Elder Proof the Home

Make the home a safe place for your elderly loved one.

Marge’s falls usually occurred in her bathroom.  She frequently ended up bumped, bruised and scolded for not being more careful.  The time her head narrowly missed the porcelain tub got her family to really take a look at what was causing the problem.  It turned out that the doorway was unusually narrow and the door opened into the bathroom room making it even more difficult for Marge to enter.  In addition, the lever on the bathroom door would constantly catch on Marge’s bathrobe sleeve as she made her way into the room which threw her off balance.  A simple fix of changing the hinges so the door opened outward increased the space and eliminated the possibility of the lever catching on her clothes.  To the relief of Marge and her entire family, the falls stopped.

Most elderly live in fear of falling.  Falls and other household accidents put elders at risk and are often the reason staying at home independently becomes impossible.  Renovating the home so it is a safe place allows your elderly loved one’s to age in place at home rather than having to move to an institutionalize setting.   Most folks think nothing of child-proofing their home when their families are young.  The same concept holds true for the aging.  A couple of simple and relatively inexpensive renovations can make all the difference in the overall safety for your elderly loved one.

Bathroom:

The combination of smooth floor surfaces and water make the bathroom one of the most dangerous rooms in the house, so it is important that this room be updated to safely accommodate the elderly. 

·        Install bathrooms doors to open outwards so there is room to maneuver through thresholds.  Doorways should be 32” to 36” in width to accommodate those in wheelchairs or using walkers.

·        Lower the height of cabinets, countertops and mirrors a few inches to accommodate those in wheelchairs or with walkers.  Insulate hot pipes under the countertops so those confined to wheelchairs don’t burn themselves when seated near the sink.

·        Allow 30” to 48” of open space in front of all fixtures in the bathroom, including sinks, toilet, tub and shower.

·        Install grab bars parallel to the floor (or at a slight diagonal) next to the toilet and in the tub and shower.  Install a vertical grab bar near the shower door for entering and leaving the shower stall.

·        Raise toilet seats to at least 17” or fit with seat extenders.  Toilets should not be placed in small alcoves or too close to vanities, shower stalls or fixtures so there is plenty of maneuver room near the commode.

·        Install a walk-in tub with water sealed door or install tub grab bar to provide balance when stepping into the tub. Get a stable 17” tub seat, a non-slid tub matt and a hand held showerhead, all which make taking a shower safer and easier for the elderly.

·       Turn on a night light in the bathroom at night.

Kitchen:

Kitchens need to be accessible to the elderly which means re-arranging cabinets so commonly used items are in easy reach.   Trying to reach items in high cabinets or crouch down to retrieve low for items on the bottom shelves can be very difficult and so organizing the kitchen with elders in mind is a priority.

·        Lower wall cabinets by 3” to 5” making shelving accessible.  Counter tops should be at 28”- 34” for wheelchair accessibility and at 40” for someone who has trouble bending.

·        Move commonly used kitchen items to lower cabinet shelves.

·        Install easy access features such as rolling carts and baskets, lazy Susan devises and full extension drawer glides.

·        Choose glare-free surfaces so elderly can easily find handles and knobs.

·        Install shallow sinks so those in wheelchairs can reach inside. 

Lighting:

By the time a senior is in his 60’s, they need nearly 15% more light to properly see.  Adding more light to hallways and stairs can help avoid falls which can be especially dangerous on stairs.

·        Install fixtures which use higher wattage bulbs and use brighter LED lights for added illumination.

·        Use ceiling lights that reflect light to the entire room without glare.

·        Install sensor light switches which turn on and off when people enter or exit a room. Use dimmer controls which can ease glare for elderly with light sensitivity issues.

·        Have hand-held remote controls for a centralize control center near the bed or easy chair.

·        Control lights from wall switches with large tilt plates or overhead pulls which are easy to grasp.  If a lamp uses a knob, be sure it is large and turns easily.  Wall switches should be installed no higher than 48” from the floor so they are accessible to someone confined to a wheelchair.

·        Use florescent lights in kitchens to illuminate work spaces.

·        Install night lights in hallways and bathrooms.

·        Use lighter colored lamp shades that emit a brighter ambient light.

Floors & Stairs

It is important to pay attention to the condition of floors and stairs.  Slips and falls can be reduced dramatically when basic precautions are put in place,

·        Secure carpets or area rugs with grip tape so they don’t shift or move.  Never allow area rugs over wall to wall carpeting as the rug will edges curl and not sit flat. Remove all area rugs from top or bottom of stairs where a trip may result in serious injury. In many cases it is best to remove area rugs altogether because they are often the culprit when there is a fall.

·        Position furniture so there is large easy pathways to navigate through.  Make sure all transitions from room to room are flat and seamless. 

·        Get rid of all clutter, electrical cords, hanging tablecloths, draping curtains or pulls from blinds that could get tangled in feet and cause trips and falls. 

·        Keep small pets out from underfoot.

·        Ensure all steps and stairs are even in height and are deep enough to place the entire foot for proper balance. 

·        Be sure there is a sturdy handrail available for all stairs and steps.

·        Install anti-slip tape on stair treads for extra traction.

·        Ensure carpeted stairs are properly installed and the carpeting is not sagging or loose.

·        Consider a stair lift for people with mobility, strength or balance issues.

·        Invest in well fitting shoes with skid-free soles, no to low heels and Velcro straps. Discourage walking on hardwood floors in stocking feet or soft slippers.

·       Consider replacing tile or hardwood floors with safer non-skid flooring especially in the bathroom and kitchen areas.

With the cost of institutionalized elder care dramatically increasing, it is a good idea to invest a little now to safeguard your elder’s home.  Reduce the risk of accidents and falls for your loved one and they can remain safe and independent at home, the place we all prefer to be.

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 family owned companies provide comprehensive care for the elderly in the Fox Valley of Wisconsin.

Sources:

“Accident Prevention Tips” by the Editors of consumer Guide, www.home.howstuffworks.com 10/21/13

“Home Improvements for Senior Citizens” by Wendy Dickstein, www.realitor.com 10/22/13

“How to Create a Safe Haven for Independent Living”, www.safetytubs.com. 10/21/13.

The Healing Touch

Many elderly people are starved for a gentle touch.

Human touch provides amazing benefits to the aged and has been used since ancient times to relieve discomfort in the body, mind and the soul.  A simple caress or gentle massage can make an enormous difference in the physical, emotional and psychological well-being of people of all ages, yet for the elderly is can be especially helpful in relieving pain, reducing anxieties and warding off loneliness.

Touch is a natural and therapeutic way of interacting with the elderly.  Yet according to leaders in touch therapy, the elderly are often denied touch and its life-enhancing benefits.  In fact the majority of residents living in facilities designed for the elderly are rarely touched outside the hands of those who care for them.  Ashley Montagu, author of TOUCHING, says that people are “unwilling to face the facts of aging” and so shy away from the elderly, failing to recognize their need for physical contact.  One only has to notice an elder’s response to a hug or caress to understand how important the tactile stimulation of touching is for their well-being.  Many elderly people are starved for a gentle touch.

Massage is natural and efficient way of administering touch to the elderly.  It is an effective complimentary therapy to traditional and conventional treatments for the many physical ailments associated with aging. The physical benefits of massage for the elderly include:

·         Restores range of motion - Arthritis and osteoporosis stiffen and cripple the aged, but massage softens tight muscles and restores natural joint lubrication increasing mobility.  Massage also aids in increasing muscle strength and coordination.

·         Reduces high blood pressure - Massage improves lymph and blood circulation and relieves the tension that often leads to high blood pressure.  Better circulation increases the amount of oxygen flowing to muscles and cells and effectively removes toxins from the body.  Lower blood pressure reduces stress on the heart.

·         Relieves pain – The gentle pressure of massage can decrease the need for pain medications.  By temporarily blocking pain nerve signals and encouraging the release of endorphins, massage can reduce pain and in some cases eliminate it completely.  Massage is extensively used for rehabilitation after surgery to hasten the healing process.

·         Improves sleep and mental clarity – Massage helps combat insomnia and other sleep problems that are common among the aged.  Cognitive functions are improved as massage temporarily interrupts patterns of stress, giving the elderly more clarity and control over their situations.

·         Assists in skin preservation – Massage has long been used in preventing pressure sores and bed sores.  Combined with oils or lotions, massage soothes dry and rough skin.

·         Aids in digestion – Massage increases appetites as well as assists with the digestion and elimination processes.

Beyond physical benefits, massage also assists with psychological and emotional issues often faced by the elderly.

·         Manages stress – Aging has its own stressors, including illness, depression, and anxiety, all of which can be alleviated by the healing power of massage. 

·         Diminishes dementia – Massage, even a simple hand massage, has been shown to diminish the agitation and confusion experiences by individuals suffering from Alzheimer’s disease.  The calming effect of massage restores a sense of well-being and aids in facilitating communication for those who live with dementia.

·         Releases emotions – Massage can be a powerful tool in allowing an aged person let go of long suppressed emotions.  By bringing feelings to surface through touch, many people are able to talk about issues they had been unable to discuss previously. 

·         Alleviates loneliness – The physical contact of massage reassures the aged that they are not alone. The process of caressing and touching reinforces the idea of human connection by giving one-on-one attention to the aged.  A gentle and caring touch can address major quality of life issues, such as depression, feelings of isolation, lack of self-esteem, fear and anxiety.

Massage for the elderly requires special care and those who provide it should have special training.  Fragile skin and bones, pain medications and multiple medical conditions must be taken into consideration before providing massage.  Avoid deep muscle massage and vigorous movements, as they may not be safe for the elderly. When performing massage on an elderly person, it is important to listen to their desires as well as their nonverbal communication or body language, to determine what kind of massage they prefer and how much pressure to use.  Find a massage therapist who specializes massage for the elderly to  provide the healing power of gentle touch for your loved one. 

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides non-medical home services for the elderly who wish to remain safe and independent at home.  HomeAid is a 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 that meets the needs of the elderly in the Fox Valley area of Wisconsin.

 

Sources:

www.livestrong.com “Massage Therapy Benefits for the Elderly” by Kristie Jernigan.  Retrieved 9/15/12.

Montagu, Ashley.  “Touching” New York, NY. Continuum, 1999.

www.amtamassage.org “Massage in Hospices” by Dawn Nelson, Retrieved 9/15/12.

Communal Living - Housing and Care Options for the Elderly

Saving on caregiver and housing costs,
communal living is a real option for the elderly

Most elderly live on a very fixed income and so seniors are on a constant lookout for ways to save.  With the goal of living independently as long as possible and remaining within a strict budget, many seniors are now looking at communal living as an option. 

Communal living is an alternative living solution for seniors and the elderly who don’t feel ready for assisted living and don’t relish the apartment type lifestyle of senior residences but can’t afford to remain alone in their own homes any longer.

In a communal living situation for the elderly, there are usually about four to five people who live together in a single-family home.  The people in the household share their meals and activities, as well as expenses. The cost of rent, utilities and food is divided between the all member of the household.  Often a home health caregiver is hired by the group to help with the heavy housework, laundry, transportation needs and general daily cares that the elderly residents may need.

Communal housing is very cost effective compared to other living solutions available for the elderly.  Depending upon location, rent alone in a senior housing complex can run up to $3,500 a month, not including caregiver costs. Living in an assisted living facility can cost over $50,000 a year with nursing homes costs doubling that figure.  With housing and care costs for the elderly rising annually at 7%, finding another solution is a necessity for many elderly. In a communal living situation the financial burden of living expenses is shared, meaning the elderly can afford to remain independent and in a comfortable family-style home rather than being forced to down-size to a small apartment or move to an institutionalized situation.  The pooling of expenses allows the group to afford the extra help needed to run their home by hiring a caregiver who serves all the residents who live there.  Under the caregiver’s watchful eye, each resident’s health is monitored and the household is kept organized and running smoothly.

Socially the elderly enjoy living in a family-like setting.  Loneliness and boredom, which can lead to depression and health concerns, are not an issue.  Rose, in her late 80’s, lives in a communal housing situation and says, “… here I have people who care like a family.  I couldn’t ask for anything better.” The residents remain independent and socially active in the community rather than being isolated to only mature adult interaction, as with most senior apartment communities.  

Finding a communal housing situation that suits an individual can require a bit of searching, but there are now many nonprofit organizations, churches and public and private agencies who can help match elderly homeowners with compatible roommates.  There are even federal rent subsidies available to elderly who participate in shared residences.  Contact the U.S. Department of Housing and Urban Development to learn more.

Of course, communal living is not for all seniors and elderly.  Health concerns, frailty and cognitive issues often mean that independent living is no longer an option. Yet for many elderly the sharing their lives and expenses in a communal living situation is a real possibility.

  

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 a 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 of the Fox Valley in Wisconsin.

Sources:

 “Cost of assisted living, nursing home care in Wisconsin higher than U.S.” Milwaukee Journal Sentinel. www.jsonline.com. 9/30/13.

“For Older People, Communal Living has its Rewards” by Michael deCourcy Hinds, New York Times. www.nytimes.com. 8/12/13.

“Guide to Senior House Options” www.aplaceformom.com. 7/20/13.

Transitions: Senior to Elderly - Letting Go

The aging process eventually leads to
the stage of letting go.

People often make the mistake of assuming that old is old and that the elderly are done with the bewildering life changes that the rest of us are constantly adjusting to.  In fact there are several developmental and emotional stages that those of advance age commonly pass through as they transition from being a senior to being truly elderly.  Although each individual differs in how they work through these stages, generally most progress through four psychological stages:  1) Slowing; 2) Life Review; 3) Transmission; and 4) Letting Go.  The tasks of completing the emotional work of each stage can be daunting for the elderly and their loved ones.  Since it is often in necessary for families to provide support to their elders as they transition through each stage, it is important to be able to recognize each step as they go through it.

4) Letting Go

The process of letting go is the culmination of all the previous developmental stages the elderly have pass through.  Advanced age really begins with a marked slowing of physical and cognitive actions and that is followed by life review and transmission, which are like a general tidying up of one’s unfinished business of life and passing on of their legacy of possessions and experiences.  Then the serious business of letting go begins. 

The passing through of the different stages of advanced age slowly strips away all the extras of life, leaving the elderly with the task of just being.  It is at this point the elderly deal with the task of letting go.  The mission of letting go and learning how to just BE is much more difficult than it sounds, especially in our fast paced and performance based culture.  People at this stage of life let go of all the things people prize and value.  Possessions, practicalities, behavior patterns, logic processes and even words all fall to the wayside as the elder concentrates on the simplicity of just being.  It is a vulnerable and emotional time for many. As an elderly person begins to let go, there is a concentrated clearness in their perceptions and tenderness in their hearts. The external trappings of life are stripped away and the beauty of existence is made clear. This is a time when small memories or little pleasures bring tremendous, almost childlike, joy.

Letting go is usually followed by a physical decline which leads to death.  For a smooth transition the Elderly need a loving environment which supports and facilitates the emotional process of letting go.  This is why family and friends are so important.  As the elderly become more aware of their own mortality, they attempt to hold themselves together to reduce their fears, anxieties, pain and panic.  Having loving and patient support makes this task easier to accomplish. 

The elderly need to be able to transition through each stage of advanced age without being made to feel a burden on those around them. They need to be able to slow down without being considered a nuisance and reminisce through their life’s perceptions and experiences without being thought of as a bore.  They need to be allowed to let go of all the excesses of life without being considered witless.  For an elder to pass through these stages unaccompanied by the loving support of family or friends is a tragedy, for they are left alone and isolated as they face the most difficult of life’s  transitions – death.

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 of Wisconsin.

Sources:    “Emotion Regulation in Older Age” y Heather L. Urry and James J. Gross, www.aps.sagepub.com. 5/15/13

                      "The Psychological Tasks of Old Age” by Victoria Fitch, www.windhorseguild.org. 5/15/13

                      “The Old-Old Years” by Brenda Sue Black, M.S., www.wvu.edu.com. 6/1/13.



Transitions: Senior to Elderly - Transmission

It is important to the elderly to be benefactors to those they love

There are four stages people pass through as they transition from being a senior to being truly elderly.  Each individual is different in how they navigate through and experience these phases of advanced age, but generally most people go through:

1)      Slowing – a time of slowing in pace, motor functions and memory.

2)     Life Review – a time of reflection of one’s past with the goal of finding meaning in their existence.

3)      Transmission – a time of passing on the essence of one’s life to others.

4)     Letting Go – a time of stripping down the excesses of life and learning  to just be.

Being able to identify each stage as a person enters it is very helpful to both the elder and their family alike.  For those making the journey through advance age, knowing the signs of the various stages make it a little less stressful as life begins to change.  For the family of an aging loved one, it is often necessary to assist an elder as they pass through each stage and having an understanding of what to expect and how to help can make the passage much easier for everyone.

3) Transmission

Just as the first stage of physical and cognitive slowing leads to the second stage of life review, this phase of introspection leads to the third stage of Transmission.  Transmission is the passing on to others the culmination of what was gathered in the elder’s life.  This can be anything from physical possessions to small gestures of care.  Giving is what is important in this stage of advanced age.  It is the passing on of things, great and small, that mark this time.

·         Inheritance - It is common for those entering advanced age to start sorting through their physical possessions.  This taking stock of their belongings and determining who to pass them onto is usually a conscious and methodical process.  Bequeathing a life time of possessions to the next generation is one very practical way the elderly pass on important aspects of their lives to those they care about.  These gifts needn’t be of great financial value, but often have a strong sentimental significance to the giver.  People of advanced age have a deep desire to be benefactors to those they care about.

·         Experience – Elders are rich in experience, knowledge and practical skills.  In living a full life they have gained the understanding of not only how to do things, but how to think about life.  They long to pass this experience and understanding on to those who will receive it.  Their lessons of life can be imbedded in conversations about seemingly inconsequential matters and so are often missed by the busy listener. 

·         Wisdom - As the world slows for those in advanced age, there is a great awareness of detail that is gained. This understanding of the intricate details of life is what elders wish to pass on to those around them.  Detailed direction on how to arrange flowers or set the table can be full of the essence of wisdom to those who take the time to receive it. 

·         Grace -   In many cases it is not the gift itself that is important to the elderly.  What shines in their eyes is the exchange that is made between themselves and those they care about.  In the act of giving and receiving, the elderly are able to bring their loved ones into their slowed world and show them a perspective of life in its simplest form.  Those who truly take the time to receive all the elderly want to give come away with a sense of grace and a deeper understanding of humanity.  The elderly at this point are able to teach us by example what it means to be human.

Advanced age brings with it many challenges.  Frailty, failing health, cognitive concerns, physical pain and emotional anxieties all burden the aging to one degree or another.  These challenges make the time of transmission all the more urgent to those in that stage.  Facing mortality prompts the aging to go through the process of sorting out and tidying up their life.  The stage of transmission is an important step in preparation for the final stage of letting go.

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 family owned companies provide comprehensive care for the elderly in the Fox Valley of Wisconsin.

Sources:    "Emotion Regulation in Older Age" by Heather L. Urry and James J. Gross, www.sagepub.com. 7/15/13

                  “The Old-Old Years” by Brenda Sue Black, M.S., www.wvu.edu.com. 6/1/13.

                   “The Psychological Tasks of Old Age” by Victoria Fitch, www.windhorseguild.org. 5/15/13.