Wednesday, December 30, 2009

They Call it Home Sweet Home: But is it Safe for People with Memory Loss to Live Alone?

By Laurie White, MSW
Let’s be honest: few of us will want to leave our homes when we grow older, despite some possible safety issues. Our home is not just a house – it is a place that is full of memories and one that symbolizes our independence. The comfort and security that our home gives us is not measurable, yet it is something we all understand.

But when a relative shows signs of memory loss or is diagnosed with Alzheimer’s disease or another form of dementia, and her condition worsens, family members often have to determine if their relative is safe living alone at home. A person with dementia may not be aware of the safety and health issues that her living situation presents.

So, what is safe? The answer can vary from family to family and even among family members. Some of us will tolerate risky or uncertain situations longer than others. To help you make the determination if your relative is safe, click here for some questions for you and your family to think about:

Tuesday, December 29, 2009

Aging In Place

What Does Aging in Place Mean?
Aging in place is a relatively new term that describes a way of life that’s been around long before there were skilled nursing and assisted living homes. It refers to older seniors choosing to stay in their homes for the rest of their lives – or at least as long as possible. Until recently the option of aging in place was only feasible for the relatively healthy, who were able to live independently – or the very rich who could afford to pay for skilled nursing care in their home. Today, people are combining advanced technology, creativity, and determination to make aging in place a viable option, even for those with diminishing capabilities.

What Aging Place Is Not
You may hear the term “aging in place” used in marketing materials for Continuing Care Retirement Communities (CCRCs), but the general definition really doesn’t apply to CCRCs because seniors have to move initially from their home to the CCRC. Once they live there, they may need to move to different wings or campuses as their level of care needs increase, from independent living, to assisted living, and so on. While these communities can be a great option, they are different than the “Aging in Place” referred to here.

It’s a Beautiful Day in the Ol’ Neighborhood
Most older adults would like to stay in their homes for the rest of their lives. Homes and neighborhoods hold memories and help us feel at place in the world. It’s comforting for your parents to be able to look out their window and see the tree they planted years ago, or wave hello to Millie across the street. Moving is often disorienting, especially making several moves over a short period of time, which is often the case when physical or cognitive health begins to fade.

Naturally Occurring Retirement Communities, or NORCs are neighborhoods where most residents have stayed in their homes and are now seniors. Many have known each other since they were carpooling to Little League games and sharing babysitters. Now they share senior transportation services, yard and home maintenance help, meal delivery, and more. By banding together, they access services to aid those needing assistance, save money, and retain a high quality of life.

Home-Field Advantages
Seniors who choose to stay and adapt their homes to their changing needs can enjoy:

Maintaining a higher level of independence.
Living in comfortable, familiar surroundings.
Staying in their community, hanging out with their peeps.
Aging in place can also make sense financially. Of course, this greatly depends on individual circumstances. If your parents’ house is paid off or has a low mortgage payment, it may be less expensive for them to stay in their home and hire home aids and health care than to try to sell the house and move in to an assisted living facility. However, certain conditions, such as late stage Alzheimer’s or other dementia, or those needing 24 hour skilled nursing care, may be better served in a healthcare environment. Talk to a geriatric care manager and your financial consultant to determine what makes the most sense for your parents.

Customize with Ramps, Handrails, Pull-Down Closet Rods, Flashing Phones, and More!
Once you and your parents have decided on the aging in place option, you’ll need to carefully assess their home. Most houses need modifications or remodeling. The good news is there’s now a multitude of options – from simple gadgets to techno-wizard gizmos – that can make home even homier for an older senior.

For more information visit Independent Living.

Wednesday, December 23, 2009

When You Don't Live Close To An Aging Parent

What to Do When Your Loved One Needs Long Distance Care
Marian Cremin
The email from my father’s wife in Connecticut was short and direct. “I need help.” My father’s moderate dementia, confusion, and poor ambulation had gotten to the point that he could no longer stay alone. He was at risk of falling, was unable to prepare food for himself, and at times became disoriented.

For years I lived a train ride away from them in NYC. In 2000 I moved with their enthusiastic blessings to start a life with my husband in California. My siblings are settled with jobs and families in the mid- and southeastern US. My father’s wife is fit and healthy but housebound by his needs. She needed respite.

Scenarios like mine play out each and every day in thousands of American’s lives. How do you manage this situation without picking up and moving your family or your parent?

If this scenario sounds familiar, remote caregiving might be the answer. Fortunately, there are now many home care agencies which focus on remote caregiving and taking the burden off families and loved ones of those that need care. Nursing homes and assisted living facilities are not the only options available. Non-medical home care allows your loved ones to live where they want to be... their own home.

Click here for some questions to consider when determining if your loved one needs professional care.

Do you need to talk to an aging parent or grandparent about driving?

Safety is the Key
In 2003, an 86-year old man accidentally plowed his car into the Santa Monica Farmer's Market, killing 10 people and injuring 63. This tragedy ignited a national debate on the issues of senior driving.

Driving Skills Come Down to More Than a Number
There are no easy answers. Experts agree that a certain age doesn't determine driving capability, but physical and mental fitness does. A healthy, active 75-year-old might be a far better driver than a 50-year-old with diminished cognitive skills. Yet, there's no denying that older drivers as a group are medically at risk. Keep in mind, too, that cognitive and physical impairments can sneak up slowly and are often progressive. So while your parents might seem fine at the wheel today, it's important to assess their driving skills on a regular basis. A restricted license can help them make the transition, imposing limitations such as not driving at night, on freeways and/or during rush hour.

Seven signs to look for:
Anxiety when driving
Slow reaction time
Getting lost more frequently
Car damage
Frequent tickets
Reluctance to drive
Comments from friends or neighbors

When the Time Comes...
Most seniors are reluctant to give up the car keys, and who can blame them? In our culture, getting your driver's license is one of the first milestones to becoming an independent adult. Driving gives us certain freedoms. It's also associated with autonomy and control. While there are ways to make the transition to living without a driver's license easier and smoother, it's important not to minimize your parent's initial feelings of loss and possibly anger.

Lift Their Spirits by Giving Them a Lift

Arrange for you or other family members to take them to the store and on plenty of outings. Help them get familiar with public transportation and other options. Encourage them by showing them there are still lots of ways for them to get out and about.

For more information visit Common Concerns

Classic Hoarding

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Tuesday, December 22, 2009

Making the Holidays Count for You and Your Relative

Holidays are often a time for families to be together, for sharing and carrying on traditions that have long been a part of a family’s history. But for families affected by Alzheimer’s disease or other forms of dementia, holidays can be a time when a person with memory loss may not be able to participate as she (or he) once did in activities or conversations. The question then becomes “How can we best get through the holidays with minimal upset and frustration for all of us?”

Holidays can be a time of heightened activity, sounds, and get-togethers.By adjusting your expectations and doing some planning ahead of time, holidays can be an enjoyable time. Here are some suggestions for getting your family ready for and through the holiday season.

Recognize that holidays may not be the same as they have been in the past. Adjusting your expectations and schedule ahead of time may help you. Common feelings of loss, sadness, and anger at the disease may be heightened at this time of the year. Talk with other family members who are likely to be experiencing some of these same feelings and may have some suggestions of how to cope.

Give yourself permission to do only what you can manage. Ask other family members and friends to help you with decisions, celebrations and events. You may be surprised how willing others are to help you, but you have to accept help when help is offered, or ask for help when you need it.

Discuss with family and close friends how the holidays will be celebrated: What traditions will you observe? What traditions or events will you not do this year?

Help prepare visitors for their visit with your relative. Family members and friends, who have not seen your relative in a while, may be surprised at the changes your relative has experienced. Tell them what to expect, in either a letter email or a phone call.

“ While I am looking forward to your visit, I thought it might be helpful for you to know what to expect and how mom is doing before you arrive. Mom is having more problems remembering and recognizing people. Although she may not recognize you, I am confident she will appreciate your company and so will I. Please do not think it is strange when I introduce you, sometimes this helps mom be more relaxed. I have some old photos of our vacations at the cabin that I thought we would enjoy looking at together….. “

Think through where your relative is most comfortable celebrating the holiday: in her home or your home? Some people with memory loss are more relaxed being in their own home. Many families find that taking the holiday celebration to their relative is better than taking their relative to a holiday celebration. Too much noise and activity, and too many people can be hard for some people with memory loss to tolerate no matter where they are.

Try several celebrations rather than one large celebration. If your relative lives in a residential care home, find out when the holiday activities are scheduled and plan to visit during those times. Participate in the sing-a-long with other residents; bring a favorite holiday food, etc.

Consider celebrating with your relative before or after the holiday. Many families with a relative in the middle – late stages of Alzheimer’s disease, find that celebrating a holiday a few days before or after the actual holiday, may be more manageable for them and less stressful for their relative. Separate celebrations may be easier for everyone. A holiday is still a holiday wherever and whenever you celebrate it with your relative.

Maintain your relative’s routine as much as you can to avoid increased confusion. Schedule holiday activities around rest times and meal times as much as possible.

Be alert to signs of agitation, fatigue and increased confusion. Facial expressions such a furrowed brow or tense mouth, pacing, increased tapping fingers or slapping hands on table, and loud outbursts may indicate the person with memory loss may be overwhelmed or over stimulated and needs to get away from a noisy or crowded room.

Try altering traditions, not eliminating them. Most people with Alzheimer’s disease, or other types of memory disorders, can enjoy the spirit of the holidays, especially if this time of year was important to them in the past. Holiday baking, holiday cards, sing-along, gift wrapping, being with grand children, etc. can be adapted to your relative’s abilities, length of attention span or your relative’s best time of day.

Enjoy the moments when meaningful activities and conversations occur, even if they are not as long as you might wish.

Keep it simple. Keep in mind it is not how much you do, but the enjoyment your relative receives from doing things and being with family and friends, if even they are different from past holidays.

Laurie White MSW

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