Joyce didn’t think too often about eczema, the scourge of her youth, anymore. That is just how it is when something that once ruled your life is long gone, you rarely think about it. But the magazine article brought it all back, the discomfort and often pain, embarrassment,  and the never ending search for the right product that would help. Joyce remembered as a child going to her mother’s dermatologist, yes, Joyce’s mom also had eczema.

Hard to believe today, but those many years ago the dermatologist had Joyce, in her pre-teen years start on Valium for her condition. And on Valium she stayed for many years, until she and her mother finally received relief with the new wonder drug cortisone. And that is what Joyce and her mom believed for many years, that they would have to use gentle scent free cleansers, special moisturizers, oatmeal baths and of course the powerful cortisone.

Now the magazine article brought it all rushing back, and the crushing news that they estimated there are 30 million people still suffering. And the heartbreak that many of them are children. Joyce remembered how it was to suffer from that itch that couldn’t be stopped. She hadn’t found her cure until she was an adult and her mom was in a nursing home.

Joyce had started to reading about food intolerance’s and decided  to eliminate some food items and see how she felt. When she eliminated all citrus fruit from her diet, to her great surprise her skin stopped itching. She had always loved citrus, especially oranges. Her mom had always made sure that she had oranges and grapefruit available for her family, while Joyce was growing up. Joyce had continued that tradition with her own family, fortunately her daughters didn’t take after her the way she had taken after her mother.

Joyce couldn’t believe it, that after all those years, it had always been oranges? So, Joyce experimented by re-introducing small amounts of citrus fruit back into her diet. She soon found that she could tolerate lemons but even the smallest amount of oranges or grapefruit brought her skin condition roaring back.

Joyce arranged meetings at her mother’s nursing home with the dietitian and nursing director. She impressed upon them the seriousness of restricting her mother’s diet and removing any citrus products. Over the next weeks seeing the red angry spots on her mother’s arms disappear and her no longer stressed by that constant itch was such a relief.

For those 30 million still suffering, the answer may not be citrus, but most likely the cause is lurking in the kitchen. And the cure won’t be found in a pill or lotion just as it wasn’t for Joyce.

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing


The conversation around the conference table was familiar. Why are our patients getting younger and younger we asked each other?  I had heard this many times before, but this time it was different. The speaker, who was so questioning about what could possibly account for this, was herself only twenty-five. Kelly was concerned for her parents and grand-parents. She said she was regularly going home and telling her Dad, “We just had another patient come in today, who is so much younger than you are.” Why is this happening she asked, “aren’t these people supposed to be old?”

We talked about the fact that these people didn’t just have one diagnosis that brought them to the nursing home. No, they had led a life that led to multiple systems breaking down.

Proven life choices that keep the elder out of a nursing home:

  • exercising and maintaining an active lifestyle
  • getting enough sleep
  • spending time outdoors, enjoying sunlight and fresh air
  • having satisfying, close relationships
  • being a life long learner
  • minimizing stress in your life
  • being of service to others
  • having employment (or volunteer positions) that use your talents and skills
  • maintaining a spiritual life – remaining close to your faith
  • eating a balanced (a variety of foods) and nutritious (focused on vegetables/fruit/protein) diet

Yes, patients in the nursing home are getting younger and younger. At the same time nursing homes are getting better at providing all the therapies, social service counseling, diet counseling, etc., to help the elder turn around their health. So much better for Kelly’s dad to make these choices now, before he has fewer options.

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing


Much is in the news of late on changes in dietary guidelines. Yes, to dietary fats, no to dietary fats. Should there be a pyramid or a plate telling the public what to eat? Even if you pick up a magazine for diabetes, it turns out to be a recipe loaded guide, to cutting sugar. Why are we cutting sugar intake, and not even telling people with diabetes, how to live without sugar?

Yet, the research is out there, sugar causes inflammation. Any carbohydrate that turns into sugar when metabolized is inflammatory. Eliminating sugar and grains which turn into sugar, reduces inflammation.

Inflammation is bad for the brain, joints, digestion, mobility, you name it. Caregiving for the elderly who are no longer able to tell you they are in pain, due to  swollen joints, is exhausting. Shirley was that type of patient, she had arthritis for over forty years. Forty years of painful knees, aching legs, and decreased mobility. However, now we know, eliminating sugar could have made those past forty years much easier for Shirley.

Shirley lives in a nursing home, and dietitians in those facilities  are working with guidelines far behind recent research. And for Shirley’s family asking for sugar and carbohydrate restrictions would seem harsh indeed, for the now elderly Shirley.  These products aren’t even eliminated for the diabetics in nursing homes.

So instead of going to the source of her pain, inflammation, we go to the medicine cabinet. We medicate Shirley for those hot inflamed joints. Just as Shirley did for all of those years, trying this anti-inflammatory after another. Trying to find relief, all the while putting the very things in her mouth that were causing her distress.

There are many fine books available telling the story of inflammation. Grain Brain by David Perlmutter, MD is one of them. Changing the way we eat can re-write the story of aging for many. Those who are on the path to dementia, diabetes, arthritis, and early aging. It also could change life for the many already impacted in their old age, by pain.

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing


Please, please can’t you open the ice cream parlor now?” the elderly woman begged the activity aide. Once again the young activity aide explained to Hannah, that it was 8 o’clock in the morning, and they don’t open the ice cream parlor till 2 in the afternoon.

The pain was easy to see in the elderly woman as she was turned away. Anyone who has experienced cravings can understand how she felt. Sugar craving is nothing new to millions of people with diabetes and pre-diabetes.

The craving for sugar is physical and so mental. For the elder with dementia and sugar cravings the time of day doesn’t matter. The fact that she had just had breakfast doesn’t matter. The fact that this tiny old lady just couldn’t be physically hungry doesn’t matter.

Hannah doesn’t remember that breakfast she just had. She will clearly tell you that no body feeds her at the nursing home. Because she believes it. Hannah knows what it feels like to be hungry and right now she is craving some ice cream and so she must be hungry.

For persons like Hannah it might have been the toast loaded with “sugar free” jam that triggered this craving. Or the large bowl of corn cereal she had with the toast. Maybe the 5 packets of sugar substitute she insists on putting in her morning coffee.

Loading up on a breakfast with empty carbs and sugar free products – served up by kind hearted nursing assistants, wanting to make all those Hannah’s happy is her problem.

Would she go back to her unit in the nursing home angry? Of course she did.

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing


The last two weeks you can’t listen to network news without hearing about measles. The numbers have just gone over 100 giving the media the ability to say “over 100 cases now reported.” How about these numbers? In 2012, 29.1 million people were diagnosed with diabetes. That was up from 2010 when the number was 25.8 million, an increase of 3.3 million people in just two years.

In 2012, it was reported 245 billion dollars were spent on the total costs of diabetes. More than 1 in 5 healthcare dollars went to the care of persons with diabetes. People diagnosed with diabetes, who suffered heart attacks, strokes, kidney failure, blindness and even amputation. And yet this isn’t even the worse part of the story.

The researches tell us the numbers to be watching are the pre-diabetics. Those who have no idea the path they are on. Current estimates are that this is 40-50% of the country, about 140 – 150 million people.

A great way to find out if you are going to be one of those statistics is to have a blood test. The A1-C blood test that measures not just what you ate last night but your blood sugar levels for the last 3-4 months. A normal reading on this test is 5.6% or under, a pre-diabetes reading is 5.7 – 6.4 and diabetes is 6.5 and higher.

Current recommendations are that children 12-15 have their first blood test to establish a baseline number. But also the blood test is not a bad idea, in order to catch those children who are eating their way to pre-diabetes on junk food. Giving the children, a chance to get used to getting sugar from fruit and eating fewer starches by reducing portion size.

So while millions of Americans are eating their dinner and watching the news, instead of being scared by Ebola or measles they should be scared of that dinner plate.

Virginia Garberding RN
Certified in Gerontology and Restorative Nursing


The John Hopkins Medicine research study just released their findings that there are specifically 22 types of cancer that are attributed to bad luck. After 5 billion were spent in cancer research last year, we are now at the bottom of the barrel, talking about bad luck.

They did report that some cancers were directly attributed to lifestyle choices. However other than smoking and not wearing sun screen, they still returned to the theme of bad luck. Why it has been asked does one person who smokes die from cancer and another is seemingly unaffected. The only answer seems to be hereditary problems, or of course it stinks to be them, and they have bad luck.

But just maybe the lifestyle choices should also include how often those smokers stopped at fast food places. How old was the smoker who developed cancer, how long had they been smoking, and oh yes, how many Big Mac’s have they enjoyed?

The only thing related to what people were putting in their mouths in the study, was that of course people need to manage their weight.

At the same time the Agriculture, Health and Human Services Department are coming up with a new and improved version of the “my plate.” (The former food pyramid) This one is reported to be dietary guidelines that are plant based, at the expense of meat. The basis seems to be not only that plant based diets are more sustainable. But, that the increased plant versus meat diet is more health promoting and environmentally friendly.

Lucky for all of us, that people are getting more interested in saving the environment, maybe now we can start to concentrate on saving more people.

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing