Elder Care ABC

By Joy Loverde

Lately there’s been a lot of controversy regarding senior-housing referral websites and financial kickbacks through high-commissioned care providers’ communities.  When Continuing Care Retirement Communities, Assisted-living Communities, and Nursing Homes pay web owners to send prospective residents their way, it begs an answer to the question, how much can you trust people who are getting paid to endorse their communities?

As an eldercare product and services spokesperson myself, I know all too well that unless whatever I am being paid to endorse passes a comprehensive assessment, including first-hand testimonials and background checks, I turn the deal down. It’s not worth the risk no matter how much money is on the table.

That said senior housing is a delicate subject, and placing Mom and Dad in someone else’s hands for higher levels of care is a scary proposition under the best of circumstances. Home-grown research can only go so far. When we visit these communities, everything appears to be on the up-and-up. We hope for the best and make a decision based on very limited information; but now that all has changed.

Valuable “insider” information is now available. Golden Reviews brings transparency to the process of choosing a senior care community through its 110,000 community listings. After going live in March 2013, the company has more than 2,000 reviews with at least 200 reviews being added or modified each day.

Here’s how it works. Golden Reviews opens the dialog between senior housing residents, family members, visitors, and industry experts. Reviews are compiled from real people with real experiences. Third-party certification helps families make informed decisions in time of need. Importantly, if someone has a bad experience, you’ll know it.

The Golden Reviews website offers the following:

• Read reviews on senior care communities
• Submit reviews on senior care communities
• Find senior care communities based on unique search criteria, including location, type of community, review ratings
• Speak to family advocates who will go above and beyond to make sure that

Golden Reviews is changing and elevating the process of choosing senior housing. Unlike direct and indirect website competitors, they are mission-driven to ensure that when a person is placed into the care of the professionals, that the best possible fit takes place between the family’s unique requirements and the services offered.

You may also want to check out this article:

http://seniorhousingnews.com/2013/04/09/golden-reviews-wants-to-bring-transparency-to-senior-housing-and-care/

It’s about time someone thought to go this route. Thank you Golden Reviews!

By Kaye Swain

Last month, I wrote about being proactively prepared for extreme weather issues and possible outages, whether due to broken heaters and air conditioners or due to power outages from major storms. Of course, those are not the only weather issues many of us caregivers deal with when caring for our aging parents, are they?

I remember 30 years ago when my mom was the caregiver for her parents. My grandfather had reached a point in his life when he was always cold. My mom was so wonderfully patient and long-suffering. She would go over for hours to help them, while roasting to death because they routinely kept their house at about 80+ all year round. And, of course, summer was the worst since, even when the sun went down, the temperatures frequently stayed high!

While I often follow her great example for caregiving, I’m afraid I’m not quite that good about suffering and I’m very grateful that, in this day and age, I don’t have to be. My senior mom and I live in a two story house. She has now reached the point of constantly freezing, just like her dad before her. Wonderfully for me, she is very thoughtful of me and realizes she can always add more clothes when she is cold and is very good about that.

Because of physical limitations, her bedroom is on the first floor and mine is on the second. As we have learned, they aren’t kidding when they say, “Heat rises!” Couple that with the computers in my bedroom, and my room is the hottest in the house while my senior mom’s room tends to be the coolest in the house. We’ve learned to work around that though by compromising on the temperature – keeping it cooler than she might prefer and warmer than I like all year round. Then she adds more sweaters and I keep one – two fans going almost non-stop in my bedroom when I’m there. It doesn’t work perfectly but it does work.

If you are thinking of moving or remodeling due to caregiving needs, I would highly recommend a heater/air conditioner set-up like I used to have – with the ability to set the first and second floor to different temperatures. That can be such a big help when dealing with multigenerational caregiving that includes our aging parents and our changing body needs. (The cars that offer dual sided controls are another big help for eldercaregivers! We don’t have one but we’ve rented them before and they really are quite useful!)

I would also recommend adding ceiling fans if your budget permits. Otherwise, free-standing fans are quite handy. Because we also stay busy babysitting grandchildren (can you tell I’m in the throes of the Sandwich Generation – multigenerational caregiving), I look for fans with the blades totally enclosed. They are much safer for little hands – and even for senior parents who might be dealing with memory loss and forget how to handle a fan.

I dearly loved my grandfather but he was not the greatest at compromise. I’m very blessed to be caring for an aging parent who DOES do a wonderful job of “sharing the load” with me and I’m already sharing that concept with my own kids and grandparents. And I’m also very grateful for plenty more options now than they used to have, including portable and ceiling fans, multi-area heaters and air conditioners in homes and cars. How about you? Do you have any suggestions for dealing with the issues of senior parents who are freezing while you are roasting? Or vice versa? We’d love to hear.

By Kaye Swain

Weather is in the news! On our TVs, in our radios, and on our phones as we check on loved ones during nasty storms. This is especially true for those of us caring for our aging parents. It seems like just yesterday we were following up on ice and snow storms and now it’s already time to check on heat-related issues and hurricanes or tornadoes – or both!  What’s a caregiver to do? Especially considering that our senior parents are so much more susceptible to temperatures that are too high or too low.

For those of us living with our senior parents, or nearby, it’s always a wise idea to make sure our elderly parents have plenty of flashlights and batteries, along with lots of bottled water. Those always come in handy, storm or not, and it’s so vital our senior parents not become dehydrated, so no fears about wasting them. I also have a battery operated fan in the garage. We’ve never used it but with all the wacky weather going on, I suspect I will need it eventually. I figure we can huddle around it in the event of a power outage on a very hot day. And if your parents live long distance, be sure to remind them to stock up on these necessities a couple of times a year.

Don’t forget to have the heater and air conditioner checked at least once if not twice a year. We have a service plan that provides for twice a year check-ups and cleaning and it’s been worth its weight in gold. Two years ago, a routine check up discovered the heater was developing an issue that would have stopped it cold during a particularly chilly and snowy winter. My poor mom would have frozen.  This year it was the opposite. We had a brief heat spell and I turned on the air conditioner. Later I noticed it didn’t seem to be running properly. Since our pre-summer tune-up was due, I had them come out for that while explaining my concerns. Sure enough – the fan stopped working and they had to order a part. This time, it only took 2 days to get here. We were a bit warm but the power was on and the fans were going, so we made it OK. A few years ago, one of our two units quit working and it took them SIX WEEKS to get the part! That was a bit tougher for my senior mom, but the electric heater we bought her then helped a lot. And, of course, don’t forget to remind your senior parents who live far away to have someone check on their heaters and air conditioners if they are not normally proactive about doing that.

As you can see, whether it’s summer or winter, hot or cold, it definitely pays to be proactive with our heaters and air conditioners – making sure they are taken care and getting regular maintenance checks – especially for our senior parents. And don’t forget to stock up on basic necessities in case of an outage – whether equipment or power. Your aging parents will appreciate you double for that. And you’ll be glad for a bit less stress in your life.

By Helen

Photo credit MARCZERO1980

You might be tempted to assume that poor sleep is a reality of reaching old age. However, most up-to-date sleep research indicates the elderly might not be sleeping so bad after all.

Encouraged by these findings we set out to find more positives about sleep after 50. Here’s what we found out:

1. Exercise may help the elderly sleep better.

Research shows that regular exercise may contribute to sleep improvement when we’re older. Moderate-intensity exercise has been found to lead to significant improvements in sleep quality in a group of over-50s after just a few months.^[1] Another study analysed the effects of physical exercise, including brisk walking and moderate resistance training, in adults aged 60 and over. These adults saw improvements in that it took them less time to fall asleep and they slept for longer.^[2]

This year’s poll by National Sleep Foundation in the US identified a link between exercise and better sleep^[3] across all ages. Even just adding a 10 minute walk is supposed to help^[3], and it’s all the better if it’s done in the morning sunshine to promote wakefulness and help regulate the circadian rhythm for better quality sleep during the night.

In elderly with dementia, it was revealed that exposure to sunlight in the morning improves sleep and increases total time spent asleep.^[4] Similar improvements have been found in treating the institutionalised elderly with bright light therapy in the morning hours between 8 and 11am.^[5]

It is suggested that any aerobic exercise, like walking, cycling or swimming, might do – elderly adults with insomnia found this type of exercise especially helpful in improving their sleep and, subsequently, quality of life.^[6]

2. Sleep problems don’t necessarily increase with age.

A hot-of-the-press, study^[7] proved us wrong in thinking that aging inevitably brings sleep problems. No link was found between increasing age and complaints about either poor sleep or tiredness and a lack of energy during the day.

In fact, in the study, it was the younger adults who reported more sleep disturbance than those in their 80s. Another upside is that even though sleep does tend to be more fragmented in the elderly^[8], they make up for this lack of sleep with naps in the daytime. Additionally, the time to fall asleep was shown to shorten with age^[9].

3. Those over 60 lose less sleep over worry.

It’s true! Analysis of sleep patterns of more than 16,000 adults over 25 years^[10] revealed a sharp decline in sleep lost over worry at age 60. Sleep disturbance due to worry continues to decline after 60, hitting its lowest points between ages 71 and 79.

Worry-related sleep loss was previously linked to increased risk of death and cardiovascular diseases^[11], so it should be a relief to find out that it decreases with age.

4. Early to bed and early to rise…

Older people are more likely to fall into the category of ‘morning larks’^[12]. This is due to the phase of their circadian rhythm coming on earlier, which leads to them going to bed earlier and subsequently, also waking up earlier. However, this pattern of getting up early evens out as the elderly also retire to bed earlier.

One thing to remember, though, is that

5. People over 50 may take longer to digest caffeine.

Avoiding caffeine is usually one of the first recommendations a person with sleep problems is given, however it might carry even more weight for the over 50s. They can take longer to metabolise caffeine^[13] unlike young children for whom it can take only a few hours.^[12] A longer digestion time delays feeling the effects of caffeine which can lead to sleep disturbance.

Caffeine has been shown to disrupt sleep in the elderly – in one study^[15], participants not only took longer to fall asleep (over an hour in total!), but also woke up more times throughout the night and slept for 2 hours less than if they’d had a decaffeinated or no drink at all.

The good news is that older people may not even need it – another study^[14] showed that while older people do feel objective effects of caffeine (like increased heart rate), they tend not to feel more alert or steady. Thus, without getting any of the benefits of hot java, there seems to be little point to drinking it at all. There are likely to be healthier hot drinks for the over-50s.

It is important to think positively about sleep – a good night’s sleep is not out of reach at any age. Sometimes, simple changes in attitude and lifestyle are all it takes to be a better sleeper. Armed with these five facts, I hope you will be able to do so.

References

[1]King, A.C., Oman, R.F., Brassington, G.S., Bliwise, D.L., Haskell, W.L. (1997). Moderate-intensity exercise and self-rated quality of sleep in older adults. Journal of American Medical Association, 277(1), 32-37. [2]Montgomery, P., Dennis, J.A. (2002). Physical exercise for sleep problems in adults aged 60+. Cochrane Database of Systematic Reviews, 4(CD003404). [3]http://www.sleepfoundation.org/alert/national-sleep-foundation-poll-finds-exercise-key-good-sleep [4]Mishima, K., Okawa, M., Hishikawa, Y., Hozumi, S., Hori, H., Takahashi, K. (1994). Morning bright light therapy for sleep and behavior disorders in elderly patients with dementia. Acta Psychiatrica Scandinavica, 89(1), 1-7. [5]Fetveit, A., Skjerve, A., Bjorvatn, B. (2003). Bright light treatment improves sleep in institutionalised elderly: an open trial. International Journal of Geriatric Psychiatry, 18(6), 520-526. [6]Reid, K.J., Baron, K.G., Lu, B., Naylor, E., Wolfe, L., Zee, P.C. (2010). Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Medicine, 11(9), 934-940. [7]Grandner, M.A. et al. (2012). Age and sleep disturbances among American men and women: data from the U.S. behvaioral risk factor surveillance system. Sleep, 35(3), 395-406. [8]Brown, S.A., Schmitt, K., Eckeert, A. (2011). Aging and circadian disruption: causes and effects. Aging, 3(8), 813-817.[9]Ohayon, M.M., Carskadon, M.A., Guilleminault, C., Vitiello, M.V. (2004). Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep, 27(7), 1255-1273. [10]Salo, P. et al. (2012). Trajectories of sleep complaints from early midlife to old age: longitudinal modeling study. Sleep, 35(11), 1559-1568. [11]Hamer, M., Batty, G.D., Kivimaki, M. (2011). Sleep loss due to worry and future risk of cardiovascular disease and all-cause mortality: the Scottish Health Survey. European Journal of Preventive Cardiology, doi:10.1177/1741826711426092 [12]Monk, T.H., Buysse, D.J., Potts, J.M., Degrazia, J.M., Kupfer, D.J. (2004). Morningness-eveningness and lifestyle regularity. Chronobiology International, 21(3), 435-443. [13]Ellis,J., Hampson, S.E., Cropley, M. (2002). Sleep hygiene or compensatory sleep practices: an examination of behaviours affecting sleep in older adults. Psychology, Health & Medicine, 7(2), 156-161. [14]Swift, C.G., Tiplady, B. (1974). The effects of age on the response to caffeine. Psychopharmacology, 94, 29-31. [15]Brezinova, V. (2012). Effect of caffeine on sleep: EEG study in late middle age people. British Journal of Clinical Pharmacology, 1(3), 203-208.

Helena writes for Sleepio, an online sleep improvement programme based on CBT for insomnia. Visit Sleepio to speak to a sleep expert.

My senior mom and I often laugh at the memory of the plans we used to talk about when we reached retirement age. We each thought we’d get so much done then. We’d finish projects we didn’t have time to do while she was working or I was raising kids.

Now that she is in full-fledged retirement and I’m approaching that season of life, we have both come to realize a vital fact we forgot to consider. Yes, she does have a lot more free time. No, she’s not getting to all those long-waiting projects, like putting every photo into a zillion albums or traveling all over the U.S.

Why not? In this season of her life, she’s found that she’s moving slower, needs to rest more often, has lost a lot of strength for lifting and moving, and just doesn’t have the energy she once had. A trip to Walmart wears her out for two days!

Occasionally that does get her down a bit. But most of the time, she continues to set an excellent example for my kids, grandkids, and me of persevering no matter what the situation. She continues to do all her own cooking, even though it can sometimes be very tiring for her. She gets on her treadmill for 20 minutes at a time, three times a day, as much as she is able. She delights in sending just the right greeting card to dear friends and beloved grandkids for every holiday Hallmark can think up. And now she’s starting to organize all the grandkids’ letters into one folder per child, to help her remember what she wanted to write to them about. And oh, how our neighborhood birds love her and the birdseed she faithfully sets out for them, not to mention the sunflowers she plants for them during the gardening activities she is sometimes able to enjoy.

It’s not exactly the way she planned it. But what a grand way of dealing with this season of life. I have to admit, sometimes I thing she is working too hard and try to help more than she wants. But then I consider the alternative.

Would she, or I, really want her to do nothing but sit in a rocker all day. Even though arthritis pains may make moving somewhat difficult at times, especially when the barometric pressure is really getting to her, she is staying active and happy. We’ve seen other loved ones take the sitting route and noticed they have many more problems with health issues.

Staying active, even when it’s slow and minimal, is the best way to deal with this aging process. Allowing her to do that, while making sure she is truly safe as she does it, is the best gift I can give her. And I’m hoping to follow her excellent example, while blazing the path for the next generation or two.