Managing Medications

Senior counselor Carol Carson advises you on Medication Management. Making sure your loved ones take their medications exactly how prescribed will ensure they are receiving the exact treatment they need, and hopefully keep them healthier for a longer period of time.

As your parents or loved ones age, the amount of medication they will take will most likely increase. Taking medication correctly is crucial to its effectiveness on our bodies. This becomes increasingly true as now, even some Cancer medications are able to be taken at home. While this convenience saves patients time and visits to their doctor, Cancer is a very serious condition, and should be treated specifically and consistently. Because some patients are opting to take their medication at home, it becomes imperative that you or your loved one take their medication exactly how it is prescribed.

As your parent or loved one becomes more dependent on others, and as their need for a primary caregiver increases, their medication can become lost, forgotten or taken inappropriately. Making sure they take their medications exactly how prescribed will ensure they are receiving the exact treatment they need, and hopefully keep them healthier for a longer period of time.

According to the FDA, 50% of prescriptions written in the US are not taken correctly. There are some very common reasons why this is the case. He or she could feel better before their medication runs out, and discontinue taking their pills or they might forget the schedule of their medicine, especially if they are supposed to take it multiple times a day. Some medications do not have an obvious benefit immediately, so one might think the drug isn't working and discontinue use. Someone might also skip medication purposefully to make their prescription last longer, and avoid the high cost of refilling it.

Communicating with your loved one's doctor is the best way to avoid these common mistakes. Ask them questions about the medication, prior to filling the prescription. This way you will know what his or her purpose is in prescribing each medication and what to expect when taking them. Things you should know:

1. How long will your loved one need to take this medication?
2. What should they do if they miss a dose?
3. What are some common side effects of this medication?
4. What amount, and in what dose should they be taking this medication?
5. Are there foods or beverages that will alter the effectiveness of this medication?
6. What is the plan of action if an unexpected side effect occurs?
7. What should they do if they double their dose of medication?

Ask your doctor to write down instructions so you can refer to them later, and also make sure to have their phone number, so you can contact them should you need to. Assisted living communities will also help keep track of medication, side effects and administer them according to the doctor's instructions.

Once you have the medication, staying on the right schedule is the most important part. Make sure to organize the medication in a way that is easy for you and your loved one to remember and keep track of. Here are a few tips to help you.

1. Read the labels on the medications carefully to make sure you or your loved one is taking the right dose at the right time. Make sure to take the medication at the same time every day.
2. Use a weekly pill organizer, so you can keep track of which day you have taken your medication. Also remember to keep the prescription bottle for reference.
3. Keep a reminder in the home of your loved one. Whether it's on the refrigerator or on their bathroom mirror. Make sure they have at least one reminder to take their medication.

While communicating with your loved one and their doctor about their medications will help you care for your loved one, keeping track of medications and other things can become overwhelming. It is very likely that the number of medications they take will increase as they age, and the more complicated the times and schedules of each pill will become. Assisted living communities administer medication manage meals for each resident. If your loved one should avoid certain foods and take their medications at a specific time each day, an assisted living community will be able to tailor their care specifically to your loved ones needs, avoiding any type of mishap with medication.

SPOTLIGHT!

 Excellence in patient care, comfort, and personalized attention..
that's what defines The Lovettsville Home.

We provide Long-Term & Short Term Care, Respite care, Rehabilitation services, Alzheimer's dementia Care, and Hospice program. All staff members trained in Alzheimer's dementia care. This means it has special care and attention for wandering seniors, and caregivers are trained in handling dementia behaviors very well.

_{Nestled in charming, private and elegant residential setting, this facility is located on three beautifully landscaped acres and features full handicapped bath with safety bars, fire alarm system and cable television.}

Step into Lovettsville Home  Assisted Living community and you can't help but feel at home. We stop at nothing to make your experience warm and inviting, from our home exterior architecture, to our comfortable community areas and taste of suites to our exceptional outdoor gardens and landscaping. Look around and you'll notice fresh flowers throughout the residence.
Our home is a wonderful alternative to a nursing home that not only provides individualized attention and compassionate, professional care to its full-time residents but also creates and maintains an environment that uplifts, enhances, and inspires the lives of our residents. In our home, the purpose is not only to provide essential care, it is to help each resident achieve and/or maintain the highest quality of life that is possible for that resident.

thelovettsvillehome@yahoo.com

The Lovettsville Home Quality Assisted Living Facility

39196 Rodeffer Rd

Lovettsville, VA 20180

 

Senior Travel Discounts!

THE FOLLOWING HOTEL CHAINS HAVE REAL SENIOR TRAVEL DISCOUNTS UP TO 50%...

Starwood Hotels (Sheraton, Four Points, W Hotels, Westin Hotels and Resorts): Though they caution that the discount can be withheld during periods of peak business, and is not applicable to minimum-rate rooms, virtually all Sheratons give a 50 percent senior travel discount to those 60 and older. Phone toll free 800/325-3535. Web site: starwood.com/.

Marriott Hotels: At more than 2000 Marriott Hotels in the United States, senior travelers (62 and older) save at least 15 percent off normal rates. This includes Marriott's Fairfield Inns and Courtyards by Marriott (two subsidiary chains), and Marriott's Residence Inns. Phone Marriott itself at 888/236-2427, Web site: marriott.com/.

Days Inns: AARP members receive 15 percent off at participating Days Inns, and all Days Inns offer 10 percent off to senior travelers over 60 with proof of age. Reservations: 800/329-7466. Visit daysinn.com/ for more information and online reservations.

Howard Johnson's: Twenty percent off for AARP members, at all the nation's Hojos. Phone toll free 800/IGOHOJO. Web site: hojo.com/.

Ramada Inn: AARP members get 20 percent off normal rates. Phone toll free 800/2-RAMADA. Web site: ramada.com/.

Radisson Hotels: Begun in September of 1997, the "Senior Travel Breaks" program allows persons 50 or older to stay at any Radisson Hotel Worldwide (there are 427 in 300 countries) at a discount of 15-40 percent off the regular rate. For more information, call 800/333-3333. Web site: radisson.com/.

Choice Hotels (Clarion Hotels, Quality Inns, Sleep Inns, Friendship Inns, Rodeway Inns and Econo Lodges): offer 20-30 percent discounts to senior travelers over the age of 60, and 10% for people 50+. AARP members get 15 percent off. Reservations must be made through the chains toll free number (800/4-CHOICE), so check first with the local hotels to make sure the "discounted" price you're getting from the nationwide reservations center beats any local discounts (sometimes it won't). Web site: choicehotels.com/.

B&B Bargains for Seniors. Consider a bed-and-breakfast club paying only $10 to $20 a night, breakfast included, to stay in the homes of travelers like you. In return, you offer your spare room for others. Members of the Evergreen Club (800.962.2392) must be 50-plus.

What gifts are best for the Baby Boomers' parent?

When asked what they might want, elders frequently say, “Oh, don’t bother with me. I don’t need anything.” Pshaw. Everyone wants something. But with elders, you might need to do some investigative work.

One of the characteristics of many elders is a loss of interest in “stuff.” In fact, some spend a great deal of time in later years cleaning out a lifetime accumulation of clutter in their homes to simplify their lives. Others may have moved to smaller living quarters – apartments, retirement communities or assisted living facilities where there isn’t space for new acquisitions.

So it is important in choosing gifts for elders to find something that is useful, needed or won’t unnecessarily complicate their lives and most of all, is something they will enjoy. Unless an elder on your list is a passionate collector of, for example, ceramic frogs, tchotchkes are not good choices. They take up space and they’re just one more thing that needs dusting.

Also, consider that many elders are on fixed incomes. We are entering our second year without a cost-of-living increase to Social Security while inflation for goods and services elders spend more on than younger people continues. So gifts that might seem too ordinary and mundane for a holiday can fill an important hole in elders' lives.

Here are some ideas:

Entertainment
Eyesight sometimes dims with age. For readers, consider a large-print version of a book they would enjoy. Or a year’s subscription to the large-print edition, if there is one, of the local newspaper.

This year, I am also recommending a Kindle or other e-reader. Kindle seems to have the clearest and easiest-to-read text and Kindle editions are cheaper to buy than hardcover books. Also, there are thousands of classics available for free or as little as 99 cents in the Kindle store.

Movie buffs might like a year’s prepaid membership to Netflix. Or even better now that Netflix is streaming movies via television, you could equip an elder's set for this and give them a year's subscription. Or, if the old-fashioned way makes more sense, a small collection of DVDs starring a favorite actor or built around a theme or genre they like might be welcome. Or a dozen pre-paid tickets to the local movie theater.

If your budget allows, a Wii could be a fun gift. At a retirement community I visited not long ago, it was the most popular equipment in the common area and it has the advantage of getting people out of their chairs and moving around.

Personal
For a woman, a monthly prepaid visit at a salon for haircut and manicure. It’s good to include a pedicure too for elders who have trouble bending over to do it themselves.

Find out if your elder likes a particular kind of clothing that needs regular renewing. I have a fondness for a specific brand of flannel nightgown that can be hard to find. Two friends know this and starting long before I entered the realm of elderhood, have kept me supplied over the years.

Perfume and cologne fall into this category too. It doesn’t appear to be so common now, but people of my age (69) and older, often settled on a particular fragrance when they were young and have used it all their lives. The price of mine is now so high that I feel it is an unwarranted extravagance, so it is always a welcome gift.

Practical
If an elder you know has had to give up driving, consider a voucher for a local car or taxi service. Even better, if you have the time, make up a certificate promising a weekly or bi-weekly trip to the supermarket or a monthly ride to the local mall.

My great aunt Edith who lived to be nearly 90 told me how she, in her early 80s then, had scrubbed the kitchen floor one day and then couldn’t push herself up off her hands and knees. She laughed when I suggested to her that there is now this newfangled invention – a mop with a long pole attached – but she said they didn’t get the floor as clean as she wanted.

Thereafter, a cleaning service was hired. Elders often won’t admit they can no longer do common, everyday chores because they don’t want to be a burden to others. So you could promise a weekly cleaning or hire a biweekly service to come in – and maybe do the laundry too.

Fresh fruits and vegetables get more expensive every day. For low-income elders, a fruit-of-the-month club would be both fun to recceive and good for their health.

A word of caution about practical gifts: there are endless old jokes and cartoons about husbands giving their wives washing machines for their birthdays or anniversaries – practical, but hardly romantic or fun. An elder in your life may need or have trouble affording some safety equipment, incontinence supplies or a new cane, but it's better to help provide those needs during the year and find something for Christmas that will improve their lives and delight them.

Home
A lifelong gardener who no longer has a yard might appreciate a Plant-of-the-Month membership or a kitchen herb garden. There is little upkeep and a continuous supply of nature’s color in the house.

If you're a blogger and have written stories about your childhood and your parents, you could print them out and make a book for a parent. If you're not a blogger or time is too short until Christmas, you could start such a project now for next year.

For cooks and bakers among the elders in your life, there are new, silicon pans, cookie sheets, muffin tins, etc. in stores that don’t need greasing and can be cleaned easily without scrubbing - more healthful and work-savers too.

For do-it-yourselfers, check to see if there are repairs needed around the elder's home and commit to getting them fixed as soon as possible.

Electronics
If an elder in your life uses a computer and the internet, check to see if they might need a large-key keyboard. Such ailments as arthritis and the natural decline of feeling in fingers can make normal-sized keyboards difficult for some elders to use. You could also pay for a year’s broadband connection.

iPods and digital cameras are marketed so relentlessly to younger people that it is easy to forget elders can enjoy them too. A camera can give an elder a reason for a daily walk they might not otherwise take. You could give an iPod already filled with music you know your elder likes.

Unless your elders are sufficiently geeky on their own, be sure to make time soon after Christmas to help them learn how to use electronic gifts.

These ideas don’t begin to cover the possibilities, but I think they should give you a place to start thinking. And when giving such things as subscriptions to magazines, monthly flower clubs, a cleaning service, etc. that are only a piece of paper, be sure to include a token gift – a box of candy, a bottle of wine, a scented candle. Even after 65, 70 and more years, it’s still fun to tear open packages with the family.

Elderly Parents During Holidays and Family Gatherings

Elderly parents require special care at family gatherings and holiday time. Taking care of their needs first will help make the event even more successful.

When you are a Family Caregiver it is important to maintain the celebration of life for festive holidays, and when family and friends come together for those special occasions at parties and dinners.

Planning a special occasion or even attending one can be stressful for Family Caregivers, requiring special occasions to be less formal and more intimate as you have enough to cope with caring for your loved one in need. The best rule – keep it simple, relaxed and cheery, so you can delegate certain jobs out to your guests, who will understand you are juggling enough responsibility, and will enjoy helping out. Just make sure everything is set up so your guests can help themselves by turning your celebration into a buffet style dinner. This way you are not so stressed out taking care of everyone else.

You a have a big day ahead of you, getting your dinner party ready and without failure, your loved one will cause something to create extra stress you certainly do not need at that time. You have your hands full. Always prepare for these mishaps to happen. Why? Because you are a part of your loved one’s world and all of a sudden you are changing your loved one’s routine causing stress in their life. Also, the excitement of the day can be a bit overwhelming for elderly folks, who need a bit more space than younger people, so they may feel a bit misplaced. Always, be in tune with your loved ones stress levels, even if they are excited about the day, family gatherings can be too much activity for the frail and elderly.

Always make sure your loved one is placed where they are part of the activity, but distant enough where they feel they are in control and feel safe. This will help greatly for feelings of anxiety with so much activity going on around them. Keep high activity and music down. Keep the ambiance of the gathering simple and one that is easy for your loved one to relate to and interact with.

Also, interactions with guests may cause a loved one to feel exhausted very quickly. The best solution is to provide your loved one with a chair with arm rests so they may sit right back and to provide a blanket to cover them up with so they feel warm and protected. Give your loved one their own comfort zone.

SUMMARY:

ELDERLY PARENTS - During family gatherings, elderly parents require additional care.  Provide them with more space and quiet time.

CAREGIVER RESOURCE - Always locate caregiver resources to keep up to date and to learn how best to care for elderly parents.

FAMILY GATHERINGS – The elderly can find themselves isolated from friends and family and enjoy family gatherings, so long as they have their needs met. It is important to provide extra care such as providing a proper chair to sit in as the elderly can become fatigued very easily.

HOLIDAYS – Even the elderly need holidays, but once again it is important to care for their needs which can be time consuming.  Learn your elderly parent’s needs and work around their care. 

Tips on talking to the Hard-of-Hearing (HoH)

Please consider passing this recap of tips and commentaries along to HOH persons, seniors centers, retirement communities, health care providers, and to those in the private and government sectors that communicate orally and interact with the HoH.

1. Whenever possible, face the HoH person directly, and on the same level.

2. Your speech will be more easily understood when you are not eating,

chewing, smoking, etc.

3. Reduce background noises when carrying on conversations -- turn off the radio or TV.

4. Keep your hands away from your face while talking.

5. If it's difficult for a person to understand, find another way to say the same thing, rather than repeating the original words again and again; also try moving to a quieter location.

6. Recognize that hard of hearing people hear and understand less well when they are tired or ill.

7. Never talk from another room. Get the attention of the person to whom you will speak before you start talking.

8. Speak in a normal fashion without shouting. Check that a light beam is not directed into the eyes of the hard-of-hearing person, making it difficult for the HoH person to see you as you speak.

9. A woman's voice is often harder to hear than a man's, because of the

pitch. Make a conscious effort to lower the pitch of your voice if you are a female.

10. Speak slowly and clearly.

11. If the person wears a hearing aid, make sure it has batteries, the

batteries work, the hearing aid is switched "ON" and that the hearing aid is clean and free of ear wax.

12. If you know (or if it becomes evident) from which side the person hears best, talk to that side.

13. It's better to speak face-to-face: Face-to-face communication in

situations where relatively diffuse lighting is adequate and also lights the speaker's face. This allows the hearing-impaired listener to see the

speaker's facial expressions as well as lip movements. Being able to do so helps the HoH understand what is being said.

14. Individuals with hearing impairment can also benefit from seating

themselves at a table where they can best see all parties (e.g., the end of a rectangular table). Asking people to let you know beforehand when they are going to change the subject of conversation can also be helpful, as it can often prevent an unfortunate "faux pas."

15. Sometimes a person who is HoH has a "good" or "better" side -- right or left -- ask them if they do. If they indicate a preference, direct your remarks to the "good" side or face-to-face, as they wish.

16. If a light is directed toward the eyes of the HoH person to whom you are speaking (or if it puts your features in deep shadow) change the position of the HoH person or the light so that you are not standing in front of it. Also, light from a window may put your head and/or face in silhouette and makes it hard for the HoH to speech-read.

17. Avoid abrupt changes of subject or interjecting small talk into your

conversation, as your HoH listener will likely use context to a considerable degree in trying to comprehend what you are saying.

18. If the HOH person wears an aid, try slightly raising the pitch of your voice. If the HoH is not using an aid, try LOWERING the pitch of your voice. Keep trying until the HOH person gets it.

19. If all else fails, rephrase or try to communicate through a relative

whose voice might be more familiar to the HOH person.

20. Don't talk too fast ... slow down.

21. Pronounce words clearly. If the HoH person has difficulty with letters and numbers then say: M as in Mary, 2 as in twins, B as in Boy, and each number separately: "five six" instead of fifty-six; keep in mind that m, n and 2, 3, 56, 66 and b,c,d,e,t and v sound alike.

22. Keep a note pad handy and write your words and show them to the HOH person if you need to -- just don't walk away leaving the hearing-impaired person puzzling over what you said and thinking you don't care.

Pets Help the Elderly Live Longer, Healthier and Happier Lives

There’s no disputing animals have always had a positive impact on their owners’ lives.

Now, evidence suggests four-legged friends are a real health benefit for elderly people, helping them live longer, healthier and happier lives.
 

Pets Encourage Seniors to Stay Active

The general care associated with a pet can help seniors live more energetic lives. As any pet owner knows, animals need attention and keep us active — whether we want to be or not. Pets help seniors establish routines and get them to do things they might not normally do, such as getting outside and walking their dog or changing their cat’s litter box, feeding, grooming or playing with their pet.
Helen Kapral, a retired school teacher in Corona Del Mar, Calif., says her dog, Muffin, enjoys being outside, which helps her get out. “I take Muffin for walks around the neighborhood all the time,” she says. “She joins me on my daily walks to Starbucks, walks with me down to the beach and has even helped me meet new people.”

Pets Make Great Companions for Seniors

Pets can give an elderly person a great sense of self and help increase self-esteem since pets need and rely on their owners for virtually every aspect of their caretaking. Seniors also benefit from the unconditional love and affection their pets give them.
Just the very presence of a pet provides camaraderie to seniors, helping them realize they are not alone. Additionally, having a pet — especially a dog — can give seniors a great sense of safety just by the barking which can keep unwanted visitors away.

Pets Help Our Hearts

Studies show that older pet-owning citizens have lower blood pressure and cholesterol levels than non-owners, helping to reduce their risk for heart disease and decrease their number of visits to the doctor. Additionally, a number of other studies suggest that pet owners have a better chance for long-term survival after surviving a coronary event than non-pet owners.

Pets Help the Elderly Overcome Depression and Loneliness

According to a study in the Journal of the American Geriatrics Society, caring for a cat or dog helps elderly people overcome depression or loneliness. Whether that be from the loss of a loved one, not having family or friends nearby to interact with, or not being able to get out much, having a fluffy friend gives older citizens a sense of purpose since they have to take care of their pet and think about things other than their own problems.

Even for elderly patients in nursing homes, animal-assisted therapy has shown to help patients decrease their anxiety levels and give them something to look forward to.

Christina Miller, a former convalescent home activities director in Southport, N.C., says she witnessed the positive impact animals had on elderly patients when a local animal shelter made weekly visits to her facility. “Residents who normally weren’t active were suddenly getting up, petting and talking to the cats and dogs, smiling and interacting,” she says. “Patients would ask me, ‘Are the dogs here? Did they come yet?’ Half the patients had better reactions to the dogs and cats than they did to people.”
The positive impact animals have on people — especially the elderly — is tremendous. So much so that there are organizations such as the Pets for the Elderly Foundation, a non-profit organization, that specifically places dogs and cats into the homes of senior citizens, helping them overcome loneliness.
Overall, pets have a positive effect on their senior companions, and benefit health-wise from their very presence.

If you liked this article, you may enjoy reading more about pets and people and how pets and people battle obesity together.

Queen Elizabeth Joins Other Grandparents on Facebook

Queen Elizabeth II is not one to be left behind by technology.  The 85-year-old British monarch has given her approval to a Facebook page. Titled “The British Monarchy,” the page already has over 100,000 followers. The site reportedly went live yesterday, although posts go back to September. I guess they wanted followers to have plenty to look at.

The Facebook page joins the monarchy's Twitter, Flickr and YouTube accounts, proving that the famous British reserve doesn't extend into the cyber universe. Queen Elizabeth is also an iPod user, a fact that came out when President Obama gifted her with one in 2009.

The Queen joins other grandparents, who now outnumber high school students on Facebook. Maybe the Queen will use her Facebook page to spread the news when she becomes a great grandmother, an event that is supposed to occur next month when her oldest grandson, Peter Phillips, and his wife Autumn become parents. I didn't see any tummy shots of the expectant mother on Facebook. I guess even a moderately hip queen has her limits.

Arthritis and Exercise

As the Baby Boomer generation ages, there has been a large increase in the incidence of arthritis. Osteoarthritis is the most common cause of age-related aches and pains in bones and joints, and is thought to affect over 46 million adults.

In addition to the normal wear and tear of joints, Baby Boomers increase the stress on theirs by overuse and obesity. Boomers are much more active than previous generations and their aches and pains may actually be from overuse as running and jumping can easily damage tendons, cartilage, or bone. There’s also an increased incidence in arthritis among Baby Boomers who tend to be more overweight than previous generations, and obesity is a risk factor for arthritis.

Despite the fact that too much of a good thing can hurt your joints, exercise in moderation is a beneficial factors in arthritis treatment. It preserves mobility, strengthens the muscles that support the joints and helps keep weight under control.

Arthritis Foundation offers tips on protecting your joints:

1. Maintain your ideal body weight. The more you weigh, the more stress you are putting on your joints, especially your hips, knees, back and feet.

2. Move your body. Exercise protects joints by strengthening the muscles around them. Strong muscles keep your joints from rubbing against one another, wearing down cartilage.

3. Stand up straight. Good posture protects the joints in your neck, back, hips and knees.

4. Use the big joints. When lifting or carrying, use largest and strongest joints and muscles. This will help you avoid injury and strain on your smaller joints.

5. Pace yourself. Alternate periods of heavy activity with periods of rest. Repetitive stress on joints for long periods of time can accelerate the wear and tear that causes OA.

6. Listen to your body. If you are in pain, don’t ignore it. Pain after activity or exercise can be an indication that you have overstressed your joints.

7. Don’t be static. Changing positions regularly will decrease the stiffness in your muscles and joints.

8. Forget the weekend warrior. Don’t engage in activities your body for which your body isn’t prepared. Start new activities slowly and safely until you know how your body will react to them. This will reduce the chance of injury.

9. Wear proper safety equipment. Don’t leave helmets and wrist pads at home. Make sure you get safety gear that is comfortable and fits appropriately.

10. Ask for help. Don’t try to do a job that is too big for you to handle. Get another pair of hands to help out.

Taking time to protect your joints will benefit you in the long run, and if necessary, advances in joint replacement have enabled people to live active lives.

How to Approach Your Parents With Concerns About Their Driving Ability

How to Approach Your Parents with Concerns about Their Driving Ability

Initiating a dialogue about safe driving

If you have concerns about a family member's ability to drive, addressing them promptly could be a matter of life and death. It may be tempting to procrastinate -- to talk to him or her next week or before the first snowfall, for example — but think how you'd feel if the delay led to an automobile accident that resulted in a serious injury or death.

Considering the possible consequences should help you overcome your hesitation -- but that doesn't mean it will be easy. It's awkward and painful to have to inform older family members that they aren't capable of doing something as basic and essential as driving the car. For them, it's another humiliating reminder of their growing inability to take care of themselves and manage the tasks of daily life.

As difficult as it is, if you have reason to believe that your parent, spouse, or other family member could be dangerous behind the wheel, it's important to deal with the issue sooner rather than later -- because later could be too late.

Before you talk to someone about driving safety

It's a good idea to plan how you're going to approach the subject before bringing it up. Take time to consider how the situation looks from the driver's point of view and what driving means to him. In his book How to Say It to Seniors, geriatric expert David Solie points out that because elderly people face so many losses at this stage of life, they tend to rigidly control the few things they can. This struggle for control will almost certainly come into play where driving is concerned, because giving up the car keys could affect where they live, who they see, and what interests and activities they can pursue. To you, this decision is a simple matter of good sense and safety; for them, it represents the end of life as they've always known it.

Elizabeth Dugan, a geriatric researcher who wrote the book The Driving Dilemma, reports that a colleague stopped using his car for two weeks before talking to his elderly father about driving safety. His carless weeks gave him firsthand experience of the inconvenience and lack of mobility that his father was going to have to endure. You may not want to give up your car before your talk with your parents or other family members, but you should give some thought to the emotional and practical issues they'll face when they give up driving.

Preparing for the discussion also means approaching it with realistic expectations. If you assume that one discussion will neatly resolve the matter, you're bound to be disappointed. Given how charged the driving issue is, you need to think of this as a process that will take some adjustment and fine-tuning. Consider this a preliminary discussion only: a way to get the issue out on the table so it can be dealt with openly.

Finally, prepare for the discussion by considering your own role. Remember that it's not up to you to convince your parent or other family member to immediately cease driving, even if you think this is the best course of action. Unless the driver you're concerned about has dementia or is otherwise incapacitated (see below), it's best to respect his right to make decisions about his life -- with your input and support.

How to talk to someone about driving safety

Plan your discussion for a quiet time of day, when you and the driver you're concerned about is relaxed and rested and no one has any deadlines or commitments pending.

When you introduce the subject, try to avoid coming on too strong, or you'll set the discussion off on the wrong foot. You may feel a keen sense of urgency, but if you jump right in with, "You have to stop driving, Dad! You're going to kill someone!" he'll probably either get angry or tune you out.
Remember that if you've noticed that your father's driving has grown erratic and sloppy, he's probably aware of it, too. You can be most helpful at this point by helping him express and work through his own concerns.

A good way to do this is to initiate the discussion with a question. For instance, if you know that your father has received a traffic ticket, ask him about it, and then follow up with another question like, "How are you doing with your driving, Dad? Are you finding it a little difficult to manage?"

At this point, your father may respond by pointing out all the practical reasons he can't stop driving ("What about my weekly golf game?" or "Your mother's physical therapy appointments are clear across town!"). Without directly answering your question about his driving ability, he's already making the case for why he can't stop. This is valuable information because it provides a glimpse of his own internal struggle: He knows that he's having trouble driving safely but can't fathom how he and your mother will manage without a car.

Encourage your father to discuss his concerns without immediately jumping in with solutions ("I'm sure Jack or Stan will be happy to drive you to the golf course." "The bus goes right by the physical therapy office."). It's usually counterproductive to offer reassurances ("Don't worry, Dad, it will all work out fine."). Such responses may offer temporary comfort, but they won't help you or your parent or other family member explore the larger issues involved.

Instead, you can help your father express his fears by using "reflective listening," a technique Elizabeth Dugan recommends when talking about driving and other difficult issues with an elderly parent or other older adult. Reflective listening -- which essentially means rephrasing what the person has said -- conveys support and encouragement and helps the speaker gain insight about his experience.

To use reflective listening in the example above, you could say something like, "Dad, I know you're probably worried that giving up driving would mean you have to give up some of your usual activities." This type of response will encourage your father to keep talking about his worries and reflect upon them, which is an important step in working through major problems and transitions.

Driving down memory lane

When reflecting about driving and its role in the driver's life, don't be surprised if he or she begins to talk about the past. He may reminisce about his honeymoon road trip to the Grand Canyon or recall how he saved up money for his first car or taught you how to drive. Resist the temptation to interrupt and get him back on track. Instead, try to encourage the reminiscences by asking questions or even requesting to see photos. Sifting through memories will help your parent or other family member come to terms with this life transition as he reflects on the role driving has played in his life and gradually accept the fact that he'll soon have to give it up.

As the discussion progresses, ask him directly what he thinks he should do about driving. You may want to help him jot down some of the pros and cons of the alternatives he faces. This approach can help someone realize that there are actually some benefits to not driving (tremendous savings on auto insurance, car maintenance, and gasoline, for example). It also may help focus him on the stark consequences -- such as a fatal accident -- that could result from maintaining the status quo.

Depending on how everyone is feeling, this might be a good point to put the discussion on temporary hold. Agree to meet again in a couple of days, after you've all had a chance to reflect on the various options. (You might want to set a specific time to meet to ensure that it happens.)

Of course, there's no telling how the discussion will unfold, since that will have a lot to do with factors unique to your family's situation. But the discussion is much more likely to be productive and positive if you approach it with a genuine desire to learn more about your family member's experiences, ideas, and concerns.

Next steps: what to do before someone gives up driving

Identify the problem.If your parent or other family member acknowledges that he's having difficulty driving, find out the specific problems. Make appointments with his physician and eye doctor, and be sure to ask about medication, side effects, and drug interactions. It's possible that the problem can be remedied with a change in medication or a stronger pair of glasses. Make sure his car is suited to his needs and physical abilities, and ask his doctor if assistive devices might help address driving difficulties.

Discuss interim measures, if possible.Once you determine the source of the problem, you can decide what to do next. His physician might suggest that he limit driving to daylight hours or essential errands. If he's going to continue to drive at all, it's a good idea for him to brush up on his driving skills and the traffic laws by taking a senior driving refresher course. AARP, AAA, and commercial driving schools all offer such courses. Agree to revisit the decision every few months to see how it's going.

Help explore other transportation options: whether or not your parent or other family member has to give up the car keys immediately, it's a good idea to help him become familiar with other transportation options. Take the bus with him if he's apprehensive and help him find out more about local senior transportation services. Encourage him to carpool with friends.

Take a break if your parent or other family member refuses to address the issue of driving safety. He may become angry when you try to talk about driving or refuse to discuss it, so it's a good idea to temporarily drop the issue. There's no point in engaging in a battle -- it will only make him more resistant. Give the matter some time, and then bring it up again in a week or so. You may find that he's become more receptive to discussing the matter over time, as he grows used to the idea and realize that the risks of continuing to drive outweigh the benefits.

If you're convinced that your parent, spouse, or other family member poses an immediate risk to himself or others, be prepared to take action, whether he's receptive or not. If he agrees, go with him to talk the matter over with his physician. You can also request permission from him to talk to his physician yourself. (Under patient privacy laws, a physician can't disclose information about a patient's health without written permission from the patient, unless the person requesting the information has power of attorney.) If the physician shares your concern, she may be willing to talk to him herself. If this doesn't work, you can contact your local Department of Motor Vehicles (DMV) and, if possible, anonymously issue a safety complaint.

The DMV routinely gives older drivers driving and written tests as a requirement for license renewal. If a driver fails such tests, his license can be suspended or revoked. In some cases, the DMV puts restrictions on an elderly person's license, forbidding him to drive after dark or on the highway, usually because of vision problems. If the DMV receives a complaint about an elderly driver, either from a private citizen, a police officer, or a physician, the driver will be asked to submit to a medical evaluation. Depending on the results of that evaluation and further investigation and evaluation by the DMV, the elderly driver's license could be restricted, suspended, or revoked.

Dementia. If your parent or other family member has dementia, the driving issue is even more urgent. The effects and progress of dementia can be subtle, but they can also have a corrosive effect on decision making and good judgment. A person with dementia may believe that he can drive safely and insist on doing so, no matter how badly impaired he is. For these reasons, if the person you're concerned about is diagnosed with dementia, he should receive a driving safety evaluation from the DMV. Some people with mild dementia can continue to drive, but if dementia is moderate to severe, the individual should stop driving altogether.

Be there. Wherever your parents or other family members are on the driving continuum -- whether they're still driving, driving with restrictions, or must give up driving altogether -- you can play a valuable role. Most elderly people dread giving up their car because they fear that it will cut them off from their community and activities they enjoy. Your loving, active participation in their lives will reassure them that ceasing to drive doesn't have to sentence them to isolation and boredom. Make it a habit to check in on them often, just to chat or share some news. Offer to drive them to the activities they enjoy when you can -- or help find someone who can. Include them in family outings, like your children's school events or a day at the beach. Encourage them to try taking the bus on their next trip to the pharmacy, or to walk, if it isn't too far away, and offer to go with them if you can. Urge them to ask for rides from friends and to reciprocate themselves. Help them develop new routines and interests that don't require driving, like gardening, walking, or swimming at the local pool. Your support and involvement in their lives will make giving up the car a far less lonely and frightening prospect.

Have you investigated your Estate Plan?

American Academy of Estate Planning Attorneys

The American Academy of Estate Planning Attorneys is an exclusive, membership organization that serves the needs of estate planning attorneys and law firms nationwide. Since 1993, we have been dedicated to promoting excellence in estate planning and elder law by providing our attorneys with comprehensive document creation software, up-to-date research on estate and tax planning matters and exceptional educational training materials.
Our wide-variety of business building and practice management systems help attorneys create and grow successful law practices. These extraordinary programs enable our members to effectively help families and businesses address all of their estate planning and elder care needs.
Academy attorneys are held to a high educational standard. The Academy expects each attorney to complete at least 36 hours of legal education each year specifically in estate, tax, probate and/or elder law subjects. To ensure this goal is met, the Academy provides over 40 hours of continuing legal education each year. This ensures that Academy attorneys are highly educated and up-to-date in these complicated areas of law. No other legal membership organization sets such rigorous standards for its members.
Our exclusive organizational structure allows only a limited number of attorneys into our membership. This unique structure, coupled with our high educational standards, allow our attorneys to be the premier estate planning and elder law firms in their communities.
For over 17 years, the Academy has been a highly-regarded and sought-after resource for attorneys and consumers alike, and has been recognized by Consumer Reports, Suze Orman in her book, 9 Steps to Financial Freedom and numerous times by Money Magazine.

Do You Need Long Term Care Insurance?

Millions of Americans will require long term care, and funding those needs is an increasing concern for senior citizens and their families. The topic of long term care insurance is very likely to come up as you age, or as you care for your aging loved ones. We are bombarded with information about it, it can be wildly expensive, yet we are made to feel it’s imperative to have.
Long term care insurance is a combination of benefits that covers expenses for those diagnosed with a chronic illness or who can no longer care for themselves. Standard health insurance policies and Medicare usually do not pay for long-term care expenses, and Medicaid (or other state programs) do not provide coverage until all of a person’s assets have been depleted.
Before making any decision about purchasing long term care insurance, it’s imperative to understand the basics. The National Association of Insurance Commissioners (NAIC) offers some useful tips regarding long term care:

1. Investigate long-term care coverage if you don’t want to rely on others to support you, and you want flexibility in choosing the type of long-term care services.
2. Long-term care insurance isn’t for everyone. If you are currently receiving Social Security or expect to have minimal or no retirement savings, you will likely qualify for state aid and should not purchase long-term care insurance.
3. Research individual insurance companies to see whether they have a history of raising rates for long-term care coverage. Check with your state insurance department to learn how your state regulates rate increases.
4. Check with your financial advisor or accountant for guidance on whether long-term care insurance is appropriate for your specific financial situation. If long-term care insurance is for you, shop around for the most appropriate coverage at the best price.
5. Make sure you understand what a long-term care insurance policy covers and just as importantly, what it doesn’t. Ask questions and make sure the company is reputable and licensed to sell insurance in your state. If you have concerns about a company, contact your state insurance department.
6. Pre-existing conditions, conditions that you have before you apply for the insurance coverage, may be excluded from coverage. In addition, for some policies, age 60 is a trigger for a rate increase. Thus, it may be beneficial to purchase your policy before your late 50′s.
7. Don’t rely on Medicare or Medicaid to cover your long-term care needs. Medicare will usually pay for a small percentage of nursing home costs. Medicaid pays for long-term care services but only if you meet federal poverty guidelines, and the choice of care facilities can be very limited.
8. Keep in mind that tax breaks are available for qualified long-term care insurance policy premiums. The benefit payments received under such policies are tax-free.
9. Do not divulge personal financial or medical information over the phone, such as your social security number, your health status, your Medicare status or your private insurance coverage. Don’t be fooled by mailings about long-term care insurance that appear to be from an official government source. If you are concerned that someone is trying to trick you, contact your state insurance department.
10. Be wary of advertising that suggests Medicare is associated with a long-term care policy. Medicare does not endorse nor sell long-term care insurance.

Additionally, the NAIC advises consumers to make sure the following items are included in their long-term care policies:

• An “outline of coverage” that clearly describes the policy’s benefits, terms and limitations in detail. It is important to understand how much money the policy would pay, and how much the policyholder would be responsible for out-of-pocket.
• A clear description of the elimination period. Some policies have a set number of days that must be spent in a nursing home or in claims status before the long-term care insurance coverage kicks in.
• At least one year of nursing home or home healthcare coverage or both, including intermediate and custodial care.
• The right to cancel the policy for any reason within 30 days of purchase and receive a full premium refund.
• A guarantee that the policy cannot be canceled or terminated because of the policyholder’s age or physical or mental health condition.
• Consider an inflation protection option that periodically increases the benefit level without the need for the policyholder to provide evidence of insurability.

As usual, please note I’m not an insurance expert, and I don’t even play one on the Internet. I just feel it’s important to educate yourself on the basics involved in paying for long term care. Please consult your financial advisor for specifics pertaining to your situation.

How To Communicate With Your Senior Parent

If you have an aging parent, you probably have received advice from friends and experts to start talking with your parent about issues such as finances, health and safety concerns. You know you shouldn’t delay any longer, and you definitely should not wait until a crisis occurs. However, it is tough to know how to get started. You respect your parent’s privacy. You have had no experience or training for this. It is downright uncomfortable.

You may be thinking:

How do I find out what my parent really wants and what he/she expects from me?

How do I broach sensitive subjects?

What if they get upset with me?

What if they refuse to talk with me?

It’s important to realize it takes just one event to change your parent’s world and yours. A seemingly simple fall can result in a broken hip or brain injury. An aneurysm can result in a coma.

None of us can predict the future. But, we certainly can start the conversations with our parent now. Here are some tips.

1. Start with an understanding of how your motivation and your parent’s motivation differ. David Solie in his book, How to Say It To Seniors, tells us that the primary driver in the elderly is to “maintain control.” That makes sense when you think about the losses they are experiencing; the loss of strength, health, and friends. As adult children, our primary driver is “safety”! We have to learn to assist, not insist.
2. Plan a special visit of 2 or 3 days with your parent. During this time, just plan to be present, listen and walk beside your parent in their daily routines. This means putting your laptop, blackberry and phone away. The first time I did this, I was amazed. I gained insight into my mother’s world, and the experience also helped me transition from my fast-paced world to hers. A natural result of the visit was a deepened trust and openness between my mother and me.
3. Broach sensitive discussions with thoughtful wording, such as using the phrase, “What If”. “What if your arthritis gets worse and you need help in your home” or “What if one day you need full-time care?” If your parent doesn’t want to talk about it at that time, know that you’ve planted a seed. It also helps to share these conversations with your other siblings (who may live states away from you and your parent). Try to get family members on the same page.

So, start with a sincere desire to understand your parent, their fears, needs and wishes. Put yourself in their shoes, and listen, non-judgmentally. Build a foundation of trust and sharing. That foundation is what will help guide you through the conversations you need to have with your parent now and in the future

2010 National Assisted Living Week®

Washington DC - NCAL is proud to announce that “Living Life” is the theme for the 2010 National Assisted Living Week (NALW) and released the accompanying logo.

The 2010 NALW begins on Grandparents Day, Sunday, Sept. 12 and ends Saturday, Sept. 18, 2010.

Established by NCAL in 1995, NALW acknowledges the unique relationships that staff, family members, and volunteers have in caring for nearly 1 million residents in assisted living communities nationwide. 

During NALW, assisted living communities plan and host a variety of events and activities for all to enjoy based on the theme, “Living Life.” 

“Assisted living communities around the country are committed to giving their residents the environment and opportunities they need to reach their goals on a daily basis,” says David Kyllo, NCAL’s executive director.  “‘Living Life’ means enjoying activities and pursuing passions, whatever they may be. It is the lifelong pursuit of happiness and growth. ‘Living Life’ reflects the commitment of assisted living professionals providing person-centered care to their residents. During National Assisted Living Week, communities create special programming that is fun for the residents, family members, and involves everyone who contributes to enhancing residents’ lives.” 

NCAL is currently developing a planning and product guide, which will contain activity ideas, media kit materials, and products featuring the 2010 logo and theme. The guide will be available in June 2010. 

To obtain a copy of the logo for use on calendars and invitations, contact sosborne@ncal.org