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Amenities Near Clover Care Centre – by car

(i) Hospitals
Hospital Sultan Aminah – 20 to 25min
Hospital Sultan Aminah – 20 to 25min
The Sultanah Aminah Hospital is a government-funded multi-specialty hospital located in Johor Bahru, Johor, Malaysia. It is the largest hospital in Johor and the main referral and tertiary health centre for the state.

Hospital Permai – 20min
Hospital Permai is equipped with 36 wards providing service, training and research in psychiatry.

Columbia Asia Hospital – 10min
In the prosperous state of Johor at the southern tip of Malaysia, lies Columbia Asia Hospital – Iskandar Puteri. It opened in 2010 and is the company’s first multi-specialty medical facility. This multi-disciplinary specialist hospital caters to residents of new townships in Johor Bahru such as Nusa Idaman, Horizon Hills, Educity, SiLC and Ledang. A 10-minute drive from Johor Bahru city center also Singapore, Iskandar Puteri is a flagship zone of the Iskandar Development Region in southern Johor.

Gleneagles Medini Hospital – 10min
The Gleneagles Medini Hospital will features 300-beds and a 162-suite medical office block. The hospital is developed by Parkway Pantai Group in close partnership with Global Capital & Development.

(ii) Attractions
Legoland Malaysia – 10min
First Legoland theme park to open in Asia.

Sanrio Hello Kitty Town – 15min
First Hello Kitty Town outside of Japan

Puteri Harbour – 15min
Waterfront Living right here in Nusajaya

Horizon Hills Golf Resort & Poresia Golf Club & Resort – 10min

(iii) Shopping Centres
Aeon Mall Bukit Indah – 15min

Tesco Bukit Indah – 15min

Giant Nusa Bestari – 15min

Sutera Mall – 20 to 25min

Johor Premium Outlets – 20min


Shingles and Unrelenting Pain after Recovery

Shingles is caused by the varicella zoster virus – the same virus that also causes chicken pox. Anyone who has had chicken pox in the past may develop shingles and this is particularly pronounced as you get older. The virus does not go completely after you have had chickenpox. Some virus particles remain latent in the nerve roots next to your spinal cord. Some cases of shingles then appear for no apparent reason where the virus multiplies and travel along the nerve to the skin to cause shingles. In other cases, a period of lower immunity such as stress or illness can also trigger an episode of shingles. After the age of fifty, it becomes increasingly common to get shingles, probably due to the lower immunity as we age. Although it is uncommon to have it more than once, some people do experience it.

The most commonly involved nerves that cause shingles are those below the skin of the chest or tummy (abdomen). The upper face (including the eye) is also a common site. The back areas behind the body are also possible. The pain can range from mild to severe and can include constant dull, burning or gnawing pain. Acute and stabbing pains might also come and go. Itchy blisters will then develop after the rash. The blister will normally dry up, form scabs and gradually fade away. Slight scarring is possible after this ends. The whole duration usually lasts two to four weeks. Feeling feverish (running a temperature) and feeling weak is also commonly experienced during this episode.

You cannot contract shingles from someone who has shingles. However, you can get chicken pox from someone who has shingles if you have not had an immunization for chicken pox, contracted chicken pox before in the past or exhibit poor immunity. The shingles rash is highly contagious and it would be good if you can exercise responsibility whereby you try not to come in contact with young children (who might not be immunized) or weaker elderly persons if you have shingles.

Post-herpetic Neuralgia (PHN) is the most common complication where the nerve pain (neuralgia) of shingles persists after the rash is gone. It is a nerve pain that continues for three months or more due to damage caused by Shingles. Alternatively, if the pain goes away and returns at a later date, this is also called PHN. The problem is not so common in people with ages under fifty but for those over the age of sixty, one in five will have PHN that lasts more than a month.

Ways to alleviate the pain include wearing loose clothing to reduce irritation of the affected skin areas. Taking frequent cool baths or icing of the affected areas might also help. Taking common painkillers such as paracetamol are unlikely to help much. Hence, seeing a physician and getting the right medication is vital. They normally will prescribe an antidepressant medicine in the tricyclic group. In this case, it is not used to treat depression. Tricyclic antidepressants ease nerve pain (neuralgia) separately to their action on depression. However, amitriptyline is the one commonly used for nerve pain. Pain is stopped, or greatly eased, in up to 8 in 10 cases of PHN treated with amitriptyline. Tricyclic antidepressants sometimes cause drowsiness. This often eases in time. To try to avoid drowsiness, a low dose is usually started at first and then built up gradually if needed. It is also usually taken at night. A dry mouth is another common side-effect. Frequent sips of water may help with this. Please visit a qualified physician or doctor to ensure you have the right advice given your current medical condition.


Excessive cholesterol lowering drugs degenerates the brain

Cholesterol is a molecule that was first discovered in 1769. Unfortunately, in the 250 years since, it has become the number one misunderstood nutrient in the body. As it was found to be a major component of arterial plague, cholesterol was instantly deemed harmful for the human body. Overnight, western medical publications released articles mentioning that your vital health signs are inversely related to the level of cholesterol in your body. In fact, scientific research has shown that arterial plague is actually the body’s way of healing inflamed injured tissues. This logic of lowering cholesterol levels is akin to reducing the number of fire brigades in order to decrease the number of fires. Does this even make sense given that fire engines and fire trucks are always found at the scene where the fire took place?

Cholesterol is so vital to human health that almost every human cell in the body is constantly producing it. Although most of it is made in the liver, the human brain is where it is needed most. Even though the brain only makes up 2% of body weight, it contains 25% of all the body’s cholesterol and 60% of brain mass is purely fat. DHA, a type of omega-3 fat, makes up around 15-20% of your brain’s cerebral cortex. The brain neurons – the “wires” of your brain and central nervous system, contain high levels of DHA to aid in structural support of the entire human body. One of the primary uses of cholesterol is that it is needed to synthesize various hormones and neurotransmitters which the brain cells use to communicate with each other. Hence, without an acceptable level of cholesterol, the brain cells will die off eventually. Some researchers have actually postulated and published articles mentioning that cholesterol exhibits antioxidant abilities that protect the body against cancer. It also helps in the production of Vitamin D and maintains cell structure integrities to prevent them from becoming porous. Porous cell membranes are logically more susceptible to damage and foreign pathogens.

In the current age of abundance, lifestyle diseases such as hypertension and other heart diseases are taking centre stage where the food we take are either too much or too rich. Without moderation and control, high cholesterol levels are seen in increasingly younger patients. This has led to widespread prescription of cholesterol lowering statins such as the generic Zocor(Simvastatin). It is unsurprising to note that with millions of people under such prescriptions, rates of dementia and Alzheimer’s are on the rise. A study published in the journal Pharmacotherapy in 2009 found that three out of four people using these drugs experienced adverse cognitive effects ‘probably or definitely related to’ the drug. It also mentioned that there were patients who experienced cognitive improvements after stopping statin therapy. In fact, since Feb 2012, the US FDA (Food and Drug Administration) ordered drug pharma companies to add a new warning label about possible memory problems to the prescribing information for statins.

Another research study published in the journal Neurology found that high levels of cholesterol actually reduces the risk of dementia in the elderly. “High cholesterol levels in late life was actually associated with decreased dementia risk, which is in contrast to previous research suggesting high cholesterol in mid-life is a risk factor the onset of dementia in late life,” conclude the study’s authors. “The contradictory results may be explained by the timing of the cholesterol measurements in relationship to age and the clinical onset of dementia.” The research was a joint venture of the Center on Aging and Health, the Alzheimer’s Disease Research Centers, the Department of Mental Health, The Johns Hopkins University Bloomberg School of Public Health, the Institute of Clinical Neurosciences, and others.

There are many other studies augmenting the premise of this research and the message is very clear. There is possibly very minimal advantage in taking statin drugs if you are over the age of 65. The primary purpose of statins is to reduce the risk of heart attacks and strokes, and the very reason statins help is because of the drug’s anti-inflammatory effects. Regrettably, statins reduces the production of CoQ10 (Coenzyme Q10), which is the number one important nutrient when it comes to the vascular system’s integrity. Perhaps it is better to talk to your physician or doctor to discuss ways and methods to reduce statin consumption. As always, moderation is key and that includes the consumption of your medications.




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Read this if you have an elderly at home – Stroke(s) can be fatal!

An episode of stroke occurs when there is a sudden and life-threatening loss of blood flow to a part of the brain that results in damage or death of brain cells. The stroke may lead to irreversible damage and disability or for fortunate cases, the patient may still be able to recover all or most of his/her abilities. To put it simply, a stroke is an attack on the brain. For Americans, stroke is the third leading cause of death.
Immediate medical attention is vitally important to the stroke patient, and the patient should be seen by medical professionals, preferably in a hospital, within an hour of the onset of the symptoms. Patients who suspect they have stroke or are exhibiting symptoms of stroke should never attempt to drive themselves to the hospital. They should preferably be driven as soon as possible to the nearest medical facility such as a hospital that is suitably equipped to handle stroke cases. If emergency services where ambulances are available, the paramedics who come with the ambulance might even be able to render aid that might save the stroke patient’s life. Every minute counts and judgement has to be exercised on which is the most appropriate course of action to take.

Some strokes go unnoticed or ignored because they only last a few minutes and the symptoms end. These strokes are called transient ischemic attacks (TIAs) and are also known as ministrokes. They are important because an untreated stroke can be followed by a major and disabling stroke within hours. It is to the patient’s benefit if treatments such as clot busting drugs are administered within the first three hours after the symptoms occur. The medical professional who is handling the situation will be suitably able to judge what should be given. According to the National Institute of Neurological Disorders and Stroke, the risk of suffering from a stroke increases by more than double for each decade of life after age 55. In addition, stroke represents 8 percent of all deaths among individuals age 65 and older, according to the Centers for Disease Control and Prevention (CDC).
Two primary types of strokes:
Ischemic stroke – This is the most common form of stroke in which the blood supply to the brain is interrupted or disrupted, leading to a loss of oxygen to the brain tissues. An ischemic stroke may result from arteriosclerosis (clogged arteries). Fatty deposits of plaque may build up on the arterial walls over time and eventually result in an abnormal blood flow, causing the blood to blot. A blood clot that stays in one place within the brain is called a cerebral thrombus while a clot that breaks loose and moves along the blood stream inside the brain is known as a cerebral embolism. An abnormal heart valve may also cause an ischemic stroke. Heart rhythms problems and severe alterations in blood pressure may also be responsible for a loss or reduced blood flow to the brain.
Haemorrhagic stroke – With a haemorrhagic stroke, a blood vessel leading to the brain or inside the brain bursts, resulting in the rupture of brain cells.
Do not self-diagnose. At the onset of symptoms, please see a medical professional. Only a physician can diagnose a stroke accurately, determine the status of the stroke and decide on course of action.

Stroke Symptoms
• Please recognise and seek immediate medical attention should you witness any of the following:
• Sudden numbness or weakness in the face, arm or leg, especially when it is only occurring on one side of the body
• Sudden confusion or trouble in understanding speech or in speaking
• Sudden problems seeing in one or both eyes
• Sudden dizziness, loss of balance or coordination, or trouble walking
• Sudden and severe headache with no known cause

Stroke Diagnostics
Medical professionals use imaging tools to determine whether a stroke has occurred and if so, the severity of the stroke. They may use a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan of the brain. They may also use an ultrasound to image the carotid arteries of the neck in order to check for blockages or clots. Magnetic resonance angiography (MRA) may be used to determine and detect blockages of the carotid and vertebral arteries. Other tests may include an echocardiogram to ascertain if a clot from the heart has caused the problem or an electrocardiogram to identify any underlying heart or cardiovascular diseases. Laboratory test will be performed to determine if there is any abnormal clotting of the blood or if there are any autoimmune conditions.

Stroke Treatments
Medications are frequently used to treat stroke patients. Anticoagulants are often prescribed. The most commonly prescribed anticoagulants are Warfarin (Coumadin) and Heparin. Antiplatelet agents (drugs that prevent small blood components from sticking together) are also commonly used, including aspirin/extended-release dipyridamole (Aggrenox) and clopidogrel (Plavix). Calcium channel blockers and pain medications may also be prescribed.
Intravenous feeding therapy is often instituted because the patient maybe unable or have difficulty in self-feeding. When the patient has lost the swallowing reflex, it is also unsafe to administer food via the mouth. Once the patient has recovered, he or she may be placed on long term aspirin therapy. Sometimes, in severe cases, surgery might be required to repair the damage caused by the stroke. Stroke victims may suffer long term effects and follow up care with a specialist like the neurologist maybe required. They may also need assistance with performing the activities of daily living (ADL). Examples of ADL include eating, dressing, toileting and so on. Stroke patients may need to receive care in a rehabilitative nursing home until they are well enough to receive care within their own home. Speech therapists, physiotherapists and occupational therapists can also be engaged to help the recuperation. Sometimes, stroke patients are also traumatized and also suffer emotionally from the fear of the onset of another attack and in most cases, the deterioration of the quality of life. Hence, they should also be cared for from the perspective of the psychological aspect.

Some stroke victims may experience a range of complications from their stroke, including:
• permanent loss of mobility in part of the body
• permanent loss of brain functions
• a reduced ability to care for himself or herself
• a decreased life span
• a reduced ability to communicate or interact with others
• muscle spasticity
• a reduced awareness of one side of the body

Stroke Risk Factors
The primary risk factors for the development of a stroke occur among those individuals who have
• Diabetes
• Hypertension
• History of heart diseases
• Smoking
• Alcohol abuse
• Family history of strokes
Individuals with high risk factors should be screened for hypertension and have their blood cholesterol checked regularly. Hypertensive patients should work to reduce their blood pressure to normal levels with a combination of medication, exercise, weight loss, diet and other recommendations provided by their physicians. Always remember this: Everything in moderation and seek your physician’s advice before going about on a regime to reduce your blood pressure. Some patients attempt to partake in strenuous exercises without consulting their doctor, leading to fatal endings.


Bedridden Patients: Sponge/Bed Bath vs Actual Bath

Hi, if you are a caregiver who is looking after someone who has difficulty bathing himself/herself, you should read this article below. Unless there is enough manpower(such as a nursing home), sponge baths or bed baths are used to bath people who are bedridden or unable to bath on their own due to health reasons. Giving a bed bath involves washing and rinsing the entire body one section at a time while the person remains in bed. It is imperative to gather all the required bathing supplies needed before you begin so you do not have to leave the person unattended. A good bed bath will leave the person feeling comfortable and clean. This is essential for good rest and the prevention of bed sores. Unclean areas always promote bacteria growth and worsen bed sores.
Sponge bath
Step 1: Feel 2 pails with warm water. One is used for washing and the other is for rinsing. Ensure the temperature is comfortably hot. We do not want to scald the person or cause discomfort as some of them cannot even voice out due to certain medical conditions.

Step 2: Choose soap that rinses away easily. Or you can also consider shower foams. Do not use soaps or foams that have exfoliating beads that are difficult to remove if the washing is not thorough. Avoid no-rinse soaps as this will cause residues that are difficult to remove.

Step 3: If shampoo is required, do consider baby shampoos. These persons are like big babies who require our tender loving care and these baby shampoos are apt and gentle enough for them. Try to get an extra shallow basin for washing the hair. If this is not available, we need to get extra towels to prevent the bed from getting too wet.
Step 4: Try to get waterproof disposable drawsheets and place it over the bed to prevent it from getting wet. If this is not available, do put additional towels below.

Step 5: Remove the clothing of the person accordingly and try to be as professional as possible. The person might feel embarrassed.

Step 6: First apply soap or shower foam to the person’s skin. Scrub it gently with a sponge to remove dirt and bacteria. Thereafter, place the sponge in the soapy basin. Dip a second piece of sponge or cloth into the rinsing basin and use it to rinse away the soap. Pat the area dry with another towel. Remember to alternate between the wash and rinse sponges. If they become dirty, switch to clean ones. Change the water in the basins as necessary.

Step 7: Start with the person’s face. Gently wash the person’s face, ears and neck with soapy water. Rinse away the soap with a clean cloth. Dry the cleansed area with a towel.

Step 8: Thereafter, when washing the person’s hair, gently lift their head into the shampooing basin or inflatable basin for hair wash. Wet the hair by pouring water over the person’s head, taking care not to get it in their eyes. Apply shampoo before rinse it away. Pat the hair dry with a towel.

Step 9: When washing the person’s left arm and shoulder, fold over the drawsheet/towels on the left side of the body down to the hip. Place a towel beneath the exposed arm. Wash and rinse the person’s shoulder, underarms, upper arms and hand. Dry the wet areas with a towel accordingly. Dry the washed areas thoroughly, especially the underarms as we need to prevent chafing and bacteria growth.

Step 10: When wash the person’s right arm and shoulder, fold over the sheet to expose the right side. Place the drawsheet/towel beneath the other arm and repeat.

Step 11: When washing the person’s torso, fold the sheet down to the waist and gently wash and rinse the chest, stomach and sides. Be sure to wash carefully among any folds in the person’s skin, as bacteria growth is common there. Towel dry the torso carefully, especially among the folds.

Step 12: When washing the person’s legs, uncover the person’s right leg up to the waist, and wash, rinse and dry the leg and foot. Recover the right leg and uncover the left, then repeat. Towel dry accordingly.

Step 13: Change the water in the pails or basins. Ask the person to roll on their side if they are able to. Assist the person if required. Make sure they are not too close to the edge of the bed.

Step 14: To wash the person’s back and buttocks, fold the sheet over to expose the entire back side of the patient. Wash, rinse and dry the back of the patient’s neck, back, buttocks and parts of the legs you may have missed.

Step 15: When washing the genital area and anus, put on latex gloves if desired. Lift the person’s leg and wash from front to back. Use a clean cloth to rinse the area. Be sure to clean thoroughly between folds, and dry the area thoroughly as well. For males, try to wash behind the testicles. For females, there is no need to clean the vagina, just wash the labia will do.

Step 16: Redress the patient after ensuring the person is towelled dry. When you’re finished, dress the patient in clean clothes or a robe. First replace the patient’s shirt, keeping the sheet over his or her legs. Then remove the drawsheet and wear the person’s underwear and pants. Elderly skin tends to get dry, so you may want to apply moisturising lotion to the arms and legs before putting their clothes back on. Comb the person’s hair and apply cosmetics and other body products according to the patient’s preferences if require.

*You can actually check many youtube videos online on the procedures for a sponge bath. The idea or central principles are the same, just that the steps taken might have some tweaks.

Nursing Home Toilet - Clover Care Centre

Nursing Home Toilet – Clover Care Centre

There you have it, the steps involved in giving a bed sponge bath. We personally feel that it is better to go for an actual real bath in the toilet. Hence, if the resident is a bedridden, put him/her on a patient trolley or wheelchair and push him/her into the toilet safely. Of course, there must be an additional pair of helping hands for this kind of endeavour. This time round, we use the soap and shower generously. We are of the opinion that this is cleaner and preferred by the residents. Somehow with sponge baths, we don’t think it is really that clean. Do remember to towel dry thoroughly since we are using a higher volume of water this time round. The time taken for both the sponge bed bath and actual real bath in the toilet can more or less be the same if done efficiently. Remember this: Quality matters! No point doing more sponge baths if it is done in a hurried manner.


Nursing Care for Alzheimer’s

Caregiving for a next of kin with Alzheimer’s can be extremely stressful as the disease deteriorates.
Clover Healthcare - Nursing Care for Alzheimer's

Suggestions for successful communication with sufferers of Alzheimer’s:
- cut down on distractions, noise and other things that will impede communication. This will enable the caregiver to understand what the individual with Alzheimer’s is saying and vice versa.
- speak calmly in simple and short sentences.
- calling by name and only continuing after getting his/her attention.
- predict or suggest words that the person is struggling to say but cannot.
- framing instructions and questions in a positive manner.

Suggestions for bathing sufferers of Alzheimer’s:
- understanding that bathing can be daunting for sufferers of Alzheimer’s and to exercise patience.
- testing the water temperature before the person bathes
- using toilet friendly features like shower chair, grab bars etc…
- never leaving the person alone in the shower.
- telling the person what you are going to do in a step by step manner to prepare him/her properly.

Suggestions for dressing sufferers of Alzheimer’s:
- having the person get dressed in a routine schedule, so that it becomes habitual.
- encouragement coupled with enough time to allow the person to dress at their own pace.
- allow only a limited range of outfits for selection.
- avoid buttons and zippers and use clothing with Velcro closures.
- arrange clothes in an order that they reduce confusion.

Suggestions for helping sufferers of Alzheimer’s eat:
- limit food choices after taking into factoring in physical and medical considerations.
- use deep bowls and crockery with large handles to promote independence while eating. Fluids can be introduced via straws or cups with lids.
- play soothing music while having meals.
- do understand that the risk of choking increases while the disease progresses.

Suggestions for helping sufferers of Alzheimer’s sleep better:
- limit daytime napping to ensure that the individual sleeps better at night.
- schedule more physically demanding activities earlier in the day.
- restrict caffeine access in the evening.

Suggestions for helping sufferers of Alzheimer’s with hallucinations and delusions:
- try to minimize confrontation or arguments about what he/she sees or hears.
- distract the person to perform another activity such as going for a walk or even just leaving the room.
- turn off the television when violent programs are shown.
- ensure harmful items are kept away from the sufferers. Kitchens should preferably be locked at night.
- consider using monitoring devices that might detect calls for help.