Home Safety Tips Part 2

Last week I talked about how to make your home safer for your aging loved one. I shared the top 5 Home Hazards that Home Instead Senior Care finds in the homes of their clients, and also suggested ways to remove the danger from these issues.

This week I’d like to consider the next 5 Hazards found in Home Instead client homes. Again, ask yourself how many of these you might see in your loved one’s home or even your own!

  1. Rooms crowded with clutter or too much furniture: I see this all the time in the homes of older adults. My own mother’s living room had a sofa, loveseat, two end-tables, two arm-chairs and two recliners. You could barely walk through the room upright, never mind with a walker! My mother accumulated this furniture over many years. It had lots of sentimental value, and she would never let any of it go, but because it was such a crowded room, she rarely went in it over the last several years of her life. A word of warning must be shared here, however. Be careful to have a conversation with others who live in the room before you begin to rearrange rooms.
  2. Steep steps, or bedrooms or laundry room that requires climbing stairs: Single-floor houses are best for aging adults. A floor plan that has the bedroom, laundry, kitchen, bathroom and living room/den all on a single floor that does not require stairs is ideal for healthy aging. If your home, or the home of the person you care for, has stairs leading up or down, try to minimize or even eliminate their use for your older adult. Many conditions make balance issues and risk of falling a dangerous possibility for people of advanced age, and stairs dramatically increase this risk. If you cannot relocate to a different living environment, consider putting in a chair lift that will let a person ride up the incline in comfort and safety. Another alternative might be to put a barrier in front of the stairs and rearrange the home, so sleeping space or the laundry center moves to the living level. You might also consider adding an extension on one level to create a “mother-in-law” suite. The remodel works well and enables your loved one to have personal space in your home.
  3. Low supply of food: Often, seniors find themselves needing to choose between paying for utilities, buying medications, and purchasing groceries. As a Family Caregiver, it’s your responsibility to make sure the budget can meet the needs of your loved one or seek assistance to supplement their shortfall. Programs like Meals on Wheels can assist with nutritional support; some pharmaceutical companies will offer lower prices if the patient cannot afford food and their medicine. Utility companies sometimes have charitable programs to supplement or discount your loved one’s rate. Check with your local Social Service Agency for more ideas on how to get assistance if your loved one cannot afford proper nutrition. And if they don’t have groceries merely because they cannot shop for themselves any longer, a service like Home Instead can offer a professional CAREGiver who can pick up groceries and put them away in your loved one’s home.
  4. Poor lighting: Seniors of advanced age don’t see as well as younger people, and they might not notice when light bulbs have burned out, or they might not be able to reach the light fixture to replace the bulb. The Family Caregiver should walk through the house periodically, turning on light switches and checking to see if bulbs are burned out. A poorly lit hallway or living space can provide any number of hazards in the dimly lighted area. A little illumination will go a long way toward making the space safer!
  5. No telephone at the bedside: This might seem like a no-brainer, but it is even more critical that the bedside phone is able to accommodate hearing loss or the diminished ability to hear well. My mom’s bedside phone was decades old, and she could no longer hear on it. It had a cord that was so twisted that it pulled the base off the table every time she picked up the handset. She would answer that phone when she was in her bedroom and say, “Hold on, I can’t hear you on this phone. Just wait while I go get the other phone (which was out in her kitchen).” She would lay the phone down, and I would hear her shuffle from the room. In a couple of minutes, she would pick up the cordless phone, which was adjusted up to its loudest volume, and say, “Now I’m here. Let me go back and hang up the other one, but you can talk now.” I urged her countless times to let me replace the bedside phone with the same cordless model she had in the kitchen, but she insisted that it was just fine. If your senior has a reliable phone by the bed, then if they are afraid in the night, they can call for help. Likewise, if they feel unwell, or even lonely, they don’t have to go through the house in the dark to get a phone from another room. It’s just smart to have this.

Wow, that’s a lot to worry about in your loved one’s home! But remember, God is in control of this. He’s watching over your loved one when you aren’t there. You need to do your part to make his or her environment as safe as possible, but then rest assured that when you can’t be there, God’s angels are. And He will never let you, or those you love, down!

Share your heart with us and let us know if you have any useful safety tips.

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Home Safety Tips – Part 1

June is National Safety Month, so Chris and I thought we’d share a little about ways to make your home, or that of a loved one, safer to support successful aging.

Most senior adult injuries occur within their own homes. The good news here is that you can remedy most of the hazards that could lead to injuries with a few simple steps. The bad news is that all too often the risks remain because they go unnoticed and unrecognized for the dangers they present.

Home Instead Senior Care identified the top 10 safety issues commonly found in the home of an aging adult. This week we will cover five and then next week the remainder. See how many are in your home or that of the person for whom you care.

  1. Loose area rugs: These are throw rugs used as accents around the house. While pretty or unusual decorator’s touches, they are not safe for someone who uses a walker or shuffles when they walk. Sometimes these rugs “creep” and have ridges and humps that develop periodically. Believe me when I tell you that no carpet is worth the pain and trauma of a broken hip, which can quickly happen with a trip and fall. Roll it up and put it in storage.
  1. The absence of a “life alert” system: These systems can alert you or another contact if your loved one falls or feels unsafe. Most require a button to be pushed, but newer versions have technology that will recognize a fall in its rapid motion from vertical to horizontal. Some systems aren’t worn but use infrared technology to “see” a person’s movement in different areas of the house. These can even learn patterns, establish baselines, and then recognize disruptions that can indicate a reduction in activity level, increase in bathroom visits, or even the occurrence of a fall. These usually require the purchase of the system and a monthly monitoring fee, but the price is well worth the peace of mind you can find when you have one of these systems.
  1. Spoiled food in the fridge: This is one of the most straightforward hazards to fix, but unlike some of the others, it requires routine inspections of the refrigerator and pantry. Many seniors become dependent on prepackaged foods, frozen meals, and simple-to-fix options. One of your jobs as a Family Caregiver is to encourage your aging loved one to eat healthier meals, which should include lots of fresh fruits and vegetables that won’t hang around long enough to spoil! If your loved one cannot chew those kinds of foods easily anymore, consider investing in a commercial blender and getting some great green smoothie recipes. We have a link to a website in our resources that will give you some ideas.
  1. No safety bar in the shower or tub: Don’t be fooled here. My mom tried one of those suction-cup grab bars on the wall next to her bathtub, but it was never secure enough to be reliable. Grab bars aren’t expensive, but if you or someone you know isn’t great at wall work, then hire a handyman. You might spend twice or more than you did on the grab bar, but your investment will be well worth every penny if it breaks a fall stepping out of the shower. Your grab bars should be able to support a good, hard pull when correctly installed.
  1. The shower is in the tub, requiring the senior to step over the tub wall: Speaking of bathtubs, as you age, it is harder to pick your knees up high, unless you are one of the Dancing Grannies! If your loved one has always enjoyed taking baths, that pleasure doesn’t have to stop because mobility is now a challenge, but you should help make this exercise safer while still being pleasant. There are lots of ways you can approach this challenge. First, you can remodel the bathroom and install a walk-in bathtub. There are several models to choose from, but I recommend one that drains quickly. Remember, you cannot step out until all the water is gone, and it will be quite unpleasant to sit, wet and chilly, while water takes several minutes to drain. Newer technology allows for tubs that empty in a couple of minutes. Alternatively, for those who enjoy showering, consider removing the bathtub and replacing it with a roll-in shower with no impediment. Newer shower designs allow for a floor drain that absorbs all the water, so none runs out onto the bathroom floor, where it would create another hazard!

Well, that’s enough hazardous talk for this week. I hope you will visit again next week to hear about the other five hazards Home Instead has found to be in almost every aging person’s home, and how to avoid them!

Continuing Care Retirement Communities

Every month Chris and I explore another option in your Care Arsenal, and this month we will help you understand what Continuing Care Retirement Communities are. For short, we call these types of care communities “CCRC’s.”

Sometimes CCRC’s are called Life-Care Communities. A CCRC is a retirement community that covers a full range of aging services and levels of care, from independent living cottages or apartments to assisted living housing, to full-blown skilled nursing services. In most cases, each change in care-level requires a move to new living quarters. The different levels of care may all be housed on different floors of a high-rise building or in different wings or buildings across a single campus.

Independent living is usually the entry-level for most residents. The idea is that residents enjoy a higher quality of life in a community of peers with similar life experiences. Independent living residents experience maintenance-free housing and landscaping, housekeeping services, and sometimes even congregational meals in a restaurant-style dining room. A variety of activities and opportunities abound for those who enjoy hobbies, concerts, games, dances, and even excursions.

As the resident begins to need assistance with personal care needs like bathing, toileting or walking, they must move into the Assisted Living section of the CCRC. This area has more of a nursing presence and closer supervision of the residents. CNA’s, Home Health Aides, or Nurse Aides will assist with those personal care items that need help. With this transition usually comes a higher monthly cost.

Skilled Nursing Assistance is the highest level of care provided in CCRC’s. You would probably think of this as a Nursing Home, but still on the campus. It will have the highest monthly cost for the resident, but it provides constant nursing supervision of the resident. Frequently when a couple resides in a CCRC, and one spouse needs Skilled Nursing Services, the other spouse will need to remain at their current level of care unless both require the same level of care. It is sad when a couple married 60+ years must live separately because of the declining health of one.

Payment options for CCRC’s vary greatly. There are many models that may apply. Some require a large sum of money for an entry fee, but remain relatively consistent with the monthly residential fee, even when levels of care increase. Others require a minimal entry fee, but the resident is in a “pay as you go” program where every level of care costs significantly more than the one before.

You might want to check out Genworth’s Cost of Care resource: https://www.genworth.com/aging-and-you/finances/cost-of-care.html

So that’s more or less the rundown on CCRC’s. They can be very expensive but can also be very enjoyable for the socially active retiree. Be sure to ask lots of questions and understand the contract and its requirements. If your loved one has dementia, or if you suspect they might, be sure to ask if the CCRC has a Memory Care facility. That’s also critically important to know. Finally, ask if they allow private duty caregivers in their facilities, and how they screen and track those individuals. Arm yourself with knowledge and visit several times throughout the year before you decide to commit so that you can experience lots of different seasons and conditions within the community. The more you know, the better the decision you can make.

Money and Care Management

As a Family Caregiver, your job can be quite demanding. Understatement of the year, right?? And if part of your responsibility is paying the bills and managing the money, this job can also be risky, especially if the one you care for is not your spouse. You can find yourself in the unpleasant position of having to defend expenditures or even being accused of embezzling from a loved one. This situation can lead to family turmoil and broken relationships, and in some cases, legal action may be taken.

Betsy found herself in an awkward situation at the end of her mother’s life. Over the last year with her mother, Betsy went with her mom to the bank and signed some paperwork to put Betsy on the list for access to the safe deposit box. She also thought she signed a card giving her signatory access to her mom’s checking account. Over the last couple of years, Betsy’s brother had moved most of Sarah’s bills to be automatically debited from that account, but there were a few things like the church tithe for which Sarah still wrote checks by hand. These contributions were a personal commitment for Sarah, but in the last year of her life her memory began to fail, and she stopped writing the checks. When Betsy discovered this, she knew that her mother would want to be caught up, but by now Sarah could no longer sign her name, so Betsy wrote a few checks and signed them.

The day after their mother died, Betsy’s brother went to the bank to ask what he needed to do about the checking account and how he could pay for the funeral expenses out of it. The bank mentioned that Betsy had written checks which the bank honored, but that she was not approved to write them. The account manager told Billy that she should not write any other checks. Betsy and Billy were equally surprised by this information, but her brother knew that Betsy had not been mishandling the money, so all was well. Had the two not been in close communication, this situation could have turned out very differently.

When a Family Caregiver is managing the money for a loved one, and others are involved in oversight of the care, one person should accept responsibility for managing the money, and accountabilities should be established to prevent the possibility of mismanagement. Such accountabilities might include the following:

  • Most utilities can be set up to pull automatically with an ACH draft. Other expenses may also be set up this way, but only with trusted businesses.
  • To minimize the possibility of fraud, keep a little money in the care recipient’s checking account. More substantial sums could be invested or held in a passbook savings account, and most banks also can automatically transfer funds into checking from savings once the account falls below a certain amount. This practice lets your loved one still enjoy a sense of financial independence while protecting them from the theft of more considerable sums.
  • If your loved one is reluctant to set monthly bills up in an auto-pay system, you could forward the bills to a professional accountant who could, for a modest monthly fee, pay the bills and balance the checkbook for you and your loved one. Remember, delegate whenever possible!
  • When you shop for groceries or other items, keep all the receipts organized in a kitchen envelope. Create a monthly filing system and when May is over, drop this month’s envelope into the “May” slot. That way other family members can look over purchases and even get a feel for what it costs monthly for their loved one to live through this stage of life.

Finally, establish a relationship with a CPA. Their knowledge is most helpful in understanding your loved ones spending, savings, and earning patterns. With the establishment of a baseline, and then regular oversight, you will quickly recognize changes that might indicate something is irregular with your loved one’s financial health. Think of your CPA as a doctor; with regular check-ups, you have a much better chance of diagnosing a problem early and preventing a long-term financial crisis.

Careless money management can lead to significant difficulties for the care recipient as well as the Family Caregiver. Some attention placed early on this vital responsibility can protect you both as you take this caring journey together.

The First Family Caregiver

There are lots of Family Caregivers mentioned in the Bible. Adam and Eve raised Cain and Abel, and then probably other children as well. Ruth refused to leave her mother-in-law’s side even after they had both lost everything and Naomi tried to send her away. Instead, she stayed and provided for Naomi into her old age and disability. Joseph cared for his whole family when famine decimated the entire area. Jesus asked John to care for his mother while he hung on the cross. There are many more examples I could give, but here’s my point:

Family Caregivers are as old as time, and even OLDER!! Consider this.

If you have come to God the Father through Jesus Christ, then you are a child of God. As a child of God, you are a member of God’s family. And in the 46th chapter of Isaiah in the Old Testament, God commits to caring for us across our entire lifespan. In this passage, God says he made us. He has cared for us since birth, and He will always care for us until our hair is white with age. So actually, God Himself is the first Family Caregiver, and He is constantly caring for you and me!

3bI have cared for you since you were born. Yes, I carried you before you were born. 4I will be your God throughout your lifetime—until your hair is white with age. I made you, and I will care for you. I will carry you along and save you. (Isaiah 46: 3-4) NLT

When we talk about having the Heart of the Caregiver, we are talking about having God’s Heart. God’s Heart has a higher capacity to care than you or I can even imagine. His care never ends. God never gets stressed out or fatigued. He never needs to take a vacation or a sick day. God doesn’t even need to sleep! And no challenge is too hard for God. He can handle caring for you, and for me, and for the whole world all at the same time. God always cares for us, even when we can’t take care of ourselves.

When being a Family Caregiver starts getting to you, when you are feeling overwhelmed or exhausted, discouraged or at the end of your rope, cling to your personal Caregiver, the First Family Caregiver, the Lord God Almighty. He will send His Holy Spirit to give you comfort, to lift you up and carry you, and to provide strength and a renewed sense of hope for even your darkest hours. He cares about what you are going through because He has the Heart of the Caregiver. He is the original Caregiver. Your Caregiver and mine is the all-powerful, ever-present, omniscient King of the Universe! Wow, I think that’s AMAZING!

How has God made his presence known to you and demonstrated how much He cares for you, even when you have nothing left to give? How has He restored your hope? I hope you will join our conversation this week at Heart of the Caregiver and share your heart.

She Doesn’t Remember Me

Today’s blog is penned by guest contributor Bobbi Carducci. Bobbi is the author of Confessions of an Imperfect Caregiver, as well as a caregiver advocate, caregiver support group leader, and blogger.

She Doesn’t Remember Me

Four of the saddest words ever spoken.

I hope my children never have a reason to say them. But it could happen. If it does I hope they know that even in my confused mind they are still in there with me.

By the time I reach that point I will have lost much already.

My short-term memory.

My rich vocabulary.

My love of long, hot showers.

My ability to cook.

My driver’s license or even how to find my way home if I did still have that privilege.

I pray I’ll still have the ability to read and understand the words my favorite authors have so painstakingly crafted.  A world without books would be barren indeed for someone who loves to read as much as I do.

Alzheimer’s or some other form of dementia will have taken me somewhere back in time. Perhaps I am reliving my days as a busy young mother and you, my darling daughter or son, are still in elementary school.  You have not yet grown into the wonderful adult you will become.  I see you pink-cheeked and out of breath after running up the steps, opening the screen door, and calling out, “Mom, I’m home. Guess what I got on my spelling test today!”

It may not seem like it in the moment but the memory of you is deeply implanted in my heart. The heart that beat so close to yours during the time I carried you. The heart that cried with you when you were hurt and rejoiced with you when you achieved a goal.

If the day comes when I look at you and ask, “Who are you?” I hope you will smile and tell me your name and share memories of your mother.

I love you. I pray you never forget that.

Many thanks to Bobbi for sharing her heart with us. Please let us know if you enjoyed the blog.

Sabotaging Care

Do you feel like a failure as a Caregiver? If you do, you are not alone! Caregiving is sometimes resisted, often unappreciated, and frequently even unrecognized!

Chris’s sister lived with their mother for several years before their mother’s death. She claimed the role of Family Caregiver to their mother, and when we were at family gatherings, she would talk about how hard she worked to provide care for her mother. Chris’s mother was a vibrant, active senior who still drove, did home-bound visits, staffed a local crisis hotline, and taught Bible study. While we all knew she moved a little more slowly, she did not appear to need anybody’s care, so his sister’s Caregiver claims mostly fell on deaf ears. The family didn’t see her as a caregiver until much later.

There are many ways that Family Caregivers can be sabotaged. Feelings of personal failure, the absence of recognition or appreciation for the challenging work you do, and even your loved one’s resistance to receiving the care you offer can undermine your best intentions to be a great Family Caregiver. If you have experienced any of these things, you might find yourself discouraged and wondering if your sacrifice is worth it.

Family Caregivers make great personal sacrifices when they embrace their role. You might give up such things as time with other family members or friends, professional advancement, monetary gain, vacations, social events, and spiritual growth. Your health may suffer if you aren’t intentional to exercise, eat right, and get enough rest. Social impacts include damage to marriage or friendships and loss of social engagement. Emotionally, feelings of isolation and failure can cause clinical depression. Spiritually, lost opportunities for corporate worship can leave you feeling as if God and your church family have all forgotten about you.

If you allow these negative feelings to persist, your attitudes and behaviors could negatively impact the care you give. Your words might grow sharp and impatient, or your hands might not be so gentle when offering assistance. Before this happens, reach out for help! Take a break and evaluate how well you are taking care of yourself. If others don’t recognize the need for the care you provide, ask for their help and let them experience first-hand what you do during your days. Reach out to your church family and ask for help or prayers for support. As hard as it may be, allow yourself to be vulnerable and admit that you cannot do this alone. Even Jesus asked for help when he needed it, and God will never call you to a task that he will not equip you to complete. Part of that equipping is the provision of resources like tools, techniques, and support from friends or family members. Don’t forget to use those resources when you need them!

The critical thing to remember is to keep yourself fresh, so you can be up for whatever your caregiving day may bring. Chris and I hope you will join the conversation and share your heart about what you do to overcome negative emotions and experiences and keep yourself healthier and happier in providing care!