Watch Your Elder-Step

Winter snow and ice can make for slippery and dangerous trekking –at any age. PREVENTING falls and slipping is essential. Consider the following:

* Flat boots or shoes are essential. Do not leave the house without footwear that offers proper traction like grooved soles or non-slip rubber. Pack dress shoes  in a separate bag if different footwear is required. Remember- no smooth soles or high heels. Think sensible!

* Avoid carrying anything too heavy as that may throw off your balance.

* Use handrails at all times.

* Use Canes, Walkers and Wheelchairs with care

* It may be helpful to change your walking style- hold your arms out at your sides slightly: this will to assist you to maintain balance. Take shorter steps and slow down.

* Be on the look-out for icy surfaces- always walk slowly in case there is black ice present.

* Allow for more travel time slower and paced walking. Also include cleaning off snow/ice-covered vehicle and slower drive time with winter conditions.

* If you do experience a fall, try to protect yourself. Always resist the urge to break falls with your arms- instead try to land on a part of your body with a bit of padding, like your bottom. Tuck your chin in if falling backward to protect your head.

* Falls contribute to a significant number of Elder injuries every year; prevention is key to maintaining good health. If your Elder does fall, obtain an urgent assessment and seek potential care-immediately-for injuries and professional assistance with gait training and fall prevention instruction.

See the following helpful links for cane winter tips:http://makinglifeeasier.com/TipsProducts/TipsProductsDetail/tabid/572/ArticleId/211/Use-ice-tips-on-your-cane-or-crutches-for-safer-winter-walking.aspx

2012 Might be the Year to Switch Financial Advisors

After a sideways 2011, it might be time to sit down with your senior, or at least get their approval to review their finances especially if they have been managed, or mismanaged by their Financial Advisor. Look for a high level of transactions, ask your senior if he or she gets a lot of phone calls from their advisor claiming that they need to “do something”. Also look for illiquid and inappropriate investments such as high risk assets like junk bonds and penny stocks.

As you know, many seniors become targets for unethical financial advisors since they may no longer be completely aware of the markets, or even their own financial situation. Be sure that you have at least reading access to their financial accounts and if in doubt, call the financial advisor yourself just so their aware that they are being scrutinized. I can’t emphasize this more. Although the vast majority of advisors are protective of their clients, a not insignificant portion have no such scruples and you don’t want a lifetime of savings to disappear in inappropriate transactions.

Finally, if your senior is working with a financial advisor, try and find out what the annual fees are. In a low growth world, even a 2% fee seriously erodes gains and can even leave your senior with negative balances.

One more Helpful Safety Hint

Did you know that it is a smart idea to install a lockbox at the home of your senior so medical personnel and neighbors can get in in an emergency?

For just a few extra dollars, you can have peace of mind that if someone needs to get in to your senior’s home, they can do so easily. And the best part is that the lockboxes come with a customizable password so you can be sure that whoever needs to get in, gets “approved” and asks for the code.

Some providers of key lockboxes are Supra, Shurlok, & Avanti.

Terms you can use in finding senior housing

Many people start thinking about their own or their loved ones’ living situation around December and to help you in this, we’ve put together a pretty comprehensive list of the types of senior housing available and what it means to a consumer. Of course, as we head into the future, we expect a lot of creativity and innovation in the field, so this list is not intended as a final product, but here goes:

Alzheimer’s / Dementia

Many Assisted Living communities cater to individuals with Alzheimer’s disease and other related memory disorders. There is a growing trend towards specialized communities that provide care and housing tailored to the special needs of individuals with this disease. What sets these facilities apart is the care provided that fosters residents individual skills and interests in an environment that helps to diminish confusion and agitation. Specialty services are provided in a secure environment by specially trained professional staff skilled in handling the behavior associated with memory impairments.

Senior Apartments

Senior apartments are independent apartments that are age restricted – starting at 55 or 62 years of age. Some senior apartment communities may have an on-site meal program (generally no more than one meal per day) and housekeeping services available at a separate cost. There are federal and state programs that help pay for this level of housing for seniors with low to moderate income. Rent payments are usually a percentage of income or a pre-adjusted low income rate for those that qualify. Many of these communities include amenities such as a club house/meeting room, library, laundry facilities, beauty/barber shop, transportation, fitness center, etc. Some may also offer a Service Coordinator to assist in procuring additional services. Other types of Active Senior Communities exist, including single family homes, condominiums or mobile homes.

Assisted Living
Residential Care

Assisted Living, the largest growing type of housing, provides a special combination of residential housing, personalized supportive services and health care designed for the individual needs of those requiring help with activities of daily living (dressing, bathing, grooming, etc.), and do not require skilled medical care provided in a nursing home. There are a variety of names and license designations in different parts of the country: Board and Care, Residential Care, Community Based Retirement Facilities, Personal Care, Adult Living, Adult Foster Care. However, the growing generic term throughout the country is “Assisted Living”. Services and level of care will vary, however most Communities provide assistance with daily activities, meals, laundry, and housekeeping.

Assisted Living Communities offer a wide range of choices from the cozy familiarity of a single family home to the more extensive apartment style environment. These communities can be free standing or part of a Continuing Care Community that provides independent, assisted and nursing care, or specialized services may be brought into independent retirement communities.

Continuing Care Communities

Continuing Care Retirement Communities (CCRC), also known as Life Care Communities, are residential campuses that provide a continuum of care – from apartments/homes to assisted living and if needed, skilled nursing care, all in one location. CCRC communities range in entrance fees/rates and available services.

Home Care and Services

Home Care is a cost-effective alternative to hospital care or other institutional care. You can receive health care or personal care services within your own home with the assistance of a home care agency. Services are available to people of all ages on a basis of daily visits, monthly visits, or hourly care, up to 24-hours a day. Increasingly, older people are choosing to live independent lives and take advantage of home care services. However, agencies are not regulated by a unified agency so be sure to do your homework and ask for referrals before hiring a service. Additionally, recent studies have shown that the longer seniors stay in their homes, the better the outcomes.

Hospice

Today, the Hospice industry is mammoth – valued somewhere in the realm of 14billion annually.  Hospice is designed to provide compassion and support for individuals in the final phase of a terminal illness and to allow them to spend their last days with dignity in as comfortable and pain-free manner as possible.  Hospice care can be in a number of settings: in the privacy of your home, in a hospice facility or a nursing home.

Independent Living

These communities, often referred to as Retirement or Congregate Living, are designed specifically for independent senior adults in an apartment like environment with 24-hour on-site supervision. Services usually include meals, laundry and housekeeping. Social Activities are a large part of the “value” and help to foster a great sense of community among the residents. Only private pay is accepted in the rental communities and there is a wide range of differences among them.

Nursing / Rehab Centers – These facilities provide room and board, personal care, protection supervision and medical care. Generally, these facilities are licensed and regulated by the State Department of Public Health and since many are reliant on Medicare options, they for the most part are tightly regulated. Visit Medicare.gov for rankings in your area. Individually certified by the State for Medicare and Medicaid. Facilities accept a variety of payment options: Medicare/Medi-Cal, Medicaid, private insurance, and private funds. Three levels of care are provided:

• Basic Care – Required to maintain activities of a resident’s daily life. This includes mobility, personal care, grooming, nutrition, personal care, supervision and safety.

• Skilled Care – Requires the regular services of a registered nurse for treatments and procedures.

• Sub-Acute – Comprehensive in-patient care for someone with an acute illness, injury, or worsening of a disease process.

Aging In Place & CCRCs -

Campus-style communities provide a continuum of housing, services, and nursing care, usually at one location, to meet residents’ needs as they grow older. These communities charge for the type of housing and level of care a resident requires at the time he or she enters the community. As the resident’s needs change, the fees also change accordingly.

Continuing care retirement communities (CCRCs) are one type of campus-style commu- nity. Typically, CCRCs charge an endowment fee to enter, and a monthly fee for a pack- age of services specified in the residents’ contracts. The entrance fees and monthly fees charged by CCRCs cover, in advance, some or all services and care, a form of insurance for a senior’s later years. Some contracts only guarantee access to nursing services, while others cover the full cost of future nursing care that the resident may need. This contract is what distinguishes a CCRC from other types of campuses that include a nursing home and senior housing.

 

Holiday Blues? A special article on Antidepressants and Seniors

Geriatric depression is a particularly rampant and debilitating phenomenon for many seniors. Without treatment, loved ones can have a hard time getting through the day, let alone enjoying precious times with friends and family. Fortunately, Geriatric clinician, Nancy is an expert on safe and effective antidepressants and an advocate of their use in treating this very real syndrome.

With proper dosing, monitoring and treatment, the prognosis of geriatric depression has remained remarkably constant over the years. About one third of depressed elderly patients get better and remain well, one third have a form of relapse, and one third do not ever get better. Successful drug therapy begins with choosing medications that are compatible with the patient’s other medications and that have minimally disruptive side-effects. Beyond this, patients need to be informed that the medication often takes anywhere from 4 to 12 weeks to work. The most common reasons for a poor response to antidepressant medicine are inadequate length of treatment and inaccurate dosing.

Significant studies in the elderly are lacking; experience with younger patients with depression has shown that the dose that provides decreased symptoms of depression, is also the appropriate maintenance dose. After remission is achieved, treatment should continue for at least 1 year. Patients who have had three or more depressive episodes, have severe depression, or experienced onset after age 50 years may need lifelong treatment.

Recent results suggest that interpersonal psychotherapy works well in addition to drug therapy, but is not effective in preventing relapse when used by itself. Even with effective treatment, relapse is more likely in patients who initially take longer to respond and who have high anxiety scores, in those with high depression scores at the beginning of the maintenance phase, and in those experiencing a medical or interpersonal event. Having a confidant or a strong social support system helps prevent relapse.

It has been shown that a system of shared care is very effective in improving outcomes in primary care. In systems like this, patients should have access to non-drug related interventions, such as cognitive behavior therapy and interpersonal therapy, and the services of a case manager and a psychiatrist. Cases that are resistant to treatment may require combination medication strategies.

We will be writing a more in-depth analysis in the next few days, but check with your medical professional to see whether this course could be effective for you or your loved one so you can be well.

In health,

Eldercompass

Four things to look for on a senior community tour

We’ve all been there; you set up an appointment with a marketing person from a facility for a tour, but normally, they only scratch the surface of what the facility provides, or what lies beneath. Here are a few things you can do to get the most out of your tour.

1. Talk to family members in the parking lot – I know this sounds presumptuous, but if you schedule your tour on a weekend, or during common visitor hours, there will be family members outside that you can stop and dig into their experience

2. Use a bathroom – I know this seems strange, but you can learn a lot about a facility from how the common areas are maintained. Is the bathroom clean and decent smelling, are paper products replenished? Are there stains or evidence of water damage? If a facility cannot be bothered to keep its common areas tidy, how will they ensure the cleanliness and safety of their residents?

3. Eat – arrange a tour that includes a meal since so much of the social life at these facilities revolves around meals and a main dining area. What about notices for activities? Are there interesting and stimulating events? Are the residents actively engaging with each other? How is the service staff?

4. Make sure your tour guide takes you to the advanced care areas. When I toured a facility for my senior, I should have really pushed harder to see how the nursing care areas worked and looked. At CCRCs and Assisted Living facilities, you will find some resistance in entering the intense care areas, but insist on a tour since you want to ensure that your senior is well treated after they can no longer . Does the facility offer hospice care, or is there a transfer service and if so, where do residents go?

I will be posting additional information about how to make better choices about a community in the next few days. Good luck as always – and we’re in this together

Another Guest post on caregiving from Michael LaVell

As our nation’s senior population and the number of seniors desiring to age-in-place continues to increase, the pressure on family members to provide care for elderly loved ones has intensified. Combine that pressure with the rising costs of care and it creates a stressful situation for almost anyone. But it should be no surprise that more than 65 million people in the United States provide care for a chronically ill, disabled or aging family member, spending an average of 20 hours per week providing care, according to the National Alliance for Caregiving.

I work with many members of the Sandwich Generation; people who provide care for their elderly loved one, in addition to their own children. The Balancing Act, as I like to call it, can quickly result in caregiver burnout and stress—in some extreme cases, it can lead to resentment of the senior. The job of a family caregiver is definitely not easy but there are resources available to provide assistance, guidance, counseling and tips to alleviate stress. Here are a few of my favorite sites that offer valuable tools for family caregivers:

FirstLight HomeCare’s Blog

National Family Caregiver’s Association

Family Caregiver Alliance

The most important thing to consider is the safety and well-being of your loved one. If you feel they are not getting the appropriate level of care, consult your local home care provider. He or she can explain the care options that are available and provide you with first-hand knowledge of this critical time in your loved one’s life.

Michael P. LaVell is the owner of FirstLight HomeCare of Oakland County, which includes Auburn Hills, Rochester Hills, West Bloomfield Township, Birmingham, Bloomfield Hills and Clarkston. FirstLight HomeCare is a provider of professional, non-medical, live-in and hourly care services to seniors and others who need assistance. These services can be provided at a private residence, assisted-living facility, retirement community, nursing home, skilled-nursing facility, adult family home or group home. LaVell can be reached at 248-636-4970. For more information, visit http://oaklandcounty.firstlighthomecare.com

a little humour goes a long way

So as we move through another tragic event, my elder mother-in-law is so quick witted and funny, it makes everything seem better. I agree that age doesn’t change us – we become more of the person we are. For some this is a curse – for others a blessing, it’s all in your perspective

A Plan for Falling?

I attended a nursing in-service this week regarding a personal/medical alert system; in this case the Phillips Lifeline. The statistics the speaker presented were staggering: 13.3 million individuals over the age of 65 sustained falls last year. Fifty percent of those people were unable to get up. This statistic indicates that 1 of 3 individuals over the age of 65 are going to fall. All these falls impact patients, their families, AND increase Medicare spending. Medical complications that may occur when one cannot get up include rhabdomyolysis(extreme muscle wasting adversely affecting kidney function, pressure ulcer formation, fractures, dehydration, hypothermia, vomiting & pneumonia caused by aspiration, and even cardiac arrest.) Returns to the hospital are often costly and result in a whole host of complications such as hospital-acquired (nosocomial) infections, changes in medications, sleep deprivation, and multiple procedures.

As it turns out, fear of falling is rooted in reality. Fear compromises quality of life by decreasing confidence and self-esteem and reduced independence. An alert device can add to your Elders’ confidence and well-being.

Does your Elder have a plan in place to protect his/her safety? For those who claim they carry a cell phone or cordless phone for safety, research indicates that these are most often dropped during the course of a fall! Several types of pendent devices are available-the most recent product actually detects when a fall has occurred and automatically places a call for help if a fall is detected. Medical alert devices are considered FDA-approved medical equipment so individuals can write off the expense as “medical.” In our geography, those with Multiple Sclerosis can obtain Lifeline free of charge AND others get a 10% discount from the American Red Cross.

If your Elder(s) live alone, please consider a medical safety alert for their safety and your better sleep.

Survey Results from our Walsh College survey…

Thanks to Nurse Nancy for all her work on this! Survey results are not scientific and date from 03/2011.

SURVEY SAYS—

People Need Help! So, in light of creating a product that meets the needs of today’s consumers, we have put our market research to work for you. Key findings from our research show that a significant number of you want AND need help getting started.  OR maybe you may be having a difficult time convincing your Elder that it may be time to take the next step for their long-term planning and increased safety. SO—we come back to how to get started with this daunting task and how to have the confidence to make decisions that lead to optimal outcomes. Eldercompass has developed an in-depth geriatric assessment that can be added to your tool kit as a resource from an impartial third party to support. Key components will be listed in a future blog entry. Could you use some help convincing your Elders to make a change for the better AND for their safety and ability to age-in-place? Let us know!