Thursday, May 30, 2013

My elderly parent becomes confused and agitated in the early evening—is it Sundown Syndrome?


By Bob Gregory

Sundown Syndrome or “sundowning” is not a disease unto itself but a symptom of early Dementia or Alzheimer's disease.  Studies show that about 20% of people with Dementia or Alzheimer's disease will experience some level of sundowning.  However, an individual may experience sundowning without being officially diagnosed with Dementia or Alzheimer's disease.  According to Mayo Clinic, the cause of sundowning still isn’t known but is often labeled when certain traits are displayed.   So is it serious?  Some of the traits of sundowning may cause the individual harm and WebMD says sundowning is a common cause of caregiver burnout.  Let’s look at how the experts describe sundowning.

According to an article by Psychiatry Investigation posted on the National Center for Biotechnology Information, “Sundown syndrome, also known as sundowning, is a common clinical phenomenon manifested by the emergence or increment of neuropsychiatric symptoms in the late afternoon, evening or at night. It particularly occurs among cognitively impaired, demented, or institutionalized elderly patients.” 

Some of the “neuropsychiatric symptoms” that may be displayed are: 
CRTGraph
CRTGraph (Photo credit: Wikipedia)
  • Restlessness
  • Confusion
  • Disorientation
  • Delirium
  • Agitation
  • Anxiety
  • Wandering
  • Yelling
  • Pacing the Floor
  • Combativeness
  • Repetitive actions

The confusion, disorientation and wandering can be most concerning for caregivers as a person who is sundowning may wander off and get lost.  The combativeness also poses a threat to both the individual and the caregiver as restraint may be required to keep the individual from harming themselves or others.  All of these require a much higher level of care than someone who does not have sundown syndrome.  The intensity and duration of these symptoms are not always the same.  Some factors that may increase the severity of the symptoms are fatigue, pain, over medication, low lighting, lack of exercise, infections, and a noisy sleeping environment.  Nutrition may also play a part in the level and frequency of the symptoms.

Here are some suggestions to help minimize the intensity and number of symptoms that may be displayed:
  • Increase or encourage exercise
  • Limit sugar and caffeine intake
    English: Elderly man with a dumbell sitting on...
     Elderly man with a dumbell sitting on an exercise ball (Photo credit: Wikipedia)
  • Limit or remove daytime naps
  • Schedule earlier dinner service
  • Well lit rooms to limit shadows
  • Surround with familiar items such as photographs

The Mayo Clinic reports “research suggests that a low dose of melatonin — a naturally occurring hormone that induces sleepiness — in combination with exposure to bright light during the day may help minimize the disorientation associated with sundowning.”  Additionally, WebMD suggests “light therapy, the exposure to bright lights during the day may reduce some sundowning symptoms, especially when used in combination with exercise, like walking.”  If you are paying attention, you will notice that exercise to reduce the energy level of the individual is a common theme! Be sure to consult your parent’s doctor for potential medical treatment.  Although antipsychotic medications are very widely used to manage symptoms of sundowning, there is limited information on this particular treatment.

If you are the caregiver of someone who exhibits sundowning, the best approach is to be calm and reassuring.  Try to minimize activities occurring around the individual to limit confusion.  You may also want to provide some form of distraction to attempt to help them focused.  Avoid arguing or getting excited yourself and remain composed.  Try to give positive commands as opposed to negative commands when instructing as negative commands may cause additional confusion.  Finally, tactics that work for one individual with sundowners may not be affective for another; in fact they may actually aggravate the situation!  There is a reason sundowning is a common cause of caregiver burnout so prepare yourself!

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com

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Monday, May 27, 2013

Alzheimer’s—“A Fight To Remember”

By Bob Gregory

As an advocate for helping our elderly, I am introduced to many charities that provide funding to help fight diseases associated with aging.  There are quite a few diseases that affect the elderly such as Arthritis, Hypertension, Diabetes, Heart Disease, Osteoporosis, COPD, Depression, Parkinson’s and of course, Alzheimer’s. The treatment and eventual cure of all of these diseases mean a longer, healthier and happier life for our seniors.  It is important to support the charities dedicated to fighting these diseases as well as others I haven’t mentioned.  I had the opportunity to sit down and discuss a new charity that is just now joining the fight against Alzheimer’s and I was impressed with their approach.  It’s different than many charities that currently provide funds for support of caregivers of those suffering from Alzheimer’s or pharmaceutical research to develop drugs to help with symptoms.  Instead, the Alzheimer’s Research Foundation is dedicated to funding the discovery of a cure—a bold a daunting task!  Here is their story:

“A Fight to Remember”

 Alzheimer’s is the most common form of dementia and currently affects over 5 million Americans. Discovered over 100 years ago by Doctor Alois Alzheimer, it is a progressive neurological disease that causes memory loss, confusion, and a decline in functioning. While the majority of people with Alzheimer’s are age 65 and older, up to 5 percent of people with Alzheimer’s are in their 40’s and 50’s. Alzheimer’s can be a devastating disease both for the people who suffer from it, and for friends and family members who have to deal with the fact that their loved one no longer remembers them. Unfortunately, there is no known cure for Alzheimer’s…but thanks to organizations like Alzheimer’s Research Foundation, we’re getting closer.

Unlike other Alzheimer’s organizations that promote education and caregiver support, Alzheimer’s Research Foundation is a 501(c)3 that is dedicated to finding a cure for a disease that affects so many lives in so many different ways.

In the past, the majority of money spent on Alzheimer’s research went to fund pharmaceutical research that treated symptoms of the disease. While treating the symptoms and slowing the progress of Alzheimer’s are noble deeds, we here at Alzheimer’s Research Foundation work with motivated researchers whose progress can be measured in quantifiable terms because we truly believe that a cure is possible.  

Helping people with an urgent need often causes an organization’s funding that would otherwise go directly to research to be used for programs that help people who are in crisis right now, pushing a cure off further into the future. That is not the case with Alzheimer’s Research Foundation 501(c)3. We will not lose focus on finding the cure. We are the research people and our goal is simple, “we fund measurable projects that are focused on identifying a cure for Alzheimer’s disease”.

We would like to remind you that there are other organizations with similar names but we are the one and only Alzheimer’s Research Foundation 501(c)3, 100% focused on funding research for the cure of Alzheimer’s.

We seek to measure, to learn, and to improve at every step along the way.  We are disciplined, because we want to maximize the effectiveness of our efforts, and learn from the results of our partners and grantees.  The collection and analysis of data and experience are critical first steps toward informed action and decision making. But these alone are not sufficient for action. Measuring progress and impact is only useful if you’re willing to act on the results. Our philosophy and approach emphasize measurement for a specific purpose or action. We recognize that the most elegant evaluation is only meaningful if its findings are used to inform decisions and strengthen our work to improve people’s lives.

As we continue to strengthen the foundation’s approach to measurement and evaluation, we will share this evaluation policy with our grantees and partners in a spirit of transparency and partnership.

There are many charities supporting a healthier and happier life for our seniors but I am particularly excited about the Alzheimer’s Research Foundation and their bold mission to find a cure for Alzheimer’s!  This disease is so prominent in today’s elder care that the Alzheimer’s Research Foundation has aligned itself with the Florida Assisted Living Association as one of its title sponsors.  All of us at Senior Facility Finder will also support and help in our way so look for special announcements on upcoming events through our social network!  Finally, if you can help Alzheimer’s Research Foundation, whether through donations or volunteer work, please do so and for more information, visit http://www.alzheimersresearchfoundation.com/.


If you would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.


Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com

Thursday, May 23, 2013

When caregivers make a difference—Marcel and his swing


By Bob Gregory

I often write about how important it is to choose the right senior facility for yourself or your elderly parent. I try to give helpful hints, questions to ask, safety issues and activities that will keep you moving and be enjoyable.  I also take time to mention how the caregivers can make the biggest difference in the quality care you receive and how happy you will be in your senior facility.  Most senior facilities pride themselves in the quality of individuals they hire and the level of service they provide.  They are very careful to choose the right staff because in the end, it is a service business.  Not everyone is cut out to work in a senior facility such as an Assisted Living Facility or a Nursing Home, as it takes heart, compassion and dedication.  When you find a facility which employs caregivers with those traits, you’ve found a gem!   I’d like to share an email that I received from a friend who owns Westbrooke Manor Assisted Living in Zephyrhills, Florida regarding just such a person that happens to be his Activities Director.  See if you agree with me that this is the type individual, and thus facility, that you or your elderly parent would appreciate!

From: Alyson Stanina

Thursday afternoon I was covering Esy’s position at the front desk while she was on her lunch break. Marcel Lavoie rolled over to the desk in his wheelchair and said to me,” We need a big strong tree out there,” pointing to the front parking area. I asked why, and he replied,” We need a swing.” I continued the conversation and asked him if he liked to swing, and he mentioned he used to swing at the park for hours upon hours, feeding the ducks and squirrels and losing track of time deep in thought. He would ponder his life, his 2 marriages, his children, why this, why that. After listening to him some more, I thought to myself, ‘I can take him to the park to swing, why not!?’ So then I asked him…”Marcel, would you like to swing at the park with me? I will take you!” His face glowed, and he accepted. I told him we would go the next afternoon.

Friday came, and he had been pointing to his watch all day when I walked by him, wondering what time we were leaving. It was obvious he had been thinking about the outing since the day before. He was so excited.

The moment had come. We loaded Marcel in the van and off we went. We had bread to feed the ducks, birds, and squirrels. I helped Marcel onto the bench swing in front of the lake at Zephyr Park…and there we swung, for an hour. Pondering life, talking about his past…he talked and talked, so comfortably. Marcel thanked me for making this outing happen for him. And then he said something that broke my heart and fulfilled me, all at the same time. He said, “ I wish the good Lord would take me tonight. Now that I have done this, I am ready to go.”

It was then, when I heard those words from Marcel that I realized that I can make last wishes, if you will, come true. Something so simple as riding a swing in the park is all this man wanted to do.  Marcel is a quiet, sweet, gentle man, with a mind full of life’s regrets and a broken heart. What youmay not know about Marcel is that he has  Lou Gehrig’s disease, (ALS). His muscles are slowly wasting away, but his brain power is all there. He has gone from walking with no shuffle, to walking with a big shuffle, and finally in a wheelchair in the last few months. Marcel knows he has this disease and knows what will happen to him. He is so silently strong.

I learned a lot about Marcel and myself yesterday afternoon on that swing in that park.

Thank you for letting me have that opportunity, and the opportunity to change a life, so simply.”

Alyson Stanina
Activities Director
Westbrooke Manor Assisted Living
6701 Dairy Road
Zephyrhills, Florida 33542
(813) 782- 4417
http://www.westbrookemanoralf.com/

Caregiving is not just a skill you learn and a routine you go through each day of the week.  Instead, it is a gift to be shared and showered upon those in need.  Yes, caregivers are paid a salary and work sometimes without a word of thanks, but they do it because they can make a difference—in this case, it was a difference in the life of a gentleman named Marcel!  I always encourage people in search of a senior facility to look beyond the décor and try to learn what’s at the “heart” of the facility—it’s the people who are the caregivers that make the facility a “home!”

If you would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com

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Monday, May 20, 2013

You parent’s elder care can ruin you if you let it!


By Bob Gregory

English:
English: (Photo credit: Wikipedia)
I hear about financial ruin and failed marriages all the time but there seems to be a trend where couples experience issues when attempting to provide elder care for one of the spouse’s parent or parents.  It generally begins with the financial burden of attempting to provide a higher quality of retirement for a parent.  It’s not uncommon for an elder parent to reach retirement and find they just do not have the financial means to support themselves for as long as they are capable of living.  This not only affects those who fail to plan, but also those who failed to achieve their plan or their plan just wasn't comprehensive enough.  More and more elderly parents turn to their children for financial help and in today’s economy, not all children have the ability to literally support another family.  I also see situations where the elderly parents refuse to ask for help, but their living situation becomes so disturbing to their children, that they feel pressured to assist.

When an elderly parent needs financial assistance, most children immediately seek benefits to help subsidize their parent’s retirement.  This is a great plan but most find this frustrating as it’s not easy to qualify for help if you have any level of retirement funds at all.  Additionally, not all senior facilities accept government subsidies such as Medicaid and require private pay.  For those that do accept Medicaid, it is important to know that Medicaid will not pay for room and board expenses.  However, there are some states that provide a Medicaid room and board allowance that usually ranges from $500 to $600 a month.  This amount is very low compared to the typical cost of an Assisted Living Facility.  Another potential source of funding can come from the U.S. Department of Housing and Urban Development (HUD).  HUD provides low income assisted living help through their Section 8 provision by providing "vouchers" to qualified individuals.
English: An old married couple in Kyrgyzstan, ...
 (Photo credit: Wikipedia)
However, these vouchers must be used at HUD approved housing developments.  There are some Assisted Living Facilities that operate as HUD Assisted Living Facilities and accept the vouchers.  If one or both of your parent’s were veterans, they may qualify for Veteran Aid. Your parent may qualify for The Aid and Attendance Benefit, referred to as A&A.  This entitles veterans and spouses or widows to benefits for long-term care provided by an assisted living facility.  There are also some state run Veteran’s homes that provide housing but space is very limited and may be difficult due to low vacancies.  All of these subsidies are based on income and may be hard to qualify.

If children are successful in finding subsidies, they have the real challenge of deciding if the facilities that accept the subsidies meet their standards for their parents.  Let’s face it, in order to provide adequate services at the reduced amount allowed by subsidies, the glitz and glamour must be sacrificed in most cases.  Focus is on service and not as much on the appearance.  That’s not to say they are not clean and pleasant, 
they are just not as appealing as a facility that charges over $3,000 to $4,000 a month!  Also, not all of these facilities are in convenient locations as land value is often a consideration to help keep construction costs low.  In most cases, children of elderly parents in need of subsidies find themselves “shopping” for facilities with their hearts and not their heads.  In the end, it’s all about the care the elderly parent receives but most children want that care to provided in the most comfortable and appealing environment that they can afford!  This is where the financial issues begin for children who truly cannot afford to support their parents in a manner that they feel their parent deserves.

English: A diagram showing the flow of knowled...
flow of knowledge in the
 Financial Planning Profession
(Photo credit: Wikipedia)
It’s time to go back to the retirement plan and current household budget and see just how much you can help your elderly parents!  If you are smart—I hope you are—you have a retirement plan to assure you don’t end up like your parents and become a financial burden on your children.  With that thought in mind, do not lower the amount you are saving for your retirement!  Instead, take a look at your current household budget and decide if you have the means to make up the difference between what your parents can afford and what you would like to see for your parent to afford.  Are you willing to get a second job, cut out vacations, get student loans for your children’s college, and downsize yourself?  These are some tough questions and they must be answered honestly by both you and your spouse to avoid the failed marriage I mentioned above.  Also, will you find yourself in a situation where you may have to provide the same assistance for your spouse’s parents?  Can you afford to do for both sets of parents what you are hoping to do for one set?  Also, if both of you work, can you be sure neither of you will become unemployed?  If your plan counts on both of you having income, make sure you are comfortable that both of you can sustain employment.  Finally, will the additional financial burden cause you or your spouse to delay your own retirement?  You don’t know how long your parents will live and how long they will continue to need support.

Couples realizing they may not be able to provide additional financial support will often come to the conclusion to care for their parents in their home.  This is a viable option but it comes with just as many challenges and decisions—more than I can discuss in this writing!  Financial problems can create tremendous stress on a marriage, especially if the financial problems could have been avoided.  Experts in marriage and divorce say lack of communication is the leading cause for divorce in our modern society.  Therefore, be honest and open with your spouse regarding funding your parents (or your spouse’s parents) retirement.  Honesty is a cornerstone to a healthy relationship and committing to support your parents financially requires both of you to be in complete agreement and understand the potential problems that may be ahead.  You should also be honest with your parents about how much you can or cannot help them with their retirement.  I’ll try to address that conversation in future writings!

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com


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Thursday, May 16, 2013

My elderly parent wants to take a vacation overseas!


By Bob Gregory

Recently, a friend was venting because his elderly father wants to take a trip to Italy.  My friend thought the trip would be a waste of money as his father currently lives in an Assisted Living Facility and suffers from mild memory issues and needs a walker to get around.  I think he was stressed the most by the fact his father didn’t want him to come along as he knew his son would not be able to take the time off from work.  He insisted his father was not physically capable of making such a trip and he would jeopardize his health and waste money needed for his future.  I was probably not the best sounding board as I like to travel and while I plan carefully for retirement days, I also know that I may never see those days! 

Cover of
Cover of The Bucket List
We all have a “bucket list” and I’m guessing this trip to Italy is probably one of the top items on his father’s list.  We generally do not grow younger and healthier so you have to consider at what point some of the items on your bucket list will never be fulfilled!  You also have to consider if the items on your list can reasonably be fulfilled financially or practically.  I spend a great deal of time writing about finding the right senior facility to provide our elderly parents’ with a comfortable, safe and healthy retirement as that is a passion of mine.  However, I am also passionate about making sure our elderly are happy and continue to enjoy life to its fullest—so let’s discuss traveling abroad!

Considerations for elder travel.

  If you follow my blog, you know the very first consideration is the health of the elder parent.  Discuss the potential travel plans with your parent’s physician and make sure they are healthy enough to travel.  Don’t be concerned about all the details at this point as it may be a moot point if the doctor believes your parent is not healthy enough to travel.

  Assuming your parent is healthy enough for the travel, decide how much your parent can comfortably spend without jeopardizing their retirement.  This is the tough part as the budget will determine how far they can travel and how long they can be gone.  The budget should be set before you look at brochures, cruises, airfares etc. and it should be determined solely on the ability to continue living a comfortable life without the funds. Once you set the “maximum” budget, then you can begin to see how far and long your parent can travel.

Boeing 747-400 takes off from London Heathrow ...
Boeing 747-400 (Photo credit: Wikipedia)
  Now that you have a budget, check with a professional travel planner to help you design a trip for your parent’s special needs.  Our population is growing older and travel destinations realize that and have special packages for the elderly or physically impaired.  A professional can help you locate the perfect “package” for your parent.  There are also many “senior” tours that specialize in helping the elderly travel and some provide special assistants to accompany the group.  If you are not going to be able to travel with your parent, make sure they go in a group—especially if they have any memory issues.  Your travel planner can also recommend travel companions that specialize in traveling with the elderly with physical and memory challenges.  All these items cost money and thus the need for the budget!

  Once you have narrowed down the list of destinations your parent can afford, it’s time to choose.  I’m not just referring to choosing between different destinations, I’m also referring to choosing to travel or stay home!  Don’t be surprised if the budget and the special assistance requirements cause your parent to give pause and change their mind!  Your parent may have dreams of spending several weeks abroad leisurely touring where as the budget and special needs may limit that trip to one week—of which two days are spent in the air.  You need to give them a few days to think this through before writing the check which will most likely be nonrefundable.  I don’t suggest you try to influence them to stay or go as it needs to be their decision.

English: The Venetian hotel (Las Vegas)
English: The Venetian hotel (Las Vegas)
 (Photo credit: Wikipedia)
After your parent has chosen a trip, you need to work closely with the travel planner to make sure you have everything your parent needs.  The more involved you are in this step, the more at ease you will be and your parent will be better prepared.  If possible, try to arrange a meeting of some of the group members or special travel companions if they are required.  At this juncture, you need to embrace the fact your parent is making the trip and make it as pleasurable and exciting for them as possible.  You may have the opportunity to travel  a lot in your lifetime, but this may be your parent’s last big trip.  Also, if the budget doesn't allow for your parent to make that “bucket list” trip, then try and improvise to help them realize part of the dream.  For instance, how about a stay in the Venetian Hotel in Las Vegas?  Alright, it’s not Venice, but it is a trip and they do have Gondola rides!  As for my friend, his father is making a trip to Italy in June and I’m not sure which of the two are more nervous.  I may have a different blog for you after he returns so stay tuned!

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com
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Monday, May 13, 2013

What is Aging in Place and is it a viable option for my elderly parent?


By Bob Gregory

Aging in place is a broad topic and depending on who you turn to for a definition, it can have many different meanings.  The Centers for Disease Control and Prevention defined Aging in Place in their Healthy Places Terminology section as “The ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.”  This is a great definition and as I stated earlier, very broad, but it doesn’t give much guidance if you are trying to decide if this is an option for you or your elderly parent.  Dr. Marcia Ory, PhD at Texas A&M Health Science narrowed it down a bit as the ability to “live at home as long as possible”.  So what is Aging in Place? Here is my take after researching and speaking with “experts” on the subject.

Aging in place, in my opinion, is really about planning to age.  We all know we are going to grow older and we know there are certain changes that occur to our physical bodies as we age such as decreased agility, loss of muscle strength, reduced or diminished vision and hearing, increased risk for falls and illnesses and potential memory disorders.  We also know that most will see a change in their financial status as retirement brings reduced earnings capacity and limited retirement income.  There are a lot more changes that I could name but the above will certainly be on the short list of whomever you may ask.  So if we know all these things will occur, then why do we fail to plan for them?  Most people do have a plan for retirement but it is usually centered on the amount of money needed to continue a certain lifestyle.  However, most see this “nest egg” as the time to have fun and enjoy life with leisure activities and travel.  Where most retirement planning misses the proverbial “boat” is in the area of aging—thus Aging in Place planning!

Older couple pose in front of their home, Gran...
Older couple pose in front of their home
(Photo credit: Wikipedia)
It is true that the majority of people who are near retirement age would prefer to remain in their current home or a smaller retirement home.  This overwhelmingly large group of retirees see themselves healthy and mobile and spending all their years in their current home right up until their last breath.  The U.S. Census Bureau reported that nearly 79% of people age 75 or older owned their own homes in 2010.  These are the individuals that would have benefited from an Aging in Place plan.  The core of the Aging in Place plan is to assure your home is ready for you to age!  The plan includes modifications to help with all  (or as many as possible) of the physical changes that occur with aging.  These modifications are designed to be made in such a fashion so as not to look institutional.

Some modifications made to a home as part of an Aging in Place plan:

ü  No step-up home.  This includes making the home’s entrance step-free by adding designer ramps and even lifts in the garage if necessary.  The plan will include removing thresholds that divide rooms that present a potential tripping hazard and installing elevators or chair lifts for multi-level homes.

ü  Bathroom safety modifications.  A typical plan would include replacing “slippery” tiles with flooring that is slip resistance.  It will also include modifying the shower so that it will have wheel chair access and the water control and shower heads are made more accessible.  Safety bars are also installed in key locations to help with toileting.  In some cases, the sink and vanity may be lowered for wheelchair access.

UDLL-handicap-accessible-kitchen-sink
UDLL-handicap-accessible-kitchen-sink
(Photo credit: homesower)
ü  Bedroom convenience.  Walk-in closets are configured so that clothing can be accessed from a wheelchair.  Light switches are usually converted to touch and lowered on the wall.  Tall dressers are exchanged for lower chests and clutter is removed for ease of movement.

ü  Kitchen modifications.  Kitchens are modified to allow ease of mobility whether the homeowner needs a walker or a wheelchair.  In general most appliances, including the sink, are lowered to make it easy to reach.  Clearance is often added to the sink and stove top to allow the homeowner to use as if they were a table top.  Upper cabinet storage is usually removed and lower storage is enhanced.

Raised Bed Garden
Raised Bed Garden
(Photo credit: Lori L. Stalteri)
ü  Lighting modifications.  Light switches are lowered and converted to touch.  Most rooms will have motion detectors to automatically turn on and off lights.  Special lighting at the floor level is usually added for safe navigation at night.

ü  Outdoor modifications.  Outdoor patios are often equipped with fashionable railings to aid with walking.  Flower beds are raised to reduce squatting or stooping.  Lighting is added for safety and beauty around walkways and paths.

Special care is taken to make sure the home does not look institutionalized while providing all of the same safety features found in an Assisted Living or Nursing Home.  Obviously these modifications, especially with the “designer” touch, are not inexpensive.  This leads me to the second part of the Aging in Place plan.  The financial part of the plan needs to consider the modifications to allow the homeowner to remain in their home and still maintain their standard of living.  This will generally lead to increased retirement savings!  It is advisable to have a contractor that “specializes” in these Aging in Place modifications take a look at your home and give you an estimate on the cost and the various safety features they will be able to add.  In some cases, you may want to consider choosing a new home that can be more easily modified!

Finally, you should also evaluate your current home to make sure it will continue to provide you with conveniences that you now enjoy should you lose the ability to drive!  You may want to consider a neighborhood or community that has shopping and entertainment within the community or on a bus route.  Also, make sure your current community is aging along with you—in other words; make sure it’s not becoming a hot spot for young couples and energetic young kids.  There is a lot to consider when creating your Aging in Place plan and home modifications and financial needs are just a couple.  Don’t forget coverage for health care needs!

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com

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Thursday, May 9, 2013

I can’t convince my family that my mother-in-law needs help with her Dementia!


By Bob Gregory

Dealing with in-laws can be a very touchy subject regardless of the relationship you may have.  You are family but then again, you’re not—or at least not blood kin.  Families like to believe they take care of their own, in fact it’s a tradition and honor in many cultures to care for elderly family members regardless of the cost or burden.  It is very difficult for family members to take advice from outsiders even if that outsider is a beloved member of the family through marriage.  In the case of my friend, she seems to see or at least admit what no other “family” member admits—her mother-in-law needs help!

My friend recently reached out for advice on how to help her mother-in-law who is suffering from Dementia.  She is receiving care in her own home by her husband but she feels her mother-in-law is not getting the proper attention that she needs.  Her basic needs are being met, but she is not receiving any type of therapy to help her memory and she receives no stimulation other than what is provided by the television in her room.  My friend has appealed to her husband, father-in-law and other family members but all seem to dismiss her call for action. I stated earlier that dealing with in-laws can be very touchy but it can be downright nasty if you are implying they are not “caring” for a family member.  So what do you do when you think an in-law is not receiving proper or adequate care?

Here are a few suggestions on approaching family about an in-law.

    Memories
     (Photo credit: Karthick R)
  • First, you need to remember and recognize that from their point of view, you are the “in-law”.  What I mean by that is that you are the outsider and it doesn't matter the relationship you have, good or bad, this is a very sensitive area.  Be respectful in pointing out what you “observe” and how you would “approach” the situation if it were your own parent.  Do your best not to be accusatory and avoid harsh words such as abuse, mistreatment or neglect even if you feel it applies.  This type of banter will do nothing to help your in-law as the advice will quickly be viewed as an attack and nothing you offer will be accepted.
  • If your in-law has been diagnosed with Dementia, then the doctor should have made some recommendations as to treatments—drug and therapy.  Ask the family members to “educate” you on what is now being prescribed to treat patients with Dementia.  Everyone likes to be put in a position of authority and knowledge so let them educate you on what the doctor recommended and then ask how the different treatments are being applied and are working.  This will force them to recognize they are not following doctor’s orders. Now you have something to discuss without being accusatory.
  • If it has been a while since the last doctor’s visit, offer to attend to provide assistance and to be a second set of ears to understand what the doctor is detecting and recommending.  If you are successful, ask the doctor to make recommendations for therapy or proper in home care.  You can then offer to take the lead in contacting these companies and arranging the needed help.  Sometimes it’s just a matter of being willing to do the work.  Be sure and use the appointment to ask the doctor questions in front of family members about the treatment and engage the family in the discussion with your own follow up questions such as “Do you agree we need to get this treatment started?” , “Do  ou have any questions about why this treatment is necessary?” “Is this treatment something we can get started immediately?”etc.  Put them on the spot in front of the doctor, he/she may become your future ally to get your in-law help!
    The Secret Garden
    The Secret Garden (Photo credit: @Doug88888)
  • If finances are an issue and you are capable of helping, offer the help!  Elderly couples will often put finances ahead of their own or a loved one’s health.  Don’t be naive and believe that money does not play a part in poor health care.  You may offer to pay for a couple of sessions of therapy or additional help.  Generally, health insurance will pay for doctor prescribed therapy but to get the ball rolling, you may want to bring a therapist by for a visit to show your family what the therapy is all about.  Fear of the unknown can easily be a road block.
  • Finally, there are legal steps you can take if you believe there is true neglect or abuse.  This is very difficult and I strongly suggest you give careful thought before mentioning this type of intervention.  You may want to seek council before even suggesting as this can ruin individual lives and marriages!  In this writing, I’m referring to “denial” of what is going on and not abuse or neglect so follow your conscience and heart if you believe it is abuse.
The above suggestions are not “one and done” steps.  Repeat them over and over and over and hopefully you will finally get proper care for your in-law.  It’s not surprising that an “outsider” sees what family members do not—denial is a powerful emotion that clouds our better judgment. Be persistent in your appeal for proper help and you will prevail at some point.  The sooner you succeed the better quality of life your in-law, and the family, will experience.  I wish you much success and I’m very proud of you for being such an advocate for your mother-in-law!

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com

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Monday, May 6, 2013

My parent keeps changing their wishes for their funeral arrangements-how do I handle arrangements


By Bob Gregory

Most children of elderly parents shy away from discussing final funeral arrangements for their parent.  No one wants to think about the time their parent will pass away and most don’t want to discuss it either.  However, I think you will be surprised to find how many elderly parents are more than willing to tell their children exactly what they would like for their final send off from this world.  In fact, you may find yourself getting new versions all the time and that’s where the real issue begins!

None of us can say with any certainty when our death will occur but we can all be sure it will occur.  Planning for the future should include more than where one will retire, how much money they will have and where they will travel.  It should also include the end of life plan.  This plan should include the proper documents that need to be in place such as a Living Will, Trust Documents, Do Not Resuscitate Form (DNR) and a Healthcare Power of Attorney.  It should also include your final wishes for the proper burial once you have passed away.  Individuals’ preferences vary widely on this matter and you should make your wishes clear.  These wishes are usually spelled out in detail as part of the Will.  If your parent does not have these documents or their final wishes detailed in the will, I strongly suggest you get them completed and read my post “What legal documents does my aging parent need to insure their end- of-life medical wishes are followed?”

butterfly (in a cemetary)
 (Photo credit: paul goyette)
If you can get your parent to complete the forms I listed above, then their end of life wishes should be detailed in the Will.  I suggest you keep a copy with you as well as with the attorney.  It is always a good practice to review legal documents from time to time as significant changes occur throughout our lives.  This can be true of funeral arrangements as well.  It is not uncommon for individuals nearing end of life to become more Spiritual or “find” God.  Certain Religions have guidelines, sometimes rules, an individual must follow for their final burial.  If so, you will want to revisit what was included in the Will and make any revisions necessary to comply with your parent’s religious belief and wish.  This can usually be achieved by a Codicil (addition) to the Will so the entire Will does not have to be rewritten.  Be sure and detail in writing your parent’s wishes before contacting the attorney.

If your parent does not have a Will and you are not successful in convincing your parent to have one written, then sit down and write down exactly what your parent would like.  I suggest you have your parent date and sign the document.  This will allow you to “remind” your parent what their wishes were at that particular time.  If they wish to change the plans, do so in the same manner so you will always have the latest version on hand with a date and signature.  Generally, if someone changes their mind about their final wishes, it is either to simplify or to embellish, so be prepared.

Prepaid funerals can be a very good way to plan and assure that your parent’s wishes are carried out properly and the financial means are available.  Most funeral homes have prepaid plans available and most are very flexible—this will allow your parent to change their mind within the budget they have prepaid!  Make sure you deal with a well established funeral home and beware of changes in ownership.  Prepaid funerals are also a good way to assure emotions do not dictate what type of funeral is purchased after a loved one has passed away.  Choosing and paying for one’s funeral in advance can be a little unsettling so prepare yourself and your parent.  Also, don’t think that the task is complete and all is settled once you have prepaid.  Often there will be some up- selling by the funeral home at the time of death so don’t let your 
Red sunset
Red sunset (Photo credit: Wikipedia)
emotions get in the way of your parent’s plan!

You parent will most likely change their mind about their final funeral arrangements at least once in their life time so be patient.  If you have not been successful in implementing any of the above, then go with the last thing your parent told you and not what you may remember from many years ago.  My mother had planned a very elaborate funeral right down to the color and type gown to wear.  She had made this wish known for years and we all knew exactly what she wanted.  In the last year of her life she literally did a 180 degree turn on what she wanted and insisted on a very simple ceremony.  In the end, her wish was to make it simple and easy on her children she was leaving behind—an unexpected favor to us!

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com

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Thursday, May 2, 2013

What is an Assisted Living Facility with Memory Care and is it right for my elderly parent?



By Bob Gregory

Choosing the right Senior Facility can be a daunting task and it can be very complicated if your elderly parent suffers from memory issues.  Memory care units within an Assisted Living Facility are designed to care for residents who suffer from mild to moderate memory loss caused by degenerative diseases such as Dementia or Alzheimer’s.  These types of facilities offer your parent the special care and assistance they need while still allowing the resident to enjoy continued independence. 
Keeping the memories alive
Keeping the memories alive
 (Photo credit: fernanda_maria)
Services provided by the Memory Care units of an Assisted Living Facility:

ü  Security:  Memory Care units generally offer a secure area for individuals with memory impairment diseases.  Generally a wing, or building depending on the size facility, is designated as the Memory Care unit and provides a higher level of security for residents who may wander off and get lost.  Some of these units are considered “lock down” units and may secure or “lock” the doors so residents do not wander off premises.  Levels of lock down vary so you will need to ask.  Some units lock the exits only at night and others have them secured all day.  The staff is normally trained to assist residents when they become “lost” and provide compassion and reassurance as they help the resident return to their quarters.

ü  Memory Therapy: Most Assisted Living Facilities with Memory Care units provide activities designed to provide therapy for their residents.  These activities are designed to be fun, engaging and rehabilitating.  Sensory and Cognitive therapies are generally the focus of the activities but most will include physical therapy as well.  Some have activities especially designed to address the symptoms of aggression and agitation that are associated with degenerative memory diseases.  Therapy may be provided on an individual basis but most are performed in a group setting to promote socializing.  Many facilities now use online memory games and skill activities.  Online programs provide an expansive and ever changing data base of games and activities to challenge and measure progress of the participant.

ü  Enhanced Medication Assistance:  Assisted Living Facilities normally provide assistance with administering residents’ medication.  In facilities with Memory Care, the nurses assure the medication is taken on time.  They are also trained to note changes in behavior and carefully document and notify the primary physician of these changes.

ü  Increased Care Level:  Assisted Living Facilities are designed to help individuals who need assistance performing normal daily functions such as bathing, eating, toileting, dressing, etc.  Facilities with Memory Care units provide a higher level of service for residents who need the same assistance, but may not “remember” they need to perform the daily functions.  In the Memory Care units, caregivers monitor whether a resident is eating, bathing, etc.
English: Logo of Alzheimer's Society.
English: Logo of Alzheimer's Society.
(Photo credit: Wikipedia)
As in any Senior Facility, not all Assisted Living Facilities with Memory Care units are the same and they don’t all provide the same level of care.  You need to do your research as to exactly what level and type of care they do provide.  Make sure your parent’s physician agrees that an Assisted Living Facility with a Memory Unit is sufficient for your parent’s degree of memory degeneration.  You should also discuss your research with the physician to get concurrence that the facility is providing the type of care your parent requires.  I also encourage you to observe the residents in the Memory Care unit and ask at what point the facility would recommend you move your parent to a higher level of care facility such as a Nursing Home.  Finally, you want to be sure your parent is living with residents with similar levels of memory degeneration to promote healthy socialization.

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com


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