NCOA Senior Housing Tool Helps You Age in Place

The National Council on Aging (NCOA) has launched a new site that can help you find information, tools, and consumer advice to use and protect the value in your home. Get custom advice for your life situation—even if you need help now.

It was created by the nonprofit National Council on Aging and made possible by a generous grant from the FINRA Investor Education Foundation.

• Want to plan ahead to ensure financial security?
  NCOA has solutions if you:
  Need to reduce debt
  Face rising homeowner expenses
  Want to refinance a mortgage
  Prepare for unplanned expenses
  Deal with an immediate problem
   
• Have a cash shortfall due to a health problem, income loss, or scam?Don't delay in finding help if you:
  Need more income
  Need cash for health expenses
  At risk of foreclosure
  Worried about home equity scams
  Protecting the house in bankruptcy
  
• Want to Enhance Quality of Life?
  NCOA addresses:
  Aging in place
  Preserving home equity
  Using home equity to enjoy life
  Investing home equity

Find out more.

Coming Out of the Closet with Caregiving

The AARP Public Policy Institute issued a paper entitled: A Call to Action: What Experts Say Needs to Be Done to Meet the Challenges of Family Caregiving.

They invited 10 authors who have written about the challenges of family caregiving to participate in an AARP Solutions Forum on the issue. Here are some of the highlights.

In many respects the conclusions are not much different than the National Alzheimer’s plan. It calls for:

• Greater public education and awareness
• More financial relief
• Better communication, coordination, and collaboration with health care professionals
• Heightened recognition of and support for family caregivers in policy initiatives

Ten areas of focus were put forth:

1. Caregiving Is a Role and a Relationship - Caregiving is based on a relationship, but caregiving is an additional role that requires preparation, acceptance, support, and resources.
   
2. Families Benefit from Discussing Preferences and Decision Making with Each Other and with Health Care Professionals.
   
3. Long-Term Services and Supports Are Expensive.
   
4. Communication, Coordination, and Collaboration Are Fundamental to Good Care.
   
5. The Most Vulnerable and Traumatic Points in Health Care and LTSS Are Transitions from One Setting to Another.
   
6. Some Help and Support to Care for the Caregiver Is Available if It Can Be Found.
   
7. Being “Proactive” Is the Key.
   
8. Public Policy Solutions Are Crucial.
   
9. Advocacy, at Both the Individual and System Levels, Is a Fundamental Part of Caregiving in Today’s World.
    
10. Culture Change Is Needed - Caregiving is now a normal part of life, yet family caregivers remain invisible, isolated, coping stoically, getting random advice. Caregiving families need public acknowledgment, family-friendly workplace environments, and affordable services and supports to assist them in their caregiving role and to help them maintain their own health and well-being.

In addition, lengthy discussions produced these observations, which I share randomly:

• Family caregivers are thrust into this role without preparation, training, or support.
  
• Older people are marginalized by society. Family caregivers must understand and speak their loved one’s language once a person suffering from dementia looses the ability to use words.
  
• It is critical for caregivers to take breaks and get out of the house.
  
• Caregivers should focus on maximizing what their loved one can do— but accept what the person can no longer do.
  
• People need to anticipate that they will become caregivers; educate themselves that there will be physical, emotional, family, and financial issues; and talk to others.
  
• An isolated army of caregivers—each operating as a force of one with little social infrastructure and cultural support needs to coalesce in a caregiver social movement similar to what occurred with the feminist and gay rights movements.
  
• Look for a doctor or nurse who can serve as your health care “quarterback.”
  
• Engage communities and faith-based institutions as a way of supporting caregivers.
  
• Improve transitions from one setting to another, and train all health professionals to communicate better with the individual and family.
  
• Incentivize health care workers to include family caregivers as partners in care.
  
• Educate Americans about what Medicare does—and does not—cover.
  
• Promote ways that people can talk to each other and share their stories.
  
• Urge a national discussion about how Americans approach advance care planning.
  
• Have the option of putting pretax dollars into flexible spending accounts to help pay out-of-pocket costs for eldercare expenses irrespective of whether or not the older adult is a legal dependent of the caregiver.
  
• Encourage primary care clinicians and other health care professionals to routinely ask every Medicare beneficiary if he or she is a family caregiver.
  
• Pursue the adoption of electronic health records that include a line designating the primary family caregiver.
  
• Educate health care professionals and family caregivers about caregivers’ rights to receive health care information about their loved one when they are directly involved with the individual’s care.
  
• Create a national council of family caregivers and advocates, including celebrities, to heighten attention to family caregiving issues, to protect the well-being and vital interests of families, and to identify potential solutions to meet the growing needs.

If you scour this blog and my other blog, you will find hundreds of posts on caregiving covering many of these issues. My platform of “Educated Aging” is meant to help not just caregivers and those for whom they care. It is about helping all of us prepare for aging so that it does not always become a crisis situation. Physical aging, emotional aging, financial aging – these are all issues that will affect quality of life as we age.

I encourage more discussion around this. In fact your input is vital to a survey I am conducting in anticipation of developing a smart phone application for caregivers. We initiated this survey last year but frankly have not acted on the development of the app. These insights from the AARP discussion really help to hone in on what might be important in an app. But you the end user are best to share that. Can you help? Click here to take survey.

Male Caregivers Have More Than Doubled (VIDEO)

Male Caregivers Have More Than Doubled

Men Increasingly Being Called on to be Caregivers

In the last 15 years, the number of men caring for loved ones with Alzheimer’s or dementia has more than doubled, from 19 to 40 percent, according to the Alzheimer’s Association. 

The trend mirrors the higher number of women with the disease — 3.4 million compared to 1.8 million men. 

Experts attribute the increase in male caregivers to several societal changes, including evolving gender expectations as well as new life expectancy rates.

“Men sometimes can be better positioned than women to serve as caregivers, said Julie Bach to the Columbus, Indiana newspaper The Republic. An assistant professor of social work at Dominican University she noted that women often attempt to tackle care giving alone, feeling guilty about the burden they place on others. Men, however, are more inclined to seek out help in the difficult process.

"Women just want to vent, and guys just want to fix things.”

The size of the average family has become smaller, so leaving the caregiving to women is not always an option. 

What is your experience?

Link Between Sleep and Alzheimer's? (VIDEO)

Cognitive Therapy + Exercise Relieves Stroke Fatigue (VIDEO)

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Link Between Sleep and Alzheimer's?

Start good sleeping habits young!
@Laurence Monneret

A preliminary study being presented this month and reported in Web MD suggests that the poorer your sleep, the more likely you may be to develop Alzheimer's disease.

"We found that if people had a lot of awakenings during the night, more than five awakenings in an hour, they are more likely to have preclinical Alzheimer's disease," says researcher Yo-El Ju, MD, assistant professor of neurology at Washington University School of Medicine in St. Louis.

Preclinical Alzheimer's disease is the term given to people who have normal mental skills but show brain changes associated with the degenerative disorder.

One hundred men and women aged 45-80, free of dementia at the study start, half with a family history of Alzheimer's disease were studied.

About 25% had evidence of pre-clinical Alzheimer's disease. Those who woke up most frequently, more than five times an hour, were more likely than the others to have these abnormal biomarkers.

Animal studies have found that sleep changes drive the accumulation of amyloid, which cause the plaques associated with Alzheimer's.

The importance of getting a good night's sleep has been increasingly shown as important. I am not sure if improving your sleep habits reduces any other predisposition to the disease. The lack of sleep may increase brain inflammation and that could be one association with the disease.

In any case, try to improve your sleep habits. Here are some tips.

Cognitive Therapy + Exercise Relieves Stroke Fatigue

The persistent fatigue that can linger for months and even years following a stroke currently has no treatment.

A new study suggest a combination of talk therapy and exercise might help. Researchers in the Netherlands recruited 83 stroke patients suffering from chronic fatigue and assigned them to one of two groups: one group underwent 12 weeks of cognitive therapy that was conducted in small groups; the other group underwent cognitive therapy plus exercise training.

At the end of the 12 weeks, 58% of the participants in the cognitive therapy plus exercise group experienced a “clinically relevant” improvement in fatigue, compared to only 24% in the group that received just cognitive therapy. 

Once again, exercise to the rescue. Frankly it only makes sense that the benefit of exercising in reawakening and invigorating the mind and body can help many people no matter what their condition.

Quality of Life for Disabled Elderly Tied to Dignity and Autonomy (VIDEO)

Quality of Life for Disabled Elderly Tied to Dignity and Autonomy

Researchers at the San Francisco VA Medical Center (SFVAMC) and the University of California, San Francisco (UCSF), studying multi-cultural residents at San Francisco's On Lok Lifeways program, concluded that quality of life for disabled elderly people is most closely tied to two factors: a sense of dignity and a sense of autonomy.

Said lead author Jennifer King, MD: “Because of disability, not all of them are able do to all activities on their own, but they want to feel they have some say in how those activities progress throughout the day.”

These seniors, average age of 78, rated their quality of life higher than some might assume it would be for older people with disabilities.

“As the number of elders from diverse backgrounds with late life disability increases, we need to learn how to assess their quality of life, and develop an assessment scale that will adequately reflect what they tell us is important,” said King.

Four areas were considered important to their quality of life: physical (e.g., pain), psychological (e.g., depression), spiritual or religious (e.g., religious coping), and social (e.g., life-space). 

Dignity and a sense of control were identified as themes that are the most closely tied to overall quality of life.

On Lok is a model community so it is not clear if seniors there enjoy a better quality of life overall. That said, isn't this all logical? Who doesn't want dignity and autonomy?

And that gives me an excuse to shamelessly plug an organization of which I am on the board called CCAL - the Consumer Consortium for Advancing Person-Centered Living.

Person-centered living (PCL) is a way of life centered on personal preferences and values that stress dignity, choice, self-determination and individuality. Many of our nation’s aging and disability services and support have been all too lacking in understanding the need for this humanistic dimension. The new federal health care reform law will begin to change this. More can be done.

We spend a lot of time talking about patient experience in hospitals and person-centered care in nursing and assisted living facilities. But there is more to the continuum of aging services than these settings. 

Some of the initiatives were are working on from the consumer perspective include:

1. Helping empower and engage consumers through a national initiative for consumers to create their own PCL Bill of Rights.
   
2. Partnering with leading national organizations to host Town Hall Forums to bring together aging consumers with aging professionals, providers, and government leaders to discuss needs, interests, and challenges in numerous cities every year.
   
3. Launching a national ‘by consumers-for consumers’ awareness campaign so that aging service and support providers clearly know what consumers want. 

Check us out. Thanks

Possible New Blog - Your Thoughts

I am considering starting a sister blog to this one tentatively entitled Caregiver Confessions. Here is the idea. I push a lot of one way information to my audience around what I call educated aging - physical, emotional and financial.

And I know that caregiving is an important issue that repeatedly comes to the surface.

I would like to set up a blog where you, not I, are the contributor.

I want readers to share their caregiving journey, its rewards, frustrations, warts and all. And then what is more important I want to create a community of support for caregivers. So comments are going to be very important so that the community can learn from each other. And if we become really successful we can create a Facebook community around this.

What do you think? Leave a comment or if more comfortable, send me an email with your thoughts.

Tips for Older Travelers

Son Tries to Evict 98-year-old Mom From House

Mary Kantorowski
Courtesy NBC

From the Associated Press

Peter Kantorowski wanted his 98-year-old mother Mary to move into a nursing home or live with him. She wouldn't go; she didn't want to leave her home of nearly 60 years. Finally, Kantorowski went to court and served his mother with an eviction notice shortly before her 98th birthday in December.

He became the owner of the Fairfield, CT home several years ago when his mother transferred ownership to him but retained the right to live there. He's concerned about her well-being, that she's seemed disoriented and has been living in poor condition.

Mary's says she can take of herself, still does some of her own cooking and is seen regularly in her home by doctors and nurses. 

The younger son, Jack says his mother is in relatively good health. He's on his mother's side of the family feud.

Peter in the meantime, who lives about 20 minutes away, hasn't seen his mother for eight months.

Peter filed a complaint against his mother in December after she refused to follow an eviction notice filed Nov. 30 to vacate the premises by Dec. 7. 

Asked where she might live next, Mary Kantorowski's says:

"I don't feel very good about it," she says. "I want to stay right here in my own home."

We'll keep you posted on this one.

 

What a scoundrel!

Tips for Older Travelers

Follow these tips for safe travels.
@Willie Maldonado, Getty Images

The New York Times travel section recently posted tips for older travelers. I'll share here but then share the tips my wife hand wrote for her parents, 81 and 84, when traveling from Charlotte to Arizona.

Booking

• Make as many requests as possible when booking a flight, including requests for expedited boarding and seats with extra legroom.
   
• Ask for wheelchairs when booking.
   
• If you have trouble walking can ask about electric carts.

Transportation

• If you can’t drive the person, arrange it with a volunteer driving program or medical transportation company instead of a taxi. Check out the Independent Transportation Network of America.

Check In

• Delta employees can help an older person through check-in with 48 hours’ notice.
   
• Oay for a concierge.
   
• American Airlines has a Five Star Service program that shepherds fliers from curb to gate.

Security and Boarding

• Inform security officials about any medical conditions.
   
• Airlines allow elderly fliers to be escorted by one caretaker through security and to the gate as long as the escort provides his or her full name, birth date and government-issued ID.
   
• JetBlue has two programs that specifically target the security and boarding processes.
   
• Even More Speed, available in 24 cities, expedites security screening, and Even More Space, offered on all flights, offers early boarding and access to bin space. Availability of the service varies among airports and costs $10 to $65 for each leg of the trip.

Arrival 

• Wait for other passengers to debark so attendants can assist with carry-ons and escort you from the plane.
   
• A relative is allowed to meet an older passenger at the gate. 

NOW THESE TIPS FROM MY WIFE TO HER PARENTS

• Pack most things and all liquids in checked bags.
  
  
• Make sure bag weighs under 50 pounds.
   
• Keep carry on bags to a minimum.
   
• Bring two decks of cards and books in the carry on.
   
• At security, before entering line, put all your pocket items - watch, phone, etc. - in a carry on bag.
   
• Show picture ID and boarding pass to security.
   
• Take two bins. Put shoes, belt, handbag into bin.
   
• Walk through.
   
• At end of security, ask guard for cart service to your gate.
   
• Buy a sandwich, bottle of water and snack for plane.
   
• As soon as you hear they are almost ready to board, go up to desk area.
   
• 1st announcement is for military, small children and those needing extra assistance. THIS IS YOU!
   
• You are in the aisle and middle seat so don't buckle up until person in window seat is seated.
   
• ENJOY THE FLIGHT!
   
• When getting off, ask for cart to baggage claim.

Gotta love it!

Bingo Benefits You Never Realized (VIDEO)

World Elder Abuse Day June 15

World Elder Abuse Awareness Day is commemorated around the globe every June 15. For this World Day, the National Center on Elder Abuse at UC, Irvine is asking people from all over the country to email them brief video clips which they will use to create a video public awareness message about elder abuse.

Go to their website and follow the simple directions.

Film your grandparents, your parents, your auntie, your kids, your MDT, your APS program, your law firm, your sheriff’s office, etc. Use signs, sign language, other languages (but please send a translation, too). 

Tell them why you “Stand for dignity, but will not stand for elder abuse.” Or why “There’s no excuse for elder abuse.” Tell your story (“My grandmother lost her house to financial abuse. That’s why I care about elder abuse prevention.”) Keep ‘em short and real. 

The deadline for submissions is April 27, 2012.