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All too many times overwhelmed caregivers are physically and emotionally depleted and need to take time to rest and care for themselves. Believing in a holistic approach to caregiver stress and a strong commitment to helping our members find the right solutions, we created this blog to help you connect with others who, like you, may be facing the same eldercare issues and challenges. Feel free to comment, ask questions, and submit articles. Please forward the blog link to your family and friends. They'll be glad you did.

Warm regards,

Patricia Grace
founder & CEO
Aging with Grace

Wednesday, August 31, 2011

Depressed housing market puts pressure on family to help pay for eldercare

After four years of depressed home values, experts say thousands of seniors remain unable to move into senior housing because they can’t sell their homes quickly enough or for the price they need reports Kaiser Health News.

This has lead to greater pressure on families to pay for parent’s and grandparents’ placements, or to care for them themselves.

“We see people coming in much older and frailer because they’re taking a longer time to make the decision,” says Donna Taylor, executive vice president for the nonprofit Arizona Baptist Retirement Centers in Phoenix. “They don’t know how long it will take to sell their house, and in some cases they’re reluctant to sell because of the lower price.” Arizona Baptist, a continuing care retirement community (CCRC), offers a spectrum of housing arrangements for seniors as they age, from independent-living and assisted-living apartments to nursing home care.

The majority of older Americans assets are tied up in their homes, but the housing downturn has made it difficult for them to sell their homes.

In Florida alone, the state’s Health Care Association estimates there are 400,000 seniors with dementia living on their own at home, with few or no services. “The U.S. has a large aging population and we do not have a long-term care plan for this country,” says LuMarie Polivka-West, the senior director of policy at association.

Thursday, August 25, 2011

The cost of medicine continues to be a problem for the elderly

Approximately 10% of Medicare beneficiaries do not comply with their prescribed medication regimen because they simply cannot afford it, researchers from Harvard Medical School reported in the Journal of Cancer Survivorship. They added that elderly Medicare patients, whether or not they are being treated for cancer, commonly skip taking a pill so that they can last longer, or forgo filling a prescription completely because it is just too expensive.

The authors believe that their findings suggest that seniors with cancer or those who survived it do not face greater medical costs than other patients.

The rise in medication costs has occurred in parallel with an aging population, leading to greater financial burdens for the patient. Cancer costs have risen considerably. Patients being treated for cancer face considerable out-of-pocket expenses while they are being diagnosed, treated and receiving follow-up care. Comorbidities are common among cancer survivors, who may be taking medication for diabetes, hyperlipidemia, hypertension or osteoporosis.

The researchers set out to understand what medication issues cancer patients have to face. They gathered data from the 2005 Medicare Current Beneficiary Survey and Medicare claims from 2005.

They looked at reasons why patients may not stick to their prescribed drug regimen, whether they spent less on basic needs, or even did without to cover their out-of-pocket medical expenses. They analyzed both cancer survivors and non-cancer sufferers.

Dr. Larissa Nekhlyudov and colleagues found that the rate of cost-related non-adherence among those without cancer was 11%, compared to 10% for cancer survivors - not a statistically significant difference.

6% of cancer survivors said they spend less on food, heating and other basic needs in order to be able to pay for their medication, compared to 9% of individuals without cancer. More than half of all Medicare beneficiaries were involved in some kind of cost-saving strategy, such as buying generic drugs, asking for free samples and shopping around from pharmacy-to-pharmacy for the cheapest prices.

Christian Nordqvist
Medical News Today

Wednesday, August 24, 2011

Are you thinking about doing a remodeling project to carve out a space for an aging loved on? Before you get started, you may want to spend time reviewing books on the process and looking at examples to help spur your imagination. A new book, In-laws, Outlaws, and Granny Flats: Your Guide to Turning One House into Two Homes, presents an informative, illustrated guide that outlines strategies for construction and design of dwelling units either as part of an existing single family residence or an additional structure on premise.

The first half of the book provides chapters on design that encompasses basic concepts of universal design applicable in designing residential living space for seniors that covers appliances, zoning, architectural plans. The author highlights various types of projects that include basement redesign, garage conversions, bump-outs, carve-outs and other strategies that might make sense when examining the options. Many of the concepts identified are applicable to any age and provide some basic fundamentals on residential design but other components are clearly aimed at a 55+ market.

The second half of the book shows over 25 variations of in-law units in the United States and Canada and chronicles the stories behind each space that the homeowner modified from general requirements to very specific personal preferences for each space. The book includes 200 color photographs, 50 floor plans and architectural details for a variety of designs and concepts.

Michael Litchfield, who has authored other home-remodeling books in the past, shows his depth of knowledge and understanding of the home remodeling market. ”In-Laws” builds on that knowledge and provides a practical approach that incorporates his deep experience in providing examples an concepts of well designed spaces for aging in place.

If you’re looking for ideas on how to remodel your home for an aging parent or relative, ”In-Laws, Outlaws, and Granny Flats” is a good starting point to evaluate your current home’s potential and provide inspiration for its future potential.

Saturday, August 20, 2011

Boomers will be spending billions to Age with Grace!

The following is an interesting article written by National AP writer David Crary.

Baby boomers heading into what used to be called retirement age are providing a 70 million-member strong market for legions of companies, entrepreneurs and cosmetic surgeons eager to capitalize on their "forever young" mindset, whether it's through wrinkle creams, face-lifts or workout regimens.

It adds up to potential bonanza. The market research firm Global Industry Analysts projects that a boomer-fueled consumer base, "seeking to keep the dreaded signs of aging at bay," will push the U.S. market for anti-aging products from about $80 billion now to more than $114 billion by 2015.

The boomers, who grew up in a culture glamorizing youth, face an array of choices as to whether and how to be a part of that market.

Anti-aging enthusiasts contend that life spans can be prolonged through interventions such as hormone replacement therapy and dietary supplements. Critics, including much of the medical establishment, say many anti-aging interventions are ineffective or harmful.

From mainstream organizations such as the National Institute on Aging, the general advice is to be a skeptical consumer on guard for possible scams involving purported anti-aging products.

"Our culture places great value on staying young, but aging is normal," the institute says. "Despite claims about pills or treatments that lead to endless youth, no treatments have been proven to slow or reverse the aging process."

Its advice for aging well is basic: Eat a healthy diet, exercise regularly, don't smoke.

"If someone is promising you today that you can slow, stop or reverse aging, they're likely trying hard to separate you from your money," said S. Jay Olshansky, a professor at the University of Illinois-Chicago's School of Public Health who has written extensively about aging.

Full article...

Friday, August 19, 2011

How to get mom to eat...and other good tips!

"Growing up my favorite time of the year was summer",says Nataly Rubenstein, author of Alzheimer's disease and other dementias - The Caregivers Complete Survival Guide. Long lazy days spent fishing on the lake, outdoor grilling and enough corn on the cob and watermelon to fill the county fair.

Just thinking about the summer of my youth brings back fond food memories and my appetite increases.

For those of you who are caring for a person who has dementia one of the frequently asked questions I get is, “How do I get Mom to eat”? The obvious answer is serve food the person liked when they were growing up. You see, over time our taste buds and our food preferences changed. The foods we prefer later in life are not always food that we liked when we were younger.

I love blue cheese salad dressing now- but hated it growing up. Same with spinach. My mom who grew up during the Depression ate a lot of bologna sandwiches and swore them off later in life. Guess what food she loved in the late stage of dementia? If you guessed bologna, give yourself a star!

Reminiscing helps to connect the past with the present. I find it helpful to go through old photos and comment on the event and the food in the pictures. It makes for a great activity. Quick tip- try not to ask the person with dementia if they remember the event or the people or the food. They will feel bad if they can’t and if they could remember you wouldn’t be caring for them now would you!

Often times it’s not what we ask, but how we ask. Some of the tips below are just starting points. Use your imagination and expand on them.

• Ask them their favorite food from their childhood.
• The first food they ever cooked.
• Memories of backyard barbecues.
• What they brought for school lunch.
• Favorite Sunday breakfast.

You can also ask about the favorite soda or pop. Most towns had a F.W Woolworths or Rexall drug store that had a lunch counter. Going to one was a special treat and the “soda jerks” were really cute. (Here’s a nostalgic video of one such counter: http://youtu.be/XZMXV0bFz5o)

When I asked one of my clients who wouldn’t drink liquids what her favorite beverage was she said a root beer float. Imagine the daughter’s surprise when I brought one over at our next visit and she drank it down.

Follow some of my special tips for asking your loved one what foods they liked and you will literally have them eating out of your hands. I will be giving additional advice based on my personal experience as a caretaker and professional counselor in an upcoming radio interview with Aging with Grace – be sure to listen in! I look forward to taking your questions. I also offer colorful caretaker commentary and tips on my blog The Dementia Zone (http://blog.alzheimerscareconsultants.com/alzheimers-blog).

Nataly Rubinstein MSW., LCSW, C-ASWCM is a professionally licensed clinical social worker and a geriatric care manager certified. For over 24 years she was also a caregiver to a person with dementia. For several years she worked full time at the Wien Center a memory clinic at Mt. Sinai Medical Center in Miami Beach where over 1,000 clients with dementia were seen each year and has recently transitioned into private practice. She is also author of Alzheimer’s Disease and Other Dementias: The Caregiver’s Complete Survival Guide. Website for more info: http://alzheimerscareconsultants.com

Thursday, August 18, 2011

Special Needs Trust for Disabled Family Members

The following is from our friends at Dutton & Casey Law Firm...

What is it? A trust is a legal document that provides for the control and distribution of assets. The assets in a trust may be money, stocks, bonds, real estate, business interests, or other possessions. A trust may provide how assets are to be distributed during a person’s life, and also how they are to be distributed after a person’s death. A Special Needs Trust is a type of trust that helps to protect the assets of a person with disabilities. A trust may be set up by one person for another with a disability, to contain an inheritance or gift. A self-funded Special Needs Trust is a trust that contains the assets that had belonged to the person with the disability, who is the beneficiary of the trust. It is designed to have the funds be used to supplement, but not replace, governmental benefits. The Special Needs Trust may be managed by a trustee (someone other than the beneficiary).
The Need

Individuals with disabilities often receive governmental assistance and would benefit from having funds in a trust used to maintain their quality of life. When an individual who receives government benefits also receives money, the government benefits may be jeopardized. This situation may arise when the individual receives a Social Security back payment, a personal injury settlement or an inheritance. Regardless of the source of the funds, once the individual has money in their own name, the government benefits may be at risk. To protect the government benefits, the excess funds can be placed in a Special Needs Trust. A Special Needs Trust is used to supplement, not replace, public benefits such as Supplemental Security Income (SSI) or Medicaid. The trust assets should be used to purchase things that government benefits do not provide, and the Trustee should be aware of the impact of any distribution on government benefits.
What You Need to Know

Even if a trust is properly established and funded, if the Trustee improperly spends the income or principal of the trust, the public benefits of the beneficiary could be reduced or eliminated. The Trustee also should be aware of the tax ramifications of distributions made from the trust. A Trustee should be familiar with investment standards and the expectations for maintaining trust records. The Trustee should be aware of the tax ramifications of distributions made from the trust. A Trustee should be familiar with the types of public benefits available, the actual benefits received by the trust beneficiary and the requirements of the public benefits, such as SSI, SSDI, and Medicaid. The Trustee also should be familiar with other types of assistance for which the beneficiary qualifies, so that the Trustee does not waste trust assets on items that would otherwise be payable by public benefits. The trust assets should be used only to purchase something that cannot be purchased with public benefits and which, if purchased, will not jeopardize the benefits of the beneficiary.

Tuesday, August 16, 2011

Senior Boom Creates A Demand For Home Health Workers

At her home health care agency here, Venus Ray quizzes 65 job applicants assembled before her: Can they cook? Do they know the right way to wash their hands? Can they safely transfer patients into wheelchairs? If they give wrong answers, speak English poorly or — God forbid — forget to turn off their cell phones, she asks them to leave.

Francess Sillah helps to transfer Tanya Pittman out of an imaginary wheel chair while role playing during a group interview at Health Management Inc. Venus Ray, the agency's executive director, looks on and assesses their skills to be a home health aide. (Photo by Jessica Marcy)

By the end of the session, Ray has dismissed 42 of the applicants, almost two-thirds, even though she's in dire need of employees.

Ray is executive director of Health Management Inc., which employs about 410 people, including 395 home health aides. With business booming, she is constantly looking to hire more, and she holds group interviews once or twice a month.

"There's a huge demand, and it's only going to get larger as the years go by," Ray said. With the nation's aging population, she added, many people "will tell you that they are more comfortable in their home."

The demand for workers by Ray's company mirrors national trends and is fueled in part by stepped-up efforts to keep seniors and the disabled out of nursing homes. The growth is likely to pick up in coming years as the 2010 federal health law tries to reduce hospital readmissions and expands programs such as Money Follows the Person, which encourages Medicaid recipients to receive care at home.

But experts warn that a shortage of qualified labor is looming. Workers often lack the training and support needed to properly care for patients, and poor working conditions lead to high turnover, experts say. In addition, salaries are low: In 2009, the median national hourly wage for direct-care workers — a term that includes home health aides — was $10.58, substantially below the $15.95 median for all U.S. workers.

Read full article...

Detroit jumping on board the senior citizen express

Independence and the ability to age at home are the top two concerns for many in the rapidly expanding senior citizen demographic, and mobility is an important aspect of seniors maintaining their freedom. In response to the aging population, Ford Motor Company has developed a number of innovations for its vehicles to make them more “senior friendly.”

“As you get older, the possible loss of that driving capability is equated with the removal of freedom, so what we can do to try to help older people continue to drive is important to them, because it really equates to a loss of freedom if they can’t do that,” says Gary Strumulo, Manager of Vehicle Design and Infotronics at Ford.

The innovations Ford has incorporated into some of its vehicles include specially contoured seats that prevent blood buildup when seated, user-friendly designs to help those who have joint stiffness or lack a full range of motion get in and out of cars easier, and easy fuel filters that let some push the gas nozzle directly into the device, making it easier on people with arthritic fingers.

In addition to this, Strumulo says Ford is also looking to address chronic illnesses that passengers may have, like diabetes, asthma, or allergies, by incorporating technology into their vehicles with a three pronged approach. This includes using Ford’s in-car connectivity system SYNC to connect to mobile health services that are on the web, and connect to devices brought into the vehicle (like a continuous glucose monitor) which communicates through bluetooth, and also to leverage the number of Smart Apps on smart phones.

Ford wants to adjust the purpose of SYNC to include health and wellness in addition to infotainment, says Strumulo, and the car company is looking beyond basic car safety features to reflect the aging population.

Another plan to make vehicles more “senior friendly” is to make font sizes on vehicle controls and interfaces bolder and wider. Ford cars arriving in dealerships next year will feature font sizes that have been increased 40%, starting with the Ford Edge and Explorer before spreading to other models.

By the year 2030, U.S. Census data shows about 20% of the American population will belong to the elderly demographic, and the number of American 50-year-olds will outnumber those under 20.

A recent Transportation for America study showed a huge “senior mobility crisis” threatening the Baby Boomer generation, as transportation options for many senior citizens are limited to driving. With an estimated 56% of the 65 and older crowd living in suburban areas where driving is the main method of transportation, it’s important to cater to this population by providing vehicle features that will help them to remain mobile longer, and therefore maintain their independence.

Thursday, August 11, 2011

New study confirms elderly women with sleep apnea at high risk for dementia

Elderly women with sleep apnea had an 85% higher risk of developing mild cognitive impairment or dementia than elderly women without sleep apnea, a new study found.

Researchers from Brigham and Women's Hospital in Boston studied a group of 298 women, roughly a third of whom had been diagnosed with sleep-disordered breathing. The average age of women in the group was 82.
Sleep-disordered breathing, which causes the brain to be deprived of oxygen, was defined as 15 sleep apnea events per hour of sleep. At the beginning of the study, none of the participants had been diagnosed with dementia. All of the participants underwent overnight sleep studies between 2002 and 2004.

Five years after the study, investigators conducted cognitive function tests designed to detect brain health and cognitive impairment. They found that 45% of study participants with sleep apnea developed cognitive impairments, compared with 31% of women without sleep apnea. Investigators said up to 60% of elderly people suffer from sleep-disordered breathing, which means addressing apnea may boost cognitive health.

“This is one of those rare, positive and hopeful articles. If the abnormalities in getting oxygen are what's causing the damage to the brain, it's a potentially reversible or preventable problem," said Gary Kennedy, M.D., a geriatric psychiatrist who was not involved in the study.

The study was published Aug. 10 in the Journal of the American Medical Association.

Monday, August 08, 2011

More evidence that vascular disease contributes to cognitive decline in later years

Those who smoke, are overweight, or have high blood pressure are more likely to have cognitive challenges later in life, a new study suggests.

Researchers from the University of California at Davis studied MRI scans of approximately 1,352 people for the purpose of identifying vascular risk factors.The subjects were part of the Framingham Offspring Cohort Study and had multiple scans over the past decade.

Among the results: researchers found that people with diabetes in mid-life lost brain volume faster in the hippocampus. Participants who smoked in mid-life lost their overall brain volume faster than non-smokers. Obese participants and those with hypertension were more likely to do badly on tests involving executive functioning or planning.

The good news is that the damage can be limited if recognized early enough, study author Charles DeCarli, M.D., said. “Our findings provide evidence that identifying these risk factors early in people of middle age could be useful in screening people for at-risk dementia and encouraging people to make changes to their lifestyle before it's too late,” he said. The study was published in the Aug. 2 issue of Neurology.

Thursday, August 04, 2011

New anti-depressants linked to falls and fractures in the elderly

The following is an interesting article that appeared in McKnight's Daily Update on August 4.

Elderly patients being treated for depression may have better luck and fewer side effects with older tricyclic antidepressants rather than newer, more popular antidepressants such as Effexor and Prozac, a new study reports.

Researchers say that while newer selective serotonin reuptake inhibitors (SSRIs) are generally considered safe and effective, there have been fewer studies testing their safety and efficacy in senior citizens. SSRIs, which include Celexa, Paxil and Zoloft, recently have been linked to an increase in falls in the elderly. However, British researchers say tricyclics could be safer in people over 65, especially those at risk for falls.

The University of Nottingham analyzed prescription data of more than 60,000 patients between the ages 65 and 100 who had recently been diagnosed with depression. They found that seniors taking SSRIs have a higher risk of dying, having a stroke, falling, breaking a bone or having seizure than seniors not on antidepressants.

Additionally, within one year, 10.6% of this group of seniors taking SSRIs died. Eight percent of seniors taking tricyclics died, versus 7% of seniors taking no antidepressants.

"When you find the right medication, it can be a lifesaver. But it's so complicated, seniors need to have an ongoing conversation with their doctors," researcher Angie Hochhalter, Ph.D., told HealthDay News.

The study was published in Aug. 2 issue of BMJ (British Medical Journal).

Wednesday, August 03, 2011

Stretching prescription medication can prove deadly.

Whether you're treating a chronic condition or trying to stock your medicine cabinet with the basics, medications can be pricey.

To cut costs, you may be considering splitting pills or taking a medication after it has expired (though staring down a bottle of Tylenol purchased during the Clinton administration can make even staunch stomachs uneasy). You may well be wondering if cutting pills or ignoring use-by dates is really safe.

As if often the case in medicine, that's a simple question with a long answer.

Pill Splitting

It's basic math: Cutting pills in half can make a bottle of medication last twice as long. And if you only need half a pill to get the job done, splitting seems to make sense.

Some medications lend themselves to being halved, but certain others should never be split, says Dr. Norman Tomaka, a clinical consultant pharmacist in Melbourne, Fla. Splitting extended-release capsules, for instance, would cause a dose that's intended to be administered over several hours to be ingested all at once. In some cases, that might result in nothing more than a stomachache. But with drugs such as anti-seizure medications that need to be constantly active in the body, a sudden dose that then tapers off quickly could pose serious health risks.

Read full article

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