Newsletter: Thoughts on Traveling With the Elderly

Anita Kamiel

Traveling with your elderly relative is often nixed out of hand.  Sure, we may have to make some adjustments since as we age we are less likely to get around as easily as when younger. However, they are still able to visit, to reminisce, and to enjoy family and travel destinations. In fact, socializing with friends and family, exploring and generally enjoying life is what keeps us feeling like a human. It makes us feel worthy and happy.

When left to sit at home, most people are more likely to deteriorate and require more medications and more assistance. When senior family members are included, their physical health as well as their mental health, is vastly improved. Oftentimes, they are able to maintain mobility longer and are less likely to suffer dementia issues.

Sometimes wheelchairs or more frequent stops are needed. Sometimes medication schedules need to be adhered to. However, Mom doesn’t have to cramp your style. She might enjoy a quiet night in her room while everyone else checks out the latest hot-spot. Arrangements can be made.

Life doesn’t last forever and neither does family. When we get to be that age, we will be wondering if anyone wants to be bothered to include us. And we don’t want to look back and think about what we should have done or that Dad would have loved it if only we had taken the time…. Do your aging senior, and yourself, the favor of including them in this family vacation. When all is said and done, with a little planning, the rewards are invaluable, for now and for years to come.

See our posts below on how to make it happen!

Happy vacationing, 


Determine What Type of In-Home Healthcare is Right for You

Determine What Type of In-Home Healthcare is Right for YouIf you are responsible for caring for an elderly loved one, you probably could use some help to lighten the load. But without experience in the medical industry, it’s hard to know what level of caregiver you need? In-home healthcare needs can be easily met with a little bit of research and the help of an experienced homecare professional.

Here is an easy-to-understand summary in-home healthcare roles that will help you determine your needs.

  1. A Personal Care Aide (PCA)

    provides general support but does not address any medical needs. They often assist with daily chores, bathing, preparing meals, cleaning, or just being a companion to someone who needs a friendly face to come visit on a regular basis.

  2. A Home Health Aide (HHA)

    is the next level up, and can do all of the above, and more. They take care of extra tasks like checking vital signs, or changing medical dressings. Home Health Aides have training and certification.

  3. A Licensed Practical Nurse (LPN)

    has a higher level of education and provides basic medical and nursing care. They check blood pressure as well as insert catheters. An LPN also ensures the comfort of patients by assisting them to bathe or dress. They discuss health care issues, and report the status of patients to registered nurses and doctors.

  4. A Registered Nurse (RN)

    is the highest level of medical professionals typically available for home care.  They usually oversee the treatment plan and administration of medication. An RN can keep an eye on medical test results and handle most of the higher-level medical needs of a patient.

While the terms can be confusing, an experienced agency can work with you to determine your needs. With a consultation, an expert in patient services can ask questions and get to know your situation so the right recommendation is made for both the patient and the family members in need of support. Questions such as procedures, fees, and insurance payments are also covered during this initial discussion.

If you have a loved one in the New York City area who is in need of in-home nursing care, contact us. We can help determine the best course of action and provide any of the above support staff to help your loved one age in place.


National Family Caregivers Month


November is National Family Caregivers Month and we at David York Agency are proud to honor the more than 15 million Americans who care for precious friends and beloved family members.

Caregiving is one of the toughest jobs there is, Those who watch our friends and family as caregivers can often tell when own loved ones are experiencing stress from their caregiving duties. But, caregivers themselves are not always good at noticing this—or admitting it–and even when they are aware, they often hide it in order to be strong for their loved ones.

David York Agency is now offering a new service to  deal with elderly and caregiver depression… Call us for confidential help and advice.

Wishing a Happy Thanksgiving to All!

Thanksgiving Day Issue              November 2016             Vol. 3  No. 8
Happy Thanksgiving
As we head out for our respective Thanksgiving Weekend activities and feasts, I wanted to stop and give thanks to all our colleagues and clients who have made this past year so wonderful. It is truly a labor of love to work with all of you and service our seniors.

Caregiving can be a stressful business. No one knows it better than family members on the front lines. Here are some insights that can help smooth you over the bumps when you feel in need of some strength and inspiration.

Wishing a Happy & Safe Labor Day Weekend to All!

Labor Day Issue                                                                             Home Healthcare Newsletter
Summer’s End 2016                                                                     Vol. 3  No. 7

Happy & Safe Labor Day Weekend

As we head into the Labor Day Weekend and the last getaway weekend for the season, you may want to take a look at these tips for traveling with the elderly.

Elderproofing for Home Safety

David York Home Healthcare Agency now offers Elderproofing Services 

from our Certified Aging-in-Place Specialist (CAPS). 

Call for a free phone consultation and estimate.

We often think in terms of babyproofing homes, but elderproofing is just as important. Elderproofing an elderly person’s environment is critical if they are to remain in their familiar surroundings and age in place safely and comfortably. It also becomes an issue when you have a loved one coming to live with you or you are helping prepare a senior’s home upon returning from a hospital or rehab stay. You must make sure that they come home to a safe environment.

Elderproofing is making modifications to a home to conform to the specific requirements of the elderly. Modifications can range from something as simple as putting in nightlights along a passageway or stove safety knobs in the kitchen to the more extensive stairlift for a stairway or a complete bathroom re-do to comply with handicap requirements.


A poorly placed area rug or a slippery shower with no grab bar or chair can lead to a devastating fall. Senior-friendly devices like cordless phones with large buttons and numbers or light switches that can be reached from a sitting position could greatly improve a senior’s quality of life.

If you are serious about elderproofing, it is a good idea to call in a professional to assess your situation. These are called Certified Aging-In-Place Specialists (CAPS). They come with a checklist for each room: bathroom, kitchen, bedroom, living areas, halls, and stairways. CAPS professionals are credentialed by the National Association of Home Builders (NAHB). They are trained in the logistics of managing the entire job and are well aware of the cost and convenience factors for the elderly when making their recommendations.

Here are some of the things CAPS professionals look for:


Mobility can be one of the largest issues facing the elderly.

  • Walkways throughout the home must be clear and wide.
  • Handrails on both sides of a stairway are a must.
  • Tripping hazards should be removed. This includes throw rugs, electrical cords, and even furniture. A table or ottoman can easily be a dangerous obstacle for an elderly person.


Falls in a bathroom are so dangerous because of all the hard surfaces. Tile floors and fixtures have no give and the edges of the sink and tub can cause injury.

  • Floors can be slippery or wet, and the person may have difficulty sitting or standing unassisted. Bath mats can be a tripping hazard, so place bath strips on existing tile floor and in the bath or shower to make it non-skid. If remodeling, place a rough cut tile on the floor for more traction.
  • Try anti-skid scuba socks for your loved one, especially for bathing.
  • Make sure you have grab bars for toilets, showers, and tubs.
  • Consider a toilet surround to help with getting up and down, especially if a grab bar is not an option. Consider buying an elevated seat if the existing seat is too low.
  • Other precautions include setting the household hot water temperature at 120° to avoid burns and placing drain traps in the sink for any small items that might fall in.

Living Areas

Common living areas should be set up so as to minimize tripping hazards. A dark, cluttered home is a safety issue.

  • Remove clutter from rooms and walkways. If you must, put items in storage. Clear paths are critical.
  • Night lights are important so that your loved one can see when it’s dark. They are more easily disoriented, so seeing is more important than before.
  • Remove any loose carpeting.
  • Bright light is beneficial. Install new lighting if lighting is not adequate.
  • Remotes for televisions and other often-used items should be within reach.
  • Make sure wires do not run along walkways. Relocate wires to the edges of the room and tack them along the walls.


  • Install handrails on both sides of the stairs. Most stairways only have handrails on one side.
  • Be sure the handrails are sturdy. Tighten down any that are wobbly.
  • Clear the stairway of all clutter. No items should be stored on the stairs.
  • Check that the lighting is adequate, so the stairs can be seen when it is dark outside.
  • Take the above steps for all stairways, including those outside that are used to enter the house.

General Safety

  • Make a printout or handwritten sheet with large letters spelling out emergency numbers for your loved one to have by the phone.
  • A list of medications, family member contacts, and doctor’s information is important to have on-hand in case of an emergency situation.
  • Use lighting and color contrasts to define areas and recognize objects. Research has shown that people with declining vision are more likely to recognize bold colors aiding their effectiveness.

If you have an elderly loved one living at home, there are many steps you can take to reduce the risk of falls. Implementing the above safety tips will help keep your loved one from being injured.

marty headshot

Martin Kamiel has become a Certified Aging In Place Specialist credentialed by the National Association of Home Builders to inspect and make recommendations regarding the safety of your home environment with respect to special needs and requirements for the elderly. Martin can manage the entire project, whether large or small, from the start through to completion. 

Martin’s vast experience in healthcare coupled with years in the home furnishing industry makes him a real ‘go-to’ person for elderproofing your home to ensure the safety of an elderly loved one. Call him today at 718.376.7755 to discuss your situation and schedule a free consultation. Please call him at 718.376.7755 today to discuss your situation and to schedule a free phone consultation and your in-home assessment.

7 Quotes When You’re Feeling Caregiver stress

You have either been a caregiver, you are a caregiver, you will be a caregiver, or someone will care for you.” – Rosalynn Carter

The former First Lady, Rosalynn Carter, knew about serving and caregiving from personal as well as professional experience. She was first to hold a caregiver conference that identified issues such as burnout and guilt. Her words focus on the interdependence at life’s foundation.

How we approach caregiving…

The question isn’t will we need care, or will our life call upon us to provide care. We are all part of a caregiving equation in our lives. The question is, how do we manage caregiving, as receiver as well as giver. In many ways, how we received shapes how we give.

And so for some, caregiving is easier and more natural than for others. And for some, caregiving is more natural with one person who requires care and not as easy or natural with another person in their life who requires it. Each experience of caregiving is unique as each relationship is unique.

For everyone, caregiving is an opportunity for growth, for increasing compassion or learning to set boundaries, for setting aside blame of others or for oneself, for deepening the dimensions of intimacy or for recognizing the limits of control.

With that uniqueness of experience in mind,

Here are 7 Quotes When You’re Feeling Caregiver Stress:

Love prevails

To the world you may be one person, but to one person, you may be the world.” Dr. Seuss

“To love a person is to learn the song that is in their heart and sing it to them when they have forgotten.” Thomas Chandler

“Some days there won’t be a song in your heart. Sing anyway.”Emory Austin

Boundaries and Negative Feelings

“If you want others to be happy, practice compassion. If you want to be happy, practice compassion.”Dalai Lama

“It’s not the load that breaks you down, it’s the way you carry it.”Lena Horne

When Love Bonds Seem Broken

“Be determined to handle any challenge in a way that will make you grow.”Les Brown

“Forgiveness is not an occasional act: it is an attitude.”Dr. Martin Luther King Jr.

Our reality is our interdependence, from birth to death. Our response to interdependence provides our greatest challenge and our greatest opportunity for growth in life. For assistance with your caregiving role, please contact us.

Senior Substance Abuse:  Prepare for an Increase – Really!

Elderly Substance Abuse

It’s something that we never associate with the elderly, but it does, in fact, exist —- it’s substance abuse.  According to the NYS Office of Alcoholism and Substance Abuse Services (OASAS), this is a “hidden national epidemic”.  While 60% of substance abusers in younger demographics are diagnosed, only 37% in the age 60 and above category are identified.  Many organizations are now highlighting this and new guidelines call for doctors and health professionals to screen each and every patient for alcohol and drug abuse.

2 Types of Abusers

According to the Hazeldon Betty Ford Foundation, one of the most respected alcohol and drug addiction treatment centers founded in 1949, there seems to be two types of abusers: those who are continuing their heavy substance use cultivated over all their lives, and those who, due to the disappointments and struggles of later years, have turned to alcohol and drugs as a way to cope with their pain, both physical and psychological.  The OASAS calls these two groups the “hardy survivors” and the “late onsets”.

While men tend to be more likely to be substance abusers, women, who generally live longer, are more likely to fall prey to this later in life.  Alcohol is generally the drug of choice, but prescription medications rank just below that.  Many of these prescription drugs include opiates for pain relief for diseases like arthritis and sedatives for anxiety and sleep disorders.

Acute Risks to Elderly

Risks associated with drug and alcohol abuse in the elderly are especially acute.

First, the elderly use so many prescription and over-the-counter drugs that their adverse interactions with alcohol or the like could be disastrous.  The OASAS reports: “Combining medications and alcohol frequently result in significant adverse reactions. Due to a reduction in blood flow to the liver and kidneys in the elderly, there can be a 50% decrease in the rate of metabolism of some medications, especially benzodiazepines.” Furthermore, overuse of over-the-counter medications can have a laxative effect or cause heart rhythm irregularities or sodium and potassium imbalances.


Second, because the way we metabolize alcohol as we age changes, it actually takes much less alcohol for the elderly to become intoxicated.  This leads to a greater risk for impaired cognitive functioning, depression and general confusion.  The elderly may even become so confused that they take extra doses of medication resulting in overdose or death.  Heavy drinking also destroys brain cells essential for memory, thinking and decision making.

Third, being sedated by drugs or alcohol combined with its cumulative effects, increases the risk of falls and serious fractures to the elderly. Tragically, these falls are often accompanied by fatal complications.  The OASAS says:“Chlordiazepoxide (Librium) and diazepam (Valium) have such long half lives (often several days) in the elderly that prolonged sedation from these drugs, combined with the sedative effects of alcohol, can increase the risk of falls and fractures.”

No Longer a Young Person’s Disease

Up to this point, addiction and substance abuse has primarily been seen as a young person’s affliction. However, a whole generation of young people is aging out and this problem is poised to explode as the baby boomers enter this age bracket.  Their exposure to alcohol and drugs in younger years makes them more open to it in later years.  In fact, the Hazeldon Betty Ford Foundation estimates that 17% of those 60 and older abuse substances, including prescription drugs, and they estimate the number to double by 2020.   In a recent blog post in the New York Times, Dr. Richard A. Friedman, M.D. confirms this to be an epidemic. In fact, Dr. Friedman raises the real fear that it has the potential to overwhelm the healthcare system.

The Center for Applied Research Solutions says that it is difficult to tease out the symptoms of abuse since they mimic many of the common signs of aging.  Still, some of the things to watch out for are:

  • Memory loss
  • Disorientation
  • Lack of balance
  • Shaky hands
  • Mood swings
  • Depression
  • Chronic boredom

The Center for Substance Abuse Treatment adds the following symptoms to the list:

  • Changes in sleeping habits
  • Unexplained bruises
  • Being unsure of yourself
  • Unexplained chronic pain
  • Changes in eating habits
  • Wanting to stay alone much of the time
  • Failing to bathe or keep clean
  • Having trouble concentrating
  • Difficulty staying in touch with family or friends
  • Lack of interest in usual activities

Ageism in Diagnosis & Screening

According to a study in the Journal of Applied Gerontology referenced in another New York Times blog post by Paula Span, doctors only screened 73% of their new geriatric patients and 44% of existing older patients for alcohol and drug use.  Many doctors and professionals are reluctant to confront this since they feel “you can’t teach an old dog new tricks”, but that is a fallacy.  The elderly can be very nimble, as proved by their ability to adapt to their personal deficiencies fairly rapidly.

The good news is that the elderly react better to intervention than other age groups.  They recognize the benefits of sobering up since not doing so threatens their independence as well as their cognitive and physical abilities.  They also require less intensive rehab called “brief alcohol interventions”.   Furthermore, early evidence supports the finding that baby boomers are actually more amenable to recovery since they don’t carry the shame of addiction that previous generations did.

Some suggestions for managing this problem include:

  • Paying close attention to the elderly family member’s daily comings and goings.
  • Getting a drug interaction list of the elderly patient’s medications from the pharmacist.
  • Raising your concerns with the doctor and having him/her assess and screen thoroughly for the problem.
  • Increasing the activity level and social activities for the elderly loved one.
  • Participating in a 12 step program or support group.
  • Employing diplomacy and nonjudgmental conversations with your elderly relative.

We Are Here

David York Agency can help.  Our medical and health professionals have extensive hands-on patient care experience. They have held staff and supervisory positions in nursing home, hospital and private home care settings.  Armed with advanced degrees in gerontological administration, we are fully aware of all the latest issues surrounding care for the elderly.  Please visit our website at to become fully acquainted with all we offer.

An Important Topic

I am excited to be sending you the second edition of the David York Agency Newsletter. I am thrilled to be able to provide this service to you and, based on the excellent feedback we received, our subscribers seem to be appreciative as well. Since professionally I am becoming more and more aware of this particular problem, I chose to focus on just one important topic this time – elderly substance abuse. I hope you find this overview article educational and practicable.

Glass of alcohol

Please feel free to forward this to anyone you feel would be interested. As always, I would love to hear your comments and suggestions with areas of interest to you. All our newsletters are archived and available through a link on our website

Best wishes,


Anita Kamiel, M.P.S., R.N.,

Director of Patient Services

Anita Kamiel, R.N, M.P.S. is the founder and owner of David York Home Healthcare Agency and is fully acquainted with all factors related to eldercare services and the latest guidelines for seniors.  She holds advanced degrees in gerontological administration and has experience in the field as a Nursing Supervisor in a nursing home.  Anita has been in the business of home care for over 40 years starting out in a NYC Medicaid agency.  Thirty years ago she realized the need for affordable, quality home health aide services provided and supervised by caring individuals, so she boldly opened David York Home Healthcare Agency in Brooklyn, New York. She is the mother of 4 and the grandmother of many and when she is not on adventures like safaris in Africa, she still works 6 days a week and runs to her workout classes 3 of those nights.  You can contact her at 718.376.7755 or at where she is happy to share her experience and help you through your home healthcare issues.