Do a Google search on caregiver resources and you will return over 24,000,000 search results. How do you weed through those results to find the website that will address your specific issue, especially since your free time is limited?  To help you navigate the caregiver resources available at the federal level, the White House Conference on Aging has compiled a brand-new resource. In this one-stop Federal Resources for Caregivers guide, you can find links to agencies and online educational resources which will support your caregiving efforts.

Do you have a question regarding how to pay for hospice or community-based services?  There’s a link for that. Do you want to learn more about reducing the fall risk of your loved one? The STEADI Initiative offers educational materials that range from suggested exercises for your love one to a checklist you can use to reduce the fall risk in a home.

There are also resources to help you be a more effective caregiver, such as how to care for a person with Alzheimer’s disease and what you can do to maintain your health and well-being. Though you may feel solely responsible for caring for your aging parents, there are many resources and advocates who can help lessen your burden. All you have to do is ask.

Your mom is ready to speed into her golden years. But are her wheels ready?

Today’s cars make driving safer and more comfortable than ever before. But some features, like hooking up a Spotify account to the Bluetooth stereo, likely aren’t what mom needs. What features will please her Need for Speed? Follow the checklist below, with some help from our favorite Hollywood films!

A. Blind-spot detection

There’s always that one blind-spot in your car. Twisting and craning your neck to see is a good way to hurt yourself. Let your new car’s blind-spot detection system do the hard work. They use visual or audible warnings to let you know when there is a car hiding in the Vanishing Point. This means no more close calls and no more aching necks.

B. Lane departure warnings

Let’s face it—sometimes we get distracted and let our cars drift. Lane departure warnings mean these momentary lapses in attention don’t cause a Crash. Some will not only warn you but will nudge your car back on track.

C. Collision avoidance systems

If the car in front of you stops suddenly or a child runs out in front of your car, you’ve got to act fast. Collision avoidance systems make a crash less likely. They not only warn you of a sudden obstacle but can brake automatically. Collision avoidance systems help you avoid causing an accident and a Two Lane Backup.

D. Rear parking assist

Today’s cars even make parallel parking easy. Let your car do it for you. Pull up beside a space, press a button and let go of the wheel. It does all the work so you can get where you’re going with less fuss. Rear parking assist uses beeping proximity sensors to warn you before you get too close to other cars. The faster the beep, the closer you are. Pair this with a rearview camera so you can see exactly what is behind the car. These tools take the guesswork out of parking.

E. Doors at the right height

Avoid tall trucks and SUVs that you have to climb into. Remember, you’re looking for a Transporter to get from point A to point B. You’re going for a drive, not a workout. Be wary of cars with doors that swing too wide–they can make crowded parking lots a dangerous proposition. Instead, choose a car with doors that are easy to open at a height that suits you.

F. Adjustable seats

Driving isn’t fun when the seat makes your back hurt. Look for cars that let you drive Fast and Furious in comfort. You should be able to adjust the seat’s height, tilt and closeness to the steering wheel—bonus points for adjustable lumbar support. And look for heated seats – your back pain will be Gone in 60 Seconds.

G. Adjustable steering wheel

Make your car adjust to you, not vice versa. The steering wheel should be able to adjust upward for more room when getting in and then adjust down to the perfect height for driving. Look for thicker steering wheels that are easier to grip. If your hands tend to get stiff, a heated steering wheel will keep them from locking up.

H. Push-button starts and automatic trunks

Give your wrists a break on your Talladega Nights. Push-button ignitions are much easier than fussing with keys. If you are in and out of your trunk a lot, look for power-operated trunk hatches. Some open with a button press, or look for one you can both open and close by moving your foot under the rear bumper.

I. Simplified dashboard

Some cars cram too much information onto their dashboards. The Driver will want to see key info at a glance, but the rest is just a distraction. Look for large gauges with high-contrast numbering. Try out a digital speedometer—they can be easier to read than a traditional gauge. Avoid cars with touchscreen displays and complicated menus. You will want knobs and buttons for the radio and climate control that you can operate without taking your eyes off the road.

J. Smart headlights

Gone are the days when headlights just pointed straight as the cars were Driven. Check out cars with bulbs that swivel when you turn the wheel to better light up curves. If you use your high beams a lot, look for systems that dim so you don’t blind oncoming traffic. For regular use, high-intensity bulbs can make all the difference when driving in the dark.

Enjoy the ride

When the time comes to upgrade your car, you want to do it right.  These cars will support you as you age so you can stay independent for as long as possible. Soon you’ll have your very own Love Bug!

Shayne Fitz-Coy is the Co-CEO of Alert-1, an aging-in-place technology company headquartered in Williamsport, Pennsylvania. Shayne has a Bachelor’s degree in Psychology from Harvard College and an MBA from the Stanford Graduate School of Business. Although he loves to drive, he looks forward to the day when his car includes an “autopilot” option. 

When Bob and I moved to this senior community, we never made an announcement to our children that this was where we were going to die. Yet I think they, and we, knew that was the plan. Yes, this is the last stop for most of us here. Our children usually know it and are satisfied that we made the decision. Or in some cases they are pleased that they helped us, their parents, make the choice, particularly when they see us leading happy lives.

I have commented before about how hard it is to walk into our mailroom and find a photo of a resident and a rose in a vase announcing his or her death. The reality is that no one lives forever and the rational wish is for our friends and ourselves to die with the least amount of suffering possible. My husband’s death at the age of ninety was like that. Sepsis, a deadly bacterial infection, struck him and he died in three days. If he had survived this virulent infection, life would never have been the same for him. Knowing him as well as I did, his death was a blessing, though it certainly was a shock for our four children, their spouses, the grandkids and me. Someday this group will have to deal with my end too.

Learn more about my thoughts and observations about how to handle end-of-life issues in my latest post The Real Last Stop.

This post was written by Margery Fridstein, an author and retired psychotherapist who lives in a CCRC outside of Denver, CO. She is chronicling her experience in the monthly series, “The Last Stop With Margery Fridstein.”

One heart-breaking consequence of having a parent with Alzheimer’s or dementia is the resulting upheaval in the family dynamics. The resulting loss of memory and cognitive ability often means you have to step in and become a caregiver, Caring for a parent with Alzheimer'sassuming responsibility for making difficult medical and financial decisions. Though it may be natural to assume your parent doesn’t comprehend his/her situation or could contribute to the discussion, this isn’t the case. As The Alzheimer’s Voice: Person-Centered and Person-Directed Dementia Care Report, prepared for the Administration on Aging’s Administration for Community Living, suggests, people with Alzheimer’s are aware of their situation and do want a say. So how can families allow their loved one to exercise autonomy in the face of a disease that seems to rob them of it?

Adopt Person-Centered Approach

Person-centered care is a new shift in the healthcare field, whereby emphasis is placed on all aspects of a person’s well-being including emotional, spiritual and social, in addition to physical and medical (page 5). Researchers have proposed a number of definitions of what is person-centered dementia care, and at the heart of all these definitions is respecting the autonomy and personhood of the individual and striving to maintain their quality of life.

The report points out that “people do not surrender their right to autonomy simply because they have a diagnosis of AD [Alzheimer’s disease] and the disease exists along a continuum of capability. Especially in the early to moderate stages of AD, individuals are able to actively participate in the decision-making that affects their lives. And even people with severe dementia can make their preferences known on a variety of important everyday decisions” (23).

Changing Decision-making Process as Dementia Progresses (Hirschman, 2005)

Adopting a person-centered approach when caring for your parent doesn’t mean you shouldn’t step in and assume responsible for aspects of your parent’s life. Instead, it means you work together to find a solution that is respectful of their autonomy while keeping them safe. For example, when it comes time for you to assume responsibility of their finances, explain to your mother or father beforehand why it is necessary to manage to their finances and how can you work together to ensure they can still continue going shopping while having the bills be paid on time.

When visiting their physician for medical appointments, make sure the physician is addressing your mother or father, in addition to you, and is considering their opinion when providing recommendations. This will ensure your parent is being included in the decision-making process.

Benefits of a Person-Centered Approach

You want create the best quality of life possible for your parent as they live with Alzheimer’s disease, and adopting a person-centered approach has been found to yield positive benefits. “[W]hen individuals with dementia have greater involvement in daily decision-making, they have lower levels of depression and less negative relationship strain (Menne, Tucke, Whitlatch, & Feinberg, 2008). Depression is significantly correlated with quality of life, but cognitive impairment is not (Thorgrimsen et al., 2003)” (9).

Studies have also shown that starting the dialogue early of what your parent’s wishes are will leave you better prepared for assuming the caregiver role when it’s time; “[w]hen treatment goals and desires are supported by both caregivers and care recipients, caregivers gain a better understanding of the person’s wishes and therefore feel better prepared and less burdened with decision-making (Whitlatch, Judge, Zarit, & Femia, 2006)” (10).

Though you cannot prepare for all the challenges that will arise when caring for a parent with Alzheimer’s, understanding their wishes will also leave you better prepared as the disease progresses and you are solely responsible for all decisions.

Where can your turn when those conversations about how to care for your parents become difficult?  Who’s available to help you sort through all the options?  Is there a neutral third party who can listen objectively and make recommendations?  If you’re miles away, who can make a personal visit to assess your parents’ health?  The answer: geriatric care managers.

Who are Geriatric Care Managers?

Geriatric care managers are health and human services professionals with specialized knowledge of and experience in senior care.  Their backgrounds may include such fields as nursing, social work, gerontology and psychology.  They advocate for senior clients and support families; offering independent assessment of the situation and arranging for and coordinating appropriate services.  More often than not, family members struggle with emotions during this time; few are prepared for how these situations will affect them personally.  Geriatric care managers help families understand not only the situation and options, but also the feelings involved.

To learn more about how geriatric care managers can help lessen the stress of caring for your parents, visit SeniorHomes.com’s page Geriatric Care Managers Can Help.

In an earlier SeniorHomes.com blog post on vision loss, we discussed how this normal condition of aging can affect the health and well-being of older adults. Vision loss can increase the likelihood of seniors requiring assistance with activities of daily living and the risk of falls. Last week the Centers for Disease Control and Prevention (CDC) released Preventing Falls: A Guide to Implementing Effective Community-Based Fall Prevention Programs and the CDC Compendium of Effective Fall Interventions: What Works for Community-Dwelling Older Adults, 3rd Edition. The reason why these reports were solely dedicated to preventing falls is because “falls are the leading cause of fatal and nonfatal injuries among adults 65 and older and 10,000 people in the United States turn 65 every day”(Preventing Falls page 1) and the economic impact that result from medical costs is reported at being $34 billion annually(Compendium 1).

The Preventing Falls report provides guidance for community programs when developing and implementing a fall prevention program, while the compendium highlights research studies on fall-prevention measures among community-dwelling seniors. Though the intended audience of the compendium is clinicians, public health practitioners senior service providers, there is one study included in the report that is of value to caregivers and seniors.

How Glasses can Affect the Likelihood of Falls

The use of eyeglasses as one ages is often due to presbyopia, a common form of vision loss. Wearing either single lens or multifocal glasses is the usual prescription to compensate for the loss of vision. A recent study conducted by researchers in Sydney, Australia, Effect on falls on providing single lens distance vision glasses to multifocal glasses wearers: VISIBLE randomised controlled trial, sought to determine whether the use of single lens distance glasses reduced the number of falls in seniors who wore multifocal glasses. Each lens type has its advantages: a single lens is useful for distant and near vision, while multifocal lens (bifocal, trifocal or progressive lens) are useful in activities, such as driving or cooking, that require the eye to switch between focusing at different distances. However, studies have found that bifocals or progressive lens affect a senior’s distant depth perception and the ability to see contrasts; “in particular, wearers of multifocal glasses have high risk of falls when outside their homes and when walking up or down stairs.”

Study Design and Results

In this randomised study, 606 participants were separated into the intervention or control group. At the first visit, subjects in the intervention group were examined by an optometrist who prescribed single lens distance glasses that matched the prescription of their multifocal lenses. On the second visit, these subjects received their new single lens glasses and were shown how multifocal glasses can affect depth perception and noticing obstacles. The optometrist recommended use of the single lens glasses for most walking and standing activities, such as walking in the street, walking up and down stairs, or walking in unfamiliar surroundings. Control group subjects also received the same exam by the optometrist and received updated multifocal lenses if needed; however, they did not receive any advice on using their glasses.

Determining the effectiveness of single lens glasses upon falls, researchers measured the number of falls in the 13-month follow-up period; falls were defined as “unintentionally coming to the ground or some lower level and other than as a consequence of sustaining a violent blow, loss of consciousness, sudden onset of paralysis as in stroke or an epileptic seizure.” They also measured other outcomes such as physical activity levels and fear of falling.

The intervention group reported 461 total falls compared to 496 in the control group. Of the falls occurring outside, the control group reported 197 while intervention only had 192. Of the injurious falls, the intervention group reported only 11 less than the control group’s 235.

Of the participants who were less likely to leave their house, their number of outside falls increased significantly, though researchers “found no indication that falls occurred at the time of switching between multifocal and single lens distance glasses. The intervention did not influence the secondary outcome measures, indicating that the intervention did not increase physical activity or improve quality of life through fewer falls.”

However, for older adults who participated in regular outdoor activities, using single lens glasses was an effective method to prevent falls.

Study Recommendations

From these results the authors had several recommendations which caregivers or seniors can make note of:

  1. older people who have minimal correctable distance refractive error should avoid multifocal glasses
  2. older people with considerable correctable distance refractive error who take part in frequent outdoor activities should use single lens distance glasses when outdoors and in other unfamiliar settings
  3. older regular wearers of multifocal glasses with considerable correctable distance refractive error who take part in little outdoor activity should use multifocal glasses for most activities (rather than using multiple pairs of glasses)
  4. insufficient evidence exists to recommend one type of multifocal glasses over another

For seniors who are accustomed to using only one set of glasses for their outdoor activities, it might take a while to remember to switch to another pair when walking outside. But falls can have devastating consequences for older adults, often leading to hip fractures, hospitalizations, and a loss of mobility. So if it means seniors are less likely to suffer falls, switching to a different pair of eyeglasses before heading outdoors is a habit worth developing.

The Alzheimer’s Association recently released its 2015 Alzheimer’s Disease Facts and Figures report and while the report doesn’t offer promise of when a cure would be delivered, it does depict what families and friends face when caring for a loved one with Alzheimer’s or dementia. Most importantly, it also highlights what the United States is currently facing and will face in the coming years as more seniors are diagnosed with this disease. The report notes that “not only is Alzheimer’s disease responsible for the deaths of more and more Americans, the disease is also contributing to more and more cases of poor health and disability in the United States”(page 29).

Cases and Mortality

Though the estimated number of the adults 65 and older with Alzheimer’s disease in 2025 and 2050 did not change from the 2014 Alzheimer’s Disease Facts and Figures report, this is a small comfort as the numbers are expected to be 7.1 and 13.8 million, respectively, unless medical advances deliver a cure or prevention(22).

Courtesy of 2014 Alzheimer’s Disease Facts and Figures

2015 Estimated Alzheimer's Lifetime Risk

Courtesy of 2015 Alzheimer’s Disease Facts and Figures

Between the two reports, the estimated lifetime risk for Alzheimer’s, based upon the Framingham Study, saw mixed news: men saw their lifetime risk decrease across all age classes while women saw an increase at the age of 75 and older.

 

Estimates place California, Florida, New York, Texas and Pennsylvania as the top five states with the highest number of cases of Alzheimer’s among adults 65 and older. The states with the fewest cases of adults with this disease are Alaska, Wyoming, District of Columbia, Vermont, and North Dakota.

 

The deaths from Alzheimer’s disease have “increased significantly” the report found, with an increase of 71 percent between 2000 and 2013. The current total of annual mortality rate due to Alzheimer’s disease for 2013 is 27 deaths per 100,000 people(26).

2015 cause of death as a result of Alzheimer's

Courtesy of 2015 Alzheimer’s Disease Facts and Figures

A Picture of Caregiving

17.7 billion hours of unpaid care were provided to friends and family with Alzheimer’s disease and other dementias in 2013; this number increased to nearly 18 billion in 2014. Though it is expected that older adults require assistance with activities of daily living, which include dressing, bathing or getting in and out of bed, adults with Alzheimer’s or dementia require more assistance with these activities compared to other older people(33). Of the states with the highest hours of unpaid care—California, Texas, Florida, New York and Pennsylvania—were the top five.

And this caregiving takes an emotional and physical toll:  59 percent of caregivers reported high to very high emotional stress of caregiving but on the physical side, only 38 percent reported it as high to very high(38).

Costs of Alzheimer’s and dementia

$226 billion is the estimated costs of health care, long-term care and hospice in 2015 for people with Alzheimer’s disease or dementias. Of this cost, Medicare foots the bill for half of these costs, followed by out of pocket and Medicaid (45). The average per-person payments were highest for adults living in nursing homes or assisted living communities compared to living in the community (45). The report projects that the cost of care will increase to more than $1 trillion (in 2015 dollars) in 2050(56).

Are people being told of their diagnosis?

The 2015 Alzheimer’s Disease Facts and Figures report also included a special report on Disclosing a Diagnosis of Alzheimer’s Disease. Studies have found that fewer than 50 percent of adults are being told they have Alzheimer’s or dementia. This is in sharp contrast to other medical conditions that are disclosed at substantially higher rates: breast cancer (96 percent), prostate cancer (92 percent) and Parkinson’s disease (72 percent)(61). It was also found that health care providers are more likely to disclose the diagnosis to the caregiver.

Of the reasons for why the diagnosis is not shared—diagnostic uncertainty, time constraints and fear of causing emotional distress, patient or caregiver wishes and lack of disease-modifying treatment and stigma—are the common reasons. Fear of causing emotional distress is the most common reason cited for not disclosing the diagnosis. Yet studies reveal clear benefits of disclosing a diagnosis of Alzheimer’s or dementia both promptly and clearly, including better decision-making, planning for the future and understanding the changes they have been experiencing.

Given that the number of cases of Alzheimer’s disease will only increase in the coming years, more families will, unfortunately, find themselves dealing with this very situation and becoming a statistic. With an ongoing commitment to research and education, the hope is that better diagnostic and treatment options will one day make it possible to slow or even stop the disease process in its tracks, enabling patients to live longer, healthier lives without the devastating effects of Alzheimer’s disease.

Husband being assisted by wifeDo you know the difference between occupational and physical therapy? If not, then you’re not alone; many people do not understand how occupational therapy differs from physical therapy. The primary difference between an occupational therapist and a physical therapist is that an occupational therapist assesses the patient’s ability to perform his/her daily “occupations” or activities and the physical therapist focuses on improving mobility. When a physical therapist treats a person with a hip fracture, his goal may be for the patient to walk and use the stairs. An occupational therapist, on the other hand, may recommend bathtub grab bars and a raised toilet seat to increase safety and independence during self-care “occupations.”

Occupational therapy is a treatment that incorporates meaningful activity to promote participation in every day life. A therapist always begins with an evaluation to determine what difficulties a person might be having that interfere with independence. To learn more about how occupational therapy and its benefits when a loved one has Alzheimer’s or dementia, visit Occupational Therapy for the Elderly.

 

Quarters, dimes and nickels are coveted coins at Holiday Villa East, (HVE) my retirement community in the heart of Santa Monica, California. Having a readily supply of cash on hand goes a long way to enhance one’s quality of life while living in a retirement community.Joan's friends playing bingo

Two quarters buy admission to an enjoyable game of bingo, usually offered three times a week. Lucky players win up to $1.85 per session. I enjoy the social aspect of the game and benefit from the practice of careful listening to the called-out numbers. Bingo also provides eye/hand coordination, dexterity practice to mark the numbers and the emotional satisfaction of the win—even if it is only 35 cents for the round.

At HVE and most senior living communities, clean bed linens and towels are provided, and their cost is included in the monthly fee. For washable personal belongings, some residents prefer to do their own laundry. Others, like me, prefer to have their personal laundry taken care of by housekeeping. Several quarters and dimes cover a week of personal washing and drying in the facility’s laundry room.

Despite three inclusive meals a day available in my community’s dining room, residents have cravings for pizza, Chinese food, ethnic food, hamburgers and french fries. Consequently, delivery trucks frequent our building. Favorite snack foods, beverages and miscellaneous items, like stamps, are often purchased on outings. Having cash on hand to cover these purchases takes away the stress of urgently calling a family member or going to the bank.

Welcome Joan’s Journeyer’s. Before moving to HVE, I was unaware of the hidden costs of joining a retirement community. These costs may only require small amounts of cash as payment, but they are sizable over time, which makes them necessary to include in one’s budget. In the next Joan’s Journey I will blog about the unexpected costs I’ve encountered in the pursuit to enhance my quality of life. I’ll share a few stories of incidences where residents didn’t have cash on hand to even buy a needed box of cough drops. There are solutions, and we will explore them.

Do you keep cash at your residence for small, unexpected and unplanned expenses?  SeniorHomes.com and I invite you to share your preferences in the Comment Section. Until the next Joan’s Journey, enjoy the trip day by day.

Assisted living inspection records for SacramentoIn April SeniorHomes.com unveiled a new feature for San Antonio senior living communities:  inspection surveys that, when paired with a tour of the community, can give seniors and their families a complete picture of how a community operates and cares for its residents. Though summaries of these inspections are available through the Texas Department of Aging and Disability Services (DADS) website, consumers weren’t able to see what specific statutes a community failed to follow. Now consumers can see those statutes and whether a community is fixing a problem or allowing it to persist.

Building upon our goal of creating a one-stop place to review a community’s cost, amenities and inspection history without having to visit multiple websites, SeniorHomes.com is pleased to announce that inspection surveys are now available for Sacramento senior living communities. The data displayed for communities is a combination of summary available from the state and inspection reports we obtained as a public records request from the Department of Social Services. Currently the only way consumers can view these inspection reports is by visiting a regional office or asking the community.

At this time we are piloting this feature for senior living communities in Sacramento, and we want to hear your feedback as to whether including the inspection records are helpful in your search. To view the inspection records of a Sacramento community, visit our Sacramento Assisted Living page. Clicking on the “State Records” tab allows you to see all the licensed communities and where they rank in terms of deficiencies. To see the inspection history for a specific community, click on the “Communities” tab and click on “Get Info” for any community. On the community’s profile page, click on the “Records” tab to see how this community’s deficiency history ranks against others and its deficiencies.

Our goal is to post the inspection records for all licensed communities within California and eventually other states as well. Please let us know of improvements we can make in displaying the inspection records or if you want to know more information about a community, such as whether it has received fines. To learn more about how assisted living communities are licensed and inspected in California, visit SeniorHomes.com’s State Licensing Center.