Falls: Prevention and What to Ask Your Older Loved One

January 25, 2024Aging in Place, Aging Life Care Professionals, Aging Parents, Aging Well, Anne Sansevero, Healthaging, Aging in Place, aging life care, Aging Life Care Experts, caregiving, Falls Prevention, family, safety Bonnie Leko-Shapiro

Falls are the leading cause of fatal injury and the most common cause of nonfatal, trauma-related hospital admissions among older adults. For many elders who have a fall, this is often the beginning of a deleterious cascade of ill health that will lead to trauma, hospitalization, decreased mobility, depression, and in some cases, even death. The sad thing about these statistics is that, for many seniors, falls are largely preventable. It all starts with an honest and caring conversation with a senior to talk about the issue of balancing safety with autonomy. If you have a family member or close friend who has fallen or is at risk of falling, share your concern and take a quick fall history.

Some of the questions you should ask include:

Have you had a fall in the past year?
If so, where and how?
If so, how many and were you hurt?
Do you feel unsteady when standing or walking?
Do you worry about falling?
Do you feel dizzy/lightheaded when you change position?
Do any of your medications make you feel dizzy/lightheaded on a consistent basis?

Risk factors for falls include chronic medical conditions such as arthritis, spinal disease, Parkinson’s disease, stroke, multiple sclerosis, neuropathy, and diabetes. Seniors with cognitive impairment are also at greater risk for falls because of impulsivity and poor judgment. Visual impairment is also important to consider, along with the side effects of medications and environmental factors.

Not to be ignored is the actual fear of falling. This can stop a senior from participating in activities and exercise, which can, in turn, lead to weak legs and further increase the risk for falls. It also contributes to social isolation and depression.

Based on the falls history and risk factors identified, some tips to reduce falls include:

A thorough review of medications with a healthcare provider to ensure that none of these are contributing to gait unsteadiness
Having vision evaluated
Exercise safely and regularly to improve your balance and strength
If appropriate, get a referral from a healthcare provider to a physical therapy program
Consider a home safety assessment by a qualified professional such as an occupational therapist or Aging Life Care Professional to help identify ways to make your home safer

Community resources include local workshops in community senior centers, online downloadable resources or in-person seminars from physical and occupational therapy groups, community exercise classes, and social groups.

This is an excerpt from Home Safety Tips for Seniors: A Comprehensive Guide to General Safety Measures on porch.com.

About the Author: Anne Sansevero, RN, AGNP, MA, CCM, Founder and CEO of HealthSense, LLC, an Aging Life Care management consulting practice, has a master’s and is a prepared geriatric nurse practitioner and a seasoned nursing professional with over 30 years of experience in the field. She has particular expertise with communication disorders relating to stroke and dementia and has developed a number of innovative nursing assessment tools and standards to improve the nursing care for frail elders. Anne was President of the Aging Life Care Association® (ALCA) in 2023 and is Fellow of the Aging Life Care Leadership Academy. She is also a President for the New York Chapter of ALCA.

Preparing for Winter Weather with Older Loved Ones

January 9, 2024Aging in Place, Aging Parents, Care Managers, Care Recipients, Caregiving, Disaster Planning, Family Members, Healthaging, aging parents, cold weather, cold weather safety, elder safety, emergency preparedness, older loved ones, winter storm, winter weather Bonnie Leko-Shapiro

Severe winter weather is descending across the United States, which greatly impacts the safety and well-being of the elderly, especially when the weather event is unexpected or comes fast. Here are some tips from the experts in aging well® to help your older loved one prep for winter weather.

Before a Storm

• Stay informed: Sign up for severe weather alerts through your local city/county/state resource
• Refill prescriptions and have an extra supply of other medical necessities on hand
• Buy extra food, including non-perishables, and bottled water (remember pet food and supplies too!)
• Keep vehicles filled with gas and have tires checked for safety
• Clear debris from downspouts and gutters
• Have trees inspected and remove any dead limbs
• Plan evacuation routes, including medical centers
• Identify an individual or company to shovel snow from driveways and stairs
• Clear outside furnace vents and check that carbon monoxide alarms are working
• Inspect outside plumbing, insulating any exposed pipes
• Know the locations of emergency warming stations in your city

Prepare for Power Outages

• If using oxygen, bi-pap, c-pap or other equipment, you will need a generator
• Purchase battery operated, plug-in lights that automatically turn on when the power goes out
• Make sure you have working flashlights within reach and extra batteries
• Keep cell phones charging so you have a full charge at power loss

Plan for Caregivers

If you rely on caregivers, consider the following:
• Arrange for a live-in caregiver for the duration of the weather event
• Build a relationship with neighbors who may be able to temporarily fill-in
• Plan a temporary or respite stay with a nursing home, assisted living community, or hospice

Safety

• Keep areas around space heaters clear
• Use space heaters with automatic shut-off
• Do not use gas stoves or ovens as a heating source
• Do not attempt to climb ladders
• Do not walk on frozen stairs, sidewalks, or driveways

For more winter weather tips and planning, visit the Winter Safety section of the National Weather Service.
With knowledge of local resources, An Aging Life Care Professional® can build an emergency weather plan for your aging loved one. Find one at aginglifecare.org.

Tips for Checking on Aging Loved Ones during Holidays

November 21, 2023Aging in Place, Aging Life Care Professionals, Aging Parents, Aging Well, Care Recipients, Family Members, Health, Mental Health, Uncategorizedcheck in, checking-in, holidays, signs Bonnie Leko-Shapiro

Whether you live down the block or across the country, holiday visits are a great opportunity to take a closer look at your aging loved one and their surroundings.

Take time to observe any changes in an aging family member’s behaviors or lifestyle during dinners, gift exchanges, parties, etc. Changes may vary widely – from outwardly visible to subtle shifts in habits. Here is a list of simple things to look for and questions to ask when spending time with aging adults to get a sense of their current physical and mental well-being:

ENVIRONMENT

Do you notice signs of damage or desrepair around or in the home? Piles of trash that haven’t been tossed out? Burned out light bulbs?
Any decline in cleanliness, especially in the kitchen and bathroom? Is there a large amount of unopened mail? Are items being stored in unusual or hazardous places?
Does their car have scratches or other damage?

FOOD

Is there adequate food? Check the refrigerator and pantry for expired or spoiled food items.
Do you notice they’ve lost weight, or suspect your loved one is skipping or forgetting meals?

MOOD OR BEHAVIOR

Has mom or dad stopped socializing and/or given up hobbies they once enjoyed?
Do they have any new friends or organizations who they have a lot of contact with? Is anyone or any organization asking for repeated or large donations or loans?
Are you noticing increased confusion? Do you notice your aging loved one repeating themselves more than they used to?
Are they showing increased irritability or apathy? Does he or shee seem more withdrawn or sad?

PERSONAL HYGIENE

Does your loved one seem more unkempt, not dressing during the day like they used to, not showering – or wearing dirty clothes when they do get dresssed?
Do they have bruises that may indicated they’ve taken falls?

Examining these four areas and answering these questions may help you detering if your aging loved one needs assisteance. This is not an exhaustive list and should be used as a guide to help you check-in.

By starting the conversation early and getting support and information, you can help your loved one as they navigate this stage of their lives. Observe, listen, and spend time together!

Aging Life Care Managers are an excellent resource for support. Working with families, an Aging Life Care Manager is a strategic planner offering options and solutions that best fit a person’s individual needs and resources. Their guidance leads families to the actions and decisions that ensure quality care and an optimal life for those they love, thus reducing worry, stress, and time away from work for family caregivers.

Keeping Older Adults Safe in the Heat

June 30, 2023Aging Well, Caregiving, Family Members, Health Bonnie Leko-Shapiro

Summer is in full swing in the Northern Hemisphere. Weather extremes are increasing, with hotter temps a concern for large swathes of the U.S. At the same time, the U.S. population is older than ever before and there are safety measures to keep in mind when we venture outdoors. It’s important to take precautions when taking aging adults out into the sun and heat.

Tips for Keeping Older Adults Safe in the Heat of Summer

by Elyse Weber-Sacks, MSW, LSW, CMC – Aging Life Care Professional®, ALCA Board Member

Older adults, and those with heart, lung, or kidney diseases, are more vulnerable to heat stroke. These seven safety tips will help you and your aging loved one beat the heat and stay healthy this summer:

Wear Sunscreen.

Whether you’re heading outside for half-hour or the whole day, proper sunscreen use is essential for skin health and blocking the sun’s rays. Use sunscreen with no less than 30 SPF and that protects from both UVA and UVB rays. And don’t forget the importance of reapplying every 80 minutes.

Wear sunglasses.

Especially if you’re driving on a sunny day, glare can obstruct vision. By the pool, ocean, river, or lake? Light can reflect into your eyes off the water. It’s a good idea to keep an extra pair of sunglasses in the car or in your bag.

Drink water.

Reusable water bottles are a great investment. Not only are they environmentally friendly, but most also do a great job at keeping water cool. Don’t leave the house without a supply of water and remember to drink frequently even if you’re not feeling thirsty. Try to avoid drinking caffeine or alcohol which can be dehydrating.

Dress appropriately.

Wear layers of breathable, lightweight fabrics – you want to keep your skin covered, but not overheat. Avoid bulky and synthetic fabrics. Wear a hat. If you are in an area that gets chilly when the sun sets, bring a light sweater.

Check the forecast.

Summer storms can sneak up on us, so check the chances ahead of time and be prepared for getting caught in the rain. Consider buying a small umbrella to keep in your car or purse.

Know the signs.

Be very aware of your physical symptoms. If you start to feel dizzy, exhausted, nauseous, excessively sweaty, or get out of breath…stop! Try to find a shaded spot, indoors if possible, and sit down. Drink and, if possible, splash cool water on your face, neck, and wrists. Rest and rehydrate until you feel steady again. Seek medical attention if you do not improve or lose consciousness. Watch your loved one for symptoms of heat stroke and take immediate action if needed. Heat stroke symptoms can include: fainting or loss of consciousness, dizziness, behavioral changes (confusion, irritability), flushed skin, and weak pulse.

Check-in on older loved ones.

Make sure they have enough to drink, aren’t exerting themselves, and have access to a comfortable environment. If they don’t have air conditioning, suggest they visit a friend who does, or that they go into a shopping center, library, or senior center to sit and cool off.

With these precautions in mind, we can all enjoy the great outdoors safely this summer!

About the author: Elyse Weber-Sacks, MSW, LSW, CMC is the president of Connie Rosenberg & Associates Care Management – celebrating 35 years seniors and the disabled. She is a licensed social worker in both New York and New Jersey. Elyse is certified as a Geriatric Care Manager by the National Academy of Certified Care Managers and is an Aging Life Care Professional®. She is a past president of the New Jersey Chapter of ALCA and was the 2016 recipient of the Outstanding Chapter member award. In January 2020, Elyse was elected to the Board of Directors of the Aging Life Care Association®.

Disclaimer: This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association® and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

The Aging Life Care Association® offering free info sessions for National Aging Life Care™ Month

May 19, 2023Aging in Place, Aging Life Care Professionals, Aging Parents, Care Recipients, Caregiving, Elder Orphans, Family Members, Retirement, Solo AgersAging Well, care managers, caregivers, Family Caregivers, solo agers Bonnie Leko-Shapiro

Aging Life Care Managers® offer a holistic, client-centered approach to caring for older adults, dependent adults, and others facing ongoing health challenges. Sometimes called geriatric care managers, Aging Life Care Managers are strategic planners with key knowledge in crisis intervention, housing, health and disability, advocacy, family legal needs, and financial and local resources.

The Challenge

With Americans living longer than ever before, many are overwhelmed by the aging journey. “Often, family caregivers feel the brunt of stress in having to take extra time off work or away from their own children,” says Anne Sansevero, President of ALCA. “Many do so enthusiastically, but without knowing the ins and outs of what their loved one needs or how to advocate for them, they become overwhelmed.”

These pressures, along with escalating costs of long-term or specialized care and the COVID-19 pandemic have increased demands on multi-generational family caregivers. There are also an increasing number of people opting to “age solo” (who never had children) or parents who live far from their children or next of kin. Our members provide options for people who need additional, objective support and guidance.

By working with an Aging Life Care Manager®, people can return to familial relationships in their elderhood. An adult child can remain the adult child, not the care coordinator or evaluator.

Free Info Sessions: Ask an Aging Life Care Manager

In May 2023, ALCA is piloting a new means of support for family caregivers or anyone expecting to be a “solo ager.” Every Friday in May, ALCA is hosting free, thirty-minute sessions where attendees can ask experts questions about aging and planning for care. Attendees must register for the events as space is very limited to allow for more personal attention. To learn more and register, visit aginglifecare.org (and look under the “Events” tab).

The hope is that these sessions help people see that Aging Life Care™ is more accessible than they realized. ALCA CEO Julie Wagner hopes these “Ask an Aging Life Care Manager” conversations will increase awareness of the Aging Life Care™ field, “Families and caregivers are facing more pressure and challenges. We want people to know that help is available.”

There will be two sessions every Friday, where attendees can speak directly with an Aging Life Care Manager® and get guidance for their situation. The sessions are free, in recognition of Aging Life Care™ Month.

HOSPICE AND PALLIATIVE CARE – UNDERSTANDING THE DIFFERENCE

February 27, 2023End of Life Care, hospice care, palliative care, Supportend of life, hospice, hospice care, palliative care, support Bonnie Leko-Shapiro

by Melissa L. Johnson, RN, BSN, MHA, CHPN, CCM – Aging Life Care Association® Member

Palliative care and hospice care are both specialized healthcare models that focus on palliation, or relief of symptoms, associated with serious, debilitating illnesses. Such symptoms may include pain, difficulty breathing, nausea, or the need for additional emotional support. Palliative care and hospice care focus on improving the patient’s quality of life.

Palliative care is a component of hospice care, but hospice care is not always part of palliative care. In other words, hospice care comprises of palliative care to treat symptoms while palliative care stands alone as a care model. Hospice and palliative care were once thought of as just the elderly, however about 20% of U.S. hopsical patients are under the age of 65 (American Hospice Foundation).

Palliative Care

Palliative care, while focusing on symptom management, also allows for aggressive treatment. For example, an individual with cancer may choose palliative care for relief of pain and nausea, as well as undergo chemotherapy and radiation. With palliative care, an individual has access to resources throughout the process and can make informed decisions about their care. This synergetic relationship between symptom management and aggressive treatment often yields better results than aggressive treatment alone. If aggressive treatment is no longer feasible or desired, the individual may opt for hospice care.

Hospice Care

Hospice is a model of care that focuses on the end-of-life when aggressive treatments are no longer indicated or desired. It focuses on palliation of symptoms to allow terminally ill individuals to fully live the rest of their life to the greatest extent possible. Hospice goes beyond a medical model, considering all aspects of the end-of-life experience: physical, emotional, psychosocial, and spiritual. A team of specially trained professionals collaborate with the patient and their family to address end-of-life issues and goals for care.

Does Hospice Speed Up the Dying Process?

It is a mistake to call hospice “giving up.” Research indicates that people receiving hospice care may live longer than those who do not receive it. A study published by the Journal of Pain and Symptom Management (March 2007) found that Medicare beneficiaries with either congestive heart failure or certain cancers lived 29 days longer on average than those who did not receive hospice services (NHPCO 2010). Another common misconception about hospice care is that terminally ill individuals are given medications, such as morphine, that hasten death. While medications like morphine are initiated, the dosage prescribed is at the lowest quantity needed to provide comfort. “Start low and go slow” is the motto hospices operate by when prescribing medications.

The Death Experience and Hospice Care

Death can be a beautiful and peaceful experience. I have many special memories of my time as a hospice nurse, but there is one that stands out: I was called to a patient’s house on Christmas night. It was pitch dark and I was in the middle of nowhere. There were many people standing outside the home as I approached. I walked into a small home with about 50 people inside – I was barely able to get to the patient! The patient was an elderly gentleman who was nearing the end. I talked to his wife about what had occurred that led to the call. As she explained the decline, family members argued in the background. Some thought the patient needed to go to the hospital while others stated that nothing more that could be done, and it was his wish to be comfortable.

I did my assessment and told the family that the patient was probably minutes from death. I am not sure what came over the family, but they all surrounded the patient’s bed and started to sing, “For He’s a Jolly Good Fellow.” The patient’s breathing became shallow and slow. As they sang the last line, “which nobody can deny,” the patient took a long, deep breath, let it out, and left this earth.

Immediately after, various wind chimes sounded. The wife stated, “He always loved wind chimes.” A death that I initially thought would be fraught became one of the most beautiful deaths I can recall. The family forever has that memory of their loved one’s death; one that was peaceful, calm, and brought them together.

Aging Life Care™ and End-of-Life Care

When facing a serious illness, Aging Life Care Managers® can help and support patients and their families throughout the journey. An Aging Life Care Manager provides assessment and monitoring, advocacy, education, resources, problem-solving, and support while you make difficult decisions. An Aging Life Care Manager is also a resource to the family, providing information, explanations, support, and communication. To find a professional in your area, visit aginglifecare.org.

About the author: Melissa Johnson has been an Aging Life Care Manager in Phoenix, Arizona since 2012. Melissa specializes in Dementia care and Hospice and Palliative Care. Melissa is the author of Embracing Dementia: Real-Life Experiences of Providing Optimal Dementia Care. She invites you to connect with her by visiting her blog or following Melissa on LinkedIn.

Helping Your Aging Loved One Manage Their Finances

December 5, 2022Aging Life Care Professionals, Aging Parents, Aging Well, Financialaging, aging life care, aging parents, Aging Well, financial Bonnie Leko-Shapiro

As our senior loved ones age, we may start seeing physical and mental signs of decline. While some signs are not worrisome, others may be more concerning: anxiety, depression, forgetfulness, and mishandling money. These could indicate more serious issues and are risky behaviors. So here are four things you can do to help your aging loved one manage their finances.

Four Ways to Help Your Aging Loved One Manage Finances

by Andrea Needham, Guest Columnist

1. Stepping Up to Help With Daily Tasks

As they age, your loved one may start having difficulty remembering important things such as taking their medications and getting refills on time. If you notice your loved one is no longer able to keep track of due dates for their bills or forgets to pick up their mail and leaves letters unopened, it is time for a conversation. Ask them if you can take charge of their finances in order to avoid overdraft fees, missed due dates, and other potential problems.

If you live far away or if you cannot visit regularly, consider hiring an Aging Life Care Manager® to check on your loved one, assess their needs, and recommend on-going services. Share a calendar with their care team to let them know about appointments, and make a readily-accessible list of phone numbers that include doctors, pharmacies, banking institutions, and emergency numbers.

2. Finding a Suitable Rental

Another consideration is your loved one’s living arrangement. A popular option is finding a new, accessible, rental home or apartment, which means less maintenance than owning a home. When scouting rentals, look in neighborhoods with the amenities they need. View online listings to find properties in their price range to locate the perfect place.

3. Getting Power of Attorney

Ask your senior loved one if they’re willing to grant you power of attorney, which will allow you to make medical and/or financial decisions for them when they’re no longer able to do so. A power of attorney is a flexible document that lets your loved one (the principal) specify what decisions can be made on their behalf by another person (the agent). The principal can amend or make changes to that document at any time, provided they are of sound mind.

Once you fill out the required forms and have them notarized, print extra copies for your records and put them in a safe place. Being legally prepared before your loved one becomes ill or incapacitated will give both of you peace of mind – taking the guesswork out of what should happen and knowing that your loved one’s wishes will be respected in the event they’re no longer able to clearly communicate.

4. Closing or Selling Your Loved One’s Business

When your loved one owns a business but can no longer manage it, it is time to close or sell it. There are many steps involved in dissolving an LLC or corporation, so consult with an accountant or attorney in order to avoid penalties. You will have to gather all documents pertaining to the company such as articles of incorporation and operating agreement and be able to provide a potential buyer with several years of tax returns, profit and loss statements, and client/vendor contracts, etc.

Get a professional business valuation in order to properly and objectively determine its value. A good business broker will help you come up with a number by analyzing the company’s management, capital structure, future earnings, and market value of its assets, and will facilitate and streamline the selling process.

It can be a difficult conversation, but it is important. Take time to discuss your loved one’s financial situation. Together, come up with a plan that will keep them financially secure. You’ll have greater peace of mind knowing that everything is in order.