Monday, January 27, 2014

Elder Care Options - Assisted Living

Knowing the Elder Care options makes the decision easier for the entire family.

It usually happens unexpectedly.  A fall or an illness leads to hospitalization and rehabilitation. In the midst of all the worry, concern and fear over your loved one’s health and well being, you are told that going home is not a safe option.  Pressed into finding a solution before your loved one is discharged and not even knowing where to start is a very stressful situation for the entire family. Knowing your care options can be a help.  Here is some basic information about one such option – Assisted Living facilities.

What is an Assisted Living facility?
Assisted Living Facilities are designed for individuals that need assistance with basic activities of daily living (ADL's). These activities are self-care tasks that we all learned in childhood, but become more and more difficult to perform as people go through the aging process. ADL’s include feeding, bathing, toileting, dressing and grooming, walking and transferring plus self administration of medications. 

Assisted Living, also known as Assisted Living Facilities (ALF) or Community Based Residential Facilities (CBRF's) are usually used by people who need assistance with their daily living. These people find it difficult to live on their own without relying heavily on family, friends or a home care agency.  People who use Assisted Living Facilities may require medical care in addition to receiving assistance with ADL’s, but they can still maintain some level of independence and do not yet need the level of continuous skilled nursing care as found in institutions like nursing homes.
 

Assisted Living Facilities are licensed and regulated by state guidelines. They are grouped into three classes depending upon the level of care provided. Typically “A” class signifies very little external help with ADL’s whereas “B” and “C” class progress in the amount of care that can be provided. A “C” class assisted living facility is licensed to provide all levels of care including most skilled medical care tasks, which traditionally used to be only managed through nursing homes.

It is important to understand the classification of the facility you are considering, as some facilities will accept a Resident at one level of care only to require them to move later as their care needs increase beyond their ability to provide care.

People generally choose between home care, assisted living or nursing home care depending upon the amount of independence the individual can maintain, the amount of care needed, and the cost of that care.

Who can benefit from Assisted Living and how?
There are many types of people who can benefit from residing at an Assisted Living Facility.  Assisted Living is ideal for elderly individuals, or couples, who are capable of some level of independence but require assistance with the basic activities of daily living.  They may also have some medical concerns that require supervision or continuous attention.  An ALF is also a safe place for those suffering from Alzheimer’s or Dementia related problems.  Assisted Living is an ideal living arrangement for disabled individuals as well as those recovering from hospitalization or illness and in need of medical supervision.

There are many benefits for those who choose to live in an Assisted Living facility. The most important benefit is derived from the basic concept of “assisted” living.  The philosophy of assisted living is that it promotes independence, autonomy, privacy and dignity for the residents who live there.  The concept of Assisted Living is more concerned with the approach towards care rather than the actual care received.  This concept is important to families struggling with the less appealing option of placing their loved one in a traditional nursing home or juggling their own lives with the many care needs of their loved ones.  Assisted Living facilities strive to support and maintain the current level of independence enjoyed by residents, but with additional supervision and assistance when necessary.

One important benefit gained for residents and families alike is family roles are often restored when caregiver responsibilities are taken over by trained staff.  The professional care provided by assisted living facilities relieves the stress and burnout experienced by families when dealing with loved ones who need daily care.

Peace of mind is gained from living in an Assisted Living facility.  The residents benefit from continual monitoring of their health by the trained caregivers, Facility Directors and RN.   Safety against accidents or falls is another plus. The availability of nutritious meals and housekeeping, in addition to opportunities for social interaction, all add to the quality of life experienced by residents at assisted living facilities.

Who lives in Assisted Living facilities?
Currently, more than a million Americans live in an estimated 20,000 assisted living residences.  Assisted living residents can be young or old, affluent or low income, frail or disabled. A typical resident is mid-eighty and is either widowed or single. Residents may suffer from Alzheimer's disease or other memory disorders.  Residents may also need help with incontinence or mobility.

How much does Assisted Living cost?
Each resident has unique needs and preferences.  That is why most Assisted Living facilities will schedule an initial assessment meeting with each potential resident and his or her family.  The goal of the assessment is to learn more about the resident and determine what type of care is needed.

After an initial assessment, the facility will work together with your loved one’s health care provider to put together a Care Plan.  The Care plan is an individualized list and schedule of the services your loved one will receive.  The goal is to provide a level of care that addresses health concerns and provides necessary assistance while helping seniors to maintain their lifestyles.

Only after the Care plan is developed should there be a determination of the monthly cost of care.  That way there never should be any hidden costs or surprises.   On average Assisted Living costs are usually half the costs of nursing home care or full-time, 24 hour a day, home care.  While some assisted living facilities charge per item of care or service, there are some that includes a wide range of services within a standard monthly fee.  There are also some assisted living facilities which base their prices on a sliding scale and often raise rates for each additional service required. Those can start out at a rather reasonable price but soon escalate to be quite costly as care needs increase.

How does Assisted Living compare to institutionalized care?
A: The main difference between an assisted living facilities and institutionalized facilities, such as nursing homes, is the level of care a resident receives and the level freedom the residents are allowed to enjoy. 

In nursing homes, a majority of the residents have health issues that require continual medical supervision as well as need of assistance with daily living tasks.  They are no longer capable of living independently.  Residents in such a facility usually live in shared rooms with little to no private space.  Nursing staff provide medical and general assistance, but are limited in their time and attention by a high resident to staff ratio.  Nursing home residents typically are unable to leave the facility on their own, mainly because they are physically or mentally unable to.

Assisted living residents are far more independent.  They typically do not need as much hands-on medical attention.  Beyond requiring assistance with medicine management, bathing and other tasks of daily living, residents remain very independent. In many assisted living facilities they have individual room furnished and decorated to their own tastes.  Assisted living residents might still cook, entertain, participate in activities, and go on outings, while still enjoying the security of medical supervision and social interaction with other residents.

In the past the main distinction between Assisted Living facilities and institutionalized facilities, like nursing homes, was the ability to provide skilled nursing care.  These days Class C Assisted Living facilities are able to provide many medical services.  Under the supervision of a RN, medical care usually includes medication monitoring, pharmaceutical services, Alzheimer's and Dementia Care, physical and occupational therapy, pain management and hospice care.

Getting an overview of Assisted Living faculties does not make choosing the best one for your loved one’s needs any easier.  But knowing some of the basics about Assisted Living can help with asking the right questions so you make the right choice. 








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 and disabled in the Fox Valley of Wisconsin.




Tuesday, January 21, 2014

Fitness for the Elder Years

Exercise needs to be the life work 
of those who wish to enjoy their elder years.

Fitness is the key to enjoying the Elder Years of life.  An active exercise program needs to become the life work of the aging if they wish to be healthy and strong enough to really enjoy their elderly years.  Many seniors and elderly can expect to live much longer due to advances in health care, but longevity without quality of life isn’t much fun.  That is where exercise comes in. 

Exercise adds to quality of life in many ways.  It can energize moods, relieve stress and help manage the symptoms of illness or pain as well as improve the overall sense of well-being. Besides that it is a lot of fun!

Many people envision exercise as high powered and intense.  That is not what seniors and the elderly really need.  The aging do not require strenuous workouts to reap great benefits from exercise.  It really is about adding a variety of movement and activity to one’s daily life.  Having a healthy mix of cardio, strength training, flexibility and balance will improve overall health keep exercise fresh and fun. Here are some things to try:

ü    Cardio Endurance Exercise - Using large muscles in rhythmic motions over a period of time, Cardio will get your heart pumping.  Cardio doesn’t necessarily mean doing high impact aerobics but can include walking, climbing stairs, hiking, cycling, rowing, tennis, and dancing.  Benefits include lessening fatigue and shortness of breath and a general improvement in endurance.  Cardio improves overall endurance for daily tasks such as walking, cleaning the house and getting out and about independently.

ü    Strength Training Exercise – This type of exercise builds up muscles with repetitive motion using light weights or resistance bands.  Strength training for the elderly isn’t about pumping iron but more about preventing loss of bone mass and preserving muscle tone.  It also improves balance and reaction speed which is important in preventing falls.  Strength training will improve walking speed and gives that extra boost for making day-to-day activities, like carrying groceries or doing household chores, so much easier.  Strength training is important to maintaining independence long term.

ü  Flexibility Exercise – Increase flexibility through either stationary or full range motion stretches.  Keeping the joints and muscles supple means enjoying a full range of motion as well as guarding against injury.  Yoga is an excellent way to increase flexibility, stay limber and increase range of motion.  Flexibility is necessary for simple tasks like turning to look behind while driving, reaching for things over your head or near the floor and playing with the grandkids.

ü    Balance Exercise – Improve posture and stability, the ability to walk or move easily and reduce the risk of falls by working on balance exercises.  Tai Chi and yoga both use a combination of poses with breathing to work on balance.  This type of exercise will increase confidence and reduce the risk of falls.

Slowing down as we enter the elder years is really not a wise move.  The aging need to see that the ultimate goal is maintaining independence and enjoying their later years are best achieved through maintaining an active lifestyle with daily exercise.  Finding a combination of exercises that suits your abilities and needs will add immeasurably to quality of life and make the Elder Years a wonderful time.  













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.


Thursday, January 16, 2014

Exercise Excuses Used by the Aging

The Aging need to re-think their attitude about exercise 

Regular exercise needs to be a priority for seniors and the elderly.  The benefits of participating in a regular exercise program are many.

ü Adds to longevity and makes a vast difference in the quality of life for anyone in the aging population. 
ü  Boosts energy levels, improves mood and confidence.
ü  Speeds up a slowing metabolism and slows down weight gain.
ü  Increases mobility, flexibility and balance.
ü Reduces impact and risk of health issues such as heart disease, high blood pressure, osteoporosis, digestive issues and colon cancer.
ü  Improves sleep.
ü  Enhances brain power and helps fight against dementia and Alzheimer’s disease.  

The consequences for avoiding exercise for the seniors and the elderly are so many that it really is foolish to steer clear of it.  A sedentary lifestyle taken into the golden years is a recipe for illness, falls, hospital and nursing home bills and a premature loss of independence.  Yet over 75% of our aging population is not participating in some sort of physical activity.

Here are some commonly used excuses to justify not exercising.

ü  There is no point in exercising. I’m going to get old anyway.  The truth is that exercise will help you look and feel much younger than your actual years.  It will also help you stay active a lot longer too.  Regular exercise lowers the risk of many health conditions, including Alzheimer’s and dementia, heart disease, diabetes, colon cancer, high blood pressure and obesity.
ü  Older people shouldn't exercise too much.  They need to save their strength and rest. The truth is that a sedentary lifestyle is very unhealthy for adults over 50.  Inactivity leads to inability very quickly.  Sedentary seniors end up with more hospitalizations, doctor visits, medications and falls than active seniors.
ü  Exercise puts the aging at risk of falling.  The truth is that by building up muscle strength, and stamina through exercise you greatly reduce the risk of falls.  Also exercise prevents the loss of bone mass and improves balance making falls even less of a risk to the aging.
ü  It’s too late to start now. The truth is you are never too old to start exercising, even if it is for the first time in your life.  There are many slow and easy ways to start including walking, stretching, yoga, and then working up to low impact aerobics or even ballroom dancing. 
ü  I’m disabled and can’t really exercise sitting in a wheelchair. The truth is that chair-bound people do face special challenges but they can still lift weights, stretch and do chair aerobics.  All of these types of exercises will increase range of motion, improve muscle tone and help promote a healthy heart.

The truth is that exercise is the key to healthy aging.  Today’s seniors and elderly who wish to be proactive about their health need to get seriously active.  No more excuses!













Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly and disabled 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.

Tuesday, January 7, 2014

Quick Tips on Keeping the Elderly Warm

The Elderly suffer when arctic temperatures hit.

We all feel the cold when temperatures dip below zero, but our elderly loved ones truly suffer when arctic blasts blow through.  

The Elderly feel the cold intensely and have greater health risks when temperature drops.  They suffer more in cold weather due to having poor blood circulations in their hands and feet. Some medications thin the blood making matters worse. Inactivity and poor nutrition add to their bodies not handling the cold well.

What can be done to help?

ü  Keep thermostat set above 75*
ü  Wear layers of natural fiber clothing
ü  Use a throw or light weight comforter 
ü  Eat high calories foods & drink hot tea, chocolate or coffee
ü  Heat clothes in dryer before dressing
ü  Seal drafts in house
ü  Use a light hat & mittens to maintain body heat

Simple measures can really help keep your aging loved one safe and comfortable, especially during the bitter cold of winter. 











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.




Tuesday, December 31, 2013

Exercise for the Elderly

It is never too late to start.

George Burns, comedian legend who lived to be 100, used to say, “If I knew I was going to live this long, I would have taken better care of myself!” As more Americans enter their golden years they can begin to identify with the wit and wisdom of Mr. Burns. Most seniors today can expect a much longer life span than previous generations, yet longevity without quality of life is a major concern for this growing segment of the population.  The golden years are really no fun if you are hindered by a fail or sick body.

Regular exercise has been proved to be a key element to improving quality of life for seniors and the elderly.  Besides boosting mood and producing a feeling of well being, the benefits of exercise among this age group include improvements in blood pressure, diabetes, osteoarthritis, osteoporosis and neuro-cognitive function.  According to the American Academy of Family Physicians, regular exercise dramatically helps the elderly:

·      Fight off infection and sickness by increasing the function of the Immune System.  This makes recovery from illness less a strain to the aging body.

·   Reduce risk of heart disease and blood pressure by strengthening the Cardio-Respiratory and Cardiovascular functions of the body.

·    Increase bone density by curbing the loss of bone mass.  This reduces the risk of osteoporosis and broken bones due to falls.

·      Promote proper elimination of bodily waste and actively aids digestive health.  This aids in the prevention of colon cancer.

·         Lower the risk of Alzheimer’s disease, dementia and age-related morbidity.

·         Aid in the management of high cholesterol and arthritis pain.

If regular exercise protects from chronic diseases, improves moods and lowers chances of injury, why is it that 75% of older Americans do not participate in physical activity? Many elderly claim discomfort or disability as their main reason not to exercise.  Some fear injury but most have fallen into the habit of a sedentary lifestyle which they continue as they age.  Yet according to a Harvard Alumni study, increases in life expectancy can be gained by people who begin regular exercise even at the age of 75.  In fact they tend to outlive those who were physically active earlier in life and later gave up exercising.  In other words, it is never too late to start.

According to the American College of Sports Medicine and American Heart Association, there are three areas of physical activity that elder adults should concentrate on.

  • Aerobic Exercise - Thirty minutes of moderate to intense aerobic activity five days a week will increase the body’s cardio respiratory endurance and improve the delivery of oxygen and nutrients to tissues.  Aerobic activity includes anything that gets the heart rate up and requires faster breathing such as walking, dancing, jogging, biking or swimming.
  • Strength/Resistance Training - Strengthen muscles by working on all major muscle groups two to three sessions a week.  Strength training builds and tones muscles, prevents loss of bone mass and improves balance.  Strength training is done with repetitive motions using light weights, resistance bands or nautilus machines.
  •  Stretching/Flexibility Exercises - Maintaining flexibility and balance are essential in minimizing fall risks.  Stretching to warm up and cool down from exercise reduces muscle soreness.   Yoga and Pilates programs focus on developing a strong ‘core,’ the set of muscles dealing with the stomach, lower back and spine which help the elderly with posture and back pain.  Tai Chi or Qi Gong exercise uses slow controlled movements which promote balance.


Many elderly people may feel that starting an exercise program at their age is beyond their abilities.  By starting slowly, elderly exercisers can build up endurance, strength and confidence over time.  Those new to exercise should set obtainable goals and chart their exercise activity to keep their program on track until it becomes a habit.  Joining an exercise class especially designed for the elderly will help ensure that exercise is done properly, reducing risk of injury.  Also participating in a class makes exercise a fun, social event. With long range health as the goal, daily exercise is one thing that the aging can do to ensure their golden years are truly golden.










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 of Wisconsin.




Sources:
American College of Sports Medicine Position Stand.  Exercise and physical activity for older adults.  Med Sci Sports Exerc. 1998;30:992-1008.

AAFP, “Promoting and Prescribing Exercise for the Elderly” by Rober J. Nied, M. D. & Barry Franklin, PH.D.  Retrieved on 5/23/12 from www.aafp.org/afp.






Monday, December 9, 2013

Falls Are Life Changing Events

25% of elderly who fracture a hip due to a fall 
will die within 6 months of the injury.

The Facts are Frightening: 

  • Falls are the leading cause of death from injury for people 65 years and older.
  • The risk of falling increases with age. One-third of 65 year old people fall annually.   Half the people over 80 year old people fall every year.
  •  Two-thirds of those who have taken a fall will fall again within six months.
  •  The elderly account for over 75% of deaths that result from falls.
  •  Over 95% of hip fractures are caused by falls.
  •  Although the risk of falling is greater for women than men, men are 40% more likely to die from a fall than women.
  • Falls almost always lead to loss of independent functioning for elderly and most require life-long nursing care.
  •  Medical costs, due to falls involving the elderly, runs over $30 billion annually.
  • Even falls that do not result in serious injury have a psychological effect among elderly as they unnecessarily restrict their activities due to fear.
Although there isn’t one single reason an elder might take a fall, there are basic risk factors that often contribute to falls.  The more risk factors present in an elder’s life, the more likely they are to take a fall.  With falls being the number one threat to an elder’s independence, it is amazing that more people are not aware of these risks and the fact that they are mostly preventable.

Risk Factors to Falls:

·         Osteoporosis Porous bones are less resistant to strain and break easily.  Osteoporosis is the primary cause of fractures in older adults, especially among women, and is caused by hormonal changes, calcium and vitamin D deficiency and lack of physical activity.  Brittle bones can be prevented by getting enough calcium in the daily diet, sunlight or Vitamin D supplements and regularly doing weight-bearing exercises.

·         Lack of Exercise – Not having a regular exercise program results in poor muscle tone and loss of muscle strength.  Bone mass as well as general flexibility are also lost.  Regular physical activity increases muscle and bone strength and improves balance and flexibility.  With as little as 15 minutes a day, even those of advancing years can gain back lost muscle strength and decrease their risk of falls.

·         Impaired Vision – Many age related vision diseases can increase the chances of falls.  Cataracts and glaucoma change an elder’s depth perception, visual acuity, peripheral sight and vulnerability to bright light.  These limitations deter their ability to safely move in their environment.  Yearly checkups with an ophthalmologist will determine if any age-related diseases require medical attention.  Also using contrasting colors will help accent balance-aids making grab bars and handrails more noticeable.  Sometimes something as simple as daily cleaning of eyeglasses can make a dramatic improvement in vision and is an easy preventative measure.

·         Medications – The elderly usually take quite a few different medications and many of these can contribute to falls.  Sedatives, anti-depressants, and anti-psychotic drugs reduce mental alertness, cause dizziness and drops in blood pressure.  People who take multiple medications always have a greater risk of taking falls because the meds affect their balance and gait.  Knowing the common side effects of medications is a good place to start, but for the elderly it is wise to discuss ways of reducing fall risks with the physician or pharmacist.  Ask for an assessment of medications from the physician. Taking the lowest effective dosage, knowing the interactions between various medications and over the counter drugs and getting rid of out of date medications is also necessary. Also consider using walking aids while taking medications that impair balance.

·         Environmental Hazards – Most falls happen at home and the majority of those are due to tripping over something on the floor, such as throw rugs or electrical cords.  Poor lighting, lack of grab bars and cluttered environments also play a role in these falls.  To reduce the possibility of falls do a walk-through of the home looking for problem areas or have an occupational therapist look at the home and assess areas of risk.  Age proof the home as a preventative measure against falls and other accidents.  For practical tips on age proofing the home see HomeAid Health Care Elder Topics Blog http://homeaidhealthcare.blogspot.com/.

For the elderly, falls are life changing events.  Beyond the pain and fear resulting from falling, the majority of elders who are injured are not allowed to return to their previous lives.  Injuries mean long stays in hospitals, rehabilitation centers and hours of physical therapy.  Fears and concerns over repeat falls often mean moving to an institutionalized setting and dramatic loss of independence.  For many, the injuries resulting from a fall is the trigger than starts a decline that leads to death.  Preventative intervention to reduce risk factors will greatly reduce opportunities for falls and fall related injuries and can be the key element that maintains an elder’s quality of life.










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:
“Falls Among Older Adults: An Overview” by Center for Disease Control & Prevention. www.cdc.gov/injury/wisqars.com Accessed 11/21/13. 
“Fall prevention: 6 tips to prevent falls” by Mayo Clinic staff, www.mayoclinic.com/health/fall-prevention.com.  Accessed 11/21/13.
“Preventing Falls in the Elderly” by K.R. Tremblay Jr. and C. E. Barber, www.ext.colostate.edu. Accessed 11/21/13.