How to pay for care

How to pay for care

Most people are surprised to learn that Medicare pays for only a limited amount of the daily care you are likely to need in your lifetime (about 14%).

Medicare covers only services delivered by medically trained professionals. That means you need to have savings or insurance and rely on a collection of local programs. Or family and friends who may be able to pitch in with labor or funds.

Assisted living and memory care $$$–$$$$
As nonmedical services, these settings are usually paid for out of your own savings. If you are a qualifying veteran or you have long-term care insurance, your costs may be covered. Contact the Veterans Administration or state Veterans Council. Check your long-term care insurance policy for eligibility requirements. Also ask about waiting periods. Is there a lifetime cap on the total amount they will pay?

Skilled nursing/rehab or nursing home $–$$$$$
Provided your stay follows a qualifying hospitalization, original Medicare—the government’s health insurance for seniors—will typically cover some portion of the costs for the first 100 days. You use your supplemental insurance for your copay. Or pay out of pocket if you do not have supplemental insurance. Starting day 101, you pay 100% of the cost. Medicare Advantage plans vary, so review the coverage with your insurance provider. If you have private long-term care insurance, check your policy for skilled nursing coverage. The Veterans Administration offers special facilities for qualifying vets.

The very poor may qualify for Medicaid. This program will pay 100% of costs. However, there are only a limited number of Medicaid openings available in any given facility. Those living long term in a nursing home usually exhaust all personal savings and assets. Then they switch to Medicaid. If you think you may need Medicaid, consult an elder law attorney early. Also, your financial planner for advice about liquidating your assets.

Continuing care retirement communities $$$$$
This is a very different model of care that merges housing and insurance. With a continuing care retirement community—also known as a “Life Plan Community”—you invest a substantial sum up front (often in the six figures). You also pay a monthly service fee. Start while you are healthy and live on campus to enjoy the deluxe amenities. Move to the most appropriate building as your care needs change. This is paid for almost entirely out of your own savings. If you have long-term care insurance, check your policy to see if it covers continuing care retirement communities.

Worried about paying for care?
Give us a call at (208) 321-5567.

Learn more about our aging life care planning services.

Choosing a home care provider

Choosing a home care provider

Frank knows they need help at home. His wife’s dementia is getting worse, and he has his own health problems. She can’t be left alone anymore.

Doing all the cooking and cleaning, and now helping with bathing … it’s just too much.

Frank needs to take breaks. But a Google search reveals a dizzying array of home care providers. How to choose?

Allowing a stranger into your home can leave you feeling quite vulnerable. It’s important that you trust the individual and the company that does the background checks, verifies training, and puts together the schedule.

You also need to interview each company to find out pricing and minimum number of hours, and to see if they have independent quality ratings.

How do you know which one to trust?
This is where an Aging Life Care™ Manager can help.

On the basis of past experience with other clients, he or she knows which companies put an emphasis on training. Which have difficulty filling a shift if a caregiver calls in sick. Which have high staff turnover resulting in the need for you to orient a new employee every few months. Which have a strong team, with employees who love their work.

Wise home care companies will let you and your Aging Life Care Manager interview several caregivers before making a choice. They know that an Aging Life Care Manager understands you as the client and understands what will result in an optimal match.

Both you and the provider and the caregiver want a good fit the first time so all of you can work together positively for the duration of your need. It makes the difficult transition to home care that much easier if a knowledgeable advocate can set expectations and provide an objective viewpoint.

Even with adult day care and medically trained services, such as home health and hospice, not all providers are alike. An Aging Life Care Manager knows the reputation and the management style of each company. He or she can look up Medicare reviews and complaints.

An Aging Life Care Manager can also coordinate care across multiple service providers and work with your physician to ensure that all the different players are aware of your changing needs.

Want to find the best fit the first time?
Give us a call at (208) 321-5567.

Learn more about our aging life care planning services.

What is “elder law”?

What is "elder law"?

Elder law focuses on the special rights, needs, and challenges that arise in the context of simply growing older and planning for possible care needs.

Attorneys specializing in elder law take a holistic perspective.

They acknowledge the interplay of health, family, disability, and housing, as well as emotional and financial issues. Consider a consultation for:

  • Estate planning. Within elder law, estate and trust attorneys advise on the best strategy for organizing and managing your assets now that also ensures ease of transfer upon your death. This may involve a will. Or a living trust. There are pros and cons to each. And, if you have a dependent adult in your life, an attorney can draw up a special needs trust to provide for care when you are no longer alive.
  • Decision-making plans. With advancing age, many of us lose the ability to manage our finances or make complex healthcare decisions. Especially if you do not have relatives to step in, you will need legal assistance to locate and contract with trustworthy professionals to fill these roles.
  • Paying for care. An elder law attorney knows about the many programs designed to assist with the cost of care. You may, for instance, be considering a reverse mortgage, but there are significant “gotchas” with this arrangement. If Medicaid is your fallback should you need a nursing home long term, you will want to work with an attorney to be sure your spouse is not left without resources when you die. Long-term care insurance is another payment option worthy of an attorney’s review.
  • Housing contracts. Before moving into an assisted living or continuing care retirement community (sometimes called a “life care” community) or a nursing home, have an elder law attorney review the paperwork. They can clarify tax implications and advise you regarding your rights and how or when you can cancel a housing contract.
  • Claims and appeals. You may have disagreements with Social Security, Medicare, your pension fund, or other insurance or benefit programs. An elder law attorney can help you navigate the appeals process and increase your chance of a successful resolution.
  • Grandparent visitation rights. Whether the schism is due to a divorce, the death of your child, or estrangement from your son or daughter, you do have rights to see your grandchildren. An elder law attorney can help you stay connected.
  • Age discrimination in employment. Have you been turned down from a job, a promotion, or fired because of your age? An elder law attorney can help you rectify the situation.

Looking for an attorney specializing in elder law?
We network with the best. Give us a call at (208) 321-5567.

Learn more about our services to help you age well.

Choosing a long-term care facility

Choosing a long-term care facility

Judy had an emergency hip replacement after a fall. She needs to be discharged tomorrow to a skilled nursing facility. She needs several weeks of intensive physical therapy to be able to walk again. Then she may need to live in assisted living.

The discharge planner has a list of options. Judy and her daughter, who lives an hour away, don’t know how to make a wise choice.  

For short-term, urgent needs, you may be at the mercy of which facility has an opening at the time.

It pays to consult an Aging Life Care™ Manager who knows the reputation and personality of the local institutions. It’s best to have a relationship with the Aging Life Care Manager before you have an urgent need. He or she can combine extensive knowledge of local resources with a thorough understanding of your medical history, your insurance and financial resources, your personality and preferences, and your social support system. As a result, you are more likely to get a match that will help you maintain good spirits and enjoy a speedy recovery.

Review all your options
Unlike “free” referral agents, an Aging Life Care Manager will present all the choices that make the most sense for your needs and personality. Not just the communities that are willing to pay a kickback referral fee.

Such independence is even more important for long-term living situations
Choosing an assisted living community, a CCRC, or a memory care facility is a big decision. You want to get a good match from the start.

Touring these communities can be daunting
A Google search delivers a dizzying array of choices. They all put their best foot forward. But architectural features and social amenities are only superficial measures of quality. An Aging Life Care Manager has had other clients who live in these facilities. He or she has a firm grasp on deeper metrics, such as the tone of the administrative leadership, the training and stability of the staff, the solvency of the company, and the overall personality of the community.

An Aging Life Care Manager also knows current conditions in the market that can save you money. For instance, if a community happens to have a lot of openings, a lower monthly rate or entry fee could be negotiated. A “senior housing advisor” paid a commission by the community would not be able to serve as your advocate in this regard.

Looking for unbiased recommendations based on all your options?
Give us a call at (208) 321-5567.

Learn more about our aging life care planning services.

Paying for care at home

Paying for care at home

How you pay for care at home depends on whether the service is by medically trained staff or by nonmedical caregivers. Also, what you can mix and match in terms of community programs and help from friends and family.

Medicare pays only for care in the home that requires the skills of a nurse, nursing assistant, physical therapist, or other medically trained professionals.

Home care $$–$$$$
The cost of nonmedical home care is NOT covered by Medicare. As a result, you must contract directly with providers. Fees depend on how many hours a week your care requires.

Consider that caregivers coming to your home need a livable wage. Add to this agency costs of staff recruitment, vetting, training, and scheduling. The price can mount up quickly.

  • Long-term care (LTC) insurance. These policies can be purchased privately and are the least expensive when begun in middle age. Typically, to draw upon the insurance, you must pay for home care services out of pocket for a waiting period. Insurance will contribute afterwards and pay up to the lifetime cap. Check policy details.
  • Veterans assistance. For qualifying vets who saw active duty with at least one day during a war, there may be benefits available to help with the costs of home-based care.
  • Personal savings. Consult with a financial planner and elder law attorney to determine the best strategy for liquidating assets to cover your care.

Adult day care $–$$$
You must pay privately. Many programs are run by nonprofits so are underwritten by donations and grants. Medicaid, LTC insurance, and veterans benefits may also help.

Home health and hospice $

  • Medicare. This is typically deducted from your Social Security check and will cover home health services (80%) and hospice (often 100%).
  • Supplemental insurance. This is insurance you buy to cover the 20% balance not paid by Medicare.
  • Medicaid. Those with VERY low income and minimal assets may qualify for state government support. The eligibility requirements are stiff. Coverage includes 100% of most medically trained care, with some restrictions. Coverage for nonmedical care is spotty and varies by county.

We can help you sort out your options.
Give us a call at (208) 321-5567.

Learn more about our aging life care planning services.

Age-friendly bathroom remodels

Age-friendly bathroom remodels

Activities that are easy now may become more difficult in the future: Going up and down stairs, standing up from sitting, getting in and out of the tub, catching your balance if you start to slip. . . . As you consider aging in place, it is wise to keep these issues in mind, particularly about the bathroom.

Structural considerations. To eliminate the need to climb stairs, the ideal is a full bathroom on the main level of the house. In addition, as we age, the likelihood of needing support increases. Whether a wheelchair or walker, or a spouse or paid caregiver is providing assistance, a spacious room is best.

Did you know the bathroom is the most dangerous room in the house? Eighty percent of falls occur in the bathroom on hard, sometimes slippery surfaces. Most falls occur in the process of sitting down on or getting up from the toilet, or getting in/out of the bath/shower.

Bathtub or shower? The most versatile design involves a water-friendly, nonslip floor with a drain, and no hard curb around the shower area. This allows for rolling a wheelchair into the shower and provides room for a helper. Even without such a radical makeover, it’s easy to install a handheld showerhead and a built-in or portable bench in an existing bathroom to create a seated shower option.

If you need to soak—great for achy arthritic joints—consider a walk-in tub. These tubs have a watertight seal on a side door that allows you to walk in, sit on a bench, and then fill the tub to the desired height. Or have a dip cut into the side of an existing tub to lower the height for ease of stepping in and out.

Toilets and bidets. Purchasing a high toilet or adding an extender that raises the sitting surface greatly reduces the physical challenges of sitting down and getting up. Many people find a bidet adds to convenience and cleanliness. (Twisting to wipe our nether regions becomes more difficult with age.) Rather than ask for help, cleaning with water can improve hygiene while preserving dignity.

Other fall prevention strategies. You don’t need a full remodel to improve safety. Installing grab bars beside the toilet and within and outside the bathing area is an easy and effective modification. Grab bars must be attached securely to the studs of the wall and be able to support 250–300 pounds. Installing nonslip flooring or applying antislip floor coatings for higher traction is also wise. Increased lighting will help visibility and reduce falls. In addition, lights installed on the wall instead of on the ceiling reduce the need to get on a ladder, and possibly fall, when changing a bulb.

How age friendly is your bathroom?
Give us a call at (208) 321-5567.

Types of long-term care

Types of long-term care

While “aging in place” has its benefits, it is expensive to get such individualized care. Plus, it’s rather isolating. Group options require a move, but are more social and cost effective.

  • Assisted living. People move to assisted living when they are ready to stop cooking, cleaning, and maybe even driving. They enjoy social activities but need more help than an independent retirement community might offer. Though not a setting for people with advanced dementia, a portion of assisted living residents may have memory problems.
  • Memory care. With activities specifically for people with significant dementia, memory care may be housed in a wing of assisted living or operate as an independent facility.
  • Skilled nursing or “rehab.” Geared for short stays—several days to several weeks—a skilled nursing facility can be thought of as a place to get stronger or learn to do things in new ways after a setback. Then you move to a more homelike environment.
  • Nursing home. This setting is a long-term version of rehab but for those with complex conditions who don’t need a hospital, yet aren’t independent enough for assisted living.
  • Continuing care retirement community (CCRC). This large “campus” offers all of the above and more. Move in while fully independent and able to enjoy the pool, golf course, etc. As care needs change, residents move to the different care buildings yet stay on the same property. Ideal for a couple when one needs more support than the other.

Let us help you understand the different options.
Give us a call at (208) 321-5567

Learn more about our aging life care planning services.

Social Security and the newly single

Social Security and the newly single

Life has a way of throwing us curveballs.

The unexpected death of a spouse—or a divorce—can certainly wreak havoc on your emotions. It can also throw a wrench in your finances.

If you are age 62 or older, here are some Social Security basics to bear in mind as you regain your financial footing or make contingency plans.

Survivor benefits. If you find yourself widowed after at least one year of marriage, then you are eligible to receive monthly survivor payments.

Did you also work outside the home? If so, you can choose the higher of the two benefits: yours personally; or as a surviving spouse.

Before deciding, confirm the amount for each one for three points in time: collecting now; waiting until age 70; or at your designated retirement age (as determined by Social Security). While you cannot receive both benefits at the same time, you can strategically claim the highest one now and then switch to the one that becomes higher later.

Spousal benefits. A divorce does not erase the contribution you made to the household. As a formerly married spouse, you are eligible for Social Security benefits based on the earnings of your breadwinning partner. As long as you were married for 10 years or more, you have earned spousal benefits.

Receiving spousal benefits does not affect what your ex will receive from Social Security. What’s more, your ex does not need to know, give permission, or sign any papers. All you need to provide is the marriage certificate, divorce papers, and your ex’s full name.

If you were also employed and are eligible for your own Social Security benefits, investigate which benefit will pay more: now; when you turn 70; or at your designated retirement age. Unlike survivor benefits, you cannot switch benefits at a later date. Decide when is the best time to apply, and choose the larger amount.

It’s important to make a fact-based decision. The difference in monthly payments, added up over many years, could mean there are thousands of dollars at stake. There are many more details than we can cover here, including information about benefits in same-sex marriages. Consider working with a certified financial planner who can run the various calculations for you and suggest the wisest strategy. There’s too much to lose to depend on Social Security staff for detailed guidance.

Find yourself suddenly single?
Let us help you get reoriented. Give us a call: (208) 321-5567.

Learn more about our services for aging well.

THE ART OF ACHIEVING BALANCE

While we all know there is no such thing as a unicorn, that does not stop us from writing stories, creating cartoons, and other fairy tales about them.  Nor is there concrete evidence that the Loch Ness Monster exists, and yet that tale persists. I have a friend who believes that he has seen Sasquatch. I would also add the concept of Time Management to this list of things that do not exist, yet people continue to dwell on it.

I firmly believe that time management is an illusion that a great many people pursue, but like a cloud in the sky, can be seen but never touched. I state this as an affirmation because I know that time simply cannot be managed. We can prioritize and micro-schedule, but we all receive the same 24 hours each day, the same 168 hours each week. Sixty seconds to each minute, sixty minutes to each hour. It is a law, and like all laws of nature and man, needs to be respected. Success follows when we are obedient to laws over which we have no control.

I recently had a conversation with a producer who spent twenty five minutes lamenting at how poor he is at time management. After listening to him ramble (his choice of words) for those twenty five minutes, he ceased, and it was my turn. I immediately pointed out to him that he had referenced ‘time management’ some seven times in those twenty five minutes, and that he should not be so self-deprecating because of an inability to manage something as illusory as time. I shared with him that we have as much chance of managing time as we do of touching a cloud. Just last week, I sat on the modern miracle of jet planes, looked out the window at approaching cloud banks, and realized that as we were flying into them and through them, that there is never any tangible contact. Yes, there is condensation on the outer surface of the plane, but for the passengers, it is largely an illusion.

At the conclusion of my agent session, I made that suggestion to him that rather than attempting to manage something that is simply unmanageable, that he would be better served if he focused his efforts to achieve happiness and success by attaining balance in his life, and being proactive rather than unbalanced and reactive.

A series of conversations with this same producer as well as several others led me to share that achieving balance in one’s life is really a series of choices that we must make every day, to wit:

  • It is about organization, not about making excuses.
  • It is about exercising discipline and being diligent.
  • It is about avoiding a state of inertia and rising above it.
  • It is about prioritizing our activities, not managing the time.
  • It is about never uttering “I’m sorry” when it comes to owning your business.

A long term care advocate can be successful by working an honest 40 hours per week. Yes, you heard it right. Not sixty or eighty hours, but only 40. An honest, yes, there is that word again, forty hours WILL make an advocate successful at the Leading Producer level if he or she employs the above tools.

  • It is about working smarter not harder.
  • It is about creating and maintaining balance in the various spheres that comprise our lives — family, professional, personal, spiritual, physical, recreational.
  • It is about maximizing — not managing — the 168 hours that we are granted each week.
  • It is about focus.

Some life lessons gleaned over the years.
More than a few years ago, I learned “Focus on everything is focus on nothing.” You simply cannot spread yourself so thin and expect to remain focused enough to accomplish anything at a level equating to success. That is a formula for mediocrity.

Second, what is your time worth? Only you can assess this and assign a value. It is important to remember and to discipline yourself so as not to chase meaningless opportunities.

Third, it is about answering the question: “Am I investing my time, or merely spending it?” Time invested in an activity such as reading to your grandchildren or family history and genealogy would surely trump the time spent playing Fortnight or spending hours on Facebook or Pinterest. Sorry, I am neither a gamer nor a social media junkie.

Simple math:

  • 40 hours of work (five 8-hour days or 4 10-hour days — it does not matter) broken down as follows:
    • 4 hours education (workshops, webinars, conference calls, self-study)
    • 5 hours marketing
    • 8 hours scheduling appoints
    • -20 hours of appointments
    • 3 hours of administration
  • 49 hours of sleep (achieving the optimal 7 hours per night)
  • 6 hours of physical exercise (six 1-hour sessions Monday-Saturday)
  • 7 hours of personal spiritual time (1 hour daily – scriptures, prayers)
  • 3 hours of church worship
  • 7 hours of service (extended family, neighbors, friends,)
  • 14 hours of recreation (2 hours daily).
  • 8 hours date night with significant other (Friday and Saturday)
  • 21 hours of family time (for those who do not have immediate family, this could be phone, Skype, FaceTime, letter writing, etc.)
  • 4 hours of maintenance and housekeeping

Leaves a reserve reservoir of 9 hours, and we were generous with some of the above allocations.

These categories can be combined; a family activity that involves hiking or skiing would encompass family time, recreation, physical exercise, etc.

You work for yourself, which means that you are primarily accountable to yourself. To this end, the first question that you must ask, and answer is “Would you have hired you in the first place?” Follow up questions should then include, “Are you measuring up?” “Would you not fire you based on your current performance if it was coming from someone else?”

Remember that when performance is measured it improves. When it is measured consistently, it improves exponentially. So, stop managing something that is not manageable and focus on the greatest resource you have in your possession: YOU.

“All good performance starts with clear goals.” – Ken Blanchard.

Source: Age Gracefully America  Written by: Don Levin

Senior Fall Prevention

Older Americans Act Reauthorization

Falls among seniors are incredibly common, and can cause serious injuries. According to the Centers for Disease Control and Prevention (CDC), some 2.5 million adults aged 65 and older in the United States are treated for fall injuries every year. Each year, three million older adults go to the ER for injuries due to falls.

And in a2015 Caring.com survey of 2,000 adults, the more than 500 respondents with a parent or grandparent living alone or with a spouse said they were concerned for those aging relatives’ safety.

Senior Fall Prevention

Source: Centers for Disease Control and Prevention

Falls can have serious consequences for the elderly. They can cause injuries such as broken wrists, arms, ankles, or hips, and are a leading cause of head trauma. At least 300,000 older adults go to the hospital each year for hip fractures – most of which are due to falling, according to the CDC, and the majority of which will not health well if at all. In 2015, falls cost more than $50 billion, most of which is paid out through Medicare and Medicaid.

Even if your aging parent falls with no injury, they (and you) may become more afraid of falls – which can lead to a decrease in necessary activities such as walking, exercising, and going out with friends and family. This decrease in activity can actually lead to muscle weakness – and increase fall risk.

To help you protect your elderly loved ones from these effects, we’ve put together a helpful guide to help you understand how and why older adults fall, how to prevent falls and what to do after a fall.

  • Causes of Falls Among Elderly Adults
  • Common Consequences of Falls
  • Lifestyle Changes That Can Help Prevent Falls
  • Home Safety Measures for Fall Prevention
  • Medical Alert Systems and How They Can Help After a Fall
  • What to Do in the Event of a Fall

Causes of Falls Among Elderly Adults

Risk factors for falling include:

  • Weakness, especially in the lower body
  • Loss of bone mass that can weaken bones
  • A lack of vitamin D
  • Challenges walking and balancing
  • Using medications that affect balance or may cause dizziness
  • Difficulty seeing clearly
  • Difficulty seeing at night
  • Painful feet or shoes
  • Neuropathy in the feet
  • Blood pressure dropping as an older adult moves from sitting to standing
  • Dementia
  • Hazards around the home, including broken steps, broken or missing handrails, lack of lighting, and tripping hazards
  • Alcohol consumption

Many people have a combination of these risk factors which can lead to falling.

Common Consequences of Falls

When older adults fall, they and their loved ones may be surprised by the severity of the consequences. Falls that once might only have left a bruise and wounded pride can lead to serious injury, fractured or broken bones, or brain injury in your aging loved one. Consequences of falling include:

  • Scrapes, sores, and other wounds
  • Fractured bones
  • Broken bones
  • Head injury
  • Fear of future falls

Unfortunately, injury from a fall can lead to a cascade of events which reduce an older adults independence. The majority of hip fractures in older adults do not heal, according to the American Academy of Orthopaedic Surgeons, and can lead to a move to a residential facility. Prevention of falls, and thorough care after a fall, can help aging loved ones maintain their independence longer.

Fear of a fall can lead to a separate set of challenges. Once your aging parent becomes afraid of a fall, she may avoid many situations that seem dangerous. She may cut back on exercise, socializing, or leaving the house. Although these actions may seem like the safest choices, they can make your loved one weaker so that a fall becomes even more dangerous.

Lifestyle Changes That Can Help Prevent Falls

While the risk of suffering a fall increases with age, that doesn’t mean it’s unavoidable. In fact, there are a number of lifestyle changes older adults can make to lower the risk of a potentially life-altering spill.

Senior Fall Prevention

1. Staying Physically Active

Your aging loved one should be engaged in regular, daily exercise that is appropriate for their physical condition. Exercise helps to build muscle strength and can improve flexibility. Aim for a mix of aerobic activity, such as walking, and weight-bearing activities, to keep muscles conditioned. Learn more about chair-based activities, water-based activities, and group fitness activities that not only strengthen the body but keep individuals socially connected.

2. Maintaining a Healthy Weight

Many older adults find their appetite decreasing, and they become underweight. Losing too much weight puts their bones at risk.

3. Quitting Smoking

Smoking cigarettes is correlated with losing bone mass more rapidly. Encourage your aging parent to protect their bones strong by giving up cigarettes.

4. Eating for Healthy Bones

Make sure your loved one is eating a healthy, varied diet and getting plenty of vitamin D and calcium. Talk to his doctor about whether he needs supplements to bolster bone health.

5. Staying Hydrated

Dehydration can make older adults weak and dizzy. Provide plenty of fluids in beverages, soups, fruits, and treats such as popsicles.

6. Limiting Alcohol

As people age, alcohol can have an even greater impact on blood alcohol levels than in the past. Research shows that the more alcohol older adults drink, the greater their risk for hip fractures. Drink minimally if at all, and make sure your aging parent is in a safe situation where she will not be at risk for falling.

7. Getting Enough Sleep

Your aging relative’s sleep needs change with age, but sleep deprivation always increases risk of falling. If your loved one is having difficulty getting the sleep he needs, talk to your doctor.  

Home Safety Measures for Fall Prevention

Despite their concerns, more than half of respondents to Caring.com’s 2015 Fall Prevention Survey said that their senior loved ones living alone lack a number of basic in-home safety items. Features such as raised toilet seats, entrance ramps and shower grab bars can help prevent unintentional falls, while emergency response systems make it easier for seniors to call for much-needed help in the event of a fall.

Senior Fall Prevention

Source: Caring.com Senior Fall Prevention study, 2015

1. Understand what you’re dealing with

Identify, with a doctor’s help, which risk factors for falls your loved one has, besides dementia (which is itself considered a risk factor). The list varies by individual, but for many people with dementia these include such common problems as poor eyesight, poor balance, arthritis, and generalized frailty. People with dementia may also have a shuffling gait, muscle weakness due to past stroke, or neurological problems.

2. Minimize or avoid medications that have been linked to increased falls

Review a complete medication list with the doctor, and ask which ones might cause increased confusion or worse balance in a person with dementia. Medications to especially look out for include drugs from a class known as anticholinergics, which includes drugs for overactive bladder, itching/allergy, vertigo, nausea and certain drugs for nerve pain or depression.

Diphenhydramine, or Benadryl, is a commonly used anticholinergic that’s often included in over-the-counter sleep aids and PM-version painkillers. People with dementia are also more likely to fall when taking sedatives, tranquilizers, and antipsychotics. Finally, blood pressure medicines can sometimes work too well and cause blood pressure to fall when a person stands.

3. Ask the doctor about leg strength, gait, and balance evaluations

These tests help determine physical risk factors. A doctor (or a physical therapist, to whom you may be referred for testing) will watch whether your loved one uses both hands to rise from a chair, for example, which indicates muscle weakness.

4. Ask about vitamin D supplementation

Many (but not all) older adults are deficient in vitamin D. Studies have found that treating vitamin D deficiency does reduce the chance of future falls. The doctor can help identify the right supplemental dose

5. Ask about osteoporosis

Senior Fall Prevention

Whether or not they also have dementia, adults with osteoporosis are more likely to suffer injuries if they do fall. Note: Both older men and older women can suffer from porous bone. But since osteoporosis is more common in women, all women over age 65 should be screened at least once.

6. Consider asking for a referral to a physical therapist or occupational therapist

These experts can work with your loved one to develop exercises that shore up weak spots. They can also evaluate the use of a cane or walker to see if the device (as currently being used) is more help or hindrance. Because forgetting to use devices is a common problem with dementia, a therapist may suggest ways to get around this.

7. Make sure your loved one has an annual eye exam

Low vision is a huge risk factor for falls, and many vision problems come on gradually but steadily. Some, like cataracts, are easily treatable. Also be cautious with bifocal glasses; although they’re convenient, one study found increased falls when people wore bifocals compared to monofocals, possibly because bifocals can make it harder to gauge depth and steps properly.

8. Keep up with foot care

Trimmed nails help people walk more comfortably and therefore properly, yet this is an often-overlooked aspect of eldercare. A podiatrist can also check out other foot-pain issues that may be affecting gait and balance.

9. Get a home-safety assessment

Social workers and geriatric care managers routinely perform these. An expert comes to the person’s home and targets danger spots (including fall risks) and suggests easy improvements. This assessment can focus specifically on the needs of someone with dementia.

10. Consider exercise classes

If your loved one is capable, consider an exercise class to improve strength and balance, such as tai chi or yoga for seniors. Even people with dementia can benefit. Bonus: It might be something you can do together, getting you out of the house.

11. Make sure slippers and shoes are safe and stable

Discourage walking around in stocking feet, loose slippers, or flimsy open-heel styles. Overlooked footwear dangers include new shoes with smooth, unscuffed soles and walking shoes with heavy treads that “catch” on carpets.

12. Remove tripping hazards around where the person walks

Scatter rugs are a top tripper, for example. In the bathroom, you can lay a towel or rug in front of the tub or shower when the person is exiting, if the floor is cold; then pick it up right away.

Also tame unruly extension cords. Better than taping them to the floor is to remove them altogether. Remove piles of old newspapers and magazines and other clutter.

13. Maintain good household lighting

Poor vision is a leading fall-maker. Watch for darkened hallways and stairs that might need more light. Replace burned-out bulbs.

Don’t forget night lighting. Keep the night path to the bathroom lit. Consider using holiday lights, spaced nightlights, motion-detector lights, or simply leaving the hall or bathroom light on.

14. Install grab bars in showers, bathtubs, and near toilets

These allow your loved one to catch him or herself in a fall. Regular towel bars are insufficient; they can be pulled off the wall if grabbed during a fall, often worsening the accident.

15. Brainstorm ways to limit the potential hazard of pets that cause falls

For example, you might consider whether a pet could be limited to one area of the house, or let it wander freely only under supervision. Beware of chew toys and bones that get scattered on the floor, too. Children’s toys can be another hazard.

Medical Alert Systems and How They Can Help After a Fall

Senior Fall Prevention

Your aging parent has a number of options for medical ID and medical alert systems that could facilitate them getting help quickly after a fall. At the most basic level, an older adult may want to wear medical ID jewelry that provides first responders and others information about their medical condition, in the event of an emergency or loss of consciousness in public.

A smartphone is an option in a pinch, however your aging parent might not have their smartphone with them when they fall or a fall might either break the phone or cause your loved one to be unable to use the phone. So you may want to consider other options that can either sense a fall or be as easy to use as pressing a button in the event of a fall.

If you are concerned about falls, your family may want to move to more advanced monitoring systems. You have a number of options in this category, and you will have to answer a number of questions in order to find the best possible system for your family:

  • What is your budget? Each service offered by a medical alert system may have an added monthly fee.
  • Do you want home monitoring or mobile monitoring, or both? If your aging parent needs a device to carry with them while they are out and about, that will be additional to home monitoring. However, an older adult who is homebound might not need a portable option.
  • Do you need a system that works well for the hearing impaired? If your loved one has hearing impairments, make sure the system you need works well for those who do not hear well.
  • Do you want 24-hour monitoring? This is particularly useful if you are concerned that your loved one may fall at night and will need an immediate response. Unmonitored systems are set up so that when your loved one signals that they need assistance, select friends and family will be called automatically to come to their aid.
  • Do you want a fall-detection option? Medical alert systems may not automatically include fall sensing equipment. You might have to ask for – and pay for – this added option.

Comparison shop to find the option that suits your aging loved one best. If possible, involve them so that they can let you know what device they will be most comfortable using.

To help you in your search, visit our comprehensive guide to the Best Medical Alert Systems for Seniors.

If your aging loved one lives independently, you also may want to check in with them daily – or ask friends, neighbors, postal workers, health aides, members of their faith community, or others who are in their neighborhood frequently to check on them regularly. If your loved one lives in a residential facility, talk to the facility managers about how they find out about falls that happen in their residents’ personal living areas.

3 Crucial Steps to Take After a Fall

Senior Fall Prevention

Your decision about what to do after an elderly loved one experiences a fall will depend on the situation. First, encourage your loved one not to try to get up immediately after a fall. It’s best to try to sit up slowly and possibly crawl to either a chair to pull themselves up, or to a phone to call for help.

1. Call 9-1-1

Certain signs indicate a medical emergency that requires immediate attention. Call 911 if:

  • The person is unconscious.
  • The person is having difficulty regaining consciousness.
  • There’s an obvious fracture.
  • The person is in a lot of pain.
  • Something about the nature of the fall warrants concern about spine or neck injury (for example, falling down the stairs or an inability to move).
  • You notice signs of an acute medical problem that could have caused the fall, including chest pain, shortness of breath, or signs of stroke.

2. Visit the Doctor the Day of the Fall

Some falls don’t warrant an ambulance but require medical care because they may lead to complications if not treated.

Get same-day medical treatment from your doctor or a walk-in clinic if:

  • The person has hit his or her head. Older adults are at higher risk for bleeding between the brain and the skull after a head trauma. A CT scan of the head is therefore wise after any head injury. This is critical and requires immediate medical attention if there’s also a worsening headache, nausea, vomiting, or a change in mental status or neurological abilities.
  • There’s been a cut that might require stitches or additional attention. A more minor abrasion can be treated the same way you’d treat one in a child: Wash it, apply antibiotic ointment, and cover the wound.
  • The person reports significant pain in any bones or joints, which could be signs of fracture or bleeding in a joint.
  • The person is no longer able to walk (but could before the fall).
  • The person has less mental or physical function than before the fall (for example, is more confused than usual or has a reduced range of motion).

3. Get a Medical Evaluation

You will likely need a medical evaluation after a fall. If a person is hurt in a fall, the first medical evaluation will probably focus on assessing the injury. Make sure a prompt follow-up appointment is scheduled to further evaluate the possible causes for the fall and to talk about how to prevent future falls.

Here’s what a thorough medical evaluation will likely cover. If the doctor overlooks certain points, don’t be shy about asking why. You can expect:

  • An assessment for underlying illnesses
  • A blood pressure/pulse reading when standing and sitting
  • Bloodwork
  • Review of medications
  • Gait and balance assessments
  • Physical exam to look for underlying heart or neurological condition
  • Vision exam
  • Foot exam
  • Home safety assessment

These evaluations may lead to some solutions that can help prevent future falls. For example, treating illness, giving supplements to address a nutritional deficiency, or adjusting medication can help your aging parent be steadier on their feet.

Some of these evaluations may require visiting more than one medical professional, such as an eye doctor or a podiatrist, or inviting a physical therapist into your home to help make your surroundings safer.

Source: Caring.com