Senior Care Corner is the source for insights and tips about caring for senior adults, whether you are doing so at home (either yours or theirs), remotely if you live at a distance, or if your loved one resides in a nursing home or other residential facility.
Technology is the part of everyone’s life including our senior loved ones.
They may not have been early adopters or seek to use technology in the way younger adults have, but that doesn’t mean they aren’t using it to their benefit.
Are they using digital therapeutics? Do they (and you) even know what it is all about?
Digital therapeutics (DTx for short) is a health process and treatment option that utilizes digital, and often online, health technologies to treat a medical or psychological condition.
Digital therapeutics is considered a subset of digital health.
Digital Therapeutics & Chronic Disease
DTx is used for the prevention and management of a wide variety of diseases and conditions including type II diabetes, congestive heart failure, obesity, Alzheimer’s disease, dementia, asthma, substance abuse, anxiety, depression, and several others.
Because seniors’ rate of chronic disease surpasses the younger population, DTx seems like an ideal solution to help them manage chronic disease and improve their quality of life.
While prevention is a goal of DTx, for many of our seniors the primary benefits will come from disease management and avoidance of emergency health crises.
What Can DTx Manage?
DTx for chronic disease management uses a variety of digital devices, such as a computer, smartphone, or tablet. It can be achieved using an app or a software program.
Devices that stand alone, have peripheral components or sensors, or work in collaboration with other technology are essential for delivering digital therapeutics.
These are some of the chronic diseases that are currently being targeted by DTx applications and may be useful for senior loved ones.
Chronic and Acute Pain Control
Neuromuscular control and physical therapy
Engaging Digital Therapeutics
Family caregivers and seniors will need to engage DTx in order to gain the benefits it promises. Both will need to interact with it, modify their behaviors as a result, maintain adherence to health treatments, and as time goes on may be able to replace certain therapies being used including drugs.
DTx will increase the level of accountability caregivers and seniors have and encourage them to become more in control of their health. Whether they follow their plan is more evident when they are being remotely monitored. Consequently, their health outcomes will improve.
However, other members of the healthcare team must also adopt it in order for our seniors to use it. Healthcare professionals are aware of the solutions that DTx will provide as there are currently so many useful applications already approved by regulatory agencies.
Adoption Low Among Healthcare Providers
While many healthcare providers are willing to use DTx applications, the current rate of adoption is relatively low. There are some obstacles for providers including reimbursement, clinical evidence of benefits which is coming but lagging at the current time, and continued knowledge gaps.
Most providers want to add DTx in combination with current therapies as they need more trust in the process and benefits for them to use as a sole intervention or as an alternative to drug therapy.
At the present time, digital therapeutics is primarily a function of monitoring vital signs, data and adherence to the treatment plan. But the potential for it to benefit seniors is powerful.
As healthcare providers begin to rely more on testimony of the usefulness of DTx until the scientific research can be completed, more will initiate it with the aging patients. Payers will likely hold their reimbursement until more robust science-based evidence is available.
Education of both providers and users is paramount to the adoption of DTx but the devices and apps must be user-friendly too.
Results of Research
The Consumer Technology Association (CTA) recently published a report “Assessing the Landscape for Digital Therapeutics.” Their findings show how much further this technology needs to come before our senior loved ones will reap the rewards of adoption.
The number of doctors who have “heard of” digital therapeutics, according to their survey is surprisingly low — with neurologists at 37% (example: pain control) and endocrinologists at 57% (example: diabetic monitoring). Those surveyed who are using some form of DTx is also relatively low – for neurologists it is 30% and endocrinologists 43%, but never used is 70% and 57% respectively.
They propose this definition of DTx in order to make it clear to consumers, healthcare providers, payers and industry insiders:
Digital therapeutics harness the power of technology to impact health by enhancing traditional medical practices, encouraging behavior change and, in some instances, serving as a direct, stand-alone therapy for a health condition.
Digital therapeutics are validated by clinical evidence to demonstrate an effect on health outcomes for specific treatment pathways, as well as primary and secondary disease prevention.
Making Digital Therapeutics a Reality
Experts agree that as the aging population gets more tech savvy using smartphones and apps, DTx will be more widely accepted by caregivers and seniors as a path to wellness as well as healthcare providers.
There is little question that digital therapeutics has tremendous potential to help family caregivers and their senior loved ones control and improve their health by putting them in the drivers’s seat.
The healthcare providers, payor entities, regulatory bodies, and manufacturers will need to facilitate how best to fully implement digital therapeutics to help seniors remain healthy using secure, effective applications.
We must overcome approval, reimbursement, and awareness for these systems and devices to benefit our senior loved ones.
Technology and the willingness to learn isn’t the obstacle anymore, as many thought in the recent past. Putting the necessary applications into the hands of caregivers and seniors and enabling providers to use it so that health can be managed is now in need of a push to make DTx a reality for more seniors.
Family caregivers are challenged everyday when caring for their senior with dementia – frustration, anger, tears, and refusals.
Alzheimer’s disease is the leading form of dementia, affecting as many as 5.5 million people in the United States alone.
Day to day caring can often be difficult when the progressive neurological disease worsens over time.
It has been said it’s our reaction to a person with dementia that needs to change in order to be the best caregiver possible and that caregivers need to stop expecting their senior to change. The senior with dementia is not the person they once were and won’t revert back to someone they used to be if we push them harder or wish it to be true.
Caregivers will get better results and improve the quality of their family life if they change their expectations and began communicating differently.
Better Communication for Caregivers
Here are some tips for family caregivers to better communicate with their loved ones who have dementia. These practical solutions will help you change the way you react and interact with a senior with dementia.
When family caregivers begin practicing these steps, they can reduce caregiving stress and avoid the arguments that all too often accompany families dealing with dementia.
10 Absolutes of Communicating through Alzheimer’s Disease
Never argue, instead agree
Enter their reality by agreeing no matter what they might say. “The sky is green.” “OK. Maybe tomorrow it will be blue.” You will not win an argument against the sky is blue or that the food is too salty (when it isn’t) or that someone took his slippers (when they are at the foot of the bed).
Go with the flow.
Tell therapeutic lies if you need to in order to agree and not argue. “Yes, I see the sky is green.” Therapeutic lies may not come naturally to you but honing your skills at this great tool in your toolbox will definitely help you navigate daily challenges.
Never reason, instead divert
Similar to arguing with a person with dementia, trying to reason with them about a particular idea they hold strongly will not end in happiness for either of you.
You won’t be able to talk them out of their belief, no matter how long you debate. It is best to change the subject or divert their attention onto something else.
They will rapidly forget what they held fast to and you can both move on to other things. Example: “I need to go home, will you take me home now?” Instead of “Mom, you are home” you should try “I understand you want to go home. How about we get you cleaned up first with a warm shower and some clean clothes before I take you home? Won’t that feel better to go home in a fresh outfit?”
After a shower it is time for a snack – – and then they may forget about going home.
Never shame, instead distract
When you and your senior are completing a task and he/she seems to be having trouble following the steps necessary to complete it, don’t say “hurry up, can’t you go any faster, what’s wrong with you, you know how to do it!”. Instead model what they are trying to do. Untie and retie your shoe, for example. Talk through each step and have them mimic you.
If this is too difficult for them, it is best to no longer expect them to tie their shoe. Perhaps it is time to use only slip-on shoes. Otherwise, you tie their shoe for them and give them something to distract them from their shoes while you put them on, such as folding their sweater so they will be ready once you are done with their shoes.
Never lecture, instead reassure
It is hard for family caregivers to remain calm all the time. We are tired, stressed, sad, and dejected sometimes when dealing with our senior with dementia.
Lecturing them or telling them what to do in no uncertain terms won’t help them. Reassuring them that you can do it together or they can do it or they will be safe or that you love them is important for them to hear.
They may not remember that you love them and are there to help them every day without constant reminders. Sometimes reassurance comes in the form of a hug, a smile, or a gentle touch — not just our words.
Never say “remember,” instead reminisce
They don’t remember – remember? Asking them if they remember where they lived or what year they were born will make them frustrated or sad or depressed that they can’t remember.
It is better to say “When we visited your parents home in New Jersey, we picked those same yellow flowers. You and your mom used to love picking flowers together just like we do.”
Share their stories with them and let them fill in any details they do remember. If they make up some details, that is OK too because they are engaging with you and being in the moment matters.
Never say “I told you,” instead repeat
People with dementia will have difficulty remembering directions or the steps to complete a task. Sequencing is a cognitive function lost early in the disease process.
Being unable to remember how to brush their teeth is frustrating for them. If they can’t remember the steps to brush their teeth even after you have reminded them it is time but don’t seem to be getting it done, using your words to badger instead of support them will only frustrate them more and may end in aggressive behavior.
Give one step at a time in the most basic directions. “Pick up the toothbrush. Put a dab of toothpaste on the brush like this. How about a little water on the paste now? Let’s just put a drop on it under the faucet. OK, now put the brush in your mouth and rub your teeth. That’s right – up and down, touch all your teeth not just the front. All done? OK spit out the paste and we’ll get a drink. Don’t forget to rinse off the brush. Put it back here in the glass so we can use it later. Doesn’t your mouth feel good?”
Having to give them this much verbal cuing for a daily task will definitely take more time from your day as you allow them to stay independent, but meaningful activity will help them and you in the long run.
Never say “you can’t,” instead do what they can
Being negative isn’t productive and they will resist you all the more. Give them all the opportunities to be successful doing tasks that you can including setting them up with all the pieces no matter the activity.
Role modeling the task, giving verbal cues, keeping everything in their reach and praising their efforts will make these daily tasks easier.
Never demand, instead ask or model
Show them the way. Don’t push them into doing something they no longer are capable of doing.
Abilities to complete tasks, remembering steps, making their hands move just right and even being able to stand long enough to finish something is lost as dementia and functional status declines.
Never condescend, instead encourage
Positive reinforcement and a loving tone will lead to more success than berating them out of your own frustration. Encourage, don’t discourage.
Sometimes our body language or facial expressions do all the talking. Be aware of what your body is saying too so you don’t get resistance.
Never force, instead reinforce
People with advancing dementia have trouble making decisions. It is best not to try to force them to come up with what they want without giving them a simple choice.
For instance, when deciding what is for lunch. Don’t just say “what do you want for lunch today” and get angry when they have no idea or they become frustrated and refuse to eat anything. It is better to say, “we will have lunch in 20 minutes. Would you like a turkey sandwich or a tuna sandwich today”?
They will be much more likely to answer that simple question and remain calm enough to actually eat it. You can prepare all the rest of the items without their input. Perhaps they can set the table with napkins while you do the sandwich making.
Praise their response to reinforce what you want from them. “That is a great choice, we both love tuna on toast. Thanks!”
Plan for Things to Take More Time
Admittedly this approach will take you more time and you will need to plan accordingly. You won’t be leaving the house in 5 minutes anymore or finishing a meal in 15 minutes. Everything will probably take longer for you both.
That is OK because what you are trying to do is facilitate their ability to do as much for themselves as they can while reducing frustration and aggressive behavior. Try to remember the adage “it isn’t them, it’s the disease”.
Caring for a person with dementia will bring new challenges each day. How you approach each new challenge will determine your success and keep you from being overwhelmed.
Understanding that you can handle the situation, communicate more clearly and have a better relationship with your senior with dementia will make your caregiving experience a little easier.
Most of us don’t choose to be caregivers, it is often thrust upon us. How you react is in your control!
We love life and want it to last forever, but the reality is that our time on earth is finite.
No one knows when the end of life will come for themselves or the ones they love, so being prepared to face it as we want and with dignity requires us to plan for the eventuality.
Facing the multitude of decisions that accompany the end of a loved one’s life can be overwhelming and heart wrenching for family caregivers and their senior loved ones.
Everyone has the right to create their own end of life plan, to withdraw or refuse medical treatment or to choose pets, visitors, or music to surround them near the end.
Everyone has the right to make his or her own decisions until such time when they are no longer capable and need someone to step in for them.
But how do we as family caregivers approach our seniors to make these decisions?
How can we learn what decisions for the end of life our senior’s may have already made?
This is one of the toughest conversations families will have but one of the most important for them to begin.
Legal Aspects at the End of Life
(Please keep in mind we are not attorneys and not providing legal advice. If unsure about laws or legal process where your seniors live, you should contact an elder law attorney or other legal expert.)
In addition to the straightforward tasks of planning for the end of life such as funeral arrangements, absolution of your senior’s personal possessions or finances or saying goodbye, it is important to ensure your senior’s medical directives are executed according to their wishes.
Here are a few documents that should be created and may require advice of experts like elder law attorneys to be sure they are done in accordance with the laws of the state where your senior resides. They will dictate whether specific treatment is used, withdrawn or withheld based on the wishes of your senior loved one.
These advance directive documents will be used when your senior is unable to speak for themselves.
Durable power of attorney for healthcare and/or finances
Who will be named proxy to control the decisions made for your senior when he/she can no longer make them? Who will pay your senior’s bills if they can’t? Who will make medical decisions in your senior’s place when he can no longer to express himself? Who will protect their rights for them? Who can be trusted?
These are questions for your senior to answer through the creation of durable powers of attorney for their healthcare and financial decisions.
Does your senior wish to have CPR if their heart stops or to have artificial means to remain alive? Are they well enough to survive chest compressions? Do you know their opinions on this?
A DNR only orders what will happen in the event their heart stops beating. It doesn’t decide if antibiotics or IV fluids will be given or if the healthcare team will give up on them.
This is an advance directive that will express your senior loved one’s desire about what medical interventions will be used to keep him alive. It can detail his or her wishes for the use of mechanical ventilation for breathing, if a tube feeding will be used to keep them alive (artificial nutrition or hydration), or if other (or any) heroic measures should be used.
These documents are witnessed by one or more individuals according to state regulations so check with a professional to be sure they are completed correctly.
Five Wishes is a document that is specific to a variety of different items that you and your senior may not have yet considered. They include decisions such as those contained in a living will but also other more personal things to be done at the end of life.
Considerations such as if they wish to die at home, if they want their pet on their bed, who should and shouldn’t be asked to visit, what music they want in the room to soothe them, what types of personal items they want nearby such as pictures of deceased spouse or certain flowers, and a host of other items.
This document will help them transition with dignity and guide caregivers to making their end more comfortable.
Don’t Just Put Advance Directives in a Drawer
None of these documents are written in cement and can be changed at any time, as long as your senior loved one is still of sound mind under the law. As a matter of fact, they should be reviewed regularly to be sure nothing has changed including the designated proxy.
Copies should be given to family caregivers and healthcare providers so that your senior’s wishes will be followed when the time comes.
Learning Senior Loved Ones’ Wishes
Older adults have probably already thought about what their end of life desires will be. They likely have dealt with family members and friends who have faced end of life.
Death with dignity is the goal for most of us, including our senior loved ones.
It is important, therefore, that family caregivers take the opportunity to learn what their senior’s wishes are and how you can advocate for them in the future.
Start the conversation with them to see if they have documents created, where they are kept and if you can read them for the purpose of understanding not changing their minds.
If they don’t have these documents executed, can you help them do that?
Completing Advance Directives
Each state has its own unique forms for advance directives. You can request a copy of your state’s forms using this locator from AARP.
Here are some questions to ask your senior when considering what to document in their advanced directives:
Do they want nature to take its course or have healthcare professionals perform heroic measures that can lengthen their life even if it could be considered futile?
Do they want their heart to be restarted or a tube down their throat breathing for them?
Do they want a tube placed in their stomach providing them with nutrition and fluids when they can no longer eat or drink for themselves?
Do they want to die peacefully and with dignity?
Where do they want to spend their final days — at home, hospital or hospice facility?
Would they prefer to receive comfort or palliative care at the end of their life instead of aggressive care?
Remember, while you may help them, it is important the answers be theirs to the advance directive reflect their wishes.
In the Event of An Emergency…
If your loved one has not made these wishes clear in a legal document, you may be asked to make some hard choices for them when the time is all too quickly upon you. That is why it is so important to learn as much as you can about their wishes now.
Talking with family members, including siblings, spouses, and other close relatives, who may have had conversations with your loved one along the way about what they might want done for them even if it was never put in writing can help you decide what is the best choice if you are called upon to decide without prior knowledge of your own.
Ask yourself-is this what he/she would want? Would they want to live this way?
If you don’t make some of these decisions quickly or if you are not prepared to respond, healthcare professionals will have to make them for you in the interest of life saving. Oftentimes, this is the very moment you need support and understanding to deal with your own emotions in the event of an emergency.
Before the Time Comes
Talking openly with all your loved ones about what their wishes are before the time comes, creating a document to record these wishes, and honoring their wishes when the time does come will not make the pain go away, but hopefully make it easier to deal with at that time.
Keep your senior’s advance directives, will and other financial documents like insurance information and burial arrangements in an easy to access place or supply a designee with copies so that they are where they can be reviewed as quickly as possible when needed.
You can prevent having to make tough choices by keeping the line of communication open with all your loved ones. Don’t be afraid to talk about death and dying, it is a natural part of life and unavoidable.
We believe there is a place in seniors’ homes for technology.
Technology innovations can also help family caregivers take better care of their senior loved one.
In many ways, family caregivers are still unsure where technology could help them.
Would installing smart home features be the best use of their money or paying for medical devices? Would a personal emergency response system be important for their senior’s safety at home?
Technology often will be purchased and maintained by caregivers, so they are the drivers of obtaining technology innovations.
The reality is that each caregiving situation is different, each senior loved one unique and how the family adopts technology is diverse.
What will work for one aging in place situation won’t necessarily work in another one. In fact, what works for one parent may not work for the other living in the same house.
Caregiving Technology Platforms
What technologies will family caregivers use?
Which innovations will solve their daily challenges to give them back some time and lift some of their burdens?
A recent study from Project Catalyst (of which AARP is a member) tried to help determine what works for caregivers of seniors and what doesn’t so that future innovations can help instead of hinder.
This report, Designing Technology for Caregivers: Understanding What Works and What Doesn’t, includes insights from the results of three recent pilot tests of how technologies can help caregivers overcome three specific challenges: care coordination, emergency alerting and selecting and hiring in-home aides.
Caregiver Technology Study Results
In this study, caregivers were given one of three platforms to evaluate.
Many family caregivers have some type of system that they use to keep track of a variety of different bits of data. Some use computer programs to manage medication lists, contact information, important documents, insurance information and doctor’s appointments. These computer programs were not designed for caregiving, just data processing. Other caregivers use the old-fashioned way – paper and notebooks (well, not really old fashioned!).
In this study, caregivers were given a smartphone platform designed specifically to manage aspects of caregiving.
For those of us who have tried these types of platforms, the results were not surprising. Caregivers didn’t like the functionality or effectiveness of the platform they tested and went back to their prior organization method. They reported that the platform didn’t meet their caregiving needs.
Personal Emergency Response Systems (PERS)
Family caregivers worry about the safety of their senior loved ones. 75% of family caregivers say they would like to have technology that allows them to check on the safety of their seniors remotely. However, in this survey group, none of them has used a PERS type system before.
Concerns of cost, awareness of the benefits, and stigma of this type of product reportedly kept them from using it. After using the PERS for 6 weeks, 85% felt that their peace of mind improved as a result of using the PERS and 90% of care recipients felt more independent in terms of their safety and well-being.
In-home care is an option many family caregivers use or strongly consider using. How to safely hire in-home care can be an obstacle for many caregivers. Would hiring a home aide online make this process easier for caregivers and give them a level of comfort knowing the workers would have background checks, proper vetting, and could be easily scheduled?
During the study, caregivers were given access to hiring in-home caregivers online. After using this platform, 82% found a suitable home aide and 100% of those caregivers were satisfied with the care they got online.
Future of Technology for Caregivers
Technology is without question going to benefit caregivers who will find ways to incorporate it into their daily routines. It has already become important to many caregivers in both big and small ways.
71% of caregivers express their desire to use technology while only 7% of caregivers are using any of the products currently on the market, according to Healthcare Innovation Technology Lab (HITLAB).
A serious concern is that the problems for which there are technology solutions aren’t necessarily the problems family caregivers say are their most pressing.
It will be important moving forward for caregivers to have input in technology solutions before they are produced or as testers before they go to market.
As we’ve seen in this study, 2 out of 3 solutions were viable but one fell flat. The problem when a product that is supposed to help caregivers is more trouble than it is worth is the potential for that caregiver to stop trusting technology. As a result, they will miss benefits of other useful solutions.
Time and Money Both Key for Caregivers
It isn’t just wasting time but money, too, that will keep caregivers from adopting beneficial technology for senior loved ones. Family caregivers are the ones buying the technology in hopes of getting peace of mind, safety and time.
Caregivers need affordable solutions that yield value. Cost is reported by a majority of caregivers as an obstacle to adopting technology.
Caregivers also don’t feel that they have the time to learn about what new technology is available, what they need, which product will help fill their gaps, how to get it and start using it and fear it won’t be any better than what they are doing now.
These are all barriers to them adopting the latest technology.
Tech Growing in Importance to Caregiving
Experts feel that as the average age of caregivers continues to lower, the use of technology will grow because this age group is already engaged with technology.
Interoperability remains a concern for caregivers, given . the variety of technology platforms and devices available now and in the future. One example given was a medication management system that tracked which medications were used but was unable to have them refilled, especially if not coming from a single provider. They may keep data in a calendar, but they want that calendar to communicate with all family caregivers and paid caregivers to keep everyone up to date.
Even more important is that these technology platforms will be able to change with needs as time goes on.
Everyone agrees that technology should relieve caregivers’ burdens, not add to them.
How exactly can technology achieve this more seamlessly? Most expect this will happen only when tech companies and caregivers communicate and then collaborate so solutions for these needs are actually created.
Having to take many pills each day, sometimes several times a day, can make it very difficult to do it correctly.
When seniors don’t get it right, the outcome can be deadly.
It has been estimated that 60% of seniors take their medications incorrectly. This results in almost 140,000 deaths a year. For others, making mistakes taking their pills can impact the effectiveness of their medications.
Common Medication Mistakes
Statistics show that nearly 70% of seniors have at least one medication, 50% take at least two medications, and 25% take five or more medications (that number jumps to 46% if your senior is over 70).
These numbers are just the prescribed medications and don’t include a multitude of over-the-counter aids or supplements many seniors use daily. It isn’t uncommon for some seniors to be taking more than 20 drugs a day.
We shouldn’t be surprised that seniors use more pills and potions of all kinds than any other age group.
That is a lot of pills to remember to take correctly. Here are some common examples of what can go wrong.
Skipped doses – 1 in 4 seniors skip a dose
Failure to fill a prescription
Taking drugs at the wrong time or wrong dose such as forgetting to cut in half
Eating a food or beverage that will interact with a medication
Not monitoring vital signs when needed before dosing like blood pressure or sugar
Mixing up similar medications taking them at the wrong time or in the wrong amount
Not informing all doctors or health professionals about what you are taking which may result in double dosing or interactions
Stopping a drug because they think it isn’t working
Not paying attention to side effects that could be creating medical problems.
It is very important that seniors and family caregivers recognize any adverse reactions when taking medications. Adverse reactions due to medication administration errors or new drugs can be very serious, including falls, depression, confusion, hallucinations and malnutrition.
In addition, memory loss and vision impairment caused by mismanagement of prescriptions can lead to more problems including continued medication errors.
Tips for Family Caregivers
With these tips, family caregivers can help senior loved ones manage their medications.
Listen to the instructions from your senior’s doctor or pharmacist. If you have any questions at all, ask until you and your senior fully understand. Read the drug facts label and package inserts to learn more about your senior’s drugs.
Bring all medications to the doctor once a year so that the medical professional can review each one to ensure they are still appropriate and no interactions exist.
Keep a current medication list, including full name of the medication, dosage, and time so that it can be used at each medical visit and emergency healthcare situation.
Talk to the pharmacist. This professional can check for potential interactions, put pills in easy to use and read containers, and give you any information you need to learn more about your senior’s drugs including the over-the-counter pills. Using one pharmacy will help keep your records clear and avoid interactions.
Set up pill boxes for your senior. It can be weekly pill boxes that are found in all drug stores or monthly like the Pillrite. This product includes a medication list and emergency information. (We were able to test the Pillrite and our senior tester loved the ease of filling, med list info, unique way the week pillbox opened for filling and the way AM and PM were separated.) Pillrite also has an informative video if you would like to learn more about this effective product. In addition to these pill boxes, there are also smartphone apps linking to their pillbox that caregivers may like that gives remote alerts when pills are not taken as they should.
Be sure medications are stored properly especially if it should be refrigerated. Also read the label instructions to be sure it is taken properly – with food, not with milk, after a meal, with full glass of water, etc.
Medications can be life saving for our senior loved ones and contribute to the highest quality of life.
Proper administration of medications will help them attain their goal of healthy and independent aging.
Family caregivers have many responsibilities caring for their senior loved ones that can quickly drain their time (and energy) each day.
They are chauffeurs, schedulers, cooks, house cleaners, dog walkers, comedians, history keepers, pill managers, and grocery shoppers, just to name a few of the hats they wear every day.
Keeping senior loved ones fed, healthy, clean, and in good spirits can take a lot of time and effort for family caregivers.
Whenever there are things that make all these job duties a little easier, it is important to share the good news and help caregivers gain the gift of some time for themselves by lightening their daily load.
We have found something that we think might help some caregivers take less time dressing, toileting, and cleaning their senior loved ones each day and night.
Adaptive Clothing to the Rescue
Have you heard of adaptive clothing?
Adaptive clothing, by definition, is designed for people with physical disabilities who may experience difficulty dressing themselves due to an inability to manipulate closures, such as buttons and zippers, or due to a lack of a full range of motion required for self-dressing.
It can also benefit seniors with cognitive impairments who no longer recognize what to do with closures or have behaviors that might lead to challenges getting or staying dressed.
Seniors and caregivers need function in all things especially clothing. A little style would be nice too.
When seniors have impaired mobility, joints become stiff, or they are unable to button up their shirt or zip their pants without help, adaptive clothing can help caregivers and seniors.
When seniors can no longer dress or toilet themselves at all, getting them ready for the day or keeping them clean and dry can be a real struggle for tired caregivers.
That is why clothes that make these jobs easier could be a great solution for many family caregivers.
Benefits of Adaptive Clothing
There are many reasons why specially designed clothing could help your senior.
Seniors who have arthritic hands and difficulty with the closures in most clothing, including buttons and zippers, can be more independent wearing clothes that use Velcro, snaps, or easy to pull zippers.
Some seniors who have cognitive issues are often unable to dress themselves. Perhaps your senior loved one enjoys disrobing during the day and you must constantly put them back together. Specially designed clothes can help them get and stay dressed.
When seniors are incontinent, they may need to be changed more frequently, which means more frequent dressing and undressing. Seniors may be unable to position themselves or have impaired mobility which makes toileting almost impossible and requiring even more hands-on care by the family caregiver.
Here are some examples of clothing modifications that can be found in adaptive clothing that will make caregiving slightly easier for you.
Closures that allow seniors to manipulate themselves
Full zipper backs to keep them in their clothes with no worry of disrobing
Secure closure tabs
Elastic waist bands for comfort
Easy care fabrics
Fabrics that ease sensitive skin, such as 100% cotton
Fabrics and stitching that withstand frequent washing, especially for incontinent seniors
Pants with long zipper on both sides for ease of dressing
Snaps instead of buttons for arthritic fingers
Cut out seat for non-ambulatory seniors for easier changing when incontinent
Socks that are made wider for swollen feet
Non-skid slipper socks
Shoulder snap closure bedclothes
Slip on or adjustable shoes with nonskid soles
Easy to pull over the head or easy to step into styles when joint pain or balance issues are present
Simple designs without belts and buckles
Built in moisture barriers for incontinence
Adaptability With Style
Adaptive clothing that is comfortable for your senior, easy to use and wears well can also be – and should be stylish.
Everyone feels better when they look nice and shouldn’t have to settle for wearing PJ’s or over-sized T-shirts every day because that is all they have when specially designed clothes are available.
There are many beautiful colors, fabrics and styles including V-necks, patterns and a rainbow of colors available in adaptive clothing.
There are styles specifically for men and women or unisex products. There are jumpsuits, separates, shoes, socks, underwear, night clothes, Capri pants, and many other available products from which to choose and meet your senior loved one’s needs.
There are more and more manufacturers creating clothes that can accommodate a variety of special needs and more will come as the demand for them increases.
Adaptive clothing may be a bit more expensive per item than standard clothing, but their utility and improvement in your daily caring will be worth it.
Here are some more examples of adaptive clothing for women and men at Amazon (affiliate links, as are pictures).
“Have patience. All things are difficult before they become easy.” ~~ Saadi
Family caregivers are quickly learning how valuable technology can be in their everyday lives as they are caring for their senior loved ones and their own families.
They are asking Alexa or Google Assistant to lend them a hand by turning on soothing music, switching on the lights in a dark room, or even ordering dinner when they just don’t have time to cook.
But there are other ways that using technology can help family caregivers provide optimal care for seniors especially with regard to their health and well-being.
Enter telehealth – – but what is it?
Principles of Telehealth
Telehealth is a fast-growing way in which medical professionals of all specialties are using a broad variety of technologies and tactics to deliver virtual medical, health, and education services.
In fact, the 2017 Telemedicine and Digital Health Survey found that 53% of providers planned to offer telehealth medical services in the coming year which is up from three years ago when 87% of healthcare providers did not think patients would begin using this technology.
Virtual health care can help family caregivers get the prompt medical attention their seniors need without the struggle of appointments, transportation, waiting time, or other hassles that make visiting the medical team impossible for many at times.
Seniors and Doctors
Unfortunately, as many family caregivers are acutely aware, seniors often are scheduled to visit a variety of medical professionals regularly.
Regular checkups, prescription refills, follow-up appointments, blood work, medical procedures, imaging studies, and other preventive care appointments keep seniors (and, in many cases, their family caregivers) forever sitting in waiting rooms. Let’s not forget, routine visits to the pharmacy to fill prescriptions or to refill their over the counter health remedy choices.
There are medical doctors, nurse practitioners, podiatrists, cardiologists, renal doctors, dentists, eye doctors, gerontologists, endocrinologists, dietitians, care coordinators and many other medical professionals that our seniors need to see on a regular basis to manage a multitude of chronic diseases.
There are many trips back and forth and time spent waiting to stay healthy. The more appointments there are, the less patience we all have when dealing with getting there, waiting, and finally returning home. It is burdensome for both seniors and their caregivers.
Is there a better way? Telehealth for seniors may be an answer to the prayers of family caregivers.
Telehealth – Digital Health
Using telehealth can reduce the amount of time spent waiting and will definitely reduce the wear and tear of transportation on seniors and family caregivers, not to mention the family car!
When technology can be engaged to monitor vital signs such as blood pressure, weight changes, blood sugar, pulse, oxygenation status, and heart rate, doctors require fewer visits and hopefully the number of health crises requiring a hospital visit will decline.
How desirous is a regular health exam from the comfort of your senior’s home?
Improvements in telehealth mean that medical professionals can do even more than checking blood sugar. With telehealth, they can monitor cardiac status with home EKG, adjust medications or dosages to prevent health crisis, monitor adherence to diabetic therapy, monitor sleep patterns, provide rehab services post stroke, and administer life-saving treatments, and give mental health counseling all virtually.
Real Time, Any Place Care
The beauty of telemedicine is that it is connecting seniors and healthcare professionals in real time!
Would your senior like to wear a t-shirt that measures their cardiac function and can detect altered heart rate, atrial fibrillation, and stroke? It’s coming!
In addition to providing routine medical care via virtual consults in rural areas where there are often few medical professionals, doctors will be able to perform surgery virtually when there may not be trained professionals in the right location to meet the needs of seniors.
In emergencies, EMTs and paramedics can use telehealth via apps to help diagnose and treat seniors in the field. This type of new app can allow hands free care by emergency personnel as they use voice control to get treatment plans from the app tailored to the specific needs of the emergent situation.
Virtual reality technology will add to the abilities of healthcare professionals to provide care and treatment out of the office and in the home.
Changes to Reimbursement Opens the Door
“Who will pay for telehealth?” has been a major obstacle for health professionals providing digital health and remains an obstacle for many practitioners.
Health professionals are licensed in the state where they reside or their office is located, so providing virtual care across state lines has been a major stumbling block for who wish to offer this care. Many health professionals are asking for national instead of state licensure to solve this issue.
State laws covering informed consent are also obstacles for the use of telehealth. Some states have dropped the requirement for informed consent of telehealth care.
Insurance providers, including the government who reimburses a majority of seniors through Medicare and Medicaid, historically will only pay the bill when the care was delivered from a clinic setting to another clinic setting, which means home visits weren’t covered.
Family caregivers need these rules and regulations to change and have reimbursement policies up to date with current technology for the benefit of seniors.
Doctors and other health professionals have been reluctant to engage with digital health solutions because they haven’t been paid to read the streams of data digital health devices and apps are generating each day. Given all the demands on the professionals’ time, it isn’t feasible for them to read emails, texts and vital sign data when they don’t get paid for it.
Reimbursement changed as of January 1, 2018. Medicare and Medicaid will begin reimbursing physicians. “Clinicians should use digital tools in such a way that allows them to provide ongoing guidance and assessments for patients outside of the in-office visit. This includes the collection and use of patient generated health data.” This will inevitably lead to more physicians encouraging seniors to begin making use of digital health.
Even the Food and Drug Administration (FDA) is being pushed to approve medical devices and telehealth service platforms to help move this tech innovation into more accessible reality.
Seniors Benefit from Telehealth
Who wouldn’t want medical care and treatment available to seniors on a 24/7 basis not just during office hours.
Preventing hospital stays, reducing ER visits, avoiding doctor office waiting and transportation logistics is worth the learning curve that using technology for health may have for some seniors and caregivers.
Seniors can get checkups via telehealth so they don’t have to sit in the waiting room for what feels like hours. Face to face visits can be done virtually using technology.
Emergency first aid with a trained health professional will mean we can keep fragile seniors out of the emergency room as much as possible.
Using digital health tools such as mobile health applications, remote patient monitoring and personal health records will improve access and ultimately the health of our senior loved ones.
Getting them connected should be on family caregivers To Do list this year!
CES 2018 — the big innovation showcase — is history, the sore feet are rested, and we’ve had a chance to ponder the implications of everything we encountered.
It is still exhausting to think of it all!
We found a lot to like for family caregivers of senior adults, some of it here now, much more to be available in the months and years to come. There were also a number of things about which we want to learn more (and will) so we can provide you deeper insights.
Rather than discuss individual products or ideas now, we want to highlight 7 theme areas we found that reflect positive developments for family caregivers.
Recognition of the roles and importance of family caregivers
Seniors’ needs on the mind of autonomous vehicle developers
Voice control of connected devices in the home
Innovations in fall prevention
Insights into a new model for family caregiving
Robot support for caregivers getting closer
Medicare playing role in care innovation
Some of those areas were anticipated by us, but others were pleasant surprises, but that is the nature of CES.
Our Week at CES 2018
CES 2018 started for us before the official start, with the media activities. It would be easy to brush aside the Media Day activities as commercials for the big CES exhibitors — and much of it is — but they also provide insight into some of their offerings that we don’t get on the crowded (truly an understatement) exhibit floors.
CES conference sessions were once high on our agenda and some started out that way this year. What we found, unfortunately, is that too many conference sessions have effectively become advertising opportunities for the sponsors and clients of the companies putting on the sessions. Even where there is information of real value, many sessions seemed an effort to put as many speakers as possible on stage, leaving little opportunity for more than soundbites.
The real benefit of CES is the ability to interact with exhibitors and their technology one-on-one on the exhibit floor. While that has become more of a challenge as the crowd has grown, we enjoy learning not just about the technology but the story behind it and plans for the future.
We also like to look for what innovations might be getting headlines in the future or highlights at CES in future years — and which things might never be seen again. There were a number of items we chalked up as solutions in search of a problem to solve, but you never know when a light bulb might go off for one of those innovators, who could transform their tech into the next big thing.
Recognition of the Roles & Importance of Family Caregivers
One theme we’ve found to be growing in recent years at CES is recognition by technology companies of not just the needs of seniors but the roles and importance of their family caregivers.
All through CES — in media events, conference sessions, and when we talked with exhibitors in their booths — there was talk about family caregivers. The word is out about the numbers of family caregivers and how their roles will continue to grow in importance as populations continue to get older.
One thing especially gratifying for us is the number of tech companies that reached out to Senior Care Corner® to get OUR attention for their products and ideas. We plan to stay in contact with them to keep you updated on tech developments.
Autonomous Vehicles & the Needs of Seniors
We have discussed a number of times how autonomous vehicles, including self-driving cars, will help seniors maintain their independence. Recognition of that is only growing among developers, but there is more.
At CES we heard a great deal about autonomous transit options, often in the context of smart cities, and how they can accommodate seniors and their schedules.
Probably the most prominent autonomous option was Accessible Olli. A partnership between IBM, Local Motors, and the CTA Foundation are striving to make Olli the most accessible self-driving vehicle, in part with seniors’ needs in mind.
Voice Control in the Connected Home
Voice control was one of the overwhelming themes of CES for seemingly everyone with whom we spoke.
What does that mean? It refers to the ability to control everything from lights to door locks to, well, seemingly everything in the home by using your voice, via one of the “personal assistants.”
You might be surprised at the number and types of devices you will be able to control without even lifting a finger.
At CES 2018, Google took the battle for voice supremacy to Amazon’s Alexa, and no wonder. We have encountered numerous home controls over the last year touting their ability to interface with users via Alexa – – and Google wants in with its Google Assistant.
Interestingly, most connected products tout their compatibility with both assistants and are striving to be open systems usable by all manufacturers.
We have been looking closely at Alexa for a while and realize we will have to see how it stacks up against the Google offering and report our findings to you. No, we haven’t forgotten about Siri (she is on our mobile devices) but we didn’t hear too much about her from CES exhibitors.
Innovations in Fall Prevention
For years we have heard much about technology that helps seniors who have fallen, primarily with notification of family members or first responders as well as sensing devices and wondered when there would be technology to help prevent senior falls.
The first fall for many seniors is often a life-changer (not in a good way) so preventing falls is high on our list of tech priorities for seniors and family caregivers.
At CES 2018, we talked with a number of people working to bring to market technology intended do just that. There will be shoes and other wearables that will signal when there is a change with potential to lead to a fall, such as a variation in how a senior is walking, and provide notification before the fall occurs. Monitoring devices that pattern activity is also intended to be more proactive with home safety.
In the meantime, we found a very interesting a product developed by Helite. It is a belt warn by seniors containing air bags that inflate when a fall is detected to cushion the landing and protect fragile hips (and provides notification to caregivers of the fall). The belt is worn as you see in the photo on the left and C02 tanks deploy during a fall to open hip protectors.
Insights Into a New Family Caregiving Model
Family caregivers often feel like we’re struggling on our own, a situation that has to change as our population continues to age. At CES we learned of a new model of caregiving that could greatly improve things for both seniors and family caregivers.
We had a chance to talk with Tom Riley, President and CEO of Seniorlink, about a collaborative model they have developed, which combines the human touch with technology. He talked about a caregiving team, with the family caregiver as the team leader, something we found very appealing.
There is a lot more to tell about Seniorlink and what it could mean for family caregiving, so we plan to explore it in-depth in a future article.
Robot Support for Family Caregivers
We saw literally hundreds of robot across CES 2018, many of them cute toys or companions (which, to be fair, is a caregiving role), but none that seemed near ready to provide a true supporting role for seniors or family caregivers.
Nothing we saw at CES seemed to approach the capability of the CareBot™, the robotic caregiver from Martin Spencer and Gecko Systems, which has been tested in a home care environment.
We were still encouraged by the intentions and approach of some developers and particularly impressed by AvatarMind. They have a robot, iPal, that seems to have real potential. They told us they realize it is not yet a “caregiver” but are taking steps in that direction, introducing it into senior care settings and learning the capabilities that would provide real value.
iPal is one robot we are going to be following closely and even considering for a trial of our own, while we continue to watch the entire field for developments.
Medicare Playing a Role in Care Innovation
For several years we have noted the innovations in home health devices and other technology coming from France, often wishing their devices were available in the US.
From our conversations with French firms, we have learned one of the drivers of their innovation abundance is the role played by their government, which is the result of its role in the nation’s healthcare system.
Yes, we realize the role of government with healthcare is an issue that divides the US, but that doesn’t mean it can’t provide a role in care innovation.
We heard from several at CES 2018 their innovation has benefited from investment (in one form or another) by Medicare. Yes, that Medicare. It makes sense if you think about it, as healthcare innovation means better care for our seniors and lower cost for Medicare, a wonderful win-win.
This is another area into which we are going to delve more deeply and report more in the future.
Another way Medicare is working to improve care through technology innovation is by reimbursing healthcare providers for reading the data obtained from seniors’ digital health devices.
Technology Future Bright for Family Caregivers
All of this means the hope we carried into CES 2018 was very much justified, with a lot of reasons for family caregivers to be confident technology will aid them in caring for senior loved ones.
Clearly we were able only to scratch the surface in discussing much of what we found and what it can mean.
We are excited about what is ahead of us in learning more to keep you on top of the innovation and are already planning the work ahead of us in the coming weeks and months.
No matter our age, we want to be healthy now and stay healthy in the future.
As family caregivers of aging parents, grandparents, and other family members, we can help facilitate a healthy lifestyle to improve our senior loved ones’ health, especially when they are faced with chronic diseases.
When they are present, high blood pressure, high cholesterol, diabetes, and other chronic diseases have no cure, only treatment to manage them.
Preventing them from occurring is a good goal to have.
We can start the year off with a bang by creating a lifestyle with healthy choices and habits for the ones for whom we care as well as ourselves so we can be better caregivers.
There are many risk factors for developing chronic diseases. We have the power to reduce the risks associated with chronic diseases by making lifestyle changes.
Uncontrollable Risk Factors
Risk factors that can’t be controlled or modified by you are known as unmodifiable risk factors.
Even though you can’t change these risks, it is important to be aware of how they may affect your senior loved one’s health, as well as your own.
Controllable Risk Factors
Things that you can change to improve your health and your senior loved one’s health are in your control or modifiable risk factors such as these.
It isn’t as easy as swallowing a magic pill that will make you and your senior ‘all better’ but a commitment to realizing what isn’t working and trying to change that to benefit your health.
Resolving to Strive for Better Health
Taking charge of your health and helping your senior see that it is never too late to make positive health changes will start your New Year off on the right footing!
Change is not easy!
Decide what risk factors you and your senior can change to make a real difference in your health and then come up with a plan to lower those risks.
Here are some things you can do together to ensure that you both will have health in the New Year!
Talk to your doctor about preventing and controlling chronic diseases. Do you know your numbers? Do you know which chronic disease you are at highest risk to develop such as heart attack, hypertension, diabetes, or stroke? Determine where your focus should be after discussing test results with your doctor to develop a plan of treatment.
Eat right. Eat a variety of fresh foods, limit fried foods, include whole grains and foods with fiber, substitute unsaturated fats for saturated fats, include fruits and vegetables each meal, drink plenty of water, and limit salt in your meals.
Stop smoking! There are many diseases directly related to smoking. There are also many smoking cessation programs that can be done with the help of your doctor or a support system such as via a smartphone app.
Get moving! Participate in some physical activity every day! It doesn’t have to cost a lot of money, take a long time, or be boring. Do what you love everyday, whether it is walking, dancing, working in the garden, golfing, or playing exergames on the gaming system. Get up and get moving. If they are more to your liking, try yoga, tai chi, or square dancing!
Lose weight and keep it off! No one wants to think they are overweight, but being heavier than we should carries with it numerous health risks. Even losing 5-10 pounds will benefit your health. You don’t have to stop eating what you love, just reduce portion sizes and snacking, limit sweetened beverages, and get active to manage your weight.
Check your cholesterol and do what is needed to get in under 200. Discuss cholesterol lowering strategies with your doctor and dietitian.
Cope with what’s bothering you and reduce your stress. Turn that frown upside down and smile! Find ways to reduce your stress or cope with the stress you know you have! Reach out if stress becomes overwhelming and turns into depression.
Keep track of blood pressure and keep it in range. If you or your senior has hypertension, be sure to monitor your blood pressure and follow your specific treatment plan with medications, diet, or activity changes.
Get your blood sugar tested and follow a treatment plan to keep your numbers in control. If you have prediabetes, make diet and health changes to avoid being diagnosed with diabetes. Keeping your blood sugar in range will pay off in health benefits by reducing the likelihood of vascular complications.
Get a restful night’s sleep. Practice good sleep hygiene by darkening the room, removing the distractions, getting a comfortable bed, controlling the temperature and air movement, and avoiding taking sleep aides.
We wish you and your senior loved ones a happy and HEALTHY New Year!
Stay on track with your lifestyle changes to be the best you both can be as you age!
We welcome your stories of success so we can share your good news with others and help them along their path!
Robots have gone from the pages of science fiction into every room of the home (yes, even the bathroom).
At CES 2018 we encountered hundreds of robots in all sorts of shapes, from simple little boxes to cute human-like forms.
Robots intended for home use can be small enough to fit in the palm of your hand, nearly adult-sized, and pretty much any size in between.
Some are inactive, while others can dance, with robots having all sorts of ranges of motion. We even watched one climb up a set of stairs, putting one foot in front of the other.
All of those things are nice, but our interest in robots is focused on what they can — or can’t — do for seniors and their family caregivers.
What Home Robots Can Do
There are many functions we’ve seen home robots perform at CES 2018.
Reading books to children
Answer questions based on answers from the web
Turn lights on and off based on voice commands
Provide reminders to take medication
Sing a song along with a video on their screen
Send notifications to specified contacts if it saw a person in the home fall
Record video of persons in a home that was supposed to be vacant
Play a board game
Conduct a video call
. . . and so much more!
There is really too much to list, even though we are still just scratching the surface of what robots are capable of doing for us.
What Home Robots Can’t Do — Yet
What we didn’t see at CES — and was not claimed by anyone with whom we spoke — is one of the things that brings us to CES each year.
We didn’t see a robot that could function as a caregiver to an independent-living senior.
There are robots that can keep our senior loved ones entertained, be great companions, remind them to take their medication, reach out to family members, and do other things we seek in a robotic caregiver.
None, though, perform all of the functions.
That doesn’t mean they aren’t close. In one of our CES wrap-up articles we will discuss one or two that really impressed us and whose developers are taking the steps needed to function as caregivers.
In the meantime, there is a lot about which to be excited!
We want to share this montage of robots, just a few of the many pictures we’ve taken so far — with another day of CES 2018 ahead.
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