Senior-Proofing the Home

Aging in place is an option more in the senior population want to pursue. There’s no place quite so comfortable as one’s own home and community. However, according to AARP, nearly one-third of all Americans over 65 experiences a fall in the home. There are other safety issues that make staying in the home a challenge and the initial accident prevention costs might be off-putting. But in the long run, the costs can be far less to stay home and renovate than to move into Assisted Living.

Senior-proofing the home is much like childproofing the home. Both encourage you to do a room-by-room assessment of potential and hidden hazards. Both take into account the physical limitations their subjects may encounter. And in both instances, safety in independence is key. But do everyone a favor and, for the senior crowd, don’t lock the toilet seat.

Elder home-proofing suggestions abound on the internet, but the most thorough and comprehensive guide to home safety I’ve found comes to us from our friends at AARP. Their AARP Home Fit Guide goes into great depth discussing home livability, home safety and home maintenance to help keep the estimated 83% of seniors who would like to, age at home.

Fall prevention is a huge concern when it comes to seniors living alone. Getting rid of scatter or throw rugs throughout the home, lighting dim passageways, installing shower and toilet grab bars, keeping passageways clear of clutter and wiring, all contribute to fall prevention in the home.  If your home needs renovation, contact your state’s Department on Aging for information on available senior home modification services.

Senior safety is addressed outside the home as well as in. Make sure medication dosages are kept current. Visit the eye doctor to gauge general as well as peripheral vision.

Owning a good Medical Alert System, as we’ve written before, is vital. In addition to providing real help in case of an accident or fall, simply possessing such a device can contribute to peace of mind for older adults who live alone.

Occupational Therapists (OTs) can be brought to the home to conduct a full assessment to help maximize an accessible living environment. Also, look for a Certified Aging-In-Place Specialist (CAPS) through the National Association of Home Builders to help with recommending home modifications to help age in place.

Taking preventative steps such as these, along with the help of a family or professional caregiver, can go a long way to help an independent lifestyle a viable senior option.

Experiencing the Sandwich Generation (Part II)

In this second of two blog posts, contributor Renata JL talks about saving your sanity and creating a balance while living in the Sandwich Generation.

My mother is an eighty-something year old widow who is relatively healthy and vital enough to live on her own. I started my family a little later in life, so my two children are still in elementary school. That means that I am, many times, caught in the middle, caring for both ends of my family’s generational spectrum. Most of the time, I like to think that I handle the pressures of care with efficiency and aplomb. But sometimes, especially during a health crisis, I find myself stretched pretty thin. And I know I’m not alone. Welcome to the world of the Sandwich Generation.

The term “Sandwich Generation” was first coined in by journalist Carol Abaya in 2006 to describe the growing segment of society simultaneously caring for both their children and their aging parents.

In a previous post, I wrote about my aging mother’s unexpected trip to the hospital and my subsequent scrambling to make sure all of my responsibilities would be met. It turns out her hospital stay (with its requisite daily visits) was not the ideal situation, but between Medicare and her insurance, the cost of her care was minimal and she had the around-the-clock attention she required. As her release date approached, we were aware that Medicare would pay for the first 20 days in a Skilled Nursing Facility, so with the help of the Caregiverlist’s Nursing Home Star Ratings system, we were able to find her a quality Nursing Home in her area. When those initial days are complete, the real challenges of being a member of the Sandwich Generation begin.

There is, of course, the financial stress involved with caring for my children and my parent, while planning for my own retirement. In this economy, I fully expect that I will need to help support my children for a longer time. Couple that with spiralling living costs, and I’m not sure how much I will have left over to help cover the costs of caring for mom, whether through the costs associated with Assisted Living or Senior Home Care. While the financial costs and responsibilities are fairly cut-and-dried, the emotional stress is the one that can really take its toll. Resentments can easily build between siblings dividing responsibilities, children losing the attentions of a parent to grandparent, and the senior realizing their diminishing independence. There are things that I plan to do to help prevent, or at least alleviate some of the stress involved with generational caring.

Here are some suggestions I found helpful:

Don’t Go It Alone
According to AARP, 29% of adult Americans spend 20 hours per week on caring for their parent(s). This growing demographic means and increased presence on the internet. Web sites catering to the Sandwich Generation abound. Look to them for ideas and support. Sites like, and AARP have a wealth of information about resources and support.

Talk About It
Gather family together, including children, parents, spouses. If you have siblings (even those living distantly), request that everyone participate in the plan of action. Communication is key and my help minimize or prevent feelings of resentment. Encourage everyone to voice their concerns and work together to find solutions.

Don’t Forget About You
If you are the primary caregiver for both children and parent(s), it may be difficult to carve out time for yourself, especially if you work outside the home as well. Although it may be difficult, you must treat the care you give yourself with as much gravity as the care you give to others. If you are fatigued, depressed or fall ill, you won’t be able to care for those around you. This one rings especially true because, as you know, we here at Caregiverlist are big advocates of “Caring for the Caregiver”.

The future will be demanding, I’m sure. I feel a little like I felt before giving birth, knowing that I would soon be entrusted to care for another human being and not sure if I was up to the task. That worked out somehow — some days are more demanding than others — but with the help of my family, my community and Caregiverlist’s resources, I hope to rise to the challenge of my new caregiver role with as much grace as I’m able to muster.

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We at Caregiverlist, along with the rest of the world, were deeply saddened by the December 14th, 2012 events at Sandy Hook Elementary in Newton, CT. We offer our sincerest condolences to all those affected — family, friends, neighbors. This tragedy reminds us that, in the midst of all the challenges we face as part of the Sandwich Generation, we are truly lucky to have the ongoing opportunity to care for our loved ones.

Alzheimer's Alone

Seniors prefer to age at home in familiar surroundings; it's a fact. The comfort derived from familiar routines and environs can be encouraging and reassuring. Many diagnosed with Alzheimer’s and dementia feel the same and choose to remain independent for as long as possible.

In March, the Alzheimer’s Association released 2012 Facts and Figures: Alzheimer’s Disease Facts and Figures, and includes a Special Report on People with Alzheimer’s Disease and Other Dementias Who Live Alone. According to the report 800,000 or 1 in 7 of those diagnosed with Alzheimer's disease lives alone.

Distance caring is the result of a mobile society — family members may live too far away to give sufficient supervision. Spouses pass away and the once tight-knit family disperses. Someone with early onset dementia or Alzheimer’s may find themselves alone.

While the desire for independence remains strong, the body may have other plans. An overwhelming aspiration to stay in one’s home and remain vital in one’s community can can turn even the most stalwart person into an ostrich, hiding their head in the sand from the disease.

The population is aging and we all need to consider that this could be our fate, or the fate of someone we love. An estimated 5.4 million people in the United States have Alzheimer's or dementia. That number is expected to reach up to 16 million by 2050. But if independence and home aging is a priority, there are things we can do to help manage.

Those who live alone, either by choice or necessity find they need to adjust their expectations.

Driving Miss Daisy. Until the self-driving car is readily available, a good choice would be to drive less. and when driving, perhaps keep drives short and to well- known routes.

Note to self: leave more notes to self. This is especially important when safety is a concern. A note by the stove with a reminder to shut off burners and oven, a note by the door with a reminder to lock, a note near the medicine cabinet with gentle reminders of which meds to take and when, could help prevent disaster.

Everything in its place. Designate a spot to place keys or sunglasses. If you ever see items that have strayed, return them immediately to their home.

Also, consider an id bracelet with address and a phone number of someone who will come to your aid. No one expects to wander off, but it happens.

The Alzheimer’s Society UK also provides a helpful factsheet with more information and suggestions on living alone with dementia.

It is important to begin to plan for the escalation of care. A quality Home Care Agency will work with finding assistance for your level of need — from simple companionship and housekeeping, to medication management to possible live-in care. A Geriatric Care Manager can consult with you to help determine the health markers that might indicate you should step up the level of care.

Early detection is so important, so discuss it with your doctor. Give yourself time to plan accordingly, especially if you intend to live alone with Alzheimer's or dementia, as so many others already do.

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Instagram: Tool for Connecting Seniors with Families

Senior caregivers often have the challenge of updating family members on the senior's activities or, they may be working with seniors who have very busy adult children and may need efficient ways to keep updated on care services.  Technology provides new ways to connect caregivers and seniors with family members.

Instagram brings an easy-to-use photo album to everyone's finger tips and can assist caregivers in communicating.

A picture is worth a thousand words and caregivers can share those pictures with just a few clicks on their smartphones using the application Instagram.  People use their smartphones to take pictures and want to share them in real time - without having to wait to connect their device to a computer and upload it.  Instagram allows this to happen and creates a feed of photos that have been uploaded for every user.  For caregivers, Instagram provides the opportunity to document their time with their senior clients.  

Four Uses of Instagram for Senior Caregivers:

  1. Document Shared Hobbies or Activities with a Senior Client. Taking on a project such as learning how to knit can create a bond with your senior client and you can use Instagram when you finish your projects to showcase your work.  Also, if you go for a walk, visit a museum or just enjoy making a flower arrangement together, you can take a photo and share this with the senior's family members.  After a few months, you'll have a collection of photos to look through and see your own progress.  When family members come to visit, they can also view the senior's activities.
  2. Share Photos with a Senior Client's Adult Children. Your senior client may not be plugged into the technological world but if their adult children have smartphones, you can use Instagram to post photos for them to see.  In return, you can also share photos the children post to their own profiles with your senior client so that the parent can feel connected to their adult childrens' daily lives. Caregivers can even help senior clients exchange comments back and forth on their children's photos.                                                                                                                                                                   
  3. Edit Photo's without Photo Editing Software.  Add an extra touch to photos without needing to learn photo editing software.  Instagram offers various “filters” for photos.  All you have to do is take the picture then pick from different 
    colorations and frame options. It adds an extra flair to preserve a moment exactly as you want it to look.
  4. Document a Day in the Senior's Life.  Many people use instagram almost like a photo journal of their day. Caregivers are often under-appreciated because their work is not visible to many people, but Instagram provides an opportunity to document your day. Try taking a picture at the start of every hour for one day if you want to share more about what you do with someone in your life.

Instagram is available for iPhones and iPod Touch. The application also was recently introduced to Android model phones as well, so most smartphone users can take advantage of the quick photo sharing provided for free.

Senior caregivers can now have an instant photo album in their phone, all for free.

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Mitt Romney Turns 65, Opts Out of Medicare, Social Security

Mitt Romney, GOP presidential hopeful, turned 65 on March 12 but has no plans to enroll in Medicare. Instead, the Republican front-runner will continue coverage through his private health-care plan.

Wealthier individuals, according to Mr. Romney’s campaign website, should pay more for government Medicare benefits, while lower-income seniors would receive more generous support. His plan would include a “premium support” contribution, allowing beneficiaries a choice between private plans and Medicare.

Social Security is another government benefit that the former Massachusetts is passing up. In response to Fox News host Neil Cavuto’s question if he was planning to sign up for Social Security on this, his eligible birthday, Mr. Romney emphatically declined. Citing the fact that retirement is far off, he stated, “I have no plans to retire at the current moment. I’m not going to be doing that anytime soon. I’m still very much in the work force, I hope.”

For both Medicare and Social Security eligibility, Mr. Romney proposes to “gradually raise the retirement age to reflect increases in longevity.” Beginning in 2022, the proposal would incrementally raise the eligibility age for both programs from 65 to 67 by one month per year.

How would the change affect beneficiaries today?

AARP Research & Strategic Analysis recently released Social Security State Quick Fact Sheets comprised of recently released 2010 data. In its findings, AARP shows that in 2009, more that one-third of the elderly population would be living in poverty if they did not receive Social Security benefits. Even in states where personal income is high, Social Security is the only income for a segment of the population.

How do you feel about delaying Social Security and Medicare benefits? While admirable from a personal (and political) standpoint, do you think Mr. Romney’s decisions and options are viable for the country at large? For information on your state’s services and resources, check your own individual Senior Services by State.

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Seniors Outliving Loved Ones

Cissy Houston’s tragic and devastating loss of daughter Whitney Houston reminds us that increasingly, our elder loved ones may outlive family and friends.

“Elder Orphans” are those seniors who have lived long enough to see their friends, siblings, spouse, sometimes even their children, pass away and are left behind alone. They are the seniors with no immediate family or friends to help care for them or to make important decisions about their care.

Smaller families, combined with the longevity rates enjoyed by baby-boomers, means that we may see a distinct decrease in family caregivers. Higher obesity rates among the young can result in shorter life expectancy and poor health. Therefore, this may be the first generation of American children to be less healthy than their parents.

Seniors who live alone are estimated at about 10 million. Of those, close to 15 percent are those who need care and have no family support. It’s been estimated that nearly 60% of nursing home residents don’t have anyone visiting them each year. That means that a significant portion of our elderly population have no one to advocate for them and no one to make sure their health care directives are carried out should they become incapacitated.

Unbefriended elders are a sad truth and why we need to investigate creative and proactive solutions to this burgeoning concern. One such program is Minnesota’s Unbefriended Elders Project run by Volunteers of America. The activities of this project include:
  • Locating estranged or lost family members of participants
  • Facilitating increased communication between participants and their primary care physicians/practitioners
  • Distributing participant HCDs to healthcare professionals and other professionals
  • Increasing network partners’ knowledge of HCDs and working with unbefriended elders
  • Developing and sharing a protocol for national replication of the project by Volunteers of America, as well as other agencies and organizations
  • Increasing public policy attention to the needs of unbefriended elders whose number will increase with the aging “baby boom” generation.
Estate Planners and Eldercare Lawyers can help you complete a health-care directive, to make sure your plans are honored in case you find yourself with no one to advocate on your behalf. Growing old alone is an uncomfortable thought and an outcome no one could wish for. However, with increasing numbers and visibility, society will have to place elder orphans on its radar.

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Early Alzheimer's Diagnosis Beneficial for Patients, Caregivers

Early Alzheimer's disease detection and diagnosis is the theme of this years’ “Let’s Face It” campaign waged by the Alzheimer Society of Canada. January is Alzheimer’s Awareness Month in Canada and internationally, Alzheimer’s organizations are urging people to diagnose early.

Although diagnosis in an early or asymptomatic stage is a challenge, researchers are looking at biomarkers to diagnose early, before the disease has a chance to affect the brain. And while there is still no known cure for Alzheimer's disease, experts assert that early detection is helpful in many ways.
  • Helps reduce anxiety on the part of the affected person and his or her family about the cause of symptoms
  • Allows for the person with the disease to partake in planning for the future
  • Allows physicians and caregivers to be aware of patients who may have difficulty managing their own health care, such as when and how to take other prescription medications
  • Allows potential management of symptoms with medication or other interventions that maintain the best possible level of health and functioning for the person with the disease
  • Allows for coordination of primary and specialty care which may help prevent prescription of medications for coexisting conditions that worsen cognitive function
  • Aids the management of possible behavioral symptoms for the benefit of both the person with the disease and their caregiver
  • Allows caregivers and family members to access training, education and support services to help them with caregiver tasks and reduce negative effects of caregiving, such as stress and depression
According to the Alzheimer’s Association, the following are 10 signs & symptoms of early Alzheimer’s and may signal the need to seek medical attention:
  1. Memory changes that disrupt daily life
  2. Challenges in planning or solving problems
  3. Difficulty completing familiar tasks at home, at work or at leisure
  4. Confusion with time or place.
  5. Trouble understanding visual images and spatial relationship
  6. New problems with words in speaking or writing.
  7. Misplacing things and losing the ability to retrace steps
  8. Decreased or poor judgment.
  9. Withdrawal from work or social activities.
  10. Changes in mood and personality.
Of course, skeptics question the value of early detection and wonder if it is just an opportunity for pharmaceutical companies to target a new group of customers. Also, they raise concern about the stigma associated with the disease. However, because of other chronic medical conditions associated with the disease such as diabetes and vascular disorders (hypertension), many physicians urge screening and tout the many benefits of early detection.

Early detection also affords the ability to put one’s financial house in order. It would be prudent to understand the ways to pay for senior care if you are facing many years of care as a result of living with memory loss.

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Siblings Caring for Aging Parents

When my mother brought my brother home from the hospital for the first time, she joked that she had had another child so I wouldn’t be alone in taking care of her in her "old age". Now that she needs the assistance, I am grateful for a sibling who shares the responsibility of caring for our elderly mother.

Not all families are so lucky. Simple geography might determine which sibling is best able to provide face-time with the senior parent. Long-time family dynamics can be challenging when siblings revert to old childhood roles. Some may find the stress of juggling work, raising children or caring for spouses limits their ability to help with parental support, so the family member with the fewest perceived obligations winds up providing the lion’s share of care. Some siblings may feel they are doing too much while others feel they do too little.

Feelings of frustration, anger, guilt and resentment do nothing to help with caring for an elderly parent.

In her book and her blog, They’re Your Parents, Too!, author Francine Russo explores and helps navigate the oftentimes tumultuous landscape of sibling tensions when dealing with eldercare. She covers topics ranging from acknowledging and accepting your parents’ aging, family decision-making and sustaining the family connection into the future.

Ms. Russo recently appeared in a video segment on the ABC News Special Series on Eldercare with Diane Sawyer. In it, she acknowledges that “the (families) who got along best accepted that they all had different relationships (with their parents), but they were in it together.”

And when the family caregiver needs a break, consider utilizing the services of a quality senior home care agency for respite eldercare.

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Planning For Retirement - Will Your Golden Years Be Golden?

Guest Blog Post by Baby Boomers Planning for Retirement

Time passes quickly by, and the day of your retirement is drawing near. Will you be prepared or will you still be thinking about planning for retirement? 

"According to Scottrade's fifth annual American Retirement Survey, 60 percent of Gen Y-ers saved nothing toward retirement last year and 40 percent plan to save nothing in 2011." Is this your situation? Not planning for retirement, is a recipe for disaster. You cannot count on Social Security providing for all your needs in your golden years. It was never intended that Social Security would be a retirement pension. It was designed to be a supplement to your savings.

Like a three legged stool, if one leg is missing, you do not have a stable seat. Savings is one very important leg of your retirement planning stool. The sooner you begin saving a minimum of 10% of your annual income, the larger your retirement income will be.

Time, saving money, and the power of compounding of interest will work miracles for your retirement years.

Consider this scenario. Who do you think would have more money saved for retirement? Person A saves a mere 5% of his gross salary of $40,000, or $2,000 for forty years and invests it for a return on investment of 10% annually. Or, person B who gets a late start and saves $5,500 annually for twenty years also at 10% R.O.I.? 

Person A would save and earn a grand total of $885,185.11. Person B would only accumulate $315,012.50 before taxes. Had Person A saved and invested a full 10% of his salary, he would have accumulated a grand total of $1,770,370.22! 

When planning for retirement, the sooner you start and consistently contribute to your savings and investment plan, the better off you will be in your retirement years. 

If you have a 401(K) Plan where you work, you should take full advantage of this plan. Often employers will also contribute a portion based on your contribution. This is an additional boost to your savings. 

If you do not have an employer 401(K) plan, you must start either a standard IRA or a Roth IRA. Your savings will grow tax free under the Roth IRA plan under current rules. 

In November 2008, there were articles that appeared that Democrats in the House of Representatives were conducting hearings on the proposals to confiscate all IRAs and 401(K)s. These accounts would be converted to accounts administered by the Social Security Administration. 

In light of the debt crisis, this Draconian measure cannot be ruled out by a cash strapped government. The wise investor will not put all of their investment eggs in one basket or account type. You might consider hiring an asset protection attorney to protect your IRA from government confiscation. 

Planning for retirement begins with a savings plan. All good investors are good savers. You should learn how to invest. Stansberry & Associates Investment Research offers excellent newsletters that will teach you the essentials of wise investing. I have found them to be a great asset. 

Once you have an investment plan in place, I would also recommend that you plan for your health issues for your latter years. Most people will need some assistance in their last years. One way to pay for assisted living care or a nursing home, is to purchase a Long Term Care insurance policy that covers these expenses. 

The average number of years a man needs assisted living is two years. A woman needs a minimum of three years. Remember, that is just an average. Some residents with dementia have been committed for as long as ten years. 

Planning for retirement early will help you have a comfortable and financially secured retirement under normal conditions. 

For more articles on Planning for Retirement consult

And to get an idea of your area's nursing home costs, take a look at  Caregiverlist's Nursing Home Star-Ratings and Costs.

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Caregiver Private Nurse Inherits $38 Million from Client

Senior caregiving pays more in fulfillment than in cash, but it seems there are exceptions.

Private duty nurse Hadassah Peri receives $38 million, left to her in the will of her client, 104-year-old Huguette Clark who was the daughter of a Montana senator who was once the second wealthiest man in the U.S.A.

The New York Post reported that Clark chose to leave money which was left over from her donation to a charity for the arts only to her accountant, lawyer, physician, goddaughter and caregiver.  She said her private duty nurse was a loyal companion and friend to her and she saw her more in 20 years than any other person.  She had a total of about $400 million and alos a Claude Monet Water Lillies series painting that will be donated to the Corcoran Gallery in Washington, D.C.

Experience the fulifillment of caregiving by working as a professional caregiver - and just remember these instances are exteremely rare but the better inheritance is knowing you assisted someone to have a better day (you know, lots of money causes lots of problems anyway).

Caregiverlist also provides job descriptions for caregivers and a directory of nursing aide schools.


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