Smart Senior

Senior Living: Self Help the Old Fashioned Way

 

Don’t knock gizmos and gadgets.   Whether your parents are getting older, or you are an independent senior yourself, you are undoubted wondering what you can do to make your life easier and your home safer.  Even if you are in good health you may find that activities of daily living are not as easy as they used to be.  Bending, stooping, climbing stairs or even just opening a pickle jar may be a challenge.

Remodeling your house or moving into a retirement community would be the ideal solution, but it is not for everyone.  You should be able to stay in your own home, without compromising your health and well-being, and be able to do it without spending money that you don’t have.   However, you do need to be aware that your house could be sabotaging your bid for independent living.  Don’t delay.  If you don’t know where to start, ask for help.  An evaluation by a professional will be money well spent, and may even be covered by your health insurance.  An occupational therapist can make practical and economical recommendations that will make your home a better place to live.    The idea of safety proofing your home or buying anything that sounds high tech can be daunting, but small changes can make a big difference.  

Family members and friends often ask what they can get for you or what they can do to help you.  Next time, tell them what you would really like.  Instead of mumbling into your hand that you are fine and that you don’t need or want anything, give them a list.  Believe me, your children and your friends will be pleased to know that they can do something useful.  Really, they hate buying bathrobes and dusting powers as much as you hate getting them.  Let them know how much you would appreciate a subscription to a taxi service, safety strips for your bathtub, an alarm pendant, or a dozen other items that you need but never get around to buying for yourself.    Do you still need some ideas?

• Get rid of wobbly television tray tables or end tables in your living room.  I have seen far too many older people use furniture to support themselves on as they move around their apartments.  This is never a good idea.

• Replace easy chairs that are hard to get into and out of.  You need solid arms supports and firm cushions.   When you were younger it was all well and good to sink into a bean bag chair, but nowadays you could be stuck there for days.

•  Replacing a slippery round doorknob with a lever will make it easier for you to open doors (there are also door knob lever adaptors that will fit right over your existing doorknob).  Lever faucet handles for sink and bath are easier to manipulate if your hand strength is less than it should be.

• An occupational therapist will introduce you to tools such as the”reacher” (a long pole with a grabber at the end) to help your reach for items high or low.  Dozens of products such as the Good Grip Jar Opener by OXO are available to help you out in the kitchen.  You wouldn’t think something so simple could mean so much.  Inexpensive bottle openers, pill dispensary units, specialty toothbrush and floss holders.  If you have a need you can find just the right gizmo or gadget to fill your needs.

Where there is a will there is a way.  Look for answers and accept help.  Independent Living could be right at your fingertips.

Senior Relationships: Grandparents and Grandchildren

 

Relationship columns in the daily newspapers are filled with questions about how to cement solid relationships. The questions are painful as people beg for help to keep or bring families together.   One lady wrote complaining that while her children were physically gone she couldn’t get them to take their “stuff” with them. Most parents have that problem at one time or another.  You are probably still wondering if it is okay to turn the kid’s room into a sewing room or give treasures to Good Will.  Is there a proper time to cut this particular umbilical cord?

Have you ever thought about why their “stuff” is still there?  It might not have anything to do with how much room they have at their new place. Have you thought about what having a home to return to means?  Keeping a room or a box of treasures is like telling them that they still belong.  When I went away to school my sister moved back home with her children.  My room became her room and my “stuff” went to Goodwill because there was no place for it to be.  When I would go home to visit on the odd weekends that I had off, I had to sleep on the floor in the living room.  I no longer had a place.  Well, you guessed it; I soon stopped going home. Of course I regret that now and I wish I had reacted differently, but I felt displaced.   Having a special place for children and grandchildren to call their own when they visit is a lovely way to let them know that they are always welcome.

This all came to mind when I read a delightful article in The Wall Street Journal (Wednesday, March 20, 2013) written by Alina Dizik.  She wrote about a new trend.  Instead of downsizing, some grandparents are renovating their homes to create comfortable living quarters for their favorite overnight houseguests.   In this instant they are talking about their grandchildren.  Basements and attics get the full treatment and are turned into suites of rooms where the grandchildren will feel like welcome members of the family.  This is a different approach than we knew when we were kids.   We were expected to be quiet and unobtrusive.  We were usually bored out of our minds when the grown-ups got together to talk.  It wasn’t fun and we weren’t very old before we started looking for excuses not to visit our grandparents.

So, does the idea of providing a haven for your children and your grandchildren appeal to you? Would you consider creating a suite of rooms that can grow with the children as they age, or accommodate multiple grandkids?  Think about height-adjustable tables and chairs, unisex color schemes, stain proof upholstery and flooring that holds up to spills and tumbles.  The sky is the limit as far as budget is concerned but it is possible to create a haven for the kids without spending thousands.   Your home could be special. It could be a fun and relaxing place for them to visit.

Senior Living: Slips, Trips and Falls

 

A fall can’t always be blamed on personal health issues.   Have you ever been walking along minding your own business, when for no apparent reason you stumble, slip or trip over something?  Of course there was a reason, but it wasn’t something that grabbed you attention and warned you to be careful.   It could have been a rough patch on a sidewalk, grease or food spilled on the floor, a misplaced throw rug, or maybe you just tripped over your own feet.  Slips, trips and falls happen every day.  You can slip if there isn’t enough traction between your foot and the surface you are walking on.   A water spill, food or grease on the floor, or a loose unanchored mat may be all it takes to land you in the hospital.   A trip is a little different.  Your foot hits against an object that probably shouldn’t have been there in the first place.  It doesn’t take much to cause a momentary loss of balance.   Different words but the same result.   You may laugh and feel dumb for not paying attention but a stumble, a slip, or a fall is not a laughing matter.

Falls that occur from other than medical reasons are lumped under the category of “extrinsic factors.”  Extrinsic factors are the things that affect your ability to move around safely, but don’t have anything to do with your health.  Common culprits are throw rugs, unsecured bath mats, clutter, and poor lighting.  Another common mistake is not having something to grab if you lose your balance.  For example, a shower curtain or a towel bar will not support your weight no matter how reassuring they may seem.

People tend to ignores things that are right in front of their noses.  It is hard to be objective about your own home. It is never a bad idea to have a physical or occupational therapist come to your house to make recommendations.  An outsider can quickly see what you do not, and can recommend quick and inexpensive ways safety proof your home.  It is easier to eliminate these extrinsic risk factors than you might imagine.   Let’s look at a few trouble areas, just so you know what I am talking about. 

• Eliminate doorway thresholds and scatter rugs.  Remove clutter, consider railings along stairways (indoors and out) and have wooden stairs carpeted or fitted with non-skid treads. Good indoor and outdoor lighting is a must.  Decide if a ramp or a stair lift would make life easier for you.

• Remove high-pile or shag rugs.  I shouldn’t have to tell you that throw rugs that slide across the floor are a major hazard.  If you really need throw rugs they should be tightly woven and secured to the floor with nonslip adhesive tape.  If you shop around you can find non-skid throw rugs and slip resistant mats, and while you are at it, ask for recommendations about carpeting that is walker or wheelchair friendly.

• Pay attention to the ground when you are walking outside, especially if the area isn’t familiar to you.  Rain, snow, ice, or leaves hide rough patches and/or make surfaces extra slippery.

 Safety-proof your home before a stumble, a slip, or a fall takes the decision out of your hands.  If you think I am over reacting I want you to take a look around your house right now, and then tell me that there aren’t at least six trouble spots waiting to trip you up.  

Independent Living: When A Senior Falls

 

Everyone falls.  Toddlers learning how to walk fall, kids riding bicycles fall, and rough-housing while playing can result in a fall.   We thought nothing about falling down when we were kids or even as young adults.   I’m not sure of the exact day, but somewhere around the time of your 60^th birthday, a fall suddenly becomes a big deal.   It is scary when words like bone density, osteoporosis, and balance become a part of your vocabulary.   If you feel unbalanced at time or are having near falls more often than you should, it is time to familiarize yourself with words like fall prevention and safety proofing your house.

Right now you are probably more concerned about your parents or grandparents than about yourself, but your time is coming too.   A friend of mine got tangled up in a pile of bedding and lost her balance.  She fell and sustained multiples fractures in her foot and ankle.  It took nearly a year for her to recover and get her life back.  She was older, but she wasn’t that old.  A fall can happen to anyone.   Tripping over a dangling bedspread, bobbling when you stand on one foot to get dressed or bumping into bed franes are all signs that you need to start thinking about your balance.  

Why are you falling?  What is going on in your life that makes you feel unsteady on your feet?  Usually it is a combination of environment hazards (how safe is your home), chronic conditions that you may be dealing with, or medications that you are taking.  Some of these issues are treatable so don’t ignore them or suffer in silence.  A few common conditions that can contribute to falls are:

• Arthritis:  Today much can be done to treat or minimize discomfort and disability from arthritis.  Medications, surgeries and physical therapy are known to work wonders.
• Sensory deprivation:  Vision and hearing loss contribute to falls because they affect how you move around our environment. Eye conditions and hearing loss are often treatable.
• Medications:   Studies show that the risk of falling increases with the number of medications you might be taking.  I know people who take 14-20 different medications every day.  It isn’t surprising that side effects and drug interactions often contribute to falls.
• Muscle Weakness:  A sedentary lifestyle or a prolonged illness can result in muscle weakness. Muscle strengthening exercises can make you less vulnerable.  Certain diseases can cause muscle fatigue and weakness, but you won’t know unless you are tested.  Neurological problems can affect stride, balance and judgment.  Parkinson’s disease, recovery from a stroke, and dementia are a few of the culprits.
• Depression as well as substance abuse might be difficult to detect but certainly contribute to falls

When you get older a fall is a big deal.   It doesn’t take much to influence judgment, balance or motor function in an older person.   Worrying about your elderly parent or even about yourself is a good thing.  Stop falls before they happen!

 

 

 

Senior Living: Hoarding

Hoarding is in the news.  There is even a television show about hoarding, which means that the rest of us can’t pretend that we don’t what the word means.   Many of us have packrat tendencies, but when does reluctance to part with a few things turn into a problem?

 What would your house look like if you never got rid of anything?  It is surprising how easy it is for homes and offices to become buried under piles of clutter. Clutter has become such a hot topic that you can find hundreds of articles about how to organize your life.    The suggestions are all marvelous and we rush out to buy all sorts of containers to store our “stuff” in, but getting rid of “stuff” is another matter altogether.  Organizing stacks or even filing things away in baskets and storage bins isn’t always good enough.

The problem is more common than you might think.  Younger offenders are just labeled poor housekeepers, but when a senior expresses reluctance to throw things away it suddenly (or not so suddenly) becomes an area of great concern.   Hoarding becomes a point of concern when the behavior is deemed to be threatening to health, safety, or quality of life.   At this point it becomes a family issue and families are expected to intervene.  How do you determine if the behavior is normal or something to be truly worried about?

The first step is to involve the health care team.  We know deep down that a stern word from the doctor is not going to change this behavior, but it is a start.  Medical, neurological or psychiatric problems may be contributing to this change in behavior.

If medical or psychiatric issues are ruled out and your senior has sound decision-making abilities it is time consider other options.    So, what’s next?  You probably aren’t going to be able to stop this behavior altogether, but control is the key word.   Have you talked to your senior about why they save everything? If they are afraid of losing important documents perhaps you could introduce computer technology or something equally creative.    Discuss the issue with them and outline what you are worried about.  You may be able to get them to agree if you invite them to be a part of the solution (while making it quite clear that you are going to have to do something).  It isn’t going to be easy, but if you understand why they are indulging in this particular type of behavior it might make it easier for you.  Hoarding is often a way of coping and they may feel that it is one of the few things that they have any control over.

As for the rest of us, start now.  Stop making token efforts at tidying and think about whether clutter is taking over your life.   If you don’t have the time or energy to do it yourself it is time to hire a professional.  Stop saving everything.  Share with charitable organizations, and figure out what really matters to you.

 

 

 

 

Senior Living: Toilets for People With Special Needs

 

Walk in tubs, shower benches, and grab bars come readily to mind when considering a bathroom remodel, but let’s not forget the toilet.  Being able to manage toilet hygiene is a big deal for a senior who wants to be independent.  Transferring on and off a toilet seat, standing up, sitting down, and basic hygiene   sounds pretty basic to most people, but when weakness associated with chronic illness or other disabilities are factored in, the priority changes.   I am familiar with raised toilet seats, toilet seat frames that attach to standard toilets, and power seats to assist with standing, but today even more options are available.

The October 2012 AARP bulletin (www.aarp.org/bulletin) mentioned some smart toilet features in an article by Candy Sagon.    The idea of a smart toilet has been around for awhile, but I found the model that she highlighted quite interesting.  If you have traveled in Europe you have probably seen bathroom bidets, chuckled a bit, and even wondered what they were for.  Think about the bidet for a minute.  Ms. Sagon writes about an attachable bidet seat.  The seat can be installed on your toilet and it can wash and dry you, front to back.  You may scoff and think this is a little over the top but if you have ever struggled to help someone clean themselves after using the toilet, you might think this a pretty good idea.  

This won’t sound so far fetched if you think back to when hands free toilets were first introduced.  At first they were a source of amusement but they have become pretty common place now.  Universal design and smart homes are introducing ways for people with chronic health issues to manage personal hygiene on their own.  There are even self monitoring sensors that will take charge of raising and lowering toilet seats.    Bathroom remodeling can be so much more than a pair of grab bars.  Some toilets go so far as to weight you, record body temperature, take your blood pressure and do a urinalysis.  The future is here now.

Independent Living: Bathroom Safety

 

Cleanliness is important.  How neat and clean you are says a lot about you.  It tells the world that you care about how you look and how you feel.    Cleanliness is important at every age, but even more so when you are older.  Being neat and clean tells everyone that you are doing   “just fine, thank you very much”, and that is the way you want to be perceived. 

Most people do not consider bathing a dangerous activity.  A relaxing bubble bath or a steamy shower sounds like pure bliss, but statistics tell us differently.  The bathroom is undeniably one of the most dangerous rooms in the house.   Protruding shelves, sharp edges, and slippery surfaces make time spent in the bathroom an “iffy” situation.    An unbelievable number of emergency calls revolve around bathroom falls.  

A bathtub is a standard item in most homes.  Bathing is so commonplace that we forget to think about everyday safety measures.   Children and anyone with medical issues or disabilities are especially prone to bathroom accidents.

Anyone can slip and fall in the bathroom, but the risk increases when people get older.  “Nonsense,” you say”.  “I have been bathing myself all of my life, what could possibly go wrong”?   A great deal can go wrong. The usual props like towel racks and shower curtains may give you a sense of security, but they are not sturdy enough to break your fall. They are not designed to bear weight. 

Chronic illness, medication side effects, decreased strength and balance issues are all reasons why bathing assistance is a good idea.  At the very least someone else should be in the house when you bathe.   It is human nature to resist being supervised during this very private time, but the time comes when safety is more important than modesty.    

 Alarm bracelets and portable phones are heaven sent, and should be within reach at all times.  I learned when working with seniors that this doesn’t always happen.  You would be surprised how often alarm pendants and phones are left on the nightstand in the bedroom. All of the alarms in the world won’t save you if you don’t have them with you.

If I had my way every home would have alarm buttons, walk in bathtubs and threshold free showers (complete with a shower chair), but that is not always possible.   It is a good plan, but what do you do while waiting for that plan to come together?  A few easy-to-install devices can make your bathroom a safer place.  Non-slip mats, grab bars, shower chairs, tub chairs, vanities minus sharp edges, and raised toilet seats can made a difference.   You will be pleased to hear that safety features do not have to be unsightly.  Universal design has become so popular that you can find grab bars and other safety features that will blend into your bathroom décor perfectly. While some consumers are perfectly happy with inexpensive utilitarian products, higher end products are available to fit any budget.    Please make bathroom safety features a priority.

 

 

 

Senior Living: Housework for the Weary

I hate housework.  Women have been responsible for house cleaning since the beginning of time, but I doubt that very many of them have ever loved it.  There are a few that view scrubbing and moping as a form of meditation, but by-in-large housework seems like a waste of time and energy. 

Coming to terms with the idea that self-worth is not determined by how white your sheets are or whether you can eat off your kitchen floor is difficult though.  Generations of women have been beating themselves up striving for perfection.  

Creating order out of chaos is certainly a good thing, but is it important enough to view every task as if the world would end tomorrow if it weren’t done?

 Hundreds of books and articles can be found to support your personal theories about housework.   Help is available if you are tired of trying to keep up.  You can learn how to create a semblance of order without obsessing.  Learn how to feel good about yourself by checking in with (www.flylady.net) or by reading the book “Side-tracked Home Executives” by Pam Young and Peggy Jones.

Housework should be easier as family size dwindles, but for some reason dust and clutter persist.  Many older homemakers come to the realization that there is more to life than a spotless house.  Arthritis and other chronic conditions also enter the picture and housework becomes more of a challenge every day.

There is more to downsizing than buying a smaller house.  Shopping around for a new place to live takes on a whole new perspective.  This time around you won’t fall prey to the lure of floor to ceiling stair cases, split levels, or difficult to clean ceramic countertops. You will be practical this time.  You will look for easy to clean shower stalls, cupboards that go all the way to the ceiling and reachable windows.   Treat yourself to a few pieces of good equipment, like a vacuum that really sucks or a mop that actually absorbs.  Get rid of knickknack shelves and nix the idea of windows with tiny individual panes.  You should know the drill by now.

Think positively about tools that actually make cleaning easier.  Investigate the possibilities of magic reach extenders, toilet wands, power kitchen scrubbers, robot vacuum cleaners and floor scrubbers.  Touch-less trash cans, shelves that slide out to meet you, and front loading washers and dryers (some even come on a pedestal that raise them up off from the floor for easier reach).  Shop wisely, use wrinkle release products and forget ironing.

Let modern technology be your guide and stop obsessing.  Use your time for volunteering, physical fitness, educational pursuits and artistic endeavors.  No one will remember in 100 years if there were dust bunnies under your bed.  They will remember your sense of humor and your joy of life.

 

 

Senior Living: House Hunting

House hunting is often objective instead of subjective, meaning that people house hunt with their hearts instead of with their minds.  You fall in love with a yard, a neighborhood, the number of bedrooms a place has, or maybe even the wall paper pattern in the breakfast nook.   Sellers know this and it is not usual for them to hire professionals to “stage” their apartments/houses so that they look really good.   The seller is hoping that you will fall in love with what you see instead of what you want or need.

 If you are going to the trouble to downsize, you want to be sure that everything is going to be just right.  Downsizing is more than just buying a smaller house.  This time around you will be looking for a place that will make life easier for you.  You don’t have to worry about what school district you will be in or how far you have to drive to work, but other considerations will come into play.   Universal design features, location, and transportation systems are a few of the words you will hear mentioned.   Some homes today include elements of “universal design”, which means they are designed to improve the lives of people with special needs.  These houses are designed to accommodate people with arthritis, older people and people with handicaps.  Retirement communities and senior only apartments are often designed with these specifications, but not everyone can afford what they might call a “smart house.”

A small one story house is a good place to start.  My husband watches the housing market closely.  We are studying what is available versus what we are really looking for.   It is not a bad idea to tour open houses in your neighborhood, whether you are in the market or not.  Think of it as good practice.  Identify what you see and think about whether it is just right or could be renovated to make it just right.  Don’t look at the wallpaper, but at whether the house would be a good fit for you.    What if you had to use crutches, a walker, or even a wheelchair?

 It is unlikely that you will find a house with all of the features that you want, but each one present is a step in the right direction.    Start with an open floor plan.  If you are thinking about remodeling you don’t want to be dealing with a lot of walls and small spaces.   Don’t forget to look at manufactured home floor plans.  Whether this kind of housing appeals or not, you will come away with some great ideas.  I am amazed at how open and airy they are and am impressed that they looked much larger than the square footage would imply.      Some universal design features will be expensive, but others are things that you can implement quickly and inexpensively.   If you feel this is above your personal level of expertise, consult an expert.   You can find architects and contractors who specialize in accessibility design and renovations.  Their input could be priceless.  You can have them inspect your existing home, or a prospective home, to see if alterations are feasible and within your budget.  

On the other hand, if you have the time and inclination you can do most of this yourself.  For example:  you can check to make sure there are no steps or stairs, or if the doorways and hallways are wide with low or no thresholds.  You probably won’t find grab bars or raised toilet seats in most bathrooms, but does it look like they could be installed?   Is there room for a walk in tub or easily accessible shower?   Are the counters lower than usual, cabinets with slide out shelves, keyless locking systems or motorized blinds and curtains?  These are just a few considerations but you can find a checklist as close as your local library, or get information from your state Division on Aging.    Take a few minutes to browse and then take a checklist with you when you tour homes in your neighborhood.

Fall Prevention: "I'm not hurt, but I can't get up!"

First of all I want to thank the ladies who responded to my piece on fall prevention, and were interested enough to ask questions.  I wish I had all of the answers, but I am going through a period of trial and error myself. I am not a physical or occupational therapist, but I am terribly impressed by the work that they do.    I did work as a nurse in a retirement center for many years so I do know that falling is a real concern.  Indeed, what does happen if your knees are bad or you fall somewhere where you can’t get to a chair to pull yourself up? What I can do is help you think this through.    Hopefully we can get other people to share their own fears, concerns, and solutions.

Older people are prone to falls for all sorts of reasons.  The only person who can keep a fall from turning into a catastrophe is you.  You absolutely must entertain the idea that a fall could happen to you, BEFORE it happens.  I did learn when working in long term care that you have the right to fall.  Does that make sense?  What it means is that no one else can prevent you from indulging in risky behaviors.

If you plan on aging in place, especially if you live alone, you need to think about what measures to take to ensure your own safety.   The best ways to reduce risks is to:

• Beginning a regular exercise program to improve strength, balance and coordination.
• Fall proofing your home
• Reviewing your medicines with your doctor and pharmacist to make sure that dizziness, sleepiness or other side effects are not setting you up for a fall.
• Vision and wellness check-ups on a regular basis.

Get down on the floor right now and practice getting up (under supervision).      Read books or watch videos if you don’t know where to start.  The easiest way (now that you are computer savvy) is to type the words “getting up after a fall” into your search engine.  You will find some excellent videos that will walk you through the process.   If you aren’t brave enough to try on your own, take a better balance class at your local hospital or senior center.  If you have difficulties with balance and walking because of poor muscle strength or a chronic illness, you can ask your doctor to refer you to a physical therapist for a one-on-one evaluation.

Basically it is up to you to make sure that you can get up or at least summons help.  Wear a voice of help pendent or keep your cell phone on your person at all times. Write and tell me what you are doing to make sure that a fall does not end life as you know it.