Be Well _ June 2011 Issue

7 Tips for Ensuring Safety in Elderly Adults

The signs can be subtle — a lack of personal hygiene, making excuses for avoiding common everyday tasks, no longer participating in social activities. Or they can be more worrisome — dents in the car, forgetting to turn off the stove, an incorrect number of capsules in the pillbox.

These events can be early warning signs that an older adult needs medical evaluation or assistance — and may not be safe living alone.

Rosemary Truchanowicz, MSW, LISW-S, BCD, a Cleveland Clinic board-certified social worker, offers this advice: It’s wise to learn about options and resources before you’re forced to intervene. But be prepared — and flexible — because unexpected medical changes may require a change in plans.

1. Target the older adult’s concerns
Before a crisis occurs, talk to older loved ones regarding their hopes and fears about  aging. Discuss the benefits of various levels of care available if they are ever needed, including assisted-living facilities, moving in with a relative and hiring in-home care. “People very much want to remain independent and don’t want to be a burden to their families,” Ms. Truchanowicz points out. “While you want to acknowledge their desire for independence, it’s imperative to consider their safety and medical needs.”

2. Get outside help if needed
When it’s time to discuss the need for additional assistance, have a one-on-one discussion with your loved one or suggest a family conference. Several meetings may be needed to give everyone a chance to share ideas and concerns, and to develop a plan. Convey your love and support, but talk about obtaining help to prevent current problems from growing bigger.

3. Put the paperwork in place
Elderly adults need to complete certain key documents before memory or health issues become a problem. A living will and durable power of attorney for healthcare are part of what’s known as “advance directives.” These specify wishes about end-of-life decision-making — and a spokesperson in case a loved one loses the ability to speak for himself or herself.

4. Rule out other possibilities
Underlying physical conditions can fuel an older loved one’s difficulties — some forms of depression or overmedication can interfere with memory, for example. Schedule an appointment with the person’s primary care physician or geriatric specialist, who will examine your loved one and can address underlying medical issues. If none is found, consider consulting a social worker or agency that specializes in working with the elderly. Call 2-1-1 anywhere in the United States, or visit these online sites:, or

5. See for yourself
While it’s important to get your loved one’s view on his or her living situation, do your own detective work, too. People with memory or judgment problems may be unaware that they are, in fact, having problems. Are medications being taken as prescribed? Is food in the refrigerator outdated? “This will motivate you to ask questions about the older adult’s living conditions,” Ms. Truchanowicz says.

6. Be aware of who is 'helping'
Certain individuals — apparently kindly neighbors, former caregivers or even relatives— may establish what looks like a caring relationship in order to exploit older adults. The predator may gradually assume complete control over the individual’s life, including bank accounts and legal documents such as power of attorney, says Ms. Truchanowicz. The elderly victim may actually begin to see the predator as a protector — at the expense of family and friends. Situations like this require contacting Adult Protective Services and pursuing legal action.

7. Do what’s right
Intervening on an older adult’s behalf can be difficult even in the best of circumstances. When a loved one’s judgment is impaired, it’s important to intervene to ensure safety — even without his or her blessing. “If you care about them, you need to keep them safe. And you have to do it before the situation becomes urgent,” says Ms. Truchanowicz.

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Tip — Exercise: It’s never too late to reap rewards

If you think your “get up and go” got up and went, think again. Researchers find that exercising at least three times a week for at least 30 minutes improves seniors’ physical and mental well-being. Physical activity like walking helps the heart and the brain, improving memory and the ability to plan, schedule, and multitask. Twice-weekly balance exercises and strength training are also key. Strength training improves mobility and relieves depression. But consult a physician if you’re just beginning.

Be Well – June 2011 Issue

Enjoy Your Pedicure — Safely

Pedicures can be fun and relaxing, but they also pose potential health risks — some quite serious. Why? Because infections can occur after your day at the spa.

Being informed can help you avoid them.

When pedicure instruments have not been properly sterilized, organisms can enter the skin or nails and cause health problems. Dina Stock, DPM, a podiatrist at Cleveland Clinic, says, “In some cases, you may know right away that something has gone awry. In other cases, it may be months before you realize something is not right.”

Battling bacterial infections

If the nail or area around the nail is red, hot, swollen and painful, you may have contracted a bacterial skin or nail infection. “These infections usually show up within a few days after having a pedicure,” notes Dr. Stock. “They should be treated with antibiotics and possibly an incision and drainage, depending on their severity.”

Staying alert for other infections

She cautions that unlike bacterial infections, fungal and viral infections may take months to appear. She suggests watching your feet and paying attention to these signs:

  • Fungal infections. If your nail turns yellow and begins to lift, you’ve probably contracted a nail fungus, one of the most common results of pedicures gone bad. Topical and oral treatments for nail fungus are available.
  • Viral infections. Plantar warts are probably the most common viral infection of the foot. You can pick them up in the spa or the neighborhood pool. A callus-like covering and dark spots beneath it give plantar warts away. So can feeling like you’ve constantly got a pebble in your shoe. Topical treatments are often helpful.
The bottom line

Seek word-of-mouth recommendations for a pedicurist from friends and beauty professionals. Ask the pedicurist about the salon’s cleaning and sterilization procedures. Autoclaving — the method hospitals use to sterilize surgical instruments—is preferred.

Finally, see your doctor or visit a podiatrist if you notice something abnormal on your feet.

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Be Well – June 2011 Issue

Your Free Guide to Kidney Stones

Kidney stones are a common problem, typically affecting adults over age 40. But they can occur at any age, and may cause excruciating discomfort or no symptoms at all. Learn how Cleveland Clinic experts tailor kidney stone treatment to each patient’s needs.

Recipe: 'Vegetarian Spaghetti'

Surprise your family with this healthy, delicious dish that boasts a secret ingredient: spaghetti squash. You'll get more nutrition than you'd believe possible from a "pasta" dish. Serve with grilled chicken and a tossed salad.


1 spaghetti squash
2.5 cups tomato sauce, brought to a boil
5 oz. fat-free shredded mozzarella cheese

  1. Cut squash in half and scoop out seeds with a spoon. Pierce a few holes in the skin.
  2. Place squash cut-side-up in a microwave-safe dish. Add ¼ cup water to bottom of dish. Cover squash with plastic wrap pierced with a fork to allow steam to escape.
  3. Microwave for 10 to 20 minutes or until skin easily gives. Using a fork, scrape out insides of squash and pile onto a plate like pasta. Warm tomato sauce and pour desired amount over squash; mix.
  4. Sprinkle with fat-free mozzarella cheese.

Makes about 10 servings (½ cup each)

Per serving:
Calories: 66 (14% calories from fat)

Fat: 2 g

Saturated fat: 0 g 

Protein: 5 g 

Carbohydrates: 18 g
Dietary fiber: 2 g
Cholesterol: 0 mg

Sodium: 333 mg

Potassium: 201 mg

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Be Well – June 2011 Issue

Let's Move It! Mondays at Progressive Field

Now you can move it with Cleveland Clinic and enjoy free, exclusive access to Progressive Field in downtown Cleveland on select Mondays this summer. Invite your friends to walk the warning track with you over the lunch hour on Let’s Move It! Mondays — and stop by our booth for free giveaways and health information.