But last week, as I was chatting with my mother, who is 87,  she mentioned how she absolutley loved her Keurig Machine.  (She saw mine when she visited and “just had to have one”!)  She told me that she enjoyed how easy it was to operate, how she could have a cup of coffee (or tea) whenever she wanted and without much trouble.

When we ended our conversation, I began thinking more about the Keurig system and how it really would be ideal for many seniors.  Even my father, who had dementia, would have been able to use it with minimal supervision.

Listed below are what I believe to be the benefits of the Keurig Coffee Brewing System for our elders:

1.  It is very simple to operate.  Just open the k-cup compartment; plop in a k-cup; close it and push the blinking start button.
2. It brews one cup at a time and takes less than a minute to brew.
3. The cup sits on a platform under the brew spout so that there is no need to POUR hot coffee into a cup.  (This is good because elders can be a bit shakey or have some weakness and can be burned, slip in liquid that spills or simply have difficulty cleaning up a spill .)
4. The coffee cup can remain on the platform until it is cool enough for the elder to handle.
5. There is a water resevoir (with models that hold up to 73 ounces) which again, takes away the need for the elder to fill the brewing system each time.  (The resevoir can be removed to be filled but can also be filled while connected to the brewing system.  Although the resevoir is a sturdy but not heavy plastic, it could also be filled using a  light plastic container.)
6. It’s very easy to clean.  The water resevoir and the drip platform, where the coffee cup sits during brewing, can go into the dishwasher and the K-Cup compartment can simply be wiped clean.
7. Yes, the system and the K-Cups are a bit expensive but aren’t we always trying to find a new and exciting gift for Mom, Grandpa or other aging loved one?  And by brewing just one cup at a time, less coffee beans or ground coffee is wasted.
8. The Keurig system also brews tea, iced tea concoctions and hot chocolate.

I would recommend a system with at least a 48 ounce resevoir so that the elder will need to fill it less often. 

K-Cups can be purchased in different amounts, flavors, etc.  Costco usually carries a large package of assorted varities.  Kohl’s will often have K-Cups on sale and then if they are purchased on a 10% or 15% off sale, they are even less expensive.  K-Cups can also be ordered on-line at www.Keurig.com.  A box of 24 K-Cups is $13.90 which is about 58 cents a cup (certainly less than a latte’). 

If you’re worried about the increased amount of waste going into landfills by using K-Cups, Keurig makes a “My K-Cup” which utilizes your own ground coffee or….. here is a You Tube video about how to reuse the K-Cups using Press N Seal and ground coffee.  When using the system for an elder, I wouldn’t recommend this).

Every once in awhile I receive a letter from one of my readers letting me know that an article I have written has helped them in some way.  I am always so grateful when that happens because this is why I do this.  It is my joy to help make caregiving easier for those who have that calling or for those who suddenly find themselves in that position. 

I wanted to pass Greg’s letter along because he has found a great new way to make his mother’s bathing experience much better.  Thank you so much for sharing this with us, Greg.   Blessings.

“Thank you Shelley for the article!
 
This was a great read, and informative as I have been taking care of my 81 year old’s Mom showering needs for the past few years and I never gave special consideration to the things you mentioned. I could never understand why my
Mom would get so upset when it came time to give her shower. She wants to shower and she has always been very clean about her appearance. But she would get scared and very nervous. I do have a volunteer that comes in 4 times a week she is wonderful and she is a female. But My Mom does not feel as secure with her as she does with me. So I do it because I love her!!!
 
Your article made me approach my Moms showering requirements in a whole new light and now I make it an enjoyable experience for her. I call it Ladies day at the spa. My Mom gets a full shower and cleaned up and hair washed. I get her nicely dressed and do her hair for her. She feels so much more relaxed and it’s an enjoyable experience for us both. My Moms anxiety does not get as bad and she is much easier to shower and take care of this way. Perhaps you can pass this along to your other readers as a tip just to help out.
 
Greg”

PS If you have not signed up for our weekly newsletter, go ahead and do it now.  You will find the sign up box in the right hand corner of the home page. 

Here’s what happened:

My Mom, who is 86, and somewhat hard of hearing as many elders are,  lives in Canada in a senior apartment complex.  She received a call from a man who stated that her grandson was in jail for drunk driving (he had been at a wedding, had a couple beers and was caught driving the wrong way up a one way street) and needed money to bail him out immediately.  He mumbled the name a couple of times, and my Mom, being the helpful person she is, volunteered my son’s name.  “Yes, Tyler!” said the man.  “We need the money within 15 minutes and then he’ll go before the judge in an hour.”  So my Mom immediately called my sister to come get her and help her wire money to “him”.  She had all the details written down.

Praise the Lord that it just so happened that my sister and I were texting back and forth about some other banking business.  I had texted “You should go out to dinner tonight.”  About 2 minutes later, she texted back “No..no dinner celebration yet…gotta pick up Mom so she can wire $ to Tyler.  I just heard. Om goodness.”  I texted back “whaaat?  I don’t think I know about this.”

Apparently the man who had spoken to my Mom had said not to notify her grandson’s parents as he didn’t want them to know about the incident. 

So that was about the time I became frantic.  I called Tyler….NO ANSWER!  I called his Dad…..NO ANSWER!  NO ANSWER from his sister either.  Meanwhile Mom is on the way with my sister to wire the money.  I finally was able to talk to Tyler’s Dad who said he had spoken to him just a couple hours earlier and he wasn’t at a wedding; he was at school.  I texted my sister “Are you SURE we’re talking about Tyler?”  “Yup”, she responded.

You might wonder why I just didn’t dial my sister’s phone and talk to her.  Well, she was on her cell phone and not supposed to receive calls from the US because it’s about $3.00 a minute.  I texted her again “Ask Mom if she actually talked to Tyler.”  No response.

It was time for a voice to voice phone chat!  I dialed several times before she finally picked up and she told me they were just about to send the money through.  I heard the clerk in the background.  I asked where it was being sent….Montreal, I heard my Mom say.  MONTREAL????  My son lives in California. 

I told my sister to stop, don’t send the money; it sounds like a scam.  So they called the police and sure enough, that’s what it was.

Seconds away from losing $4400.00. 

If you are a caregiver for a family member who is under constant surveillance, this is less likely to happen, but for those of us with elders living elsewhere, it’s a absolute possibility, especially if they are living in a senior apartment complex or a community of “55 plus” residents.  Please advise all of your aging relatives or friends to NEVER send money by wire OR by mail  without first speaking to another family member.  Never follow anyone’s advice who tells them not to “trouble anyone else” with the information.  Tell them that if a family member is unavailable, to call their minister, rabbi or even their family physician for advice before acting on requests for money, no matter how urgent the matter might seem. 

Incidentally, Tyler was very glad to hear that he was NOT under arrest, as was his girlfriend, sister and father.

What is Aging In Place and Why is it Important?             

By Alesha E. Churba,

guest author

An important subject just coming to the forefront of the design and construction industries is the concept of Aging In Place.  Aging In Place has a rather negative connotation but in reality, it is a fantastic idea.  Aging In Place is related to Universal Design. 

What specifically is Universal Design?  Many times, the notion of grab bars and funky, big bathroom stalls comes to mind but that is just a small part of Universal Design.  Universal Design itself is a great thing: it is the notion of accessibility for all, not just the handicapped or wheelchair bound population.  It is the idea of making as many spaces as accessible (read easily navigated, intuitive, and easy to figure out) as a space can be.  The idea of Aging In Place takes this notion and makes it even more personalized to the users of the space, particularly the home. 

Aging In Place takes into account the safety and comfort of those living in the space.  This doesn’t necessarily mean that you have to be a senior yourself, it could be that you have a friend who comes by and you would like your home to be visitable.  Maybe you have an aging parent that sometimes visits or maybe something has happened and an aging relative is going to live in the space with you or you, yourself have become limited in some way and you would like to make your home more comfortable and livable now and down the road.  Aging In Place Design helps to create a space that makes living easier, for you and for someone coming into the space.

Our population is aging.  Baby Boomers (born between 1947 and 1964) are entering the stages in their lives where they are considering the future: their future and even their parent’s futures.  Many Baby Boomers are becoming their parents caretakers and some are just looking ahead to prepare their homes so that they can retire in their homes comfortably and safely.  Aging In Place takes these concepts into consideration and provides some basic guidelines for safety and comfort.  It should be noted that each living situation is separate and unique and can be evaluated just from this article but there are a few things that should be  basic design considerations when looking to either re-design the current living situation or evaluate a new living situation.

Some things to look for or consider when evaluating a home for safety and comfort include:

·       At least one entrance that is on the level (no steps to navigate)

·       The entrances that will be used should be at least three foot wide

·       The hallways to the main areas like the kitchen, living, bathroom and bedroom areas should be at least three feet wide.

·       There should be ample lighting or the ability to add extra lighting in the hallways, kitchen, bathrooms, and living areas.  

·       A master bedroom and bathroom on the main floor is a good idea or the ability to add one in the future if circumstances require it.

The AARP site (http://www.aarp.org/families/home_design/rate_home/a2004-03-23-caps.html) has a link to locate a Certified Aging in Place Specialist (CAPS) who can help you specifically with your own home design recommendations.  Each family has unique needs and situations that can be evaluated.  Those trained in this particular area have extensive knowledge that can help you with your needs.  Not all recommendations and Aging In Place modifications require extensive remodeling.  Remember that Aging In Place is really about making your home safe and comfortable for you and everyone in your home. 

Written by Alesha E. Churba, owner of A.E.Churba Design, LLC- Simple and Divine Interior Design, a Pocatello, Idaho based interior design business. She can be reached by phone (208)-313-6414, by e-mail at Alesha@aechurba-design.com or through her business website at http://aechurba-design.com.  A.E.Churba (Alesha E. Churba) recently completed the CAPS Training and is the only Allied Member ASID (American Society of Interior Designers) and Certified Member of the SDP with experience in Residential and Commercial Interior Design and Decorating in Southeast Idaho. Her business niche is primarily designing and decorating with her clients futures in mind- i.e. aging in place, color story investment, and designing for the long term safety and comfort of her clients.

Look for a family practitioner or general practice physician to be the primary care physician for your loved one. General and family practitioners are trained to treat all aspects of a person’s health and well-being even though they have not specialized in a specific field. They treat the elderly as well as newborns, children and adults for everything from a splinter to a more serious illness.

Health Insurance Coverage

Choosing a doctor can be based upon several factors. One of the first aspects to look at is whether or not the patient’s health coverage is accepted by the physician being considered.  Most physicians will accept Medicare but it’s important to determine whether or not they will accept Medicaid and/or the supplemental policy if one is available.  If the doctor will accept the health coverage, the next thing to look at is accessibility.

Location and Accessibility

It is important to choose a doctor whose office is located close enough to be easily accessed for routine care and emergencies. If the elderly loved one is homebound, a physician who understands this and is willing to work around this detail to provide care is ideal.

Physicians can order home health nurses to draw blood, administer injections, take vitals signs and other basic medical procedures then report to the doctor. These procedures would normally be done at the doctor’s office, but when dealing with a homebound patient, getting them into the office may be a problem.

In addition, when transporting an elderly homebound loved one, distance to the doctor’s office can play a part in the convenience of the location. Determine if the time spent driving and the distance to and from a doctor’s office makes the doctor in question an acceptable choice for your loved one’s needs. If the doctor requires that your loved one must been seen at the office frequently, then distance can be an important factor when choosing the physician.

Office Hours

When choosing a doctor there are a few important questions about the doctor’s schedule that you should ask. What kind of office hours does the doctor hold? Do they have evening or weekend hours? How can you get in touch with them when the office is closed? Are the physicians who cover the “on-call” hours acceptible to you?

Hospital Choices

Most doctors have privileges at specific hospitals. When choosing a doctor, it is important to find out which hospital or hospitals the doctor has privileges at. This is the same hospital the patient would go to for emergency care, tests and surgeries in most cases. The size, location and reputation of the hospital may play a large role in your decision to choose or not choose a specific doctor.  Some towns and cities have specialty hospitals for certain conditions.  If your loved one has a condition that is treated by one of these specialty hospitals, it is important to determine if the primary physician has priviledges there.

Personality

Even the most qualified and credentialed doctor may not be the best choice for your loved one’s personal physician if their personality clashes with yours. You’ll probably want to choose a doctor that you genuinely like and feel comfortable with. Remember that you will need to be working closely with this person to advocate for the best health care for your loved one.  Imagine my surprise when I asked my father’s physician if he might be discharged in the afternoon only to hear him say “What part of HE WILL BE DISCHARGED TOMORROW MORNING did you not understand?”  However, there are also surgeons that I have worked with in the past who had terrible bed-side manners yet they are the ones with whom I would have trusted my life.

Choose a doctor who will take the time to speak with you as you advocate for your loved one’s health care. The doctor should be willing to listen to your concerns and answer your questions to your satisfaction. Remember, you are hiring them and paying them for their time.  The days of the primadonna physician OUGHT to be over.

Another consideration is the physician’s staff.

Do you like the physician’s staff? Are the doctor’s employees personable, respectful and pleasant? If you find receptionists, nurses and other staff members to be rude, then perhaps you should consider other physicians. These are the people you will be working with to schedule appointments, update prescriptions and access patient information. If you find them difficult to work with initially, it might improve over time but don’t expect it to automatically occur.

Ask the doctor if they have a Family Nurse Practitioner or a Physician’s Assistant in practice with them. These medical professionals assist doctors in caring for patients in many private practices. Decide if this is acceptable to you for your loved one’s care. If not, then you may need to continue looking or specify in the patient records that care must be provided by the doctor.  Keep in mind though that Nurse Practitioners and Physician’s Assistants generally have more time to spend with the patient and are trained to be patient advocates.  They are also often more accessible.

Making the Choice

After taking all of these factors into consideration, decide which physician you would like to care for your loved one. Schedule a new patient appointment and commit to making the new relationship work.

It wasn’t until I began looking at them as a means of respite care placement for my father that I learned of their costs.  In my father’s case, the daily respite cost was $220 but the monthly cost would have been over $5000.00 for a semi-private room.  This rate did not include medications or transportation to medical appointments. (Rates seem to vary between $4000.00 and $7500.00 per month depending upon the residence.)   None of these facilities accepted Medi-Care and private insurances don’t cover such things.  A couple of them stated that if a person were 2 guarantee private payment for 3 years, then they would not “evict” the resident once their money was gone.  At that time, they would then accept Medicaid reimbursement. 

Recently I have read several articles about assisted living facilities being available mostly in areas of higher income.  In areas of lower income, rural areas and in areas where minorities live (and all 3 of these are equivalent to areas of lower mean income), there are less available assisted living facilities.

In a study at Brown University, a conclusion was made that hispanics would be more likely to use nursing homes than assisted living facilities because they at more likely to be at the lower end of the socio economic scale and did not have the money.  Because of lack of money, they were more likely to be placed in nursing homes with less than desirable facilities, receiving less than adequate care which sent them back to the hospital and began a downward spiral.

I think that another reason that there are fewer assisted living facilities in areas where hispanics live is that their culture has the tradition of elder care being handled by the adult children of the family in a home setting.  My best friend’s mother took care of both her mother and aunt in her home until she was physically unable to do so anymore.

Assisted living facilities vary tremendously; they can contain a myriad of amenities and consist of private apartments with a nurse on duty 24 hours a day or at the other end of the spectrum, they can be closer to a nursing home environment with semi-private areas that consist of 2 beds in a room with a television set.

Assisted living homes are not the right choice for everyone.  Unless a facility has a special unit  (and many are opting to include these), dementia patients should not be placed there.  Sometimes patients have medical conditions that are too complicated for this type of living arrangement, as well.

Nursing homes don’t have much variation.  In MY words, they are simply sad places where lonely people live out their final days. 

In between, there are skilled nursing facilities, but in most instances, these are temporary placements until the “patient” can either be returned home or to a more permanent placement in a different facility.

I’m concerned about what will happen when the aging population runs out of money to pay for these expensive assisted living homes.  At between $ 50,000 and $90,000 per year, who will be able to live there long?  Our elders were a little more prepared but I don’t believe that the baby boomer generation has prepared themselves well enough to be able to cover even a year of living there.  And now that many boomers are upside down on their mortgages, selling their home won’t help to pay for that care.  Not many of us have long term care insurance either. (And in reality, how can long term care insurance continue to exist when almost ALL of us will need it at some point?)

I also think that with health reform, more families are going to be responsible for the care of their elders.  Hospitals will discharge elder patients sooner and before they are able to care for themselves.  This is happening even now !  I literally had to beg that my father be admitted to help remove the 12 pounds of fluid that had accumulated in his legs due to congestive heart failure.  Sure…..they’ll put a defibrillator in an 86 year old man with dementia (because insurance will pay for THAT)  but when it comes to managing the care of that man post procedure, they’ll leave it to the family.   (And they won’t discuss end-of-life care…but that’s a whole other issue.)

Already, a big portion (17% of employees in south Florida, according to a recent study)* are having to leave the work force in order to care for their aging loved ones and another 15% have cut their hours. 

During the past year, as we have experienced a financial crisis, more family members are gathering together under one roof in order to make ends meet.  Do you think that we will return to the days of Leave it to Beaver and Father Knows Best where Moms become the caregivers for the family while Dads return to providing the financial contribution?

• 65.7 million Americans (29% of the U.S. Population) are family caregivers for an adult child with disabilities, an elder or a child under the age of 18 with special needs.
• Out of those, 48.9 million are caring for someone over the age of 50.
• The average length of time for a caregiver caring for a person over the age of 50 is 4 years. 
• Caregiving is still mostly a woman’s job with many women having to put their career and financial future on hold because of caregiving duties.
• 25% say that they spend 21-40 hours per week caring for a loved one over age 18.
• Only 1 in 10 say that if they have siblings, they split the care equally. 
• 10% are caregiving for loved ones with either  Alzheimer’s disease or another type of dementia.
• The programs that caregivers support most are the $3000.00 per year tax credit, respite service scholarships, voucher programs that some states offer that pay them a minimum wage to be a caregiver and transportation services.

What I found very interesting is that while caregivers often seek out the help of those who have gone before them in the caregiving arena, nearly 1/2 say that they have not gone to a web site in the past year to seek information related to being a caregiver.

Would any of you like to comment on why that might be?

Gary’s article can be found immediately below.

“Coumadin^®, available generically as warfarin, has been widely used to reduce the risk of stroke for well over 50 years. Dwight Eisenhower, Richard Nixon and George Bush senior were all taking Coumadin during their active years of former Presidency. Despite millions of prescriptions written annually for this medication, practical, easy to use information remains a challenge.

One of the most common and historical needs of managing warfarin is diet, specifically, dietary vitamin K. Physicians use warfarin to increase the bleeding time in patients at risk for developing unwanted blood clots. The goal is to prolong the bleeding just time enough to prevent clot formation where it isn’t needed (the heart and lungs for example) but allow clotting to take place for normal blood vessel bleeding repair. While warfarin prolongs your bleeding time, dietary vitamin K increases the body’s natural ability to form clots.

The simple blood test called an INR test measures that active anti-clotting effect of warfarin. The higher the dose of warfarin, the more potent or longer the blood takes to clot. A diet high in vitamin K can reduce the effect of warfarin and lower the number of the blood test result. For this reason, it is important for patients to keep a consistent intake of dietary vitamin K to help maintain safe levels of protection warfarin provides without interfering too much.

It is difficult to monitor vitamin K intake when food and beverage labels do not provide this information and the FDA does not require it. While professionals teach vitamin K is abundant in leafy green vegetables – there are many hidden sources patients and their care givers need to know about. Salad dressings and some mayonnaise are good examples.

The vitamin K registry

An easy to use, extensive vitamin K database is available for patients and their family. The vitamin K diary allows you to simply type the first few letters of a food or beverage you’re interested in and a menu of products is displayed listing the serving size and the amount of vitamin K. The vitamin K registry can help you keep balance and choice in your diet. A printable version is also available to assist in creating grocery lists for the Coumadin patient.

The vitamin K diary

The vitamin K diary is an interactive resource for patients or caregivers to keep track of vitamin K intake. While using of the vitamin K registry as a source guide, the vitamin K diary allows the user to record the vitamin K (listed in micrograms) consumed for each meal. The diary, offered as a word document, calculates the total daily and weekly intake of vitamin K. The vitamin K diary is best used 7 days prior to the patient’s blood test to best evaluate the effect of diet and shared with the patient’s healthcare provider.

For other helpful resources on maintaining your quality of life, visit www.PTINR.com  ”

With that in mind, we must be proactive in trying to reduce the odds of delirium occurring when our aging parent or loved-one becomes a hospital patient.

By taking the following ten steps, you may be able to reduce the risk of delirium:

1. Bring  a complete list of all medications (and their dosages), as well as a list of all over-the-counter medicines to the hospital with the patient.  It may help to bring the medication bottles as well.
2. Prepare a “medical information sheet” listing all allergies, names and phone numbers of physicians, the name of the patient’s usual pharmacy and all known medical conditions. If you have any reports such as CT scan results, recent lab tests or notes from a recent doctor visit, bring those too.
3. Bring glasses, hearing aids (and extra batteries), and dentures to the hospital. Older persons do better if they can see, hear and eat.
4. Bring in a few familiar objects from home. Things such as family photos or favorite photos in an album, a pillow, a favorite comforter or blanket for the bed, rosary beads, a beloved book and relaxation tapes can be quite comforting.
5. Help orient the patient throughout the day. Speak in a calm, reassuring tone of voice and tell the patient where he is and why he is there.
6. When giving instructions, state one fact or simple task at a time. Do not overwhelm or over stimulate the patient.
7. Massage can be soothing for some patients, but remember that for others, it can be over-stimulating. 
8. Stay with the hospitalized patient as much as possible. During an acute episode of delirium, relatives or perhaps friends should try to arrange shifts so someone can be present around the clock.  If family is not close, and it is affordable, ask about having a “sitter” present. 
9. If you detect new signs that could indicate delirium — confusion, memory problems, personality changes — it is important to discuss these with the nurses or physicians as soon as you can. Family members are often the first to notice subtle changes.
10. Find out more about delirium. The American Psychiatric Association’s “Patient and Family Guide to Understanding and Identifying Delirium” is available on line.

Adapted from The Hospital Elder Life Program 2007