Improve Home Access and Mobility For Seniors – Tune Up Your Doors!

Creating an accessible home with doors and doorwaysAre the doors in your home sticky, narrow or just plain unwieldy? For most of us, this can be a big annoyance. However, for seniors, it can be a significant impediment to mobility in the home.

Fortunately, there are many things you can do to improve the situation and make daily life a little easier.

Here are some ideas:

Door Knobs - Consider replacing door knobs with door levers. These are simply easier for seniors to open than a traditional round door knob. Internal door hardware is affordable and relatively easy to replace. Entry door locksets are more expensive, but won’t necessarily break the bank if you shop around.

Misaligned Doors - When doors are out of alignment, they can rub on the frame and become difficult to open and close. There are a few quick tricks you can try before you resort to re-framing the door.

  • If the problem is very minor, you can sometimes just sand the edge of the door that is rubbing. This is permanent and is not recommended if the problem is seasonal or if too much material must be removed.
  • Use shims to move the upper or lower hinge out from the door frame slightly. While you may be able to use cardboard or washers to accomplish this, it’s probably better to purchase door shims that are specifically designed for this purpose.
  • Another trick is to slightly bend one or both of the door hinge knuckles. Crescent wrenches are frequently used for this, but there are now knuckle bender tools to make it easier.

Narrow Doorways - Some doorways are too narrow to provide access for a walker or wheelchair. You have a few options:

  • ‘Swing clear’ hinges are a great way to improve access. As the name implies, these hinges allow the door to swing completely out of the door opening. In some cases, this can add a couple inches of badly needed clearance.
  • If you don’t need to close that particular door, consider removing the door and hinge altogether. You can also remove the innermost strip of trim that functions as a door stop. If the doorway needs to be even wider, you can try removing the entire door frame and trimming out the opening with thin sheet-rock.
  • Depending on the location in your home and the wall framing surrounding the door, you may be able to replace the existing door with a wider pre-hung door. While this may not be a DIY job, a good contractor can probably do it for a reasonable price.

Garage Doors - Not only can garage doors be difficult to open and close, they can be downright hazardous for some seniors. While most problems with garage doors can be easily fixed, it is recommended that you hire a licensed contractor for significant improvements. Garage door springs are dangerous to work with and some municipalities may even require building permits.

  • If you have a slab garage door, check into getting a roll-up door. These should be much safer and easier for seniors to manage.
  • Remove dirt and debris from the garage door and the areas around it.
  • Lubricate your door hardware. If you are unsure of the best type, look for a lubricant specifically labeled for garage door hardware.
  • Replace your garage door springs. If the springs are old, they may not be functioning as well as they should. They could also be dangerous in the event of a failure.
  • If you don’t have one already, consider purchasing an automatic garage door opener. The quality of these continues to improve and they are more affordable than ever.

Sliding Doors - Sliding doors are inherently more difficult to open than swinging doors and can be even more of a challenge for seniors. These generally require more ongoing maintenance to function smoothly.

  • Clean out the tracks regularly.
  • Lubricate moving parts.
  • Although it can be tricky, many sliding doors have screws to adjust alignment. If needed, replacement parts are generally available as well.
  • Consider replacing a sliding door with a pair of swinging French doors. Because the sliding door opening is typically wide, replacement with French doors is generally easier than many other installations.

Keyless Entry Systems - Some seniors have difficulties when using keys. Door locks with combination buttons and remote key fobs are now available. Some of these can even be activated by other remote devices such as cell phones or security systems.

While these are all great improvements for the doors themselves, don’t forget to address the lighting near your doorways. For example, motion detectors can automatically turn on the lights when approaching the door. This will free up both hands for opening the door, carrying groceries or even stability. Now all you need is a friendly welcome mat!

7 Ways to Make Your Bathroom More Accessible for the Elderly

senior friendly bathroomFor the elderly, using the bathroom effectively – whether it is the toilet, faucets, or the shower and bathtub – can be difficult. For people who have lost mobility and strength, standing in a shower for a long time isn’t possible, and getting in and out of a bathtub is a risky proposition.

Thankfully there has been progress in bathroom remodeling geared towards helping seniors navigate the bathroom with ease. The remodeling covers a wide range, from something as simple as a sprayer attachment that allows for the person to sit while bathing, to curbless showers that remove the need to step up for access. These changes can help the elderly be more independent in the bathroom, and they also help the elderly caregiver give better care to their loved one.

Here are seven ways you can make your bathroom more accessible for the elderly.

1. Install lever faucets. Having a lever faucet gets rid of the twisting and turning that can be difficult for the elderly. There are hundreds of different styles to choose from, including foot operated faucets. Installing a new faucet isn’t as difficult as it once was, but anytime you’re dealing with plumbing, it is good to at least talk with a professional before making the change yourself.

2. Get a sprayer attachment for your shower-head. A shower-head that you can detach and hold in your hand makes bathing really easy. It furthermore eliminates the need to stand while showering, certainly a bonus for those who have problems standing for long periods. Being able to sit and shower also means more independence for the elderly.

3. Install grab bars and rails. This is one of the easiest and cost-effective ways to make your bathroom more elderly-friendly. Installing grab bars and rails in the shower, bathtub and near the toilet makes bathing and using the toilet easier not only for the elderly person, but for the caregiver as well. The grab bars and rails can be installed yourself or you can hire someone to do the work.

4. Raise the height of the toilet. Simply raising the toilet’s height as little as three inches can make all the difference for seniors. There are a lot of options for raising the height of the toilet. You can simply raise the height of your existing toilet with a thick toilet seat, or you can replace your old toilet with a “Comfort Height” toilet. Once again, this can be a DIY project, or a project where you call a plumber.

5. Thick rugs for cushioning. This simple and easy addition to the bathroom is for the elderly caregivers that are spending time on their knees bathing someone. Placing a well-padded rug or pillow under your knees can keep your knees from hurting, making the bathing process less of a chore.

6. Non-slip bath mats and rugs. This is another easy way to prevent falls in the bathroom. Placing a non-slip mat in the shower prevents the senior from falling while showering and a non-slip rug on the floor outside the shower prevents any slipping once the senior is out of the shower. Non-slip tape is a lower cost option for shower pans and tub bottoms.

7. Curbless showers and Walk-in bathtubs. For the seniors that can’t lift their legs, putting in a curbless shower can be a lifesaver. A curbless shower can make the transition from wheelchair to shower seat simple and easy for the senior and the caregiver. Walk-in bath tubs are another popular option, as they are much easier to access than traditional tubs and most have a built in seat as well. There are many different options for installing a curbless shower or a walk-in bathtub. You can buy and have installed a pre-fabricated unit, or you can do it yourself. The advantage to having a new unit installed is that they are specifically designed for senior care.

There are twin goals to redoing your bathroom: the first is to increase the independence of your loved one, and the second is to make life easier for you the caregiver.

What changes to your bathroom have you made? What is the most cost-effective way to change your bathroom to suit the elderly?

Product Review: Video Care- Family Communication Made Simple

family communication made easy with Video CareMany of today’s seniors living at home don’t have a son or daughter next door.  The interaction with immediate family may be limited to phone calls, occasional visits, and holiday gatherings.  Video Care has developed a personal communication tool with a unique approach to solving the long-distance caregiver gap by combining complex technology with a simple, elder friendly interface.

Video Care brings face-to-face companionship and interaction to the elderly through a touch screen system that requires no mouse, keyboard or computer skills to operate.  A touch of the screen opens a two way video screen with a family member, caregiver or friend.

Video Care was kind enough to send me one of their systems to check out and see exactly how easy it would be for a senior with little or no computer skills.  I was very impressed with the simplicity of the unit and ease to set it up.  In addition to using two-way-video, loved ones can also share instant photos, videos and music.  Video Care also offers a nifty senior app if you want to share videos and photos directly from your smartphone.   The system can also be set up for medication, appointment, and activities of daily living reminders. Loved ones will be notified if the user does not respond to the reminders.

video care can be used to share photos

Video Care can be used to remind users to take their medication.

 

For professional caregivers, Video Care allows remote visits without the cost and time of driving to the home.  Clients can be checked on several times a day for a fraction of the cost of a typical home care visit.  Geriatric care managers could also use Video Care to check in with caregivers already in the home as a quality assurance tool, or as a problem solving option (in the case of any unusual behavior or symptoms).   Video Care is currently being used by in-home care agencies and geriatric care managers as a value-add to their current client base (I think this is a fantastic idea by the way).

I had the opportunity to speak with David Trescot, Co-Founder and CEO of Video Care.  One of my favorite stories he told me about Video Care users was about a daughter and her elderly mother who turn on Video Care every morning and use it as a “window” into each other’s homes.  They chat, have breakfast together, and go about their day with the two-way video all day long.  They’re able to participate in each other’s lives, and the daughter has peace of mind each morning when she sees her mother appear on the screen.

The other aspect I love about Video Care is that it can be used along the continuum of care for a loved one.  Video Care can operate from any location that has internet access (wireless works too).  I imagine the transition into assisted living or a skilled nursing facility could be greatly eased with daily check-ins and support from family and friends, even if they live on the other side of the world.

I look forward to following Video Care and others that will follow in the exploding telehealth and aging-in-place space.

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SafteyBunns Offer A Safer Seat With Non Skid Pants

SafetyBunns non-slip pantsOne of our members at The Senior List on Facebook submitted an interesting article about her company called; SafetyBunns!  Obviously we had to inquire about them and found a really creative idea that offers seniors a safer seat at the table… This product offers safety grips on the back of the pant legs so a person doesn’t slip out of their wheelchair, dining room chair or any other slippery sitting surface.  This is a product that solves a very common problem… with a very simple solution!  Think of them as studded snow tires vs. snow tires.  Snow tires can do the job… but Studs give you a little bit more grippage, and a lot more confidence… :)  SafetyBunns pants for seniors

Barb Przybylowicz, (a nurse for over 33 years) developed SafetyBunns after caring for her ailing father.  Her many years of serving seniors (as well as her father) led her to identify a need, and she filled it.  Click thru to read more about SafetyBunns.

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Caregiving During The Holidays

Holiday Surprise PhotoThe year-end holidays are coming, and I want you to think for a moment about your plans to celebrate.  Rather than do your traditional celebrations, please consider alternative plans and reducing the burden to both honor and support your loved one.  People who are dealing with chronic ailments or who are in pain shouldn’t be expected to go through the holidays as they once did.  No matter how much you (or they) may want “the usual traditions”, you need to take into account reduced stamina and increase frailty.

Tips For Caregiving During The Holidays

Be sure you include your loved one in the planning process, this is very important.  They may want to do everything as it’s always been done… So you’ll need to help your loved one understand that there needs to be new traditions started (in order to account for the place you all find yourselves in now).  That’s not to say you can’t or shouldn’t celebrate!  It’s just a way of remembering that whatever you do, you need to take your loved one’s state-of-health into account.

Here are a few examples of how to reduce stress on your loved one:

  • Instead of a day-long cookie-baking extravaganza that will only exhaust mom, why not pre-bake the cookies?  That way mom can join in the shortened party to decorate them.  She’s still participating, but at a level she can handle.
  • Instead of the big traditional holiday dinner, why not down-size to a series of short events with much lighter menus.  A tea-and-cookies event, wine and appetizers, or even a bring your favorite soup party?
  • Folks who are frail and those suffering from dementia can be overwhelmed by even a handful of familiar faces.  It quickly becomes too much information to recall, too much energy to absorb, and your loved one may respond not with enjoyment, but with highly anxious behaviors.  It’s a good reason to keep your gatherings very small, maybe only two or three people at a time.
  • For the elderly, the process of selecting, buying and wrapping gifts may be too taxing.  Instead of doing a gift exchange, what not use the time to pull out the family photo albums, videos or 8 mm movies?  Other alternatives to spending time exchanging gifts would be to play board or card games that your loved one enjoys, or watch holiday-themed videos.  Our family holds a comic movie film fest.  Laughing together really makes for a great holiday mood.

You get the idea—think small and intimate.  You can still do all the holiday decorating, just have mom supervise from her favorite chair.  You can share and enjoy the music and food of the season.  Just keep your loved one’s state of health in mind and then make appropriate plans.

Blessings, Joanne

Photo: freedigitalphotos.net

Nutrition and Caregiving: You Can Eat AND Have Fun

Glass of WineOne leg of the “self-care trinity” for caregivers is healthy eating. I don’t know about you, but the combination of those two words makes me think about “sticks and berries” (in other words… food that’s not fun to eat).

I’ve got good news for you caregivers:  I’ve discovered some fun food that can help keep you at your best so you can offer your highest level of care!

Healthy Food That’s Fun To Eat:

  • Fruity cocktails may actually be good for us. According to Woman’s Day magazine, research shows that alcohol can increase the level of antioxidants in certain fruits, such as strawberries.  That means one strawberry daiquiri or margarita has health benefits, along with tasting good.
  •  Pizza can be healthy provided you make some changes in preparation: use a whole wheat crust and low-fat cheese (in moderation).  Skip the meats, especially the high fat ones like pepperoni and sausage, and pile on the veggies.
  •  Fruit juice can be healthy as long as it’s 100% fruit juice.  Orange juice, especially, has plenty of fiber and antioxidants.  Some research has shown that daily consumption of 6 to 8 ounces can lower Alzheimer’s risk by as much as 76%… But that’s not a direct correlation.  It’s dependant on other factors as well, the most important one being age.
  •  For women, red wine and dark chocolate are heart-healthy foods, provided they’re eaten in moderation.  One small chocolate (not a box of them) and a glass of red wine can actually have health benefits.  Gentlemen, it’s also been found that a wee bit o dark chocolate is good for your hearts, too.

“Moderation and Balance are Key Components of any Healthy Eating Plan” – Joanne Reynolds

A Healthy SaladAnd that brings me to the closing thought about healthy eating:  It’s about moderation. TOO MUCH OF ANY ONE THING, whether it’s toffee or tofu, isn’t going to be good for you.  Moderation and balance are key components of any healthy eating plan.  Remember that the goal is to fuel your body well to keep you strong for your caregiving assignment.

Blessings, Joanne

Senior Care and Caregiving for Mesothelioma Patients

boomer on the beachWhen a family member is diagnosed with mesothelioma, relatives may take on caregiver roles. Spouses are often primary caregivers, but because mesothelioma disease mostly affects seniors, adult children often take on caregiving responsibilities for their parents.

The roles that a mesothelioma caregiver must play often evolve over the course of their loved one’s disease. The cancer is highly aggressive, and the symptoms intensify rapidly after diagnosis. Chest pain, shortness of breath and extreme fatigue can become so disabling in the later stages of mesothelioma that caregivers must step in and help with daily tasks.

Common Duties of a Mesothelioma Caregiver:

• Helping the patient make and get to doctor’s appointments
• Filling and administering the patient’s prescriptions
• Guiding the patient through hygienic activities such as showering and getting dressed
• Assisting the patient with comfortably resting and moving around the house
• Completing basic household duties such as laundry and cooking

In some families, several people pitch in to provide care for the mesothelioma patient. Families also have the option of arranging inpatient health care from a senior caregiving organization if the patient’s condition gets too severe to manage at home. Thankfully, there are many treatment options to reduce or heal symptoms of mesothelioma. From minor surgeries to simple, out-patient procedures performed in a doctor’s office, there are numerous health care options for seniors with mesothelioma.

The process can be difficult – for both the patient and the caregivers – but many patients successfully receive at-home assistance from their loved ones.

How Caregivers’ Coping Mechanisms Impact their Experience

The pressure of providing care to a terminal cancer patient often leads mesothelioma caregivers to develop coping mechanisms. Many of these habits are mental – and a recent study found that certain negative coping strategies are associated with increased stress and even negative health outcomes.

According to the study, which appears in Supportive Care in Cancer, three negative expectation coping strategies are most associated with emotional and psychological distress: worrying, expecting the worst and getting nervous.

Although caregivers often unconsciously engage in these behaviors, there are easy ways to counteract the detrimental habits.

Coping Strategies for Caregivers:

Focus on the positive. Caregivers who anticipate poor outcomes are only adding to their stress. You may think that you are only being realistic – but even with mesothelioma, this is not always the case. Patients are continually sharing stories of how they beat their prognosis by months or even years – sometimes without a scientific explanation. There’s no reason that the next mesothelioma patient to defy expectations couldn’t be your loved one.

Acknowledge – then dismiss – your worries. It’s easy to panic about your loved one’s diagnosis. It’s also easy to worry that you’re not doing enough to help or that you’re abandoning your other duties. However, these worries are often unfounded. Recognize worrisome thoughts as they pop into your head, and employ healthy ways to process them.

Use healthy coping mechanisms to calm your nerves. When fear arises, look for a healthy coping mechanism to dissipate the nervousness. Different techniques may work for different people – don’t fret if one does not work for you! Yoga, meditation, massage therapy, support groups and counseling can all help calm your worries – and provide some valuable personal time in the process.

These strategies can help alleviate psychological distress in caregivers, but they may also enhance the efficacy of clinical interventions. Caregivers can yield “stronger, long-lasting benefits” by redirecting their coping mechanisms – ultimately benefiting both themselves and the patient.

Successful Aging In Place begins with the Right Partners

America is aging and our life expectancy is increasing.   By the year 2030, there will be more than twice as many people aged 65+ years than there are today.  AARP surveys repeatedly indicate that people would prefer to reside in their existing homes.  However, only 16% of survey respondents have done home modifications.

The primary goal of a successful aging-in-place remodel is to gain or maintain the client’s independence over time.  This goal is best accomplished when an occupational therapist and a remodeler work as a team.

It is best to have an occupational therapist available at the beginning stages of a remodeling project because an occupational therapist brings a medical perspective and helps determine what will meet the client’s needs for now and in the future.  Occupational therapists are skilled at recognizing how the home environment affects the ability to participate in activities.   An occupational therapist evaluates balance, endurance, safety awareness, vision, and many other functional areas such as taking a shower or climbing the stairs.

The occupational therapist collaborates with the remodeler whose expertise is needed to determine the structural integrity regarding the installation of the modifications.  The remodeler has knowledge of building codes and specifications.  A remodeler who has a certified aging in place specialist (CAPS) designation understands universal design concepts and customizes the renovations based on the individual’s needs.  Together, the occupational therapist and remodeler create a much better outcome that will meet the client’s needs over time.

To learn more about partnering an occupational therapist with a remodeling professional, contact:

Nancy Dillinger, OTR, SCEM, ATP
AOTA Environmental Modification in SCEM
liveLife@Home, LLC
303/775-4984 (cell)
nancy@denverhomemodification.com

Home Modification to Reduce Falls?

On the surface, home modification appears to be a straightforward solution to reducing falls.  Free home safety audits are offered by many businesses and organizations at no cost to the consumer.  However, the effectiveness of home safety audits as a valid tool for reducing falls has been controversial and inconclusive.

To address this confusion, Clemson et al. (2008) conducted a systematic review of the highest quality studies that investigated the effectiveness of environmental interventions in reducing falls.  The authors concluded that there is evidence that home visit interventions that are comprehensive, focused, and incorporate an environmental-fit perspective can be successful in reducing falls when targeted to high-risk older adults.

Home Modification reduces falls when interventions include Occupational Therapy

This study also found that the highest reduction in falls was achieved when the home interventions were provided by an occupational therapist.  Occupational therapists are skilled at recognizing the fit between a person and the environment.  A home assessment by an occupational therapist goes beyond hazard identification to an analysis of the environmental-fit.  The occupational therapist problem solves,  identifies solutions, and bases recommendations on many factors including medical conditions, history of falls, daily activity patterns, balance, strength, vision, cognition, and other functional skills.

Fall reduction is further achieved when the older person is willing to change risk-taking behavior.  An occupational therapist teaches behavioral strategies to raise older adults awareness about their environment and how to negotiate it safely.  A follow up visit is vital to the home modification process to ensure the recommendations have been carried out according to the client’s needs and desires.

To learn more about occupational therapy and home modification contact:
Nancy Dillinger, OTR, SCEM, ATP
liveLife@Home, LLC
303/774-4984
nancy@denverhomemodification.com

Source.  Clemson, L., Mackenzie, L., Ballinger, C., Close, J. Cumming, R. (2008). Environmental interventions to prevent falls in community-dwelling older people:  a meta-analysis of randomized trials.  Journal of Aging and Health, 20, 954-972.

What’s in a Name? Caregivers Deliver All Kinds of Care

I’ve always thought the word “caregiver” did a good job of describing someone who makes time on a regular basis to care for and support someone who is ill, injured or suffers from a chronic condition.  But there can be issues, even with a word as mundane as this.

In states that have laws allowing for medicinal use of marijuana, the term “caregiver” is one that is defined in those laws.  In order to grow or dispense marijuana, an individual must become licensed or certified by the state as a medical marijuana “caregiver.”

There’s potential for confusion here when I’m talking about people who are givers of care, versus people who are in the medical marijuana business in the states where it is permissible.

I have also noticed a tendency of certain kinds of caregivers to not identify themselves with that word.  It’s especially true for caregivers who are spouses.  I first noticed the shying away from being called a caregiver by spouses of cancer patients.  They see themselves as being in a support role for their loved ones, especially in the initial diagnosis and treatment phase.  The mind-set is that it’s a temporary situation and the word “caregiver” is too fraught with long-term and terminal connotations to be used.

Karen Galloway of the Western Slope Region of the Colorado Chapter of the National Multiple Sclerosis Society says they have a similar situation with their clients and their spouses.  “We don’t want to have people stop listening to the advice we have to offer because we use a word they don’t feel applies,” she said.  So instead of using “caregiver” for these spouses and partners, Karen and her colleagues use the term “support partner.”  That seems like a good choice if the person in question feels more comfortable with that descriptor.  Other groups use the term “care partner.”

By the way, caregivers are people who give care to other people.  Caretakers are people who take care of other people’s property.  Just thought you’d like to get that clarified, even if the meaning of “caregiver” isn’t as plain as it used to be.  What terms do you use to describe yourself as a giver of care?  Have you heard of other terms you would prefer?

Blessings, Joanne