Important Facts about Falls

 (Article written by CDC)

Each year, millions of older people—those 65 and older—fall. In fact, one out of three older people falls each year, but less than half tell their doctor. Falling once doubles your chances of falling again.

	2004 - 2013, United States Unintentional Fall Death Rates per 100,000 All Races, Both Sexes, Ages 65+  Source: www.cdc.gov/injury/wisqars 2004: 41.15, 2005: 43.12, 2006: 44.8, 2007: 48.47, 2008: 50.91, 2009: 51.54, 2010: 53.76, 2011: 55.36, 2012: 56.07, 2013: 56.96

 

Falls Are Serious and Costly

  • One out of five falls causes a serious injury such as broken bones or a head injury.1,2
  • Each year, 2.5 million older people are treated in emergency departments for fall injuries.3
  • Over 700,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture.3
  • Each year at least 250,000 older people are hospitalized for hip fractures.5
  • More than 95% of hip fractures are caused by falling,6 usually by falling sideways.7
  • Falls are the most common cause of traumatic brain injuries (TBI).8
  • Adjusted for inflation, the direct medical costs for fall injuries are $34 billion annually.8 Hospital costs account for two-thirds of the total

What Can Happen After a Fall?

Many falls do not cause injuries. But one out of five falls does cause a serious injury such as a broken bone or a head injury.1,2 These injuries can make it hard for a person to get around, do everyday activities, or live on their own.

  • Falls can cause broken bones, like wrist, arm, ankle, and hip fractures.
  • Falls can cause head injuries. These can be very serious, especially if the person is taking certain medicines (like blood thinners). An older person who falls and hits their head should see their doctor right away to make sure they don’t have a brain injury.
  • Many people who fall, even if they’re not injured, become afraid of falling. This fear may cause a person to cut down on their everyday activities. When a person is less active, they become weaker and this increases their chances of falling.9

What Conditions Make You More Likely to Fall?

Research has identified many conditions that contribute to falling. These are called risk factors. Many risk factors can be changed or modified to help prevent falls. They include:

  • Lower body weakness
  • Vitamin D deficiency (that is, not enough vitamin D in your system)
  • Difficulties with walking and balance
  • Use of medicines, such as tranquilizers, sedatives, or antidepressants. Even some over-the-counter medicines can affect balance and how steady you are on your feet.
  • Vision problems
  • Foot pain or poor footwear
  • Home hazards or dangers such as
    • broken or uneven steps,
    • throw rugs or clutter that can be tripped over, and
    • no handrails along stairs or in the bathroom.

Most falls are caused by a combination of risk factors. The more risk factors a person has, the greater their chances of falling.

Healthcare providers can help cut down a person’s risk by reducing the fall risk factors listed above.

What You Can Do to Prevent Falls

Falls can be prevented. These are some simple things you can do to keep yourself from falling.

 photo: older adult talking to her doctor
Talk to Your Doctor
  • Ask your doctor or healthcare provider to evaluate your risk for falling and talk with them about specific things you can do.
  • Ask your doctor or pharmacist to review your medicines to see if any might make you dizzy or sleepy. This should include prescription medicines and over-the counter medicines.
  • Ask your doctor or healthcare provider about taking vitamin D supplements with calcium.
 photo of man doing tai chi
Do Strength and Balance Exercises

Do exercises that make your legs stronger and improve your balance. Tai Chi is a good example of this kind of exercise.

 older woman getting an eye exam
Have Your Eyes Checked

Have your eyes checked by an eye doctor at least once a year, and be sure to update your eyeglasses if needed.

If you have bifocal or progressive lenses, you may want to get a pair of glasses with only your distance prescription for outdoor activities, such as walking. Sometimes these types of lenses can make things seem closer or farther away than they really are.

 grab bar

Make Your Home Safer
  • Get rid of things you could trip over.
  • Add grab bars inside and outside your tub or shower and next to the toilet.
  • Put railings on both sides of stairs.
  • Make sure your home has lots of light by adding more or brighter light bulbs.

References

  1. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall–related injuries in older adults. American Journal of Public Health 1992;82(7):1020–3.
  2. Sterling DA, O’Connor JA, Bonadies J. Geriatric falls: injury severity is high and disproportionate to mechanism. Journal of Trauma–Injury, Infection and Critical Care 2001;50(1):116–9
  3. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web–based Injury Statistics Query and Reporting System (WISQARS) [online]. Accessed August 15, 2013.
  4. National Hospital Discharge Survey (NHDS), National Center for Health Statistics. Health Data Interactive, Health Care Use and Expenditures. www.cdc.gov/nchs/hdi.htm. Accessed 21 December 2012.
  5. Parkkari J, Kannus P, Palvanen M, Natri A, Vainio J, Aho H, Vuori I, Järvinen M. Majority of hip fractures occur as a result of a fall and impact on the greater trochanter of the femur: a prospective controlled hip fracture study with 206 consecutive patients. Calcif Tissue Int, 1999;65:183–7.
  6. Hayes WC, Myers ER, Morris JN, Gerhart TN, Yett HS, Lipsitz LA. Impact near the hip dominates fracture risk in elderly nursing home residents who fall. Calcif Tissue Int 1993;52:192-198.
  7. Jager TE, Weiss HB, Coben JH, Pepe PE. Traumatic brain injuries evaluated in U.S. emergency departments, 1992–1994. Academic Emergency Medicine 2000&359;7(2):134–40.
  8. Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention 2006;12:290–5.
  9. Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age and Ageing 1997;26:189–193.
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California Disasters Leave Disabled Elders in Peril

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Marian Bunting, 72, has Parkinson’s disease and a caretaker. She had not smelled smoke, nor had she received official warning about the Valley fire, when a neighbor came pounding on the door of her Lake County home and told her she needed to leave.

Though she moves slowly with a walker, Bunting managed to load her cat into the pickup she rarely drives, and wound up living in the parking lot of a Red Cross shelter.

“I have a person who takes care of me,” she said. “But he wasn’t around when it was time to go.”

Others had no way out. As the fire progressed, loved ones deluged the sheriff’s dispatch with calls, reporting those who were bedridden, without cars, standing in the roadway with pets — nearly all of them alone.

“Elderly female alone with Alzheimer’s, will not know to leave,” read one dispatch entry logged just before midnight on Sept. 12, 11 hours after the Valley fire began its manic progression.

Communication, evacuation and sheltering are key areas in which the disabled elderly, and others with what are known in government and advocacy circles as “access and functional needs,” require special attention.

The still-evolving area of disaster preparedness took hold after Hurricane Katrina in 2005 — when nearly three-fourths of those who died in the New Orleans disaster were older than 60 — and captured the attention of California officials two years later after two San Diego County wildfires. It is now viewed with urgency as the state increasingly goes gray, particularly in rural counties.

Senior Moments Katrina

Of 4.8 million Californians who identify as disabled, about 30% are 65 or older. In Calaveras County, where the Butte fire began to rage Sept. 9, 20% of residents are seniors, the highest proportion in the state, according to census data. Lake County is not far behind with 18%, compared with 11% for the state as a whole.

And as ashes smolder, those fires, which collectively burned more than 2,300 homes, are providing lessons on what worked and what didn’t.

“If you don’t shine a light on this issue, it just gets overlooked,” said L. Vance Taylor, chief of the Office of Access and Functional Needs at the Governor’s Office of Emergency Services. “This state is just a tinderbox. We know that if this doesn’t get addressed it’s going to be that much worse tomorrow.”

The office was created in 2008 after widespread complaints by the elderly and disabled over the two San Diego County fires.

Two years ago, Assemblyman Ken Cooley (D-Rancho Cordova) pressed legislation requiring that those populations be integrated into every aspect of California’s update to its state emergency plan. Due out two months ago, the update was delayed, Taylor said, “because we’ve kind of gone from disaster to diaster.”

His office in the meantime has urged local governments through its website to better educate vulnerable residents such as Bunting, alert them when it’s time to go, help get them out and meet their needs while they’re homeless.

In Lake County, the fire moved so fast that alerts and evacuation systems broke down, giving county officials no time to deploy accessible vans to ferry out those in need, as they did during two previous fires this summer.

There were deaths: a 72-year-old woman with multiple sclerosis trapped in her home, and three men over the age of 65, two of whom miscalculated the fire and decided to stay put.

The Butte fire moved more slowly, though both people who died were seniors: a one-legged 65-year-old man who remained to protect his property, and an 82-year-old man who a friend said had become depressed and increasingly immobile.

Almost immediately, the five-county region’s Area Agency on Aging sprang into action.

Primed by experience with Mariposa County’s Rim fire in 2013, staff members reached the providers who deliver home meals, offer community dining to seniors or provide transportation and alerted their own care managers, who got on the phones before they went dead and coaxed clients to leave immediately, said Doreen Schmidt, the agency’s disaster coordinator.

“People were thinking that maybe we were overreacting,” Schmidt said. “But we had been through it. We understood that people who are medically fragile, people who have dementia, it’s harder to get them out. … We thought, ‘We’re going to do this, even if it doesn’t spread.'”

Common Ground Senior Services, the area’s Meals on Wheels provider, was summoned by emergency officials to aid evacuations with their wheelchair-accessible van, while the local paratransit company deployed a bus. With adult protective services workers alongside them, they evacuated two mobile home parks and a senior apartment complex, Schmidt said.

Then they launched a frantic search for lodging for those too fragile to stay at Red Cross shelters, for batteries to keep oxygen tanks working and more.

Disability rights advocates had been pressing for better disaster planning for years when the 2007 wildfire season in California provided more impetus.

A report by the Pomona-based Center for Disability Issues and the Health Professions noted that the deaf community had not received emergency notifications, those with mobility issues could not be evacuated with their power wheelchairs, and shelters had trouble accommodating those with medical conditions.

“Most disaster response systems are designed for people who can: walk, run, see, drive, read, hear, speak and quickly understand and respond to instructions and alerts,” the report noted.

Plenty has changed. Among the programs launched soon after the report was FAST, or functional assessment service teams. The state Department of Social Services, which oversees the program, dispatched four teams of government workers and volunteers to the Valley fire, where they observed conditions, met residents and figured out what was missing.

For example, there are only five portable accessible showers in the state under contract to the Emergency Services office, and a number of them had to be commandeered from a music event in Southern California and trucked north.

Winnie Pugh, 85, had reluctantly left her Middletown home, abandoning her power wheelchair and a new electric scooter. Everything burned.

Thanks to a FAST team working with Red Cross and emergency officials, she received a donated power chair — two days after she was assessed but six days after arriving at the shelter.

The state contracts with Sacramento-based Ability Tools for assistive devices, and the organization found two wheelchairs, one for Pugh, in Concord, said Teresa Favuzzi, executive director of the Sacramento-based California Foundation for Independent Living Centers who was on scene for FAST. Two more chairs were scrounged from separate organizations in Berkeley.

Favuzzi was struck by how many people in the disaster zone had been unprepared to make their way to safety. She said these fires offer a teaching moment, much as the 2007 blazes did.

“We’re not there yet,” she said. “We should not let folks perish like this without responding in some way to improve the chances of people like them in the future.”

lee.romney@latimes.com

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The Particular Grief of the Adult Orphan

I am sharing this article from Fairfax Digital out of Canada as I experience the lost of my last parent.  It has been my faith, family and spiritual community that has sustained me and I hope others who experience losing both parents will have all the support they need to help them through this difficult time of their lifeDelane Sims & Father. I hope this article will be helpful to those who may need it. – Delane

They’re the forgotten grievers, the lucky ones whose parents had a good innings, the people who after a few months or even weeks are expected to dust themselves down, put their pain behind them and get back to a normal, happy life.

Midlife orphans, orphaned adults — there’s no established term for them, yet losing your parents is one of adult life’s most significant rites of passage. And while society recognises the loss that children feel when their parents die, adults are supposed to be fundamentally different, quickly dealing with the grief of losing the people that raised them from the cradle.

If only it were that simple. Psychologists warn that the impact of losing your parents goes way beyond organising the funeral and sorting out the will. It might be the natural order of things that parents die before their children, but the sheer inevitability is no cushion to the pain, soul-searching and sheer feeling of rudderlessness that so often follows.

Sue Cooper, who lives in Mt Martha, lost both her parents within 10 months of each other nine years ago. “I remember sitting with my sister crying and saying to each other ‘We’re orphans now’. There was a horrible emptiness, like all our back-up was gone. I felt very alone.”

Jack, a journalist with a wire service in Melbourne, lost his mother at the age of eight. He was in his early 20s when his father died. “Dad’s death hit me very hard,” he says. “About a month after he died my brother said to me, ‘You know, we’re orphans now.’ I hadn’t thought about it in those terms till then. It made me feel really alone, like I had a huge obstacle in front of me.”

Rob, a bank officer who lives in St Kilda, was 27 when his mother died, 29 when his father succumbed to bowel cancer. “I had this great sense of loneliness,” he says. “I ended up having quite severe depression. There was a lot of reckless partying, a lot of drinking, two phases of depression of about six months. At one stage I was quite suicidal.”

The second parent’s death plunges us into what can feel like a bottomless pit of emotion.

Bettina Arndt, Age columnist and member of the National Advisory Committee on Ageing, says she got an “enormous shock” when her parents died one and two years ago respectively, a shock that still affects her deeply.

American author Jane Brooks was almost 50 when her mother’s death stopped her in her tracks. “For a 47-year-old mother of two to admit to feeling like an orphan was somewhat embarrassing, making me seem needy and childish,” Brooks writes. “Especially since everyone assumed within weeks after the funeral that I was fine. I continued to work, to parent, and to go about my life. Internally, however, something was happening to me. The avalanche of emotions churning inside was throwing me off balance.”

Brooks, who has since written a book called Midlife Orphan: Facing Life’s Changes Now that Your Parents Are Gone, thought she was an unusual case until by chance she heard a woman voice similar emotions. “When I heard (her) words, I realised that perhaps my reaction wasn’t as extreme or unique as I imagined,” she writes.

“What we’re talking about here is disenfranchised grief,” says Chris Hall, director of the Centre for Grief Education at Monash Medical Centre. “It’s not a grief that tends to be appreciated,” he says. “The first question people ask is `How old were they?’ And because people can say the older parent had a good innings that grief can be disqualified by others.”

“Parents are like repositories of memory. They’re the only ones who hold certain memories of you as a child. It’s like a mirror — we define ourselves in terms of our relationships so our parents’ deaths challenge us to define who we are.”

Jack Lockett was one who had a good innings. Australia’s oldest man, he was 111 when he died in May last year in Bendigo. His son Kevin was thus 74 when he finally became an orphan. “I was lucky enough to play bowls on the same team with him, we went on fishing trips together,” says Kevin. He’s kept plenty of memorabilia, including newspaper photos of his father carrying the Olympic torch through Bendigo. “But it was a milestone (when he died),” the septuagenarian says sadly. “No matter who you lose, it always hurts. I still get emotional about it sometimes. There’s no use dwelling on it too long, but sometimes we certainly have our moments!”

American psychologist Alexander Levy in his book The Orphaned Adult describes the despair that can follow losing your parents. “At a minimum, parental death in midlife elicits lingering feelings of loneliness, memories of former losses, unresolved conflicts, and doubts concerning life’s purpose,” he writes.

“Feeling adult, a member of the eldest generation, brings the chilling knowledge that there is now no one between us and death. Without exception, those whom I have spoken to soon after the death of their second parent have said to me, I just realised that I am the next in line to die.”

The death of the last parent can also trigger grief for other losses, in particular reactivating mourning for the first parent. Brooks says adult children often do not fully mourn the first parent because they become so preoccupied with the surviving parent. “Thus, the second parent’s death plunges us into what can feel like a bottomless pit of emotion as we struggle with grief that had not previously been fully acknowledged.”

Bettina Arndt uses that term “a good innings” to describe her elderly parents’ lives. “Before they died I had this sense of dread not being able to contemplate what it would be like, but beyond that I hadn’t thought much about it,” she says. “It’s just been an enormous shock, the extent of the loss, even now over a year or two year later. I’ll just never get over it. Every day it hits me, that they’re not there any more.

“As your parents get older the whole process of dealing with them can be difficult, yet you end up with so many regrets, the things you don’t know, the questions you would’ve liked to have asked, the things you would like to have said. When my mother died I looked at every scrap of paper in the whole house hoping she’d written something for me.”

Arndt has been struck by what she calls the “selfishness of the younger generation”. Parents, she says, are always interested in what’s happening to their children but when the children grow up the interest is not always reciprocated. “The gaps are starting to emerge now in what I’d like to know. I’m rather shocked at what I don’t know about them — when they’re around you’re used to the fact that you can always ring up and ask them.”

Family relationships have changed. Losing her parents has drawn Arndt closer to her brothers, she says. “Organising the funeral was amazing, extremely stressful of course. These experiences do create a bond we hadn’t experienced for many years. There was good as well as bad in all of that.”

Rob has similarly bonded with his three older sisters. “Our parents’ death definitely strengthened my relationships with my sisters,” he says. “As children we didn’t get along so well but we’ve got over a lot of animosity and sibling rivalry.”

Jack, too, says the bereavement has strengthened ties, in his case with his brother and his stepmother. “We’re united now. We’ve all lost the same person, we’re the only people who can help each other.”

Sue Cooper’s parents held the family together socially. “All of a sudden that history was gone,” she says. “From being a very close family that did everything together, suddenly there was this void — our children had no grandparents and we had no parents. All the dynamics had changed. It seems stupid because I had a husband and children, but it felt like I lost my family — you do lose that family that you grew up in.”

Cooper has assumed some motherly duties with her relatives, visiting her mother’s aunt and helping her younger sister look after her pre-school-age children. “I used to ring my mum every day, now my sister rings me every day.”

Family experiences are not always so positive, Hall warns. The bereaved may be exhausted physically as well as emotionally, particularly if they have been looking after their parents. Disputes can arise over a range of matters, including inheritances, drawing in siblings, step-parents and children.

“Every sibling will have a different relationship with their parents,” says Hall. “You can have five people in a room crying for five very different reasons. There can be a lack of communication between siblings, and different ways of grieving.”

Melbourne mother-of-four Karen Rusden hoped that one of her older sisters would step into the role of organiser of family celebrations and events when her mother died 13 years ago. “But noone really did, so we lost all the family traditions and all just drifted apart. The family became fairly fractured. Mum was the link that kept us all together.”

Relationships with partners can also be rocked by a parental death. Brooks notes that those seeking comfort and support might find their partner insufficiently sympathetic, leaving the bereaved angry or disillusioned.

Furthermore, married adults can often experience some resentment of the spouse whose parents are still living. When that happens, she says, its not that the wife, for example, wishes her in-laws were dead, but it’s still “he has his parents and I don’t have mine anymore”.

Brooks concludes that midlife orphans are compelled to examine the past, dredging up both meaningful and unpleasant memories. “Expressing our ambivalent feelings about our deceased parents affords us a measure of comfort, and, at the same time, encourages our personal growth,” she writes. “Really knowing our parents — that’s what enables us to think of them gently.

“Finally we must make conscious decisions to move on, if only with tiny, tentative steps until we find comfort in our own shoes, shoes that fit us better than those of our parents.”

Hall, though, challenges the notions of “moving on” and “letting go”. “There’s the idea that what we need to do is sever the emotional connection, that out of sight is out of mind, which dates back to the early work of Freud that says grief is about disconnecting,” he says. “We now know this is incorrect. After a parent dies we continue to carry their voice in our heads at some level, as an encourager or as an admonisher. Death ends a life, it doesn’t end a relationship.”

Levy describes parental death as a compulsory subject in the school of life. “Everyone is enrolled. Everyone pays tuition in the form of grief. Nearly everyone learns something valuable.”

The primal fear we experience from childhood that our parents might not be there next morning when we wake up, is what makes losing parents so confronting, he argues. Yet, the enormity of the loss can ultimately be liberating.

“After we recover (and, hard as it is to imagine at the time, we do recover), our life and reaction to death is changed,” he writes. “And it is the gradual realisation we will survive the loss that makes parental death so transforming.”

– Additional reporting by Michelle Hamer

*Some surnames have been omitted by request.

 

 

 

 

 

 

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Developing Intergenerational Relationships

Senior Moments Pic Youth and Elder

 

 

 

 

 

 

Witten by: Lynda Spence & Heidi Liss Radunovich

The make-up of our society is rapidly changing as the aging population increases at an unprecedented rate. Since 1900, the percent of Americans ages 65 and older has tripled. In the year 2000, there were 3.5 million people in Florida over the age of 60. This number is expected to nearly double by 2020.

When people are raised in different time periods, their values and perceptions of the world can be quite different, and this can lead to difficulties in understanding one another. Because of this gap in understanding between generations, it’s important to find links between younger and older generations. This can be accomplished by helping children learn how to relate to older adults, and vice versa. Parents and caregivers can facilitate this process in many ways. For instance, they can create opportunities for children and older adults to spend time together in order to build a relationship. Research shows that what matters most is the quality of the visits between children and older adults.

Benefits of Intergenerational Relationships

According to Erik Erikson, one of the first psychologists to describe social development across the lifespan, the final stage of emotional development is experienced around the age of 60 and older. During this stage, people seek to find meaning in their lives and make sense of the lives they have lived. Developing connections with a younger generation can help older adults feel a greater sense of fulfillment. In fact, linking older adults with youth can provide advantages for both groups. For example, such relationships can:

  • Provide an opportunity for both to learn new skills
  • Give the child and the older adult a sense of purpose
  • Help to alleviate fears children may have of the elderly
  • Help children to understand and later accept their own aging
  • Invigorate and energize older adults
  • Help reduce the likelihood of depression in the elderly
  • Reduce the isolation of older adults
  • Fill a void for children who do not have grandparents available to them
  • Help keep family stories and history alive

Barriers to Intergenerational Relationships

Social

In the recent past, extended families often lived within the same home or very close to each other; however, this does not occur as frequently today. Even though people live healthier, longer lives, they expect to be self-sufficient. The trend in recent decades is for older Americans to live alone. As a result of this desire for independence, either by nuclear families or older adults, only one in eight single elderly adults now lives with extended family. The paradox is that although children today are more likely to have healthy, active grandparents, they are also less likely to know their grandparents well or visit with them frequently. These patterns do vary by ethnic group. For example, African American and Hispanic families are more likely than Caucasian families to have multiple generations residing in the same home or close to one another.

Another social barrier is created by the messages that society provides regarding older adults. Many advertisements promote youth and seem to suggest that growing older is a negative thing: something to fear or feel bad about. At the same time, people are living longer than they ever have. The increasing number of older adults, along with societal messages that aging is bad, may lead to negative thoughts or feelings about older adults.

Developmental

According to Piaget, an important child development researcher, children’s cognitive abilities are developed as they build, refine, select, and interpret information using their current understanding of the world. They modify that understanding based on their life experiences. Young children are very concrete in their thinking: what they see is what they know. This means that if children don’t interact with older adults, they will have difficulty understanding them. Research shows that the earlier children are made familiar with older adults, the better their perceptions of them are. Children’s negative perceptions about the elderly increase as they grow older, so developing positive relationships at an early age helps reduce negative perceptions.

Relating to older adults can be particularly challenging for adolescents. Adolescents tend to be focused on the present and think mainly about themselves, so they may be less interested in learning about older adults. Also, recent studies have shown that the brain is still developing through adolescence and into early adulthood. This means that the ability to make decisions and control impulsive thoughts and behaviors is not yet fully developed in adolescents. As a result, teens may display negative behavior that is hard for older adults to understand. Adolescents will need guidance and encouragement to help them relate to older adults and understand the implications of aging.

Senior Moments Elder Teaching Sewing

Facilitating Intergenerational Relationships

Here are some ways for parents to help children form rewarding intergenerational relationships:

Set reasonable goals for the relationship

Findings indicate that it’s the nature of the contact that is the most important quality of the relationship. Personal relationships develop over time and cannot be hurried or forced. In the beginning, your children may not want to develop this new relationship. Be patient and model respect and admiration for the older individuals in your child’s life.

Plan appropriate activities

Again, it’s the quality of the time spent together that is most important. Frequent, one-on-one visits enable the two generations to bond more readily than occasional visits or group activities. Be aware of children’s limitations (attention span, needs for food or sleep, etc.) as well as older adults’ physical limitations, and try to find activities that are of interest to both generations in order to ensure a positive experience.

Activities that Initiate, Build and Strengthen Intergenerational Relationships

Few communities have programs that encourage and facilitate intergenerational relationships between children and older adults. However, parents can encourage relationships between their children and older family members (or, if no older family members are available, older adults in the community). Here are some activities that could help nurture the relationship:

  • Storytelling. Swapping stories is a great activity and can help build a connection.
  • Letter writing/pen pals. If transportation presents a problem, writing letters is another great option. Everyone loves to get a letter in the mail! If there are no appropriate family members, your church or any number of local organizations may be able to provide you with potential pen pals. It is good to choose a pen pal who lives in the community. An introductory meeting is ideal, and correspondence can be supplemented with occasional visits. They can ask each other questions. For example: What can/could you buy with 10 cents, 25 cents, 50 cents when you were my age? What can you buy now?
  • Learning skills. Many older adults have skills or talents that would be interesting for children. Perhaps your child could learn to weave, crochet, fish, bake, or even take care of animals.

 

  • Planning/preparing a meal (if applicable).
  • Scrapbooking. Would an organization in your community that has older members like a scrapbook of their activities? You and your child could begin this project together with a member from the organization. Many children like to cut and paste and many people like to talk about their experiences.
  • Establishing phone pals. This activity can connect older community members with children who are alone after school.
  • Talking about ethnic heritage. Share ethnic customs, discuss the meaning of a name in native language, or relate special stories passed down about culture.
  • Planting seeds or gardening. This illustrates the stages of the life cycle. A container garden can be created if bending or space are issues.
  • Weather watching.
  • Telling jokes.
  • Discussing hobbies and sharing examples.

Activities for Children and Older Adults to Do Together

Conduct an interview: http://careerservices.siu.edu/students/interviewprep.html [22 March 2013]

Make a greeting card: http://familycrafts.about.com/od/greetingcards/Cards_Invitations_and_Gift_Tags.htm

Make a worry stone: http://www.teachers.net/lessons/posts/790.html

Make a family tree: http://www.pbs.org/americanfamily/tree/

 

This publication is FCS2282, one of a series of the Family Youth and Community Sciences Department, Florida Cooperative Extension Service, Institute of Food and Agricultural Sciences, University of Florida. Original publication November 2007. Reviewed August 2012. Visit their EDIS website at http://edis.ifas.ufl.edu.

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Why You Shouldn’t Drop Your Landline Just Yet

DNNC-Portrait-of-senior-woman-on-landline-phone-

Cellular and Internet-based phone service can delay first responders

by David Wallis

Susan Odom of Atmore, Ala., believes she would have choked to death if she hadn’t dialed 911 on a traditional copper wire landline. A 911 call from a cellular phone or an Internet-based Voice over Internet Protocol (VoIP) service often requires routing the call to the correct emergency response center, which can cause delays for first responders when every second counts.

“If you call 911 from a landline, you get several advantages,” Odom said on her local newspaper’s website of the 2009 incident. “First, the call shows up on a computer screen in the correct 911 center. The screen shows a map and exactly where the call is coming from, the address and the name of the residence. Should the caller be unable to speak, get confused or not know where they are, the 911 screen shows EMS … right where to go.”

While “tech-savvy seniors can save money by switching to mobile and Internet-based services,” Santanam says, he recommends keeping a landline as a plan B: “It’s important to gauge the age-related changes and the convenience of keeping things simple. Given that all seniors are most familiar with landlines, it should be either the first option or the emergency backup option.”

Since copper lines are self-powered, “it makes even more sense,” for older people in rural communities or areas prone to storms to resist offers from cable, cellular and satellite companies, Santanam says. “In case of bad-weather conditions, landline phones are much more likely to be available,” he says. “For example, satellite-based Internet services in rural areas can have outages during storms.” And cellular towers can be vulnerable to losing power in natural disasters, as occurred during Hurricane Sandy.

“If they don’t have enough backup battery power for these towers, your cell services will disappear,” says Barbara Cherry, a professor in the telecommunications department at Indiana University and a former senior counsel at the Federal Communications Commission’s Office of Strategic Planning & Policy Analysis.

“Reverse 911 calls” — prerecorded robocalls that enable authorities to notify people about imminent dangers such as tornados — don’t automatically contact cellular or VoIP phones.

“Landline carriers are required to provide the phone numbers of their customers to local reverse 9-1-1 systems,” writes Carmelita Miller on the website of the Greenlining Institute, a think tank in Berkeley, Calif. Cellphone users and VoIP customers generally must sign up to receive emergency alerts.

Harold Feld, senior vice president of Public Knowledge, a consumer watchdog organization in Washington, D.C., says that abandoning a landline to save a few dollars per month can prove costly. “Unlike traditional phones, there’s no mandatory quality of service for any of the newer technologies,” says Feld. The quality of VoIP and cellphones is “very variable,” he says. Medical alert services and remote monitoring of medical devices such as pacemakers that are designed for traditional landlines may or may not “work on an IP substitute and will absolutely not work on wireless,” he says.

Feld says landlines could become an endangered species. AT&T and Verizon, the two largest landline providers, are eliminating some landlines because maintaining them is less profitable than providing wireless or VoIP services.

“In a country where we have an increasing number of elderly who need to make sure that medical device and medical alert services work, who need the superior voice quality,” says Feld, “how do we make sure they are protected? That’s a very big question right now.”

David Wallis is a freelance writer for AARP Media.

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Dementia and Depression Among the Elderly A Public Health Issues

Senior Moments Pic of elderly couple

Dementia

Dementia is a syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities. It mainly affects older people, although it is not a normal part of ageing.

It is estimated that 35.6 million people worldwide are living with dementia. The total number of people with dementia is projected to almost double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050, with majority of sufferers living in low- and middle-income countries.

There are significant social and economic issues in terms of the direct costs of medical, social and informal care associated with dementia. Moreover, physical, emotional and economic pressures can cause great stress to families. Support is needed from the health, social, financial and legal systems for both people with dementia and their caregivers.

Senior Moments pic of black woman

Depression

Depression can cause great suffering and leads to impaired functioning in daily life. Unipolar depression occurs in 7% of the general elderly population and it accounts for 1.6% of total disability (DALYs) among over 60 year olds.1 Depression is both under diagnosed and undertreated in primary care settings. Symptoms of depression in older adults are often overlooked and untreated because they coincide with other late life problems.

Older adults with depressive symptoms have poorer functioning compared to those with chronic medical conditions such as lung disease, hypertension or diabetes. Depression also increases the perception of poor health, the utilization of medical services and health care costs.

Treatment and care strategies

It is important to prepare health providers and societies to meet the specific needs of older populations, including:

  • training for health professionals in old-age care;
  • preventing and managing age-associated chronic diseases including mental, neurological and substance use disorders;
  • designing sustainable policies on long-term and palliative care; and
  • developing age-friendly services and settings.
Health promotion

Mental health of older adults can be improved through promoting active and healthy ageing. Mental health-specific health promotion for the older adults involves creating living conditions and environments that support wellbeing and allow people to lead healthy and integrated lifestyles. Promoting mental health depends largely on strategies which ensure the elderly have the necessary resources to meet their basic needs, such as:

  • providing security and freedom;
  • adequate housing through supportive housing policy;
  • social support for elderly populations and their caregivers;
  • health and social programmes targeted at vulnerable groups such as those who live alone, rural populations or who suffer from a chronic or relapsing mental or physical illness;
  • violence or older adults maltreatment prevention programmes; and
  • community development programmes.
Interventions

Prompt recognition and treatment of mental, neurological and substance use disorders in older adults is essential. Both psychosocial interventions and medicines are recommended.

There is no medication currently available to cure dementia but much can be done to support and improve the lives of people with dementia and their caregivers and families, such as:

  • early diagnosis, in order to promote early and optimal management;
  • optimizing physical and psychological health, including identifying and treating; accompanying physical illness, increasing physical and cognitive activity and optimizing well-being;
  • detecting and managing challenging behavioural and psychological symptoms;
  • providing information and long-term support to caregivers.
Mental health care in the community

Good general health and social care is important for promoting older people’s health, preventing disease and managing chronic illnesses. Training all health providers in working with issues and disorders related to ageing is therefore important. Effective, community-level primary mental health care for older people is crucial. It is equally important to focus on the long-term care of older adults suffering from mental disorders, as well as to provide caregivers with education, training and support.

An appropriate and supportive legislative environment based on internationally accepted human rights standards is required to ensure the highest quality of services to people with mental illness and their caregivers.

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Role Reversal: Caregiving for Aging Parents

Adult Child CaregiverWhen an aging parent needs caregiving, the children often need to take responsibility. But what happens when only one of many siblings steps up to the plate?

 Written By
 Reviewed by  Louise  Chang, MD

Hannah Kalil is 83 years old, and lives by herself in upstate New York. She has aides who help with her caregiving throughout the day. But the responsibility of managing her finances, health care — both mental and physical — and long-term living situation falls to one person: her daughter — and my mother — Eleanor.

It’s almost a full-time job. Making sure my grandmother is happy and not feeling lonely means daily visits. Her never-ending stream of medical issues means weekly — if not more frequent — trips to the doctors. Paying her rent and her aides while keeping an eye on the bottom line means constant vigilance if she is going to have any financial security in the long term. Finally, my mother must deal with the endless stack of paperwork for Medicaid and health insurance.

To make matters worse, my mother shoulders these responsibilities on her own — despite the fact that her two brothers and sister all live nearby.

This situation is not uncommon: When an aging parent needs care, it’s often one child out of several siblings who steps up to the plate to offer help. And with more Americans living longer — to 75 years and beyond — this scenario will only become more familiar.

WebMD talked to experts for their insights into the aging of America. What it means for adult children, like my mother, who are put in a position to care for their aging parents. How the one child who shoulders the responsibility of parent-care can enlist the help of others, without starting a family war.

Aging in America

The dynamic of age in America has shifted dramatically over the last 60 to 80 years, experts agree, and its impact on the family is clear.

“There is definitely a changing age structure within families today,” says Neal Cutler, PhD. He is the executive director of the Center on Aging for the Motion Picture and Television Fund in Woodlawn Hills, Calif. “Its cause is simply greater longevity.”

With more Americans living well beyond their 70s, more adult children are now left in a position where they have to be caregivers for their aging parents.

“There’s a greater likelihood today that, as a 55-year-old, you will have surviving parents, than there was say in the 1920s when both parents passed away before you reached the age of 50,” says Cutler, who is also dean of the American Institute of Financial Gerontology. “This means that middle-agers, who are planning for their own older years, also have to think about their parents.”

To complicate matters, one adult child of an aging parent often bears the responsibility of the parent’s care alone. What factors play a part in determining who takes on the care of Mom or Dad?

“There is a gender bias in terms of who cares for an aging parent,” says Lisa Hollis-Sawyer, PhD, coordinator of the Gerontology Program at Northeastern Illinois University. “It’s fairly universal that we think of women as a caregiver, so their role in helping an elderly parent is not uncommon.”

Another factor in determining who will take on the role of caregiver to a parent is age.

“It’s also likely it’s going to be the oldest,” Cutler tells WebMD. “While gender does play a big part, now — with women in the workforce — it’s not necessarily the case anymore, and age and order of birth can come into play.”

But there’s more to who is going to care for a parent than gender and age. Instead, siblings should consider who is the best fit.

It’s selective matching, explains Hollis-Sawyer, meaning that personalities, geography — simply who lives the closest — and finances all play a role in determining who might be able to provide the best care.

Caregiving for an Aging Parent: Taking Charge

If you are nominated — willingly or not — to be the caregiver for an aging parent, dealing with the situation can be a challenge. It can be especially difficult if your brothers and sisters aren’t willing to recognize their sibling responsibility.

What’s the key to enlisting the help of your family to ensure the best care for your parent? Read on for tips from the experts that will help you wade through not only the family issues that caring for a parent presents, but the practical ones as well:

Open the lines of communication. As a family, with all of your siblings and surviving parents, talk about how you will care for Mom or Dad before the situation turns into a crisis, suggests Cutler.”Anticipate that these are decisions and choices that are best made before a crisis happens,” says Cutler. “Sit down with everyone together, and talk about what you want to do, whether it’s a financial issue or geographical issue. The key is conversation rather than crisis management.”

Then, when it is time for a parent to reach out to their children for help later in life, it’s clear who is responsible for what, from a financial and support perspective, without creating a family conflict.

Pick an age. Have this conversation when your parent is still of a “functional” age, whether it’s your mother’s late 60s or early 70s — meaning she still has her mental and physical health on her side.

“A good guideline is to talk about long-term care with a parent when issues like a health care proxy or living will come into play,” says Hollis-Sawyer. “If these are topics a person needs to think about, then how their long-term care will be handled should also be on the table.”

Support comes in many shapes. If one person is elected to be the primary caregiver for a parent, the siblings should think about how they can provide indirect support, whether it’s by pitching in with paperwork, finance management, or in-person help.

“A family needs to think about how to help support the sibling in charge of a parent, either with help or compensation of some sort, to help defray the cost that they are incurring,” says Steven Stern, PhD, a professor of economics at the University of Virginia, who specializes in aging and disability.

Understand the finances. “Talk to a financial planner about finances if you are caring for an aging parent on your own,” says Cutler. “You may be able to take a parent as a dependent on your tax return, if you are paying for more than half of their well-being, such as rent, nursing home care, or food.”

The financial aspects of caring for an aging parent need to be taken into consideration for the sake of your parent, but also for your own sake.

“Increasingly, the baby boomers will stay in the workforce longer, primarily because they can’t retire on time because of the need to care financially or otherwise for a parent, maybe even a grandparent, and the cost of raising children,” Hollis-Sawyer tells WebMD.

When help isn’t forthcoming. If the productive discussion before a crisis strikes doesn’t happen, and one child is left in charge with no support from his or her siblings, the key is still communication.

“This situation happens a lot,” says Hollis-Sawyer. “When it does, the caregiver has to look at their options, and ask themselves questions like, ‘Would I benefit by attempting to communicate my needs to others?'”

Reaching out to your siblings or other family members for support is a better option than trying to take on the situation entirely on your own.

“If you do reach out, and you don’t get the help you need internally from your family, then it’s time to look elsewhere,” says Hollis-Sawyer. “Turn to your community for support, like county-wide respite-care programs, or caregiver support programs, or estate-planning consultations to understand the financial issues at hand.”

It’s not all about you. Pay attention to your parent and his or her needs, and remember that there are two people in this situation — not just one.

“It’s so important to realize that there is a lot of stress to being the care recipient,” says Hollis-Sawyer. “There are just as many mental hurdles that need to be overcome for the aging parent — like accepting care and depending upon someone else almost entirely later in life maybe when you’d like to be financially secure — as there are for the adult child in charge of their care.”

 

The Upside of Caregiving for an Aging Parent

While the responsibilities of caring for an aging parent might overshadow the benefits at times, it’s important to remember the rewards of the situation as well.

“There are definitely benefits of a positive caregiving relationship for an elderly parent and an adult child,” says Hollis-Sawyer. “The bonding experience can create an intimacy that may not have been encountered when the adult child was going through their own mid-adult phase. Maybe hopefully, they are becoming closer to the parent.”

Many people, she says, find that caring for an aging parent is a growth experience, which creates an opportunity for both people to learn more about themselves.

For the parent, having a child around to spend time with, and provide care, may make a difference in quality of life.

“When kids provide help for the parent, it has a significant effect on the parent,” says Stern. “They have a stronger emotional connection to their child than they would to a stranger who is an aide or a nurse in a living facility. While it may not necessarily make them healthier, I believe it does make them happier.”

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Palliative Care

What does one do when given challenging news regarding their health?  In cases of terminal illness, Palliative care may be one important answer.  The World Health Organization offers this information regarding Palliative care:

Senior Moments Palliative Care

Improving the quality of life of patients and families

Palliative care improves the quality of life of patients and families who face life-threatening illness, by providing pain and symptom relief, spiritual and psychosocial support to from diagnosis to the end of life and bereavement. Palliative care:

  • provides relief from pain and other distressing symptoms;
  • affirms life and regards dying as a normal process;
  • intends neither to hasten or postpone death;
  • integrates the psychological and spiritual aspects of patient care;
  • offers a support system to help patients live as actively as possible until death;
  • offers a support system to help the family cope during the patients illness and in their own bereavement;
  • uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated;
  • will enhance quality of life, and may also positively influence the course of illness;
  • is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.

Effective approaches to palliative care

In most of the world, the majority of cancer patients are in advanced stages of cancer when first seen by a medical professional. For them, the only realistic treatment option is pain relief and palliative care. Effective approaches to palliative care are available to improve the quality of life for cancer patients. The WHO ladder for cancer pain is a relatively inexpensive yet effective method for relieving cancer pain in about 90% of patients.

Related links

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Transportation Cost for Seniors

Senior Transportation 

 

 

 

Written by Ronnie Friedland, Care.com editor   |

Finding transportation options is a major issue for seniors who have had to give up driving. Having alternative means of transportation, whether through a town’s senior services or through family and friends, can be tremendously important to a senior’s sense of independence.

But, as one senior said to Candace Gould, a licensed mental health counselor for Jewish Family & Children’s Services in the Boston area, “I have difficulty getting rides since giving up my car. Friends and relatives are forgetful.” Some seniors find that although they are lucky to have friends and family to provide transportation assistance, conflicting schedules mean it’s often difficult to make arrangements that work for all involved.  Senior Transportation 2

Despite the importance of town-operated transportation services to elders, their availability and cost vary greatly from town to town.

  • Many communities try to meet senior transportation needs in some way — either through offering vouchers to defray the cost, basing costs on a sliding scale, or by providing some sort of free or minimally priced transportation — usually a van that will pick up seniors at their home and bring them to a grocery store or senior center. In addition, they offer reduced fares for seniors on regular public transportation.

For seniors who do not have any transportation services in the town where they live, the cost of transportation will depend on their location and the type and frequency of transportation services they require.

  • If the senior needs to hire a home care aide to provide transportation, MetLife in 2007 estimated that the average hourly cost of a home care aide worker was $19 per hour. However, in some states the surveyed rate was as high as $30 per hour and as low as $9 per hour.
  • The costs of taxis and car services also depend on location, with urban areas generally more expensive than rural areas, and with competition among providers in a particular area usually leading to lower prices.

Prior to a move or in anticipation of the need for alternative means of transportation, it may be helpful to assess the availability and cost of town-owned senior transportation services. Seniors should know what to expect in terms of how they will be able to get around town independently, especially if their needs or health suddenly change

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Aging

Senior Moments Oldest Senior

Leandra Becerra Lumbreras, born in northeast Mexico, claims to have been born on Aug. 31, 1887 – meaning she turned 127 on Sunday and that would make her the oldest human being ever on the face of the earth. She is still able to chat and has some mobility despite her deafness and severe cataracts, EFE reports.

She celebrated her birthday over the weekend in the company of some of her 153 descendants. They made sure she got enough rest and was awake for the event: these days this witness to three centuries usually sleeps in 72-hour periods, relatives say.

My dad, Andrew Frank Hatch, will be 116 next month, so living a long life is something I know a little something about.  People often ask the much repeated question, “How does he do it?” My father always says his longevity is due to the man upstairs and I will add that having loving family is the next important ingredient.  I hope you enjoy this article endorsed by the National Institute of Aging that can perhaps shed light on the aging process.

Just like millions of Americans, the National Institute on Aging’s (NIA) Baltimore Longitudinal Study of Aging (BLSA) celebrates its 50th birthday in 2008. The study was the first to ask a most basic question: What is normal aging?

There is still much to learn, but so far two major conclusions can be drawn from BLSA data. First, “normal” aging can be distinguished from disease. Although people’s bodies change and can in some ways decline over time, these changes do not inevitably lead to diseases such as diabetes, hypertension, or dementia. A number of disorders that typically occur in old age are a result of disease processes, not normal aging.

Second, no single, chronological timetable of human aging exists. We all age differently. In fact, in terms of change and development, there are more differences among older people than among younger people. Genetics, lifestyle, and disease processes affect the rate of aging between and within all individuals.

These fundamental changes in our thinking about age and disease have led the BLSA and the field of aging research in important new directions. As we further pinpoint the influences on how we age, we can also think about new and more effective interventions that may prevent disease and promote healthy aging.

You can find the complete BLSA booklet at this website http://www.nia.nih.gov/sites/default/files/healthy_aging_lessons_from_the_baltimore_longitudinal_study_of_aging.pdf

Healthy Aging: Lessons from the Baltimore Longitudinal Study of Aging

 

 

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