Eldercare Planning: Your Parents & Home Healthcare

Many adult children start to worry about their aging parents. They see them struggling as they get on in years and believe they would be better off with help. Eldercare planning is a difficult subject to broach (especially with seniors who are resistant to such discussions see our post on the subject), but it’s also a necessary conversation for seniors who are experiencing a decline in health or finding it hard to care for themselves.

Portrait of a young woman holding her happy grandmother

Approaching Eldercare Planning with Your Parents

Conversations about diminished capacity can be very difficult to have with your parents. They may get offended that you are worried about them and they may have no interest in hearing your viewpoint. It can be frustrating for you to make your concerns clear. However, it doesn’t have to be that way!

Here are some tips to help you through this discussion.

  • Choose the right time. Don’t think that you are going to talk to your parents when you both have five minutes. This conversation cannot be rushed. Instead, find some time that you are all free to sit down and talk.
  • If possible, include all of the children. It can be helpful if all of the children are on the same page. Otherwise, it might look like you are ganging up on your parents.
  • Be prepared with the options. It is important that you are ready to have the talk. Write down the different options that are available to your parents. Prepare a list of pros and cons, as well as the costs associated with each of them.
  • If it gets heated, take a break. The conversation may get heated, and it may be better to take a break before things get said that can’t be taken back. Leave the list of options, pros, and cons, and plan on coming back in a day or two (after your parents have had time to think).

Difficult Now, Helpful When Necessary

Talking to your aging parents about getting help can be quite difficult. However, if you find the right time and come prepared, it is more likely to go well. If not, take a break and revisit the issue once everyone has settled down. David York Agency has a Checklist and Workbook to help guide you through the discussion. Please check them out on our website.

Remember, though this discussion is difficult now, it could lead to a better future for your parents. Decide on small changes that can be implemented now and others that will be helpful down the road.

 

If eldercare planning is a concern for you and your loved ones, please consider the David York Agency. Our qualified, compassionate caregivers are ready to help. Contact us online or by phone at 718.376.7755. A free phone consultation can help you decide how to provide your loved ones with the assistance they need.

If you’d like to hear more from us, please like us on Facebook or follow us on Twitter, Google+, or LinkedIn.

Loss of Vision and Hearing May Cause Cognitive Decline in Seniors

It’s not uncommon for seniors to experience hearing and vision loss. Sadly, these changes can cause both physical and emotional hardships. They may feel a loss of independence, an inability to do the things they love, and a disconnect from the world around them. Beyond these discomforts, with the loss of vision and hearing, they may experience cognitive decline.

Read on to learn more about how hearing and vision loss causes dementia and cognitive decline in seniors.

Senior woman inserts hearing aid in her ear learning about Cognitive Decline in Seniors from nurse

Vision Loss and Cognitive Decline in Seniors

The most recent study on the relationship between vision loss and cognitive decline looked at two datasets. This data covered 16 years and included more than 33,000 people aged 60 and up. Published in JAMA Ophthalmology in September 2017, it concluded that “vision dysfunction…was associated with poor cognitive function.”

This confirms a study conducted at the University of Michigan in 2010. This six-year study followed 625 elderly participants and had similar findings. These findings were published in the American Journal of Epidemiology, and concluded that “untreated poor vision is associated with cognitive decline, particularly Alzheimer’s disease.”

Hearing Loss and Cognitive Decline

Hearing loss also plays a part in cognitive decline in seniors. The reason for this is unclear, but there is speculation that  uncorrected deficits in vision and hearing may accelerate this.

The New York Times recently interviewed Dr. Suzann Pershing – lead author of the study and an ophthalmologist at Stanford University School of Medicine – to learn more. Pershing said that “this association doesn’t prove vision loss causes cognitive decline. Intuitively, it makes sense that the less engaged people are with the world, the less cognitive stimulation they receive, and the more likely their cognitive function will decline.”

A study published in JAMA Internal Medicine in 2013 observed 1,984 adults with an average age of 77. The study confirms that “hearing loss is associated with accelerated cognitive decline and incident cognitive impairment.” Also noteworthy, Adults with hearing loss will experience cognitive decline 30-40% faster than those with normal hearing.

A Causal Relationship?

According to Dr. Frank R. Lin, otolaryngologist at the Johns Hopkins Center on Aging and Health, said, “Older adults with hearing loss face an increased risk of dementia even when you control for diseases like diabetes and high blood pressure. So we think they’re causally related.”

There are a few reasons this may happen:

  • hearing-impaired people tend to become isolated and lack stimulation
  • hearing loss causes brain atrophy that affects memory and thinking
  • the brain has to work harder to understand muffled or distorted speech

But There is Hope for Improvement.

Dr. Pershing also said that cognitive function can be improved if vision problems are treated. Regular visits with your ophthalmologist can lead to improvement, and help prevent deterioration.

Almost two-thirds of adults over the age of 70 have hearing loss, yet they remain significantly undertreated. Hearing aids are affordable and accessible. Hearing is again possible with treatment.

Cognitive decline is a problem for seniors, but now that we know the causes we can help prevent deterioration. With this information, our elderly loved ones can live fuller lives, and tackle future health problems.

David York Agency Can Help

Cognitive decline in seniors does not need to be a continuing trend. With the help of trained healthcare professionals your loved ones can learn more about their wellbeing, and fight the problems that come with age. Knowledge and proper care are the keys to living a better life.

If you would like to learn more about David York, please contact us. Our healthcare services are the best available. We provide transportation, care, and companionship to the elderly, as well as specialty services.

For more information about David York Agency’s qualified and compassionate caregivers, contact us at 718.376.7755. A free consultation can help you decide what services will provide the assistance your loved one needs. Also, please like us on Facebook, or follow us on Twitter, Google+, and LinkedIn. We hope to hear from you soon and look forward to providing the very best in care.

Managing Long-Distance Caregiving

If you live an hour or more away from a parent or relative who relies on you for some form of care, you are considered a long-distance caregiver. Managing long-distance caregiving is no easy task.  It is stressful and time-consuming and difficult to accomplish without additional help. Being far from your loved one when they need assistance can be draining and, as this role-reversal presents itself, you are thrust into a realm of new responsibilities.

There is no one right method to approach your new role. Every situation is different. But the task of managing long-distance caregiving doesn’t have to be daunting with these helpful tips.

managing long-distance caregiving

How will I know help is needed?

Regrettably, if your parents need care, they probably won’t tell you when they need help. The last thing they want is to become a burden to their children. Typically, a person will experience a health crisis or a “wake-up call,” triggering the awareness that they need assistance. Barring a sudden health event, difficulties and changes in performing ADLs (activities of daily living) will be a telltale sign that help is needed. Routine ADLs include:

  • Bathing and showering
  • Personal hygiene and grooming
  • Dressing
  • Toileting
  • Transferring (for example, moving from a chair to the bed)
  • Self-feeding

 

What is my role?

As a long-distance caregiver, you will play the role of information gatherer as well as coordinator of assistance.

As the information gatherer, you can use websites and other resources to locate local community services that specialize in care for older persons or the disabled. You will also gather relevant data pertaining to your loved one. This information will be your go-to resource in the event of an emergency. David York Agency provides an excellent resource in the form of our Essential Documents and Emergency Information Workbook.

As the coordinator of assistance, you will make arrangements for care as well as set appointments. Consult with your loved one to determine their needs in the following areas:

  • Meal delivery
  • In-home care
  • Medical devices
  • Transportation
  • Help with Medicare/Medicaid claims
  • Support groups
  • Telephone check-ins
  • Financial Assistance

 

Additionally, David York Agency publishes a handy Essential Documents and Emergency Information Checklist to make your new role more manageable. This checklist provides a place to record pertinent information that will help you determine what your loved one can and can’t do. The AARP also offers a Caregiver’s Checklist that may be of use as well.

 

Evolving Care

It is never too early to start thinking about the future needs of your loved ones and how you will handle the evolving nature of your caregiving journey. Once you have completed the caregiver’s checklist and determined the wishes and needs of your loved ones, it will be time to speak to professionals in the caregiving industry. Check references and do whatever you can to make things as straightforward as possible for the caregiver. In-home caregivers help with a variety of household and personal tasks and will be in a good position to update you on day-to-day progress.

Remember that you are not alone.  An estimated 43.5 million Americans provide care, advocacy, and healthcare navigation for a relative or friend 50+ years or older.

 

For more information about David York Agency‘s qualified, compassionate caregivers, contact us online or by phone at 718.376.7755. A free phone consultation can help you decide how to provide your loved ones with the assistance they need. If you’d like to hear more from us, please like us on Facebook or follow us on TwitterGoogle+, or LinkedIn.

Overuse of Benzodiazepine in the Elderly

The New York Times recently reported that even after 30 years of warnings regarding the dangers it poses to the elderly, use of benzodiazepine, sedative-hypnotic drugs like Valium, Xanax, Ativan and Klonopin, rises sharply with age. A study in the February 2015 edition of JAMA Psychiatry reports that 9% of those between 65 and 80 years of age take them and the proportion is even higher among women at 11%. These are astounding figures for any class of drug.

The known adverse effects of these drugs include increased risks of falls and fractures, diminished cognition in terms of memory and other neuropsychological measures, as well as an increased risk for car accidents.

497526103Yet, doctors persist in prescribing them. Why?

Doctors like to prescribe them because they work fast for such things as insomnia and nervousness. Doctors encounter resistance to employing alternatives like meditation and talk therapy by their senior patients.

Seniors don’t want to give them up. They are addicted to either the drug or the notion that a magic pill will cure any symptom that ails them. Moreover, the withdrawal process from the drug brings on some of the same symptoms such as insomnia, sweats and nervousness that prompted their use initially and patients don’t want to go through it.

Doctors are afraid to fight with their elderly patients about discontinuing the prescription. They are also under the mistaken notion that the process is too daunting. A Canadian study has shown that even a brochure with a schedule for weaning can have a dramatic effect on those wishing to make the change.

There is plenty of support out there if you want to find it. Doctors and healthcare professionals need to be more motivated identifying potential abusers and heed the long standing warnings of over prescribing these drugs. The elderly need to be fully counseled on the associated dangers and assisted in weaning themselves off these drugs.

David York Home Healthcare Agency is fully acquainted with all factors related to eldercare services and is always available to set up a senior care plan taking the whole patient into account. David York Agency provides skilled home health aide services for the elderly in their home and is abreast of all the latest guidelines for seniors.  Contact us at 718.376.7755 and visit our website. A nurse is waiting to take your call. You can also like us on Facebook and follow us on Twitter, Google+ and LinkedIn.

 

Prescribed Drugs: Possible Risk to the Elderly

A study out of Brown University finds that doctors in the U.S. are prescribing drugs to the elderly that can have harmful side effects and the problem is even more acute in the south.

122422920Many drugs such as valium are harder for the elderly to metabolize so they stay in their systems a lot longer and this lingering effect can cause lightheadedness in an older person. This compromised physical state can very well lead to falls which we all know can have deadly consequences for the elderly.

Furthermore, a problem now termed as polypharmacy seems to be taking hold as a public health issue. This relates to the fact that the average senior citizen’s treatment plan includes four prescription drugs at the same time opening endless possibilities for harmful interactions which are suspected to be responsible for almost 33% of all hospital admissions.

The elderly and their caretakers need to review their medications regularly to make sure they know all associated risks, possible side effects and negative interactions. This link from Merck can be a handy reference.

David York Home Healthcare Agency provides skilled home health aide services for the elderly in their home and is abreast of all the latest guidelines for seniors.  We would be happy to discuss your case with you.  Please call us at (718) 376-7755 or visit our website.  You can also follow us on FacebookTwitter or LinkedIn.

Getting Important Documents Assembled for the Elderly

So often, when crisis hits, a family can be caught unawares by this emergency situation. Adult children are blindsided by not knowing where to find critical documents necessary for deciding on the care for their elderly parents and they feel handcuffed by not having access to important assets or documents that are needed. However, it is never too early to start that ‘just in case’ file.

While the holidays are a wonderful time for family sharing and bonding, it is also an opportunity for adult children to help organize essential information for their elderly parents. I think that in addition to feasting and spreading joy this holiday season, all of us, whether we be seniors, caregivers or potential caregivers, should take the opportunity to get some ‘ducks in a row’ and organize those all important documents and bits of information. David York Agency has compiled a handy checklist and a small packet of worksheets to assist in this task. Both are accessible through these links or on the Caregiver Resources page of the David York Agency website.

Essential Documents & Emergency Information Worksheets (pdf version)

Essential Documents & Emergency Information Checklist (pdf versionDec newsletter

  • Professionals List – All Contact Information for:
    • Doctors: Primary Care and Specialists
    • Accountant
    • Attorney
    • Financial Advisor
    • Insurance Brokers
  • Important Documents Packet (Originals and/or Copies):
    • Social Security Card
    • Birth Certificate
    • Driver’s License
    • Marriage Certificate
    • Divorce Certificate
    • Passport
    • Medical Information
      • Allergies
      • Medications
      • Treatments
      • Major Operations
      • Immunization Records
    • Medicare/Medicaid/Insurance Card
    • Life Insurance Policies
    • Military Discharge Papers
    • Deeds
    • Titles
    • Tax Returns for last 6 years
    • Instructions on Location of all files
  • Financial Accounts List – All Contact Information and Account Numbers for:
    • Bank Accounts
    • Investment/Brokerage Accounts
      • Stocks
      • Bonds
      • CDs
    • Credit/Debit Cards
  • Financial Assets List:
    • Car Ownership
    • Mortgage Documents
    • Real Estate Holdings
    • Loans Owed or Owed to them
    • Tax Returns
    • Insurance Policies
      • Home
      • Auto
      • Health
      • Long Term Care
      • Life
    • Original Invoices for Important Possessions
    • Partnership Documents
    • Jewelry and Valuables
    • Safe Combination and Directions
    • Location of Safety Deposit Key
  • Sources of Income:
    • Annuities
    • Social Security
    • Pensions
    • Annual Distributions from Retirement Accounts
    • VA Benefits
    • Disability Payments
  • Recurring Bills:
    • Mortgage
    • Loans
    • Utilities
      • Telephone
      • Electric
      • Gas
    • Insurance Premiums (monthly & quarterly)
    • Car Lease
    • Annual Expenses (i.e. home alarm)
    • Deliveries (i.e. newspaper, milk)
  • Computerized Information:
    • Email Accounts and Passwords
    • Password for Computer
    • Recurring Online Billing
  • Estate Planning Documents:
    • Will
    • Special Instructions regarding personal property
    • Durable Power of Attorney
    • Advanced Healthcare Directive/Living Will
    • Healthcare Proxy
    • Do Not Resuscitate (DNR) Order
    • Retirement Plans
    • Disability Plans
    • Governmental Benefits for which they are eligible
  • End of Life Arrangements:
    • Cemetery Plot Ownership
    • Pre-Planned Burial Papers
    • Personal Statement regarding burial services

Most important is that all this information be easily accessible clearly labeled and a trusted person know its location. Also, if you choose to keep this all stored on a computer, make sure a back up is made and a print out is kept in a location known to a close friend or relative. Healthcare decisions are often quite pressing, so knowing where to find medical records and decision makers in time can be crucial. With respect to assets, at times the government takes possession of unclaimed assets and while you might be able to get a hold of something belonging to you that was overlooked, it is not always an easy process. It is best not to get into that situation and have everything organized ahead of time.
When home healthcare becomes necessary, David York Agency provides skilled home health aide services. David York Home Healthcare Agency can satisfy all your questions and would be happy to give you more information and discuss your case with you. Visit our website at David York Agency – providing healthcare professionals to the elderly and infirm, with the highest degree of personal service. Please like us on Facebook or follow us on Twitter, Google+ or LinkedIn.

For Seniors, It’s All About Companionship

For our most senior citizens, the way to their hearts and minds is through simple companionship.  Rather than wasting money and energy on new fangled gadgets for older loved ones, a visit and a simple dinner is the best gift in the world.  What they most want is time and friendship. 

CompanionshipA New York Times article entitled “What Makes Older People Happy” by Judith Graham, analyzes various studies on consumer behavior and psychology to posit that the reason older people shun new experiences and products that the young crave is, having lived most of their lives already, they now prize the simple pleasures and experiences in life. 

Contrary to public opinion, it is not about seniors cocooning themselves thinking that life has passed them by.   It is just that, according to a Journal of Consumer Research report entitled Happiness from Ordinary and Extraordinary Experiences, the type of experiences that make people happy change over time.  While senior citizens still enjoy being active and current, they do not use these experiences to solidify their identities as young people do.  The elderly forged their identities long ago and their maturity level and seasoned attitude toward life has allowed them to appreciate the here and the now all the more. 

However, when attempting new things, energy level is a real concern for those who are not as spry as they used to be and the fear of getting hurt is very real for them as they see others around them not bouncing back as they used to when they were young.  They know that a careless move can lead to an injury that sparks a whole chain of events that could have lasting, if not dire consequences.  In that instance, a home health aide in tow is a perfect solution for enabling them to have new experiences accompanied and in a safe manner. 

At David York Home Health Agency we understand the importance of companionship above all and our home health aides are quite sensitive to this as well as the host of other factors relating to senior home care.  They know how to make our clients feel appreciated in the safe and comfortable environment of their homes and familiar destinations. Please call David York Agency at 718.376.7755 or visit the website at www.davidyorkhomehealthcare.com to learn more about what they offer.  Please like us on Facebook or follow us on Twitter or LinkedIn.

 

February 11, 2014, 4:01 pm
What Makes Older People Happy  By Judith Graham
http://newoldage.blogs.nytimes.com/2014/02/11/what-makes-older-people-happy/_php=true&_type=blogs&nl=health&emc=edit_hh_20140218&_r=0

Guardianship and Power of Attorney for Senior Citizens

A Frightening Aspect of Aging

What would happen to you if you reached a stage in life where you were no longer able to make decisions about yourself? Your healthcare?  What would become of you?  Even if you have loved ones, do you trust all of them to make the kinds of decisions you would about your welfare?  A truly frightening prospect that few people want to think about is legal guardianship, but we all need to. 

Legal Guardianship

Legal Guardianship

Legal guardianship must be considered at a certain stage. That stage is when you or your loved one is no longer able to make rational decisions for himself.  The court does this by hearing evidence, declaring someone incompetent and assigning a guardian, also known as a conservator. The guardian is then legally responsible for deciding the financial, living and medical arrangements for their ward.  When possible, the guardian is supposed to consult their ward with respect to certain decisions specified by the court. 

Appointing a guardian entails a dramatic loss of individual rights and may not be in keeping with the ward’s wishes.  Therefore, setting up a power of attorney (POA) designating someone of your own choosing to act on your behalf will ensure that the person you trust is in charge of your care.  The POA must stipulate that the appointed decision maker, known as the principal, should continue in the event of incapacity which would then make it a durable power of attorney.  The power of attorney can also go into effect at a pre-specified time at the time of writing. 

David York Agency has dealt with both guardians and POAs in planning the senior home care of their elderly clients.  The agency is fully aware of the issues surrounding these senior care plans and is abreast of all the latest guidelines for seniors.  Agency Intake Coordinators be happy to discuss your case with you.  Please call the home care agency at (718) 376-7755 or visit our website.  You can also like them on Facebook or follow them on Twitter or LinkedIn.

 

 

How to Choose a Home Healthcare Agency

Choosing a Home Healthcare Agency

When it comes to choosing the right Home Healthcare Agency for you or your loved one, it can sometimes feel like a daunting and emotionally charged task.  But, it does not have to.  If you have the right questions to ask, the answers will lead you to the right agency.

Six Questions Will Make It Easy

Choosing home health agency

  • Can the agency provide all the services you require?  Ask the agency if they will develop a personalized care plan designed to meet your individual needs and requirements as determined by you, your family and your doctor.  Ask that it includes the parameters for making revisions, should needs change in the future.  Then, request this plan in writing. 
  • Does the agency require special certification for their employees? For example, do the aides they send need to be certified and does the agency do anything in terms of checking that this certification is current.  All qualified agencies offer in-service classes to keep the aide’s skills current with new procedures and refresh their skills.  They also make sure that the aide’s work papers and state required medical forms are up-to-date.
  • Is the agency licensed by the state?  All states require licensing of home health care organizations, except Idaho, South Dakota, and Vermont.  If an agency is supposed to have a state license but does not, then you should look for another agency.  Check with your state health department to confirm.  
  • Is the agency certified by Medicare/Medicaid and/or The Joint Commission?  To become certified, an agency must meet specific state and federal requirements and quality standards for patient care.  Accreditation may indicate a commitment to providing a higher level of quality care.  An agency may also be contracted to accept Medicaid patients through a larger certified one.  It’s best to clarify your situation with each individual agency if you plan on Medicaid reimbursement.
  • Will your insurance cover a home health aide?  Long-Term Care Insurance plans usually cover home health aide services.  Your insurance company will likely require that you contract with an agency that is licensed by the State Department of Health and will probably not cover you if you hire someone privately.  You should call your plan to verify.
  • How much can I expect to pay for this service?  A recent New York Times article on choosing a caregiver cited that the median rate for a home health aide that provides personal care such as bathing and dressing is $20 per hour. Of course, prices vary by location and agency.

The Home Healthcare Agency that can answer all your questions and that you feel comfortable with will be the right choice for you.  David York Agency would be happy to give you more information about issues relating to home healthcare.    Contact us and visit our website where we have a resources page for further research.