Not to be out done by the Navigator development team, the SCANS team is continuing their "rolling release" of V1.3.  SCANS is the Senior Care Navigation System that provides geriatric care managers with expert advice, best practices, and practical tools to help families with the well-being or their parents.

The June edition of V1.3 includes 26 new resources, process, or tools.  The list includes items like these:

• Death in the Home – Information for Caregivers
• Tips for Alzheimer Caregivers
• Delirium vs. Dementia
• Transitioning an Individual with Dementia into a Facility
• Member Portal Instructions
• Continence Education – Constipation
• Urinary Incontinence – When to Seek Immediate Medical Attention
• Crime Prevention Education for Older Adults
• IADL (Independent Activities of Daily Living) Education
• Physical Therapy and Occupational Therapy
• My Medicare Matters
• Advance Directives for Mental Health Treatment
• Drug Review and Side Effects
• Geriatric Friendly Pharmacy
• Medicine Reconciliation:  Brown Bag Consultation
• Feeding Tube Education
• Special Diet Needs Education
• Defibrillator Education
• Diabetes Education
• Fibromyalgia Education
• Pacemaker Education
• Physician Planner Case Note
• Alternative Living Options Education
• Speech Therapy Education
• Social Participation Barriers
• Social Support Plan

These tools are available to the clients of My Health Care Manager and our affiliates.  Some of the content is also discussed in our blogs and can be accessed for free.  Check out Natalie Langley's blog titled "Healthy Aging".  Natalie is one of the principle researchers and authors of the tools in SCANS.  Her blog covers a holistic look at healthy aging and senior well-being.

My Health Care Manager's care management system (Navigator) has just been updated to version 1.9.  This is the core system that geriatric care managers use to assist families caring for aging parents.  From past blogs you may know that this includes the assessment, care planning, implementation, and tracking support for seniors and their families.

Navigator 1.9 includes:

• Key changes for work flow
• Assessment and tracking improvements in the following dimensions:
  • Client Designees
  • Financial
  • Advance Directives
  • Engagement – Social Support
  • Provider Information
  • Medication History
  • Family Medical Health History
  • Functional Status
  • Assistive & DME Devices
  • Sensory Status
  • Nutritional Status
  • Anxiety
  • Environmental
• Reporting enhancements in areas like legal and Insurance, personal health record outputs, services listing, and more

This system is available to our clients and clients of our affiliates and partners.  We also provide much of this information in our Guide for Senior Well-being and Eldercare.  This is a self help guide is available at http://www.myhealthcaremanager.com/guide/product.asp.

As a caregiver, the responsibility for decisions regarding your parent’s care falls to you.  Often you wish you could discuss the options, choices and next steps with your parent, just as you discussed so many choices in the past…where to go to college, where to have your wedding reception, which neighborhood to select.  But parents with Alzheimer’s cannot help with current decisions as their ability to reason, compare and choose has been ravaged by the disease.  Sadly, dementia robs them of their ability to chart their own course.

So, what should caregivers do when faced with a variety of paths – how do you know how to choose what is best for your parent? How do you know when a parent’s living environment is no longer safe? How do you know when a parent needs more assistance? 

Here are a few suggestions:

• Pay attention to your parent – they may be confused, but they will give you clues when things aren’t going well.  They may seem more agitated, confused or disoriented.  Their routine may change and a situation that has worked well in the past, now poses problems.  For example, they may no longer want to eat dinner because they either can’t remember where the Assisted Living Dining Room is located, or they are afraid to leave their apartment.  
• Check in with their caregivers – have other family members, a companion, assisted living staff or adult day care workers noticed a change in your parent?  Are they concerned? 
• Take your parent in for a check-up – have the Doctor evaluate your parent and review their medications and mental and physical health. 
• Review your parent’s ability to complete Activities of Daily Living – things like bathing, dressing, continence, mobility, feeding.  Has there been a change in their ability to do these things?
• Engage a Geriatric Care Manager – have them conduct an independent assessment to provide an unbiased view of the situation.

Once you have gathered the above information, spend time thinking and talking to others you trust about the findings.  Choose the next step based on what you think is best for your parent at this moment in time.   For instance, if you determine that they need more assistance, think about the pros and cons of providing additional assistance in their current environment vs. moving them to a new environment such as a Memory Care Unit.   There is no “right” decision.  Take comfort in the fact that you have been both thorough and thoughtful when you made the decision.  Always remember that your parent is better off when you address concerns as they arise vs. postponing decisions until a crisis arises.

The SCANS content team headed by Jean Bandos along with the development team announced today that the SCANS Version 1.3 - May release is now available.  SCANS Version 1.3 is a major content release to the SCANS Knowledge Base.

In order to make more real-world tools for eldercare available more quickly, Jean and the team have devised a "rolling release".  For 3 months beginning in May another group of resources, processes, and tools will be made available to geriatric care managers at My Health Care Manager and our affiliates.

The May release contains 57 new and/or revised resources, processes and tools.  Some sample items include: 
 

• Behaviors and Alzheimer's Disease
• Grief Education
• Activities of Daily Living Education
• Depression and Alzheimer's disease
• Early Stages and Impact on Health
• Memory & Cognition Questions
• Memory Care Unit Checklist
• Memory Care Unit Education
• Mild Cognitive Impairment
• Sobriety Programs Resource
• Handyman Resource
• Private Handyman Contractor Checklist
• Smoke & Carbon Monoxide Detectors
• Daily  Money Management Education
• Financial Planning Education
• Trust Education
• Verifying Funeral Arrangements
• Veterans Benefit Information
• Elder Law Resource & Checklist
• Medication Management Procedure
• Medication Reconciliation
• Polypharmacy
• How to Find a Pain Specialist
• Pain Education
• Pain Resources
• Pain Visual Analog Scale
• Arthritis
• Heart Failure
• Hypertension Education
• Family History - Cancer Education
• Family History - Dementia
• Family History - Diabetes Education
• Family History - Heart Education
• Seat Belt Education
• Cataracts Education
• Glaucoma Education
• Hearing Aid Education
• Sensory Changes
• Assistive Devices
• Hospice Education
• Spiritual Connections

Stay tuned; the June release will include resources on incontinence, cognition, supporting services, and more processes.

Be sure to visit Jean's blog, click here.

Our Senior CAre Navigation System (SCANS) has released in a new edition - Version 1.2!
 
This version includes major extensions of the search functionality to make it easier for geriatric care managers to find specific tools and solutions.  This provides quicker access to hands on practical solutions for families caring for aging parents.  Of course, the structure and caregiver advice in each of the 25 Care Categories remains in place to assist the geriatric care manager overall care planning.

Also including in the 1.2 release are a variety new solutions, actions, resources and other content for helping with senior well-being and senior health care.

HBO is doing a documentary series on Alzheimer's starting this Sunday, May 10.  Titled 'The Alzheimer's Project', the series is comprised of four parts.

1. The Memory Loss Tapes
2. Grandpa, Do you know who I am? (with Maria Shriver)
3. Momentum in Science
4. Caregivers

There is also an accompanying book and DVD, as well as supplemental series of 15 videos focusing on the research and medical side of Alzheimer's available to stream online.

A national survey completed in conjunction with The Alzheimer's Project found that 54% of the US population has been affected by some way in Alzheimer's.  With such a huge impact on our society, I encourage health care providers, caregivers, seniors, and anyone else affected by Alzheimer's or a loved one's cognitive decline to watch this series.

The website has great information, but please make sure to ask your health care provider if you have questions.  A geriatric care manager can also help caregivers and seniors address issues associated with Alzheimer's and cognitive decline.

For more information on the series, visit http://www.hbo.com/alzheimers/index.html.
To watch the supplemental series, visit http://www.hbo.com/alzheimers/the-supplementary-series.html.

Caregivers for those with cognitive decline or Alzheimer's can find free help from their local Alzheimer's Association.  Whether you're looking for ways to better communicate with someone with Alzheimer's, ways to reduce your caregiver stress, or even seeking other local resources, the Alzheimer's Association is a great place to start your search.

Local Alzheimer's Associations often give conferences for caregivers.  Topics often covered include communication, home safety, and well-being.  Presenters have extensive experience in geriatrics and caregiving topics.  In addition, you can connect with other caregivers for support.

There will be a caregiver's conference on May 15th in Indianapolis, and I encourage you to attend.  For more information, visit the local Alzheimer's Association website. 

For information on events in your city and state, visit the national Alzheimer's Association website.

**The following post is from my guest blogger, Natalie Langley, MSW.  She is a Geriatric Care Research Analyst for SCANS (for more on SCANS, please see Eric Tinsley's blog by clicking here).**

There are several barriers that can impact the older adult’s ability to achieve good nutrition.  The following checklist can help to ensure older adults are getting the proper nutrition. 

Determine if there is a problem that impairs their ability to eat:

1. Have a physician/pharmacist review side effects of medications.
2. Are their teeth/dentures in proper condition?
3. Are there any physical limitations relating to pain and arthritis?
4. Is there a decrease in a sense of smell and taste?
5. Are finances a barrier?
6. Is their eyesight failing?
7. Do they have weakness and are not able to carry grocery bags?
8. Is forgetfulness or dementia present?

As a caregiver or an older adult, make sure to enlist people and programs within the community to help with meal assistance.  One way is to contact your local Area Agency on Aging for meal programs for older adults, such as Meals on Wheels.  This program offers deliverable meals for older adults in their homes.  For a list of local Area Agencies on Aging, you can visit www.n4a.org. 

Another good resource for meal assistance is Seattle Sutton's.  This is an Illinois based company, but they have locations everywhere.  They offer healthy, prepared meals for a reasonable price.  To find a location near you, please visit their website at http://www.seattlesutton.com/.
 

In working with seniors and their families, end of life care issues always come up.  It is a hard decision for the senior and families to make end of life care decisions, for example, whether to continue treating an illness or disease, implementing palliative care, or inserting a feeding tube.  These difficult decisions can often be made ahead of time by the individual via a Living Will.  Living Wills allow individuals the ability to document their end of life wishes, treatment preferences, and care options.  Any person over the age of 18, who is considered competent to make their own decisions, is able to complete a Living Will.  Living Will forms can be found at your local library, the internet, or an attorney's office.  Some states develop and recognize state-specific Living Will forms.  To download your state's specific advance directives form, check out Caring Connections.

The most difficult end of life decision to make is whether to insert a feeding tube or not.  A recent article from Health Behavior News Science, addresses recent studies on this issue.  For people with Advanced Dementia or degenerative dementia, the body is unable to metabolize food properly due to the brain damage.  The biggest fear for families is wondering if their loved one is "starving to death" or experiencing pain from hunger and thirst.  Hospice studies have indicated that few people experience this type of pain.  And if pain is exhibited it is often alleviated with palliative care and pain management.  In my career, I have had several physicians state that due to the brain damage and with the body going through the end of life process, that our bodies do not feel hunger or thirst.  But will we really ever know the answer to that question??  My motto as a geriatric social worker has always been, if I've made someone as happy and as comfortable as possible while they are here with us then I've done my job.  What I do know is that the decision to place a feeding tube is an individual decision and each person's situation should be considered separately.

For more information on studies, reviews of health care interventions, and evidence of clinical trials, check out the Cochrane Collaboration.

My Mother has declined precipitously during the past six weeks.  We’ve watched helplessly as her confusion increased, her mobility worsened and her sense of time and place evaporated.  Yet, a routine Doctor’s  appointment and lab work did not reveal any treatable physical changes.
Yet, everyone around her noticed the decline – my sister, the companion, her Health Care Manager (a geriatric care manager from My Health Care Manager) and the nurses at the Assisted Living facility.  We were saddened to see my Mother struggle with this new stage of life and worked together to offer additional support.  We all ASSUMED that this was the natural progression of the dementia.

Our Health Care Manager was puzzled by what my Mother was experiencing.  She had worked with many, many seniors and felt that my Mother’s cognitive decline did not fit the typical pattern.   She felt that the changes my Mother started to experience happened overnight vs. being a gradual process.  It bothered her, so she sent a letter to my Mother’s physician and explained her concerns.  This led to a conversation between my Mother’s Doctor and the Health Care Manager.  As they reviewed my Mother’s case, a light bulb went off.  My Mother had a medication change in December….was it possible that the med change was negatively affecting her current physical and mental state?   Was it possible that the changes we’d noticed were not necessarily caused by the next stage of the dementia, but a medicine interaction? 

Thanks to the Health Care Manager’s detective work and follow up with the health care provider, we’ve stopped the new medicine that was added to my Mother’s care plan in December.  We have our fingers crossed that we will see a difference and that some of the decline will be reversed.  It is possible that there are other causes – a series of small strokes, for example.  But for now, we are addressing what the Doctor thinks is the most likely cause.

We’ve learned a good lesson.  Never assume that even small changes are “normal” …question everything!  And seek professional help whenever necessary. 

 

A number of people have been asking me about starting a Personal Health Record(PHR) with Google Health, Microsoft Vault, or other free tools.  The question eventually cycles around to, "Why would I pay for a PHR when I can get one for free?"

Good question.

Of course, the answer is as old as the health care business itself.  "There's no such thing as a free lunch" ... or even a free PHR.  It's simply a matter of what you are willing to trade for the service. 

If you build your own PHR you have to take extra time to build, maintain, and even think through all the necessary information to collect.  Likely you have to type everything by hand rather than pulling from medical records, pharmacy records, or other sources of ready data.  What you are "paying" is your time and what tools you decide to use.

I the case of Google Health of Vault you are "paying" with your personal information.  In particular, detailed information about your medical conditions, treatments, and health situation.  If you are caring for aging parents you are trading their information.  What you get in return is the result of hundreds of thousands of dollars of development and though.

But, where did all the development money come from?  Where does the money come from to pay for the computers, bandwidth, and support staff?  It comes from advertising dollars aimed directly at you, your parents, or you as a caregiver.  These advertisers love the idea of being able to get directly at you and the health problems you or your parents face.  Not all bad, really... but no so good either.

The other model of course is to pay for a PHR application yourself and eliminate the need for a "third party payer".  In this case, of course, you are paying with an annual or monthly access fee.  This is also true if you are using a geriatric care manager or other provider of eldercare services who is using a system on your behalf.

There isn't a right answer.  You simply have to evaluate the trade off between your time, your private health information, or your money.

**The following post is from my guest blogger, Natalie Langley, MSW.  She is a Geriatric Care Research Analyst for SCANS (for more on SCANS, please see Eric Tinsley's blog by clicking here).**

If you are a veteran, a surviving spouse of a veteran, or a caregiver of a either, I'm sharing some important information on veterans benefits today.  Veterans or surviving spouses of veterans who may now or in the future need caregiving assistance in the home, assisted living, or long term care facility you may be eligible for the Aid and Attendance Benefit.  Veterans Financial (not affiliated with the Veterans Administration) is an organization that can help veterans and their families obtain any eligible benefits.  Veterans Financial is accredited by the Better Business Bureau (BBB). 

The Aid and Attendance benefit is a benefit paid in addition to a monthly pension.  You may be eligible for the Aid and Attendance benefit if the veteran or the surviving spouse:

• Requires the ongoing aid of another person (caregiver, home health aid, or another) in order to perform basic personal functions required in everyday living (i.e. bathing, eating, dressing, etc.)  -OR-
• Is bedridden  -OR-
• Is a resident in a long term care facility or nursing home due to cognitive or physical incapacity    -OR-
• Is blind, or nearly blind

For more information on Veterans Financial, Inc. please visit:
www.veteransfinancial.com or contact them at 800-835-1541.

Remember Hillary Clinton’s book It Takes a Village which was written to address caring for children?  I find this same approach applies to the senior population.  It really does take a group of people, making a concerted and coordinated effort, to assist seniors as they age.  It takes time and careful thought to build a “village” for your parent.  Following are a few ideas to help you get started:

• Family – Primary:  spouse (if living), brothers and sisters, children, grandchildren, great grandchildren
• Family – Secondary:  nieces, nephews, cousins
• Friends: lifelong friends, new acquaintances, neighbors, club associates, church members
• Health Care Providers:  Primary Care Physician, Specialty Physicians, Physical Therapists
• Geriatric Care Manager:  Professional (typically nurse or social worker) to provides care advisory/advocacy  service addressing  specific needs of senior
• Companion:  Paid caregiver to provide services as needed:  cooking, transportation, companionship, assistance with activities of daily living
• Skilled Care:  Paid clinical care provided by licensed practitioners
  Independent Living or Assisted Living Facility Staff:  Nurses, administrators, social workers, certified nurse assistants

Care assistance and expertise is available from many sources.  Plan your village now - don’t overlook the many ways a support system can be built for your parent.   
 

There are many drug-free (non-pharmacological) options that have been proven to help relieve certain types of pain, which could be from arthritis, chronic pain, or another chronic disease. These techniques can help complement the pain management medications prescribed by your doctor.
1. Apply heat or cold to the affected area
2. Ask your geriatrician or health care provider about specific exercises to help with pain
3. Find something that distracts you such as music or a hobby
4. Practice relaxation or deep breathing techniques
5. Massage or vibration can help relax you and may relieve the pain
6. Applying pressure to the area that is in pain
7. Find support groups or someone to talk with
8. Modify your environment so that it is more comfortable for you
9. Plan activities earlier in the day when pain is sometimes not as bad
10. Learn how to manage pain- learn what triggers it, what makes it worse, and what makes it better
11. Consider keeping a journal of when pain occurs and what helps relieve it
 
If you are not sure of how to use these techniques ask your health care provider and/or discuss with your Health Care Manager.  If you're a caregiver, you can discuss these options with your aging loved one and have them work with their health care provider to integrate the techniques into daily life.

A friend forwarded an email recently about something called the "Wellness Wizard".  This is system for automated reminders.  The caregiver records messages to be played at specific times and dates.  The idea is to provide reminders about medications or important appointments.  It also provides a mechanism for the senior ask for help from caregivers.

All-in-all this tool probably has some utility.   It's relatively inexpensive and could help people caring for aging parents who live independently feel more comfortable about their parent's situation.   

The only part of this that really bothered me was the claims about this product.  The company claimed it would:

• decrease avoidable readmissions
• maximize the well-being of their loved one
• reduce caregiver stress
• and more

The product can contribute to these, but it's really a stretch.

The truth is, it takes a coordinated effort.  Eldercare is not a tool.  Tools can only help.  Be wary of "over sell".  There's nothing that can replace a caregiver's involvement.  Even a geriatric care manager still needs the connection with family. 

Care managers and tools for eldercare can save time, improve situations and even well-being, but they are aides not replacements.

**The following post is from my guest blogger, Natalie Langley, MSW.  She is a Geriatric Care Research Analyst for SCANS (for more on SCANS, please see Eric Tinsley's blog by clicking here).**

Where can I go to find the right doctor for me?

Finding the right physician is one of the most important health decisions you will make.  Whether you do not currently have a doctor or you are unhappy with your current doctor, there are several resources available that can help you find the right health care provider for you.  To start, you want to make sure the physician you choose is in your insurance network.  If not, you may call the insurer and ask if they would consider adding this physician to their list. Whether you are a senior looking for yourself or a caregiver looking for your aging loved one, the following is a list of helpful websites for locating a physician. 

American Medical Association 
www.ama-assn.org   

National Institute on Aging – Age Page on Finding a Physician
http://www.nia.nih.gov/NR/rdonlyres/67530CA6-7AC1-4C45-BB8D-27D0E3C54A65/7441/Choosing_A_Doctor.pdf

American Board of Medical Specialties
www.abms.org 

American College of Surgeons
http://www.facs.org/public_info/yourhealth/findadoc.html

Diabetes and Heart/Stroke Physician Recognition Program
http://recognition.ncqa.org/

Healthfinder
www.healthfinder.gov 

Medline Plus
www.medlineplus.gov

American Geriatrics Society Foundation for Health in Aging
http://www.healthinaging.org/public_education/physician_referral.php
 

**The following post is from my guest blogger, Natalie Langley, MSW.  She is a Geriatric Care Research Analyst for SCANS (for more on SCANS, please see Eric Tinsley's blog by clicking here).**

Bathing is a challenging task in Alzheimer’s care with which caregivers have trouble.  I’ve heard caregivers say their loved one just refuses to take a shower or becomes agitated in the bathroom.  Many caregivers become frustrated because they know their loved one hasn’t showered in days and is still wearing the same clothes. 

One thing we have to remember is that as the disease progresses, the person is losing brain cells and cannot remember short term events.  Often, they are placed in big showers where water is coming down at them.  They are scared because sometimes they do not even know what water is - much less what is going on.  The bathing experience can often be very frightening for the individual. 

I would like to share some tips that may be helpful in getting your aging loved one with Alzheimer's to bathe.

1. Keep the bathroom warm and inviting. 
2. Refer to the shower the way the individual with the disease refers to the shower.  Generations ago, people referred to taking a shower as “washing up”, “the wash room”, “sponge bath”, etc.  Rather than saying, “OK, Mom, it is time for your shower”, say “Mom, let’s go wash up before dinner.”  Learn what they called the shower back when they were younger, because they may be more likely to understand you if you use those terms.
3. Provide towels for them to cover up for privacy and warmth during the bathing process.
4. If they did grow up using sponge baths, try using that method.  Even though it may not be the method you use, that may be what the person with Alzheimer’s remembers and understands. 
5. If the person doesn’t want to shower because they don’t want to change their outfit, buy several of the same outfits in the same color so they will be able to put the “same” outfit back on after they are clean.
6. Include the person as much as possible during the bathing experience.  Give them a washcloth to hold on to.  This will allow them to think they are a part of the process. 
7. Fill up the tub with only a few inches of water.  Make sure the water is not too hot – their skin may be more sensitive.
8. Use a handheld shower head and make sure the spray is not too intense.  The harder the water comes out, the worse it could feel on their skin (since it may be sensitive).
9. Offer praise to the person for their efforts in helping
10. Have activities ready if the person becomes agitated, such as playing soothing music or singing their favorite songs. 
     

Natalie, one of your key researchers, just let me know about a long list of materials released to SCANS.  In previous blogs I mentioned the development that is underway for SCANS, but we are also improving the Knowledgebase of the current production release. 

Here is a sampling of some of the new material available to geriatric care managers and the families they are helping:

My Medicare Matters	Insurance – Resources
On-line Services at the Social Security’s Website	Financial – Resources
Food Pyramid for Older Adults	Nutrition
How to Find a Geriatric Physician – updated	Provider Coordination  - Protocols
How to Locate a Neurologist	Provider Coordination - Protocols
How to Locate a Speech Therapist	Service Coordination - Protocols
DME Resource – Updated	Communications, Continence, Environmental, Functional health, Physical Health, Sensory
Caregiver Support Resources – Updated
Pet Plan	Social
Tips on getting an older adult to the doctor when they refuse	Provider Coordination
How to locate a Urologist	Provider Coordination – Protocols
How to locate a Audiologist	Provider Coordination – Protocols
Medical Transport Services	Service Coordination - Protocols
Home Modification Resources	Environment
Tips to a Successful ER Visit	Service Coordination
Veterans Benefits Information	Financial

When our weather changes,  everyone is worried about the “winter dangers”  such as broken bones from falls on ice (especially for older adults with mobility issues) or breathing problems caused by cold air, but cold weather is very risky for older people. The winter chill can lower the temperature inside the body and that can be deadly if not treated quickly.  A dropped body temperature, hypothermia, can be caused by staying in a cool place.  The normal body temperature is 96° F and it only takes a couple of degrees below the body’s normal to be dangerous such as causing an irregular heartbeat leading to heart problems and death.

It is very important for a senior to know his/her surroundings and prepare for the winter months.  Changes in the older adult that accompany aging make it harder for them to know when they are getting cold.  It is also harder for the body to warm itself. So it is very important for older adults to pay attention to the weather and how cold it is going to get.

Some general safety recommendations from the American Geriatric Society are:

1. Stay indoors when it's very cold outside, especially if it's also very windy; and keep indoor temperatures at about 65 degrees or above
2. If you have to go outside, don't stay out in the cold or the wind for very long
3. Wear two or three thinner layers of loose-fitting clothing. (They are warmer than a single layer of thick clothing.) Always wear: a hat, gloves or mittens (mittens are warmer), a coat and boots, a scarf to cover your mouth and nose and protect your lungs from very cold air
4. Stay dry; wet clothing chills your body quickly
5. Go indoors if you start shivering- it's a warning sign that you're losing body heat.
6. Know the warning signs of hypothermia: lots of shivering; cold skin that is pale or ashy; feeling very tired, confused and sleepy; feeling weak; problems walking; slowed breathing or heart rate. *Note: Don't rely on shivering alone as a warning sign, since older people tend to shiver less -and some, not at all-as their body temperature drops. Call 911 if you think you or someone else has hypothermia.

For safety reasons, remember: stay warm, keep your thermostat set above 65, and have a plan if you lose power. 

**The following post is from my guest blogger, Natalie Langley, MSW.  She is a Geriatric Care Research Analyst for SCANS (for more on SCANS, please see Eric Tinsley's blog by clicking here).**

Brrr, its cold outside, what can we do?

The winter months are often a barrier when it comes to being able to go outside and enjoy the weather.  For seniors, this can restrict the ability to go outdoors for exercise and entertainment.  Caregivers may be struggling to find activities for their loved ones to keep their spirits high during the winter months and avoid isolation.  Below are some helpful ideas to help keep your aging loved one engaged.

• Reminisce with the person.  Take out vacation, family, or wedding photo albums, and share memories
• Watch classic movies
• Play games or cards
• Invite friends/family over for tea and snacks
• Visit the library
• Have the health care provider recommend simple exercises for your loved one, which could help improve balance and mobility 
• Attend a musical/play
• If arts and crafts are interests, go to the craft store and start a project (sew a blanket, paint a picture)
• Play CDs of all the person’s favorite songs