Senior Home Safety Tips for Aging in Place

As our elder loved ones age, their ability to adeptly handle the common obstacles around their home is probably not what it was when they were younger.  The Home Safety Council is encouraging us to take a good look at the homes of our seniors – wherever they live – to be sure they are living in as safe an environment as we can make it.

We should also be prepared for emergencies, such as tornadoes, thunderstorms, hurricanes, floods, power outages, fires and other natural disasters.

Here are some tips to think about this month:

  • Check your smoke detectors, carbon monoxide detector or radon detector to be sure it is functioning properly; change batteries if needed
  • Get a first aid kit or update your current kit removing expired items and outdated supplies
  • Make an emergency plan in case evacuation is needed so everyone knows where to go and meet up
  • Keep emergencies supplies on hand such as non-perishable food and drinking water for at least three days including three gallons of water per person
  • Have prescription drug list handy and a supply of needed medications

Preventing Seniors’ Injuries

According to the Centers for Disease Control (CDC), 20,000 people die each year following a slip and fall.  A million people a year are estimated to be injured through a slip and fall, with 30% suffering from severe injuries such as broken bones, bruises and head injuries. Every 13 seconds a call is answered at the National Poison Control Center and 90% of poison exposures occur in our homes.  Every year 76 million people will get sick from improperly prepared or stored food most often in their homes.

  • Falls – the leading cause of death for seniors over 65 years. Keep floors free from hazards such as spills, sticky spots, water, dirt, and anything that would make them slippery.  Avoid highly polished floors that can be slippery.  Remove throw rugs and mats that present a tripping hazard.  Be careful what type of material is used marble, stone or ceramic because these surfaces don’t always dry well or provide good traction leading to a fall.  Keep halls and stairways well lit. Keep walkways free of clutter.
  • Fire – Don’t smoke in bed.  Keep flammable materials away from source of heat.  Have a fire evacuation plan.  Keep smoke detectors functioning properly.  Keep a fire extinguisher handy.  Know where the exits are and keep them free of obstacles.
  • Poison – Keep chemicals stored properly with original labels. Ventilate gas appliances.  Store medications safely in their original packages. Keep the poison control number next to the phone.
  • Food Safety – Wash your hands often.  Keep foods at proper temperatures.  Store leftovers promptly. Use a meat thermometer to kill bacteria. Keep a thermometer in the refrigerator and freezer.  Keep food preparation surfaces clean.  Separate cooked and raw foods during preparation.  When in doubt, throw it out!

When we learn, plan and stay prepared, we can handle any emergency.  We can prevent illness and injuries to our seniors when we know what to do.

We encourage you to share your experiences with us so we can all stay prepared.

Seniors’ Simple Pleasures

We all have little things that bring us joy in our day to day lives.  What are yours?

Today I sat back and thought: “This is a great moment.”  I was sitting on a boat on a beautiful blue green lake with the wind in my hair and the warm sun on my face.  It was a perfect day.  The boat ride on the lake brought back many memories I have made during my life having special times with my family.  What a simple pleasure!

The dictionary defines a pleasure as a feeling of happiness, enjoyment, or satisfaction.  Whatever happening brings you joy whether it is large or small or involves someone else, is a pleasure to be appreciated!

Another simple pleasure I am experiencing at this time is a sweet and luscious summer peach that drips juice down my chin when I take a bite.  How simple but wonderful!

This simple pleasure many of you have experienced I am sure.  The big grin lighting up the face of a grandchild when they see grandma!  Let’s not forget the ear to ear smile on grandma’s face when she sees her grandchild running straight into her arms.

How about sitting on your front porch watching the birds flit from tree to tree as you sip on a cold glass of iced tea?

How about watching your favorite baseball team on a lazy Saturday afternoon?

How about reading the comics on Sunday morning and enjoying yet another adventure of your favorite character?  What is Snoopy up to or Garfield on this sunny Sunday?

How about the taste of a warm chocolate chip cookie as it comes out of the oven?

How about the smell of fresh clean sheets as you lay in bed for the night?

We hope you take a moment to enjoy life’s simple pleasures especially if you are a caregiver.

What is your simple pleasure?  We would love to hear your favorites!

Clinical Trials & Our Senior Loved Ones

We report about studies every day that have found new information about a disease.  Things we often hear about in the news from recent studies are new drugs to treat a chronic condition, a new gene that will unlock a cure, how siblings are affected by a particular condition, how a mother’s nutrition can affect the potential of developing a particular disease, how what we eat can improve our health and a multitude of other important findings.

Research requires in depth study in the field of science, medicine, nutrition and behavior to name a few.  Oftentimes, studying in a lab using animals or plants will tell scientists more about an disease but sometimes more investigation is needed to uncover the answers we all seek.

Clinical trials use human volunteers to investigate certain diseases in order to learn from the research findings.  These trials will help decide if particular drugs or treatments can be beneficial for everyone afflicted by the particular disease being studied.  Many studies are looking for participants and your senior or family members may be interested in furthering our knowledge of a disease that has plagued them personally over the years.  Participation is usually free and often a small stipend is provided to the participants.

Finding Clinical Trials

If you think your senior might be interested, here are some possible links that you might want to pursue.

1.  Informal/Family Caregivers of Veterans with Traumatic Brain Injury:  Please contact Dr. Karen Saban, Health Research Scientist, Edward Hines, Jr.  VA Hospital at 708/202-5264 or Karen.Saban@va.gov. Project examining stress and perceived health of female informal caregivers caring for a Veteran who has experienced a moderate or severe traumatic brain injury within the past six months to ten years

2.  Web-based Study: Promoting Alzheimer’s Caregivers Communicative Skillfulness (PACCS)

Please contact Amanda Gentry at 412-624-3798 or amg168@pitt.edu for more information.  This study will test whether a new educational program can help caregivers to communicate more effectively with their loved one’s doctors.

3. Dementia Caregiver Support Research Study:  Contact Kelley O’Connor, the research coordinator, at (401) 444-4528 or koconnor2@lifespan.org. This study is focused on the caregiver and the project will examine the impact of a telephone intervention on reducing the stress and burden associated with caring for a person with dementia.

4. Alzheimer’s Disease Genetics Study:  Contact: Study Coordinator at 1-800-526-2839 or alzstudy@iupui.edu The purpose of the Alzheimer’s Disease Genetics Study is to help identify the genes that may be responsible for causing Alzheimer’s Disease (AD) by collecting genetic material from families with multiple members diagnosed with AD.

5. Assessment of Sleep Disturbance in Alzheimer Disease: Contact: Philippe Robert  robert.ph@chu-nice.fr or Contact: Renaud David  renaud.d@chu-nice.fr This study takes place in France. The purpose is to determine a genetic relationship between sleep disturbance and Alzheimer’s disease.

6. Screening for Memory Studies: Contact: J Wesson Ashford, MD, PhD (650) 493-5000, ashford@stanford.edu The purpose of this protocol is to advertise, recruit, and do a preliminary screen for various clinical trials. Information collected will be entered in a database available to researchers connected with the Stanford/VA Aging Clinical Research Center, located at VA Palo Alto Health Care System, Palo Alto Division.

7.  Study to Identify Clinical, Imaging and Biologic Markers of Parkinson Disease Progression (PPMI): Michael J Fox Foundation, Institute for Neurodegenerative Disorders Kenneth Marek/Coordinating Investigator. 21 study locations with contact info, 15 in US. (http://clinicaltrials.gov/ct2/show/study/NCT01141023?term=parkinsons&rank=16&show_locs=Y#locn). The primary objective of this study is to identify clinical, imaging and biologic markers of PD progression for use in clinical trials of disease-modifying therapies.

These are just a few examples of what types of trials on happening.  If your senior or family members find this interesting,  You can search for trials based on location, disease process and interventions.

If you have any questions about the appropriateness of a trial for your senior, be sure to check with their doctor.

We would love to hear experiences if your senior or family have been trial participants in the past.

Planning Seniors’ Transition from Home to a Senior Living Facility

While most American seniors and future seniors want to live out their lives in their own home (often referred to as “aging in place”), the simple truth is that many will have a need for a greater level of care, such as may be found at an assisted living facility or nursing home.

Many families find this to be one of their most difficult discussions and decisions, but something they need to face. In this episode, we discuss some topics that may help family members and other caregivers to make the transition from a senior’s home to a senior living facility go more smoothly.

Some of the topics we cover include:

  • Warning signs that your senior loved one may need more help and no longer be able to live comfortably and safely at home alone
  • How to determine what type of facility is the most appropriate to be the next home for your senior
  • Choosing the right facility for your senior’s home based on needs and financial situation
  • Making the transition as comfortable as possible for your loved one

We will cover these topics more in depth in future posts and shows, but really want to provide an overview for those for whom the time is now to make a transition or who have concerns or questions whether their senior loved one can still be safe and comfortable at home alone.

We’d love to hear your questions or comments.  Please leave them below or through the Contact page on the website.

Links to some items mentioned in the episode:

Thank you for stopping by & hope to see you again soon!  Remember that you can also follow our podcasts by signing up for our updates, by clicking on the RSS feed above or through iTunes.

Special Thank You to Dad & Grandfather

I owe great thanks to my dad and grandfather for the gift of … baseball.  Now before you roll your eyes please hear me out.  Baseball is something I shared with them, that I share with my family and that I know our daughter and son will share with their children.  For us, as in A Field of Dreamsthe one constant through all the years … has been baseball.”

It all started, fittingly enough, with a visit to one of the cathedrals of baseball, Boston’s Fenway Park.  My father and grandfather took me to see my first game and, as magic would have it, I left with a foul ball.  When you’re a kid it doesn’t matter that it was given to you by the person in front of you who actually caught it – it’s a major league baseball!  And thus the gift was first unwrapped.

Through my youth I saw a number of games with them, be it in the stadiums of my grandfather’s beloved New York teams or minor league and spring training games with my dad, since we didn’t live in major league towns.  I didn’t matter, I was hooked.

When it came time for ME to play baseball, my dad neither pushed nor held me back.  He simply supported me and was there.  I think often of the times that my dad would hit me fly balls in the street after dinner until it got dark.  It didn’t seem to matter that I primarily played catcher so that skill was not key to my playing, it was just something special we enjoyed together.

When I got married, one of the first things my wife and I got for our first apartment was cable TV, not nearly as big then, because we had moved away from home and wanted to keep up with OUR team, the Braves.  Summer nights watching the Superstation made us forget we didn’t have money for other entertainment (thanks, Ted Turner!).

Once we had our own family, baseball became a family activity.  My weekly softball games were a family outing.  Once our community got its own team, some of our best family time was spent with season tickets at the ballpark.  Cheap seats maybe, but the important thing was being there for the games.

When my son decided he wanted to play baseball, I was pleased and proud that he wanted me there with him as a coach.  Thus started a many-season chapter in our family book of baseball, him playing, me coaching, my wife often coming out of the bleachers to be team mom and our daughter keeping score.  Our teams were seldom the best but my focus was on making sure each player learned and enjoyed baseball.

I am pleased that during these years we moved back near my grandparents and that some of the last times we had with my grandfather were at some of our games.  I know he enjoyed both seeing his grandson coach and his great-grandson play, almost as much as we all enjoyed having him there to share it with us.

The fact that our kids are no longer kids hasn’t impacted this gift we share.  Recently the family, now increased by one son-in-law, came together to go see our Braves play.  While sitting there taking in my family as they enjoyed the game, I could not help but think back to that first game in Fenway Park, certain my grandfather was looking down and thinking the same thing.

You might wonder why I have a (years old) picture of myself with my son here when I am writing about my father and grandfather.  I feel the greatest “thank you” I can give them is in the dad I became and my passing along of the gift they gave to me.

Happy Fathers Day!

Caregiver’s Inspiration

Inspiration –  defined by Merriam Webster as the action or power of moving the intellect or emotions.

We all need a little inspiration especially those who are working day in and day out to care for a loved one.  Many days seem so difficult when our names are forgotten, when we get yelled at for trying to help, when we are exhausted from the workload, when we don’t get the help from our family that we think we should and when we feel like all our effort is unappreciated.

The following poem was written by Audrey Hepburn and read aloud at her funeral.

For attractive lips, speak words of kindness. For lovely eyes, seek out the good in people.

For a slim figure, share your food with the hungry. For beautiful hair, let a child run his/her fingers through it once a day.

For poise, walk with the knowledge that you never walk alone.

People, even more than things, have to be restored, renewed, revived, reclaimed, and redeemed; never throw out anyone.

Remember, if you ever need a helping hand, you will find one at the end of each of your arms.

As you grow older, you will discover that you have two hands; one for helping yourself, and the other for helping others.

We thank you for your dedication and love.  Your care is appreciated by your loved one even when they can’t express it as well as those in whose stead you are providing that care!

 

Accountable Care Organizations and Seniors

If you are like us, you are hearing more and more lately in the news and on the web about Accountable Care Organizations or ACOs.

In a nutshell, an Accountable Care Organization is a system or model of payment that encourages all healthcare organizations to get better at providing care and being efficient.  The better they perform, the more reimbursement they will receive under the Medicare Shared Savings Program.  ACOs have been introduced as part of the recent health reform law to help reduce the burden on the federal budget currently spent on healthcare.  It is a shift in reimbursement for healthcare providers using performance based guidelines.

According to the Centers for Medicare and Medicaid Services (CMS), an ACO is “an organization of health care providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it.”

What improvements are Accountable Care Organizations targeting?

Healthcare organizations will be judged on many fronts including customer satisfaction scores, readmission rates to the hospital, quality outcomes and lower costs.  Currently as many as one in five Medicare patients who have been hospitalized are readmitted within 30 days.  This need for more care often resulted from treatment that could be improved or coordinated more effectively.

These areas are being monitored by healthcare organizations using specific tracking criteria and tools with the results compared to other healthcare providers to determine who is achieving the desired results and who is not.

What will happen to the organizations that perform poorly?

These organizations will be at risk of losing funding from Medicare which accounts for a large percentage of revenue especially as the population continues to age.  Currently more than half of the nation’s seniors have five or more chronic diseases requiring visits to these facilities.  Most have more than one doctor which can often lead to duplication in services costing the system money.  In the future, it could affect reimbursement from third party payers such as insurance companies who generally follow the lead of the government.

What affect will ACOs have on the healthcare industry?

Groups of healthcare providers will work together to manage and coordinate care for specific populations to be more cost effective and efficient when providing care.  They will focus on specific types of care to a targeted group where they are better able to provide good care in a cost effective way.  The providers will be held responsible for the outcomes of the care they deliver receiving ultimate rewards/reimbursement for excellent service to those who are judged to be leaders in the industry.  They need to provide the highest care at the lowest cost through collaboration during transitions using best practices, technology investment, monitoring quality outcomes and focusing on community based services. Hospitals will not be reimbursed for re-admissions resulting from poor quality treatment that would result in needing more care.  On the other hand, top performers will be reimbursed for services they do provide.  Providers will have to accept more risk for the quality of care they provide-delivering good care will be rewarded and delivering inferior and inefficient care will not be rewarded.

How will this new model affect seniors?

The goal will be increased accountability for healthcare service providers across the continuum of care for optimum outcomes.  This means that our seniors should be receiving improved care, coordinated and managed in a more efficient way than in the past. Hopefully it will result in a decreased burden on the federal government when healthcare organizations are more efficient.

There are still many unanswered questions about ACOs such as how the model will be put in place, how Medicare beneficiaries will be handled and assigned an ACO, who will collate and analyze the data required to decide which organizations are performing well and other rules governing its structure.

We will continue to follow the new reform law and how upcoming changes will affect our seniors so that you can keep up to date on the latest developments along with us.

Seniors at Risk in Power Outages as They Age in Place

Does your senior rely on a home medical device powered by energy?

A medical device is equipment used to cure, treat or prevent a disease.  It is often used in the home by a person who has been trained to use it such as a healthcare provider, caregiver or the person using the equipment themselves.  These devices need to function properly for safety and effectiveness.

What will happen to your senior who uses a medical device if the power goes out during a storm or other event?  You should have a plan in place to handle any breaks in power service whether for just a short time or for a longer than expected time.

As soon as an essential medical device is put in service in the home, the local electric utility (and sometimes other authorities) should be notified of its existence and need.  This will put your loved one on a list for immediate attention during a power outage.

Preparing a document for each medical device and creating a book kept on hand for easy access will help you, your senior or any other person who comes to your senior’s aid during an emergency.

What to Put in Your Senior’s Book

Your senior’s book should include:

  1. The phone number of all utility companies including power, gas and water.  Also include emergency numbers such as the fire department, police, healthcare provider and the company that services your senior’s medical devices.  Quick access to these phone numbers is invaluable.  Don’t forget to keep your name and phone number in this book in case it is needed by a responder.
  2. The name, model # and instructions for using the medical device.
  3. A list of your senior’s medication and pharmacy contact.
  4. Your senior’s insurance card and any other important paperwork such as your senior’s power of attorney and advance directives.
  5. A list of information specific about each device such as will it run without power, does it have a battery backup, how long the battery is expected to last, how many batteries does it use and can a lay person replace them, where the replacement batteries can be found, what will happen during a power surge to the equipment, how is it restarted, can the device operate on an alternate power source, can your senior be off the equipment for a period of time and how long would that be.
  6. Information about the treatment the device provides:  What needs to be done if the power is lost in the middle of a treatment? When the power returns, is the treatment started again or finished for that time?
  7. Location where medical supplies are kept.  Is there enough for at least three days?
  8. Does the device or supplies need to be kept at a certain temperature, will it need a cooler and ice to function properly?
  9. Instructions for how the device should be cleaned and where the supplies to clean it are stored.
  10. Where are flashlights and batteries stored?
  11. Instructions on the safe use of supplies: don’t use if package is torn, wet or contaminated, if it is too hot/cold, or if pieces are broken or missing.
  12. Instructions for settings of medical device.

If your senior has to relocate during a storm or power outage, be sure he takes his equipment, any supplies needed, batteries and this book of information wherever he goes.

Being prepared for an emergency will help you and your senior weather the storm.

We look forward to hearing your ideas for care of all medical devices so we can share with others.

Communications = Piece of Mind & Safety

What’s your plan for assuring your senior loved one is safe after a tornado, hurricane or other severe weather event?  Storms have carried tragedy to many areas of the US this Spring and along with it helplessness for those cut off by the storm and worry for distant loved ones.  Those issues were particularly strong for seniors living at home and their distant family members during the recent weather outbreaks.

With June bringing in another hurricane season and an early arrival of Summer heat, while we likely have not left Spring’s storms behind us, we want to discuss a step that could help with some of those issues.  We can’t stop the storms, of course, but we can alleviate some of the helplessness and needless worry afterward.  The key is a communications plan, something that also provides benefits year round.

Plan in Advance

Seniors and family members should work out in advance means and timing of communicating, such as “at 5:00 pm each afternoon Mom calls (or emails) child X” to chat about the day and, of course, provide assurance that all is well.  The plan includes progressive steps to be taken if Mom does not call, such as phoning a neighbor advancing up to calling the local authorities to check in.  That provides peace of mind for the family and a safety net should something happen and Mom not be able to call, assuring she won’t be alone for days in case of illness, fall or tragedy.

The plan should also include special calls after an event like a tornado, in which case the child called by Mom would notify the rest of the family that all is (hopefully) well or let them know that further steps are needed to address Mom’s needs.

This plan will not work, of course, when lines of communications are down such as after a severe storm.  For those situations, designated family members should have a roster of phone numbers, email addresses and websites of community agencies and government offices (such as first responders and the Red Cross) to contact for more information about those affected by the storm.   This also allows for key information about your senior, such as specific medical needs, to be communicated by you for help in prioritizing searches and assuring rescuers have appropriate equipment or medication available.  Know where your senior would take shelter in a storm and how to contact her or the staff at the designated shelter.

Include a Backup Plan

You should pick a means of communications that works for both you and your senior loved one and also a back up.  For example, you may choose to use email or one of the technologies we discussed in our podcast episode on Senior Home Technology for regular day to day communication but should also have a backup plan to use a land line or cell phone should internet service and/or power be knocked out.

Remember, the keys here are two: (1) making sure your senior loved one gets help if needed and (2) to reassure loved ones that someone will help when it’s needed and family members when help is NOT needed.

Do you have a plan in place for your family?  If so, we would love to have you share it with our readers!