Archive for the ‘Home Care’ Category

A Parallel Universe: Alongside Dementia/1

By Susan Lyons for The Little Old Lady Stays Put (or doesn’t) blog

Dementia, a terrifying term, is a condition which more and more of us are experiencing first hand as life expectancies increase. Susan Lyons is a longtime journalist whose life has been rocked by this scourge as her much loved husband’s developing cognitive decline permanently altered her daily routine, as well as her broader perspective. This column will afford her a venue to share her insights into caring for him — as well as for herself — during this difficult period of their lives.

Susan Lyons’s work has appeared in The New York Times and other northeastern newspapers. She was an award-winning senior reporter for The East Hampton (N.Y.) Star for 10 years before she and her husband moved to Charleston, S.C., where she continues to write and edit on a freelance basis as her personal life allows. LOL

The morning was mild on the Saturday after Thanksgiving and the sunshine beckoned me outdoors to refill the little vase on our dining room table where four-day-old blooms had tired. The vase was a gift years ago from a dear friend, and I think of her whenever I use it. It is the perfect size for the delicate purple lantana and periwinkle plumbago that still color my yard this time of year.  Having my pick of flowers in late autumn is one of the joys of living in the garden-infatuated city of Charleston, S.C., and part of what inspired me to move here with a new husband after more than 60 years as a northerner.

Richard and I met when he was somewhat farther along life’s path than I, but the 15 years between us seemed less important than the commonality we found as journalists eager to explore the world – and conquer the weekend crosswords. We each loved French food, American music, original thought, the stuff of nature and, in time, one another.

Today, the years between us matter more.

Today, Richard won’t notice that I have refilled the little vase, even though he will be at the dining room table most of the day reading and rereading a collection of newspapers. He still notices if I don’t, though, sensing something missing if flowers are gone from the table, or the mantle. Is that just a man-thing, I wonder, or another sign of the invisible, unpredictable, unwelcome condition that has grabbed hold of his mind, and our lives, for some five years now.

Every day I ask myself 100 questions like that: Is his reaction to this or that a guy-thing, a Richard-personality thing, a “normal” aging thing – or is it the dementia marching on?  The answer is pretty clear when packaged cookies turn up in the freezer. It’s clear when, in the space of five minutes, he asks three or four times, “Is it cold out today?”

Actual memory loss is only one effect of vascular dementia – medical-speak for the mini-strokes that clog his brain’s blood vessels. Undeniably, it is the fog of dementia when, out of the blue, the atmosphere bristles with tension over the smallest decision – when to leave for a movie, which herbs to add to a salad.  It is also the culprit that makes the television remote control too complicated, the automated phone message from a doctor’s office too confusing, the checkbook impossible to manage, and sometimes, the passage of time unfathomable.

And it is unremitting. This is a man, who for half a century filed stories on the most complicated political and scientific subjects for international wire services and national newspapers; today he cannot remember who is running for president.

Yet (at this stage of life, isn’t there always a “yet?”) there is still much to share. Last week we delighted, together, at three terrific movies at a local French film festival. A few evenings later, our public television station aired a Motown Sound look-back, and we rocked, together, in our living room. As he does frequently, Richard recalled an interview he had done as a young reporter for the Memphis (TN) Commercial Appeal with a “genuinely nice young man” named Elvis Presley, and, claiming bragging rights, spoke as though it had happened the day before yesterday.

On Thanksgiving, because it is increasingly difficult for him to manage visitors or socialize in a group, we agreed on a seafood dinner at a cheery local eatery and thoroughly enjoyed a hearty Bouillabaisse, chatting intermittently with the couple at the next table. A stress-free Turkey Day.

Stress. That is what this is often about, big time. Stress, above all except the sadness. For dementia in all its forms, most often as Alzheimer’s, carries an acute poignancy for those who care, and caregive, playing out, day after day, as something now known as the long goodbye.

This is just the first in the series of articles by Susan Lyons for The Little Old Lady Stays Put (or doesn’t) blog. You could read the rest and more wonderful posts by visiting Jacqueline Herships’ The Little Old Lady Stays Put (or doesn’t) blog Susan can be reached personally at [email protected]

Company Spotlight: Hearthside Home Care

When it comes to care for your loved one, you are hoping to find a caregiver who will treat your loved one with the respect and compassion that they deserve.  Many seniors desire to age in place and in-home care agencies are filling the need for companionship, non-medical and medical care in order to make that a reality.

It was an unmet need in Greensboro, NC that led the late Dr. Robert J. Glenn and Tina Glenn to begin Hearthside Home Care.  The Glenns worked to build a company that could meet the demand for non-medical homecare and companionship while allowing their clients to live as holistically, naturally, responsibly and independently as possible.

Since 1999, Hearthside Home Care has been providing non-medical, in-home care in North Carolina. The company offers flexible hours to meet the family caregivers’ needs and services are available around the clock.Hearthside Home Care

Hearthside provides a variety of medical and non-medical, in-home care services including:

  • Companionship and Personal Care
  • Alzheimer’s Care
  • Transitional Care
  • Chronic Disease Care
  • Respite Care

Hearthside’s comprehensive website includes a quick and easy Consumer Checklist designed to help caregivers make the best decisions when it comes to choosing a care provider, a decision that can be both overwhelming and scary. Hearthside makes it a little easier with three key questions you should consider when assessing agencies and caregivers. The company also explains why these questions are so important to the selection process.

Additionally, Hearthside’s blog offers tips and tricks for dealing with an aging and ailing loved one. The most recent series appearing on the Hearthside blog uncovers some of the risks associated with poor dental hygiene on overall health and examines the effects of radiation and chemotherapy on the mouth.

Hearthside is committed to providing customized care to its clients based upon their unique and individual needs and circumstances. And, according to one long-time client of Hearthside, the agency surpassed all others that he had experienced in the past. As a below the chest quadriplegic with no use of his arms and legs, RL of Greensboro said, “Hearthside has far and away been at the forefront of meeting my needs, delivering quality CNAs to care for my difficult needs. With Hearthside Home Care I have found the stability that is needed.”

Senior Home Care Options: Aging at Home

Guest post written by Alex Chamberlain, Executive Director, home care, Aging Wisely

Various surveys of seniors return the same results: seniors say they wish to stay in their own homes as they age.  What this most likely reflects is the desire to stay independent and in control more than simply the attachment to the home (though a home often has great emotional significance as well).  The reality is that many of us will remain healthy and strong well in to our later years, but we will be more prone to chronic conditions and possibly less able to manage a household.

What resources are available to help?  Senior home care covers a wide range of services, delivered a variety of ways.  It can all be quite confusing, so we will help break it down along with some tips and considerations.

Many individuals and families hire someone privately to assist with household tasks or care.  They may use classified ads, recommendations or matching services to find help.  It is important to understand the pros and cons of these methods.  You do expose yourself to potential liability and take on certain employment/tax responsibilities.  You also will typically forego having backup, so you will need to make other arrangements if the individual is ill or has conflicts.  Get good advice before you make a decision and determine how the costs break down when all factors are considered.

Alex Chamberlain

Alex Chamberlain, Executive Director, Easy Living, Inc.

There are also various types of agencies/companies you can hire for home care.  Unfortunately, these entities are regulated by each state, so there is some variation in standards/requirements.  Some states do not regulate companion or non-medical care.  Other states license and regulate both medical home health care (which also may be Medicare certified) and non-medical home care.  Check with your state to find out more about the regulations.  It can help you to “compare apples to apples” and be more educated on your options.

Regardless of the type of provider you hire, have a good understanding of their background and track record in providing care.  Get recommendations and find out how they hire, train and supervise staff.  Ask them about experience with your particular situation, disease or needs.  Ask them how they will match caregivers to your needs, how they plan care specific to you and how they manage backup care.  If you are a family caregiver, especially at a distance or caring for a loved one with dementia, how will they communicate with you?

After determining your home care options and finding some local resources, the next question is usually financial.  Who pays for home care? What does insurance cover? Medicare pays for limited home health care, but not custodial care (the long-term type of care often needed to remain home such as household support, meal preparation, help with hygiene etc.).  Long term care insurance policies typically have a home care option, so if you have purchased long-term care insurance you may be able to submit a claim to have your care covered.  There are some state, federal and other assistance programs available to help, especially for individuals with limited financial resources.  To learn more, you can get a copy of EasyLiving’s Paying for Home Care Fact Sheet.

There are a number of supportive services that can also be beneficial to the senior living alone who begins to need some help.  Senior nutrition services, ranging from Meals on Wheels to senior dining programs or hiring someone to prepare meals, can aide in good health.  There are a number of technologies that can help too, from personal emergency response systems (“fall buttons”) to monitoring systems and electronic medication dispensers.

About the author:  Alex Chamberlain is Executive Director at EasyLiving, Inc., a fully licensed, private duty home health care company serving individuals and families in Pinellas and Pasco counties in Florida.  EasyLiving was named a 2011 “Top Small Business in the South” by Business Leader Magazine and the 4th fastest growing company in Tampa Bay Business Journal’s “Fast 50” of 2010.

How To Choose The Right Medical Alert System For You

Guest Post by Bryan Stapp, President of American Response Technologies, Inc.

There are many good medical alert systems available on the market today, and the choices can be overwhelming.  The good news is there are lots of options; they are highly reliable, and also very affordable.  The bad news is that it can be confusing to sort through all the choices.

Here is an overview of the differences between some of the most popular medical alert systems available to you, and some ideas on things to look for.

With any system you consider, we recommend you look for companies who offer:

  • Name brand equipment with warranty.  Look for quality names you’ve heard of like BOSCH or GE
  • No long term contract – never sign a long term contract, your situation may change
  • 30 Day return policy

Two-Way Medical Alert System with 24/7 Monitoring

This is the most popular type of medical alert system, and is often called a Personal Emergency Response System (PERS).  You’ve probably seen these systems advertised on TV.  This type of medical alert system consists of a two-way console which communicates with a monitoring center.  A signal is sent when you press the button that is worn on your wrist or around the neck as a pendant.

The monitoring center will have your complete information on a computer screen at the time you call.  They will take appropriate action depending on the situation, including dispatching 911 to your location and notifying people on your call list.  This is the type of medical alert system offered by Medical Care Alert and many other good companies.

Typical Cost: $27.45 a month and higher.

Things to look for:

  • Range of the pendant signal to the base unit  – 800 feet minimum
  • US Based monitoring agents, not based overseas
  • Name brand equipment with warranty.  Look for quality names you’ve heard of like BOSCH or GE
  • No long term contract – never sign a long term contract, you situation may change
  • 30 Day return policy

American Response Technologies, Inc.


Two-Way Medical Alert System, No Monitoring, Calls 911 or other number

This type of medical alert system consists of a two-way console and button which will dial any phone number you program into the unit.  It will call a neighbor, family member, doctor, 911 (except in California and Illinois) or any other number you program.

Typical Cost: $275.00 – $350.00 to purchase.

Things to look for:

  • Range of the pendant signal to the base unit  – 800 feet minimum
  • Phone type – many do not support VoIP phones or DSL phones from your cable company
  • 911 policy in your local area – residents of California and Illinois may not program 911 into this type of medical alert system – check your local laws before considering this type of system

Two-Way Medical Alert System with Speakerphone Pendant – Monitored or not-monitored

This type of medical alert system may have monitoring, or may dial a number you choose directly.  The distinguishing feature is that the pendant itself is a two-way speakerphone and allows the user to communicate with the base as long as they are within range.  The range of these systems is limited, often only  100-300 feet from the base.

Medical Alert SystemsThe advantage of this type of medical alert system is the ability to speak into the pendant if you are far away from the base unit and cannot be heard.  However, these pendants are large, and look like a small walkie-talkie around the neck.  They also require frequent battery changes, and are uncomfortable to wear at night in bed.

Typical Cost: $34.95 a month and higher for a monitored system.  $275.00 – $350.00 to purchase a system without monitoring.

Things to look for:

  • Range of the pendant signal to the base unit  – These systems tend to have a shorter range
  • Will the senior actually wear it?  Users tell us that seniors find these large pendants annoying and tend to remove them, placing them on a nightstand or table nearby.  This defeats the purpose of the system, which needs to be on your person at all times in the event of an emergency.

Cellular Medical Alert Systems – Not Monitored, Calls 911

This type of medical alert system is often sold as an “add-on” to a traditional Medical Alert system with monitoring.  The small, hand-held device transmits a signal via GSM cellular when the button is pressed and dials 911 directly.

The advantage of this type of medical alert system is the perceived added security to have access to emergency personnel when you are outside of the home, or beyond the range of your home medical alert system.

However, it’s important to understand what these systems do, and what they don’t do:

  • Calls 911 – the call will be routed to 911 based on the location of the nearest cellular tower that connects your call
  • No Location Information Provided – these are not GPS systems.  If you are unable to speak, 911 will only know the location of the cellular tower closest to your current location.  In 2012, cellular providers are required to give 911 a geo-location within 300 meters (about 1,000 feet) of the location of the signal.
  • No Personal Information Provided – 911 will not know your name, or personal medical history.

We are aware of a very high dissatisfaction rate, and high cancellation rate for these kinds of 911 call devices.  Most of the dissatisfaction is due to having to keep the unit charged, and that it does not contact a monitoring center with your specific information.  Some people often think these are GPS locator units, but they are not designed for that purpose.

Typical Cost: $10.00 – $20.00 a month in addition to a monthly PERS plan of $30-60 a month.

Things to look for:

  • Battery life – these systems need to be constantly charged
  • Actual need – will the person using the system be alone outside of the home enough to justify the cost?

Cellular Phone As a Substitute for a Medical Alert System

Some families will provide a cellular phone to a senior and suggest they use it in an emergency instead of getting a dedicated medical alert system.

The expectation is that in an emergency, the senior will have the cell phone charged up and on their person, be able to open it up and dial 911, and be able to communicate their name, location and emergency.

The advantage is cost.  However, a cellular phone is a poor substitute for a medical alert system, and provides a false sense of security.

There are 3 basic problems with calling 911 from a cell phone:

  • They Don’t Know WHO You Are.  The caller ID from your cell phone does not identify who you are, just your phone number and possibly the general metropolitan area where your cellular service originates from.   They won’t know your name, home address, medical conditions, or who to call in the event of an emergency.
  • They Don’t Know WHERE You Are.  911 responders won’t immediately know where you are. The closest they will know is the location of the cell tower you happened to have used when placing your call.  If you lose your connection or drop your cell phone before you can give your location, they might not be able to find you.
  • Cell Phones DON’T SEND GPS Coordinates.  Your phone may have GPS on it, but that information is not sent to 911.  U.S. wireless carriers are not required until 2012 to provide emergency responders with the latitude and longitude of a 911 caller.  And once they do, they are only required to be accurate to within 300 meters (984 feet) of the caller.  That’s three football fields away from where you may be.

Typical Cost: Typical cellular phone plans cost around $30.00 – $50.00 a month with a two year contract.  Phone hardware extra.

Things to look for:

  • Are the buttons large and easy to push?
  • Is there a dedicated 911 button?
  • Does 911 in your area route to local dispatchers?  Some 911’s route to county or highway patrol offices
  • Will the senior keep it charged, on their person, and be able to use in an emergency?

Choosing the right medical alert system for you:

We know the choices are overwhelming and confusing, and that families need to balance the needs of the senior, convenience, costs, and reliability.  Speak to your doctor or caregiver, or contact a reputable medical alert system provider to learn more.

Bryan Stapp is the President of American Response Technologies, a leading provider of medical alert systems for seniors nationwide.  Their “Caregiver Tips” blog was chosen as the People’s Choice Best of the Web winner of 2012 Best Senior Living Blogs by an Organization.  Learn more at or .

Senior Housing Options

Choosing the right senior housing solution could be a very difficult decision given the myriad of senior housing options available. Each individual has very specific needs that could only be answered by selecting the right senior housing solution. A careful look into each senior housing option gives you the best chance of finding the best services for your needs. Below is a list of the different senior housing options to guide you in making a better and well-informed decision.

Home Care

Image by Dietmar Temps on Flickr

Home Care services allow seniors to receive care in their homes. Long-term caregivers visit the home regularly or live with them providing assistance in activities of daily living (ADLs). Services include assistance in bathing or meal preparation. Long-term caregivers are also tasked with meal and activities planning. Home care providers are trained in providing emergency medical care intervention. Length of stay depends on the needs of the senior. Rates are usually based on an hourly basis and 24 hour services are provided by a team of long-term care providers.

Residential Care Homes

Residential Care Homes provide seniors care in a residential or private home setting. These homes often house several seniors and receive care from long-term caregivers. Residential Care Homes are great for seniors who want a more homely atmosphere. These centers are great for seniors who are transitioning from their homes.

Residential Care homes are recommended for seniors who don’t require special medical care. Seniors who live in these centers enjoy a great degree of freedom. Residential Care Homes provide seniors a community where they could interact and establish relationships with other seniors.

Independent Living Communities

Independent Living Communities house seniors who require little supervision or medical assistance. Senior housing options include apartments or private bedrooms. Services include meals and housekeeping. Seniors are also provided planned activities and recreational programs.

Short Term Care Facilities

Short Term Care communities provide seniors who require short term care. Seniors recovering from injuries or surgery could stay at a short term care facility for rehabilitation. Length of stay depends on the extent of injury or until the senior is able to perform activities of daily living (ADLs) independently. Short Term Care services are also available from other senior housing options.

Assisted Living Communities

Image by mat4226 on Flickr

Assisted living communities are facilities that provide seniors long-term care services but do not require the level of care found in nursing homes. Long-term caregivers work closely with medical professionals to provide medical care to seniors. Housing options include private or shared bedrooms. Prices are based on the amount of care and housing option.

Nursing Homes

Nursing Homes are places that provide seniors with 24 hour skilled nursing care. These are facilities that specialize in providing seniors who require assistance and a high level of medical care. Nursing Homes also give rehabilitative services to seniors recovering from injuries or illnesses. Seniors residing in these communities often require constant medical attention and professional services.

Residents are usually found sharing a room and served meals in a central dining area. Room occupancy varies and those who are too ill are given private rooms and served meals individually. Seniors who require special care may also be found in separate units to optimize treatment.

Special Care Centers

Special Care Centers are facilities that provide highly skilled medical services designed to treat specific illnesses or injuries. These centers provide targeted medical care services to seniors suffering from Alzheimer’s or post-surgery patients. Around the clock support and a highly trained medical staff ensure that seniors get the best treatment possible.

Special Care Centers provide seniors individualized care and treatment designed for specific illnesses or injuries. Similar to Nursing Homes, these facilities give seniors suffering from Alzheimer’s for example medical care that are needed to help them perform optimally. Part of these services that make Special Care Centers unique from other communities is that these facilities maintain a highly trained and specialized medical staff.

Elderly Dehydration

Detecting the symptoms of illnesses in the elderly can be very challenging. This is because most signs and symptoms of diseases in seniors are often shrugged off as being part of the “normal” aging process. Dehydration manifests itself according to the stage of illness. It can start with a simple complaint of thirst and steadily progress to loss of consciousness.

Dehydration in the elderly should not be taken lightly. It is a serious medical condition that can hurt an elderly person and if left untreated can cause death. Dehydration in the elderly occurs when water intake is not proportionate to the body’s needs.

Image by taronana on photobucket

The body is composed of 70 percent water and low levels of water could have a serious effect on the body’s normal processes. Dehydration is easily avoidable but if left untreated it can pose a serious threat to a person’s health.

Water plays a vital role in regulating the body’s normal temperature. It is responsible for decreasing the body’s temperature by bringing out heat from inside the body. Internal heat is picked up through the body’s circulatory system and released by sweating.

Drinking adequate amounts of water also minimizes the risk of infection. Urinary tract infections are especially high in people who are unable to eliminate toxins through urination. Toxin buildup causes muscle and joint pains causing great stress and discomfort among seniors.

A major portion of the blood in the body is composed of water. When there are low levels of fluids, the heart pumps at a higher rate. This is especially dangerous for the elderly who are already suffering from heart ailments. If fluids are not replaced immediately, this can worsen existing heart conditions and lead to death.

Symptoms of Dehydration in the Elderly

Detecting the early signs and symptoms of dehydration in the elderly can only be done through close monitoring and communication. Dehydration if allowed to progress could lead to serious injury or death in the elderly. One of the first signs that the elderly is not drinking adequate amounts of water can be seen in the color of their urine. Some medications can cause discoloration but urine should be generally clear. This could be a sign that chemicals and waste products are not being diluted properly or a urinary tract infection is present.

Another early sign that the elderly might be suffering from dehydration are a dry mouth and clouded thinking. A dry mouth is not part of the normal aging process. This should not be mistaken for wrinkles. A dry mouth signals that not enough fluids are present in the body. Other symptoms that directly cause dry mouth include lack of production of saliva, again a direct result of inadequate fluid intake.

Most of the danger signs of dehydration could not be directly associated with the disease. Clouded thinking for example could be mistaken as something normal for seniors. Fatigue and sluggishness are also danger signs of severe dehydration that long-term care providers and families should look out for.

Fatigue. Normal amounts of fluids are required for the body’s normal functioning. Even the slightest change in the levels of fluid in the body can adversely affect how our body works. A major component of blood is water and a decrease makes our hearts harder. Oxygen and nutrients are harder to distribute leaving seniors feeling tired and weaker.

As the body compensates for lower levels of blood circulating in the body, blood is directed to the essential organs and away from the skin and muscles. The body is unable to release internal heat which causes muscle cramps and confusion.

Headaches. This is caused by stress which is a direct result of the senior’s inability to cope with high temperatures. Without adequate amounts of fluid circulating inside the body, internal heat is difficult to release.

Cloudy Brain. Seniors suffering from dehydration can have a difficult time making even the simplest decisions. Headaches and high stress levels contribute to a decreased level of mental alertness. Short-term memory loss, confusion and mental fogginess are also reported by seniors suffering from dehydration.

Muscle, joint pains and cramps. Fluids act as natural lubricants that minimize friction between bones. Seniors may feel joint pains and muscle cramps making it difficult for them to perform activities of daily living. Cramps could be felt because muscles are not receiving enough nutrients or oxygen due to poor blood circulation.

Unusual food cravings. Water is essential to the body’s normal functioning and the brain may send different signals in an attempt to get people to start drinking again. A sudden urge to eat or drink means that the body is in survival mode and is trying to get its hands on much needed fluids.

Seniors suffering from dehydration may also notice decreased levels of urine output. This is a result of the body’s attempt to save as much fluids as possible. Elderly dehydration can easily be avoided by close monitoring.

Most of the senior homes and assisted living facilities are located in sunny states such as Florida and California. During hot summers, temperatures in these states could rise into unhealthy levels increasing the risk for heat stroke and dehydration among seniors.

Drinking sufficient amounts of water daily is a simple way of keeping dehydration at bay. Some contend that some drinks and foods could actually increase the rate of fluid loss. Beverages such as tea or coffee for example contain diuretics or substances that encourage urination. But new research has shown that in order for it to be health damaging you have to take abnormally large amounts (5 to7 cups). The amount of liquids contained in such beverages still outweighs its negative effects. Water or beverages are not our only sources for fluids.  A great portion of our daily fluid intake comes from food.

How Much Water Should We Take?

Drinking eight or more large glasses of water daily has traditionally been the recommended amount of water intake. However, a study made by the American Journal of Physiology in 2002 said that there was inadequate evidence that healthy adults living in temperate climates and not engaged in rigorous activities need large amounts of water.

In 2004, the Institute of Medicine agreed with the findings and said that healthy adults may use thirst to determine fluid needs. However, athletes, individuals engaged in prolonged physical activities, people living in extremely hot areas and those suffering from medical conditions are still required to take more liquids.

Dehydration can easily be treated by replacing lost fluids. Educating seniors and long-term care providers in assisted living or long-term care facilities helps prevent the development of serious medical complications. Lack of fluids deprives the body of vital nourishment and its ability to cleanse itself. It doesn’t take much to keep ourselves healthy. Keeping sure that we keep ourselves hydrated especially during hot summer days saves us from the dangers of elderly dehydration.

Hip Fractures in the Elderly

As the country continues to age, fractures will be a major cause of concern for healthcare professionals, patients and their families. According to the American Academy of Orthopaedic Surgeons, the number of hip fractures in 2050 will reach 650,000 annually or 1,080 hip fractures a day.

The Center for Health Statistics reported that there were 220,000 hip replacement surgeries in 2003. 25 of these patients were able to experience full recovery while 50 percent will require a cane or walker; 40 percent will need nursing home care and 24 percent of people age 50 and over will die within the next 12 months.

Hip Fractures – Risks and Causes

Image by JimScolman on Flickr

The risk for hip fractures is higher in the elderly. Different factors that are sometimes unique to seniors contribute in making them a high risk population for falls and injury. Advancing age brings so many physical changes that simple accidents that they were able to walk away from in the past could easily cause hip fractures in the elderly. Risks for hip fractures are highest for people age 50 and over. From there the rate of hip fractures doubles every five or six years.

Osteoporosis. A report made by the National Institutes of Health estimates that 40 million Americans are already suffering from Osteoporosis or at high risk due to poor bone mass. This medical condition is the leading cause of spine, wrists, and hip fractures in the elderly. Natural bone mass loss due to aging coupled with osteoporosis increases the possibility of hip fractures from simple falls or injury.

Nutrition. Calcium is the most abundant mineral in the body. It is needed for the growth and long-term health of the bones. But adequate calcium intake should not be our only concern.

Lifestyle. Smoking and excessive alcohol drinking interferes with the uptake of calcium and weakens the bones. Seniors confined for long periods of time in beds or are unable to exercise due to a debilitating illness are at high risk for hip fractures. Prolonged inactivity weakens bones.

Heredity. Asians and Caucasians with smaller bone densities have a higher risk for hip fractures. Seniors who have a family history of weak bones and poor bone mass are at risk for hip fractures.

Medications. Long-term used of glucocorticoids and some anticonvulsants leads to bone loss and weakening. Increasing calcium and Vitamin D intake could help decrease the effects of these medications.

Sex. Women are two or three times more likely to suffer from hip fractures compared to men. Numbers show that almost half of all women over the age of 90 have suffered from hip injury. Women who are 5’8” and over also have twice the chances for hip fractures compared to women who are 5’2” and below. Women are at higher risk for poor bone health due to decreasing levels of estrogen levels as they age.

Hormonal factors. Low estrogen levels and menopausal women weaken the bones. Abnormal levels of thyroid stimulating hormones and thyroid hormones affect the levels of calcium in the bones. Men like women also experience changing levels of sex hormones with aging. Decreasing levels of testosterone also contribute to bone weakening in men.

Preventing Hip Fractures in the Elderly

Hip fractures are the second leading cause of hospitalization in the elderly. Incidents of hip fracture increase directly with age. It is estimated that 23 per 100,000 adults age 50 are hospitalized for hip fractures. By the age of 80, this number increases to 630 for men and 1300 women per 100,000 of the population.

Serious and life-threatening injuries caused by a simple fall increases with age. While we were able to shrug off falls when we were younger, advancing age and deteriorating bone health makes it impossible for adults age 65 and older to ignore the danger of fall and accidents. Fortunately, falls are very preventable. Below are simple tips on how seniors could reduce the risk of falls and injury.

Check your medications – Consult with your physician regarding prescribed and over the counter medications that may cause drowsiness or dizziness. Any medication which may affect your mental state or sense of balance increases risk for falls. If there are no alternative medications, ask your physician about the drug’s side effects and how long before you could resume activities of daily living.

Exercise – Keeping our bodies active improves overall body strength. Simple exercises such as walking or flexing exercises are an excellent way of building inner body strength. Low impact exercises and Tai Chi programs, swimming and walking for example help seniors improve strength and flexibility without causing injury.

Proper Nutrition – Osteoporosis is a real concern among seniors. Weak bones increase the risk for falls and hip fractures. The National Institutes of Health Consensus Development Conference on Optimal Calcium Intake found that a large percentage of Americans failed to meet the recommended daily intake of calcium.

  • Men and women more than 65 – 1,500 mg per day
  • Men 25 to 65 – 1,000 mg per day
  • Postmenopausal women without estrogen therapy – 1,500 mg per day

Vitamin D helps the body absorb calcium, thus essential in building and maintaining strong bones. Inadequate amounts of Vitamin D in the body leads to calcium being taken out from the bones in an effort to maintain normal blood calcium levels.

Regular Eye checkups – Failing or poor eyesight increases the chance for falls. Regular eye checkups prevent further eyesight deterioration and maintain proper eye health. Good chances are that poor eyesight might be caused by improper eyeglasses.

Fall-proof your Home

  • Proper lighting
  • Install rails, grab bars on walls and stairs
  • Place rugs and carpets on slippery surfaces
  • Place the senior’s bedroom on the first floor and near the bathroom
  • Position frequently used objects within easy reach
  • Ensure that all furniture, chairs and tables are stable
  • Wear low, non-slip shoes and slippers

Purchase a Medical Alert

Sadly, even with dutiful prevention, accidents do happen. So no matter how safe you make your home, or what safety precautions you make, you can’t always protect against a fall. Or, worse yet, a fall where a senior can’t reach a phone to call for help.

Often times, unexpected falls happen in the shower, which is why you want to make sure any alert system you buy is waterproof & can be worn as a wristband or pendant. After all, it really only takes one slip for it to be too late. So take the time to do your homework, read the customer reports to hear what consumers are saying & purchase the medical alert that best suits your functional & financial needs.


Signs of Hip Fracture in the Elderly

Hip fractures can occur at any stage of life but a majority of injuries occur for seniors age 65 and older. Injuries from falls are more serious due to lower bone density or weaker bones. The signs of a hip fracture are immediately felt and visible after a fall. Pain radiates from the hip area and the senior is unable to move or standup.

Swelling, redness and bruising in the hip area are also tell-tale signs that a hip fracture has occurred. Stiffness, contusions and unequal leg length indicate that a senior has experienced hip fracture or trauma. However, there are some hip fractures where the head of the hip bone has impacted into the neck of the hip bone. This produces less pain which may mislead the senior or care provider that no serious injury has happened.

Any accident or fall where a senior clearly verbalizes pain in the hip area should not be taken lightly. Calling emergency services and preventing movement to avoid further injury are the first steps in emergency care. Doctors can confirm hip fractures through identification of symptoms or an MRI and x-ray is done to positively verify hip fracture has occurred.

Emergency Care and First Aid Treatment

If you suspect that a senior has suffered from a hip fracture, prevent movement unless necessary to avoid further injury. Hip fractures require immediate medical attention, call 911 or your local emergency number to report the injury.

Emergency care for seniors with hip fractures includes immediately stopping any bleeding arising from injury. This is done by applying direct pressure to the wound with a clean cloth and sterile bandage. After stopping the bleeding, immobilize the injured area. Only those medically trained to apply splints are advised to perform emergency care.

Placing pads or positioning the elderly in a more comfortable position is recommended to reduce stress and discomfort while waiting for professional medical help. If the senior appears to be in shock or shows short, rapid breathing position the head lower than the body and elevate the legs if possible. This is to improve blood flow to the head area and help the patient maintain consciousness.

Treating Hip Fractures in the Elderly

Treatment immediately starts by ensuring that the senior is medically stable. Once stable, the doctor assesses the best treatment available for the patient. Fractures are rarely stable and any movement could cause further injury in the patient.

Non-surgical treatment for hip fractures is possible if the fracture seems stable. Some hip fractures actually heal without surgery. This would require patients to be confined to bed for eight to twelve weeks. But doctors have found that placing seniors in bed for prolonged periods of time could cause serious medical complications than having the patient undergo surgical treatment for a hip fracture.

Almost all of hip fractures in the elderly are treated by surgery within 24 hours of hospital admission. The goal of surgery is to stabilize the fractured hip and help the senior recover from injury in the shortest possible time.

Metal Pins. Fractures that happen in the neck of the femur if still positioned correctly may only require the placement of two or three metal pins to stabilize the fracture. Also called hip pinning, it is a simple surgical procedure that allows patients to place weight down immediately after surgery.

Metal Plate and Screws. Hip fractures that are located below the femoral neck or in the intertrochanteric region are treated by the use of metal plate and screws. This type of fracture is usually the result of a fall that results to multiple breaks. It is one of the hardest fractures to treat requiring several pieces of bones to be joined together. Intertrochanteric fractures are treated by placing a metal plate and compression hip screw that aligns the bones and uses the muscles to compress fractured bones together.

Artificial Replacement of the Femoral Head. When hip fracture occurs at the neck of the femur and results to the ball being completely displaced, replacement of the femoral head is recommended. A fracture of this kind often results to disruption or blood supply to the femoral head. The femoral head collapses and dies a few weeks later.

The chances of the femoral head dying from this type of fracture are so high that a surgeon often recommend femoral head replacement immediately. Only half of the joint is replaced while the socket of the hip joint is untouched.

Recovering from a Hip Fracture

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The goal of treatment for seniors with a hip fracture is to help them recover as quickly as possible. This is to avoid serious medical complication that can result to long-term inactivity that includes blood clots, joint stiffness, chronic pain and pneumonia in the elderly.

Patients who are physically able to undergo recovery treatment are usually assigned with a physical therapist. Exercises start by helping seniors move from their beds to a chair several times daily. All these exercises are designed to help seniors regain independence and return to their normal daily activities. Simple exercises are done to strengthen leg muscles and prevent blood clot formation. Walkers and crutches are assigned to free them from the confines of their beds.

The amount of weight that can be placed on the injured leg depends on the type of surgical treatment done. Most patients are able to place weight a few days after surgery. Those who have undergone artificial replacement of the femoral head however, are required to follow stricter guidelines or hip precautions.

Patients who have undergone femoral head replacements are advised to follow these guidelines for at least six weeks after surgery. This provides time for delicate tissues to recover enough strength to prevent the joint from dislocating. Precautions include limiting the amount of weight placed on the leg and using walkers or crutches.

Doctors may recommend elders recovering from a hip fracture to work with a physical therapist to assist the patient in transitioning safely to a home environment. These include instructing the patient on how to avoid placing too much weight on the injured leg and how to use crawlers and crutches when moving inside the home.

The goal of treatment is to help seniors slowly regain hip strength and resume their normal activities without aggravating the injury. Doctors and physical therapists could only do so much in helping senior recover from a hip fracture. The success of treatment ultimately lies in the hands of long-term care provider, family and patient.

Pneumonia in the Elderly

According to the Centers for Disease Control and Prevention, an estimated 900,000 Americans get pneumonia each year, and adults over 65 are more likely to be among them. In fact, the disease continues to be one of the leading causes of death among seniors.

Pneumonia, especially if diagnosed early responds well to treatment. But even with the best health care services, pneumonia continues to kill 40,000 to 70,000 Americans each year. The chances of older adults fully recovering from pneumonia is lower compared to the younger population. Even seniors who were able to recover have a higher chance of dying over the next several years.

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Pneumonia Risk Factors in the Elderly

Age is a major risk factor for developing pneumonia. Adults age 65 and older continues to be one of the hardest hit sectors of the population. It is the most common infectious cause of death and responsible for millions of hospitalizations yearly. Numbers coming from the National Hospital Discharge Survey in the US has placed the number of hospitalizations for age 65 or older at 21.4 million between 1990 and 2002. More alarming is the fact that 70 percent of those hospitalized for pneumonia are from the senior population.

Age – Seniors age 65 or older are at high risk for acquiring pneumonia. A weaker immune system and especially those suffering from medical conditions are at great risk developing pneumonia.

Diseases – Diseases that compromise or weaken the immune system such as HIV/ AIDS and chronic illnesses such as lung disease, emphysema and heart disease increases the risk for developing pneumonia.

Immune System Weakening Treatments – People undergoing chemotherapy or any treatment that negatively affects the immune system such as immune suppressant drugs are at high risk for developing the disease.

Exposure to Chemicals and Pollutants – seniors who are constantly exposed to chemicals at home or in the workplace are in danger of acquiring uncommon types of pneumonia. The risk is particularly high for seniors who work with chemicals and fertilizers in their gardens.

Unhealthy Lifestyle Habits – Smoking exposes your body to harmful chemicals and diseases causing toxins. It weakens the immune system especially on seniors who are already suffering from compromised immune systems. Seniors who live more active lifestyles are also at less risk for developing pneumonia.

Pneumonia by Origin of Infection

Pneumonia may be classified according to where the infection was acquired or its causative agent. Doctors often classify pneumonia based on its origin of infection. This makes it easier for them to identify the likely cause of infection and symptoms associated with the disease.

Community-Acquired Pneumonia (CAP) – The American Academy of Family Physicians defines CAP as a pneumonia not acquired in a hospital or long-term care facility. This usually follows a viral infection such as flu. This makes treatment of common colds and flu important to prevent its progression towards pneumonia.

Pneumonia Acquired from an Institutional Setting – This includes pneumonia acquired from a hospital or long-term setting. Senior living assisted facilities, long-term care or senior homes are also included in this category. Seniors are in great risk for acquiring pneumonia through this setting due to a weaker immune system. Infecting agents are also more virulent compared to those found in the community setting.

Compared to community-acquired pneumonia, hospital-acquired and healthcare-acquired pneumonia are controllable. Medical and long-term care personnel are in a better position to control healthcare settings thereby reducing the risk for infection.

Pneumonia in the Elderly

The difficulty with diagnosing pneumonia is that many of its early symptoms can be mistaken for the common cold or flu. According to an Oxford Journal on Aging and infectious diseases, pneumonia in the elderly may present itself with few respiratory symptoms and signs and instead may be manifest as delirium, worsening of chronic confusion, and falls. Delirium or acute confusion was also found in 44 percent of those suffering from pneumonia. Falls may also indicate that a person is ill or severely weakened.


Older adults with pneumonia may not show traditional symptoms of pneumonia. Symptoms might be milder, different or fewer. Seniors with pneumonia may not suffer from fevers or have nonproductive cough (coughing without sputum).  Symptoms that are commonly seen in seniors include confusion or delirium. Chronic illnesses or a lingering cough are also clear indications that the elderly is already suffering from pneumonia.

  • Cough – yellowish, greenish or bloody mucus
  • Mild or high fevers
  • Chills
  • Shortness of breath especially when performing strenuous activities
  • Sharp stabbing pain when coughing or breathing deeply
  • Headaches and migraines
  • Excessive sweating
  • Loss of appetite
  • General body weakness
  • Confusion especially in the elderly

Symptoms may vary according to the type of infection. Pneumonia caused by bacteria may cause high fevers (as high as 105 degrees F). Other symptoms may include rapid and shallow breathing. Poor blood circulation can cause bluish lips and nail beds, a clear indication that oxygen is not reaching these areas. Bacterial pneumonia may also affect the person’s mental status causing confusion or delirium.

Initial symptoms of viral pneumonia are similar to influenza. Symptoms include fever, headaches, dry cough, weakness and muscle pain. The next 12 to 36 hours shows difficulty in breathing, worsening cough with small amounts mucus. Blood circulation is also impaired with bluishness seen in the lips and nail beds of the patient.

Diagnosis of Pneumonia in the Elderly

Chronic illnesses such as colds and flu in the elderly are tell-tale symptoms that the individual might be suffering from a major disease. Common colds should be treated immediately to prevent it from developing into pneumonia.

Seniors suspected of suffering from pneumonia are advised to consult with their doctors and discouraged from self medicating. Simple diagnosis is done by first letting the doctor listen to the senior’s lungs. An infection is suspected when the doctors hear rales, rattling or bubbling sounds. This is a clear indication of infection and additional tests are advised to identify the illness.

When infection is suspected, pulse oximetry tests are used to compute blood oxygen levels to determine lung functioning. CT scans or chest x-rays are then recommended to determine the area of infection and degree of illness. A blood or sputum test is used to determine the specific agent responsible for infection.

Preventing Pneumonia in the Elderly

Pneumonia’s main mode of transmission is through direct contact with people who are ill. It could also be transmitted through respiratory droplets from the nose or mouth. Preventing the spread of infection could easily be done by being proactive and ensuring that seniors are not exposed to the illness. This is especially true for seniors who are at long-term care and hospital settings where the medical team exercises full control over the environment.

Eating healthy and living an active lifestyle goes a long way in helping seniors boost their natural immune system. Exposure to pneumonia infective agents could not be totally eliminated but ensuring that seniors are at their optimum health is an achievable goal.

Seniors are at high risk for developing pneumonia. Underlying medical conditions and a weak immune system makes them susceptible to infection. Simple antiseptic techniques such as washing your hands before handling a senior’s personal things dramatically reduce the spread of infection. Good oral hygiene should also be practiced to prevent infection.

Senior Pneumonia Vaccinations – A Quick Look into the Numbers

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Almost 65 percent of Americans age 65 and older have been vaccinated against pneumonia. According to the Agency for Healthcare Research and Quality, 2000 to 2008 saw the numbers of seniors vaccinated against pneumonia increase from 53 to 60 percent. The 2010 National Healthcare quality Report which examines the nation’s access to and quality of healthcare showed that:

  • 65 percent or two thirds of high-income seniors have been vaccinated against pneumonia while 46 percent or less than half of poor seniors have received similar treatment.
  • Seniors living in a large inner-city area where a majority of the population were low-income and minorities only had 52 percent vaccinated against pneumonia. However, seniors living in medium-size cities reported that 64 percent of them had undergone vaccination.
  • 65 percent of white seniors were vaccinated against pneumonia compare to 45 percent for Asian and Black seniors. Hispanic seniors were at the bottom of the list with only 37 percent of them vaccinated against pneumonia.

Pneumonia continues to be one of the leading causes of hospitalization and death in the elderly. Preventing pneumonia in the elderly should always be a priority among family members and long term care providers. So the next time you suspect your love one is suffering from the early symptoms of pneumonia, consulting with a medical professional gives your love ones the best chance of full recovery.

Staff Turnover Closely Tied to Quality Care

Research from the Institute for the Future of Aging Services indicates that annual staff turnover levels in home health care companies can vary between 60 and 100 percent across the nation. An article appearing in USA Today last week reflects on the issue, pointing out that turnover can have a significant impact on the quality of care received by clients. It’s these hands-on caregivers who are interacting with patients day in and day out, learning specific wants and needs and forming relationships.

So when these front-line staff are like a revolving door, seniors lose the feeling of security that comes with consistency. High turnover rates also impact the frequency of errors, as it often takes several months on the job to get a firm grasp on daily routines and procedures.

Home health care agencies face high turnover

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Is pay the problem?

Part of the problem, according to some, is the low pay common to home health aides in these settings. In December, the U.S. Department of Labor issued new rules requiring home health care agencies to pay their employees minimum wage and overtime. Currently, the federal minimum wage is just $7.25 an hour.

Still, some employees are making less than $7.25 per hour. Twenty-one states have regulated the industry requiring agencies to comply with the minimum wage, yet those who have not still frequently encounter pay less than the federal minimum wage. Further, the concept of time-and-a-half for hours worked over 40 per week causes further complications. According to Catherine Ruckelshaus of the National Employment Law Project, agencies will typically enlist several workers to fulfill client needs when they exceed the 40-hour threshold. This avoids the necessity of paying overtime, yet creates inconsistency for the seniors being cared for.

The Center for Business and Economic Research at Ball State University found that since 2000, employment in the home health care sector has increased 23 percent, yet salaries have remained stagnant. Another study conducted by the Carey Institute at the University of New Hampshire finds that the average hourly wage for home health care workers in New Hampshire is $10 per hour. More shocking is that 70 percent receive no paid leave and a mere 20 percent receive healthcare through their employers.

Better pay for better care

Kristin Smith, a University of New Hampshire family demographer, notes that research has shown a clear link to higher wages and higher quality of care. Yet agencies fight against regulations requiring overtime and other benefits, pointing out that those increased costs would have to be passed on to seniors, making home health care considerably more expensive.

So what’s the solution? An already struggling healthcare system can’t realistically alleviate more of the cost burden than it currently does through programs such as the Medicaid Waiver. Yet as more seniors require in-home care, the industry must adapt to changing economic demands to hire qualified caregivers.

Find a Job as a Caregiver Today

At we are consistently getting inquires about jobs at the communities we feature on our site.  We are not able to tell the person if the community is hiring, but we try to help them anyways by offering resources that can help.

But, Caregiverlist has taken the next step and created a easy to use widget that can direct you straight to a caregiver job in your area.  Once you find a job you can also use their site to help you build you resume or brush up on your caregiver knowledge with a certification course.

Providers please let us know what you look for in a caregiver and we will share it with our readers!