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.

Are Brain Games Vital to Great Senior Care?

Whenever my older sister misplaced things, or forgot a word or phrase, or walked into a room and couldn’t recollect why, she was fond of saying that she was having a “senior moment.” While it’s true that memory and processing speed can be challenged as we age, there are some aspects of the cognitive mind that are sharper in the elderly than in the young. Older people have a depth and breadth of knowledge and experience from which to draw. Decision-making processes can be stronger and certainly, the elderly probably have better language skills than their younger counterparts. But, as with the rest of the body, the mind should exercise or face possible atrophy.

According to Marbles, the Brain Store, the brain is malleable and can continue to create more neurons and neuronal connections, even older adults can exercise their brains and improve areas that they may not be as sharp in. SharpBrains, an independent research and advisory company on brain fitness, concurs. Cofounder and CEO Alvaro Fernandez states in an article on Social Work Today, that brain fitness is becoming a standard in older adult residential facilities, with more than 700 facilities in the United States alone installing computerized cognitive training programs since 2007.

Although I love computers, I wanted to find some good old-fashioned offline games to help increase brain strength. With that in mind (pun intended), I’ve enlisted the help of my local Marbles to give caregivers an idea of some games they can play with their seniors. Here are some of the suggestions from their website:

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Marbles Good Thinking Kit – This portable kit boasts over 100 activities to help improve memory, critical thinking, coordination, visual perception and word skills.

 

Pengoloo – Pengoloo is as much fun as one of penguins’ favorite pastimes: sliding down icy hills on their bellies! The best part? This charming game works your memory without you even realizing it. (The greatest brain health games are sneaky like that.)

 

Rush Hour – This multi-award winner is one of Marbles’ bestsellers; my kids love it too. Perhaps it’s the fun of setting up the game board based on pictures of traffic jams and then plotting your escape as you slide cars and trucks out of the way. Although it looks like a kid’s game, it’s challenging to even the best adult puzzlers.

 

 

 

Sherlock Deluxe – As Sherlock searches for clues, players are asked to recall objects on a facedown card. If the player is correct, the card is turned face-up and Sherlock moves on. If Sherlock lands on a face-up card, the player gets to keep that card. The first player to collect six cards wins. For adults, the game just might help you remember that you left your keys in the freezer.

 

And because we are not always around or available to play, a good solitary brain game continues to be:

Little Black & White Book of Crosswords – Of course, there areother crossword puzzles out there. But The New York Times Crossword is the gold standard. The bible. The one that all others are measured against. Now you can get 200 of these brilliant bad boys in The New York Times Little Black (and White) Book of Crosswords from puzzle master Will Shortz.

Caregiverlist® suggests that the next time you think of healthy aging and senior caregiving, remember to add some brain exercises. Along with physical activity and good nutrition, it will help you help your senior to age well.

Sun Safety Especially Important for Seniors

Ah, June! Finally, the cold, dreary days of winter are gone and the summer sun warms our bones. Last weekend, city pools were full to capacity. This is perfect weather — the recent numbing cold weather is a just a memory, and we well know that unbearable heat that will have us scrambling for air conditioning is right around the corner. But for right now, we will take advantage of these halcyon days and spend every available moment outdoors.

Before caregivers head outside with their seniors, it’s important to know that skin cancer is the most common type of cancer in the U.S. In fact, according to the Skin Cancer Foundation, the odds of developing skin cancer rise as you age; in fact, between 40 and 50 percent of Americans who live to age 65 will have at least one skin cancer.

Why is it that those over 70 years old have the highest incidence of skin cancer of any age group? I remember the days when baby oil was used as suntan lotion. A recent study conducted in Germany concluded that repeated sunburns during a lifetime increased the chances of melanoma later in life, writes Susan Evans, MD.

Tanning beds, introduced into the U.S. in 1979, were touted as the epitome of health and fitness. Tanning salons became hugely popular. However, we now know that using a tanning bed will increase your chances of getting skin cancer. The American Academy of Dermatology says studies have shown people who have been exposed to UV rays from indoor tanning have a 59% increase of developing melanoma, the most dangerous form of skin cancer. And just recently, the FDA reclassified them as "moderate-risk devices" instead of "low-risk". (The Skin Cancer Foundation, along with a host of other experts, feels that the reclassification doesn’t go far enough.)

But all is not lost. Damage can be mitigated and we can safeguard ourselves and our seniors from destroying any more precious skin cells. The following precautions can keep keep skin damage at a minimum and reduce the chance of future melanoma:

  • Wear waterproof sunscreen with an SPF of 30 or higher.
  • Cover up with broad brimmed hats, protective clothing, and UV-filtering sunglasses.
  • Seek shade instead of direct sunlight, especially during 10am and 4pm, when the sun is strongest.

In the meantime, seniors should arrange for regular skin cancer screenings with their doctors and educate themselves on what types of skin changes for which to be vigilant. Caregivers should also know the indicators of melanoma and be on the lookout for any skin anomalies.



Caregiverlist® invites you to learn more about helping seniors age well with Caregiverlist® Basic Training, powered by Caregiver Training University. The 8-hour training course provides easy-to-access online caregiver training for professional and family caregivers and meets senior caregiver orientation training requirements for many states.

German Nursing Homes to Try 3D Printed Food for Seniors

Senior caregivers can find it quite challenging to keep the elderly well-nourished, especially if the senior has problems with chewing and swallowing. A steady diet of baby food-like mush can make seniors dread their next meal. Dealing with the challenges of feeding those seniors can lead to caregiver stress.

So, the European Union is funding a consortium of five European countries along with 14 companies called PERFORMANCE (which stands for PERsonalised FOod using Rapid MAnufacturing for the Nutrition of elderly ConsumErs), to help develop 3D-printed “smoothfood” to create a more appetizing-looking meal.

German company Biozoon created Smoothfood, in which deconstructed foods that are safe to ingest without chewing are reconstructed to look like conventional meals by using plant-based solidifying agents and poured into food-shaped silicon molds. While the food retains its shape on the plate, it completely dissolves in the mouth, making it safe for those with chewing and swallowing impairments.

Dysphagia, or difficulty swallowing food, affects as many as 15 million Americans and according to the Agency for Health Care Policy and Research (AHCPR), over 60,000 Americans die from complications associated with swallowing dysfunctions each year. Many times, victims of stroke find themselves unable to chew and swallow regular food.Currently, those seniors have no choice but to eat a variety of pureed foods, much like baby food. Needless to say, a constant diet of unappealing and uninteresting food has been shown to cause a loss of appetite and lead to malnutrition.

Nursing homes and assisted living facilities are already overtaxed and overburdened with senior care, so the objective of the PERFORMANCE project is to utilize new processing approaches and tailor-made technologies for the use by small and medium sized (SME) food producers to produce personalised food for the frail elderly European consumer, thereby improving the quality of life.

Over 1,000 retirement homes in Germany have already implemented the smoothfood concept according to Wired UK. The PERFORMANCE project is hoping to take that idea and, by applying automated 3D printing technology, make it easier and more affordable to use on a broader scale by nursing homes and assisted living facilities.

But how does that food taste? Sandra Forstner, the project manager at Biozoon spoke to food blog Munchies about the taste of 3-D printed food. “The food tastes like normal food. It is made from fresh ingredients, so the taste doesn’t change. One of our goals is not to change the flavor; the texturizing system doesn’t change it.”

Senior Housing Building Boom: Too Much Too Soon?

I am part of a very substantial population of the United States known as Baby Boomers. According to the U.S. Census Bureau, 76.4 million American children were born post-World War II, between the years 1945 and 1964, making up almost 40% of the American population. As much as we would love to age in place, the fact is that if we see 80+ years old, we will need some sort of help with Activities of Daily Living, and the cold, hard truth is that a lot of us will receive that help in some sort of assisted living community.

It’s no wonder that many real estate developers are banking on building for a significant niche market. Home and commercial real estate building in 2014 point to a post-recession recovery. However, are those developing housing for the elderly building too much too soon?

Analysts say that a glut in the supply of senior housing is destined to hurt hurt health-care real estate investment trusts (REITs). Bloomberg News reported that the jump in supply is forecast to cut growth in senior-housing net operating income to 1.8 percent in 2015 and 1.4 percent in 2016 from 3.3 percent this year, according to Green Street Advisors Inc. These projections have translated into a 17 percent fall in the Bloomberg health-care REIT index during the last 12 months.

Brookdale Senior Living Inc. (BKD:US), is buying competitor Emeritus Corp. (ESC:US) for about $1.4 billion, Green Street Advisors told Bloomberg, making it the biggest owner of senior properties, with 1,161 senior care facilities in 46 states.

While the supply of senior care communities is increasing, the over-85 population is projected to increase to just 7 million by 2020. Senior housing won’t be in full swing for a few more years, when the nation’s “oldest old” could number as many as 31 million in 2050, although Jacob Gehl, managing director and founding partner of Blueprint Healthcare Real Estate Advisors, a brokerage and advisory firm in Chicago, told Bloomberg that peak demand is projected to be 15 to 20 years away.

It will be interesting to see how these new properties compete by way of staff, amenities, and senior housing costs. It will also be interesting to see if the trend in preferring to age at home with the assistance of quality home care continues. A lot can happen to the senior care landscape in 20 years.

Caregiverlist® would love to know about you and your family's projected needs. Where do you see yourself living when you are in need of assistance? Are you hoping your family will care for you? Do you see yourself moving into some sort of assisted living well before you absolutely need it?

Advanced Style: Celebrating Over-Sixty Chic

I’ll admit it — I’ve been known to occasionally fall down the rabbit hole of online fashion sites. I’ll start at LE CATCH, drift over to FashionIndie, then lose a few hours on The Sartorialist. But because the nature of my job is to acquaint myself with all things senior and elder-related, I’ve always held a very soft spot in my heart for Ari Seth Cohen and his amazing New York street-style blog, Advanced Style.

The Advanced Style blog documents older women (and men) who dare to express themselves in fashion. Mr. Cohen began the blog in 2008 after moving to New York City, where he roams the streets looking to document the fashionable over-60 set — both male and female. As he states on his site, “Respect your elders and let these ladies and gents teach you a thing or two about living life to the fullest."

The international popularity of the blog has translated into a book, and even a coloring book. Now Mr. Cohen brings seven stylish ladies, aged 63 to 95, to the big screen in his affectionate and inspiring documentary, Advanced Style. Advanced Style had its U.S. premier at the Montclair Film Festival in New Jersey on May 3. Below is the long trailer of this fantastic film featuring some of the world’s most stylish seniors. Directed by Lina Plioplyte and produced by Ari Seth Cohen, I’m hoping the documentary finds wider distribution here in the U.S.

 As the American Baby Boomer generation ages, coming into one’s own style is just one aspect of aging well. Since we’re all living longer, it just makes sense to do it on your own terms. Or as Jean, of Valerie & Jean, the duo behind Idiosyncratic Fashionistas puts it, “I dress for myself. If someone doesn’t like what I’m wearing, I don’t give a sh*t.”

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