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Grandchild-Proof Your Home

Grandchildren are a great bonus of growing older. You may have heard the old joke: “If I knew grandchildren were going to be this fun, I would have had them first.” Grandparents and grandchildren alike benefit by this special connection. For example, a study presented last month by the American Sociological Association showed that grandparents and grandchildren who have a close relationship lower the risk of depression for both of them.

Today’s grandparents are serving an ever more important role in the lives of their grandchildren. According to a recent MetLife study, there are more grandparents than ever in the U.S.—and despite the stereotype of Granny sitting on the porch in her rocking chair, today’s grandparents are more actively involved than ever with their grandkids.

Maybe your grandchildren live nearby, and you often fill in as a babysitter. Perhaps they live at a distance, and visits are an eagerly awaited special event. You might even be one of the growing number of seniors who are raising their grandchildren when the children’s parents cannot. No matter what your situation, when grandchildren are in your home, you want them to be safe…and you want to be able to enjoy their visits without worry.

Your concern is justified. According to the U.S. Consumer Products Safety Commission, each year 2.5 million children are seriously injured—some fatally—by hazards in the home. Most of these accidents were preventable! Read on for a quick refresher course in childproofing your home, including some information that may be new to you if it’s been a while since you scrutinized your home for things curious little hands could get into.

A few things to remember:

Child safety precautions may seem more stringent. Health and safety experts continue to refine ideas about keeping children safe. For example, toy safety regulations are much more strict than they used to be, and many experts and young parents are more cautious about the materials from which toys are manufactured. Read labels to be sure toys are safe for the age of the child. And if you’ve saved treasured playthings from when your children were young, or picked up fun-looking items at a garage sale, inspect them carefully to be sure they contain no small parts that could cause choking (smaller than two inches in diameter), sharp edges, or materials that could break into pieces. Some heirloom toys are best kept on display—out of reach.

Outdated safety equipment may be UNsafe. Child safety devices have come a long way. For example, the evolution of the child car seat alone would make quite a story! Remember the pre-seatbelt days when kids crawled all over the back seat during family trips? And those unanchored car seats with a toy steering wheel? Since then, child car seats have been continually improved, so that even a decade-old car seat is probably not consdiered state-of-the art. The same goes for home safety equipment. For example, the common flat plastic outlet protector could fit in a small child’s mouth—a choking hazard. A child’s neck could get caught in the old scissor-style safety gate. Hand-me-down or garage sale equipment may not provide an acceptable degree of protection.

Our homes have changed over the past few decades. The homes of today are likely to have exercise equipment, hot tubs, home offices with computers, and other relatively recent features requiring a new set of precautions. Computers, for example, are often placed on the floor within reach, and monitors and laptops can be pulled down by the cord.

Some grandparents recommend having a designated “kid friendly” section of the house, keeping more dangerous areas locked off (for example, the home gym and garage). Be creative! If the living room has the fewest hazards, make it the playroom while you have visiting little ones.

Be open to suggestions! Don’t get your feelings hurt if your kids correct you. They’re Mom and Dad now, and they’ve probably done plenty of homework about childproofing. Be proud of them.

For More Information

The American Academy of Pediatrics’ consumer site, Healthy Children  http://www.healthychildren.org/English/Pages/default.aspx, features home safety tips http://www.healthychildren.org/English/safety-prevention/at-home/Pages/default.aspx, including “A Message for Grandparents: Keeping Your Grandchild Safe in Your Home” http://www.healthychildren.org/English/safety-prevention/at-home/pages/A-Message-for-Grandparents-Keeping-Your-Grandchild-Safe-in-Your-Home.aspx.

Copyright © AgeWise, 2013

 

Safety First When Turning Up the Heat

As temperatures drop, more people will turn on heaters to stay warm. The nation’s emergency physicians warn about the potential risks involved with heating your homes and bodies.

“Every year, tragically, people are burned, start fires, get an electric shock and even die from carbon monoxide poisoning, because they weren’t taking proper precautions,” said Dr. Alex Rosenau, president of the American College of Emergency Physicians (ACEP). “I don’t want anyone in my emergency department suffering from an injury that could have been easily prevented.”

Each year more than 2,500 people died in house fires in the United States, according to FEMA and another 12,600 are injured.

Another big concern each fall and winter is carbon monoxide poisoning. Carbon monoxide is an odorless and colorless gas that can cause sudden illness and even death. People can be poisoned by breathing it.

The most common symptoms of carbon monoxide poisoning are headache, dizziness, weakness, nausea, vomiting, chest pain and confusion. High levels can cause loss of consciousness. Every home should have a carbon monoxide detector, and if you have any of these symptoms, you should seek emergency care.

ACEP recommends the following:

  • Check all smoke detectors and carbon monoxide detectors. Make certain they are working properly. If they are battery operated, change the batteries. There should be one of each detector on every floor of your house.
  • Have a professional inspect your gas furnace at least once a year. One with leaks or cracks can be dangerous for your home, leaking carbon monoxide or possibly causing a fire.
  • If you use a fireplace, have a professional inspect and clean it every year to avoid fires. Also make sure any flammable materials are away from the open flame area. Never burn trash, cardboard boxes or items that may contain chemicals that can poison your home.
  • If you use a wood burning stove, have a professional inspect and clean the chimney each year. Make sure you have a safe perimeter around it, because it can radiate excessive heat. Place on a flame-resistant carpet, and use a screen to prevent sparks and hot coals from coming out of the stove. Use safe woods, such as oak, hickory and ash — avoid pine and cedar.
  • Never use a range (electric or gas) or oven as a heating source. It’s not only a dangerous fire hazard; it can also release dangerous fumes, such as carbon monoxide.
  • If you use an electric space heater, keep a safe perimeter around it. Make sure it is away from water or anything flammable like curtains, paper, blankets, or furniture.

Check for any faulty wiring that can cause electric shock or fire. Supervise children and pets around space heaters, and turn them off before leaving the room or going to sleep.

For more on this and other health related topics, go to www.emergencycareforyou.org.

Source: The American College of Emergency Physicians (ACEP), the national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Visit the ACEP website for more information (www.acep.org)

 

Home Care Supports Seniors Who Want to Age in Place

The U.S. Census Bureau reported last year that the percentage of seniors who are living in a nursing home dropped by 20 percent over the last decade. Are seniors just healthier today? The truth is, older adults today need as much care as did previous generations, but more of them are receiving it in assisted living communities, adult day centers and, in growing numbers, in their own homes.
This information comes as little surprise to the 65 million Americans who are already serving as family caregivers for older loved ones who need help managing health conditions and the activities of daily living. Many of these caregivers are members of the baby boom generation, who are reaching the age when they themselves might be expected to need care! From the local to the federal level, government agencies, too, are taking notice of the financial impact resulting from this population shift. The discussion about how to best and most cost-effectively care for our seniors is taking center stage.
The Census study showed that 90 percent of seniors would wish to receive care in their own homes. Is this realistic? Can they be safe and well-cared for even if they are living with age-related illnesses such as heart disease, diabetes, arthritis, or memory loss? Several demographic changes in our society make this more of a challenge than it was in the past:
• A University of Michigan study showed that almost 40 percent of chronically ill older adults in the U.S. live alone, and the majority of those who are married have spouses who are themselves facing health challenges.
• Our lower birthrate equals fewer adult children to help out as parents’ care needs increase.
• Adult children are more likely to live at a distance, having moved to find employment.
• A higher divorce rate means more seniors live alone, and family caregivers’ financial and time resources are stretched when parents live in different households, or even in different parts of the country.
The cost of institutional care continues to grow. For some seniors with medically complex health challenges, nursing homes and other residential health facilities are the best choice. But for many other seniors, home care is a desirable and cost-effective arrangement.
Dr. Soeren Mattke of the RAND Corporation noted, “The aging of the world’s population and the fact that more diseases are treatable will create serious financial and manpower challenges for the world’s healthcare systems.” He added, “Moving more healthcare into the home setting where patients or family members can manage care could be one important solution to these challenges.”
A wide variety of care services can be provided right in a patient’s home:
Skilled healthcare services can be provided at home and are cost-effective. Visiting nurses and rehabilitation professionals provide skilled medical services in the home. Registered nurses (RNs) and licensed practical nurses (LPNs) perform hands-on procedures such as wound care and IV therapy. Rehabilitation professionals include physical, occupational and speech/language therapists.
Nonmedical home care provides companionship and homemaking services that support the senior’s independence, at a much lower cost than nursing care. Caregivers provide supervision, assistance with dressing grooming and other personal care, laundry and housekeeping, meal preparation, transportation, socialization, and respite for family caregivers.
Dementia support is also available. Even when adult children live close to home, dementia complicates the caregiving dynamic. Trained in-home caregivers who understand the challenges of Alzheimer’s disease and similar conditions can help patients remain home longer, even as the need for assistance and supervision grows.
Many experts believe that bringing more care into seniors’ own homes will allow them to take better charge of their own care—and will save seniors and the healthcare system money.
Source: IlluminAge AgeWise, 2015

Planning Ahead When a Loved One Has Alzheimer’s Disease

When a loved one is diagnosed with Alzheimer’s disease, you need to start getting their health, legal, and financial affairs in order. You want to plan for the future, if possible, with help from your loved one while they can still make decisions. You need to review all of their health, legal, and financial information to make sure it reflects their wishes. Here is a planning checklist from the National Institute on Aging’s Alzheimer’s Disease Education and Referral Center:

Update health care, legal, and financial information

  • A Durable Power of Attorney for Finances gives someone called a trustee the power to make legal and financial decisions for the person with Alzheimer’s.
  • A Durable Power of Attorney for Health Care gives someone called a proxy the power to make health care decisions for the person with Alzheimer’s.
  • A Living Will states the person’s wishes for health care at the end of life.
  • A Do Not Resuscitate (DNR) Form tells health care staff how the person wants end-of-life health care managed.
  • A Will tells how the person wants his or her property and money to be divided among those left behind.
  • A Living Trust tells the trustee how to distribute a person’s property and money.

Check for money problems

People with Alzheimer’s disease often have problems managing their money. As the disease progresses, they may try to hide financial problems to protect their independence. Or, they may not realize that they are losing the ability to handle money matters. Someone should check each month to see how your loved one is doing. This person might be a family member or the trustee.

Protect your loved one from fraud

Scams can take many forms, such as identity theft; get-rich-quick offers; phony offers of prizes or home or auto repairs; insurance scams or outright threats. Here are some signs that a loved one with Alzheimer’s is not managing money well or has become a victim of a scam:

  • Your loved one seems afraid or worried when he or she talks about money.
  • Money is missing from your loved one’s bank account.
  • Signatures on checks or other papers don’t look like your loved one’s signature.
  • Bills are not being paid, and your loved one doesn’t know why.
  • Your loved one’s will has been changed without his or her permission.
  • Your loved one’s home is sold, and he or she did not agree to sell it.
  • Things that belong to your loved one are missing from the home.
  • Your loved one has signed legal papers (such as a will, a power of attorney, or a joint deed to a house) without knowing what the papers mean.

Reporting problems: If you think your loved one may be a victim of a scam, contact your local police department. You also can contact your state consumer protection office or Area Agency on Aging office. For help finding these offices, contact Eldercare Locator at 1-800-677-1116 or www.eldercare.gov. For a list of state consumer protection offices, see www.usa.gov/directory/stateconsumer/index.shtml. You can also look in the telephone book for a listing in the blue/Government pages.

Who would take care of your loved one with Alzheimer’s disease if something happened to you?

It is important to have a plan in case of your own illness, disability, or death.

  • Consult a lawyer about setting up a living trust, durable power of attorney for health care and finances, and other estate planning tools.
  • Consult with family and close friends to decide who would take responsibility for your loved one. You also may want to seek information about your local public guardian’s office, mental health conservator’s office, adult protective services, or other case management services. These organizations may have programs that could assist your loved one in your absence.
  • Maintain a notebook for the responsible person who would assume caregiving. Such a notebook should contain the following information:
    • emergency phone numbers
    • current problem behaviors and possible solutions
    • ways to calm the person with Alzheimer’s
    • assistance needed with toileting, feeding, or grooming
    •  favorite activities or food
  • Preview long-term care facilities in your community and select a few as possibilities. Share this information with the responsible person. If your loved one is no longer able to live at home, the responsible person will be better able to carry out your wishes for long-term care.

Contact the Alzheimer’s Disease Education and Referral (ADEAR) Center at 1-800-438-4380 or www.nia.nih.gov/alzheimers for more information on planning for health, legal, and financial matters.

Source: National Institute on Aging, adapted by AgeWise, 2014.

 

Raining? Snowing? That’s No Reason to Skimp on Physical Activity

Mom always told us to get outside for some exercise. But if you’re like many of us in the U.S. these days, freezing cold, snow and ice might make it unsafe—at the least unpleasant—to get our workout in the great outdoors.

If it’s too cold, rainy or icy (or in a few months, too hot), it takes a little creativity to be active indoors. The National Institute on Aging (NIA) offers these great ideas for seniors who want to get some exercise even when weather conditions aren’t great:

  • Walk on the treadmill, ride the stationary bike, or use the rowing machine that’s gathering dust in your bedroom or basement. Or use one at a nearby gym or fitness center.
  • Work out with an exercise DVD. You can get a free one from the NIA’s Go4Life program (www.nia.nih.gov/Go4Life).
  • Go bowling with friends.
  • Join a local mall walking group.
  • Walk around an art gallery or museum to catch a new exhibit.
  • Check out an exercise class at your neighborhood Y or senior center.
  • If you like dancing, take a Zumba or salsa class.
  • Try yoga or Tai Chi.
  • Go to the gym and work on your strength, balance, and flexibility exercises or set up your own home gym. All you need is a sturdy chair, a towel, and some weights. Soup cans or water bottles will do if you don’t have your own set of weights.
  • Go to an indoor pool and swim laps or try water aerobics.
  • How about a game of indoor tennis, hockey, basketball or soccer?
  • Go indoor ice skating or roller skating.
  • Maybe it’s time for some heavy-duty cleaning. Vacuum, mop, sweep. Dust those hard-to-reach areas.
  • Play ping pong with the grandkids.

The NIA reminds us that we’re more likely to exercise if it’s convenient. Put your weights next to the sofa so you can do some lifting while you watch TV. Walk around the house while you’re talking on the phone. Make an extra trip up and down the stairs when you do the laundry.
Visit www.nia.nih.gov/Go4Life to find more tips and resources for staying active.

Source: National Institute on Aging, adapted by IlluminAge AgeWise.

Supplements May Contain Dangerous Ingredients

Many seniors take dietary supplements in an effort to improve their health. Some supplements have medical value. But many are worthless, even dangerous. Seniors can be at risk for health fraud by scammers who target people who are at their most vulnerable. These crooks prey on the hopes of those who are experiencing ill health, pain and fear. The companies spend a bundle on infomercials and ads in the back of magazines—often more than they spend on the ingredients that go into their products.

The U.S. Food and Drug Administration (FDA) reminds consumers that supplements are not FDA-approved. Consumers should be wary of products that promise fast, easy weight loss or a miracle cure for diseases and conditions such as arthritis, cancer or HIV/AIDS. They should be aware of red flag terms such as “male enhancement,” “anti-aging” and “scientific breakthrough.” Consumer protection experts also warn of pyramid schemes that recruit seniors to invest in worthless supplement products and sales materials.

The hit to your pocketbook isn’t the top danger of these products. Some supplements can endanger your health. It’s important to know that, for the most part, supplements are not regulated, and the FDA only steps in if a safety issue is suspected. Many supplements are produced in unregulated plants, often out of the U.S., with no safety standards or inspections. Some contain substances that have not been tested on humans, as well as pharmaceutical ingredients that should not be available over the counter or have been banned entirely. For example, “all-natural muscle builder” products have been found to contain steroids. Some “Chinese herbal” weight loss pills actually contained sibutramine, a dangerous and banned drug. A recent study appearing in the Journal of the American Medical Association found that even when the FDA orders a recall of supplements containing banned ingredients, manufacturers and dealers regularly ignore the order and these products continue to be sold.

The study authors, from Harvard Medical School, analyzed recalled supplements and found that many remained on store shelves over a year after the recall. Dr. Pieter A. Cohen and his colleagues said, “Action from the FDA has not been completely effective in eliminating all potentially dangerous adulterated supplements from the U.S. marketplace. More aggressive enforcement of the law, changes to the law to increase the FDA’s enforcement powers, or both, will be required if sales of these products is to be prevented in the future.”

For now, it is largely up to consumers to protect themselves. Read up on supplement safety on the FDA website  http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm246742.htm. Speak to your doctor before you spend your money on supplements. Following the advice of a trained, licensed healthcare provider is the wisest choice when it comes to making healthcare decisions. Scam artists take advantage of our hopes. But the best source of a sense of well-being comes from knowing we have made educated choices.

Copyright © IlluminAge AgeWise, 2014, with excerpt from the Journal of the American Medical Association.

Emergency Preparation for Loved Ones with Alzheimer’s Disease

During the last few years, our country has seen natural and man-made disasters that have disrupted lives, destroyed property and taken lives. Many in the East are still recovering from Hurricane Sandy. The West has experienced wildfires, earthquakes and the devastating Oso mudslide in Washington state. Tornadoes swept through the Midwest and South. And last winter brought prolonged, sometimes deadly, cold temperatures to much of the country.

One lesson we all learned during those events: In the wake of disasters, seniors and people with disabilities are especially hard-hit. Elders with mobility challenges, visual impairment or hearing often find themselves trapped at home without electricity or water. Family caregivers anxiously try to reach their loved ones to be sure they are safe.

People with Alzheimer’s disease are especially vulnerable in disaster situations. According to the Alzheimer’s Disease Education and Referral Center (ADEAR), impaired memory and reasoning may severely limit these seniors’ ability to cope. For caregivers, it is important to have a disaster plan that incorporates the special needs of loved ones who have Alzheimer’s or other dementia. ADEAR offers these suggestions:

“Riding it out” at home

In some situations, you may decide to stay at home during a natural disaster. Plan ahead to meet your family’s needs and those of your loved one with Alzheimer’s for a period of at least three days to a week. Include supplies and backup options in case you lose basic services.
You also will need special supplies for your loved one with Alzheimer’s. Assemble a kit, and store it in a watertight container. The kit might contain:

  • Warm clothing
  • Sturdy shoes
  • Spare eyeglasses
  • Hearing aid batteries
  • Incontinence undergarments, wipes and lotions
  • Pillow, toy or other comfort object
  • Medications
  • Favorite snacks and high-nutrient drinks
  • Zip-lock bags to hold medications and documents
  • Copies of legal, medical, insurance and Social Security information
  • Physician’s name, address and phone number
  • Recent photos of your loved one

As part of your disaster planning, hold practice drills, with each member of the household performing specific tasks. Assign somebody to take primary responsibility for the person with Alzheimer’s.

Because the needs of a person with Alzheimer’s will change as the disease progresses, periodically update your plan to reflect these changes. For example, your loved one is likely to become less mobile in the later stages of the disease. How will that affect your plan?

If you must leave home

You may need to move to a safer place, like a community shelter or the home of a family member. Consider how you will get your loved one to go quickly and calmly. Be ready to use tactics that have worked in the past.

During relocation, the person with Alzheimer’s might become anxious and start to behave erratically. Remain as calm and supportive as possible. Your loved one is likely to respond to the tone you set. Be sensitive to his or her emotions. Stay close, offer your hand, or give your loved one a reassuring hug. Do not leave him or her alone.

To plan for an evacuation:

  • Know how to get to the nearest emergency shelters. Some areas have shelters for people with special needs. Your local Red Cross chapters can direct you.
  • Make sure that the person with Alzheimer’s is wearing an identification bracelet and/or identifying tags sewn into articles of clothing.
  • Take along general supplies and your Alzheimer’s emergency kit.
  • Bring your cell phone charger and keep the phone charged. Save emergency numbers to your phone.
  • Plan to keep neighbors, friends and family informed of your location. Give them your phone numbers and a list of emergency numbers.
  • Be sure that other people have copies of your loved one’s medical records. If necessary, they can provide these records to emergency medical staff to ensure that your loved one receives appropriate treatment and care.
  • Prepare to prevent wandering. Many people with Alzheimer’s disease wander, especially under stress.
  • If possible, plan to take along the household pet to comfort your loved one. (Remember that this might not be possible; FEMA offers preparation information for pet owners; see below for the link.)

If you become separated

You should not leave a person with Alzheimer’s alone, but the unexpected can happen. Avoid asking a stranger to watch your loved one if possible. Also, do not count on the person with Alzheimer’s to stay in one place.

To plan for possible separation:

  • Provide local police and emergency services with photos of your loved one and copies of his or her medical documents, so they are aware of your loved one’s needs. Be ready to alert them if you and the person in your care become separated.
  • Be sure that your loved one wears an identification bracelet.
  • Contact your local Alzheimer’s Association chapter and enroll the person in the Medic Alert + Safe Return program [http://www.alz.org/care/dementia-medic-alert-safe-return.asp], an identification and support service for people with Alzheimer’s disease who may become lost or injured.
  • Make plans with trusted people who can help your loved one. Educate them about his or her disabilities.
  • Give a trusted neighbor, friend or relative a house key and a list of emergency phone numbers.

For More Information

The Alzheimer’s Association offers a disaster preparedness checklist http://www.alz.org/national/documents/topicsheet_disasterprep.pdf  with more reminders and safety preparation tips.

Your Pet May Be Disturbing Your Sleep, Says Mayo Clinic

Rest assured, there may be a good reason you’re dog-tired.

While countless pet owners peacefully sleep with a warm pet nearby, a new Mayo Clinic study, presented in June at the 29th Annual Meeting of the Associated Professional Sleep Societies, finds an increase in the number of people experiencing sleep disturbances because of their pets.

A previous Mayo Clinic study published in 2002 reported that of patients who visited the clinic’s sleep center and owned pets, only one percent reported any inconvenience from their pets at night. The new study shows a larger number of patients—10 percent in 2013—reported annoyance that their pets sometimes disturbed their sleep.

“The study determined that while the majority of patients did not view their pets intolerably disturbing their sleep, a higher percentage of patients experienced irritation—this may be related to the larger number of households with multiple pets,” says Lois Krahn, M.D., Mayo Clinic psychiatrist and author of the study. “When people have these kinds of sleep problems, sleep specialists should ask about companion animals and help patients think about ways to optimize their sleep.”

Between August and December 2013, 110 consecutive patients at the Mayo Clinic Center for Sleep Medicine in Arizona provided information about pets at night as part of a comprehensive sleep questionnaire. Questions covered the type and number of pets, where the animals slept, any notable behaviors and whether the patient was disturbed. The survey showed that 46 percent of the patients had pets and 42 percent of those had more than one pet. The most popular pets were dogs, cats and birds.

The disturbances by pets that patients reported included snoring, whimpering, wandering, the need to “go outside” and medical needs.

“One patient owned a parrot who consistently squawked at 6 a.m.,” Dr. Krahn says. “He must have thought he was a rooster.”

Source: Mayo Clinic

“Plant a Garden” Word Scramble

When you plant a garden, you harvest a bumper crop of health benefits! Gardening provides all three types of exercise that are important for healthy aging: aerobic, resistance and stretching. Your work rewards you with fresh produce that’s loaded with nutrients. Add to that an emotional boost from spending time in nature, even if it is only a container on your patio.

Take a break from tending your crop to give your brain a workout with this month’s puzzle , which contains the scrambled names of 14 implements people with a green thumb might use to make their task easier!

Copyright © IlluminAge AgeWise, 2014

How Are Today’s Seniors Adapting to Disability?

Only about a third of Americans ages 65 and older are fully able to take care of themselves and go about their daily lives completely independently, according to a recent study published online in the American Journal of Public Health.

Understanding that there are different ways older adults adapt to disability is a big step in developing public health policies that maximize the quality of life for all older Americans, said the study’s lead author, Vicki Freedman, a research professor at the University of Michigan Institute for Social Research.

Freedman and colleagues analyzed data on a nationally representative sample of 8,077 older men and women, part of the National Health and Aging Trends Study. The National Institute on Aging, part of the National Institutes of Health, funded the research.

Among the findings:

  • About a quarter succeed in accomplishing what they need to do on their own by using walkers or other assistive devices. Another 18 percent say they have trouble even when using these devices.
  • Six percent cope by reducing their activities—bathing or going outside less often, for example.
  • Twenty-one percent manage by receiving help from others.

The study is the first to provide national estimates of ways the Medicare-age population adapts to limitations in daily life.

“Nearly 80 percent of all older adults find ways to manage on their own without assistance from others,” Freedman said. “The group using devices on their own without difficulty is especially interesting. They seem to be able to participate in activities they enjoy and report well-being as high as those who are fully able to care for themselves.”

The researchers asked about seven activities of daily living: going outside, getting around inside, getting out of bed, eating, getting cleaned up, using the bathroom and dressing.

During face-to-face interviews, study participants were first asked whether they used devices or environmental modifications including canes, walkers, wheelchairs, scooters, grab bars, and bath/shower seats and whether they received help from another person during the previous month.

Then they were asked whether they experienced any difficulty doing any of the activities even when they used modifications, and about whether they had changed how often they performed any basic activities over the last year.

According to Freedman, the proportion of older adults able to function independently varies greatly by activity and by age. For example, 90 percent of older adults are fully able to eat by themselves, while only 54 percent are fully able to bathe by themselves. About 45 percent of those ages 65 to 69 are fully able to carry out all activities independently, compared with only 4 percent of those ages 90 and older.

Women are more likely than men to do things on their own by using devices to assist them (26 percent compared to 23 percent). But African Americans and Hispanics are much less likely than whites and Asians to do so. Older adults with low incomes are also less likely to successfully accommodate declines in their functional abilities.

“Two groups that we identified may be especially important targets for public health intervention,” Freedman said. “These are the seven million older adults who have difficulty carrying out activities alone with whatever accommodations they have already made, and the additional 2.1 million who have reduced their activity levels but do not experience or acknowledge that they are having difficulty.”

Source: University of Michigan Institute for Social Research (http://home.isr.umich.edu)