Has your mother fallen recently? She’s not alone! One out of four adults 65 and over experiences a fall each year. That makes falls the leading cause of injury for older adults.
Falls are serious business
A few statistics: In the U.S. an older adult dies once every 20 minutes as a result of a fall. Disabilities from a fall include injuries that can be life changing: a traumatic brain injury or broken hip. Especially for seniors, falls pose a danger to an independent lifestyle. They often usher in a permanent need for daily assistance.
Who is at risk for falling?
Has Mom or Dad fallen twice in the past year? Have you noticed balance or gait problems? Has there recently been a severe fall? These are signs of “high risk.” Other signs involve poor vision, or taking medicines that list dizziness as a side effect.
A fall risk assessment
To be safe, ask your relative’s doctor to do a fall risk assessment. This includes a review of
- underlying medical conditions. Many chronic diseases affect and the ability to get around.
- the home environment. The doctor can write an order for an occupational therapist or other trained professional to do a home assessment. They can identify simple ways to remove hazards and make the home safer.
- medication use. Some types of drugs, or daily use of four or more prescription drugs, increase the risk for falling.
A recent review of numerous studies show that some strategies are better than others. The most effective measures for preventing a fall include:
- Exercise, especially activities that promote balance.
- Getting regular eye exams and following through with corrective procedures.
- Removing hazards around the house.
- Wearing sturdy shoes and slippers. A firm sole is better than a soft cushy one because it’s easier to feel the ground below.
Are you worried about a fall?
As the Northern Virginia expert in family caregiving, we at Senior Care Management Services understand the difficulty of your situation. You can’t be too forceful about changes. And at the same time, the consequences can be pretty serious. Put our experience to work for you. Give us a call at 703-329-0900.
It’s not easy to lose abilities and admit you need help. The reluctant elder in your life is more likely to ease into acceptance if you provide good listening, compassion, and a commitment to working together. In this third installment of our series, we look at elders’ concerns around privacy and pride.
Having someone underfoot can feel intrusive, especially if your relative is used to living alone. Perhaps he or she fears being judged, or that word of unhealthy food choices or alcohol use may get back to the family. Maybe your relative tends toward hoarding and is embarrassed. Or has worries about safety with a stranger or the risk of theft. All of these are reasonable concerns for any adult who values their independence. You can address privacy concerns by
- starting with part-time help;
- hiring a friend;
- working with an agency that does background checks and drug testing.
“Do you think I need a babysitter?!” Our culture values self-reliance. Anything that implies a need for help suggests weakness or incompetence. When you approach your relative,
- shift from “we think you need help” to “we want to help you stay in charge of your life.” As noted in Part 1 of this series, working with your relative toward a common goal is a welcome and respectful approach;
- clarify what type of care is needed. For instance, a nurse to dress a wound is different from someone who cooks and cleans;
- start with a short-term arrangement, framed as “while you recover” or “just to see how it goes.” Then consider a more permanent arrangement;
- talk about getting help as a way to liberate your loved one’s energy to do other activities he or she really enjoys;
- emphasize your relative’s other abilities. If Mom can no longer do housekeeping, make sure to praise her often about her cooking talents.
Would a little coaching help?
At Senior Care Management Services we understand what a delicate line you have to walk— respecting a relative’s concern while at the same time addressing real issues of health and safety. As the Northern Virginia experts in family caregiving, we can help you grapple with your own frustrations and find the balance you need to take the next step with your loved one. Give us a call at 703-329-0900.
If Mom or Dad has summer vacation plans, be aware that older bodies are more vulnerable to the stresses of travel.
Begin with a pretrip appointment with the doctor
Suggest a meeting with the physician 4–8 weeks ahead of the vacation. Ask the doctor to assess overall health for travel. Heart and lung issues are the primary culprits in terms of cutting a vacation short. Ask about precautions while traveling or things that can be done now to prepare.
Other medical issues
- Plan to bring extra pills in case travel home is delayed. Check to see if a prescription renewal is needed.
- Ask about the scheduling of doses when crossing time zones.
- Pack prescriptions in the carry-on in case luggage gets lost.
- Order oxygen for the flight. If your loved one has a lung condition, the airlines will require you to order oxygen from them. They need 1–2 weeks’ notice.
- Ask the airlines for help with a wheelchair if your loved one has trouble getting around the airport.
- Pack lightly and carry a wheeled suitcase to avoid back injuries.
Exercise during long seated trips
If drive time or flight time is more than four hours, your relative may be at risk of deep vein thrombosis. Although not common, this involves a clot that develops quite suddenly. It can result in a deadly embolism if it travels to the lungs. Cancer patients, overweight individuals, and people who have been recently injured or hospitalized are most at risk. Watch for painful pink or bluish hot areas in the thigh or abdomen.
Prevention involves seated exercises such as marching in place and “drawing circles” with the toes (while pointing and flexing to stretch the calf in all directions). Properly fitted medical compression socks may also help—just make sure they don’t bind at the knees. If possible, it is helpful to stand up and move about every hour or so.
Want help preparing?
Traveling is fun, but it can be physically challenging. As the Northern Virginia experts in aging well, we at Senior Care Management Services can help you or your loved one make needed preparations and set up support systems along the way. Give us a call at 703-329-0900.
We all accumulate belongings over the years. But when is it too much?
According to Michael Tompkins, PhD, author of Digging Out: Helping Your Loved One Manage Clutter, Hoarding and Compulsive Acquiring, your family member may be in the early stages of hoarding if he or she
- keeps parts of the home off limits and the curtains drawn;
- talks with you endlessly about the stuff. You’ve stated your concerns, offered help, even gotten angry, and yet there’s no action;
- gets overwhelmed decluttering even a small area. It becomes a major job that can take more than a few hours or days;
- often fails to pay bills. Not necessarily for lack of money, but because the bills can’t be located. Or the stamps. Or the checkbook;
- is in debt because of compulsive shopping;
- has trouble finding things and resists storing belongings out of sight;
- puts off home repairs. He or she may not recognize the need. Or may not want to let a repairperson see the house;
- insists on meeting you at your home. This avoids embarrassment or confrontation about the clutter;
- rents one or more storage units. There is a seemingly unquenchable need for more storage space;
- will not let you touch or borrow his or her possessions. Possessions are guarded fiercely and may be treated as if they are “friends.”
If these symptoms look familiar, your family member may well have a hoarding disorder. He or she literally lacks the ability to eliminate clutter. Suggestions for next steps:
- Don’t rush to action. Force will only alienate your loved one. By maintaining your relationship, however, you may be able to help manage the problem.
- Learn more. The most extensive studies on hoarding are done by scientists researching obsessive-compulsive disorder.
- Consider professional help. Especially if there are safety risks. Consider a geriatric care manager or in extreme cases, Adult Protective Services.
Might it be more than clutter?
If you are worried, it may be time to call in professional help. We at Senior Care Management Services understand the full range, from an exuberant joy of shopping to extreme conditions that can even become a health hazard. As the Northern Virginia experts in family caregiving, give us a call at 703-329-0900. We can help you get perspective and take the next steps.
Morphine, hydrocodone, fentanyl . . . with the opioid crisis in our country, it can be scary to hear that a frail or seriously ill relative needs this type of medicine. What are the risks of addiction?
Fortunately, addiction is rarely an issue for individuals dealing with cancer or a painful terminal condition.
People who are “addicted” have such an intense desire for a drug, they do whatever it takes to get more of it. Their craving overpowers their concerns about relationships and their ability to function in the world. People with a painful, serious illness rarely behave this way.
The need for more medication
Over time, the body develops a “tolerance.” This means that a higher dose of the drug is needed to achieve the same relief. This is just a biological truth. A legitimate need for more medication is a far cry from an addictive craving that sparks irrational behavior.
It is also very common with cancer and other conditions to have pain spikes in between doses. A booster dose of the medication is then essential. It is not a sign of addiction. Simply part of the unpredictability of pain.
Possible signs of addiction
- Going to multiple doctors for pain medicine
- Going to multiple pharmacies to fill prescriptions
- Using up a prescription early
- Taking ALL the breakthrough doses
If you are worried
Ask your relative’s health provider if they are concerned. If your loved one has a history of substance abuse, let the doctor know early on. Ask about trying different types of pain medication. Perhaps the opioid can be used in rotation with others. Spiritual distress can also be a source of physical pain. If medication is not enough, ask if a visit with a chaplain—a member of the clergy—is possible.
Is pain a problem?
Pain profoundly impacts an individual’s quality of life. It dominates every experience. And it changes relationships. At Senior Care Management Services we know that a person in pain needs extra support, as do his or her family members. If pain is part of your picture, give us a call at 703-329-0900. We are the Northern Virginia experts in family caregiving and can help all of you get a healthy handle on pain.
When a loved one obviously needs help at home but refuses to allow it, it’s frustrating! Below are two common concerns, with suggestions for ways to problem solve together.
Cost is a very practical barrier
Many older adults feel particularly vulnerable where money is concerned. They don’t want to spend! But the cost of help depends on the type of help needed.
If licensed care providers are what your relative needs—for example, home visits with a physical therapist after a hip surgery—Medicare and supplemental insurance usually cover these costs.
If nonmedical help is needed (cooking, laundry, errands), there may be resources to assist. Maybe your relative has long-term care insurance. Perhaps he or she is eligible for VA benefits. Consulting with a care manager can bring those possibilities to light.
Or it may be that your loved one does not have an accurate picture of his or her financial resources. If you are the person your loved one trusts with money matters, ask if you can review the facts together to better understand his or her concerns.
Retaining control over their life
It’s common for accepting help to symbolize “the end of my independence.” That’s a scary thought. Realistically, though, all of us will need assistance at some point. You might try asking, “Under what circumstances would you see yourself accepting help at home?” This allows your loved one to explore his or her own red flags. Plus, it gives you insight about what life event might make home care acceptable and why.
When hiring help, look for ways your relative can retain as much control as possible:
- Pick the caregiver.
- Choose the days and times for help.
- Decide on the care attendant’s tasks and participate in giving the instructions.
- Clarify if this is a short-term or long-term arrangement.
Does this conversation feel like a battle?
At Senior Care Management Services we often notice that an older adult will be more resistant to their child’s suggestion regarding help than they are when they talk with a professional. With a professional, there is less face to save and no family baggage. As the Northern Virginia experts in aging well, we’d be happy to talk with you about options for introducing the subject. Give us a call at 703-329-0900. Let’s see what we can do.