blood de- tected in their stool. The exact age at which screen- ing should begin varies depending upon risk factors. In general, all adults should be screened starting at age 50 with yearly rectal exams and evaluation for microscopic blood in the stool (stool cards). It is also recommended that all adults have a flexible sigmoi- doscopy every three to five years Personal money and valuables. How are they handled? Valuables and money shouldn't just be kept in a bedside table, Griggs said. A small amount of personal spend- ing money can be kept by the ad- ministration office in a locked safe. Appearance/cleanliness. What do your senses tell you? Is the home attractive and well-kept? How does it smell? How does it sound? Does the facility have a homelike atmosphere? Is the light- ing adequate? No facility is prob- lem-free, but when there are prob- lems, are they taken care of quick- ly? Staff attitude. Is the staff atten- five, responding quickly to calls? Do they treat residents with re- spect? Do they smile and converse with patients? Do they touch ap- propriately when interacting? Al- so, is there enough staff? Is there high turnover? Be sure and visit in the evenings and on weekends to determine if there's adequate staffing during off-hours. In a nursing home, there really are no off-hours. Staff training. Many facilities are staffed by nurses aides or as- sistants who are paid premium wages. An adequate number of registered nurses should also be on staff. In addition, does a nurse practitioner or physician see resi- dents on a daily basis? It also helps if the staff has special train- after age 50. If flexible sigmoi- dosopy is not available, then screening with a barium enema can be done. Screening may be done in patients younger than 50 if there is a family history or person- al history concerning colon cancer or precancerous conditions. The exact frequency of screening and appropriate tests for an individual should be discussed with his or her health-care provider. Editor's note: Dr. Greg Bah- tiarian is a family pract&e physi- cian at Bayside Health Associa- tion. For more information, call 645-4700. Hearing Aids are now a part of the Digital Revolution, Siemens, the world's iatgt,'a h4ng aid manufoatwer and glo ltader in gital souad processing technolo ttmuces PRKXMA%/t fully digital he.ag aid designed to h imprope . tke way you heur. Digital .round lmXXsi,g that sugpa.  for plea.me, t. enjjabte ii.,ttming all day. - PRISMAamtm-aticatly adau)dmnging ' ....  sima6tms -- there's no need fc, a volume .t I ,lu t(mch a btmo, on tile hearing aid "and PRISMA's cx, clttsive TwinMic TM System lets you fx.ais on lhe nds in frtmt of you. one-to- , Imeractive adjustment; -- we u a cmapmer to ttt/a, gxt,stom-adjt PRISM A to your heating loss, while it's in your eat- I o,, information! p#,. : . ....... (302) 934-1471 1 "Ill ill/If ..... Hearing Aid Associates l rnh)l1tA Sales Repairs Batteries Assistive Devices I Hot l,st digital. 6 Mi. S. of Rt. 9 on Rt. 30 I Slerrn$ digital. Man. - Fri. 9-5 Evening & Weekends by Appointment ing in caring for elderly patients. Volunteers - l.x)ok for facilities that have a strong volunteer pro- gram. A committed group of vol- unteers can enhance the activities and services of the nursing home. Does the facility recognize cultural and religious preferences? Also, clergy who visit the facility can be valuable information sources when you are choosing a Continued on page 41 ao2,645,1192 .Lewes Pediatrics Dr. John J. Ludwicki and Dr. Nancy Gideon specialize in the diagnosis and treatment of Children from infancy through adolescence, Beebe Medical Center with the utmost skill and care. To schedule an appointment at Lewes Pediatrics, please call 644-2860 400 Savannah Rd., Lewes, DE