Loading...

Follow Deborah Fins Associates on Feedspot

Continue with Google
Continue with Facebook
Or

Valid


Spring promises to be a busy season at Deborah Fins Associates. In addition to serving our clients, I am committed to helping fellow professionals and students sharpen their skills for serving elders. Among my speaking engagements for the coming weeks and months:

February 27

Aging Life Care® Association Webinar
“Serving as a Client’s Decision Maker: The Pros, the Cons and What the Aging Life Care Professional® Should Consider”
4:00 p.m. ET/3:00 p.m. CT/2:00 p.m. MT/1:00 p.m. PT
Click here for details and registration for ALCA members.

March 8

Becker College Counseling Program, Worcester, Mass.
Guest speaker, graduate class session on “Mental Health and Elders”

March 15

National Academy of Certified Care Managers
Part 3 of 5-part Webinar series on Five Essential Knowledge Areas for CMCS
“Entitlements, Benefits and Legal Issues”
Click here for details.

May 11

ALCA 34th National Conference in Chicago
Panel discussion on “Awareness in Preparedness: Disaster Lessons”
Click here for details.

May 22

Worcester Alzheimer’s Partnership
“What is Aging Life Care®?” at Noon
100 North Parkway #105, Worcester, Mass.
508-799-2386

May 23

Alzheimer’s Association of Massachusetts and New Hampshire
A Map Through the Maze Conference for Alzheimer and Dementia Care Providers
“Collaborative Care Planning in the Community,” with Attorney Laura Traiger, at 10:45 a.m.
DCU Center, 50 Foster St., Worcester, Mass.
Click here for details.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care® manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

Image Credit: Biegun Wschodni

Read Full Article
Visit website
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

Freedom to go where we want, when we want. It’s a deeply held American value, part of our cultural DNA. The iconic 1960s TV series, Route 66, about two young men coming of age as they drive cross-country in a Corvette, still resonates.

But what if the one with wanderlust is your aging parent with dementia? You don’t want to lock her in her home, but you’re also terrified that she’ll take off on foot and go missing for an hour or a day—or more. So-called “elopement” takes just an instant. Even experienced caregivers can briefly turn their backs, only to discover that their charge has slipped out the door and disappeared. According to the Alzheimer’s Association, 6 out of 10 people with dementia will wander eventually. The risks are real.

These GPS Tools Can Help You Keep Track of Your Loved One

But now there’s an app for that. The same kind of GPS devices that enable you to find your missing smartphone can also help you find your missing loved one. All involve a subscription for some kind of tracking device that is worn by your loved one, paired with text or email alerts, tracking apps and/or a hotline network. Among the options:

Project Lifesaver: Requires your loved one to wear a personal transmitter ankle bracelet. If he wanders, you receive an alert. When you call the local Project Lifesaver agency, a trained team goes into action to find your loved one. Most people are found within a half hour, a few miles from home. This service specializes in helping people with cognitive conditions that cause them to wander. The international search and rescue program also works with local public safety agencies to educate staff about risks of wandering.

GPS Smart Sole: If your loved one objects to wearing a tracking device or is likely to forget to put it on, this option may be the solution. GPS Smart Sole is an insert equipped with GPS technology that fits into most shoes with removable insoles. This works best if your loved one wears the same shoes daily or if you purchase multiple pairs of inserts. The device transmits location data every 10 minutes via smart phone, tablet or computer. You can define a safe radius for your loved one; if she goes beyond, you receive an email or text alert.

Alzheimer’s Association Comfort Zone: This service, paired with Medic-Alert, uses location based mapping to track your loved one. The locater device can either be worn or mounted in a car, and transmits signals via satellites and cell towers to a web-based system that you can monitor. Options include real-time location monitoring, alerts if your loved one leaves a safety zone that you define, and emergency assistance if your loved one wanders.

But Technology, Alone, Is Not the Full Solution

These tracking systems can help your loved one to live safely at home as long as elopement episodes are relatively infrequent. But it’s important to understand that this technology doesn’t prevent wandering, any more than a wheel chair alarm can prevent falls. Be sure to have a current photo or digital image of your loved one, in case he goes missing. Call the local police as soon as you realize he’s wandered off. Massachusetts is one of three dozen states to participate in Silver Alert—a public notification system, similar to Amber Alerts for missing children, that broadcasts information about missing individuals with Alzheimer’s and other dementias or cognitive conditions.

If wandering becomes a serious safety concern, you may need to consider moving your loved one to a secure setting that specializes in memory care. Even that’s not foolproof, since it’s still possible for someone to exit a “secure” setting; however, there are several systems used both to prevent wandering and to quickly alert staff in case someone elopes. An Aging Life Care Professional® can provide a thorough assessment of your loved one’s safety issues and needs, and help you determine the best alternatives.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care® manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

Read Full Article
Visit website
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

The onset of early dementia is not always obvious. Especially when your loved one is smart and can compensate for memory loss, or is clever and determined to hide symptoms, it can be difficult to know whether what seems “off” is really so.

Maybe your dad has always been a dapper dresser, and you notice him wearing a stained shirt on more than one occasion. When you mention it, he shrugs it off and says he’s having his eyes checked next month (despite the fact that he has no trouble surfing the Internet on his smartphone).

Or your mom, ever the vigilant money manager, who always paid bills ahead of time, has some unopened, month-old invoices on her desk. You point them out, and she laughs and informs you she’s now paying online (even though she’s always mistrusted online fund transfers).

Or perhaps your great aunt, the most punctual person you have ever known, comes late to a luncheon date without calling. Once she reassures you that she’s fine, she explains that she misplaced her car keys and also missed the turn for the restaurant (where you always meet).

How Have Things Changed?

For all three scenarios, the explanations may seem logical, possibly true. But if the incidents repeat often enough to indicate a pattern of unusual behavior, it’s time to be more vigilant about the real chance that something more serious is at play.

At the crux of the issue is determining how your loved one’s behavior has changed relative to what has been normal for that individual. For someone who is smart and able, the changes may be subtle. And even if there are notable changes, he or she may be able to compensate creatively and still be able to do the New York Times crossword. Then the question becomes how much loss of ability is too much.

For example:

Can he still manage his own medications? Warning signs include a pill minder box with lids open out of order, pills not taken that should have been, or empty pill bottles that have not been refilled.

Does she leave bills unpaid or stacks of mail unopened? Especially for someone who was once very organized, increased clutter can be a warning flag. Missed payments, tax returns that were never filed, a bank account that hasn’t been balanced in months—all add up to a decline in cognitive functioning.

Is he at risk driving? Aside from slower reflexes, declining sight and increased fatigue—all good reasons to have driving skills evaluated—your loved one may evidence poor judgment, confusion or forgetfulness, all of which could endanger his safety and others on the road.

Has her appearance changed? Again, the standard of comparison is how your loved one normally presented herself to the world. If she always wore meticulously applied make-up, had every hair in place and dressed impeccably, and now seems less attuned to her appearance, she may have decided that she doesn’t want to bother with it all anymore. But she may also be less aware.

What’s at Stake for You?

Recognizing that your loved one is declining brings challenges beyond mere observation. There is a significant emotional hurdle to overcome: recognizing that your aging parent is vulnerable, admitting to yourself that his or her time on earth is limited, accepting that the status quo no longer works. You may have a lot of other demands on your time, and the idea of taking this on can seem overwhelming.

It can also be extremely difficult to confront your loved one with your observations, depending on the history of your relationship. A parent who has always maintained the upper hand, who insists on control, or who is belligerent and critical when challenged can be a nightmare to deal with.

For all of these reasons, if you suspect that your loved one is showing signs of dementia that could put her at risk, consider having an Aging LifeCare Professional® conduct an independent assessment. This information can provide the basis for informed—and mediated, if necessary—discussions with your loved one about next steps. And you may be surprised that you’re not the only one who is relieved to finally address the issue. Your loved one—whether or not she admits it—may be, too.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care® manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

Read Full Article
Visit website
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

Smart phones, laptops, tablets, desktop computers—these digital devices have become so much a part of our home and work environments that any form of communication other than electronic texts, emails, videos, social media sharing (phone calls? hand-written notes? snail mail anyone?) are considered far too slow and just plain old-fashioned.

So what happens if you can’t use your hands to type? Or suffer a stroke, sustain a brain injury or have some other form of cognitive or physical impairment that severely limits your ability to use electronic devices that are now at the center of our techno-fueled universe?

Fortunately, even as technological advances in size, speed and applications of computing have fostered an over-reliance on digital devices, technology also provides some remarkable ways for people with disabilities to stay connected with the world. Voice recognition devices, dictation software and a host of other high and low tech adaptive tools can make the difference between remaining independent and having to rely on others for even the simplest tasks.

Assistive Technology Options in Massachusetts

So, how do you know where to start, if you or a loved one is in need of assistive technology? Here in the Commonwealth, the Massachusetts Rehabilitation Commission (MRC) contracts with three organizations to provide Assistive Technology (AT) assessments, purchase and set-up of equipment, training and follow-up: Easter Seals Massachusetts, United Cerebral Palsy of Berkshire County, and UMass-Dartmouth Center for Rehabilitation Engineering.

Who is eligible? Any Massachusetts resident

  • who has a severe physical or mental impairment that substantially limits their ability to function independently at home or in their community;
  • for whom AT services and training will improve their ability to function, continue to function or move toward functioning independently in family and community.

Easter Seals Massachusetts provides AT services in its Boston and Worcester offices, including a bundle of free services and low cost loans that can help you determine best options and even sample tools before committing to purchase. Offerings include:

Assistive Technology On-Demand

Free, curated kits of essential assistive technology for people in Massachusetts who have acute, urgent needs for assistive devices to help regain independence and communicate while hospitalized or recovering. Supported by a grant from Comcast NBC Universal.

Assistive Technology at Work

AT assessments and training that help job-seekers gain equal access to the work environment, increase career opportunities and maximize ability to perform essential skills. Examples include assistive computer devices, communication devices, adaptive software, environmental controls, amplification accessories, time management aids, vision aids, and workstation modifications.

Assistive Technology at Home

AT for the home or community setting to improve the ability of individuals with significant disabilities to live independently.

Assistive Technology at School

Consulting services and iPads, tablets, computers, dedicated speech generating devices, access equipment and low tech aids to help meet students’ curriculum and augmentative communication needs.

Augmentative Communication Services

Experts work with individuals with congenital or acquired disabilities who have difficulty using speech for communication.

Try Before You Buy

Easter Seals Massachusetts also operates three regional MassMATCH centers, as part of a state initiative to maximize access to AT. At these centers, you can learn more about available AT, try out or even borrow equipment to sample at home.

In addition, the Massachusetts Assistive Technology Loan Program, funded with state and federal resources, gives people with disabilities and their families access to low-interest cash loans to purchase needed AT devices. For more information and to locate your nearest MassMatch Center, visit mismatch.org.

To learn more about what AT services are available in your Massachusetts community, contact the Massachusetts Rehabilitation Commission: 617-204-3851 (voice); 617-204-3815 (TDD); 617-204-3877 (FAX); AT@MRC.state.ma.us.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

Image Credit: Carl Heyerdahl

Read Full Article
Visit website
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

One of the major thresholds of parenting is knowing when you can leave your kids at home on their own. Are they responsible enough to make appropriate choices while you’re out? Could they leave the house safely in case of an emergency? Would they be able to handle the unexpected, like a fall or scraped knee?

As our loved ones age, similar concerns can arise about their ability to continue living alone. It’s a complex dilemma for adult children, because we want to see our parent as we (ideally) always have: competent, strong, the person we turn to for advice and support.

But there may come a time when the risks of an aging parent living alone outweigh the benefits of independence, particularly for someone with cognitive or physical issues. So, how do you know when it’s no longer safe for your loved one to be on her own?

Here are a few key questions that can help to guide your (joint, if possible) decision:

Does your loved one know what to do in case of emergency?

While, of course, you don’t want to wait until an emergency happens to answer this question, you can learn a lot by asking how your parent would handle various scenarios, such as a fire, a power outage, a fall, or simply not feeling well.

  • Does he know when it’s appropriate to call 911? Can he show you how he would use the phone to do this (without actually placing the call)? Older adults may fall back on “calling the operator”— and become confused speaking to an automated call service.
  • Does she know how to use her emergency pendant? Does she actually wear it all the time? Over and over, we hear of loved ones who leave their pendants on a dresser or don’t understand what it’s for.
  • Is he able to call you or another emergency contact? Can he make an appropriate judgment as to when that’s necessary? Not wanting to “be a bother” can be overdone to the point of avoiding asking you for help when it’s essential; at the opposite extreme, an anxious parent may call so often that it’s difficult to discern when an emergency is real.
  • Is she physically capable of getting out of her home if there is a fire or other emergency, such as a carbon monoxide monitor alert? This requires good judgment as well as mobility and speed.
Does your loved one engage in unsafe behaviors?

This can run the gamut from leaving an unwatched pot on the stove or forgetting to turn off water in the bathroom, to insisting on maintaining old routines that are beyond their capabilities, such as shoveling heavy snow or driving when no longer able to react quickly.

This issue can have another, complicated dimension: if one parent still cares for the other, but has compromised judgment around safety issues. For example, leaving a sleeping spouse alone in order to run errands or socialize—believing “nothing can happen” while the partner is safe in bed—can be risky if the one supposedly asleep falls while going the bathroom or becomes confused by the spouse’s absence.

Does your loved one have friends nearby who check in regularly?

Being social increases the chances that your loved one has friends and neighbors who care about her well-being and who will take the initiative to check in. These are people with whom you can share your contact information, people you can count on to be your eyes and ears on the ground if you do not live nearby. Conversely, if your loved one has always been more private or isolated socially, his ability to care for himself alone requires greater attention.

Does your loved one’s living situation enable you to sleep at night?

Ultimately, the decision about whether to leave an aging parent living alone is a matter of confidence in your loved one’s judgment and your own — and what risks you both are willing to take. If your concerns are keeping you up at night, that may well be the best indicator that it’s time to consider bringing in help or looking for a safer living situation with appropriate support.

It’s possible, of course, that your loved one may choose to remain in an unsafe living situation. If legally competent, he or she has the right to do so. Should this be the case, you may want to explore options so that you’re prepared in the event of (the almost inevitable) crisis.

Working through these issues often prompts difficult but necessary conversations. An Aging Life Care Professional™ can help you and your loved one to find the best solution together.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care™ manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

Image Credit:  Brooke Campbell

Read Full Article
Visit website
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

When you have a complicated medical condition, keeping track of all the doctors’ appointments, tests, medications, prescription renewals, insurance questions and myriad other details can feel like a full-time job. Managing your own care on top of doing your best to battle fatigue, pain and a raft of other symptoms can be downright exhausting. Managing a loved one’s care can be exhausting, too.

Not everyone can afford an Aging Life Care™ Manager to take the load off. Here are some key strategies, based on our years of experience, that can help you to keep better track of all the moving parts.

One of the most time-consuming aspects of managing a complex disease is dealing with a variety of medical specialists. They may be part of the same healthcare system or different systems; if the latter is true, more time is involved with sharing medical records and insuring that the specialists communicate with each other. A few tips:

  • Create an easy note-taking system that enables you to keep track of what was said in each appointment, relevant test results, and any other observations you want to share with the physician. You may want to keep a notebook or maintain your record electronically on a smart phone or tablet. Explore apps such as CareSync or CareZone that streamline personal health record-keeping. This will help you to manage important details between and across specialists’ appointments.
  • Make sure that all healthcare consents are in place so that the specialists can consult with each other. Without permission, especially across systems, they will not be able to share confidential medical information.
  • Have someone accompany the patient who also knows his or her medical story and is good with details. This might be you, another family member, or a friend. If you are the patient, and you’re having difficulty keeping track of all the details, then bring someone along who can fill in the blanks.
  • Bring a written summary of the patient’s relevant medical history along to appointments with specialists, especially if they are new to the case. This will save everyone time, and allow you to think ahead about key details that must be mentioned. When creating the narrative, keep these points in mind:
    • You only need a concise summary of the medical history; don’t write a full biography. The past six months to a year of details will be enough. Confine the rest of the past history to one paragraph.
    • Include a list of medications that have worked and those that have not.
    • List the other doctors that the patient has seen.
    • List previous relevant treatments and outcomes.
    • Bring a list of questions that you want answered. Be sure you get the answers before you leave!
  • If possible, when there are many specialists involved and important decisions to be made, request a group meeting. This may be easier to accomplish when all the specialists are in the same healthcare system. In any case, it does not hurt to ask. You must be your own best healthcare advocate.

If you are feeling overwhelmed by all of this, and hiring an Aging Life Care Manager exceeds your budget, consider one other option: a consultation with an Aging Life Care Manager can help you, your loved one and family to sharpen your care coordination skills and identify community support services that may be affordable or even free.

And be sure to do your own cost-benefit analysis; especially if you are taking time off from work in order to provide care management for a loved one, and losing income as a result, you may just find that hiring a professional will save you money, time and much stress in the long run.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care™ manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

Image Credit: Chilanga Cement Flickr via Compfight cc

Read Full Article
Visit website
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

We’re entering a busy fall season here at Deborah Fins Associates. Debbie was quoted in two articles in Consumer Reports that focus on how to make wise decisions for your loved one when considering assisted living:

Putting the Assisted Living Facility Contract under a Microscope
Elder Care and Assisted Living: Who Will Care for You?

And be sure to put these two informative events on your calendar for October and November:

To register for the MOLST workshop, download the PDF here.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care™ manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

Read Full Article
Visit website
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

As of last Friday, the GOP push to repeal and replace Obamacare (officially, the Affordable Care Act) died in the Senate when three Republicans — Susan Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona — joined with Senate Democrats to block a stripped-down version of legislation from going to conference committee with members of the House of Representatives.

At least, it seemed as if Senate Majority Leader Mitch McConnell’s efforts to push through repeal and replace legislation were finally over, with McCain’s dramatic thumb’s down vote in the wee hours of Friday morning. But reporters have taken to calling this the Zombie Bill, because it keeps rising in a new form when everyone has written its obituary.

Sure enough, on Saturday, President Trump took to Twitter to threaten Republicans with loss of government subsidies to Congressional health insurance coverage if they didn’t keep trying: “If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!” he tweeted.

Medicaid Cuts Off the Table — For Now

While it’s not clear what impact that threat will have on Republican leadership, it is clear that the health care insurance exchanges are in for more rocky pricing and the risk of insurers dropping out of the marketplace. Uncertainty breeds higher costs. The President has threatened to allow Obamacare to die on the vine, starved of federal subsidies that make insurance premiums affordable for lower income citizens.

For now, however, it appears that significant cuts to Medicaid over the next decade, a central point of contention in the bill, have been taken off the chopping block. That is a major victory for disability advocates, who protested fiercely on behalf of the millions who depend on Medicaid for home- and community-based care to remain independent. Medicaid also covers nursing home care, rural health clinics, services for pregnant women, inpatient and outpatient hospital care, and more for individuals who meet financial and clinical needs criteria in each state.

Massachusetts Struggles with Rising MassHealth Costs

Here in Massachusetts, about 1.9 million people are covered by Medicaid, known as MassHealth. Enrollment has increased in recent years due to expanded eligibility under Obamacare. In fiscal year 2015, 30 percent of the Commonwealth’s $15.6 billion in Medicaid spending went to long-term care.

Rising costs for MassHealth have become a stumbling block in finalizing the fiscal year 2018 budget. Governor Charlie Baker is wrestling with state legislators over how to pay for rising MassHealth costs and whether to institute tougher eligibility rules.

How to Plan Ahead in the Midst of Uncertainty

So, what’s next? How can you plan ahead for long-term care for a loved one or even yourself in such a volatile political climate?

Our best advice is to team up with a good elder law attorney. These are legal experts who have extensive experience with issues affecting us as we age and for those with disabilities. Answering questions about eligibility, unraveling issues with getting benefits, negotiating Byzantine rules and regulations — all this and more are their specialties. An excellent resource is the National Association of Elder Law Attorneys. Membership indicates a commitment to the field. The initials CELA refer to Certified Elder Law Attorney.

It’s also worth speaking with a financial adviser to help you create a realistic, comprehensive plan for the future. The Certified Financial Planner Board of Standards, Inc., website is a good resource for finding a trustworthy fiduciary adviser.

As with any decision about hiring a professional consultant, get referrals and research pricing to be sure you can stay within your budget. At the same time, remember that an investment in a good elder law attorney and financial adviser may save you a considerable sum down the road — not to mention, provide you with much-needed peace of mind.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care™ manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

Image Credit: Charlotte Coneybeer

Read Full Article
Visit website
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

By now, we are all far too familiar with that ubiquitous announcement in airports and train stations: “If you see something, say something.” Of course, we’re all supposed to be on the lookout for suspicious, dangerous behaviors among our fellow travelers.

But that phrase takes on a totally different significance when we are asked to be on the lookout for people at risk who need help. Specifically, how can we be of most help to our neighbors and other community members who are dealing with Alzheimer’s and other forms of dementia?

That’s the mission of the Dementia Friendly America® Initiative. A coalition that brings together nonprofits, medical professionals, community leaders and people living with dementia, the initiative promotes a four-step process at the local level to assess needs of people with dementia and how the community can respond to make basic services and resources more accessible.

Building a Dementia-Friendly Community

Currently, more than three dozen states are working to promote dementia-friendly communities, including Massachusetts. In Boston, Jewish Family & Children’s Services and the Department of Elder Affairs are leading an effort to promote this model statewide.

So, what does this effort involve?

The basic idea is to examine all the different sectors of a community to determine the best way that each could be more welcoming and supportive of people with dementia. For example, how can public signage be designed to make it easier for those with Alzheimer’s to find directions or public services, such as hospitals or the library? Or how can emergency responders be better trained to help people with cognitive impairments? How can bank tellers, librarians or store clerks learn to recognize the specific challenges faced by people with dementia and make their services more accessible? Sensitivity, planning and education can go a long way toward making a community more inclusive.

Making Restaurants More Inclusive

Purple Table is another creative approach to fostering dementia-friendly communities. Participating restaurants provide reserved tables in quiet corners that are well lit and close to restrooms for customers with Alzheimer’s and other forms of dementia, as well as those with autism, PTSD, hearing or vision impairments, or other conditions that require special accommodations. Staff are trained to provide extra attention and to show patience and kindness to these guests. In Central Massachusetts, to date, The Red Raven in Acton offers Purple Table reservations.

Religious communities can also play a very important leadership role in the effort to make communities dementia-friendly. Religious leaders are often aware of members in their community who are dealing with dementia. Home outreach, help with transportation, ensuring that religious spaces follow principles of universal design — all of this and more are ways to be sure that community members with cognitive impairments do not become isolated.

What Each of Us Can Do

And what about “see something, say something”? If each of us pays a little more attention to friends and neighbors who seem to be having a more difficult time managing day-to-day, offering a helping hand, contacting their family if needed (to the extent that this kind of communication is welcome), chances are we can make our own little corners of the world more inclusive and welcoming, too.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care™ manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

Image Credit: Nina Strehl

Read Full Article
Visit website
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

The older we get, the greater the risk of falling. Lost flexibility, diminished sense of balance, medications that cause dizziness or weakness, lack of attention, nerve damage to feet, chronic disease that takes a toll—any or all may contribute to a dangerous misstep.

A broken wrist, ankle or hip can be a major set-back for anyone; all the more so for a fragile older adult. But public health officials have identified another, growing risk for elders who fall: brain injury. According to a March report by the Centers for Disease Control, 2.8 million people suffered traumatic brain injuries (TBIs) in 2013 that resulted in emergency department visits, hospitalizations and deaths, with older adults accounting for the highest rate of TBIs—roughly one out of every fifty Americans aged 75 and older.

In addition, the CDC study found that the rate of hospitalizations for TBIs among these older adults jumped 27 percent between 2007 and 2013, “primarily because of falls.” Men across all age groups had a higher incidence of severe TBIs than women.

While the reasons for the increased rate of falls among older adults is unclear, the risks of brain injury for elders are significant. As we age, we shrink—including our brains. That process leaves more space between the brain and inside skull wall—a harder internal knock in case of a fall. Blood vessels connecting the brain and skull also get thinner and more easily damaged with age, increasing the possibility of a brain bruise, or subdural hematoma, which is effectively a slow leak. For those on blood thinners or anti-inflammatory medications, this kind of injury can morph into a severe health crisis. Moderate to severe TBIs also increase the risk of dementia significantly, anywhere from 2- to 4-fold.

While it’s impossible to prevent all falls, there are steps you can take to safeguard your loved one from unnecessary fall risk, as well as strengthen her odds (and yours!) of maintaining balance:

  1. Make surfaces safe. One of the easiest ways to minimize falls is to stabilize throw rugs with slip-proof backings or remove them altogether. If the rugs have sentimental value, consider creative repurposing, such as turning them into wall hangings. Use bathtub liners with suction cups. Mark outdoor steps with reflective tape. Add grab bars to toilets and showers, if needed. Be sure that stairs have sturdy railings.
  2. Wear well-fitting shoes and slippers. Loose slippers or house shoes may be more comfortable for elders struggling with bunions, neuropathy, arthritis or other forms of foot pain, but floppy foot-ware can also cause falls. An increasing number of shoe brands are now available with removable insoles for custom orthotics. A good podiatrist can provide essential foot care and recommendations for appropriate support.
  3. Understand medication side effects. Blood pressure meds can cause weakness or dizziness if your loved one stands suddenly. Pain meds can, too; they can also cause blurred vision or confusion. Sleep aids can be particularly risky for elders, and psychotropic medications require careful monitoring. Not all side effects are obvious; be sure that you and your loved one are fully aware of associated fall risks for all his medications—and arrange for extra help, as needed. Be especially careful to monitor side effects when your loved one starts any new meds.
  4. Illuminate hallways, stairs and walkways. A simple nightlight can help prevent a fall on the way to the bathroom. Motion sensors for both nightlights and outdoor lighting around stairs and walkways can provide needed illumination without driving up electric bills.
  5. Have regular eye check-ups. Blurred vision accounts for falls, as well. Be sure that your loved one has appropriate, up-to-date eyeglasses and annual ophthalmologist appointments to evaluate her for glaucoma and cataracts.
  6. Use a medical alert device. A variety of devices worn as pendants or bracelets contact emergency support if the wearer falls. Smartphones are not really a substitute; your loved one might not be carrying his phone at all times, or he could drop it if he falls. Worse, if he loses consciousness from a fall, a smartphone is useless. Make sure your loved one actually wears the device!
  7. Exercise for strength, flexibility and balance. This is probably the most important factor: fight the urge to become sedentary with age. The more we move, the greater our ability to retain strength, flexibility and good reflexes in case of lost balance. Strength workouts help to maintain bone mass. Exercises such as Pilates, yoga and t’ai chi improve core strength and balance. Walking outdoors on an even surface revives energy and mental clarity. Even a few minutes a day standing on one foot can make a difference. Consider arranging a session or two with a physical therapist or personal trainer to put together a realistic exercise program for your loved one.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care™ manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

Image Credit: James Sutton

Read Full Article
Visit website

Read for later

Articles marked as Favorite are saved for later viewing.
close
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

Separate tags by commas
To access this feature, please upgrade your account.
Start your free year
Free Preview