September is National Senior Center Month

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 Seniors to Prevent Future Falls

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.

Will Maine Senior Voters Say "Keep ME 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.

Teriyaki Bowl Makes for Surprisingly Quick Dinner

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.

 

Nursing Home Staff Turnover Rate Affects Care

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.

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Seniors and Suicide: Depression Drives Decision

The world lost a comedic genius earlier this week when Robin Williams was found in his home in California, dead of an apparent suicide. It’s been reported that Mr. Williams had been battling severe depression as of late. When I heard the sad news I thought, Here’s a man who had everything—wealth, fame, the love of a good family, the adoration of the world. How could someone who had so much decide to take his own life? And if his depression could drive him to commit such a final act, what chance do those with less—less money, fewer loved ones, failing health, have?

That’s the misinformation we as a nation have about depression—that it’s a choice, a moral failing. But depression is a disease, like cancer or heart disease. Although some seniors will have battled depression all their lives, many experience their first onset late in life, in their 80s and 90s. And because depression is the primary risk factor in most suicides, left undiagnosed and untreated, the elderly are a high-risk demographic. 

According to the National Institute of Mental Health (NIMH), older Americans comprise 13 percent of the population but account for 18 percent of all suicides. In the U.S., elderly white males, especially the old-old (over the age of 85), have the highest risk of suicide in the nation. In a fact sheet produced by the American Association of Suicidology, the 2010 suicide rate for these men was 47.33 per 100,000, or 2.37 times the current rate for men of all ages (19.94 per 100,000).

Not to be confused with normal (and relatively temporary) sadness and grief which can be caused by the loss of a loved one, changes in one’s environment, or deteriorating health, depression doesn’t go away by itself and needs professional intervention. In short, the senior needs treatment.

If you are a senior caregiver, be on the lookout for these signs of depression. Symptoms of depression in the elderly can include:

  • memory problems and confusion
  • social withdrawal and isolation
  • loss of appetite, weight loss
  • complaints of pain where there are no apparent physical causes
  • inability to sleep
  • irritability
  • delusions or hallucinations
  • also, heavy alcohol consumption is a known risk factor for depression and suicide.

Like many other diseases, depression is treatable and, according to experts, suicide can be prevented. If you suspect your senior loved one or elderly client shows signs of depression, the first step is to seek medical help. Some simple tests performed by their primary care physician can help determine a course of action to treat the disease and thereby, help prevent suicide. If more immediate action is needed, The National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) operates a 24-hour confidential suicide hotline.

We at Caregiverlist extend our sincere condolences to the family of Robin Williams, as well as to the families of all the victims of suicide. We can only hope that his passing will open the discussion of depression and suicide, help remove its stigma, and encourage sufferers to seek help.

Healthy Summer Slushy for Seniors (and Caregivers)

Senior caregivers know that seniors often have their specific food preferences. At the same time, making sure a senior's eating habits are delivering proper nutrition can be an ongoing challenge.  Now that it is summertime, you can have fun with nutrition by making cooling slushies, especially if a senior's diet includes the purchased nutrition shakes - what a nice change of pace to have a homemade smoothie or slushy to enjoy a new flavor.

Myfamilydish.com shares an easy recipe with us on how to make a delicious peach slush and you can even toss in some of your summer herbs that perhaps you are growing in your yard or on your kitchen shelf.  Farmer's markets offer a fun outing for seniors, too, and a way to engage in conversation about their gardening past if they no longer are gardening.  And everyone likes an excuse to share a favorite recipe.

Nutrition tips for seniors: add some of the following to give your Peach Basil Slush a boost:

 

  • Protein Powder
  • Flax Seed
  • Wheat Germ 

 

This recipe uses peaches, basil and a fun drink you can buy at the store called Cascade Ice.  As always, you can make substitutions.  Check out the Peach Basil Slushy recipe and if you don't decide to make it, you can definitely enjoy the photos (but I think you'll be craving one, too, when you see these pictures).  Happy summertime! Don't forget that senior care companies are still hiring and send anyone looking for a senior caregiving job to Caregiverlist to apply.  Online caregiver training also helps anyone begin to develop senior care skills by taking this online training course.

Peach Basil Slushy from Myfamilydish.com

Shots for Seniors: Vaccines Recommended for Older Adults

There’s a national debate going on questioning whether vaccines are safe.

Vociferous anti-vaccine activists link vaccines with rising numbers of children with autism, although studies have shown no correlation between the two. Nor has it been proven that vaccinations cause childhood leukemia, as previously thought. Despite scientific findings (or, in the opinion from the other side of the aisle, pharmaceutical company propaganda),  the anti-vaccine movement continues its rally against childhood vaccinations due to their proposed dangerous side effects while public-health experts contend that high rates of non-vaccination are the cause of recent contagious disease outbreaks.

But what about the elderly? Are they in danger of vaccine complications?

August is National Immunization Awareness Month (NIAM). Sponsored by the Center for Disease Control, the purpose of the campaign is to “provide an opportunity to highlight the value of immunization across the lifespan”.  The CDC recommends that the elderly (those 60 years +) receive the following vaccines to promote good health:

Seasonal flu (influenza) vaccine
The CDC estimates 90 percent of seasonal influenza-related deaths and more than 60 percent of seasonal influenza-related hospitalizations in the U.S. each year occur in people 65 years and older.

Tetanus, diphtheria, and pertussis (Td or Tdap) vaccine
Everyone, including the elderly, should have booster shots for tetanus and diphtheria every 10 years.

Pneumococcal  (pneumonia) vaccine
Pneumonia, which often starts as a simple viral respiratory disease, and can develop into a severe inflammation of the lungs, often cited as the fifth leading cause of death in the elderly and frail.

Zoster vaccine, to protect against shingles
The risk of getting shingles increases as one ages. Not only that, but shingles can be extremely painful in the elderly. The persistent pain, called postherpetic neuralgia (PHN), can last for months or years.

This is not to say that vaccines for seniors have been without their own controversy. Several years ago, “Fluzone High-Dose”, a flu vaccine manufactured by Sanofi Pasteur especially for those over 65 years old. And although Sanofi Pasteur reported finding the vaccine 24.2% more effective in preventing influenza in the aged, some believe the vaccine, which contains four times the amount of antigen compared to the regular flu vaccine, brought with it stronger side effects.

You can learn more about the vaccines you or your senior client or loved one may need at vaccines.gov. Their Adult Immunization Scheduler tool offers personalized vaccine suggestions based on your age (and other factors.)

How do you feel about immunization and vaccines? Do you believe them necessary to continued well-being or is it a dangerous scam perpetrated by big pharma? Is it part of your job as a senior caregiver to influence the decision of the elder in your charge whether to get that shot or not? We’d love to hear you opinions in the comment section. Regardless of where you stand on the issue, Caregiverlist® continues to believe in utilizing everything in one's health toolkit in order to age well.

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Minnesota Leads the Way in Senior Care

Minnesota’s comprehensive senior care programs may well become the nation’s standard. In addition to scoring a first-place position in AARP’s 2014 State Long-Term Services and Supports (LTSS) Scorecard (also in 2011), Minnesota’s Department of Human Services announced in a July 1 press release a plan to award $3.5 million to providers of services to older Minnesotans, as well as for people with disabilities. The money is specifically earmarked for innovative projects designed to improve quality for home and community-based services.

The program comes on the heels of the state’s successful 2006 Performance-based Incentive Payment Program (PIPP) that provides nursing homes with additional funds for proven quality improvement projects. In 2013, an article published in the journal Health Affairs determined that PIPP facilities showed significantly increased quality after PIPP funding and continued to have higher overall quality scores than nursing homes not in the program.

In fact, Good Samaritan Society - Albert Lea (Private), which rates over 4 stars in Caregiverlist's® Nursing Home Star Ratings, used its PIPP money to implement a nursing assistant mentorship program to increase its C.N.A. retention rate with great success.
 
The Minnesota Department of Health and Human Services is hoping to see a similar outcome by funding 27 projects in 39 Minnesota counties. Recipients must put policies in place to improve quality of life or deliver better service more efficiently.

For example, Knute Nelson Home Care will receive funding to implement GrandCare technology, an interactive touchscreen used as a communication portal between the older person and family caregivers. The Lutheran Home Association will use funds to decrease staff turnover in its in-home services, and the grant will help Tealwood Senior Living to develop and apply dementia care culture change in its assisted living facilities.

“Home and community-based service providers are key to helping people with disabilities and olderadults live independently, which is what most people prefer,” Human Services Commissioner Lucinda Jesson said in a written statement. “We have found that initiatives like this promote greater, lasting quality and efficiency and a better overall experience for people being served.”

Caregiverlist salutes Minnesota for taking a proactive approach to improving the quality of care for its elderly citizens. Minnesota’s initiatives are proving to set the bar for the best senior care in the U.S.  Now if they could just do something about those winters!

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Senior Driving Safety

School’s out and that means a whole slew of new teen drivers will be on the road. While the thought of a 16-year-old behind the wheel makes me nervous, senior drivers who have not recently evaluated their driving skills can also make me run for cover.

June is National Safety Month and the National Safety Council has designated this year’s theme as "Safety: It takes all of us," and was inspired by the idea of continuous risk reduction. The Council’s emphasis this year is on putting an end to distracted driving but I think its a great time to revisit the challenges facing the mature driver.

It’s been written that “Adult children would rather talk to parents about funeral plans than about taking away the car keys.” It’s a difficult conversation—many seniors associate driving with independence (that they don’t want to relinquish.) For the adult children of driving seniors, revoking that driving privilege can mean picking up the slack and becoming chauffeur to mom or dad, at least until Google’s self-driving car becomes available.

So how do you know if it’s time to take away the keys, or are there steps to ensure the senior can hang on to those keys just a little longer?

Caregiverlist® provides our own Safe Driving Checklist. We’ve provided some basic red-flags that might mean it’s time to reexamine a senior's on-road capabilities. These include:

  • Vision: Is the senior able to pass a vision test? (Cataracts, Glaucoma and Macular Degeneration can all impact vision quality).
  • Are there any unexplained dents in the paint of the car or on the garage?
  • Does the senior allow others to ride in the car with them when they are driving?
  • Does the senior seem nervous or extra anxious when driving? Does the senior take alternate routes to avoid major highways?
  • Does the senior fail to stop at red lights or stop signs?
  • Are speed limits obeyed (Not driving too slow or too fast)?
  • Have neighbors or others who see the senior driving (anyone who also attends a regular event they may drive to) observed anything unsafe? 

Also, talk to their physician to see if any of their medications can affect their driving ability.

If the above are not at issue and your senior is feels relatively safe to drive, the Massachusetts Registry of Motor vehicles suggests some self-imposed limitations which may include driving only during daylight hours, staying home when weather conditions are poor, avoiding rush hour, and driving less.

AAA, the leader in driver safety, offers many online tools to evaluate and improve senior driving skills. They also suggest taking driver improvement courses. These can teach older drivers how to adjust for slower reflexes, weaker vision and other changes. Taking and passing a comprehensive driving improvement course can result in potential discounts on insurance premiums.

It’s important that seniors realize the risks associated with accidents. Statistics say drivers age 85 and older are injured or killed in crashes at a higher rate than any other age group. This is due primarily to increased fragility that comes with age. Older senior drivers are generally less able to withstand the forces of a crash, so they are more likely to become injured.

Effective September 30, 2010, drivers 75 years of age or older can only renew a driver's license at an DMV branch or AAA office. The operator must either pass a vision test or present a completed Vision Screening Certificate. If you need to contact your local DMV, check out Caregiverlist’s® Department of Motor Vehicles by State list.

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