Technology is being developed in a variety of areas to assist in geriatric care. Significant efforts are underway in both the consumer and professional markets. Already these efforts are bearing fruit. You can read about some in my earlier blogs and I'll be highlighting others in the coming weeks.
Let's start the discussion with some categories. Technology is entering the the consumer side of eldercare both in the home and on the Internet. This work could be grouped as follows:
In Home:
Consumer Products
On the Internet:
- Family Communication
- Wellness and Assistance
Health Products
- Services
- Diagnostics Reporting
Safety
- Monitoring Services
- Products
Research Initiatives
- Continuous Monitoring – Automatic Detection
- Decision Support
Person Health Records
- Microsoft Vault
- Google Health
- Hundreds of Others
Medical and Non-Medical Information
- Health Sites
- Support Group Sites
- Commercial Sites
- By 2030 the population of seniors in the United States will be 71.5 million, more than doubling in just 30 years - Department of Health and Human Services, Administration on Aging, 2006.
- 24 billion hours were spent in caregiving in 1997. - Arno PS, Levine C, Memmott MM. The economic value of informal caregiving. Health Affairs. 1999
- In 2006, productivity loses to U.S. business were estimated at $33.6 billion. Nearly 80% of these caregivers, were caring for someone over the age of 50 - The MetLife Caregiving Cost Study: Productivity Loses to U.S. Business. MetLife Mature Market Institute and National Alliance for Caregiving. 2006.
You can see from these statistics caring for aging parents is big and growing problem. It also too big to expect health care providers to provide the solutions. Caregivers themselves are going to be overwhelmed, as well. On a personal scale many are already.
Technology can help and may be the only way to cope with the growing issues.
After posting my blog yesterday about caregiver stress, I discovered that Dear Abby just gave advice to a stressed-out reader on the 10th (read the letter by clicking here). The letter was from ‘Overwhelmed in Cincinnati’, who is struggling to balance her roles as a caregiver for her mother, who has Alzheimer’s, and a mother of three – while also juggling a career. She feels she’s in over her head with worries about her mother’s safety, well-being, and financial considerations.
Dear Abby wisely referred ‘Overwhelmed’ to the Caregiver Stress Check from the Alzheimer’s Association (www.alz.org) that I mentioned in my blog yesterday. If you’re a caregiver, please remember the importance of taking care of yourself. If you are experiencing a lot of stress, take the quiz here. Your local Alzheimer’s Association, health care provider, or a geriatric care manager are all good resources to help you manage your responsibilities and reduce your stress.
During this Holiday season, learn how you can recognize the signs of caregiver stress. If you are a caregiver, it's important to take care of yourself. The Alzheimer's Association has information specifically for caregivers or those with Alzheimer's Disease and dementia. Take the Alzheimer's Association Stress Quiz and learn how you feel. Then review resources, many of which can be found through the Alzheimer’s Association. There is a special web page filled with helpful tips to make the holidays less stressful for families coping with Alzheimer's. Caregiving is stressful anytime of the year.
If you answer YES to more than two of the following questions you may want talk to your physician.
Y N I don’t get enough sleep.
Y N I get too much sleep.
Y N I have recently experienced unplanned weight gain or loss.
Y N I feel tired or without energy most of the time.
Y N I don’t have much interest in activities I used to enjoy, such as
reading, walking, or visiting with friends.
Y N I am easily irritated, angered, or saddened.
Y N I have frequent headaches, stomachaches, or other physical
problems.
Remember this holiday season to take care of yourself – Make YOUR health a priority by following these tips:
- Get adequate rest.
- Exercise most days of the week.
- Eat a low-fat diet rich in fruits and vegetables.
- Participate in social activities—they can help you feel connected and may
actually reduce stress. - Keep in touch with friends and family.
- Find out what community resources are available to you.
- Ask for and accept help.
- Establish a routine. Prioritize and make lists.
- Look to faith-based groups for support and help.
- Visit your health care provider or doctor for a checkup if you are having physical problems.
The bottom line is that my Mother suffers each time staff turns over. Caregivers suffer too, as they are concerned about lapses in care and frustrated by dealing with the same issues over and over. It doesn’t seem that it should be that difficult to get the laundry done….esp. when the facility is charging $5K a month.
Turnover is a problem for everyone. Number one – it impacts care. Number two – it is time consuming to constantly readdress the same issues. Number three – it can’t help but influence staff morale which can affect actions and attitudes during daily resident interactions.
Based on our experience, I would definitely ask questions about management and staff turnover when touring Assisted Living Facilities or other senior residences. If the number seems high, think seriously about how this will affect your parent’s care and well-being. The most beautiful building in the world won’t make up for a breakdown in staff communication, training and service delivery.
"Caring for an older adult can be rewarding and fulfilling but can also place great physical, emotional and financial demands on those who take care of them. In fact, a recent issue of the Journal of Immunology compared Alzheimer’s caregivers to non-caregivers, finding that caregivers aged between four and eight years faster than non-caregivers. In light of these statistics, and in recognition of November as both National Alzheimer's Disease Awareness Month and National Family Caregivers Month, the American Occupational Therapy Association (AOTA) is offering tips for caring for the adult caregiver.
Research recently published in the American Journal of Geriatric Psychiatry tested an occupational therapy home intervention, the Tailored Activity Program (TAP), that systematically evaluates and tailors activities to individual capabilities and trains families in setting up and using activities in daily care. TAP reduced behaviors that trigger nursing home placement and the amount of time families spent supervising and providing care.
“Our research shows that occupational therapists play a critical role in the care of individuals with dementia and their family caregivers,” said Laura N. Gitlin, Ph.D., director of the Jefferson Center for Applied Research on Aging and Health and professor in the Department of Occupational Therapy at Thomas Jefferson University. “Occupational therapy practitioners are uniquely qualified to evaluate individual capabilities, engage individuals with dementia in activities, help families learn specific communication, task and environmental simplification strategies and to take care of themselves.”
Laurel Cargill Radley, MS, OTR, associate director of professional affairs at AOTA, adds, “Occupational therapists can help individuals and their families promote or maximize independence, safety and function.”
Occupational therapy practitioners recommend adult caregivers:
1. Join a therapy or discussion group for caregivers of older adults.
2. Share the responsibility of caring for an older adult.
3. Ask others for help.
4. Develop a schedule that distributes caregiving responsibility.
5. Consider adult daycare or home health aides to provide occasional breaks to full-time caregivers.
6. Create moments of joy throughout the day by participating in pleasurable activities.
Additional caregiver resources can be found on the Centers for Medicare&Medicaid Services’ (CMS) new Web site, http://www.medicare.gov/caregivers/.
Founded in 1917, the American Occupational Therapy Association (AOTA) represents the interests and concerns of more than 36,000 occupational therapists, assistants and students nationwide. The Association educates the public and advances the profession of occupational therapy by providing resources, setting standards including accreditations and serving as an advocate to improve health care. Based in Bethesda, Md., AOTA’s major programs and activities are directed toward promoting the professional development of its members and assuring consumer access to quality services so patients can maximize their individual potential. For more information, go to http://www.aota.org/."
This article was originally published by the American Occupational Therapy Association.
NFCA is hosting a free family caregivers teleclass to teach family caregivers how to improve their communication with healthcare professionals and become better healthcare advocates for themselves and their loved ones. The 2-hour teleclass is being held November 6 and 13 at 2:00pm EST. More information on the free teleclass is available here.
Check your local Alzheimer's Association chapter, Area Agency on Aging, and local senior community for caregiver events in your area.
A recent New York Times article highlighted the negative impact of “elderspeak” on the mental health of older adults. The term “elderspeak” was defined as “the sweetly belittling form of address that has always rankled older people.” I decided to find out if lawyers thought this was a problem and I received the following response from a 76 year old lawyer, which says it all. I will change his name to Joe Smith to protect his identity.
At my age (76), I resent being called "Joe" by younger health care workers,
so I correct them "It's Mr. Smith to you." Now, in restaurants when the waitress calls me "sweetie" or "honey," I don't take offense - they don't know my name. What "bugs" me is when a waitress says to my wife and me, "What can I get for you guys?" I gently remind her that there is only one guy present.
One time I took one of those "sweet young things” (a Purdue student) aside
and told her, gently, that she could increase her tips by not calling old people
"guys," and that if she wanted to call a booth of youngsters "guys," they
probably don't mind (they don't tip very much anyhow). She seemed to really
appreciate my suggestion.
What really gets me is when a particular younger usher at church greets
me with a handshake and says, "How are you today, young man?" Every
time, I remind him that I am an old man, but he persists. So, I think I'll use
a different entrance from now on!!!!
The article itself is worth reading and may be found at http://www.nytimes.com/2008/10/07/us/07aging.html?_r=1&oref=slogin
As a state affiliate of the American Geriatrics Society, IGS was created to enhance the visibility of geriatric medicine in Indiana, to provide local educational programs in geriatrics, and to provide input to the national organization on policy issues. This all-day conference demonstrated the intent of the organization. For more information on Indiana Geriatric Society, contact Kathy Frank RN, DNS, Geriatrics Program Administrator and the IGS COSAR representative for AGS at katfrank@iupui.edu.
Medicare Prescription Drug Coverage (or often referred to as Medicare Part D) covers prescription drugs and may help lower a person's prescription drug costs and helps protect against future higher costs.
So how does a senior know which is the best prescription drug plan for them? A plan that has low premiums for the most coverage is ideal. There are several ways a person can evaluate their current plan or search for alternative plans. One way is on the internet at www.medicare.gov. This website allows individuals the opportunity do a personalized search, which allows the person to enter in their personal information and their prescriptions; or by doing a general plan search, which allows people to search and review plans. Navigating this website can sometimes be tedious and overwhelming, especially if multiple plans show up as alternatives...how do you choose? The positive is that the website will list the plans in graph format in the order of most coverage to least coverage, just watch for premium costs. Another way to evaluate your current plan or search for an alternative plan is to have your local pharmacist run your prescriptions in the Medicare system for you. Another suggestion is to consult a professional care manager or medical social worker for guidance. I do not suggest calling Medicare directly....I don't think I've ever talked to a human being on that phone line and callers are usually on hold for long periods of time.
In addition to caregivers having to shoulder the work load of the growing senior population, they are also naturally more engaged in caring for aging parents than health providers for most time their parents face the challenges of aging.
If you create a "smoothed" picture of the health challenges faced by older adults, you get a continuum like the one shown below.
The health care providers only intersect with the caregiving need at the green arrows for acute or assistive care. The vast majority of the continuum is addressed by family caregivers who are typically not trained health professionals. These caregivers need support tools and services to provide the best quality of life for their parents and themselves.
I wanted to share a few thoughts from the conference. We are facing a serious problem in our Heath System. The growing population of seniors, their expected longevity, and the small number of health care professionals entering geriatrics or even primary care make for an alarming future. Health care providers simply won't be able to keep up.
This means that families will need help with aging parents. That help will come from caregivers. Most will be family members and some will be professionals such as Geriatric Care Managers, companions, and other eldercare service providers.
These caregivers (especially the family members) need more tools, more resources, and more expertise. Most will not be trained health professionals and many will be caring for an senior for the first time.
I have the privilege of speaking tomorrow (October 10, 2008) at the Indiana Geriatrics Society Fall Conference. My topic is:
Vision for the Future: Impact of Informatics on the Continuum of Caregiving
At the core of the material I'll be covering I want to share ideas about how technology can improve the lives of seniors and the caregivers around them.
This in not only a desirable thing; it is a necessary thing. By 2030 the population of seniors in the United States will be 71.5 million, more than doubling in just 30 years according the Department of Health and Human Services, Administration on Aging, (2006).
The truth is that there are not enough senior health care professionals, continuous care retirement communities, or even professional geriatric care managers to provide complete and meaningful support for all these seniors. Caregivers dealing with aging parents or other loved ones must have tools that do not rely exclusively on the individual people from provider community.
After the conference tomorrow, I'll share more on these ideas.
For a complete program on the IGS Fall Conference follow this link http://iucar.iu.edu/igsfall2008.pdf
Alzheimer's Disease is the 6th leading cause of death in the U.S. There is no current cure for Alzheimer's but researchers are hopeful and continue to make great strides in treatment options and working towards finding a cure.
I encourage everyone to participate in your local Memory Walk. For more information, check out the national Memory Walk website to register for a walk or to donate.
In today’s society, we value independence… and part of that is being able to jump in our car and go where we need to go. A major challenge for older adults who are unable to drive is feeling that they have lost some of their independence. As times are changing, older adults’ schedules are becoming busier than before. Whether it is picking up the grandkids, going to the doctor, beauty shop, or senior center to play cards, etc. older adults are not just sitting at home anymore. However, older adults who are living independently and are unable to drive can still get to where they want/need to be in their community. There are resources in our communities that do just that. The following are some good resources that will help connect older adults to local transportation resources while still living at home. Happy traveling!
Area Agency on Aging office – Search by state and find the closest office nearby and contact the Area Agency on Aging to learn about transportation resources locally. (http://www.n4a.org/about-n4a/?fa=aaa-title-VI)
AARP: State-by-State Guide to Transportation Assistance
(http://bulletin.aarp.org/yourworld/gettingaround/articles/state-by-state_guide.html)
1. Higher housing costs and the nation's current economic status
2. Families are closer now than in the past
3. Intergenerational households are increasing each year
The number of parents under the age of 65 that moved in with family grew 75%. I recently read an article that stated 60 is the new 40. Becoming a grandparent at a younger age is growing. Some parents are moving in with their children to help raise and care for the grandchildren. This concept gives the grandparent a "job" and responsibility while contributing to the family and takes away the cost of daycare. Combining family resources is helping families and their expenses while also providing assistance, a stronger family bond, and preserving memories.
So pull out the sofa bed, clean out the guest room, or build on a small apartment cause mom may be moving in! ECHO Housing is becoming more popular, Elder Cottage Housing Opportunity, sometimes coined "granny flats" or "mother-in-law suites". This refers to a housing opportunity for seniors to share a separate living space on the same property or attached to a family member's home. This concept brings parents closer to their families while also maintaining a sense of independence. Zoning regulations do apply, so check with your local county or city zoning board. For more information, check out ECHO Housing.
For the past year, I have been doing my Mother’s laundry. In the beginning I did everything – sheets, towels and personal laundry. Soon that became too much – and I made arrangements for the Assisted Living facility to wash the sheets and towels. But, I still did my Mother’s personal laundry because she did not want other people “touching” her things.
This plan worked at first, but proved to be very time consuming. It seemed that I was always behind on laundry. I tried putting loads in before work and drying them when I got home at night. I tried doing multiple loads on a Saturday AM. I tried picking it up from my Mother more frequently and doing smaller loads at a time. I tried multi-tasking by doing laundry and paying bills in the same evening. But the laundry was ever present and the pile seemed to grow each day, despite my best efforts to take control of a seemingly easy task. My frustration piled up too.
I finally accepted the fact that “doing the laundry” was a task that could easily be done by someone else. All I had to do was convince my Mother that someone else could do it too. First, I talked with the administrator at the Assisted Living facility. I learned that they could do the laundry and that they did each resident’s laundry separately. They also used the detergent provided by the family, so that the laundry did not come out with an industrial smell and feel. Finally, I had a frank discussion with my Mother and told her that I was having a difficult time finding the time to do her laundry and tote it back and forth. I suggested that we “try” having her clothes washed on site.
Thankfully, she agreed and so far so good. I have been “laundry-free” for two weeks. I cannot begin to describe how getting rid of this chore has improved my caregiving outlook. My Mother has adjusted very well to the new arrangement.
My advice to all caregivers is to evaluate the many tasks on your plate and try to find ones that can be done by others. Whether it is laundry, grocery shopping or driving a parent to a weekly physical therapy appointment – enlist or hire someone else to assist with these tasks. You will be so glad you did. You will be better able to face the next caregiving challenge because your reserve of time and patience has not been depleted by routine tasks.
- Search Capability for Issues, Solutions, and Resources
- New Resources and Tools for the following:
• Alcoholism
• Suicide
• Pressure Ulcers
• Falls
• Confusion and Alzheimer’s disease
• Hoarding behavior and Alzheimer’s disease
• Sun-downing and Alzheimer’s disease
• Wandering
• Prescription Drug Abuse
• Transportation resources for both FL and IN
• Resources by state
• Alzheimer’s disease resources
• Malnutrition info
• Cultural
• Spirituality
• Long Term Care Insurance
• Nutrition and Osteoporosis
• Nutrition and Cancer
• Nutrition and COPD
• Dehydration
• Oral Health for Older Adults
• Nutrition and Vitamin B-12 deficiency
• Beliefs and Practices
According to a recent study, more than 1/2 of those providing care to an aging adult experience some form of stress and strain. This amount of stress can negatively affect your physical health, your emotional health and well-being, and your ability to provide care. Taking care of yourself, taking breaks when needed, and utilizing the help of others is very important! Some caregivers have been taking care of "mom" for years and oftentimes other family members forget how hard the caregiver is working, because it just becomes second-nature that you take care of mom. I would like to take the time to say THANK YOU and shower all caregivers with applause and praise for their tremendous hardwork for being a caregiver of another person while still maintaining their own lives, jobs, children, etc. I love greeting cards, and I tend to spend quite a bit of time finding that right card for that right person. A friend recently found a Caregiver Support greeting card, made by Carlton Cards...but only 1 card in a store full of every other kind of greeting cards, doesn't seem quite right. However, the card reads, "The dedication and strength it takes to care the way you do is truly amazing. It's hard giving so much of yourself, and yet you do so generously and lovingly. You have a beautiful, caring heart - and you're doing a truly incredible job. Hope you know what a difference you're making. Hope you know how wonderful you are."
THANK YOU FOR BEING A CAREGIVER!
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Eric Tinsley
George Slater
