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A Look at Aging China

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Since the beginning of time, the Chinese culture has been deeply rooted in family. Grandparents take care of their grandchildren and children care for their aging parents. In recent years, this rich tradition has been forced to look at change.

In the late 1970’s the China population was about to reach the one-billion mark giving cause to the Chinese Communist Party to seriously look at regulating one child per household. By 1980 the central government sought to standardize the one child policy nationwide. Although there were some exceptions, the one child policy stayed strong until recent years when it became apparent that one consequence of the policy was the growing population of seniors.

Now there are more seniors than there are children to care for them. Consequently, elder neglect has become an ugly side effect of the nation’s once well intended plan for protecting the rapidly growing nation. In 2013, The Chinese Government went as far as to pass a controversial law, Protection of the Rights and Interests of Elderly People, where the obligation of the young offspring was very clearly spelled out.

So the tug of war is in place for the children who need to work and yet care for their aging parents. While speaking with families during a recent visit I took to Shanghai the assisted living home model as we know it here in the United States has not yet been able to take off in China. Even though there are private investors willing to fund the brick and mortar of a building, the issue of creating a safe and healthy infrastructure has not yet been a sustainable part of the equation. There are not administrators, RN’s, social workers etc., with the soft skill set required to put the necessary programs in place for the ADL’s, activity of daily living, care model.

To say there is big pendulum swing in both generations is true, but how will this play out? Only time will tell. Chinese government continues to make changes necessary to care for their aging population, but for a culture so deep in caring for their own, it will take time to prove that housing for the aging is a successful, viable and affordable solution.

Respectfully submitted by Pam Rinehart
Right Fit Senior Living
503.568.1640

Virtual Tour Gives Family Insight About Dementia

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This powerful, heart wrenching video gives an excellent insight into the daily life of a son taking care of his mother who has Alzheimer’s Disease.  In moments that are so real and emotionally raw, it is easy to see the toll that caring for his mother in his home is taking on him and his wife.   It also becomes clear that they have very little understanding of what they are dealing with as she continues to slip deeper into the diseases’ hold.  At one point, he admits that he has no idea what his mom is experiencing or what it may be like for her to struggle everyday with Alzheimer’s.  He agrees to participate in an Alzhiemer’s simulation project that proves to be an eye opening experience.  Watch the video below for their story.

 


ABC Breaking US News | US News Videos

Having “The Conversation” About Moving to Assisted Living

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Kate called me last month asking about assisted living options for her mother. Mom had been living at home by herself and was doing fine (her words when family checked in on her by phone).  It wasn’t until there was a family gathering at Mom’s house that they realized things weren’t as “fine” as they thought. The milk was expired and the bread was moldy. Piles of bills and other paperwork covered all the tables, unread newspapers were piling up by the front door and the yard which she took pride in was obviously untended.  Everybody could tell Mom had lost weight, her clothes and her house were very dirty and she seemed confused.  The family got together and decided she wasn’t safe to be at home any longer and needed to move somewhere where she would get some assistance.  We toured several assisted living buildings and found one the family thought was perfect. Next came the question I dreaded “How do we tell Mom she needs to move?”

According to recent Marist research, 80 million Americans are reportedly conversation avoiders, meaning they haven’t talked about any important end-of-life issues with their parents or children.  In addition, research by Home Instead Senior Care revealed 70% of family conversations about aging are prompted by an event such as health crisis or other emergency.

Why aren’t families talking? It’s difficult! Research by Home Instead Senior Care indicates a majority of adult children (54%) described their critical conversations with parents as uncomfortable at times, difficult but necessary, emotional with yelling and tears, or difficult and unsuccessful.  How do we get the conversations started earlier so it’s not prompted by a crisis?

Home Instead Senior Care has very comprehensive materials on getting the ‘talk’ started and focuses on areas such as driving, health care, relationships and dating, end of life.  In an effort to guide Kate, in the example above talking about the future far in advance of the crisis would have helped a lot.

Starting the conversation is the hardest part. Caring phrases can get the conversation going. “I know we want the best for one another. Let’s talk about options that will work for both of us” or “I know you want to remain home for as long as possible. But I want you to be safe. I’d be less worried if we had a plan now in case something happens in the future.” “I know you want to be independent as long as possible, let’s make short, medium and long term plans and define what may trigger implementing each of the plans when necessary.”

During the conversation ask questions such as “What if you could no longer drive, what would you want to do?” “If you’re unable to navigate the stairs in your house what would you do?” “Where would you live if you have to make a change someday?” “Who (or what) do you want to live near?” “What can you afford?” “Do you have long term care insurance that would help pay for care at assisted living?” “What activities are important to you that you want to continue doing if you move in to assisted living?” “What possessions are important to you that you must have if you move to assisted living?” You may want to tour some assisted living communities to see what’s available and choose where to go when the time comes. Document the plan and keep in a safe but accessible place so it’s readily available when needed.

Making decisions, identifying choices and conveying wishes are an important part of the road ahead. Working together to develop the plan helps Mom feel like a part of the decision rather than having the decision made for her. By having the conversation early you’ll both feel more comfortable with the aging process and you’ll avoid having to make decisions during a crisis.

How to Deal with Aggressive Behavior in a person with Dementia

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Recently I met with two sisters to discuss housing options for their mother with dementia. Mom was living with one of the sisters in a two bedroom apartment. The other came one day per week to spend time with mom and give the caregiving daughter a break. They do live in a town which is what I would say is focused on a senior population.   Mom is still pretty functional, but wants to go out and cruise around the neighborhood.  This is a real hardship for the daughter who has physical and mental limitations herself. During our conversation we discovered that she would try to reason with her mother, when this kept re-occurring she of course would get irritated.  Turns out she doesn’t understand that you do not reason with a person with dementia.  We hope we got that message through to her to make her life somewhat easier until we find a new home for mom.

So far there hadn’t been any major aggressive behavior from mom but this leads into how to deal with aggressive behavior in a person with dementia.

What is aggression?

It’s a destructive or hostile action or behavior directed toward oneself, other people or objects.

What can trigger aggression in a person with dementia?

Pain, physical illness, dehydration, depression, anxiety, not enough sleep, drug changes or the wrong one, and it can be as simple as being constipated. Or just being frustrated – feel that they are not understood, not able to communicate how they feel, the list can go on.  Maybe they just don’t understand what they are being asked to do something.

How to deal with aggression.

Try to identify if there is a pattern to the person’s aggressive behavior, then take steps to hopefully prevent it in the future. Do this by keeping a written account/diary of these events, noting if there is a pattern, then figuring out how to avoid the triggers.  For example if you find that these outbursts occur when they are asked to do something, maybe the request can be simplified or made more specific: instead of saying “dress yourself”, say “put this shirt on”.

What about medication for aggression?

Sometimes behavior modification isn’t enough to help control aggressive behavior.  Currently there are no drugs specifically approved for treating aggression in dementia, but research does show that a number of medications may be helpful. These include antidepressants, antipsychotics, and anti-anxiety drugs. Be sure to discuss this their doctor.

In review, steps to take to diffuse aggressive behavior in a person with dementia:

  1. Stay calm and stop whatever it is you are trying to get the person to do.

  2. Give them space so they do not feel threatened.

  3. Do not argue, make degrading comments or punish the person physically or psychologically.

  4. Remember they will most likely not recall the event or be able to learn from it.

  5. Get support, e.g. contact the Alzheimer’s Association for caregiver support groups and training programs for caregivers.

Submitted by Anita Oberhelman of Anita’s Senior Referrals

Anita has been helping Seniors and their families find housing and care when they no longer can live independently since 1991. Anita and her husband have lived in Portland area since 1975, raising 3 sons and 1 daughter outside of Hillsboro.  Now there are 7 grandchildren to spoil and enjoy. She continues to enjoy helping Seniors and their families find the best care and housing, her motto has always been would I place my own parents there.

 

Keeping Home Safe for Older Adults

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Our goal as elder care advisors are to help seniors find appropriate housing and care. If a senior has the mental and physical capacity to be able to remain at home, their existing home can usually be modified to make it a safer environment for them. Here are some ideas that can be implemented easily or for a nominal fee:

Stairs

  • Add handrails to both sides of any steps or staircases

  • Mount non-slip tape on wooden steps

  • Place nightlights or automatic lights to illuminate stairs

Lighting

  • Increase light bulb wattage to create a brighter environment

  • Install automatic lights in bathrooms, closets and hallways

  • Place nightlights in hallways, staircases, and bathrooms

Flooring

  • Remove area rugs or secure them with adhesive

  • Consider replacing high-pile carpeting with low-pile solid-color carpeting

  • Mount non-slip tape on slippery surfaces such as entryways and kitchen floors

Furnishings

  • Remove unnecessary furniture to create wide open spaces

  • Be sure furniture is heavy and steady enough to withstand leaning on

  • Add one-inch blocks to the rear legs of chairs and sofas to make it easier for the senior to get up

General safety

  • Gather up and secure electrical cords

  • Place decals or colorful tape on sliding glass doors or large windows

  • Be sure smoke detectors and carbon monoxide detectors are in good working order

  • Consider a pendant system which will alert emergency personnel if the button is pressed

  • Replace door knobs with lever-style handles

  • Add tennis balls or rubber tips to the feet of walkers or canes

  • Make sure there is a telephone available in several areas of the house

Bathroom

  • Install sturdy grab bars in the bathroom – in the shower and next to the toilet

  • Install shelving to keep needed items at arm’s reach, rather than too high or too low

  • Mount non-slip in bathtubs and showers

Kitchen

  • Make sure fire extinguishers are within easy reach, in good working order, and the senior knows how to use them

  • Keep needed items on shelves that are easily reachable

Hanging Up The Keys: When Is It Time?

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Age-related declines in vision, physical health, and cognitive ability can make it more difficult to drive. It is not a matter of age alone, since many of us are at different physical and cognitive stages than someone else the exact same age.

If you think you may be experiencing difficulties due to age-related matters, such as vision impairments, speak with your doctor or an occupational therapist about your concerns. There may be ways to counteract the symptoms you are experiencing, or there may be adaptive equipment that can be used to help you drive longer.

However, once it is no longer safe to drive, consider the consequences. You are at a greater risk of hurting yourself and others. You may also run into issues with insurance policies, legal matters, and finances if you continue to drive longer than you should.

If you experience any of the following, it may be time to hang up the keys:

  • ·            You get lost driving home from a place you have been hundreds of times (such as a local grocery store)
  • ·            You have had more than one car accident in a six month span
  • ·            Friends and family have expressed they are scared to drive with you
  • ·            You feel an overwhelming sense of anxiety while driving
  • ·            You don’t feel like you have the cognitive ability to keep up with traffic or road conditions

 

Always remember that your safety and the safety of others on the road should take a priority over your driving once it is no longer safe to do so.

There are alternatives to driving, such as public transportation, riding with friends, and taxi cab companies. In addition, many community services and retirement communities offer transportation when utilizing their services. Signing up for Meals on Wheels or using grocery delivery services can also be very beneficial.

For more information about driver’s safety, visit www.cdc.gov/motorvehiclesafety.

Dementia is on my mind….please approve the $200 million for research

Dementia is on my mind….please approve the $200 million for research

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There are currently more than 5 million Americans living with Alzheimer’s disease and that number is poised to grow to as many as 16 million by 2050. Caring for Alzheimer’s, the country’s most expensive disease, costs our nation $214 billion annually with projections to reach $1.2 trillion a year by 2050. Yet today, for every $26,500 Medicare and Medicaid spend on caring for individuals with Alzheimer’s, the National Institutes of Health (NIH) spends only $100 on Alzheimer’s research. That just doesn’t make sense. Smart investments in other major diseases have shown great success and are paying off, both in terms of cost and lives saved.

The appropriations committee is meeting next week to review, and our senators need to hear from us. Jeff Merkley (OR) is on the committee and he needs to hear from his constituents that this is important to all tax payers – the folks that answer his phones are wonderful and receptive – if you could please call his office and ask for his support of this budget item, it will impact all tax payers in a positive way. Phone is 202-224-3753, in district 503-326-3386