The Costs of Aging in Place

Home Health Care allows

the elderly to age in place.

Image abandoning the place you’ve called home for the past 40 years, surrendering all your income and moving into a long-term care facility, a nursing home.  There you must share a room with a stranger, follow the facility’s schedule and spend the majority of your time alone or with nursing staff.  Of course this is a stereotype, many long term care facilities are lovely places, but this lonely scenario is what many older Americans fear to be waiting for them when they are too ill, injured or grow to frail to live independently. The majority of elderly are adamant that they do not want to end up in an institutional setting.  Today, with the rising costs of care, there is an increasing interest in home health care as an alternative to long term facilities.

Age in Place

Home Health Care provides health care and support services that can be received at home and is available for ill or disabled people of all ages.  The main goal of Home Health Care for the elderly and frail is to allow the individual to age in place.    Home Health services allow aging individuals to maintain their independence and remain comfortable in a familiar setting.  With Home Health Care, the aging can avoid moving to institutionalized long term care facilities.  Studies have shown that Home Health Care can actually improve the quality of care received and many times will reduce the need for hospitalization. 

Benefits of Home Health Care

With outcomes often as effective as care received in assisted living, rehabilitation and skilled nursing homes, Home Health Care brings a lot of benefits to those who use it.  Home Health Care providers get to really know their patients and families and can tailor their services to best meet the Client’s health care needs, finances and family preferences.  They can help families navigate the confusing web of health care resources and can effectively advocate the needs of their patients.  Another advantage is family is invited to become more involved and can participate in providing support and hands on care for their loved one.  In addition patient morale is often better at home and people tend to recover faster with less incidents and safety issues in a home setting.  Finally, there can be significant cost savings when using Home Health Care as there are no room and board costs compared to nursing home, rehabilitation centers and other institutional care settings.

Types of Home Health Care

There are two types of Home Health Care options available; Skilled Home Health Care and Non-Medical Home Health Care. 

Skilled Home Health Care is medical in nature and is used to provide skilled care or treatment or rehabilitation services to homebound patients.  This type of care is usually initiated by a physician and provided by a licensed medical professional such as an RN, LPN or Physical, Speech or Occupational Therapists.  Providers must follow specific federal guidelines and criteria regarding patient care.  Skilled Home Health Care providers are usually Medicare certified and can accept 3^rd party billing of health insurance which is great because out of pocket expenses range from $85 - $150/hour.

Non-Medical Home Health Care provided home services which are not considered to be skilled care but help the individual be safe and comfortable at home.  Services are usually initiated by social workers, family members or by the aging person in need.  Care is provided by trained Caregivers and CNAs (Certified Nursing Assistants).  Providers can be licensed by the state but requirements vary state to state.  Non-Medical Home Health is usually an out of pocket expense and ranges from $20 - $30/hour in cost.  Non-Medical Home Health Care can be covered by Medicare if coupled with Skilled Home Health Care.  Long term care insurance policies as well Veterans Aid and Assistance benefits can be used to pay these Non-Medical services.

How they work together

Let’s work through a scenario to see how Skilled and Non-Medical Home Health Care work together.  Margaret is an 83 year old female who was hospitalized due to a fall.  She was released after 3 days in the hospital.  Upon her discharge, the physicians and social workers agreed that Margaret could not be home alone during her recovery even though she was expected to make a full recovery in time.  Margaret elected to use Home Health Care rather than move into an assisted living or stay at a skilled rehabilitation center. 

Skilled Home Health Care was set up to monitor Margaret’s recovery and ensure she would not have to be readmitted to the hospital.  Weekly, 30 minute RN visits were scheduled to check her vitals, medications and general health.  Physical Therapists visited her at home biweekly to work with Margaret on her walking and balance skills to prevent future falls.  Non-Medical Home Health Care was set up to visit Margaret twice a day.  A 4 hour AM and a 2 hour PM shift came daily to help with companionship, medication reminders, assistance with exercise routines, transfers, showering, toileting and dressing as well as household chores and meals.  Within a month Margaret no longer needed the Skilled Home Health Care which was discontinued.  She retained the Non-Medical Home Health Care long term but reduced the hours to only 3 per day.  Margaret’s combined use of the services cost her very little compared to moving into a facility to recover.  The fact that she retained the Non-Medical Home Health Care means that she will be able to remain at home in the future even as her care needs increase. 

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

Living with Urinary Incontinence

The loss of bladder control can be embarrassing

 and is a common problem among the elderly.

Joe tends to avoid company.  His peers think of him a crotchety old man and usually  give him his space.  His demeanor discourages close contact.  But all that is a guise Joe maintains to keep people at a distance.  Joe suffers from urinary incontinence and is embarrassed by his condition. 

A cough, sneeze or just laughing out loud can trigger it.  Urinary incontinence is a common problem for many people, not just the elderly, although it becomes more of an issue with age.  It is a topic which is difficult to talk about with family, friends or even a doctor.  The wetness, odor and the constant need to change clothing can be very embarrassing. 

What is Urinary Incontinence?

Defined as loss of bladder control, the term urinary incontinence covers anything from the occasional leaking of urine to the inability to make it to the toilet in time. These incontinence episodes can occur any time, even when asleep in bed. 

There are five types of urinary incontinence.

• Stress Incontinence – Pressure on the bladder from coughing, sneezing, exercising, or lifting heavy objects.
• Urge Incontinence – an urge to urinate is followed by involuntary loss of urine.  This is often caused by infections or more serious conditions such as neurologic disorders or diabetes.
• Overflow Incontinence – a constant or frequent dribbling of urine due to the bladder not being able to completely empty. 
• Functional Incontinence – a physical impairment, such as limited mobility or severe arthritis, which prevents getting to the toilet in time. Mental impairments, such as inability to recognize the need to get to the toilet are also considered in this category.  
• Mixed Incontinence – a combination of two or more types of insentience.

Factors which increase development of Urinary Incontinence

There are several factors which play a role in developing an incontinence problem.

• Gender – Women are more likely to have Stress Incontinence due to the physical effects of pregnancy, childbirth and the female anatomy.  Men with prostate gland problems have an increased risk for Urge and Overflow Incontinence
• Age – Unfortunately age causes the muscles around the bladder and urethra to lose strength.  With age the bladder reduces the amount it can hold and increases the likelihood of incontinence.
• Being Overweight – Carrying extra pounds can increase the pressure on the bladder.  The muscles surrounding the bladder can weaken and allow the urine to leak when coughing or sneezing.
• Diseases – Neurological disease or diabetes may increase risk of incontinence.  In addition a Urinary Tract Infection (UTI) and constipation can also aggravate the problem. 
• Diet – Temporary incontinence can be caused by certain drinks, foods or medications.  The diuretic stimulants which can increase the volume of urine in the bladder are alcohol, caffeine, decaffeinated coffee or tea, carbonated drinks, artificial sweeteners, corn syrup, foods high in spice, sugar or acid (especially citrus fruits).  Heart and blood pressure medication, sedatives and muscle relaxants also are diuretic stimulants as well as large doses of vitamin B or C.

Complications of Chronic Urinary Incontinence

Incontinence can greatly affect a person’s personal life by its negative influence on social, work and personal relationships.  Skin problems such as a rash, infections and sores can also develop from constantly being wet with urine.  Incontinence also increases the change of repeat UTIs and can aggravate constipation.

Overcoming Urinary Incontinence

It is important to seek medical advice if urinary incontinence is a frequent concern or is having an effect on the quality of life. Before speaking to a physician:

• Start a journal to track symptoms and frequency of incontinence.  Keep notes about what was happening at the time of the incident, i.e. laughing, lifting groceries, or sleeping.
• Make a list of all medications being taken.   Multiple physicians may prescribe medications and there is always a possibility of negative interactions from various pharmaceuticals.   Be sure to including over the counter pills.  The doctor will be able to look at all the medications being taken to see if there if incontinence is a side effect from one or a combination of medications.
• Track the kind of foods being eaten and how much fluid is consumed daily.
• Provide a brief health history and compile a list of questions to ask the physician.  It is sometimes helpful to bring along a friend or family member to take notes and help remember what the physician said.

Giving as much information as possible to the physician helps with getting the correct diagnosis and making a plan of action to correct the problem.

What to expect from the physician

The physician will review the information provided and ask questions to get a complete picture of the problem.  Possible questions that could be asked are:

• How long has urinary incontinence been a problem?
• Are there any issues when trying to empty the bladder?
• When is the problem most noticeable?

The physician will do an examination, order blood work and/or radiology testing and could recommend a specialist called an Urologist.  Those who suffer from urinary incontinence often experience different symptoms and may receive a variety of treatment plans.

For most people simple lifestyle changes combined with some medical treatment can ease the discomfort and stop the problem of incontinence.  It is a difficult topic to speak about but gathering information and taking steps to control the problem can lead to a happier and healthier life.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Deb Hintz is Assistant to the Director for HomeAid Health Care. HomeAid provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

Options of Elder Care

Know when it is time to get extra help 

and which type of care is appropriate 

for your loved one’s needs.

There is an awful lot to be said for an elderly person remaining at home as long as possible [1]. Home is familiar, its the place that holds a lot of treasured memories, and staying at home is key to retaining independence and feeling less like a 'burden' on family members (however inaccurate that feeling may be). However, there may well come a point when home is simply no longer a healthy, safe, or practical option. People who need medically intensive  round the clock care, or are unable to afford the assistance required to keep themselves safe and their homes running efficiently may well be better off if they receive care in a facility setting. This can be a hard decision to make, but there are a few pointers which may make choosing easier.

Struggling With ADLs and IADLs

'ADL' stands for Activities of Daily Living [5]. These activities include ambulation, bathing, continence, dressing and grooming, eating and toileting.  The ability to manage these activities is necessary to live independently.  IADL means Instrumental Activities of Daily Living and they include doing housework and laundry, shopping and preparing meals, managing medications, money and caring for pets, as well as other basic functions which supplement independent living. As people age they lose the ability to perform these activities as they used to.  Inability to perform ADLs and IADLs are usually the sign that assistance is necessary. Most elderly will maintain a degree of function with their ADLs and IADLs and can often still live quite happily in their own homes with a greater or lesser amount of outside assistance. However, when functionality of these activities drop significantly, then it's considered a sign that your loved one should make some changes so their care needs can be met on a more permanent and professional level.

Home Health Care Option

Staying at home for as long as possible is usually a very good idea. Many elderly prefer to stay at home and will refuse to move despite their need for increased daily care with their ADLs and IADLs.  Moving elderly people away from the comfort and familiarity of home can be very distressing, which in turn can affect their health. For such people, home health care is probably the best option. Home Health care can help your ageing loved one maintain their treasured independence and stay safe in the comfort of their own home. 

With home health care medically trained Caregivers come to the home and provide the individualized care that the elderly person needs. Home health care can be very flexible and provide as little as an occasional visit every two weeks to tidy up the house to round the clock care daily care.  In some cases with the help of home health care, it is possible to remain at home long term and receive appropriate care which includes hospice and end of life care.  The home health Caregiver forms a unique bond with their home patients and in many cases, become part of the family. The elderly person receiving care has dependable care that is tailored to their preferences.  Not only does this keep them feeling comfortable and safe at home, but it also allows them to maintain their independence which is indescribably valuable to the elderly.

Assisted Living Option

The hardest part of sending a parent or loved one to a facility setting can be persuading them that it's the right thing to do. Often they just don't want to go, and it's not unusual for distressing scenes to develop [3]. On these occasions, it may be a good idea to look at assisted living options. In most assisted living situations the facility is set up to feel like home.  The buildings have individual rooms which Residents can decorate with personal items from home.  There are common living areas which promote socialization among all the elderly who live there.  It may not be home, but assisted living facilities try to maintain a home-like atmosphere while providing the care that an elderly person needs. 

When looking at assisted living facility, also known as a CBRF, Community Based Residential Facility, it is best to remember that there are many types of facilities which offer different degrees of care.  It is wise to ask about the facility’s state classification to get a clear idea of what degree of care they are allowed to provide.  Some facilities provide limited care and assistance while others can provide full health care on site, including up to end of life care.  Choosing a facility according to its location and decor is often short sighted as your loved one’s care needs will increase and that may mean having to change facilities in the future. 

Nursing Home Option

If your loved one has an acute health condition, a nursing home may be the best option. When an elderly person requires care which isn't feasible to manage at home with home health care, or is beyond the scope of care for an assisted living facility, then a stay in a nursing home might be the best option. Typically a nursing home has a more institutional atmosphere as the focus in health care rather than just assisting with ADLs and IADLs. 

The bottom line is, if your loved one is seriously struggling to manage their ADLs and IADLs in their own home, and their quality of life is declining as a consequence, then it is time to start considering the various options.  Care solutions can be found in many locations, even at home, but matching the type of care to your loved one’s needs requires some thought and planning. Remember the goal is to ensure that your loved one is safe and can enjoy a rewarding quality of life no matter which option is chosen.  

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Mel Higham is a writer and editor with a special interest in mental health and wellness.  As a guest writer for HomeAid Health Care’s Elder Topics, Mel brings her expertise to our audience.

HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999. Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

[1] National Institute On Aging, "There's No Place Like Home - For Growing Old", 

[2] Council On The Ageing, Victoria, "The Voice of older people on Independence", 2009

[3] Carol Bradley Bursack, "Handling a Parent Who Doesn't Want to Live in A Nursing Home",AgingCare.com

[4] KwikMed, "20 Truly Exceptional Elderly Care Sites"

[5] PBS, "Checklist Of Activities Of Daily Living (ADL)"

[6] Alzheimer's Association, "Choosing a Care Facility"

Seasonal Influenza for the Elderly

Weaker immune defenses put the

elderly at serious risk from the flu virus.

I went to a friend’s home for a visit a few weeks ago and about 3 days later I came down with the flu.  I felt terrible. I woke up with a headache, body aches, coughing with a sore throat.  I was sure I had the flu but wondered where I had got this bug.  After some thought, I remembered my friend was coughing and complaining about a sore throat.  At that time, I didn’t think too much about her symptoms.  Later it dawned on me that we are season and I had not yet gotten the flu shot. I was angry with myself for not taking the necessary precautions in time. 

The flu can appear with no warning. One moment you are feeling well and – bam – the next you are not.  In the United States, fall and winter is the typical time for getting the flu.  The exact timing and duration of the flu seasons varies.  Flu outbreaks often begin in October and can last as late as May, however most of the time flu activity peaks between December and February. 

Unfortunately, those who are 65 years or older are at greater risk of serious complications from the flu compared to younger people.  This is because human immune defenses become weaker with age and makes it harder for the elderly population to fight disease.

What is the flu? 

Influenza (flu) is a contagious respiratory illness caused by influenza viruses.  The illness affects a person’s nose, throat and lungs.  It can cause mild to severe illness and at times can lead to death.  Some people such as the elderly, younger children and people with certain health conditions are at higher risks for serious complications.  The flu can make existing health conditions worse.  People who suffer from diabetes, heart disease, chronic obstructive pulmonary disease (COPD) and asthma are more at risk for serious complications and can result in hospitalization and even death.  Some of the complications can include bacterial pneumonia, ear infection, sinuses infection, dehydration and worsening of their chronic medical condition.

How does the flu spread? 

According to the CDC (Center of Disease Control), the flu virus is spread by droplets made when people with the flu cough, sneeze or even speak.  These droplets can land in the mouth or nose of people who are nearby.  A person may also get the flu by touching a surface or object that has the viruses on it, then touches their own mouth, eyes or their nose.

What is the period of contagiousness? 

The viruses may be passed on to another during several days when the carrier is contagious.  Beginning a day before actual symptoms develop, and running up to 5 to 7 days after becoming sick.  During that time, the person with the flu can pass it on to others.

What are some of the symptoms of the flu?  

Individuals who have the flu often feel some or all of the following signs and symptoms: fever or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches,  feeling fatigue, and some people may have vomiting and diarrhea although this symptom is more common in children than adults.  It is important to know that not everyone with the flu will have a fever. 

Protect yourself and others from getting the flu? 

1. Get vaccinated - The number one thing a person can do to protect themselves and others is to get a yearly flu shot.  A flu vaccine protects against the flu viruses that has been identified by researchers to be the most common during the upcoming flu season.   
2. Practice good health habits - The second thing to do to protect yourself is to practice standard precautions.  Cover your cough or sneeze with a Kleenex or use the bend of your elbow or upper arm.  Never cough into your hands. Avoid close contact with others-stay at home if you are sick.  Wash your hands with soap and water often. Avoid touching your eyes, nose or mouth. Clean and disinfect surfaces or objects in your home.  Simple precautions can make a difference when trying to prevent getting sick with the flu.
3. See your doctor - The third thing you can do to protect yourself is seek medical advice quickly if you develop the flu symptoms.  The professionals can evaluate whether you need treatment and can prevent the symptoms from becoming a serious health threat.

Becoming sick after getting a flu shot

People often ask “Can I get the flu after I get a flu shot”?  The answer is yes - it is possible for people to get the flu even if they received the flu shot for the following reasons: 

• Prior exposure - You may have been exposed to the flu before getting the shot or during the period it takes the body to getting protection from the flu shot.  It takes about 2 weeks after getting the flu shot for antibodies to develop in the body.
• Different strain of flu - You may have been exposed to a flu virus that is not included in this season’s flu vaccine.  
• Diminished immunity - Some older people and individuals who have certain chronic illnesses may develop less immunity after receiving the vaccine.  

The flu vaccine is not a perfect tool but it is the best way to protect against the flu infection.

 

Vaccinate ever year

It is important to know that the flu vaccine declines over time and that is why people need to get vaccinated every year.  The effectiveness of the vaccine is influenced by the age and the general health of the person who was vaccinated as well as the antigens used in the medicine.  Older people or those who have a weakened immune system may not generate the same amount of antibodies after receiving the vaccine and the antibody levels may drop more quickly compared to young health people.

Is there treatment for the flu? 

The answer is yes-the drugs are called “antiviral” drugs.  These antiviral drugs can make your illness milder and make you feel better faster.  These medications can also prevent serious flu-related complications like pneumonia.

During flu season it is best to be proactive and follow the guidelines set by the CDC for the flu.  Always check with your provider to be evaluated for the best treatment and to answers any questions you may have regarding the flu.  

For more information about the flu visit the following websites: www.noca.org/flu, www.cdc.gov/flu or www.cdc.gov/flu/about/disease/65over.  

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Deb Hintz is Assistant to the Director for HomeAid Health Care. HomeAid provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

Hoarding Troubles

What looks like clutter to us, represents

 memories, travels, friends and love to seniors.

Charlie was a young boy during WWII and like many of his peers he remembers how it was to make do.  He tended to keep things just in case he might need them down the road.  Yet a lifetime of storing things became something far more than being frugal when his wife passed away.   After Marge’s  death the stuff accumulating around the house grew into more than just piles of clutter.  There were newspapers, old pill bottles, and empty food containers covering every flat surface, heaps of dirty laundry on the bed and floor and no clear path to move from room to room.  Clutter took over Charlie’s home and started to have a negative effect on many aspects of his life.

The hoarding of objects among the elderly is a serious problem.  Piles of hoarded objects can be a sign of a serious cognitive disorder and present a safety concern which requires immediate intervention.

Hoarding as a disorder

We all keep things.  For some, the item has sentimental value and for others it is about a possible need in the future, but often times the elderly keep things because they suffer from a cognitive disorder.  Diogenes Syndrome is a type of obsessive-compulsive disorder which is prevalent among the elderly.  It often presents itself in those suffering from dementia or frontal lobe impairment.  According to the American Geriatrics Society, Diogenes Syndrome is usually characterized by extreme self-neglect, household squalor, social withdrawal, apathy, compulsive hoarding of rubbish and a lack of shame.  This syndrome is usually found in people who lack social interaction and cognitive stimulation, have suffered a traumatic event or have a genetic predisposition to the condition. The elderly are prime candidates for hoarding prevalent in Diogenes syndrome. 

Those who suffer from elderly hoarding tend to use their possessions as a coping mechanism.  The onset of this condition can be triggered by an emotional trauma, like the death of a spouse.  The elderly person has a hard time dealing with their loss and so fixates on something they can control.  The disorder is also associated with those suffering from fear of loss, anxiety and depression.  In some cases hoarders just don’t know how to get rid of their unwanted possessions.  In other cases the collected items are kept out of sense of loyalty to the past or a compelling need to conserve.  No matter what is the underlying cause of hoarding, the accumulation of things over time combined with the daily bombardment of junk mail, bills, newspapers, dirty dishes and laundry can very easily become too overwhelming for the elderly to deal with. 

Risks of Hoarding

Having clutter around the house is risky for the elderly. Piles of newspaper and old books not only represent a potential fall risk but can add fuel to a fire.  Old clothes lying about on the floor invite damp, mold and mildew into the home.  Dirty dishes and expired food in the cupboard lure mice, rats and insects.  Piles of mail could hide important documents, unpaid bills or checks that need to go to the bank.

 

Hoarding not only creates anxiety, stress, guilt and embarrassment for the elderly but often destroys relationships with family members.  Adult children have a hard time trying to convince their elderly loved ones to allow them to sort through things and throw the junk away.  Relationships are strained and isolation becomes more of an issue when family stays away due to the unhygienic state of the home. 

What to watch for

Sometimes it is hard to recognize and label the problem as Diogenes syndrome.  Since confronting this issue can be difficult for family members, it is helpful to know what signs indicate a real problem. 

• Piles of clothes, newspapers, mail and unpaid bills
• Difficulty navigating safely through the house
• Frustration with sorting and organizing
• Difficulty managing activities of daily living
• Expired food in the refrigerator and cupboards
• Closets and drawer crammed with things
• Compulsive shopping
• Difficulty with discarding items
• Stroke or signs of dementia
• Loneliness

Helping an elderly loved one who is struggling with hoarding requires a lot of patience.  Bombarding the home with a ‘get this done today’ attitude or secretly clearing out things behind the hoarder’s back can only aggravate the stress in their lives.  It is important to remember that the house didn’t get this way because of poor housekeeping skills.  A hoarder is suffering from a disorder and needs emotional help before they are ready to toss anything. 

What to do to help

Experts suggest taking on small areas at a time.  Help an elderly loved one clear off a table and then praise the results.  Suggest donating items to a local charity or thrift shop.  Remind that safety in the home is important to being able to remain independent at home.  Work out an agreement of not keeping unused things for more than 6 months.  Clutter is about control and hoarders have a hard time letting things go, but allowing them to decide where things go can be very helpful.  Don’t think that once the house is clean, the problem has gone away.  Hoarders will continue keeping things and the place will slowly fill up again unless the underlying emotional issues are dealt with and there is practical help in keeping the clutter at bay.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

Vulnerable Seniors - Substance abuse among the Elderly

The most common forms of elderly addiction are

alcoholism and painkiller dependency.

It's not something you often hear about, but the elderly of America are increasingly at risk of becoming addicts [1]. Our notion of seniors doesn't tend to fit with our viewpoint of addicts - I'm willing to bet that you raised an eyebrow at the first sentence - but the problem exists nonetheless, and is growing. The most common forms of addiction are alcoholism and painkiller dependency - both of which can be just as devastating for seniors as younger people.  

Stereotypes

Stereotypes can be a major obstacle in all areas of drug rehabilitation [2], but it's particularly relevant when it comes to seniors. Typically seniors aren’t what is pictured when we think about addicts. In fact, if asked to describe the stereotypical antithesis of an addict, a nice old lady is probably what you'd come up with. This kind of attitude frequently leads people to miss the warning signs of a growing substance dependency.  It may even lead them to unwittingly encourage substance-abusing behaviors.

"Oh go on, Granny, have another glass of wine!"   Well meaning people often encourage addictive behavior with the belief that they are not likely to be adding to an existing problem or it can’t do their elderly loved one any real harm anyway. There is also a prevailing belief that seniors should be allowed to indulge their taste for alcohol, or pop an extra pain pill if they want to. The general attitude is that the elderly are old enough to have 'earned it’.   There is also the misconception that the elderly are too old for an addiction to really damage to their lives.

For seniors themselves, there is an attitude that they don't have to worry too much about their bodies any longer, so indulging a bit really won’t hurt them.  Relying on a former self-image of living a sober lifestyle may cause some Elderly to miss the signs that an addiction has taken hold.  The belief that they are not the kind of people who abuse substances makes it all the easier to 'let themselves go'[3].  

Loneliness and Boredom

As we age, many of us may find ourselves more isolated than we used to be. Too many seniors find themselves living excruciatingly lonely lives.  Loneliness is incredibly bad for anyone's mental health, but it can be especially damaging to an older person who may need human stimulation to keep their mental faculties active. Coupled with grief, which often affects seniors as they lose friends and loved ones, the recipe for a slide into depression-related addiction is a potent one. Loneliness has been proven to have a strong association with alcoholism in many studies [4] - particularly when, as is often the case with retirees who live alone, it is coupled with an excess of free time and boredom. Grief and depression may also trigger comfort drinking, or encourage a growing reliance upon the emotional numbing effects of opioid painkillers.

Opportunity

Older people are a lot more likely to be on medication than younger people, which unfortunately gives them a lot more opportunity to become addicted to prescription drugs. Prescription drug addiction is an enormous problem within the United States, taking more lives on an annual basis than heroin and cocaine combined. Many of the painkillers prescribed to our seniors are opioids, just like heroin, or benzodiazepines, which affect the central nervous system. They're powerfully addictive, and a vast swathe of our population is currently in the grip of prescription drug dependency, to which many lose their lives [5].

Most addicts stumble accidentally into addiction, assuming that pills given to them by a doctor can't be bad.  The often get hooked by upping their doses by increments in order to help them 'get by' on 'bad days'. In the case of seniors with cognitive impairment, a dependency can be developed by forgetting having taken the medication and accidentally repeating dosages. Alternatively, even non-addictive prescription medication can interact poorly with alcohol, thus contributing to other dependency issues. And the fact that the symptoms of addiction often mimic symptoms which we generally associate with old age [6] and its related illnesses means that often these addictions are not recognized until it is too late.

What Can We Do?

So how can we help our ageing loved ones to steer clear of the addiction trap? If you have concerns about an elderly loved one's inclination towards addictive substances, keeping an eye on worrying behaviors is the best way to confirm any suspicions. One excellent way to help is to remove the burden of loneliness, boredom, and grief by providing emotional support, visiting regularly, and providing them with plenty of human stimulation.  Keeping an eye on drinking habits and any medicines they're taking is also a good idea. Taking an interest in their health and emotional state can work wonders in preventing a problem from developing!

A home health Caregiver can also be an enormous boon in this situation. Not only will a medically trained Caregiver keep track of what your loved one is taking and when, they'll also be on hand to pick up on any worrying symptoms and trends within their lives.

Addictions can ruin a person's golden years - but good health, both physical and mental, will make the elder years a time of joy.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Mel Higham is a writer and editor with a special interest in mental health and wellness.  As a guest writer for HomeAid Health Care’s Elder Topics, Mel brings her expertise to our audience.

HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999. Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin

[1] American Osteopathic Association, "Substance Abuse in Senior Citizens - A Serious Problem"

[2] Bruno Gnaneswaran, "Shattering Society's Stereotypes Of Drug Users", Concrete, Jan 2013

[3] Rita Milios, "Seniors and Substance Abuse: The Invisible Epidemic", Recovery.org, Sept 2015

[4] Igemar Akerland, Jan Olof Hornquist, "Loneliness and alcohol abuse: A review of evidences of an interplay", Journal of Social Sciences and Medicine, Feb 1992

[5] Centers For Disease Control And Prevention, "Injury Prevention And Control: Prescription Drug Overdose"

[6] Medical News Today, "All About Addiction"