When It’s Time for Home Care

There are a lot of guides available to help you decide if someone you care about has reached the point of needing outside help. If you do a web search for “time for home care”, an incredible list of sites appears with all kinds of signs to look for in your aging parent or loved one that will signal their need for help with daily living. These clues include poor personal hygiene, difficulty managing daily living activities such as housework and grocery shopping, missed appointments, and problems taking medications as prescribed. Although these clues are certainly important when deciding if you should look to professional help for your loved one, a consideration that is often overlooked is YOU.

If you’ve been your loved one’s primary caregiver, you need to assess your own condition also. According to the Family Caregiving Alliance there are over 44 million unpaid caregivers in America and they are definitely paying a price. The effects of being a caregiver are both psychological and physical. The strain of caring for a friend or relative who is frail or elderly causes significant clinical symptoms of depression in 40%-70% of all unpaid caregivers. Take some time to think about yourself. Do you feel stressed all the time? Do you feel frustrated, angry or hopelessly drained at the end of the day? Are you no longer in control of your own life? Are you becoming more isolated and do you continue to maintain social contact with friends and relatives … when did you last have some “me time”? Are all the hours of your day filled with obligations to your job, your family, and your loved one?

How are you doing physically? The stress felt caring for someone long term has been linked to elevated blood pressure, a compromised immune system, and heart disease. Is your blood pressure up? Do you seem to catch every cold or bug that comes your way? Caregivers typically don’t have time to take care of their own health needs. Do you get regular checkups with your doctor and your dentist? Do you take the time to prepare nutritious meals for yourself or to get some exercise? Do you have insomnia or stomach complaints? Do you actually feel guilty if on some rare occasion you take the time to enjoy a former hobby or interest?

Be careful not to miss the signs of needing help, both in your loved one and most importantly in yourself. Don’t wait for a crisis to happen with the one you care for or with yourself. After all, the best way to help your loved one is to make sure you are at your best. It may be time to get some help. How did you know it was time to get professional help? Share below and vist us at http://www.trilliumhomecare.com

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Seniors and Scams

According to AARP, over 70% of the wealth in this country is controlled by seniors. That statistic alone is more than enough reason for senior citizens to be targeted by scammers. In fact, while most crime victims fall in the 18-35 year old age bracket, the victims of the scammers are disproportionately senior citizens. Scams targeting senior citizens generally spike during the summer months.

Some of the most common scams include the “grandparent” scam, the “lottery scam”, and the “utility” scam. In the grandparent scam, the con artist typically calls a senior and tricks them into providing personal information by saying something like “Hi Grandma, this is your favorite grandson”. When Grandma responds with “Hi Tony” (freely supplying a grandchild’s name) the con artist then claims to be that grandchild and lets Grandma know he needs cash for some sort of emergency while swearing Grandma to secrecy so his parents won’t find out. Scammers prey on the grandparent’s fear that their grandchild may be in trouble and needs help. In the lottery scam, the scammer informs the senior that they’ve won a foreign lottery. They then request money to be wired to cover taxes and fees. In addition, the scammer may ask for banking information in order to supposedly direct deposit the winnings. Foreign lotteries are illegal and this scam steals a person’s identity and allows access to personal finances. According to the Better Business Bureau, over $100 million dollars is scammed from unsuspecting “winners” on a yearly basis. In the utility scam, a caller pretends to be from one of the local utility companies and claim there’s a past due amount. They demand immediate payment to prevent a service shut off and require the payment be made through a Western Union MoneyGram. These scams and others like them have cost senior citizens over 2.9 billion dollars a year. This figure will certainly rise as more an more baby boomers reach their senior years and the pool of available victims grows.

The best defense against scammers is knowledge. With that in mind, the Better Business Bureau will now be producing a series of videos with reenactments of scams that target seniors. The videos will include alerts and information on how to recognize the signs of a particular scam. The first video reenacts the “lottery” scam and can be viewed on BBB’s Facebook page at Facebook.com/bbb1936. When it comes to senior scams, knowledge definitely is power. Please share your thoughts below and visit us at http://www.trilliumhomecare.com

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Risky Senior Driving

In our culture, getting your driver’s license at 16 is a rite of passage that most teens look forward to. It’s a symbol of independence and represents the freedom to go places and do things. It becomes a major key to social activities, shopping, and even getting a job. This is true throughout our entire adult lives and especially true for aging seniors. That’s why seniors are so reluctant to give up their car keys, even if they suspect they should.

Although there is no specific age at which seniors need to stop driving, statistics by the Hartford Insurance Corporation show that in seniors over the age of 75 there’s a much greater risk of being in a car accident with every mile driven. The risk is about the same as for new drivers between the ages of 16 and 24. This increase in accidents is due primarily to the aging drivers’ decrease in senses, multiple chronic health conditions, and increased medication consumption. There are warning signs to look for that will let you know your loved one needs to give up the keys or to at least decrease the amount of driving they do. It’s a good idea to take a ride with them and see for yourself how they’re doing. Do they drift into other lanes or straddle two lanes? Do they drive particularly slowly or unduly fast for the road conditions? Do they fail to use their turn signal or do they leave it on without changing lanes? Do they ignore or miss traffic signs or traffic signals? Do they make sudden lane changes? Does your senior get disoriented easily, even when in familiar places? Have there been any “warnings” by the police? Are there any unexplained dents or scrapes on the car?

If you see any of these warning signs, it’s time to have that dreaded conversation about giving up the keys or at the very least minimize the amount of driving your senior does. Until that time when your loved one gives up their keys there are things they can do to help minimize the risks. Encourage them to limit their driving time to the daytime and not during rush hours. Get them to drive only during good weather and optimal road conditions. Make the trips short and use the most direct but safe routes. Keep the radio turned off and minimize the number of passengers in order to reduce distractions. Basically, apply the same strategies with your senior driver that you would apply to a novice teenaged driver. It’s also a good idea to have the pharmacist review your senior’s medications to determine if they can affect their driving. Making these gradual changes may allow your senior to ease into giving up driving. Surrendering the car keys is a major life change. It makes good sense to reduce the risks well before a major crisis mandates an immediate change. Please share your thoughts and experiences below. Visit us at www.trilliumhomecare.com

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The Road To Caregiving

According to the US Department of Labor, over half of America’s workforce is involved in some way with caring for an aging parent or relative. Up to eighty percent of this help is unpaid and according to AARP, the average caregiver provides personal care and does household maintenance chores for at least twelve hours per week. The road to becoming a caregiver for a loved one is often winding with a son or daughter occasionally “helping out”. Your parents slowly age and adaptations are made to accommodate gradual changes in their abilities. Perhaps you offer to help with their banking or write out the bills. If they need groceries you offer to drive them to the store or pick up a few things for them yourself. Maybe you go to the doctor with them to make sure they clearly understand what the doctor has to say. At this point, you don’t view yourself as a “caregiver”. You’re just being a helpful child.

As time goes by and your “helping out” becomes a necessity, it will dawn on you that you are in fact a caregiver. You realize one day that if you stop doing all those helpful things, your loved one won’t be able to function on their own. You now feel obligated to do all these things or to make arrangements so that they do get done. Your loved one’s daily functioning is now your personal responsibility. Welcome to the world of caregiving. You will soon realize what a demanding job this is particularly because you’ll also be juggling a job, family, and personal issues of your own. If your parent or loved one suffers a medical crisis, your level of providing care will rise dramatically. Although your desire may be to tackle this job totally on your own, doing that will surely result in stress, exhaustion, and even physical illness. No matter how much you love someone, where will you find all the hours in the day that you and your loved one need? Be careful not to allow yourself to reach the point of total exhaustion. If you use up all your time and energy to be a caregiver, you will no doubt be robbing you and your loved one of quality time that could otherwise be spent with each other. Be aware there will come a time when it makes sense to get some help. Be wary of taking on so much that you lose sight of your well meant goal of providing the best of care which your loved one both needs and deserves. The road to caregiving is long and full of potholes. Don’t let yourself get run over. Please share your thoughts and experiences below. Visit us at http://www.trilliumhomecare.com

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The Caregiver at the Doctor Visit

According to the Census Bureau, there are over 43.1 million persons in the United States that are 65 years of age or older. The elderly population is expected to double to 80 million when all the “baby boomers” have reached their elderly years. Due to advances in medical science these baby boomers will be living longer and that translates into huge numbers of people living with chronic conditions like arthritis, diabetes, osteoporosis, or dementia. A large population of chronically ill older people means that more and more seniors will be dependant on others for help with their activities of daily living – in short, they’ll have a caregiver whether it’s a family member or a professional from an agency.

Caregivers are now and will increasingly in the future be an important component of doctor visits for the elderly. According to a study by Jennifer Wolff, PhD of the Johns Hopkins Bloomberg School of Public Health, doctor visits that include caregivers are an increasing trend that has important benefits. Her study showed that visits that included a caregiver lasted at least 20% longer and resulted in less social conversation between the doctor and the senior and more biomedical information being given to the patient. This is really important because a trip to the doctor is all about communication and the exchange of information. Doctors need information from patients to provide an accurate diagnosis and to provide treatment options. The patient needs to be able to clearly discuss and understand what’s going on. This is where the caregiver’s presence can be very valuable.
A caregiver can help the senior with every aspect of the visit beginning with getting ready for the visit by gathering all the necessary medical history information and making a list of current medications and by preparing a list of symptoms for the doctor along with any questions the senior may have. During the visit, the caregiver can make notes for the senior and can remind them of any symptoms they may have forgotten and can relate to the doctor any changes in the senior’s general health and abilities. In effect, the caregiver is a second set of eyes and ears and can request further clarification about the diagnosis, treatment options, and what can be expected down the line. After the visit, a caregiver can support the senior’s compliance with the doctor’s instructions by encouraging them to follow the prescribed course of treatment along with taking their medications as prescribed and by helping them further understand the doctor’s instructions if necessary. This in turn can help reduce possible hospital readmissions.

According to the study by Dr. Wolff, seniors and loved ones who have been accompanied by a caregiver to a doctor ended up being more satisfied with their overall care and were shown to be more likely to remember important information after their visit to the doctor. Please share your thoughts and experiences below and visit us at http://www.trilliumhomecare.com

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Preventing Dehydration

It’s been slow coming but summer has finally arrived. It won’t be long before we start hearing TV and radio announcements about municipal “cooling centers” being opened. These announcements point to the importance of staying hydrated, particularly in the summer. This is especially critical for the elderly and the frail. Dehydration can quickly lead to heat exhaustion or heat stroke for this group. Older people are at a greater risk of dehydration for several reasons. While a younger person’s body naturally cools itself through the production of perspiration, this mechanism may not work as well in a senior due to natural aging changes and the assortment of medications they may be taking for a variety of chronic conditions. These medications include antihistamines, antidepressants, motion sickness medication, anti asthma drugs, diuretics which are often prescribed for hypertension, and some heart medications. In addition, as we get older our kidneys are less efficient at conserving water and unlike camels, we can’t store it. By the time your aging loved one’s body sends them the “I’m thirsty” signal, they may be well on the way to being dehydrated. Seniors who have dementia may simply forget to drink and those who suffer from neurological disorders may have difficulty swallowing. Those who are frail need assistance to drink. Any combination of these factors can lead to dehydration.

According to the CDC (Center for Disease Control), there are signs of dehydration to look for: dizziness, confusion, constipation, increased fatigue, increased body temperature, dry mouth, reduced sweating, sunken eyes, and low blood pressure. As a caregiver, taking extra measures to keep your loved one hydrated requires vigilance but in this case, an ounce of prevention is definitely worth a pound of cure. Be sure to offer fluids on a regular basis, at least every couple of hours. Although plain, clear water is the best choice, any liquid is better than none so offer your loved one their preferred beverage frequently. Be sure to serve beverages with meals and encourage more than a sip of water to wash down medications. Try serving foods that are naturally “wet” such as soups, yogurt, ice cream, and smoothies. Encourage your loved one to drink small quantities frequently rather than a lot at one time. A frail senior needs at least 6 cups of fluids per day but consult their doctor if they take diuretics, have kidney disease, or have congestive heart failure. How do you make sure your senior gets enough fluids? Please share your thoughts and experiences below. Visit us at http://www.trilliumhomecare.com

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Time To Hire A Professional Caregiver?

Hindsight is 20/20 but it’s important not to get to that point when it comes to making care decisions for an elderly parent or loved one. Very often, by the time you’ve made the decision to get some help from a professional caregiver, you’re already past the point of burnout. You’re more exhausted than you ever thought could be possible and you wonder why you didn’t get help sooner. Guilt very often plays a part in your delayed decision because you feel it’s something you should have been able to do for your loved one so they could remain comfortably in their homes as they aged. Your role as caregiver slowly and almost imperceptibly increases and perhaps on a deeper level you don’t want to see that your loved one needs more help than you can give. Be careful not to miss the signs that your parent or loved one can’t go it alone.

*How’s their personal hygiene? Do they bathe regularly or is there an odor about them? Is hair combed and are teeth brushed? Are they wearing the same clothes for days on end?
*Is the house clean and being maintained? Is there a lot of clutter or unopened mail? Is the garbage taken out on a regular schedule? Is there an odor of urine when you step inside?
*Are nutritional needs being taken care of? Is there any spoiled food in the refrigerator? Is there food in the cupboard? Have they lost any weight and are they remembering to eat?
*Is your loved one able to drive safely? Are there any unexplained dings or dents in the car? Do they get to where they’re going without incident? Do they get lost in familiar location or when traveling a route they’ve taken many times before?
*Do they miss any doctor or dentist appointments? Are they able to follow the doctor’s directions? Do they take their medications as prescribed? Do they remember to get prescriptions filled?
*Is your loved one maintaining a social life? Do they stay in contact with friends and relatives or have you become their sole source of human interaction? Have old hobbies or interests gone by the wayside?

If you see some of these changes, it may be time to get some help. There is nothing to be gained from ignoring the signs. Getting some help to keep your loved one safely in the home they want to be in, is truly an act of love. Please share your thoughts and experiences below. http://www.trilliumhomecare.com

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Hiring a Caregiver Privately?

According to the National Alliance for Caregiving, more than 65.7 million Americans provide informal care for a family member or loved one. Most of us come by the role of caregiver gradually. We start by “helping out” when we notice a parent or loved one is having some difficulty taking care of some routine tasks they once managed well. In time our list of responsibilities gets longer and our loved one needs much more help. And then it happens….we see there is so much more to do than we have hours in the day for. Perhaps there’s been a medical crisis or an accident. We realize some outside help is needed.

Once you’ve made the decision to get help, it’s easy to believe all you have to do is hire someone. If you choose to hire someone directly to care for your loved one be sure you know what goes with your new role as employer. This means that now you have switched jobs from “caregiver” to “accountant” because you will now have to take care of payroll and tax requirements since the IRS views you as the caregiver’s employer. According to foxbusiness.com, if the caregiver you hire earns more than $1000 a quarter or over $1900 a year, you’ll have to file payroll taxes including Social Security and Medicare taxes, Federal Unemployment Tax, state unemployment and disability insurance taxes levied on the employer, and advance payments of the earned income credit if your employee is eligible. These thresholds and figures may change yearly so you will need to verify them every year. You also have to know what taxes your employee has to pay and will have to provide a Form W2 to your employee by January 31st of every year. In addition, you’ll need to pay for worker’s compensation and disability insurance in case your caregiver gets hurt while caring for your loved one.

If the caregiver you hire claims to be working as an “independent contractor” and no money should be withheld for any taxes, they are wrong. According to the IRS an independent contractor has total control over their work hours, their responsibilities, and schedules. This does not apply to your employee because the caregiver will be providing the services you want on the schedule and terms you set. Failure on your part to fulfill your accounting duties as the employer of a caregiver will alert the IRS, set you up for an audit, and can even result in compromising your own personal taxes. You’ll have to pay back the unpaid taxes along with interest and possible penalties. Be certain you make the correct decision when hiring a caregiver. Are you prepared to be an accountant in addition to dealing with all the work and responsibility of caring for a loved one? Share below and visit us at http://www.trilliumhomecare.com

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Older Adults and Medication – Part 2

As you get older or someone you care for enters their “senior” years, you have to be very careful about which medications are used. Older adults usually have several chronic medical conditions they are dealing with at any given time so that means they’re probably using a variety of drugs. The more medication you take, the greater are the odds that you can end up dealing with the effects of drug interactions. In addition, seniors are more sensitive to some drugs due to the natural changes in their bodies as they age.

Among the most commonly used and abused drugs are non-steroidal anti-inflammatory drugs (NSAIDS). Long lasting versions include Feldene and Indocin which are available by prescription while shorter acting ones include Motrin, Advil, and Aleve. Because the shorter acting NSAIDS are available over the counter, there’s a misconception that they must be totally safe but keep in mind that they’re mean for short term use only. In fact, all NSAIDS carry a risk of indigestion and ulcers and in the over 75 age group there is a possibility of bleeding in the stomach or colon especially if your senior is taking aspirin or a blood thinner like Coumadin for their heart. In addition, NSAIDS can increase your blood pressure so if you’re taking medication for hypertension which is very common in seniors and you take an NSAID for your arthritis, the medications are fighting each other.

Other medications to use with caution include muscle relaxants and over the counter allergy and cold medications. Muscle relaxants such as Flexeril and diphenhydramine , which is the active ingredient in Benadryl and over the counter sleep aids like Tylenol PM, can cause confusion and grogginess along with blurred vision. This can be particularly troublesome for seniors since it can increase the risk of falling. If your senior takes something to help them sleep and something else because their allergies are bothering them, you can see how easily they could be double-dosing without realizing it!

In light of the fact that there is an endless list of possible drug combinations you or your loved one may be taking, it’s important to keep a CURRENT list of all drugs being used, including any over-the-counter medications and herbal supplements. Take this list with you to every doctor visit and ask lots of questions. If your doctor prescribes a drug, be sure you are clear about what it’s for and how to properly take it. Ask if it will interfere with anything on your list and if any adjustments need to be made. Be sure to get all your prescriptions filled at the same pharmacy so the pharmacist can also keep track of any possible interactions. Using a pill organizer at home can help you keep track of whether you’ve taken the medication as prescribed. If you start noticing a possible side effect to a medication, don’t just stop taking it without contacting your doctor. Follow his advice and be safe. Do you have any tips for managing your senior’s medications? Share below and visit us at http://www.trilliumhomecare.com

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Older Adults and Medications – Part I

When you are younger and in need of medication for an illness or injury, things are pretty simple. You go to the doctor, get a diagnosis, fill your prescription, and a few days later you’re feeling better. If you get a headache or pull a muscle at the gym, you pick up some over-the-counter analgesics and in a bit you’re back to your busy life good as new. It never occurs to you to monitor what you’re taking because you’re not taking a lot of medications with a lot of frequency. That changes as you reach your senior years. As you get older, it’s typical to be dealing with more than one chronic condition resulting in taking multiple medications which are very often prescribed in multiple doses. In fact, the average older person takes at least four prescription medications and at least two over-the-counter drugs on a regular basis. Seniors over 65 are responsible for the purchase of 30% of all prescription drugs and over 40% of all over-the-counter drugs. You can see where this is going. As you get older or someone you care for enters their senior years, it becomes increasingly important to manage medications.

Seniors are particularly vulnerable to problems with medications for a variety of reasons. The more medications are taken, the greater the odds are that they may have an interaction that could be dangerous if not unpleasant. It’s not uncommon for a senior to simply stop taking a medication because of its side effects. Between 40% and 75% of seniors stop taking their medications at the right dosage and the right schedule. This issue is compounded by the fact that older adults are more sensitive to drugs because of their now slower metabolisms and organ functions, thus keeping drugs in their system for longer periods of time. Physical problems such as poor vision or a weak grip due to arthritis can result in dosing errors. Cognitive and memory issues can prevent the older adult from following the doctor’s orders and since so many seniors live alone there’s no one to assist them with nor monitor their use of drugs. Simply forgetting is a major reason medication doses are skipped by the elderly. With an increased number of chronic conditions the typical older adult sees a number of different physicians — the endocrinologist for their thyroid, the cardiologist for their heart problems, and so on. Multiple doctors equal multiple medications that can conflict with each other. You can see why studies have shown that any combination of these factors causes 30% of hospital admissions of older adults. It’s apparent that being able to manage an older adult’s medications is critical to their well being and even their ability to remain independently in their own home. Next time we’ll talk about which medications to be especially cautious about and what action you can take to help keep your senior safe with their medication. Visit us at www.trilliumhomecare.com

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