At North River Home Care, we’ve increasingly been asked about Live In Care, what the difference is between Live In Care and 24 hour/ 7 day per week care and when Live In Care makes sense. Read More…;

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Did you know that roughly 25% of senior citizens take more than 3 pills per day? With most seniors taking some kind of medication necessary for their health, it’s an unfortunate reality that many do not take their medication as prescribed. Here are a few suggestions on how to remember to take medications on time for you or your loved one: Read More…;

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If you are concerned about the safety and ease of living for yourself or your parents as they grow older and want to stay in their home, some home modifications make sense.  As a leading provider of senior home care we have some hints and tips for you.

Remodeling a bathroom is the most common alteration within homes.

Consider incorporating some of these bathroom design features to make your bathroom or the bathroom of your parent safer, more convenient and easier to use now and in the future. This list includes simple changes to more extensive remodeling:

Easy mobility

Easy on the hands

Easy on the eyes

Aging In Place Specialists can offer a number of helpful remodeling and modification ideas. North River Home Care is happy to refer you to a suitable senior home care safety specialist, please give us a call.

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It seems increasingly likely that some form of driving test will become a reality for Massachusetts seniors.

The Boston Globe ran this article today.

Pressure mounts to test elder drivers
Lawmakers urged to stiffen rules
By Peter Schworm Globe Staff / June 8, 2009

Pressure is building on state lawmakers to monitor elderly drivers more closely, renewing the heated, politically sensitive debate over whether seniors should have to prove their continued fitness to drive.

Massachusetts, like many states, does not have testing for older drivers, other than universally administered eye tests. Advocates for the elderly have sharply opposed age-based oversight as discriminatory, and noted that the state prohibits age discrimination in licensing.

But with more seniors on the road than ever before - people over 65 will make up 25 percent of all drivers by 2025, according to the Insurance Institute for Highway Safety - calls are growing for more aggressive regulation.

“The time is ripe for change,” said Rachel Kaprielian, who heads the state’s motor vehicle registry and speaks at senior centers across the state about the issue.

Governor Deval Patrick last week threw his support behind legislation introduced on Beacon Hill that would require drivers 85 and older to pass a road test and eye test every five years to have their licenses renewed. A Massachusetts coalition of advocate groups for the elderly, Safe Roads Now, is urging lawmakers to bolster retesting for all drivers to improve road safety.

Two high-profile accidents last week involving elderly drivers intensified the pressure. Seven people were injured in Plymouth after a car driven by a 73-year-old woman jumped a curb and ran into a crowd gathered at a war memorial. It was the woman’s third accident since turning 70, authorities said. In Danvers, a 93-year-old man drove his car into the entrance of a Wal-Mart, injuring six people, after he mistook the gas pedal for the brake.

“The reality is we need to do something,” said state Senator Brian Joyce, who filed the legislation. “This is a growing problem, and I hope we act before another tragedy forces us to.”

Massachusetts drivers must renew their licenses every five years, but are required to take an eye test only every 10.

Nationally, there is little consensus on whether - or at what age - drivers should be required to be screened. But a growing number of states have imposed additional requirements for seniors renewing their licenses. About 20 states have more-frequent renewal cycles. Rhode Island, for example, requires that drivers 75 and older renew every two years.

Yet just two states, New Hampshire and Illinois, mandate road tests for drivers 75 and over.

“There’s great resistance to bringing people in for testing just because of their age,” said Adrian Lund, president of the Insurance Institute for Highway Safety. “It’s not clear there is some level of rejection rate that would justify bringing in millions of people.”

Researchers say that drivers begin to pose a greater risk around age 70, with crash-rates increasing markedly after age 80. Older drivers are also more likely to be involved in fatal accidents than other age groups, researchers say, although many attribute that to frailty.

Demographics are magnifying the problem, supporters of greater oversight say. Drivers are hanging on to their licenses longer, and driving more miles, surveys show.

“It’s a national debate,” said Elin Schold Davis, who coordinates the American Occupational Therapy Association’s older driver initiative. “We’ve had a ‘don’t ask, don’t tell’ policy, but that’s not going to work any more.”

Most road-safety advocates agree that states are not doing enough to prepare for the shift, and urge them to require more frequent renewals.

“There’s a political reluctance to even address the issue, but we can’t continue to ignore this,” said Peter Kissinger, president of the AAA Foundation for Traffic Safety. “We clearly know that as we age, our functional performance and cognitive abilities decline.”

At the same time, fatal crash rates for elderly drivers have sharply declined in recent years, a trend that researchers are at a loss to explain.

“Despite the high-profile crashes that get a lot of media attention, there is almost no basis for singling out elderly drivers as being a menace to others out on the highway,” said Russ Rader, a spokesman for the insurance institute.

Simply requiring seniors to take a road test, Rader said, does succeed in weeding out unfit drivers, who realize they would not fare well and simply let their license lapse.

In a few states, doctors are legally obligated to report when patients’ medical conditions pose a driving danger, but in Massachusetts it is voluntary. Massachusetts does require a doctor’s assurance that a driver is safe when issuing disabled parking placards, and requires medical and road tests when drivers are cited in crashes. Last year, the registry reviewed medical records of 8,000 drivers who were flagged as risks by doctors or family members.

But some of those interviewed doubt the registry could handle administering more road tests, and said decisions on when to take someone’s car keys away will remain a personal, and often deeply painful, family matter.

“It’s the single issue that brings people to their knees,” said Lissa Kapust, a clinical social worker who coordinates a driving safety program at Beth Israel Deaconess Center.

Kapust and others who work with the elderly say that many limit their own driving by making only short trips, avoiding highways, rush hours, and nighttime.

At New England Rehabilitation Hospital in Woburn, therapists work with patients to prepare them for a return to the road, using simulators to hone their reflexes, depth perception, and other skills in a two-hour program.

Susan DeCarlo, a 57-year-old from Lexington who lost mobility on her left side after suffering a stroke in March, said she is learning to drive one-handed with the help of adaptive tools, such as a directional signal extension she can reach with her right hand.

Having applied for a handicapped placard, DeCarlo needs medical clearance from the hospital to resume driving.

“I’m sure I’ll be fine,” she said. “I need to drive. If I couldn’t, I’d lose all my independence. I’d have to impose on everyone else.”

About eight patients a week attend the program, which culminates with a road test. It costs $450 and is not covered by health insurance, but gives many patients peace of mind that they are safe to drive.

Sherry Rodrigues and Keith Poulin, therapists in the program, said they support more frequent testing of older drivers, who often find it hard to accept that their abilities are declining.

“A lot are in denial,” Poulin said. “The kids usually have to get involved.”

DeCarlo faces the same issue with her father, who is 81. He doesn’t drive much, and only takes a couple of well-worn routes. But a couple of times he has gotten lost, and DeCarlo suspects his driving days may be nearing an end. For now, she’s content to kick that conversation down the road.

“It would kill him,” she said. “I’ve mentioned I’m worried, but he laughs and says, ‘I made it home, didn’t I?’ ”

© Copyright 2009 Globe Newspaper Company.

If you are looking for more information about seniors and driving, check out our resources page: www.northriverhc.com/resources/driving-and-the-elderly

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As an elder care provider in the Boston area, we are concerned about the flu. It’s that time of year again. We’ve had many home care clients, caregivers, and families asking us how to prevent and avoid the flu.

There are some great ideas on the CDC website: CDC Flu Website

and on the Health and Human Services website: Health and Human Services Flu.Gov

Here’s another approach to avoiding the flu (video is from the Dept. of Health and Human Services contest for a public service announcement to raise flu awareness) :

Obviously, the flu is no joke, even if the PSA is humorous.

According to the CDC:

As a caregiver you have to find a doctor that you can trust and develop a rapport with, this can be challenging at best. Finding a qualified doctor can be especially challenging for a caregiver of the the elderly population because many doctors are not specially trained in geriatric medicine. The reason that this presents a problem is because people of advanced age have different health issues than younger people do. Further, common ailments such as the flu or common cold can turn into life threatening situations in the elderly. Because their immune systems are usually compromised by a host of ailments in addition to advanced age, they are unable to rebound from minor illnesses the way other age groups are able to do.

This can present a challenge for doctors because they have to treat run of the mill diseases very differently in patients of advanced age. If they are not trained in doing that, the health care of the elderly patients will be compromised. Thankfully, there are some advocates on the medical science front who are bringing these concerns to light.

In a recently published medical journal called Academic Medicine, a group of doctors and other healthcare providers comprised a list of basic geriatric training that every newly graduating and currently practicing physician should know. The majority of the list was comprised of preventive techniques, such as fall prevention, varied presentations of common diseases, and better patient in-office assessment. This journal comes on the heels of the 2008 Institute of Medicine study titled “Retooling for an Aged America”. That study also outlined and lobbied for all healthcare practitioners to be versed in basic geriatric care.

The caregiver, or family member, should be prudent in choosing a healthcare provider. Most people are leery of fresh out of medical school physicians already, but these studies show that there is even more cause for alarm when it comes to healthcare management in the elderly. Newly trained doctors do not have the experience that established doctors do, which means they also have not had the chance to treat many - if any - elderly patients. This further limits their understanding of the patients’ needs. If a geriatric specialist cannot be found locally, the next best option for families of elderly loved ones is to see a general practitioner that has several years of experience. While a doctor with many years of experience may not have specific geriatric care training, the chance is higher that he or she has seen enough aged patients to understand the differential care that they require.

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Many of us do not get the proper nutrition that our bodies require from the foods that we consume. In general, most people do not maintain a healthy and well balanced diet from which the nutrients could be derived. Failing to do this could result in a number of adverse health effects due to vitamin deficiencies within the body - especially among the elderly. Our bones may weaken because of low calcium intake, our eyesight may fail due to the omission of certain vitamins, or our immune system may become compromised because our bodies are weak and deprived in general. Luckily, if receiving home health care, from either a professional service like ours or from a loved one, you will be in a situtaion to make a difference.

What are dietary supplements?

Dietary supplements are pills, capsules, or drink mixes that contain a mixture of vitamin and minerals to supplement the body‘s intake of the daily requirements of each one that, for whatever reason, is not being achieved through diet alone. Optionally, there is a supplement for each individual vitamin and mineral so that people can pick and choose what’s right for them based on their deficiencies. Supplements may include herbs, animal extracts, and amino acids in addition to their vitamin and mineral content.

Who may need to take a dietary supplement?

People who are not consuming the recommended daily amounts of vitamins or minerals should consider taking a dietary supplement. Meeting the body’s required amount of each one is crucial for maintaining a healthy body and lifestyle. The elderly population often consumes the bulk of dietary supplements due to increased risk factors from having a deficiency that accompanies age. The chances of a senior needing to take supplements if they are receiving home health care are slim due to the supervision and care they are receiving.

Who should not take dietary supplements?

People who are taking regular medications, whether they are prescribed or the over-the-counter variety, should seek the advice of their dietician, doctor, and/or pharmacist to rule out any possible interactions between the supplements and their medications. Just because the supplements contain important vitamins and minerals does not ensure that they are safe to take in every circumstance.

People who have recently had surgery or are scheduled for surgery in the near future should not consume dietary supplements. The consumption of dietary supplements before or after a surgical procedure could lead to severe complications such as blood pressure and bleeding issues. People who are already consuming dietary supplements should discontinue their usage two to three weeks prior to having a surgical procedure performed.

Regardless of whom is providing your home health care dietary supplements are best used under the supervision of a qualified health professional. Always consult your doctor with questions and concerns before taking any dietary supplements.

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Caring for an aging and ailing loved one can be a daunting task. Most families make an effort to keep their elderly loved ones at home, sacrificing much of their own lives in the process. For some families, care giving begins to take its toll on the care provider and they eventually find themselves being forced to consider alternatives that they may never have otherwise. So begins the search for a suitable, trustworthy caregiver to take their place.

That search is never an easy one. Families find it very difficult to trust a stranger with the life and well-being of their elderly loved ones. Finding an in-home senior care provider is the second best thing to doing it themselves, which is why most families who are able opt for this alternative when they cannot be the caregiver themselves. This situation allows the elderly loved one to remain in their home and within familiar surroundings, both of which are vital to their mental health and well-being.

Nursing homes are another popular option when an elderly family member cannot be cared for by an in-home senior care provider or the by family. However, recent statistics regarding abuse inside nursing homes may lead to a drastically reduced number of families opting for this kind of care. The Special Investigations Division of the House Government Reform Committee found that thirty percent of all nursing homes in the United States were cited for a total of 9,000 instances of elderly abuse and neglect over a two year period from 1999 to 2001. That equates to one in three residents suffering abuse at the hands of their care providers.

The most common reason for the complaints was neglect. Untreated bedsores, unsanitary conditions, malnutrition, slack medical care, and poor hygienic practices were the most frequently cited situations in the complaints against the nursing homes. Some of the complaints were vastly more disturbing. They accused the staff of striking the residents, punching them, kicking them, and other physical abuses to the point of causing broken bones and bruising. Sexual abuse of the elderly residents by the care providers themselves were also reported.

These statistics should be red flags for any families who are considering nursing homes as a care giving option for their elderly loved ones. They should also bear in the mind that just because a nursing home has a clean record, free of abuse claims does not mean that abuse will not occur there in the future. On the other hand, just because abuse has occurred there in the past does not mean it will continue to occur in the future.

However, if you choose an in-home senior care provider like us you can have piece of mind knowing your loved one is in very capable hands, receiving one on one special care and in their own home with all the familiar surroundings they need.

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Problems with joints and bones are a painful fact of life for many people. However, these conditions are often exacerbated in the elderly. These afflictions make getting around difficult at best, thereby forcing many to rely on mobility aids for walking or even standing, and possibly home care. Most of the aged population just chalk up the aches and pains to ‘arthritis’ - a common occurrence in the natural aging process. However, the true underlying definitions and causes of arthritis are seldom known or understood by those it affects.

There are two forms of arthritis that most commonly affect the elderly population - osteoarthritis (OA) and rheumatoid arthritis (RA). Osteoarthritis is a condition where the cartilage between the bones at the joints is depleted and the bones rub against each other with movement. The lack of support from the cartilage causes severe pain for the person having OA. The most likely places for OA to present itself in the body are the knees, back, hips, and hands. Estimates indicate that 27 million Americans suffer from OA.

Rheumatoid arthritis is an autoimmune condition that causes thickening and inflammation of the membrane surrounding and covering the joints. Rheumatoid can lead to weakening of joints, tendons, and other parts of the body. When one side of the body is afflicted by RA, the other side will follow suit, making it a symmetrical condition. Both RA and OA are most prevalent in women and are the leading cause of disabilities in older Americans.

Home care is dificult for arthritis because there is no cure for these conditions, those suffering from arthritis eventually learn to live with the pain and discomfort that they cause. However, recent discoveries on the medical front have provided new hope to those afflicted by arthritis that the pain can be managed more effectively using natural products instead of narcotics. Glucosamine, chondroitin, and omega 3 essential fatty acids are some of the natural products that have show promise to those suffering from arthritis. Glucosamine is an amino sugar used to produce cushioning fluid around the joints. Chondroitin is a substance found naturally in animal and human cartilage that also produces cushioning joint fluids. Omega 3 fatty acids are derived from fish oils and are used in a number of different medical treatments, including heart ailments and cholesterol management.

Just because these products are touted to be ‘natural’ does not mean they cannot be harmful - especially when taken without the supervision of a qualified physician. Harmful side effects and adverse reactions could result, especially when combined with other medications. Seniors and people receiving home care should always consult their doctor before self administering any natural remedy.

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