Elderproofing for Home Safety

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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.


Elderproof chart

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. They come with a checklist for each room: bathroom, kitchen, bedroom, living areas, halls, and stairways. The better ones are Certifed Aging-In-Place Specialists (CAPS) from 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:

Walking

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.

Bathrooms

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.

Stairways

  • 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.

 

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Martin Kamiel is now a Certified Aging-In-Place Specialist (CAPS) credentialed by the National Association of Home Builders (NAHB). His 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. 

Senior Substance Abuse:  Prepare for an Increase – Really!

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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.

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.

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,

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“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 which are often accompanied by fatal complications.  The OASAS says,

“(C)hlordiazepoxide (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.”

Up to this point, addiction and substance abuse has primarily been seen as a young person’s affliction, but 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 and 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

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 group.  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.

David York Agency can help.  Our medical and health professionals have extensive hands on patient care experience having 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 www.davidyorkagency.com to become fully acquainted with all we offer.

An Important Topic

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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.

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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 www.davidyorkagency.com.

 

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 www.davidyorkagency.com where she is happy to share her experience and help you through your home healthcare issues.

 

Exercise & Alzheimer’s Disease Prevention

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The New York Times just reported on a fascinating study published in the May edition of Frontiers in Aging Neuroscience in an article entitled, “Can Exercise Reduce Alzheimer’s Risk?” by Gretchen Reynolds. By examining people aged 65-89 who possess a gene related to Alzheimer’s development, APOE epsilon4 allele (e4 gene for short), the hypothesis that even moderate amounts of exercise or physical activity can help to slow the progression of the disease is confirmed.

The study was based on relating the following factors:

  • Researchers suspect that it takes years for Alzheimer’s to actually present symptoms in patients.
  • People with the e4 gene have a higher risk for Alzheimer’s Disease.
  • Elderly people with the e4 gene who exercised were shown to have better brain functioning than those who did not exercise.
  • Brains of people with Alzheimer’s have hippocampi, a part of the brain necessary for memory processing, that are more shrunken when compared to those in similar age groups without the disease.

The study divided almost 100 men and women between 65-89 years of age into four groups:

  1. Those who have the e4 gene and do exercise.
  2. Those with the e4 gene that do not exercise.
  3. Those who do not have the gene and do exercise.
  4. Those who do not have the gene and do not exercise.

After 18 months, the group who had the e4 gene and exercised had the same normal hippocampi as the two groups who did not have the gene while the group who had the e4 gene and did not exercise saw significant atrophy.  Obviously, this has tremendous implications for those who have the e4 gene.  An exercise regimen is an absolute must for those who have the e4 gene way before any signs and symptoms of Alzheimer’s appear.

Whether you know you have the e4 gene or even just a family history of Alzheimer’s or neither, with all the research indicating the benefit of exercise, it would seem prudent on many levels to incorporate it into your weekly routine.

Alzheimer’s Disease: To Know or Not to Know

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Whether or not one is likely to get Alzheimer’s Disease, or any other disease for that matter, may not be something people want to know.  In a Washington Post article entitled, “Would You Want to Know if You’re Likely to Get Alzheimer’s Disease?” we learn of an interesting phenomenon where people are reluctant to sign up for a study to develop protocols to prevent memory loss in Alzheimer’s patients because it requires that they be tested for the presence of amyloid plaque in their brains which has been found to be highly associated with developing Alzheimer’s Disease.

Amyloid plaque is clusters of protein in the fatty membrane around nerve cells whose buildup seems to be associated with people with the disease.  According to a study out of Stony Brook University, cognitive impairment may likely result when this protein begins to amass.

Alzheimer's written in wooden cubes on a table

In light of this, researchers are eager to get ahead of the curve and find ways to target and reverse this buildup.  The first study in this area, Anti-Amyloid Treatment of Asymptomatic Alzheimer’s (A4 Study), tests the drug solanezumab.  Although the drug was unable to reverse the effects of full-blown Alzheimer’s, it shows promise for greater impact earlier on by flushing out the amyloid before its buildup can affect cognition.

Yet, few seniors in the 65-85 age range seem willing to be screened in order to be part of a study.  It seems that they would prefer not to be alerted of an impending doom to which they are, at the moment, defenseless.  The screening does include preparing participants for results, but takers are scarce.

This ambivalence about being tested is likely to get even more dicey since a group of British Researchers just announced that they are closing in on a blood test for 10 different blood proteins that can predict with 87% certainty that early signs of dementia will result in Alzheimer’s Disease.

Unfortunately, to move the playing field in the fight of Alzheimer’s to the pre-symptom stage, researchers might have trouble bussing the players to the field.

Devastating Alzheimer’s Disease

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In this, our third edition of the David York Agency Newsletter, I wanted to focus on one topic that is so devastating to many of our elderly – Alzheimer’s Disease.  Given that many of us are confronted with this debilitating disease on either a professional or personal level, I wanted to bring you some of the latest research and prevention strategies recently mentioned in the news.  I hope you find this informative.

David York Agency is well versed in the treatment of Alzheimer’s Disease in the elderly and our home health aides and home healthcare team are adept at its requisite in-home senior care.

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.  Please call us at (718) 376-7755 or visit us at our website www.davidyorkagency.com and we would be happy to give you more information about our elder care services.  You can also like us on Facebook or follow us on Twitter or LinkedIn.

 

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 an 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 www.davidyorkagency.com where she is happy to share her experience and help you through your home healthcare issues.

 

Ensuring Bathroom Safety:  Quick Review

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Ensuring Bathroom Safety:  Quick Review

Of the falls that occur within the home, approximately one-half of these occur in the bathroom.  There are many bathroom safety products that are designed for ease of transfer in and out your shower or tub. Raised toilet seats, toilet safety frames, and non-slip suction mats or rubber silicone appliqués in the tub can help prevent falls.  In addition to bathroom safety products, a home health aide can assist with bathroom safety.  A home health aide can assist an elderly person or someone recovering from surgery or illness with access to and from the bathroom.  A personal care aide can help with bathing, drying off, dressing, and grooming.  Having another person to help with balance and ensure that a wet surface is wiped dry can ensure bathroom safety.


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 www.davidyorkagency.com where she is happy to share her experience and help you through your home healthcare issues.

 

Preventing Falls in the Elderly

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Falls can be prevented and a good caregiver can minimize any negative long term effects if one does occur.  David York Agency is intimately aware of what a safe living space for an elderly person should look like and can help set that up.  Things to do to prevent falls include:  (The National Institute on Aging has a handy tip sheet.)

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Ritalin and Falls

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The September 2013 issue of Nurse.com Magazine cited a recent study released by Ben Gurion University which stated that “researchers have discovered that a single dose of methylphenidate (MPH), used to treat Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy, helps to improve balance control during walking, hence reducing the risk of falls among elderly adults”. They posit that the results may in part be due to the improved attention brought about by the medication, but they also say that the MPH, also known as Ritalin, actually has “a direct influence on areas of the brain that deal with motor and balance control” (Ben Gurion University). This could be an encouraging breakthrough for our senior population for whom falls are the leading cause of injuries resulting in emergency hospital admissions and accidental deaths.