Grief

“Grief is the price we pay for love.” – Queen Elizabeth II

Grief can come in waves, sometimes the things that you believe should affect you are more manageable than expected, and other times a simple happening can start a wave of emotions. I am learning that being sad and crying is not a sign of weakness, but it means that I care and it means that someone I cared for mattered greatly.

Home improvement for better senior living

Home improvement can be a challenge for seniors who decide to live at home instead of in an assisted living facility, included, are some DIY home improvement tips for better and safer senior living.

Home improvement can be a challenge for seniors who decide to live at home instead of in an assisted living facility.

Studies show that 90 percent of people over age 65 would prefer to remain at home as long as possible — and 80 percent of older Americans have firm plans to stay put.

How great would it be if all homes could be suitable for anyone, regardless of their age or physical ability? What if someone who wants to live independently — regardless of his or her age or physical ability — could do just that?

It starts with incorporating design principles and products that are adaptable, safe, and easy-to-use. These smartly designed features are attractive, stylish, and come at all price points. They will also help reduce the falls and accidents that are more likely to occur with senior occupants.

Many of these improvements are DIY projects like those below.

Do-it-yourself ideas

House wide:

  • Replace doorknobs with lever-style handles
  • Replace knobs on cabinets and drawers with easy-to-grip, D-shaped handles

Stairs and flooring:

  • Apply nonslip adhesive strips to uncarpeted stair treads
  • Use double-sided tape to secure rugs to the floor

Bathrooms:

  • Install rubber-suction bathmat or nonslip floor strips in the tub or shower
  • Install hand-held, adjustable height shower head for easier bathing

Major projects and renovations needed for seniors.

Sometimes, major home improvements are also necessary. Start with a home assessment by an occupational therapist, physical therapist, geriatric care manager or other certified aging-in-place specialist. People with these jobs can recommend proper modifications and remodeling projects for your home.

Here are nine ideas that will make life easier and safer in the kitchen and around the house, but require installations by someone like a skilled relative or friend — or hiring a contractor.

Consider installing:

  1. A wheelchair ramp (at least one step-free entrance into the home?)
  2. Rocker-style light switches
  3. Handrails for both sides of a staircase
  4. Lighting for staircases, hallways and exterior walkways
  5. Motion-sensing entry lights

Other additions/enhancements:

  1. Interior doorways at least 36 inches wide.
  2. Lower kitchen countertops and light switch height (work surface that can be used while seated).
  3. Adjustable, pull-down shelving to cabinets (kitchen cabinets and shelves easy to reach).
  4. Grab bars in bathtub and near toilet.

These upgrades will help keep homes safe for senior occupants well into their golden years.

When safety planning for senior occupants, don’t forget to create an emergency exit plan to help get everyone out of the home safely.

AARP created a HomeFit Guide to help people stay in the homes they love. The guide provides lessons, suggestions. and other practical home improvement solutions.

Find it online at: www.aarp.org/livable


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Senior safety: Knowing when to go to the emergency room versus urgent care

How do you know when to go to the emergency room and when to go to urgent care? Learning how to tell which type of care is best, can literally be a life saver.

Emergency room versus urgent care can be a hard decision under inevitable chaos. You already know to schedule regular wellness appointments at your doctor’s primary care clinic. But where do you go for more acute injuries and illnesses? When you don’t feel well, you want immediate care.

Knowing when to go to urgent care and when to go to the emergency room could get you the right care, faster!

Some people think they will be seen more quickly in the ER, but ERs see the most acute patients first. That means if your injury or illness isn’t serious, you may have to wait to see a doctor. Also, ERs are often busiest on Mondays and in the evenings.

When to go to the ER

You should go to the ER if you are in a life-or-death situation with any of the following symptoms:

  • Inability to breathe
  • Major trauma
  • Lost consciousness
  • Altered mental state
  • Head injury
  • Serious abdominal pain
  • Suicidal thoughts or actions
  • Chest pain
  • Stroke
  • Uncontrollable bleeding
  • Broken bones with the bone exposed

When to go to Urgent Care

Urgent care is for same-day care when you are experiencing problems like:

  • Breathing difficulty
  • Ear discomfort
  • Eye infections
  • Migraines and headaches
  • Sprains, strains and broken bones
  • Skin irritations
  • Upset stomach or stomach pain
  • Concerns of urinary, bladder or sexually transmitted infections
  • Work injuries (workers compensation)
  • Physical exams

Many urgent care clinics have convenient scheduling options so you can book your appointment online or by phone — and relax at home instead of sitting in a waiting room.

It’s important to note that some urgent care clinics cannot see patients younger than three months old, do not offer IV fluids/medication and do not have narcotics on site.

Other Options for when it isn’t a life-or-death situation

Many insurance carriers provide 24-hour nurse advice lines you can call if you aren’t sure where to go. Urgent and same-day care clinics often have expanded hours so you can get care outside of business hours.

Primary care or family medicine offices are usually open during business hours, sometimes with offset hours to accommodate work schedules.

The biggest takeaway

If you fear you have a serious, life-threatening illness or injury — you should go to the nearest ER or call 911.


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3 Steps to escaping senior loneliness

Loneliness is nothing to be ashamed of. And if you educate yourself about loneliness, you can recognize and combat its effects before it becomes a major problem.

Are you a senior who sometimes feels a deep sense of loneliness? Are you someone who worries about a senior who seems lonely?

Loneliness is nothing to be ashamed of. And if you educate yourself about loneliness, you can recognize and combat its effects before it becomes a major problem.

Loneliness in medical studies

Research shows that loneliness poses a true health risk for elderly people — one that can lead to higher blood pressure, greater stress, reduced immune defense (lowered production of white blood cells) and earlier death in some cases.

The study also revealed the startling fact that loneliness is a better predictor of early death than obesity. Those who felt lonely were more likely to die within six years than their nonlonely counterparts even when the study adjusted the results based on individuals’ ages, health problems and other factors.

Three steps to beat loneliness

Seek companionship. Many people look only to caregivers and family members for friendship, but local support groups, senior centers or faith-based organizations can be wonderful places to make new friends.

If you are a friend or caregiver to an elderly person, encourage them to lead an active social life and look for opportunities to help them connect with others.

Rediscover interests. After retirement, seniors may find they finally have time to take up hobbies that career or family responsibilities made difficult. Consider volunteering, caring for a pet, gardening, arts and crafts, reading, following sports or playing an instrument.

Having a hobby helps people of all ages stay motivated and keep an eye toward the future.

Be patient. The process can take time. A casual acquaintance can slowly become a close friend. A new hobby may take a little dedication. But loneliness is preventable. Taking steps to avoid loneliness helps your emotional and physical health.


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Appetite loss: 10 tips to a bigger appetite

Appetite loss can be a problem, especially for the elderly who live alone and lack interest in cooking. Appetite loss is common for people facing illness, cancer, depression – and medication side effects they come with – are also at risk of poor nutrition.

Appetite loss can be a problem, especially for the elderly who live alone and lack interest in cooking. Appetite loss is common for people facing illness, cancer, depression – and medication side effects they come with – are also at risk of poor nutrition.

“I wish I had THAT problem!” you’re probably laughing. But appetite loss is no laughing matter when you’re worried about a loved one’s appetite. Not eating right leads to low energy, which reduces appetite further.

Top 10 helpful tips

Make your loved one’s FAVORITE foods. Try new recipes featuring favorite ingredients. If they like cheese, consider melting it on a cracker with a slice of tomato on top.

  1. Make the eating environment lovely: tidy up, use beautiful colors for dishes and tableware, play calming music, turn off the TV, have flowers or another beautiful center piece.
  2. Eat together at routine times, and have good conversation. Feeling loved and listened to can stimulate an appetite … or at least make them feel “guilty” enough to eat a little just to please you, which lights up their tastebuds and leads to more bites.
  3. Keep the meal sizes small. When they see a large meal on the table, they might feel overwhelmed because they can’t finish it.
  4. Consider smells that can stimulate the appetite, like sautéing a little garlic with vegetables in butter or oil.
  5. Leave enough room between meals and snacks for your loved one to get hungry again. A food tradition from Panama says that if you eat an apple before a meal, it makes you hungrier and prepares your stomach for food.
  6. Keep them hydrated by helping them drink enough water throughout the day. This can facilitate faster digestion and will make them feel hungry more often.
  7. Physical activity as appropriate can stimulate the digestive system and may improve appetite. Take a short walk before a meal.
  8. Sometimes chewing might be difficult, so consider liquid or semi-solid foods, such as a protein smoothie. Smoothies can pack a lot of nutrients and calories; choose a good protein powder, veggies like kale or spinach and carrots, plus fruits.
  9. Snack! Prepare snack-sized bags with berries, nuts and chopped veggies.

 

Generally, women over 50 need about 1,600 to 2,200 calories a day; men need 2,000 to 2,800. Resist the urge to fill up on empty calories like baked goods, chips and soda. As you age, you don’t need as many calories, but you need more nutrients. Choose from fresh fruit, vegetables, whole grains and lean protein.

 

When you cook for yourself, make extra—like stew or hearty soups. Freeze left-overs in handy one-serving containers to leave behind in the freezer. Prepared food is easy to heat … and easier to eat!

 


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FAQ: Oregon’s Death with Dignity Act

The Death with Dignity Act allows terminally ill Oregonians to end their lives through the voluntary self-administration of lethal medications prescribed by a doctor expressly for that purpose.

What is Oregon’s Death with Dignity Act?

The Death with Dignity Act allows terminally ill Oregonians to end their lives through the voluntary self-administration of lethal medications prescribed by a doctor expressly for that purpose.

Who can participate?

A patient must be:

  • 18 years of age or older
  • An Oregon resident
  • Capable of making and communicating health care decisions for him/herself
  • Diagnosed with a terminal illness that will lead to death within six months, as determined by two doctors.

Can a patient take their Death with Dignity medication while staying at the hospital?

No, doctors may choose to participate or not. Some employers may prohibit doctors from participating in this process. A doctor must be an MD or DO licensed in Oregon.

How does a patient get a prescription from a participating physician?

  1. The patient must make two verbal requests to the attending physician, separated by at least 15 days.
  2. The patient must provide a written request to the attending physician, signed in the presence of two witnesses, at least one of whom is not related to the patient.
  3. The attending physician and a consulting physician must confirm the patient’s diagnosis and prognosis.
  4. The attending physician and the consulting physician must determine whether the patient is capable of making and communicating health care decisions for him/herself.
  5. If either physician believes the patient’s judgment is impaired by a psychiatric or psychological disorder (such as depression), the patient must be referred to a psychological examination.
  6. The attending physician must inform the patient of feasible alternatives to the Act, including comfort care, hospice care and pain control.
  7. The attending physician must request, but may not require, the patient to notify their next-of-kin of the prescription request.

 

Must a physician be present?

The law does not require the presence of a physician. The patient self-administers the prescribed medication; it is not administered by the physician. A physician may be in attendance if the patient wishes it.

If a patient’s doctor does not participate in the Death with Dignity Act, how can he/she get a prescription?

The patient must find another doctor (MD or DO) who is licensed to practice in Oregon and who is willing to participate.

Does insurance cover medical care that is part of the Death with Dignity Act?

As with any medical procedure, insurers will determine what is covered by policy. However, federal funding cannot be used for services rendered under the Death with Dignity Act.

 

For more information: www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT


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Residential Hospice Care: An under-considered option for seniors end-of-life care

Today, 50% of Oregonians die on hospice, but of those, over 40% do not die at home. Learn why residential hospice care for you and your loved one.

Today, 50% of Oregonians die on hospice, but of those, over 40% do not die at home. Without willing and capable family or friends to provide end-of-life support, dying at home on hospice care may not be an option. Photo from Steve Buissinne via pixabay.com 

Residential hospice care helps ease the burden of 24-hour in-home caregiving while providing a respectful, comfortable care setting for your loved-one’s last days. It is an option that is often under-considered for many Oregonians and can be especially helpful for those without friends or family to provide end-of-life care.

In the 1980’s when the hospice Medicare benefit was created, the plan was for free family caregivers to do the majority of the day-to day care. Visits from hospice nurses, social workers, chaplains, home health aides and volunteers made it possible for hospice patients to spend their last days at home. They often relied on the able-bodied loved-ones, adult children, and grandchildren to provide daily care 23 out of 24 hours.

Today, 50% of Oregonians die on hospice, but of those, over 40% do not die at home. Providing care for a loved one dying at home is difficult and exhausting. Many don’t realize that though medicare-covered hospice nurses, social workers, and chaplains may visit a few times a week, they often delegate the majority of caregiving to the spouse, child, parent, or paid caregiver at great expense. For those dying without willing and capable family or friends to provide end-of-life support, dying at home on hospice care is not an option.

What is residential hospice care?

A hospice residential care facility is the next best thing to dying at home.

A residential hospice specializes in end-of-life care, unlike hospitals that are focused on finding and curing disease, nursing homes which are designed for rehabilitation and long-term assistance, or foster homes that provide long-term residential support. The cost of a hospice residential care facility, or RCF, is often a more affordable alternative and much less expensive than paying for 24/7 private duty nursing care that you bring into the home.

A dedicated hospice residence provides patients and families with a peaceful home-like environment to spend their final days.

What are the benefits of residential hospice care?

  • Residential hospice care allows patients to remain safe, comfortable, and cared for, so that their last weeks or days are peaceful and dignified.
  • The home setting and care ensures that patients can pass with dignity and respect that honors their individuality and personal traditions.
  • A hospice-supported passing provides lasting benefits for the patients’ loved-ones by allowing them to spend precious time together to deal with unfinished business, reflect, meet their own needs, and perhaps reconnect with the patients or others close to the patient.
  • Because the staff provides the physical care and follows the plan of care outlined by Medicare hospice providers, loved-ones are free to focus on what’s most important – that final precious time together.

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Active aging: The importance of social activity for seniors

Approximately seven million individuals over the age of 65 experience symptoms of depression, recent studies revealed that social activity for seniors can reduce depression and dementia.

Approximately seven million individuals over the age of 65 experience symptoms of depression, recent studies revealed that social activity for seniors can reduce depression and dementia. Photo from Micheal Gaida via pixabay.com

Maintaining healthy relationships is crucial for individuals at every age, but especially for seniors. Isolation can be an extremely common problem among seniors who are living alone. While seniors may enjoy their independence living in their own home, they can still experience loneliness. Many seniors have spent a considerable portion of their lives in the company of others – be it in the workplace or raising children. Upon reaching retirement age, and with children leaving the house, the opportunities for remaining socially active often decrease, especially if the senior has to rely on others for transportation. It is important for seniors to stay engaged and connected, which is why moving to a senior living community can be extremely beneficial.

Benefits of social activity for seniors

The relationship between physical activity and vitality is well-documented, but multiple recent studies have revealed an increasingly stronger link between social interaction and a senior’s mental and physical well-being. Research has indicated that an active social lifestyle is more important than ever in helping seniors maintain a sharp mind, remain connected to the world around them, increase their own feelings of happiness, and to develop a sense of belonging. Various studies have shown that social activity for seniors has the following effects:

Improved mental health
Symptoms of depression and memory problems affect many seniors. Approximately seven million individuals over the age of 65 experience symptoms of depression, and it is estimated that dementia touches 1 in 7 Americans over the age of 71. Recent studies revealed that consistent human contact and interaction can reduce depression and dementia.

Improved nutrition
The need for proper nutrition is crucial for seniors, but healthy habits can be difficult to maintain when living alone. Many elderly people suffer from malnutrition. Studies show that seniors who have more social interactions were not only more friendly and lively, but that they also had more food intake.

Finding ways for seniors to stay socially active

Many seniors have family members or other caregivers who occasionally interact with them, but that is not always enough to keep them happy and engaged. While it is comforting for seniors to know their needs are met, they should also be consistently engaging with others, primarily with peers.

There a variety of different social activities for seniors to help them stay engaged. These include:

  • Volunteering
  • Joining clubs and groups
  • Moving to retirement communities
  • Staying connected with friends and family
  • Getting a pet
  • Attending a church
  • Learning new skills
  • Learning to use the internet

When it comes to socializing, the more the merrier! Seniors in large groups are more likely to encourage healthy habits among each other, including exercise.

Staying actively engaged while aging

Seniors may resist change and may need additional gentle encouragement to get more socially involved, but the benefits of an active social lifestyle reach well into the future.


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Wise and Well: Tips for family caregivers

Caregivers are most effective when they are well-informed, practicing consistent self-care and aware of their own limitations. If you are a family caregiver, here are some tips to help you remain happy, healthy, and wise about your role.

Caregivers are most effective when they are well-informed, practicing consistent self-care, and aware of their own limitations.

Caregivers are most effective when they are well-informed, practicing consistent self-care, and aware of their own limitations.

Tips for family caregivers #1

Self-Care Isn’t Selfish!

Ask yourself,“what good will I be if I become sick?” You can’t help others if you become sick, chronically ill or overwhelmed.

  • Get proper rest and nutrition
  • Set aside time each day for yourself
  • Take a walk, relax, or read a book

Tips for family caregivers #2

Set Relationship Boundaries

Caring for a family member makes sense for many reasons – familiarity, instincts to help/protect, and financial constraints. However, one of the main stressors is blurred relationship lines/ boundaries.

Define your roles and have a conversation with everyone involved to understand when you have to make decisions as a caregiver vs. child.

  • Be well informed about your loved one’s current situation – understand what they can/can’t do for themselves. Don’t feel you have to do it all. It will help them maintain a sense of independence if they remain responsible for some decisions.
  • Evaluate early on what you’re willing and able to do. Caregiving often is not a one-person job.
  • Prioritize needs—including yours. Then, be realistic and set expectations as to when/how you can meet the demands of those you are caring for.

Tips for family caregivers #3

Know the Signs of Burnout

We all have moments of feeling overwhelmed, over-burdened, and stressed out; watch for caregiver burnout. If you consistently exhibit these behaviors, it’s time for a break:

  • Lack of sleep
  • Unhealthy eating habits
  • Failure to exercise
  • Failure to properly care for yourself when sick
  • Skipping regularly scheduled medical appointments
  • Forgetfulness 4. You’re Not Failing by Asking for Help Recognizing the need for—then asking—for help in caregiving is one most important things you can do.
  • Ask family or friends for help. Even if it’s temporary, it will give you the break you need to feel refreshed and balanced.
  • Get support, encouragement, and ideas from other caregivers. Look into joining a caregiver support group where you can share tips and best practices.
  • Look into short-term options. Many senior living communities offer short-term stays to give you a well-deserved break or vacation to recharge and take care of yourself.

Caregiving is an important role. But remember you matter. Your needs are important too. Not only are you ensuring that you’re doing what’s in the best of interest of the person you’re caring for – you’re taking care of you! No one is expected to do it all by themselves.


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