Tag Archives: elderly

Elder Care at Home

With a rapidly aging population, caring for your elders is likely going to be a big part of your life. According Medicare.com, a recent survey by the National Caregiver Alliance and the AARP Public Policy Institute revealed that approximately “34 million adults in the U.S. are unpaid caregivers to an individual over 50 years old, with 85% providing care for a family member.”

Care giving is a fairly broad term and responsibilities depend on the physical and mental health of an individual but may include anything from helping with everyday activities to medication reminders to hiring and coordinating with assisted living staff. Regardless of the level of involvement, caring for the elderly requires patience.

Every day tasks that we take for granted, such as getting up and getting ready for the day can be challenging as we age. The elderly often need help with daily living activities like bathing or getting dressed. Though these tasks may be time consuming, the physical and emotional benefits of grooming, bathing and putting on clean clothes should not be underestimated to making someone feel more good.

The National Institutes of Health National Institute on Aging (NIA) provides several resources and tips for caregivers including:

Communication

  • Be simple, direct and positive when speaking. Clear and upbeat communication is generally a good idea, especially if the person you are caring for has health problems that could affect memory and cognitive skills.
  • Establish eye contact, use the person’s name and if appropriate, touch or hold his or her hand to encourage conversation
  • Ask simple yes-or-no questions rather than open-ended questions. For example, ask “Are you hungry?” instead of, “When would you like to eat?”
  • Limit choices to reduce confusion. For example, ask, “Would you like to wear your jeans or your khakis?” instead of asking, “What do you want to wear?” You might even want to show the options to the person you are caring for to help them make the decision.

Bathing and Dressing

  • Easy wear, easy wash clothing. Comfortable, loose-fitting clothing with elastic waistbands will not only make it easier to get dressed, it will also make it easier to remove clothing to use the bathroom.
  •  Assist in dressing as needed. Let the individual do as much as possible without assistance but be ready to lend a hand. To assistance, lay out the clothes in the order they will be put on. For example, place underwear and socks before pants and shirt.
  • Make the shower safe. Use a sturdy shower chair, grab bars, non-slip bath mats and a hand-held shower-head to reduce the chance of falls.

Eliminate Safety Hazards to Prevent Falls

  • Remove or secure rugs. Try using double-sided adhesive tape to firmly attach any large area rugs.
  • Hide electrical cords. Tuck cords behind furniture, under large rugs or tack to the baseboards so they are out of the way.
  • Create clean lines and open spaces. Remove any extra furniture that would be difficult to maneuver around with a cane, walker or wheelchair.
  • Install handrails and grab bars. Most commonly used along stairways, on the side of the bed, next to the toilet and in the bath or shower.
  • Install good lighting inside and outside home. If the elderly individual has difficulty seeing, install the highest recommended bulb per light fixture. For their safety at night, install nightlights in bedrooms, bathrooms, kitchen and hallways.

Remember, it is also important to make sure your loved one not only has health food and beverages available but that they are eating regularly. Proper nutrition and hydration can have a significant impact on an individual’s physical and mental abilities.

If the time has come when your aging loved one is no longer able to live independently, please contact the knowledgeable staff at ElderLink to help you find elder care services or an assisted living facility within California that is customized for your family.

Feel Like The Last Friend Standing? Here’s How To Cultivate New Buds As You Age.

Donn Trenner, 91, estimates that two-thirds of his friends are dead.

“That’s a hard one for me,” he said. “I’ve lost a lot of people.”

As baby boomers age, more and more folks will reach their 80s, 90s — and beyond. They will not only lose friends but face the daunting task of making new friends at an advanced age.

Friendship in old age plays a critical role in health and well-being, according to recent findings from the Stanford Center on Longevity’s Sightlines Project. Socially isolated individuals face health risks comparable to those of smokers, and their mortality risk is twice that of obese individuals, the study notes.

Baby boomers are more disengaged with their neighbors and even their loved ones than any other generation, said Dr. Laura Carstensen, who is director of the Stanford Center on Longevity and herself a boomer, in her 60s. “If we’re disengaged, it’s going to be harder to make new friends,” she said.

Trenner knows how that feels. In 2017, right before New Year’s, he tried to reach his longtime friend Rose Marie, former actress and co-star on the 1960s sitcom “The Dick Van Dyke Show.” Trenner traveled with Rose Marie as a pianist and arranger doing shows at senior centers along the Florida coast more than four decades ago.

“When we were performing, you could hear all the hearing aids screaming in the audience,” he joked.

The news that she’d died shook him to the core.

Although she was a friend who, he said, cannot be replaced, neither her passing nor the deaths of dozens of his other friends and associates will stop Trenner from making new friends.

That’s one reason he still plays, on Monday nights, with the Hartford Jazz Orchestra at the Arch Street Tavern in Hartford, Conn.

For the past 19 years, he’s been the orchestra’s pianist and musical conductor. Often, at least one or two members of the 17-piece orchestra can’t make it to the gig but must arrange for someone to stand in for them. As a result, Trenner said, he not only has regular contact with longtime friends but keeps meeting and making friends with new musicians — most of whom are under 50.

Twice divorced, he also remains good friends with both of his former wives. And not too long ago, Trenner flew to San Diego to visit his best friend, also a musician, who was celebrating his 90th birthday. They’ve known each other since they met at age 18 in the United States Army Air Corps. They still speak almost daily.

“Friendship is not be taken for granted,” said Trenner. “You have to invest in friendship.”

Even in your 90s, the notion of being a sole survivor can seem surprising.

Perhaps that’s why 91-year-old Lucille Simmons of Lakeland, Fla., halts, midsentence, as she traces the multiple losses of friends and family members. She has not only lost her two closest friends, but a granddaughter, a daughter and her husband of 68 years. Although her husband came from a large family of 13 children, his siblings have mostly all vanished.

“There’s only one living sibling — and I’m having dinner with him tonight,” said Simmons.

Five years ago, Simmons left her native Hamilton, Ohio, to move in with her son and his wife, in a gated, 55-and-over community midway between Tampa and Orlando. She had to learn how to make friends all over again. Raised as an only child, she said, she was up to the task.

Simmons takes classes and plays games at her community. She also putters around her community on a golf cart (which she won in a raffle) inviting folks to ride along with her.

For his part, Trenner doesn’t need a golf cart.

His personal formula for making friends is music, laughter and staying active. He makes friends whether he’s performing or attending music events or teaching.

Simmons has her own formula. It’s a roughly 50-50 split of spending quality time with relatives (whom she regards as friends) and non-family friends. The odds are with her. This, after all, is a woman who spent 30 years as the official registrar of vital statistics for Hamilton. In that job, she was responsible for recording every birth — and every death — in the city.

Experts say they’re both doing the right thing by not only remaining open to new friendships but constantly creating new ways to seek them out — even at an advanced age.

Genuine friendships at any age typically require repeated contact, said Dr. Andrea Bonior, author of “The Friendship Fix: The Complete Guide to Choosing, Losing and Keeping Up with Your Friends.” She advises older folks to join group exercise classes or knitting or book clubs.

She also suggests that seniors get involved in “altruistic behavior” like volunteering in a soup kitchen or an animal shelter or tutoring English as a second language.

“Friendships don’t happen in a vacuum,” she said. “You don’t meet someone at Starbucks and suddenly become best friends.”

Perhaps few understand the need for friendship in older years better than Carstensen, who, besides directing the Stanford Center on Longevity, is author of “A Long Bright Future: Happiness, Health and Financial Security in an Age of Increased Longevity.”

Carstensen said that going back to school can be one of the most successful ways for an older person to make a new friend.

Bonior recommends that seniors embrace social media. These social media connections can help older people strike up new friendships with nieces, nephews and even grandchildren, said Alan Wolfelt, an author, educator and founder of the Center for Loss and Life Transition.

“It’s important to create support systems that don’t isolate you with your own generation.”

Many older folks count their children as their best friends — and Carstensen said this can be a big positive on several levels.

“I don’t think it matters who your friends are,” she said. “It’s the quality of the relationship that matters most.”

 

Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.

The Elderly and Falls

The older you get the harder you fall might be a misquote from the old adage, but has some truth to it. For those aged 65 and older, falls are among the leading cause of death due to injury and it is estimated that in the United States, one out of every three adults 66 years or older falls each year.

Unfortunately, research published in the American Journal of Preventative Medicine found that 60 percent of fatal falls for older adults 65 and older occur at home, 30 percent happen in public places and 10 percent occur in health care institutions. Unfortunately, many falls cannot be foreseen or prevented but there are some risk factors that can be controlled.

Risk Factors
Environmental factors, including slippery surfaces, poor lighting, steps and loose rugs
Use of equipment, such as a cane or walker
Non-adherence to safety practices
Gait and balance impairments
Visual impairment
Physical conditions, such as stroke, arthritis, muscle weakness, glaucoma, cataracts, hearing loss or foot problems
Age
Fall history and fall related injury
Neurological disabilities, including Parkinson’s disease or stroke
Cognitive impairment and/or behaviors
Medication use, side effects, multiple medications or psychotropic utilization

While caretakers cannot necessarily prevent an elderly adult’s fall, they can work to minimize the risk as well as increase the response time of medical assistance should a fall occur. The most common fractures from a fall include pelvis, hip, femur, vertebrae, hand, forearm and ankle.

In addition to the stress and pain, the elderly who have taken a fall are also at a greater risk of complications such as pressure sores resulting from immobility as well as decreased appetite, infections, respiratory issues, pneumonia and incontinence.

So what can you do if your aging loved one does experience a bad fall? Develop a care plan that takes into account your loved one’s age, medical history, risk factors for falling again, mental health, functional abilities, expectations and willingness to follow the plan. Determine whether recovery and rehabilitation should occur in home or in a care facility and work with doctors, physical therapists, occupational therapists and other care givers on developing and following exercise, restorative and/or physical activity programs.

If the time has come when your aging loved one is no longer able to live independently, please contact the knowledgeable staff at ElderLink to help you find elder care services or an assisted living facility within California that is customized for your family.

Holiday Scams Target Elderly

You answer the phone and an unfamiliar voice with a scary message urges you to take urgent action to prevent something terrible from happening – your grandchild is in trouble, you owe back taxes or your computer has been hacked. But, you can make it all go away if you just purchase an iTunes gift card (or Amazon gift card) via online or in a store and then once the card has been activated, provide the 16-digit code on the back of iTunes cards via phone, email or text message to the caller/con artist. Often multiple gift cards may be “required” by the caller, equaling hundreds, or even thousands, of dollars.

For a holiday twist on the “grandparent scam,” the caller pretends to be their grandchild who is in trouble and needs help (money) to come home for the holidays. The caller will plead for secrecy, claiming to be embarrassed or not wanting to get in further trouble with his/her parents. This seasonal adaptation is in place of request for money so the caller (“grandchild”) can avoid jail, come home from a foreign trip or to get their car repaired.

These types of scams can also occur via email, text or even regular mail and as a loving grandparent and concerned citizen, you want to do the right thing. But in these cases, the right thing is to recognize these types of calls are scams and you should report them to the Federal Trade Commission (FTC).

Phone scams are nothing new, nor are playing on the sympathies of older adults. Creating a sense of urgency and panic are tools of the trade for scammers. What is new is taking advantage of senior citizens’ lack of knowledge about how digital gift cards actually work. For example, it is likely that a grandparent has purchased gift cards, including iTunes and Amazon cards for their grandchildren, but are unlikely to be aware that such gift cards can only be used to purchase items from the issuing merchandiser (such as iTunes or Amazon). Like prepaid debit cards, iTunes and Amazon gift cards are a simple and practically untraceable method for con artists to get money, or for their victims to get those funds back.

According to the FTC, as soon as money has been put on a card and code has been shared, the money’s gone for good. Almost immediately, the card’s value will be drained, traded or sold on the black market. Unfortunately, the victim will not only have lost those funds, they are likely to be become a target for even more frauds.

Being able to convert these types of gift cards to the equivalent of cash as resulted in a recent uptick in popularity in scams and should be a tip-off of fraud. Apple, the parent company of iTunes, issued a warning on their website, “iTunes Gift Cards are solely for the purchase of goods and services on the iTunes Store and App Store. Should you receive a request for payment using iTunes Gift Cards outside of iTunes and the App Store please report it at ftc.gov/complaint.”

Other scammer-preferred payment demands also include reloadable cards, such as MoneyPak, Reloadit or Vanilla; PayPal and wire transfers like Western Union and MoneyGram but according to AARP, the FTC states that, “no government agency nor any but a handful of businesses require any of these payment methods.”

To find out about other scams, particularly those targeting the elderly, as well as discover tips and resources to help spot and avoid identity theft and fraud, consider signing up for AARP Fraud Watch Network. You can also track scams and law enforcement alerts in your area on the AARP Scam-Tracking Map.

Key Takeaways

  • Do not trust any caller who asks for money but insists on secrecy, including a government agency or a non-profit organization. If you do not recognize the voice or are unsure who the caller is, ask for more information so you can verify what you have been told. No one should ever discourage you from seeking support and counsel from family members, friends or trusted advisers, especially before making any financial transaction.
  • No government agency, including the IRS, will require you to use a specific payment method, such as a prepaid debit card, nor will they threaten you with arrest for not paying.

If the time has come when your aging loved one is no longer able to live independently, please contact the knowledgeable staff at ElderLink to help you find elder care services or an assisted living facility within California that is customized for your family.

Electronic Records Offer A Chance To Ensure Patients’ End-Of-Life Plans Aren’t Lost In Critical Moments

In a perfect world, patients with advance directives would be confident that their doctors and nurses — no matter where they receive care — could know in a split second their end-of-life wishes.

But this ideal is still in the distance. Patients’ documents often go missing in maze-like files or are rendered unreadable by incompatible software. And this risk continues even as health systems and physician practices adopt new electronic health records. So advocates and policymakers are pushing for a fix.

The problem isn’t new, experts noted. Advance directives were lost during the era of paper records, too. But, so far, digital efforts have fallen short.

“When these systems don’t work — and currently, they don’t work well enough — then that has a huge negative feedback on doctors and patients and families,” said Dr. Lachlan Forrow, director of the ethics and palliative care program at Boston’s Beth Israel Deaconess Medical Center. “Like, why even bother?” Thinking through and writing down end-of-life preferences can be grueling, he added.

Still, end-of-life planning has been encouraged by ethicists and experts in recent years, who say it communicates patient choices about medical interventions like being connected to a ventilator or feeding tube, or being resuscitated after heart failure — especially when patients can’t speak for themselves. This January, Medicare began paying doctors to discuss end-of-life wishes with patients, a policy almost 90 percent of Americans support. Meanwhile, according to 2015 figures from the Kaiser Family Foundation, 60 percent of adults older than 65 have such directives. (KHN is an editorially independent program of the foundation.)

Here’s how difficulties arise. Maybe a patient’s doctor uses one record system and the emergency room another. If the software doesn’t match up, the ER doctors may be unable to tell if the patient has a preference like a “do-not-resuscitate” order.

EHR_AdvanceDirective“An individual will fill out an advance directive, but unless they bring a copy with them, the provider will likely not know or see it exists,” said Kim Callinan, chief program officer at Compassion & Choices, a Colorado-based group that advocates for end-of-life care options.

Also, older patients, who are increasingly likely to have a directive, often get treatment from varied sources — surgeons, hospitals, nursing homes, primary physicians. That increases the odds of unaligned systems, said Dr. Irene Hamrick, who directs geriatric services in family medicine at the University of Wisconsin-Madison.

An additional complication stems from system design. Many systems don’t have a dedicated tab to mark where such information — if it exists — is stored. After doctors and nurses click through various pages, they still don’t know whether they looked in the right place. Time doesn’t always allow this kind of search.

“If they’re not able to access the advance directive quickly and easily, they’re honestly likely not to use it,” said Torrie Fields, senior program manager for palliative care at Blue Shield of California. “They’ll end up erring on the side of the most treatment possible.”

No one has researched how often this flaw yields unwanted treatment for dying patients. Based on anecdote, it’s “really common,” said Judy Thomas, CEO of the Coalition for Compassionate Care of California, an end-of-life care advocacy group.

Changes may lie ahead. Developers of record systems are introducing functions that could make it easier to find and read an advance directive, said Harriet Warshaw, executive director of the Boston-based Conversation Project, which encourages families to discuss end-of-life options. Epic Systems, a Madison, Wisconsin-based company that is among the dominant sellers for electronic health records, has added a tab intended to indicate clearly whether a patient has an advance directive on file. Cerner, based in Missouri, has partnered with a website, MyDirectives. Patients can upload their forms to that website, and doctors can reach it through Cerner.

“Advance care planning is an important issue we’re tackling,” said Bob Robke, Cerner’s vice president of interoperability. “To that end, we’ve made recent improvements … that address advance directive documentation.”

Cerner, Robke added, is dedicated to helping “overcome [the] barriers to data exchange” between different software systems that can currently block doctors from seeing advance directives.

Additional efforts are underway.

In Congress, lawmakers have expressed interest in making directives “portable” — that is, easily accessible. Legislation introduced in the Senate by Sen. Mark Warner, D-Virginia, includes provisions that could push health facilities to ensure compatibility across different health records for advance directives. Rep. Earl Blumenauer, D-Oregon, is also working on legislation, he said in an interview.

Hospitals and health systems are also making adjustments. The hospital at Oregon Health & Science University, California-based Sharp Hospice and Gunderson Health in Wisconsin are among those that have made in-house software revisions to make advance directives easy to find in electronic health records — for instance having IT teams add tabs on the record’s main page to indicate if a patient has end-of-life planning documents. Representatives of those hospitals said such efforts aren’t the norm, though.

Meanwhile, a number of states, including Virginia, Vermont, North Carolina and Arizona, have created online databases for residents to upload and store their advance directives. Recent figures are hard to come by, but in 2007, nine states were counted to have these in place. In these instances, doctors can go online to find a patient’s advance directive on those websites. They’re secured websites, and directives are password protected, requiring special logins from both patients and doctors, but specifics vary from state to state.

But there’s debate over how to finance state websites — in North Carolina, for instance, patients pay a $10 one-time fee to upload their advance directive. That can be an easy, low-cost way to maintain a site’s upkeep, but it can also discourage people from doing something they already find unappealing, said Marian Grant, director of policy and professional engagement at the Coalition to Transform Advanced Care and an associate professor at the University of Maryland School of Nursing.

These fixes lead to other complications, too. Directories specific to a particular state don’t necessarily accommodate patients who travel regularly between states — for example, a patient who sees one doctor in New Jersey and another in New York. And doctors navigating a cumbersome health record system may not take the additional time to check multiple websites.

“If you are sick enough and worried about finding your advance directives, it’s a critical situation. We are moving very fast,” said Grant. “We don’t have extra staff to say, ‘She might have an advance directive somewhere — check the top five directories and let me know.’ A busy resident is going to look in one place, and if they don’t find it, move on.”

If the time has come when your aging loved one is no longer able to live independently, please contact the knowledgeable staff at ElderLink to help you find elder care services or an assisted living facility within California that is customized for your family.

This article was originally published on