Balancing Act

Quick reminder: be sure to vote tomorrow and be sure to check in with any seniors you know to offer assistance in getting to and from the polls.

Falls become more common for all of us as we grow older.  The increase in falls for seniors is not all related to loss of muscle strength, but to the steady decline of some of the contributors to good balance:   vision, proprioceptors on the bottoms of the feet that communicate position information to the brain, and tiny hairs in the semicircular canals of the inner ear that relay gravity and motion information to the brain  (who knew ear hair was good, right?).

There is a simple exercise you can do to test your capability for balancing (and it is more difficult than you might think it should be regardless of your age):  Stand with your eyes closed and lift one foot up, bent at the knee in front of you (as if taking an exaggerated step up) and hold it for 15 seconds.  Then try it for 30 seconds.  If you can do this, you are in great shape and all is in balance! 

The Anti-Aging Plan book discusses this and more, based on many lessons the physcian for the Biosphere team and his daughter learned in Biosphere 2.


Aging Well

What are the secrets for healthy aging?

My second cousin and her husband are visiting this weekend, while attending a wedding.  We are friends as second cousins because my Great Grandmother lived to be 101 and was her Aunt.  We have a generation gap because Great Grandpa was the oldest child and my cousin's Grandmother was his younger sister by 18 years.  Our ancestors lived long lives - not easy lives as they grew up in a cabin that was homesteaded in 1862 with no indoor plumbing and tried to earn a decent living as farmers.  They always told us that hard work was the secret to healthy living but definitely good genes help too.

It is interesting that many people who were born in the beginning of the 20th Century have lived long lives - even without all the modern luxuries we enjoy.  Yet, not everyone today is living longer, even with our knowledge of healthy living.  Many aspects of aging are made more difficult when a senior is overweight or has failed to exercise or eat the right foods.  Many seniors also may have quit smoking years ago but because they did smoke for 20 or more years, they now are suffering from emphysema or lung disease. 

High blood pressure, high cholesterol and other age-related diseases can often be slowed or reversed with proper diet and exercise. 

Are you taking care of yourself now, at whatever age you are?  There are many health issues we all cannot control but if you are eating right and exercising and controlling your stress level,  you will increase your odds of living well as long as you live.  It is especially important for Caregivers to take the time to care for themselves.

My favorite resource for healthy living is Dr. Andrew Weil.  He is well educated (Harvard) but also has been in the trenches and understands the challenges for healthy living in America.  He has traveled the world to meet with herbalists and local doctors to learn other culture's secrets for living well and living long.  He believes in healthy aging, rather than anti-aging - because the fact is, we are all going to age.  His website offers recipes, vitamin information, and answers to health issues.

I did get to meet Dr. Weil a couple of years ago at a seminar on healthy aging which he and his associates at the University of Arizona hosted. They were all "mature" - in their 50's or older - and one thing I noticed is they all seemed healthy, and even more amazing, really happy - they were managing their lives well and the joy showed.

Dr. Weil has also written a cookbook with one of Oprah's former chefs and has a skin care line which is sold by Origins.  Check out his website and his products and you'll probably learn something new - he is a huge fan of mushrooms and all their benefits and even uses them as an ingredient in his skin care products.

And, feel free to share with us any tips you have for healthy aging.




Types of Dementia

Yesterday's Caregiverlist Blog post mentions the free memory loss testing at 2,000 locations nationwide provided by the Alzheimer's Foundation of America (a few drug companies are sponsoring this so it is free for seniors).

Why is early detection important?  Because it can enable the senior and their family to understand the progression of various forms of memory loss to prepare for the progression and to implement systems for safety and proper care.

What are the types of dementia?  Alzheimer's Disease is talked about the most but is not the only type.  This is why it is important to be diagnosed for the type of memory loss in order to receive the best treatment.

Other types of dementia and other diseases and disorders which will also cause dementia are:  Huntington's Disease, Pick's Disease, Frontal lobe dementia, Frontotemporal dementia, Lewy bodies, Normal pressure hydrocephalus, Vascular dementia, Parkinson's Disease, Subdural hematomas, brain tumors.

Also, some vitamin deficiencies and hypothyroidism can also cause some memory loss for seniors.

This is why it is vital to have proper diagnosis from a doctor trained in detecting the various forms of memory loss.  A senior can be restored to health with some forms of memory loss when properly diagnosed or with medications and treatments can be able to slow the decline of memory loss.

As an owner of a senior home care agency, I saw many elderly clients who were visiting their same family doctor they had gone to for years and because this doctor did not include memory evaluation during the visits, it went undetected.  Find out if your parent or grandparent or senior client you are providing care for is visiting a doctor who specializes in geriatric care - it does make a big difference.

Rush University's Geriatric Care Practice in Chicago is a wonderful example of an integrated approach to care for seniors.  A social worker meets with each client along with the medical doctor and their team includes professionals in psychology and other areas.  They also have an Alzheimer's Disease research department which offers support groups and participation in studies and their Anne Byron Waud resource center is free to seniors and offers everything you would want for a senior resource center.  They make sure seniors are prepared for their emotional and physical needs as they age. Check it out and find something similar in your area - if Medicare is paying the bill for the doctor, you might as well go to one specializing in senior care needs.


Free Memory Screenings at more than 2,000 locations

My Mother thinks that I am always keeping tabs on her memory. After working in senior care, I have seen first hand that early detection of memory loss can make a positive difference.  I have seen senior's memories improve after starting medications and developing a regular routine with a caregiver to guide them.  I have also witnessed the agony that memory loss can cause for the senior and their loved ones, especially when proper diagnosis of the type of dementia occurs too late.

It greatly helps family relationships when everyone understands what is happening when the memory loss first begins.  Sometimes during a conversation, my Mom will inform my Dad that I am really quizzing him on his memory.  My father has a better memory than I do and so far so good with Mom.  Her father suffered from memory loss, which was never formerly diagnosed as Alzheimer's Disease, although now, looking back, we are all sure that it was.  The early diagnosis and tests were not widely performed 20 years ago.  I remember that my Grandfather would "read" the Wall Street Journal upside down,- which actually might not be a bad idea with the recent market turmoil -a different view might be nice.  But that was just one example of some of the ongoing confusion he experienced.

On November 18th, the Alzheimer's Foundation of America (AFA) will offer free memory screenings at more than 2,000 local sites across the country as part of its 6th annual National Memory Screening Day.

This annual initiative is aimed at promoting early detection of memory problems and appropriate intervention.
The AFA encourages adults with memory concerns, a family history of Alzheimer's disease or a desire to establish a baseline score for future comparison to get screened and to pick up educational materials about memory concerns, successful aging and local resources.
Alzheimer's disease is now the sixth leading cause of death in the United States.
The face-to-face screening takes approximately five minutes and consists of a series of questions and tasks. Sites, spanning all 50 states, include the entire chain of Kmart pharmacies, senior centers, houses of worship, assisted living facilities and doctor's offices.
The results do not represent a diagnosis, and screeners encourage those with abnormal scores as well as those who still have concerns to pursue a full medical exam.
How are they able to pay for this?  The drug companies are sponsors - so another good reason to take advantage of the free memory screening since you are sort of paying for it anyway through your medication purchases.
If you are a caregiver for a senior, find out if there is a location in your area.
For information about National Memory Screening Day, including screening sites, visit or call 866-AFA-8484. 
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Assist Seniors to Vote next Tuesday

The Federal Election Commission created a National Voter Registration Form which is accepted by most states for the registration of voters. Organizations providing care services and assistance to older adults were able to assist them to register to vote by providing this registration form.  In addition, those seniors who are homebound could apply for absentee ballots after registering to vote (or if they are already registerd to vote, they could apply for the absentee ballot).  This allows homebound seniors to participate in this year's important presidential election.

If you are providing care services for a homebound senior, find out if they were able to cast an absentee ballot, and if not, you can assist them to vote ahead of time if this is offered in their area or to get to the polls on election day.

Check with your local Department on Aging if you or another senior needs transportation to the polls on election day as there are volunteers available to assist in most communities.

And to find out where to vote:


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Hospice Volunteering Opportunity

Hospice provides many services to terminally ill patients, from end-of-life planning to hands-on care with a Registered Nurse who will manage the overall care.  A Certified Nursing Aide is available for bathing visits and assistance with personal care.  Hospice also provides a Social Worker to assist with managing family and personal issues.  In addition, many hospice services provide volunteers who will visit the hospice pateint to offer companionship services and assist them with any specially requested tasks.

If you have lost a loved one and are looking for new activities to fill your day or have an interest in becoming a caregiver, contact a local hospice company to find out about possible volunteer opportunities.  You will gain as much as you give.


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Advantages of a Senior Home Care Agency

Seniors needing additional care services provided by a Caregiver have the option of hiring a Senior Home Care agency to professionally provide the services or of finding a direct-hire Caregiver. only connects seniors with services provided by professional Senior Home Care Agencies.  This is because these senior care agencies meet the legal guidelines established in their states for providing senior home care and also meet Caregiverlist's quality standards.

Although it might seem like a cheaper option to go out and find a caregiver to provide the senior care services on your own, it rarely turns out to be the case once care begins.  When I owned a senior home care agency, over and over again we would begin care services for a client who first hired a caregiver on their own who did not work out because they either were not trained properly to provide the care, became burned out without management to vent to, started to charge the client for any services they deemed as "extra" from going to the grocery store to their travel time to get to the senior's house.  This is because senior care is very different from child care.  There is not a Mother and Father there at the beginning and end of each day to supervise the care needs and keep the checks and balances in place.   Seniors also are dealing with many emotions as they are accepting age-related illnesses, the deaths of friends and constant change.  Because of this, senior caregiving presents challenging days for a caregiver which can take an emotional toll.  Seniors may be resistant to care, too, even though they know the care is needed.  This resistance along with memory loss and emotional challenges all present the need for customized training and case management support.  I have seen situations where even wonderful caregivers can begin to take advantage of the situation when they do not have professional supervision and support.  Some seniors are difficult to care for - they may be unhappy, angry, pinching pennies and they then will take out all of their frustrations on the caregiver.  A professional senior home care agency knows how to step-in and professionally mange the care and the caregiver.  Agencies also have experience in understanding the best approach for each senior.

The senior home care agency fee will also take care of all payroll taxes, as required by law, and insurance coverages which will not be present in a hire-direct situation.

The news stories that you see about caregiver theft are not about caregivers working for senior home care agencies.  Senior home care agencies have proper systems in place to prevent theft and insurance coverage which requires them to implement policies and procedures for added protection.  A caregiver would never have access to a senior's bank account information nor the power to make purchases with the client's money.  A Supervisor would set-up systems for these purchases to be made by the home care agency and then billed to the client.

On Friday, the news media reported on a recent caregiver theft of $304,000 from a senior's estate - another hire-direct caregiver situation.  The Caregiver, Marilyn Fenderson, withdrew $304,000 from accounts the senior had intended to be for donations to three nonprofit groups in Sonoma County.  This caregiver was given power-of-attorney, another mistake which a senior home care agency would prevent.  Unfortunately, there are individuals who seek the hire-direct caregiving jobs in order to take advantage of these opportunities for theft.

Background checks come in many flavors.  It is good protocol to understand the various levels of background checks.  Run fast from a website that says they are providing "free" background checks as rarely will a free check absorb the cost of a multi-state criminal background check matching every past address of the applicant, along with name and social security number verification for past addresses.  Senior Home Care Agencies understand how to do background checks and screening which will go beyond the background check (if someone was given community service for a crime, which is very common for the first couple of offenses, it most likely will not show on their record)  and how to hire quality caregivers who will both provide care and protect a senior from anyone who would not have the senior's best interest in mind.  Caregiverlist also connects individuals seeking to work as caregivers with hiring senior home care agencies and other senior care companies in their area and explains all the necessary skills and requirements for working as a senior caregiver.

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"Away From Her", a movie about Alzheimer's Disease

Alzheimer's Disease presents many challenges for the senior suffering from the disease, as well as for family members and caregivers.  It is very difficult to watch someone lose their memory and their ability to communicate with loved ones.  Often, the people who are closest to the senior with Alzheimer's Disease are the ones they take out their frustrations on.

"Away From Her" brings Julie Christie back to the movie screen.  She portrays a senior suffering from Alzheimer's Disease She and her husband of nearly 50 years are faced with making a decision for her long-term care and eventually decide it will be best for her to move to an Assisted Living community.

The movie does a wonderful job of showing how difficult it is for loved ones to watch the disease progress.  It is the 'long goodbye" and this movie helps provide perspective by telling the story from the perspective of family members and caregivers.  Definitely rent this movie if you are caring for someone with Alzheimer's Disease - it does provide a few laughs and surprises, along with a few tears.





Discussing Senior Care Options with Family

As the news media reports on the presidentail campaigns, we now all know Barack Obama is taking a couple days off the campaign trail to visit his sick Grandmother, Madelyn Dunham, in Hawaii.  She was discharged from the hospital to her home and her condition is described as serious.  Details of her illness have not been released but it is clear she preferred to go home to recover.

Medicare will pay for a temporary stay in a nursing home for rehabilitation after a hospital stay.  Medicare does not pay for long-term care in the home nor in the nursing home.  Only Medicaid, which very low-income seniors can qualify for, will pay for permanent long-term care in a nursing home (there are a few states, such as Vermont, developing in-home programs for Medicaid care).  Typically states require a senior to have no more than $2,000 in assets to qualify for Medicaid benefits.

Have you had the discussion with your parents regarding where they would like to receive care if the situation would present itself?  Do they prefer to go to a nursing home for recovery?  If so, which nursing home in your community do they prefer?  Hospitals will send a patient to any nursing home in their area, based on the discharge planner's instructions.  One time I was going to a hospital to meet with a patient regarding her care needs.  She had no immediate family and when I arrived, I discovered she had already been discharged and sent to a nursing home.  Her Guradian thought she was going to be discharged to a different (and better) nursing home.  The nursing home she was sent to was primarily a nursing home for Medicaid patients and unfortunately all the stereotypes that go with that were present (it did smell like urine, patients were medicated and parked in a room, sitting in their wheelchairs for the day).  This client was uncooperative at the nursing home, as soon as she was moved back to her home she was eating and talking again and her health improved.

Every situation is different.  Many times a nursing home can be the best option.  But it is important to discuss the wishes for care with the senior and become educated on the options in your area.   Medicaid is what it is - a regular government check the nursing facility will receive until the senior passes on.  A Medicaid pateint is not going to threaten to leave if conditions are not up to par - they are receiving a free place to stay from the government and do not have that option.  As nursing homes are businesses seeking to make a profit, it is important to ask the right questions. Find out what percentage of beds are Medicaid and find out the staff-to-patient ratio.

As the cost is typically nearly the same, more and more seniors are opting to go home and receive a private duty caregiver rather than go to a nursing home - - they are guaranteed one-to-one care from a caregiver where most nursiing homes have one nursing aide for as many as 12 to 15 patients.




Barack Obama: Taking Time Out for Grandma

This week, Barack Obama's campaign announced that he will be taking time off from the campaign trail to visit his ailing Grandmother in Hawaii.  Barack's Grandma, Madelyn Dunham, age 86, is in declining health and her situation has become critical after being discharged from the hospital.

We will all be Caregivers at some stage of life.  As a family or professional caregiver, you will experience the daily challenges of assisting someone else with their "activities of daily living".  This is the term used in the care industry for all the tasks we engage in throughout the day from eating to bathing to exercising.  Seniors with memory loss may also require additional reminders to maintain their daily schedule.

Hospice training teaches that the healthiest way to lose a loved one is to be able to plan ahead for their death.  This allows you to better come to terms emotionally with the expected loss and to have quality time to share with them to say the things you would like.  Just being able to say goodbye makes the loss a little easier. 

I have found that this only comes true after the person you love has passed on.  It is still difficult to make peace with the loss ahead of time, as you are still dealing with anger, sadness and perhaps denial.

I respect Barack for maintaining a relationship with his Grandmother and for making the time to spend with her to say goodbye.  This sets a nice example for dealing with the loss of a loved one for other's to follow.  And it also highlights how much more difficult caregiving can be when you are a long-distance caregiver.  Caregiverlist tries to assist in long-distance caregiving by providing information on services in each state.

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