Senior Matters

Tips for Downsizing

DownsizingAdvice from Amy Roberts
at Out of the Box Moves

Thinking about moving out of your home and downsizing to a smaller home?  Out of the Box Moves is a company that specializes in moving and downsizing and has a few tips that will make this process flow smoother. The first step you will have to make is to decide what you want to take with you and what to do with the rest of your stuff!

The best way is to focus on one room at a time, do not try to do the whole house at once; you will get overwhelmed. Work your way around the room clockwise, or if you insist, counter-clockwise.

Ask yourself the following questions:

Do I use it?

When did I use it last?

Do I need it?

You may want to use sticky notes and label things accordingly. Some suggestions we have are to label items: keep, donate, sell, or give to family or friends.  Other items may just go right into the trash bag or recycle bin.  Once your decision is made, place items in a bin or box that is labeled appropriately.

When organizing the master bedroom, go through your clothes in your closet and bureau, and ask yourself the following questions…

When did I wear it last?

Does it still fit? 

Be sure to have a trash bag ready because it is okay to throw out old socks, nylons, or pilled sweaters.   When an item can be appreciated and worn by someone else, it can be donated. Throw out old hangers and give back the metal ones to the dry cleaners.  Look down at all of those shoes on the floor or hiding in boxes. Old sneakers, which are worn down and actually not good for your posture, can go in the trash, and dress shoes that you will never wear again, can be donated.  And do you really need four pairs of bedroom slippers and those chic expensive boots that hurt your feet? It is time to donate those!

I bet there are a lot of things you can throw out in your bathroom!  First, gather all those expired medications and dispose of them according to your community’s guidelines.  Toss the little soaps and shampoos you have collected from hotels and those ragged washcloths and stained towels.  There is probably an old hairdryer that always shorted out and a curling iron or an electric shaver that has not been used in years. Those can all be thrown out as well. A great way of getting rid of your old sheets, towels, and blankets is to donate them to your local animal shelter to help pets in need.

Now in the living room, you may have shelves full of books or maybe even some textbooks from college collecting dust.  Fill grocery bags with these books and donate them to the local library. If you have a very large amount of books, contact More Than Words, a worthy nonprofit organization in Waltham. They will come and pick up the books from your home. You may also have some decorative items in your living room that may be valuable. Have an antique dealer or auctioneer visit your home to provide you with an estimate of what they are worth. It all depends on the condition of the piece and if it is in demand.

Now onto tackling the office…what about those piles of papers, warranties, cancelled checks, and tax returns that you are determined to sort through some day? If you have a good filing system, that’s great.  If not, buy folders and sort through the papers, and then label each folder accordingly. To make this process easier, listen to music or do it while watching T.V. Create a minimal amount of files and at the same time fill the recycle bin with all the unnecessary papers. Confidential papers should always be shredded. If you do not have a shredder, you can take your papers to Staples, which only charges a small fee for shredding. You do not have to keep things for years and years anymore because so much is electronically stored today.

Photographs are an essential part of our lives and a lot of our memories live within them.  So choose a few of your favorite framed photos to bring with you to your new home.  The rest of the photos can be removed from the frames and put into photo albums.  You can also go through and sort your collection of family photos and distribute them to the appropriate family members.  I am sure they would love to have them! Another option is to scan your photos to make them digital, which would enable you to share fond memories online with family and friends and preserve your memories.

And now for the real challenge—the kitchen! When was the last time you used that George Foreman grill or the waffle iron or the electric percolator? If the small appliances are clean and in good working condition, they can be donated. If any of your mugs, plates or glasses are stained or chipped, it is time to toss them into the trash.  Start using your nicer dinnerware, why wait? If you have a collection of vases, keep just a few, recycle the chipped one, and donate the rest.

As far as your garage and attic are concerned, you may need to recruit some family members or a service to help you. Especially, if you have accumulated quite a lot of gardening equipment, paint cans, and old sports equipment over the years.

Another helpful hint is to create a schedule, put it on the fridge, and give yourself a deadline so that this whole process doesn’t drag on and drag you down. By taking this first step of de-cluttering your home, you will be able to envision your new life in your next home surrounded by the things that you chose and that make you happy!

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SENIORS PREPARE FOR WINTER WEATHER!

Senior Citizens are encouraged to prepare for Emergencies such as severe winter weather this time of year.

The Town of Lexington Health Division and the Human Services Department join the Massachusetts Department of Public Health “Together We’re Ready” Campaign to Encourage Senior Citizens, Individuals and Families to Plan Ahead for various Emergencies.  “Emergencies can happen at any time as evident by recent weather related events, such as the record breaking snowfall in Buffalo New York. Taking a few simple steps now to prepare yourself and your family will help Lexington recover more quickly and lessen the impact to your normal schedule.  Every step that we take to prepare ourselves and our families for emergencies makes Lexington stronger and more resilient when the unexpected happens,” said Gerard F. Cody, Health Director for the Town of Lexington. “Now’s the time to be informed, plan ahead, and get prepared.”

Senior Citizens should consider these steps to better prepare for an emergency:

PREPARE A KIT OF EMERGENCY SUPPLIES FOR YOUR HOME

Make an special kit for winter emergencies.

Make a special kit for winter emergencies.

While there are many things that might make you more comfortable, think first about fresh water, food and your specific medical supplies. For example, if you use eyeglass or hearing aids, be sure you always have extra supplies in your kit. Also have copies of your medical insurance, Medicare and Medicaid cards readily available. If you have a service animal, be sure to include food, water, collar with ID tag, medical records and other emergency pet supplies.

Medications and Medical Supplies: If you take medicine or use a medical treatment on a daily basis, be sure you have what you need on hand to remain independent for at least a week and keep a copy of your prescriptions as well as dosage or treatment information. If it is not possible to have a week-long supply of medicines and supplies, keep as much as possible on hand and talk to your pharmacist or doctor about what else you should do to prepare. If you undergo routine treatments administered by a clinic or hospital or if you receive regular services such as home health care, treatment or transportation, talk to your service provider about their emergency plans. Work with them to identify back-up service providers within your area.

Emergency Documents: Include copies of important documents in your emergency supply kits such as family records, medical records, wills, deeds, social security number, charge and bank accounts information and tax records. It is best to keep these documents in a waterproof container. If there is any information related to operating equipment or life-saving devices that you rely on, include those in your emergency kit as well. If you have a communication disability, make sure your emergency information list notes the best way to communicate with you. Also be sure you have cash or travelers checks in your kits in case you need to purchase supplies.

MAKE A PLAN FOR WHAT YOU WILL DO IN AN EMERGENCY

Develop a Family Emergency Plan:  Your family may not be together when disaster strikes, so plan how you will contact one another and review what you will do in different situations. Consider a plan where each family member calls, or e-mails, the same friend or relative in the event of an emergency

Create a Personal Support Network: If you anticipate needing assistance during a disaster, ask family, friends and others to be part of your plan. Share each aspect of your emergency plan with everyone in your group, including a friend or relative in another area who would not be impacted by the same emergency who can help if necessary. Include the names and numbers of everyone in your personal support network, as well as your medical providers in your emergency supply kit. If you use a wheelchair or other medical equipment, show friends how to use these devices so they can move you if necessary and teach them how to use any lifesaving equipment or administer medicine in case of an emergency. Practice your plan with those who have agreed to be part of your personal support network.

Consider Your Pets: Whether you decide to stay in your home or go to another home, hotel or shelter, you will need to make plans in advance for your service animal and pets. Keep in mind that what’s best for you is typically what’s best for your animals.  If you choose to leave your home, take your pets with you or make other arrangements to keep them safe.

BE INFORMED ABOUT WHAT MIGHT HAPPEN

Watch television and listen to the radio for official instructions as they become available. For specific news in Lexington, sign up for Code Red® Emergency Notification System. Code Red is utilized by the Town of Lexington to notify residents and businesses by quickly providing information, instructions and updates on an emerging threat or emergency situation.  It is a high speed telephone and text messaging system that uses a combination of published white page listings. Residents and business owners can help ensure a better response by logging on to the Town of Lexington Code Red website, (http://lexingtonma.gov/police/codered.cfm) to add preferred mobile phone numbers, text numbers or email addresses. If you do not have a traditional land line phone service, you can still participate in the Code Red Emergency Notification System but you must log onto the website to add your mobile phone number or email address.

The Together We’re Ready – Massachusetts Prepared campaign features online videos and resources developed by the Massachusetts Department of Public Health.  Check out the “Together We’re Ready” web page at www.mass.gov/dph/ready  where you can find more information about individual and family preparedness, volunteer opportunities, emergency planning for the whole community and tips for flu prevention.

For a free “Emergency Medical Info Kit”, please visit the Office of Community Development, Health Division in the Town Office Building at 1625 Massachusetts Avenue. If you have any questions concerning this matter, you may contact Gerard F. Cody, REHS/RS at (781) 698-4522 or by email at gcody@lexington.ma.

WINTER DRIVING CAN BE CHALLENGING, EVEN FOR THE MOST EXPERIENCED DRIVERS

Here are some tips from MassDOT Registry of Motor Vehicles Division.

THINK TWICE IF THERE’S SNOW OR ICE

Listen to traffic and weather reports. Use the news as a guide – when school is cancelled, consider staying home.  This allows plows the time and space needed to treat and clear roads of any snow or ice.

PREPARE YOUR CAR FOR WINTER

  • Before driving in winter weather, there are several things you should do to ensure your safety and the safety of others around you.
  • Take extra time to remove ice and snow from your vehicle. Clear all windows, windshield wipers, headlights, and brake lights, forward sensors, and back-up camera.
  • Clear the roof of your car so ice and snow does not blow into vehicles behind you.
  • Keep windshield washer fluid reservoir filled with winter fluid that won’t freeze and keep extra winter fluid in your car.
  • Equip your car with winter wipers
  • Be sure the exhaust pipe is clear of packed snow before starting engine. Cold temperatures affect tires. Check tire pressure with a portable tire gauge, to make sure pressure is equal to the vehicle manufacturer’s recommended inflation pressure. The manufacturer’s recommended inflation pressure is listed in the owner’s manual as well as on the driver’s side door frame of rear edge of the driver’s door.

KEEP THE FOLLOWING ITEMS IN YOUR VEHICLE:

Fully-charged mobile phone; mobile phone car charger; ice scraper; blanket; flashlight; energy bars; water; small shovel; play sand or non-clumping kitty litter. Spread play sand or kitty litter on snow directly in front of and behind tires to create traction for tires that are stuck in snow.

WINTER DRIVING TIPS

  • Motor vehicles perform very differently on ice and snow than on warm, dry pavement. Keep speeds down. Tires have less traction on cold, slick surfaces.
  • Delay driving until snow plows have had time to treat roads and remove snow. If you must go out when it is snowing, start slowly and if it is safe to do so, test your brakes by gently tapping them to see how much traction your tires have.
  • Drive carefully and accelerate slowly.
  • Leave more distance between your vehicle and the vehicles in front of you. More space is required to stop safely on slippery surfaces.
  • Never lock your brakes on icy roads. You will lose steering control. If you skid, remember to turn into the direction of the skid until vehicle straightens out.
  • Drive with headlights on to help you see and be seen.
  • Intersections can be dangerous, even more so in the winter. Heavily traveled intersections can become “polished” and slick. Make turns slowly and gradually. Gently brake and slow the vehicle before a curve, not while you are in it.
  • Give active snow plows plenty of space, leaving at least 5 car lengths between you and the snow plow. Don’t drive beside a snow plow . According to NHTSA, the road behind an active snow plow is safer to drive on. If you find yourself behind a snow plow, stay behind it or use extreme caution when passing.

HANDLING A SKIDDING VEHICLE

  • Handle the skid the same for front-wheel drive and rear-wheel drive vehicles.
  • Fast acceleration can make wheels spin on ice and snow. Locking brakes on icy roads causes the driver to lose steering control. If you skid, stay calm and remove your foot off the gas pedal.
  • Do not hit the brakes – this will make the skid worse.
  • Turn your steering wheel in the direction of the skid. If your rear tires are skidding to the left, turn your steering wheel left. If they are sliding right, steer right.
  • You may need to steer left and right a few times until you get your car completely under control.

More detailed information can be found in the Massachusetts Driver’s Manual at MASSRMV.COM as well as at NHTSA.GOV.

Sources-  http://www.safercar.gov/Vehicle+Owners/Resources/Winter-driving-tips-static

http://www.massrmv.com/rmv/dmanual/chapter_5.pdf

Make an special kit for winter emergencies.

Make an special kit for winter emergencies.

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November is National Family Caregiver Month

Care Managers: A Valuable Resource for Family Caregivers

A By Leslie May-Chibani

POWERFUL TOOLS FOR CAREGIVERS

Free educational workshops offer information and support in a caring environment. Funded in part through the Northwest Suburban Health Alliance/CHNA 15 DoN funds from Lahey Hospital and Medical Center and Winchester Hospital. If you would like more information about upcoming classes, or if your organization would like to host a class, please call Amy DeAngelis at 781-221-7045.

Lexington: January 20 – February 24
Class meets Tuesdays for 6 weeks, 9:00 AM – 10:30 AM.

Please call 781-860-7084 to register. Classes will be held at Lexington Senior Center, 1475 Massachusetts Avenue, Lexington, MA

 

Minuteman Senior Services skilled and experienced Care Manager can be a stabilizing force during times of crisis and transition.  Imagine that someone you love has experienced a health crisis that changes their ability to accomplish basic daily living activities or makes the home no longer a safe or convenient place to live. Coping with increased doctors appointments, medications and the lifestyle changes often required can be overwhelming and stressful, as few of us are prepared to adapt to these changing circumstances. Difficult conversations may be needed among family and friends and decisions made to support a better future.

Most people begin their journey alone and try to work their way through the maze of private and government services making a lot of phone calls, internet searches leading to dead ends, and a lot of time spent just getting oriented to this new landscape. It can be very confusing and time consuming.

An experienced guide to help navigate these systems of care is invaluable, especially when family resources are needed to deal with the emotional aspect of the loss and the changing prospect of future care needs and responsibilities. Care Managers can save a family a lot of time because they know the existing community resources and will create a plan of action to focus the families’ energy and efforts expediting necessary changes.

What does a Care Manager do?

Care Managers begin by having a lengthy discussion with both the person needing assistance and the family to learn about what is important, especially quality of life preferences. Releases are obtained so that physicians can be contacted to review medical history (including current medications), financial information is reviewed to determine eligibility for government funded programs, and insurance information is reviewed to know what benefits are covered – all to establish a comprehensive understanding of the person’s needs and resources.  At this point a care plan with recommendations for the family to consider is created and discussed.  Care options are an important part of the plan, allowing the family to weigh alternatives and be a real partner in the process.

Building a care team is essential to optimizing health and preventing further decline, as well as maximizing the inner resources of the family caring for their loved one.  A Care Manager can help identify family and friends that might be able to help, augmenting the gaps with professionally vetted services, and creating a workload that is healthy and manageable for everyone. Care Managers can assist with medication management, medical appointments and transitions from hospital or another facility to home. They can help with relocation and/or home organization, serve as a liaison to health and social service providers, and communicate with family members near or far.  It is important to continually evaluate the care plan and the care team to ensure that it meets the needs of the entire family.  A Care Manager can monitor the situation and look down the road a bit, modifying the plan and adding members to the team as needed, in order to avoid a crisis whenever possible.

Frequently, caregivers wait until they are heavily stressed and depleted (sometimes to the point of their own health decline) before acknowledging that the workload is too great, instead of putting in adequate supports at the start.  If you think of a bridge and how many supports are needed to carry the weight safely, no one would cross a bridge with only one support or even inadequate support.  It is very dangerous!  Adequate supports strengthen families, often allowing the loved one to remain in the community longer and healthier.

Skill and experience vary among the many professionals offering care management services.  It is important to ask about the Care Manager’s expertise:  do they know the area and the community resources, what license does the Care Manager have, how long have they been practicing, what range of tasks will they provide, what if any financial incentives do they have with any other agencies, and what is their availability after business hours?

Help is just a phone call away.

Minuteman Senior Services is your local Area Agency on Aging, and offers over 20 different programs, including free information and referral to resources both local and long-distance.

The Family Caregiver Support Program is a taxpayer-supported, free service provided locally through Minuteman Senior Services to assist with resource information, emotional support, and a short term action plan with referrals to other services to help family caregivers better manage their needs.  Minuteman Senior Services has worked with hundreds of family members who are caring for an aging parent, an ill spouse, a grandparent caring for a grandchild when the parents are no longer able to, or other family situations.

The evidence-based “Powerful Tools for Caregivers” workshop is a free, six week educational program that gives caregivers the opportunity to focus on themselves, come together with other caregivers who understand the difficulties faced in caring for a loved one over a long period of time, and begin to build the skills necessary to not only survive this caregiving situation but learn how to thrive.  Minuteman Senior Services and the Lexington Council on Aging are joining together to offer this class at the Lexington Senior Center beginning on Tuesday, January 20 through February 24, from 9:00 to 10:30. To register please call 781-860-7084.

Minuteman Senior Services now offers a care management option for seniors, disabled adults of all ages and caregivers. Some people may qualify for subsidized care management and others may access care management on a fee basis through our newest program, Minuteman By Your Side. We bring our 40 years of experience in serving your community to you and your family. Asking for assistance can be difficult but as you work your way over that hurdle know that there are many supports available that you can use to strengthen your situation and your own health.


 

PrintLeslie May-Chibani, Assistant Director of Minuteman Senior Services, has over 15 years of experience working with seniors and their family caregivers of all ages. Call her directly at 781-221-7096 for more information about Minuteman’s new program, Minuteman By Your Side. Please visit www.minutemansenior.org for information about all the programs available.

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Senior Matters~Tips for Recovering at Home and Avoiding Hospital Readmission

By Jack Cross  |

The nurse comes into your hospital room and says that you are ready to be discharged. You’re happy to be going home to the comfortable surroundings of your home and your own bed. The last thing you want is to be readmitted to the hospital because you run into problems taking care of yourself after you are discharged.

The hospital staff also wants your transition from hospital to home to go smoothly with no return visits. However, almost 20 percent of Medicare patients are readmitted to the hospital within 30 days after discharge, according to a New England Journal of Medicine article. This is a huge financial issue for Medicare which is searching for solutions to the “readmission” problem. Why do so many elderly patients need to be re-admitted to the hospital?

They may not understand or may be too weak to fully comprehend the discharge instructions provided by the doctors and nurses.

They may have difficulty understanding and managing changes to their medications.

They may find it difficult to get to follow-up medical appointments because of fatigue or lack of transportation.

They may be too tired or uncomfortable to prepare nutritious meals which can jeopardize their recovery.

They may not recognize warning signs that require medical assistance and may delay notifying their physicians until the situation becomes acute.

They value their independence and may be reluctant to ask for help at home. They may neglect their discharge plan when they return home because they are tired, confused or frustrated but still hesitant to ask questions or to seek help.

When elderly patients are ready to return home from the hospital, it is very important for everyone involved in their care – patients, families and medical caregivers – to be realistic about the challenges facing the elderly while they are recuperating from illness.

As a patient, what can you do to better ensure a successful recuperation after you are discharged from a hospital? When you receive a discharge plan, ask yourself the following questions:

Do you have the names and phone numbers of all medical personnel you may need to contact when you return home?

Do you have a schedule of all follow-up medical appointments? Do you feel strong enough to call to set up medical appointments when you return home? Can you get to these appointments on your own or do you need help with transportation?

Are you willing to ask another family member or professional caregiver to coordinate your discharge plan if you feel too weak to handle it yourself?

Do you need help with normal housekeeping duties, such as food shopping, cooking, household chores and personal care, during your recovery?

Do you have any new dietary restrictions? Do you feel strong enough to prepare nutritious meals and to shop for groceries? Do you understand that certain medications need to be taken with food at certain times of the day or that some medications cannot be taken with specific foods?

Do you have a list of all your medications, especially any new or unfamiliar medications? Do you understand the dosage and when to take your medications? Are you aware of any possible side effects, especially adverse reactions that require prompt medical attention?

Will you be able to pick up prescriptions from your pharmacy and do you know that you can ask for easy-open bottles with large print labels if needed?

Do you use a pill box to organize and manage your medications and are you able to refill it and use it properly while you are recuperating? Do you understand how to incorporate new medications into your pill box? If you have not used a pill box, is it time to start using one now? Are you willing to ask a family member, your pharmacy or even a professional caregiver to manage your pill box until you feel better?

Do you know the warning signs that your recuperation is in trouble and that your health may be declining – or are you willing to ask someone else to look out for these warning signs – so problems can be addressed before they turn into a medical crisis?

After you look over this checklist, you may decide that you can handle all the discharge instructions on your own — or may decide that extra help is needed while you are trying to get back on your feet. Are family members willing or able to help you or is a professional caregiver a better option during this transition period? It is normal to feel frail and confused — and even angry or anxious — when you return home. With the right support and kind encouragement, you will stay on the road to recovery without a readmission back to the hospital.

Jack Cross is President of Home Instead Senior Care-Lexington a provider of companionship and home care for the elderly. He can be reached at 781-402-0060 or jack.cross@homeinstead.com . See our website at www.homeinstead.com/404.

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Lexington Fire Department and Lexington Lodge of Elks Install Smoke Alarms

Firefighter Paramedic Shawn Ormiston Installs a smoke dectector.

The Fire Department with support from the Lexington Lodge of Elks #2204 installed smoke alarms in several homes of seniors living in Lexington at no cost to them this past Saturday. “Funding for the program was received by a grant of the Benevolent and Protective Order of Elks of the U.S. designed to have local Lodges impact the community they serve,” stated Christopher Cavanaugh, President of the Lexington Lodge.

This pilot program supplied new battery-operated smoke alarms and carbon monoxide detectors to seniors. Lt. Tremblay, Fire Prevention Inspector along with Charlotte Rodgers, Director of Human Services coordinated the program each deemed it a success. “In almost all the homes visited this Saturday smoke alarms were either missing batteries, incorrect type or out-of-date or installed incorrectly,” said Lt. Tremblay. “Members of the fire department S.A.F.E fire safety educators team helped to install the detectors,” Lt Tremblay went on to say.

Having a properly operating and maintained smoke alarm in your home reduces the chancing of being injured or dying in a fire by nearly 90% – however nearly half the homes in the United States do not have smoke alarms or they are not properly maintained (missing or dead batteries for example). National statistics have shown older adults have a much higher risk of being injured or dying in a fire.

All residents are encouraged to look around your home and make sure you have smoke alarms and carbon monoxide detectors located on each level of your home. Press the test button either with your finger or the end of a mop handle to see if it sounds at least monthly. Change the batteries in the smoke alarms and carbon monoxide detectors annually. A good reminder is when we change our clocks in the spring or fall.

If you’re a resident over the age of 60 and would like to be part of this program, we encourage you to call Gwen Jefferson, at the Senior Center 781-861-0194 to sign up.


Senior Center Summer Trips

Maine Lobster Bake
Thursday, June 21
9AM – 5:30PM
$62

We will stop at the Nubble Light and York Village before we go to Foster’s for an authentic Lobster Bake. After our meal, choice of lobster or chicken, there will be time to walk to the beach to view the Annual Sand Sculpture show.


Tall Ships 2012

Tuesday, July 3
8:30AM – 5PM
$62

On arrival in Boston, we will board the Provincetown Cruise vessel for a one and one-half hour narrated Harbor Cruise to view the world’s largest and grandest sailing ships. After the harbor sail, we will go to Quincy Market to have lunch (on your own) and browse the shops before heading home.


Tanglewood Overnight

Sun, Mon., July 29-30
Sun., 8AM – Mon., 5-5:30PM
$345-double; $385 single

Emanuel Ax will be the featured pianist at the Sunday afternoon performance of the Boston Symphony Orchestra, when he plays Beethoven’s Piano Concerto No.3. Tchaikovsky’s Symphony No. 5 is the other feature on the program. The overnight stay at the William’s Inn in Williamstown includes a complete dinner and breakfast. On Monday, we will visit the Clark Art Museum, noted for its Impressionist collection. Lunch on your own at the museum.

Park at the Lexington High School, Worthen Rd. Lot. Deposit of $25 required; balance due July 2.
If you have questions, please contact Phyllis Rand at the Senior Center at 781-861-0194.

 

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Living All the Way

By Sandy Simon  |

Why does there seem to be an increased fascination with the experience of growing older? I think it is safe to assume it is because the baby boomers have come of age. On January 1, 2011, the first baby boomers turned 65 years old. The US Census Bureau defines baby boomers as those born between January 1, 1946 and December 31, 1964. Everyday for the next 19 years, 10,000 people per day will celebrate their 65th birthday.

Perhaps you are a member of this group, which may explain why you have found yourself interested in reading this column, even though you might have passed by it just a few years ago. There are several generations of older people who are paving the way for baby boomers who are just beginning to experience the challenges associated with aging. Their experiences of aging are diverse. Often times, people who are older, find that the quality of their lives is subject to the newly developing limitations of their body and mind. With life expectancy in the United States at 79.4 years for women and 75.5 years for men, people are living longer. Our challenge is to maintain good quality of life as longevity increases.

As a geriatric care manager, I come across many wonderful older adults who have lived meaningful lives with purpose and direction. Unfortunately, as a result of age-related conditions, some find their world becoming smaller. Due to challenges with impaired eyesight, hearing, mobility, cognitive challenges, chronic pain or other medical conditions, they may become less engaged in purposeful activities. Before they realize it, they no longer recognize the person they’ve become nor do they feel meaningfully connected to the life they are living. This is sad on many levels. However, in his book, Age-ing to Sage-ing, Rabbi Zalman Schecter-Shalomi encourages us to think differently: “Aging doesn’t mean diminishment or exile from the ranks of the living. As the period in which we harvest the fruits of a lifetime’s labor, it gives us the panoramic vision from which spiritual wisdom flows.”

At a time when our elders could benefit from thoughtful, compassionate options to help maintain a precious connection to their own lives, they are often left frustrated and alienated by the possibilities available to them. Fortunately, there are programs being developed that are shifting the way we respond to the lifeline our elders desperately need and deserve.

A new program that focuses on meaningful engagement, specifically for people living with dementia, is the Learning for Life program developed by Hearthstone and it’s president, John Zeisel, PhD. I asked Dr. Zeisel to share the impetus and evolution of this groundbreaking new program:

“Learning for Life is a school for people with memory challenges specially developed to make such challenges irrelevant. Learning for Life is the start of a revolution in dementia care—a movement that will return people with memory challenges to their place in society—with the rights and opportunities they deserve.

One of the commonly held beliefs people have about those living with memory challenges—Mild Cognitive Impairment (MCI), Alzheimer’s and other dementias—is that people living with these conditions are no longer able to learn. This is just wrong and the first Learning for Life Academy—now welcoming students at The Groves a 62+ Senior Living Community in Lincoln, is proving it. People learn in different ways and the brain’s procedural memory and learning systems remain fully functional in this population. That’s why Learning for Life works.

I knew that this program would benefit everyone with memory challenges living at home or in an Assisted Living Residence who misses social contact, meaningful discussion and the joy of learning. Instead of keeping these people safe with continuous caregiver supervision and secure perimeters, why not, I asked, keep them safe by giving them something to care about that keeps them interested and engaged—learning?

Learning for Life was conceived when three things came together: I published I’m Still Here (Penguin, 2006), my book about how people with dementia are very much present throughout their lives and their voyage with dementia; I learned that Maria Montessori’s original subjects for her Montessori Teaching Methods were children with learning difficulties and that these approaches are well suited to helping people with dementia learn new things; and drawing on my background in Environment-Behavior (E-B) studies, I recalled how the physical design of the learning environment can have a truly positive impact on students’ ability to learn.

Learning for Life is a student-driven program where the Director of Learning regularly asks students what is of interest to them and then creates the tools for them to explore those subjects, including architecture, law enforcement, being blind, the history of New England and space travel—among others. The Learning for Life day includes social contact, study, cognitive stimulation, exercise, healthy meals—all the things that research has shown to improve memory and ward off memory loss. Learning for Life principles and practices reinforce decision-making and a sense of time—the past and future—in the lives of students. Experts now agree that brain vitality, including all these elements, is central to maintaining brain health. Learning for Life is based on all these principles.” John Zeisel PhD.

Sandy Simon is the Director of Senior Support Solutions, a Geriatric Care Management company based in Lexington. Sandy and her team of certified geriatric care managers, Rachel Kushner and Carolyn Shea, provide assessment and care planning for older adults. Their mission is to assist older adults and their caregivers with the changing needs associated with aging in order to promote a safe, dignified and purposeful aging experience.

781 862-2829 www.seniorsupportsolutions.com

 

 

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Supporting Family Caregivers

A new study from AARP on how well states support family caregivers who support seniors at home ranked Massachusetts 39th in the nation. Let’s just say that leaves plenty of room to improve.

According to AARP, the economic value of family caregiving was $450 billion in 2009 — four times the total that Medicaid spent on long term care. If family caregivers do not receive needed support, they’re more likely to burn out and reduce their efforts. The result would put greater demand on government programs that provide long term care.

In 2004, 72% of older people living in the community who received personal assistance relied exclusively on unpaid caregivers. These caregivers face physical, emotional, and financial stress that put them at risk. Services such as information and assistance, counseling, and respite care can help family caregivers navigate the service system.

In ranking states, AARP measured such items as: the percentage of family caregivers who say they usually or always get needed support; the extent to which the state exceeds federal and state requirements for family leave and mandatory paid sick leave; policies to prevent discrimination toward working caregivers; policies on financial protection for the spouses of Medicaid beneficiaries; and response to family caregiver needs.

Many caregivers are spouses — some with their own health issues. Others are daughters and sons, more than half (58%) of whom are trying to hold down a job, sometimes taking care of their own children as well. “It is critical,” AARP says, that states “recognize, respect, and support family caregivers.” States can help family caregivers by providing supportive services, respite breaks, education and training. In 2009, Massachusetts ranked 31st in the country for the percentage of caregivers who said that they usually or always received the social and emotional supports they needed.

In terms of providing legal and system supports, Massachusetts ranked 26th in the nation. Our state allows families the maximum federal spousal protection of $2,739 in monthly income and $109,560 in assets as the floor of protection when a spouse qualifies for Medicaid nursing facility care. The federal Family and Medical Leave Act allows workers to take up to 12 weeks of unpaid leave in a year to care for themselves or for a parent, spouse, or child with a serious health condition. There are no federal laws that require private sector employers to provide paid sick leave benefits – and only 2 states provide paid sick leave. Massachusetts is not one of them.

Finally, the AARP survey examined 16 home care tasks, including administration of various types of medications, ventilator care, tube feedings, and other kinds of help that many people with chronic conditions need. This help is critical for family caregivers. Allowing nurses to train and delegate these tasks to direct care workers can ease the burden on family caregivers. Massachusetts, which only allows nurses to administer medications, ranked 32nd in the nation on delegating tasks.

To read the full AARP Scorecard report on caregivers and supports, go to www.aarp.org.

 

 

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Taking the Fear and Fiction Out of Hospice

By Christine Dixon  |

There are few words that cause more fear, or are more misunderstood, than “hospice”. Mention the “h” word, and most people, including some doctors, have misconceptions about what hospice truly is.

Visiting Nurse and Community Health’s (VNCH) Hospice Care program, which opened in July 2009, has provided compassionate care and dignity for almost 300 end-of-life patients and their families. Many of our patients had little or no idea of what hospice actually entailed until they came under our care. The most common statement made by families who chose hospice for their loved one is “we wish we had known about hospice sooner.” This article is in response to their requests that we help others distinguish between the fact and fiction surrounding hospice.

Here are 10 of the most common myths about hospice care, and the truth about each.

1. Hospice is a place.

True and false. Hospice care is provided wherever the need exists – usually in the patient’s home. About 80% of hospice care takes place in the home, but services can also be delivered in a nursing home, assisted living facility, hospital, or a residential hospice facility.

2. Hospice is a death sentence.

False. Hospice patients live, on average, 29 days longer than non-hospice patients. This is because the patient is in a familiar environment – their home, the assisted living or skilled nursing facility in which they reside – and their symptoms are being managed. All of their needs are being met, not just the physical, but the psychosocial and spiritual as well. Those VNCH Hospice Care patients who had previously experienced numerous or long hospital stays during the course of their illness have told us that their desire to live actually increased after entering our program because they enjoyed a marked improvement in their quality of life.

Patients can remain in hospice longer than six months, and some patients even get better after starting hospice because of the intensity and focus of our services. These patients are no longer considered to be appropriate for hospice care.

3. Hospice is only for old people.

False. Although the majority of hospice patients are older, hospices serve patients of all ages.

4. Hospice is only for cancer patients.

False. Cancer victims make up only about half of hospice patients, according to recent statistics from the National Hospice and Palliative Care Organization (NHPCO). The remainder is comprised of end-of-life patients who have Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), liver or kidney disease. Dementia and Alzheimer’s patients can also qualify for hospice once they reach the point where they are not walking and cannot hold a lucid conversation.

5. Hospice doesn’t involve the patient or family in making decisions about treatment.

False. Hospice puts patients and families at the center of care. VNCH’s Hospice Care staff members provide guidance and encourage open, honest communication about individual wishes and choices.

6. Hospice requires that family members are available to provide care.

False. Since a number of end-of-life patients live alone or with family members who are unable to provide care, VNCH’s Hospice Care staff often coordinates non-family resources to make home care possible. They can also help to find an alternative location where the patient can safely receive care.

7. Hospice patients starve to death.

False. Hospice encourages patients to eat for as long as they are willing and able. But patients may, at some point, refuse to eat or drink liquids. It’s not the hospice staff that stops the feeding, it’s a patient’s choice.

8. Hospice patients are taken off all medications.

False. Hospice provides medications related to the disease process and the patient’s comfort. These can include pain medication, anti-anxiety, anti-nausea and vomiting drugs. Another falsehood is that hospice gives the patient massive doses of IV morphine. Morphine can be used to control pain or shortness of breath along with other narcotic medications, but usually is given in pill or by patch applications.

9. Hospice is paid for by the patient.

False. Medicare covers the hospice benefit for those who qualify. Most hospice patients are over 65 and are entitled to the Medicare Hospice Benefit. This benefit covers virtually all hospice services related to the diagnosis, usually requires no out-of-pocket expenditures, and hospice care can be less expensive than other end-of-life care. Many insurances and managed care organizations also have hospice benefits, and VNCH’s Hospice Care staff will be happy to help you understand what payment sources are available.

The hospice benefit also covers medical equipment, appliances and supplies. These can include electric hospital beds, lifts, bedside toilets, shower chairs, wheelchairs, wound care supplies, etc. – whatever is considered necessary for the hospice symptom management in the home. Additionally, hospice includes physician services, nursing care, home health aide services, social work services, spiritual care, volunteer assistance, bereavement services, and physical therapy, occupational therapy and speech/language pathology services.

10. Hospice patients can no longer receive care from their primary care physician.

False. Hospice medical directors work with primary care physicians to manage the patient’s condition. VNCH’s Hospice Care medical director is available 24 hours a day for consultation, but the primary care physician actually follows the patient to ensure that his/her symptoms are managed, and they are getting the best quality of life possible.

Hopefully, we have provided useful information about hospice care. We cannot stress how important it is to learn about your healthcare options, so that you can make informed decisions and choices before you or your family needs care. Learn about what an advanced directive is, and how to implement it. Voice and be specific about your healthcare decisions, and engage others, most importantly family members, to learn about hospice.

VNCH Hospice Care focuses on how the patients entrusted to us live. Their dignity and quality of life, and that of their families, are always foremost in our minds. But when death is inevitable, hospice doesn’t abruptly go away. We provide bereavement counseling and support to family members for 13 months after their loved one’s passing. We also conduct bereavement support groups for residents in the 28 communities VNCH serves, including Acton, Arlington, Bedford, Belmont, Billerica, Burlington, Cambridge, Carlisle, Chelsea, Concord, Everett, Lexington, Lincoln, Malden, Medford, Melrose, Newton, Revere, Somerville, Stoneham, Wakefield, Waltham, Watertown, Wayland, Weston, Wilmington, Winchester, and Woburn.

Our Hospice Care program is also a We Honor Veterans partner. As such, we provide veteran-centric education for staff and volunteers, and identify and honor patients with military experience.

To learn more about VNCH and its Hospice Care program, visit the agency’s website at www.TheVisitingNurses.com, or call 781-643-6090.

Since its founding in 1898, VNCH, a 501(c)(3) non-profit, has had a deep rooted tradition of providing quality health, private pay and hospice care to patients in their homes. Awarded for its quality ranking in the top 25% of home care providers nationally, VNCH is committed to using modern, state-of-the art medical technology to help achieve its goals.

 

 

About the Author:

Christine Dixon has been Visiting Nurse and Community Health’s CEO since 2004. She joined VNCH in 1994 as Nurse Team Manager, and quickly rose through the ranks to be named Chief Operating Officer and Director of Clinical services in 1996. She received her diploma in Nursing from New England Baptist Hospital School of Nursing, a BSN from Regis College, and her Master’s degree in Health Care Management from Cambridge College. She serves on the Board of Directors of both the Visiting Nurses of New England and Massachusetts Bay Self Insurance.

 

 

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Strong Bones, Strong Bonds

Age doesn’t count in this class, but getting fit for life does

By Elena Murphy

They are grandmothers and great-grandmothers, but when the opening bars of the song “Y.M.C.A.” start to thump from the stereo in the corner of Beverley Ikier’s Osteofitness class, all these women are doing is getting fit for life.

“I’ll have you know, some of my students have driven Harleys,” Ikier smiles as the women begin flexing their wrists. This gets laughs from around the room. She says, “I’m not kidding. I’ve also taught some ex-Playboy bunnies.” Bigger laughs and a few names are tossed around as the women lean into their next stretch. This is not an ordinary exercise program. [Read more…]

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