Senior Driving

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.

• Senior Driving Checklist (PDF)

Additional Resources:

• 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

Eight Reasons To Choose Homecare

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."

Source: http://www.seniorsforliving.com/content/article/eight-reasons-to-choose-home-care/18/

Elder Abuse, Neglect, and Exploitation

Protect yourself or your loved one

The elderly often rely on others to meet their most basic needs. Statistics tell us that about 9.5% of the elderly population is abused every year. Elder abuse includes neglect, physical abuse, financial exploitation, emotional abuse, and sexual abuse. One out of every 14 cases occurs domestically, usually within the victims homes. Abuse also occurs in nursing homes and other facilities. Physical Abuse is defined as the use of physical force that may result in bodily injury, physical pain, or impairment. This can happen even if the motives are good. For example we have seen family members who force there elderly mother into the tub, because she has dementia and would not cooperate. This forcing caused minor injuries. When confronted the family stated they were just doing what the nursing home did.  This is a shocking story, and often how physical abuse occurs. Psychological Abuse is defined as the infliction of anguish, pain, or distress through verbal or nonverbal acts. What is often just family conflict and strife can easily get out of control and lead to psychological abuse. Financial Abuse or exploitation is defined as the illegal or improper use of an elder’s funds, property, or assets. A family member, neighbor, friend, even a hired caregiver, anyone who is close to the person can manipulate and abuse them for personal selfish gain. Neglect is defined as the refusal or failure to fulfill any part of a person’s obligations or duties to an elder, or the failure on the part of an in-home service provider to provide necessary care. This can easily happen just by family members conveniently forgetting about their elderly parent. Caregiving is a hard stressful job, rather than properly finding the help that is needed. Ignoring the problem is abuse.

We all have the right to be free from abuse, neglect, and exploitation. If you suspect any form of abuse to an elderly person, it is important for you to report it. The types of abuse discussed above could happen to any of our community’s elders. Without intervention, abuse almost always escalates. Because victims are often reluctant to report abuse, a person’s safety may depend on you to recognize and report suspected abuse. It would be far safer for you to report a suspicion and be wrong, then remaining quiet while abuse occurs. It is important to know that more than two-thirds of elder abuse perpetrators are family members of the victims or close family friends, typically serving in a caregiving role. When elder abuse occurs, it can be addressed – if it comes to the attention of authorities.

If you need to hire homecare assistance, we recommend using a licensed agency rather than hiring privately. Homecare agencies must conduct criminal background checks, and BEAS registry checks. The BEAS registry (bureau of elderly and adult services) is a database containing information on founded reports of abuse, neglect or exploitation of incapacitated adults by a paid or volunteer caregiver, guardian or agent. There are individuals with a clear criminal background check who in in the BEAS registry. The NH BEAS registry can be reached at (603) 271-3269. Also, keep in mind; only criminals who get reported and charged have criminal records. Some homecare agencies and nursing facilities conduct pre-hire personality tests. These tests help determine if an applicant has a tendency toward certain types of crime or questionable behavior. 

4 Ways to Prevent Elderly Dehydration + Must-Try Summer Mocktail Recipes

by Dana Larsen

Our elderly loved ones need a little extra TLC during the hot summer months. Find out why dehydration increases with age and get valuable tips on keeping your favorite senior hydrated.

Senior dehydration is a common health issue that can lead to bigger problems if proper hydration is not made a priority, such as urinary tract infections and low blood pressure. Proper hydration helps to keep the body and vitals regulated. The University of Chicago Medical Center found that 40% of heat-related fatalities in the U.S. were among people over 65.

What Can Cause Dehydration?

There are a number of reasons the elderly are so prone to dehydration:

1. The ability to notice changes in body temperature typically decreases with age.

2. As people get older, body water content decreases.

3. Many medications the elderly take make them more susceptible to dehydration.

4. The elderly often experience diminished thirst; which leads to a reduced fluid consumption.

5. With aging, the kidneys have a reduced ability to concentrate urine and retain water during water deprivation.

6. Specific conditions, such as reduced swallowing capacity, decreased mobility, comprehension and communication disorders, as well as, decreased mobility and/orincontinence can contribute to dehydration.

7. Many seniors have underlying health conditions that make them less able to adapt to heat.

What Health Issues Can Dehydration Create?

There are some staggering statistics, compiled from The Department of Health, The Hydration for Health Initiative, The Adult & Geriatric Institute, European Review of Aging and Physical Activity, and the  Department on Aging, about dehydration in seniors.

Things you should know about dehydration:

• Dehydration has been associated with increased mortality rates among older adults

• Dehydration can accelerate or bring about emergency hospitalization and/or increase the risk of hospital stays

• Dehydration is a frequent cause of hospitalization of older adults and one of the ten most frequent diagnoses responsible for hospitalization in the U.S.

• Dehydration has been associated with many elderly health issues, including elderly confusion, impaired cognition, falling and constipation

• It is estimated that avoidable costs of hospitalizations resulting from dehydration is $1.14 billion, annually

What Steps Can Be Taken To Prevent Dehydration?

Fluid intake is key. Families and caregivers need to be cognizant about risks and plan ahead to make sure aging loved ones are properly hydrated. Here are some tips to help encourage fluid consumption and reduce the risk of elderly dehydration:

1. Offer fluids on a regular basis throughout the day.

2. Encourage 8 oz. of fluid intake every time the senior takes medication.

3. Keep water bottles and/or a water cooler available throughout the day wherever the senior is (for example, in bed, on the patio, throughout the house or at the senior living community).

4. Provide favorite “mocktail” concoctions (see below for some great recipes) or your senior’s favorite beverages (make sure they’re not caffeinated or alcoholic).

Tasty Recipes To Keep Your Elderly Loved Ones Hydrated

Strawberries and Coconut Water

Ingredients

To make 2 Strawberry Mocktails combine:

• 1 cup (250ml) of fresh coconut water

• 1 cup (250 ml) strawberries hulled and sliced

• 3 T of sugar syrup or agave nectar

Directions

1. To make the sugar syrup, boil sugar and water together in a ratio of 1:3 sugar to water until it thickens to a runny syrup consistency. Store in a jar for all future cocktail making.

2. Measure 1 cup of coconut water, either directly from a cut-open coconut or from a store-bought container (if you are lucky enough to live in an area that sells fresh coconut water in a bottle).

3. Combine the strawberries and sugar syrup and blend with a blender to desired consistency.

4. Serve with ice.

Get more information on making this delicious 

strawberries and coconut drink

.

Cucumber Lemonade with Basil

Ingredients

To make 3 to 4 Cucumber Lemonade treats combine:

• 1 English cucumber

• 3 C water

• 3 lemons

• 2 T sugar

• 1 small bunch basil

• 1 C soda water

Directions

1. Start by cutting your cucumber in half. Peel one half and cut it lengthwise (you can cut it in half again first if need be).

2. Scoop the seeds out and chop it into pieces.

3. Put the cucumber pieces in a food processor and puree until smooth.

4. Put puree in a fine mesh sieve over a container and push with a wooden spoon or spatula, extracting as much liquid as you can from the cucumber puree.

5. Fill a separate bowl or container with 3 cups water. Squeeze 2 lemons into the water and mix in the sugar.

6. Pour lemonade and cucumber juice into a pitcher or serving container. Slice remaining cucumber half (unpeeled) and remaining lemon and add to pitcher. Add basil, too. Refrigerate until chilled.

7. Serve with ice.