Begin by talking to your parents about the strong association between falls and nursing home admission.  Schedule some time with your parents and ask them to show you how they do things around the house.  Get your pencil ready and take notes!

 Entrances/Exits

Which entrance does your parent use the most?  Which entrance is the most covered?  Observe your parents exiting and entering the house.  What do they hold onto?  The door frame?  Is there a hand railing?  Is it secure?  Is their performance safe?  How do they get the mail?  Have them walk to and from the mailbox.  Can your parent safely take out the trash?  Ask your mom or dad to show you how they transport the trash can to the curb.  Is the driveway sloped?  Is the sidewalk cracked?  How would they take out the trash if they had to use a walker?  Is their performance safe?

Is there a hand railing along the steps to enter the house?  If your parent uses a walker, what does he do with it on the steps?   Does he leave the walker behind and use a cane instead?  Do they have a storm door?  Does it close in on your mom when she tries to get the walker through the doorway?  How does she bring in the groceries from the car?  Ask her to carry a bag of groceries from the car into the kitchen.  Is her performance safe?

Take notes on what areas appear to be potential safety hazards that may place your parent at risk for falling. 

Kitchen

Do your parents still cook or mostly microwave their meals?  Do they wash dishes?  Empty the dishwasher?  Use the microwave?  Make sandwiches/cereal/coffee?  Do they use the stove?  Ask them if they have ever left the stove on?  Ask them to show you how they transport a cup of coffee from the counter to a chair.  If your mom uses a walker, how does she transport items around the kitchen?  Ask her to show you how she carries a cup from the sink to the table.  Is her performance safe?  If your dad uses a walker, what does he do with it when he approaches a chair?  Can your parent move from the kitchen door to the sink, counter tops, and table without risk of tripping over something?  If they needed a walker in the future, could they travel these paths without bumping into the edges of the door?  Examine the thresholds.   Is there a change in the level of the floor surfaces?  If your dad has visual deficits, is there a contrasting color between the floor surfaces?  Does your Mom have to pick up the walk up to get over the threshold?  Does she do this safely?  Is there a rug beneath the sink – is it nonskid?

Are you taking notes of safety hazards and potential problems that could cause a fall?

 Bathroom

Seniors rate bathing as the #1 most difficult activity.  This is a critical area in the house for safety!  A fall in the bathroom has a high likelihood of resulting in a serious injury.  Ask your parents how often they are taking a shower.  Is your dad in the habit of going to the basement to shower?  Falling on the stairs has a high chance of resulting in an injury.  Ask them if they have ever fallen or almost fallen getting in or out of the shower.  Does your mom like to take a bath instead?  Ask her to show you how she gets in and out of the tub.  Does she struggle to get up?  Does your dad try to help?  Is the performance safe?  Does your dad use a towel rack to hold onto as he steps over the tub?  Is there a nonskid surface on the floor of the shower?  Is the bathroom cluttered with items such as a hamper, decorative baskets on the floor?  Is there a waste basket obstructing the pathway in/out of the tub/shower?  If your parent uses a walker, does he have to leave it outside of the bathroom because the door is too narrow?  Can your mom turn the faucet handles easily?  What is the water temperature set at?  Could your parent get into the bathroom using a wheelchair?

Take notes of anything that concerns you.

 Stairs

Many falls occur on the last 2-3 steps.  Analyze the staircases at your parents home.  Does the hand railing stop short of the last step?  Is there a light switch at the top and bottom?  Is the light adequate?  Is there a throw rug below the last step?  Does it slip around?  Is the carpeting on the stairs frayed in any areas?  Are they using a plastic runner to protect the stairs?  Do your parents have to manage stairs to access a bedroom or full bathroom?  Could a main floor bathroom be enlarged to include a shower?  Could a bedroom be created on the main floor?  If they only have to manage steps to access the basement, could the activities they do in the basement be brought to the main level?  Could the washer/dryer be moved to the main floor?  Could a handyman check the furnace/water heater?  Ask your mom and dad to show you how they negotiate the stairs.  Is their performance safe?

Gather your notes, thank your parents, and call me.

 Who am I?  I am an Occupational Therapist specially certified by the American Occupational Therapy Association in Environmental Modifications.   An occupational therapist has a medical background with knowledge about the progression of health conditions.  A home assessment by an occupational therapist trained in home modifications has been shown to prevent falls.  A fall is a major threat to your parents’ independence and ability to remain living at home.

 I offer a $97 one-hour home assessment that will save your parents money because I focus on no cost and low cost home modifications and simple essential safety solutions.

Nancy Dillinger, MOT, OTR, SCEM, ATP

liveLife@Home, LLC

nancydillinger1@gmail.com

In their new paper, the UCLA authors discuss the importance of heart failure disease-management and early identification, as well as the treatment of body-fluid congestion, using a number of home-monitoring strategies, including self-care, such as daily weighing and medication management; phone calls from a nurse or automated response system; home health visits; and telemedicine and remote monitoring with implantable and external devices to track vital information.

Impact: The field of heart failure home-monitoring is fairly new. Further study will help assess optimal approaches, such as identifying which patients may benefit the most from such monitoring, and will determine which health data – blood pressure or shortness of breath, for example – may be the best to monitor. Promising new technologies, including devices to track heart-ventricle and pulmonary artery pressures, which are closely related to congestion development and clinical outcomes, may be particularly promising.

The authors suggest that the best approach is most likely multi-pronged, including monitoring along with patient follow-up and feedback.

A typical pattern with an overloaded caregiver may unfold as follows:

• 1 to 18 months – the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.
• 20 to 36 months – the caregiver may be taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless.
• 38 to 50 months – Besides needing tranquilizers or antidepressants, the caregiver’s physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help.

It is often at this stage that family or friends intercede and find other solutions for care. This may include respite care, hiring home health aides or putting the disabled loved one in a facility. Without intervention, the caregiver may become a candidate for long term care as well.

With the holiday season upon us, caregivers feel even more stress — with planning, shopping and participating in holiday activities. This is a perfect time for family and friends to step up and provide some respite time and caregiving help. Whether it is provided personally or arranged as a gift of services to be provided by a professional respite company or home care provider, it is a welcome gift.

An article in “Today’s Caregiver” states:

“Nearly one in four caregivers of people with Alzheimer’s disease and other dementias provide 40 hours a week or more of care. Seventy-one percent sustain this commitment for more than a year, and 32 percent do so for five years or more. One of the best gifts you can give someone caring for Alzheimer’s is something that relieves the stress or provides a bit of respite for the caregiver.
The Gift of time: Cost-effective and truly meaningful gifts are self-made coupons for cleaning the house, preparing a meal, moving lawn/shoveling driveway, respite times that allow the caregiver time off to focus on what he/she needs.”

It is also important to note that hiring professional care provider services can provide valuable ongoing support to an overloaded caregiver.A financial planner, care funding specialist or a reverse mortgage specialist may find the funds to pay for professional help to keep a loved one at home. A care manager can guide the family and the caregiver through the maze of long term care issues. The care manager has been there many times — the family is experiencing it for the first time.

An elder law attorney can help iron out legal problems. And an elder mediator can help solve disputes between family members. There are also cash benefits for Veterans, who served during a period of war, that pay for home care or assisted living.

If you are the one providing daily care for a loved one, you owe it to yourself to seek help.
Take care of yourself and your needsm, both physically and mentally. Seek out professional help that will ease your burden and look for community service organizations that offer respite help.

Alzheimer’s disease is one of the top ten diseases Americans die from each year, but it is the only one on the list that is expanding as the other causes of death are declining. Alzheimer’s Disease is a degenerative brain disease and the most common form of dementia.

“Alzheimer’s is becoming a more common cause of death as the populations of the United States and other countries age,” notes the Alzheimer’s Association ”While other major causes of death continue to experience significant declines, those from Alzheimer’s continue to rise.”

One reason for this difference is that the other leading fatal illnesses are preventable, such as stroke and heart disease, but Alzheimer’s cannot be prevented with lifestyle changes, According to the Alzheimer’s Association.

View the entire article at the Huffington Post by clicking here.

Click here for more information about the 2011 Walk or to register!

Please stop by our tent near the finish line on Saturday morning and receive a FREE Elderlink Home Care, Inc. T-Shirt while supplies last! Mention this blog post!

Join the Alzheimer’s Association Walk to End Alzheimer’s™ and unite in a movement to reclaim the future for millions. Walk to End Alzheimer’s is the nation’s largest event to raise awareness and funds for Alzheimer’s care, support and research. Together, we can end Alzheimer’s disease — the nation’s sixth-leading cause of death.

Elderlink Home Care, Inc. is the proud ‘Finish Line Sponsor’ for the 2011 Walk To End Alzheimer’s. Please join us on September 17th! You can participate in the Walk, start a team, fund raise or show your support by simply coming out to the event.

Details and registration information can be found at www.alz.org/walk

The National Alzheimer’s Project Act (Public Law 111-375) requires creation of a national strategic plan to address the rapidly escalating Alzheimer’s disease crisis and will coordinate Alzheimer’s disease efforts across the federal government.

Click here to see  A Message From The President Get involved, make a difference, share your input!

If it’s been a while since you last saw your aging parents, you may be shocked at how your mother’s health status has changed in such a short time. Is she losing weight, does she appear unkempt? Did you always have to shout so loud for your dad to hear you? At some point you will be struck with the realization that your parents are getting older. It’s time to broach the subject of ‘what happens next’ and to start making plans for the future.

Why is it difficult for children of aging parents to discuss the future? Although each situation is different, most of us have difficulty with the sudden reversal of roles, or we may feel like we are meddling in our parents’ private lives. There may also be a reluctance to admit that the inevitable has happened; that our parents have gotten old.

Yes, it’s a tough discussion to initiate, but remember it is never too soon to discuss the future with your aging parent. It is much easier to make plans before a crisis, such as a fall or a stroke catches you off guard. It’s much better to have a plan in place early, rather than scrambling around at the last moment.

Although this looming conversation may feel like one of the hardest things you’ve ever had to do, don’t let your parent sense that. Plan your approach and timing carefully and you may be pleasantly surprised. Chances are if the subject is on your mind, it has been on your parents’ mind as well.

Start Talking About It

Just the idea of having this discussion with your parents may be enough to increase your blood pressure, but no one ever said that discussing your aging parents’ future would be easy. Most of us are used to having our parents ask the questions. Yet now, as your parents’ current or potential caregiver, it’s up to you to start asking the difficult questions.

It’s always best to sit and discuss with the parent the plan to hire homecare before actually doing so. If possible, pick a time when there is no immediate crisis and when your parent is emotionally and physically up for this discussion. Explain that while you enjoy being with your parent and being able to help, there just aren’t enough hours in the day to be able to take care of their needs correctly and still have quality time together for visiting. Parents may initially feel abandoned. like you don’t care. The parent may also feel like they have been such a tremendous burden on you that you want to push them off on someone else.

Everyone will react differently to the idea. Some will be very accepting, others will argue, some will do the guilt trip thing and others will just say no!

If the reaction you get isn’t positive, explain again why it is that you want to bring in homecare, explain your problem and then ask your parent to come up with alternative ideas. to help you! Parents are often willing to do something to benefit their children, which they would not be willing to do for themselves. It’s best not to bombard parents with a list of things they are doing “wrong” or a list of things that they are unable to do, instead a simple sentence like, “Mom, I am concerned because you are not eating properly and are losing weight,” will get a better response. Parents tend to accept the idea better if it is viewed as a luxury or benefit, something they deserve, rather than something being forced upon them because they can no longer care for themselves; “Mom, you deserve someone to come in and prepare some good meals for you,” is more likely to be met with a positive response.

It can be frustrating and it may take some time, but eventually most will come around. It’s best not to force the issue, but to be persistent.

Remember to Listen

While it’s a good idea to plan the topics you’d like to cover and the decisions and conclusions you’d like to reach, try not to make the conversation appear too prepared and scripted, this could frighten your parent. Remember – this is meant to be a conversation between two people. Your parent will likely be more accepting of a new plan if they feel they had a part in making the decision. Be prepared to listen to what your parents have to say – they may already have some pretty clear ideas of their own.

Here are some tips and pointers to help you try and make the conversation go smoothly:

• Don’t let your questions appear as though you are interrogating. If you are sensitive and show genuine interest and concern, chances are your loved one will open up to you.
• Be support ive and empathetic, not judgmental or accusatory. The last thing you want to do is appear threatening and put your parent on the defense.
• Ask open-ended questions to give your parent an opportunity to share their opinions and wishes with you.
• Have an open mind regarding your parents’ decisions and wishes, even if you find it hard to agree, remember it is their lives you are discussing.
• Don’t overwhelm with too many questions. It may take several discussions over a period of days or weeks to cover all the areas you feel are important. However, when wrapping up a conversation, be sure to make a definite time for the next discussion or there is a danger the subject will get brushed under the rug.
• This is a good time to share your thoughts and plans for your own aging. Let your parent know that she is not alone in her concerns.

Begin the Transition

Bringing a new caregiver in your home is never an easy thing. It is hard for anyone to have a stranger in their home doing the things that they have always done for themselves. Having a caregiver for your parents may be a great relief for you, but will be a difficult transition for your parent. If possible, start slow.

A good idea is to start with non-personal care, such as light house-keeping and meal preparation. There is an understandable dislike for the idea of someone coming in to help in the bathing process or even doing laundry. Such feelings are rarely expressed about someone who prepares dinner, does the dusting, and provides transportation to appointments; those things are not as personal. The parent will get used to the idea of having a caregiver and will be more responsive when the time comes for assistance with personal care.

Things that parents are reluctant to ask you to do are easily asked of the home caregiver. Also the parent will discover that you have time to spend with them when you do come for a visit, instead of rushing around trying to get everything done. Over time, you will likely find that your parents have not only become used to having the caregiver around, but they enjoy it as well; this does not happen overnight.

Often in the senior years, the parent takes on the role of the child and the child takes on the roll of the parent. Usually, this is uncomfortable for both. Bringing in homecare can help put you back in the adult/adult relationship and give you back some quality time with your parents.

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Loneliness or depression

The majority of people, when asked, prefer to stay in their own homes for as long as possible. People need to feel they have control, and when they are in their own homes, they set the standards. Simple things like when to wake up, when to eat and when to bathe are personal choices that can not be accommodated in an institutional setting.

Elderlink is your resource for hourly and live-in caregivers. We offer, at no cost, an initial home visit to address questions and to ensure the highest level of compatibility between our clients and their caregivers. Please call or e-mail for affordable rates or to receive additional information. We welcome your questions.

Help is just a phone call away!

How To Introduce Your Parents To The Idea of Home Care