Home Modifications

• Do you need assistance getting into or out of bed?
• Are you able to navigate getting to the bathroom during the night?
• Do you feel comfortable getting up and down from the toilet?
• Are faucets easy to turn on and off?
• Do you feel comfortable in getting in and out of the shower or bathtub?
• Do you have visual limitations or depth perception difficulties?
• Are all areas of the home appropriately lighted?
• Do you have difficulties with self-feeding?
• Are things you need arranged within your reach?
• Are windows, doors, cabinets easy for you to open and shut?
• Are light switches within easy reach?
• Are all rooms easily accessible?
• Is the phone in easy reach and at an appropriate volume?
• Are stairs easy and safe to navigate?
• Are all entrances easy to navigate?
• Is the furniture arranged to provide clear pathways and support as needed?
• Are outside pathways smooth and easy to navigate?

1. a.  Check for adequate lighting in all rooms, outdoor walkways, and hallways. Note any extra lighting needed: night light, noise-response lighting (the Clapper), brighter bulb, new lighting installation, or motion sensor lights
2. b.  Make note of any changes needed to provide clear pathways, safe and easy access, and balance supports especially for outdoor walkways, entrances, hallways, and stairways: rearrange furniture, remove obstructions or loose rugs, provide additional seating, install non-slip surface, mark level changes with colored or reflective tape, add handrails, install ramp or stair lift
3. c. Evaluate each room for functionality, potential hazards, or physical obstacles. Consider appropriate solutions.

Kitchen 

Living Room

• ramps
• lifts
• smooth pathways
• wide doorways
• wide hallways 
• electric door opener
• table, counters, sinks, adjusted to appropriate height

• reach extender
• walker
• cane
• walking stick

One advertisement was especially polarizing. The commercial, which aired nationally, showed an ambulance driving with sirens blaring. The driver was obviously trying to get to the hospital as soon as possible, but every time he tried to turn, a car cut him off. Every avenue was blocked. The voiceover explained that America desperately needs the health care reform being discussed in Congress, but there were people stopping it. And those obstructionists were making the patients die.

The entire campaign inspired thousands of seniors to abruptly leave the powerful lobbying group. Why? Because not everybody in the group saw things the way that the AARP leadership did. Millions of the group’s members have wanted nothing to do with the president’s health care plan, sensing it will lead the country toward socialism, something they have seen in action and believe will ultimately harm the country.

The discussion angered many seniors including, not surprisingly, Senator and former presidential candidate John McCain, who urged American seniors to cut up their AARP member cards and send the broken pieces back to the group.

Fortunately, there is choice on every corner in America. There are more choices in America besides the AARP. Most notably, the American Seniors Association (ASA) is specifically geared toward elderly citizens, and the 60 Plus Association is a politically active group for conservative seniors age sixty and over. Both groups bill themselves as alternatives to the giant AARP, which is far larger and more influential.

Recently, the Chairman of the 60 Plus Association, Jim Martin, testified before the GOP Doctors Caucus that the AARP was bias toward President Obama’s health care plan because it would favor their own business practices. Martin said “The AARP makes millions of dollars every year in royalties from selling insurance. They have a vested interest in this reform, but that interest is in their bottom line, not in the best interest of the seniors they supposedly represent.” (quote from www.60plus.org)

Since the election of Scott Brown in Massachusettes, the health care debate has slowed down. There will probably not be a new piece of legislation to reform the health care system for quite a while. The AARP and it’s counterparts will, in the mean time, continue to argue over the future of health care, and how it affects American seniors.

Whatever your political leaning, there is a place for you to add your voice to the discussion. While they may not be politically neutral, the AARP is still going strong for anyone over 50. Their website www.aarp.com is a comprehensive resource center for news, information, and services for seniors. On the other side of the aisle, you can find news, information and services at www.60plus.org and www.americanseniors.org.

1) Go for a visit. This is obvious, and certainly not everyone will be
able to do this. But remember that above all, your loved one wants to
be with family and friends. Do not underestimate the power of your own
presence in his or her life. You might not think you are very special,
but Grandma sure does!

2) Send notes! Do not just send a regular Christmas card and leave it
there. Everybody sends those. Show her how special she is by hand-
writing cards for her. That is Cards–plural! If you send multiple
letters, it will give her a better feel that you have not forgotten
her. Tell her the details of your life. Even mundane things will
probably be of great interest. Tell about the kids, about how they are
preparing for Christmas. Have them hand-write a message, or draw a
picture especially for her.

3) Give a meaningful gift. In Texas nursing homes, gifts can be especially
tricky. Residents have limited space. Their laundry is done in masse,
so things easily get lost. And they do not have a whole lot of
privacy. So what can you give? How about something especially
meaningful and personalized like a Potobook or personalized picture
calendar? If you take lots of pictures of the kids, and if you have
some good ones, you can easily order a surprisingly nice personalized
gift through most online services. Photobucket, Shutterfly, and
Snapfish are three of the most common. I prefer Apple’s iPhoto. Each
of these services will easily guide you through a step-by-step process
of plugging your picture into an attractive template and ordering the
product. This is an inexpensive option as well. You can probably order
a calendar for under $20.00. My wife and I ordered calendars featuring
our children for both of our parents years ago, and they loved it. And
they weren’t even in an nursing home, so imagine how much more someone
isolated would enjoy it!

4) Call! Make sure you carve out a good time to talk with your loved
one. It might seem boring for your family, but the sound of your
voices can mean the world to someone who has not seen them in ages.

In short, make your loved one a part of the holiday festivities as
best as you can. Keep them well informed through phone calls, notes
and gifts. That personal touch will do more to warm their hearts than
any old present could!

We have already discussed some very helpful methods of dealing with caregiver stress, and these are tips that will help in dealing with any kind of senior illness, including Alzheimer’s. But one of those tips might be more important for caregivers of memory impaired patients: The support group.

The very idea of support groups can be off putting for many people. The term conjures up images of circles of people who have to share their feelings, like at an Alcoholics Anonymous meeting. It’s an easy picture to reject. After all, care giving is a good thing. It isn’t an illness or addiction to be worked through. And when all is said and done, you will be fine, right?

Maybe. But Alzheimer’s and Dementia are complex problems with no clear solution. Nobody knows how to perfectly navigate the issues of memory loss, or the ripple effects they can cause in a family. And because it’s so complex, many feel like they are alone. They sense their efforts are not helping, and they ultimately get so stressed out that they burn out.

Support groups can be a wonderful source of information for caregivers. They are very often part of the “pipelines” of new research and strategies for dealing with the disease. Many are linked directly with groups like the Alzheimer’s Association (alz.org), which is on the forefront of research, fund raising and information on memory loss.

But the real reason people need support groups is that people need people. And not just any people will do. They need to be around people who understand what they are dealing with. People who have no emotional entanglements with their situation. People who will not judge them. Support groups provide these people. Caregivers can let their guard down and “be real” with other human beings who won’t think less of them for feeling exhausted, helpless or resentful, because they are or have been in the same situation. And if they have come through, they can offer the kind of human insight that no website or book could ever provide.

If you are a care giver for a senior with Alzheimer’s or dementia, you owe it to yourself to find a support network. It will help and your family. Residents of Smith County Texas who are looking for a support group can download a list of groups and schedules at the Alzheimer’s Alliance of Smith County website.

Residents of the greater Dallas area should go to this page instead. Alzheimer’s support groups for all other regions in the US should go to www.alz.org/apps/findus.asp .

Don’t Fall For a Too Good To Be True Ploy

The Mobile Phone has become a staple in society and a symbol of the
digital world. But not everybody uses them. Senior adults often find
them infuriating. The buttons are too small, the screen is too dim,
and the icons and options are overwhelming. Many would rather bring
change for a pay phone than carry one.

With this in mind, one company has launched a massive campaign for its
senior friendly phone: The Jitterbug. The premise is simple: It’s a no-
contract phone with a tenth of the functionality but twice the price.

We’ll look at the positives first. There is no contract that a senior
will get locked into. The numbers and the display really do make
calling easier for people with vision loss. And the fact that there
are “old time style” operators that can assist not only with directory
assistance but with calling from the customer’s own contact list is
appealing to many.

But the cost of using a Jitterbug is simply way, way too expensive for
what it gives you. The phone itself is $147, and their rate plans
start at $14.99 for 50 minutes per month. That is a total of more than
$0.30 per minute! And unlike every other major cell phone service,
there are no Nights and Weekend minutes or mobile to mobile
privileges. The only conceivable reason anyone would buy this plan is
for emergencies.

The more popular plans are $29.99 for 200 minutes, $39.99 for 300
minutes, $49.99 for 500, $59.99 for 700, and $79.99 for 1000. Each of
these include 500 Nights & Weekend minutes and no mobile to mobile
minutes. For those who are familiar with cell phone pricing, this is
obviously and unnecessarily expensive. Basic cell phone service for
AT&T begins at $39.99 for 450 minutes. 5000 (that’s thousand, not
hundred) Nights and Weekend minutes, and unlimited Mobile to Mobile.
And from there, the deals get better, offering unlimited talking time
on nights and weekends.

What does this mean for Seniors? With a little help from their loved
ones (people like you), they could get set up with a cell phone with
simple functionality, big buttons, and much, much more freedom to call
when they need to. Many of the big-button older phones are still
available online and can easily be set up for service. And I can
guarantee you they’re not going to charge anywhere near $147!

The funny thing about Jitterbug’s tiny calling allowances is that most
seniors I know enjoy talking on the phone to their families. If the
point is to give them freedom, why not give them more minutes to
actually exercise that freedom? Wouldn’t that be better?

But Jitterbug is more concerned with condescending to Seniors and
bilking them for all their worth. The Jitterbug is dramatically
overpriced, but many will pay it, because the man on the TV said it
was a good deal. But it is not a good deal.

If your loved one is considering buying a Jitterbug, make sure they
understand what they’re getting into, and present them with options.
If they have plenty of money, it’s not going to be a big deal. But
most are on a fixed income, and could do without the bilking, thank
you very much!

Here’s a common scenario: a senior begins to have trouble with IADL’s (Instrumental Activities for Daily Living) like cooking and driving. his eyesight is wearing down, and he gets tired too quickly to stand for an hour in the kitchen. The family gets really concerned. They’re not close enough to help him, so they reach for a phone book to find an Assisted Living Home.

If you are one of those family members, you might be overreacting. Does your parent or grandparent’s limitations actually warrant full- time care? Or is there another way to help manage his newfound limitations?

Most communities across the US have built their own network of volunteer services for seniors. These services can be of huge assistance for your loved one. Even though you can’t be there to give him rides or prepare his meals, there might be other people who can. Here are a few examples:

■ Meals-on-Wheels is a national program that offers home delivery of lunches to seniors who are not able to drive themselves. This is an excellent program, and one that is perfect for elders who need assistance but not supervision.

■ Friendly visitor programsSometimes a senior citizen just needs a ride to the supermarket and a friendly conversation to remind him that he isn’t alone. The Friendly Visitor program is designed with that kind of person in mind–a person who does not have family living close by, but who needs the benefits that come from personal contact. These volunteers are good people who want to help however they can.

■ Senior centers Sometimes we are quick to overlook Senior Centers as a healthy, vibrant part of the senior community. Not only are senior centers fun places to network and develop a social life, they are also hubs for all kinds of Elder Care information, including these very valuable Volunteer Services and many, many others. Could your loved one use these services? Would meal deliveries and friendly visitors help to minimize his impairments? Would a senior center help him find new avenues for friendship and functionality? If so, then you should probably take a breath and HOLD OFF on the Assisted Living Option. After all, if there is a way for him to maintain his independence, don’t you owe it to him to help him do that?

Last time I saw him and grandma, they had moved into an assisted
living community. It was sad to see them out of their house, but I was
glad to see that he had started using computers. Alot. He showed me a
website where he has connected with his old military buddies who had
also served on a nondescript North Pacific island during the war. The
men reminisced, swapping old pictures and stories that only they could
fully appreciate.

His computer use certainly doesn’t stop there. Grandpa constantly uses
email, and is always on the prowl for some useful bit of information
on the web, from new developments in technology to the latest
conspiracy theories abroad.

According to a recent study by the PEW Research center, my grandpa
isn’t alone. Internet use by seniors is dramatically on the rise.
Acquisition of high speed internet connections rose from 26% to 45%
among seniors ages 70-76. That’s a rise of nearly 80%, easily the
highest of any demographic.

This could be a significant trend. Seniors have been stereotyped as
being intimidated and inept at dealing with technology. And many still
are. Some will stick with their stack of magazines and their telephone
and never bother to take the leap. But, as the study shows, more and
more elders are finding reasons to sign on. Social Network sites like
Facebook are starting to hit the mark with seniors, too, and it only
makes sense. If a 30 year old can have a rush of nostalgia when he
receives a friend request from an old high school buddy, imagine the
possibilities for a someone more than twice his age!

The biggest draw into the digital age might be data speed increases.
With broadband, seniors are able to use Skype or iChat to talk face to
face with their grandchildren. That is reason enough for some seniors
to buy a computer in the first place! And beyond webcams, who has time
to get bored with 15 Mbps transfer rates?

Getting your loved one connected may take a bit of arm twisting, but
it can yield big benefits. One study showed depression showed a 20%
drop in senior depression among those who are active on the internet.
Before you dismiss that, just think about how much it can lift your
spirits to connect with your friends and family. For someone who can
hardly see and who can’t get out anymore, the effect is doubled.

If you’re trying to convince your loved one that they ought to get
online, don’t go for the “limitless possibilities” angle. That works
for you and I, but it won’t likely work for them. What does work is
the relationship angle. Our generation puts a higher value on
entertainment than relationship. Not so with our parents and
grandparents. Let them see the possibilities to reconnect with
friends, stay current with family, and make new friends who can relate
to their past experiences and current situations.

Then, make the process as simple as it can possibly get. Get as many
icons off the desktop as you can. Increase font and icon size, and
adjust the brightness and contrast (this is the only way my grandpa
can read anything). Hook up the camera and set up a Skype or iChat
account, and make sure their usernames and passwords are saved and
will be entered automatically. Then, help them find avenues for
networking. Get their Facebook account up and running. Show them how
to add pictures with a click, and how to search for old classmates.

Once the digital world becomes relevant to their stage of life, they
will be off and running. Now just be prepared for your new job as a
technical support specialist.

Seniors with Dementia or Alzheimer’s have needs that other Elders do
not. Their memory impairment and frequent disorientation can be a
constant source of anxiety for their loved ones and caregivers. Memory
Care Facilities can be a huge help for these individuals. Memory Care
is offered in the form of short-term respite care or long-term
assisted living. Elder care services are increasingly recognizing
Memory Care as a necessary form of specialized care.

So how is Memory Care different than regular Assisted Living?

The most major component is the increased focus on safety. Alzheimer’s
patients are especially prone to wondering around, getting lost, and
sometimes hurting themselves. Most Assisted Living facilities aren’t
equipped to deal with this type of problem. Memory Care facilities
place a high priority on a safe, contained environment. Sometimes,
facilities provide an entire wing, sometimes called an Alzheimer’s
wing, that is always well-staffed and keeps doors locked. That way,
the staff can keep track of potential wanderers.

But just because facilities are locked and safe doesn’t mean they have
to be institutional, stifling and dull. Many Memory Care centers offer
lots of room for residents to roam and explore in total safety.
Outdoor courtyards and gardens are very common, and very helpful.

In addition, the staff of Memory Care facilities are trained to deal
with the difficult effects of memory loss. Much of this comes in the
form of routine building. Routines are an important part of any
person’s life, but they become especially important for those with
memory loss.

There are kinds of variations in treatment and environment between
memory care facilities. If you are considering placing your loved one
in this type of assisted living facility, it is important that you
actually go to visit several in your area to compare the level and
kids of care they offer.

Dealing with Alzheimer’s is never easy, and it almost always means the
end is not far away. Memory Care facilities are acutely aware of this,
and uniquely suited to help make your loved one’s final days just a
little bit more comfortable and, if possible, maybe even pleasant.