Wednesday, June 28, 2017

Driving and Independence

A new study found that older adults who are able to continue driving safely are less likely to enter long-term care than those who have given up driving or who have never driven. The study included 1,593 older adults, ages 65 to 84, and was conducted over a 10-year period. While driving itself did not produce this effect, the independence driving represents enables older adults to delay entry into a long-term care community. Non-drivers were four times more likely to enter long-term care than drivers, and the risk doubled for non-drivers without any other drivers in the home. Although the slower driving habits of some seniors often steam impatient younger motorists, researchers at Johns Hopkins School of Medicine have found that elders who stay behind the wheel are less likely to enter nursing homes or assisted living centers than those who have never driven or who have given up driving altogether. “We are not recommending continuation of driving for seniors who are a threat to themselves or others on the road,” said the study’s lead author. “Instead, we hope that understanding the very real health impact that losing the ability to drive has on seniors will encourage families to plan contingencies to assist elderly members with transportation issues.” The researchers also pointed out that losing the ability to drive poses an especially significant hardship to seniors living in isolated rural areas or any place without good, accessible public transportation for the elderly. “We set out to learn whether or not the loss of driving ability played a measurable role in an older person’s eventual need for long-term care,” according to John Hopkins School of Medicine. “The independence that accompanies a driver’s license and car has long been linked anecdotally to a better quality of life for seniors.” This probably isn’t so much about the process of driving but rather the larger issue of mobility as it relates to a person’s independence. When someone becomes a shut-in due to the loss of their primary transportation, the likelihood that they will require living assistance categorically increases. Non-drivers across the entire age group studied had four times the risk of long-term care entry compared to drivers, and the absence of other drivers in the home doubled the risk of entering long-term care. Nine percent of those studied entered long-term care for three months or more. By the end of the study, 29 percent of men and 58 percent of women had no other drivers in the household, and 22 percent of people who were driving at the beginning of the study reported that they stopped driving during the study. These findings point to the importance of research into how to keep seniors driving and independent as long as is safely possible.

Mobility and Gardening

This week I am combining suggestions for people with limited mobility and/or vision impairment and one of my favorite hobbies – gardening! The timing for this topic is fitting – with the official start of summer this week. When you think about moving around in your yard, do you think how limited mobility can make it difficult to enjoy your garden? Do you have physical impairments or does someone with physical limitations live in your house or visit frequently? Another factor that may be keeping you from enjoying your garden may be problems with vision or hearing. Even minor sensory problems multiply problems of movement, as do problems of balance in such disorders as inner-ear disturbances or diabetes. Don’t focus on being able to pronounce the next word, just work on understanding its meaning. Proprioception is the technical name for the collection of senses and brain functions that tell you where you are spatially at any given moment. Certain conditions can damage or destroy the nerves of proprioception in the legs and feet, so that a person has to rely on visual orientation only. A person who has problems with proprioception is likely to sway or wobble especially in bad light. Enjoying a garden means different things to different people. Some want just to look to take in the beauty and some want to dig in the dirt. The best way to make gardening easier is to move the plants closer to the gardener by constructing raised beds. There are two measurements to consider – height and width. Two feet is a good height. Topping the retaining wall with a foot wide (or wider) stone or concrete seat offers a convenient place to sit or lean, or to keep tools handy. The bed should also be no wider than is convenient for you to reach; perhaps 2-3 feet wide if it’s only accessible from one side or 3-4 feet wide if it’s accessible from both sides. Rounded corners eliminate sharp edges. Another way to bring the plants closer to the gardener is to plant in containers. Plants grown in pots generally need to be watered more often than plants grown in the ground, so make sure there’s a faucet or other water source convenient to where the pots will be set. Select low maintenance plants that do not need frequent deadheading or complicated pruning. Many plants are identified as “low maintenance” at the nursery. Easy to handle tools are also available to make your gardening easier. Look for tools with long handles, which increases your reach, and those with cushioned or oversized grips, which are more comfortable to handle. Make sure the tools you select aren’t too heavy, since it can be awkward to use. For even slightly limited mobility, transitions can be tricky. Some front walks are too narrow to accommodate a quad cane or walker and the uneven grass strip can be treacherous. A person with a leg brace, or even a cane, needs a hard surface that is wide enough to walk in a straight line, with additional space for changing or reversing direction. A 4-foot walk that’s ample for the agile is tight for someone with a cane walking alone. Consider a 6-foot minimum for high use walks, so a helper can walk on the same surface, if necessary. Steps and sloped paths should have graspable railings or other firm handholds at crucial spots. Make sure the steps and stairs are well lighted. Make sure the light source is well above or below eye level. Blinding lights can be hazardous, because as one gets older, your eye’s response to changes in light slows with age. There are 10 million blind and visually impaired people in the United States. 5.5 million people over the age of 65 are blind or visually impaired. Gardening may seem like an activity for only the sighted, but it doesn’t have to be. Gardens can be a haven of sound, fragrance and textures. According to American Foundation for the Blind, by continuing to garden, people who have experienced vision loss gain self-confidence and that self-confidence bleeds over to other areas of their life. If you continue to garden, you set aside limitations set upon yourself. Longtime advocate for those with disabilities say that growing plants provides inspiration and that vision loss is simply not enough reason to hang up the watering can and trowel. Some safety tips for people with visual limitations include: Clear plants hanging over paths Carefully coil hoses and store them out of the way Use labels or tags with large, readable letters or Braille or colored stakes to identify different plants Use tools with bright colors to make them easier to find Use an apron or tool belt to store tools while in the garden Avoid spraying pesticides Avoid thorny plants Making the garden lower maintenance in general can help the vision impaired gardener say independent. Simple enjoyment is a good reason for making your garden accessible for those with limitations. Even if you don’t want to or can’t completely re-landscape your garden, you should be able to make a least some of your outdoor space easily accessible to someone who has trouble walking, bending or kneeling.

Tuesday, May 16, 2017

Older Americans Month

May is Older Americans Month. The 2017 Older Americans Month theme is “Age Out Loud”. The Administration for Community Living (ACL) of the U. S. Department of Health and Human Services, declares May Older Americans Month. The theme is intended to give aging a new voice – one that reflects what today’s older adults have to say about aging. President Lyndon B. Johnson signed the Older Americans Act into law in 1965. Since that time, the act has provided a nationwide aging services network that helps older adults live with dignity in the communities of their choice for as long as possible. These services include home delivered and congregate meals, caregiver support, community based assistance, preventive health services, elder abuse prevention, and much more. Older adults are a growing and increasingly vital part of our country. The contributions they make to our communities are varied, deeply rooted, and include influential roles in the nation’s economy, politics, and the arts. The theme for this year gives us an opportunity to shine a light on many important issues and trends. More than ever before, older Americans are working longer, trying new things and engaging in their communities. They are taking charge, striving for wellness, focusing on independence, and advocating for themselves and others. They expect to live their life to the fullest. What it means to age has changed and Older Americans Month is a perfect opportunity to recognize and celebrate what getting older looks like today. While The Dale Association provides social and supportive services for older adults year round, Older Americans Month offers an opportunity to focus on how older adults in our community are leading and inspiring others, how we can support and learn from them, and how we might follow their examples. It’s also an occasion to highlight how older adults are engaging with and making a difference in those communities. Throughout the month, The Dale Association will be conducting activities and proving tips on how to access programs and resources designed to maximize the independence of older adults in our community. The annual observance offers the opportunity to learn about, support, and celebrate our nation’s older citizens. I hope you will participate.

Monday, May 1, 2017

Making Well Informed Decisions

The New York State Bar Association’s Elder Law Section is sponsoring National Healthcare Decision Making Day 2017. What is National Healthcare Decision Making Day? It is a volunteer, public-service project which will involve attorneys speaking on topics relevant to older New Yorkers, their family members and caregivers. The National Healthcare Decision Making Day initiative is a collaborative effort of national, state and community organizations committed to ensuring that all adults with decision-making capacity in the United States have the information and opportunity to communicate and document their healthcare decisions. Despite recent gains in public awareness of the need for advance care planning, studies indicate that most Americans have not exercised their right to make decisions about their healthcare in the event that they cannot speak for themselves. The National Healthcare Decision Making Day will help people understand that making future decisions includes much more than deciding what care they would or would not want; it starts with expressing preferences, clarifying values, identifying care preferences and selecting an agent to express healthcare decisions if patients are unable to speak for themselves. According to a recent research study: 71% of Americans have thought about end-of-life treatment preferences, 95% have heard of a living will, but only 29% have a living will. The public is invited to attend a free session of National Healthcare Decision Making Day 2017, which is being held locally on May 9, 2017 at 10:00am, at The Dale Association, 33 Ontario Street, Lockport. A local attorney from Patricia George Law Office will be the speaker. The program will include a question and answer session, and a “legal checklist” with an overview of legal documents every New Yorker should be aware of. Topics will include: Health Care Proxies Powers of Attorney Wills DNR Organ Donations Probate What are healthcare proxies and powers of attorney? How do they differ? How can these documents help avoid problems regarding guardianship, DNR orders and organ donation requests? Why do I need a will? What insurance, pension and financial documents should I have? What must be done to complete and maintain these documents? It is important for everyone to understand the importance of having these documents in order, it doesn’t matter what your age is. When people are unprepared, it can be emotionally devastating, financially costly, and an obstacle for people to take care of everyday dealings. The program is free of charge, will last approximately one hour and the community is welcome. For more information or to register for the session, please call 433-1886. Side Bar Box: WHAT: National Healthcare Decision Making Day WHY: Volunteer, public-service project WHEN: May 9, 2017 TIME: 10:00 am WHERE: The Dale Association 33 Ontario Street, Lockport Free and open to the public Please call 433-1886 to register

Monday, March 20, 2017

Be Aware of these Scams!

Over the past several years, I have used this column numerous times as a community resource to talk about the latest scams and how to avoid becoming a victim of a scam. Scams are still out there, so I am providing some general information and ways to help you, so you don’t fall victim to scams. And, scammers are getting slicker and more daring in ways that can easily catch you off guard- making you easy prey for newer scams – one of the newer scams is threatening to withhold funds from your Social Security Benefit Payment via an authentic looking letter from US Department of the Treasury. Scam artists are sophisticated and often prey on trusting victims – their single purpose is to make money. They want anybody’s money, including your money! Included with this week’s article is a copy of a scam letter that is circulating; it is authentic looking at first glance and an example of how scammers go to great lengths to make the situation seem legitimate. This letter was personalized with name and address, which has been blacked out. Be very careful and do not give out information. And, tax time is also scam artist time. Aggressive and threatening phone calls by criminals impersonating IRS agents remain a major threat to taxpayers, also. The IRS con game peaks during filing season as people prepare their tax returns or hire someone to do so. Scammers make unsolicited calls claiming to be IRS officials. They demand that the victim pay a bogus tax bill. They con the victim into sending cash, usually through a prepaid debit card or wire transfer. They may also leave “urgent” callback requests through phone robo-calls or via phishing email. Many phone scams use threats to intimidate and bully a victim into paying. They may even threaten to arrest, deport or revoke the license of their victim if they don’t get the money. Some schemes may even say you are entitled to a huge refund. They all add up to trouble. Scammers often alter the caller ID numbers to make it look like the IRS or another agency is calling. The callers use IRS titles and fake badge numbers to appear legitimate. They may use the victim’s name, address and other personal information to make the call sound official. The IRS reminds taxpayers to guard against all sorts of con games that arise during filing season. The IRS Commissioner says, “Don’t be fooled by callers pretending to be from the IRS in an attempt to steal your money. We continue to say if you are surprised to be hearing from us, then you’re not hearing from us.” Here are five things scammers often do, but the IRS will never do: • Call to demand immediate payment, nor will the IRS call about taxes owed without first having mailed you a bill. • Demand that you pay taxes without giving you the opportunity to question or appeal the amount they say you owe. • Require you to use a specific payment method for your taxes, such as a pre-paid debit card. • Ask for credit or debit card numbers over the phone. • Threaten to bring in local police or other law-enforcement groups to have you arrested for not paying. If you get a call from someone claiming to be from the IRS and asking for money, here’s what you should do: If you do not owe taxes, or have no reason to think that you do: • Do not give out information. Hang up immediately. • Contact the Treasury Inspector General for Tax Administration (TIGTA) to report the call. Use their “IRS Impersonation Scam Reporting” web page or call 800-366-4484. • Report it to the Federal Trade Commission. Use the “FTC Complaint Assistant” on FTC.gov webpage and please add “IRS Telephone Scam” in the notes. If you know you owe, or think you may owe tax: • Call the IRS at 800-829-1040. IRS workers can help you. • Each and every taxpayer has a set of fundamental rights they should be aware of when dealing with the IRS. For more information about your Taxpayer Bill of Rights, visit IRS.gov. Identity theft is one of the fastest growing crimes in America. One out of ten adults have been victimized by identify theft. Presenting them self as a representative from IRS or US Treasury is not the only way a scammer can victimize you. Garbage pickers routinely set up phony accounts in your name. They get all the information they need from your trash. Be sure to shred or burn solicitations or pre-approved applications from credit card companies. Or, the scam begins with a phone call. NEVER give out personal information. Banks, credit card companies, mortgage companies have the information they need. They will never call to ask your social security number or other personal information. Another version of identity theft is hackers call you and say your email has been hacked. They lead you to believe they are calling from a legitimate company and are calling to help resolve your problem. Then the hackers steal your private files and identity. They often say if you send us a pre-paid Visa cash card for $500 they can completely take care of things. Another scam that has been in the news lately is an urgent call from a “grand child” who has been in an accident or some other type of trouble and need their grandparent to wire money to get them out of trouble. Beware – this type of scam has been successful and takes advantage of an escalation of emotions. This information is being provided to help stop the number of innocent people who fall victim to scammers – I hope it makes you pause and not become the next victim. Thousands of individuals already have.

Proper Lighting for Older Eyes

Lighting is a serious matter for older adults. Seniors require three times the amount of light to see as well as younger people, but are more sensitive to glare. And, people with dementia have impaired contrast perception, so they can’t see the edges of objects as well – especially if the object and background appear similar. To assist older adults maintain a safe and independent home, consider the some of the following tips: Chair seats should contrast with the floor so people can see the edge of their seat. Sink basins should contrast with the surrounding counter/vanity top. Toilets or toilet seats should contrast with both the floor and surrounding walls to make them more visible. Table settings should provide high contrast between the plates (usually white or pale color) and the table or tablecloth (dark color). Colors that are a mix of hues from the opposite side of the color wheel (red and green, or yellow and blue) will look muddy and be less attractive to older adults whose lens may be yellowed. According to a recent study, 83% of older Americans want to stay in their current homes for the rest of their lives - where they are comfortable and secure and feel independent. Safety precautions become increasingly important in order to maintain a safe environment conducive to independent living. How many of you have thought about the affect of diminished lighting?

Wednesday, March 1, 2017

Caregiving: An Attitude of Gratitude

Caring for your family member demonstrates love and commitment and can be a very rewarding personal experience. Caregiving can also be an emotional roller coaster. Family caregivers are at increased risk for excessive use of alcohol, tobacco and other drugs and for depression. You cannot stop the impact of a chronic or progressive illness or injury on someone for whom you care. But, there is a great deal that you can do to for your own well-being. Many times, attitudes and beliefs form personal barriers that stand in the way of caring for yourself. Not taking care of yourself may be a lifelong pattern, with taking care of others an easier option. However, as a family caregiver, you should ask yourself, “What good will I be to the person I care for if I become ill?” Breaking old patterns is not an easy proposition, but it can be done. The first task in removing personal barriers is to identify what is in the way. For example, Do you feel you have to prove that you are worthy of the care recipient’s affection? Do you think you are being selfish if you put your needs first? Is it frightening to think of your own needs? What is the fear about? Do you have trouble asking for what you need? Do you feel inadequate if you ask for help? Why? Sometimes caregivers have misconceptions that increase their stress and get in the way of taking good care of themselves. Here are some of the most commonly expressed: I am responsible for my parent’s or loved one’s health. If I don’t do it, no one will. If I do it right, I will get love, attention and the respect I deserve. Because we base our behavior on our beliefs and attitudes, misconceptions like those noted above can cause caregivers to continually attempt to do what cannot be done and to try to control what cannot be controlled. Once you’ve started to identify personal barriers to your self-care, you can begin moving forward one small step at a time. How we perceive and respond to an event is significant in how we adjust and cope with it. The stress you feel is not only the result of your caregiving situation, but also the result of your perception of it – whether you see the glass as half-full or half-empty. It is important to remember that you are not alone in your experiences. Your level of stress is influenced by many factors, including: Whether your caregiving is voluntary. If you feel you have no choice in taking on the responsibilities, the chances are greater that you will experience strain, distress and resentment. Your relationship with the care recipient. Sometimes people care for another with the hope of healing the relationship. If healing does not occur, you may feel regret and discouragement. Your coping abilities. How you coped with stress in the past predicts how you will cope now. Identify your current coping strengths so that you can build on them. Your caregiving situation. Some caregiving situations are more stressful than others. For example, caring for a person with dementia is often more stressful than caring for someone with a physical ailment. Whether support is available. Remember, it is not selfish to focus on your own needs when you are a caregiver – it’s an important part of the job. And, current research is finding that taking care of tired caregivers could be as important as providing care for their care-recipients. Simply listing what you, as a spousal caregiver, are grateful for can provide you with the much-needed "tender loving care" that you are providing for your spouse -- and that you are typically not receiving from any other source. So the question that I have for you is: "How is your 'attitude of gratitude'?" As we all know, we are often stressed out by the various caregiving activities we perform for our spouses. The lead professor associated with the study theorized that something as simple as writing about gratitude will help relieve that stress. Specifically, in order to show the link between gratitude and health, researchers are analyzing just how gratefulness impacts the lives of men and women who care for loved ones with Alzheimer's disease. "Caring for a person with Alzheimer's disease is a prime example of unlimited love. There is a lot of sacrifice involved, a lot of cost, and no reward" the lead researcher said. While her research is focused on Alzheimer's caregivers, the results of that research can be extrapolated to all caregivers - especially spousal caregivers. In order to better understand how to help caregivers, half of the research group fill out "gratitude journals" in which the participants listed what they were grateful for each day. The other half of the research group filled out "hardship journals" in which the participants listed the hardships incurred each day. Both groups wrote in their journals for two weeks. Researchers theorize that those who completed the gratitude journals will have increases in their respective psychological well-being, general health, and life satisfaction. Previous research with college students found that gratitude had improved their physical and cognitive health. Since caregivers are dealing with much more serious issues, an emphasis on gratitude could conceivably help them cope with their daily problems more effectively. I have a GREAT "attitude of gratitude" -- how about you? It really does help get through challenging days as a caregiver.

Adversity and Well Being

A recent study lends a fresh perspective to the famous quote, “That which does not kill us, makes us stronger.” The authors of this study examined the relationship between cumulative lifetime adversity and human resilience. By analyzing a nationally representative sample of the population, the authors found that individuals who experienced a moderate amount of adversity during their lifetimes had higher levels of mental health and wellbeing than (a) people with an extensive history of adversity and (b) people without any history of adversity. Taken at face value, these results seem to contradict prior research which has consistently found the experience of adversity to be positively correlated with poor mental and physical health. That said, the authors of the current article emphasize that this is the first study to examine cumulative life adversity—compared to prior research which has historically analyzed individual events or singular categories of events. In other words, in the past, researchers have either studied the occurrence of a single event in a person’s life (e.g., asking a person to describe one adverse event that occurred during their lifetime), or a single category of adverse events that can be experienced by many people. This study took a novel approach by to the topic of adversity by combining both of these methodological techniques to assess the cumulative effects of multiple events affecting the same individual across multiple categories of adverse events that tend to affect different individuals. If both the prior findings and the current study are valid, this would suggest that the experience of adversity, can produce both a debilitating effect in the immediate time-frame in which the event occurs, and a toughening (i.e., overall strengthening) affect over one’s entire life time. Consequently, this accrual of lifetime toughness would continue to bring new perspective to one’s future appraisals by placing them in a position of greater wisdom via the confidence stemming from the knowledge that they have successfully dealt with past experiences of adversity. In short, if aging is defined by the wisdom and strength that comes from it, then what doesn’t kill us may actually make us stronger—in moderation.

Signs Your Parents Need Help at Home

By Marlo Sollitto Knowing when to begin discussions about needed assistance with aging parents is not always as simple as one might think. Maybe you've noticed that dad's unopened mail is piling up. Or mom, once meticulous about her appearance, is wearing wrinkled clothes and not doing her hair. Perhaps there are bruises on your loved one's arms. When you bring up these observations, their instant response is, "Everything is fine, there's no need to worry." Admitting they need help would mean they can no longer take care of themselves, and no one wants to lose their independence. "Denial is the unrealistic hope that a problem is not really happening and will go away by itself. Admitting they need help and accepting assistance is not easy for people as they age. It represents a loss of independence. Denial plays a major role and signs get ignored," says Paul Hogan, Founder and Chairman of Home Instead Senior Care. The burden often falls on the family to recognize the signs that an aging parent might need help with daily living tasks. This doesn't necessarily mean that your loved one has to move to assisted living or a nursing home, but they may need some extra help in their home. If they're not willing to admit it, how do you know if your elderly parent needs home care? Look for the red flags listed below. Signs Your Parent Needs Help at Home • Spoiled food that doesn't get thrown away • Missing important appointments • Unexplained bruising • Difficulty getting up from a seated position • Difficulty with walking, balance and mobility • Uncertainty and confusion when performing once-familiar tasks • Forgetfulness • Unpleasant body odor • Infrequent showering or bathing • A strong smell of urine in the house • Noticeable decline in grooming habits and personal care • Dirty house, extreme clutter and dirty laundry piling up • Stacks of unopened mail or an overflowing mailbox • Late payment notices, bounced checks and calls from bill collectors • Poor diet or weight loss • Loss of interest in hobbies and activities • Changes in mood or extreme mood swings • Forgetting to take medications, or taking incorrect dosages • Unexplained dents and scratches on a car Once the problem is realized, the family must decide if home health care is the best option. It is generally defined as non-medical support services delivered at the home of the senior. "The aim of this kind of care is to allow seniors to remain at home longer rather than moving to an assisted living community, nursing home or other type of senior care facility. It may be appropriate if a senior prefers to stay at home but needs minor assistance with activities of daily living," says Sam Almengor, National Accounts Director for Senior Helpers, a national company that provides professional in-home assistance services. "One of the most frightening prospects for seniors is leaving home," Hogan says.