Choosing a homecare provider for your loved one can be a stressful decision.  When faced with many choices in agencies, it is sometimes difficult to know why one is better than another.  We are excited to share with you the news that Partners In Care was again honored with a “Best of Home Care” award!

What does it mean to win a “Best of Home Care” Award?  Simply put, a “Best of Home Care” award means that we have proven that we care about quality in both our client and caregiver interactions.

It is important to us that we truly go beyond making statements about “quality and satisfaction” and put them into action. We wanted to share this exciting news with you and hope that it helps you understand how much we care about your experience and your loved one’s quality of life.

by Steven Allred, MS,PT, and Jennifer Ellis, MS,PT

“I’ve fallen and I can’t get up!” How many times have we heard comics deliver that line from a now-famous 1980s TV commercial?

The truth is that a dangerous fall is no laughing matter. It’s a real worry — for those who suffer from balance dysfunction and for the family caregiver.
Just the fear of a parent, spouse or other loved one falling is enough to give a caregiver chills. And the statistics bear that out. The National Institutes of Health says that falls are the leading cause of fatal and non-fatal injuries in people 65 and older. And The New England Journal of Medicine reports that if you’re elderly and are injured by a fall, there’s a good chance you’ll end up in a skilled nursing facility, such as a nursing home.

Hip fractures alone are a serious problem. The American Academy of Orthopaedic Surgeons has estimated that 90 percent of the 352,000 hip fractures recorded in the U.S. each year are the result of a fall. Only a quarter of hip fracture patients make a full recovery. About 40 percent will require nursing home care, half will need a cane or walker and another quarter over age 50 will die within a year of the injury. In fact, the rate of hip fractures begins to increase at age 50 and doubles every five to six years. Women over 50 suffer such fractures at two to three times the rate of men.

Fortunately, there are a series of steps that the caregiver and patient can take to reduce the risk of dangerous falls and increase the safety of maneuvering at home. If balance dysfunction appears to be an issue, both should visit the family doctor for a discussion of the symptoms and possible treatments.

A typical solution will be for the doctor to refer patients to a fall prevention program. Today, there are both traditional and advanced programs available on an outpatient basis and at home. Home therapy programs can offer some distinct advantages over treatment at an institution:

Patients who have balance problems or who have already fallen may not be able to travel to a rehab facility, and it may be inconvenient or impossible for the caregiver to provide transportation.
Home treatment allows the patient to progress in a familiar environment, while institutional therapy can sometimes require a patient to learn movements all over again when he or she gets back to the house.
Home therapy allows a patient to remain among family and friends.
Home programs typically involve individual one-on-one therapy focused on a speedy recovery, while institutional rehab may treat patients in a group setting.
Those patients who still have an active career find it easier to work at home and keep in touch with the office while they’re recovering.

Traditional home fall prevention methods have typically involved “gait training,” which is essentially teaching someone to walk. The patient also gets general strengthening exercises and instruction on how to use an assistive device, such as a cane or walker. The challenge with these basic programs is that they sometimes leave the patient coping with certain limitations when they could actually achieve a higher level of mobility through more advanced treatments.

To guide patients toward the most successful recovery, newer, more advanced therapy programs have emerged to deal proactively with the root causes of balance problems. The causes might involve vision, inner ear or other balance-related issues. Sensation and coordination problems could be factors. There might be pain or numbness in the feet. A patient’s lack of strength or flexibility could be the cause. Or a person’s living area and environment could reveal hazards which increase the likelihood of falls.

These newer programs examine the potential causes through a detailed evaluation. Working with the physician, specially trained therapists then develop and launch treatment plans that are customized for each patient. The success rate is high. Sponsoring home health organizations have begun to document patient outcomes demonstrating the ability of such programs to relieve pain, increase sensation and reduce the risk of dangerous falls.

As part of any fall prevention program, a therapist can make recommendations to the patient and caregiver about improving safety in a home environment. The caregiver can follow through on these and other possible recommendations:

Keep floors clear and reduce clutter.
Ensure that floors are clean and not waxed.
Use non-skid throw rugs.
Install handrails or grab bars in stairways or bathrooms.
Make sure the home is well lit.
Use a sturdy step stool or ladder to reach high places.
Excellent do-it-yourself fall prevention information can often be found on Web sites of state or local health departments, and through local or regional fall prevention coalitions.

Balance programs can help to change the lives of patients and allow them to live more independently at home. A Florida woman resumed her walking regimen and said that her life was worth living again. An 87-year-old pharmacist was able to return to work. Even a 100-year-old Hurricane Katrina survivor was made mobile enough to return to relatives in New Orleans. These new balance therapies can also help to reduce stress for caregivers and help them sleep at night, knowing that an older relative is safe from fall injuries that could send them to the hospital – or worse.

The message is clear: there’s no reason for patients or their caregivers to suffer from a fear of falling when solutions are just a phone call away.

Reference link:

http://www.caregiver.com/articles/general/helping_family_members_with_fall.htm

Last March, Brad Veitch, 60, of Moraga, Calif., discovered that his mother, Marion, had given thousands of dollars to swindlers who used the phone and mail to peddle hard-luck stories and get-rich-quick schemes. To stop the fraud, Veitch had to change his mother’s phone number — twice.

By June, Veitch began to notice that his mother, a former executive for the American Red Cross, was becoming increasingly forgetful and agitated. Around that same time, Veitch lost his job as an administrator for a for-profit school.

Veitch’s mother lives alone in a small town in California’s San Joaquin Valley, a five-hour drive from Moraga. For a while, he drove to her home every other week, usually for three days at a time. She doesn’t own a computer, so Veitch couldn’t use the Internet to search for a job while caring for her. He also worried that he would miss calls from potential employers while on the road.

“So much of job searching today is networking,” he says. “When you connect with a person and they say they’ll call you back, it produces anxiety when you realize (you’re) going to be gone for three days.” Veitch says he’s been out of work before, but this time, “The burden seems to be much greater, and I think it is because my emotional reservoir is depleted. So much of it has gone to Mom.”

Veitch feared he would need to hire a caregiver, something he knew his independent-minded mother would oppose. But a group of friends from his mother’s church has helped him avoid that step. One friend stops by in the morning to make sure she’s taken her medication, another stops by for lunch or dinner, and two check in daily by phone. Their aid has let Veitch, who hopes to be working soon, reduce his visits to once every three weeks.

“The church has really done the day-to-day care,” he says. “If they hadn’t been there, I’d be hiring somebody to do that.”

In many respects, Veitch’s mother is fortunate: She has a committed support group and the financial resources to pay a caregiver if that becomes necessary. Many seniors don’t have those advantages, which means their children are forced to shoulder at least some of the cost of their care. More than 40% of caregivers are spending more than $5,000 a year on a loved one’s care, according to a survey by Caring.com, a consumer website.

The economic downturn has made that burden even heavier. Unemployment, wage cuts and furloughs have diminished many families’ incomes, leaving less money for caregiving. The problem is particularly acute for women, who are the majority of caregivers. Nearly 40% of female caregivers say the downturn has made it harder for them to care for loved ones, according to an April 2010 survey by Volunteers of America.

The downturn “has had an immense impact on women and their ability to care for older loved ones,” says Jatrice Gaiter, executive vice president of Volunteers of America. “Women weren’t making as much in the first place, and a lot have low-level service jobs that don’t allow them to have a lot of extra money.”

There are steps you can take to cut costs that won’t compromise your parent’s care. Five ways to manage caregiving costs:

•Claim your parent as a dependent. Depending on the amount of support you provide, you may be eligible to trim your tax bill by claiming your parents. To do this, your parent’s income, excluding Social Security, must be less than the amount of the personal exemption. For 2010, the personal exemption was $3,650; for 2011, it’s $3,700. In addition, you must provide more than 50% of a parent’s financial support. If the parent lives with you, you can include a percentage of your mortgage and utilities, says Graham Weihmiller, president of Griswold Special Care, a provider of in-home care. You can claim more than one parent as a dependent if both meet the income and support tests, he says.

•Deduct your parent’s medical expenses. If you contribute to a parent’s health care expenses, you may qualify to deduct those costs, even if you can’t claim the parent as a dependent. To claim this deduction, you must provide at least 50% of the parent’s financial support, but you don’t have to meet the income test, Weihmiller says. In addition, the deduction is limited to medical expenses that exceed 7.5% of your adjusted gross income. Qualified expenses include the cost of a nursing home, in-home health care, dental care and prescription drugs. You can include your own unreimbursed medical expenses when calculating total costs.

•Find out if you qualify for government help. Fifteen states offer a Cash & Counseling program for low-income seniors who are eligible for Medicaid. These programs provide eligible seniors with funds to pay for in-home care, including care provided by family members, says Robin Joy, vice president of marketing for Caring.com. A few other states offer similar grants to seniors who have limited income but earn too much to qualify for Medicaid. Your local Area Agency on Aging office can provide information about programs in your state.

•Pay a family member to provide care. More than a third of caregivers surveyed by Caring.com have been forced to quit jobs, take early retirement, reduce hours or take leaves of absence. If you’re in that situation, using a parent’s savings to pay yourself a salary can replace some of that lost income.

To avoid conflicts and confusion, draw up a contract outlining the terms of the agreement and share it with other family members, Joy says. If your parent applies for state assistance, you may need the document to show how his or her money has been spent. You can find more information about caregiving contracts at Caring.com.

•Don’t overlook your own long-term care needs. Veitch says he and his wife have purchased long-term insurance policies because they don’t want to be a burden to their children.

But many families with competing demands on their finances have a hard time paying the premiums. Jeannie Parr, 53, of Columbia, Md., says she’s looked into long-term care insurance, but has some immediate concerns, such as contributing to a college savings plan for her son, Sebastian, 5.

Parr hopes family history is on her side. For most of her 88 years, Parr’s mother was healthy and active. “My mother was a role model,” she says. “She did water aerobics a couple of times a week.”

There are low-cost steps you can take, says Alyson Burns, director of the AARP’s Long-Term Care Awareness Campaign. For example, it costs nothing to draw up a living will and a health care proxy, she says. If you plan to stay in your home, low-cost modifications such as railings and better lighting can reduce the risk of disabling accidents.

Long-term care should be “top of mind for everyone over age 35,” Gaiter says. “You must prepare and take care of yourself.”

Reference link:

http://abcnews.go.com/Business/ways-manage-costs-caring-aging-parent/story?id=13018969&page=1

A fall can change your life. If you’re elderly, it can lead to disability and a loss of independence. If your bones are fragile from osteoporosis, you could break a bone, often a hip. But aging alone doesn’t make people fall. Diabetes and heart disease affect balance. So do problems with circulation, thyroid or nervous systems. Some medicines make people dizzy. Eye problems or alcohol can be factors. Any of these things can make a fall more likely. Babies and young children are also at risk of falling – off of furniture and down stairs, for example.

Falls and accidents seldom “just happen.” Taking care of your health by exercising and getting regular eye exams and physicals may help reduce your chance of falling. Getting rid of tripping hazards in your home and wearing nonskid shoes may also help. To reduce the chances of breaking a bone if you do fall, make sure that you get enough calcium and vitamin D.

Reference link:

http://www.nlm.nih.gov/medlineplus/falls.html

It’s normal to forget things every now and then. We’ve all misplaced our keys, blanked on an acquaintance’s name, or forgotten a phone number we’ve dialed a hundred times before. When we’re young, we don’t tend to pay much mind to these lapses, but as we grow older, sometimes we worry about what they mean.

What’s normal when it comes to memory loss as we age? When should we be concerned? And is there anything we can do to prevent age-related memory loss? Read on to find the answers to these questions and more. Learn the difference between normal forgetfulness and more serious memory problems, the causes of memory loss, and how to stay mentally sharp throughout your golden years.

Memory and aging: What’s normal, what’s not

Forgetfulness is a common complaint among older adults. You start to talk about a movie you saw recently when you realize you can’t remember the title. You’re giving directions to your house when you suddenly blank on a familiar street name. You find yourself standing in the middle of the kitchen wondering what you went in there for.

Memory lapses can be frustrating, but most of the time they aren’t cause for concern. Age-related memory changes are not the same thing as dementia.

As we grow older, we experience physiological changes that can cause glitches in brain functions we’ve always taken for granted. It takes longer to learn and recall information. We’re not as quick as we used to be. In fact, we often mistake this slowing of our mental processes for true memory loss. But in most cases, if we give ourselves time, the information will come to mind.

Memory loss is not an inevitable part of the aging process

The brain is capable of producing new brain cells at any age, so significant memory loss is not an inevitable result of aging. But just as it is with muscle strength, you have to use it or lose it. Your lifestyle, health habits, and daily activities have a huge impact on the health of your brain. Whatever your age, there are many ways you can improve your cognitive skills, prevent memory loss, and protect your grey matter.

Furthermore, many mental abilities are largely unaffected by normal aging, such as:

• Your ability to do the things you’ve always done and continue to do often
• The wisdom and knowledge you’ve acquired from life experience
• Your innate common sense
• Your ability to form reasonable arguments and judgments

Normal forgetfulness vs. dementia

For most people, occasional lapses in memory are a normal part of the aging process, not a warning sign of serious mental deterioration or the onset of dementia.

Normal age-related forgetfulness

The following types of memory lapses are normal among older adults and generally are not considered warning signs of dementia:

• Forgetting where you left things you use regularly, such as glasses or keys.
• Forgetting names of acquaintances or blocking one memory with a similar one, such as calling a grandson by your son’s name.
• Occasionally forgetting an appointment.
• Having trouble remembering what you’ve just read, or the details of a conversation.
• Walking into a room and forgetting why you entered.
• Becoming easily distracted.
• Not quite being able to retrieve information you have “on the tip of your tongue.”

Does your memory loss affect your ability to function?

The primary difference between age-related memory loss and dementia is that the former isn’t disabling. The memory lapses have little impact on your daily performance and ability to do what you want to do.

When memory loss becomes so pervasive and severe that it disrupts your work, hobbies, social activities, and family relationships, you may be experiencing the warning signs of Alzheimer’s disease, or another disorder that causes dementia, or a condition that mimics dementia.

If you or a loved one is experiencing any signs of a more serious memory problem, it’s important to see a doctor to root out the cause. See Understanding Dementia: Signs, Symptoms, Types, Causes, and Treatment.

Reversible causes of memory loss

It’s important to be aware of ways that your health, environment, and lifestyle may contribute to memory loss. Sometimes, even what looks like significant memory loss can be caused by treatable conditions and reversible external factors.

• Side effects of medication. Many prescribed and over-the-counter drugs or combinations of drugs can cause cognitive problems and memory loss as a side effect. This is especially common in older adults because they break down and absorb medication more slowly. Common medications that affect memory and brain function include sleeping pills, antihistamines, blood pressure and arthritis medication, antidepressants, anti-anxiety meds, and painkillers.
• Depression. Depression can mimic the signs of memory loss, making it hard for you to concentrate, stay organized, remember things, and get stuff done. Depression is a common problem in older adults—especially if you’re less social and active than you used to be or you’ve recently experienced a number of important losses or major life changes (retirement, a serious medical diagnosis, the loss of a loved one, moving out of your home).
• Vitamin B12 deficiency. Vitamin B12 protects neurons and is vital to healthy brain functioning. In fact, a lack of B12 can cause permanent damage to the brain. Older people have a slower nutritional absorption rate, which can make it difficult for you to get the B12 your mind and body need. If you smoke or drink, you may be at particular risk. If you address a vitamin B12 deficiency early, you can reverse the associated memory problems. Treatment is available in the form of a monthly injection.
• Thyroid problems. The thyroid gland controls metabolism: if your metabolism is too fast, you may feel confused, and if it’s too slow, you can feel sluggish and depressed. Thyroid problems can cause memory problems such as forgetfulness and difficulty concentrating. Medication can reverse the symptoms.
• Alcohol abuse.Excessive alcohol intake is toxic to brain cells, and alcohol abuse leads to memory loss. Over time, alcohol abuse may also increase the risk of dementia. Because of the damaging effects of excessive drinking, experts advise limiting your daily intake to just 1-2 drinks.
• Dehydration.Older adults are particularly susceptible to dehydration. Severe dehydration can cause confusion, drowsiness, memory loss, and other symptoms that look like dementia. It’s important to stay hydrated (aim for 6-8 drinks per day). Be particularly vigilant if you take diuretics or laxatives or suffer from diabetes, high blood sugar, or diarrhea.

Depression: A common, treatable cause of memory problems

The difficult changes that many older adults face—such as the death of a spouse or  medical problems—can lead to depression, especially in those without a strong support system. But depression is not a normal or necessary part of aging.

Read: Depression in Older Adults and the Elderly: Recognizing the Signs and Getting Help

Preventing memory loss and cognitive decline

The same practices that contribute to healthy aging and physical vitality also contribute to healthy memory.

• Exercise regularly. Regular exercise boosts brain growth factors and encourages the development of new brain cells. Exercise also reduces the risk for disorders that lead to memory loss, such as diabetes and cardiovascular disease. Exercise also makes a huge difference in managing stress and alleviating anxiety and depression—all of which leads to a healthier brain.
• Stay social. People who don’t have social contact with family and friends are at higher risk for memory problems than people who have strong social ties. Social interaction helps brain function in several ways: it often involves activities that challenge the mind, and it helps ward off stress and depression. So join a book club, reconnect with old friends, or visit the local senior center. Being with other people will help keep you sharp!
• Eat plenty of fruits, vegetables, and omega-3 fats. Antioxidants, found in abundance in fresh produce, literally keep your brain cells from “rusting.” And foods rich in omega-3 fats (such as salmon, tuna, trout, walnuts, and flaxseed) are particularly good for your brain and memory. Also avoid saturated and trans fats, which helps cholesterol levels and reduces your risk of stroke.
• Manage stress. Cortisol, the stress hormone, damages the brain over time and can lead to memory problems. But even before that happens, stress causes memory difficulties in the moment. When you’re stressed out, you’re more likely to suffer memory lapses and have trouble learning and concentrating.
• Get plenty of sleep. Sleep is necessary for memory consolidation, the process of forming and storing new memories so you can retrieve them later. Sleep deprivation also reduces the growth of new neurons in the hippocampus and causes problems with memory, concentration, and decision-making. It can even lead to depression—another memory killer.
• Don’t smoke. Smoking heightens the risk of vascular disorders that can cause stroke and constrict arteries that deliver oxygen to the brain.

Walking: An easy way to fight memory loss

New research indicates that walking six miles to nine miles every week can prevent brain shrinkage and memory loss. According to the American Academy of Neurology, older adults who walked between 6 and 9 miles per week had more gray matter in their brains nine years after the start of the study than people who didn’t walk as much. Researchers say that those who walked the most cut their risk of developing memory loss in half.

Brain exercises to prevent memory loss and boost brainpower

When it comes to memory, it’s “use it or lose it.” Just as physical exercise can make and keep your body stronger, mental exercise can make your brain work better and lower the risk of mental decline.

Here are some ideas for brain exercise, from light workouts to heavy lifting:

• Play games that involve strategy, like chess or bridge, and word games like Scrabble.
• Try crossword and other word puzzles, or number puzzles such as Sudoku.
• Read newspapers, magazines, and books that challenge you.
• Get in the habit of learning new things: games, recipes, driving routes, a musical instrument, a foreign language.
• Take a course in an unfamiliar subject that interests you. The more interested and engaged your brain, the more likely you’ll be to continue learning and the greater the benefits you’ll experience.
• Take on a project that involves design and planning, such as a new garden, a quilt, or a koi pond.

To learn more, see: How to Improve Your Memory: Tips and Exercises to Sharpen Your Mind and Boost Brainpower.

Compensating for memory loss

Even if you are experiencing a troublesome level of memory loss, there are many things you can do to learn new information and retain it.

When to see a doctor for memory loss

It’s time to consult a doctor when memory lapses become frequent enough or sufficiently noticeable to concern you or a family member. If you get to that point, make an appointment to talk with your primary physician and have a thorough physical examination.

The doctor will ask you a lot of question about your memory, including:

• how long you or others have noticed a problem with your memory
• what kinds of things have been difficult to remember
• whether the difficulty came on gradually or suddenly
• whether you’re having trouble doing ordinary things.

The doctor also will want to know what medications you’re taking, how you’ve been eating and sleeping, whether you’ve been depressed or stressed lately, and other questions about what’s been happening in your life. Chances are the doctor will also ask you or your partner to keep track of your symptoms and check back in a few months.

Further evaluation of memory function

If your memory problem needs more evaluation, your doctor may send you to a neuropsychologist, who will provide you with pencil-and-paper tests that gauge different aspects of mental ability. If those tests show abnormal results, the doctor will try to rule out causes of cognitive dysfunction based on conditions such as vascular disease, psychological problems, eating and drinking habits, and environmental factors.

A problematic showing on mental ability tests means you’ll probably go in for imaging studies of the brain, such as a CT or MRI scan, which can detect anything putting pressure on your brain, and, if that’s normal, a SPECT or PET scan, which track blood flow and metabolic activity in the brain. These are currently the most sensitive tools for revealing brain abnormalities.

If you are diagnosed with mild cognitive impairment or early Alzheimer’s disease, you may benefit from one of the medications that work by protecting acetylcholine, a brain chemical that facilitates memory and learning.

Reference link:

http://www.helpguide.org/life/prevent_memory_loss.htm

Listen now

People across the country are already facing the tough decisions on how to care for an aging parent. How do you bring up the topic with your elderly parent? What kind of care is best for your relative? What skills do you need to navigate the unfamiliar and sometimes difficult waters of caring for an elderly loved one? We’ll talk about it with a panel of experts.

Guests

Dr. William Cody – Dean, Blair College of Health at Queens University of Charlotte

Heather Roberts – RN, Instructor/ Program Coordinator, Certified Nurse Assistant Program at Queens University of Charlotte

Marilyn Morenz – RN and Certified Hospice and Palliative Care Nurse, Hospice and Palliative Care Charlotte Region

Debi Hinkle – Heather Roberts’ mother, cares for an elderly parent

http://www.wfae.org/wfae/18_93_0.cfm?do=detail&id=12987

Macular degeneration (MD) is an eye disorder affecting more  than 13 million Americans, and is generally considered to be irreversible. In fact, more people are affected by MD than by glaucoma and cataracts combined. It is the leading cause of blindness in those over the age of 55, with a new case of age-related macular degeneration (AMD) diagnosed every three minutes. (Age-related macular degeneration is a term used for the disorder when it affects people over the age of 60.) The cause of MD is not known, but the condition runs in families, and it likely has a genetic component. It affects an equal number of women and men, but seems to be more common among Caucasians than African-Americans.

Macular degeneration refers to the breakdown of the macula – the central portion of the retina. The function of the retina is to receive visual images, to partially analyze them and transmit the information to the brain. The macula contains the most concentrated collection of light-sensing nerves in the retina and is responsible for producing the most critical aspects of vision. There is a rich supply of blood vessels that carry oxygen and important nutrients to the retina that are required for healthy vision, and disruption of this vasculature can be a contributing factor in MD. The retina has no pain nerve fibers, therefore most diseases that affect the retina do not cause pain.

There are actually two forms of MD. The first, atrophic or dry MD, results from a gradual breakdown and degeneration of critical photoreceptors in the eye that provide night vision and visual acuity. The second, exudative or wet MD, is caused by leaks in the blood vessels of the retina. The bleeding causes scarring and retinal tissue death. About 80 to 85 percent of those with MD have the atrophic form; but most cases of severe vision loss can be attributed to the exudative form. About 10 percent of those with dry MD will also develop the wet form.

Causes and Symptoms

Although there are no definitive answers as to what specifically causes MD, there are a few emerging theories that may help explain what circumstances lead to the problem. Since the macula depends for its healthy functioning on one of the highest rates of blood flow through its blood vessels, anything that interferes with this blood flow can cause the macula to malfunction.

The following dietary or lifestyle choices can reduce the supply of oxygen and vital nutrients to the retina and eventually lead to the death of cells in the retina and macula:

• Smoking can decrease blood supply by causing a narrowing of the blood vessels and a thickening of the blood, much the same as in a heart attack or stroke.
• High saturated-fat diets can cause plaque buildup along blood vessel walls, including the macular vessels, which impedes blood flow.
• A lack of antioxidants, such as vitamin C, vitamin E and lutein may increase the ability of plaque to stick to the blood vessel walls and promote the damage of the tissue.

With macular degeneration there is typically a loss of vision in both eyes. The initial symptom may be a distortion of vision in one eye, causing straight lines to appear wavy. Eventually, loss of central vision worsens, making it difficult to see at long distances, read up close, see faces clearly or distinguish colors. Peripheral vision (what you see out of the corners of your eyes) is not affected.

Recommended Lifestyle Changes

• Don’t smoke and avoid exposure to second-hand smoke.
• Protect your eyes. Be sure to wear sunglasses that contain UV protection.
• Follow a diet that is very low in saturated fat and rich in antioxidants, focusing on vegetables, fruit, and legumes including soy, whole grains and fish.
• Eat antioxidant-rich berries, especially blueberries, frequently.
• Increase your intake of antioxidants such as vitamins C and E, lutein and zinc.

Nutrition and Supplements

Try to choose foods or take supplements that contain vitamin C, vitamin E and lutein, as well as zinc. Vitamin C-rich foods include citrus fruits, melons, tomatoes, potatoes and broccoli. You can get vitamin E from soybeans, greens, fish, wheat germ, nuts and seeds. Dietary sources of zinc are legumes (peas, dried beans, garbanzos/chickpeas, black-eyed peas, lentils and soy products) and whole grains. The carotenoid pigment lutein is found naturally in spinach, kale, collard greens, romaine lettuce and peas. Other protective compounds are the red and purple pigments found in berries and other fruit. Eat berries, especially blueberries, often. You can also get these pigments into your diet with supplements of bilberry, grape seed extract or pine bark extract. My recommendations for daily vitamin E are to take 400-800 IU of natural mixed tocopherols, or at least 80 mg of natural mixed tocopherols and tocotrienols. People under 40 should take 400 IUs a day; people over 40, 800 IUs.

Reference link:

http://www.drweil.com/drw/u/id/ART02006

What is “Aging in Place”

We are using the term “aging in place” in reference to living where you have lived for many years, or to living in a non-healthcare environment, and using products, services and conveniences to enable you to not have to move as circumstances change. More recently “Aging in place” is a term used in marketing by those in the rapidly evolving senior housing industry. CCRCs, (Continuing Care Retirement Communities), by definition offer the chance to age in place, but first you must move to their community to “start aging”. Multi-level campuses market “Independent Living”, “Assisted Living” and perhaps Alzheimer’s care and Skilled Nursing in one location, and claim to offer the opportunity to “age in place.” But again you must move there first. In many cases you must also move from one wing of the campus to another to receive the increased services.

What is a “NORC”

A NORC is a community or neighborhood where residents remain for years, and age as neighbors, until a Naturally Occurring Retirement Community develops. A NORC may refer to a specific apartment building, or a street of old single family homes. Residents would just have stayed and just aged.

It is possible to band together and develop, or seek help to develop, access to services to aid those needing assistance, thereby retaining the highest quality of life for all residents as they age.

Fair housing laws provide for a complex with 80% of its residents over 55, to become officially age restricted. Another classification for restricted age is for 100% of residents to be above the age of 62, but this is rare in an evolving NORC.

For many years the law required an age restricted community to offer significant amenities and services if it was age restricted. That is no longer the case, but to compete, and attract residents, we still see most age restricted communities offering amenities and services to serve their residents.

Significant amenities and services may include:

• Social and recreational programs
• Continuing education programs
• Information and counseling
• Outside maintenance and referral services
• Emergency and preventive health care programs
• Meal Programs
• Transportation on a schedule

Why Aging in Place

A significant concern as people grow older is that they may have to leave their home. This would mean leaving behind a comfortable setting familiar community and many memories. In addition a certain amount of control is lost when one leaves home. This “control” provides the underpinning to our feelings of dignity, quality of life and independence. One’s home is a strong element in that sense of security.

Most American seniors desire to stay in their homes for the rest of their lives. In fact an AARP survey found this number to be greater than 80% of seniors. This “stay at home” approach is also known as “Aging in Place” Several reasons are cited for this strong Aging in Place preference. These include:

	Comfortable Environs			Feelings of Independence
	Convenience to Services			Familiarity
	Safety and Security			Proximity to Family

“Aging in place” successfully requires planning. To accommodate physical, mental, and psychological changes that may accompany aging, physical changes should be made in your home.

Changes Related to Aging

Contrary to popular belief, most American seniors live independently while maintaining strong relationships with family and friends. Their personalities remain relatively stable throughout their lives. Depression occurs less in uninstitutionalized seniors than among young adults.
Normal age related changes do occur. These may include:

Hearing impairment

Failing vision,

Osteoporosis.

Increased likelihood of arthritis, diabetes, heart disease, and hypertension,

Mental process changes

• speed at which information is processed
• speed of responding to changes in the environment
• long term memory decline
• word finding ability declines

Visual decline

• decreased reading speed
• seeing acuity in dim light
• reading fine print
• sensing peripheral changes

These changes may lead to difficulties in interacting with one’s living environment. These include:

Decreased mobility and dexterity

Decreased strength and stamina

Reduced sensory acuity: vision, hearing, thermal sensitivity, touch, smell

However some functions tend to remain the same with advancing age and changes differ between people. While seniors tend to process new information slower, daily social and occupational functioning ability remains stable. Most language related skills also tend to remain stable with age. Most notably, creativity and wisdom continue at strong levels.

In addition to physical changes, seniors experience social changes that may be disruptive. These include: isolation from family and friends, loss of peers children living far away and a changing neighborhood

The majority of seniors learn to adapt to their changing situations and lead happy and productive lives. Read more about changes related to aging.

Aging and Your Home

The aging process is blamed for many problems seniors may encounter with daily activities. However quite often it is the home creates the difficulties. Most residential housing is geared to young healthy adults. Builders do not take into account age-related conditions such as reduced mobility or limited range of reach. Hence, dwellings do not support the physical and sensory changes that older adults encounter as they age. What appear to be insignificant home features can have significant effect: for a person with even minor aging issues.

Many seniors avoid home modifications and helpful technology items designed for people with disabilities,.because these products have an industrial appearance. No one wants to have their home look like a hospital. Consumer demand and computer technology have pushed institutional products to be redesigned to be more acceptable in the home. Some of these include:

Chairs designed for easier in and out

Enhanced high and low frequency tones for doorbells and telephones

Grab bars and hand rails with decorator colors

Hospital type beds with wooden headboards and footboards

Items that are easier for arthritic hands to handle,

Larger print for declining eyesight

On/off buttons with color contrasts

Walkers in bright hues

The National Center for Injury Prevention and Control (NCIPC) states that falls are the number one cause of home injury, and studies suggest that a significant proportion of all falls are due to environmental factors
The three leading causes of home injuries, according to the NCIPC, are: falls, burns and poisoning. Seniors are especially susceptible to these types of injuries. Most falls are caused by environmental factors such as a home not truly suited for a person with elderly issues. Burns are caused primarily from fires. Older adults are killed in home fires at twice the rate of society as a whole (National Association of Home Builders [NAHB], 1990) Poisoning is mostly caused by medicine non-compliance: older adults are six times more likely than other age groups to suffer adverse medical reactions (Alliance for Aging Research, 1998).

One of the bigger challenges is to identify safety issues that may be unique to an individual based on their particular aging status and conditions. While research via books and the internet can help focus on such issues the use of a good checklist in assessing the home environment is helpful.

Home Assessment

It is important to do a thorough assessment of the home to assure that it can properly handle an elderly or infirm individual. The following table provides a summary of items to review and or consider.

Senior Difficulty	Possible Remedy
Balance and Coordination Problems	Bath seat in the tub or shower.
	Bath tub with transfer bench
	Counters edges are rounded
	Grab bars near the bath and toilet.
	Handrails extend beyond the top and bottom of the stairs.
	No stairs to bedroom or bathroom.
	Phone in the bathroom.
	Stairway handrails on both sides.
	Walk-in shower with pull-down seat.
Hearing Impairment	Dishwasher is ultra-quiet to reduce background noise.
	Increased volume on phones.
	Smoke detectors have strobe lights.
Limited Reach	Cabinet shelves are no more than 10 inches deep.
	Closet organizer to reach belongings.
	Closet rods pull down to a comfortable level.
	Clothes washer and dryer are front-loading
	Cooktop has easy-to-reach controls at the front.
	Electrical outlets are 27 inches above the floor.
	Hand-held shower in bathroom.
	Kitchen and closets have pull-down shelving.
	Lazy Susan to reach things stored on deep shelves.
	Microwave oven is no higher than 48 inches above the floor.
	Oven doors swing to the side.
	Pull-out shelves in the kitchen.
	Side-by-side refrigerator.
	Sink controls are on the side
	Upper kitchen cabinets are 48 inches from the floor.
Limited Vision	Edge of counters a different color than the top.
	Edge of each step is a color that stands out.
	Increased wattage of light bulbs.
	Lights are in all closets.
	Outside walkways, and entrances are all well-lit.
	Stairs are well lit.
	Steps are a different color than the surrounding area.
	Stove controls are clearly marked and easy to see.
	Stove has big numbers that can seen from across the room.
	Stove uses different colors to tell which parts are hot.
	Under-the-cabinet lights are over the kitchen counter.
Poor Hand and Arm Strength	Automatic garage door opener.
	Cabinets and drawers have D-shape handles.
	Countertops smooth so heavy pans can slide across them.
	Doors have lever handles.
	Garbage disposal to reduce trash
	Heat-resistant counter near microwave oven.
	Push-button controls are on appliances.
	Rocker light switches
	Sinks with lever faucet handles.
	Special hardware to make drawers slide easily.
	Spray hose to fill pots on the stove
	Trash compactor to minimize trash bags.
	Dishwasher is eight inches from the floor.
Trouble Bending	Elevated toilet or toilet seat.
	Lower kitchen cabinets six inches above the floor.
	Sink no more than 6 inches deep.
	Carpet is low pile and a firm pad.
	Clutter and electric cords are out of pathways
	Countertop that can be used while sitting
	Doors are wide enough for a walker to get through.
Trouble Walking and Climbing Stairs	Driveway is smooth, but not slippery.
	Floors are smooth and slip-resistant.
	Knee space under sinks, can sit while washing.
	Knee space under the stove, can sit while cooking.
	No area rugs.
	Ramp to front door with handrails on both sides.
	Stairs have slip-resistant surface.
	The threshold on door is no higher than 1/4 inch.
Uses a Wheelchair	“Walk-in” closet wide enough for wheelchair.
	Appliances have controls at the front
	Cabinet shelves no more than 10 inches deep.
	Can use my counter while sitting in a wheelchair.
	Can wheel from car to the front door and then inside.
	Can wheel to bedroom, bathroom, and kitchen.
	Closet organizer to help reach all belongings.
Uses a Wheelchair (cont’d)	Closet rods pull down to a comfortable level.
	Clutter and electric cords are out of pathways.
	Doors and hallways are wide enough for a wheelchair.
	Electrical outlets are 27 inches above the floor.
	Enough floor space near doors to move wheelchair.
	Floors are smooth; carpet has a low pile and a firm pad.
	Handheld shower.
	Heat-resistant counter near my microwave oven.
Uses a Wheelchair (cont’d)	Kitchen ad closets have pull-down shelving.
	Knee space under all sinks.
	Knee space under the stove.
	Lazy Susan to reach things stored on deep shelves.
	Microwave oven is no higher than 48 inches above the floor.
	Oven doors swing to the side.
	Pullout shelves in the kitchen.
	Ramp has an edging.
	Ramp to my front door with landings at bottom and top.
	Roll-in shower.
Uses a Wheelchair (cont’d)	Side-by-side refrigerator.
	Space to transfer from wheelchair to toilet.
	Threshold on door is 1/4 inch or less.
	Walkway and driveway are smooth but not slippery.
	Way to transfer into the tub.

Additional items to review

Safety Related Items

Successful “aging in place” requires identifying and correcting any safety pitfalls. These may include many things some of which were noted in the table above. However, preventing falls must be a major focus to assure a safe environment.

Senior Low Vision

Over one million Americans aged 40 and over are currently blind and an additional 2.4 million are visually impaired.

The leading causes of vision impairment (low vision) and blindness in the U.S. are diabetic retinopathy, age-related macular degeneration, cataract, and glaucoma.
– DIABETIC RETINOPATHY is a common complication of diabetes. Retinal blood vessels can break down, leak, or become blocked, affecting and impairing vision over time. Nearly half of all people with diabetes will develop some degree of diabetic retinopathy during their lifetime, and risk increases with age and duration of diabetes. People with diabetes are encouraged to seek annual dilated eye exams. Currently, laser surgery and a procedure called a vitrectomy are highly effective in treating diabetic retinopathy. Research into pharmaceutical treatment options is continuing.
– AGE-RELATED MACULAR DEGENERATION is a condition that primarily affects the part of the retina responsible for sharp central vision. There are two forms of AMD — dry AMD and wet AMD. Because AMD often damages central vision, it is the most common cause of legal blindness and vision impairment in older Americans (AMD rarely affects those under the age of 60). While there is no generally accepted treatment for dry AMD, laser therapies to destroy leaking blood vessels can help reduce the risk of advancing vision loss in many cases of wet AMD. Research sponsored by the National Eye Institute has recently shown that a combination of zinc, vitamins C and E, and beta-carotene may also reduce the risk of advanced AMD by 25 percent.
– CATARACT is a clouding of the eye’s naturally clear lens. Most cataracts appear with advancing age. Scientists are unsure what causes cataract. The most important factor is increasing age, but there are additional factors, including smoking, diabetes, and excessive exposure to sunlight. Cataract is the leading cause of blindness in the world, and affects nearly 20.5 million Americans age 40 and older. By age 80, more than half of all Americans develop cataract. Cataract is sometimes considered a conquered disease because surgical treatment that can eliminate vision loss due to the disease is widely available. However, cataract still accounts for a significant amount of vision impairment in the US, particularly among people age 65 and over who may have difficulty accessing appropriate eye care.
– GLAUCOMA is a disease that causes gradual damage to the optic nerve that carries visual information from the eye to the brain. The loss of vision is not experienced until a significant amount of nerve damage has occurred. For this reason, as many as half of all people with glaucoma are unaware of their disease. About 2.2 million Americans age 40 and older have been diagnosed with glaucoma, and another two million do not know they have it. Most cases of glaucoma can be controlled and vision loss slowed or halted by timely diagnosis and treatment. However, any vision lost to glaucoma cannot be restored.
Those affected by low vision often become depressed, are prone to falls and resultant injuries, and many are socially isolated. There are several things that can be done to assist those with low vision.

Senior Fire Safety.

The physical and mental impairments that tend to accompany aging tend to reduce older adults’ reaction times and place them at a higher risk for causing fires, and thus at a higher risk of fire injury.

Disabilities present additional fire risks and concerns for the elderly. Many Medicare enrollees re unable to complete at least some of the normal activities of daily living (ADL) necessary for a degree of self-sufficiency.

Economic and social concerns also contribute to the fire risk for older adults. Most live on fixed incomes and many live in poverty. Hence, they may be unable to afford to make necessary home improvements that could substantially reduce their risk of fire.

Remodeling Your Home

There are a number of items to consider when remodeling your home. You may wish to consult a professional early in your evaluation process. No one is going to make all of the modifications, but be wise regarding those you focus on. i.e. if you already know your eyesight is failing, focus on modifications that benefit poor, or poorer eyesight the most. If you have arthritis that impairs mobility, focus on modifications that cater to your anticipated increasing mobility limitations.

Wheelchair Options and Accessories

Patient Lifts

Patients Lifts offer caregivers the ability to utilize mechanically assisted transfer. Using patient lifts help prevent occupational injuries associated with repeated manual lifting. Transfers are difficult on both the caregiver and the patient’s body. Patient lifts allows for transfers from beds, wheelchairs, showers and bathtubs. While you might first encounter a patient lift in a hospital, there are affordable options made for your home. The following is a rough overview of your choices when it comes to patient lifts. 1. Manual Patient Lifts: a bit of a misnomer, these lifts use hydraulics. o Pros: o Cons: Economical Greater portability No motor to maintain or power More effort required of the caregivers part 2. Powered Lifts: uses a motor to power transfer. o Pros: o Cons: Less effort and strain, simply press a button to lift and lower the patient Quiet and smooth transfer the patient Remote controlled allows easier patient transfer Cost - 3x to 4x manual lifts Less portable 3. Overhead Ceiling Lifts: Attaches a track and lifting mechanism to the ceiling o Pros: o Cons: Most stable Extensive initial set-up Not transportable

Reference link:
http://www.seniorresource.com/ageinpl.htm#place

Fall Prevention Program   :

http://www.theseniorschoice.com/mm/fall-prevention.html

Cognitive Retention Therapy Program  :

http://www.theseniorschoice.com/mm/cognitive-retention-therapy.html

Here are a couple recent Charlotte Radio Records from WBT with Keith Larson:

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