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Dear Ally,

I recently received a call that my 87-year-old mother fell and was being transported to the hospital.  My mother broke her hip.  She refuses to use a mobility aide such as walker or cane.  I’d like her to get a fall alert pendant, but she says she will not use.  HELP- I am frustrated.  What steps can I take to ensure my mother’s safety and prevent future falls?

 

Sincerely,

Frustrated Son


Dear Frustrated Son,

Thank you for your question.  Many other adult children are concerned about preventing falls for their parents.

As a Geriatric Care Manager, I have an up-coming visit scheduled to do a home safety check.  Come look over my shoulder and see what changes your mom might consider if she wants to increase her safety and minimize the chances of future falls.

The couple I am visiting are determined to stay in their own home and are fearful of ending up in a nursing home. The number one reason older adults end up living the rest of their lives in a nursing home is falls. Knowing this might motivate your mother to make necessary changes.

The first thing I notice is the steep stairs leading to the entrance of the house.  There is only one railing on the left side of the stairway.  To maximize safety, there should be a railing on both sides of a stairway both inside and outside of the house.

When the door opens, I immediately see an area rug right at the entry way. This is the first of three area rugs, one with curling edges and wrinkles across its hand-woven surface.  To maximize safety, remove all area rugs. They are a tripping hazard. I pay attention to the transitions from one room to another, from the wooden floor in the dining room to the tile floor in the kitchen. Floors should be level. Luckily, this is not a problem here.

The house faces north, and though there are multiple lights all over the house, they are all turned low, and the house is dark. Nightlights during the night, and good lighting during the day all contribute to safety.  Nightlights are particularly important in bedrooms and in the bathroom.

Grab bars by the toilet and in the shower make a bathroom safer for older adults. As I check each room, I am looking for clear passageways.  Dog beds and extension cords can be tripping hazards, particularly if they are in the middle of the room.  These are all the environmental factors that contribute to safety and make falls less likely.

Now we sit down and look at the personal factors that can contribute to falls.  As we age our balance naturally changes due to changes in vision, bone mass, restricted mobility, muscle strength and endurance, and increased likelihood of chronic diseases.  These all can increase our likelihood of falling.

A proactive step that your mother can take is to exerciseWe need to work on strength, balance, flexibility as well as endurance. Not unexpectedly, they tell me that they walk every day-their only exercise. They don’t like hearing that walking isn’t enough.  Exercise programs such as Tai Chi, Water Aerobics, Yoga, dance and Pilates are all types of exercise that help us be more confident in our ability not to fall.  I recommended that they consider working with the senior personal trainer on my team to assess their fitness levels, make recommendations for maintaining leg and core strength, and finding exercise programs they can enjoy.  The personal trainer can also come into the home for personalized 1:1 session for balance training.  As I mentioned during the home safety check and consultation:  “If you don’t use it, you lose it.”  More and more research points to the importance of a comprehensive exercise program to prevent falls.

Change is hard. Those older adults who actively make the changes they need to make (such as using mobility aids like canes and walkers) or wearing a PERS (personal emergency response system such as a pendant) or making modifications to the home and EXERCISING are the ones who are more likely to avoid unnecessary falls. No one can “be careful” all the time.  I hope you can share some of this information with your mother, and when she returns home, she will be more receptive.

Regards,

Ally

Written by Malka Young, LICSW, CCM and Laila Vehvilainen, MS, MPH, NASM-CPT, CDP – Your Geriatric Care Managers at Allies in Aging

If you are worried about an aging parent, contact the experts at Allies in Aging to learn how a Geriatric Care Manager can assist you providing the supports needed to ensure the safety of your loved ones.

 

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I was having coffee with a friend earlier last month, and they seemed unusually tired. They had spent the morning working in their garden on a very hot and humid day. The next day, she texted me to let me know she had tested positive for COVID. A few days later, I heard her husband was positive too. They had both been at a party where at least ten other people also contracted COVID. I had heard about a summer COVID wave, but seeing it happen around me was a wake-up call. I was glad I followed the CDC recommendations last spring and got a second COVID booster. I know vaccines aren’t perfect, but I want to do anything in my power to avoid getting sick and staying out of the hospital.

In June, the FDA announced there would be an updated COVID-19 vaccine in the fall. This new vaccine aims to reduce hospitalizations and deaths, especially among older Americans. Adults 65 and older account for two-thirds of COVID hospitalizations and 82% of in-hospital deaths. People aged 75 and over are at the greatest risk if they contract COVID-19. Most of the older adults hospitalized due to COVID-19 were not vaccinated, highlighting that the biggest risk factor for severe illness is age.

Plan now to get both the updated flu and COVID vaccines this fall before the respiratory virus season hits. You don’t need two separate appointments; you can get both your flu and COVID-19 shots at the same time. Both COVID and the flu tend to increase during the winter months, known as “cold season.”

If you want to avoid getting sick, get your vaccines. The pandemic may be over, but COVID-19 is still affecting people. Like the flu vaccine, you need the COVID vaccine every year. This past year, the CDC recommended that older adults get an additional booster shot. They anticipate doing the same this coming year as well.

COVID vaccines are available for free to everyone six months and older living in the US, regardless of immigration or insurance status. August is National Immunization Month. Celebrate it by making your vaccine plan for this fall.

Key Takeaways:

  1. Get Vaccinated: Follow CDC guidelines and get the updated COVID-19 vaccine and flu shot this fall.
  2. Plan Ahead: You can get both vaccines at the same time, saving you a trip.
  3. Protect Yourself and Others: Vaccines reduce the risk of severe illness, especially for older adults.
  4. Stay Informed: Keep up with CDC recommendations for any additional booster shots.
  5. Accessibility: Vaccines are free for everyone in the US, regardless of immigration or insurance status.

Stay safe and healthy this season by ensuring you’re up to date with your vaccinations. Your health and the health of those around you depend on it.

If you or someone you love needs help managing their medical appointments or needs other support related to their health care needs, contact the experts at JF and learn how our team of Geriatric Care Managers can help you and the ones you love live better, longer.

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Every year, during open enrollment, you have the opportunity to review and make changes to your current Medicare coverage.

Even if you have been with the same insurance plan for a long time, what you pay and what coverage you have can change. As you grow older, your medical needs may change, and your current plan may not be right for you.

Here are some reasons to review your coverage:

  • You notice that you are paying more for your prescriptions.
  • You are now wintering in Florida or spending your summers up in Maine.
  • Your income has dropped.
  • You have a new diagnosis of a chronic condition.
  • You are in a Medicare Advantage plan and your doctor is no longer in network.
  • Changes to your former employer’s retiree health benefits
  • You are very healthy, and only see a doctor infrequently
  • Your plan has changed or removed some benefits.

 

Contacting your local senior center and to schedule an appointment with a SHINE (Serving the Health Insurance Needs of Everyone) counselor. These highly trained volunteers can review your current coverage with you and help you evaluate whether it still meets your needs. If not, they will review your options.  SHINE offers free, unbiased health insurance information and counseling to people with Medicare and their caregivers.  Any changes you make will become effective on January1, 2024.

 

Common Medicare mistakes we see:

Thinking that an AARP membership card provides you with prescription coverage under Medicare Part D.

Not signing up for Medicare Part B. You get Part A automatically. By not signing up for Medicare Part B in a timely manner, you may delay coverage and need to pay a late enrollment penalty for the rest of your life.

Thinking that Medicare Advantage plans cove prescriptions in  the “donut hole”

Thinking you earn too much to get help paying for prescriptions. You can earn $70,000 as an individual and $98,000 as a couple and be eligible for the Massachusetts sponsored prescription drug program for older adults and people with disabilities.

The Care Managers of JFS Allies in Aging can answer your questions about Medicare help you understand your health insurance needs so you can make wise decisions during this year’s open enrollment period.

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As summer approaches, it is important to be prepared for the heat, especially older adults. With higher temperatures and longer days, the risk of heat-related illness and dehydration increases.

Here are some tips to stay safe, comfortable and active during the summer months:

 

  1. Drink water! Avoid alcohol and caffeine as these can lead to dehydration. Carry a water bottle with you and take frequent sips throughout the day.
  2. Dress for the weather! Light colors and loose-fitting clothing is the way to go. A hat with a wide brim can protect your face and neck from the sun’s strong rays.
  3. Plan your outside time before 11 and after 3. Avoid the strongest sun in the middle of the day.
  4. Keep your home cool: Air conditioning is no longer a luxury. Use fans to circulate air and keep the temperatures cooler. Close your curtains or blinds during the day to block the sun’s rays.
  5. Careful! Know the symptoms of heat exhaustion and heat stroke. These include heavy sweating, weakness, dizziness, headache, nausea and vomiting. Heat stroke can increase body temperature, cause confusion, seizures or even loss of consciousness. If you or loved one experience these symptoms, Get help immediately.

 

By following these tips, older adults can enjoy the summer months while staying safe and healthy.

If you are concerned about yourself or your loved one, call the experts at Allies in Aging, JFS Elder Care Solutions. We can help you and your loved ones stay safe this summer and throughout the year.

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Dear Ally,

Before COVID, my mother had many friends, sang in the choir and volunteered at the local school. Now she mainly is at home, the school no longer welcomes volunteers, and the choir is not meeting in person. Should I be worried?

Wondering

Dear Wondering,

Older adults are at higher risk for social isolation and loneliness due to a number of factors, including physical and cognitive declines, loss of loved ones, and changes in social roles and support systems, more noticeable since March 2020.

Research has shown that social isolation and loneliness can lead to a range of negative health outcomes in older adults, including:

  • Higher rates of mortality and morbidity
  • Increased risk of heart disease, stroke, and hypertension
  • Decreased immune function
  • Increased risk of cognitive decline and dementia
  • Increased risk of depression and anxiety
  • Increased risk of falls and accidents

Someone can be socially isolated without feeling lonely, and vice versa. For example, an older adult who lives alone but has a rich inner life and strong connections with friends and family may not feel lonely, even though they are technically socially isolated. On the other hand, an older adult who lives with others but lacks meaningful social connections and support may feel lonely, even though they are not socially isolated.

It is important for older adults to have social connections and a sense of community in order to maintain good health. There are many ways that older adults can stay connected and engaged.

It is also important for friends and family to check in on older adults who may be at risk of social isolation and loneliness and to offer support and assistance as needed.  Be curious! You can call your mom and ask her how she feels about these changes in her social life. Encourage her to find other volunteer activities that are open like JFS virtual visitors or patient navigator.

Ally

 

If you need help caring for an aging loved one, contact us today to learn how JFS Allies in Aging can help your loved one live better, longer.

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Dear Ally, 

What is the difference between social isolation and loneliness, and why is it important? 

Wondering and Alone 

___________

Dear Wondering and Alone, 

During the COVID lockdown we were physically separate from others We could count on one hand the number of social contacts we had in any given week, often zero and mostly brief and fleeting. Loneliness is a feeling, a perception of being alone. 

What we have learned: 

  • People experiencing loneliness and/or social isolation have a greater risk of developing heart disease or stroke. They have a higher rate of mortality and experience more depression and anxiety. 
  • In 2020 56% of older adults reported feeling isolated from others compared to a poll taken in 2018-more than double! 
  • Research shows remaining socially engaged improves quality of life and may even live longer. They have better emotional well-being and mental health.  Their health and physical fitness improve. They are more likely to have a sense of purpose and live longer. 

What does it mean to be socially engaged? 

  • Volunteering 
  • Creative art activities 
  • Lifelong learning 
  • Health and Wellness activities 
  • Knowing how to use the internet and smart phones 
  • Being involved in the community 

Now that you are vaxed and double boosted, have you begun to venture out again? Many older adults are still nervous about going out and getting COVID. 2022 is not 2020. We now have plenty of PPE, vaccines and treatments.  We are transitioning from a pandemic to learning how to live with a disease that is endemic, part of us, just like the flu or any other infectious disease.  Every person needs to decide for themselves which risks they are willing to take. It is risky to ride in a car, eat in a restaurant, or move furniture-but these are all things that most of us do.  

Things are reopening and more and more opportunities to socialize face-to-face are happening. Wear your mask, (I wear an N-95 whenever I go out) and put yourself out in the world.  If you need help re-entering your life, help with technology; want to make a plan to become stronger and more physically active, contact us-JFS Allies in Aging Care Management team. We can help you make an aging life plan to live longer and happier in this not quite post-COVID world. 

Ally 

 (With input from JFS Elder Care Solutions expert care managers Eileen, Jennifer, Laila and Malka) 

Contact us and get support today! 

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Kindness and Caregiving 

What does kindness have to do with caregiving? Caregiving is a relationship between two people, both with their own feelings, thoughts and needs. Because of the demands of caregiving, a caregiver often loses sight of the relationship, and caregiving becomes a series of tasks to be accomplished, boxes to be checked on a to-do list. Unlike other relationships in our lives, the relationship between a caregiver and their loved one often lacks reciprocity. A caregiver has the experience of giving, giving, giving, doing, doing, doing without acknowledgement or thanks. Where does kindness come in? 

Caregiving demands kindness and radical empathy… Try to imagine that you have dementia, and in your confusion, you don’t know where you are. The familiar house you have lived in for decades appears strange to you, and you want to go home. You are panicked. Only your long-term memory is intact, and you long for your old room in the house you grew up in. As caregivers, our natural impulse is to say, “Honey, we are home. This is our house that we have lived in since 1986! This is not convincing to a person with dementia. If you came upon a stranger who told you they were lost, and wanted to go home, how would you react? Kindly, with reassurance. You might put your arm around them and tell them that you will help them get home or you might say that you will stay with them and not leave them alone. To respond with kindness and patience each time you are asked “When are we going to go home?” as if this is the first time you are hearing this question. 

There is nothing worse than feeling alone in a marriage. Because of this lack of reciprocity, a caregiver often feels alone, abandoned by their spouse, even though they know if is the illness that is the cause. As friends, neighbors, and family we are called upon to be kind. Anything we can do alleviate the social isolation of a caregiver is welcome. A card, sending flowers on a birthday or holiday, dropping off a meal, shoveling a walk, picking up some groceries, a gift card for house cleaning, taking the dog for a walk, giving a gift of respite, whether it is you offering to spend time with their loved one with dementia or providing an aid for a few hours these random acts of kindness and 10’s of others, can make a huge difference in the life of a caregiver. 

Kindness begets kindness. The kinder you can be to a caregiver, the kinder they will be to their loved one. Caregiving doesn’t take place in a vacuum. Let us create a community of kindness, one act of kindness at a time. If you want more information on how to support the caregivers in your life, contact Allies in Aging 508-808-3263.

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AARP.org 

It can be challenging to follow the CDC’s recommendations that encourage older adults to limit their travel and close interactions with other people as much as possible. To many, this translates into staying at home for the duration. For those who were starting to feel as if it was safe to venture out again, the surging infection rates have forced many back into isolation, deepening feelings of loneliness and depression. 

Maintaining social connections is key to maintaining health and well-being. Elder care expert and Director of Allies in Aging JFS Elder Care Solutions Malka Young suggests, instead of social distancing, think physical distancing + social connection. She was recently quoted in the aforementioned AARP blog, a national organization that advocates for older adults. 

During World War II the planting of victory gardens, and the rationing of gas, food, and clothing connected Americans of all ages, classes, and cultures in a shared effort to save these precious resources for soldiers. Now, mask wearing, sheltering in place, washing our hands frequently, and limiting the spread of the virus allows us to connect to neighbors, friends and family no matter where they are. 

Here are 10 actions that you can do every day to keep your spirits up: Call someone* (keep a list of family, friends, neighbors by your phone) 

    1. Call someone** (keep a list of family, friends, neighbors by your phone) 
    2. Move your body (CDC recommends 150 minutes of moderate exercise weekly) 
    3. Straighten up one area in your home 
    4. Eat something healthy and stay hydrated 
    5. Get outside 
    6. Get a good night’s sleep 
    7. Limit how much news you listen to (15 minutes 2x/day is more than enough!) 
    8. Name one thing you are grateful for 
    9. Learn something new 
    10. Do something creative (listen to music, bake, make something, etc.) 

**At Call2Talk 508-532-2255 someone is available to listen 24 hours/day/7 days/week. 

For more ideas, read AARP’s article 6 Ways to Overcome Social Isolation During Another COVID Winter. 

Are you or a loved one struggling with social isolation due to the pandemic? Are you worried about managing the coming months amidst the ongoing COVID-19 crisis? Contact Malka Young to learn how a Geriatric Care Manager can assess your concerns, arrange services and provide critical support to ensure that you or your loved ones are safe and cared for during the coming months. 

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November is National Family Caregivers Month.  Why do we need a special month to recognize and appreciate family caregivers?

Family Caregivers are the invisible link in our health care system.

Christine is an 80-year-old retired lawyer. She had a stroke last year and is struggling to regain her independence. She lives alone in a beautiful apartment that she and her husband decorated with mementoes from their years of travelling together. He died while she was in the hospital and their daughter lives on the other side of the country caring for a grandchild with special needs. She is now home with 24-hour care.  There is no one person who cares about her, who can be available 24 hours a day who can intervene and be her advocate. She can outsource some of the discrete tasks a family caregiver does, but it is difficult if not impossible to replace a family caregiver who loves and cares about the person needing care and has a holistic understanding of who they are and what they need. 

It is not easy being a family caregiver.  It usually happens gradually. If one partner no longer is comfortable, driving at night it is natural for the other to start to take on the night driving.  The transition between picking up medication at the pharmacy and setting up the pillbox may be next. When someone falls, of course, a person in the same household will try to help them up, and if that is not possible call a neighbor or even 911 to get help. Task after task, incident after incident, occasional caregiving changes into a constant that is part of the fabric of their shared life together. 

Medical care focuses on the needs of the patient.  The working assumption, no questions asked, is that a family member exists and will be available to help and support the patient. 17-35% of all caregivers report their health as fair to poor. The longer someone is a caregiver, the more likely they are to say their health has been impacted. Caregivers caring for someone with dementia also report worst health outcomes. 40-70% of spousal caregivers suffer from depression.  Family caregivers need help and support. We need to appreciate the amount of care they provide and make sure their needs are being met and they are not taken for granted. JFS Allies in Aging can work with caregivers and their family to put a support plan in place.  

Let us take the time to appreciate and acknowledge the importance of family caregivers in our lives. 

 Click here to learn about JFS’s Elder Care services!

 

 

 

 

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