by trevor@addfuelfire.com | May 22, 2014 | Dear Donna, Healthy Aging, Uncategorized
Dear Donna:
My mother will be undergoing hip replacement surgery at a hospital in Saginaw, Michigan in late June. Her surgeon has advised us that she will likely need to go to a rehab center for a few weeks of therapy after she leaves the hospital. We are trying to figure out if Medicare will pay for that and how to choose the best one for her recovery. Can you help us understand what this means?
Diane in Adrian, Michigan
Diane:
It is a definitely a good idea to tackle all of this before your mother’s surgery. That will help her make a smooth transition to the skilled nursing and rehab center and then, eventually, back home.
Here is how the Medicare Skilled Nursing & Rehab Benefit works:
- Your mother will qualify for the benefit if she spends three nights at an inpatient level of care in the hospital.
- Once she transitions to the skilled rehab center, Medicare will pay for the first 20 days in full.
- Beginning on the 21st day, she will be liable for a co-payment amount. In 2014, that is $152 per day. If she has a secondary insurance, it may cover this amount.
- If she still isn’t back on her feet after day 100, she will be liable for the entire cost of the stay. But don’t worry. Most seniors are back on their feet and home long before this!
As far as finding the best provider, Medicare has a few tools that can help. One is the Nursing Home Compare rating system on Medicare.gov. It allows you to review each provider’s state survey results and (if applicable) complaint surveys from residents and their family members. Medicare also has a Skilled Nursing Facility Checklist you can download to help you compare one community with another.
Finally, our best piece of advice is to tour every community you are considering for your mother. It would probably be a good idea to have a list of 2 or 3 options. That way if one or two of them are full, you still have another option that your family has already visited and approved of to turn to for rehab.
I hope this helps, Diane! Best of luck to your mother in her surgery and rehab.
Donna
by trevor@addfuelfire.com | May 18, 2014 | Alzheimer's and Dementia, Caregiving, Uncategorized
When a loved one living with Alzheimer’s disease moves to an assisted living community, one of the toughest things for families to cope with is hearing them say the words, “Please take me home. I want to go home.” Adult children know they have made the right choice for safety reasons, but the guilt those words create can be tough to overcome.
What Someone with Alzheimer’s Means When They Say “I Want to Go Home”
Here is what your loved one might really be saying:
- I don’t recognize anything or anyone around me.
Because Alzheimer’s disease robs people of their memory, it creates confusion. Your loved one may not understand why no one seems familiar and nothing looks like home no matter where they are. They are likely feeling lonely.
- “Home” may not be their most recent house.
When shorter term memories are lost, home may be the place they lived when they were a child or younger adult. They may be remembering happier times when they lived with their parents and siblings.
How to Respond When an Aging Loved One Says “I Want to Go Home”
There are a few suggestions we know other families have found worked with their loved ones:
- Try to determine what they need.
We know this can be difficult to do when their verbal skills are impaired. The problem may be that they are hungry, tired, in pain or need to use the bathroom. Try to ask them yes or no questions to see if you can find out if something is wrong or upsetting to them.
- Try to respond positively.
Arguing with them or telling them the assisted living community is home now probably won’t work. Instead, try acknowledging their request and agreeing to do it “later.” Using a simple phrase like, “I know you miss your garden. Maybe next week when we are at the dentist we can stop there.” It may help placate them for now and they likely won’t remember later.
- Encourage them to talk about it if they are able.
Ask them what they miss and what they liked about home. Getting the conversation going might give you an opportunity to determine what they are missing and see how you can help fix it. It might also provide you with the chance to re-direct the conversation. For example, if they miss their garden or the neighbor’s dog, tell them about a new dog on your street or a problem you are having in your garden.
This issue is one of the most common struggles for families. Almost everyone who moves a loved on to a memory care program encounters it at one time or another. We hope these tips help provide you with a few ideas on how to handle it.
Photo Credit
by trevor@addfuelfire.com | May 16, 2014 | Caregiving, Uncategorized
As we grow older, our once safe home environments often begin to create safety risks. Many of us have read the frightening statistics that reinforce the importance of bathroom safety. A large number of falls that happen to senior citizens take place in their own bathroom. Falls can be more dangerous in the bathroom because floors are typically tile and not carpet that may help to cushion the impact. There are also more objects in closer proximity for older adults to hit their head on if they go down including the toilet, the side of the tub and the bathroom vanity. For the 1,361,530 Michiganders who are age 65 or older, we offer the following tips to create a safer bathroom:
- Consider adding a panic button with a long cord to the wall of your senior loved one’s bathroom. That will allow them to call for help if they fall or otherwise run in to trouble while they are in there. If that isn’t feasible, make sure they have a waterproof medical alert pendant they can wear in the shower.
- Take a close look at how their bathroom is set up. Are items they use most frequently within easy reach? If not, try to re-arrange the room. The goal should be to keep them from having to climb on a step ladder or reach too far over their head to retrieve an item. Either situation could cause them to lose their balance and fall.
- Try to renovate their bathroom to create a walk-in shower that doesn’t require them to step over the side of the tub. For less than steady older adults, that can cause a fall.
- Remove older sliding glass doors. For someone with a physical impairment or poor balance the doors often become something to grab on to for support getting in and out of the tub. Most sliding doors were not made for that kind of use and may break.
- Raise the height of their toilet seat if necessary. A raised toilet seats is inexpensive and easy to install. You can even find them at your local pharmacy.
- Install sturdy grab bars in place of towel bars. Another common source of bathroom falls for seniors is when they try to use the towel bar to leverage themselves with and it pulls out of the wall.
- Be sure they have good lighting in the bathroom and nightlights that illuminate their path to it after dark.
If you are concerned that your loved one’s home needs to be evaluated for safety by a professional, talk with their primary care physician. They can probably help you find a physical therapy company in your area that offers that service.
Photo Credit
by trevor@addfuelfire.com | May 12, 2014 | Alzheimer's and Dementia, Uncategorized
Storytelling and spending time recalling happy memories is a common part of family bonding. For those with Alzheimer’s disease, it can be a way of helping them reconnect with events and times that are still a part of their memory. Reminiscence therapy (RT) is based on that idea. RT is the process of helping those with Alzheimer’s or dementia recall personal experiences from their past. It works by decreasing demands on the individual’s impaired cognitive abilities by utilizing those that still remain. That means you understand and accept that recent memories are likely gone for good and reminisce about those from more distant days. It has been shown to reduce anxiety and depression.
Getting Started with Reminiscence Therapy
If you are exploring ideas for how to get started using RT with a senior loved one living with Alzheimer’s disease, these tips should help:
- Enlist friends and family to help collect old photos and other family memorabilia. Your goal should be to track down those items from your loved one’s past that will elicit happy memories for them.
- Think about what other physical props might trigger good memories for your loved one. Are there pieces of furniture in their home or yours with an important story behind them? Maybe an old rotary phone or ice cream maker? How about an old piece of jewelry?
- Another way to help your loved one reminisce and reconnect with good times is by using their sense of smell to prompt a response. For example, if their mother baked apple and cherry pies for them as a child, recreating those scents might stimulate a response.
- Music might be another way to help you and your loved one share some memories. Track down CDs of their favorite bands from their youth. You can probably even find videos of them on YouTube.
- Don’t forget about movies they loved back in the day. Scheduling a family movie night featuring the oldies can be a good way for multiple generations to connect and share.
- Finally, consider creating a Talking Family Album or family movie that combines old and new memories. That will make it easier to visit the past together more often.
by trevor@addfuelfire.com | May 8, 2014 | Caregiving, Healthy Aging, Uncategorized
Now that the snow is finally behind us for another year, it’s a great time to head outdoors and get moving again. Older adults often see the numbers on the scale creep up during winter months. It’s often because they avoid going outdoors during a Michigan winter for fear of falling on the ice and snow. A less active lifestyle often results in weight gain. Walking has both physical and mental health benefits, as well as the added benefit of helping you safely drop those extra pounds.
Here are a few tips on how to get started with your own walking program.
Tips for Older Adults Beginning a Walking Program
- As with any form of exercise, check with your family physician before starting. Ask for their approval and any advice they can share. They will likely encourage you to begin slowly and build up your endurance.
- Invest in a good pair of walking shoes that support the structure of your foot. Everyone’s foot is shaped a little differently. If you are flat-footed or have a high arch, for example, make sure the shoe is designed to support that. It may be worth a trip to sports store at your local mall to have your foot measured and fitted.
- Set manageable goals for yourself. Unless your physician has indicated otherwise, you might want to start out with a daily 10-minute walk. Add 5 minutes at a time until you are up to about 20 to 30 minutes most days of the week.
- Be sure to stretch and warm up your muscles before you head out. This video offers some good pointers on how to warm up before and after walking.
- A pedometer or sports watch that measures heart rate and distance can help you track your progress.
- As your physician may have shared with you, the rule of thumb on how fast to walk is referred to as a “walking pace.” That means you have elevated breathing but can carry on a conversation.
- Watch your posture as you walk. Keep your head up and your shoulders back and relaxed. Your arms should hang comfortably at your sides.
- Find a buddy or two to walk with you. It is safer and more fun!
- If you are walking alone, be sure to bring your cell phone and a photo ID with you and to avoid walking in isolated areas.
After you’ve been walking for a few months, you can reevaluate your success and talk with your physician about increasing the distance or pace of your walking if you feel like you need more of a challenge.
by trevor@addfuelfire.com | Apr 24, 2014 | Alzheimer's and Dementia, Caregiving, Uncategorized
For Michigan caregivers of an aging parent or loved one with Alzheimer’s disease, one of the most frightening behaviors is an unfortunately common one. Wandering is generally believed to be a means of attempting to communicate after language skills are largely gone.
A person living with more advanced Alzheimer’s disease may not recognize their surroundings any longer. They may be trying to find their way “home” where home is a place they lived as a child or young adult. It might be that they are hungry or thirsty or need to use the restroom and don’t know where or how to find help. Whatever the reason, wandering causes stress and concern for caregivers trying to keep them safe.
5 Tips to help Michigan caregivers decrease a loved one’s wandering
What can you do to try to decrease the odds that your aging loved one will wander? Here are a few recommendations to try:
- Keep a clear path for your loved one to safely pace indoors. That means packing up throw rugs and eliminating clutter.
- Store potential “leaving cues” out of plain sight. Items like car keys, coats, mittens, and umbrellas should be kept in a closet or cupboard. It isn’t always as convenient, but it may prevent their mind from being triggered to the fact that an exterior door is nearby.
- Installing an additional lock at the top of all exterior doors might also help. As Alzheimer’s disease progresses, a person’s gaze often becomes directed down toward their feet. A lock that is located higher on the door will be out of their line of vision.
- Paint the interior side of exit doors the same color as the walls. That will make them harder to distinguish and less likely to attract attention if your loved one is seeking an exit.
- Another common strategy used in senior living communities is one that is very easy to implement at home. Consider placing STOP or DO NOT ENTER signs on the inside of exterior doors. These universal signs and symbols are recognizable to even those with advanced Alzheimer’s disease.
Prepare Ahead in Case a Senior Loved One Wanders
If the unthinkable happens and your loved one does wander away, having an emergency plan in place can minimize the time it takes to find them. Some preventative measures you can take care in case a crisis happens include:
- Always have a recent photo of them available. A digital photo that can be quickly emailed to media is even better.
- As much as you don’t want to hurt the dignity of your loved one, consider labeling their clothing with tags containing their name and your phone number.
- Don’t hesitate to call 911 as soon as you realize your loved one is missing. Every minute counts in helping them make a safe return home.
- The Alzheimer’s Association offers several GPS tracking programs you can use called, ComfortZone and Comfort Check-In. They use cellular technology to help you monitor your loved one’s location.
Are you caring for a loved one who wanders? Have we missed anything you’ve found to be of help?
