Smart Senior

Senior Living: What Home Can Can Mean For You

 

Surveys indicate that most seniors want to age-in-place.  This means that they want to be independent and they want to stay in their own homes.  This isn’t a new concept, but it is being revisited because people are living longer than ever before.  Aging in place is clearly a popular option but it requires a certain amount of planning to make it successful. 

We all know that age brings on certain limitations, and these limitations may make it difficult to manage. It is not unusual for seniors to require help performing basic activities.  You may have hated doing housework and couldn’t boil water all of your life, and that was fine.  Now, all of a sudden, everything you do is under scrutiny.   Housework, cooking, and shopping have become indicators of whether you are capable of managing on your own.

 Most seniors who remain in their own homes get help from an informal network which includes friends, neighbors, and family.  As you grow older your network shrinks or disappears altogether. You may find it necessary to hire help via a home care agency or move to be near a family member.  This is your support system.  We have all heard about the seniors in the community who are teetering on the edge but refuse to leave their own homes.  Hopefully a plan has been put into action long before the hair pulling stage.  The plan needs to include your physical, emotional, and financial capabilities.

Needing help is nothing to be ashamed of.  Needing help does not mean that you are not capable of managing in your own home.  Think of accepting help as a safety net.  It is a known fact that older people who do not have help with daily tasks are more apt to be hospitalized than those who do. Seniors are less likely to experience medical catastrophes such as hunger, dehydration, falls and skin problems if someone is checking in with them on a daily basis

Moving into a retirement community is always an option but it doesn’t have to be the only option.  Many older adults can continue to live in their own homes if they receive assistance with basic needs.   Many of them do not need round-the-clock medical care, just some a little help with activities that elude them.  Area Divisions on Aging can provide a wealth for information about community services to help beleaguered families do what is best for their loved ones.

A Hired Companion: A Different Kind of Senior Home Care

 

The senior care industry is growing, and by all indications will continue to grow as seniors opt to stay in their own homes.  It is unfortunate that the medical model is the only type of home care that most people know about.   Visions of matronly nurse-types come to mind and you think of them as caregivers in the true sense of the word, but home care isn’t always about personal care and medical check-ups.   Some home care franchises offer companionship and non-medical assistance

 Let’s face it.  Even independent seniors like and need to get out and about on occasion.   Your mother/father might be doing fine at home but they may long for the days when they could go out on their own.  A hair cut, a physical therapy session, lunch in town, a trip to the grocery store, or even a movie could be very librating.   Asking a family member to provide transportation, and an arm to hang on to, is not the same feeling as having a friend to go places with. A companion not only provides all important human contact, but also served to reassures family members that someone is checking in on a loved one when they cannot.

Generally speaking the family takes it on themselves to provide transportation to appointments outside the home or facility.  Working families have to rearrange their lives in order to meet these needs and it is difficult.  It is difficult for them because they have jobs, and it is difficult for the senior who already feels that they are a burden.   Sadly, most outings occur only when medical attention is required.  In all of my years working with seniors, I only knew one lady who took advantage of a companionship service, and I remember thinking what a great idea that was.  It gave her an excuse to get dressed up and to go out into her old community on a regular basis.   Medical and housekeeping personnel definitely have a role in home care, but there may be times when a parent doesn’t want to be seen in public with someone that looks like a caregiver.

Some home care agencies offer non-medical assistance with services that include everything from meal preparation and light housework to companionship.    One of the CNN channels aired a segment on what might be called “concierge care” last week, which could best be described as a rent-a-daughter, granny nanny, or a Girl Friday to take seniors out and about.  Home care is not covered by Medicare so has to be privately arranged, but what a wonderful gift.  It isn’t that expensive and it is a gift that can be appreciated by everyone in the family.

Senior Health: Nutrition and Convalescence

 

The first thing that comes to mind when you feel a cold coming on, or are being discharged from a hospital bed, is how tired you are.  Nutrition is probably the last thing that you worry about.   Rest is important, but what you eat and drink will play an important role in your recovery.   

If the procedure is elective you will have plenty of time to plan for your convalescence.   It is a little different if the surgery or illness occurs unexpectedly, but give it some thought anyway.    Illness is rarely planned for but cold and flu season comes around pretty regularly.  It wouldn’t hurt to have a small stash of easily prepared food items, medications, and a list of resources grouped together for emergency situations.

After your surgery or illness it may be awhile before you feel well enough to go grocery shopping, cook meals, or even clean up after yourself.   When friends and acquaintances ask what they can do to help, swallow your pride, and let them know that a few simple meals or a grocery store run would be heaven sent.   If you live alone make arrangements for a service such as Meals on Wheels until you get your strength back.  Keep phone numbers at hand and even splurge a little on take out foods from your favorite restaurants.  Call around and ask if your favorite grocery stores offer home delivery services.

The hard part of planning ahead is mustering up enough enthusiasm to prepare for the days when you just don’t feel like eating. These are the most important days, because you absolutely must keep your strength up and your body well hydrated.  Dehydration can be a real problem for older people and it happens very quickly.   Always keep plenty of fluids in your refrigerator as well as soups (canned or homemade).  Popsicles and puddings count so don’t deny yourself anything that will makes nutrition palatable. There are times when bland comfort foods like chicken noodle soup, cinnamon toast, and tea with honey will hit the spot when nothing else appeals.  Ready prepared meals on supermarket shelves make it easy to keep a small stash on hand.   In addition to complete frozen meals there are liquid and snack items designed to boost energy and add calories.

Most people start slowly with clear liquid fluids (water, apple juice, jello, broth packets, tea, cranberry or white grape juice and even soft drinks).  When you can tolerate clear liquids you can move on full liquids (cream soups, milk, puddings).  If that tastes good you can start eating easily digestible comfort foods.   Take care of your nutritional needs before and after a surgery, but don’t forget that colds and flu symptoms can take a lot of you too.  You need your strength to fight infections and stay hydrated.  How well nourished you are can affect how quickly you will recover.

 

 

 

 

 

 

Senior Health: Do You Lie To Your Doctor?

 

People lie to their health care providers all the time.  It is easy to blame the doctor for a missed diagnosis, but have you ever thought that it might be your fault?  We’ve talked about the importance of list making and having frank discussions with your doctor, but if you aren’t telling him/her the whole truth you won’t get the treatment that you deserve.   Sumathi Reddy wrote an article for The Wall Street Journal (Tuesday, February 19, 2013) about the lies people tell their physicians, and she wasn’t just talking about senior moments or dementia.

You probably thought it was outrageous when Dr. House on the well known television series would say that “all patients lie”, but it seems he wasn’t that far off base.   Lies, from half truths and deceptions to all out lies, are pretty common.  I know this because I do it myself.   Do you always answer truthfully when the dental hygienist asks you how often you floss and brush?   We tell them what they want to hear because we are embarrassed or because we don’t want to be seen as failures.  You may down-play your symptoms because you are afraid of what the doctor will say, or you may embellish a little to get your own way.  Perhaps you need a slip declaring how sick you are to satisfy your employer or you want a handicap sticker just because it would be nice to have, but are you being truthful?

Your doctor is one of the few people in your life who will not judge you. He/she needs to know the details, but it is not up to them to have ESP.  They need to know about everything related to your health and well being.  Are you taking supplements or diet pills, using a laxative regularly, using stimulant? Do you smoke or do you exercise regularly?

People often go to the doctor because a family member or acquaintance recommends it, and they feel pressured.  Because the visit isn’t entirely voluntary they tend to clam up or try to hide issues that they don’t want to talk about.   Health care providers care about you but they don’t care in the sense that they will judge you for your imaginary shortcomings.  If you are doing anything that you feel guilty about it you should probably be talking about it.

 No matter what your excuse, it isn’t a good idea, and you know it.  Your appointment will never be long enough to address your health issues if the doctor has to pry correct information out of your lips.  Omitting important information could lead to the wrong treatment, the wrong medicine or even a wrong diagnosis.  

 

 

 

 

Senior Health: Home from the Hospital after Joint Replacement Surgery

 

Joint replacement surgery is pretty common these days.  You probably know of at least one person right now who is either planning on or recovering from a knee or hip replacement.  It could even be you.  

The decision to have any elective surgery is a big deal, especially if you are a senior.  Much time and though is given to getting ready for the big day and you are undoubtedly anticipating the outcome.   Less thought is given to how you are going to manage immediately after returning home from the hospital.

 You can choose to return to your own home, transfer to a hospital rehabilitation unit, or go to a nursing home/rehabilitation center.  My cousin just had a second knee surgery.  She went directly home after her first surgery but opted to try the hospital inpatient rehabilitation center unit this time around.  She agreed to share a few of her observations and opinions:

In-patient Hospital Rehabilitation or Transitional Care Unit:  “For me, two weeks was far too long.  The P.T. was good, but I was able-bodied enough to do most everything for myself.  I was able to bathe and dress myself and after a couple of days able to walk the halls with my husband.  It was easier not having to worry about meal preparation and going for out-patient sessions but I was happy when it was time to go home.”

Home Care:  “I think the visiting nurse and therapist cost less than the hospital stay.  They were at the house often enough to check on me and, of course, guide my husband and myself through therapy.  It seems that I was as far along doing it that way as I am now.  It is important and necessary to have someone at home to assist you.  You do have to be self motivated enough to do therapy sessions on you own as the therapists only come once or twice a week.  They expect you to make progress but it is not their job to stand over you with a whip.

The positive part of being in your own home is that you can maintain your usual schedule and sleep in your own bed.”      Both choices were positive experiences for her.  Your choice will depend on how much returning to your own home means to you.

You get specific instructions on how to get ready for surgery but getting your house ready for your return home is up to you.    Arthritis Today (www.ArthritisToday.org) featured an article (March/April 2013) by Emily Delzell about preparing yourself for your return home.  The information is pertinent whether you go directly home or if you go home from a rehabilitation center.    These are things that you already know but may not have thought about in awhile.  So here we are again:   ditch the throw rugs, get rid of the clutter, and have things that you use everyday within easy reach.  This means everything from books and magazines to cooking utensils. You don’t want to be reaching, stooping, crawling under or doing anything that might put you in an awkward situation.  You will probably be using a walker or crutches so make allowances for that as well as keeping a chair or stool in the kitchen and bathroom.   I am not going to remind you about shower benches and grab bars because you should have them whether you are having surgery or not.

You are not going home to rest.  You are going to have to work hard.  Therapy sessions may only be scheduled once or twice a week but that doesn’t let you off the hook.  You will need to exercise every single day.  This is important even though the urge to slack off will be hard to resist.  Take pain medications as directed so that the pain doesn’t get out of hand, and so that you can run through your exercises as ordered. Get out comfortable loose fitting clothing.  It might not be a bad idea to buy a few items in a size larger to accommodate swelling and difficulty dressing.  PT/OT will outfit you with gadgets for reaching and grabbing, sock aids, long handled shoe horns and elastic laces for your shoes.  Have some ice packs on hand and don’t balk at wearing compression hose.  You should be ready to get to work as soon as you get home.

Speak with your health care team if the pain is more than you can handle or if a fever, swelling or redness becomes a problem. Shortness of breath, chest pain, or anything that doesn’t feel right should be handled as an emergency.  Take care of yourself.  Even a minor surgery is a huge insult to your body it might take you longer to get back on track than you expect.  Your team will tell you if you are on track.  Please feel free to share comments and observations from your own experiences.

 

Senior Health: Meditation

 

The idea of meditation is quite fascinating and I often wonder why it is so difficult to master, especially for seniors.  Perhaps it is because meditation is often associated with martial arts and wise old men chanting on a mountaintop.  A senior might not feel they are ready to embrace something that to them is a “new age” discipline.   

There is nothing new about meditation. The thought that people have studied and practiced it for a very long time should be reassuring.   It is not the “how-to” that keeps meditation from becoming a part of our lives, but the feeling that a mind-body connection somehow goes against western religious ideals. 

The art of meditation is said to sharpen the mind, reduce stress and improve overall health and well-being.  What could possibly be wrong with that?  It has nothing to do with converting to a new religion, lighting incense sticks, or sitting cross legged for hours on end.    Meditation is about learning how to relax.   We all feel stress and we all respond to it, but learning how to turn that response off is difficult.    Stress makes the muscles tense.  Breathing and heart rate go up, blood pressure increases, and adrenalin surges.  No wonder we can’t relax after a hard day at the office.

We make meditation more difficult than it needs to be.  Meditation goes way beyond sitting quietly in a darkened room for long periods of time.    Sitting quietly is difficult for most of us because our minds are so active.   Getting your mind to shut up and stop reminding you of all the things you have to do is hard.    I must that I was quite relieved when I read on an article by Diane Peters (Chatelaine: July 2001) that focused on “meditation for the rest of us”. 

You would like to meditate, but sitting quietly in a dark room drives you crazy or puts you to sleep.  Do you think falling asleep while meditating counts as sleep therapy?  Ms. Peters described active meditation to help you learn how to focus.  These techniques help you relax, focus your mind, and concentrate on the moment.   One technique that she described allows you to walk around (active meditation). Your attention is on the movement of your body (this can be done inside or outside).  Concentrating on the three parts of walking (lifting, moving and placing the feet) gives you something to think about while learning to focus.

Another idea was to use mood lighting.  Light a candle and train your mind to focus on it (any candle will do).  You aren’t trying to think about the candle but are using it to hold your attention.  The photography buffs will like her third suggestion where you can (contemplative photography) use a camera to focus on color, light or textures.  There are other techniques mentioned but I think you get the idea about being able to focus on something soothing. 

In order to reap the benefits from meditation it is necessary to do it regularly and properly.   Classes, groups, seminars, audios, and visual programs are all worth exploring.  Whether you try meditating at home or join a group is up to you, but keep in mind that this is not a quick fix.  It takes more than casual dabbling with meditation, tai-chi, yoga or relaxing music to do this. 

Meditation needn’t be hard or mysterious.  If you can close your eyes, breath and count you can meditate.  All you are really trying to do is relax your body and distract your mind.  Imagine being able to rid yourself of a host of medical or psychological maladies without drugs or psychotherapy.  Meditation is one of the most overlooked forms of therapy.  Meditation has been proven to lower the heart rate, decrease stress hormones, strengthen the immune system, improve concentration and memory and make people feel more rested.  What could be better than that?

 

Senior Health: Seniors Feel Stress Too

 

The children have left the nest, the house is paid for, and the day job is history.  What could possibly be better than that?  What could a senior possibly find to worry about?

Think again.  It seems we never outgrow having things to worry about.  We not only dredge up the past, but we stew about the present and we worry about the future.  Life is not easy, and feeling stressed out about one thing or another is the human condition.

Seniors do feel stress.  The high incident of mental symptoms, depression and suicide among older adults reveals that stress management is important at every age.  Stress is related to health and who knows the importance of good health better than a senior?  

If you are a senior or if you have a senior in your life; you know they reject the idea of stress management more often than not.  The need for stress management is perceived as a sign of weakness and weakness means lack of control.   How do people (seniors and otherwise) deal with stress?  Studies indicate that the most common forms of stress management include:

• Expressing feelings of concern to family and friends
• Seeking professional help
• Religious activities and support
• Participating in enjoyable activities
• Developing a positive attitude

Seeking outside help had become fairly commonplace today, but older people are still reluctant to expose their thoughts and feelings to others.  Surveys indicate that older people would rather handle their worries on their own.   Perhaps this is because they worry that they will be looked down, they worry that they will be a bother to others, or they feel that their family and friends have problems enough of their own.   

Older adults prefer to manage stress on their own but they don’t really know how. The idea of problem solving and of learning relaxation (coping skills) techniques is foreign to them.   Common barriers to effective stress management techniques often include:

• A lack of access to services (they don’t know who to approach)
• An inadequate social support system (few living relatives)
• Difficulty in performing activities (poor mobility)
• Lacking motivation (not interested)

 It is obvious that stress reduction techniques are important at every age.  Solutions revolve around taking the mystery out of relaxation techniques and minimizing the barriers that may cause lack of participation.  How do you handle stress in your life?

 

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.

Senior Living: When Help Is Refused

Is stubbornness sabotaging your bid for independent living?   If you didn’t have a certain amount of stubbornness you wouldn’t have made it this far, but digging in your heels is seldom a good strategy.  We all know this, but the number of seniors who resist home care is astronomical.  The situation is painful for all involved.  Why is it that so many seniors get caught up in this game?

I know of three incidences right now; where refusal to accept help has or is about to deteriorate into a crisis situation.  Two are men and one is a woman, but these situations are not gender specific.  If your stubbornness has reached the point where it is clouding your judgment, it is time to let it go.  You have every right to insist that you be a part of the action but be sure that you are using good judgment.  When you refuse to listen to suggestions from family and friends you are creating a situation. You are forcing the people who love you most to take that decision making ability away from you.  You have backed them into a corner and they cannot in good conscience back out.

 It is important to understand that asking for help does not make you less of a person.  Being older does not automatically mean that your decision making abilities are suspect, but refusing to listen to reason does.

 I read an article in Prevention magazine by Mark S. Lachs (Sept 2001).  The article was written a number of years ago, but I can’t see that much as changed since them, except that more options are available.  Then, as now, it was felt that money was seldom the issue.

Even the most devoted friend or family member is at loss to know what to do.  Discovering why is the first step of course, but if the topic isn’t open for discussion what are they suppose to do?  For some reason accepting help is perceived as a loss of independence.  An older person sees accepting help as the first step toward nursing home placement.  The goal of course is to change that mindset.  Accepting help should be seen as a step in the other direction.  It should mean that you have become an active participant in your bid for independence.

What if your parent/grandparent truly believes that there is no need for help?   Make sure that she is not right; perhaps you are worrying too much.  Is the situation such that he/she is endangering self or others?  Everyone has a right to make decisions, but step back just a little before deciding to micromanage.

Insisting on an evaluation is always a good way to open a dialogue.  Everyone needs to have a primary care physician.  Many people are open to accepting recommendations from an authority figure rather than from family.   All being told, it is wise to make sure that poor decision making capabilities are not being augmented by reversible medical issues.  In some cases where the individual flatly refuses medical or social service assistance a court order may be needed in order to get that evaluation.

 Convincing an older person to accept outside help may not be easy.  They can always come up with an excuse why they don’t like such and such.  It wouldn’t hurt for family to be present when introducing a new person to the mix.  This may take awhile, old prejudices often surface and will serve as an excuse to refuse care.  Ultimately, it is hopeful that the right cord will be struck, and things will go smoothly.   Check with your local area agency on aging for recommendations and for support before making any major decisions.

 

 

 

 

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