Understanding Health Care Reform

During the month of March, and after much debate, the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Affordability Reconciliation Act of 2010 were signed into law. This new legislation, commonly referred to as “health care reform,” made sweeping changes to health care as we currently know it, including the introduction of new programs aimed to assist older Americans with long term care.

The ElderCounselor™ this issue will focus on four areas where health care reform impacts our senior population and their loved ones: Medicare improvements, prescription drug help, expansion of Medicaid to home-based services, and long term care insurance available for any working adult.  For the full article, to go http://shikumalaw.com/understanding-health-care-reform/#more-238

Combating the Stress of Elderly Care

It is stressful being a caregiver for an elderly parent or loved one, no matter how much you may love them. There is a significant amount of disruption to your life and schedule, as well as the worry and sorrow of watching one you love become more helpless. There are also feelings involved with elderly care including frustration, guilt, resentment, and hopelessness. Feeling unappreciated for all of the work you do also contributes to anxiety. There are some ways to combat the stress of elderly care including getting help and support, maintaining your health, and staying organized about the patient’s health and care.

http://articles.vp.ly/senior-care-combating-the-stress-of-elderly-care/

Elderly Cat Care

Hey, cats can be elderly, too.  Here are some insights on helping our senior felines.

http://instantmoby.com/2010/05/elderly-cat-care/

Tai Chi and Yoga for Seniors

 

Knowing how to fuel your body’s furnace is a great beginning to being healthy. However, without exercise, the rate of metabolism, especially as it relates to those bad things we tend to load up on (chips, sugars, etc.), will never stay ahead of the food we do eat, and thus we will always lose the “let’s be healthy” battle. Yet, even as we age, the need for exercise is always present. The good news is that exercise is not just for the young and the athletic. Tai Chi is a form of exercise founded in the 13th century and Yoga is an Indian tradition; providing both relaxation and a beneficial form of exercise that is enjoyed by both young and old alike.

    Tai Chi is designed to exercise the major muscle groups of the body in slow, gentle movements, called “The Dance.” Yoga focuses on breathing and meditation to both improve mental, as well as, physical health. However, the real wonder of both these forms of exercise is that they can easily be adapted to fit the more limited physical abilities of an aging population. With the correct instructor and a supportive group (every group for Tai Chi that I have attended was wonderfully supportive); these two activities can be both fun and beneficial.

    Tai Chi or Yoga can provide very useful results, often, in a very short time frame. In 2006, the University of Illinois performed a controlled study with a group of seniors with an average age of 80. The study showed positive results in approximately six (6) months in balance, energy levels, flexibility and sleep. Numerous additional studies have shown benefits such as reduction in chronic pain, fewer falls, reduced stress, reduced blood pressure and overall improved fitness. Clearly, to get involved in either form of exercise is good for the body and the soul.

    Yoga, the Hatha form, the most commonly practiced in the US or Tai Chi, the Yang school, the most prevalent in this country, gives the practitioner a renewed “life force.” It is likened to a form of sunshine within the body – a force or power that heightens one’s awareness of the self in your own environment – this increase in awareness of one’s presence helps to prevent falls, as well as, reduce stress. Holistically, these forms work well as preventative measures for overall health.

    We know that exercise and nutritional health go hand-in-hand, yet as we age, the tendency is to move further and further away from exercise. One reason for this is that we see strenuous exercise as only for the young. However, exercises that offer benefits to our bodies need not be strenuous; they simply need to focus on the proper elements of exercise and the positive results will be forthcoming. Tai Chi and Yoga combine aerobic, strength training, stability and flexibility/balance into forms that are adaptable to all age groups – even for seniors in wheelchairs. So, check out your local community for the availability of either or both of these exercises. Most likely a community center will offer such group classes. See if you, your family or friends, or your staff would benefit from such a program. I’m betting they would . . . .

(Remember to always check with your doctor before doing any new exercise routine)

by Jeffrey Johnson, Founder of Visiting Angels

Sleep Disorders in the Elderly

In many of our past Weekly Messages, we have talked about the benefits of a healthy life style for our elderly (not to mention for ourselves).  Although we have generally focused on the needs/benefits of proper nutrition and regular exercise as the main stays of a healthy life, a few comments have been directed toward the area of sleep and the necessity of a solid night’s sleep.  This week we will look more specifically at sleep disorders in our elderly and some ways to resolve those disorders.

    Many of us think that as we age, we need less sleep in order to function well during our waking hours, possibly due to the perceived lack of activity of older folks as compared to the young who run, jump, and play all day long.  There is no general consensus among sleep professionals on this subject.  It is clear that kids do seem to require more sleep in order to maintain such an active lifestyle.  However, one thing is certain, we all need a solid night’s sleep in order to keep running at optimal speed during the day.  For many older folks, that is just not happening.  Why?  Well, there are a few agreed upon reasons.  As we age, our lifestyles change, which can and does create potential sleep disturbing issues.  For example, we take on more responsibilities, which can develop into worrisome thought, which then can lead to sleep interruption.  You can see where we going with this line of reasoning . . . So as we get older there are many “issues” that can develop, thus adding to sleep disorders.  However, there are other more specific reasons for these sleep disorders. Sleep apnea is a major cause of sleep disruption.  Apneas (and there are several forms: obstructive, central, and mixed) are basically an absence of airflow for 10 seconds or longer during our sleep period.  When multiple sleep apneas occur during a sleep period, restful sleep is clearly interrupted and the solid night’s sleep is lost.

    There are also sleep related movement disorders, such as restless leg syndrome which is the need to move one’s legs as a result of “uncomfortable” urges.  There is also the more prevalent movement disorder, periodic limp movement disorder, where one’s limbs (again, usually the legs) jerk every 20-40 seconds during sleep periods. Both of these sleep related movement disorders can easily be seen as disruptive to sleep.REM behavior disorder is a disruption of our normal dream process.  In this disorder, the elder (and often in men beginning at age 60) experiences incomplete REM atonia, or a temporary paralysis (low muscle tone during REM), that prevents the dream from being enacted, and can often manifest itself in more violent dreams forms.  Often, this form of sleep disorder is a precursor to another form of illness, such as dementia or Parkinson’s. The result of these different sleep disorders can be correlated to many of the elder’s symptoms: lack of full night’s sleep, waking up often during the night, difficulty falling asleep, and increased confusion.  Often, an elder will seem more depressed, have associated memory issues, will begin napping more during the day and/or begin using more over-the-counter sleep medications as the affects of their sleep disorder(s) continue.  It is important to recognize these symptoms in order to treat the underlying disorder.  And several easy treatments are readily at hand:

?         Develop a healthier lifestyle (eat better, exercise regularly, etc.

?         Avoid eating too close to bedtime.

?         Develop a bedtime routine and stick with it.

?         Use the bed for sleep and intimacy, not for watching TV, etc.

?         Don’t use caffeine prior to bedtime.

?         Put your worries to bed before you put yourself to bed.

?         Avoid daytime napping.

?         Keep the bedroom dark, quiet, and cool during sleep periods.

    There are plenty of medically related issues that create sleep disorders for elder folks (medical illnesses, medication side effects, etc.). Try to recognize the symptoms of the sleep related disorders that we discussed above, have a discussion about those symptoms with your elder, and move forward with either medical treatment (via a physician) or with a well thought out plan of our own.  Remember, adequate sleep is mandatory for everyone . . . Without that necessary sleep our bodies will begin to break down and malfunction.  Take care of yourselves and take care of those around you.

by Jeffrey Johnson, Founder of Visiting Angels

Macular Degeneration

  Macular degeneration, or AMD (ARMD – age related macular degeneration) is the leading cause of vision loss among Americans who are age 65 or older. Although it affects any and all ages, gender groups and races; it is generally found to affect whites and females more frequently. Possible risk factors are: heredity, smoking and lifestyle. AMD (which is found in both dry and wet phases – with wet AMD found to be the more advanced form), is the aging and thinning of macular tissues, which are part of the retina responsible for clear images (central vision required for reading and driving). It has also been suggested that some nutrients such as beta carotene, vitamins C and E may help to slow the progress of AMD. Yet, no FDA approved treatment is available; though there has been much progress in the field with several clinical trials currently underway.

    It is important to diagnosis AMD early, but this may prove to be difficult as the disease hits our elderly the heaviest. With the increase of dementia related illnesses among our elderly, feedback from an elderly patient could prove inaccurate. However, if one of your care recipients is complaining of shadowy areas in their central vision or even some fuzzy vision, it would be important to have this checked by their physician immediately (of course, it goes without saying, that regular eye exams are mandatory as ophthalmologists may be able to find the disease before any symptoms are appearing to the patient).

    So, what can be done with regard to treatment for AMD? As mentioned above, there is no FDA approved treatment; though there are a few well known and accepted practices to help adapt and cope with AMD. For example, increasing the use of one’s peripheral vision (the ability to see to one’s side) might compensate for the loss of central vision due to AMD. Consult with the care recipient’s ophthalmologist to determine how best to adapt and use the patient’s peripheral vision better (i.e., turning one’s head slightly to find the best line of clear vision). Developing a patient’s hearing skills will allow that person to use sounds as a means of directing them towards completing their tasks. If, for example, an AMD patient was working in his kitchen and needed to move about preparing a meal, the unique and particular sounds of the different appliances could direct him to where he needs to go in order to complete the task, i.e., refrigerator motor humming. Also, clothes can be selected by use of touch rather than full vision. Corduroy is rougher than most cotton fabrics and can easily be identified. And it is well noted that protection from the sun through the use of sunglasses can help to prevent AMD and also slow the progress. Glasses should be able to block 98-100% of both UVA-A and UV-B rays. The glasses all of us have seen that completely wrap around the eyes, top, bottom, and sides, are best. And as always, proper diet, one with an abundance of dark, leafy greens, plenty of colorful foods (peppers, carrots, beets, etc.), and lots of fruits will always stem the tide of most illnesses and disease as naturally as possible.

    Knowing that we cannot prevent AMD, our hope is that through education, our young will learn to take good care of themselves through wholesome diets and an abundance of exercise. And, it is further suggested that for those that are already seeing some signs of AMD in their lives, they will seek the aid of their physician in slowing the progress of this disease. Our caregivers are in a strong position to notice and act upon their observations with their care recipients. Please educate your staff as to the symptoms and treatments for AMD. Every little bit of effort on our part can make a huge difference in our elder’s lives. 

by Jeffrey Johnson, Founder of Visiting Angels

Computers for the Elderly

  It seems to be the way of the world: the young seem to have the mental nimbleness and the desire to stay on top of all the new technology available to the general public . . . while those over 65 years old stand on the sidelines and mumble that all that technology is simply for the young.  Yet, with a few changes in computer settings, our elderly can learn to use today’s technology with ease and with a fair amount of satisfaction.

  This learning process for our elderly is more a matter of taming frustration than it is of having a unique skill set.  It is true that our youth are blessed with a speed of fingers that makes anyone over 50 years old feel like an antique.  And, this same youth group certainly has, for the most part, no need for reading glasses.  However, today’s computers can solve those very areas of frustration stemming from the ravages of time on our bodies: failing eye sight, slower hand-eye coordination, somewhat slower processing of new information, and the essence of computers themselves – doing everything faster and faster and faster.  What matters in adapting computers for use by our elders is making the learning process comfortable and introducing that learning in a method with which the elderly can identify.  With that in mind, below are 7 steps, as identified in an article by Tina of http://www.makeuseof.com on September 19, 2009, that will greatly assist the elderly in being able to use today’s technology for their benefit and the benefit of the younger generation also:

1. Screen Resolution:  In essence this means the amount of “stuff” able to be placed on a screen.  By reducing screen resolution, fewer, but larger sized items can be placed on a screen (some modification might need to be completed for visual clarity).
2. Contrasts:  Changing the contrasts to a higher level will help with clarity of images on the screen.
3. Sizes:  Increase font size for easier readability. Font style and color can also be controlled so that reading screen texts is made easier.
4. Start menu buttons:  Increasing icon size and reducing the number of icons on the screen will help to eliminate confusion and increase speed of locating desired programs.
5. Magnification:  Windows will allow you to set part of the screen for magnification use. This magnification screen window can be moved around the bigger screen.
6. Keystrokes:  Unlike the millions of times we have all pressed multiple keys at the same time while attempting to hit just one key, keystrokes can be controlled,  So for example, to make a capital A, simply press shift, then the letter a, rather than needing to press both keys at the same time.  This makes it much easier for someone with less dexterity.

7. Mouse:  The on-screen pointer can be made larger, and, the speed of the pointer as it moves across the screen can be slowed down.  Both would clearly aid someone with visual issues and also hand-eye coordination problems (in all age groups).

  Computers are becoming smaller, faster, and more sensitive each time a new generation model is introduced.  Screens are smaller with more and more information packed into smaller spaces.  Personally, I have no idea how anyone can see, let alone read, some of what is presented on today’s cell phones.  All this new technology is geared towards the young, whose eyesight and dexterity lends itself to easy manipulation of smaller and faster technology.  To help our elderly, and those with any “issues” that might inhibit the easy use of today’s technology, it would be useful to adapt the above 7 points (as well as educating yourself, your staff, and your clients/care recipients on methods of easier computer use for our elderly). Please review the websites listed below for further information on this subject.

www.uta.edu/cussn.html
http://www.crm.mb.ca./scip/cyberpal/index.html
http://www.seniornet.com

 by Jeffrey Johnson, found of Visiting Angels

Frauds Against the Elderly

 

  If there is an opportunity to scam someone, it most likely is happening. Yet, why does it seem the elderly in our country bare the brunt of such frauds against humanity? Well, if you were to spend just a few moments to consider the plight of our elderly population, the “why” becomes easily understood . . . the solutions – more difficult to integrate.

  Our elderly live in a different world than most of the rest of the population: most have fixed incomes resulting in the ever present need to increase this income in the face of annual inflation/price increases. They also have accumulated major assets to protect their futures, i.e., homes free and clear of mortgage debt, retirement assets, and personal assets. These monies offer those committing fraud easy targets to focus on. There are many, many people who know how best to take advantage of this population and who often present themselves as trusting of anyone who can speak their “language.” For example, telemarketers know how to make an offer seem as if it is the only opportunity that the elderly home owner may get to refurbish their home by replacing every window in this once in a life-time “deal.” Telemarketers know the elderly are home more frequently than those younger Americans. So, calls to that population are easier to find during the day. And, the telephone is clearly not the only method that can be used by those committing fraud against the elderly. Door-to-door sales is not dead . . . it is just focused more specifically on our elderly.

  How do we help keep our loved ones and our care recipients from succumbing to fraud? Below are some ideas that seem to be universal in their approach:

1. Don’t give out personal information to anyone unless the elderly person has initiated the contact.
2. Shred mail and other documents before placing in the trash.
3. Keep important and confidential documents in safe places (i.e., safe-deposit boxes, safes, etc).
4. Just say “no” to telemarketers.
5. Use friends and neighbors as faux financial advisors – direct all calls to them (most telemarketers will not even attempt to make that type of second call).
6. Keep doors locked at all times.
7. Install alarm systems, with intercoms connected to the front door, etc. This should prevent the door-to-door sales people at bay.
8. Always ask for any offer in some type of written form.
9. Attempt to not use the Internet to purchase anything.
10. Be aware of your “do-not-call” rights. Call either 1-888-382-1222 or go to http://www.donotcall.gov to report violators.

  Staying on top of thieves is an endless and very difficult task, even for law enforcement authorities. However, by embracing the simple techniques listed above (and others too numerous to mention in this piece), non-law enforcement members of our society can (and do regularly) effectively fight back against crime against the elderly. We recommend that all agencies and clients visit their local police departments, get to know them, and gather the valuable information they have amassed on fighting fraud. Every little bit helps . . .  . . .  

 

by Jeffrey Johnson, founder of Visiting Angels

How to Save Money on Senior Care

With America’s population aging, billions of dollars are spent each year on senior care expenses. But with economic worries affecting many families, cutting costs has become more important than ever. With a little creativity, seniors and their families can save a substantial amount of money.

Compare Prices

Family members and caregivers can help seniors out by comparison shopping for goods and services online. Changing homeowner’s insurance policies alone can save hundreds of dollars each year. Review all bills and find out if it is less expensive to bundle services like phone and cable.

Take Advantage of Existing Services

The fall prevention alarms advertised on television can be a great tool to help seniors prevent serious injuries from falls and other medical emergencies, but most of them come with a costly monthly monitoring fee. Look for a personal alarm system that can connect directly to 911 and charges no monitoring fees and has no service contracts.

Consider Home Care

According to a 2007 MetLife survey, the average annual rate nationally for a private room in a nursing home is $77,745 and is steadily increasing each year. The annual base rate for an individual residing in an assisted living community is $35,628. The average annual cost of home care can be half the cost of nursing home care. An organization like Visiting Angels provides a cost-effective alternative to assisted living facilities and nursing homes. Caregivers provide up to 24-hour elderly assistance in the comfort of home at affordable rates. Home care makes it possible for seniors to remain in their homes and maintain their independence.

Reverse Mortgage

Many senior citizens have owned their homes for decades and can take advantage of a reverse mortgage — a loan that allows a homeowner to convert a portion of their equity into cash. Unlike a traditional mortgage, repayment of a reverse mortgage is not required until the borrower no longer uses the home as their principal residence.

Buy in Bulk

Seniors often use the same products, such as personal care items or incontinence supplies, month after month. Purchasing such nonperishable items in bulk online or from a warehouse store can save a great deal of money. Also consider signing up for automatic monthly delivery for health and personal care products. Auto delivery ensures products will no longer run out and shipping is often free.

For more money-saving ideas and to find out if home care is right for you, visit http://www.VisitingAngels.com

Putting Financial Affairs in Order

“Today’s Caregiver” has published the following list of things to do to put financial affairs in order.
1. All bank accounts, account numbers and types of accounts and the location of banks.
2. Insurance Company, policy number, beneficiary as stated on the policies and type of insurance (health, life, long term care, automobile, etc).
3. Deed and titles to ALL property.
4. Loan/lien information, who holds them and if there are any death provisions.
5. Social Security and Medicare numbers.
6. Military history, affiliations and papers (including discharge papers).
7. Up-to-date will in a safe place (inform family where the Will is located).
8. Living Will or other Advanced Directive appropriate to your state of residence.
9. Durable Power of Attorney.
10. Instructions for funeral services and burial (if arrangements have been secured, name and location of funeral home).

It seems to me to be a good list, but missing a couple items:

• Location of lock box keys and the lock boxes themselves. 
• Stocks, bonds, annuities and related money accounts that are not held in a bank.
• Optional – withhold the user names and passwords of financial accounts, but to inform where they may be found.