Battle of the Ages

Battle of the Ages

Free resources help families overcome resistance of seniors who need help

Just when you thought that a family caregiver’s job couldn’t get more difficult, consider this: Many of the estimated 79,500 households caring for a senior in Jefferson and Shelby Counties are trying to help an aging relative who’d rather not have help.

A study of family caregivers who responded to a survey on caregiverstress.com revealed that more than half of the respondents (51 percent) said that their aging relative was very resistant to care. These seniors often object to help whether it’s from their own children or a professional who tries to come into their homes to assist.

“This is a real problem for family caregivers worried about the safety of a senior loved one who might be forgetting food on the stove or neglecting to take their medications,” said Dan Pahos, owner of the Home Instead Senior Care® office serving the Birmingham area.

But experts say that keeping fiercely independent seniors safe at home isn’t a lost cause; there are solutions for them and their family caregivers. That’s why the Home Instead Senior Care network is launching Caring for Your Parents: Education for the Family Caregiver.

The unique, educational program includes a number of resources that address senior resistance to care as well as a variety of other topics such as choosing an in-home care provider, the signs of aging, long distance caregiving and communicating with aging parents. The free materials and videos are available at www.caregiverstress.com.

Why do seniors resist help? “If seniors admit they need help, they feel their independence is in question,” said Pahos. “Seniors believe that once they acknowledge they need help, they’ll lose control of their affairs. They are trying to maintain dignity. Unless they feel they can trust someone, they resist change. I believe it’s the fear that life as they’ve known it will be taken away from them.”

Sometimes seniors only want help from a son or daughter, which can put undue pressure on that family caregiver who feels he or she can’t call for professional help. Most caregivers can go into “crisis mode” to rally around a loved one in the short-term, “but you can't be totally immersed in a crisis mode long-term without your own family, work and health suffering,” according to family caregiving consultant Dr. Amy D’Aprix, who holds a Ph.D. and master’s degree in social work and is author of From Surviving to Thriving: Transforming Your Caregiving Experience.

The strain can take a particular toll on working family caregivers. The Home Instead Senior Care study revealed that 42 percent of caregivers spend more than 30 hours a week caregiving. That’s the equivalent of a second full-time job.

And that’s what makes countering that resistance to assistance so important. “Many times family caregivers make assumptions but never ask: ‘Mom, I’ve noticed that every time I bring up having someone come in to assist, you don’t want help. Why is that?’ Sometimes the parent doesn’t realize they’re being resistant,” D’Aprix added.

“Also, reassuring a senior loved one that you have the same goal in mind will help,” D’Aprix said. “Start with: ‘My goal for you is to be independent, too. You know I can’t be here all the time. A little extra assistance will help you stay at home.’”

Pahos said the battle to turn resistance into assistance can be fierce, like seniors who call police when a professional caregiver shows up. “Education can help arm family caregivers with the tools they need to create a win-win for everyone.”

Tips to Help Caregivers Navigate the System

One out of every four persons – or more than 65 million people in the United States – serves as informal, unpaid caregivers, according to the National Alliance for Caregiving.

Providing assistance to another person who is ill, disabled or needs help with daily activities can be physically and emotionally draining. Blue Cross and Blue Shield of Georgia offers these tips to help caregivers navigate the system on behalf of their parents, grandparents and others:

• Gathering information: The first step is to gather as much information as possible about the loved one’s health and health benefits. While a loved one might be reluctant to share this information at first, experts recommend caregivers remain patient.
• Getting permission: While the Health Insurance Portability and Accountability Act protects patient privacy, it also can be an obstacle for caregivers. It’s critical caregivers file the proper paperwork with their loved one’s health benefits provider.
• Enrolling in a chronic disease program: Eight out of 10 Americans age 65 and older have some chronic illness. Those enrolled in a Medicare plan may have access to free programs to help them manage their diseases.
• Knowing your rights: Once the disclosure/authorization papers have been filed, caregivers can speak to a customer care agent on a beneficiary’s behalf and access information online.
• Investigating ‘extra help’: Extra help may be available to low-income people with a Medicare prescription drug plan through the Social Security office. Even if the senior doesn’t qualify for this extra help, other state and community resources may be available.
• Caring for yourself: The final and perhaps most important tip is for caregivers to take care of themselves. Get enough sleep, go for a walk, take an occasional day off, and maintain a sense of humor.

See full article here.

Do You Have a Senior Loved One in Need That is Resistant to Care?

A study of family caregivers conducted for the Home Instead Senior Care® network revealed that more than half of the respondents (51 percent) said that their aging relative was very resistant to care.

We are here to help. Over the next few months we will post videos available to you to help you with the following topics...
1) Aging Parent Care
2) How to Select an In-Home Provider
3) Patient-Doctor Communication
4) Senior Communication Issues

All videos are from www.caregiverstress.com and can be viewed at anytime.

Comments From Our Clients

Home Instead Senior Care demonstrates commitment to quality care through our proprietary PEAQ program, "Pursuing Excellence by Advancing Quality". Through an exclusive partnership with JD Power and Associates, CAREGivers and clients are routinely surveyed to ensure consistent delivery of high quality service. When a client rates us a 10/10 we get an alert congratulating us. Here are some of the comments that were attached to our 10 our of 10!

"THE CAREGIVER WE HAVE FROM THE AGENCY IS RELIABLE AND COMPASSIONATE. THEY TAKE INITIATIVE. THEY ARE EAGER TO PLEASE. THEY ARE VERY INTUITIVE."  - B.Smith

"THEY DID EVERYTHING THEY WERE SUPPOSED TO DO. THEY SHOWED UP ON TIME. BILLING WAS FINE. THE EXPERIENCE WAS GREAT." - B. Patton

"THE CAREGIVER IS VERY GOOD AT TAKING CARE OF MY HUSBAND. WE ARE VERY PLEASED WITH HER." - B. Stewart

"THEY WERE GOOD PEOPLE. THEY DID GOOD WORK."- R. Hairston

Handling Your Parents’ Social Security

Don’t show up at the local Social Security office with your eldery parent’s power of attorney form and expect to to talk about his or her Social Security check. Having a power of attorney for an elderly relative may help in handling some financial matters, but is useless when it comes to handing Social Security matters.

If presented with a power of attorney form, a Social Security worker must answer, “I’m sorry, that’s not a form we recognize.” Having power of attorney or having a joint bank account with the beneficiary gives no authority for managing Social Security and/or SSI benefits. In order to handle Social Security matters for an elderly person, one must take steps with the local Social Security office to become a “representative payee.” .

So, just what is a representative payee? As a representative payee someone else, for example, a friend or relative, accepts responsibility for managing Social Security funds for a person no longer able to handle his own finances. The Social Security Administration appoints the payee to receive those benefits for the current or forseeable needs of the elderly person. A representative payee must save benefits unused to meet current needs and must keep records of expenses. At the request of the Social Security Administration, a payee must provide an acounting of how the benefits have been used or saved.
How does someone become a representative payee? One must take steps with the local Social Security office. Becoming a representative payee requires a face-to-face interview with a Social Security representative for you. The process also requires a physician’s evaluation of your parent’s ability to manage his own benefits. If more than one person applies to be the representative payee, Social Security personnel will talk to third parties—often, family members–about who is best able to take care of the elderly person’s financial affairs.

There’s another option for those who can handle their own benefits, but for whom assistance from a caregiver would be helpful. Seniors wanting some assistance from a designated family member can give formal consent by speaking by phone with or making a visit to their local Social Security office. The beneficiary can also request that a consent form be mailed to him or can upload the form from the Social Security website.

For further information, check out the Social Security website http://www.socialsecurity.gov or call toll-free (800) 772-1213.

Sourced in part from “Programs Offer Tips for Caregivers” by Ellyn Couvillion, THE ADVOCATE, JULY 20, 2009

Home Instead Center for Successful Aging Celebrates Grand Opening

Home Instead Center for Successful Aging celebrates grand opening in July.

Monday, July 26 marked a shining moment for the Home Instead Senior Care network as 250 people gathered to celebrate the grand opening of the Home Instead Center for Successful Aging in Omaha.

Local, state and national figures lauded the principal donors, Paul and Lori Hogan, as well as the other benefactors and the University of Nebraska Medical Center for partnering to help seniors age better and live healthier lives. The center is the only geriatric center in the state that offers comprehensive care for older adults. Services include a geriatric medicine clinic, geriatric psychiatry clinic and clinical trials involving geriatric-specific disorders.

The center has more than local and regional distinction, however, said Sharon Brangman, president of the American Geriatrics Society, which represents more than 7,000 home-care professionals who care for older adults. Few centers in the country take such a comprehensive approach to geriatric care, said Dr. Brangman, chief of geriatric medicine at State University of New York Upstate Medical University.

“I really see this as a complete example of how we can provide care to older adults,” Dr. Brangman said. “It’s a model that could be disseminated to other parts of the country.”

Paul told the crowd that the center is part of Home Instead’s vision and the vision of UNMC’s Dr. Jane Potter to create better care for seniors and a more optimistic view of aging. “We simply want to be part of the solution to better aging.”

Dr. Potter, professor and chief of the section of geriatrics and gerontology at UNMC, thanked the Hogans and others for their contributions.

“Home Instead Senior Care knows the importance of not only paying attention to the physical needs of their clients but also their social, spiritual, intellectual and emotional health,” Dr. Potter said. “The Home Instead Center for Successful Aging hopes to work in partnership with Home Instead Senior Care and its network of 50,000 CAREGivers to learn how best to assist people to age successfully in their homes.”

Lori shared with the crowd how the network’s excitement extends to our international franchise partners and CAREGivers, who have expressed enthusiasm about being a part of studies that can help seniors age better. After she and Paul presented Dr. Potter with a bouquet of flowers, the audience stood and applauded.

The three-story, $10.2 million building was open to invited guests for self-guided tours, and a public open house is set for Saturday, July 31st. The center opens for business Sept. 13th.

New York Times Article About the Need for More Senior Medical Services

An article in the New York Times indicated that the population of U.S. seniors is expanding at such a rate that, “Before long, 90 percent of American nurses will have to provide care for older adults” — in part, because the country’s number of medical personnel trained to work with seniors is not keeping up with this growing need (In 2009, only 11 percent of research funding at the NIH went to support aging-related studies.)  This story is worth reading because it provides an interesting overview of important aging-related trends within the U.S. medical community, to include addressing preventable hospital readmissions of Medicare enrollees; the potential viability of the new “medical home” care-coordination concept; and the doubling by the National Health Service Corps of funding to repay student loans for “caregivers who work [with seniors] in rural and underserved urban neighborhoods.” 

See full article here.

Brookwood Medical Center Baby Boomers & Beyond Education Series

 The next program is tomorrow, August 4, 2010. Please click here for more information

It's HOT Outside...Check on Your Elderly Neighbors!

If you know someone who is home bound, elderly, and low income, please check on them today. 

Elderly suffer most in this type of heat from unconditioned homes and respiratory problems.
Need a resource try United Way 211 for general public or Positive Maturity if you have a senior in need. 

Elderly Women Susceptible to Heat Wave Deaths, Mostly From Respiratory Causes
Emma Hitt, PhD

 

July 16, 2010 — Researchers have defined heat wave intensity and have compared the effect of heat waves on European cities, showing a significant increase in total daily mortality with heat waves, especially in elderly women, mostly from respiratory causes.
Daniela D'Ippoliti, PhD, from the Regional Health Authority, Rome, Italy, and colleagues reported their findings online July 15 in Environmental Health.
"This study is the first in Europe to compare the impact of heat waves on mortality in different cities using a common heat wave definition and a standardized methodological approach," the researchers note.
The researchers investigated 9 European cities (Athens, Greece; Barcelona, Spain; Budapest, Hungary; London, United Kingdom; Milan, Italy; Munich, Germany; Paris, France; Rome, Italy; and Valencia, Spain) as part of the EuroHEAT project, which is evaluating the specific contribution of heat wave events to mortality, allowing for a comparison among cities. Both temperature and humidity levels during the day, as well as high nighttime temperatures, were considered when defining heat waves.
The researchers' definition of a heat wave was a period of at least 2 days when Tappmax, an interaction between maximum air temperature and humidity, was among the highest monthly 10%, or when the minimum temperature was among the highest 10%, with Tappmax above the average.
Heat waves of long duration had the greatest effect on mortality, resulting in a 1.5- to 3-fold higher daily mortality than for shorter heat waves. Duration of heat waves was defined in relation to the median length of time — heat waves lasting longer than the median were considered long duration, whereas those lasting fewer days than the median were classified as short duration. The elderly, especially women, appeared to be most at risk during heat waves, and the excess mortality was mostly from respiratory — not cardiovascular — causes.
In 2003, there was a heat wave across Europe, which was considered in a separate analysis. In the study period from 1990 to 2002 and 2004, a significant increase in total daily mortality was observed in all cities, with the greatest increase in Milan (+33.6%; 95% confidence interval, 28.5% - 39.0%) and the lowest in Munich (+7.6%; 90% confidence interval, 3.8% - 11.5%).
During the 2003 heat wave, all cities except Athens and Budapest showed an increased mortality, with the rate of mortality increasing by about more than 30% to roughly 100% compared with other years. "The greatest impact on mortality was observed in cities where heat wave episodes are rare events or were characterized by temperatures largely outside the usual meteorological conditions," the authors note.
According to the researchers, a greater effect of heat waves of longer duration and high intensity was observed in most cities, and the findings suggest that heat wave duration has a greater effect on mortality than intensity. The researchers also report that when stratified by sex and age, the greatest increase in mortality was "observed for respiratory diseases and among women aged 75-84 years."
One limitation of the trial, among others, was lack of investigation of lag time effect.
"Considering our results," Dr. D'Ippoliti and colleagues conclude, "prevention programs should specifically target the elderly, especially women, and those suffering from chronic respiratory disorders, in order to reduce in the future the burden of heat-related mortality."
The EuroHEAT Project was coordinated by the World Health Organization Regional Office for Europe and was cofunded by a grant from the European Commission. The study authors have disclosed no relevant financial relationships.
Environ Health. Published online July 15, 2010.

Barefoot seniors may be more prone to fall

Going barefoot in the home, or wearing slippers or socks with no shoes, may contribute to falls among the elderly, according to a new study from the Institute for Aging Research of Hebrew SeniorLife. Researchers found nearly 52 percent of the participants who reported a fall were either barefoot, wearing socks without shoes, or wearing slippers at the time of their fall. These people also reported more serious injuries, including fractures, sprains, dislocations, and pulled or torn muscles, ligaments or tendons, as a result of their fall. Study participants underwent a comprehensive baseline falls assessment, including a home visit and clinic examination. During the assessment, they were asked what type of shoe they usually wear. Options included athletic shoes (sneakers), flat-sole canvas shoes, oxfords or other tied shoes, loafers, sandals, pumps, slippers, socks or stockings only, or barefoot. Participants were followed for an average of 27.5 months and were asked to record each day whether they had fallen; those reporting falls were asked about the shoes they were wearing when they fell. Of those who reported falling, more than 18 percent were barefoot when they fell. Nearly 27 percent were wearing slippers and 7 percent were wearing socks only.  “On the basis of this and other studies,” says Dr. Marian T. Hannan, an associate professor of medicine at Harvard Medical School, “we suggest that advice about wearing shoes whenever possible be included in fall prevention programs. More research is needed on the design of acceptable and comfortable footwear that provides optimal safety for older people.”

Options for Seniors - A Forum

OPTIONS FOR SENIORS FORUM

VESTAVIA HILLS UNITED METHODIST CHURCH
2061 Kentucky Avenue
Vestavia Hills, AL 35216

AUGUST 24, 2010
3:00 PM – 4:30 PM

RECEIVE INFORMATION FROM PROFESSIONALS
IN THE AREAS LISTED BELOW

OPEN TO SENIOR ADULTS, ADULT CHILDREN, & PROFESSIONALS
1.8 CE for Nurses
1.5 CE for Social Workers
Princeton Baptist Medical Center Nursing Education Department is an approved provider of continuing nursing education by the Alabama Board of Nursing (Provider Number: ABNP1210, Expiration date: 08/01/2013)

RSVP to stepbre@aol.com

Hallucinations in Hospital are Risk to Elderly

Hallucinations while in the hospital are disproportionately affecting older people, often causing longer hospital stays and even leading to death.

Hospital delirium affects about one-third of patients over 70, and a greater percentage of intensive care or post-surgical patients, the American Geriatrics Society estimates. While the cause is unclear, there are many apparent triggers, according to an Ocala.com article. These include infections, surgery, pneumonia and procedures like catheter insertions, all of which can spur anxiety in frail, vulnerable patients. Some medications also seem associated with delirium.

While doctors once dismissed delirium as a “reversible transient phenomenon,” new research shows significant negative effects. Delirium can hinder recovery from patients’ initial conditions, extending hospital stays. It can delay scheduled procedures like surgery. Patients often are placed in nursing homes or rehabilitation centers, and older delirium patients are more likely to develop dementia later, the article notes.

“It’s terrible, more dangerous than a fall,” said Dr. Malaz A. Boustani, a professor at the Indiana University Center for Aging Research. He found that elderly patients experiencing delirium were hospitalized six days longer and placed in nursing homes 75 percent of the time. Nearly one-tenth died within a month. Experts say delirium can contribute to death by weakening patients or by leading to complications like pneumonia or blood clots.

Delirium triggers can include sleep interrupted for tests, isolation, changing rooms, being without eyeglasses or dentures, and some medications.

Some hospitals are developing delirium-prevention programs that adjust schedules, light and noise to help patients sleep, ensure that patients have their eyeglasses and hearing aids, and has them walk, exercise and do cognitive activities like word games.

See full article here

A Loved One with Alzheimer's

Submitted by Allison Youngblood, Operations Manager

I received a call yesterday from a client's daughter. There was sadness in her voice that brought a lump in my throat and tears in my eyes. The first words out of her mouth were “I need someone to help me. My mom…” and then the tears started. She explained that her mom was in the first stages of Alzheimer’s and would not eat her breakfast, is screaming at her and will not get off of the floor. I asked her a few more questions just so that I had all the information I needed to try and get her some help.

Her mom still lives at home but doesn’t think it is her home. She tried to hit the daughter the day before because she was so angry but couldn’t really explain why she was angry. I tried to speak to the mom to try and get her to get off the floor but all she could tell me was that she had a son that had been missing for two years. It turns out this son lives in Georgia and comes and visits all the time.

The daughter was at the end of her rope. She mentioned that her mom was at the first stage of Alzheimer’s. Based on our conversation I would say that her mom is at stage 5 – which according to the Alzheimer’s Association is:
Moderately severe cognitive decline
(Moderate or mid-stage Alzheimer's disease)
“ Major gaps in memory and deficits in cognitive function emerge. Some assistance with day-to-day activities becomes essential. At this stage, individuals may:
• Be unable during a medical interview to recall such important details as their current address, their telephone number or the name of the college or high school from which they graduated
• Become confused about where they are or about the date, day of the week or season
• Have trouble with less challenging mental arithmetic; for example, counting backward from 40 by 4s or from 20 by 2s
• Need help choosing proper clothing for the season or the occasion
• Usually retain substantial knowledge about themselves and know their own name and the names of their spouse or children
• Usually require no assistance with eating or using the toilet”

When you are the one living with someone who has Alzheimer’s, it is hard to recognize or even admit to a decline. Emotionally it is exhausting. And like our client’s daughter, you can’t do it alone.
Our CAREGivers are trained to work with Alzheimer’s clients. Our approach of encouragement and assistance helps family members cope with the challenges of dementia. Please contact us for more information or visit www.homeinstead.com/bham.

As far as our client goes we are working on creating a schedule to have a CAREGiver in the house a few days a week. This will give the daughter a break and allow her to come back refreshed so that she can care for her mom.

Seniors Not Combating Muscle Loss

Nearly nine in 10 people think feeling weaker is one of the worst parts of aging, but few Americans over the age of 45 are taking steps to prevent muscle loss, a new study finds. The survey, commissioned by Abbott and developed in conjunction with the AGS Foundation for Health in Aging, found that nearly 90 percent of Americans older than 45 are not making daily exercise and proper nutrition part of their daily routines to protect their muscles as they age. “Muscle loss is a serious issue that can lead to severe health and lifestyle consequences, yet building and maintaining muscle isn’t top of mind for most adults,” said Evelyn Granieri, M.D., M.P.H., MSEd., of Columbia University College of Physicians and Surgeons. “Especially with an aging baby boomer population, it’s important that people take charge of their health and take action now so that they can continue doing the things they enjoy in the future.” According to Medical News Today, clinical research shows that starting at age 40, a person can lose 8 percent of muscle per decade, which can lead to loss of strength, mobility and the freedom to enjoy life. Granieri said that talking to one’s doctor or dietitian is a great way to identify small steps to take to protect muscle health today for a more active future. You may view the whole press release here. Home Instead Senior Care CAREGivers are in a position to help clients protect against muscle loss by encouraging them to exercise and making sure they are eating nutritious meals. If your loved could use a little encouragement, please call us for a non-obligation assessment at 822-1915.

Ten Top Tips for Aging Well**

**From the American Geriatrics Society's Foundation for Health in Aging Website

Simply living longer isn't enough. What we really want is to live longer well, staying healthy enough to continue doing the things we love. While having good genes certainly helps, a growing body of research suggests that how well you age depends largely on you and what you do. Fortunately, research also finds that it's never too late to make changes that can help you live a longer and healthier life.

Here, from the American Geriatrics Society's Foundation for Health in Aging, are ten top tips for living longer and better:

Eat a rainbow You need fewer calories when you get older, so choose nutrient-rich foods like brightly colored fruits and vegetables. Eat a range of colors -- the more varied, the wider the range of nutrients you're likely to get. Shoot for two servings of salmon, sardines, brook trout or other fish rich in heart healthy omega-3 fatty acids a week. Limit red meat and whole-fat dairy products. And choose whole grains over the refined stuff.

Sidestep falls Walking as little as 30 minutes, three times a week can help you stay physically fit and mentally sharp, strengthen your bones, lift your spirits -- and lower your risk of falls. That's important because falls are a leading cause of fractures, other serious injuries, and death among older adults. Bicycling, dancing, and jogging are also good weight-bearing exercises that can help strengthen your bones. In addition to exercising, get plenty of bone-healthy calcium and vitamin D daily.

Toast with a smaller glass Drinking a moderate amount of alcohol may lower your risks of heart disease and some other illnesses. But what's "moderate" changes with age. It means just 1 drink per day for older men and ½ a drink daily for older women. (A "drink" is 1 oz of hard liquor, 6 oz of wine, or 12 oz of beer.) Since alcohol can interact with certain drugs, ask your healthcare professional whether any alcohol is safe for you.

Know the low-down on sleep in later life Contrary to popular belief, older people don't need less sleep than younger adults. Most need at least 7 or 8 hours of shut-eye a night. If you're getting that much and are still sleepy during the day, see your healthcare professional. You may have a sleep disorder called sleep apnea. People with sleep apnea stop breathing briefly, but repeatedly, while sleeping. Among other things, untreated sleep apnea can increase your risk of developing heart disease.

Flatten your (virtual) opponent, sharpen your mind Conquering your adversary in a complex computer game, joining a discussion club, learning a new language, and engaging in social give-and-take with other people can all help keep your brain sharp, studies suggest.

Enjoy safe sex Older adults are having sex more often and enjoying it more, research finds. Unfortunately, more older people are also being diagnosed with sexually transmitted diseases. To protect yourself, use a condom and a lubricant every time you have sex until you're in a monogamous relationship with someone whose sexual history you know.

Get a medications check When you visit your healthcare professional, bring either all of the prescription and over-the-counter medications, vitamins, herbs and supplements you take, or a complete list that notes the names of each, the doses you take, and how often you take them. Ask your healthcare provider to review everything you brought or put on your list. He or she should make sure they're safe for you to take, and that they don't interact in harmful ways. The older you are, and the more medicines you take, the more likely you are to experience medication side effects, even from drugs bought over-the-counter.

Speak up when you feel down or anxious Roughly 1 in 5 older adults suffers from depression or anxiety. Lingering sadness, tiredness, loss of appetite or pleasure from things you once enjoyed, difficultly sleeping, worry, irritability, and wanting to be alone much of the time can all be signs that you need help. Tell your healthcare professional right away. There are many good treatments for these problems.

Get your shots They're not just for kids! Must-have vaccines for seniors include those that protect against pneumonia, tetanus/diphtheria, shingles, and the flu, which kills thousands of older adults in the US every year.

Find the right healthcare professional and make the most of your visits See your healthcare professional regularly, answer his or her questions frankly, ask any questions you have, and follow his or her advice. If you have multiple, chronic health problems, your best bet may be to see a geriatrician - a physician with advanced training that prepares her to care for the most complex patients. The AGS' Foundation for Health in Aging can help you find one; visit www.healthinaging.org.