Staying Independent with Age

The Importance of Independence

By Jennifer Kilgore, GCM Consultant

Seniors in high school and seniors in their golden years may not like the same music, watch the same movies or show off the same dance moves, but they do have one thing in common. Both groups desire a more independent lifestyle.

Although what it means to live independently can change drastically as we age, independence is an essential part of what it means to be human. It means making your own decisions about how and where you live, who you spend time with, and what you spend time doing. It contributes toward the creation and preservation of our sense of self.

The way we spend our time and energy speaks volumes about who we are as people. And when we no longer have the ability to choose what we do and how we do it, it can be extremely difficult to maintain a sense of ownership over our own lives. However, those who are blessed with longevity will likely require assistance at some point.

One area where independence is keenly sensed, for both teenagers and their elders, is in the area of transportation. Particularly in American culture, driving signifies independent adulthood. A driver’s license is something that is dreamed about and looked forward to by the young, and not relinquished without a fight by the old. It means we can come and go as we please, and that’s certainly something that is hard to give up.

Maintaining an Independent spirit 

Sometimes being independent as we age means finding creative ways to maintain independence despite obstacles. For example, The Silver Runner Transportation service is one creative way for seniors who no longer drive to maintain transportation independence. The Silver Runner offers transportation for errands and appointments as well as group and private outings to help maintain a healthy social life.

Experiencing difficulty with mobility does not mean that you can no longer visit the places that you love. However, it may mean that you need to rethink the way that you visit these places. Enlisting the help of a mobility manager or other cargiver can be a great way to ensure a successful trip. You may also need to talk with a medical professional about how a walker, cane or self-propelling wheelchair could be used to increase your mobility and independence.

Because of new rules in America and across Europe to accommodate those with disabilities, traveling for those who have trouble walking long distances is even more possible than it has ever been. If you or a loved one have trouble getting around, but want to travel, the sky is the limit! To make your vacation a success, be sure to arrange for the assistance you need in airports and consider hiring help with ground travel and luggage.

Lastly, sometimes being independent means knowing when to ask for help. As we age, this may mean hiring an advisor to be your advocate, a person you can consult with to assist with many difficult decisions that must be made. You may also wish to create advance planning documents so that your choices are known and honored in the event that you are unable to express yourself later down the road.

The Geriatric Care Management team is available to listen to what is important to you or your loved one. We value and respect the unique qualities of each aging person, evaluate their needs, and locate the best resources to maximize that person’s level of independence.

Being independent is important at every age. Geriatric Care Management and The Silver Runner are committed to helping seniors remain as independent as possible, while also receiving a high level of care. Please contact us with questions or to schedule a consultation
(505) 897-3009.

Worried About your Memory? Is it Dementia? Alzheimer’s?

Guest Post by Linda Fodrini-Johnson, MA, MFT, CMC, Aging Life Care Association™ member and Fellow of the Leadership Academy

We all have bouts of forgetfulness. We drive past the exit we wanted, we forget the name of a neighbor we have known for years, or we go to the market and buy everything but the milk we went for! If you find yourself forgetting names, places, dates, or appointments, you might think you have  dementia like like Alzheimer’s.

But stress, dehydration, multi-tasking, being a caregiver for another, and numerous other situations can all contribute to forgetfulness. Before you panic or before you just chalk it up to being overtired, consult with a professional to discuss your specific situation.

Aging Life Care Professionals™ can help guide you to appropriate resources that can evaluate your individual situation and provide answers or possible diagnosis. The Aging Life Care Professional, also known as a geriatric care manager, is a conduit to the appropriate medical or psychological referrals that may be necessary.

Some memory loss can be attributed to other illnesses such as depression, vitamin deficiencies, thyroid problems, and several other medical diagnosis. This is why symptoms should not be ignored, but brought to the attention of your physician immediately.

The benefit of getting a diagnosis of a dementia early is that you may be a candidate for medication that can help slow down, or reverse, your symptoms. These medications may enable you to function independently, longer.

Finding out early that you have a dementia gives you a chance to modify your lifestyle, eat healthy foods, stay engaged and exercise more. You can design the care you want and make the necessary legal and financial decisions to support your wishes.

Pro-actively working with an Aging Life Care Professional ensures that the plan and resources in place respect your values, fit in your budget and meet your current and future needs.

Linda Fodrini-Johnson, MA, MFT, CMC, Founder and President of Eldercare Services in Walnut Creek, CA. She is also a partner of the VillagePlan Linda is a Fellow level member and Past President of the Aging Life Care Association. Linda has over 30 years experience working as a Care Manager. You can reach her at linda@EldercareAnswers.com, or connect with her via social media: FacebookTwitter, and LinkedIn.

 

Talking to Elderly Parents about Falling

In his blog for the Huffington Post, Jim T. Miller, NBC contributor and Creator of SavySenior.org states:

It’s an unfortunate reality, but every year, one in three older Americans fall, making it the leading cause of both fatal and nonfatal injuries for seniors age 65 and older.

A simple fall can cause a serious hip fracture, broken bone or head injury, which can lead to hospital stays, disability, loss of independence and even death. But even falls without a major injury can cause seniors to become fearful or depressed, making it difficult for them to stay active.

 

We couldn’t agree more. Fall prevention is one of the most crucial aspects of Aging life care. Learn more about fall prevention by reading Miller’s blog post.  Or read about how gardening improves balance!

Balance Exercises for Seniors

Finding Balance
By Jennifer Kilgore, GCM Consultant

We often hear about the importance of achieving balance in our daily lives. We know that we need to find work-life balance. We need to slow down and weigh the significance of our activities. We need to balance others’ expectations with our own ability to meet them. We should eat healthy, balanced meals.

However, there is one kind of balance that you may not be thinking about as much as you should be—your ability to maintain physical balance.

When was the last time you paid attention to how well you can, for example, stand on one foot? If your answer is sometime in a distant high school physical education class, pay attention. It turns out that this skill is more important to our health than it seems. And this is especially true as we age.

According to the National Institute on Health, each year more than one third of people older than 65 fall. And fall-related injuries, such as hip fractures, can have a serious life impact. Falls can limit activities and make it hard, even impossible, to live independently.

For this reason, we at Geriatric Care Management want to encourage everyone, especially seniors, to evaluate their balance. We urge you to take charge of this vital component to a long, healthy and independent life. To improve and maintain good balance, we suggest involving your physician in the evaluation process. You may also want to request a physical therapy evaluation.

It’s important to realize that most of us are not as agile as we were in our younger days, and we should be realistic with our own limitations to avoid physical risks that would limit us even further. A medical professional can help you to determine which exercises are right for you. You may also want to include some of the following simple exercises from the National Institute on Aging in your journey to a more balanced life.

Simple exercises to improve balance:

Stand on one foot.
Stand on one foot behind a sturdy chair, holding on for balance.
Hold position for up to 10 seconds.
Repeat 10-15 times.
Repeat 10-15 times with other leg.
Do 10-15 sets on each leg.
Heel to toe walk.
Position the heel of one foot just in front of the toes of the other foot. Your heel and toes should touch or almost touch.
Choose a spot ahead of you and focus on it to keep you steady as you walk.
Take a step. Put your heel just in front of the toe of your other foot.
Repeat for 20 steps.

Balance walk.
Raise arms to sides, shoulder height.
Choose a spot ahead of you and focus on it to keep you steady as you walk.
Walk in a straight line with one foot in front of the other.
As you walk, lift your back leg. Pause for one second before stepping forward.
Repeat for 20 steps, alternating legs.

For a slideshow of more balance-related exercises to try, visit the MAYO clinic website.
And please contact us if you or a loved one need any assistance. We are here to help. Visit us on the web, or call us at 505-897-3009.

How Do I Get There From Here?

Featured

Handing over the keys

By Jennifer Kilgore, GCM Consultant

We Americans love our cars. We love the romance of the open road, the wind in our hair. We have a love affair with road trips, car camping and drive-in movies. And getting your driver’s license is a right of passage in most young Americans’ lives. It’s part of the American dream, part of who we are. But that’s because a car isn’t just a car to us. It represents something so much more significant; it represents our freedom and independence. For some, it’s even a part of their identity.
 
Maybe that’s why losing the ability to drive hits American seniors so hard. It isn’t merely about the loss of transportation. Losing the ability to drive represents a major life change. Unless you live in a densely populated urban city, giving up your driving rights essentially means giving away your independence. It means relying on others in a way that you haven’t before. It means you can’t just hop in the car and go – now you have to schedule and coordinate transportation ahead of time for your everyday activities. It can also affect one’s identity. Sometimes the type of car a person drives makes that person feel set apart. Living without a car, for some, means blending into the background.
 
“Driving a car is a symbol of independence and competence and is closely tied to an individual’s identity. It also represents freedom and control and allows older adults to gain easy access to social connections, health care, shopping, activities and even employment,” says Kristine Dwyer from caregiver.com.
 
Sometimes giving up driving comes in stages. Seniors might first begin driving only in a certain radius or only during certain hours. Then they may gradually begin to go out of the way to make only right hand turns–to avoid cutting across traffic. They might also find themselves not driving on the highway any longer, or not driving at night. Still, at some point, most Americans have to turn in their keys. And this transitional moment in an elderly person’s life can sometimes lead to isolation and depression.

What drives you?

Living in an assisted-living community with available transportation is helpful if you are unable to drive yourself around. However, after a lifetime of driving independence and spontaneity, it can be frustrating to be limited by someone else’s timetable and location list. And too often, seniors have to wait long periods of time to be dropped off and picked up. It can also be confusing, time consuming, and tedious to coordinate transportation to appointments, errands, and to attend social events. This may help to explain why elderly people sometimes stop making the effort to maintain vital social connections; it’s just too much work. But those social connections are essential to our emotional and mental health.
 
In fact, according to Harvard researcher Shari S. Bassuk, ScD, “Social disengagement is a risk factor for cognitive impairment among elderly persons.”  In other words, seniors need to maintain social interaction, even after they hand over the keys in order to maintain optimal brain health.
 
So what’s the solution? Taxis are expensive and may not be able to provide the care that an elderly person needs to safely attend appointments and social events. Cabs are also impersonal and drivers do not accommodate any extra needs. They show up, curbside, honk and wait. And on the return, even if you are carrying things, they drop you off, literally, curbside.  A personal driver would be great, but for most people that isn’t practical financially. What’s really needed is a driver with experience in elder care who can be scheduled according to your individual needs.

The Silver Runner solution

New transportation services are cropping up in our community to address the needs of seniors who require assistance and transportation. The Silver Runner Mobility Managers recognize the specific attention, compassion and reliability that is required when transporting our community’s aging adults.
 
Scheduling services in advance allows us to guarantee punctuality. Our highly trained Mobility Managers provide quality transportation and care with our “door-through-door” service. Mobility Managers ensure that needs are met and that the entire Silver Runner experience is pleasant and timely.
 
Putting independence back in your life is what The Silver Runner is all about.  You don’t have to depend on friends, family, or volunteers to take you to do the essentials – keep appointments, grocery shop, and do errands. You can now be in charge of arranging to go wherever you’d like, including scenic drives, taking a class at Oasis, going to a museum or concert, or heading up to Santa Fe for the day.
 
To help foster social connections among seniors in our area, we also offer regularly scheduled group outings each month. If you or someone you care for is learning to live without their car keys, please call us today at 505-872-0451, or visit our website www.TheSilverRunner.com for more information and a full list of our scheduled outings. You can also create your own individual or group outings.
 
 
 

The Caregiver’s Brain

The Cost of Caring

It takes a special person to be a caregiver, especially if you are caring for a family member in addition to your other life responsibilities. That’s because caregiving is a selfless act, one that requires time and money, energy and love.

Taking care of a family member or friend is a noble calling, and a decision you can feel good about making. But neuroscientists and brain researchers now warn that caregiving could be costing you more than your time, love and financial resources.
 

Caring too much

Is caregiving really causing brain damage? Well, not exactly. Researchers say that the problem isn’t about taking care of others or selflessness at all. Instead it has to do with an issue that comes part-and-parcel with caregiving—chronic stress.
 
It’s long been understood that the stress hormone cortisol affects mental health. But University of California, Berkeley Neuroscientists have discovered that chronic stress actually triggers long-term changes in brain structure and function, including “an overproduction of myelin-producing cells and fewer neurons than normal.”  Stress can even cause your stem cells to malfunction.
 
In other words, your stressful lifestyle is literally damaging your brain. However, there are some things you can do to slow, and even reverse the affects of chronic stress.
 

Combating cortisol

So what’s a caregiver to do? To intentionally protect your brain from the negative affects of the stress you put it through, you need to do three things. 

1. Get help. Don’t try to be a superhero. Despite your childhood dreams, you are not Wonder Woman or Super Man. You may have incredible strength, but everybody needs help sometimes. If you are caring for a family member, don’t be afraid to ask the rest of your family to help out.
 
Another option is to hire a professional Geriatric Care Manager. Having a professional in your corner means that you don’t have to make all the care decisions yourself with limited information and training. Go to www.mbgcm.com to learn more about our specific services, and the National Association of Professional Geriatric Care Managers to learn more about Geriatric Care Managers in general.

2. Practice relaxation. According to Philippe Goldin, PhD, from the Neuroscience division of Stanford and UC Davis, Something called “mindfulness” is about “cultivating an ability to be fully present in a single moment,” he says.  His research shows that intentionally choosing to be aware of your stressors, and then learning to relax despite them, results in “improved self-observation [that] may promote the use of a range of coping skills.” And these coping skills lead to a reduction in stress and allow the brain to repair itself.

You don’t necessarily need to seek out a professional to learn how to relax (though you might find one helpful). The next time you feel stressed, try taking a deep breath, slowing down and enjoying the moment. Pay attention to what is around you today and focus on the present. Pray, meditate or take a quiet moment for yourself, your brain will thank you!

3. Get moving. It’s common knowledge that exercise can help relieve stress, but new research from Princeton University shows something even more amazing. Their research explains that the brains of physically active mice responded to stress differently than the brains of sedentary mice. Specifically, the brains of the physically active mice showed “a boost of activity in inhibitory neurons that are known to keep excitable neurons in check.”  

In other words, the physically active mice were able to remain calm in the face of stress because their brains responded differently than the brains of the sedentary mice. Exercise not only helps reduce stress, but it may actually prevent it from occurring in the first place
 
Exercise has many health benefits, including maintaining brain health. If you are not currently physically active, it’s time to begin making a plan to incorporate physical activity into your daily life. 

Caring from a distance

When parents need help, and you’re far away.

Jennifer Kilgore, GCM Consultant

 
Question: My parents are in their nineties, and live two states away from my brother and me. They are both living with significant age-related limitations.
 
My mother has used a walker for years and is now relying more on her wheelchair to get around. My father is recovering from a recent heart surgery. Both have severe arthritis, macular degeneration, and I suspect some loss in cognitive function—perhaps even the beginnings of dementia.
 
Despite our pleas, they won’t even consider moving closer to us, either to live in my home or in an assisted living facility near my brother and me. This has become a significant financial and relational drain on our families, as we alternate visiting every-other-weekend.  The stress and guilt we feel is overwhelming.  It is difficult for us to give our families and our parents the time and attention they deserve.  I always feel like we are forgetting something important regarding their care, it’s so hard to keep track of all their bills, health conditions and various health issues, and house upkeep. We need help!
 
Answer: 
 
The financial and emotional stress of traveling to visit your parents twice monthly is significant, and you are concerned about not being able to properly care for them.  In addition, being away from your own family causes more stress, guilt and burdens.  Utilizing the services of a Geriatric Care Manager will allow you and your brother to be able to be your parents’ children, not a caregiver. This will also free up time to be with your immediate family.
 
You mentioned that your parents do not want to move near to you, I wonder if that is because they are afraid to be a burden. It may also be that it’s difficult for them to accept that they are no longer able to be as independent as they once were.  Change is always difficult.
 
Because you and your brother are both overwhelmed, I recommend finding a Professional Geriatric Care Manager near your parents. A Geriatric Care Manager can assess the situation and provide resources to you and your parents. They are trained to assess, plan, coordinate, monitor and provide services to older family members and their families. Geriatric Care Managers are skilled at having difficult discussions and discovering fears and concerns. Once everyone’s concerns are understood, a Geriatric Care Manager is trained to address those concerns and develop a plan that all are comfortable with.

Geriatric Care Managers can provide the peace-of-mind that you need, while helping to maintain your parent’s independence, safety and dignity.  They communicate as often as agreed upon so that you feel that you are aware of what is going on in your parents’ lives, while being able to live your own life.  Hiring a Geriatric Care Manager can help you all live the lives you hope for while continuing to be a loving, caring family.
 
Visit the National Association of Professional Geriatric Care Managers website for helpful articles, local providers and other information.  You can also contact us at Geriatric Care Management and we will be happy to answer your questions, set up a consultation and provide you with resources.
 

A Home Within A Home- Guest Post!

Many thanks to Mary Lynn Pannen, RN, BSN, CCM, Owner and President of Sound Options for this wonderful article about creating space for aging parents living with adult children.


A Home Within a Home

According to AgingCare.com, 34 million Americans are personally providing care for older family members. As an aging society, more and more adult children are meeting the challenges of elder care by opening their homes to aging parents and in-laws. Whether it is a short-term solution or a long-term plan, here are a few important tips for making a home within a home, reducing conflicts, and setting expectations:

1. Sacred Space: Make sure your elderly loved one has their own defined space. Much of the house will be common area, but it is a crucial part of autonomy to have your own sacred space that you have control over and can go into at any time.

2. Personalize Space: Help your loved one feel at home by adding photos and objects that are special and important to them. Every space should tell the story of the individual living there. A few well-chosen objects such as a piece of art, a family quilt, or favorite books, can really redefine a room.

3. Family Dynamics: Setting up ground rules, boundaries, and a schedule such as quiet hours, family dinners, and expectations of how spaces will be used is really important for navigating the transition. Especially if you are part of the sandwich generation and still have children at home, posting expectations will help them adjust to the changes.

4. Meal Planning: Allow input and make sure expectations are set around food preparation including dietary restrictions. Setting expectations of who will be contributing financially will also help reduce stress and conflict later. Often tasks of daily living are difficult for aging adults to give up. Compromise and look for ways they can make decisions and contribute.

5. In-Home Care & Care Management Services: Create a plan for increased care needs and relief care for adult children providing care and management for loved ones. Often it is not apparent what the role will entail or feel like until you are in the middle of it. Make a plan if care becomes too much or if an emergency arises before you need it.

6. Common Spaces: Set expectations for common areas such as laundry room, kitchen, TV room, garage, outdoor spaces. Placing simple instructions around the house on new appliances such as the washer/dryer or TV remote/ etc. can help orient an aging loved one to the new space.

7. Safety: Making small changes to the home dramatically reduces the risk of falls and injury in the home. Consider the following modifications: Remove small area rugs, install grab bars and anti-slip mats in the bathroom, make sure walkways are free from clutter, furniture arrangements should accommodate mobility devices, and repair outdoor areas with loose handrails or walkways that are uneven and cracking.

8. Taxes: Consult your tax advisor to ensure that you’re taking advantage of appropriate tax deductions such as claiming a parent as a dependent or deducting other expenses related to care.

9. Relationships: Impacts on relationships and dynamics within the home are inevitable. Make sure that you have a regular family meeting to discuss concerns and questions with everyone living in the home. It is important that relationships with your own family members do not come at the expense of helping mom and dad.

10. Asses Care Needs Regularly: Make sure that you plan for changes and discuss wishes and options before they are needed. It is crucial that you create a plan for difficult decisions such as driving, end-of-life care, and setting up a Durable Power of Attorney. Consider keeping a simple journal to track changes in behavior, habits, mobility, and other observations that may change over time.

11. Storage: Discuss what will happen to items that will not be coming into the home. A combination of storage, purging, gifting, and donations can be important during any transition. Help a loved one choose a few items to have around them at any given time.

12. Finances: This can be the most crucial aspect to discuss and set expectations on when considering moving a parent into your home. Discuss expectations of who will contribute to care costs and how finances will be managed. It can be very difficult to surrender control of finances to an adult child, but it may be necessary if bills are going unpaid or late.

13. Dementia: If your loved one is experiencing symptoms of Alzheimer’s or other dementias it is crucial that you have appropriate training and education to equip yourself with knowledge and expectations of care. Close monitoring by a physician will be important for optimum safety for your loved one. Consider joining a support group and be open with your workplace about your changing responsibilities.

 Weighing the Options

The right care choices for every person and every family are different. What may feel right for one family may not be the right option for another. What is important is that you weigh the pros and cons and honor your choice as difficult as it may be to make.

 PROS

  • If you’re a part of the sandwich generation and have younger children in the home, they will be able to witness firsthand the aging and care process.
  • If you are the primary caregiver, it can be helpful to not waste time commuting to or managing two separate households.
  • Especially if a loved one is ill or actively dying, the time spent in the home can foster invaluable memories and moments together.

CONS

  •  Financial and time strains on family and work can be great
  •  Family caregivers often have lower quality health and are at risk for burnout.
  •  Family relationships can be strained in this role reversal of a child caring for a parent.

 

Eldercare Coaching

If you are considering or are in the process of moving an aging parent into your home, an excellent option at the outset of this transition is to sit down with an eldercare expert for a one hour consultation. As an RN or MSW, a Geriatric Care Manager is able to make recommendations for your specific situation and help create a game plan for your family. They are a wonderful resource to lean on for crisis management and long-term planning to ensure that your loved one remains safe and that everyone involved enjoys a high quality of life. You can find a Professional Geriatric Care Manager anywhere in the country at http://www.caremanager.org/ and here in the Puget Sound region at http://www.soundoptions.com/.

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