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A Shift in Care

New Hampshire is one of the first states that acts as a bellweather every four years as we ready ourselves for presidential elections. They may also be the leader and state that the nation looks to when it comes to senior care. The number of people 85 and older is among the fastest growing population in the state of New Hampshire and with this growth comes an increase in the number of adult children facing decisions about how to care for their aging parents who can no longer care of themselves. More caregiving children are looking towards options such as home health aides and adult day care programs to provide health and social services for their parents during the day as they maintain their position in the work place.

This shift to day services is favored by the senior population. According to a release by the New Hampshire branch of the AARP, 84% of retired people surveyed in the state support a shift to state funding from nursing homes to home and community based services. These programs promote socialization as a major part of their curriculum through activities such as arts and crafts and card games with new friends. Some programs even provide transportation, health services and meals.

In comparison to the fees of a nursing or assisted living facility, the price of adult day care or an at home health aide is cost effective for many families. It allows the caregiver the chance to maintain their daily lifestyle and helps the senior maintain some level of independence. With our troubling economic times, a shift in how care is provided could again follow New Hampshire's lead.

Pre-Planning a Plus

In terms of caregiving, we are often thrust into a situation that is going to change things for our families logistically, financially and emotionally. We have to keep in mind to react to our new situation logically. The key to this is to research all available elder care options before making a hasty decision that will affect both our lives and the lives of our loved ones. There are several different types of elder care facilities that are available and some factors to look at when making your decision include:

• What does each facility have to offer?
• How much do the facilities cost?
• How will these costs increase based on level of care needed by your parent or loved one?
• How does each facility measure up in terms of quality of care?
• What option is going to work best for one or both of your parents?

But why should the burden be left on you to make these decisions? Sitting down with your parents or loved ones to discuss and pre-plan what methods will be used if/when the time for caregiving comes will alleviate stress for both them and for you. This should be a process and not a single discussion that requires a definitive outcome. Let your parents be involved as much as possible for it is their every day lives that are being discussed. Here are some topics to think about during these talks.

• Your parent(s) health and finances
• Needs / wants for socialization
• Risk and value of moving versus "aging in place"
• Size and style of facilities to suit your parents needs (smaller care homes, residential communities for the elderly, assisted living and continued care retirement communities)

Planning and preparedness will help all involved with this emotional time. Having a plan of action in place will allow you to worry about things of more importance such as the health of your loved one and what you can do to continue to make them comfortable during these trying times.

History Repeats Itself

In the late 70s and early 80s, large numbers of women returned to the workplace on a full time basis. This led to a boom in the child care industry as many facilities popped up across the United States to fill the need for two income families. The child care industry increase from just under 300,000 child-care workers in 1985 to just over 800,000 workers in 2007.

History is repeating itself but this time around, the increase is in the amount of senior caregivers and facilities across our nation. According to Home Instead Senior Care, it appears that the senior care industry is following the trends of the child-care boom. Personal and home care nurses and aides are expected to grow by more than 50 percent between the years 2006 and 2016. This is an increase in jobs from 767,000 to 1.5 million according to the U.S. Bureau of Labor Statistics. Personal aides who help seniors at home with meal preperation, light housekeeping and general companionship is the second fastest growing occupation in the industry.

Boomers have been the key in fueling both industries. It was their children that boomed child-care and it is now their parents that are creating the need for new services and regulations for the elderly. This "sandwich" generation is the stimulus for industry growths and declines. Who knows if we will ever see this type of history repeat itself with future generations.

Incontinence and the Elderly

Just a quick example of an article that you can also find in the Advice section of our web site, www.fenwaymedical.com.

Excerpts from Department of Urology, William Beaumont Hospital, Royal Oak, Michigan.

A probability sample of noninstitutionalized elderly people in Washtenaw County, Michigan, was interviewed to determine the relationship between urinary incontinence and various health conditions. The results show that between both male and female respondents physical mobility problems, specific neurologic symptoms, lower urinary tract problems, bowel problems, respiratory problems, and history of genital surgery are more prevalent among those who are incontinent than among those who are continent. Additional factors associated with incontinence in females are: history of parent and sibling incontinence, incontinence either during pregnancy or postpartum, hearing problems, use of female hormones, and vaginal infections. Incontinence among males is associated with vision problems and a history of and symptoms of cardiovascular disease. These findings suggest urinary incontinence is part of a complex and multifactorial problem. Further studies are needed to confirm and explain these findings.

Cutting Costs

Retirement savings are being decimated. Medical costs are skyrocketing. The generation caring for their parents and also for their own children is being overwhelmed with no immediate help in site. According to a 2007 survey by the National Alliance for Caregiving and Evercare, the average cost for day to day expenses like food and doctor's visits for an elderly parent is $5,500 per year. Here are five tips from SmartMoney on how to manage the costs of caring for an elderly loved one.

1. Negotiate - It never hurts to ask, especially when dealing with a nursing or assited living facility that is not filled to capacity.

2. Offer to share a room - Some nursing facilities set aside a number of "shared" rooms that are designed for lower income seniors.

3. Hire a geriatric care manager - They can help with everything from asssessing your parent's long term care needs to mediating family conflicts over care decisions.

4. Adult Day Care - This is often more affordable than private, in-home caregiver fees and allows you to still be active at work and valuable to your employer.

5. Hire a part-time caretaker - For someone who does not require full time care, ask a neighbor, church acquaitance or trusted friend to check on your parent a couple of times a day. This also promotes independence if the senior is able.

Help is Out There

Taking on the responsibilities of being a caregiver has a stressful impact on your every day life. Often, the caregiver ignores their own personal health issues and well-being to provide the best care for their loved one. They feel as if they every thing needs to be done by them and believe that they have failed if they are unable to stay on top of these additional duties. Many first time caregivers are unaware of the help network that is available to them in their communities and on-line.

A growing business sector is designed to assist caregivers and let them know that they are not alone with the feelings that they are experiencing. New companies in Dallas include a business that helps families draw up plans for how an elderly parents will be cared for when the time comes for needed assistance. Another company lines up care for the serious and chronically ill when their families do not know where to go next.

Non-profit organizations can also help address caregiver questions. This month, the American Cancer Society is offering a telephone workshop called Coping with Caregiving: Recognizing Depression & Anxiety. The next scheduled time for this workshop is Thursday, February 19th from 7:00 to 8:15 Eastern Standard time. Future workshops with similar topics are planned in March, April and May.

Even our company site, www.fenwaymedical.com, is designed with the caregiver in mind as we offer advice on how to cope with these new responsibilities. We also offer certain lines of supply products that can be delivered directly and discretely to the home. As with all of the aforementioned businesses and organizations, Fenway Medical wants to help and support you as you learn how important you are to someone else.

The Effect on the Workplace

In a recent publication, The Family Caregiver Alliance estimated that one out of four households in the United States has some involvement in caring for a family member 50 years or older. Between one third and one half of these caregivers also work outside of the home. In the workplace, the Family and Medical Leave Act of 1993 (FMLA) allows eligible employees up to 12 weeks of unpaid leave to be used all at once or intermittently for serious illnesses to themselves or a family member, including an elderly parent. These demographic and government changes are creating an increasing amount of problems for employers who are having to juggle their staffing schedules when the caregiver needs to tend to more important issues at home than at work.

But many work places are realizing that this is a sign of the times as the demographics of our nation changes and we become an "older" population. Companies are becoming more flexible with their work structures and some have even offered elder care assistance. It is in the employer's best interest to show some efforts to help the caregiver and let them know that they are still valued by the organization. It is the hope of these companies that these offered benefits result in employee loyalty, productivity and retention of their workers.

One never knows when they will called on to care for a loved one. Caregiving is going to be a part of all of our lives at one point in time. Whether to boss or assistant, compassion to all employees will only help the reputation of the business and make it a better environment for productivity and teamwork.

An Added Stimulus

We highlighted in an earlier blog how the (now passed) economic stimulus would help senior citizens and those who are collecting social security. This assistance would come in the form of a $300 check to seniors and social security benefactors. While still true, a last minute addition into the stimulus may end up negatively affecting the elderly.

The addition is the creation of the office of National Coordinator of Health Information Technology, which will monitor medical treatments across the United States. This office is created as a quality control type agency that will oversee doctor's decisions and treatments of particular illnesses or conditions. Doctors can be penalized by a review board should the board find their treatment methods to be too "excessive". Groups such as AmericanSeniors.org believe this stimulus provision to be the starting point towards rationed healthcare which, in their opinion, would unfairly impact senior citizens. They believe that the threat of penalties to doctors will lead to restricted treatment options for patients.

This may turn out to be an extremist view or in a few years a brilliant observance but there is no denying that America's health care system needs an overhaul and an upgrade. Let's all hope that whatever steps are taken do not turn out to be detrimental to our aging society.

Love is in the Air

Today is Valentine's Day and love is in the air for couples of all ages. A quick glance at some senior news media outlets shows that today's amourous activities are not just celebrated by those who are young at heart. Here's a sampling

• A senior citizen's Valentine's Day dance in Omaha held this past Tuesday
• A senior citizen's dance that drew more than 150 seniors to the University of North Carolina-Wilmington
• A high school in Arizona has re-created a senior prom for senior citizens in their area to attend
• A Best Chocolate Dessert contest was held at a senior center in Texas
• A Valentine's Day cookie decorating party involving seniors and young children in Iowa

I could go on and on with this list of activities that are happening all over the world. This is proof that aging does nothing to inhibit the feeling of being loved. Studies show that most people the ages of 57 to 85 feel that a relationship and sexuality are an important part of life.

If you are a caregiver, take a little extra time today to tell your parent or loved one how much they mean to you. Also, take some time for the one that you should care for and love the most..yourself. Happy Valentine's Day!

Wave of the Future?

A sheriff in Genesee County, MI has teamed up with an Elder Care Abuse & Prevention program to utilize technology to care for elderly loved ones. Small GPS devices are being used with patients who have Alzheimer's and/or dementia. An unfortunate result of memory loss associated with these illnesses is the tendency for the person to wander. If not monitored by a caregiver or if the appropriate alarms or securities are not in place, a patient can wander from the home. When this happens, the results can often be tragic.

A total of 50 devices were purchased using federal grants and distributed by the prevention program. They attach to the senior's clothing with a clip and the light weight of the device (less than 3 ounces) does not hinder movement for the user. Caregivers, loved ones and even emergency services can go to a web site to monitor the exact location of the GPS.

Time will tell if this technology will catch on in other communities but with the aging of our society, the future is now.

Three Generations, One House

To break the doldrums of winter, I took my kids out tonight to get some ice cream. When we were almost finished and as I sat and wondered how my son got more ice cream on his face than in his mouth, an elderly gentleman came in with two young children. It was clear that grandpa was taking his grandchildren out for a treat. I watched them order and as grandpa was paying, the young girl asked if they could buy some ice cream and take it home. But who's home was she talking about? Back to Grandma and Grandpa's? Back to her Mom and Dad's? Or, in today's society, is that all of the above?
With the elderly population growing and the costs of healthcare rising against an unsteady economy, more seniors are moving in with their children, who themselves are now parents. This can be both harmful and healthy to all generations involved. From the decision on what furniture or belongings can fit into a probably already crowded space to the changing of schedules to accommodate both young and old, new stresses are introduced to the family dynamic. Boundaries must be established as to not make the grandparents a permanent "babysitter" for the kids and to allow the grandparents to continue to live their lives to the fullest. This new living arrangement should be embraced and looked at as a learning experience for all family members. Multi-generational arrangements should be cherished and treated as a time to share pictures, stories and maybe the occasional trip to get ice cream.

Eat Your Bananas

I wrote an article for the Fenway Medical advice page a couple of days ago, http://www.fenwaymedical.com/advice/127-eat-your-bananas.html, talking about a study of the sodium - potassium ratio in the body. We all know increased levels of sodium can be a cause of high blood pressure and pre-hypertension, especially in the elderly. This study come to the conclusion that an increased level of potassium intake can help "counteract" the effects of the sodium. We have also included quite a large list of food items that have high potassium contents to help you to include these into your diet. I knew the tale of eat your bananas but I must have missed the day when they taught us to eat our halibut and drink our prune juice.

Call Your Grandma

Today is my Grandma's birthday so I gave her a call earlier this evening. We sang happy birthday to her and she proceeded to tell me about her busy day. An orchid show, a trip to a candy factory and lunch with her sister..all very grandmotherly things to do. She was very happy to hear from me and very open with what she has been doing. I, of course, introduced myself at the beginning of the conversation but there is a scheme going around called Grandparent Scams that preys upon the elderly and their friendliness and often, lonliness.

Theives call a random phone number and hope to hear an elderly voice on the other end. If they reach their target, they start into a normal "how's it going" conversation and bombard your loved one with information and stories. This builds a comfort level with the senior and often makes them forget that the caller forgot to introduce themselves. After a few minutes of small talk, the thief begins their pitch. They tell made-up stories of hardship and how if they had a little money they would be able to turn the corner and set things straight. They often add the line, "please don't tell mom or dad or anyone else as I don't want them to know" to assure anonymity. When your confused loved one agrees to send some money, they send them a set delivery address and never call again.

Don't let your loved one be vicitmized by this scam. Though this may sound like a far fetched scam to those of us who are of good mind, an eldely person's cognitive senses can be muddled and confused. As a caregiver, let your parent know to watch out for theives like these as not all callers are phoning to wish you a Happy Birthday.

Banking on the Future

In a small town in a remote province of China, a man on the verge of retirement has come up with quite an intereting idea. He has created the concept of "Age Banks". China is going to see a senior boom greater than that of the United States with one third of their population being over the age of 60 in the next forty years. Age Banks are designed with caregiving in mind. A volunteer can go into an Age Bank and spend time with an elderly member of the population who may not have family or loved ones to assist them. The hours that they spend volunteering is recorded and placed into their "bank" to be used on care towards themselves when they are the ones needing the assistance. Their work done shopping, cleaning, obtaining medicines, etc. is logged into a personal data base and will conceptually assist them at a later date. Would a program like this work in the United States? Would our society of what's in it for me volunteer time to the elderly if we didn't see an immediate return? It may be a question that we need to ask ourselves if this concept catches on.

Men Assuming the Caregiving Role

According to the National Alliance for Caregiving and the Alzheimer's Association, men now make up 40% of family care providers. This number is up 19 percent from a similar study in 1996. Men have become more of a "hands on" style of caregiver in the past 10 years, straying from their roles of just taking care of financial records, arranging parent's schedules, etc. In some cases they are now the primary source for personal hygeine (including changing of incontinence supplies and bathing), meals, medications and other tasks that have in the past been left to a female relative such as a sister or wife. Why the change? Several factors such as more women being full time workers, smaller family and support roles and the rising costs off healthcare all have contributed.

Elderly and the Internet

When we started Fenway Medical, we wanted to design a web site for baby boomers who have taken on the responsbility of caring for their parent at home. We wanted www.fenwaymedical.com to be a place where medical and incontinence supplies could be ordered and shipped directly and discretely to your home. We also wanted our site to be a place where adults could go for caregiving advice since the majority of them would be taking on this change for the first time. Skeptics of our business, some of our own family members included, stated that our target audience is not internet saavy enough to utilize our services. Statements were made that the elderly and not so affluent population did not even have access to computers to gather the information that we provide.
A recent study by the Pew Research Center out of Washington DC shows that this is not the case. In research done from 2005 to 2008, the popluation ages 70-75 have increased their internet useage by 19%. One-fourth of this demographic was on-line in 2005 compared to 46% being on-line in 2008. Most elderly users access the internet for e-mail but as they become more familiar with the format, they will visit sites and informational pages such as Fenway Medical's. It is this audience and this demographic that we know will change as the world changes and who we hope we can provide with services that they need.

One Step Away

When creating the Fenway Medical web site, I was aiming for a specific target audience of baby boomers who are now taking care of their elderly parents at home. During the process though, I have learned first hand that caregivers are not only tending to the needs of an older loved one.
My best friend in life has recently been overcome by frequent panic attacks and mild depression. Always a traveller and someone who has a zest for life, the past few months have taken their toll. I have been thrust into the caregiver role. Due to uncertainty about public places, I now am in charge of tasks such as shopping and picking up carry out. Frequent tiredness has required that I take on additional responsibilities around the house and in our friend circles.
I have learned several things during this experience. The first is to respect what your loved one brings to a relationship and the little things that they offer every day. Second, you need to take care of yourself. My site has published frequent advice on the health of the actual caregiver and how you need to also look after yourself. Maybe I didn't fully buy into this when just writing the words but now I understand. You may not feel that you have enough time in the day but as a caregiver you need to remember to care for you. And, if you are not currently a caregiver, keep in mind to look after yourself if you are given these responsibilities as we are all just one step away from being the rock that they look to for guidance.

Aging Does Not Equal Poor Health

It is known that our nation is fast approaching an aging revolution. By the year 2030, the population of adults 65 and older will double to close to 70 million people. One out of every five Americans will be considered a “senior citizen”. But with the growing elderly population comes a growing burden on our public health and health care systems and facilities. Are these systems going to be reliable when you or your loved one is in need of first rate care for treatment of their illness or condition?
You can eliminate the guess work of the quality of care you or your parent is going to receive by taking preventative measures to decrease the chance of illness or disability. Poor health does not have to be consequence of getting older. A healthy lifestyle such as increased physical activity, healthy diet and the exclusion of tobacco is encouraged. Another step to take is using early detection practices for breast, colonic and cervical cancers, diabetes and depression.

A Grim Reality in Hawaii

A recent article in the Honolulu Advertiser highlighted the strain that the cost of elderly care is having on the state's middle class. A combination of the high costs of senior care, longer life expectancies and the country's current economic status are not only depleting the elderly's assets but also those of their children who are caring for them.
The cost of a semi-private room at a nursing facility in Hawaii ranks among the highest in the nation at just under $98,000 per year. This number is twice Hawaii's median annual household income. Less extensive assisted living facilities average a cost of $41,000 annually and the average yearly cost of adult daycare services is $15,000. According to the results found in a State of Hawaii Older Adults Needs Assessment, over 76% of seniors in the state indicate that they go without proper care because services offered cost too much. 31% say that services are not even available to them.
This is not just a problem in Hawaii. Across the United States, millions of people are being hit with economic hardships. These tough times are magnified when taking on the additional responsibilities of caring for a loved one.

Good news for Seniors in the Stimulus Plan

There is potential good news for the elderly population included in the $900 billion stimulus package that President Obama has taken to the Senate. Should the package pass without change, seniors who receive Social Security benefits would receive a $300 payment from the government. A $300 check would also be sent to those covered under the Supplemental Security Income program for elderly and disabled people living in poverty. These checks are a one time only payment but any little bit can help seniors and their caregivers in today's economy.

Helping with Exercise

I just posted a new article in the Advice section of my site, www.fenwaymedical.com, detailing a study published by NIH (National Institutes of Health) about exercise and the elderly. A case study was done using diagnosed obese men and women, ages 60 to 80, that shows that increased aerobic activity, resistance training and a healthy diet increases motor skills and decreases the risk of diabetes in the elderly. Check it out with the rest of the caregiver advice that we have to offer.

Seniors and the Internet

I read an article today that stated that only 7% of the population 65 years and older utilize the internet daily. This number is going to change in the next decade as the baby boomers will move into this demographic. It is expected that 35% of "seniors" will be utilizing the web but this will be the equivalent of 65% of teens due to the larger amount of elderly in the nation's population. Fenway Medical has designed our site keeping this demographic change in mind. We feature products that many will need to utilize for loved ones or themselves. We have also installed a font changing tool on our site and hope in the near future to develop a virtual shopping cart to ease each transaction. Visit us often at www.fenwaymedical.com to watch how we change as our population changes.

A Caregiver's Checklist

At Fenway Medical, we offer not only bulk medical supplies to our site visitors but also an advice section that caregivers can utilize for helpful information and insight on current caregiver news. Here is an example of a caregiver "checklist" posted at www.fenwaymedical.com.

Assessing Their Needs
Does your parent need help with grooming, bathing, or dressing?
Does your parent need help with housekeeping, shopping, or yard work?
Does your friend need help planning or preparing meals?
Is your parent unable to drive or get around on public transportation alone?
Does your parent need help managing finances and paying bills?
Does your parent need help making legal and other important decisions?
Does your parent have trouble functioning at home? Would modifications help?
Does your parent have trouble with hearing, vision, or memory?

Get Permission
Financial power of attorney to make financial decisions and pay bills
Living will to make life-support decisions
Medical power of attorney to make health care decisions
Durable power of attorney to make legal decisions
Access to safe deposit box
May choose to be added to deeds and mortgages
May need to be added to automobile insurance
Know the person's wishes (medical treatments, funeral, finances, etc.)

Information to Have on HandI

Insurance (Medicare / Medicaid number, supplement, other policies)
Doctors (names, phone numbers, and other contact information)
Medical history (medications, allergies, conditions, procedures)
Identification (social security, military ID, driver's license numbers)
Address list (friends, neighbors, family)
Service providers (attorney, financial advisor, clergy, accountant)
Financial (account numbers, checkbook, investments, tax records)
Legal (wills, powers of attorney, health care directive)
Deeds (house, other property, car title, boat title)
Insurance (life, medical, auto, homeowner's)
Household (mortgage, apartment lease, property tax records)
Vital records (birth certificate, marriage license, divorce decree)
Final wishes (organ donation, burial, property distribution)

Make Sure that You
Respect your parent's independence, even while taking care of them
Allow your parent to make as many decisions as appropriate
Have reasonable expectations of what your parent can do independently

Talk regularly with your parent about their concerns, desires, and frustrations
Make informed decisions that are in the best interest of your parent's needs
Show compassion while you are trying to be efficient and responsible

Taking Care of Yourself
Recognize when you are getting worn out and need a break
Make use of support groups, family, and other caregivers in your situation
Take regular breaks to do something enjoyable for yourself

Welcome to Fenway Medical

Thank you for visiting the Fenway Medical blog. We hope to offer professional insight into the growing world of elderly home care and provide you with the information that you need to take care of yourself as well as your loved one.
With more of us taking care of our parents outside a professional setting, we understand that your responsibilities are constantly changing and your valuable time is limited. Fenway Medical offers efficiency and value with our bulk medical supplies and we also are a professional advice source to help you with your care-giving. We appreciate your interest and look forward to helping you with your medical supply questions and needs.
Please come see what we have to offer at www.fenwaymedical.com.