As you think about your parents, what are some of your hopes and dreams for them as they age?

For my own mother, I hope that she

• can live her life the way she chooses
• will have the best possible health and quality of life
• will always be part of a loving, caring community surrounded by support

And yet I realize the many challenges.  We have a growing aging population that is straining our healthcare and senior care system.  Debilitating chronic diseases can wear down even the most resilient body and spirit.   And, then there’s the isolation that all too often accompanies aging due to loss of spouse and loved ones.

It’s seems that our hopes and the reality are at odds.  Or, are they? 

I want to share an innovative approach to helping older adults live an active and healthy life in their own homes with the aid of a senior-friendly tool.  There are quite a few technologies that are senior friendly, but this approach goes one critical step deeper!

Recently I spoke with Denise Rabidoux, President  & CEO, Evangelical Homes of Michigan, and Steve Hopkins, VP Wellness and Home Based Solutions.  Evangelical Homes is a Continuing Care Retirement Community (CCRC) with a bold vision.  They want to extend the care of older adults beyond their walls, and they want to connect with older adults (living independently in their own homes) prior to a care need.   Their goal:  help older adults be proactive in their health so they can avert the progressive decline that often leads to a health crisis.

So, Evangelical Homes searched the marketplace for the right tool and partner in this effort.  They found Intel/GE’s Care Innovations “Connect.”  “Connect” is a senior-friendly device with touch screen and includes wellness surveys, medication compliance reminders, brain fitness games and social networking tools.  But, as Steve Hopkins pointed out, it wasn’t enough to just put a device in the senior’s home.

There had to be a strong and persistent link between the senior and a trained staff member.  Evangelical Homes call these support staff, Lifestyle coaches.  So, here is that critical step – the “high touch” component.  Each senior would have a Lifestyle coach, based at Evangelical Homes.  Each coach would develop a trusting relationship with “their seniors”, and, on a daily basis, intervene and handle issues as they arise, and also guide & educate.

Ok, this sounds great in theory.  But, what would make the senior want to use the device so they could reap the benefits?  Let me share the how it works, and then you’ll see the beauty of the way Evangelical Homes implemented the tool.

(Assume Mary is the senior, and John is the lifestyle coach.)

As part of Mary’s morning routine, she turns to her “Connect” device, touches the large icon on the screen labeled, “Wellness.”   She is prompted with 20 random questions, and simply touches the answer that best describes her answer.  For Mary, it’s a quick and simple process.  It makes her more self-aware plus she feels a sense of security, knowing that her lifestyle coach, John, is reviewing her responses and will contact her with a follow-up call, if he feels it’s necessary.  (Behind the scenes, this survey is not totally random.   If question #2 indicates a problem, question #3 will dig in deeper, and so forth.)  As John receives the data from Mary’s responses, he immediately recognizes potential risk factors of depression, trouble with balance, with medications, etc.  In fact, Mary may not even be aware that she has a problem.  She has come to know and trust John, and appreciates John when he calls and helps her out.

Evangelical Homes is currently in pilot with their program and 35 members.  And, as Denise Rabidoux points out, it is also important to recognize the way in which this new solution has changed the nature of the lifestyle coach daily work and job satisfaction.  It is indeed shaping the overall culture throughout Evangelical Homes (members, families and staff) in an amazing way.

Integrating technology and lifestyle coaches to deliver individualized care!  It is my hope that Evangelical Homes will share their new model of “senior wellness” around the country.  With their “Connect” solution, they are expanding the very definition of what it means to be a “Continuing Care Retirement Community.”  They are offering care and support to seniors throughout the “continuum” of their lives so they can indeed have the best health and quality of life possible.

For more information about Evangelical Homes of Michigan, click here.

For more information about Intel/GE’s Care Innovation “Connect”, click here.

Aging in place (AIP) costs considerably less than assisted living care, but it’s not free.

Though funds are dwindling for many senior-related programs (Medicare, Medicaid and Social Security have all spent ample time on the chopping block lately), there are still a number of federal, state, local and private organizations that offer financial support to seniors who want to stay where the heart is.

To begin – because first you might need to sell the idea to skeptical family members, or just figure out what modifications are needed before getting the capital to do it – get to know what services and resources are offered in your home state via these helpful sites:

• Search for home repair and modification resources in your region at Eldercare.gov.
• HomeMods.org is a national information clearinghouse on all things related to home modifications. Professionals and consumers alike can peruse an extensive resource directory on the site.
• Not sure if your own home or a senior loved one’s residence is adaptable for AIP? Most are, but the WellCome Home site helps you clearly see the potential and know where to direct your energies and efforts when it’s time to transform the home.
• Download this Home Safety Checklist from Rebuilding Together, Inc. to remove fall hazards and resolve accessibility issues, many of which may be implemented without spending a dime.

Should the need arise for assistive equipment (such as power chairs or stair lifts) or home modifications (like wheelchair ramps or door-opening systems), here are a few ways to ease the burden of purchasing or installing these costly components.

Claim a deduction. Russell Glickman, a DC-based home design and remodeling expert, recommends conferring with a Certified Public Accountant (CPA) to find out whether you or a loved one is eligible to deduct the cost of home modifications on your federal income tax. You need a written recommendation from your doctor as proof that the modifications are medically necessary. Glickman also states that you can claim a deduction for the costs of operating and maintaining the modifications, whether or not the stair lift, ramp, or other equipment qualified as a medical expense. Home improvements (or capital expenses) that may be deducted per the IRS.gov are as follows:

• Constructing entrance or exit ramps for your home.
• Widening doorways at entrances or exits to your home.
• Widening or otherwise modifying hallways and interior doorways.
• Installing railings, support bars, or other modifications to bathrooms.
• Lowering or modifying kitchen cabinets and equipment.
• Moving or modifying electrical outlets and fixtures.
• Installing porch lifts and other forms of lifts (but elevators generally add value to the house).
• Modifying fire alarms, smoke detectors, and other warning systems.
• Modifying stairways.
• Adding handrails or grab bars anywhere (whether or not in bathrooms).
• Modifying hardware on doors.
• Modifying areas in front of entrance and exit doorways.
• Grading the ground to provide access to the residence.

Note: You can only itemize these deductions if the main purpose of installation is medical care for you, a spouse or dependent (modifications made for aesthetic, architectural or other personal reasons do not qualify). Permanent improvements that boost your property’s value may be partially included as a deduction; in this case, the cost of the home modification is reduced by the amount of the property value increase (whatever the difference is what your qualified medical expense to deduct will be). If the home modification does not increase your property value, you can deduct the whole cost as a medical expense.

Visit the Area Agency on Aging. Every state offers different incentives, programs, and benefits to their senior residents. The best way to learn about them all, in addition to any tax credits or federal monies available through Medicare, Medicaid (in some states, you may be able to qualify for funding via the Medicaid HCBS – home and community-based services – waiver), HUD, the VA, or the USDA that would be disbursed through the state, is at your local Area Agency on Aging. The AAA is a one-stop-shop neighborhood branch of your state’s department that handles senior care (i.e. Department of Aging, Department of Public Welfare, etc.). Go to Eldercare.gov or N4A.org to find your AAA by zip code, city or county.

Apply for grants or take advantage of state assistive technology projects to make your home wheelchair accessible. According to HomeMods.org, funding is available for this specific modification through the Department of Veteran Affairs (call 800-827-1000 or your local VA for more details) and via the United Cerebral Palsy Association (call 800-872-5827). The IRS also permits those with disabilities to claim some of these expenses as a tax deduction. Check in with the National Council on Independent Living Center (call 703-525-3406) to get local funding information and referral services.

Get a loan to add a room. If Mom is moving in and she has health needs or disabilities, you may be eligible for government funding. FannieMae offers the HomeChoice program, Home Keeper program, and the Home Equity Conversion Mortgage (get more details at http://www.efanniemae.com, or visit the local office). In Texas, New Mexico, California and Illinois, residents can apply for a Home Modifications Loan for Homeowners (with fixed interest rates and low minimum loan amounts) via Bank of America, under the “Access Loans” category. For more information, call 800-843-2632 (in CA, IL) or 800-900-9000 (in TX, NM).

Contact local foundations and non-profit organizations. Some may offer financial assistance or services referrals for those providing care for someone with disabilities or diseases like Alzheimer’s, multiple sclerosis, or rheumatoid arthritis. Easter Seals and Rebuilding Together both offer low- or no-cost community-based home modification and repair programs.

Take out a second/reverse mortgage. If you have the equity, this is a good way to secure a loan for a home modification, which, if done well, should add value to the home as more people will be seeking homes where aging in place is possible. You must be over 62 to secure funding via a reverse mortgage. (Learn more about reverse mortgages here.)

Check your insurance policies and healthcare plans. The National Association of Home Builders says that some programs – auto insurance, worker’s compensation, long term care policies (some will cover the cost of major modifications in lieu of a transition to a long-term care facility), state catastrophic accident insurance plans, and medical trust funds – might cover the costs of a home modification.

If you have a Medicare Advantage Plan, check with your care/case manager to find out if some home modification costs may be covered in the plan (note: those that do generally require participation in a care management program).

Move your parents in. If you have decided it’s best for Mom and Dad to just move in with you so you can provide care more readily, Glickman says you may be able to use proceeds from the sale of their home to make an accessible suite at your residence. He adds that adult children can avail themselves of the space in the future too, as their own care needs change.

Ready to consider a home modification for a family member’s residence, or your own? 101 Mobility has a full line of products (stairlifts, auto lifts, ramps, and more) and a team of highly-trained professional installers standing by to get AIP construction underway. Learn more about their services and find the local office serving you at http://101mobility.com/locator/.

Additional Sources:

• http://www.homemods.org/FAQ/index.shtml
• http://www.nahb.org/generic.aspx?genericContentID=89799

My mind quickly became overwhelmed as she shared the rapid pace of her husband’s decline in terms of his health and the way in which he had been “handled” by the health care system and moved from place to place, from ER to hospital to rehab to acute long term care to long term care.  Betty shared her saga with amazing clarity but also with great emotion.

Through her tears, she shared her love for her husband, dismay at the health care system, and  astonishment at the differing quality of care and attitude of physicians.  One thing she said to me several times, “Dale, please tell people the information they need to know about their loved ones (before hospitalizations), and the conversations they need to have NOW.”  Betty is so right! This is the foundation we need to have in place in order to be the best advocate for our loved one.  Advocating for a loved one in an often complex healthcare system “requires” that we have the facts and know the wishes of our loved one.

To that end, I have listed below key information we need to know about our aging loved ones. And one other important point … as my Elder caring attorney -friend, Doug Germann, reminds me.  It’s not enough to know information and have legal documents in place.  You also need to have a discussion with your loved one about their wishes (healthcare and end of life.)  I encourage everyone to make this a priority in the new year.  We never know when illness or accident will occur.  Recognize that this is a gift of love!

Before your parent’s next Emergency Room (ER) visit, here are 5 things you should know about them: 

•  Names of their doctors and their contact information.  This was critical in the diagnosis and treatment of my mother when she was rushed to the hospital with a supposed stroke, close to death.  I was the one who called her long-time specialist and alerted him to her condition and hospitalization.  Without his timely help, I don’t know what the outcome would have been.
• Birth dates and insurance information.  If an aging parent loses consciousness, you will need to provide their birth dates, name and phone number of their insurance provider.  If you think you would just reach for the card in their wallet, think again.  In the chaos of an emergency, that may not be so easy.
• Allergies and other medical conditions.  It is important to know allergies to medications, as well as major medical issues and past surgeries.  We hear about the new EHR (electronic health record) with a patient’s history following him/her through the health care system.  This is NOT yet in place for most of us!  Even if your loved one is conscious, they will likely be in a state of pain, confusion and stress.  You need to know their medical history.
• Medications and supplements.  Every adult should have a list of their medications (prescription and over-the-counter), including vitamins and supplements.  Vitamins and herbal supplements can interact with medications given in an emergency situation.  You can Google for “medication tracker.”  Print it out, work with your parent to complete it, give one copy to your parent to post on the frig and one copy for you to keep.
• Advance directives.  This document outlines your parents’ wishes in the event they cannot make medical decisions for themselves.  In many retirement communities, each resident keeps this posted inside their door.  Not a bad idea for any older adult.  In case of emergency, ambulance personnel would know whether to resuscitate.  And, then the document is critical later, as you, your family and the physician discuss and determine care.

There may be other things that you have found are important to know.  I encourage you to continue this conversation at our ‘Transition Aging Parents’ Facebook page.  Click here.

(Source:  “Aging Parents:  During emergency, details counts”, MayoClinic.com)

(Thanks to our guest blogger for highlighting a matter that is critical to quality of life and death for everyone!  Douglas D. Germann, Sr. is an Elder

Here is an article from the Annals of Surgery which headlines that surgeons don’t discuss end of life care, especially when they are performing risky procedures.  (To read the article, click here.  More details are available by clicking here.)

But, if you read more closely, at least in this Reuters news piece, what you see is that the surgeons feel their hands are or may be tied by a paper that says “No CPR” or “DNR” (do not resuscitate)  or the like. So some do not want to ask in the first place.

The surgeons are right to be confused and frustrated by Advance Directives. What they need to do their healing is to have a flexible, reasoned approach to the exigencies that come up during operations.

What is needed is someone they can consult (an authorized and informed, but more than that, reflective and caring person) and with whom they can make a decision.

And that spells just one thing: Conversation, lots of conversation before the day of the operation with a trusted person to whom you have given a broad POA. Conversation, lots of continuing conversation.

(To reach Doug at his website and blog, click here.  You are invited to post comments there as well.)

But, our parents do still have control over many over factors and, ultimately, their quality of life.  I want to share the findings and insight from a long-term research study.  Dr. Howard Friedman and Leslie R. Martin looked at the behavior patterns of 1,500 people over their entire life spans, using data from the 80 year long Longevity Project.

Dr. Friedman’s advises: “envisioning health as a cluster of interconnected behaviors and habits, rather than a checklist of things to get done, is really what we should strive for.”

So, what can you do to help your aging parent and yourself live healthy and live well?  Let’s look at some of the  behavior patterns of people who lived long, healthy lives:

• The CDC recently published a study showing there are 4 healthy behaviors – not smoking, limiting alcohol, exercising and eating right.  These will have a significant difference in the your likelihood of dying from any cause, in particular heart disease and cancer.

• Get and keep your body in motion.  Any form of activity is a “fountain of youth.”

• Be socially “rich”.  Involve yourself in your community, family, and non-profit causes however you can.

• Persistence has been shown to be one of the best predictors of health and long life.  By being aware of your environment and how you interact with it, you can actually nurture the personality traits most beneficial to your physical and mental health.

• Achieve a sense of personal accomplishment, and be resilient.

I hope you will share these insights with your aging parent.  Psychologists tell us that one key motivating factor in older adults is that they want control over their environment and life.  Can you imagine the difference it can make in one’s mindset when an older adult puts their focus on their overall health and quality of life, versus dealing with increasing medications, procedures and physical and mental decline?

I know it is possible.  I have seen my mother go from near death 3 years ago to becoming, quite literally, a new person.  Sure, she is still coping with a number of chronic health conditions, but she now is a woman of purpose, is part of a vibrant community with a real sense of hope.  I love it when she says, “I’ve really got to get these legs working better for when I go to my grandson’s graduation in NYC next June.”   I encourage you to walk on this journey of the pathway to good health with your aging parents and family.

Let’s all declare that 2012 will be the year when we commit to living our lives fully and in a healthy way.

Source: “Living Better and Longer: Lessons from an 8-Decade Study” 

Not surprising, the most popular was a post I wrote about how to help an aging parent who refuses help.  As family members and caregivers, I imagine we’ve all faced this situation, and may likely face it again in the future.

I encourage you to take a few minutes now to read these short blog posts, reflect and gain insight on some of the key issues that you may face now or in the coming year.

1.  How to Help an Aging Parent Who Refuses Help

One question I hear over and over goes something like this, “We see our parents struggling with their living situation, and we have tried every way possible to talk with them about it, but they refuse to accept help in their home.  What can we do?” In this post, I explore the situation from our parents’ perspective, and then provide some suggestions.  Click here.  

2.  Transitioning An Aging Parent to Assisted Living – When & How

Although our aging parents may wish to age-in-place in their homes, the day may come when we need to think about a move to Assisted Living.  In this post, I provide key criteria that would indicate consideration of a move to Assisted Living.  As always, I encourage us (adult children and families) to be thinking ahead and to become knowledgable about local options in our community now.  Don’t wait for a crisis to occur when you have to abruptly choose an Assisted Living facility for your parent.     Click here.

3.  Safety and Innovation – Bathroom Design for the Elderly

If you’re a caregiver to an older adult, you know that bathing is a difficult challenge.  In this post, you’ll read about innovative bathroom equipment for older adults.  You don’t have to have a huge budget or grand remodeling scheme to consider some of these items.  Open your mind to some of the new possibilities (in showers, tubs, toilets) supporting safety, independence and quality of life for your aging parents.  Click here.

4.  Validation Technique – Communicating with Those with Dementia

The Validation technique, created by by Naomi Feil 30 years ago, is a tested method of communication with disoriented elderly that helps reduce stress, and enhance dignity and happiness.   In this post, I share the principles behind the Validation Technique and key benefits.  Both families and professionals can utitlize this powerful technique and ensure that older adults in their care never reach a vegetative state.  Click here.

5.  How to Deal with a Difficult Sibling in Decision-making for an Aging Parent

Why is it so hard for a family to listen to Mom or Dad, consider the options and then, in a unified way, make the right decision in Mom or Dad’s best interest?  In this post, I share key reasons I believe to be true and then a few possible strategies.   Click here.

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NOTE:

If you’re new here, you may want to request my Free eCourse, “Five Essential Strategies to Help Your Aging Parent Face Change”.  Click here.

If you’d like to continue this conversation, please join us on Facebook at our ‘Transition Aging Parents’ page. Click here.

Many of us live across the country from “aging in place” parents. A lot can happen in one year, in terms of your parent’s health and home. If you find yourself in a home that’s in disarray or facing someone who is in frail health, you may find yourself in a reactive mode, wanting to jump at a solution. You may want to immediately ask direct questions. But that will likely put the your parent on the defense. There’s a better way to approach the situation.

Before you leave for to visit your aging parents, here is a simple checklist and suggestion on how to approach concerns with your parents.  And, by all means, if you face a deteriorating or emergency situation with your parent, take a step back (and some deep breaths)…and try to frame the situation with an empathetic and loving approach.

Here are the main points of the checklist:
1. Look in the frig (is there outdated food in it?)

2. Drive their car (check the state of the tires, oil, antifreeze)

3. Take a peek at the mail (keep an eye out for unpaid bills)

4. Investigate the bathroom (check for cleanliness)

5. Take a note of how the pets are doing

6. Talk to the neighbors (a bonus is establishing a relationship with the neighbors and also someone to keep an eye on their home and them, even if just from the outside)

7. Identify some benchmarks ( consider marked declines from the previous year)

8. Go to the source. This is probably the most important ‘next’ step. Take the time to sit down with your parent, listen to their concerns, worries and perceptions. Ask what you can do to help. As when dealing with any of life’s difficult problems, oftentimes an individual (young or old) needs time to process a conversation, suggestions, etc. Give your loved one time to let your conversation sink in. Then, after the holiday, you can (as a family and ‘team’) engage in devising plan for solutions that meet your parent’s needs.

If you’d like to continue this conversation, please join us on Facebook at our ‘Transition Aging Parents’ page. Click here.

Dale Carter (left) before presenting. On the right, host Brenda Torres

Give Me Just 3 Hours … and I’ll Share my ADAPT framework for caregiving so you can be the guiding force in your family, bring your family together, save precious time, money & your health while respecting your aging parent’s dignity and independence.

Join me for 3 evenings in November (one hour each evening over the phone) when I show you exactly how to help your aging parent, regardless of the challenge.  I will provide you with the same roadmap I used in helping my mother.

Based on sound principles of communication, project management, and gerontology, you’ll learn the innovative ADAPT tool that you’ll be able to use time and time again.

Why take the time now to learn about ADAPT and how it can help your family?  The holidays are fast approaching and are often the first time in months or perhaps a year (or more) when family gathers and realizes there are changes in Mom or Dad’s health or living conditions.  It can throw a family into a panic.  I know!  The information and insight I provide in this 3 hour seminar will serve as a roadmap and provide you with guiding principles … so you are not caught up in the panic.  You will know what to do!

Why this seminar and my ADAPT approach?  Let me share feedback from two other people who completed my seminar.  One young man told me (months later) that when his grandfather became ill and faced end of life, that because of what the young man learned in my seminar, he was able to guide his mother (primary caregiver) through the difficult decisions and care during his grandfather’s last weeks of life.

Another attendee, a director of a hospice organization, later told me that “one concept” I shared made all the difference at the end of her father’s life.  She told me it helped her family give her father ‘quality of life” and gave the family peace.

This 3 part seminar will give you both the tools (the ADAPT framework and a host of resources) and insight into your relationship with your aging parent, your family and your community.

We’ve often heard “it takes a village to raise a child.”  It also takes a village to care for an aging parent.  After my seminar, you will be able to find your village.

This special seminar begins November 15, 8pm Eastern.  If you cannot one or more of the calls, you will still receive the recordings and hand-outs.

For more information and to register, click here.

Just about every elderly person I know is dealing with chronic pain in some form.  My mother has daily headaches and pain in her shins.  She has been to a number of specialists and has had all the possible testing.  But, still no answers or relief.  My friend Cathy, with a rare skin condition, has been to the very best specialists at Mayo Clinic.  She is currently taking the maximum dosage allowed of the relevant medication, and still ends many days in chronic pain, exhausted and going to bed for relief.  If you think about your aging loved ones and friends, I’m sure you could share your own stories.

Hearing the stories and understanding the negative impact chronic pain can have on quality of life and relationships, I have always wondered … what can be done to minimize it?  Is there some combination of non-medication factors that could offer relief?

There is a wonderful, no-cost Stanford University online workshop, “Better Choices, Better Health”, a service of the National Council on Aging.  Whatever the chronic condition – diabetes, arthritis, high blood pressure, heart disease, chronic pain, anxiety or something else, the workshop can help a person learn to be proactive and take better control of their health and life.  Let me share its benefits and how it works:

Registration and participation is at no cost.  It is open to anyone!

First of all, let me state that the workshop facilitators are not trained to offer medical or mental health advice, counseling or crisis intervention.  But, many of the trained volunteer leaders have dealt with their own chronic health conditions.

The online workshop is a self-management tool “designed to assist individuals with chronic conditions improve their quality of life.” I realize that many elderly may lack access to a computer and to this online environment.  Wouldn’t it be wonderful to facilitate this by sharing access to your computer and helping the older adult through this program?  When you realize the value of this program, I think you’ll be motivated to “find a way” to make it available to your loved ones.

The Benefits.  The “Better Choices, Better Health” workshop can help a person:

• find practical ways to deal with pain, fatigue and stress
• discover better nutrition and exercise choices
• understand new treatment options
• learn better ways to talk with your doctor and family about your health
• get the support you need

How It Works … the person will

• be in a weekly online session and in discussion with about 25 other people for 6 weeks
• log on to the program’s web site about twice a week
• spend a total of 2-3 hours each week, reading the material, making action plans, sharing your concerns and supporting others in the group

I have enrolled in the program to help my mother learn how to better manage her chronic pain.  How about you?  Might this be a good alternative for your aging parent or loved one? For more information and to register online for the “Better Choices, Better Health” workshop, click here.

If you’d like to continue this conversation, please join us on Facebook at our ‘Transition Aging Parents’ page. Click here.

• Do you have an aging parent?
• What would help you at time of the next crisis or transition?
• How about several key resources & tools at your fingertips?

Then, there is a no-cost teleseminar just for you!  Tuesday, November 8th at 8pm Eastern.  You’ll be able to listen over the phone in the comfort of your home!

I’ll share

• 3 key resources to turn to in the event of any crisis or challenge
• AND
• a preview of my upcoming 3 evening seminar … featuring the simple but powerful ADAPT framework for caregivers and families.

So, come and join us!

Find out how you can

• become the guiding force in your family
• bring your family together,
• find the right resources and professionals to help your parent
• and, create and sustain balance in your own life.