Falls

We keep track of falls. Sometimes it hard to determine exactly what constitutes a fall. For example, if a person slides out of a chair and lands on the ground, is that really a fall?

I asked if anyone had an official definition and, sure enough, they did.

A fall is:  Loss of upright position that results in landing on the floor, ground, or an object or furniture, or a sudden, uncontrolled, unintentional, non-purposeful, downward displacement of the body to the floor/ground or hitting another object like a chair or stair; excluding falls resulting from violent blows or other purposeful actions.

A slide out of a chair therefore represents a fall.

Anniversary bling times two

Mr. and Mrs. G have been married 63 years and have had 126 wedding anniversaries.

"Why? " I asked.

"We got married while I was stationed in Japan on December 28th at the American consulate but it wasn't recorded by the Bureau of statistics until January 5th because the offices were closed for the holidays."

"It's been pretty nice. We've celebrated twice each year with a cake and a gift to mark the anniversary of both dates."

I noticed that Mrs. G. wore a lot of jewelry when I arrived.

Now I know why.

An added "O"

A relatively new administrative staff member wanted to relay a message.

"Mrs. J just called and said her husband had a colonic seizure earlier today. He has a past history of colonic seizures but hadn't had one for awhile. She wanted to know if he needed to be seen."

I hope she didn't see me smile because she did a good job of relaying the message.

I was curious, however, if she actually thought it was colonic or if Mrs. J reported a colonic seizure instead of a clonic seizure.

I didn't ask but may re-visit it in the future when she's more settled into working here and gets more comfortable with my, at times, warped sense of humor.

He paid it forward

Mr. W adopted a boy who was 2 years old and significantly disabled due to cerebral palsy. His son is now 30 and working full time as an executive chef after graduating from high school, college and culinary school.

Mr. W adopted a girl who was abandoned at age 3 by her drug abusing parents. His daughter is now 35 and has a family of her own.

Mr. W is now 87 and totally dependent, for the last 5 years, due to an unfortunate series of events.

His son and daughter go to great length to help Mrs. W care for Mr. W.

Both have nothing but wonderful things to say about their father and how he went to such great lengths to provide for them despite their less than optimal start.

They let me know they will go to great lengths to help provide for their father in his time of need and to make this stage of his life as wonderful as possible.

Mr. W doesn't say much these days but I'm sure I saw him smile when he overheard this discussion.

Microwave Joe

When asked if he's still preparing his own meals, 91 year-old Joe C. reports that his nickname for many decades has been "microwave Joe."

His daughter either makes meals for him that he can re-heat in the microwave or purchases ready made meals for which he can do the same.

He thinks he might have had one of the original microwave ovens.

He remembers it being called the "Radarange."

Some quick research shows that, in 1967, Raytheon offered for sale the first popular in home countertop microwave oven; the "Radarange."

It sold then for almost $500, close to roughly $4000 in today's dollars.

So it's easy to make a couple of conclusions:

1. Since about age 49 he's been microwave Joe
2. Back then he was rolling in the dough!

Happy tears

Mr. G (name changed). is 87 years old and has advanced dementia.

I saw him recently for a medical evaluation.

His wife is his devoted caregiver and showed me all the many picture Christmas cards of their children and extended families.

They have a beautiful family.

Mrs. G. wanted me to know more about this man who now has great difficulty communicating.

"I married my first husband at age 16 and we had 4 children. He died unexpectedly from a brain hemorrhage. I didn't know what I would do. Rob was a college professor. We fell in love and got married two years later. The kids were all still so young. We've been married for 54 years and he's been a wonderful father. We had a family celebration at our 40th wedding anniversary and everyone wanted us to give a speech. Rob's was short. He wanted to thank two people: my mother for giving birth to me and my first husband for being the biological father of his 4 amazing children. There was not a dry eye in the room that day."

There was still not a dry eye in our room.

Human lameness

I've often been jealous of my veterinary colleagues who get to use the term "lame" to describe a variety of physical illness/diseases that usually afflict older animals.

There's finally a human equivalent: Frail.

Frailty is an important medical syndrome that occurs as a result of a range of diseases and medical conditions. A consensus group agreed on the following: it has multiple causes and contributors and is characterized by diminished strength, endurance, and reduced physiologic function that increase an individual’s vulnerability for developing increased dependency and/or death.

Two commonly used and validated tools are:

The FRAIL tool:

The FRAIL tool asks five questions and those who answer yes to at least three likely are frail.

·         Fatigue: Are you fatigued?

·         Resistance: Do you have difficulty walking up one flight of steps?

·         Aerobic: Are you unable to walk at least one block?

·         Illness: Do you have more than five illnesses?

·         Loss of weight: Have you lost more than 5 percent of your weight in the past six months?

And the Clinical Frailty Scale:

http://cwcg.mcms.org/Portals/0/Guidelines/Clinical%20Fraility%20Scale.pdf

The four things that are currently identified as being able to potentially improve physical frailty include exercise, protein-calorie supplementation, Vitamin D (when low), and the reduction of polypharmacy.