Stroke Awareness

John and Edith were eating dinner one night when John asked Edith a question. She began to answer, but couldn’t speak. John knew something was very wrong. Could Edith have had a stroke? Without waiting, he called 911. The ambulance took Edith to the hospital right away. Emergency room doctors confirmed John’s fear…it was a stroke. But because of John’s quick action in calling for help, Edith got the medical care she needed without delay. She got well quickly, her speech came back, and she’s once again having long talks with John at dinner.

Edith was lucky. Stroke is the third leading cause of death in the United States after heart disease and cancer. It is a major cause of physical and mental disabilities in older adults. And every year, more and more people are affected when they or someone they know has a stroke.

What Is a Stroke?

A stroke happens when blood can’t flow to a part of the brain. When the brain doesn’t get the oxygen and nutrients it needs from the blood, its cells are damaged or begin to die. If brain cells are only hurt, they sometimes can be repaired. But brain cells that have died can’t be brought back to life. This means that the brain may stop sending signals to other parts of the body that control things like speaking, thinking, and walking.

There are two major types of strokes. The most common kind (ischemic) is caused by blood clots or the narrowing of a blood vessel (artery) leading to the brain. The clot keeps blood from flowing into other regions of the brain and prevents needed oxygen and nutrients from reaching brain cells in these regions. The second major kind of stroke (hemorrhagic) happens when a broken blood vessel (artery) causes bleeding in the brain. This break also stops oxygen and nutrients from reaching brain cells.

Stroke Is an Emergency. Call 911.

Never ignore the warning signs of stroke.

Call 911 RIGHT AWAY if you see or have any of these warning signs:

* Sudden numbness or weakness in the face, arm, or leg-especially on one side of the body
* Sudden confusion, trouble speaking or understanding
* Sudden problems seeing in one eye or both eyes
* Sudden dizziness, loss of balance or coordination, or trouble walking
* Sudden severe headache with no known cause

DON’T IGNORE THE SIGNS!

The warning signs of a stroke may last only a few minutes and then go away. When this happens, it could be a mini-stroke, which is called a TIA (transient ischemic attack). This is also a medical emergency that requires attention right away. An unrecognized and untreated TIA can be followed within hours by a major disabling stroke. Always pay attention to any stroke symptoms, even if they are fleeting.

What if it is a Stroke?

Recovery from a stroke is most successful if treatment begins within the first 3 hours after symptoms appear. The clot-busting drug t-PA can greatly lower the damage caused by a stroke, but it must be given within the 3 hour time frame. Getting to the hospital as soon as possible allows time for a CT scan of the brain. This scan will show whether t-PA is the right treatment. Only patients with ischemic stroke, caused by a clot, are candidates for this treatment. The doctor will diagnose stroke based on the patient’s symptoms, medical history, and medical tests that let doctors look closely at the brain to see the type and location of the stroke.

There are many different ways to help people recover from a stroke. Drugs and physical therapy work to improve balance, coordination, and other deficits from the stroke such as speech and language problems. Occupational therapy can make it easier to do things like bathing and cooking. Many therapies start in the hospital and continue at home.

A family doctor can provide follow-up care. Progress is different for each person. Some people recover fully soon after a stroke. Others take months or even years. Sometimes the damage is so serious that therapy cannot help at all.

Lower Your Risk of Stroke

Talk to your doctor about what you can do to lower your risk of stroke. Even if you’re in perfect health, follow these important suggestions:

* Control your blood pressure. Have your blood pressure checked often. If it is high, follow your doctor’s advice to lower it. Treating high blood pressure lowers the risk of both stroke and heart disease.
* Stop smoking. Smoking is linked to increased risk for stroke. Quitting smoking at any age lowers the risk for stroke as well as for a lot of other serious diseases.
* Exercise regularly. Activities such as brisk walking, riding a bicycle, swimming, and yard work lower the risk of both stroke and heart disease. Researchers think that exercise may make the heart stronger and improve blood flow. Before you start a vigorous exercise program, be sure to check with your doctor.
* Eat healthy foods. Eat foods that are low in fats, cholesterol, and saturated fatty acids. Include a variety of fruits and vegetables in your daily diet.
* Control your diabetes. If you have diabetes, work with your doctor to get it under control. Untreated diabetes can damage blood vessels and lead to a build up of fatty deposits in the arteries (atherosclerosis). This narrows arteries and blocks normal blood flow. A blocked artery will lead to a stroke.

For More Information

The National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health (NIH), has a wide range of information.

National Institute of Neurological Disorders and Stroke
www.ninds.nih.gov

National High Blood Pressure Education Program
www.nhlbi.nih.gov

National Stroke Association
www.stroke.org

American Stroke Association
www.strokeassociation.org

For more information about health and aging, contact:

National Institute on Aging Information Center
To order publications online: www.niapublications.org
Visit the National Institute on Aging website at www.nia.nih.gov

Visit NIHSeniorHealth.gov (NIHseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website features popular health topics for older adults. It is simple to use, has large type, and a ‘talking’ functions that reads text out loud.

Source: National Institute on Aging Information Center, www.niapublications.org

Provided by: The Staff at www.RetirementConnection.com
For more information: www.niapublications.org
Copyright © 2008 RetirementConnection.com. All rights reserved.

Telephone Reassurance

Telephone Reassurance is regular, pre-scheduled calls to individuals who live alone. The service is provided as a routine safety check and to reduce loneliness. There are a variety of Telephone Reassurance Systems available. Telephone Reassurance systems can be completely automated or provided as a professional service by professional caregivers or volunteer organizations. Here are some of the basic programs:

Automated Systems

With the an automated system a computer calls the resident and plays a recorded message, inquiring if the resident is okay. If the resident answers the call and replies, the automated system knows that the resident is okay. If there is no answer then the local sheriff or other law enforcement organization is notified to do a wellness check. This system can be managed through local law enforcement.

Personal Call Services

Some organizations and professional caregivers offer personal telephone reassurance calls. These calls are made at a predetermined time when the older adult is expected to be home and awake. With this program the older adult receives the reassurance call on a regular basis, which can be daily, weekly, or some other predetermined schedule. This type of program can also include home visitation services.

Find Local Telephone Reassurance Program

* Use www.Google.com and search on:
Telephone Reassurance Your City State

Source: The Staff at www.RetirementConnection.com
Copyright © 2008 RetirementConnection.com. All rights reserved

The Importance of Planning LTC

No one wants to think about a time when they might need long-term care. So planning ahead for this possibility often gets put off. Most people first learn about long-term care when they or a loved one need care. Then their options are often limited by lack of information, the immediate need for services, and insufficient resources to pay for preferred services. Planning ahead allows you to have more control over your future.

Why Plan Ahead for Long-Term Care?

Planning ahead for long-term care is important because there is a good chance you will need some long-term care services if you live beyond the age of 65. About 60 percent of people over age 65 require some services, and the likelihood of needing care increases as you age.

Planning ahead helps you understand what service options are available in your community, what special conditions may apply for receiving services, for example, age or other eligibility criteria, what services cost, and what payment options – public and private – apply. Having this information helps ensure you will have a range of options when you need long-term care, and makes it more likely that you will have more choice and control over where and how you receive services.
Planning ahead is important because the cost of long-term care services often exceeds what the average person can pay from income and other resources. By planning ahead, you may be able to save your assets and income for uses other than long-term care, including preserving the quality of life for your spouse or other loved ones. With planning, there is a greater likelihood of being able to leave an estate to your heirs, because you are less likely to use up your financial resources paying for care.

Planning ahead also means less emotional and financial stress on you and your family. It can provide a way to involve your family in decisions without depending on them to bear the entire burden alone.

Finally, for many people, one of the most important advantages of planning ahead is to ensure greater independence should you need care. Your choices for receiving care outside of a facility and being able to stay at home or receive services in the community for as long as possible are greater if you have planned ahead.

Why People Don’t Plan Ahead

There are many reasons why people don’t plan ahead for long-term care. These include the natural tendency to avoid thinking about becoming dependent on others for your care, misinformation about the risks of needing care, and lack of knowledge about the cost of care and payment options.

Most people don’t like to think about getting older, developing a disability, becoming less independent, or needing help with personal care. Many people don’t realize that their chance of needing long-term care by the time they turn 65 is as high as 60 percent.

People commonly misunderstand how expensive long-term care is, and how it is paid for. Consumer surveys have shown that many individuals don’t realize that health insurance, Medicare, and/or disability coverage do not pay for most long-term care services. Medicaid pays for some long-term care services, but only if you qualify for the program because you have limited income and financial resources.

Some people find it too difficult to raise these subjects with their loved ones, making it difficult to explore and define their plans. Adult children often feel like they are patronizing their parents if they raise the subject or they are afraid of giving the impression that they might not want to provide care if it is needed. Parents often don’t want to make adult children uncomfortable or to discuss details of their finances with them.

Finally, some people realize it is important to plan, but don’t know how to go about it. The best way to begin is with small and easy steps. Even just talking with your loved ones is a great first-step!

Examples of People Who Planned

What exactly do we mean when we say “planning?” Below are some examples of how people might plan for long-term care before they need care. While these are fictional illustrations, they represent a variety of real-life situations.

The people described here are composites drawn from a variety of real-life scenarios; they illustrate the range of personal circumstances people might find themselves in and the different forms that “long-term care planning” might take. There is no “one-size-fits-all” plan. As you read these examples, think about your own circumstances and the types of options you might want to consider.

Mrs. F is 81. She has osteoporosis, arthritis, and high blood pressure. Otherwise she is basically healthy, but frail. She lives on a limited, fixed income and does not have significant assets to draw upon to help her meet her long-term care needs. She has been living in a modest one-bedroom rental unit, but is finding it difficult to maintain her apartment on her own.

* Plan:

o Pay for modifications to daughter’s home (outfit spare bedroom and second bathroom for Mrs. Friedlander).

o Move in with daughter.

o Establish “Advance Directive” and create “Durable Power of Attorney.”

“My daughter and I, we have a good time together. I know that until my time comes she’ll be with me, helping me. It was hard to talk about some of this, but I feel good that she understands. I worked all my life and I want to be at home. I don’t want to be in any hospital or nursing home.”

Mrs. W is 78. Since having a stroke several years ago, she depends on a wheelchair to get around. She and her husband still live in the three-bedroom house they bought when they were first married. The home’s value has increased dramatically since they bought it and they are lucky to have paid off the mortgage a few years ago. The upkeep of such a large home is taking a toll on both her and her husband.

* Plan:

o Sell home and use the resulting proceeds to move to a Continuing Care Retirement Community when she and her husband turned 75.

o With no children, the Wielands decided to establish a Charitable Remainder Trust to pay for their care and willed the remainder of the trust after they both passed away to the California Horticultural Society.

“George and I were fortunate all our lives. We both worked and managed to save. We don’t really have any family. Both of us were only children and we never had any of our own. We wanted to be able to stay together as long as we could, but be sure that the other would be cared for, no matter who was first to go.”

Mr. C is an 82 year old widower. He lives in the modest home in which he raised his children. He has prostate cancer and has had a pacemaker for the past two years. At this point he is still able to take care of all his physical needs and he is very keen on remaining at home to receive the care he needs, because of all the wonderful family memories it holds for him. But his income and assets may not be enough to pay for the care he needs at home.

* Plan:

o Stay at home and receive care there if necessary.

o Pay for care with a combination of savings and a reverse mortgage.

o Son and daughter to coordinate care and repay the reverse mortgage loan amount when it is due (upon Mr. Curley’s death or when and if he needs to permanently move out of the home). His children can keep the house in the family if they wish, after paying off the loan amount from other financial resources they or Mr. Curley have, or they can sell the home and use the proceeds to pay off the loan amount. They are allowed to keep any additional funds from the sale of the home that exceed the loan amount to be repaid.

“I know I’m not gonna be around forever. But I told my kids I was going nowhere! I want to be in my own place. Me and the dog. My son lives here in town and my daughter is only a few miles west. We worked it out so the house can help pay for care if and when I need it and then it’s theirs when I’m gone. I don’t want to be a burden to no one, but they’re good kids and this way I get to see the grandkids too. They mow the lawn. This house has important memories for me, but once I’m gone, the kids already have their own places; they don’t need or want this house, so I like the idea of putting the home’s value to work for me!”

At 46, Ms. S had the opportunity to purchase long-term care insurance as a Federal employee. She has chosen coverage that will allow her to be cared for at home, in an assisted living facility, or in a nursing home if necessary. She bought the policy now since the cost is based on her age when she buys it. Waiting would only mean higher premiums and the possibility that she might develop a health condition that would cause her to be declined for the insurance. She does not want to have to rely on her family to pay for or provide care for her if and when she needs it. She likes being independent and having peace of mind that comes from planning ahead.

* Plan:

o Purchase long-term care insurance, which she pays for through an automatic deduction from her bi-weekly paycheck.

o Prepare a living will so that her family will know her preferences and wishes for care and life support if she becomes unable to communicate or carry out her preferences on her own.

o Speak with daughter and niece and specify her preferences for care.

“Long-term care insurance is a great deal for someone like me. I have a daughter and a niece I’m close to, but I don’t want to become a problem for them; they have their own busy lives. This way, we’re there for each other, but when the time comes that I get sick or very old, they will know what I want and I’ve set up a plan ahead of time. I don’t want to worry and I don’t want them to worry.”

Source: www.LongTermCare.gov

Provided by: The Staff at www.RetirementConnection.com
For more information: www.LongTermCare.gov
Copyright © 2008 RetirementConnection.com. All rights reserved.

Practical Tips for Caregivers of Alzheimer’s Patients

Caring for a person with Alzheimer’s disease (AD) at home is a difficult task and can become overwhelming at times. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior. Research has shown that caregivers themselves often are at increased risk for depression and illness, especially if they do not receive adequate support from family, friends, and the community.

One of the biggest struggles caregivers face is dealing with the difficult behaviors of the person they are caring for. Dressing, bathing, eating-basic activities of daily living-often become difficult to manage for both the person with AD and the caregiver. Having a plan for getting through the day can help caregivers cope. Many caregivers have found it helpful to use strategies for dealing with difficult behaviors and stressful situations. Through trial and error you will find that some of the following tips work, while others do not. Each person with AD is unique and will respond differently, and each person changes over the course of the disease. Do the best you can, and remind yourself to take breaks.

Dealing with the Diagnosis

Finding out that a loved one has Alzheimer’s disease can be stressful, frightening, and overwhelming. As you begin to take stock of the situation, here are some tips that may help:

* Ask the doctor any questions you have about AD. Find out what treatments might work best to alleviate symptoms or address behavior problems.
* Contact organizations such as the Alzheimer’s Association and the Alzheimer’s Disease Education and Referral (ADEAR) Center for more information about the disease, treatment options, and caregiving resources. Some community groups may offer classes to teach caregiving, problem-solving, and management skills. See page 20 for information on contacting the ADEAR Center and a variety of other helpful organizations.
* Find a support group where you can share your feelings and concerns. Members of support groups often have helpful ideas or know of useful resources based on their own experiences. Online support groups make it possible for caregivers to receive support without having to leave home.
* Study your day to see if you can develop a routine that makes things go more smoothly. If there are times of day when the person with AD is less confused or more cooperative, plan your routine to make the most of those moments. Keep in mind that the way the person functions may change from day to day, so try to be flexible and adapt your routine as needed.
* Consider using adult day care or respite services to ease the day-to-day demands of caregiving. These services allow you to have a break while knowing that the person with AD is being well cared for.
* Begin to plan for the future. This may include getting financial and legal documents in order, investigating long-term care options, and determining what services are covered by health insurance and Medicare.

Communication

Trying to communicate with a person who has AD can be a challenge. Both understanding and being understood may be difficult.

* Choose simple words and short sentences and use a gentle, calm tone of voice.
* Avoid talking to the person with AD like a baby or talking about the person as if he or she weren’t there.
* Minimize distractions and noise-such as the television or radio-to help the person focus on what you are saying.
* Call the person by name, making sure you have his or her attention before speaking.
* Allow enough time for a response. Be careful not to interrupt.
* If the person with AD is struggling to find a word or communicate a thought, gently try to provide the word he or she is looking for.
* Try to frame questions and instructions in a positive way.

Bathing

While some people with AD don’t mind bathing, for others it is a frightening, confusing experience. Advance planning can help make bath time better for both of you.

* Plan the bath or shower for the time of day when the person is most calm and agreeable. Be consistent. Try to develop a routine.
* Respect the fact that bathing is scary and uncomfortable for some people with AD. Be gentle and respectful. Be patient and calm.
* Tell the person what you are going to do, step by step, and allow him or her to do as much as possible.
* Prepare in advance. Make sure you have everything you need ready and in the bathroom before beginning. Draw the bath ahead of time.
* Be sensitive to the temperature. Warm up the room beforehand if necessary and keep extra towels and a robe nearby. Test the water temperature before beginning the bath or shower.
* Minimize safety risks by using a handheld showerhead, shower bench, grab bars, and nonskid bath mats. Never leave the person alone in the bath or shower.
* Try a sponge bath. Bathing may not be necessary every day. A sponge bath can be effective between showers or baths.

Dressing

For someone who has AD, getting dressed presents a series of challenges: choosing what to wear, getting some clothes off and other clothes on, and struggling with buttons and zippers. Minimizing the challenges may make a difference.

* Try to have the person get dressed at the same time each day so he or she will come to expect it as part of the daily routine.
* Encourage the person to dress himself or herself to whatever degree possible. Plan to allow extra time so there is no pressure or rush.
* Allow the person to choose from a limited selection of outfits. If he or she has a favorite outfit, consider buying several identical sets.
* Arrange the clothes in the order they are to be put on to help the person move through the process.
* Provide clear, step-by-step instructions if the person needs prompting.
* Choose clothing that is comfortable, easy to get on and off, and easy to care for. Elastic waists and Velcro enclosures minimize struggles with buttons and zippers.

Eating

Eating can be a challenge. Some people with AD want to eat all the time, while others have to be encouraged to maintain a good diet.

* View mealtimes as opportunities for social interaction and success for the person with AD. Try to be patient and avoid rushing, and be sensitive to confusion and anxiety.
* Aim for a quiet, calm, reassuring mealtime atmosphere by limiting noise and other distractions.
* Maintain familiar mealtime routines, but adapt to the person’s changing needs.
* Give the person food choices, but limit the number of choices. Try to offer appealing foods that have familiar flavors, varied textures, and different colors.
* Serve small portions or several small meals throughout the day. Make healthy snacks, finger foods, and shakes available. In the earlier stages of dementia, be aware of the possibility of overeating.
* Choose dishes and eating tools that promote independence. If the person has trouble using utensils, use a bowl instead of a plate, or offer utensils with large or built-up handles. Use straws or cups with lids to make drinking easier.
* Encourage the person to drink plenty of fluids throughout the day to avoid dehydration.
* As the disease progresses, be aware of the increased risk of choking because of chewing and swallowing problems.
* Maintain routine dental checkups and daily oral health care to keep the mouth and teeth healthy.

Activities

What to do all day? Finding activities that the person with AD can do and is interested in can be a challenge. Building on current skills generally works better than trying to teach something new.

* Don’t expect too much. Simple activities often are best, especially when they use current abilities.
* Help the person get started on an activity. Break the activity down into small steps and praise the person for each step he or she completes.
* Watch for signs of agitation or frustration with an activity. Gently help or distract the person to something else.
* Incorporate activities the person seems to enjoy into your daily routine and try to do them at a similar time each day.
* Try to include the person with AD in the entire activity process. For instance, at mealtimes, encourage the person to help prepare the food, set the table, pull out the chairs, or put away the dishes. This can help maintain functional skills, enhance feelings of personal control, and make good use of time.
* Take advantage of adult day services, which provide various activities for the person with AD, as well as an opportunity for caregivers to gain temporary relief from tasks associated with caregiving. Transportation and meals often are provided.

Exercise

Incorporating exercise into the daily routine has benefits for both the person with AD and the caregiver. Not only can it improve health, but it also can provide a meaningful activity for both of you to share.

* Think about what kind of physical activities you both enjoy, perhaps walking, swimming, tennis, dancing, or gardening. Determine the time of day and place where this type of activity would work best.
* Be realistic in your expectations. Build slowly, perhaps just starting with a short walk around the yard, for example, before progressing to a walk around the block.
* Be aware of any discomfort or signs of overexertion. Talk to the person’s doctor if this happens.
* Allow as much independence as possible, even if it means a less-than-perfect garden or a scoreless tennis match.
* See what kinds of exercise programs are available in your area. Senior centers may have group programs for people who enjoy exercising with others. Local malls often have walking clubs and provide a place to exercise when the weather is bad.
* Encourage physical activities. Spend time outside when the weather permits. Exercise often helps everyone sleep better.

Incontinence

As the disease progresses, many people with AD begin to experience incontinence, or the inability to control their bladder and/or bowels. Incontinence can be upsetting to the person and difficult for the caregiver. Sometimes incontinence is due to physical illness, so be sure to discuss it with the person’s doctor.

* Have a routine for taking the person to the bathroom and stick to it as closely as possible. For example, take the person to the bathroom every 3 hours or so during the day. Don’t wait for the person to ask.
* Watch for signs that the person may have to go to the bathroom, such as restlessness or pulling at clothes. Respond quickly.
* Be understanding when accidents occur. Stay calm and reassure the person if he or she is upset. Try to keep track of when accidents happen to help plan ways to avoid them.
* To help prevent nighttime accidents, limit certain types of fluids-such as those with caffeine-in the evening.
* If you are going to be out with the person, plan ahead. Know where restrooms are located, and have the person wear simple, easy-to-remove clothing. Take an extra set of clothing along in case of an accident.

Sleep Problems

For the exhausted caregiver, sleep can’t come too soon. For many people with AD, however, the approach of nighttime may be a difficult time. Many people with AD become restless, agitated, and irritable around dinnertime, often referred to as “sundowning” syndrome. Getting the person to go to bed and stay there may require some advance planning.

* Encourage exercise during the day and limit daytime napping, but make sure that the person gets adequate rest during the day because fatigue can increase the likelihood of late afternoon restlessness.
* Try to schedule more physically demanding activities earlier in the day. For example, bathing could be earlier in the morning, or large family meals could be at midday.
* Set a quiet, peaceful tone in the evening to encourage sleep. Keep the lights dim, eliminate loud noises, even play soothing music if the person seems to enjoy it.
* Try to keep bedtime at a similar time each evening. Developing a bedtime routine may help.
* Restrict access to caffeine late in the day.
* Use night lights in the bedroom, hall, and bathroom if the darkness is frightening or disorienting.

Hallucinations and Delusions

As the disease progresses, a person with AD may experience hallucinations and/or delusions. Hallucinations are when the person sees, hears, smells, tastes, or feels something that is not there. Delusions are false beliefs from which the person cannot be dissuaded.

* Sometimes hallucinations and delusions are a sign of a physical illness. Keep track of what the person is experiencing and discuss it with the doctor.
* Avoid arguing with the person about what he or she sees or hears. Try to respond to the feelings he or she is expressing, and provide reassurance and comfort.
* Try to distract the person to another topic or activity. Sometimes moving to another room or going outside for a walk may help.
* Turn off the television set when violent or disturbing programs are on. The person with AD may not be able to distinguish television programming from reality.
* Make sure the person is safe and does not have access to anything he or she could use to harm anyone.

Wandering

Keeping the person safe is one of the most important aspects of caregiving. Some people with AD have a tendency to wander away from their home or their caregiver. Knowing what to do to limit wandering can protect a person from becoming lost.

* Make sure that the person carries some kind of identification or wears a medical bracelet. Consider enrolling the person in the Alzheimer’s Association Safe Return program if the program is available in your area. If the person gets lost and is unable to communicate adequately, identification will alert others to the person’s medical condition. Notify neighbors and local authorities in advance that the person has a tendency to wander.
* Keep a recent photograph or videotape of the person with AD to assist police if the person becomes lost.
* Keep doors locked. Consider a keyed deadbolt or an additional lock up high or down low on the door. If the person can open a lock because it is familiar, a new latch or lock may help.
* Be sure to secure or put away anything that could cause danger, both inside and outside the house.

Home Safety

Caregivers of people with AD often have to look at their homes through new eyes to identify and correct safety risks. Creating a safe environment can prevent many stressful and dangerous situations. The ADEAR Center offers the booklet, Home Safety for People with Alzheimer’s Disease, which lists many helpful tips.
Install secure locks on all outside windows and doors, especially if the person is prone to wandering. Remove the locks on bathroom doors to prevent the person from accidentally locking himself or herself in.

* Use childproof latches on kitchen cabinets and anyplace where cleaning supplies or other chemicals are kept.
* Label medications and keep them locked up. Also make sure knives, lighters and matches, and guns are secured and out of reach.
* Keep the house free from clutter. Remove scatter rugs and anything else that might contribute to a fall. Make sure lighting is good both inside and out.
* Be alert to and address kitchen-safety issues, such as the person forgetting to turn off the stove after cooking. Consider installing an automatic shut-off switch on the stove to prevent burns or fire.

Driving

Making the decision that a person with AD is no longer safe to drive is difficult, and it needs to be communicated carefully and sensitively. Even though the person may be upset by the loss of independence, safety must be the priority.

* Look for clues that safe driving is no longer possible, including getting lost in familiar places, driving too fast or too slow, disregarding traffic signs, or getting angry or confused.
* Be sensitive to the person’s feelings about losing the ability to drive, but be firm in your request that he or she no longer do so. Be consistent-don’t allow the person to drive on “good days” but forbid it on “bad days.”
* Ask the doctor to help. The person may view the doctor as an “authority” and be willing to stop driving. The doctor also can contact the Department of Motor Vehicles and request that the person be reevaluated.
* If necessary, take the car keys. If just having keys is important to the person, substitute a different set of keys.
* If all else fails, disable the car or move it to a location where the person cannot see it or gain access to it.

Visiting the Doctor

It is important that the person with AD receive regular medical care. Advance planning can help the trip to the doctor’s office go more smoothly.

* Try to schedule the appointment for the person’s best time of day. Also, ask the office staff what time of day the office is least crowded.
* Let the office staff know in advance that this person is confused. If there is something they might be able to do to make the visit go more smoothly, ask.
* Don’t tell the person about the appointment until the day of the visit or even shortly before it is time to go. Be positive and matter-of-fact.
* Bring along something for the person to eat and drink and any activity that he or she may enjoy.
* Have a friend or another family member go with you on the trip, so that one of you can be with the person while the other speaks with the doctor.

Coping with Holidays

Holidays are bittersweet for many AD caregivers. The happy memories of the past contrast with the difficulties of the present, and extra demands on time and energy can seem overwhelming. Finding a balance between rest and activity can help.

* Keep or adapt family traditions that are important to you. Include the person with AD as much as possible.
* Recognize that things will be different, and have realistic expectations about what you can do.
* Encourage friends and family to visit. Limit the number of visitors at one time, and try to schedule visits during the time of day when the person is at his or her best.
* Avoid crowds, changes in routine, and strange surroundings that may cause confusion or agitation.
* Do your best to enjoy yourself. Try to find time for the holiday things you like to do, even if it means asking a friend or family member to spend time with the person while you are out.

At larger gatherings such as weddings or family reunions, try to have a space available where the person can rest, be by themselves, or spend some time with a smaller number of people, if needed.

Visiting a Person with AD

Visitors are important to people with AD. They may not always remember who the visitors are, but just the human connection has value. Here are some ideas to share with someone who is planning to visit a person with AD.

* Plan the visit at the time of the day when the person is at his or her best. Consider bringing along some kind of activity, such as something familiar to read or photo albums to look at, but be prepared to skip it if necessary.
* Be calm and quiet. Avoid using a loud tone of voice or talking to the person as if he or she were a child. Respect the person’s personal space and don’t get too close.
* Try to establish eye contact and call the person by name to get his or her attention. Remind the person who you are if he or she doesn’t seem to recognize you.
* If the person is confused, don’t argue. Respond to the feelings you hear being communicated, and distract the person to a different topic if necessary.

If the person doesn’t recognize you, is unkind, or responds angrily, remember not to take it personally. He or she is reacting out of confusion.

Choosing a Nursing Home

For many caregivers, there comes a point when they are no longer able to take care of their loved one at home. Choosing a residential care facility-a nursing home or an assisted living facility-is a big decision, and it can be hard to know where to start.

* It’s helpful to gather information about services and options before the need actually arises. This gives you time to explore fully all the possibilities before making a decision.
* Determine what facilities are in your area. Doctors, friends and relatives, hospital social workers, and religious organizations may be able to help you identify specific facilities.
* Make a list of questions you would like to ask the staff. Think about what is important to you, such as activity programs, transportation, or special units for people with AD.
* Contact the places that interest you and make an appointment to visit. Talk to the administration, nursing staff, and residents.
* Observe the way the facility runs and how residents are treated. You may want to drop by again unannounced to see if your impressions are the same.
* Find out what kinds of programs and services are offered for people with AD and their families. Ask about staff training in dementia care, and check to see what the policy is about family participation in planning patient care.
* Check on room availability, cost and method of payment, and participation in Medicare or Medicaid. You may want to place your name on a waiting list even if you are not ready to make an immediate decision about long-term care.
* Once you have made a decision, be sure you understand the terms of the contract and financial agreement. You may want to have a lawyer review the documents with you before signing.
* Moving is a big change for both the person with AD and the caregiver. A social worker may be able to help you plan for and adjust to the move. It is important to have support during this difficult transition.

For More Information

Several organizations offer information for caregivers about AD. To learn more about support groups, services, research, and additional publications, you may wish to contact the following:

Alzheimer’s Disease Education & Referral (ADEAR) Center
Web address: www.alzheimers.nia.nih.gov

Alzheimer’s Association
Web address: www.alz.org

Children of Aging Parents
Web address: www.caps4caregivers.org

Eldercare Locator
Web address: www.eldercare.gov

Family Caregiver Alliance
Web address: www.caregiver.org

The National Institute on Aging Information Center
Web address: www.nia.nih.gov

The Simon Foundation for Continence
Web address: www.simonfoundation.org

Well Spouse Association
Web address: www.wellspouse.org

Source: U.S. Department of Health and Human Services, Public Health Services, National Institutes of Health, National Institute on Aging – March 2007, Oct 26, 2007
http://www.nia.nih.gov/Alzheimers/Publications/caregiverguide.htm#intro

The National Institute on Aging gratefully acknowledges the following Alzheimer’s Disease Centers for their valuable contributions: Duke University Joseph and Kathleen Bryan Alzheimer’s Disease Research Center and The Johns Hopkins University Alzheimer’s Disease Center.

Provided by: The Staff at www.RetirementConnection.com
For more information: www.nia.nih.gov

Copyright © 2008 RetirementConnection.com. All rights reserved.

Transportation Resources Older Adults & Caregivers

The National Center on Senior Transportation website, offers information and free resources to help you become more familiar with public transportation and the resources and services available in your community. The resources listed below offer directories of transportation-related services, information about safe driving, and policy discussions.

Transportation Providers and Programs

If you are looking for help finding senior friendly transportation in your region the Transportation Guidance web page provides links to resources that will help you.

Safe Driving Programs

National Association of Area Agencies on Aging’s Older Driver Safety Project http://www.n4a.org/older_driver_safety/research.cfm

AARP’s Driver Safety Program
http://www.aarp.org/families/driver_safety/

Safe Driving for Older Adults, tips for older drivers from the National Highway Transportation Safety Administration
http://www.nhtsa.dot.gov/people/injury/olddrive/OlderAdultswebsite/

Supplemental Transportation Programs for Seniors – a report by the Beverly Foundation and the AAA Foundation that discusses the importance of different Supplemental Transportation Programs and transportation options for older adults once they stop driving.
http://www.aaafoundation.org/pdf/STP2.pdf

Mobility Options

Getting By Without Driving, a brochure published by the American Medical Association was developed for older drivers, caregivers, and physicians to provide safety information and driving alternatives for older Americans. Ideas and alternatives for driving are included, along with information on home delivery services and agencies offering assistance to older Americans who do not drive.
http://www.ama-assn.org/ama1/pub/upload/mm/433/get_by_without_drive.pdf

The Surface Transportation Policy Project, in coordination with AARP and the American Public Transportation Association, wrote Aging Americans: Stranded Without Options (pdf) which concludes that as Americans grow older, our existing transportation network is unable to meet their needs of the nation’s aging population particularly as they become less willing and able to drive.
http://www.transact.org/report.asp?id=232

Community Livability
AARP’s Policy and Research section of its Web site offers extensive content related to the topics of housing, mobility and care options
http://www.aarp.org/research/housing-mobility/

The Complete Streets initiative endeavors to build road networks that welcome all citizens not just drivers.
http://completestreets.org/

Aging in Place Initiative – a publication by the National Association of Area Agencies on Aging (n4a) and Partners for Livable Communities that helps community leaders in developing an action plan to ensure programs and services are in place so that communities are good places to grow old.
http://aipi.n4a.org/

Eldercare Locator

A telephone and web based service of the Administration on Aging (AoA). Older adults and their caregivers can locate eldercare resources, local area agencies on aging and community-based organizations in any state.
http://www.eldercare.gov/Eldercare/Public/Home.asp

Vision Loss

The American Federation for the Blind has developed a section targeting older Americans diagnosed with low vision. The site links to a comprehensive database of senior services covering both the United States and Canada.
http://www.afb.org/seniorsitehome.asp

If you have a disability

Easter Seals Project ACTION is a national program that brings together the issues of people with disabilities and providers of public transportation. If you have a disability, you have rights to access wherever a public transportation system exists (this extends to providers of taxi service and over-the-road bus service, such as tour vehicles). ESPA also offers information on how to use transit and explains rights under the Americans with Disabilities Act.
http://www.projectaction.org/

Source: National Center on Senior Transportation website

Provided by: The Staff at www.RetirementConnection.com
For more information: http://seniortransportation.easterseals.com
Copyright © 2008 RetirementConnection.com. All rights reserved.

Transporting A Loved One With Dementia

National Family Caregiver Support Program Resources

When impairments resulting from Alzheimer’s disease and related dementias prevent older adults from safely driving or using public transportation, caregivers often become primary transportation providers. Transporting your loved one can be a challenge, but does not have to be a struggle every time. Try to keep in mind the advice given by a long-time caregiver, “The slower you go, the faster things get done.”

• Be patient and allow time to get ready and get into the car.

• Try to allow your loved one to calm down before entering the car.

• Be prepared with relaxing music, sunglasses, photos, food, etc.

• Seat your loved one in the rear passenger side seat with seat belt on and child lock in the ‘on’ position.

• Encourage your loved one to do as much as possible for him/herself.

• Try to keep glare from the sun to a minimum.

• Give information in small bits.

• Stay calm.

• Validate your loved one’s feelings whenever possible.

• Give brief, step-by-step directions.

• Encourage reminiscence.

• Be aware of your body language.

• Ask your loved one to use the bathroom before getting into the car.

• If possible, have a cellular phone in the car in case of emergency.

Source: Administration on Aging, Washington, DC, www.aoa.gov and Easter Seals, www.easterseals.com

Provided by: The Staff at www.RetirementConnection.com
For more information: www.aoa.gov
Copyright © 2008 RetirementConnection.com. All rights reserved.

Understanding Clinical Trials

Choosing to participate in a clinical trial is an important personal decision. The following frequently asked questions provide detailed information about clinical trials. In addition, it is often helpful to talk to a physician, family members, or friends about deciding to join a trial. After identifying some trial options, the next step is to contact the study research staff and ask questions about specific trials.

What is a clinical trial?

Although there are many definitions of clinical trials, they are generally considered to be biomedical or health-related research studies in human beings that follow a pre-defined protocol. ClinicalTrials.gov includes both interventional and observational types of studies. Interventional studies are those in which the research subjects are assigned by the investigator to a treatment or other intervention, and their outcomes are measured. Observational studies are those in which individuals are observed and their outcomes are measured by the investigators.

Why participate in a clinical trial?

Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research.

Who can participate in a clinical trial?

All clinical trials have guidelines about who can participate. Using inclusion and exclusion criteria is an important principle of medical research that helps to produce reliable results. The factors that allow someone to participate in a clinical trial are called “inclusion criteria” and those that disallow someone from participating are called “exclusion criteria”. These criteria are based on such factors as age, gender, the type and stage of a disease, previous treatment history, and other medical conditions. Before joining a clinical trial, a participant must qualify for the study. Some research studies seek participants with illnesses or conditions to be studied in the clinical trial, while others need healthy participants. It is important to note that inclusion and exclusion criteria are not used to reject people personally. Instead, the criteria are used to identify appropriate participants and keep them safe. The criteria help ensure that researchers will be able to answer the questions they plan to study.

What happens during a clinical trial?

The clinical trial process depends on the kind of trial being conducted clinical trial team includes doctors and nurses as well as social workers and other health care professionals. They check the health of the participant at the beginning of the trial, give specific instructions for participating in the trial, monitor the participant carefully during the trial, and stay in touch after the trial is completed.

Some clinical trials involve more tests and doctor visits than the participant would normally have for an illness or condition. For all types of trials, the participant works with a research team. Clinical trial participation is most successful when the protocol is carefully followed and there is frequent contact with the research staff.

What is informed consent?

Informed consent is the process of learning the key facts about a clinical trial before deciding whether or not to participate. It is also a continuing process throughout the study to provide information for participants. To help someone decide whether or not to participate, the doctors and nurses involved in the trial explain the details of the study. If the participant’s native language is not English, translation assistance can be provided. Then the research team provides an informed consent document that includes details about the study, such as its purpose, duration, required procedures, and key contacts. Risks and potential benefits are explained in the informed consent document. The participant then decides whether or not to sign the document. Informed consent is not a contract, and the participant may withdraw from the trial at any time.

What are the benefits and risks of participating in a clinical trial?

Benefits

Clinical trials that are well-designed and well-executed are the best approach for eligible participants to:

* Play an active role in their own health care.
* Gain access to new research treatments before they are widely available.
* Obtain expert medical care at leading health care facilities during the trial.
* Help others by contributing to medical research.

Risks

There are risks to clinical trials.

* There may be unpleasant, serious or even life-threatening side effects to experimental treatment.
* The experimental treatment may not be effective for the participant.
* The protocol may require more of their time and attention than would a non-protocol treatment, including trips to the study site, more treatments, hospital stays or complex dosage requirements.
* What are side effects and adverse reactions?
* Side effects are any undesired actions or effects of the experimental drug or treatment. Negative or adverse effects may include headache, nausea, hair loss, skin irritation, or other physical problems. Experimental treatments must be evaluated for both immediate and long-term side effects.
* How is the safety of the participant protected?
The ethical and legal codes that govern medical practice also apply to clinical trials. In addition, most clinical research is federally regulated with built in safeguards to protect the participants. The trial follows a carefully controlled protocol, a study plan which details what researchers will do in the study. As a clinical trial progresses, researchers report the results of the trial at scientific meetings, to medical journals, and to various government agencies. Individual participants’ names will remain secret and will not be mentioned in these reports
* What should people consider before participating in a trial?
* People should know as much as possible about the clinical trial and feel comfortable asking the members of the health care team questions about it, the care expected while in a trial, and the cost of the trial. The following questions might be helpful for the participant to discuss with the health care team. Some of the answers to these questions are found in the informed consent document.
* What is the purpose of the study?
* Who is going to be in the study?
* Why do researchers believe the experimental treatment being tested may be effective? Has it been tested before?
* What kinds of tests and experimental treatments are involved?
* How do the possible risks, side effects, and benefits in the study compare with my current treatment?
* How might this trial affect my daily life?
* How long will the trial last?
* Will hospitalization be required?
* Who will pay for the experimental treatment?
* Will I be reimbursed for other expenses?
* What type of long-term follow up care is part of this study?
* How will I know that the experimental treatment is working? Will results of the trials be provided to me?
* Who will be in charge of my care?

What kind of preparation should a potential participant make for the meeting with the research coordinator or doctor?

* Plan ahead and write down possible questions to ask.
* Ask a friend or relative to come along for support and to hear the responses to the questions.
* Bring a tape recorder to record the discussion to replay later.

Every clinical trial in the U.S. must be approved and monitored by an Institutional Review Board (IRB) to make sure the risks are as low as possible and are worth any potential benefits. An IRB is an independent committee of physicians, statisticians, community advocates, and others that ensures that a clinical trial is ethical and the rights of study participants are protected. All institutions that conduct or support biomedical research involving people must, by federal regulation, have an IRB that initially approves and periodically reviews the research.

Does a participant continue to work with a primary health care provider while in a trial?

Yes. Most clinical trials provide short-term treatments related to a designated illness or condition, but do not provide extended or complete primary health care. In addition, by having the health care provider work with the research team, the participant can ensure that other medications or treatments will not conflict with the protocol.

Can a participant leave a clinical trial after it has begun?

Yes. A participant can leave a clinical trial, at any time. When withdrawing from the trial, the participant should let the research team know about it, and the reasons for leaving the study.

Where do the ideas for trials come from?

Ideas for clinical trials usually come from researchers. After researchers test new therapies or procedures in the laboratory and in animal studies, the experimental treatments with the most promising laboratory results are moved into clinical trials. During a trial, more and more information is gained about an experimental treatment, its risks and how well it may or may not work.

Who sponsors clinical trials?

Clinical trials are sponsored or funded by a variety of organizations or individuals such as physicians, medical institutions, foundations, voluntary groups, and pharmaceutical companies, in addition to federal agencies such as the National Institutes of Health (NIH), the Department of Defense (DOD), and the Department of Veteran’s Affairs (VA). Trials can take place in a variety of locations, such as hospitals, universities, doctors’ offices, or community clinics.

What is a protocol?

A protocol is a study plan on which all clinical trials are based. The plan is carefully designed to safeguard the health of the participants as well as answer specific research questions. A protocol describes what types of people may participate in the trial; the schedule of tests, procedures, medications, and dosages; and the length of the study. While in a clinical trial, participants following a protocol are seen regularly by the research staff to monitor their health and to determine the safety and effectiveness of their treatment.

What is a placebo?

A placebo is an inactive pill, liquid, or powder that has no treatment value. In clinical trials, experimental treatments are often compared with placebos to assess the experimental treatment’s effectiveness. In some studies, the participants in the control group will receive a placebo instead of an active drug or experimental treatment.

What is a control or control group?

A control is the standard by which experimental observations are evaluated. In many clinical trials, one group of patients will be given an experimental drug or treatment, while the control group is given either a standard treatment for the illness or a placebo.

What are the different types of clinical trials?

Treatment Trials test experimental treatments, new combinations of drugs, or new approaches to surgery or radiation therapy.

Prevention trials look for better ways to prevent disease in people who have never had the disease or to prevent a disease from returning. These approaches may include medicines, vaccines, vitamins, minerals, or lifestyle changes.

Diagnostic trials are conducted to find better tests or procedures for diagnosing a particular disease or condition.

Screening trials test the best way to detect certain diseases or health conditions.

Quality of Life trials (or Supportive Care trials) explore ways to improve comfort and the quality of life for individuals with a chronic illness.

What are the phases of clinical trials?

Clinical trials are conducted in phases. The trials at each phase have a different purpose and help scientists answer different questions:

In Phase I trials researchers test an experimental drug or treatment in a small group of people (20-80) for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.

In Phase II trials the experimental study drug or treatment is given to a larger group of people (100-300) to see if it is effective and to further evaluate its safety.

In Phase III trials the experimental study drug or treatment is given to large groups of people (1,000-3,000) to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the experimental drug or treatment to be used safely.

In Phase IV trials post marketing studies delineate additional information including the drug’s risks, benefits, and optimal use.

What is an “expanded access” protocol?

Most human use of investigational new drugs takes place in controlled clinical trials conducted to assess safety and efficacy of new drugs. Data from the trials can serve as the basis for the drug marketing application. Sometimes, patients do not qualify for these carefully-controlled trials be cause of other health problems, age, or other factors. For patients who may benefit from the drug use but don’t qualify for the trials, FDA regulations enable manufacturers of investigational new drugs to provide for “expanded access” use of the drug. For example, a treatment IND (Investigational New Drug application) or treatment protocol is a relatively unrestricted study. The primary intent of a treatment IND/protocol is to provide for access to the new drug for people with a life-threatening or serious disease for which there is no good alternative treatment. A secondary purpose for a treatment IND/protocol is to generate additional information about the drug, especially its safety. Expanded access protocols can be undertaken only if clinical investigators are actively studying the experimental treatment in well-controlled studies, or all studies have been completed. There must be evidence that the drug may be an effective treatment in patients like those to be treated under the protocol. The drug cannot expose patients to unreasonable risks given the severity of the disease to be treated.

Some investigational drugs are available from pharmaceutical manufacturers through expanded access programs listed in www.ClinicalTrials.gov. Expanded access protocols are generally managed by the manufacturer, with the investigational treatment administered by researchers or doctors in office-based practice. If you or a loved one are interested in treatment with an investigational drug under an expanded access protocol listed in www.ClinicalTrials.gov, review the protocol eligibility criteria and location information and inquire at the Contact Information number.

Source: www.ClinicalTrials.gov
Provided by: The Staff at www.RetirementConnection.com
For more information: www.LongTermCare.gov
Copyright © 2008 RetirementConnection.com. All rights reserved.

Program of All inclusive Care for the Elderly- PACE

PACE is unique. It is an optional benefit under both Medicare and Medicaid that focuses entirely on older people, who are frail enough to meet their State’s standards for nursing home care. It features comprehensive medical and social services that can be provided at an adult day health center, home, and/or inpatient facilities. For most patients, the comprehensive service package permits them to continue living at home while receiving services, rather than be institutionalized. A team of doctors, nurses and other health professionals assess participant needs, develop care plans, and deliver all services which are integrated into a complete health care plan. PACE is available only in States which have chosen to offer PACE under Medicaid.

Eligibility

Eligible individuals who wish to participate must voluntarily enroll. PACE enrollees also must:

* Be at least 55 years of age.
* Live in the PACE service area.
* Be screened by a team of doctors, nurses, and other health professionals as meeting that state’s nursing facility level of care.
* At the time of enrollment, be able to safely live in a community setting.

Services

PACE offers and manages all of the medical, social and rehabilitative services their enrollees need to preserve or restore their independence, to remain in their homes and communities, and to maintain their quality of life. The PACE service package must include all Medicare and Medicaid services provided by that State. In addition, the PACE organization provides any service determined necessary by the interdisciplinary team. Minimum services that must be provided in the PACE center include primary care services, social services, restorative therapies, personal care and supportive services, nutritional counseling, recreational therapy, and meals. Services are available 24 hours a day, 7 days a week, 365 days a year.

Generally, these services are provided in an adult day health center setting, but may also include in-home and other referral services that enrollees may need. This includes such services as medical specialists, laboratory and other diagnostic services, hospital and nursing home care.

An enrollee’s need is determined by PACE’s medical team of care providers. PACE teams include:

* Primary care physicians and nurses.
* Social workers.
* Personal care attendants.
* Dietitians.
* Drivers.

The PACE team has frequent contact with their enrollees. This helps them to detect subtle changes in their enrollee’s condition and they can react quickly to changing medical, functional, and psycho-social problems.

Payment

PACE receives a fixed monthly payment per enrollee from Medicare and Medicaid. The amounts are the same during the contract year, regardless of the services an enrollee may need.

Persons enrolled in PACE also may have to pay a monthly premium, depending on their eligibility for Medicare and Medicaid.

Current Sites

For a listing of PACE organizations nationwide, please visit the following website:
www.cms.hhs.gov

Source: www.medicare.gov, www.LongTermCare.gov
Provided by: The Staff at www.RetirementConnection.com
For more information: www.LongTermCare.gov
Copyright © 2008 RetirementConnection.com. All rights reserved.

Injuries and Mobility Issues Don’t Always End Independence

As people age, they sometimes experience a loss of mobility. Whether it’s arthritis, injuries, respiratory diseases, heart disease or other illness, such conditions can make it difficult to not only move through the home, but also to accomplish the daily tasks of living: dressing and bathing, meal preparation, laundry, grocery shopping and light cleaning, to name a few.

In the past, such conditions would usually mean an end to independence and being able to continue to live at home. But in today’s society, an array of in-home care services and support make it possible for adults with limited mobility to obtain the help they need without leaving their homes.

Families of aging adults and aging adults themselves should know they are not alone in living with mobility issues. In fact, according to the United States Administration on Aging, nearly 10 million Americans live with a physical disability that can hinder mobility on a regular basis.

The following tips can help adults with mobility issues maintain their independence.

* Honestly assess your mobility. Is your condition permanent or temporary? Is it painful/difficult/impossible for you to move? Are you limited in the duration of your activity or limited by obstacles, such as stairs?
* Determine what activities you have difficulty accomplishing because of your condition. Is it now hard for you to bath or get dressed? Do laundry? Shop for groceries? Do certain cleaning tasks?
* Consult a physician on what you can do to increase and/or maintain your activity level.
* Research the types of assistance available in the home, including in-home care services, social services and ambulatory equipment.

It’s no secret that we all will age. However, thanks to advancements in care options and medical equipment, we can get the support we need to continue living at home, even though we may not be as mobile as we once were. This assistance can be tailored to an individual’s exact needs.

Source: Right at Home, 503-574-3674
For more information: www.RAHcares.com, 503-574-3674

Copyright © 2008 RetirementConnection.com. All rights reserved.

Boomer’s Balancing Act: Juggling Careers and Caregiving

Individuals who are part of the “sandwich generation” are juggling the responsibilities of working, caring for their children, and providing home care for their aging parents, thus causing them to bite off more than they can chew. The United States includes an estimated 34 million unpaid family caregivers for adults, typically older relatives, according to a study released by AARP.

Family members frequently face challenges in the workplace while caring for a loved one at home. Often times they are forced to make the difficult choice between work and family: “Do I go to my 3 o’clock meeting or take my mother to the doctor?” Managing both responsibilities can often increase stress while decreasing productivity in one or both of these tasks.

According to national studies by MetLife Insurance and the National Alliance for Caregiving, nearly 65 percent of family members who worked while caring for an aging parent experienced conflict with their jobs, including tardiness, lost hours or income, and the sacrificing of vacation. The following are other effects caregiving can have on employee relations in the workplace:

PROBLEMS EMPLOYED FAMILY CAREGIVERS FACE:

* Career Stands Still
Home caregiving responsibilities can mean missing out on promotions and training at work, opportunities for job transfers or relocations, and acquiring and keeping up with necessary job skills.
* Loss in Wages
Income can drastically be cut as a result of caregiving obligations. In the national MetLife and AARP study, nearly two-thirds of respondents said that caregiving had a direct impact on their earnings. As a result of caregiving, the average loss in aggregate lost wages, Social Security and lost pension benefits reported was $659,139 over a lifetime.
* Reductions in Savings and Spending
Providing home care for a loved one can cause significant limitations to personal savings and spending, home improvements, vacations and/or investments.
* Toll on Health
Caregiving responsibilities can often take a toll on the health of a family caregiver leading to increases in absenteeism in the workplace, early retirement and job turnover. This can lead to a loss in employee productivity and overall workplace morale.
* Economic Loss for Employers
Employers also lose money due to employees’ caregiving responsibilities. A previous MetLife study estimated that absenteeism, partial absenteeism, workday interruptions, eldercare crises and costs associated with supervising employed caregivers conservatively averages $11.4 billion per year.

TIPS FOR BALANCING WORK WITH HOME CARE:

* Find out if the employer must follow the federal Family and Medical Leave Act. If so, an employee is entitled to up to 12 weeks of unpaid time off annually to care for a parent with a serious health condition.
* Long-distance caregivers shoulder an even greater burden of caring for an aging parent while meeting job demands. Employees should find out if they can work remotely for greater flexibility. For instance, an employee may be able to work from the home of the relative for whom they are caring.
* Employee Assistance Programs, such as WorkPlace Options, are an example of a growing trend in employer-subsidized caregiving programs that employers and employees around the country are embracing. This program enables employees to continue working when they experience a temporary breakdown in their elder care arrangements. WorkPlace Options offers a comprehensive, fully integrated Backup Care Program that features a network of thousands of individually contracted home care agencies, including Right at Home, to provide Backup Caregivers in case of an emergency.
* Hiring a national home care and assistance agency, such as Right at Home, is another solution for many families. Right at Home provides in-home non-medical care, often at a fraction of the cost of moving into an assisted living facility or nursing home. Services offered included companionship, meal preparation, light housekeeping, grocery and errand services, incidental transportation, personal care assistance, and more. Best of all, Right at Home is available 24/7, catering to an employee’s varied work schedules. All Right at Home caregivers are fully screened through professional references, rigorous criminal background checks and are fully insured and bonded.

For more information on support for the family caregiver, and options for receiving home care services, check out the following resources:

The Free 2007 Adult Caregiving Show Me Guide by Right at Home and Secure Horizons

Download a free version of the Show Me Guide on this page from Right at Home
www.rightathome.net

Family Caregiver Alliance
www.caregiving.org

National Family Caregivers Association
www.nfcacares.org

AARP
www.aarp.org

Source: Right at Home Managing Director, www.RAHcares.com 503-574-3674
For more information: www.RAHcares.com, 503-574-3674

Copyright © 2008 RetirementConnection.com. All rights reserved.