We’ve already explained when and why seniors should stop driving. It’s easy enough to go through a checklist and realize that an elderly person may no longer be safe behind the wheel. However, the hard part is now convincing them of their need to become a passenger instead of a driver. Despite all of the common sense logic, many seniors will refuse to give up their licenses because they believe it is the key to their independence. And who can blame them? Giving up their license solidifies their status as an “old person” – it is embarrassing and leaves them lonely, isolated, and depressed. It will take a kind yet firm push from a loved one to finally convince them it is safer without them on the road. Follow these steps for a
1. Gather Your Case Against Them
There’s probably a reason you want the senior in your life to stop driving. Whether you noticed a decline in driving ability or your loved one was just diagnosed with a debilitating condition, these are important facts in your argument. Make a list of all the reasons you are afraid for them to take the road. Watch out for telltale signs, such as difficulty in turning their head or neck, decreased strength, road rage, getting lost, or an increased rate of accidents. Medical conditions, such as macular degeneration or hearing loss, also pose a problem to elderly drivers.
2. Quote Statistics
Elderly driving statistics are pretty grim, so it’s important to mention these if you senior is reluctant to give up the wheel. Fatal senior crash rates begin to increase at age 75 and rise sharply after 80. In fact, 5,300 seniors were killed in 2009 in traffic crashes while 187,000 were injured. One of the reasons so many seniors die in car crashes is because their bones become more fragile – something that even the most alert and aware senior can’t prevent against.
3. Ask Their Friends for Support
As a family member, your loved one may not want to listen to you. They may think you are nitpicking all of their faults. Therefore, it is important to gain support from their friends as well. Their friends may be able to reason with them in ways you cannot. Additionally, friends can offer support in the form of carpooling.
4. Bring it up Gently and Have a Caring Discussion
When it’s time to bring up the subject, do so gently. Do not be accusatory or threatening. Instead, explain your points calmly and rationally with a firm touch. State right away that you are doing this out of concern for their safety because you love and care for them. Additionally, try the technique of reflective listening. This involves rephrasing and repeating what a person has said to show you have been paying attention and support and encourage their ideas. Leave enough time for the discussion to go on for as long as it needs to. Always be sure to ask for their input and feelings; sometimes asking seniors to make a pros and cons list helps them to more clearly see the issue at hand.
5. Expect Anger and Refusal
If your senior is feeling too frustrated and you don’t seem to be making any progress, you can put the discussion on hold until a later date to give them time to mull over your concerns. Be prepared for any backlash or arguments, and try to have counterarguments prepared against them. Many seniors flat out refuse to give up their keys, especially if they are being confronted by one of their children. It is hard for some parents to accept the fact that the tables are turning on them and that their children have more authority over their lives. If the situation gets especially tense, you might have to forcefully confiscate and hide their keys so they cannot drive.
6. Put it in the Hands of the DMV
If all else fails and your loved one still fails to see your point… let the DMV handle it. Ask their doctor to write a letter to the DMV requesting that the senior take an eye test before being allowed to drive again. In some states, seniors can even be forced to retake paper examinations and driving tests in order to maintain their license. This method prevents you from being the “bad guy,” as it is not you who takes away their ability to drive, but the state. Some seniors may realize before taking the test that they will fail and then voluntarily relinquish their driving privileges.
7. Offer Driving Alternatives
As a bit of encouragement, stress to your senior that giving up driving is not the end of their life. There are plenty of alternative ways to get from place to place, such as senior shuttles or public buses. Offer to pick them up and drop them off at their outings to help ease the transition.
If you own a TV and have ever turned it on, chances are you have seen the infamous “I’ve fallen and I can’t get up!” commercials from Life Alert. While the commercials are a bit silly and low budget, the threat of seniors falling in the home is real. One out of every three seniors falls each year, with 734,000 people needing hospitalization because of it. Medical alert systems provide an important safeguard for seniors living home alone. They allow seniors to live without fear, as if they do experience a fall, they simply need to press a button to receive medical assistance.
However, such a system does not come without some cons. Home medical alert systems have unarguably saved thousands of lives since their inception in the 1970s; however, do the cons outweigh the pros for an individual older adult? Decide for yourself by reading our list of pros and cons of a home medical alert system.
1. Can detect falls: A somewhat new technology is the ability for medical alert devices to actually detect when someone falls. Devices are fitted with motion sensor detectors that automatically place a call if a fall occurs.
2. Offers two-way voice communication: During some falls, the fear of being alone and unable to move is worse than any actual injuries. Seniors can give themselves severe anxiety, wondering if anyone will ever find them. The ability to chat with a call center representative is calming and reassuring and can save a senior so much trepidation.
3. Choose from a wristband or pendant: These days, you can choose how exactly you wear your medical device. For example, females may prefer to wear it as a necklace, while males might prefer the wristband option. Either way, they are both effective and unobtrusive in everyday life.
4. Mounted help buttons throughout the house: Imagine this. A senior removes his or her device to take a shower, then slips and falls in the tub. Is all hope lost? No! Many medical alert systems allow you to have mounted help buttons throughout the house in case you are in need of assistance and not wearing your button.
5. Can call 911 or a selected contact: Whenever you fall, you might not always need medical assistance. You could be physically fine, but just need some help getting up. Medical alert systems often allow you to choose between dialing 911 or a selected contact, such as a family member or friend. This can save money on an unnecessary emergency room bill.
1. Cannot detect 100 percent of falls: If you are relying on a medical alert device, be aware that it is not foolproof. Sometimes falls are not detected, which can be deadly if the senior is rendered unconscious during the fall.
2. Requires a landline phone: Nearly all medical alert systems use a landline phone to connect to their call centers. This can be tricky for seniors who do not have a phone or who have opted to switch over to cellular service.
3. Expensive monthly fees: This is perhaps the number one drawback of these services. A medical alert system can cost anywhere from $25 to $50 a month for basic plans. There are additional fees for added services, such as automatic fall detection, carbon monoxide detection, and fire alarm detection.
4. Requires signing a contract: Medical alert systems typically require the user to sign a contract ensuring they will continue services for a specified period of time. This is limiting, as seniors might not need the service for the whole period, especially if they move to assisted living or get a live-in caretaker. Breaking the contract requires paying a fee.
5. Follow-up sales calls: If you are shopping around for several different medical alert systems, you may find the number of sales calls you receive to be very off-putting. As there are a lot of choices out there, each company is trying their hardest to obtain your business.
As you can see, there are an equal amount of pros and cons of a home medical alert system. However, most of the pros definitely outweigh the cons, especially when you consider the stakes. Paying a fee or dealing with sales calls is nothing compared to the health and well-being of the senior citizen in your life. In this case, we’d have to agree with the commercials… all senior citizens should have some kind of home medical alert system.
Driving is a sign of independence and freedom, so it’s no surprise that seniors are reluctant to relinquish this privilege as they age. Giving up driving is seen as a loss of pride and makes many people feel like they are no longer in control of their life. Therefore, many elderly people ignore the warning signs of when to give up driving until they hurt themselves or others. This is why it is important to know what signs and symptoms to look for in a senior when you think it is time for them to hand over the keys.
Reasons Seniors Need to Give Up Driving
Most of the time, there is nothing a senior can do to preserve their driving skills. Many of the reasons that seniors need to give up driving are health-related. There are certain conditions that greatly increase the risk of accident or incident, putting the senior driver as well as any passengers or other drivers in danger. Therefore, it is essential to monitor your condition and make sure you are not suffering from any of the following reasons seniors typically need to give up driving:
- Parkinson’s disease
- vision impairment
- hearing loss
- lower tolerance to alcohol
- slower responses
- prescription drug use
Mental disorders, like dementia, can compromise driving agility and judgment. Vision impairment makes it hard to see the road clearly, while hearing impairments prevent people from hearing horns, screeching tires, sirens, and other warning sounds. Lastly, prescription drug use can cause a number of side effects that make it dangerous to drive. If you do suffer from any of these conditions, talk to your doctor to get his opinion on whether it is still safe for you to drive.
Warning Signs to Stop Driving
It can be hard to know exactly when to give up your license, especially if you feel pressured to live an independent life. You may still feel in control of your reflexes and reactions and see no reason to stop something you’ve been successfully doing for years. However, the rate of accidents per mile increases for drivers over 65. For drivers over 80, death rates by automobile crash are higher than any other group other than teenagers. It is important to be on the lookout for the following warning signs to know when to stop driving:
- abundance of traffic tickets
- price increases in auto insurance
- damage to the car
- reluctance to drive at night
- concern from family or friends
- driving behavior changes
These events are usually indicators of a decline in driving ability. It is important to listen to these signs before a dangerous accident occurs. Hopefully these conditions and warning signs have provided you a good idea of when it may be time for an elderly person to stop driving.
While everyone might be put off by hot temperatures, it is seniors who are most at risk for heat-related health issues. A study by the University of Chicago Medical Center found that 40 percent of heat-related deaths in the US were in people 65 or older. There are several different reasons for this, including a decreased ability to notice changes in body temperature. Seniors can be slow to react to changes in heat, meaning that they don’t start the sweating and cooling down process until their internal temperature has already increased. Additionally, sweat glands may be less efficient with age, slowing down the release of heat from the body. Other factors that contribute to a senior’s vulnerability to heat include obesity, many different health problems, and even certain medications.
Therefore, it is extremely important to watch for signs of heat stroke and exhaustion in older adults.
What is heat stroke?
Heat stroke occurs when is unable to control its body temperature, causing it to rise rapidly. The body is then unable to sweat and cool itself down. Body temperatures can reach up to 106 degrees in as little as 10 minutes! If not treated, death or permanent disability are real threats. Signs and symptoms of heat stroke include:
- Red, hot, and dry skin with no sweating
- Rapid, strong pulse
- Throbbing headache
- Cool, moist skin
What is heat exhaustion?
Heat exhaustion is not as severe as heat stroke, but is still a serious problem. It occurs over a period of several days of exposure to high temperatures and inadequate hydration. If not treated, it can lead to heat stroke. Signs and symptoms of heat exhaustion include:
- Heavy sweating
- Low blood pressure
- Muscle cramps
- Dark urine
- Weak, rapid pulse
- Cool, moist skin
- Fast and shallow breathing
How to prevent heat problems
Lucky, there are many ways to help prevent heat stroke and exhaustion in older adults. they include:
- Drink cool, nonalcoholic beverages to keep you hydrated (water is best)
- Get plenty of rest
- Take a cool shower or bath to lower your temperature
- Stay in an air-conditioned environment
- Wear lightweight clothing that allows your skin to breathe
- Remain indoors during the hottest part of the day
- Avoid engaging in strenuous activities outside
- Stay in shade if you must go outside
If you see someone you think is suffering from heat stroke or exhaustion, the first thing you should do is get them out of the heat. Try and cool them down as fast as possible by immersing them in a tub of cool water or spraying them with a hose. Call for medical assistance as soon as you can, as they will need to be checked out and re-hydrated quickly.
Everyone knows the dangers of sunburn. However, did you know that for people taking certain medications, there is an entirely different sun disorder to worry about? Photosensitivity is an inflammation of the skin caused by the combination of sunlight and certain medications. While photosensitivity might look like sunburn, it’s actually quite different. There are two types of photosensitivity – phototoxic and photoallergic.
In a phototoxic reaction, the drug absorbs UV light and then releases it into the skin, causing cell damage. This causes a rash on sun-exposed skin, which typically clears up after the drug is out of your system. In a photoallergic reaction, UV light actually alters the structure of the drug, which makes your body think the drug is an invading force. Therefore, it produces antibodies against it, which cause inflammation of the skin in both sun-exposed and non-sun-exposed areas.
One additional factor to consider when taking certain medications is sensitivity to heat. Certain medications affect your body’s ability to regulate its temperature, meaning that you could quickly become overheated and suffer heat exhaustion or heat stroke. In severe cases, this can lead to organ failure or death.
Luckily, just because you are taking medications that make you sensitive to the sun does not mean you have to stay sequestered. Simply using plenty of sunscreen, frequenting shady areas, and avoiding outdoor activity during the hottest parts of the day can keep you safe and sound.
Here is a list of common medications that cause problems in the sun. If you are taking one of these, ask your home health nurse for more information about how to stay safe. He or she can better explain the side effects of sun sensitivity as well as come up with a plan to keep you protected.
|Allergy drugs (loratadine, promethazine)
||Antibiotics (quinilones, tetracyclines, sulfonamides)
||Sunscreens (para-aminobenzoic acid, oxybenzone, cyclohexanol, benzophenones, salicylates, cinnamate)
|Muscle spasm drugs (atropine, scopolamine)
||Anti-microbials (chlorhexidine, hexachlorophene, dapsone)
||Malaria medications (quinine, chloroquine, hydroxychloroquine)
|Mental illness drugs (thioridazine, chlorpromazine, prochlorperazine)
||Cancer chemotherapy drugs (5-fluorouracil, vinblastine, dacarbazine)
||Cancer chemotherapy drugs (5-fluorouracil)
|Major tranquilizers (phenothiazines, butyrophenones, thioxanthenes)
||Cardiac drugs (amiodarone, nifedipine, quinidine, diltiazem)
||Fragrances (musk, 6-methylcoumarine)
|High blood pressure drugs (mecamylamine )
||Diuretics (furosemide, thiazides)
|High blood pressure drugs (beta blockers)
||Diabetic drugs (sulfonylureas)
|Migraine drugs (triptanes)
||Painkillers (non-steroidal anti-inflammatory drugs)
|Ephedrine/pseudoephedrine (OTC decongestant, Sudafed)
||Skin medications (photodynamic therapy for skin cancer)
||Acne medications (isotretinoin, acitretin)
|Attention-Deficit Hyperactivity Disorder (ADHD) drugs (amphetamines)
||Psychiatric drugs (phenothiazines, tricyclic)
If you’ve never heard of neuropathy, consider yourself lucky. However, if you are one of the 20 million Americans that suffer from this disease, you know how painful and irritating it can be. Neuropathy is a disease of the nerves in which the peripheral nerves (those in the arms and the legs) are damaged. This results in pain and numbness in the hands and feet. Additional symptoms include loss of ability to detect heat and cold, loss of coordination and proprioception, a pins and needles feeling, ulcers, gangrene, and changes in the skin, hair, or nail.
Neuropathy typically affects diabetics and cancer patients. Over time, the high blood sugar levels caused by diabetes can damage nerves. Chemotherapy and other cancer treatments can also damage nerves. Other conditions which may cause neuropathy include vitamin B-12 deficiency, alcoholism, kidney disease, liver disease, Guillain-Barre syndrome, connective tissue diseases, injury, or infection.
Unfortunately, there is no cure for neuropathy. However, if the underlying cause is targeted, it can sometimes be stopped or reversed after a period of time. For those currently suffering from neuropathy, there are some steps you can take to deal with the disease. Follow these tips to make your neuropathy more manageable and less of a problem in your everyday life.
Tips for Coping with Neuropathy
1. Wear loose clothing. Tight socks, shoes, pants, gloves, or shirts can actually worse pain and tingling. Always wear soft, loose cotton socks and padded shoes to keep your feet comfy.
2. Quit smoking. A good health tip in general. However, in particular, cigarette smoke can affect circulation, which increases your risk of foot problems and amputation.
3. Eat healthy. Again, another obvious tip. A low-fat diet rich in meat and dairy as well as fruits, vegetables, and whole grains can help you feel better!
4. Massage your hands and feet. Massaging helps to improve circulation, stimulates nerves, and can temporarily relieve pain.
5. Avoid prolonged pressure. While it may be your go-to lounging position, avoid crossing your knees or leaning on your elbows for a long time. This can actually cause new nerve damage.
6. Don’t drink too much. Since too much alcohol can cause neuropathy, it makes sense to limit your intake of the drink.
7. Get in shape. To complete the obvious trifecta… studies show that regular exercises may help reduce neuropathy pain.
8. Transcutaneous electrical nerve stimulation. This therapy involves placing electrodes on the skin to help stimulate nerves.
9. Plasma exchange and intravenous immune globulin. This helps if you suffer from an inflammatory condition as it suppresses immune system activity. Otherwise, it won’t help.
10. Take medication. Over-the-counter pain medications can help you cope with pain. Additionally, your doctor may prescribe anti-seizure medications, anti-depressants, or capsaicin to help.
Mental health issues affect more than just Caucasian people. Luckily, National Minority Mental Health Awareness Month was created to help everyone realize the extent of mental health problems. Its purpose is to improve access to mental health treatment and services, especially among minorities.
As a home health services company, we are committed to treating all of our patients equal, regardless of their ethnicity. We have several mental health nurses that can evaluate and help treat an array of mental issues. Unfortunately, statistics show that African Americans and Hispanic Americans used mental health services at about one-half the rate of Caucasian Americans in the past year and Asian Americans at about one-third the rate. That is why we are supporting minority mental health awareness! We just want everyone to have access to the services they need to help feel better.
Below are some more statistics on multicultural mental health, as well as a video interview with several black people who have suffered from a mental disorder. Take the time to review these materials and consider what you can do to help!
To download this infographic as a PDF, simply click here.
This is part 3 in the series. Click here to read part 1 or part 2.
Getting released from the hospital is an overwhelmingly intense feeling. You are flush with relief and hope; finally you are escaping the white-walled prison that has held you for who knows how many days. Physically and mentally, you are healing, and most likely getting stronger and healthier with each passing moment. Clarity and excitement rush through you as you exit through the hospital doors. But there is also the doubt, the worry that you may begin to decline and need to be readmitted. You are not certain if you will be able to receive the proper care at home. The fear weighs down on you, causing you stress and anxiety on what should be a happy day.
Hospital readmissions can be a real problem for seniors. According to the Medicare Home Health Compare, 16 percent of our patients have to be readmitted to the hospital while under our care. While this is 1 percent under the Pennsylvania average of 17 percent and on par with the national average of 16 percent, it is still a number that is too high. In some cases, these readmissions are impossible to prevent, as a patient can suffer an emergency or simply not heal correctly. However, in many cases, the risk of being readmitted to the hospital can greatly be lowered through patient education, quality care, and advanced technology.
We employ some of the most advanced healthcare technology in order to assure our patients are receiving the best experience possible. One of these advances is known as Telehealth. This is a program that allows us to virtually monitor vital signs of patients with congestive health failure and cardiovascular disease. On a daily basis, the patient’s weight, blood pressure, blood oxygen level, and heart rate are recorded by the machine. If there are any problems in this data, our office staff is immediately alerted and can intervene when necessary. Without this technology, changes in condition might go unnoticed in many patients, leading to an increased chance of hospitalization.
All of our patient files and documents are now stored online, which makes it incredibly easy to look up any patient’s data at a moment’s notice. The days of sifting through filing cabinets and unmarked folders are over. This saves valuable time and makes it simple for the staff at Gallagher to work with one another. Now therapists, nurses, social workers, and office staff can all access patient information at the click of a button, making it easy for all disciplines to coordinate their care.
Our nurses all submit their patient notes electronically through iPads. This allows them to instantly alert the office or doctor about any changes in the patient’s condition. Additionally, at the start of care an OASIS assessment is conducted on the patient. This completely measures every aspect of their health to assure they are fit to be back in their home, as well as assists the nurse in creating a suitable plan of care for the patient. This information is electronically verified by our coding and OASIS experts to assure everything is as it should be.
Part 3 in a series. Click here to read part 1 on Home Modifications and part 2 on Exercise.
One often overlooked area of fall prevention is medication. 75% of older adults take one or more prescription drugs, and 25% take five or more drugs regularly. While most medications do not typically cause problems, there is always a risk that any new medication can cause severe side effects. These side effects, such as dizziness, weakness, vision impairment, or sleepiness can contribute to the risk of a senior falling. What’s worse, aging affects the absorption, distribution, metabolism, and elimination of medications. Age can also increase sensitivity to potential side effects.
In particular, antidepressants, pain medications, antipsychotics, and antihypertensives put seniors at the biggest risk. Even some over the counter medications, such as diphenhydramine and naproxen, have side effects which can affect patients. Additionally, if a senior is taking several of these drugs at one time, they can interact with one another negatively.
Always follow your doctor’s advice when taking your medications, and let your doctor know if you feel any side effects from your meds. Follow the rest of these tips to keep yourself safe and lower your risk of falling due to medication.
Tips for Preventing Medication-Related Falls
- Ask your pharmacist to review your prescriptions to ensure they won’t clash with each other. This is standard procedure, but if you are receiving prescriptions from two different doctors, they may not realize what the other doctor is prescribing you.
- Never take someone else’s medication! You don’t know what effect it will have on you.
- Use a magnifying glass to read prescription labels. Taking the wrong pill or the wrong dose could lead to disastrous consequences.
- Use a tablet box to keep your pills organized. This will decrease your chance of mixing things up and also of missing doses.
- Whenever starting a new stress or anxiety medication, also be sure to take extra caution. These medications in particular can mess with your perception, mood, and reflexes. Monitor your condition and if you feel like the new pills are making you too sluggish, immediately alert your doctor.
- Keep a list of all your current medications with you. Since you may receive different prescriptions from different doctors, they might be unaware of what the other one has prescribed for you. Having a list will keep them up to date and aware of potential problems.
- Ask your doctor if you can wean off of any medications that are giving you side effects. While some medications are vital for survival, many others can be adjusted or switched out for less harmful meds. See if you have any of these options available.
- Be aware of all the possible side effects you may experience with a new prescription. You may be able to prepare for some of the side effects. For example, if a particular prescription increases your need to use the restroom, be sure to have a night light on so you can see the way to the bathroom at night.
It can be daunting to try and decide on home health care or a nursing home for your loved one. Both have distinct advantages and disadvantages, depending on your situation. Generally though (and we’re not just saying this because it’s in our interest), home health care seems to benefit ailing seniors. In an AARP survey, 86 percent of people over the age of 50 expressed a desire to stay in their home. People enjoy the comfort and quiet of their home. It is a familiar place and it represents their independence and strength. Nursing homes, on the other hand, often represent a lack of independence. Generally, patients there are not allowed to freely roam around, and often times are boarded with a roommate.
Home health offers patients more flexibility and freedom. They can choose when a nurse comes to visit them. Nursing homes, on the other hand, decide your schedule for you. Whenever the nurse shows up to your room is when you will be receiving your care for the day. One downfall of home health is that it does not provide around-the-clock coverage (or rather, your insurance will not pay for this). In this case, nursing homes can be a great option for someone who needs assistance or monitoring at all times of the day.
Overall, home health seems to be a good choice for patients who do not need 24 hour care, who have a comfortable home where they can recover, and who have the mobility and drive to live independently. Nursing homes, on the other hand, are the best choice for patients who need to be monitored continuously, who may not have a home that is suitable for recovering, or who are too weak or unstable to live on their own.
Confused? Still not quite sure which option is right for you? This handy infograph explains everything in much greater detail than we can! Peruse it at your leisure to determine whether home health or a nursing home is right for you.