Being a long-distance caregiver can seem impossible but it can be done. Long distance caregivers are just as important as caregivers that are in the home providing the physical care. As our family member ages, the caregiving that a family member can offer from a distance is vital.Read More
Many of us know the value of having a pet in the house, many of us have experienced the joys of snuggling up beside our furry companions. But have you considered that having a pet could improve the overall health of your elderly loved ones?Read More
It’s rare for me to find someone who does not like to read. To be considered an avid reader, one does not necessarily read just novels. The sky’s the limit when it comes to what written words will attract one’s attention. Who hasn’t read the cereal box while noshing that important meal of the day? Ingredients, nutritional value, even where the manufacturer is located seems pretty interesting as we spoon those tiny oat circles into our mouth. Perhaps it’s the daily newspaper that partners with breakfast. Maybe it’s your favorite monthly DIY magazine that you can’t wait to read. As a Caregiver, I’ve seen seniors who read the paper with their morning coffee, browse a magazine with lunch and peruse a novel during the afternoon. I’ve also been a caregiver for seniors who don’t read at all due to lack of interest, poor eyesight or their mind no longer can focus to keep on task.
I would be a lost soul if I could not read.
To me, reading soothes my troubled spirit when my world is crazy. I thank God I was never a smoker but I confess I am a bookworm; I am addicted to reading. I often said to Rich, my late husband, “reading is my cigarette”. Sometimes I am reading three books at once. There’s a paperback I keep in the car (waiting in my car for a family member who has run into a store is not boring when I can read – it’s like a stolen moment in time!). Umm…maybe my pocketbook is on the heavy side because of the novel I carry. My bedside table always holds at least two to three books – I tend to read according to my mood of the night. The written word takes my hand and leads me into a land where my stress, troubles and fatigue magically disappear.
I learned to read in first grade when I sounded out the words in DICK, JANE AND SALLY. Mrs. Reed, my teacher, let us read if we didn’t want to play in the sandbox or with the make-believe kitchen. She always read to us at naptime – what an awesome way to fall asleep! Ms. Farrell captured the minds of my peers in fifth grade as she read CHARLOTTE’S WEB on snowy school days. Christie, my best friend since second grade, shares my love of the written word. We were both so intrigued with MERRY LIPS by Jean Dixon that we read it many times. That novel was about a little girl who dressed as a boy to get into the colonial Army to find her brother. I always wanted to own a copy. About ten years ago, I finally tracked it down online and bought it. Out of print and no longer available in libraries, I felt like I had found a lost treasure. I wanted my grandchildren to be as intrigued with little Miss Merry Lips as I was.
In seventh grade, I read GONE WITH WIND, probably twice, and then once a year until I graduated high school (and a few times since). I smile as I remember the Librarian at Stillwater Central School telling me that book would be too challenging for a 12-year-old because it had so many pages and was for adults. Not daunted, I read every chance I had and would lose myself among the hanging moss trees in the Old South, sashay down the winding staircase of Tara and yearn for a chance to be Scarlet O’Hara – if only for a day. My love of history was born with the reading of that novel – thank you, Margaret Mitchell.
I also journeyed with Auguste Rodin in NAKED CAME I by David Weiss. This fascinating novel opened my eyes about a rebellious sculptor from the late 1800’s whose passion was to create true-to-nature sculptures. Now that was a hefty book that took me more than a few days to read. I must say that the subject matter was not my “usual read” but it touched the rebel part of my heart and allowed me to identify feelings I hadn’t ever put a name to. That book is on my “must read again” list.
Caregiving gives me the opportunity to engage seniors in conversations about favorite novels – the ones I enjoy and the books they have read or are currently reading. It is interesting to hear their comments when I ask questions, such as “what’s the book about?” I smile at their answers -- “Oh, so and so wants to solve a mystery but I can’t figure out why” or “Not sure, there are too many people running all over the pages who confuse me”. The important part about seniors reading is that their minds are teased into remembering what’s going on in the book. They are able to lose themselves, as I do, in the world of others’ imaginations. They are stepping out of the humdrum of their now less active life and journey with the main character who perhaps has the adventures and lifestyle they once had, or wished they had lived. I smile when I think about Paul, a senior I cared for a few years ago. He had the most remarkable collection of literature about Abraham Lincoln, his favorite inspirational man. Paul often confused what day it was, or what we had done yesterday. However, his recollection of what the books that lined his den’s bookshelves were about – what era, what deeds were part of Lincoln’s life and what was his favorite part of the book -- was absolutely phenomenal. Paul would often spend his afternoons lost in the life of Lincoln. His eyes would shine and his body language reflected his joy when talking about that historical figure. I believe his collection outshone any local village library’s books about that revered man.
If you are a caregiver for a parent, you have an awesome opportunity to give them a special gift. Take some time from your caregiving and read to them – as they did to you at bedtime, so many years ago. Wasn’t it awesome to hear about Peter Pan and his home in Never-Never Land, or laugh at Huck Finn’s trick when he was told to whitewash a fence? Newspaper print may be too small for your Dad to read about his favorite sports team. Why not read him the article about the game and then engage in some banter about the sport? Not only are you engaging in conversation, but you are spending some time with your beloved parent – time that is so precious as their sun begins to set in the land of their life.
I’m about to begin reading THE SHACK to a senior I am presently caring for. I had been told that novel has been made into a movie that will soon be in theaters. That book was very, very special to my husband and me. I had first read it in 2008, and then my husband, at my urging, read it. It touched our hearts with awesome emotions. When my husband and I took a road trip from our retirement home in Florida in June 2009, he asked me to read him the book during our drive. He drove, I read. He became teary many times as though the words in THE SHACK were touching his very soul – they were. Unknown to us, this was our last road trip together. We reached our family in upstate New York and the next day my husband met with his former doctor of many years – Rich was not feeling well. He was diagnosed with esophageal cancer stage IV and given perhaps a year to live. I lost the man who was the love of my life, for 43 years, six short weeks later. When we had driven back to Florida after the diagnosis, my husband shared that he felt God had put THE SHACK in his life to prepare him for his journey to Heaven.
When I told the senior I care for that THE SHACK was a great book and explained the subject matter, she became very interested. I asked if she would like me to read it to her (as it is in small print and she can only read large print), she said she would look forward to that. Voila! And so, we’ll soon be walking the path in the woods, smelling the flowers and enjoying the warm weather, as we look for the mysterious shack and discover what role that rustic abode plays in the lives of a grieving family. I will read and she will listen. Our minds won’t be focusing on the cold, snowy wind as it blows across the lake. We’ll be listening to the birds singing as we join a man searching for that old shack hidden in the woods. Perhaps Spring just might come early this year!
From time to time a family member may become concerned about a loved ones driving abilities. Although driving ability is not necessarily determined by age and many seniors drive safely and successfully, there are changes which can affect driving ability over time. Many of these changes happen as we age and these can contribute to unsafe driving practices. Some changes can affect the ability to turn the head to check for traffic, or to brake quickly. Other changes affect the ability to respond appropriately to situations as they occur. All drivers must have the ability to react quickly to other cars and people on the road.
How dangerous is it?
Some elderly drivers are a danger to themselves and others on the road. Driving is an activity which requires many thought processes, actions and movements all happening simultaneously. It requires quick thinking and quick reactions, which for many people, diminish with age. According to the National Highway Traffic Safety Administration (NHTSA), statistics do show that older drivers are more likely than younger ones to be involved in crashes. Risk of injury or being killed in a motor vehicle accident does increases as people age. In addition, a senior who is involved in a motor vehicle crash is at greater risk of injury or death than someone younger. If you are hesitant about having the discussion about driving with your loved one, considering the possible outcome could help you overcome your hesitation.
How do you know when the time has come?
There are warning signs to look for if you are concerned about a family members driving or even your own. We have put together a "Senior Driving Checklist" for you to print and fill out. When you notice some of these warning signs it is time to assess the situation. Don't wait for an accident to happen. You can also take a look at the other resources we have listed.
How to talk with your loved one about driving
First of all, do not assume that one discussion will be all that is needed. This is a delicate situation which may require many conversations. You must be respectful of their right to make choices.
Secondly, don’t come on too strong or as a “know it all”, be considerate of their thoughts and feelings, and let them have a say. If your loved one has Alzheimer’s disease or dementia they may be unaware of the changes in their abilities and capabilities. When someone is unaware of the changes, this can result in great reluctance on their part of giving up the ability to drive. They may see this as a great loss of their independence and can be quite traumatic for some people. It is important to consider the person’s feelings.
Ask them questions. Lead the conversation with questions to get them talking. This may help them to see the need to give up driving. Ask them “How have you felt recently when driving or after driving?”, “Have you gotten confused at all recently when driving?”, “Can you tell me about the new dents on your vehicle?” It may even be possible for you both to fill out the “Senior Driving Checklist” together.
What if they are reluctant to give up driving?
Many seniors are reluctant to give up driving because they fear the loss of their independence. In this situation, rather than just taking their keys, a road test would be a good consideration. In some states, the local Department of Motor Vehicles offers testing to determine a person’s abilities when driving and responding to situations when on the road and in traffic. They can also test for vision and distance perception. If your state does not offer this service, there are companies which offer this service. The Alzheimer’s Association or other similar agency may be able to provide a list of resources. Some places offer a Mature Drivers course, if your loved one is reluctant to take the course, remind them that their insurance and their roadside assistance may offer a discount for taking it.
What if they refuse to give up driving?
- If at all possible it is always best to get your loved one to agree to give up driving voluntarily. The loss of the independence can be traumatic and can lead to depression, having that right taken from them can be even more traumatic. Be prepared for this ahead of time. Sometimes however, they simply refuse to do so voluntarily. Then comes to the difficult decision, for their safety and the safety of others, to take drastic measures.
- Involve their physician: Schedule an appointment with your loved one and their physician so you can discuss the situation together, seniors often will listen to and respect the opinion of their physician. If you do go to talk to the doctor, bring alone a copy of the “Senior Driving Checklist” filled out. Sometimes the loss of driving ability is a process and the doctor may recommend some first steps such as the agreement to not drive after dark. Discuss these options together.
- Involve their optometrist/ophthalmologist: as stated above, seniors will often respect their opinion.
- Involve the State Department of Motor Vehicles (DMV): In some states, it might be best to alert the department of motor vehicles. The caregiver can often meet with a representative and request a driving test and vision examination, some states do not honor this request. In some states you can write a letter directly to the DMV and express your concerns, or request that the person’s license be revoked. The letter should state that “(the person’s full name) is a hazard on the road,” and offer the reason (Alzheimer’s disease). The state may require a statement from your physician that certifies the person is no longer able to drive. Research your state or talk to a physician who may be able to guide you. Contact your local DMV to find out their recommendation on how to proceed.
- Control access to the keys: designate one person to do all the driving and give them exclusive access to the car keys.
- Disable the car in some way: Discuss this with a mechanic.
- Give the person a set of keys that looks like his or her old set, but that don’t work to start the car.
- Consider selling the car: Discuss with your loved one the potential financial savings which comes with selling the car. There could potentially be enough savings to pay for any public transportation or even taxi rides. There would be savings on insurance, vehicle payments, gas, maintenance, etc.
If you have increasing concern about your loved one’s driving, the above information should give you some ideas for how to begin the conversation. If you are in our area and need transportation services, feel free to call us to discuss some options for your family.
- Drivers 65 Plus: Check Your Performance A Self-Rating Tool with Facts and Suggestions for Safe Driving https://www.aaafoundation.org/sites/default/files/driver65.pdf
- How to Help an Older Driver: A guide for planning safe transportation by AAA
- We Need to Talk: family conversations with older drivers by The Hartford Group
A beautiful song by a 15 year old boy singing about his relationship with his precious Nan who battles Alzheimer's and his love for her. This goes out to anyone who's life has been impacted by this terrible disease. We understand, and we're here. Well done Harry!
Not Alone by Harry Gardner
By Michelle Perez
Yes, you can buy a present for a loving grandparent from a store, but they can be very impersonal. Why not make one with your kids? Kids will love the craft time and grandparents will love having something homemade.
"When a grandchild makes a handmade gift, the present is unique and the grandchild is giving of his time," says Sue Johnson, a grandmother of six from Lancaster, Virginia, grandparenting expert and author of Grandloving: Making Memories with Your Grandchildren. "It's also meaningful because we know they have been thinking about us when they made the gift, and it contains something of himself."
Like Johnson, Kimberly Jo Ellingsworth, a grandmother of five in Monterey, California, understands the significance of a handmade gift. "I always remember the look on my oldest grandson's face when he would bring something he made home and give it to us," she says. "He was so excited, and then even more excited because we used it rather than putting it on a shelf somewhere."
With the help of some very creative grandparents, we came up with eight fun ideas for things your little one can make (sometimes with your help) for this special person in their life.
- Create a Collage
- Grab your family photos and laminate them to place mats to send to grandma and grandpa. You'll always be there with them bringing joy to each meal.
- Make a CD
- Record the kids telling their grandparents about their favorite times with Nana and Papa "as a reminder of the importance of being together," Johnson says.
- Share Some Sunshine
- Have the kids draw grandma's favorite flower, then cut it out and have them paste their photo on it. Draw a big sun with your child's photo in it, and caption it "You are my sunshine!" Teach your kiddos the words to the song and put it on a CD to accompany the gift.
- Assemble a Coupon Booklet
- Have the kids come up with 10 things they can do for their grandparents -- everything from raking the yard to baking their favorite cookies -- and make each idea a coupon to put in a book.
- Personalize Magnets
- Get some magnetic tape and put pieces on the back of family photos to create instant fridge magnets.
- Film a Homemade Video
- Grab the video camera and record your kids being goofy. Or, as Johnson suggests, ask the kids to relay "our family history from the eyes of your grandchild."
- Puzzle It Out
- Paste a photo of your child on cardboard, cut it into pieces and send with instructions saying, "Put this together and see who loves you!"
- Make a List
- Write a list of "I love you because ..." statements to send to the grandparents to let them know how special they are.
- Plan an Activity or Outing
- Yes, physical gifts are nice, but grandparents often treasure the gift of memories with their grandkids even more. Your child and their grandparent can organize something fun for them to do together. For example, create a family trivia game with facts about each person, set up a scavenger hunt or get messy with an afternoon of finger painting. You can take photos of the special day and put them in an album from grandparents to look over.
Handmade gifts can be a tradition that grandkids and grandparents alike can look forward to. Get the little ones thinking of a new gift idea weeks, or even months in advance. This will make for a rewarding present the grandparents won't forget.
Michelle Perez is a freelance writer covering all things Denver. Her work can be found here.
By Sarah Stevenson
Being stuck indoors due to winter weather can put seniors at risk of social isolation and poor quality of life. Find out what you can do to keep your elderly loved ones engaged and healthy.
The wild winter weather across much of the country is keeping many people indoors more than they would like, and being stuck inside can be a particular problem for seniors living alone– putting their mental, emotional, and even physical health at risk. Not only is it more difficult for the elderly to leave without risking winter dangers like the cold, falls, and dangerous driving conditions, it’s also harder for visitors to reach them. Winter weather can also have an effect on senior nutrition, if someone is unable to leave the house and shop for food. An even more distressing result of being trapped inside, unable to come or go, can be social isolation and loneliness.
Loneliness Affects Elderly Health and Well-Being
We often think of the elderly as residing in a senior community, with family, or in other shared housing situations, so it may be hard to imagine that loneliness is an issue for seniors. According to the U.S. Census Bureau, however, the probability of living alone actually increases with age. For women, the likelihood of living alone is 32 percent for 65- to 74-year-olds, but this increases to 57% for those aged 85 years or more; for men, the corresponding proportions are 13% and 29% . Even for centenarians—seniors who are 100 years of age or older—the numbers are astonishingly high: about a third of centenarians live alone at home.
Isolation in the elderly can lead to some distressing health outcomes, and even increase the risk of death. A 2012 review of the scientific literature, published in The Journal of Primary Prevention, stated that “social isolation has been demonstrated to lead to numerous detrimental health effects in older adults, including increased risk for all-cause mortality, dementia, increase risk for re-hospitalization, and an increased number of falls.”
Recent research reports shows how it effects seniors: at the 2014 annual meeting of the American Association for the Advancement of Science earlier this month, University of Chicago psychologist John Cacioppo reported that feeling extreme loneliness can increase an older person’s chances of dying early by 14%. “Feeling isolated from others can disrupt sleep, elevate blood pressure, increase morning rises in the stress hormone cortisol, alter gene expression in immune cells, increase depression and lower overall subjective well-being,” stated UChicago News.
What You Can Do If Your Loved One Is Isolated
According to Cacioppo, the danger isn’t necessarily solitude itself, but a subjective feeling of isolation, of lacking social engagement and face-to-face connections with others. Age-related health issues like vision loss, hearing loss or incontinence can increase this sense of isolation. So what can families and caregivers do to address the issue if we fear our loved ones are isolated? Here’s a list of suggestions for preventing senior loneliness and keeping our loved ones healthy and happy this winter:
1. Address Any Underlying Health Issues
Whether it’s arranging for the delivery of incontinence supplies or making sure your loved one has regular hearing or vision tests, being proactive about seniors’ health can help them feel better on a day-to-day basis. What’s more, it can diminish the social anxiety related to hearing, vision, or continence concerns.
2. Reach Out to Family, Friends, and Neighbors
If the weather makes it impossible for you to check on your senior loved one as much as you’d like, enlist the help of others who may be nearby and more easily able to visit. Can a neighbor knock on the door and check in? Don’t forget to call or email your loved one often to keep those connections strong even when you can’t visit in person.
3. Prevent Senior Malnutrition With Food Delivery
Seniors who live alone may be at greater risk of getting poor nutrition when the weather turns nasty. Consider getting food delivered by an online grocery service, or by an organization such as Meals on Wheels, which can provide not just nutritious food but social contact.
4. Encourage Safe Transportation and Mobility
Encouraging your loved ones to use the adaptive technologies they may need, from hearing aids to walkers, which can help them become more active and socially engaged. When it comes to getting outside the house, though, storms and snow can present a challenge. Give senior relatives rides when you can, or arrange safe transportation for them, whether it’s senior-friendly public transit, an ambulette or paratransit service, or a taxi.
5. Connect Older Loved Ones with Necessary Local Services
You can use the U.S. Administration on Aging’s Eldercare Locator website to get in touch with your local Area Agency on Aging. The AAA will know where your loved one can find senior centers, transportation services, and other helpful programs for the elderly. “Some AAAs even have volunteers who call and check in on home bound seniors living alone,” says a recent article by the AARP.
6. Consider Respite Care or Assisted Living
Sometimes our loved one needs more care than we are able to provide, especially in cases where the weather throws a (literal) roadblock. One option in this case is to book your loved into a short-term stay in a facility that offers respite care, so that their day-to-day needs are taken care of for the duration of their stay. However, if a senior requires ongoing help that is beyond your abilities – for instance, if they are cognitively impaired, or their physical care needs are increasing – this could be a sign they are ready for assisted living.
Connecting with others is at the core of being human - and it's something that doesn't change when a person has dementia. We're often asked what are good activities for dementia patients. It's important to know that there are many ways you can continue to form connections and strengthen bonds with your loved one during this time.
12 WAYS TO MAKE A CONNECTION
People with dementia often return to long-term memories of childhood. Their minds seem to only recall their younger years, and this is often where connections can be made. The next time you visit with your loved one, try one or more of the following activities to create a connection with them:
- Create a Memory Bag
- Fill the bag with items reminiscent of their late teens/early twenties. Scented products work well for this, as scents are strongly tied to memory. Try including soap, perfumes and aftershave, or holiday scents like gingerbread, pine and peppermint.
- Look Through Photo Albums
- Photo albums with pictures from their childhood or young adulthood are best for this. Old periodicals are another good option, particularly those that include many photos such as Life or Time magazines.
- Read Out Loud
- If your loved one has a favorite book, read it out loud to them and let them hold the book and feel the pages. Encourage them to enjoy the distinctive "old book smell." Reading aloud works especially well with poetry, as the cadence of the words are familiar and calming.
- Listen to a Playlist of Favorite Music
- Download songs or set up radio to stream that features music from their teenage years. Many internet radio stations include everything from classic rock to big band sounds, their favorite music should be easy to find.
- Sing Old Songs
- If they grew up going to church, sing old hymns with them. If it's around the holidays, sing holiday carols or other special songs. Class sing-a-longs and music classes were much more common in schools prior to the electronic age. You might be surprised at what songs your loved ones know and remember from elementary school.
- Watch Old Movies and TV Shows
- Did your parents grow up watching westerns like Gunsmoke or family dramas such as My Three Sons? Perhaps they were more interested in musicals like "The King and I" or "Singing in the Rain." You can find many favorite movies and shows from the 40s, 50s and 60s on Netflix or other streaming services.
- Go on a Nature Walk
- Use nature to integrate sensory experiences into conversation. Listen to birdsong, touch the wet grass, smell the roses and feel the sunshine on your shoulders. Ask what their favorite outdoor activities were during their youth and try to safely recreate similar scenarios if possible.
- Look Through Old Cookbooks
- In the past, women spent a great deal of their teenage years learning to cook and young adult years cooking for their families. Discuss origins and variations on old family recipes, or better yet, cook with those old family recipes and share the results with your loved ones.
- Enjoy Favorite Treats
- Look for candy or other indulgences that were commonplace when your loved one was young. Many companies specialize in nostalgic candy where you can buy old favorites like horehound candy and soft peppermint sticks. Even simple things, like an orange, can be a treat to someone who remembers when you only had them during holidays.
- Visit and Connect with Animals
- People who grew up on farms may enjoy an outing to a petting zoo or family farm where they can touch and talk to horses and other farm animals. Ask questions about animals, old pets, or what it was like to grow up on a farm. This is a great activity to involve grandchildren in, since many kids today are not familiar with farms.
- Reminisce Over Childhood Toys
- Nothing elicits childhood memories like familiar old toys. Erector sets, kewpie dolls, sock monkeys and marbles were some of the most popular toys during the 40s and 50s. There are many websites dedicated to antique toys. If you have any old toys available, bring them when you visit, ask questions about how they were played with, or, in the case of construction toys, build something together.
- Bring Back Old Skills
- Did your loved one quilt, crochet or knit? Put a homemade quilt or skein of yarn in their hands and let them feel the weight of the quilt and the scratchiness of the yarn. You may be surprised to find that your loved one can still crochet or knit a little bit, even though they have serious memory or cognitive deficits. Often, the muscles remember what the brain has forgotten.
Your loved one may be different than the person you have always known, but they still long for connection and companionship. You can encourage that connection by using these activities to enrich both of your lives.
by Vicki Salemi
As tough as it may be to enlist the help of a "stranger" when it comes to caring for your parents, sometimes it's for the best. For one thing, it will take the strain off of you, but your parent will also benefit from professional care in the comforts of home. Whether it's being attentive to special medical needs of assisting with personal care or homemaking, having a home health care professional will provide a variety of benefits to both the patient and the family.
1 - Home care promotes healing.
"I know that our clients enjoy a much better quality of life which many families have said helped to extend the lives of their lived ones.," says Peter Ross, CEO and co-founder of Senior Helpers. "We focused on healing the mind, not just the body." Maxine Hochhauser, CEO of Visiting Nurse Regional Health Care System adds that in many circumstances the person rehabilitates better in the home. "They are in a familiar environment and are more comfortable. This is particularly true with individuals suffering from dementias."
2 - Home care is safe.
"Many risks such as infection are eliminated or minimized when care is given at home," says Ross. Quality home care by professional caregivers can help prevent issues that may become very serious within the home. One example includes preventing falls in the home since seniors may be too weak or dizzy from medication since they fall when they're cleaning or bathing.
3 - Home care allows for maximum amount of freedom for the individual.
Patients at home may be engaged with their typical daily activities as their health permits plus it allows patients to receive care in the least restrictive environment. "This is the most conducive to patient-centered care which allows individuals the most control over the care they'll receive and the manner in which they receive it," notes Hochhauser. "Plus, it allows individuals to remain in the community."
4 - Home care gives them some control.
As baby boomers age the home care option gives them more control over the type of care they'll get to choose. Hochhauser explains, "They want more choices and want to be a more active participant in their own care. Home care allows them the most say in their care as they are in the least passive situation."
5 - Home care is personalized.
According to Milca Pabon, RN, a home health care nurse with Adventist Home Health, "the best reason to choose home care is because the care that will be received in the home will be individualized to each patient according to their specific needs." Essentially home care is tailored to the needs of each patient as they receive one-on-one attention.
6 - It eases burdens on the family.
Pabon explains, "With the length of stay in the hospital decreasing patients are going home earlier and many of them do not choose to go to a rehabilitation center to recover," explains Pabon. Rather, they want to go home to their own environment with their loved ones and have someone provide them with care they'll need to reach their maximum level of function. She continues, "Families are willing to have their loved ones with them, but may feel inadequate or unable to provide their loved ones with the help that they might need."
7 - Home care is comfortable.
"Every study done has shown that people would prefer to stay in their home," says Constance Row, executive director of the American Academy of Home Care Physicians. There is familiarity and comfort of being in one's own environment surrounded by their loved ones. She notes, "It's a type of quality care that people would want for their senior relatives."
GEORGE F. FULLER, COL, MC, USA, White House Medical Clinic, Washington, D.C.
Am Fam Physician. 2000 Apr 1;61(7):2159-2168.
See related patient information handout on the causes of falls and tips for prevention, written by the author of this article.
Falls are the leading cause of injury-related visits to emergency departments in the United States and the primary etiology of accidental deaths in persons over the age of 65 years. The mortality rate for falls increases dramatically with age in both sexes and in all racial and ethnic groups, with falls accounting for 70 percent of accidental deaths in persons 75 years of age and older. Falls can be markers of poor health and declining function, and they are often associated with significant morbidity. More than 90 percent of hip fractures occur as a result of falls, with most of these fractures occurring in persons over 70 years of age. One third of community-dwelling elderly persons and 60 percent of nursing home residents fall each year. Risk factors for falls in the elderly include increasing age, medication use, cognitive impairment and sensory deficits. Outpatient evaluation of a patient who has fallen includes a focused history with an emphasis on medications, a directed physical examination and simple tests of postural control and overall physical function. Treatment is directed at the underlying cause of the fall and can return the patient to baseline function.
Elderly patients who have fallen should undergo a thorough evaluation. Determining and treating the underlying cause of a fall can return patients to baseline function and reduce the risk of recurrent falls. These measures can have a substantial impact on the morbidity and mortality of falls. The resultant gains in quality of life for patients and their caregivers are significant.
Epidemiology of Falls in the Elderly
From 1992 through 1995, 147 million injury-related visits were made to emergency departments in the United States.1 Falls were the leading cause of external injury, accounting for 24 percent of these visits.1 Emergency department visits related to falls are more common in children less than five years of age and adults 65 years of age and older. Compared with children, elderly persons who fall are 10 times more likely to be hospitalized and eight times more likely to die as the result of a fall.2
Trauma is the fifth leading cause of death in persons more than 65 years of age,3 and falls are responsible for 70 percent of accidental deaths in persons 75 years of age and older. The elderly, who represent 12 percent of the population, account for 75 percent of deaths from falls.4 The number of falls increases progressively with age in both sexes and all racial and ethnic groups.5 The injury rate for falls is highest among persons 85 years of age and older (e.g., 171 deaths per 100,000 white men in this age group).6
Elderly persons who survive a fall experience significant morbidity. Hospital stays are almost twice as long in elderly patients who are hospitalized after a fall than in elderly patients who are admitted for another reason.9 Compared with elderly persons who do not fall, those who fall experience greater functional decline in activities of daily living (ADLs) and in physical and social activities,10 and they are at greater risk for subsequent institutionalization.11
Falls and concomitant instability can be markers of poor health and declining function.12 In older patients, a fall may be a non-specific presenting sign of many acute illnesses, such as pneumonia, urinary tract infection or myocardial infarction, or it may be the sign of acute exacerbation of a chronic disease.13 About one third (range: 15 to 44.9 percent) of community-dwelling elderly persons and up to 60 percent of nursing home residents fall each year; one half of these “fallers” have multiple episodes.14 Major injuries, including head trauma, soft tissue injuries, fractures and dislocations, occur in 5 to 15 percent of falls in any given year.15 Fractures account for 75 percent of serious injuries, with hip fractures occurring in 1 to 2 percent of falls.15
In 1996, more than 250,000 older Americans suffered fractured hips, at a cost in excess of $10 billion. More than 90 percent of hip fractures are associated with falls, and most of these fractures occur in persons more than 70 years of age.8 Hip fracture is the leading fall-related injury that results in hospitalization, with these hospital stays being significantly prolonged and costly.16 It is projected that more than 340,000 hip fractures will occur in the year 2000, and this incidence is expected to double by the middle of the 21st century.17
One fourth of elderly persons who sustain a hip fracture die within six months of the injury. More than 50 percent of older patients who survive hip fractures are discharged to a nursing home, and nearly one half of these patients are still in a nursing home one year later.18 Hip fracture survivors experience a 10 to 15 percent decrease in life expectancy and a meaningful decline in overall quality of life.
Most falls do not end in death or result in significant physical injury. However, the psychologic impact of a fall or near fall often results in a fear of falling and increasing self-restriction of activities. The fear of future falls and subsequent institutionalization often leads to dependence and increasing immobility, followed by functional deficits and a greater risk of falling
We are all probably aware that exercise is good for us. It improves our overall functioning, both physically and mentally. It not only helps us live longer, healthier lives, but it also goes a long way in keeping us more independent as we age and allowing us to continue to participate in many of the activities that we enjoy. It improves our mood, and it feels good for our body. Exercise has found to be an effective treatment for many health concerns such as depression, diabetes, arthritis, and high blood pressure. It can prevent or delay the onset of other health conditions as well. And on the opposite end of the spectrum, those who are inactive are twice as likely to suffer from heart disease. They also have a higher risk of hospitalization and are dependent upon more medications than those who remain active throughout their lives.
It is easy for anyone to make excuses about exercising. We are too busy, too tired, unmotivated at times. As we age we have even more excuses at our fingertips. Aches and pains, lack of stamina, feeling the need to “take it easy”. These things add up and over time a lot of older adults become more inactive as they age, when it is actually a time in our lives that it is more important than ever to stay fit. There are many moderate endurance activities that are recommended for older adults such as walking, swimming, dancing, tennis, golf, and bicycling. Make your exercise program a priority, and to help with this try to keep it interesting and fun. Make it a social activity if possible.
If you have not been active in a long time, start slowly and build up your endurance over time. Talk to your doctor before beginning any new exercise program and ask what is safe for you given any medical conditions, or to learn how to modify certain activities to avoid any problems. If you smoke, are obese, or diagnosed with any chronic health problems such as heart disease or diabetes, your doctor can give you the best advice on which activities will be the most beneficial to you. Time is precious and we only get one chance at life, make yours the best that it can be!
Is the following story familiar to you?
You have been the family caregiver for your aging mom for some time now. She thinks she is entirely independent and doesn’t need help, you know better. You have been helping with laundry, cleaning, and even help her organize her medications. Although mom is in denial that she needs any help, you are at your limit; physically, emotionally, and your time is stretched to the max. You would like to get some Homecare help, but you dare not bring it up, yet.
Then Mom falls. She is hospitalized for a while, and after is moved to the rehab. The doctor gives a choice of either a nursing home or 24/7 homecare, and Mom gets angry. She insists she is not going to a nursing home and the thought of having strangers in her home invading her privacy is unsettling to her.
The solutions to situations such as this will be unique to each individual family. You as the family caregiver can greatly relieve any anxiety mom may have by showing care, concern, and calming her. Let her know you are there for her. Tell her, “let’s just try this and see how it goes”.
There are many options and programs available for families in situations such as this. Following are some resources to get you started.
More than 65 million people, 29% of the U.S. population, provide care for a chronically ill, disabled or aged family member or friend during any given year and spend an average of 20 hours per week providing care for their loved one.
The value of the services family caregivers provide for "free," when caring for older adults, is estimated to be $375 billion a year. That is almost twice as much as is actually spent on homecare and nursing home services combined ($158 billion).
In 43% of U.S. families, one sibling has the responsibility for providing most or all of the care for Mom or Dad, according to a survey of family caregivers. In only 2% of families in the U.S. the siblings split the caregiving responsibility equally.
The family caregiver is usually the adult child of senior parents who lives the closest. Between providing care, making decisions, and dealing with family members, the family caregiver has a stressful difficult job. This article is for the primary family caregiver, to help you in your role. Families come in all shapes and sizes, the situations are as varied as you can imagine. Many family siblings all have to work and have their own families, who will help? Many siblings may live a distance from Mom or Dad making being a part of caregiving difficult. If you are a family caregiver following are some tips.
The best advice is to plan ahead with your siblings and parents before care is needed. Discuss all possible situations and what Mom and Dad want. If it is too late to plan ahead, don’t worry. There are many resources available to help you. It is never too late to plan. Even if you have been caring for your Mom for many years, if you haven’t taken these steps, it is not too late.
Research – discover senior options in your area. This could be from senior centers programs, to assisted living options, to homecare services. There are family caregiver respite programs and senior day out services. Below is a list of resources to help you learn what options are available.
Have a family meeting – all siblings and parents should be at this meeting. Some may have to participate via telephone speakerphone, or skype, but it is best to have everyone in the immediate family involved. If you are planning ahead, your parent(s) may be in their 70’s and may be mostly independent. This is the best time to make decisions and hear what they want. Planning ahead is less stressful and can be more productive. However, if you are in the midst of having to make imminent decisions a family meeting is still important. There are many things to discuss and consider at a family meeting such as; who has the power of attorney? If no one knows, or if this isn’t planned ahead, you may want to call an elder law attorney to help. An elder law attorney can help with many areas of senior planning and options. When the other family members they see what is involved in caregiving they may be able or willing to contribute something. Open caring communication is key at this stage.
Get outside help – Some families have trouble agreeing on what is best for Mom or Dad. If this is the case get a social worker, or care manager to join the family meeting. To have an unbiased third party helps more often than not.
Don’t neglect your needs – many family caregivers are overworked and stressed. The job of caring both for Mom and for your own needs can be overwhelming. Schedule time for yourself. Homecare agencies may be able to help with short term respite so you can have a day off, or take a vacation. There are many caregiver support groups available where family caregivers meet to encourage one another, share ideas, and what programs are available. Do not try to do this alone and do not forget your own needs.
Give your Mom or dad as much independence as possible. You may need to take the car keys away at some point, if so, find an alternative means for them to get around. Make sure they feel they are making their own decisions. Every senior has care needs are at different levels. Do your best to help them feel as capable and independent as possible.
1. Caregiving in the United States; National Alliance for Caregiving in collaboration with AARP; November 2009
2. Evercare Survey of the Economic Downturn and Its Impact on Family Caregiving; National Alliance for Caregiving and Evercare. March 2009 Page 2
3. Study conducted by The Boomer Project, included 711 adults in the U.S. and 383 in Canada ages 35-64 with living siblings or stepsiblings, who said they either currently provide care for a parent or older relative, or did provide care in the past 18 months.
Today I had the opportunity to speak at the Alton Senior Center, where we discussed Senior Living Choices. Most seniors wish to remain in their own homes, however, as age related disabilities occur; assistance of others becomes a necessity. Most often a family member becomes the primary caregiver. Most adult family caregivers have their own families and jobs, etc. to attend to; making caregiving for their aging loved one challenging. Then there is the challenge of learning the skills necessary to accomplish this difficult job. In helping those with Alzheimer’s/dementia, mobility challenges, and other needs, it is important to know the skills to properly help. This is why Abundant Blessings Homecare has skilled experienced professionals. Abundant Blessings Homecare can help family caregivers have that much needed and deserved break. Whether your need is short term, only a few days a week, or up to 24/7 care we can help. We work with your schedule not ours. At the Alton Senior Center today we discussed these and other challenges seniors aging at home experience. We thank you all the Alton Senior Center for having us, you have a great program.