Vikrams blog.png

Hello everyone!
I am very excited that I have completed  one and half years at Epoch Elder Care, and there are lots of amazing memories which I have earned from my Epoch family in these last 18 months!
On one hand, I am a very introverted person,and on the other hand, I also love to interact with new people. One of my friends advised me "why don’t you join the hospitality industry, you are totally made for that industry", and I worked in F&B at hotels for 6 years. In the hotel industry we served food to the guests with etiquette & decorum. Here, in Epoch, I have learnt how to serve food with emotion, love & affinity.
When I joined Epoch, I was excited that my role was going to be multifaceted - within my genre of F&B. I would be handling not only making diet and nutrition plans, but also using F&B as a tool for engagement for our elderly residents. In the beginning, these were completely new tasks for me.It is truly amazing when you love your work as a worship, because here you have to care & serve the loveable elderlies. Over the last 18 months I love my work, and even more when I work with our wonderful elderly residents. 
Food & care are the heart of every human being, and Epoch has set a milestone in providing person-centered care  through food and beverage. I learnt from my mentor how to make a healthy and nutritious diet for our elderly, like a diabetic diet, weight loss, less protein, carbs diet & healthy diet. That’s my new learning in menu planning & diet making. It always feels right to mix the right amount of nutrition and flavours to prepare a delicious meal!
It’s good to see that our elders engage in activities and participate in them. I am a creative person, and adding creativity to my work is very exciting. Every day, I think about what more I can do for our elderly and this makes me happy. So, we schedule different activities every week; like  potting plants, stringing pasta, cutting & stamping food, making food pyramids, doing food carving, picking food with chopsticks and many more activities for our elderly. 
I learn life lessons & life values when I interact with our elderly, they always admire my efforts. It's great when I am talking to our elderlies, and among them, I talk to an uncle who tells me the importance of discipline in life, how to always plan your goals, and he always motivates me. 
We have a cooperative & energetic team who always guides me towards the right path. They always help me to come up with nice activity ideas for our residents, and with my creativity, I make beautiful and engaging activities.  
Thanks to everyone for their wonderful support, for accepting me in the Epoch family and always supporting & motivating me. I wish to do more new creative, fun-loving engagement activities for our dear elders keeping in mind their nutrition intake through food and beverage. This is just the beginning for me. I want to learn and earn more knowledge and good memories from Epoch!

Vikram blog thumbnail.png

Story of my second home

Anju Blog (1).png

**Do you have elderly people at your home? Are they not able to hold their urination?
Are they on a catheter?**
**If your answer is yes, then they all are prone to urinary tract infection (UTI).**

**I am Anju Bobin, Senior Nurse and Training Manager at Epoch Elder Care. With my 16 years of experience, I am sharing with you some aspects and care management of UTI, which will be useful to you, as a caregiver.**  
 
Urinary Tract Infection (UTI) is a common abbreviation that all are aware of. This is common in young and old but older people have higher chances of getting UTI.
 
Experiencing pain and burning sensation and cloudy urine are all signs of a UTI. The infection can affect any part of your urinary system—kidneys, ureters, bladder, and urethra—however, most UTIs involve the lower urinary tract (specifically, the bladder). The painful symptoms of a UTI not only irritate the elderly, but they can lead to serious consequences if the infection reaches the kidneys.
 
Women have more chances of developing an infection as compared to male elderly as the urethra of a woman is close to the anus. And the urethral opening is close to the bladder. This makes it easier for bacteria around the anus to enter the urethra and travel to the bladder.
 
UTIs are generally caused by a type of bacteria called E. coli that resides in our digestive tract but when it enters our urinary tract.
 
**Do you have any idea why our elderly develop UTIs more than the young population?**
 
As age advances the muscles of the bladder and pelvic floor become very weak causing urine retention or incontinence. The bacteria remain in the urine present in the urinary tract, they grow and colonize gradually and later develop UTIs in the elderly.
 
Another contributing factor is an indwelling catheter in old age people. Other than these we have to watch out if these conditions are present in the elderly.
Diabetes mellitus
Enlarged prostate (In males)
Bedridden
Kidney stones
 
**How can you identify a UTI in an elderly as a primary care provider?**
Confusion or delirium
Increased or urgent urination
Fever
Painful urination
Nausea
Urine with abnormal color or odor
Pelvic pain
Sudden changes in behavior or agitation
Poor motor skills or dizziness
 
In many cases when you are a caregiver to the elderly with dementia, you may not be able to find all the symptoms in the elderly because they lack communication skills, so watch out for any behavioral changes. Healthy people display physical symptoms like burning when urinating, elderly patients may not complain of such pain. If not detected early, the infection can lead to serious health problems.
 
**Tips for preventing UTIs in elderly**
Hydration is the only key factor helping to prevent UTIs in the elderly. Drink at least 1.5 liters to 2 liters of water a day
Use cranberry juice or tablets. It is suggested by a research paper published in NCBI that daily consumption of 200ml-300ml of cranberry juice cocktail can prevent 50% of the recurrences of UTI and can reduce bacteriuria (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863270/)
 Limit the use of caffeine
Avoid cleaning or wiping from back to front (especially for elderly women)
Use cotton underwear and change on daily basis or when required
Keeping the genital area clean and dry
Avoid catheterization if not required
 
**Tips to prevent UTI if the elderly are on a catheter at home**
Always do handwashing before and after every procedure
Always keep the urobag below hip level to prevent backflow of urine to the bladder
As a caregiver please watch that the catheter tube should not be folded at any point in time else it will cause urine backflow
Perineal care once a day daily around the catheter and more frequently if the elderly are suffering from incontinence
Cleaning the rectal area thoroughly after the elderly passed their motion
Empty the urobag every 8 hours or whenever it is full
Changing the catheter every 14 days if the regular catheter is inserted and if the silicon catheter is inserted change in 1 month
 
**What happens if a UTI is untreated?**
If UTI is not treated, it will cause permanent damage to the urinary tract.
 
**How are UTIs treated?**
UTIs are treated with antibiotics
Antibiotics should be taken for a week or two so that the infection gets cured 
If the kidney gets infected then antibiotics are given for more than a week
 
Every primary caregiver at home has questions about what should be incorporated and what should be avoided if the elderly is diagnosed with UTI.
Here are some of the tips.
 
**Food to be included:-**
 
A higher fiber diet including lentils(dal), nuts, beans, whole grains, and oats
Eat probiotic-rich foods like greek yogurt which are available in the market easily nowadays
Eating cranberries, and blueberries is helpful. Drink cranberry juice which should be sugar-free
Fish oil with omega-3 fatty acids is good. If you are a vegetarian then take walnut, chia seeds, and flax seeds that are readily available in the Indian market
 
**Food to be avoided:-
Avoid coffee, cold drinks, and alcoholic beverages
Do not eat spicy foods
Don't eat acidic fruits like orange, lime, or lemon
 
**As a Senior Nurse & a Training Manager, I believe that prevention is better than cure.**
In our Epoch Elder Care facilities, we have elders who are in the age group of 75-100. Our elderlies are also prone to develop UTIs.To decrease the morbidity rate caused by this infection, continuous training is given to our staff. Training is given to our care attendants and nurses to identify the symptoms in the elderly such as a sudden change in behavior, complaints of pain, and changes in toilet habits like frequent urination.
We apply various preventive measures like frequent diaper changes, giving catheter care to the elders, and also keeping them hydrated by giving them flavored drinks. 
Hygiene is another important tip that helps in prevention. So, here at our Epoch homes, we make it a habit to do perineal care daily. If the elderly has a catheter, we make sure that we do proper catheter care and ensure that during the insertion procedure all aseptic techniques are applied to prevent CAUTI (Catheter-associated urinary tract infection). Our elders who are living with later stages of dementia face difficulty in conveying their urge to urinate. So, on regular intervals, we do take them to the toilet and help them with toileting.
 
Urinary tract infections are very common. Anyone living with or caring for an elderly family member should be aware of the potential for UTIs. Knowing how to avoid a UTI and knowing what symptoms to look out for can make all the difference in an elder’s quality of life.
P.S.: Never ignore the signs of infection in your elderly loved ones!

Anju blog thumbnail.png

Urinary tract infections in the elderly and their management

Karina's 2nd blog banner.png

Epoch homes are humble abodes for elders who need care round the clock. Most of our elders come and stay with us for life. And that’s why our aim is to facilitate happy and healthy ageing for all our residents, give them the best quality of physical and emotional care and build a trustworthy bond with their families assuring them of their parent’s safety. This lies on the shoulders of our team members, especially support staff who are instrumental to the operations of each home as they are the ones who are involved in taking care of their day-to-day requirements including care, food, grooming, hygiene, cleanliness etc. 

As a caregiver, it is important to understand residents’ behaviour and health conditions. Most importantly, they are required to build & establish a bond of trust with the residents. A bond of faith and confidence, so strong as to understand and interpret the unspoken words. This and all is possible only when the caregivers have their peace of mind, and are happy and satisfied.

Caregiver burnout is common and occurs when one feels overwhelmed by how challenging the process of caring for someone can be. With time, one may begin to lose the interest or motivation that brought them to this role in the first place. It eventually gets to the caregiver and affects them both psychologically and physically. 

The life of a caregiver is like a ride, sometimes smooth, sometimes bumpy! They are trained and are required to deal with the agitated behaviour of our residents. It becomes more critical to understand their physical and mental health to minimize their stress and burnout. 

Being cared for has a profound effect on our emotional state. It gives a sense of relief and relaxation. Doesn’t everyone want such in their work-life balance?  

At Epoch, most of our support staff comes from a challenging environment where their entire family is somewhat dependent on them. Also, most of our support staff are from distant areas. They live apart from their families; so it becomes our responsibility to make them feel that Epoch is their home and we all are here for them. They expect an environment of care, respect, safety, motivation and empowerment along with competitive pay packages. 

Epoch constantly works toward achieving the goal of keeping them motivated and flowing. For fulfilling such, we at Epoch have an “Employee of the Month” program for our support staff. We recognize the employees for their extraordinary performance and reward them with tangible rewards. Believe me, it makes a huge difference!

From my years of experience, and rolling, I have witnessed different organizations and their different approaches to staff management. However, in an eldercare sector such as ours, the structure and management of human capital slightly vary. 

Caring and managing support staff is very different from managing corporate staff given their different job roles. Also, the role which our support staff plays is very crucial and demanding. While dealing with them, we have to be very sensitive and conscious. Must to do things- spend time with them regularly, counsel them and discuss their personal and family concerns, we make them feel they are at home. On the other hand, corporate staff are more comfortable in a healthy and conducive environment.

At Epoch, we believe our team members are our assets and being an HR professional it is one of my key responsibilities to perfectly manage these assets in a true sense and retain them for a longer term. We care for our team members and their happiness. We believe in investing in our team and providing them with an opportunity to grow both personally and professionally.

For keeping them motivated and going, the keystone is to have a heart-to-heart conversation with the team members. Trust and Care are the two main ingredients to motivate and retain our employees.
Sharing some pivotal tools- Epoch’s personal touch to caring for its team and boosting their morale to retain them in their profession 

1. **Listening:** We believe patiently listening to the thoughts and issues of our team members can do magic, and give them a feeling that someone cares for them. This reduces their stress level and burnout. It’s better if I share this through a relatable story: During the peak of the COVID-19 surge, most of our team members were bound to stay inside 24*7 and were not allowed to step outside the resident's rooms for their own safety as well as for our residents' safety. This was the time they got very stressed and some of them felt like quitting because of this burnout. During that time the listening approach did a miracle, and our team members felt so motivated that they started working more efficiently and happily and none of them left!

2. **Empowering the team by involving:** We believe in involving team members in decision-making related to care plans and operations or explaining the reason for a particular decision, rather than just imposing it onto them. We believe it is important that team members should know the reasons, be comfortable and familiar with the process, share their feedback, be open about any challenges and then be in a position to acknowledge and accept the changes happily.

3. **Transparency:** Being transparent in all our processes is what we firmly believe in and hence practice. It is another key factor that plays an important role in building trust and earning the loyalty of our team members, and it’s a boon! We give our best, and we are true to ourselves. Being transparent with our team acts as our strength. And the understanding is not one-sided, in return, the team mutually adds their effort and will to establish seamless transparency in their mode of conduct, communication, and course of work. We at Epoch believe in doing open, honest and direct communication with the team, and are always open to honest feedback.

4. **Conflict resolution:** We strongly believe that every conflict/issue should be resolved on priority by defining a timeline. It should not just linger. I personally follow this to resolve each and every grievance/concern raised by our team members on time. I feel that for resolving the issues, we have to focus on incidents and events and not on individual personalities. For every healthy relationship, one needs to listen and talk out what’s stuck in their heart and mind. It ain’t any different for an employee-employer relationship. As Head-Human Resource at Epoch, I bridge people and their emotions and pave a way so that Epoch's workspace remains an exemplary hub for learning, exploring, prospering and building strong connections. 

5. **Everyone is a part of our mission statement:** We believe in evolving and constantly growing together with our team. We consider that our team members matter more than anything. Making them feel that they play a key role in executing our vision is a vital thing for us. This forms a powerful bond between an employee and the employer. We call each of our team members, a brand ambassador of Epoch! We let them own this title with pride and its responsibilities therein. We firmly believe in functioning as a torch bearer for the betterment of ourselves and our organization, Epoch.

As Epoch’s HR personnel it is my top most priority to take care of my team members’ happiness by ensuring that they are promptly heard and understood. It gives a sense of satisfaction to both me and my team to know that I will always be there for them. My aim is to make our team members truly feel they are always **Supported**, **Valued**, **Heard** and **Validated**.

Given my personal experience, I can say that a personal touch is integral for an employee’s motivation and thus their retention.

Karina's 2nd blog thumbnail.png

Caring for our team members: A key Epoch value

Aditi interns Blog.png

My name is Aditi Sharma and I am a research intern at Epoch Elder Care. Currently, I am completing my masters in clinical psychology from Symbiosis College of Arts & Commerce, Pune. I am a mental health research aspirant who has worked with special children, children & adult disabilities ranging from neuro-developmental disorders to mental disorders, and rehabilitation. 

Today, on the occasion of world students day, I would like to put light on the three principles that shape my journey as a student. First principle is **“never giving up”** which I learnt from my mother. When I was about 7 years old, I had a minor squint issue in my right eye which severely affected my learning abilities & self-esteem. My inability to see my capabilities affected my vision to see beyond my disability. In the midst of all the chaos around me, I paused and saw my mother. She guided me with love. Seeing her unconditional effort towards me, eventually made me conquer my disability.

Which brings me to my second principle, being **“courageous”**. I was 15 years old when I decided to become a clinical psychologist. A lot of people told me a lot of things about this profession. Some positives but many negatives. I was 18 years old when I got the opportunity to intern at a hospital in Delhi where I saw the difficulties of this profession & the harsh realities of encountering various psychological disorders, as well as the helplessness that comes with it. Surprisingly, I saw myself willing to continue to step into the clinic the next day and hear many other challenging realities. This is when I met the “courage” in me towards my ambition. 

I was fortunate enough to recently learn the third principle that shaped my student life. This principle is called **“expertise”**. Being a college student, I found myself too occupied with books, assignments and the competition to top my class. I would spend hours reading a research or blog article on neuropsychology and try to discuss it with my professor in the next class. However, after a point I found myself feeling helpless! Helpless, reading about the people and their psychopathological deficits without actually helping them live normally with their impairment. It was a point in my life where I realized that I had something more to offer to the world and I felt as if I was wasting that skill. This is when, Epoch happened to me! 

Now, it has been more than a month with Epoch and I found myself not only studying but also expanding my skills for a larger cause. My mentor, Anju ma’am at Epoch has pushed me to study and expand my knowledge to not only help Epoch residents but also to develop my skills. She has been my backbone and teacher beyond my college classroom. Epoch helped me learn that expertise lies in not only scoring good in college or studying but also in developing skills to serve the “one in need” and most importantly it taught me the power of companionship. 

Expertise also lies in seeing & sensing the knowledge for real. Recently, my friend & I visited Epoch Monet house in Pune. He’s an engineer in defence technology and holds a certain notion of viewing care for dementia. This view rests on the societal belief that residents with dementia care are treated typically like patients. However, when we arrived, both of us were surprised to encounter a familiar home-like environment over there. He saw elders with dementia interacting as normally as anyone else. There was a difference not just in terms of the aesthetics of the place but also the interaction with dementia residents that made the place feel like home to both of us. Interacting, playing games and listening to residents sing songs were the highlights of the day for us. My visit to Epoch home has been a learning experience. My mentor at Monet was Saju sir who made us see a different perspective on dementia care. 

In this developing phase of my life, my mentors uplifted the spirit of a student and a beautiful human in me. My mentors poured the light into my colorful canvas. They helped me see the capabilities of situations rather than their disabilities. 

I would like to end by quoting Dr. A.P.J. Abdul Kalam, “Creativity is seeing the same thing but thinking differently.” 
With this thought, I will continue to positively impact the lives of many people around me as I shape myself in this journey called life. 


Aditi's intern blog thumbnail.png

Looking beyond the textbook

Dr. Prem blog.png

The month of September is celebrated as Alzheimer’s Disease awareness month and 21st September is World Alzheimer’s Day. Dementia is increasing and by 2050 India is expecting 14.3 million people to deal with it. The COVID-19 pandemic has only worsened the scenario.

**Dementia**  is a term used to describe a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with your daily life. **It isn't a specific disease, but several diseases can cause dementia.** 

**Importance of early detection** 

It has been shown in research that the average lifespan after the diagnosis of dementia is approximately 10 years, but it can be in the range of around 5 to 15 years. There is no complete cure for dementia. The three pillars of dementia care have been medication to slow down the disease, behavioural intervention and psychosocial support for the family/caregivers which enhances the quality of life of the patients and  their caregivers.

Early detection is very important as it helps in earlier access to pharmacological, behavioural and psychosocial support. It allows the families to take plan for long term care. Handling legal matters and end of life support can also be dealt with earlier.

**Role of Memory Screening Camps**

A memory screening is an evaluation of memory and thinking skills. A memory screening is a simple and safe evaluation tool that checks memory and other thinking skills. It can indicate whether an additional check-up by a qualified healthcare professional is needed.

Early detection of dementia is very important to decrease the disease burden. This is where memory screening camps play a crucial role. It is important to understand the risk factors of dementia and do timely cognitive assessment.

Memory screening camps can be done with housing societies, senior citizen associations, hospitals, parks and community centres.

These camps include clinicians performing cognitive assessments in the form of scales. These can be done by a team of Geriatricians, Trained health care professionals, Psychiatrists, Neurologists and Clinical psychologists.

It should be done in government clinics as well as private healthcare clinics.

These camps are important as:
1. They help in assessing mental health of older adults and detect early signs of cognitive impairment
2. To raise awareness of risk factors and dementia 
3. To develop an understanding of the difference between normal ageing and dementia
4. To identify cases of anxiety and depression
5. To encourage preventive action against developing cognitive impairment
6. To help older adults to live productively as they age 
7. To provide a baseline cognitive assessment for future reference
8. To sensitize older adults regarding cognitive impairment 

**When to do a Memory screening?**

Memory screenings make sense for anyone concerned about memory loss or experiencing warning signs of dementia; whose family and friends have noticed changes in them, and for those who believe they are at risk due to a family history of Alzheimer’s disease or a related illness. Screenings are also relevant for anyone who does not have a concern right now, but who wants to see how their memory is now and for future comparisons.

The following questions when in the affirmative will need a memory screening.
1. Am I becoming more forgetful?
2. Am I having trouble concentrating?
3. Do I have difficulty performing familiar tasks? 
4. Do I have trouble recalling words or names in conversation?
5. Do I sometimes forget where I am or where I am going? 
6. Am I misplacing things more often?
7. Have I been reminded by my family or friends that I often repeat questions or say the same thing repeatedly? 
8. Do I get lost when walking or driving? 
9. Have my family or friends noticed changes in my mood, behaviour, personality, or desire to do things?

**Diagnosis** 

1. **Cognitive and Neurological Tests** - These tests are used to assess thinking and physical functioning

2. **Blood Tests** - To rule out Hypothyroidism, Vitamin Deficiencies (Vit B12/Folic Acid)

3. **Brain Scans** - These include CT Scan, MRI Scan and PET Scan

4. **Mood Assessment** - Depression cannot be missed!
 
Screening for Caregiver stress is also very important.
 
 
Sharing some strategies for prevention of dementia:
1. Regular exercise
2. Social engagement
3. Healthy diet
4. Mental stimulation
5. Quality sleep
6. Stress management
 
 
Memory screenings help in pointing in the right direction. Early detection helps in better care.

Let us remember those who forget.


Dr. Prem blog thumbnail.png

Dementia Screening and Diagnosis

2.png

As an intern with Epoch, I worked closely with all the residents at both Epoch Assisted Living facilities, i.e Vermeer and Frida and was responsible for observing the behavior that was inhibited by all residents during the socializing time. I was also working with their care staff and together we worked on creating activities for the residents that would help with their motor, sensory and cognitive skills and each task was designed according to the needs of the individual.
 
My experience here has not only enhanced my psychological knowledge but also has given me an insight about how life is with dementia. As an adolescent, it has helped me gain a new perspective on life! As a psychology student, talking to the elders who are 80+ and observing all the symptoms in a person that were once just words on a page is just the best possible practical exposure any psychology student can get and it becomes extremely helpful for one to have fruitful conversations with people who are diagnosed with dementia.

All the time that I've spent engaging with the residents has also helped me understand how to interact with the elderlies. As a person of this generation, I have discovered brilliant ways to connect with these beautiful oldies! Moreover, daily I observed more about how they have managed to enjoy their life even after their diagnosis and how much they enjoy talking about their past, their achievements and reminisce the good times they spent with their loved ones and that makes me motivated to get the most out of my life and keep my loved ones close. 
 
Epoch has created an environment which feels like home and while offering care for people with dementia, they also offer assisted living and facilities for people suffering from other clinical conditions. This not only helps individuals spend their life in a safe and secure environment with care available 24/7 but it also plays a part in reducing the stigma around dementia and the proper and necessary care which is required.

My time with elders and teams at Epoch homes has helped me figure out a clearer path to pursue my career further. Somewhere in my mid-20s, I would love to see myself doing my best bit for the elder community. And later, when I grey, I would love to look back at my time spent here and probably would be walking in their shoes, educating and interacting with more and more youngsters of the upcoming generations.


1.png

Stepping outside the bracket of generation

Blogs aid you through Assisted Living & Dementia Care Scenarios, Challenges faced & Appropriate Care for Elders in India.

Blogs

About us

Our care & services

Library

Contact us