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One challenge to Aging Gracefully occurs when we must take responsibility for caring for an ill spouse or parent. We can become so engrossed in caring for our loved ones that we lose sight of caring for ourselves. This is a significant problem in communities all over the country. In order to be good caregivers, Family Caregivers must look after themselves and find a good balance between caring for their loved ones and their personal lives. Here are a few tips to help reduce Family Caregiver Burnout:

• Start smart by setting limits for yourself. Let your loved one know what you are capable of giving in terms of time and assistance, and discuss the options available to make sure they feel safe and secure while you do the things necessary to maintain your health and positive attitude.
• Make occasional time for fun and social interaction. Take time out to enjoy yourself and participate in healthy activities like walking or an exercise class, or take a day trip once in a while.
• Have a friend over or make time each day to chat with friends or family on the phone. Even brief talks can lift your spirits. This sounds simple but can help greatly in not developing feelings of isolation and depression.
• Find quiet, meditative times to clear your mind throughout the day. Engage in prayer or meditation, listen to soothing music, or simply breathe and relax.
• Eat nutritious food and exercise regularly. Keeping up with your health will help combat stress and boost your mood.
• Talk about it. Join a caregiver support group in your area to be able to share your thoughts, feelings and information with others in similar circumstances.
• Feelings of guilt sometimes prevent Family Caregivers from adequate self-care. These are feelings that are best addressed in a support group or with friends, instead of allowing them to dicta
• Occasional or regularly scheduled In-home Respite Care can give you the breather you need. This will provide free time for errands and personal time, while also providing a Personal Attendant for brief periods of personalized care and attention for your loved one.

Making time to take care of yourself is NOT selfish. It is an important aspect of the care you provide to your loved ones. If you are able to stay healthy and maintain a positive attitude in caring for your family, EVERYONE benefits. If you would like to receive more information on Respite Care to help you lead a more balanced life as a Family Caregiver, contact Central Coast Senior Services at 831-649-3363.

The single most frequent reason that seniors seek home care is that there has recently been a fall. If the senior was lucky, there was no injury. However, what seemed like a minor fall can sometimes result in a severe injury such as a fracture of the hip, pelvis or femur requiring a hospitalization that can lead to other debilitating health problems.

Until it happens to you, most people do not contemplate falling down. Why would you? Walking is such a normal part of life that until we have an injury or a surgery, we take it for granted.

Smart planning for Aging In Place requires you to give Fall Prevention some thought. Balance declines with age, and many factors contribute toward making older adults susceptible to falls.

These include:

• Impaired hearing and vision;
• General loss of muscular strength and tone; Arthritis;
• Osteoporosis (Many people think osteoporosis is only a problem for women past menopause, but it can also affect older men);
• Vertigo;
• Cerebrovascular insufficiency;
• Neurologic disabilities such as a past stroke, Multiple Sclerosis, Parkinson’s Disease, or Dementias;
• Postural hypotension (sudden decrease in blood pressure).
• Sometimes a newly prescribed medication may cause dizziness.

Doing things like getting together with friends, gardening, walking, or going to the local senior center are important for staying healthy. The good news is that there are simple ways to prevent most falls. By taking care of your overall health, you may be able to lower your chances of falling.

In general, you should stay physically active within your abilities, but also seek to gently challenge your abilities so that you maintain them. Regular walking improves your muscle strength, and keeps your joints, tendons, and ligaments flexible. Yoga is wonderful anti-aging medicine. Many local yoga schools have seniors who are maintaining their strength, balance and flexibility through yoga classes.

It can be useful to consult with a Physical Therapist to receive an exercise prescription that is suitable for current state of strength and health. The therapist can identify areas of weakness and imbalance that you are able to strengthen through specific exercises.

A Fall Prevention Assessment from our Home Care Coordinators will provide you with the information you need to plan for either minor or major adjustments to your home.

To receive more information on Fall Prevention and Aging in Place, call Central Coast Senior Services, Inc at 831-649-3363.

 

Caring for an elderly or disabled loved one can be highly demanding and stressful for family caregivers. Many caregivers allow stress to become a way of life in their effort to provide constant, absolute care no matter what. However, people who permit themselves to live under the continual stress and anxiety of caregiving without respite end up paying the price both physically and psychologically.

Chronic stress can lead to serious health issues such as:

• High blood pressure
• Suppressed immune system
• Increased risk of heart attack or stroke
• Anxiety and depression

That’s why it is important to recognize the signs of caregiver burnout before you become overwhelmed. Take a moment to ask yourself the following questions:

• Have you stopped participating in activities that you once found pleasurable?
• Do you feel tired all the time?
• Are you angrier than usual? Do you feel irritable often?
• Are you coming down with illnesses more frequently than normal?
• Do you feel sad often or have feelings of hopelessness or helplessness? Do you cry often?
• Are you spending less and less time with family and friends?
• Do you have anxiety or panic attacks?
• Do you constantly feel overwhelmed and worry how you will manage?
• Do you have feelings of wanting to harm yourself or the care recipient?

If you answered ‘yes’ to several of these questions, it is time to seek help for caregiver burnout before it harms your health.

Central Coast Senior Services can help give you the break you need while providing outstanding respite care for your loved one. Let us put your mind at ease today. Contact us at 831-649-3363 to find out more about our services.

Medications for Depression in Late Life

by Robert Dolgoff, MD

Medical Director, Mental Health Services, Alta Bates Summit Medical Center

Medical Director, Berkeley Therapy Institute

Reprinted from Engaging Aging e-Newsletter, May 2011, Pages 4-5

To subscribe to this newsletter: mail to: jisrael@berkeley.edu with “subscribe newsletter” on the subject line.

Anyone can get depressed at any time in life. Most people don’t realize that the rate of depression in seniors living in the community is rather low – most seniors living at home, especially if they are physically healthy, report that they are more content and happy than at any other time of their lives. The incidence of depression in institutional settings, however, is very high, approaching 50% or even more in some studies. This is probably because seniors in institutional settings are not physically healthy and they have been uprooted from the lives and people that provided emotional gratification and support.

The three pillars of treatment for all psychiatric disorders throughout the lifespan are:

1. Psychotherapy or Counseling
2. Psychosocial support from family, friends, and the community; and,
3. Medications.

Medical illnesses can cause depression or can make depressive disorders worse. Thus it is important for an older adult who has become depressed to have a full medical evaluation, including basic lab work and possibly other diagnostic studies. Sometimes the treatment of a medical condition can also treat the depression! When I see an older adult who has a mental health problem I want to be sure that the treatment will be comprehensive, but when the depression is mild, medication may not be needed.

When the depression is moderate or severe and medical causes have been ruled out and when patients aren’t improving with counseling and psychosocial support we turn to medications. In my experience this is usually very successful and the person’s suffering can be relieved. I hope here to provide a very broad and necessarily brief survey of the psychopharmacological treatment of depression in the aged. Most readers of Engaging Aging will have some basic familiarity with the drugs that are used for depression in young and middle aged adults. The medications used in late life are the same but there are differences in dosing and in side effects in the elderly.

At one time there was little scientific evidence about how seniors do with antidepressants. Now numerous studies have been done in geriatric populations; a survey published in 2007 cited more than 30 randomized clinical trials with 5,000 geriatric subjects.

The antidepressants that are commonly used in early and middle life have been found to work well in the elderly and they have been shown to be safe even if the depressed person has mild cognitive impairment or even dementia. Citalopram (Celexa), Sertraline (Zoloft), and Escitalopram (Lexapro) have certain advantages over the other drugs. These three drugs are less likely than others to have unpleasant or dangerous interactions with other drugs that patients may be taking. The first two on the list are generic and so are more affordable. Common side effects of nearly all antidepressants for patients in all age groups are gastrointestinal disturbances, jitteriness, sedation or mental fogginess, weight gain, and impairment of sexual function. Patients with bipolar disorder (diagnosed or not-yet diagnosed) may become so overstimulated when given antidepressants that they can actually become manic. Most patients don’t get any of these side effects or if those side effects do occur they are mild. Older adults should be started on low doses of antidepressants – usually 50% of the dose one would give to a young or middle aged adult. Then the dose can be raised slowly. This is because many but not all drugs are metabolized more slowly in the elderly than in young people. Also older persons may have concurrent medical problems and may be on a number of other medications, thus making adverse drug interactions more likely to occur.

There are a few side effects which are seen at times in young and middle-aged patients which may be more prominent or serious in the elderly. Some antidepressants can impair blood-clotting and bleeding may occur; this may be particularly risky for seniors who are already on aspirin or other drugs that impair clotting. It is thought that antidepressants may cause osteoporosis or thinning of the bones. Antidepressants may slow the heart, and this could present problems for seniors who are taking other medications which may do that as well, for example drugs for high blood pressure. Also some antidepressants may at times cause sleepiness or sedation and/or may lower blood pressure making it a bit more likely that a person taking the medication might fall.

If one medication does not provide benefit another should be tried. Unfortunately it is not possible to predict what the right drug will be for an individual patient. Ultimately most people will get better! There is a lot of hope for geriatric patients who suffer from depression, especially if there is a comprehensive approach to their care, with attention to counseling or psychotherapy, psychosocial support from friends, family, and the community, and thoughtfully prescribed and monitored antidepressant medications.

Aging with vitality, staying healthy and avoiding many major diseases as we grow older in years has a lot to do with caring for our hearts. Even the risk of Alzheimer’s has shown to decrease with proper heart care. If you would like to improve your own heart care or encourage a loved senior in his or her heart care, simply follow these ABC’s:

Avoid tobacco: Stopping the habit of smoking or encouraging others in the household to quit smoking is not easy. However it is much more difficult to recover from a heart attack or stroke or to live with chronic heart disease.

Be more physically active every day. Research has shown that getting at least 30 minutes of physical activity on 5 or more days of the week can help lower blood pressure, lower cholesterol and keep weight at a healthy level. For seniors, even 10 minutes a day of exercise of some sort has shown to improve health.

Choose good nutrition. A healthy diet is the most important weapon in your arsenal to fight heart disease. What you eat can affect heart disease risk factors such as cholesterol, diabetes, blood pressure and obesity. Prepare heart-healthy meals that are low in fat and cholesterol and rich in vitamins, minerals and fiber.

Central Coast Senior Services, Inc. can help seniors with making healthy choices through meal preparation and exercise suited to a person’s abilities and interests. Our goal is to help Pacific Grove seniors maintain independence for as long as possible while living in the comfort of home. To learn more about our home care services, contact us at 831-649-3363.

Genworth Financial reports that 40 percent of caregivers expect to contribute financially to the care of a family member. However, it is 83 percent that actually do end up contributing. These statistics demonstrate how important it is for adult children to understand what sort of plan their parents have for affording long-term care.

Here are some thought provoking questions to ask about affording long-term care which will help to get the conversation started:

What are their assets?

It is important to establish roughly how much money your parents have in cash, investments, and Social Security.

Do they anticipate needing financial support?

Increasingly more people are outliving their retirement savings. Ask your parents whether they think they have enough to sustain themselves for the rest their lives. If not, how much support do they anticipate needing?

What types of insurance do they have?

Do they have adequate health insurance? Long-term care insurance? Life insurance?

Understanding their policies can save you time and money in the long run.

Will they share passwords and account numbers?

Ask your parents to give you a copy of all important account numbers and passwords, along with contact information for financial advisers and lawyers. If they have a safety deposit box containing estate plan documents, jewelry or other valuables, find out where the key is stored. This will make it easier to sort out their affairs if they fall ill or die suddenly.

Have they signed a power of attorney?

Make sure they have, so that you know who is responsible for making decisions on their behalf in the event of a medical emergency.

Central Coast Senior Services, Inc. Home Care Coordinators can help seniors and their families understand their long-term care options and provide ideas for affording care. Many times, the policies have been paid for 20 years or more. Our Home Care Coordinators will review your policy with your insurer to help you completely understand your specific benefits. For more information or to learn more about our home care services for seniors and the disabled in Monterey, Salinas, Carmel, Carmel Valley, and Pebble Beach, contact us at 831-649-3363.

When it comes to phone scams, seniors are particularly susceptible. Sometimes a lonely senior simply enjoys talking to someone else on the phone and can get swept up into the scam without realizing it. Abusers know this and often specifically target older adults. To help protect a senior from phone scams, educate him or her on how to recognize the red flags of fraud:

Red flags of senior phone fraud include:

A promise to win, make, or borrow money easily

A demand to act immediately or else miss out on a great opportunity

A refusal to send written information before agreeing to buy or donate

An attempt to scare the victim into buying something

Insistence on wiring money or having a courier pick up a payment

A refusal to stop calling after being asked not to call again

A senior should understand that it is illegal for companies that operate contests or sweepstakes to ask a person to pay to enter or claim a prize or even suggest that chances of winning will improve if there is a purchase. It is also important to stress that there is no reason to give a credit card number or bank account number to a telemarketer unless a payment is actually being made with that account.

If you are trying to help an older person with a telemarketing fraud problem, don’t be critical. It could happen to anyone—con artists are very good at what they do. A senior can be registered on the Do-Not-Call list by calling 1-888-382-1222 or by registering online at www.donotcall.gov.

Central Coast Senior Services, Inc. believes that knowledge is power when it comes to protecting seniors from abuse. For more information or to learn more about our home care services for seniors and the disabled in the Monterey Peninsula, contact us at 831-649-3363.

Many seniors are afraid of falls, and for good reason. According to the International Fall Prevention Institution, falls are the leading cause of injury-related visits to emergency centers in the United States and the primary cause of accidents in persons over the age of 65. Though falls are usually preventable, few people are educated on preventing the risks before becoming a victim.

The National Center for Injury Prevention and Control indicates that approximately half of all falls happen at home. Common threats are falls from ladders, as well as tripping over vacuum cleaner cords, telephone cords, and dog leashes. Here are a few simple and affordable ways to make a senior’s home safer from the threat of a fall:

Outdoors

Install handrails on stairs and steps

Living spaces (including hallways, pathways and stairways)

• Secure rugs and carpet edges with nonskid tape; avoid throw rugs

Bedrooms

• Utilize a bedside light that is easy to turn on and off, such as a touch light
• Locate a telephone within easy reach of each bed

Kitchen

• Use a sturdy step stool for reaching a high shelf
• Make sure appliance cords are out of the way
• Avoid using floor polish or wax in order to reduce slick surfaces

Bathrooms

• Install grab bars on walls around the tub and beside the toilet, strong enough to hold your weight
• Add nonskid mats or strips to bathtubs

Our Home Care Coordinators will assess and begin implementing the appropriate fall prevention home modifications during their first  no-cost assessment visit. Central Coast Senior Services, Inc. offers care for individuals who have suffered from a fall, and the presence of our Personal Attendants helps to reduce the risk of future falls. To learn more about our home care services in Monterey County, contact us at 831-649-3363.

Probably one of the worst nightmares for family caregivers of frail seniors is the thought of them falling and getting injured. Thankfully, there are ways to help prevent falls in a senior’s home. Besides making modifications to the home such as removing throw rugs and adding stair rails and extra lighting, there are a few technological safety devises you may want to take advantage of:

Door alarms

How they work: Alarm sounds when a door banner is detached from a monitor.

Monitoring systems

How they work: These fall monitors alert caregivers when a senior gets out of bed or a wheelchair. They work with a variety of pressure sensors on a bed or chair. The alarms on the different models vary from different tones to voice recordings.

Uplifts for toilets or chairs

How they work: The simple locking mechanism on these uplifts secures the raised toilet seat to the toilet bowl. They come with built-in handgrips for easy handling.

Bedrails and transfer handles

How they work: These rails are designed for use on standard home beds. The rails can be easily raised and lowered with a push button adjustment.

Adjustable toilet safety frames

How they work: These frames are for use over a standard toilet or with a raised toilet seat. Armrests provide secure hand support and adjust in and out, and legs adjust up or down for height.

As a part of our in-home care assessment, Central Coast Senior Services, Inc. will provide a free home safety evaluation and suggest simple home modifications that will allow a frail senior to be safer at home. We can then coordinate implementing those alterations and further help reduce fall risks by providing reliable, attentive, and dependable care. To learn more about our home care services in Pacific Grove, Carmel, Pebble Beach, Monterey and Salinas, contact us at 831-649-3363.

by John O’Brien

em·pa·thy

noun /ˈempəTHē/   The ability to understand and share the feelings of another

Our Home Care training program includes a module called “The Aging Game”  which our employees complete during their exclusive Seven Day Training Program.  The Aging Game transforms the Personal Attendant:  They  become “old” in order to experience, if only for this class, what it is like to have impaired hearing, vision, range of motion and speech.

Using devices such as fogged goggles, ear plugs with ear muffs, neck collars, elastic splints and popcorn in the shoes, we are able to simulate aging and help the Attendant gain empathy of what it is like to be dependent on another person. We put them in wheelchairs, a hospital bed, and on commodes.  We give them “lunch” which is room temperature Ensure through a straw “because the doctor ordered it.” We pretend they are hard to understand and dismiss their requests and talk about how “confused” they have become.

All in all it can be a powerful experience as evidenced by the group conversations after the exercise.  A common comment has been: “I have been an Attendant caring for older adults for years and had no idea what it was like to feel so dependent, so helpless.” It is not unusual for Attendants to become tearful when describing the emotional impact of the game.

I had a first hand opportunity to experience the sense of helplessness that comes from dependence during a recent trip back East. Not much ages you faster than throwing out your back and then sitting for 12 hours on the trip home.  It was nearly midnight when we landed in SFO and I could just barely walk off the plane and collapse in a wheelchair.

After a while I found myself parked in front of a plate glass window looking out onto the Arrivals curb, luggage piled next to me as Susan went for the car in the long term parking garage.  If someone had helped themselves to the luggage the best I could of done would be to ask them not to take it. If I had to go to the bathroom, I would have had to soil myself.  I could not push the wheelchair an inch let alone get out. The pain was like nothing I had ever experience in my life, it brought tears to my eyes and my hands shook. People avoided looking at me as if I  was invisible.

Staring out that plate glass window in those very early hours of the day, watching people move freely without pain, I recalled the Aging Game.  Why?  I think because I was having an intense experience of dependence.  The Aging Game is not really a game at all, it really is about us.   Tomorrow, the next month or decade from now we will all experience a loss of ability, at the least needing reading glasses to read to immobility at the worst.  Aging is a process of adjusting to the profound changes that occur to us as we age.  Disability and dependence is not a place far off, distant from us.  It is always as close as just around the corner.

While I have recovered from my temporary period of “aging,” my experience showed me that the words so many of my clients have said over the years to be very true: “Getting old ain’t for sissies.” Ain’t that the truth.