Is It Safe For Our Aging Parents to Drive?

Should our aging parents be driving and what can be done to make driving easier and safer for them?

Please don't take away your parents driving privileges unless you have a good replacement because otherwise you will leave them stranded and lonely and I know that isn't what you want for them.

I have an Aunt who has always been very independent and loves going out and shopping every day.  Last year she turned 90 and her daughter decided that she didn't want her mother driving anymore so she took away the car, but she didn't give her a suitable option for getting around.  Now my Aunt sits at home alone and is very lonely and depressed.  Her daughter is always busy and doesn't have time to take her out and see to her driving needs daily so taking away her driving privileges has has a very negative effect on her mental status.  

There are recent studies that show taking away driving privileges can cause depression and lead to a failure to thrive in a elderly person unless measures are taken to allow them the freedom they had with a car.

 AARP has a list of ten signs to help you determine when it's time for an older driver to hand over their keys.

*Frequent "close calls"

*Dents, scrapes on the car, fences, mailboxes,     garage doors, curbs, etc.

*Trouble judging gaps in traffic at intersections and on highway entrance/exit ramps

*Other drivers honking

*Getting lost.

*Trouble seeing the sides of the road when looking straight ahead

*Slower response time, trouble moving foot from gas to brake pedal or confusing pedals.

*Getting distracted easily or having trouble concentrating

*Difficulty turning head to check over shoulder while backing up or changing lanes

*Traffic tickets or warnings by law enforcement officers in the last year or two.

Experts say that your parent may still be able to drive with some modifications, like self-regulating when and where to drive.

Giving up the keys is not usually the answer and most people can safely drive through the end of their lives as long as they are aware of their limitations and only drive in situations where they are comfortable doing so.  It could be as easy as them planning their route and taking only right turns to their destination even if it takes a little longer. 

Most older drivers self-regulate by taking only roads they're familiar with, avoiding certain roads and places and not driving in bad weather or at night.


In my opinion you should let your parent drive for as long as they feel comfortable.  Tell them that any time they need you to drive them somewhere they don't feel comfortable driving you will always be available and this way they avoid driving in situations they don't feel that they can manage.


Helping our aging parents to maintain their independence for as long as they can is important for their well being and if they know they can always count on us to be there when they need us that will make it so much easier for them to ask for help when they need it.   

   

Would Bed Rails Help?

If your parent needs a little help getting in and out of bed or is a little unsteady on their feet it may be time to consider getting some Bed Rails.  

Bed Rails really help a great deal if your parent has trouble sitting up in bed and also prevent them from falling out of bed during the night.  Sometimes a parent who has trouble walking will attempt to get out of bed during the night and end up falling, having bed rails will keep them in bed until someone can get to them to help.

Dad used to get up in the middle of the night, forgetting he couldn't walk on his own, thinking he needed to use the bathroom even though he was in a diaper and had a Texas catheter on, he'd just pull the catheter off and end up in a mess on the floor.  That's when we realized we needed to install full length bed rails to keep him in bed and prevent him from falling and breaking a hip. 

When you choose a bed rail you'll want to make sure you get one appropriate for your parent, if your parent is very small you'll want to make sure that the bottom rail sits very close to the mattress so they don't slide under it and get stuck.  Ease of lowering the rail is very important as well.

If your parent just needs a little help and can get in and out of bed themselves they may just need an assist handle type bedrail.  These bedrails only provide a single stable area that your parent can slide past as they exit the bed, these bedrails remain in the upright position at all times and do not need to be lowered. 

If your parent is unsteady and needs assistance walking you would want to consider a full length bedrail that a caregiver would need to be present to lower, thus keeping your parent in the bed until their aide lowers the rail.  This is a good option if you don't want your parent getting out of bed unassisted. 

The good thing about bed rails that can be lowered is that they can be put completely out of the way, so installing it before your parent really needs it isn't a problem or a huge inconvenience to them.  

As we care for our aging parents we need to always think ahead for the next thing we can do to make their everyday lives easier.  Ask them about their challenges and find ways to keep them independent for as long as possible.  

Is It Time To Install Handrails In The Bathroom?

Has your parent become a little wobbly on their feet?  Do they have a little trouble getting around on their own without the help of a cane or walker?  Then it's probably time to consider installing some handrails in their bathrooms for safety.  

Handrails for the bathroom are essential to prevent falls.  Balance is an issue for many aging parents for a variety of reasons so installing handrails in the bathroom should be done before anyone falls.  Remember, it's wet and slippery in the bathroom and it's easy to fall even if you don't have balance issues. 

Take a look at the bathroom set up and see where handrails would be helpful, I like to put handrails around the toilet also, to help with getting up.  Handrails help to keep your parent independent for as long as possible, giving them the ability to use the bathroom on their own without assistance is important.      

You'll want to use sturdy handrails, I like the strong stainless steel grab bars, that can hold all your weight because that's what it will be receiving once your parent starts to use it and you don't want the handrail that you installed for safety to come loose.  Be sure that whoever installs your bars knows that it will be used to support the entire weight of your parent and you don't want it ripping out of the wall.  You'll want to be sure that the handrail is anchored to the studs so it's solid.   Your parent needs to be able to trust that the handrail will be there when they need it and that it won't fail and cause them to fall.

A physical therapist or occupational therapist can assist you in deciding where to place each handrail.

A bathroom redesign is sometimes necessary if a parent becomes disabled and wants to remain in the home.  Getting in and out of a bathtub is very dangerous when you're wet and slippery so I prefer to get rid of the bathtub and put in a large enough shower for two people, you see if your parent needs help bathing then you need enough room in the shower stall for a shower chair and an aide.  You may have the space and prefer a built-in bench seat in the shower, that's fine as long as you make sure a shower chair will still fit into the shower stall and allow enough room for an aide to get around.  This way if your parent can no longer transfer to the built-in bench they can still be wheeled into the shower in a shower chair for bathing. 

Install a shower head that can be used as a personal shower, this way an aide can easily wash your parent safely without getting wet themselves.  Another thing to take a look at in the shower is access.  Can you get a wheelchair into the shower?  If the room is large enough you can have the shower stall built with a slight ramp that allows a wheelchair to be rolled in and still keeps the water from flowing out onto the floor.  I recently saw a great product used for just that reason, it's called a "collapsible dam" and what it does is it keeps the water from flowing out of the shower but will collapse to allow a wheelchair to roll over it. 

A Flip Up grab bar should be installed next to the toilet to aid in standing and if possible change the toilet to a higher toilet, you won't believe how much easier it is for a parent with balance and arm strength issues to get up from a higher bowl.  

I believe that we need to do everything we can to keep our aging parents independent for as long as possible and safe, so installing safety handrails in the bathroom should be done at the first signs of balance issues.  

How To Find The Right Retirement Community

Maybe you've decided it's time to move into a Retirement Community and have just started looking around but are confused by how many different types of communities there are to choose from, well, I can totally understand that feeling  because I felt the same way when we needed to find a solution for my in laws.  At that time I had no idea that there were so many choices, so I've broken them down into types of community to give you a little explanation about each to help you along the way.  

Dementia/Alzheimer's Care

If your parent has memory problems, is often disoriented or has Alzheimer's then your options for housing are greatly reduced.  Most of the better housing options won't accept a parent who has dementia before moving into the community.  You'll be looking into a skilled nursing situation that offers care for Alzheimer's and Dementia patients.  These places are better equipped to deal with a parent who gets lost and confused easily and you won't need to worry about them running off and not being able to find their way home.              

Nursing Home

Nursing Homes offer skilled nursing care 24 hours a day.  I'm not a big fan of placing someone into a nursing home unless there is no other option or if your parent needs 24-hour nursing care.  A Nursing Home is basically like living in a hospital, you have a room with a hospital bed and very little space for personal items.  Most times you will need to use a communal bathroom and it may be down the hall.  I feel that there are so many better options out there that a nursing home should be an absolute last resort choice.  If a parent needs constant nursing care and isn't eligible for Hospice it seems that a nursing home may be your only option, unless, you could place them into the healthcare unit in a Continuing Care Retirement Community.  In all states there are rating systems for healthcare centers and nursing homes are rated along with them, as well as the healthcare facilities located within Continuing Care Retirement Communities.  You'll want to only consider the nursing homes that get the highest ratings and even then make sure you visit the facility to check it out thoroughly.

When looking into Nursing Homes don't confuse them with Rehab Centers, Rehab Centers are for short-term care and are fantastic to bridge the gap between Hospital and Home for someone who needs 24-hour nursing care after surgery or acute illness.  Check out the Official U.S. Government Site for Medicare at Medicare.gov.  You can find and compare Nursing Homes there.

Retirement Homes

I'm not sure if the traditional Retirement Homes we all remember are still around but I know there are homes similar to the old Retirement Homes that are run privately by individuals in their own homes.  I would stay away from these.  They are often just people renting out rooms in their home to make a profit and leave your aging parent to fend for themselves with little or no services.    

    

Assisted Living

An Assisted Living Facility is a place where you live if you need help with little things for only part of the day.  This can be achieved by hiring an aide anywhere you live, but I guess some people don't want to deal with the hiring so they opt to move to a facility where the staff is already in place.  In Assisted Living you will have your own room and bathroom but no cooking facilities.  

These communities are similar to the old retirement homes we remember and have similar living arrangements and activities.  In assisted living you live in one large house with many bedrooms similar to a Bed and Breakfast Inn you may have visited.  There is a central dining room and activity room and daily activities you can enjoy.  All your housekeeping is taken care of by the staff and all meals are provided each day.  I think that Assisted Living is what the Retirement Homes of the past have become.   

55+ Community

A 55+ community is just like any other community except there is an age requirement to live there, they really don't offer much in the way of activities or socializing.  I really don't see any benefit to living in a 55+ community unless you really just don't want anyone younger living near you.  Most 55+ communities have a clubhouse where parties and activities are held.  These communities are usually very large and often are a town unto themselves, here in Florida we have one such community that is called "The Villages" and it has its own zip code.  It's a town with everything any other town has except schools because everyone living there is over 55.  It's independent living in a town with only people your own age or older.  They have town squares and live entertainment with huge parties, festivals and parades, movie theaters, shopping centers, churches and a medical center.  Some even have learning centers for personal enrichment.  A 55+ community is a great choice for when you are young enough to be able to do anything you want, but once you start having mobility or health issues it begins to be very difficult to live in the community and you'll need to move somewhere more accessible.  In my opinion, the 55+ communities are great until you're in your late 70's and then, unless you're genetically blessed, things begin to become too difficult and you're forced to move to another community.  So I would call these communities the 55 - 75 community.        

Active Adult Retirement Community

An Active Adult Community is very similar to a Continuing Care Retirement Community only it doesn't have a Healthcare Center.  They do offer independent living and assisted living but if you need round the clock nursing care you would need to move to a nursing home or a skilled nursing facility.  This is a good alternative to look at if you don't have the "buy-in" money that most CCRC's require.  In an Active Adult Community you can lease your apartment as you would any other apartment, you sign a 3 month lease and after 3 months you have no obligation to stay if you don't like the community.  Your monthly fee entitles you to daily meal plans, activity programs that include outings and educational seminars, telephone and internet, TV programming, weekly housekeeping and all community activities.  And just like a CCRC your independent living apartment would have a full size kitchen and private bathroom, most apartments have a washer and dryer, walk-in closet, individually controlled heat and air conditioning and an emergency response system including smoke detectors and fire alarm.

Amenities on site usually include a movie theater, card room, bar, library, swimming pool and fitness center.  Access to these communities is restricted by a manned security guardhouse and security in the community is provided by the guards.     

Continuing Care Retirement Community

A CCRC or Continuing Care Retirement Community is without question my favorite type of community.  Included in your monthly fee is weekly housekeeping that includes washing your bed and remaking it, emergency call monitoring, unlimited access to on-site health care services, home maintenance, one meal at the restaurant per day and entitles you to participate in all community activities and use all the community facilities.  It combines a variety of living arrangements so as you age you can continue to live in your community among friends.  A CCRC is set up with Independent, Assisted and 24-hour nursing care all in one community.

So you can live in an independent apartment and do everything for yourself or have assistance from an aide.  If you become ill or need to recover from surgery you can remain in your community and spend some time in the Healthcare Center on property until you're well enough to go back to your apartment.  This way your friends are still able to visit and support you each day so you don't feel all alone.  These communities have an atmosphere like a college campus or a cruise ship, there is always someone to talk to and there are always activities going on in the Clubhouse.  In a CCRC you have your own apartment with a full kitchen, private bathroom, up to 3 bedrooms in most communities, washer and dryer, walk-in closet, individually controlled heat and air conditioning and an emergency response system including smoke detectors and fire alarm.  Most CCRC's also have villas or patio homes that offer larger accommodations and the feeling of living in your own home instead of apartment living.  These are usually scattered around the community and require a little more walking to get to the clubhouse, restaurant and activities.

 

In a CCRC you can live among your friends for the rest of your life, no matter how much care you require.  In my opinion, these communities offer the most for your money.  You can participate as much or as little as you like and there are so many activities that you won't be able to do all of them.  Most CCRC's also offer bus service to local doctors and shops and offer group bus trips to the theater or other events.  There are also group vacations offered for those who like to travel.

When it comes to amenities you couldn't ask for more than you receive at a CCRC, like I mentioned before it feels like living on a cruise ship there is so much to do every day.  For instance, on Monday you could go to Chorus, Poker and Play an organized game in the game room.   On Tuesday you can go to a lecture, play Canasta and then Bridge.  On Wednesday you could participate in a Bible Study then take the community bus to the mall come back in time for the Ladies Luncheon and later play an organized game in the game room.  On Thursday play Wii bowling, then Mahjong see a Musical in the auditorium then end the day with either Poker or Line Dancing.  Friday is Watercolor painting, the book club, poker and bridge.  Saturday starts with bocce ball then Gin Rummy and in the afternoon you can learn Ballroom Dancing then go see the Philharmonic.  Sunday the bus takes you to church in the morning then there's a Jazz Concert in the afternoon.   Now, this is just an example of a normal week but at least once a month there are community dinner dances and parties to enjoy.

On property amenities include restaurants, beauty salon, fitness center, health center, arts and crafts room, library, bar, card room, and auditorium.  Access to these communities is restricted by a manned security guardhouse and security in the community is provided by the guards.                    

I hope this helps you choose what type of community you want to look for and will give you a better idea of what choices will work best for you.  

Remember to visit each community and to be sure to eat in the restaurants, the quality of the food is a great indicator of the quality of the community.  You don't want to be eating frozen fish sticks for the next 20 years! 

Are you ready?

When your parents get to a certain age, usually their 70's, they will need more help from you.  In an emergency, are you ready to provide the medical providers with information about your parent such as, what medications they're taking or what surgeries they've had in the past and what medical conditions they currently have?  

No?

Well, you're not alone.  

Sadly, most of us wait until something happens to a parent before we start to pay attention to their needs.  Here's what you need to do.  

First, keep an up-to-date list of their medications with the dosage, how often they take it and the medical reason for taking it.

Next, have a discussion with your parent and find out any medical conditions they currently have and write it down.  You'll need to know this in an emergency.  Do they have high blood pressure?  Diabetes, Asthma?  These are all questions you need to ask your parent.  If you find it difficult to discuss these things with your parent you could offer to take them to their next doctors visit and get their information from their doctor while they are being seen.  Also, make a list of all the surgeries they've had. 

That brings me to the next thing you need to know, who are their doctors, you need to have a list that includes phone numbers of every doctor they visit on a regular basis.  It also helps to have the name of their regular pharmacy and the phone number to call in prescriptions.

If you don't choose to be your parent's caregiver you will need to choose someone who can check in on them at least once a week to talk to them and find out if there are any medical issues that have come up.  

In my experience, most of the time your parent "won't want to bother you" with their day to day aches and pains so they don't tell you, until it's too late or becomes medical emergency.  If you or someone with medical or caregiver knowledge of your parent visits them at least once a week you can keep on top of any issues that arise and prevent emergency visits.

Unless that person is their spouse.....then you will need someone outside the house to go in and check on both of them.  Sometimes a parent will tell you when the other parent is having a problem but it is rarely an accurate appraisal of the situation.  On the other hand, you have the parent who doesn't want to bother you so they don't mention that dad has been delusional at times and talking about a mermaid sleeping on the chair next to him.  

I can't stress enough how important it is to have someone personally check things out at least once a week.  The person you choose to check in on your parents will need to spend at least a couple of hours time with them to get an accurate picture of how they're doing.  Another thing is that you'll want to check on them after dark occasionally because I've found that sometimes symptoms of delusion don't occur until the sun goes down.  For some reason nighttime causes some people to become very disoriented, so you'll want to check on that too.

As your parents age and need more care you will need to check on them everyday and at that time you may need an additional caregiver to help you.  Don't be afraid to hire outside help, they can be a lifesaver and there are many reputable companies that screen and train people for just that reason.  We used several companies but our best help came from Granny Nannies which offers services in Florida, Georgia, Pennsylvania, Michigan, Kentucky, Ohio and South Carolina.    http://www.grannynannies.com/  

1-800-316-2669

So now you know what you need to keep handy to care for your parents.

1.  List of all current medications

2.  Names and phone numbers of all their doctors

3.  Name and phone number of their pharmacy

4.  What surgeries they've had

5.  Someone to check on them at least once a week    

    

Make good use of HOSPICE

Hospice is a term we're all familiar with but do you know what they do?

I had no experience with Hospice until a doctor recommended we call for my father-in-law.  He wasn't sick but he had been in the hospital for little things quite a few times that year.  He was in his late 80's and we figured that was just something we had to deal with on our own.....but I was wrong.  

I always assumed they were to be called when someone had no hope of recovery and only had weeks to live.  When the Hospice doctor came to evaluate dad he said we should have called sooner.  Within days the Hospice people had supplied us with a hospital bed, a lift to get dad in and out of bed, a wheelchair, and many, many other supplies too numerous to name and all of this for no charge!

Dad was placed on a schedule to receive visits each day from aids to care for him, clergy to talk with him and a doctor on call at all times.  The rest of the family were told that if they had any questions or needed someone to talk to about dad we could call at any time.

Hospice was handling his every need and making all of our lives so much better.  We had been taking care of all these things on our own for years before we found out about Hospice and it was getting VERY expensive.  

In my experience, the people who work for Hospice are the nicest, most compassionate, caring and knowledgeable people I've ever met.  They knew what to expect and gently guided us through the most difficult time of our lives and were by our side through the entire process.  

Our Hospice people were angels and I'll never forget them or everything they did for us and that's why I'm making sure that you all know how much they can help you.  

The criteria for qualifying for hospice is as follows:  If you answer yes to any of these questions, you qualify.  

1.  Is his or her treatment  no longer helping or working?

2.  Has he or she experienced one or more life-threatening infections during the past six months?

3.  Have there been multiple trips to the hospital or emergency room during the past year?

4.  Has there been unintentional weight loss and/or decreased food intake?

5.  Is there difficulty swallowing?

6.  Has there been a continued decline in his or her ability to function?

7.  Have you been told there's no further treatment available and care will now focus on providing comfort or relieving the symptoms, as opposed to prolonging life?  

8.  Do the patient's caregivers need support to help care for their loved one?

9.  Is there any expectation for a meaningful recovery?

10.  Has a medical professional given the patient a prognosis of six months or less?

If you're caring for a loved one and you need additional help, don't hesitate to call a Hospice near you.  When you choose a Hospice be aware that there are non-profit and for profit Hospices.  I don't know if it makes a difference but the Hospice we used was a non-profit.  

If you're are in the Central Florida area and reside in Orange, Seminole or Osceola County you are in the service are of the Hospice I used.  Words can not express my gratitude for how well they cared for Dad.  They are Hospice of the Comforter and as I said they are non-profit so if you are looking for a wonderful place to donate to a great cause, where you can really make a difference, look no further.

 http://www.hospiceofthecomforter.org/   

Here is a website to find a Hospice near you.

http://www.hospicenet.org/

               

    

Universal Walker Glides

We've all seen people with tennis balls on the legs of their walkers and wondered why there isn't something better to help the walker slide across the ground.

Well, there is!  The Universal Walker Glide or skis.  I found them at our local medical supply company and also Amazon.com has them online.  

We used these for Dad when he was using a walker and they last a very long time and don't mark or scratch the floors.  I don't know how people can use tennis balls on their walkers, they must have to replace them every week! And aside from that it just doesn't look nice seeing nasty, dirty tennis balls used as walker slides.

They're not just great inside, they work just as great outside on pavement, etc.  

If you or someone you love uses a walker, please buy Universal Walker Glides also known as Walker Skis.  It will make it so much easier to get around without falling.

A tiny investment to make someone's life much easier!

Please leave me comments below.  I welcome ideas for what you'd like to read.  

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