Thursday, February 28, 2008

Way To Go, Mom!

We know that exercising the brain is said to be a good way to slow dementia and memory loss in general. It makes sense that reading and working puzzles and learning something new could be effective in keeping our brains in good working order.

I think I mentioned in the past that my mother has loved to play scrabble for years. And she was a whiz too! When she moved close to me, I located a scrabble group and she played with them for several months. She was age 83 then and the oldest of the players. But she kept up with the group and enjoyed playing until they started making some changes to the rules.

My sister had given her an older laptop computer and I put the scrabble game on it. She was learning to enjoy it, although it is definitely different playing a computer opponent than a human one! Then for various reasons, she stopped using it for a while.

Now, after a year or so, she is ready to play "Maven" (the computer) again. She is well aware that exercise of different kinds has been prescribed to help with her memory loss. And she is the one who asked me to help her with start up and how to play again. I've written out the instructions from start to shutdown and spent some time today explaining the ins and outs of the computer to her. I don't expect her to catch on immediately, but I must say, I'm awfully proud of her. Almost 85 and learning new skills to play a game that will help her in so many ways. Way to go, Mom!

Wednesday, February 27, 2008

Cruising through Old Age

How's this for an idea? The Journal of American Geriatrics Society has reported great similarities between living on a cruise ship and in an assisted living facility. In fact, the November 2007 issue of the Journal described the "at sea" option as a feasible and cost effective alternative to landlocked living!

The many amenities on a cruise ship, including 3 meals a day, escorts to meals, on board physician, and housekeeping/laundry services rival those of assisted living and for very little cost difference.
For seniors who love to travel, have good to excellent cognitive memory, and who require a little help with activities of daily living, it sounds like an unusual and attractive arrangement.

Factored into the research were life expectancy of seniors moving into assisted living and nursing homes, costs of treating acute illness, medicare reimbursement and other costs.

Tuesday, February 26, 2008

Slow Medicine

There are times I wonder what it must feel like to be 85. Most of those times are when I take my mother on errands or when we take our 1 mile walk around the neighborhood.

Mother has begun using a cane some. I wish she would use it all the time, but she feels self conscious about it. She has a knee disfigured from arthritis and every once in a while, it gives out and she catches herself before she goes down. Any time we walk without the cane, I walk arm in arm with her. It's reassuring for her and I naturally slow down to accommodate her gait.

Slowing down is something we should all remember when dealing with seniors. I read an article online in the New York Times health section recently that talked of a book written by a doctor with his own mother in mind . The book called My Mother Your Mother embraces "slow medicine" as Dr. McCollough calls it. Dr. McCollough is a geriatrician and has several good ideas on the compassionate approach to caring for the elderly. Check it out and let me know your thoughts.

Monday, February 25, 2008

Speaking vs Hearing

I hate to admit it but I find myself getting a bit impatient at times when older people don't hear what I've said. There is no doubt many seniors have hearing difficulties that preclude effective listening. As I remind myself that I too may one day rely on the patience of others, here are some suggestions from The Hearing and Speech Center in Maryland on ways to communicate more effectively with people affected by hearing loss.
  • Keep a distance of three to six feet from the person with whom you are communicating.
  • Face the person in adequate light so the listener can see and hear the speaker.
  • Do not speak loudly or overarticulate.
  • Speak at a normal or bit slower rate of delivery
  • Be prepared to restate not repeat information.
For more strategies on effective communication, go to www.hearingcenter.com.

Sunday, February 24, 2008

Walk-in Bathing

Experts tell us that 80% of all people in a nursing home are there due to fall related injuries while trying to bathe. The new technology of walk-in bathing could be the most important step to thriving and living independently for as long as you choose.

As we age, our strength, stamina and flexibility diminish and we eventually face a range of bathing issues that didn't exist when we were younger. But our bathing environment stays the same. Aside from a grab bar, we don't remodel our bathrooms to incorporate new technologies to eliminate the dangers. Many seniors are embarrassed to acknowledge they have these problems and the family may tend to ignore the problem until the senior is injured.

Aside from jacuzzi tubs, bathrooms have not changed a lot in their basic designs. Citing the statistic above of the percentage of seniors in nursing homes from fall injuries, this makes the bathroom the most dangerous room in your home! Walk in baths have high side walls and low threshold doors that permit bathers to enter without needing to lift their feet more than a couple of inches. There is no risk of slipping and falling, or trying to get up and down from floor level.

I am told high quality walk-in bathtubs offer the relaxation, pain reduction and invigoration of Medical Hydrotherapy. It sounds like this should be an option in new home construction as well as remodeling targeted at seniors. I'd love to set a new trend!

Saturday, February 23, 2008

Family Trees

Are you interested in your family tree? My mother almost 85, can trace her family back to the days of the American colonists and beyond to her German roots. My mother-in-law almost 89, has no interest in her lineage past her immediate family. I find it fascinating to catch a glimpse of our past and enjoy the research as much as the knowledge of family.

My mother's family has held a reunion every summer for as long as I can remember (and that's a long time!). The current organizers have announced this summer's reunion will likely be the last. They are expecting over 120 relatives from 21 states to attend. My mother is one of the older generation left and wants to be there, of course. This is a special trip for us, over 1200 miles and Mom doesn't want to fly. She is more comfortable with me driving. Unfortunately, it would probably be the last mother could attend from a physical standpoint even if someone takes over organizing future events.

As ironic as it is, my stepdaughter has taken an interest lately in organizing a family reunion for my husband's family. She handled the arrangements last year for the first annual and is now working on this year's reunion. I've encouraged her to dig into her lineage while her grandparents are still with us. I think my mother-in-law would enjoy telling family stories and since she has a sharp memory even to this day, could make the research easier with what she can recall. It takes some time and effort but can be so rewarding.

As one family ends its tradition of reunions, another begins. For our children and grandchildren, I'll have to see how I can help the family tradition.

Thursday, February 21, 2008

Parents in Financial Trouble

For most older people, the fear of outliving their money ranks right up there with having to move out of their homes. If you find out your parents are in financial trouble, here are some things to look at to determine your next step.

First is to determine the source and amount of their income. Second, list their monthly payments. See what can be eliminated. If they have used all their savings and investments, check for maintenance fees on those accounts. Be sure to check for penalties on CDs or annuities before you close all accounts that are empty or nearly empty. You may find your parents have several checking accounts that are charging a service fee. Except for unusual circumstances, they only need one checking account at this time. Unless they have told you in so many words, this may be when you find that your parents are living on social security income and the bills are not being paid.

Scrutinize their health care plans. If they are on Medicare and paying for a medicare supplement, go online to www.medicare.gov or talk to an agent about other options. They are available and can save a ton of money. If one of your parents is a veteran, see if they qualify for veteran's benefits. See if there are life insurance plans that could be cashed in. Many parents balk at this until they realize their lifestyle will have to be subsidized by their children.

Check into a reverse mortgage. Your parents could be living off the equity in their home. That, combined with social security could save you and your family from having to pony up the money to keep them going. Downsizing, if they haven't already done so, could be the only other option to keep them living on their own.

Ideally, expenses can be eliminated and living arrangements altered enough to provide relief from expenses. If your own finances or other siblings are not in any shape to take on the extra burden of helping your parents, qualifying them for state run medicaid is the final option. But that's another blog.

Wednesday, February 20, 2008

Boomer Statistics

Sometimes it's interesting to read some of the statistics that are out there regarding the Baby Boomers, of which I am one. Experts say boomers are redefining life as well as retirement. We do things our way. But is that good?

Here are some of the numbers.
  • According to the Dept of Labor, the average baby boomer has less than $50,000 saved for retirement.
  • Age 70 to 75 may become the new age for retirement
  • From Boomer Market Advisor, a lifestyle survey in 2007 showed the following:
    • 24% prefer to be contacted by email, 34% by cell phone, which is also their preferred communication outside of work
    • 47% indicated they had any financial discipline
    • 53% were concerned about changes to Social Security
    • 55% were concerned about changes to Medicare
    • 40% were concerned about effects of inflation
    • 68% have a certain degree of denial and believe they will be able to lead a comfortable lifestyle in retirement
    • 51% feel spending time with their family will be their most important activity in retirement, with 12% indicating travel as most important
    • 50% of boomers have a will
    • 37% of boomers have a living will and healthcare directives
    • 16% have a formal written financial plan
I hate to say it, but it looks like some of us have our heads in the sand.

Tuesday, February 19, 2008

Tips on Choosing an Assisted Living Facility

If your parent or loved one has made the decision to move to assisted living, congratulations to you both! Now that the hard part of making the decision is over, finding the right facility can be almost as difficult.
Here are some tips and questions to ask in finding the best assisted living facility.
1. All assisted living facilities are regulated by the state. Ask the regulating agency if any formal complaints have been made against the facility and to see copies of inspection reports.
2. Ask the facility to show you the employees certifications and licenses. Ask specifically how medications are managed and to see the certification of the person who administers the medications. It is important to know if residents can use over-the-counter meds themselves. Learn who is responsible for prescription refills.
3. No one wants to move again after adapting to a new home, so learn about the levels of care. Ask if they handle dementia patients. Are there a doctors and nurses on staff? It is important to know under what circumstances they would discharge a resident and how much notice they would give.
4. Check out the social and recreational activities. If possible, talk to some of the residents and their families to see what they like and don't like about the programs. Staff members who have been at the facility a long time provide a good indication of a well run, friendly atmosphere for the residents. Ask about religious services, pets on campus, transportation provided, meal plans and dietary restrictions. Now is the time to know if the residents have a complaint system and an advocate in place. Ask about visitors and family dinners.
5. Last but not least, find out all you can about financial matters before moving your parent into the facility. If a resident can no longer pay, are they out or is there a payment plan? Find out what happens if the resident is admitted to the hospital. Are charges pro-rated? Ask about deposits and refunds. Make sure what is included and what is an extra charge, such as transportation, special meals or activities charges. If your parent is into technology and uses a computer even minimally, find out about internet connections and special charges to connect.

Remember, with the costs of assisted living running on average $2500 to $3000 per month, be certain you are getting the best living arrangement for your money. Happy hunting!

Monday, February 18, 2008

Retirement Planning for Caregivers

The number of caregivers in the United States is growing daily. And guess what folks? Most of the caregivers are themselves approaching retirement age. Yes, that's right. We are the Baby Boomers the media talk about.

How many caregivers have plans for their "golden years"? Retirement planning is more than travel plans and how much money is in our 401K. While these are important issues, caring for an aging parent should be a clear reminder to get several important documents in order for ourselves. A Power of Attorney, Living Will, Healthcare Power of Attorney and personal Will are what immediately come to mind. If you already have them in place, make certain they have been updated in keeping with important events in our lives. This would be births, deaths, divorces, remarriages, and job changes to name a few. In addition to your attorney, talk with your accountant or financial advisor if you have one. Tax strategies can change as we reach retirement and tax brackets adjust.

Now is the time to take a serious look at long term care insurance to see if it is right for you. As with any insurance, the time to purchase it is when you don't need it. Once you do, it's too late. Also, check with your insurance advisor to update beneficiaries if necessary.

So, fellow caregivers, I hope I've put a bug in your ear to get busy and begin getting your house in order. And to those who are way ahead of the game, Kudos!

Sunday, February 17, 2008

Superbrain Yoga

In an article taken from AARP Magazine, I've discovered a new way of boosting brain power! Now, this is something anyone may be interested in, the aging parent or the caregiver.

Yoga has been around a long time, and before you panic at the thought of trying to put your body through the many contortions Yoga is known for, let me reassure you, that is not the case here. Actually, it's one of the reasons I was so excited to read the method for Superbrain Yoga as it is called, because there is no way I could twist myself into a pretzel for my brain or anything else! I truly admire those who have mastered the art of Yoga, but I still have difficulty sitting cross legged on a mat. While I believe I'll have to leave the intricate positions to the masters of Yoga, I think I can accomplish the one described in AARP magazine under the Mental Muscle heading.

Basically, you hold onto your right earlobe with your left thumb and finger, and your left earlobe with your right thumb and finger, stimulating accupressure points on the earlobes. While pressing on the earlobes, squat a little with your legs about shoulder width apart and do about 10 deep bends while you breathe in and out. I've taken some liberty with the instructions, so it would be best if you check it out in AARP magazine. The article says it should be done daily.
Don't you wonder how my mother is going to like this exercise? I'll let you know.

Friday, February 15, 2008

Senior Co-op Neighborhood

I have often met older people who are alone. Some are estranged from their families and others had never married or married but never had children. Their immediate families of brothers or sisters have predeceased them and they are alone. Yet, they want to remain in their own homes as the majority of seniors do, even with family all around them.

While many organizations exist to support seniors who wish to age in place at home, one of the newest of these is the senior co-op concept. What is a senior co-op? Taken from the CSA Journal 37 2007, "it's as simple as a group of people agreeing to make their neighborhood a comfortable place to grow old."

The Northeast area was first to begin a senior co-op at Boston's Beacon Hill Village in 2001. The scene goes something like this; a community forms a non-profit organization and members pay dues for services ranging from transportation to home repair, and security to companionship. The idea is to ensure older people can remain in their homes as long as possible. It would be a comforting concept that predetermined chefs, carpenters, or a home health aid is just a phone call away.

Services offered by a non profit membership organization may be able to offer the prearranged services more cost efficiently than individual hire for the same services. The co-op concept is still in its infancy and critics of the idea say it's only for the wealthy. It seems to me that taking proposals from subcontractors works the same for everyone. It depends on the level of service to determine what cost is assigned to that service. After all, it's about keeping the seniors in their homes and maintaining dignity and independence as long as possible. I think I'd like to get a testimonial from a co-op member before I form an opinion. It's an interesting concept and I'll be watching this one.

Wednesday, February 13, 2008

Robot Pets?

There is plenty of documented evidence that caring for a pet is therapeutic for older people. The closeness and companionship of a cat or dog can bring a sense of comfort and calmness to both the senior and the pet.

What if the person is unable to care for a pet? Well, there is an option out there. Developed in 2003 by the National Institute of Advanced Industrial Science and Technology in Japan, "Paro", the robot seal, is a furry creation designed to arch its back when scratched, turn its head to make the reach easier when rubbed, and coo and whimper just like a baby seal. Because Paro is so lifelike, people tend to believe in it and be affectionate to it. The creator, Dr. Walter Shibata, says he modeled the robot after a baby seal because people think they are cute but have little experience with them. Dr. Shibata says people that interact with the robot tend to be cheered up, motivated and talkative, just like those who care for animals.

At this time, the robot is not widely sold in the United States and like any new technology, is a bit pricey. But perhaps, its time has come.

Tuesday, February 12, 2008

The Power of Water

Water is pure liquid refreshment. Not only is it necessary for your body to digest and absorb vitamins and nutrients, it also detoxifies the liver and kidneys and carries waste from the body. According to Dr. Donnica Moore, founder and president of Sapphire Women's Health Group, a small 2% drop in body water can cause fuzzy short term memory, trouble with basic math, and difficulty focusing on a computer screen or a printed page. Mild dehydration is one of the most common causes of daytime fatigue. According to Dr. Moore, 75% of Americans have chronic dehydration.

Outside the body, water continues to be a powerful force, particularly for healing. The many proven benefits of exercising in water include relief of pain and muscle spasms, increased range of motion, increased muscle strength, faster recovery from many types of surgery and more. A simple explanation for the benefits of water therapy is that the buoyancy supports and lessens stress on the joints, allowing freer movement to occur. In addition, the water acts as a resistance to help build muscle strength. Therefore, though you must use your muscles more while in the water, it doesn't feel strenuous.

Older people can benefit from more water inside and out. So drink up! For water therapy or a great workout without the pressure on your joints, find the nearest pool and get going! As always, check with your doctor before beginning any exercise program.

Monday, February 11, 2008

Walk with Sticks?

In my research on exercise for the elderly, I came accross an article on Nordic Walking. The walking technique was developed in Finland ( hence Nordic) in the 1900's as training for cross country skiers. Walkers use poles to push off with each stride, and used properly, this walking gives a whole body workout. The poles help take weight off the weight-bearing joints and increase stability which is great for any age!

Nordic Walking is becoming more popular with seniors in the United States and poles can be purchased on line or at sporting goods stores everywhere. If you are talented enough to make your own poles, make sure the height is correct for your legs and stride, and be certain to install rubber tips that will grip any surface. Wrist straps can be made of velcro and you are good to go!

I'm going to see about a pair of sticks for me and my mother. I'll let you know how that goes.

Thursday, February 7, 2008

Now We Wait

This morning was my mother's monthly appointment to check the levels of blood thinner in her system. Until recently, I took her for this blood work every week and her medications were adjusted each time as necessary. Her new doctor felt that was excessive and told her he didn't do things that way. Needless to say, the new schedule made ME happy, so long as it was good for Mom.

This appointment was also the first time she had been back to her primary care physician since the last visit to Memory Care. I spoke of this in my post Let's Face It...Who Likes Exercise? as exercise was one of the things suggested to keep the brain functioning better for longer. No one can be really certain they have the beginnings of Alzheimers disease, but the doctor at Memory Care felt there was enough concern from the initial testing that Mom should go ahead with the full battery of tests, including an MRI. If she wanted to. And up to today, she wanted to! According to Mom, she "just didn't want to say anything about it right now".

So now we wait. I hope I'll be ready to hear the verdict when she finally is ready. In the meantime, lots of exercise to do!

Wednesday, February 6, 2008

The Times of Your Life

Ahhh...Valentine's Day. Just the name conjures up visions of roses and candy, romantic dinners and love is in the air. What better time to change the focus from all that needs to be done for your aging parents to all the ways to express your love for them?

Time is fleeting, and while it is a scarce commodity for you, it is even scarcer for your parents. You don't have to spend a lot of money to show your love for them. Spend some time with them. Create lasting moments to remember with photos, a hug, and a sincere "I love you".

I'm sure I sound like a Kodak ad, but these are the times of your life. Will you remember?

Tuesday, February 5, 2008

The 40-70 Rule

I was happy to see in the Port Clinton News where a national company has started a campaign urging adult children to initiate conversation with their older parents about the "delicate" issues. By delicate, I mean when to stop driving, and money, among others.

Home Instead Senior Care has called its public education campaign the "40-70 Rule". If you are 40 and your parent is 70, it's time to begin the conversation on their wishes as they age. As I wrote in my post Never Too Soon To Plan, this is not always easy. Parents don't always want to discuss sensitive issues with their children. Some may not see their children as adults and that is a big hurdle to get past. On the other hand, many adult children don't want to get involved early and find themselves in crisis mode when they must be involved.

The Home Instead campaign has a "40-70 Rule" guide they will give you for free. According to the arcticle in The Port Clinton News, the guide provides many tips and conversation starters to help break the conversation barrier. You can pick one up at your local Home Instead Senior Care office or call 877.733.5050. You can also visit online at www.4070talk.com.

Saturday, February 2, 2008

To Be or Not To Be...Guilty, that is

Living thousands or even hundreds of miles from your elderly parents can be like living on another planet. Independence is of primary importance with many older people. . So much so, they may not tell you over the telephone when something is wrong. Unless you are very good at detecting small changes in their voices or noticing a change in schedule and other deviations in their daily lives, parents can fool their family into believing all is well.

Why would they do that? Most say they just don't want the kids to worry. They know it is hard for the family member to drop everything to get to them and expensive to boot! But do they recognize the guilt their children experience at not being there for Mom and Dad? Could be another very good reason for not telling them. If they don't know, how can they feel guilty? Too bad it doesn't work that way.

I know myself that in the days when I was a long distance caregiver, the feeling of guilt because I could not be there got overwhelming at times. Part of that, too, was because I could not find services available for help at their home. Fortunately, times have changed and even in their small town, services have increased. The Administration on Aging is responsible for a website called Eldercare Locator. Eldercare Locator is a resource for state and local agencies that could be the answer to your prayers. The office can be reached by telephone as well at 800.677.1116.
I'll be discussing more on where to go for assistance in subsequent posts. In the meantime, be good to yourself. Guilt only wears you down.