There’s often a natural role reversal that occurs between adult children and their parents.  In the beginning, it may include gentle recommendations on the activities of daily living to helping out with financial decisions.  As the years progress, these situations become more frequent and can turn to difficult discussions about the change in lifestyle.  One of the tougher tasks includes the conversation about an aging parent’s ability to continue to drive.

It’s important to note that the issue is less about a person’s age than it is the diminished physical and mental capacities that come along with aging.  Multiple medications, impaired vision, decreased hearing and slower reflexes can all contribute to increased risks for seniors on the road.

Observing your parent’s driving skills from the passenger seat, monitoring the car for any dings and dents, and scheduling time with your parent’s physician to discuss your concerns are good starting points.

When you are ready to have the conversation, it’s important to remember to stress the safety factors for your parent and others on the road, keep the tone firm but respectful, and be ready for objections.  The idea of no longer driving is a sensitive issue and can be considered a loss of independence.  Provide a list of alternatives, such as a schedule of availability for rides from family members and friends, local senior services and public transportation.   You could also talk about the financial benefits to giving up the car in respect to payments, repairs and insurance bills that will no longer need to be paid.

The best scenario is to bring up the matter with your parent early on before any of the signs begin to appear.  Agree on the terms beforehand to help make an easier transition for your parent and to provide peace of mind for everyone involved.

Did you know that falling is the number one cause of injury among seniors who are 65 and older? According to the Centers for Disease Control and Prevention (CDC), each year 1 in 3 senior adults suffers an injury due to a fall. While some may recover and continue living an active or independent lifestyle, many seniors end up in the hospital or transition into a nursing home because of serious injuries. In the most severe cases, like a broken hip or leg, a senior may develop complications that result in death.

Even if the fall is not life threatening, it can be costly. The CDC reported that in 2012, the total cost of injuries and injury-related complications in seniors was approximately $30 billion. What is most frustrating about these types of incidences and injuries is that they typically can be prevented.

What are the most common types of falls?

While a senior can slip, trip or fall in almost any place or situation, there are some areas where special care can be taken to provide a safer environment for your loved one. For example, a set of stairs to a second floor or basement could be hazardous, but so could that step leading into the garage, or one down into the utility room? What might be a quick entry point into a different room of the house to most could be a hazard to a not-so-nimble senior.

Also, front porches and outdoor steps are dangerous areas where falls often occur. In the winter, icy conditions can make those hazards even more of a concern. In addition to steps and stairs, any slippery surface around the home can be a fall hazard. Bathtub falls are among the most common causes of accidents at home for seniors. Aside from getting in and out of the tub, walking along smooth surfaces in stockings or socks and tripping hazards, such as cords and furniture legs, also present increased fall risks.

What steps should be taken to make a home fall-proof?

Fall prevention should not be taken lightly, since it could mean the difference between life and death. The focus should not be on simply eliminating the hazards but creating a safe environment in and outside of the home.

First, install handrails along any stairs or steps, including the areas where only one step exists. Handrails may need to be installed on both sides, such as areas leading into the garage or utility room. Remember that your senior may need to go both up and down the step. The bathroom is an area that should be closely observed for the installation of support rails. Install handrails and guards in and around the tub and toilet. Next, focus on the floor. If there are any slippery areas, provide rugs that are firmly secured to the floor and make sure that your loved one wears rubber-gripped slippers for traction. Provide clear walkways from room to room, keeping all cords secured carefully along the baseboards.

Slip and fall accidents can be prevented through careful observation and action.  Sometimes the most obvious things can contribute to a hazardous situation.  When in doubt, take action to ensure safety for your loved one.

A caregiver is often lacking for time but has an abundance of stress. A gift that will help make life a little easier is always appreciated. Here are some gift ideas for the caregiver on your list.

Time Away
A gift that will give the caregiver a break from difficult responsibilities is one of the most welcomed gifts of all. Caregivers frequently put their own needs aside while caring for their loved ones. If providing the care yourself is not an option, check to see if there is a local respite care facility that offers gift certificates toward the services of a reputable caregiver.

A Day or Night Out
Caregivers often isolate themselves while spending all of their time taking care of someone else and can often use some outside social interaction. Consider taking them out for a special meal where they can enjoy good food as well as good conversation.

Movie, Play or Concert Tickets
A night of entertainment where the caregiver can take their mind of their worries for the evening would surely be appreciated. Is there a new movie or a play they’ve wanted to see? How about their favorite band or musician? They say laughter is the best medicine – if the caregiver enjoys comedy, an evening with a good comedian could provide just the right dose!

Massage
A massage can help relax the tense muscles of the neck, shoulders and back that develop from the stress and hard work of caregiving. Consider a gift certificate for a massage – if you can find a massage therapist that will visit the caregiver at home, all the better! You might pair this gift with a hand held massager that can be used to provide relief in between sessions.

Beauty Salon
Take the caregiver out for a “day of beauty”, or purchase a gift certificate they can use to get their hair or nails done. Many people neglect taking care of themselves when they have so much on their plate, and this can be a perfect pick-me-up.

Aromatherapy
A gift basket filled with aromatherapy products that the caregiver can use in their own space and take time away from a stress-filled day, provides a great excuse to close the door and forget about their cares; even if it’s only for a few minutes. Scented candles, bubble bath and soothing lotions are just a few of the sweet smelling items you might choose to add.

Homemade Treats
Comfort foods, such as homemade chocolate chip cookies or brownies, especially those made with love as a gift from a friend or family member, make a wonderful gift. If baking is not on your forte, check your yellow pages or search online for a local bakery that delivers.

Meals
Many caregivers have a difficult time fitting cooking into their long list of other chores. If you aren’t close enough or unable to help with cooking, consider purchasing meals from a company that can deliver to their door. Many companies even offer special diets and will deliver packages of frozen meals at a discount.

Caregiving can take a toll on anyone, emotionally and physically. A gift that can ease their burden and lift their spirits is sure to be one that will be remembered and appreciated.

As we grow older, there are key changes that we can make in our homes to make it more conducive to our own safety. From expired food to a cluttered furniture layout, our homes may pose hazards to us that we don’t even realize. Below is a list of simple things that can be done in order to limit the hidden hazards that could lead to injury.

Kitchen Safety:
• Set up a weekly routine to check the expiration dates on your food to avoid consuming something that is unsafe to eat.
• Put frequently used bowls, cups, pans, etc. in easy-to-reach locations.
• Purchase easy-grip oven mitts and pot holders.
• Place anti-skid mats in front of the dishwasher or sink where water may gather.
• Invest in a Class K fire extinguisher to put out fires caused by vegetable oil or grease—common causes of kitchen fires.
Bathroom Safety:
• Install grab bars in the shower to allow for better leverage when needed.
• Install a non-slip bath mat in the shower and non-slip rugs in front of the bathtub, toilet, and sink to allow for better footing in areas where water can be a serious hazard.
• Invest in a shower stool/chair to be able to sit while showering.
• Utilize a night light for visibility during those late-night trips to the bathroom.
Fire Safety:
• Keep several fully charged fire extinguishers on-hand throughout your house in case of a fire.
• Keep an open passage to all exits as that can mean the difference between life and death if there is a fire.
• Have smoke detectors in place in all rooms and replace batteries at least once a year.
General Safety
• Keep in constant contact with loved ones so they will know to check-in if there hasn’t been any recent contact.
• Install carbon monoxide detectors to alert you to this invisible danger.
• Make sure to have at least one phone per floor, preferably wireless, and also consider buying a cell phone for the ultimate in mobility.
• Ensure all stairs have a securely fastened hand rail to utilize while ascending and descending steps.
• Place anti-slip grip tape on exterior steps to prevent an accidental tumble.
• Consider rearranging furniture if it will allow for clearer pathways and the elimination of potential trip or bump hazards.
• Have critical medicines and a first aid kit readily available for emergency purposes.
• Install security poles to allow for better leverage in any room of the house. These have grips and are designed to hold on to while moving to or from areas such as the shower, chairs, sofas, or beds.
By following the basic safety tips listed above, our homes can become a much safer place. We can now perform our daily routines and comfortably move about our homes knowing that many of the hazards have been eliminated that all too often cause falls resulting in bruises, broken bones, or even more serious injuries

We are all living longer and healthier lives. Once we have reached the age of 65, we can expect to live on average another 20 years. In 2009, persons over the age of 65 numbered 39.6 million, about 12.4% of the U.S. population. By 2030, that number is expected to reach 72.1 million or 19% of the population 1. Things are changing fast and while much of this is good news, it also ushers in a number of challenges that many of us are facing everyday. As we approach our later years, we often wonder how we will care for ourselves in a way that maintains our independence, dignity and sense of connection to our communities without burdening our loved ones. As families, we strive to make decisions that will benefit not only our elderly parents or relatives, but also lessen the stress, guilt and disruption that come right on the heels of our best intentions. As a society, we struggle with how best to allocate finite resources from our struggling healthcare system, so that our growing senior population can have access to the care that they, and ultimately all of us, will need. More and more evidence suggests that in many situations, home care may be an option that potentially addresses these issues.
Home care allows you to live at home or in a familiar environment with enough help from a professional caregiver that you can maintain your sense of independence. It also provides for an individualized care plan, giving you a greater sense of freedom and control over your activities. The presence of a reliable in-home caregiver may also foster engagement in a broader social network that can significantly improve quality of life 2. In addition to helping with daily life activities, a trusted caregiver can often serve as a companion who can decrease feelings of isolation and loneliness. Symptoms of depression, which affect up to 10% of men and 18% of women over the age of 65 1, improve significantly in those who have a stronger social support system available 3. Depression may also lessen if you find that your functional ability is improving as a result of the consistent personal care you are receiving 4. For many families, home care can reduce the stress involved in caring for a loved one by providing more flexibility to their schedules and giving them much needed time to attend to personal needs. Home care can also be less costly than a nursing home in both the short and the long term.
Between 1992 and 2007, the proportion of seniors living in long-term care facilities has declined while the use of personal assistants has increased 1. Home care has become an integral part of this trend towards more independence. For the right candidate, home care can offer physical, emotional and economic benefits for them, their families and our society as a whole.

References
1. Older Americans 2010 Key Indicators of Well-Being. Access at www.agingstats.gov/agingstatsdotnet/Main_Site/Data/2010_Documents/Docs/OA_2010.pdf.
2. Hellstrom Y, Andersson M, Hallberg IR. Quality of life among older people in Sweden receiving help from informal and/or formal helpers at home or in special accommodation. Health & social care in the community. Nov 2004;12(6):504-516.
3. Charlson ME, Peterson JC, Syat BL, et al. Outcomes of community-based social service interventions in homebound elders. International journal of geriatric psychiatry. Apr 2008;23(4):427-432.
4. Nyunt MS, Lim ML, Yap KB, Ng TP. Changes in depressive symptoms and functional disability among community-dwelling depressive older adults. International psychogeriatrics / IPA. May 22 2012:1-9.

When you learn that a loved one’s health has deteriorated to the point where it becomes necessary for someone to monitor or assist with daily activities, the idea of arranging for the care may be stressful. The situation is further complicated if you live far away from your ailing loved one. According to AARP, there are over 7 million long-distance caregivers in the United States. “Long-distance” is considered living at least an hour away. Short of moving, what can you do to make sure that the loved one receives the proper care and at the same time, make sure that you have peace of mind? Fortunately, the seemingly daunting task of supervising the care of your loved one from afar can be successfully managed by approaching it in an organized way and tapping into resources to handle what you cannot.
To be an effective long-distance caregiver, you will need to familiarize yourself with your loved one’s condition and make sure that his or her medical team understands your role. Also, make sure you know the details of your loved one’s medical expenses and health insurance, and that you or another trusted relative has the legal authority to tend to your loved one’s affairs if necessary.

Do not try to handle the caregiving responsibilities alone. Instead, identify trusted family and friends who live in close proximity to the loved one. Discuss his or her condition and needs, and enlist assistance for regular well-being checks. You should not rely on the loved one to give you accurate information over the phone or through email about changes in his or her health. The loved one may not notice subtle changes, or may be hesitant to admit that his or her health is deteriorating. Even if you have reliable support to keep you informed of your loved one’s condition, plan the occasional visit to not only make a personal assessment of your loved one’s condition, but to also spend quality time together.

Even after you have set up an effective long-distance care arrangement, you may find that your loved one needs on-site assistance to help him or her perform every day activities. As an alternative to moving your loved one into an assisted living facility, in-home care can provide your loved one with the assistance he or she needs, while allowing him or her to stay in comfortable, familiar surroundings.

In-home service providers can perform a variety of daily tasks for your loved one in his or her home, including companionship, meal planning and preparation, housekeeping and assistance with grooming and hygiene. Providers may live in, visit each day, or visit a few times a week.

Hiring an in-home care provider does not require you to abandon your role as long-distance care provider. On the contrary, you will remain the person who manages and directs the caregiving arrangement, continuing to provide direction on medical issues, managing financial issues, overseeing legal documents and providing emotional support to the loved-one. Ultimately, you will find that this team approach will provide you with peace of mind, while allowing your loved one to receive the care he or she needs.

Lynette Brown* can attest that bringing her father-in-law, Andy, into their home had originally been more difficult than she anticipated. “It changes the dynamic of your life completely.” she confessed. “It’s emotionally challenging and it can be hard on a marriage. It doesn’t cause us to fight, but it takes away from the romance and our alone time.”

Their decision to bring him in was based on principle; cost was not a factor at all. “We knew that Andy’s quality of life would change drastically if we were to move him in to a nursing home,” she said. “And really, he didn’t belong in one either. He had some health issues, but mentally he was still very sharp.”

When Andy first moved in, they were able to leave him alone on the weekends, but soon thereafter they were not able to do that anymore. They could have driven Andy to his daughter’s house, but it was a five hour drive and it became harder for him to sit for that long in the car.

“We began to look at private home care options and found Trova Home Care. They were able to provide a caregiver to stay with Andy in our home while we were away” she said. “It worked out so well! The caregiver made a connection with Andy and provided companionship, cooked his meals, drove him wherever he needed to go, and basically acted as our eyes, ears and hearts while we were gone.”

Acting as a full-time care-taker is a huge undertaking and it can get overwhelming at times. “I try to take care of myself by spending time with friends, going on long walks, and getting an occasional manicure or pedicure,” said Lynette. “And I snag alone time with my husband whenever I can.”

Researching and finding professional support was crucial to their day-to-day sanity. “Until I found Trova Home Care, there were days I wanted to pull my hair out,” said Lynette. “But we’ve found a great caregiver and I feel confident and secure when he’s around to help.

“For us, it was a decision we will never regret,” said Lynette. “I wouldn’t be able to sleep at night wondering how Andy might be treated outside of our home, which is another reason I’m really glad we found Trova Home Care.”

*Names changed to protect privacy

Nearly every family reaches a point that requires tough decision making. One of the hardest is when a decision must be made for the care and welfare of an elderly or disabled family member. In the past, most people who weren’t able to care for themselves or were not safe when left alone wound up in an institutional facility. This causes feelings of guilt among family members along with trauma and anguish for the uprooted patient.

In many situations the elderly or disabled individual doesn’t need skilled nursing or medical care. They simply can’t be left alone because of physical or mental deficiencies. They may need assistance with grooming, getting up and down in a bed or chair, meal planning and preparation, or quite simply – companionship.

Hiring sitters, home care attendants, or companions can be far more cost effective than utilizing a long term care facility. In these facilities you pay for room, board, and skilled nursing and medical care whether your loved one needs it or not. Plus many times the health of the loved one deteriorates because of the psychological impact of being away from home and family. No matter how well a long term care facility is run, or how wonderful the staff is, most incoming patients go through periods of severe depression and anxiety.

People who can stay in their home environment feel safer and more secure in their familiar surroundings. Studies show that recuperation can be more successful in patients who have the option to go home from the hospital instead of into a long term care facility. With family and hired attendants available to work with the patient one on one at home, progress is made in a shorter period of time.

Home care options are as varied as families that need it, so in home care plans are customized to each family’s situation. Whether a couple of hours a day or 24/7 live in care, plans can be modified as needs change.
One of the best things about in home care is that you can choose caregivers based on skills and personality. Great references are important of course, but so is a caring personality that will fit in well with the needs and expectations of the patient and their family.

If you have chosen to keep the patient in your own home you might just need someone to come in for a couple of hours each day to give you time for shopping and running errands. If you work then you will need a caregiver for the days or shifts that you have to be at your place of business.

If the patient is still in their own home you may need around the clock care. You can plan their time off for when family members can come in and take over. This may be a better solution if you don’t have extra room in your home, or if the move would be too disruptive to your family. The stress of taking a parent in and becoming their caregiver has psychological effects on both sides.

In home care is not just comforting to the patient, but also gives peace of mind to family members who would otherwise have to place their loved one in an institution. This choice has proven to alleviate guilt and worry for family member whether they are across town or across the country.

For seniors, the upcoming holidays may not be as joyful as holidays of years past, especially if loved ones and friends have passed on. Many seniors can easily fall into a depression if left alone to focus on what no longer exists. Newness breeds excitement for life. Below are tips that can make for a cheerful holiday season for your loved ones or any special senior in your life.

Schedule a Massage
Has your mom ever had a soothing, yet rejuvenating massage? Consider treating her to a few hours at the most luxurious spa in town. Massage is a good way to relax and the touch of hands on the body is quite soothing.  You can even get creative, opting for a sea salt scrub with a luxurious back and body massage, a chocolate massage used with massage lotions made with cocoa, or raindrop therapy, which is a massage with essential oils that truly enliven the body and keep it “buzzing” for a few days.

Get Together with Friends
This one is very important for anyone who is lonely and longing for human companionship. Bring in a good friend or a group of friends for a fun holiday get together.  Bringing in friends and/or companions helps stimulate the mind, interrupts the pattern of lonely thoughts, focuses on the present, and makes real progress to getting out of the doldrums for the holiday.

Create a Calendar of Thankfulness
Create a calendar for the following year that focuses on 12 of the most positive moments that you and your father have shared.  For example, January reminds you of the time your car was stuck in the driveway after a snowstorm.  Include a picture of your father standing next to the car with a shovel (or a re-creation through Photoshop) and a few lines about that experience.  He’ll love it, and it may even bring a few tears of joy.

Schedule a Baking Day
Invite your elderly neighbor over for a day of baking.  This is a great activity and you can make it productive by creating some wonderful cookie baskets for friends and family. The aroma of fresh chocolate chip cookies and spiced apple cider is enough to put anyone in a good mood. Cinnamon is known for its ability to stimulate the mind. Cookies are relatively easy to bake, and baskets are easy to stuff with cookies and a note of good cheer with a card. There’s no hard labor involved and even if your friend is wheelchair bound, she can help assemble the cookie baskets with you or match up the baskets with the recipients on your gift list.

Always remember that once you tap into the season with new activities, you can help generate new positive thoughts, and these thoughts can go far and long to creating a happier, brighter future, well beyond the holiday season.