As you senior caregiver readers know, I’ve embarked on a mission to bring some technology into my elderly mother’s home so she can live independently longer, the way she wants to live. I made a list of her needs, the most important of which are keeping safe, connected, and engaged.
My mother is not alone in her needs. The 80+ age group is the fastest-growing segment of the world’s population. By 2050, it is estimated that there will be 392 million persons over the age of 80, more than three times the present. At the same time, there will be fewer caregivers for the elderly. Smaller and more geographically disparate families mean fewer family caregivers. We are already experiencing a shortage of trained certified nurse assistants and home care aides. And, of course, ever-increasing senior care costs, whether in the home or in an institutional setting, means the entire system of elderly care needs to be rethought.
Technological advancements are growing exponentially, just as is our elder population. It makes sense, then, that someone utilize the advances in technology to address the true needs of people. The Jetsons’ Rosie, Luke Skywalker’s C3PO, fiction is rife with examples of robot family helpers. Beyond the physical assistance these robots provided, they were also companions and assistants. Those imaginings are now becoming reality.
Jibo, the “world’s first family robot”, is the brainchild of MIT professor and social robotics pioneer Dr. Cynthia Breazeal. Dr. Breazeal saw the necessity for technology that supports the needs of the human being.
“I do this because I want to empower people to stay healthier, to learn better, to age with dignity and independence (my emphasis)”, Dr. Breazeal writes on the Jibo blog. “... to support more empathic and emotionally engaging telecommunication with those you love, to delight and surprise & entertain so that people laugh and experience joy and wonderment more often, and to make our lives just a bit easier with a touch of technological magic.”
For seniors, that means an “attentive companion that can help you live with greater independence and stay connected to those you love.”
Here’s what Jibo can do (from the Jibo website):
Two hi-res cameras recognize and track faces, capture photos, and enable immersive video calling.
360° microphones and natural language processing let you talk to Jibo from anywhere in the room.
Hands-free reminders and messages, so you'll never forget and can always be in touch.
Artificial Intelligence algorithms learn your preferences to adapt and fit into your life.
Like a personal assistant, Jibo proactively helps you, to make everyday tasks simpler and easier.
Communicates and expresses using natural social and emotive cues so you understand each other better.
Here's Jibo in action:
The Indiegogo campaign to crowdsource funding for Jibo started on July 16 and ended on September 14, 2014 and raised $2,289,506, and astonishing 2,290% of its $100,000 goal. Those numbers make it the most successful technology campaign on Indiegogo to date.
Over 4,800 Jibos were pre-ordered at $499, 28% of which are Developer Editions and upgrades (new application development is ongoing.) 71 Jibos will be donated to Boston Children's Hospital.
What do you think about Jibo and the future of carebots? Is this something you would welcome into your home? Personally, I’d love to see it in action. And if the response on Indiegogo is any indication, Siri’s in for some stiff competition.
How do you envision growing old? I dream of living in a lake (or oceanside) house, growing my own food, within walking distance of a town with a vibrant cultural community, with family or friends nearby who I can count on if I’m in trouble. I am near transportation that allows me quick travel to a world-class city like New York, Chicago, Paris, London, Tokyo (or a myriad of others around the world—and if we’re dreaming, I also have a flat there) and access to an airport for occasional national and international travel.
For that dream to come true, I will need a few things. First, I will need an enabling environment. That means the place in which I live should have socioeconomic and political policies and programs in place to help me age with safety and dignity, and give me access to the best resources I need to age well.
I’d like to surround myself with vital members of the community, the educated (and, dare I say, employed.)
I will need some money, of course. The society in which I live should provide a little bit of a financial net. Some call it a pension, in the U.S. we call it Social Security.
Finally, you have nothing if you don’t have your health. The ideal spot to grow old will give me access to a clean environment and good medical care. Life expectancy should be high and I should live those years in good health and feel that my life has meaning.
How does one find such a spot?
HelpAge International's Global AgeWatch Index brings together data on health, income security, employment and education, social connections, safety and transportation into one number and ranks countries from 1 to 96 (with 1 ranking highest). The index represents nine out of ten people over 60 years old, all across the world.
Norway tops the list of overall global rankings. It earns first place in both income security and capability (employment and education). It comes in at number 4 in the enabling environment domain (social connections, safety, civic freedom, and transportation)—Switzerland wins here, and 16th in Health Status (Japan takes the number 1 spot.)
Overall, the U.S. ranks 8th, behind (in order), the aforementioned Norway, Sweden, Switzerland, Canada, Germany, the Netherlands, and Iceland. Better in some measures than others, I was surprised to learn that we as a nation rank 25th in Health Status, just behind Malta.
The worst places to grow old, according to the index are Afghanistan (96), Mozambique (95), West Bank and Gaza (94) and Malawi (93). But all around the world, life expectancy is on the rise.
The entire index is a fascinating interactive website with more data points than I can list. In addition to rankings by geographic area, the report includes emerging pension policies to help create basic regular income for the poorest of populations. Peru, Mexico, and Tanzania are among the countries highlighted for their new non-contributory “social pensions” as safety nets.
In a statement released by Help Age International, Professor Sir Richard Jolly, advisor to the Index as well as architect of the UNDP Human Development Index said, “People do not stop developing when they reach sixty or seventy or eighty. Our older years should be as much a time to expand our horizons as our earlier years.”
If you want to make a difference and make your aging voice heard, join Help Age International’s campaign Age Demands Action that is calling for a UN convention to protect older people's rights by law.
No one is immune to breast cancer—it is an equal opportunity disease. However, we know that breast cancer is the most common cancer among women and women between the ages of 75 and 79 have the highest incidence rate. The chance that a woman will get breast cancer increases from 1-in-233 for a woman in her thirties, to a 1-in-8 chance for a woman in her eighties. The good news is that the death rate for breast cancer in women has decreased since 1990. This is due primarily to early detection and treatment.
October is Breast Cancer Awareness Month and a good time to create an Early Detection Plan. The National Breast Cancer foundation has created and made available an application to receive reminders to do breast self-exams, and schedule mammograms based on your age and health history.
The Mayo Clinic lists these primary risk factors:
- Chest radiation as a child
- Menstruation before the age of 12
- Adolescent weight gain
- No pregnancy or late pregnancy (after 30)
- Lengthy use of oral contraceptives
- Post-menopausal weight gain
- Late menopause (after age of 50)
- Increased breast tissue density
I had my own breast cancer scare a few years back. My annual screening mammogram showed an abnormality, so I was scheduled for a diagnostic mammogram. That was the longest week of my life. At the time, I had two small children and was beyond worried. I also had a lot of questions. I went to the website BeyondTheShock for answers and to prepare myself for my possible journey. What I found there was an incredible community full of support. Luckily for me and my family, my lesion was benign and there was no cancer. But the survivor stores I found at BeyondTheSchock, had I not been so lucky, would have been an inspiration.
When detected and treated early enough, your chances of surviving breast cancer are better than ever. Do it today. Make an appointment for that all-important screening, especially if you are a woman over 40. Remember, 1 in 8 women will be diagnosed with breast cancer in their lifetime, but when breast cancer is detected early, the 5-year survival rate is 98%.
Caregiverlist wants to remind seniors and senior caregivers alike to use National Breast Cancer Awareness month as a reminder to schedule your annual mammogram.
I love MasterChef. And Iron Chef. And just about any show that features competitive cooking.
If you didn’t see Monday’s MasterChef finale, I’ll stay clear of spoilers, but one of the final contestants, Leslie Gilliams, was complimented by Gordon Ramsay for disproving the adage “cooking is a young man’s game.” Mr. Gilliams is 56.
Seniors are an anomaly on MasterChef. The oldest contestant, Sue Drummond, was 61 when she competed on MasterChef New Zealand. Kumar Pereira was MasterChef Australia’s oldest ever Top 24 contestant at 62.
While a small number of contestants were a bit older, the food they presented was not necessarily food that should be served to older adults.
As we age, it’s harder for our bodies to fight off the germs and bacteria found in raw or undercooked food. Salmonella, E. coli, and other bacteria can grow to high levels in some of the “healthiest” and tastiest dishes. Some of the MasterChef dishes that are not necessarily elderly-approved included:
- Ceviche: a seafood dish especially popular in South and Central America. The raw fish is “cooked” by curing it in citrus juices such as lemon or lime.
- Raw or undercooked eggs: these are found in Hollandaise sauce, homemade Caesar salad dressing, and tiramisu.
- Raw meat: like carpaccio (thin shavings of raw beef fillet) and steak tartare.
- Raw fish: shellfish, such as oysters, mussels and clams, and raw fin fish, like sushi and sashimi.
- Soft cheeses: cheeses like feta, Brie, or Camembert (my favorite!) can be breeding grounds for bacteria.
Senior caregivers need to be especially careful when preparing meals for the elderly. Yes, the food needs to be palatable, look appealing, and be nutritious, but meals should be safe, first and foremost.
If you are a caregiver who subscribes to Caregiverlist’s newsletter, The Caregiver’s Gist, you know we provide a delicious, nutritious recipe—safe for seniors.
We’d also love to hear from you caregivers. Do you have a special recipe that your senior client or loved one especially enjoys? Send it to me at firstname.lastname@example.org. I promise to try them all and report back on my favorites. Who knows? Maybe your recipe will make it into an online Caregiverlist safe-for-seniors cookbook.
And I’d like to challenge the MasterChef franchise. Your MasterChef Junior, the kids version of MasterChef, was incredibly popular. So popular in fact, that MasterChef Junior returns for Season 2 on Friday, Nov. 7. Come on, Chef Ramsay, how about a MasterChef Senior?
Falls—they’re not just for seniors. However, whereas my recent tumble after meeting with a Chicago pothole resulted in some scrapes, bruises, and a banged-up ankle, injuries from falls for the elderly can be much more dire.
Have a nice trip, see you next fall!
September 23 marks the first day of fall in 2014, and it’s also the 6th annual National Falls Prevention Awareness Day, sponsored by the National Council on Aging (NCOA). This year's theme is Strong Today, Falls Free Tomorrow, and seeks to unite professionals, caregivers, and older adults in raising awareness and preventing falls proactively.
We at Caregiverlist have written a lot about falls and fall prevention over the years, and there’s good reason for that. Among older adults (those 65 or older), falls are the leading cause of injury death—over 21,700 older Americans die annually from injuries related to unintentional falls. By 2020, the annual cost of fall injuries (direct and indirect) is expected to reach $67.7 billion, according to the CDC. Those senior who survive falls can face long post-hospital nursing home rehabilitation.
The American Occupational Therapy Association (AOTA) and other professional associations, along with several federal agencies are part of the Falls Free© Initiative. Specifically, AOTA is promoting the role of occupational therapy in fall prevention.
What is Occupational Therapy (OT)?
Occupational therapist practitioners work with older adults in their homes or in facilities to do the day-to-day activities they want to do, safely. They perform an individualized evaluation, determine a person’s goals, help improve the person’s ability to perform daily activities, and evaluate if those goal have been met.
How does OT help in fall prevention?
The occupational therapist will remove environmental hazards in the home. They can suggest furniture arrangement so that there is plenty of room to walk without obstacles. If you hold onto furniture for balance, they will advise whether it is heavy enough to do that safely or suggest alternatives.
The therapist will review your entire home and be sure you can safely and easily get to the items you use on a regular basis. They’ll help create a plan for accessing things that are used most frequently.
The OT will evaluate the lighting throughout your home, making sure that you can see in potentially unsafe areas.
Occupational therapists will work with caregivers as well, educating them on proper patient transferring techniques, and providing proper guarding techniques while a patient is moving or managing stairs to reduce the risk of patient falls without
injury to the caregiver.
This 2008 video from University of North Carolina at Chapel Hill's Institute on Aging, offers advice on preventing falls and shows how an occupational therapist assesses potential hazards in the home.
Medicare often pays for occupational therapy if prescribed by a doctor. Speak to a medical professional to determine if an occupational therapist can increase your or your senior’s quality of life and perhaps reduce the risk of falls. I just wish they could fix potholes.
We know most seniors prefer to age in place, at home. In fact, according to AARP, over 90 percent of older Americans want to stay home as opposed to relocating to assisted living or nursing homes.
The challenge with aging in place is that unless the senior has a full time caregiver, they can wind up being alone most of the time. That isolation and inactivity can begin a downward spiral of depression and loneliness. Not exactly the picture of a happy way to age.
Senior care at home can also get expensive, especially if you’re paying for simple companionship. Paying a companion caregiver $15 per hour to sit and play bridge might be a bit of overkill, especially since most seniors live on a fixed income.
The National Council on Aging has designated September as National Senior Center Month, and the theme for 2014 is Senior Centers: Experts at Living Well — Discover, Play, Create, Challenge.
Not to be confused with Adult Day Care Centers which are more costly and offer a higher degree of structure and supervision, Senior Centers are facilities that offer a wide variety of activities and offer opportunities for independent seniors to interact. It’s perfect for the active elderly—those who would like a place to “hang out”, have fun, and maybe learn a little something new.
Senior Centers often offer classes, trips, parties, volunteer opportunities, and recreational activities, and lifetime learning programs, including expert lectures. A healthy meal can also be had for an additional minimal fee. Oftentimes, they provide opportunities for day- and sometimes even overnight-excursions.
Regionally, some senior center endeavors are pushing boundaries and giving area seniors a little extra this month.
- In Livermore, California, the California Highway Patrol will be offering a free public presentation on “How to Recognize Elder Abuse”.
- The Glastonbury, CT Senior Center are inviting seniors to take part in a 10-week fitness challenge that includes a variety of activities to make people more aware of their own health and well-being.
- The St. Clair Street Senior Center in Tennessee is featuring a Drum Circle, Tai Chi, St. Clair Walkers and an Art Show.
Some programs have been developed specifically to highlight this month’s senior center theme, but some communities see a great opportunity in working with local seniors.
In New York, for example, the Department on Aging is teaming up with local arts councils and the NYC Department of Cultural Affairs to present SPARC : Seniors Partnering with Artists Citywide. The initiative places 50 artists-in-residence at senior centers across the five boroughs of New York City. The goal is to produce arts programming for seniors in exchange for workspace and a small stipend. As reported by website Hyperallergic, last year, participating dance company De Novo staged Houseguest at the Martha Graham Center for Contemporary Dance and included seven seniors from the Astoria senior center where they had been in residence.
I plan on exploring this month’s theme by taking my own mother to a local senior center. Looking ahead to winter, it may be just the place for her to spend some time among her peers in the community. While I don’t expect she’ll be performing any contemporary dance moves, they might just get her to Zumba.
Tripping the elderly on purpose would seem to be a cruel joke. Falls among seniors (those 65 or older) are the most common cause of nonfatal injuries and hospital admissions for trauma. They are also the leading cause of injury death. So who could possibly think that tripping older adults is a good idea?
Researchers at the University of Illinois in Chicago have developed a lab-built treadmill system that trips its subjects unexpectedly. After striding several paces, a sliding section of the treadmill walkway suddenly moves, causing the test subject to stumble.
Leading the research is physical therapy professor, Clive Pai. He calls the method a potential "vaccine against falls." He’s seen elderly subjects fall a few times on the treadmill (saved from actual injury by a harness), and then, after several “trips”, they subconsciously learn how to keep themselves upright.
Sensors attached to various points on the experiment participants track and analyze the muscle groups involved in catching oneself before one falls. The idea is to then concentrate on strengthening and improving the range of motion of those muscles. In theory, this will help prevent the injuries incurred when an elderly person falls to the floor.
"This is all implicit learning. We don't give any instruction. They don't have to be motivated — they're naturally motivated because they don't want to be on the floor," Prof. Pai said.
The National Institute on Aging is providing the five-year, $1 million grant to study and develop the treadmill system. There are plans to enroll 300 participants within the next five years. Researchers then hope to bring the treadmills to the public via doctor’s offices and physical therapy centers.
This photo taken on July 28, 2014, shows a UIC physical therapy assistant professor Tanvi Bhatt, left, with research subject Mary Kaye, 81 as they demonstrate a treadmill balance session. (AP Photo/M. Spencer Green)
Until this research proves effective in preventing falls and the treadmills are widely available, consider these 6 tips to prevent falls from the Mayo Clinic:
- Consult a doctor to check eye and ear health and review medications.
- Exercise to improve strength, coordination, balance and flexibility.
- Wear sensible shoes or none at all. No high heels, slippers, thick-soled shoes. Stocking feet, especially on hardwood floors, can also be hazardous.
- Keep walkways clear of clutter. Use non-slip mats in showers. Secure rugs with double-stick tape. Keep household items like dishes, food and clothing within easy reach. Use plenty of lamps with bright bulbs.
- Turn on lights when going up and down stairs.
- Hand rails, grab bars, raised toilet seats can be of great assistance in the bathroom. Place a plastic seat in the shower along with a hand-held shower nozzle.
Senior caregivers need to know how to maintain a clean, safe, and healthy environment. Caregiverlist Basic Training, powered by Caregiver Training University, provides a training module to help prevent accidents and injuries in the home.
Maine is a state with many unique distinctions. In 1641, the city of York became America's first chartered town. Eastport, the most eastern city in the United States, is the first city in the country to receive the morning sun. And the lobster! You can’t think of Maine without thinking about lobster. Maine provides almost 90% of the nation’s lobster supply.
Maine is the oldest state in the nation. According to projections, one in four Mainers will be over the age of 65 by 2030. It also has some of the oldest housing stock in the nation. Expensive to heat and difficult to maintain, seniors in the state of Maine find themselves on waitlists (typically 140 names long) for affordable housing.
Maine's Democratic House speaker Mark Eves has outlined a series of policy proposals to help the state's rapidly aging population live independently longer.
The "KeepME Home" initiative is a package of bills intended to create affordable, energy-efficient senior housing communities, increase property tax credits, and provide higher pay for in-home direct care workers.
In-home care, in addition to being the more prefered type of eldercare, can be more economical than institutional care. According to Muskie School of Public Service, MaineCare (Medicaid) spent an average of $558 per month for each client who received in-home care in 2010, compared to $4,150 per month for each nursing home resident during the same year.
According to Caregiverlist’s® Nursing Home Ratings and Costs, the average daily price of a single-bed in a Maine nursing home is $266.45 per day.
The proposed $65 million bond issue would help address senior housing concerns, home care, long-term care, transportation, and a myriad of other senior service shortages.
House speaker Eves may just be courting the substantial silver-haired voter demographic in his bid for a November re-election (he can’t submit the legislation unless wins.) However, committing yourself to fight for your state’s elderly to live in their homes longer, or move to an aging-friendly community, or not having to choose between paying the heat or buying groceries is an honorable quest for someone who can affect public policy change.
Having Medicaid supplement home care agency wages for direct in-home workers — professional caregivers and C.N.A.s — helps draw and retain quality caregivers since they may finally eke out a living wage. With the work they do, they certainly deserve a raise, their first in a decade. A politician championing that fight is worthy of consideration.
Improving quality of life for all citizens, creating jobs, spending money more efficiently — that’s a politician’s job. As the population ages, I expect more senior issues come to the forefront, with more proactive initiatives to benefit an aging population. That’s smart politics.
Senior caregivers spend long hours at work and once they come home, the idea of cooking dinner from scratch can seem like a daunting and time consuming task. Many home cooks don't realize how easy making their own sauces from scratch can be nor how little time it takes. Myfamilydish.com shares with us their homemade teriyaki sauce recipe, which they say can be made in less time than it takes to pick up an order from your local Chinese restaurant.
Teriyaki sauce from Myfamilydish.com
The basic ingredients for the teriyaki sauce include garlic, ginger, soy sauce, water, Mirin and vinegar. Health benefits of creating your own sauce include being able to control the specific ingredients that make up the final product. If you or a senior client have a dietary restriction limiting your daily sodium intake, then that need can be accommodated with a homemade sauce recipe by using low sodium ingredients or a salt substitute. In this particular recipe, take note of the amount of sodium in the soy sauce you plan to use before purchasing.
Once the safe is made, combine your favorite Asian noodle with vegetables of your choice. Try broccoli, snap peas, eggplant or cabbage and add some cooked shrimp or chicken in for additional protein. Top with your teriyaki sauce and serve. The recipe overall shouldn't take more than twenty minutes for a healthy customizable dinner.
Aging-in-Place: there’s no doubt about it—when given a choice of where to spend their waning years, the majority of Americans, nearly 90 percent, want to stay in their own homes as they grow old. However, that’s sometimes not possible. Although the Census Bureau reports the number of American nursing home residents decreased by 20% from 2000 to 2010, falling from 1.6 million to 1.3 million, the fact is that many elderly need care they cannot receive at home.
Nursing homes used to (and perhaps still do) have an attached stigma. I grew up on horror stories about neglect, theft, and all sorts of senior abuse running rampant in facilities. Grainy “hidden camera” news reports showed the horrific institutions where the elderly were left to die alone. While I am sure that those situations still unfortunately remain, I also know from first hand experience that top-notch, quality nursing homes do exist.
Modern skilled nursing homes provide safe and comprehensive care that might be difficult to receive at home. As our Elder Law Expert, Ben Neiberger asserts in Tip Nine of his 10 Elder Care Tips to Make Senior Care Easier, nursing home placement isn't death sentence.
There are many factors that go into determining what makes for a great (or even good) nursing home. Caregiverlist's® Nursing Home Star Ratings are calculated utilizing the nursing home’s overall Medicare Star Rating, percent of short-stay residents with bed sores, Certified Nursing Aide hours per resident per day, and percentage of long-term residents whose need for help with ADLs has increased.
Nursing home staff turnover is another factor that determines quality nursing home care. Direct care staff, registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (C.N.A.s) have an immediate affect on the quality of life for nursing home residents. The longer a caregiver stays on the job, the more they know their patients and are better equipped to provide the continuity of care they need. If a nursing home’s staff turnover is high, the caliber of care may suffer.
The American Health Care Association (AHCA) conducts an annual survey to collect data on staff turnover, retention, and vacancy rates in nursing homes nationwide. The 2012 survey shows the median turnover rate in skilled nursing centers for RNs was 50.0%, LPNs was 36.4%, and C.N.A.s was a whopping 51.5%. High C.N.A. turnover increases the odds of a nursing home being cited for deficiencies by 54 percent, according to a 2014 study published in February by the Journal of American Medical Directors Association.
States are beginning to take notice of nursing home staffing concerns and are putting systems in place to help retain quality workers. In Iowa, the Public Health Department has developed an online Prepare to Care course for direct care workers and is collaborating with the Caregivers Association to help nursing home workers sign up for health benefits. Ohio has instituted a Long-Term Care Quality Initiative to help raise the bar for long-term care staff.
One (of four) of AHCA’s Quality Initiative goals, whose deadline is March 2015, is to reduce turnover of long-term direct care staff by 15 percent.
Here’s hoping they achieve those lofty goals, for the sake of nursing home staff and residents alike.
Do you have an issue you'd like to see tackled on this blog? Connect with Renata on Google+