Tag Archives: aging

Elder Care at Home

With a rapidly aging population, caring for your elders is likely going to be a big part of your life. According Medicare.com, a recent survey by the National Caregiver Alliance and the AARP Public Policy Institute revealed that approximately “34 million adults in the U.S. are unpaid caregivers to an individual over 50 years old, with 85% providing care for a family member.”

Care giving is a fairly broad term and responsibilities depend on the physical and mental health of an individual but may include anything from helping with everyday activities to medication reminders to hiring and coordinating with assisted living staff. Regardless of the level of involvement, caring for the elderly requires patience.

Every day tasks that we take for granted, such as getting up and getting ready for the day can be challenging as we age. The elderly often need help with daily living activities like bathing or getting dressed. Though these tasks may be time consuming, the physical and emotional benefits of grooming, bathing and putting on clean clothes should not be underestimated to making someone feel more good.

The National Institutes of Health National Institute on Aging (NIA) provides several resources and tips for caregivers including:


  • Be simple, direct and positive when speaking. Clear and upbeat communication is generally a good idea, especially if the person you are caring for has health problems that could affect memory and cognitive skills.
  • Establish eye contact, use the person’s name and if appropriate, touch or hold his or her hand to encourage conversation
  • Ask simple yes-or-no questions rather than open-ended questions. For example, ask “Are you hungry?” instead of, “When would you like to eat?”
  • Limit choices to reduce confusion. For example, ask, “Would you like to wear your jeans or your khakis?” instead of asking, “What do you want to wear?” You might even want to show the options to the person you are caring for to help them make the decision.

Bathing and Dressing

  • Easy wear, easy wash clothing. Comfortable, loose-fitting clothing with elastic waistbands will not only make it easier to get dressed, it will also make it easier to remove clothing to use the bathroom.
  •  Assist in dressing as needed. Let the individual do as much as possible without assistance but be ready to lend a hand. To assistance, lay out the clothes in the order they will be put on. For example, place underwear and socks before pants and shirt.
  • Make the shower safe. Use a sturdy shower chair, grab bars, non-slip bath mats and a hand-held shower-head to reduce the chance of falls.

Eliminate Safety Hazards to Prevent Falls

  • Remove or secure rugs. Try using double-sided adhesive tape to firmly attach any large area rugs.
  • Hide electrical cords. Tuck cords behind furniture, under large rugs or tack to the baseboards so they are out of the way.
  • Create clean lines and open spaces. Remove any extra furniture that would be difficult to maneuver around with a cane, walker or wheelchair.
  • Install handrails and grab bars. Most commonly used along stairways, on the side of the bed, next to the toilet and in the bath or shower.
  • Install good lighting inside and outside home. If the elderly individual has difficulty seeing, install the highest recommended bulb per light fixture. For their safety at night, install nightlights in bedrooms, bathrooms, kitchen and hallways.

Remember, it is also important to make sure your loved one not only has health food and beverages available but that they are eating regularly. Proper nutrition and hydration can have a significant impact on an individual’s physical and mental abilities.

If the time has come when your aging loved one is no longer able to live independently, please contact the knowledgeable staff at ElderLink to help you find elder care services or an assisted living facility within California that is customized for your family.

Feel Like The Last Friend Standing? Here’s How To Cultivate New Buds As You Age.

Donn Trenner, 91, estimates that two-thirds of his friends are dead.

“That’s a hard one for me,” he said. “I’ve lost a lot of people.”

As baby boomers age, more and more folks will reach their 80s, 90s — and beyond. They will not only lose friends but face the daunting task of making new friends at an advanced age.

Friendship in old age plays a critical role in health and well-being, according to recent findings from the Stanford Center on Longevity’s Sightlines Project. Socially isolated individuals face health risks comparable to those of smokers, and their mortality risk is twice that of obese individuals, the study notes.

Baby boomers are more disengaged with their neighbors and even their loved ones than any other generation, said Dr. Laura Carstensen, who is director of the Stanford Center on Longevity and herself a boomer, in her 60s. “If we’re disengaged, it’s going to be harder to make new friends,” she said.

Trenner knows how that feels. In 2017, right before New Year’s, he tried to reach his longtime friend Rose Marie, former actress and co-star on the 1960s sitcom “The Dick Van Dyke Show.” Trenner traveled with Rose Marie as a pianist and arranger doing shows at senior centers along the Florida coast more than four decades ago.

“When we were performing, you could hear all the hearing aids screaming in the audience,” he joked.

The news that she’d died shook him to the core.

Although she was a friend who, he said, cannot be replaced, neither her passing nor the deaths of dozens of his other friends and associates will stop Trenner from making new friends.

That’s one reason he still plays, on Monday nights, with the Hartford Jazz Orchestra at the Arch Street Tavern in Hartford, Conn.

For the past 19 years, he’s been the orchestra’s pianist and musical conductor. Often, at least one or two members of the 17-piece orchestra can’t make it to the gig but must arrange for someone to stand in for them. As a result, Trenner said, he not only has regular contact with longtime friends but keeps meeting and making friends with new musicians — most of whom are under 50.

Twice divorced, he also remains good friends with both of his former wives. And not too long ago, Trenner flew to San Diego to visit his best friend, also a musician, who was celebrating his 90th birthday. They’ve known each other since they met at age 18 in the United States Army Air Corps. They still speak almost daily.

“Friendship is not be taken for granted,” said Trenner. “You have to invest in friendship.”

Even in your 90s, the notion of being a sole survivor can seem surprising.

Perhaps that’s why 91-year-old Lucille Simmons of Lakeland, Fla., halts, midsentence, as she traces the multiple losses of friends and family members. She has not only lost her two closest friends, but a granddaughter, a daughter and her husband of 68 years. Although her husband came from a large family of 13 children, his siblings have mostly all vanished.

“There’s only one living sibling — and I’m having dinner with him tonight,” said Simmons.

Five years ago, Simmons left her native Hamilton, Ohio, to move in with her son and his wife, in a gated, 55-and-over community midway between Tampa and Orlando. She had to learn how to make friends all over again. Raised as an only child, she said, she was up to the task.

Simmons takes classes and plays games at her community. She also putters around her community on a golf cart (which she won in a raffle) inviting folks to ride along with her.

For his part, Trenner doesn’t need a golf cart.

His personal formula for making friends is music, laughter and staying active. He makes friends whether he’s performing or attending music events or teaching.

Simmons has her own formula. It’s a roughly 50-50 split of spending quality time with relatives (whom she regards as friends) and non-family friends. The odds are with her. This, after all, is a woman who spent 30 years as the official registrar of vital statistics for Hamilton. In that job, she was responsible for recording every birth — and every death — in the city.

Experts say they’re both doing the right thing by not only remaining open to new friendships but constantly creating new ways to seek them out — even at an advanced age.

Genuine friendships at any age typically require repeated contact, said Dr. Andrea Bonior, author of “The Friendship Fix: The Complete Guide to Choosing, Losing and Keeping Up with Your Friends.” She advises older folks to join group exercise classes or knitting or book clubs.

She also suggests that seniors get involved in “altruistic behavior” like volunteering in a soup kitchen or an animal shelter or tutoring English as a second language.

“Friendships don’t happen in a vacuum,” she said. “You don’t meet someone at Starbucks and suddenly become best friends.”

Perhaps few understand the need for friendship in older years better than Carstensen, who, besides directing the Stanford Center on Longevity, is author of “A Long Bright Future: Happiness, Health and Financial Security in an Age of Increased Longevity.”

Carstensen said that going back to school can be one of the most successful ways for an older person to make a new friend.

Bonior recommends that seniors embrace social media. These social media connections can help older people strike up new friendships with nieces, nephews and even grandchildren, said Alan Wolfelt, an author, educator and founder of the Center for Loss and Life Transition.

“It’s important to create support systems that don’t isolate you with your own generation.”

Many older folks count their children as their best friends — and Carstensen said this can be a big positive on several levels.

“I don’t think it matters who your friends are,” she said. “It’s the quality of the relationship that matters most.”


Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.

Lifting Therapy Caps Is A Load Off Medicare Patients’ Shoulders

Physical therapy helps Leon Beers, 73, get out of bed in the morning and maneuver around his home using his walker. Other treatment strengthens his throat muscles so that he can communicate and swallow food, said his sister Karen Morse. But in mid-January, his home health care agency told Morse it could no longer provide these services because he had used all his therapy benefits allowed under Medicare for the year.

Beers, a retired railroad engineer who lives outside Sacramento, Calif., has a form of Parkinson’s disease. The treatments slow its destructive progress and “he will need it for the rest of his life,” Morse said.

But under a recent change in federal law, people who qualify for Medicare’s therapy services will no longer lose them because they used too much.

“It is a great idea,” said Beers. “It will help me get back to walking.”

The federal budget agreement Congress approved last month removes annual caps on how much Medicare pays for physical, occupational or speech therapy and streamlines the medical review process. It applies to people in traditional Medicare as well as those with private Medicare Advantage policies.

As of Jan. 1, Medicare beneficiaries are eligible for therapy indefinitely as long as their doctor — or in some states, physician assistant, clinical nurse specialist or nurse practitioner — confirms their need for therapy and they continue to meet other requirements. The Centers for Medicare & Medicaid Services (CMS) last month notified health care providers about the change.

And under a 2013 court settlement, they won’t lose coverage simply because they have a chronic disease that doesn’t get better.

“Put those two things together and it means that if the care is ordered by a doctor and it is medically necessary to have a skilled person provide the services to maintain the patient’s condition, prevent or slow decline, there is not an arbitrary limit on how long or how much Medicare will pay for that,” said Judith Stein, executive director of the Center for Medicare Advocacy.

But don’t be surprised if the Medicare website doesn’t mention the change. Information on the website will be revised “as soon as possible,” said a spokesman, who declined to be identified. However, information from the 800-Medicare helpline has been updated.

Until then, patients can refer to the CMS update posted last month for providers.

Lifting the therapy caps is just one of the important changes Congress made for the 59 million people enrolled in Medicare. Here are two others:

Shrinking The ‘Doughnut Hole’

Beneficiaries have long complained about a coverage gap, the so-called doughnut hole, in Medicare drug plans. That’s when the initial coverage phase ends — this year, that happens after the beneficiaries and their insurers have paid $3,750 for covered drugs. When it happens, a patient’s share of prescription costs shoots up. This year, when people hit this stage, they are responsible for paying up to 35 percent of brand-name drug costs.

When beneficiaries’ total yearly drug expenses reach a certain amount ($5,000 this year), they enter the catastrophic coverage stage and pay just 5 percent of the costs. But studies have shown that fewer than 10 percent of beneficiaries spend enough to reach that last stage.

Beers relied on Medicare for physical therapy and other forms of therapy to help slow the progression of his Parkinson’s disease. (Bert Johnson for KHN)

The Affordable Care Act had called for the patient’s doughnut hole share to be narrowed to 25 percent by 2020, but the budget deal moved up that adjustment to 2019.

Much of the drug cost will be shouldered by pharmaceutical companies. And those payments by drugmakers will also count as money paid by patients, which will help them progress to the catastrophic level more quickly, said Caroline Pearson, senior vice president at Avalere Health, a research firm.

The deal could have an added attraction. “Premiums will come down because the drug plans are not being required to cover as much as they used to,” Pearson added.

Lower premiums will also save money for the government because it will spend less on subsidies for low-income beneficiaries.

Expanding Medicare Advantage Benefits

Another important change allows private Medicare Advantage plans in 2020 to offer special benefits to members who have a chronic illness and meet other criteria.

Currently, these private insurance plans, which limit members to a network of providers, treat all members the same.

But under the budget law, benefits targeting those with chronic diseases do not have to be primarily health-related and need have only a “reasonable expectation” of improving health. Some examples that CMS has suggested include devices and services that assist people with disabilities, minimize the impact of health problems or avoid emergency room visits.

This wider range of benefits might help people remain at home, increase their quality of life and reduce unnecessary medical expenses. “We’re really excited that the law is catching up with what plans have known for a long time,” said Mark Hamelburg, senior vice president of federal programs at America’s Health Insurance Plans, an industry association.

But the changes will affect only those beneficiaries enrolled in these private plans, about a third of the Medicare population. “We would like to see some of these innovations happen in the traditional Medicare program as well, so that all beneficiaries would be able to reap these benefits,” said Lindsey Copeland, federal policy director at the Medicare Rights Center.

by Susan Jaffe | Republished Courtesy of Kaiser Health News

Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.

Aging in Place Tips

Many seniors prefer to stay in their own homes as they age – or “age in place” – but not all homes are set up to accommodate the physical challenges of aging adults. If you or your loved one would like to remain in your home, there is good news. Often just several small changes can have a big impact on successfully aging in place and by utilizing the principles of Universal Design (UD), homes can be adapted to be more accessible, more functional and safer.

Small changes in the home can actually make a big difference, such as changing lighting to reduce glare, installing handrails on staircases or smoothing thresholds. These changes make the living environment easier and safer for all ages, from toddlers to seniors.

Depending upon the current set up on the home, some changes may involve select remodeling, such as updating a bathroom with roll-in shower or removing loose rugs and installing wall-to-wall carpeting instead. These types of Universal Design elements require a monetary investment but it would be less expensive and less disruptive than moving into an assisted living facility.

If you planning on building a home, consider incorporate UD elements in your new space no matter what your current age and physically ability is. With the aging populations, incorporating features such as hallways wide enough for wheelchairs or walkers, low light switches, higher electrical outlets and installing blocks behind walls to accommodate grab bars later can add great resale value to the home.

You may also want to consult with interior designers and home builders who are Certified Aging in Place (CAP) specialists. These professionals can help determine which UD elements to bring into your current home or incorporate into your new home’s blueprints.

Helpful Universal Design Elements:

  • Motion detector lights
  • Reduced or no-glare lights for general lighting, task lighting for tasks
  • Handrails on both sides of stairs
  • Electric outlets that can be reached from a wheelchair
  • Lowered light switches that can be reached from a wheelchair
  • Programmable thermostats
  • Drawers instead of cabinets in kitchen
  • D-shaped cabinet and drawer pulls
  • Wall-to-wall carpet instead of rugs
  • Wires neatly managed, off floors or behind walls
  • Grab bars by toilets and in showers
  • Roll-in showers and room for shower seat
  • Hand-held shower heads on glides
  • Non-slip, low-maintenance floors in bathrooms
  • Kitchen, bedroom, bathroom and laundry on same floor (ground level or accessible by elevator)
  • Side-by-side refrigerator/freezer
  • Accessible from wheelchair/counter height dishwasher, microwave, stove and oven
  • Flat cook top/range with front controls
  • Varied counter heights so cooks can sit or stand
  • Beveled corners on counters, furniture and walls
  • Front-load, front-control washer and dryer
  • 36-inch-wide doorways and hallways

Visit the National Aging In Place Council to learn more about how you can age in place and visit The National Association of Home Builders to find a Certified Aging in Place (CAP) specialist.

If the time has come when your aging loved one is no longer able to live independently, please contact the knowledgeable staff at ElderLink to help you find elder care services or an assisted living facility within California that is customized for your family.

The Elderly and Falls

The older you get the harder you fall might be a misquote from the old adage, but has some truth to it. For those aged 65 and older, falls are among the leading cause of death due to injury and it is estimated that in the United States, one out of every three adults 66 years or older falls each year.

Unfortunately, research published in the American Journal of Preventative Medicine found that 60 percent of fatal falls for older adults 65 and older occur at home, 30 percent happen in public places and 10 percent occur in health care institutions. Unfortunately, many falls cannot be foreseen or prevented but there are some risk factors that can be controlled.

Risk Factors
Environmental factors, including slippery surfaces, poor lighting, steps and loose rugs
Use of equipment, such as a cane or walker
Non-adherence to safety practices
Gait and balance impairments
Visual impairment
Physical conditions, such as stroke, arthritis, muscle weakness, glaucoma, cataracts, hearing loss or foot problems
Fall history and fall related injury
Neurological disabilities, including Parkinson’s disease or stroke
Cognitive impairment and/or behaviors
Medication use, side effects, multiple medications or psychotropic utilization

While caretakers cannot necessarily prevent an elderly adult’s fall, they can work to minimize the risk as well as increase the response time of medical assistance should a fall occur. The most common fractures from a fall include pelvis, hip, femur, vertebrae, hand, forearm and ankle.

In addition to the stress and pain, the elderly who have taken a fall are also at a greater risk of complications such as pressure sores resulting from immobility as well as decreased appetite, infections, respiratory issues, pneumonia and incontinence.

So what can you do if your aging loved one does experience a bad fall? Develop a care plan that takes into account your loved one’s age, medical history, risk factors for falling again, mental health, functional abilities, expectations and willingness to follow the plan. Determine whether recovery and rehabilitation should occur in home or in a care facility and work with doctors, physical therapists, occupational therapists and other care givers on developing and following exercise, restorative and/or physical activity programs.

If the time has come when your aging loved one is no longer able to live independently, please contact the knowledgeable staff at ElderLink to help you find elder care services or an assisted living facility within California that is customized for your family.