Home Posts tagged Senior
Senior Planning

Start the Conversation

From the AARP FOUNDATION

The reality is that some conversations are just plain difficult — even with the people to whom you feel the closest. When preparing to discuss a difficult topic like senior care needs, it helps to follow the ground rules below to ensure that everyone’s feelings are respected and viewpoints are heard. To help make the conversation as productive and positive as possible:

1. Try not to approach the conversation with preconceived ideas about what your loved ones might say or how they might react. “Dad, I just wanted to have a talk about what you want. Let’s just start with what is important to you.”

2. Approach the conversation with an attitude of listening, not telling. “Dad, have you thought about what you want to do if you needed more help?” — as opposed to “we really need to talk about a plan if you get sick.”

3. Make references to yourself and your own thoughts about what you want for the future. Let them know they are not alone, that everyone will have to make these decisions. “Look, I know this isn’t fun to think about or talk about, but I really want to know what’s important to you. I’m going to do the same thing for myself.”

4. Be very straightforward with the facts. Do not hide negative information, but also be sure to acknowledge and build on family strengths. “As time goes on, it might be difficult to stay in this house because of all the stairs, but you have other options. Let’s talk about what those might be.”

5. Phrase your concerns as questions, letting your loved ones draw conclusions and make the choices. “Mom, do you think you might want a hand with some of the housekeeping or shopping?”

6. Give your loved ones room to get angry or upset, but address these feelings calmly. “I understand all this is really hard to talk about. It is upsetting for me, too. But it’s important for all of us to discuss.”

7. Leave the conversation open. It’s okay to continue the conversation at another time. “Dad, it’s OK if we talk about this more later. I just wanted you to start thinking about how you would handle some of these things.”

8. Make sure everyone is heard — especially those family members who might be afraid to tell you what they think. “Susan, I know this is really hard for you. What do you think about what we are suggesting?”

9. End the conversation on a positive note. “This is a hard conversation for both of us, but I really appreciate you having it.”

10. Plan something relaxing or fun after the conversation to remind everyone why you enjoy being a family. Go out to dinner, attend services together, or watch a favorite TV program.

These are just a few suggestions of things you, your loved ones, and other family members can do to unwind after a difficult conversation.

Senior Planning

Having the Talk

From VISITING ANGELS

Here are sample conversation starters and strategies to introduce home-care services to your loved one. Each scenario is a catalyst to take action and start talking. Prior to talking, prepare and arrange with a reliable friend or your spouse to take part in the plan.

SCENARIO: Your loved one mentions plans to drive to the grocery store. He’s shown signs of unsafe driving (getting lost or confused or unexplained dents on the car). Coordinate with a trusted neighbor, friend, or spouse to serve as a driver for one trip. 

SAY: “I see you’re planning to go to the grocery store.  I think it would be a great idea to ride with [the neighbor/friend/spouse] next time or even hire a professional who can take you where you need to go. You could tell her exactly where you want to go, and she’ll get you there. You’d be in control.”

SCENARIO: You noticed your mom or dad isn’t eating.  

SAY: “I don’t have the time to stay and cook tonight, but [neighbor/friend/spouse] loves to cook, and said she would love to cook with you tomorrow night, and she won’t have to leave early. Then you won’t have to worry about making dinner, and the family will feel good knowing someone’s with you to help you out in the kitchen. You can tell them what you’d like to eat, and you’ll be in total control. Let’s at least try it and talk about it afterward to see if it’s an arrangement you’d like.”

SCENARIO: Your loved one forgets to take her medicine repeatedly. (Alert the doctor first.)

SAY: “I’m worried that you forgot to take your medicine again. I spoke with your doctor, and he’s especially concerned about missing doses. He suggested we find a way prevent it from happening. I thought a professional caregiver would be really helpful. Let’s at least give it a try and see how you like it. Then we can talk about it and see if it’s something you want going forward.”

SCENARIO: Your elderly loved one is struggling to get dressed, whether it’s a fall or a misbuttoned shirt. You’ve realized they need help in the bedroom to get dressed.

SAY: “I’ve noticed you’re wearing the same clothes again. What if we got you a helper for the mornings — someone who can stop by and help get you ready for the day? She could even do a load of laundry or two; that’s completely on your terms. Think of how nice it’ll be knowing there’s one less thing you have to do. Mind if we give this a try?”

SCENARIO: You notice a high pile of dishes in the kitchen sink. 

SAY: “I know you care about keeping your place clean and tidy. But your dishes have piled up again, and the kitchen’s getting dirty. I’ll help you get those done, but what if we explored getting someone in here to keep the dishes done and the place clean? We’d love to take that off your plate, and then everyone can feel good knowing your house is clean and the way you like it. Let’s at least give it a try and go from there.”

Senior Planning

Understand the Difference, and Seek Help If It’s Needed

By Beth Cardillo

As Baby Boomers are getting older and representing the largest age group, the questions concerning dementia, as opposed to normal aging, continue to crop up in medical offices.

In the Greater Springfield area, 16.9% of residents over age 65 are living with a diagnosis of Alzheimer’s disease or other related dementia. The national average is 13.6%.

Someone develops Alzheimer’s disease every 68 seconds, with 5 million Americans affected, and the number expected to increase to 20 million by 2050.

Given these numbers, it’s understandable when loved ones become concerned when they notice a family member having memory issues. It’s also understandable when people start to wonder themselves if they a problem. So how does one know if it’s dementia or simply normal aging?

“Someone develops Alzheimer’s disease every 68 seconds, with 5 million Americans affected, and the number expected to increase to 20 million by 2050.”

Let’s discuss normal aging first, so you can have a sigh of relief. We all have occasional word-finding difficulties, but you can come up with the word given a bit of time. Not remembering someone’s name if you don’t see them often, or see them out of context, is normal. That is something we all do. Misplacing an item, but having the ability to retrace your steps and locate the item, is also normal. How many times do we all walk into a room and not remember why, then walk out and immediately remember, ‘oh yeah, I was getting the book I left on the couch’?

Rest assured, these are all normal signs of aging. Have any of you purchased ‘the tile’ so you can keep track of your keys, work keys, iPad, and whatever else you need? It can even help you find where you parked your car, which is extremely helpful in New York City, where there’s alternate parking every day.

What isn’t normal is having new problems finding words when speaking or writing (more than being on the tip of your tongue) and you just can’t bring them up. Or forgetting things more often, such as appointments, events, and your way around familiar places. Perhaps you can’t remember or keep up with conversations, books, movies, or newspapers. Are you stopping in the middle of the conversation because you can’t remember what was just said, or the thread of the conversation?

Also, are decisions harder to make? Is your judgment a bit skewed? Are friends and families asking if you are OK? Are you showing up to people’s homes or appointments on the wrong date? Is your mood and behavior a bit unstable or unpredictable? Are you withdrawing from social activities because you don’t want people to notice that you are having difficulty, but instead they notice you aren’t showing up?

These are symptoms of mild cognitive impairment, a precursor to a full dementia diagnosis.

There are more than 100 types of dementia. People are very reluctant to use the ‘A’ word. They quickly point out it’s not Alzheimer’s or they have just “a little bit of dementia.” The reality is that Alzheimer’s disease accounts for approximately 75% of all dementias. It could be vascular dementia, frontotemporal lobe dementia, Parkinson’s disease, or the 97 other types, and often they are concurrent. If you feel like this could be you, contact a neurologist, or a neuropsychologist, or the Alzheimer’s Assoc. at (413) 787-1113.

Today, there is no cure, but there are medications that can slow down the progression of the disease. Diet, exercise, genetics, and co-morbidities all play a part in the diagnosis, and it is said that those physiological changes could be forming in the brain 10 to 20 years before the actual symptoms start to show. There is no shame in asking for help if you feel you may have increased symptoms or you suspect them in a loved one.

On a side note, worth mentioning is that COVID-19 has wreaked havoc with the senior population, and the virus could be a new type of dementia. It has many side effects consistent with dementia if the virus has traveled to the brain. People are experiencing physiological and neurological changes within the brain, causing confusion, seizures, emotional dysregulation, and strokes that are having long-term effects.

Beth Cardillo, M.Ed., LSW, CDP is a licensed social worker, certified dementia practitioner, and executive director of Armbrook Village, and has worked in the dementia field for more than 20 years. Previous to working with dementia, she opened the nation’s first state-funded traumatic brain injury program in Westfield. She was named Western New England Social Worker of the Year in 2016, and was the 2019 Friends of the Alzheimer’s Assoc. Honoree of the Year; [email protected]; www.armbrookvillage.com

Senior Planning

How Will You Know If Your Older Parents Need Help?

By Brenda Labbe

Many experience aging as a joyful time in their life, filled with retirement, travel, and spending more time with family. But for some, aging represents a series of losses — loss of employment, health and energy, friends, mobility, and independence.

As such, it is not uncommon for older adults to resist reaching out for help. To help start the conversation, we have listed some common signs that might indicate your loved one may need some extra support.

“Stacks of unopened mail, late-payment notices, unfilled prescriptions, and the lack of general upkeep of the house can all be signs that your loved one may need someone to assist with bill paying or homemaking.”

1. Neglecting household responsibilities. Stacks of unopened mail, late-payment notices, unfilled prescriptions, and the lack of general upkeep of the house can all be signs that your loved one may need someone to assist with bill paying or homemaking. Lack of interest in eating or preparing nutritious food and/or lack of food in the home can be a sign that they may need help with grocery shopping or meal prep.

2. Frequent falls. If your loved one experiences frequent falls or you have observed new bruises on their face or body, chances are they should be evaluated by their physician for illness, dehydration, or infections, or X-rayed for fractures. Other items that can increase the risk for falls include the lack of proper medication management and the lack of proper safety equipment in the home. You may want to consider having a safety evaluation of the home to look for any other factors that may be contributing to their falls.

3. Unsafe driving. As our bodies slow down in the aging process, so too will our reflexes, which can make driving even more difficult. Observe your loved one’s car for new scrapes, scratches, dings, or missing mirrors. Avoiding driving or not being able to tolerate any changes in directions may indicate some cognitive changes which signal that now might be the time to consider transportation assistance.

4. Listen for clues in conversation. Many seniors will state they do not want to burden their busy adult children with requests for help. They describe feeling foolish for not being able to keep up with cleaning, medications, or repairs. However, if you listen closely, you may hear repeated areas of concern. Your loved one’s close friends or neighbors may also have input to offer, if asked in confidence.

Finally, consider the old adage “it is all in how you wrap the gift.” In this case, the gift is the offer of help and support. Try asking the question in a manner that is non-threatening and neutral. For example: “gosh, I would be so overwhelmed if I got all this mail — how about I help you go through it?”

Unfortunately, many people will experience a traumatic event before realizing that they need assistance. One way to help better prepare for any emergencies is to monitor your loved one’s physical and mental abilities and start researching care options before you need them. Greater Springfield Senior Services is your local resource to find help, support, and care for your loved one.

Call our office Monday through Friday, 8 a.m. to 5 p.m., and ask to speak with one of our highly trained information and referral specialists to find out more. Knowledge is power, and we are here to help.

Brenda Labbe is the caregiver specialist at Greater Springfield Senior Services and specializes in assisting caregivers in accessing respite and support services for their loved ones.

Senior Planning

It’s Important to Understand Your Alternatives

By Eric Aasheim

Moving from home to a senior-living community is one of the most consequential decisions elder loved ones may be faced with in their lifetimes.

The move is usually permanent; is unfortunately often made in crisis mode or under duress, and involves a host of emotional and psychological implications around declining physical capabilities, perceived loss of independence, and financial worry.

“Moving from home to a senior-living community is one of the most consequential decisions elder loved ones may be faced with in their lifetimes.”

Knowing the answers to these commonly asked questions will help seniors and their adult children plan ahead and ultimately put themselves in a position to make thoughtful and informed decisions about the most appropriate living and care options for their needs.

What is the difference between independent living, assisted living, memory care, and skilled nursing?

Independent living (IL) is intended for seniors who do not need assistance or supervision with independent activities of daily living (IADLs) like showering, dressing, toileting, eating, or transferring (mobility, bed to standing, sitting to standing, etc.).

Most IL communities provide apartments with full kitchens, and the monthly fee includes one main meal per day in the dining room. Independent living in Western Mass. ranges from $2,000 to $5,000 per month.

Assisted living (AL) communities are appropriate for seniors who require some level of assistance with two or more IADLs and help with medication management; apartments are typically equipped with a kitchenette only because the monthly fee includes three restaurant-style meals per day. Assisted living in Western Mass. ranges from $4,000 to $9,000 per month.

Memory care (MC) is intended for individuals who have dementia, Alzheimer’s, or other neurogenerative diseases and require an intensive or specialized program of care and supervision. Memory-care communities are secure settings with passcode entrances and enclosed outdoor spaces to keep residents on site, and can be stand-alone facilities or a separate wing or ‘neighborhood’ within a traditional assisted-living community. Memory-care communities most often provide private studio or shared companion suites for their residents. Memory care in Western Mass. ranges from $3,500 (companion suites) to $11,000 per month.

Skilled-nursing facilities (SNFs) are licensed healthcare residences for individuals who require a higher level of medical care than can be provided in an AL setting. Skilled-nursing staffs consisting of RNs, LPNs and CNAs (certified nursing assistants) provide 24-hour medical attention for their long-term and short-term rehabilitation residents. While private rooms are available in many SNFs, shared living arrangements with two or three residents to a hospital-style room are much more common. Skilled-nursing facilities in Western Mass. range from $250 to more than $500 per day.

Can I receive care at home rather than moving to a senior-living community?

Absolutely. There are any number of quality home-care companies that can provide a wide range of custodial and healthcare services in the comfort of your own home. Home care is often referred to as non-skilled care (grooming, dressing, bathing, cleaning, and other everyday tasks) and home health care as skilled care (skilled nursing and therapy).

Seniors who are largely independent but can benefit from limited home care or home-healthcare services may choose to continue living in their homes as long as these services help them do so safely. Unless you hire a full-time live-in, skilled and non-skilled care are typically provided for only a few hours per day a few days per week, meaning family members often are called upon to supplement the home-care schedule on their own.

Seniors who are at risk for (or have experienced) frequent falls or who require consistent overnight supervision or assistance may find that moving to an assisted-living community provides them with a more secure living environment.

The choice between home care and senior living is highly personal and almost always comes down to a question of safety, location, the desire and need for socialization, and finances.

What is a continuing-care retirement community (CCRC), and what are the benefits compared to other senior-living communities?

Continuing-care retirement communities (CCRCs) are senior-living communities that offer a complete continuum of care (IL, AL, MC, and SNF), usually on a single campus. The primary benefit of a CCRC is that you can stay in the same community and never have to move, even as your care requirements change as you age. CCRCs (also referred to as life-plan communities) do typically require a substantial up-front community fee that can range from $10,000 to $300,000 or more depending on the community, the structure of the life-care plan, and the size and type of apartment.

Many CCRCs offer declining, refundable options that can return 70% to 90% of the up-front community fee to the resident when he or she moves, or to her estate when the resident passes away. CCRCs do still charge monthly fees, but they are often lower and increase less from one level of care to the next than traditional senior-living communities. CCRCs also offer a potential tax-deduction benefit that many non-CCRCs do not provide.

Will my health insurance cover the cost of assisted living or memory care? What if I am eligible for Medicaid?

Medicare and private insurance plans do not cover the cost of assisted living or memory care. Medicare will cover short-term and intermittent home care or rehabilitation stays in a SNF following hospitalization, but will not pay for either long-term. Seniors generally must pay for assisted living, memory care, and home care privately unless they have long-term-care insurance with benefits specifically designed to cover these services.

Qualifying veterans and their spouses may be eligible for the aid and attendance benefit from the VA to help pay for the cost of assisted living, memory care, home care, and skilled-nursing facilities.

Some, but not most, assisted-living and memory-care communities do participate in programs administered by Medicare and Medicaid that are designed for low-income seniors who could otherwise not afford senior-living communities.

Medicaid does cover the cost of long-term care in Medicaid-certified skilled-nursing facilities and home healthcare services for recipients who would qualify for nursing-home care.

What other senior-living and care options are there?

• Residential care facilities (also called rest homes) provide meals, housing, supervision, and care for seniors who need assistance with activities of daily living but don’t yet require skilled nursing care.

• Congregate housing is a shared-living environment that combines housing, meals, and other services for seniors but does not provide 24-hour care or supervision. Public congregate housing is administered by municipal housing authorities and is partially subsidized by the state and federal government.

• Adult foster care is an alternative to residential care and matches seniors who can no longer live on their own with individuals or families who provide room, board, and personal care in their homes.

• Respite care is short-term care and supervision provided for seniors at home or in assisted-living or skilled-nursing facilities to provide family members who need some time off from their caregiver duties.

• Adult day health programs (also called adult day care) provide a wide array of community-based services for seniors during the day (skilled nursing, supervision, direct care, nutrition and dietary services, and therapeutic, social, and recreational activities) so that family members can work or attend to other responsibilities.

• Hospice care is available for individuals with life-threatening illnesses or a life expectancy of six months or less and can be provided in the home, in assisted-living or skilled-nursing facilities, in the hospital, or in specialized hospice facilities. When curative treatment is no longer an option, hospice professionals work to make a patient’s life as dignified and comfortable as possible and provide critical emotional and spiritual support services to the patient and family members.

How have senior-living and care options been impacted by COVID-19?

In short, the impact has been profound, and the ‘new normal’ is taking shape as we speak. Most home-care providers and senior-living communities have resumed services to current and new clients at some level. However, the provision of these services is governed by strict protocols to protect the health and safety of residents, staff, and family members.

For instance, many assisted-living communities are not currently offering in-person tours and assessments and instead facilitating these interactions virtually. Since most senior-living communities are observing social-distancing guidelines, new residents must quarantine for 14 days after move-in, and residents are dining in their apartments rather than in the community dining room. Social activities and outings have largely been modified or canceled, and visits from family members have been curtailed for the time being.

Eric Aasheim is a certified senior advisor and owner of Oasis Senior Living of Western Massachusetts. He assists seniors and family members through the entire process of transitioning from home to senior-living communities in Hampden, Hampshire, and Berkshire counties and surrounding areas.

buy ivermectin for humans buy ivermectin online buy generic cialis buy cialis