Delirium

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Delirium – Information for patients, families and Friends

 

It is our hope that this article will help you learn more about:

What is Delirium?

  • The signs and symptoms
  • How it can be prevented and
  • What families, friends and caregivers can do to help
  • Where to find more information

What is Delirium?

Weaving Secret Riddle Confusion Thread Patterns

Delirium is a condition that causes a person to be confused. It is a physical problem (a change in the body) that can cause temporary change in the person’s thinking. Delirium usually starts over a few days and often get better with treatment.

Delirium can happen to anyone, anywhere. But, it often happens when someone is in the Hospital

 

Once identified, delirium is often treated as a medical emergency. Treatment is put in place right away because it can be a risk to patient safety.

 

Delirium can cause patients to slip and fall or to feel a lot of emotional and spiritual distress. A person with delirium may not be able to understand when people are trying to help them. They may become angry with family and hospital staff. They may start to think that everyone is against them or are trying to harm them. Some people with delirium may want to call the police to get help.

Delirium is like being in the middle of a very strange dream or nightmare, but the person is having these experiences while they are fully awake.

 

What is the risk of delirium?

  • About 20 out of 100 patients admitted to hospital will experience.
  • About 70 patients out of 100 admitted to the intensive care unit will experience delirium. 

 

What causes delirium?

Delirium can be caused by:

A Physical illness (that brought someone to the hospital)
  • Someone who is ill can have changes in their body chemicals, become dehydrated (not enough water in the body) or get an infection, such as a bladder infect or urinary tract infection. These kinds of problems can cause delirium.

 

Medications

  • The medications the hospitals use to treat illness or control pain can cause delirium

 

Is delirium the same as depression or dementia?

No. Delirium can happen more often in people who have dementia or depression, but it is different.

Delirium happens quickly. It can come and go at any time. This does happen with dementia and depression.

Patients with delirium cannot focus their attention. This is different from patients with dementia and depression.

 

Types of Delirium

There are 2 types of delirium:

  1. Hypoactive delirium

This type of delirium happens most often in elderly patients but can affect anyone at any age.

Patients with hypoactive delirium may:

  • Move very slowly or not active
  • Not want to spend time with others
  • Pause frequently when speaking or not speak at all
  • Look sleepy
  1. Hyperactive delirium

This type of delirium is easier to recognize.

Patients with hyperactive delirium may:

  • May be worried and afraid
  • Be restless (not able to stay still or have trouble sleeping)
  • Repeat the same movement many times
  • Experience hallucinations (seeing something or someone that is not really there).
  • Experience delusions (believe something that is not true).

At times a patient can have both hypoactive and hyperactive symptoms.

 

What are the signs and symptoms of delirium?

A check list:

Disorganized thinking                                                      YES                NO

Saying things that are mixed up or do not make sense

Difficulty concentrating                                                   YES                NO

Easily distracted or having difficulty following what is being said

Memory changes                                                                YES                NO

Not able to remember names, places, dates, times or other important information

Hallucinations                                                                     YES                NO

Seeing or hearing things which are not real

Having delusions                                                                YES                NO

Thinking or believing things which are not true or real

Feeling restless .                                                                 YES                NO

Not able to stay still, trouble sleeping, getting out of bed

Changing energy levels                                                     YES                NO

Changes from being restless to being drowsy or sleepier than usual

 

How can delirium be prevented?

All patients should be carefully screened (checked) for these factors that may cause delirium:

  • Hearing problems
  • Vision problems
  • Not enough water in the body (dehydration)
  • Not being able to sleep or other sleep problems
  • Dementia, depression or both
  • Difficulty getting up and walking around
  • Medication being taken
  • History of alcohol or recreational drug use
  • Chemical changes or imbalances in your body
  • Low oxygen in your body
  • Other health condition or illness

Having trouble:

  • Thinking clearly, reasoning, remembering and judging
  • Concentrating
  • Understanding
  • Express ideas

 

How is delirium be treated?

  1. The health care team helps the patient stay safe and calm
  1. They will try to find the cause of the delirium. Often, there is more than one cause. They also make sure any factors they find are not caused by another medical condition
  1. Then they will address the factors or ease the symptoms.

This could include:

  • Reviewing and changing medications
  • Provide fluids to rehydrate
  • Correcting chemical problems in the body
  • Treat infections
  • Treating low oxygen levels

 

What can family and friends do to help?

Family and friends and caregivers can all help to prevent delirium for their loved ones in hospital.

 

Keep a careful watch for the signs and symptoms of delirium

  • If you see any signs that could mean delirium talk with your health care team right away. Family members are often the first to notice these small changes.
  • Use the signs and symptoms check list and factors list listed on this article to guide your findings.

 

Help with healthy eating and drinking while at the hospital

  • Ask what is right for your loved one before they eat and drink.
  • Make sure they have their dentures (if needed).
  • Encourage help with eating. Feel free to bring their favourite foods from home, check with the health care team about foods they should not eat.
  • Encourage them to drink often, if that is right for them.

 

Keep track of medications

  • Share a complete list of their prescriptions and any over the counter medications they take with the health care team… including the dosage.

 

Help with activity

  • Ask what is right for your loved one before starting any activities.
  • Talk to the team about helpful and safe activities.
  • Help them sit, stand and walk.

 

Help with mental stimulation

  • Make a schedule for family and friends to visit. This will help your loved one feel safe and comforted.
  • Speak to them in a calm, reassuring voice.
  • Tell them where they are and why they are there throughout the day. If possible, place a large sign in their room or write information on it.
  • For example, you could write: Today’s date, weather, where they are and their room number… this will help them stay connected.
  • Give them instructions one at a time. Do not give too much information at once.
  • Bring a few familiar objects from home, such as photo albums and their favourite music. If your loved one needs special care to prevent the spread of infection, check with the care team first.
  • Open the curtains during the day time.
  • Talk about current events.
  • Read the newspaper out loud or use talking books

 

Help them with eyesight and hearing

  • Make sure they wear their hearing aids or glasses, if they need them.
  • Make sure there is enough light in the room.
  • Help them use a magnifying glass, if they need one.

 

Help them rest and sleep

  • Reduce noise and distraction.
  • Soothe them with handholding, a massage, a warm drink or music.
  • Bring a night light, but check with the health care team first.
  • Use comfort items like their favourite pillow and blanket.
  • Limit the number of visitors who come to see your loved one until the delirium goes away.
  • The health care team may not give your loved one sleeping medications because it could make delirium worse.

 

Take care of yourself

It is not easy to be with a person with delirium, even though you may understand the problem

  • Make sure to look after yourself and get some rest. Go out for short walks, remember to eat and drink fluids to keep up your energy levels.
  • It may help to share your thoughts and feelings with someone. Feel free to speak with the health care team.
  • Try not to become upset about the things your loved one may say during their delirium state. People with delirium are not themselves. In many cases, they will not remember what they said or did.

Who can I talk to if I have more questions or concerns?

There are many members of the health care team who can offer help and support. Talk with your doctor or nurse and any member of the health care team, including a Psychiatry, Spiritual Care or Social Work departments. They will answer any questions or concerns you may have about delirium.

 

Delirium should go away or be greatly reduced with the right kinds of treatment… although in some cases some of the symptoms may remain for an extended period of time.

More information can be found on these helpful websites:

Delirium Mayo Clinic                     www.mayoclinic.com/health/delirium/DS01064

Delirium MedlinePlus                   www.nlm.nih/gov/medlineplus/delirium.html

 

Videos:

Youtube – How to recognize Delirium             www.youtube.com/watch?v=hwz9M2jZi_o

Many other videos choices will be available when you log on to this site.

 

Things you need to know about talking to your ageing parents

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Having the Talk? Here’s a few tips.

If you have not had “the talk” with your ageing parent/s, don’t put it off any longer. While mom and dad are cognitively intact the process is pretty straight forward… albeit, it can be somewhat uncomfortable for both parties. It needs to be approached from the same angle as if the conversation was to be had with you by your own grown children.

IOC The talk1Talking about the future can be hard. Such discussion will invoke anxiety in even the most calm of us when we start to think about all the unknowns in our futures and those of our loved ones. These discussions can get even harder when it’s not our future we’re talking about, but rather someone else’s. However, as difficult as it may be, there are some questions that we need to have answers to when it comes to our ageing parents and it is wise to have these conversations sooner rather than later. On that note, here are 7 basic questions that you should include in the “talk” with your ageing parent/s… as soon as you can.

1. How do they feel about getting older or having to get help to sustain their independence?

A parent/s can have all the legal stuff taken care of, but that doesn’t tell you how they feel. To really understand your ageing parents, it’s important to talk about how they feel about the situations that might happen.  Allow them to talk about their fears, their wishes, how they envision things unfolding in the event of a medical situation, and so on.  This is the type of conversation that will tell you if they have made decisions based on what they think will be easiest for others or what they really want.  This is the type of conversation that will allow you to make sure that the legal documents accurately represent your loved one’s wishes.  Most importantly, it is the type of conversation that will allow your ageing parent/s to know how much you support and love them and want what is best for them.

2. Do they have a will? Is the Will is safe keeping and up-to-date?

Bringing up a will can seem like you only care about what you’re getting, but a will contains so much more than just ‘who gets what’ and is essential to the process of handling matters when a loved one passes. This is your parent’s opportunity to dictate how they would like their affairs to be handled and who they want to handle things.  It is equally important for our parent/s to ensure their will is up-to-date so that loved ones don’t end up in bureaucratic chaos trying to simply execute the wishes of a loved one while simultaneously trying to mourn. Importantly, the same questions pertain to life insurance, which is separate from a will and requires the beneficiaries to be named to the life insurance company directly.

3. Do they have a living will?

Although many people plan for their deaths, many forget to also plan for any situation that might render them incapable of making their own decisions while still living.  Your parent/s may assume that the “right” decision will be made for them, by those in charge. This is not always how it plays out. Taking the time to decide what they want and making sure those wishes are legally noted is the only way to ensure your parents will be cared for in that way.

4. Do they have a Power of Attorney?

This can be one of the trickier topics to discuss if there are multiple children or individuals who might expect to be “chosen”.  Parents sometimes put this off because they simply don’t want to be seen as picking favourites, but it’s an essential document to have.  For this reason it is important that children (and any other interested individual) are respectful of whatever decision the elder makes.  No offense should be noted to the parent/s and if there are concerns about a selection, it would be wise to make sure all parties are involved in discussing this instead of trying to quietly bring it up to the parent. By involving everyone, the right decision for your aging parent can be made.

5. Do you have long-term care insurance?

Not all people have invested in long-term care insurance and with the costs of long-term care. This is something your parents may want to consider if it’s not too late to invest. If they have invested, being aware of what is covered, who to contact to initiate the insurance claim, and what services your parent will want to take advantage of is important to know ahead of time and can save money and hassles if/when the time comes.

6. What kind of care situation do you want?

Does your parent have a retirement or assisted living home in mind?  Do they want to stay at home as long as possible, focusing on ageing in-place (Home Care)? What nursing homes are they comfortable with if the situation were to become necessary? Having these discussions before a decision needs to be made ensures that people can look for the right care, make any needed arrangements, and not scramble at the last minute and have to take whatever is available.

7. What are your wishes for a funeral/memorial?

IOC-The talk2Sometimes there’s a lot of pressure to do things in a “traditional” way when it comes to how we remember our loved ones, but that’s not always what they want.  Although funerals/memorials need to reflect both the person that is gone and those who are left behind, having a discussion ahead of time can mean that all sides get their voices heard.  When a decision is reached beforehand, our loved ones know their wishes will be respected and those of us left behind can know we’re memorializing our parents in a way that they accept as well. This means no guilt for anyone and that’s a much-needed relief at a time of sorrow.

However hard it may be, please take the time to talk to your loved ones about these issues.  It’s also not too late to start thinking about them for yourself as well. The more prepared you are, the easier it is for those around us and the more open we are, the more likely we are to respect everyone’s wishes and know that ours will be respected too.

5 Things you should know about dementia

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Dementia21 – Dementia is not a natural part of ageing

When someone becomes forgetful or confused, friends are often quick to reassure them that this is just ‘what happens when you get older’. Some of us do struggle with our memory as we age or during times of stress or illness. But dementia is different. Lots of people momentarily forget a friend’s name – someone with dementia may forget ever having met them. They usually experience a range

of other symptoms alongside memory problems and will begin to struggle with daily life. Dementia is not a normal part of ageing. It’s caused by changes to the structure and chemistry of the brain.

Dementia doesn’t just affect older people. Younger people are also susceptible have dementia. This is called early-onset or young- onset dementia.

The chance of developing dementia increases with age. One in 14 people over 65 – and one in six people over 80 – has dementia. It’s more common among women than men.

Help and support:  If you are worried about your memory, or about someone else, the first step is to make an appointment to see the GP. The GP can help rule out other conditions that may have symptoms similar to dementia and that may be treatable. These include depression, chest and urinary infections, severe constipation, vitamin and thyroid deficiencies and brain tumours. The earlier you seek help, the sooner you can get the information, advice and support you need.

2 – Dementia is caused by diseases of the brain

The word dementia describes a group of symptoms that may include memory loss, difficulties with planning, problem-solving or language and sometimes changes in mood or behaviour.

What causes dementia? Dementia occurs when the brain is damaged by a disease. There are many known causes of dementia. The most common is Alzheimer’s disease. This changes the chemistry and structure of the brain, causing the brain cells to die. The first sign is usually short-term memory loss.

Other types of dementia include vascular dementia, mixed dementia (Alzheimer’s disease and vascular dementia), dementia with Lewy bodies and frontotemporal dementia (including Pick’s disease). Each of these diseases affects the brain in slightly different ways. For example, Alzheimer’s disease tends to start slowly and progress gradually, while vascular dementia following a stroke often progresses in a stepped way.


Everyone’s dementia is different: Whatever type of dementia a person has, everyone will experience the condition in their own way. How it affects a person over time is also unique to the individual – their own attitude, relationships with others and surroundings will all have an impact.

People often associate dementia with memory loss. And it does often start by affecting the short-term memory. Someone with dementia might repeat themselves and have problems recalling things that happened recently – although some people easily remember things from a long time ago. But dementia can also affect the way people think, speak, perceive things, feel and behave.

Common symptoms: Dementia often causes difficulties with concentration, planning and thinking things through. Some people will struggle with familiar daily tasks, like following
a recipe or using a bank card. Dementia also makes it harder to communicate.
For example, a person with dementia might have trouble remembering the right word or keeping up with a conversation. Many people have problems judging distances even though their eyes are fine. Mood changes and difficulties controlling emotions are common too. Someone might become unusually sad, frightened, angry or easily upset. They could lose their self-confidence and become withdrawn.

As dementia progresses: Dementia is progressive, which means that symptoms gradually get worse over time. How quickly this happens varies from person to person – and many people stay independent for years. Dementia is a condition that can affect anyone regardless of background, education, lifestyle or status.

There’s no known cure for dementia, but there are ways to help with symptoms and make life better at every stage. The more we understand about the condition, the more we can do to help people stay independent and live the life they want for as long as possible.

4 – It’s possible to live well with dementia

Scientists and researchers are working hard to find a cure for dementia. In partnership with people with dementia and their families, they are also looking into its causes, how it might be prevented and diagnosed earlier, and how to improve quality of life for people living with the condition.

Until we find a cure, there are drugs and other therapies that can help with some of the symptoms, so people can lead active, healthy lives and continue to do the things that matter to them most.

Drug treatments: There are medications available that may help with some types of dementia and stop symptoms progressing for a while. This is one reason it’s important to go to the doctor as soon as you suspect there’s a problem. It can feel like a big step to take, but a diagnosis can open up many opportunities to help overcome problems and find better ways of coping.

Non-drug treatments: People with dementia can also benefit from approaches that don’t involve drugs. For example, life story work, in which the person is encouraged to share their experiences and memories, or cognitive stimulation, which might involve doing word puzzles or discussing current affairs. Keeping as active as possible – physically, mentally and socially – can really help. It can boost memory and self-esteem and help avoid depression.

Dementia35 – There’s more to a person than the dementia

Living with dementia is challenging. When someone is diagnosed, their plans for the future might change. They may need help and support with everyday tasks or to keep doing the activities they enjoy. But dementia doesn’t change who they are. With the right support, it is possible for someone with dementia to live well and get the best out of life.

‘It’s important to carry on doing the things you enjoy, and not sideline yourself from your friends and family. We still go to the pictures and to the theatre.
We keep in touch with family and friends. We still go on holiday. We still go out together and do the things we always did.’ Brenda, whose husband has dementia

‘The art classes, choir and Memory Café are all brilliant for boosting my confidence. I’ve come away from my art classes and choir practice feeling like I’ve really achieved something. The choir has helped with my speech and memory too – I’m amazed that I can remember all the songs.’ Linda, living with dementia

‘Mum still does the things she used to do regularly – she still takes the dog to the woods like she used to. If she does something regularly and carries on doing it, she doesn’t normally forget it. Routine is really important.’ Pip, whose mother has dementia

Senior Care: Personal & Home Safety

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Panic Alarm Bracelet

Personal and home safety, for people with alzheimer’s disease and dementia.

Seniors can still remain in their homes, as long as safety measures are put in place to ensure their safety.

As Dementia and Alzheimer’s progresses, a person’s abilities change. But with some creativity and problem solving, you can adapt the home environment to support these changes.

How Dementia affects safety

Alzheimer’s disease causes a number of changes in the brain and body that may affect safety. With creativity and flexibility, you can create a home that is both safe and supportive of the person’s needs for social interaction and meaningful activity.

Depending on the stage of the disease, these can include:

  • Judgment: forgetting how to use household appliances
  • Sense of time and place: getting lost on one’s own street; being unable to recognize or find familiar areas in the home
  • Behavior: becoming easily confused, suspicious or fearful
  • Physical ability: having trouble with balance; depending upon a walker or wheelchair to get around
  • Senses: experiencing changes in vision, hearing, sensitivity to temperatures or depth perception

Home safety tips

  • Assess your home: Look at your home through the eyes of a person with dementia. What objects could injure the person? Identify possible areas of danger. Is it easy to get outside or to other dangerous areas like the kitchen, garage or basement?
  • Lock or disguise hazardous areas: Cover doors and locks with a painted mural or cloth. Use “Dutch” (half) doors, swinging doors or folding doors to hide entrances to the kitchen, stairwell, workroom and storage areas.
  • Home Safety Checklist: Contact us at “In Or Care – Home Care Services to conduct a safety survey and discuss measures to correct findings. The process is easier than you think and solutions need not be cost prohibitive.
  • Be prepared for emergencies: Keep a list of emergency phone numbers and addresses for local police and fire departments, hospitals and poison control helplines.
  • Make sure safety devices are in working order: Have working fire extinguishers, smoke detectors and carbon monoxide detectors. Routine inspections, testing and replacing back-up batteries on applicable devices as just as important… Don’t assume because you have then, that they’re functioning as they should.
  • Install locks out of sight: Place deadbolts either high or low on exterior doors to make it difficult for the person to wander out of the house. Keep an extra set of keys hidden near the door for easy access. Remove locks in bathrooms or bedrooms so the person cannot get locked inside.
  • Keep walkways well-lit: Add extra lights to entries, doorways, stairways, areas between rooms, and bathrooms. Use night-lights in hallways, bedrooms and bathrooms to prevent accidents and reduce disorientation.
  • Place medications in a locked drawer or cabinet: To help ensure that medications are taken safely, use a pillbox organizer or keep a daily list and check off each medication as it is taken.
  • Remove tripping hazards: Keep floors and other surfaces clutter-free. Remove objects such as magazine racks, coffee tables and floor lamps.
  • Watch the temperature of water and food: It may be difficult for the person with dementia to tell the difference between hot and cold. Set water temperature at 120 degrees or less to prevent scalding.
  • Support the person’s needs: Try not to create a home that feels too restrictive. The home should encourage independence and social interaction. Clear areas for activities.

Six in 10 people with dementia will wander

A person with Alzheimer’s may not remember his or her name or address, and can become disoriented, even in familiar places. Wandering among people with dementia is dangerous, but there are strategies and services to help prevent it.

Who is at risk of wandering?

Anyone who has memory problems and is able to walk is at risk for wandering. Even in the early stages of dementia, a person can become disoriented or confused for a period of time. It’s important to plan ahead for this type of situation. Be on the lookout for the following warning signs:

Wandering and getting lost is common among people with dementia and can happen during any stage of the disease. 


  • Returns from a regular walk or drive later than usual
  • Tries to fulfill former obligations, such as going to work
  • Tries or wants to “go home,” even when at home
  • Is restless, paces or makes repetitive movements
  • Has difficulty locating familiar places like the bathroom, bedroom or dining room
  • Asks the whereabouts of current or past friends and family
  • Acts as if doing a hobby or chore, but nothing gets done (e.g., moves around pots and dirt without actually planting anything)
  • Appears lost in a new or changed environment

 Tips to prevent wandering

Wandering can happen, even if you are the most diligent of caregivers. Use the following strategies to help lower the chances:

  • Identify the most likely times of day that wandering may occur:
Plan activities at that time. Activities and exercise can reduce anxiety, agitation and restlessness.
  • Reassure the person if he or she feels lost, abandoned or disoriented: If the person with dementia wants to leave to “go home” or “go to work,” use communication focused on exploration and validation. Refrain from correcting the person. For example, “We are staying here tonight. We are safe and I’ll be with you. We can go home in the morning after a good night’s rest.”
  • Ensure all basic needs are met: Has the person gone to the bathroom? Is he or she thirsty or hungry?
  • Avoid busy places that are confusing and can cause disorientation: This could be shopping malls, grocery stores or other busy venues.
  • Place locks out of the line of sight: Install either high or low on exterior doors, and consider placing slide bolts at the top or bottom.
  • Camouflage doors and door handles: Camouflage doors by painting them the same color as the walls, or cover them with removable curtains or screens. Cover knobs with cloth the same color as the door or use childproof knobs.
  • Use devices that signal when a door or window is opened: This can be as simple as a bell placed above a door or as sophisticated as an electronic home alarm.
  • Provide supervision: Never lock the person with dementia in at home alone or leave him or her in a car without supervision.
  • Keep car keys out of sight: A person with dementia may drive off and be at risk of potential harm to themselves or others.
  • If night wandering is a problem: Make sure the person has restricted fluids two hours before bedtime and has gone to the bathroom just before bed. Also, use night-lights throughout the home.

Make a plan

The stress experienced by families and caregivers when a person with dementia wanders and becomes lost is significant. Have a plan in place beforehand, so you know what to do in case of an emergency.

  • Keep a list of people to call on for help: Have telephone numbers easily accessible and update them every six months.
  • When someone with dementia is missing: Begin search-and-rescue efforts immediately. Ninety-four percent of people who wander are found within 1.5 miles of where they disappeared.
  • Ask neighbors, friends and family to call if they see the person alone.
  • Keep a recent, close-up photo and updated medical information on hand to give to police.
  • Know your neighborhood: Pinpoint dangerous areas near the home, such as bodies of water, open stairwells, dense foliage, tunnels, bus stops and roads with heavy traffic.
  • Keep a list of places where the person may wander:
This could include past jobs, former homes, places of worship or a restaurant.
  • Provide the person with ID jewelry: Medical alert bracelet and or electronic wander guard device preferably with GPS capability.
  • If the person does wander, search the immediate area for no more than 15 minutes: Call “911” and report to the police that a person with Alzheimer’s disease — a “vulnerable adult” — is missing. A Missing Report should be filed and the police will begin to search for the individual. Make a point of knowing what they’re wearing for a more accurate description.

Many people with dementia want to live at home for as long as possible. Often, this is with support from others. However, it can be difficult managing everyday situations if you have dementia, particularly as the dementia progresses and you get older. As a result, some people may not be as safe at home as they used to be. This factsheet looks at how a person with dementia can stay safe at home and in the surrounding environment. It identifies some risks in the home environment and suggests ways to manage them.

 It is important to find the right balance between independence and unnecessary harm. The person with dementia should, where possible, be involved in decision-making and their consent sought and given about changes. If this is not possible, it is important that those making the decision do so in the person’s best interests.

Many of the issues in this factsheet are related to the normal ageing process. However, having dementia can place a person at higher risk of experiencing some of these issues. Everyone will experience dementia in their own way. The type of risks they face, and strategies to manage these, will depend on the individual and their situation.

Avoid falls

Falls are a common and potentially serious problem affecting older people. The risk of falls increases with age. This may be because of a range of factors: medical conditions (such as stroke), medication, balance difficulties, visual impairment, cognitive impairment and environmental factors. Falls can have detrimental effects on people, including injuries, loss of confidence and reduced activity.

For some people with dementia, the condition can also increase the likelihood of falling.

There are a number of things that can be done at home to reduce the risk of falling:

  • Home safety: Check the home for potential hazards such as rugs, loose carpets, furniture or objects lying on the floor. An occupational therapist may be able to help with identifying hazards and suggesting appropriate modifications.
  • Exercise: Regular exercise can improve strength and balance and help to maintain good general health. A referral to a physiotherapist may also help. Speak to your GP to find out more.
  • Healthy feet: Foot problems, including foot pain and long toenails, can contribute to an increased risk of falls. Seeing a podiatrist (a health professional who specializes in feet) can help. Contact your doctor to find out more.
  • Medicines: Medication can have side effects, including dizziness, which could increase the risk of a fall. Changes to medication or dosage, as well as taking multiple medicines, can increase a person’s risk of falling. Speak to the doctor about a medicine review if the person with dementia is taking more than four medicines.
  • Eyesight: Regular eye tests and wearing the correct glasses may help to prevent falls.
  • Keep objects in easy reach: If something is going to be used regularly, keep it in a cupboard or drawer that is easy to access.
  • Try not to rush: Do things at an appropriate pace; many people fall when they are rushing.

Improve lighting

As people get older they need more light to see clearly. This is because of age-related changes to the eyes. These changes include:

  • Pupils becoming smaller
  • Increased sensitivity to glare
  • Reduced amount of light reaching the retina.

Dementia can cause damage to the visual system (the eyes and the parts of the nervous system that process visual information), and this can lead to difficulties. The type of difficulty will depend on the type of dementia. Problems may include:

  • Decreased sensitivity to differences in contrast (including colour contrast such as black and white, and contrast between objects and background)
  • Reduced ability to detect movement
  • Reduced ability to detect different colours (for example, a person may have problems telling the difference between blue and purple)
  • Changes to the visual field (how much someone can see around the edge of their vision while looking straight ahead)
  • Double vision.

Improved lighting can reduce falls, depression and sleep disorders, and improve independence and general health. The following tips may help:

  • Increase light levels and use daylight where possible.
  • Minimize glare, reflection and shadows. Glare can be distracting and can reduce a person’s mobility.
  • Lighting should be uniform across any space, and pools of light and sudden changes in light levels should be avoided. This is because when a person gets older, their eyes adapt slowly to changes in light levels.
  • Remove visual clutter and distractions such as carpets with floral patterns.
  • Use colour contrasts to make things clearer, ie: a light door with a dark frame.
  • Leave a light on in the toilet or bathroom during the night. A night-light in the bedroom may help if someone gets up in the night.

Store dangerous substances safely

Dangerous substances, including medicines and household cleaning chemical should be stored somewhere safe. If the person with dementia is unable to administer their own medication safely, arrangements should be made for someone else to do this. A dosette box could be helpful. These have separate tablet compartments for days of the week and/or times of day such as morning, afternoon and evening.

Adaptations to the home

As people get older they may experience difficulties in managing everyday activities such as cooking or bathing, for a variety of reasons. People with dementia may experience additional challenges as their dementia progresses, because of memory problems or a reduced ability to carry out tasks in the correct sequence.

Adapting the home can help people with dementia to maintain their independence and reduce the risk of harm. It can also help to adapt some everyday tasks slightly. The following tips may help:

  • Label cupboards and objects with pictures and words so that they can be identified.
  • Where possible, use devices that only have one function and are easy to identify, for example a kettle.
  • Place clear instructions that can easily be followed somewhere visible.
  • Make sure the kitchen is well lit.
  • If there are concerns about using gas or electrical appliances inappropriately, contact the gas or electricity company and ask for the person to be put on the priority service register. This means that they will be eligible for free regular safety checks and will be able to get advice about safety measures such as isolation valves (advice is also available for care givers).
  • Fit an isolation valve to a gas cooker so that the cooker cannot be turned on and left on. Devices are also available for electric cookers.
  • Look into products that may help to maintain independence and safety such as electric kettles that switch off automatically.
  • If the person’s ability to recognize danger is declining, consider removing potentially dangerous implements such as sharp knives, but place other items for everyday use within easy reach.
  • Create a “wander loop” in your home, a safe pathway that allows the patient to safely roam.
  • Use reflector tape to create a path to the bathroom.
  • Cover radiators and electrical outlets with guards.
  • Lock doors that lead to places like basements and garages.
  • Install safety locks and alarms on exit doors and gates.
  • Cover smooth or shiny surfaces to reduce confusing glare.
  • Eliminate shadows with a lamp that reflects off the ceiling.
  • Cover or remove mirrors if they are upsetting to a person with hallucinations.
  • Store car keys in a locked container; disable the car.
  • Do not allow unattended smoking.
  • Make sure an I.D. bracelet is being worn at all times.
  • When selecting home care, make sure to hire an aide who has been trained to deal with dementia and Alzheimer’s patients, and is under the supervision of a skilled home care nurse.
  • And, most importantly, constantly re-assess your parent’s abilities with the help of a nurse or physician.

Avoid fire

There are ways to minimize the risk of fire in the home, including fitting smoke alarms and carbon monoxide detectors, and checking home appliances.

Local fire and rescue services can provide free home safety visits. They offer advice about how to make the home safer, as well as fitting smoke alarms and planning escape routes. Electric and gas appliances can be dangerous. It is important to check appliances to make sure they are working safely. Some appliances will have built-in safety features. Consider placing safety devices on stoves so that they are not accidently placed, or left on the on position.

Stay safe outdoors

Being outdoors is important for people of all ages and has many benefits. It is good for mental and physical health, including wellbeing, sleep and appetite Being outdoors can have psychological benefits such as reduced depression and agitation. Activity can also enhance a person’s independence and wellbeing. A garden, balcony or outdoor space can help to bring these benefits to people with dementia. It is important to manage any risks that may come with being outdoors.

The Following suggestions may help:

  • Make sure the area is well lit. This could be done with a sensor light, so that if a person is outside and daylight is fading they are still able to see adequately.
  • Put a rail on any stairs to help the person get up and down them. It can also help to highlight the edges of each step.
  • Avoid trip hazards such as loose paving slabs or uneven surfaces.
  • Have seating areas so that the person can take a rest or enjoy being outside if they are unsteady on their feet.
  • Use shelter to protect people from the elements if they want to spend a long time outside – a parasol or hat to minimize sun exposure.

Ensuring your home is adequately assessed for safety concerns is you first step in assuring that your love one enjoys their decision to remain in their home for as long as possible.

We can help. From an initial assessment to providing the home care services you need to meet your needs.

Loneliness & Isolation

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The eyes do speak

The eyes do speak

Feelings of loneliness & isolation can lead to serious consequences for senior health. Understanding the causes and risk factors for senior isolation can help us prevent it.

My 30+ years of Healthcare Administration experience, particularly the 26 years of Geriatric Care, has taught me much above caring for older adults. However, researching for this article made me realize that although I wanted to focus on how Loneliness & Isolation is pertinent to older adults… it is equally applicable to all age groups. For the sake of relevance and theme of Eldercare, this article reviews the context of loneliness and social isolation in later life is that of “successful aging” and “quality of life”. The term “quality of life” includes a broad range of areas of life.

There is little agreement about a single definition of the term. Models of quality of life range from identification of “life satisfaction” or “social wellbeing” to models based upon concepts of independence, control, social and cognitive competence. However, regardless of how the concept of quality of life is defined, research has consistently demonstrated the importance of social and family relationships towards the achievement of “successful aging” and “quality of life”.

No one relishes the prospect of aging without a spouse, family members at their side or without friends to help them laugh at the ridiculous parts & support them through difficult times. Yet, that is just what many North American seniors face. As the baby boomer generation crosses the over-65 threshold and the overall population of older adults skyrocket many of our aging loved ones are still feeling alone in the crowd.

While living alone does not inevitably lead to social isolation, it is certainly a predisposing factor. Yet another important consideration is how often seniors engage in social activities. Statistics Canada reports that 80% of Canadian Seniors participate in one or more social activities on a frequent basis (at least monthly) – but that leaves fully one-fifth of seniors not participating in weekly or even monthly activities. Social contacts tend to decrease as we age for a variety of reasons, including retirement, the death of friends & family or lack of mobility.

Regardless of the causes of senior isolation, the consequences can be alarming and even harmful. Even perceived social isolation – the feeling that you are lonely – is a struggle for many older people. Fortunately, the past couple of decades have seen increasing research into the risks, causes, and prevention of loneliness in seniors.

Below are the major documented facts about senior isolation to help you stay informed:

Senior isolation increases the risk of mortality
According to a 2012 study in the Proceedings of the National Academy of Sciences, both social isolation and loneliness are associated with a higher risk of mortality in adults aged 52 and older.

One possible explanation: “People who live alone or lack social contacts may be at increased risk of death if acute symptoms develop, because there is less of a network of confidantes to prompt medical attention.” Efforts to reduce isolation are the key to addressing the issue of mortality, said the study’s authors.

Feelings of loneliness can negatively affect both physical & mental health
Regardless of the facts of a person’s isolation, seniors who feel lonely and isolated are more likely to report also having poor physical and/or mental health, as reported in a study using data from the National Social Life, Health, and Aging Project. Connecting seniors with social resources, such as senior centers, home care agency and meal delivery programs, is one way to combat subjective feelings of isolation.

Perceived loneliness contributes to cognitive decline and risk of dementia
Dr. John Cacioppo, a neuroscientist and psychologist at the University of Chicago, has been studying social isolation for 30 years. One frightening finding is that feelings of loneliness are linked to poor cognitive performance and quicker cognitive decline. We evolved to be a social species, says Dr. Cacioppo – it’s hard-wired into our brains, and when we don’t meet that need, it can have physical and neurological effects.

Social isolation makes seniors more vulnerable to elder abuse
Many studies show a connection between social isolation and higher rates of elder abuse, reports the National Center on Elder Abuse. Whether this is because isolated adults are more likely to fall victim to abuse, or a result of abusers attempting to isolate the elders from others to minimize risk of discovery, researchers aren’t certain. A critical strategy for reducing elder abuse is speaking up: abuse, neglect and exploitation often go unreported. As for prevention, maintaining connections with senior loved ones helps us ensure their safety.

LGBT seniors are much more likely to be socially isolated
LGBT seniors are twice as likely to live alone, according to SAGE (Services & Advocacy for GLBT Elders); they are more likely to be single and they are less likely to have children – and they are more likely to be estranged from their biological families. Stigma and discrimination are major roadblocks to support for LGBT seniors, but there are more and more community groups and online resources devoted to helping these elders avoid isolation.

Social isolation in seniors is linked to long-term illness
In the Proceedings of the National Academy of Sciences study, illnesses and conditions such as chronic lung disease, arthritis, impaired mobility, and depression were associated with social isolation. Ensuring appropriate care for our loved ones’ illnesses can help prevent this isolation. For homebound seniors, phone calls and visits can be a critical part of connecting with loved ones. Others may find that moving to an assisted living community or obtaining home care arrangements mitigates both issues – the need for ongoing care, empathy and the desire for meaningful companionship.

Loneliness in seniors is a major risk factor for depression
Numerous studies over the past decade have shown that feeling loneliness is associated with more depressive symptoms in both middle-aged and older adults. One important first step is recognizing those feelings of loneliness, isolation and depression and seeking treatment – whether it’s on your own behalf or for the sake of a loved one.

Loneliness causes high blood pressure
A 2010 study in Psychology and Aging indicated a direct relationship between loneliness in older adults and increases in systolic blood pressure over a 4-year period. These increases were independent of race, ethnicity, gender, and other possible contributing factors. Early interventions for loneliness, say the study’s authors, may be key to preventing both the isolation and associated health risks.

Socially isolated seniors are more pessimistic about the future
According to the National Council on Aging, socially isolated seniors are more likely to predict their quality of life will get worse over the next 5-10 years, are more concerned about needing help from community programs as they get older, and are more likely to express concerns about aging in place.

The National Association of Area Agencies on Aging says community-based programs and services are critical in helping ward off potential problems and improving quality of life for older people.

Physical and geographic isolation often leads to social isolation
“One in six seniors living alone in the Canada & US faces physical, cultural, and/or geographical barriers that isolate them from their peers and communities,” reports the National Council on Aging. “This isolation can prevent them from receiving benefits and services that can improve their economic security and their ability to live healthy, independent lives.” Referring isolated older adults to senior centers, activity programs, and transportation services can go a long way toward creating valuable connections and reducing isolation.

Isolated seniors are more likely to need long-term care
Loneliness and social isolation are major predictors of seniors utilizing home care, as well as entering nursing homes, according to a 2004 report from the Children’s, Women’s and Seniors Health Branch, British Columbia Ministry of Health. The positive angle of these findings, says the report, is that using long-term health care services can in itself connect seniors with much-needed support. Particularly for seniors in rural areas where home care may not be viable, entering a care facility may provide companionship and social contact.

Loss of a spouse is a major risk factor for loneliness and isolation
Losing a spouse, an event which becomes more common as people enter older age, has been shown by numerous studies to increase seniors’ vulnerability to emotional and social isolation, says the same report from the British Columbia Ministry of Health. Besides the loneliness brought on by bereavement, the loss of a partner may also mean the loss of social interactions that were facilitated by being part of a couple. Ensuring seniors have access to family and friendship support can help alleviate this loneliness.

Transportation challenges can lead to social isolation
Life expectancy exceeds safe driving expectancy after age 70 by about six years for men and 10 years for women. Yet, 41% of seniors do not feel that the transportation support in their community is adequate.

Having access to adequate public transportation or other senior transportation services is key to seniors’ accessing programs and resources, as well as their feelings of connectedness and independence.

Family Caregivers of the elderly are also at risk for social isolation
Being a family caregiver is an enormous responsibility, whether you are caring for a parent, spouse, or other relative. When that person has Alzheimer’s disease, dementia, or a physical impairment, the caregiver may feel even less able to set aside his or her caregiving duties to attend to social relationships they previously enjoyed. This can trigger loneliness and depression. Seeking support, caring for yourself, and even looking for temporary respite care can help ward off caregiver loneliness and restore your sense of connection.

Loneliness can be contagious
Studies have found that loneliness has a tendency to spread from person to person, due to negative social interactions and other factors. In other words, when one person is lonely, that loneliness is more likely to spread to friends or contacts of the lonely individual. Making things even worse, people have a tendency to further isolate people who are lonely because we have evolved to avoid threats to our social cohesion. It’s a complicated situation, and simply telling seniors to engage in more social activities may not be enough. Considering our loved ones’ needs as individuals is a valuable first step to figuring out how to prevent or combat isolation.

Lonely people are more likely to engage in unhealthy behavior
A 2011 study using data from the English Longitudinal Study of Ageing (ELSA) found that people who are socially isolated or lonely are also more likely to report risky health behaviors such as poor diet, lack of physical activity, and smoking. Conversely, social support can help encourage seniors to eat well, exercise, and live healthy lifestyles. Living in a community situation can be an effective barrier to loneliness, and most senior communities specifically promote wellness through diet and exercise programs.

Volunteering can reduce social isolation and loneliness in seniors
We all know that volunteering is a rewarding activity, and seniors have a unique skill set and a richness of life experience to contribute to their communities. It can also boost longevity and contribute to overall mental health, wellbeing, and it ensures that seniors have a source of social connection. There are many opportunities tailor-made for seniors interested in volunteering

Feeling isolated? Take a class
A review of studies looking at various types of interventions on senior loneliness found that the most effective programs for combating isolation had an educational or training component: for instance, classes on health-related topics, computer training, or exercise classes.

Technology can help senior isolation – but not always
Even though modern technology provides us with more opportunities than ever for keeping in touch, sometimes the result is that we feel lonelier than ever. The key to finding technological interventions that really do help, says Health Quality Ontario, is matching those interventions to the specific needs of individual seniors. One simple strategy that does help: for seniors with hearing loss, simply providing a hearing aid can improve communication and reduce loneliness. Phone contact and Web-based support programs were less consistent in their effectiveness, but for some, they might provide a lifeline.

Physical activity reduces senior isolation
Group exercise programs, it turns out, are a wonderfully effective way to reduce isolation and loneliness in seniors – and of course they have the added benefit of being great for physical and mental health. In one study, discussed by Health Quality Ontario, seniors reported greater wellbeing regardless of whether the activity was aerobic or lower-impact, like stretching.

Loneliness & Isolation is neither inevitable nor irreversible. Getting the facts can help us better understand and prevent loneliness in the lives of our older loved ones, as they face the life changes of aging.

In reference to the beginning of the article, one can easily relate how this article is not to simply to understand, intervene and mitigate loneliness & isolation as it pertains to affecting the lives our older loved ones. Loneliness and isolation affects individuals in all age categories and the above points will go a long way in staving off those affects and achieving “successful aging” and “quality of life”.

In Our Care – Home Care Services, understand that care is not simply based on the physical support your older loved one may need… there are a broad spectrum built-in service components to achieve our overall goal… Enriching the lives of those we love and deliver care to.

Your loved one may not be direct family, but they’re part of the In Our Care family… therefore they are.

Please contact us today, to discuss any challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

You got questions, we have answers: (905) 785-2341 or email us at 

Myths & Facts About Aging

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elderly-womanThis article delves into ageist stereotypes dressed-up in the garb of myth that biases perceptions and experiences of being old. The article argues current ”mythmaking” about aging perpetuates that which it intends to dispel: ageism. It considers how traditional myths and folklore explained personal experience, shapes social life, and offers meaning for the unexplainable. The current myths of aging perform these same functions in our culture; however, they are based on half-truths, false knowledge, and stated as ageist stereotypes about that which is known. Recent studies in the cognitive sciences are reviewed to provide insight about the mind’s inherent ability to construct categories, concepts, and stereotypes as it responds to experience. These normal processes need to be better understood, particularly regarding how social stereotypes are constructed. Finally, the article argues that ageist stereotypes when labeled as ”myth” even in the pursuit of the realities of aging, neither educate the public about the opportunities and challenges of aging nor inform social and health practitioners about the aged.

Think you know the facts about growing older? Think again.

Take a brief quiz to determine your knowledge on myth versus fact as it relates to aging:

Myths of Aging Quiz – Answer true or false to each statement.

  1. Polypharmacy (administration of many drugs together) can lead to a change in mental status.
  2. Aging is a universal phenomenon.
  3. Older adults may present with atypical symptoms that complicate diagnosis.
  4. The body’s reaction to changes in medications remains constant with advancing age.
  5. If the rehabilitation nurse observes a sudden change in mental status in an older adult, medication side effects should be investigated as a likely cause.
  6. Primary causes of delirium in older adults include medications, dehydration, and infection.
  7. Dehydration is not common in older adults.
  8. Older adults experiencing a decline in daily function will show no benefit from early rehabilitation.
  9. A decline in functional ability for a person residing in a long-term care facility may indicate the onset of a new illness.
  10. Urinary incontinence is so common in older adults that it is considered a nor- mal part of aging.

Answers: 1. True; 2. True; 3. True; 4. False; 5. True; 6. True; 7. False; 8. False; 9. True; 10. False

In no particular order… what are the common 20 myths that are often associate with Aging

Myth: Dementia is an inevitable part of aging
“Dementia should be seen as a modifiable health condition and, if it occurs, should be followed as a medical condition, not a normal part of aging. In other words, if you or your loved one becomes forgetful, it could be related to medication, nutrition or modifiable medical issues, she said. Don’t assume Alzheimer’s.

Just consider that when doctors examined the brain of a 115-year-old woman who, when she died, was the world’s oldest woman, they found essentially normal brain tissue, with no evidence of Alzheimer’s or other dementia-causing conditions. Testing in the years before she died showed no loss in brain function.

Not only is dementia not inevitable with age, but you actually have some control over whether or not you develop it. “We’re only now starting to understand the linkages between health in your 40s, 50s and 60s and cognitive function later in life. Studies find that many of the same risk factors that contribute to heart disease—high blood pressure, high cholesterol, diabetes and obesity… may also contribute to Alzheimer’s and other dementias.

For instance, studies on the brains of elderly people with and without dementia find significant blood vessel damage in those with hypertension. Such damage shrinks the amount of healthy brain tissue you have in reserve, reducing the amount available if a disease like Alzheimer’s. That’s important, because we’re starting to understand that the more brain function you have to begin with, the more you can afford to lose before your core functions are affected.

Myth: Creaky, Achy Joints are Unavoidable
Not exercising is what makes achy joints inevitable. When Australian researchers at the Monash University Medical School looked at women ages 40 to 67, they found that those who exercised at least once every two weeks for 20 minutes or more had more cartilage in their knees. It suggests that being physically active made them less likely to develop arthritis.

In Fact – You may actually dodge the dementia bullet… Exercise your body and your brain. Physical activity plays a role in reducing the risk of diseases that cause Alzheimer’s. It also builds up that brain reserve. One study found just six months of regular physical activity increased brain volume in 59 healthy but couch-potato individuals ages 60 to 79. Other research finds people who exercised twice a week over an average of 21 years slashed their risk of Alzheimer’s in half.

Then there’s intellectual exercise. It doesn’t matter what kind, just that you break out of your comfort zone. Even writing letters twice a week instead of sending e-mail can have brain-strengthening benefits. That’s because such novel activities stimulate more regions of the brain, increasing blood flow and helping to not only build brain connections, but improve the health of existing tissue. 

Myth: If you didn’t exercise in your 30s & 40s, it’s too late to start in your 50s, 60s or 70s
It’s’s never too late! In an oft-cited study, 50 men and women with an average age of 87 worked out with weights for 10 weeks and increased their muscle strength 113 percent. Even more important, they also increased their walking speed, a marker of overall physical health in the elderly.

Myth: Your Bones Become Fragile And Your Posture Bends
Remember, only death is certain when it comes to aging. Osteoporosis is definitely more common in older people, but it’s also very preventable. 

A study of females over 100 years of age found that only 56 percent had osteoporosis, and their average age at diagnosis was 87. Not bad, given these women grew up before the benefits of diet and exercise on bone were understood. Thankfully, you know better.

Myth: Old Age Kills Your Libido
Impotence and reduced libido are related to normally preventable medical conditions like high blood pressure, heart disease, diabetes, and depression. The solution is keeping yourself in shape. Something as simple as lifting weights a couple times a week can improve your sex life. Sexual desire might decline a bit as you age, but that doesn’t typically occur until age 75A survey of 3,005 people ages 57 to 85 found the chance of being sexually active depended as much if not more on their health and their partner’s health than on their age. Women who rated their health as “very good” or “excellent” were 79 percent more likely to be sexually active than women who rated their health as “poor” or “fair.” And while fewer people ages 75 to 85 had sex than those 57 to 74, more than half (54 percent) of those who were sexually active had intercourse two or three times a month. emember – Sexually transmitted diseases do not discriminate based on age. If you’re not in a monogamous relationship, you or your partner should use a condom.

Myth: Getting older is depressing so expect to be depressed
No way! “Depression is highly treatable. If older people could just admit to it and get help, they could probably live a much more active and healthy life.” That’s because studies find that older people who are depressed are more likely to develop memory and learning problems, while other research links depression to an increased risk of death from numerous age-related diseases, including Parkinson’s disease, stroke and pneumonia.

Myth: Genes Play The Biggest Role In How You’ll Age
Even if you’re born with the healthiest set of genes, how you live your life determines how they behave over your lifespan. Your genes can be changed by what you eat, how much physical activity you get, and even your exposure to chemicals.

Myth: Women fear aging more so than men
Not so! A survey conducted on behalf of the National Women’s Health Resource Center found that women tend to have a positive outlook on aging and to be inspired by others who also have positive attitudes and who stay active as they grow older. Women surveyed were most likely to view aging as “an adventure and opportunity” and less likely to view it as depressing or a struggle.

Myth: You Lose Your Creativity As You Age
Creativity actually offers huge benefits for older people. A study found that older adults who joined a choir were in better health, used less medication, and had fewer falls after a year than a similar group that didn’t join. The singers also said they were less lonely, had a better outlook on life, and participated in more activities overall than the non-singing group, who actually reduced the number of activities they participated in during the year.

Myth: The pain and disability caused by arthritis is inevitable, as you get older
senior in the poolWhile arthritis is more common as you age, thanks to the impact of time on the cushiony cartilage that prevents joints and bone from rubbing against one another, age itself doesn’t cause arthritis. There are steps you can take in your youth to prevent it, such as losing weight, wearing comfortable, supportive shoes (as opposed to three-inch spikes), and taking it easy with joint-debilitating exercise like running and basketball. One study found women who exercised at least once every two weeks for at least 20 minutes were much less likely to develop arthritis of the knee (the most common location for the disease) than women who exercised less.

Myth: Your Brain Stops Developing After Age 3
This developmental myth was overturned in the 1990s, and ever since, researchers no longer look at the older brain as a static thing. Instead, studies show your brain continues to send out new connections and to strengthen existing ones throughout your life — as long as you continue to challenge it. It really is your body’s ultimate muscle.

Myth: Your Brain Shrinks With Age
This myth began with studies in 2002 showing that the hippocampus, the part of the brain that controls memory, was significantly smaller in older people than in younger people. This never sounded right to Dr. Lupien, particularly after she conducted groundbreaking research in the late 1990s showing that chronic stress shrinks the hippocampus. 

Was it age or stress that was responsible for the shrinking brains of older people? Probably stress. When she examined brain scans of 177 people ages 18 to 85, she found that 25 percent of the 18- to 24-year-olds had hippocampus volumes as small as those of adults ages 60 to 75.

Myth: Seniors Are Always Cranky And Unhappy
When researchers from Heidelberg, Germany, interviewed 40 centenarians, they found that despite significant physical and mental problems, 71 percent said they were happy, and more than half said they were as happy as they’d been at younger ages. Plus, when the researchers compared them to a group of middle-age people, they found that both groups were just as happy. Most important: Nearly 70 percent of the centenarians said they laughed often. What does it all mean? It means there is no universal definition of aging. How you’ll age is entirely up to you – and the time to begin writing that definition is today.

Myth: When you get older, you don’t need as much sleep
You may need as much sleep as when you were younger, but you may have more trouble getting a good night’s sleep. “It is not so much that there is a decline in the number of hours needed, but rather that sleep patterns may change with a tendency to more naps and shorter nighttime periods of deep sleep.

Myth: If you live long enough, you’re going to be senile
The odds are against it. “The probability of senility at age 65 is only about five percent. It rises to about 20 percent by age 85.

The term “senility” is no longer used to describe dementia. Alzheimer’s disease is the most common type of primary progressive dementia. Alzheimer’s is linked to age, Dr. Gorbien says, and older people worried about it should seek an assessment with a geriatrician, neurologist or psychiatrist.
“Early detection of Alzheimer’s disease is so important,” he says. New medications may slow the progression of the disease and help keep people independent.

Myth: Older adults are always alone and lonely
In proportion the number of older people living alone are greater than their younger counterparts, but they are not necessarily lonely. Relationships may grow more intense in old age, Dr. Schaie says. More people live alone as the population ages, Dr. Gorbien says. And Dr. Schaie says gender differences in average life spans leave many more women than men widowed. Widowed men are more likely than women to remarry, Dr. Schaie says, “because of the availability of a larger pool of eligible partners.”

“Most seniors are active,” adds AARP spokesman Tom Otwell. Many have paying jobs, regularly volunteer, garden or help care for grandchildren, for instance.

Myth: Old age means losing all my teeth
If you’re not worried about losing your mind when you’re old, you might fret about losing your teeth. Periodontitis, or late stage gum disease, is the primary cause of tooth loss in adults. This condition commonly begins as gingivitis where gums turn red and begin to swell and bleed, a situation experienced by too many people. Fortunately healthy gums and avoiding false teeth are both reasonable goals.

The elderly of today are much more likely to keep their teeth than previous generations. Even so, dental disease is prevalent. The New England Elders Dental Study found the beginnings of periodontal disease in over 3/4 of the 1150 persons examined. Part of the problem, said these investigators, was that education and dental care for this population are overlooked by both dentists and the patients themselves. The sad part of this situation is that proper dental hygiene and regular cleanings by the dentist are usually enough to stave off infection. Healthy people should replace their toothbrushes every two weeks; those with a systemic or oral illness more often. Everyone should use a new toothbrush when they get sick, when they feel better and again when they completely recover.

Myth: The older I get, the sicker I’ll get
It’s true that as we age, our physiology changes. These changes can lead to poor health if not addressed. But old age doesn’t have to mean feeling sick and tired. An important part of staying well into the older years is keeping your immune system operating at its peak. Aging is generally associated with lagging immunity and consequently more infections especially of the respiratory system. However, John Hopkins’ Professor Chandra discovered that when independent, apparently healthy, elderly people were fed nutritional supplements for a year, their immunity improved. Immunological responses were so marked that those who were supplemented (versus the placebo group) were plagued with less infections and took antibiotics for less days. Besides taking care of your immunity with supplementation, diet, exercise and other measures, you can prevent many age-related diseases with specific health precautions. For example, there is evidence that smoking and low plasma levels of vitamins C and E, and beta-carotene contribute to cataracts.

Calcium and magnesium supplementation helps some individuals with hypertension. Most are helped by high potassium foods (fruits and vegetables), salt restriction and weight maintenance. Keeping blood pressure under control can also decrease the risk of a stroke.

Adult-onset diabetes is usually treated best with dietary measures such as reducing simple sugars, consuming a lot of fiber and taking chromium supplements. It’s estimated that half of all types of cancer are linked to diet. This explains why less fat, lots of fruits, vegetables and fiber, vitamins A, B6, C and E and zinc and selenium all appear to play a role in cancer prevention.

Myth: Urinary incontinence is considered a normal part of aging
Although urinary incontinence (UI) occurs more frequently among older adults (10%–42% of hospitalized elders), it is not considered a normal part of aging and is highly treatable. A new onset of UI can signal problems such as urinary tract infection, electrolyte imbalances, mobility limitations, or medication side effects. Before beginning any rehabilitative interventions for incontinence, all possible causes should be investigated to rule out reversible factors. Bladder retraining for those with urge or stress incontinence is still highly effective for older adults. Behavioural management is the first line of treatment for incontinence.

Myth: Growing older means accepting the loss of independence and a Home for the Aged
There is absolutely no evidence to support that as we age we accept loss of independence or going into a nursing home as part of the aging process. In fact today’s older adults enjoy a more vibrant and vigorous lifestyle. Remaining active, engaged and enjoying a more robust social life. An ever-increasing number of older adults are adopting home care in order to preserve the very things that the myth depicts. However, older adults do share common fears… in fact the 5 greatest noted fears among older adults are:

  • Loss of independence
  • Loss of loved ones
  • Loss of friends
  • Going into a Nursing Home
  • Death

In Our Care supports the aging process so effectively that you never have to ever see the inside of Nursing Home, unless you’re visiting friends and family. We are fully equipped to handle all your care needs – Effectively, Efficiently & Affordably.

Please contact us today, to discuss any challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

You got questions, we have answers: (905) 785-2341 or email us at homecare@inourcareservices.com

Final Plans – Pre-paid Funeral Services

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We have often heard the term – In Life there are two only things that are for certain – Death & Taxes. 

Money Wise – Tax Advantages of Prepaid Funeral Certificates

You have Kapriva Taylor Funeral Homedied. Over the next few days what will that look like for your loved ones? Your family is grief stricken and they must decide what to do with your body. They love you and want to honor your life. They go to the funeral home to make the arrangements and it is here they learn just how much their ideal tribute to you will cost.

We caught up with Katherine (Kat) Downey, Funeral Director and expert in Funeral preplanning who shared with us the benefits of investing in a prepaid Funeral plan.

According to Katherine Downey, the average funeral in Ontario costs approximately $8,800, but the range can vary from $1,600 to $15,000, and more. “The cost is influenced by the level of service people choose, and the type of casket, urn, vault or container selected; this can vary significantly,” says Downey. “Direct Disposition is the least expensive Service and adheres to the minimum requirements of Provincial law. A Memorial Service is an additional cost, followed by a full funeral including visitation and the body present being the traditional service.”

The average age that people consider their own funeral arrangements is 68 years. “I recommend people begin looking at this investment in their higher earning years of 40, 50 or 60,” says Downey. “Investing sooner one can contribute to the costs over a longer term with earned income rather than retirement income.”

As of July 1 2012 all Funeral Homes in Ontario must guarantee prepaid funeral contracts. This means that everything chosen today is priced from a current pricelist, including applicable taxes, and locked in and guaranteed from the date of the contract, until the funeral is required.”

There are also tFuneral Homesax advantages associated with an EFA (Eligible Funeral Arrangement). The Federal Government permits any amount to be paid into a prepaid funeral certificate, and the first $15,000 earns tax-exempt interest.

Downey further states, “The purchaser’s money is invested in an insured guaranteed certificate earning up to 2.0% interest annually. These funds remain in a tax sheltered escrow account during the investor’s lifetime. When the funeral is required, it is paid for from the guaranteed certificate and any extra money is returned to the estate.”

“When I speak with people about the benefits of prepaid funeral arrangements, they are often surprised at the financial gains. This ignites my passion to do what I do. There are financial benefits to families and this gives them a sense of relief that their funeral expenses will not be a burden on their loved ones.”

People with life insurance often say they will use this to pay for the funeral.   Though the key difference is that there is no guaranteed funeral cost. “In my opinion there is room for both prepaid funerals and life insurance,” says Downey. “With life insurance, usually the spouse is the beneficiary and they can use this money in any manner they see fit, and it is tax free. The money may be required to maintain one’s lifestyle or cover unexpected expenses. Taking care of the funeral costs ahead of time is in everyone’s best interest.”

The emotional and financial benefits of prepaid funerals are truly invaluable and provide families with a sense of accomplishment and peace of mind.

 

Kat- DowneyKatherine Downey is a professional educator and licensed funeral director specializing in prepaid funeral planning.
For further information contact (905) 717-9197 or at (905) 399-5341

Email: katdowney@legacymatters.ca
Website: www.legacymatters.ca

Senior Care: Driving for Seniors

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Senior Driving CarCan a person be too old to drive?

The answer to this question is not clear-cut and not one that should be applied across the board to all seniors. Nonetheless, with the current growth in our aging population we need to seriously review current and future policies on driving as they apply to seniors. As a community and society, we need to better understand the challenges / barriers and step in to mitigate. Policy review and changes is not something that affects seniors… it will affect our selves in the coming years. This is a delicate balance as we attempt to protect society from senior drivers we also need to ensure that we protect their rights and inevitably, our own rights as a senior citizen. Statistically speaking: Next to young male drivers, people aged 70 or older have highest accident rate

The New Retirement: In a recent, CBC News presented a series on life for people 60 years and older. Canadians Seniors are living longer than ever before, a fact that is radically changing the meaning of retirement. Many people see it as a time of reinvention, a time to try new things. CBC News is published stories on seniors who are doing remarkable things in the so-called twilight years. In one instance, a police officer pulled over a driver for driving too slow and impeding traffic. The officer glanced at the driver’s license and saw her age — 94 — and explained he wasn’t going to give her a ticket. But a couple of weeks later, she said she received a letter notifying her that her license was suspended for medical reasons.

“Never thought of not having a car, never crossed my mind,” explained Ellison. “When you can’t go out and get in your car and go where you want to go, it’s like having your arm cut off.”

According to the latest figures from Statistics Canada, three-quarters of Canadians aged 65 and older have a driver’s license. But research also shows that the older a person is, the greater risk they are on the road. StatsCan reports that other than young male drivers, people aged 70 or older have the highest accident rate. Furthermore, seniors are much more likely to be killed in collisions.

The loss of a driver’s license can affect quality of life: 

Those statistics don’t change the fact that once a person loses their license, it greatly affects their lifestyle and overall mental health. “It’s been demonstrated and said many times, that receiving the news that you will be losing your driver’s license has the same weight as being diagnosed with cancer,” said Sylvain Gagnon, a researcher for the Canadian Driving Research Initiative for Vehicular Safety in the Elderly (CANDRIVE). He explained the news of losing your license, can often be followed by depression and a significant loss in quality of life. Figures show that access to a car affects a person’s social habits. StatsCan found that seniors who primarily travelled via their car were the most likely to have partaken in a social activity in the past week, at 73 per cent. The StatsCan research shows that seniors who depend on others to get around are more likely to be reluctant when asking to attend leisure activities (rather than essential activities, like doctor’s appointments). Since losing her license, Ellison must now rely on her daughters and friends for transportation to her personal and social errands.

Life without wheels:

The loss of a license may be even more detrimental for seniors living outside urban areas. According to StatsCan, people aged 65-74 are slightly more likely to live outside urban areas. Of those seniors, a large number reportedly do not use transit because of a lack of service in their area, which may only further immobilize them.

According to Ellison, if you are out in the country and don’t drive, “you just might as well be dead”. — Peggy Ellison, Ontario Senior .

Ellison was 21 when she first got her license. She went on to two driving-related jobs, including parking cars at a garage and driving a bus for 20 years. She said that in the seven decades that she had a license, she was never in an accident. “I haven’t changed because I got old, at least I don’t think I have,” said Ellison. It is estimated that people make eight to 12 navigating decisions for every kilometre they drive. According to the Ontario Ministry of Transportation, even small changes as a result of aging can affect your driving. In Ontario, a person’s driver’s license can be suspended if a doctor or optometrist feels a person has a condition that may impair their ability to drive. Doctors are bound by law to report this condition to the Ministry of Transportation, which then reviews the information and acts accordingly. A doctor may take into account a number of factors when assessing a senior’s ability to drive, including vision, mobility and cognitive abilities. “You will never be able to tell in a doctor’s office whether someone is safe to drive,” said Gagnon, who is also a psychology professor at the University of Ottawa. Gagnon explained driving is a complex task, and there is no one single indicator of a driver’s competence. A doctor can only hope to narrow down the grey area of who is safe to drive. CANDRIVE is currently trying to come up with an instrument that could be used by doctors to assess older drivers.

Renewal process for seniors:

In the meantime, some provinces require that drivers be retested once they reach a certain age. For instance, in Ontario at the age of 80, drivers must renew their license and continue to do so every two years. They complete a vision test, a written test and sit in on a group education session. They may also be required to take a road test. In provinces such as Alberta, a driver needs to take a medical exam at the age 75, and again at 80 and every two years after that. Doctors are not required by law to report seniors who they believe are unfit to drive. However, the province has other safety measures in place. For instance, when drivers renew their license they have an obligation to disclose whether they have a medical condition that would affect their ability to drive. In Alberta, anyone can request that someone’s driving privileges be reviewed if they suspect that person is becoming a danger on the road. Trent Bancarz, a spokesperson for Alberta Transportation, said the majority of the requests probably come from family members. “If you do have someone in your family that either due to age or due to a medical condition is maybe not a safe person to be out there, it’s really hard to either confront them or to take their driving privileges away,” said Bancarz. But he said there should be no age bias involved with the decision to take away someone’s license. “Some people are better able to drive a vehicle at 82 then some other people at 45,” Bancarz said.

Seniors forced to change lifestyle:

Gagnon warned the recommendation to take away someone’s license should not be made lightly, because of the dramatic impact it can have on a person’s life. How a senior reacts to the news that he or she can no longer drive may depend on a number of factors, including a senior’s autonomy, how far away they are from their services and what the alternate transportation methods are.

The day after Peggy Ellison sold her Buick to a young man in town, she took out the Yellow Pages with the intention of buying a golf cart, a four-wheeled vehicle that doesn’t require a license. Her new ride was delivered to her home the next day. “There’s nothing like having a car,” Ellison says, “but it makes me feel a little bit of independence again since I got my cart. I love to have wheels.

This year, more than 3.5 million drivers over 65 will strike out on Canadian roads – the highest number in history. That fact is fuelling a simmering debate over whether Canada’s provinces ought to have tougher licensing criteria for elderly drivers. Most provinces require drivers aged 80 and up to renew their license and take a written test every two years. None have mandatory in-car driver tests. However, on a per-kilometre basis, seniors are the most collision-prone operators on the road. They are also subject to some of the highest insurance rates, on par with the rates levied on newly licensed young males. The problem with those statistics, experts argue, is that they belie much of the grey that muddies the senior driving issue. “The mere fact that you are old doesn’t mean you have a problem,” said Dr. Jamie Dow, the medical adviser on road safety for the Société de l’assurance automobile du Quebec, a crown corporation responsible for licensing drivers and vehicles. “The fact that you are older does make you more susceptible to having a problem.” Public health data supports this.

In 2010, two thirds of Canadians over the age of 65 were using multiple medications and nearly nine out of 10 suffered from a chronic condition; a quarter of adults in the 65 to 79 age group suffered four or more chronic conditions. In the over 80 year old group, the number jumped to more than a third, according to data from the Public Health Agency of Canada. “There is clearly a strong association between age and illness,” said Bonnie Dobbs, and Edmonton-based gerontologist who helms the Medically At-Risk Drivers’ Centre at the University of Alberta, a research centred devoted to studying the impact of medical conditions on driving. “Age is not the primary determiner of fitness to drive. [But] as we get older, we’re more likely to have one or more of the illnesses that can impact our ability to drive.” Nellemarie Hyde, an occupational therapist and program co-ordinator for Saint Elizabeth Driver Assessment and Training service in Ontario, regularly evaluates senior drivers with medical illnesses. The most common are diabetes, which can impact both vision and sensory function – think ability to gauge force on gas or brake pedals – Parkinson’s Disease with its hallmark physical tremors, stroke victims and people living with dementia and other mild cognitive impairments. “Mild memory deficits don’t necessarily affect driving directly,” she said, adding that she focuses more on a driver’s ability to concentrate, focus and multi-task. She also tests for strength, range of motion, co-ordination, sensation and visual perception. “We want the client to be able to continue driving safely,” she said, adding: “The challenge is when a medical condition starts to change how they drive.” Picking up on that condition is where policy makers struggle.

In most provinces, doctors are legally mandated to inform licensing bodies when they suspect a patient is no longer competent to drive. However, most doctors are “totally unprepared to do it,” said Dow. “Most physicians have no training in evaluating drivers or the effects of medical conditions on driving,” he said, adding the subject is rarely touched on by medical schools. The result is that some provinces are deluged with declarations from physicians. In other cases, physicians barely report at all. Several efforts are under way to provide physicians with tools to easily and efficiently identify medically at-risk drivers without risking discrimination by age. Through the SAAQ in Quebec, Dow runs free seminars for doctors on which exam observations ought to trigger red, road-related flags. Last year, Quebec recorded 16,000 physician declarations, compared with just 1,800 in 2003. In Ontario, Shawn Marshall, an Ottawa-based rehab medicine specialist, is near the end of a five-year, multi-province study called CanDrive, which follows 1,000 drivers over the age of 65 and aims to produce an even more accurate tool. “You want to have a screening tool that is valid, reliable and has high accuracy. You don’t want to identify people falsely,” he said, noting it strains provincial systems and unfairly restricts individuals who belong on the road. “The average 65-year-old is a healthy person,” he said. “Driving is important. To maintain your independence in many places throughout Canada, you need to be able to drive.”

How Does Age Affect Driving?

More and more older drivers are on the roads these days. It’s important to know that getting older doesn’t automatically turn people into bad drivers. Many of us continue to be good, safe drivers as we age. But there are changes that can affect driving skills as we age.

Changes to our Bodies: Over time your joints may get stiff and your muscles weaken. It can be harder to move your head to look back, quickly turn the steering wheel, or safely hit the brakes. Your eyesight and hearing may change, too. As you get older, you need more light to see things. Also, glare from the sun, oncoming headlights, or other street-lights may trouble you more than before. The area you can see around you (called peripheral vision) may become narrower. The vision problems from eye diseases such as cataracts, macular degeneration, or glaucoma can also affect your driving ability. You may also find that your reflexes are getting slower. Or, your attention span may shorten. Maybe it’s harder for you to do two things at once. These are all normal changes, but they can affect your driving skills. Some older people have conditions like Alzheimer’s disease (AD) that change their thinking and behavior. People with AD may forget familiar routes or even how to drive safely. They become more likely to make driving mistakes, and they have more “close calls” than other drivers. However, people in the early stages of AD may be able to keep driving for a while. Caregivers should watch their driving over time. As the disease worsens, it will affect driving ability. Doctors can help you decide whether it’s safe for the person with AD to keep driving.

Other Health Changes: While health problems can affect driving at any age, some occur more often as we get older. For example, arthritis, Parkinson’s disease, and diabetes may make it harder to drive. People who are depressed may become distracted while driving. The effects of a stroke or even lack of sleep can also cause driving problems. Devices such as an automatic defibrillator or pacemaker might cause an irregular heartbeat or dizziness, which can make driving dangerous.

 Smart Driving Tips

Planning before you leave:

  • Plan to drive on streets you know.
  • Limit your trips to places that are easy to get to and close to home.
  • Take routes that let you avoid risky spots like ramps and left turns.
  • Add extra time for travel if driving conditions are bad.
  • Don’t drive when you are stressed or tired.

 While you are driving:

  • Always wear your seat belt.
  • Stay off the cell phone.
  • Avoid distractions such as listening to the radio or having conversations.
  • Leave a big space, at least two car lengths, between your car and the one in front of you. If you are driving at higher speeds or if the weather is bad, leave even more space between you and the next car.
  • Make sure there is enough space behind you. (Hint: if someone follows you too closely, slow down so that the person will pass you.)
  • Use your rear window defroster to keep the back window clear at all times.
  • Keep your headlights on at all times.

Car safety:

  • Drive a car with features that make driving easier, such as power steering, power brakes, automatic transmission, and large mirrors.
  • Drive a car with air bags.
  • Check your windshield wiper blades often and replace them when needed.
  • Keep your headlights clean and aligned.
  • Think about getting hand controls for the accelerator and brakes if you have leg problems.

Driving skills: Take a driving refresher class every few years. (Hint: Some car insurance companies lower your bill when you pass this type of class. Check with AARP, AAA, or local private driving schools to find a class near you.)  

Medicine Side Effects: Some medicines can make it harder for you to drive safely. These medicines include sleep aids, anti-depression drugs, antihistamines for allergies and colds, strong pain-killers, and diabetes medications. If you take one or more of these or other medicines, talk to your doctor about how they might affect your driving.

Am I a safe driver? Maybe you already know of some driving situations that are hard for you–nights, highways, rush hours, or bad weather. If so, try to change your driving habits to avoid them. Other hints? Older drivers are most at risk when yielding the right of way, turning (especially making left turns), changing lanes, passing, and using expressway ramps. Pay special attention at those times.

Is It Time to Give Up Driving? We all age differently. For this reason, there is no way to say what age should be the upper limit for driving. So, how do you know if you should stop driving?

To help you decide, ask:

  • Do other drivers often honk at me?
  • Have I had some accidents, even “fender benders”?
  • Do I get lost, even on roads I know?
  • Do cars or people walking seem to appear out of nowhere?
  • Have family, friends, or my doctor said they are worried about my driving?

Am I driving less these days because I am not as sure about my driving as I used to be? If you answered yes to any of these questions, you should think seriously about whether or not you are still a safe driver. If you answered no to all these questions, don’t forget to have your eyes and ears checked regularly. Talk to your doctor about any changes to your health that could affect your ability to drive safely.

How Will I Get Around? You can stay active and do the things you like to do, even if you decide to give up driving. There may be more options for getting around than you think. Some areas offer low-cost bus or taxi service for older people. Some also have carpools or other transportation on request. Religious and civic groups sometimes have volunteers who take seniors where they want to go. Your local Agency on Aging has information about transportation services in your area.

If you still have a vehicle consider a companion service that will keep you company as needed and provide you with a driving service, to and from where you need to go.  In Our Care – Home Care Services can do that, its effective, inexpensive, convenient and safe.

Elder Abuse – Know it, Report it, Stop it

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Elder Abuse – Have you heard about it?

Know it, Report it, Stop it!Abuse and Neglect

Canada’s population demographics is shift, the number of seniors in Canada has increasing by 57.6% between 1992 and 2012. Within the same period, the number of children dropped by 3.6%. This shift hypotheses that an increasing number of people will be put into a position of caregiver for their parents/grandparents even as they are caregivers to their own families. Juggling these dual care giving roles & responsibilities can bring on a great deal of stress, anxiety, and despair.

While no one underestimates the level of responsibility, accountability and stress levels associated with caregiving, caring for an older senior can present a number of new challenges. Caring for an adult is much different than caring for child yet the level of patience and compassion required must be the same. An untrained person can easily become overwhelmed with the demands required to effectively manage, care for, and delivered care… in a caring manner. With that being said, there’s a real potential for frustration levels to escalate, setting the stage for elder abuse. Unfortunately, it does not happen quite like that. If that were the case, it would be so easy to intervene and resolve it. Elder abuse is far more complex and widespread than just the physical abuse. Not to say that it does not begin there.

So. What is Elder Abuse?

Although elder abuse includes the types of behaviours attributed to domestic violence, it also includes additional types of abuse such as neglect and financial exploitation. It also occurs in a wider range of settings and relationships. Perpetrators of elder abuse cases can be spouses but can also be children, grandchildren, other relations, friends, fellow residents in an institution and personal caregivers. Issues related to individual cognitive and physical functioning are central concerns in elder abuse and consequently frail older people have become identified with this perspective.

The World Health Organization defines elder abuse as, “Single or repeated acts, or lack of appropriate action, occurring within a relationship where there is an expectation of trust, which causes harm or distress to an older person.”

Fast facts:

  • Among seniors who’ve been physically abused, 68% report the assault was committed by a family member (Source: Ministry of Citizenship and Immigration)
  • 96% of Canadians think most of the abuse experienced by older adults is hidden or goes undetected (Source: Environics poll for Human Resources and Social Development Canada)
  • Female seniors (38%) are more likely to be abused than male seniors (18%). (Source: Ministry of Citizenship and Immigration)

Under-reporting

Some studies suggest that women and men differ in their tendency to report abuse and may interpret questions about abuse differently. For example, women seem to be more willing than men to identify themselves as perpetrators of emotional abuse. However, as is the case in all surveys about sensitive issues, respondents may also be reluctant to disclose their experiences due to shame, fear or lack of trust. Older women may have fewer resources and less independence than men and may be less inclined to report abuse due to fear of leaving their home or accusing someone who provides for their daily needs. Older men, on the other hand, may be embarrassed or ashamed that they are no longer in a position of control in their home. There may be a shift in this with the aging of the baby boomers as the stigma associated with masculine need for help lessens.

There is a huge under-recognition of abuse of seniors in Canada. I would say this field is 20 years behind where we were when we were trying to raise awareness about violence against women and, before that, how to prevent and respond to abuse of children.”

Elder abuse is often referred to as ‘the hidden crime.’ It can take many forms, including physical abuse, sexual abuse, financial abuse, mental abuse and neglect.

Fortunately, there is no better time than now to tackle the issue because seniors are by far the fastest growing segment of the population. Statistics Canada predicts that by 2026 seniors, aged 65 and older, who now account for 13% of the Canadian population, will grow to 21%.

A closer look at Elder Abuse:

  • Elder abuse is an issue that may affect seniors in all walks of life. However, some seniors may be at greater risk of experiencing some type of abuse: those who are older, female, isolated, dependent on others, cared for by someone with an addiction, and seniors living in institutional settings.
  • Those who are frail, who have a cognitive impairment or a physical disability.
  • In most cases, the person being abused knows and trusts the abuser and relies on him/her in some way, which makes it even worse. It might be a child, another family member, another senior, a fellow resident in an institution, a paid caregiver or even a spouse.
  • Unfortunately, seniors can make easy targets. Many live alone and are socially isolated, which increases their vulnerability. Others are dependent on their abuser for care. Some suffer from dementia or other health issues that may prevent them from responding to the abuse or reporting it. Some may feel it’s impossible to get away from the abuser if the relationship has been long standing. And many seniors who simply are not as physically strong as they once were are unable to defend themselves.

Forms of Elder Abuse:

The Ontario Network for the Prevention of Elder Abuse (ONPEA) uses the following descriptions:

Financial Abuse – One of the most common forms of elder abuse. It often refers to the theft or misuse of money or property such as household goods, clothes or jewelry. It also includes forcing the sale of property or possessions, misusing power of attorney responsibilities, coercing changes in a will, withholding funds and/or fraud.

Physical Abuse – Is any physical pain or injury that’s willfully inflicted upon a senior. It includes unreasonable confinement or punishment resulting in physical harm, as well as hitting, slapping, pinching, pushing, burning, pulling hair, shaking, physical restraint, physical coercion, forced feeding or withholding physical necessities.

Sexual Abuse – Is any sexual activity that occurs when one or both parties cannot or do not give consent. It includes, but is not limited to, assault, rape, sexual harassment, intercourse, fondling, intimate touching during bathing, exposing oneself, and inappropriate sexual comments.

Psychological (Emotional) Abuse – Is the willful infliction of mental anguish or the provocation of fear of violence or isolation. This kind of abuse diminishes the identity, dignity and self-worth of the senior. It can include name-calling, yelling, ignoring the person, scolding or shouting, insults, threats, intimidation or humiliation, treating as a child, emotional deprivation, isolation, and the removal of decision-making power.

Neglect – Can be intentional or unintentional. It happens when the caregiver of a dependent senior fails to meet his/her needs. Forms of neglect include not providing adequate food, housing, medicine, clothing or physical aids, as well as inadequate hygiene, supervision and safety precautions. It also includes withholding medical services and medications, overmedicating, allowing a senior to live in unsanitary or poorly heated conditions, and denying access to necessary services, such as homemaking, nursing, and social work. For a variety of reasons seniors themselves, may fail to provide adequate care for their own needs, and this is known as self-neglect.

Older women who’ve been abused have been socialized to believe this is not something they’re supposed to talk about. This is a historical problem and their mothers and grandmothers, who may also have also been victims of abuse, probably didn’t talk about it either. To go specifically to an agency that serves abused women is very difficult for them and there’s a stigma attached to it. We need to be able to reach these women wherever they are – and we need to let them know it’s okay to talk about and it’s okay to get some help.

Recognizing the signs of elder abuse

Sometimes it can be difficult to determine if an elder is actually being abused since there may be other explanations for the signs, such as a fall, self-neglect or poor personal choices. Other times it’s more obvious abuse is going on. One thing experts agree on is the longer the abuse goes on, the worse it tends to get.

The following are possible signs an elder is being abused:

Financial Abuse/fraud:

  • Significant withdrawals from the elder’s accounts
  • Sudden changes in the elder’s financial condition
  • Items or cash missing from the senior’s household
  • Suspicious changes in wills, power of attorney
  • Unpaid bills, even when the elder has enough money to pay
  • Financial activity the senior couldn’t have done, such as an ATM withdrawal when the account holder is bedridden
  • Unnecessary services, goods, or subscriptions
  • Paying far more for work/service than others would be charged
  • Large advance payments with nothing to show for it

Physical Abuse:

  • Unexplained signs of injury such as bruises, welts, or scars, especially if they appear symmetrically on two sides of the body
  • Broken bones, sprains, or dislocations
  • Reports of drug overdose or apparent failure to take medication
  • Regularly (a prescription has more remaining than it should have)
  • Broken eyeglasses or frames
  • Signs of being restrained, such as rope marks on wrists
  • Caregiver’s refusal to allow you to see the elder alone

Sexual Abuse:

  • Bruises around breasts or genitals
  • Unexplained venereal disease or genital infections
  • Unexplained vaginal or anal bleeding
  • Torn, stained, or bloody underclothing

 

Psychological/Emotional Abuse:

  • Threatening, belittling, or controlling caregiver behavior witnessed by others
  • Behaviour from the elder that mimics dementia, such as rocking, sucking, or mumbling to oneself

Neglect: (By caregivers and/or self)

  • Unusual weight loss, malnutrition, dehydration
  • Untreated physical problems, such as bed sores
  • Unsanitary living conditions: dirt, bugs, soiled bedding and clothes
  • Being left dirty or unbathed
  • Unsuitable clothing for the weather
  • Unsafe living conditions (no heat or running water; faulty electrical wiring, other fire hazards)
  • Desertion of the elder at a public place

Addressing the growing concern over elder abuse

Some jurisdictions have designated resources to deal exclusively with elder abuse.

On April 17, 2009, the Ontario Network for Prevention of Elder Abuse launched a province-wide toll-free hotline for at-risk seniors (1-866-299-1011), which is part of an elder abuse strategy funded by the provincial government at a cost of nearly $900,000 a year.

On June 15, 2009 the Government of Canada launched a nation-wide elder abuse awareness campaign, including an advertising campaign dubbed Elder Abuse – It’s Time to Face the Reality. The 2008 federal budget also earmarked $13 million over three years to help seniors and others recognize the signs and symptoms of elder abuse and to provide information on available supports.

The challenges in detecting and preventing elder abuse in long-term care facilities and retirement homes are compounded by the number of people providing care, the often high ratio of residents to workers, the various cognitive and physical impairments of residents, and by the demands and expectations of family members. Enhanced non-abuse training and increased staffing levels are critical to minimizing the chances of elder abuse occurring.

The Bill of Rights for People Living in Ontario Long-Term Care Homes was published in September 2008 by the Advocacy Centre for the Elder and Community Legal Education Ontario. It outlines 19 fundamental rights for long-term care residents and most long-term care facilities post these rights so staff, residents and family members are all aware of them. Knowing these rights is especially important given the increasing number of media reports about elder abuse in institutions.

Most of the cases of elder abuse that are reported to police tend to involve fraud, the most common form of elder abuse.

“To address elder abuse, it is imperative that action take place at the community level and that resources be allocated to this. Participants delivered a unanimous message:
that without adequate and sustainable funding, efforts to combat elder abuse in local communities are compromised.”

Fast facts:

  • The greater the impairment of a senior or the more severe the illness, the more likely it is that he/she will be abused. (Source: Canadian Mental Health Association)
  • Male seniors (9%) are more likely to report financial or emotional abuse, compared to female seniors (5%). (Source: Ministry of Citizenship and Immigration)
  • A study involving 31 nursing homes reported that 36% of nursing home staff had witnessed the physical abuse of an older adult and 81% had witnessed some
    form of psychological abuse. (Source: Canadian Mental Health Association)

Risk Factors for Elder Abuse

Some of the risk factors for elder abuse apply to the abuser, others the victim. Caregiver stress, for example, is a key factor in abuse in both the home and in institutional settings. That stress is intensified if the senior has mental health issues or physical care needs the caregiver is incapable of providing. Caring for a senior with multiple needs can be overwhelming and eventually lead to depression.

Even caregivers in institutions can experience stress levels that can lead to abuse. Excessive responsibilities, poor working conditions, long hours and inadequate training can all be contributing factors.

Sometimes family caregivers are poorly informed and lack the education and support required to properly care for an elder at home.

“When it comes to neglect, we see some families who aren’t providing appropriate care for their elderly loved ones, but it’s not necessarily because there’s any ill intent; sometimes it’s because they don’t know how to care for someone who’s sick, debilitated and has Alzheimer’s.”

Other risk factors include a history of family violence. If there has been abusive behaviour within the family in the past, there’s a greater likelihood an elder will be abused at some point in the future.

There are also the personal problems and personalities of the abusers themselves. According to the Canadian Mental Health Association, abusers are more likely to have mental health problems, substance abuse issues and/or financial problems.

Signs that a caregiver may be abusing an elder may include:

  • Being aggressive, insulting or threatening behaviour
  • Speaks for the elder and doesn’t allow him/her to make decisions
  • Reluctant to leave the elder alone with a professional.

Signs that an elder may be a victim of abuse:

  • Is anxious, withdrawn, agitated, evasive, depressed or suicidal.
  • Shows fear of caregiver; behaviour changes when care giver enters/leaves room.
  • Is frail or cognitively impaired and presenting for emergency treatment alone or without regular caregiver.
  • Has low self-esteem.

Habits:

  • Sudden/unexpected change in social habits.
  • Sudden/unexpected change in residence or living arrangements.
  • Unexplained or sudden inability to pay bills, account withdrawals, changes in his will or Power of Attorney, or disappearance of possessions.
  • Refusal to spend money without consulting caregiver.
  • Claims of being “accident-prone”.
  • Missed/cancelled appointments, especially medical appointments.

Some people say, “I wonder why I’ve never come across a case of physical elder abuse, especially when you know the statistics”. I think this really speaks to the fact that elder abuse is so hidden and it reminds us how vigilant we all need to be in looking for the signs.

Health & Well-Being:

  • Sudden/unexpected decline in health or cognitive ability.
  • Poor/decline in personal hygiene; skin ulcers.
  • Dehydration or malnutrition; sudden/rapid weight loss.
  • Signs of over/under-medication.
  • Suspicious injuries: bruising in various stages of healing; on the face or eye area, the inner part of the thighs or arms, or around the wrists or ankles.
  • Sexually transmitted disease; itching, pain or bleeding in genital area; difficulty sitting or walking.
  • Explanation of injury or condition: inappropriate to type/degree; vague or bizarre; conflicting information from elder and care giver.
  • Unexplained delay in seeking treatment.
  • Denial in view of obvious injury.
  • Previous reports of similar injury.

Environment:

  • Poor living conditions in comparison to assets.
  • Inappropriate or inadequate clothing.
  • Lack of food.
  • Lack of required medical aids, functional aids, or medications.
  • Evidence of locks or restraints.
  • Living in worse conditions than others in the home.
  • Involuntary separation from others in home, friends or other family members.

Fast Facts:

“Sometimes our role becomes helping the adult children realize their parent still has the ability to make his or her own choices and that they have that right. Just because someone is 80 doesn’t mean they can’t think clearly or make decisions.”

  • 12% of Canadians have sought out information about a situation or suspected situation of elder abuse or about elder abuse in general.
    (Source: Environics poll for Human Resources and Social Development Canada.)
  • There are almost 300,000 seniors living in institutions in Canada. (Source: Statistics Canada)
  • Fewer than one in five situations of abuse actually come to the attention of any public agency, and fewer still come to the attention of a public agency operating in the criminal justice system. (Source: Canada’s Aging Population: Seizing the Opportunity, Special Senate Committee on Aging, 2009)

Taking Action: What to do if elder abuse is suspected

It’s a job for police when a crime has been committed under the Criminal Code of Canada. These offences include assault, forcible confinement, sexual assault, extortion, fraud, forgery, theft, (including theft by a person with power of attorney), uttering threats, criminal harassment, criminal negligence and failure to prove the basic necessities of life. If in doubt, people are advised to call police, who will help determine what to do next.

There are no quick fixes or simple solutions in addressing the issue of elder abuse. The challenges in raising awareness, responding to elder abuse and ultimately mitigating and eliminating it are many, but the energy, commitment and expertise already exists among those who have taken on this task across the country.

There is also a toll-free, confidential elder abuse hotline in Ontario that provides information, support and referrals to services 24 hours a day, seven days a week at 1-866-299-1011. In emergency situations dialing 911 is the best option.

Even though there are no legal requirements to report suspected elder abuse of people living in their own private residences, anyone who witnesses harm being done to an elder in a long-term care facility is required by law to report it to the Ministry of Health and Long-Term Care. This can be done by calling the toll-free Action Line at 1-866-434-0144.

“The field of prevention of abuse and neglect of older adults in Canada is lagging behind other areas of family
violence prevention. It is largely the case that multiple small-scale projects and a few noteworthy larger programs exist in a patchwork of service delivery and under- coordinated effort. It is also far from being able to use practice standards that are available for other fields.”

The Canadian Network for the Prevention of Elder Abuse suggests the following as the best steps to take for seniors who are being abused:

For seniors living in the community:

  • Tell someone what’s happening to you.
  • Ask others for help if you need it.
  • If someone is hurting or threatening you, or if it is not safe where you are, call police.
  • Find out more from community resources about your options to take care of your financial security and personal needs.
  • Call for counselling and support.
  • Make a safety plan in case you have to leave quickly and contact Optimism Place, Victim Services or the Emily Murphy Centre for help developing a plan that’s right for you.

You might also:

  • Set aside an extra set of keys, I.D., glasses, bank card, money, address book, medication, and important papers. Keep this outside of your home.
  • Find a safe place with friends and family so you have a place to go to in an emergency.
  • Consider obtaining a restraining order to protect yourself.

“We believe that when people learn about victims who’ve had the strength to come forward and reach out for help it encourages others to do the same.”

For seniors living in a nursing home or other kind of assisted living facility:

  • Tell someone what is happening to you.
  • Ask others for help if you need it. Staff members have a responsibility to see that abuse stops and that you get the help you need.
  • If someone is hurting or threatening you, or if it is not safe for you where you are, call the police.

“Most people working in Home Care Services, including those in long-term care are in the field because they choose to be. They love the elderly and are committed to their care and wellbeing.

“The elderly in our community need to know it’s okay to ask for help. Too often they’re too nervous or they don’t want to bother the police; they don’t even know if what’s happening to them is a crime. They don’t realize there are other organizations they can turn to for help – and which would put them in contact with the police if need be.”

Therapeutic Touch & Sensory Quilt

/in , , , , , , /by

“Busy Hands & Mind”

Sustain a clients natural need to keeps hands engaged and active

Sustain a clients natural need to keeps hands engaged and active

Pre-amble: Market and Economic Impact

As of 2013, there were an estimated 44.4 million people suffering with dementia worldwide. This number is expected to increase to an estimated 75.6 million by 2030, and 135.5 million by 2050. Alzheimer´s Disease will be one of the biggest burdens of the future society showing dramatic incidence rates: every 69 seconds someone in the US develops Alzheimer´s Disease, by mid-century someone will develop Alzheimer´s Disease every 33 seconds. In 2013 44 million people will be affected with the disease worldwide  In the US Alzheimer´s Disease is now the 6th leading cause of death across all ages. It was the fifth leading cause of death for those aged 65 and older. Since the incidence and prevalence of Alzheimer´s Disease increase with age, the number of patients will grow dramatically with our society getting older. By 2050 we need to expect that patient numbers have tripled to 135 million Alzheimer´s Disease patients worldwide.

The Alzheimer´s Disease market is currently estimated at $ 5 billion annually with projections that show the market potential will surpass $ 20 billion by 2020.

The global economic impact of Alzheimer´s Disease is shown by the worldwide cost of $ 640 billion, which exceeds 1% of gross world product. It can be seen as the most significant health crisis in the 21st century. 

The 2010 annual costs of treating and caring for patients worldwide was an estimated US$604 billion and in the the US alone was $183 billion. This figure is expected to increase to $ 1.1 trillion in 2015. Alzheimer´s Disease is becoming the third most expensive disease counting for 30% of the US healthcare costs. The medical costs for Alzheimer´s Disease patients are three times higher than for other older patients. There is also a big financial impact for the individuals and their families as the out-of-pocket-costs for the Alzheimer´s Disease patients are higher than for any other disease. As expenses for assisted living or nursing homes can often not be afforded, 70% of Alzheimer´s Disease patients live at home resulting in high impact of family’s health, emotional well-being as well as their employment and financial security.

Cost of Treatment
Currently there is no disease-modifying treatment for the Alzheimer´s Disease on the market. The disease usually is diagnosed late when already 70% of the nerve cells in the brain are dead. Several high-impact nutritional and supplementary treatment products are being developed and should particularly impact on prevention. Five drugs are approved and marketed which treat the symptoms. Better understanding of the underlying biology will lead to several new axes of treatment in different stages of clinical testing. The impact of a disease-modifying treatment can be huge: Delaying the onset of Alzheimer´s Disease by 5 years starting 2015 could result in a prevalence reduced by 5.9 million (43%) in 2050 in the US alone. Expressed in money, a delay of onset of 5 years would could result in savings of $ 447 billion of the total expected costs of $ 1.078 billion in the US alone.

Costs of informal care (unpaid care provided by families and others) and the direct costs
 of social care (provided by community care professionals and in residential home settings)
 contribute similar proportions (42%) of total costs worldwide, while direct medical care costs
are much lower (16%).

So how can WE help?
We cannot claim to be able to mitigate nor have a direct impact on the projected ageing population growth and relevant Dementia/Alzheimer’s statistics. However, we can offer a number of Home Care Services solutions to help families who are caring for a loved sufferingwith Dementia/Alzheimer’s? To review our full line of services, please visit our home page… under Services. For the purpose of this article we are offering a tool to help the family caregiver gain some control and management over their loved one who may be suffering with these deceases… A Therapeutic Touch and Sensory Quilt. This is not a typo… “QUILT”.

According to the College of Nursing at the University of Arkansas for Medical Sciences, Little Rock 72205 – U.S.A.

Abstract
Agitated behaviour in persons with Alzheimer’s disease (AD) presents a challenge to current interventions. Recent developments in neuro-endocrinology suggest that changes in the hypothalamic-pituitary-adrenal (HPA) axis alter the responses of persons with AD to stress. Given the deleterious effects of pharmacological interventions in this vulnerable population, it is essential to explore non-invasive treatments for their potential to decrease a hyper-responsiveness to stress and indirectly decrease detrimental cortisol levels. This within-subject, interrupted time-series study was conducted to test the efficacy of therapeutic touch on decreasing the frequency of agitated behavior and salivary and urine cortisol levels in persons with AD. Ten subjects who were 71 to 84 years old and resided in a special care unit were observed every 20 minutes for 10 hours a day, were monitored 24 hours a day for physical activity, and had samples for salivary and urine cortisol taken daily.

The study occurred in 4 phases:

    • Baseline (4 days),
    • Treatment (therapeutic touch for 5 to 7 minutes 2 times a day for 3 days),
    • Post-treatment (11 days), and
    • Post – “wash-out” (3 days).

An analysis of variance for repeated measures indicated a significant decrease in overall agitated behaviour and in 2 specific behaviours, vocalization and pacing or walking, during treatment and post-treatment. A decreasing trend over time was noted for salivary and urine cortisol. Although this study does not provide direct clinical evidence to support dysregulation in the HPA axis, it does suggest that environmental and behavioral interventions such as therapeutic touch have the potential to decrease vocalization and pacing, 2 prevalent behaviors, and may mitigate cortisol levels in persons with AD.

Alzheimer’s patients, particularly those in the more advanced stages can get quite tense and fidgety. To help relieve stress and tension in these special people, we have developed our own line of fidget quilt. As the disease worsens, hands become more restless and fidgety. These quilts offer something tangible to occupy their hands… providing gentle yet constant therapeutic stimulation for the mind and soul. Resulting in an enhanced quality of life for both the patient and the caregiver.

So how do our quilts work?
They help to stimulate curiosity, memories and awareness, provide a sense of purpose and of “doing something”, and this having a calming & soothing affect on the user.

Active Hands & Mind Quilt - Engaging, calming and soothing those clients suffering with Alzheimer's

Active Hands & Mind Quilt – Engaging, calming and soothing clients suffering with Alzheimer’s

Our quilts are more than just a “tangible repository of memories.” 
They are user-friendly, functional, induce comfort and warmth… providing a constant reminder of a family that loves them. Whether it’s the combination of textures used (softly contoured corduroy, faux fur, textured linens,,, etc) this quilt will provide the kind of tactile stimulation that will calm and soothe your loved one. It keeps their anxious hands engaged, mind occupied and their legs warm. Great for anyone, this is a must for anyone with progressive dementia or alzheimer’s.

Because people with Alzheimer’s and other dementia experience an ongoing decrease in their brain’s functions, simple, repetitive movements and sensory experiences become more important. That’s where our lap quilts come in. With their intentional variety of textures and extra accessories, fidget quilts provide comfort through the hands and the eyes. For a men’s quilt, you might want to personalize with items of a past hobby or interest (nuts, bolts, golfing or fishing items). We safely fasten the items or string them so that the patient will fidget with the items from one end of the lace to the other. Our quilts are handy & conveniently sized (24”X 30”) made from colourful patterns to entertain the eyes and with a warm backing to keep the lap warm. Attached to the quilts are buttons of various sizes to captivate the fingers and the eyes, a zipper, strips of cloth, and shoe laces, which can be tied or manipulated in a number of ways (over and over again). There’s a plush toy, shapes, a pocket with things in them, jingle bells and anything else that may be of significance to your loved one. Our quilts can be a Godsend to a caregiver while bringing significant relief to the patient… through it’s calming and soothing therapeutic affect.

We take extreme care to ensure that all items are safely secured so that they cannot become free or removed (unless cut out) to avoid any potential choking hazard. The laces, fabric strips or anything that dangles are also cut to lengths whereby they cannot be used as a means of restraining, or become a ligature capable harming your loved one.

Our quilts are easy care for and washable… of course anything that cannot be washed, is fastened so that it can be easily unclipped and reattached after washing.

The quilt will give the family a feeling of joy watching their loved one’s restless fingers occupied with all the different activities and textures that gives them that soothing and calming disposition.

They make wonderful birthday, Christmas, anniversary, or any special occasion gift, or to simply say “I Care and I love you”

We engage the family’s input when creating a custom quilt or you can opt for a generic quilt already pre-manufactured, incorporating a number of therapeutic sensory activities and items.

Our core business is providing Home Care for seniors in their homes or wherever home may be. However, we also understand that although you may not yet require our assistance, you can still benefit from something that we can offer… like our “Busy Hands & Mind Quilt”.

Our quilts are inexpensive, provide such rewarding results and delivered for free anywhere in Toronto, Mississauga, Oakville and Brampton. Outside of these areas there “MAY” be an additional charge for shipping… but we can discuss it. Of course outside of Ontario, national and international orders shipping costs are extra.

Please contact us today, to discuss the order of one of our Quilts, or to discuss any challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

You got questions, we have answers: (905) 785-2341 or email us at