‘Aging Parents’ Posts

Fall Prevention…How? April 28, 2017

April 5th, 2017 by Doris Bersing
Living Well Proudly Presents Dr. John Fullerton, MD and Hampton Health, Ltd
Falls don’t “just happen,” and people don’t fall because they get older. Often, more than one underlying cause or risk factor is involved in a fall. As the number of risk factors rises, so does the risk of falling. Many falls are linked to a person’s physical condition or a medical problem, such as a chronic disease. Let Dr. Fullerton explain how a fall could be a sign of a new medical problem that needs attention, such as an infection or a cardiovascular disorder. It could also suggest that a treatment or interventions for a chronic ailment, such as Parkinson’s disease, Alzheimer’s disease or dementia, needs to be changed.

Speakers: John H. Fullerton, MD and Minoo Parsa, BS

Dr. Fullerton is Board Certified in Internal Medicine, Geriatrics, Hospice, Palliative Medicine, and Addiction Medicine, as well as board certified Medical Review Officer, Medical Director, Forensic Physician, and Home Care Physician. A primary care physician and clinician educator for 26+ years, Dr. Fullerton is the Co-Founder and CMO for Hampton Health., which specializes in ambulatory and urgent care, including a focus on the transitions of care between acute, rehabilitative & hospitalbased SNF, secured Dementia Units, Assisted and Independent Living Facilities, Home Care, and Hospice & Palliative Care. Minoo Parsa is the Founder of Fall Prevention and Dizziness Therapy a program she established in November 2016 and which has become a trademark of Hampton Health.

Date & Time
Friday, April 28, 2017
3:30 — 5:30pm
Location
The Coventry Place — 5th Floor
1550 Sutter Street
San Francisco, CA 94109
RSVP
1.800.805.7104 or events@LivingWellAH.com

Refreshments will be served.

Download Flyer


Social connection is key for senior well-being

August 24th, 2016 by Doris Bersing

Visiting your eldersWhen talking healthy aging, we need to stress the fact that social connection is key for senior’s well-being. Loneliness and isolation can have serious consequences for seniors’ physical and mental health.

Social isolation and loneliness go hand in hand with poor health outcomes. Numerous side effects have been connected to social isolation in the elderly, including dementia, loneliness, and severe depression. Aging parents want to feel included in the lives on their loved ones; sadly, very few have the time to come visit. To make sure our beloved mothers and fathers stay happy and help preserve their general health, it is important to include them in our lives. Edward Francis from Forest, an eldercare village, gives us some tips on how to reduce elders’  loneliness and some ways to help them reconnect with family and friends.

Make transportation accessible

The main cause of social isolation in aging parents is lack of transportation. Most seniors are not in the capacity to drive, so it is important to help them get around in order to socialize and make independent choices. If your parents leave someplace where public transportation is not available, it might be a good idea to call them and ask if they need a lift. Do this twice a week. If you can’t, ask a friend or send them a taxi. Some seniors don’t even know they have public transportation in the area; make time to visit and teach them how to use the bus or the train. It will make them feel more independent, and even prevent a sense of loneliness.

Give aging parents a sense of purpose

Seniors who have hobbies or a sense of purpose are less likely to become isolated. Apart from making seniors find meaning in life, interests and hobbies are social activities by nature. Playing bridge or chess, cooking classes, exercising are all excellent activities aging parents should do to stay entertained. Local senior centers have all sorts of events planned out for seniors; checking those out might also be a great way to meet new people and interact. Doing some volunteering work is an excellent way of expressing and preserving a sense of purpose as well. Encouraging aging parents to stay active and engaged keeps them away from becoming lonely and isolated from the rest of the world.

Encourage your parents to get a pet

Research has demonstrated over and over again that the mere act of caring and nurturing relieves feelings of depression and social isolation. Getting a pet for example, is a great way of staying engaged, feeling more secure and having motivation to use time in a constructive way. Animal companionship fosters relationships with neighborhoods. It is a social stimulant, an icebreaker that gives seniors a serious reason to wake up in the morning and do fun things. Prior to recommending your parent to get a pet, you need to make sure that they can take care of it.

Boosting self-esteem

Many seniors don’t want to socialize because they have a poor image of themselves, particularly of their bodies. Those who lack confidence are prone to being lonelier than those that do choose to interact and have a social life. For instance, overweight seniors feel embarrassed and ashamed; they don’t like to engage because they fear that people will judge their physical appearance. Positive comments and compliments can go a very long way; they help boost self-esteem and prevent seniors from freaking out over their weight and physical appearance. It might be a good idea to encourage your aging parent to adhere to a healthier lifestyle; not just to lose weight, but also to feel better and more self-assured in their own skin.

Recommend vision and hearing tests

Seniors suffering from untreated or undiagnosed hearing or vision issues may want to stay isolated because of their inability to communicate properly. In this case, it might be a good idea to take your parents to the doctor; have them checked out and treated so that they can be back on their feet. A hearing aid can help them overcome their fears of social interaction. Vision tests are equally important because they will allow older people to see better and thus pay more attention to the things happening around them.

Senior parents who refuse to socialize usually have a very good reason for their behavior. It’s up to you to find the root cause of their depression; then you can work together on a solution. In most cases, it’s all about boosting their self-esteem and convincing them that they can have friends and be happy even if they’re in their 70s or 80s.

 

Elders’ Driving: Rights and Concerns

July 4th, 2016 by Doris Bersing

senior driving driving a car slowly on highwayElders’ driving is one common concern adult children have regarding their senior parents’ safety . Home Care providers and geriatricians specialized in elder care, often hear the following questions from concerned children: How do I tell Mom or Dad, they cannot drive anymore. Is it safe for them to be driving at their old age? How to stop my parents from driving? and the problem seems to become bigger.

According to the Pew Research Center, 10,000 baby boomers will turn 65 every day for the next eighteen years. By 2030, almost one in five drivers will be over the age of 65, and they’ll outnumber teenage drivers more than three to one. Some experts are calling this the silver tsunami—and it’s not a movement that’s coming peacefully.

Statistically speaking, elderly drivers are involved in more car accidents and highway fatalities than any age group but teenagers. Elderly drivers often have trouble keeping up with traffic on the road, but unfortunately, there’s no easy way to prevent unsafe drivers from getting behind the wheel while still allowing experienced and competent senior drivers to keep driving. Several procedures have been discussed, from mandating vision tests (which isn’t always effective in identifying drivers whose visual impairments raise their accident risk) to issuing restricted licenses that only allow for daytime driving (which might not impact elderly drivers significantly, since they already tend to remain at home). Implementing an age cap on licensing, on the other hand, raises constitutional due process and equal protection concerns, as federally imposed restrictions must not be at odds with the Fourteenth Amendment. Clearly, balancing senior driving rights and safety precautions is a serious concern with few obvious answers. Speeding violations lawyer Zev Goldstein cites a recent study by Katherine Mikel of University of Miami School of Law which sheds light on the subject.

State Testing Initiatives

State governments, rather than federal governments, control driver’s licensing across the United States. States vary widely in how they treat elderly drivers. Thirty states and the District of Columbia have imposed additional requirements for older drivers, ranging from improved vision testing to more frequent license renewal for elderly drivers.

License Renewal Restrictions

No states will revoke a driver’s license based on their age alone. Some states, however, have put additional restrictions on license renewals for elderly drivers.  Some states, however, don’t differentiate based on age: they have few or no requirements at all for older drivers. In Tennessee and North Carolina, however, elderly drivers are given more leniency than their younger counterparts: drivers over the age of 65 don’t have to renew their license in Tennessee, while North Carolina drivers over the age of 60 don’t have to parallel park to pass a road test.

License Renewals

States vary on their requirements for older drivers when it comes to renewing their license. Many states institute shorter renewal periods for people over a certain age. These periods, however, can vary widely. In Colorado, individuals over the age of 61 have to renew their license every five years, while those under 61 may renew theirs every ten years. In Illinois, on the other hand, the average driver must renew their license every four years. Between the ages of 81 and 86, this shortens to every 2 years. From the age of 87, drivers must renew their license every year.

Testing

Several states have instituted increased testing requirements for elderly drivers. Many of them require a vision test in order to renew a driver’s license. In Illinois, a driver who is 75 years old or older must take a road test. Some states, however, are more lenient than others. In Florida, elderly drivers are able to renew their licenses by mail for up to 12 years before experiencing testing requirements. If they are over the age of 79, Florida drivers must pass a vision test; however, they can submit results from an approved test by an eye doctor or physician by mail. Most states don’t require a road test to renew a license at any age.

Unsafe Driver Referrals

All states may not have restrictions on license renewals, but there are systems in place to help keep unsafe drivers off of the road. In every state, the Departments of Motor Vehicles, Highway Safety, or Transportation have offices where family members or doctors can make referrals concerning unsafe drivers. The state office will investigate the claim, which may lead to the driver needing to take a road test. Doctors don’t have to report unsafe patients. The state of California, however, mandates reporting of patients with dementia; other states require doctors to report patients with epilepsy.

Age Caps on Licensing: Constitutional Concerns

As was previously mentioned, age caps must adhere to the Fourteenth Amendment. The Due Process Clause of the Fourteenth Amendment states that no citizen can be deprived of constitutional rights—including the right to “liberty”—without due process. The Equal Protection Clause protects everyone within the state and insists that no one should be arbitrarily denied any right granted to others. These clauses protect drivers from age discrimination, which means that no arbitrary cap on age can be assigned in order for a person to hold a driver’s license in any state.

Simply put, these amendments protect United States citizens from having their driving privileges arbitrarily revoked. In other words, there can be no “mandatory expiration” of driving privileges after a certain age. States also can not restrict the use of their highways. Like the Age Discrimination in Employment Act of 1967, these regulations prevent drivers from experiencing discrimination on the basis of age alone. Because of this, the responsibility falls on each individual senior and/or their adult children to keep an eye out for any changes in driving ability. When they reach an age where it is no longer safe for them to be behind the wheel, it is up to individual families to note the continuing signs of age and prevent their loved ones from endangering themselves and others.

Across the United States, people in every age group tend to view driving as a necessity rather than a privilege. However, there is a significant conflict of interest on the issue of elderly driving. Elderly drivers want to retain personal autonomy—and as seniors lose some of their mobility, it becomes even more imperative for them to retain their independence and ability to get around—but states and other drivers wish to increase safety on the road. As the rise in senior drivers continues, state and federal governments must continue to seek solutions in order to provide the best outcome for everyone.

Guilt Busters For Caregivers

June 24th, 2016 by Doris Bersing

forehead-65059_640Caregiving brings about a swirl of feelings and guilt is one of them. As the saying goes, guilt is a useless emotion, says Ruth Folger (*). While that may be true, as compassionate human beings we experience guilt more frequently than we may like, especially when it comes to taking care of an aging loved one.

Caring for the elderly is a frustrating task. You may find yourself getting angry at the slightest things, like having to prepare an extra meal or finding the time to help them change. Then, you start to feel selfish or guilty. These feelings are normal, but in order for you to be happy and continuing to enjoy your elderly loved one while they are still here, it’s important to learn to let go of the guilt associated with caring for them.

  • Don’t feel guilty for not spending enough time with your loved one. Any time spent with your loved one is quality time – time they will be grateful for it. Most often, when you are acting as the caregiver, it is in addition to the full time job you already have. Think about the time you spend with them like a budget. How many hours a week can you put towards visits and phone calls? Making a mental plan of how you will allocate your time can help ease the guilt.
  • Don’t feel guilty for taking a vacation. This is probably one of the biggest fears caregivers carry with them. In addition to not spending enough time with a loved one, you feel the second you leave or go away somewhere that you’re going to get “the phone call.” Thinking this way will only add more stress to your life and make the time that you do spend with your loved one strained. If you want to go away, have a plan in place in case of an emergency, but do not halt your plans all together.
  • Don’t feel guilty when other emotions take over. Do you sometimes feel like you are losing your patience? Some days are more difficult than others, and occasionally your emotions may take over. This is completely normal. No one is perfect and you are allowed to be angry, sad, or tired. Just take a deep breath and remember that it is okay to feel this way.
  • Don’t feel guilty when you find yourself resenting this role. Being a caregiver is a very trying job. Resentment is another emotion that can develop over time. You begin to resent your loved one for the little things they do. You resent that you are in charge of being the caregiver. You resent other members of your family who could be helping a lot more but aren’t. At the end of the day, you have to remember that you are doing the right thing. While something trivial may send you spiraling down the path of resentment, you know deep down that you would have even more resentment if you weren’t helping out your loved one.
  • Don’t feel guilty for taking time for yourself or the other members of your family. Do you want to read a book? Catch up on your favorite TV show? Go get a massage? Do it. You deserve to take time for yourself so you can rejuvenate and relax. When you take time for yourself, it can help ease your guilt and the other emotions because you are restarting your mind. You may also have a family of your own, and they need to spend time with you as well. Don’t stretch yourself too thin, but make sure you aren’t neglecting your family or friends because you’re taking care of one of your elders.
  • Don’t feel guilty if you have to put your loved one in a nursing home. No one can do it all, and it is okay to ask for help. As much as you would love to be the sole caregiver of your loved one, with full-time jobs, families, and other obligations, it can be close to impossible. You can relieve yourself from a lot of stress when you find the right healthcare center to move your loved one into. There are many stigmas against senior homes, but in today’s society, most of those are just old wives’ tales. Finding a good senior home can be the best decision you make both for you and your loved one, mentally and physically.

With care giving comes a lot of stress. It is essential that you don’t let the guilt associated with that stress consume you.

(*) Ruth Folger Weiss is a writer for the Westgate Hills Rehabilitation and Healthcare Center, a nursing home in Baltimore, MD, who shares with us tips for busting the guilt associated with caring for an elderly family member.

 

 

 

How being a caregiver for aging parents can be one of the most challenging realities in life

July 1st, 2015 by Doris Bersing

The Center for Diseases Control and Prevention (CDC)  states that more than 34 million unpaid caregivers provide care to someone age 18 and older who is ill or has a disability; an estimated 21% of households in the United States are impacted by caregiving responsibilities; and unpaid caregivers provide an estimated 90% of the long-term care (IOM, 2008).

It is estimated that one in eight people are now official caring for an aging parent. Edward Francis, a Living Well collaborator, at Forest Health Care estimates that this is a result of the baby boom years combining with improved healthcare and an increase in the average life expectancy. This responsibility may come to these caregivers suddenly or it may become a gradual, progressive path of commitment. It requires a change to your mindset, no longer are you the child, you now need to take care of your parents as they have always done for you.

 

It can be a challenging experience to be a caregiver for a parent dealing with memory loss that eventually materializes in dementia or Alzheimer’s.

Role change

Illness can cause a gentle shift in roles but it is a lot moiré difficult when an accident changes the situation dramatically in moments. This is often the case as elder people are more prone to injury and a broken hip can have a serious impact on their ability to care for themselves. The role reversal can be exceptionally difficult for those who were never that close to their parents but do feel the need to care for them.

It can be very difficult to make the right decision in either your own eyes or your parent’s eyes and you may bear the brunt of a parent’s frustration. For your role as caregiver to work you need to accept that you are now responsible for the decisions and care of your parent.

Balance

It can be tempting to visit your parent every day or even multiple times during the day. In reality this will make the process far more difficult. You will end up physically and emotionally exhausted whilst emphasizing your parent’s dependence on you. It can be very difficult to find the right balance between being there and making the best decisions whilst providing them some space to be as independent as possible. It is essential for your own survival to maintain a balance between caring, time for yourself and your own family commitments.

Planning ahead

From the moment you start caring for your parent you will have to start thinking about the future. If their condition deteriorates will they need additional caregivers, professional homecare, or perhaps assisted living facilities are the way to go; after all one size does not fit all.

The harsh reality of knowing your parents have a finite amount of time left will combine with concerns over the future, this can become a serious burden and it is essential you share the responsibility as much as possible.

Strengths and weaknesses

Like anyone you have areas of expertise and areas which you are not so knowledgeable or good at. You may be more sympathetic than your siblings or more financially orientated and it is important to utilize the skills you have. Knowing your areas of weakness and accepting that someone else can do that part better is a better way of caring for your parent and yourself than attempting to do it all on your own.

Dealing with a parent experiencing memory loss

One of the most challenging and draining aspects of being a caregiver is when your parent starts to lose their memory. It can feel that day by day they are drifting away from you and you are losing one of the people who have always inspired you and have always been there for you. It is essential to focus on the positives; a memory problem is probably more of an issue to you than to them. Encourage them to visualize their past by using photographs and talking to them, cherish the moments you have and the experience will be rewarding instead of challenging.

Network

Both the caregiver and the parent need to have a good network of support. You need to be able to vent your frustrations and gain advice from others to ensure you know you are doing the best possible for your parent. Your parent needs to remain in contact with as many people as possible to avoid loneliness and frustration building up and making the situation worse.

Every situation will be slightly different but it will always be a challenging time and a difficult journey. Your feelings and emotions will be tested to the limit but the ultimate reward will be worth it; knowing that you were there for your parents when needed and did the best you could, after exploring all the alternatives you could have. Look for consultation with the experts in the field, even if it is a long journey, you are not alone.

Empathy Plays an Important Role in Care Giving

June 10th, 2015 by Doris Bersing

Empathy and caregivingBe kind for everyone you meet is fighting a hard battle   ~ Plato

Many of our elders who had reached the golden years, find difficult to see the golden part of aging and at least, initially, they are aware of the transitions and respond with a myriad of emotions from shame and anger to depression, anxiety, and fear. Let’s remember theirs was the generation that survived the Great Depression and fought the last “good war.” Aging was not on their agenda, not for this long, not with so many medical issues, and with so little resources for retirement; to care for them we need knowledge, skills but overall empathy.

What is Empathy?

The simplest definition is the feeling of understanding you get when you stop and put yourself in someone else’s shoes. For caregivers this can mean imagining what it must be like to be in constant pain, or to be facing your own death. It could even be picturing oneself as constantly dependent on others, without any privacy. Once you understand what this would feel like you are able to relate better to the patient and will be much less likely to be frustrated by their actions.

Understanding their pain is only the first part of the job. You will also need to overlook your own feelings regarding how they may have arrived at their situation. It is imperative to accept people as they are and help them in any way you can. Empathizing with them will make your job easier as you understand why they need the care and the best way of approaching it.

Edward Francis with Foresthc.com shared with us some of the important points about how relevant empathy s when caring for our elders. He says, “…There are an increasing number of care givers in the world. This is a combination of people living longer and the steady increase of people in the world. Many caregivers fall into the role and can be excellent at taking care of someone’s needs; however this does not mean that they emphasize with them; a good caregiver can simply treat others, as they would like to be treated.

Understanding the Patient

Some patients can seem incredibly rude and make it very difficult to either help them or emphasize with them. In fact these are the ones that need your empathy more than any other. The rudeness is generally a result of severe frustration with the situation they find themselves in. Part of the role of a good caregiver is to understand how the family and friends are coping and to emphasize with them as well.

They may need a break or be struggling with dealing with the issue and a supportive shoulder can work wonders. Understanding their needs and fears can also provide you with the opportunity to help a family member deal with their own emotions and offer a better care giving experience to their loved one. Embarrassment is a common feeling in patients, like all of us they have been used to looking after themselves and doing what they like when they want to.

To have this all taken away and be completely dependent on others is difficult for anyone to adapt to. This often shows as rudeness or aggression but once you understand the patient you will be able to see it for what it is and react accordingly. Be patient and whatever you do make sure you don’t lose your temper in front of them; you certainly don’t want to make them worse, not to mention that it is unprofessional.

Listening can help caregivers empathize more with the patient

It can be very difficult when you are in constant pain and dependent on others to assist you. This can become much worse if you are not able to share your fears with anyone. A good caregiver will see these fears and will listen. Talking to someone allows a patient to lighten the load and this will help them to cope with the situation. It will also prevent either the patient or their family from getting wound up when there are so many factors, which are beyond their control.

Level of care

Caregivers who take the time to understand their patient’s personalities, needs and situation can offer a far better service. You will be able to relate to the patient and this will trigger a better response from them as they register your intentions. A caregiver who can emphasize with their patient will automatically look for ways to improve both the level of care and the general care experience. The best caregivers have empathy, sympathy and integrity, a difficult mix to balance.

Empathy is vital when caregiving for someone with dementia, Parkinson’s or Alzheimer’s. You must find a way to control your negative emotions and focus on the positive. This will help you get a better response from the patient, not to mention that you’ll be more relaxed and willing to help them out too.

Aging in Place: Assistive Technology and Human Touch to Solve the Caregiving Issue

May 4th, 2015 by Doris Bersing

Aging in PlaceWe all know those smart and dynamic elders, who used to be professionals, hard workers, homemakers, very engaged in their communities, who slowly but surely, are aging with aches and pains and diminishing faculties, with some times chronic and debilitating diseases rising in the horizon. We all try to help them to little (or no) avail, since the response is: “I do not need help …I am not moving from my home…I am not going to one of those places full of old people”… Does it sound familiar? If you have an elderly parent or loved one in need of care and help, I am sure you have.

Many studies since 2007 have focused on Aging in Place and what seniors and baby boomers want. Besides being in denial of needing help, elders fear moving into a nursing home and losing their independence more than they fear death, according to a study, “Aging in Place in America,” commissioned by Clarity and The EAR Foundation, which also found that the Baby Boomer children of seniors also fear for their parents. Boomers express particular concern about their parents’ emotional and physical well being should they have to enter a nursing home, finds the study, which examines the attitudes and anxieties of the nation’s elderly population. Although since 1997 AARP survey, we know (89%) of the interviewees answer they wanted to stay at home, and age in place – or live independently, but more than half of those surveyed (53%) are concerned with their ability to do so.

Some of the issues that force older adults out of their homes is not only illness and frailty but houses that do not accommodate their needs, isolation, and lack of support –we know our communities, sad to say, are not equipped with volunteerism enough to help some of these seniors or systems that protect not only the low income ones but the middle class, as well.

Projects like Capable in Baltimore, where volunteers come helping seniors run errands and reach the next community even that day while retrofitting their houses has proven to keep seniors at home longer. The project started as a major research effort in the Baltimore area called the CAPABLE project – it stands for Community Aging in Place, Advancing Better Living for Elders – is sending handymen, nurses and occupational therapists into the homes of hundreds of low-income seniors aging in place to see how far $4,000 can go in preserving people’s independence. The project’s initial success has captured nationwide media attention and piqued the interest of federal officials straining to hold down Medicaid costs. If it can be scaled up and tried nationwide, it could potentially save U.S. taxpayers millions of dollars. The average cost of nursing home care in the U.S. is $6,700 a month, much of it paid through Medicaid, so even postponing a move to a nursing facility by just a few months can have a major impact.

Another well known solution but difficult to implement, on one hand because seniors resistance to technology, and on another because of baby boomers not turning their parents into it, is Gero-technology that can lower the cost of home care when needed and/or help keep seniors independently but safely at home. Aging in a high tech world is not easy for these seniors but there are agencies and resources in the community to help them and their families navigate through the maze of options and what is really needed.

These technologies go from the safety ones to guarantee people are safe at home, and monitor their comes-and-goes, as needed without invasion, to the tablets to communicate with loved ones, receive medication reminders, or access services in the community. Organizations like Living Well use leading-edge technologies to evaluate their members’ health and mental status, reduce the cost of care, communicate medical and other information to physicians and relatives, provide cognitive vitality programming and monitor personal safety. When needed, they will evaluate the layout of the home and undertake modifications to ensure mobility, access, and security. In addition, our professional housekeeping and maintenance staff keep our members’ homes updated, clean, and impeccably maintained.

Just today, May 4, 2015 California Health launched a report discussing the caregiving issue and if really this technology involving social networking and technology will “…save the day for one of America’s most intractable social problems — caring for the country’s aging population? The article proposes a different way of hiring caregivers but still posits the issue of just having a caregiver. One size does not fit all and for some of our loved ones just low-tech or high tech intervention can save the day. Now if in need of home care, options are there with agencies as the article states charging more than what a privately hired caregiver could cost but no- back up, or services that will monitor the process for you, and more. Read the article.

In reality, the high tech and high touch is a better answer. It is not only technology but the human connection what makes a real answer: personal services and advanced assistive technology can add a strong measure of comfort, convenience and control to those that desire to remain at home but have conditions that may limit their ability to move freely, communicate effectively or otherwise navigate their environment. Together they can ensure and encourage those that desire to age in place the opportunity to do so with safety and choices for the seniors and peace of mind for family members and friends. Check all the options and remember one size-does-not-fit all.