Thursday, December 31, 2015

Study Demonstrates Benefits of Brain Training

Image result for old people brain training
A trial from the National Institutes of Health (NIH) showed a 10-year benefit in realms of reasoning and speed.
Ten years after completing a brain training program, a group of older people still had improved cognitive abilities, according to results of a randomized clinical trial supported by the National Institutes of Health.
The report, from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, appeared in the Journal of the American Geriatrics Society. The project was funded by the National Institute on Aging (NIA) and the National Institute of Nursing Research (NINR), components of the NIH.
“Previous data from this clinical trial demonstrated that the effects of the training lasted for five years,” said NIA Director Richard J. Hodes, M.D. “Now, these longer-term results indicate that particular types of cognitive training can provide a lasting benefit a decade later. They suggest that we should continue to pursue cognitive training as an intervention that might help maintain the mental abilities of older people so that they may remain independent and in the community.”
“ACTIVE is an important example of intervention research aimed at enabling older people to maintain their cognitive abilities as they age,” said NINR Director Patricia Grady, Ph.D. “The average age of the individuals who have been followed over the last 10 years is now 82. Given our nation’s aging population, this type of research is an increasingly high priority.”
The investigators were also interested in whether the training had an effect on the participants’ abilities to undertake some everyday and complex tasks of daily living. They assessed these using standardized measures of time and efficiency in performing daily activities, as well as asking the participants to report on their ability to carry out everyday tasks ranging from preparing meals, housework, finances, health care, using the telephone, shopping, travel and needing assistance in dressing, personal hygiene and bathing.
At the end of the trial, all groups showed declines from their baseline tests in memory, reasoning and speed of processing. However, the participants who had training in reasoning and speed of processing experienced less decline than those in the control groups. Results of the cognitive tests after 10 years show that 73.6 percent of reasoning-trained participants were still performing reasoning tasks above their pre-trial baseline level compared to 61.7 percent of control participants. This same pattern was seen in speed training: 70.7 percent of speed-trained participants were performing at or above their baseline level compared to 48.8 percent of controls. However, the researchers said memory training did not have an effect after 10 years.
“The speed-of-processing results are very encouraging,” said Jonathan W. King, Ph.D., program director for cognitive aging in the Division of Behavioral and Social Research at NIA and co-author. “The self-reported improvements in daily function are interesting, but we do not yet know whether they would truly allow older people to live independently longer; if they did, even a small effect would be important, not only for the older adults, but also for family members and others providing care.”
Source: The National Institute on Aging (NIA). The NIA leads the federal government effort conducting and supporting research on aging and the health and well-being of older people. The Institute’s broad scientific program seeks to understand the nature of aging and to extend the healthy, active years of life. For more information on research, aging, and health, go The study was published here.

Monday, December 21, 2015

Top Ten Healthy Aging Resolutions for 2016

Seniors, people who provide care for seniors, and people who are looking ahead to their own senior years will want to add a few of these great ideas to their list of resolutions.
The New Year is the traditional time when many of us are motivated to make positive changes in our lives. Why not add a few resolutions that can impact your health and well-being through the New Year and beyond? During 2015, research institutions from around the world released new studies shedding light on factors that encourage optimum aging. Take advantage of this information as you make your list, and share these ideas with senior loved ones.
Resolution #1: Increase physical activity in your daily routine. Study after study demonstrates the vital role that exercise plays in keeping us well and independent as we grow older. No matter what a senior’s health status, there is some form of exercise almost everyone can do. Talk to your healthcare provider about an exercise program that is right for you.
Resolution #2: Read food labels. Look for “heart smart” foods that are rich in nutrients and fiber. Avoid foods with added sweeteners and trans fat. Look for foods labeled “low sodium” or “reduced sodium.” Talk to your doctor about a diet that is right for you.
Resolution #3: Give your brain a workout by learning a new skill. Did you know that today’s imaging technologies allow neurologists to observe the effects of mental stimulation in our brains? Experts tell us that activities that stimulate the brain in a new way are especially effective. Take a language class, try a new instrument, or improve your computer skills. It’s never too late to learn.
Resolution #4: Discover a great new walking path. Walking is one of the best forms of exercise, but we can lose motivation and become bored with our same old routine. Check out local parks, neighborhoods, even shopping malls when the weather is bad. And invest in a pair of good quality walking shoes.
Resolution #5: Ask your doctor about the shingles vaccine. The Centers for Disease Control and Prevention (CDC) recommends that people aged 60 years and older get this one-dose shot, which can help seniors avoid this often painful, sometimes debilitating condition. While you’re at it, ask your doctor to be sure your other immunizations are up to date.
Resolution #6: Plant a vegetable garden. What a nice way to get some exercise and add nutritious veggies to your menu! Spring isn’t far away, so start planning your garden. If you don’t have a yard or if kneeling to the ground is challenging for you, a container garden or pots of windowsill herbs can also yield a nutrient-rich “crop.” Or, check out local farmers markets for fresh, locally grown produce…and perhaps a flower bouquet for a mood boost?
Resolution #7: Watch a funny movie. Studies confirm that laughter is good for the heart and immune system, relieves depression, and is a great social “icebreaker.” Your public library probably has a good collection of comedy films that you can borrow at no cost—or check out the latest offerings on YouTube.
Resolution #8: Take a fall prevention tour of your home. Look for situations and conditions that could be hazardous as you move from place to place. Removing clutter and fixing unsafe conditions helps older adults avoid falls and live more confidently. Improve lighting indoors and out, and add grab bars and other modifications that make the home safer for everyone.
Resolution #9: Ask your doctor to review your medications. During your next appointment, arrange in advance to bring in a list of all drugs you take, both prescription and over-the-counter. (Some healthcare providers suggest bringing along the containers.) Ask about side effects, possible interactions, and whether switching to a generic might save you money.
Resolution #10: Spend more time with other people. This year, several more studies confirmed the damaging effects of loneliness, for both our bodies and our minds. Good relationships are one of the top ways to stay active and achieve emotional well-being. Companionship has even been shown to strengthen our immune system, and offers a host of other benefits.
No matter what your age and health condition, taking positive steps to follow healthy aging guidelines can pay off and help you have a happier 2016!

Monday, December 14, 2015

Use Space Heaters Safely

The Burn Center at Loyola University Medical Center is warning the public about the dangers of space heaters.
Whenever bitter cold, ice and snow arrive, hospitals see more burn injuries caused by improper use of heating devices, said Michael Mosier, MD. Mosier is a burn surgeon at the Loyola Burn Center, which treats nearly 700 patients annually in the hospital and another 3,500 patients each year in its clinic.
The Consumer Product Safety Commission (CPSC) estimates that more than 25,000 residential fires and more than 300 deaths are caused each year by space heaters. More than 6,000 Americans receive hospital emergency room care annually for burn injuries associated with room heaters.
Some tips from Loyola and the U.S. Department of Energy for space heater safety include:
  • Keep space heaters at least three feet away from furniture or other combustible material, such as curtains and bedding. Don’t place heaters on carpets or rugs.
  • Locate space heaters on a hard, level surface where a child or family pet cannot brush up against them.
  • Never leave a space heater on when an adult is not present in the room.
  • Never keep flammable liquids near a space heater.
  • Mobile homes should use only vented fuel-fired heaters or electric heaters.
Electric space heaters are the safest space heaters for the home. Plug electric space heaters directly into a wall outlet and use a heavy-duty cord of 14-gauge wire or larger if an extension cord is needed. Buy a unit with a tip-over safety switch to shut off the heating element if the unit topples over.
Use unvented combustion heaters only outside your home, because they can introduce harmful products such as carbon monoxide and nitrogen oxide into your breathing area. With these combustion heaters, remember to never fill a heater that is hot and make sure there is a guard around the heating element or flame area.
Source: Loyola University Health System (, which includes over 30 primary and specialty care facilities throughout the Chicago area. Loyola Burn Center consists of a multidisciplinary team, which includes resuscitation, pulmonary support, wound management, nutritional support and rehabilitation personnel, and was awarded verification by the American College of Surgeons (ACS) and the American Burn Association (ABA). This recognition is only granted to those programs that have met and exceeded the ACS and ABA standards and review.

Friday, December 11, 2015

Resolve to Have a Better Attitude About Aging

Those of us in the field of aging have seen a big change in the ways we think and talk about growing older. There’s been a movement toward empowerment, toward helping everyone remain as independent, active and engaged as possible, even as they face physical and intellectual challenges. With our increased longevity, this is so important to individuals, families and our society as a whole.
But, says a new report released by the American Geriatrics Society, general public opinion has not kept up with this evolution. And this can be a barrier in the way of improved supports and solutions for promoting good quality of life for seniors.
The report was created by Leaders of Aging Organizations (LAO), a collaborative of aging expert groups. Titled “Gauging Aging: Mapping the Gaps between Expert and Public Understanding of Aging in America,” the report is intended “to reclaim the social narrative on what aging really means by building better perceptual connections between health care experts, advocates, and the thousands of Americans who turn 65 every day.”
The report showed that while improved healthcare and support services have improved the lives of seniors today, allowing them to be productive and independent longer, negative attitudes about aging persist. The report identified several areas of misperception, where the public believes that aging is…
  • Someone else’s problem. Instead of perceiving aging as an inherent aspect of development, people tend to focus on “the aged” as an “otherized” group to which they do not belong.
  • Undesirable. The public associates aging with decline and deterioration. A large percentage of interviewed individuals emphasized their belief that capability “faded away” with time.
  • Inevitable. For most, this “fading away” also is tied to a strong sense of inevitability—a resignation to “slowing or breaking down” as a central aspect of growing old.
  • Isolated. A majority of the public perceives old age not only as an outside obstacle or opponent, but also as a personal or familial problem and not a challenge that society shares.
  • Fatalistic. Intimately tied to these perceptions are fears of decline, depression, and dependence. Such fears not only imbue the aging process with dread, but also impede support for policies and solutions that actually address the challenges (and opportunities) associated with age.
  • Out of sight and out of mind. Fear and misperception ultimately fuel a lack of attention to older adult health. But keeping aging “off the radar” does little to remedy impediments to health as we grow older.
“Aging is something we all experience. It isn’t a barrier or a battle, but it is a characteristic of who we are—and who we are becoming—and it needs to be reflected in public thinking, public policy, and public discourse,” said Eric Lindland, PhD, a senior researcher with the nonprofit FrameWorks Institute and a lead author of the report. “Not surprisingly, that type of change begins with the public—or more specifically, with our ability to convey a truer vision for what aging in America really means for us all.”
Source: IlluminAge AgeWise reporting on news release from the American Geriatrics Association. Read the full “Gauging Aging: Mapping the Gaps between Expert and Public Understanding of Aging in America” report here.

Monday, December 7, 2015

Low Vitamin D May Hasten Dementia

Vitamin D, sometimes called “the sunshine vitamin,” is necessary for building strong bones, and lowers the risk of high blood pressure, certain cancers and problems with the immune system. Studies have shown that consuming adequate vitamin D lowers the risk of falls, improves mobility and even leads to a longer life.
This year, researchers from University of California Davis Alzheimer’s Disease Center and Rutgers School of Environmental and Biological Sciences revealed that vitamin D also appears to help slow the development of memory and thinking problems.
Over the course of eight years, the researchers tested the levels of vitamin D in a diverse group of older adults, and also tracked their cognitive abilities. Researcher Charles DeCarli of the UC Alzheimer’s Disease Center reports, “We expected to see declines in individuals with low vitamin D status. What was unexpected was how profoundly and rapidly [low vitamin D] impacts cognition.”
Indeed, the researchers found that people who were deficient in vitamin D showed cognitive declines two to three times faster than those with adequate vitamin D! Professor Joshua Miller says, “Independent of race or ethnicity, baseline cognitive abilities and a host of other risk factors, vitamin D insufficiency was associated with significantly faster declines in both episodic memory and executive function performance.”
We can get a certain amount of vitamin D from the foods we eat. Egg yolks, fatty fish and mushrooms are some of the naturally occurring sources, and other foods may also be fortified with vitamin D, such as milk, cheese, juice and cereal. We also soak in vitamin D from sun exposure. But during the cooler months of the year, the latter is a challenge for most of us. Even in the summer, most of us limit our sun exposure to avoid raising the risk of skin cancer, so supplements may be recommended.
The researchers note that elderly African Americans and Hispanics are at particularly high risk of vitamin D deficiency. People with more pigment in their skin absorb less of the nutrient from the sun. African American and Hispanic seniors also on average consume fewer dairy products, the other main source of vitamin D.
Miller, who was a professor with the UC Davis Department of Pathology and Laboratory Medicine at the time that the research was conducted, and now serves as professor and chair of the Department of Nutritional Sciences at Rutgers University, says that the results of this study should encourage people in their 60s and older to discuss taking a daily vitamin D supplement with their healthcare provider. Vitamin D is stored in the body’s fat, so taking too much can allow dangerous levels to build up, making it important to discuss our vitamin D intake with our healthcare provider.
DeCarli says, “This is a vitamin deficiency that could easily be treated and that has other health consequences. We need to start talking about it. And we need to start talking about it, particularly for people of color, for whom vitamin D deficiency appears to present an even greater risk.”
Source: AgeWise reporting on news releases from University of California Davis Alzheimer’s Disease Center and Rutgers School of Environmental and Biological Sciences

Thursday, December 3, 2015

Practical Holiday Gifts to Keep Senior Loved Ones Safe

Santa is making his list and checking it twice. This holiday season, make your own list—of emergency preparation plans, that is! Are you shopping for your older parents, grandparents or other senior loved ones? It can be hard to think of the perfect gift for older adults. A tie, a fruitcake, cologne, a gadget that he or she is unlikely to use…?
Here’s an idea for a thoughtful holiday gift: give the gift of preparedness! Year after year, news coverage of natural disasters and other emergencies raises awareness that older adults are hardest hit by the effects of storms, tornadoes, earthquakes and other disasters. For example: almost three-fourths of the people who died as the result of Hurricane Katrina were over 60. When Hurricane Sandy hit the east coast, about half of the victims were seniors. Older adults in Japan are still feeling the effects of the 2011 tsunami. And heat waves claim the lives of seniors every year.
Seniors with physical limitations may be stranded in their homes, unable to evacuate, cut off from the services upon which they rely. Older adults who use oxygen, power wheelchairs, dialysis and other medical equipment face real danger in power outages.
It may not seem very festive to focus on this reality during the holidays—but this is a great time for the whole family to show their love and caring for senior relatives by taking practical steps to ensure their safety.
Recently, the Federal Emergency Management Agency (FEMA) compiled a list of holiday gift ideas that can help loved ones be prepared.
“Disasters can happen anytime, anywhere, and the holiday season provides a great opportunity to ensure that you and your loved ones are taking simple steps to be prepared,” said FEMA Administrator Craig Fugate. “As families gather this holiday season, I encourage everyone to take a few minutes and discuss what you would do in case of an emergency or disaster. The public is the most important member of our nation’s emergency response team and the more the public does to be prepared, the more successful this team will be.”
Fugate reminds us that the most important gift is the gift of time. During holiday visits, discuss with your loved one what they would do in case of an emergency or disaster. Find out the location of the nearest emergency shelter. If your loved one has medical challenges, uses dialysis, oxygen, or an electric wheelchair, find out which shelter is designated for people with special needs. Arrange for someone to help if your loved one needs to evacuate, and someone to check in if your loved one is advised to shelter in place. Create a family communications plan so everyone knows how they would get in touch if they were separated when an emergency takes place.
Once the planning stage is over, you still probably want to wrap up a pretty package for that Christmas, Kwanzaa or Hanukkah gathering, right? What about emergency preparedness supplies that are practical and show your concern for your loved one’s well-being? FEMA suggests these gifts that could assist in disasters:
  • A home disaster kit, including first aid supplies, food, water, blankets, flashlight and some extra clothing
  • NOAA weather radio with extra batteries
  • Enrollment in a CPR or first aid class
  • Smoke detectors
  • Fire extinguishers (for kitchen, garage, car, etc.)
  • Foldable ladders for second-story escape from a fire
  • Car kits (emergency flares, shovel, ice scraper, flashlight and fluorescent distress flags)
  • Pet disaster kit (food, water, leash, dish, carrying case or crate)
  • Battery powered lamps
For more information and preparedness tips, visit, where you will find special information for older adults (
Love and caring are the real spirit of the holidays. And knowing your loved one is that much safer brings increased peace of mind to everyone—a welcome gift indeed!
Source: IlluminAge AgeWise with information from the Federal Emergency Management Agency (FEMA).

Monday, November 30, 2015

“Sharing Holiday Cheer With Seniors” Word Find

The holidays are a time when many of us would like to do something for others. As you’re thinking of ways to make the season more meaningful, consider if you know of any older adults who could use help from you in order to take part in traditional holiday events. Mobility, sensory and cognitive challenges can stand in the way of participation in beloved spiritual and social opportunities. You can make all the difference! If none of your older family members or friends needs help, check with your local senior center, nursing home or senior services agency—volunteers are always needed this time of year.
To get you into the holiday helping spirit, try your hand at this month’s word find puzzle. Click here to download the puzzle.

Need a little help? Click here for the solution.
Source: IlluminAgeAgeWise, © IlluminAge 2015

Tuesday, November 24, 2015

Celebrating the Holidays When a Loved One Has Alzheimer’s Disease

The bright lights and big crowds make the holidays fun and exciting for many of us. But the season can present special challenges if you are a family caregiver of someone with Alzheimer’s or other form of cognitive impairment. A little planning can make the season less stressful for everyone in this situation. Geriatrics physician Dr. Cindy Carlsson, an Alzheimer’s disease researcher at the University of Wisconsin School of Medicine and Public Health, explained that Alzheimer’s patients may feel a sense of loss during the holidays, while caregivers can become frantic trying to keep up with holiday traditions and caring for their loved ones at the same time.
Carlsson shared advice for making the holidays more enjoyable for everyone. Here are four easy suggestions as you plan this year’s holiday time with your friend or loved one:
Follow a routine. Sticking to a routine can reduce the stress on the person with dementia, as well as his or her caregiver and family. “Holidays are anything but routine, yet a routine is the best way to be kind to the patient,” Carlsson said. “Make sure the day is as normal as possible by providing meals at the same time they usually are.”
Help your loved one remember. People with Alzheimer’s can become frustrated when someone tries to challenge their memories with questions like, “Do you remember me?” and “Do you remember what we did last summer?” Advised Carlsson, “Regardless of how close you are to the person, introduce yourself. You could also update them on your activities so that they don’t have to ask questions.” Carlsson said reminiscent therapy can be effective. She suggests going through old family photos with your loved one. In addition, you might even ask guests to wear name tags.
Involve your loved one in activities. “We recommend that you involve an Alzheimer’s patient with straightforward activities like wrapping gifts, folding napkins or simple crafts,” said Carlsson. Activities can provide mental and physical stimulation.
Take care of the caregiver. The best gift for a caregiver can be the gift of time and respite. The typical stress of caring for a person with Alzheimer’s can become even more overwhelming during the holidays. Carlsson said you can help a caregiver by offering to give them some time off. Families can prepare a plan to share the caregiving. For caregivers who will be hosting the holiday get-together, Carlsson suggests smaller gatherings or even a potluck.
Source: University of Wisconsin School of Medicine and Public Health, adapted by IlluminAge AgeWise.

Thursday, November 19, 2015

How Seniors Can Beat the Holiday Blues

[Medford, NJ] – [November 19, 2015] – With silver bells, bright lights and the anticipation of brighter days ahead, it’s sometimes hard to realize that the holidays, for many, bring on feelings of sadness and even depression.
“Feelings of loneliness among people who have lost a loved one, or those who are coping with a chronic health condition are just a couple of the reasons seniors are at a higher risk for depression,” says Brett Summerville of APFC Home Care. “Unfortunately, the holidays can often exacerbate these feelings because the loss is felt more acutely during a time of year when everyone else seems so happy.”
To help combat holiday depression, APFC Home Care is offering these tips for seniors and anyone feeling depressed.
  • Adjust your expectations
    Recognize that this holiday doesn’t have to be like ones in the past. Honor those traditions you can and be open to creating new ones. For example, if you can’t be with your loved ones in person, find new ways to celebrate together, such as Skyping, sending videos and emailing.
  • Acknowledge your feelings
    If you’ve recently lost a spouse or other loved one, recognize that feelings of sadness and grief are normal and appropriate. Don’t force yourself to be happy simply because you think it’s expected.
  • Reach out to someone
    If you’re feeling isolated and lonely, seek out friends and family. If they aren’t available, find out what community, religious or other social events are happening where you live. Volunteering is an excellent way to meet new people and lift your spirits.
  • Take care of yourself
    Don’t abandon exercise routines, eating well, a good night’s sleep, and finding time for friends and family. Maintain your healthy habits. This will help stave off depression.
“By making some adjustments and seeking help if you need it, the holidays can still be a time of renewal and joy,” says Summerville. “That is our hope for all of us this season.”

Friday, November 13, 2015

Infections Raise the Risk of Senior Falls

As we grow older, we are at higher risk of falling. Millions of seniors are hospitalized each year as a result of falling, often suffering a hip fracture, head injury or other serious injury. In fact, falls are a leading cause of accidental death among older adults. Many seniors and family caregivers take steps to reduce the risk of falling. But they may be unaware that common infections may be the true underlying cause for some of these falls.
At the recent annual meeting of the Infectious Diseases Society of America, researchers from Massachusetts General Hospital reported that urinary, respiratory and bloodstream infections can cause low blood pressure, dizziness and confusion that make it more likely that a senior will fall.
Said researcher Dr. Farrin A. Manian, “Over the years I’ve been struck by the fact that some of the more serious infections I treated were in people who came to the hospital because they fell.” Dr. Manian says that these patients often had no other noticeable symptoms of the infection, such as fever or abnormal white blood cell count. The fall itself was the first sign that something was amiss. Reports Dr. Manian, “Even though many of the patients had vague early signs of an infection, such as weakness or lethargy, it was the fall that brought them in.”
Dr. Manian suggests that family caregivers and healthcare providers should consider infection as a possible cause of any falls a senior experiences, and seek a diagnosis.
Not all falls are the result of infection, of course. Here is a quick overview of some of the other fall factors—and what seniors and families can do to reduce the risk:
Environmental causes—Throw rugs, electrical cords, wet and slippery floors, rough floor surfaces, slick walkways and steps, and poor lighting are all examples of things or conditions that can trip us up. Inspect your home for things that could trip you up, and remove hazards. While you’re at it, add safety improvements such as grab bars in the bath or shower, a second handrail on stairs, and improved lighting throughout the house.
Physical and mental changes—Most seniors, sooner or later, will experience problems with their eyesight, sense of balance, mobility, bone structure, and reflexes. Confusion, forgetfulness, stroke, Parkinson’s disease, and Alzheimer’s disease are also important risk factors. Ask the doctor about a fall prevention exercise class. Keep your eyeglass prescription up to date. If you’re experiencing dizziness or balance problems, get that checked out.  If the doctor recommends additional testing, take their advice.
Medications—Most seniors take a variety of medications, both over-the-counter and prescription. These medications help us manage health conditions that raise the risk of falls—yet, ironically, many medications can cause dizziness, drowsiness, or other side effects that make it harder to keep one’s balance. At your next appointment, ask your doctor to review all your medications, and report any side effects that you’re experiencing.
Things we don’t expect—Often, a contributing cause in a fall is the circumstance we do not expect and have not prepared for. We lean against a door, thinking it is closed. We walk down a poorly lighted walkway, not prepared for the small pile of weeds and clippings someone has left there. Be aware of your surroundings. Don’t be tripped up by something you didn’t anticipate. Plan your motions a little more ahead than you used to. Give yourself time to react to your physical surroundings and the other people around you. Pay special attention any time you are in new or unfamiliar surroundings. Don’t let the fear of falling cause you to be less active—but be alert.
Source: IlluminAge AgeWise, with information from the Infectious Diseases Society of America

Monday, November 9, 2015

When Elderly Parents Resist Help

As Americans get ready to visit family and friends over the upcoming holidays, a survey reveals experts’ top tips for overcoming a common and difficult family problem—aging parents resisting the help they need. Experts surveyed by the Aging Life Care Association (ALCA) say that emphasizing to aging parents that receiving assistance can help them maintain self-sufficiency and continue living independently is the best strategy.
This release came on the heels of related findings from ALCA (formerly the National Association of Professional Geriatric Care Managers), finding that 80% of care managers reported regularly encountering cases where seniors are resisting needed help or declining assistance from their children or loved ones. ALCA also reported that the three types of help aging life care professionals most often find seniors resisting or declining are: decisions about whether to continue driving (cited by 67% of those surveyed), getting needed home health care (62%), and assistance with household chores like cooking, shopping and cleaning (60%).
Here are the top six tips for overcoming aging parents’ resistance to help, offered by aging life care professionals from around the country:
  1. Emphasize that receiving help can help aging parents maintain their self-sufficiency and allow them to continue to live independently.
  2. Acknowledge their fears/concerns and talk about what might ease their mind.
  3. Be sure to start slow with caregiving, even if you know they need many more hours of help. Prepare the caregiver with your parent’s likes and dislikes and prepare them for possible resistance.
  4. Tell your parents that nothing is written in stone, and that the help they will get is “a trial period.”
  5. Figure out which family member(s) should have the conversation with your parent. Which ones are they most likely to listen to on a matter like this?
  6. If a parent has dementia, it is best to consult with a professional care manager on strategies that might work.
“Getting help is often key to allowing aging loved ones to keep their independence and remain in their own homes,” said ALCA Past-President Emily Saltz. “Acknowledging your parents’ fears and emphasizing that help can keep them independent are good steps to overcome resistance to needed help.”
Source: The Aging Life Care Association (ALCA), formerly known as the National Association of Professional Geriatric Care Managers, was formed in 1985 to advance dignified care for older adults and their families in the United States. Aging Life Care Professionals have extensive training and experience working with older adults, people with disabilities, and families who need assistance with caregiving issues. They assist families in the search for a suitable nursing home placement or extended care if the need occurs. The practice of Aging Life Care and the role of care providers have captured a national spotlight, as generations of Baby Boomers age in the United States and abroad. For more information or to access a nationwide directory of Aging Life Care Professionals, please visit

Friday, November 6, 2015

“We Love Family Caregivers” Wordfind

November is National Family Caregivers Month
This is a great time to express our appreciation to friends and family who provide care for loved ones who are living with chronic illness and disabilities.
This month’s puzzle contains the names of 16 things we can offer the caregivers we know. Click here to print the puzzle.
Need a little help? Click here for the solution.
Practical Ways to Help
Telling our caregiver friends how much we respect what they do is only the beginning. They could also use our help! On top of the wish list for most caregivers is time! Could you offer a few hours, maybe even a few hours a week, to stay with their loved one to allow the caregiver some respite time? How about help with cooking, cleaning, yard work? Could you provide transportation so their loved one can go on outings? What about advocacy? Tell everyone you know—and your lawmakers—about the importance of services that support family caregivers as they provide the quality care that is worth upwards of $450 billion per year to our long-term care system.
The best way to find out what a caregiver needs? Ask!

Tuesday, November 3, 2015

Foot and Ankle Surgeons Warn of Diabetic Foot Condition That’s Often Misdiagnosed

For nearly 30 million Americans with diabetes, there is a debilitating and often preventable foot condition that is underdiagnosed and undertreated. A lack of awareness of Charcot foot (pronounced shar-koh) means that many patients undergo painful surgeries, and even amputations, to correct what can be a highly treatable condition.
Charcot foot is the result of peripheral neuropathy, a condition that results in the loss of feeling in the lower extremities, including the feet. An estimated one third of all diabetic patients develop peripheral neuropathy. This lack of feeling can lead to increased blood flow along with nerve problems in the feet, which can result in development of Charcot foot. Without proper care, Charcot foot can lead to permanent deformity, disability and even result in amputation of the leg and foot.
According to the American College of Foot and Ankle Surgeons (ACFAS), Charcot foot is highly treatable when caught early. Doctors and patients agree that early detection is the key. Unfortunately, the condition is often misdiagnosed because its symptoms can be attributed to other problems.
Annita Shaw, a retired school teacher and diabetic, knows this all too well.  Shaw visited the emergency room three times for foot pain over several years, before finding a foot and ankle surgeon who ultimately diagnosed her with Charcot foot.
“Several physicians suggested my foot pain was due to arthritis or that my shoes were too tight. No one x-rayed my feet. Finally I found a physician specializing in foot and ankle care, who determined that Charcot was the cause of my ongoing foot problems,” says Shaw.
In the early stages of Charcot foot, bones of the foot become weak and may fracture. With continued walking, the foot changes shape and, as the disorder progresses, joints collapse and the foot takes on an abnormal shape. Because they cannot feel pain, many people do not realize they have Charcot foot until this late stage, when severe complications have occurred.
“People think they don’t have a problem because they feel no pain, but that isn’t the case,” says Valerie L. Schade, DPM, FACFAS, FACFAOM, a foot and ankle surgeon in Tacoma, Washington and a Fellow Member of ACFAS, who now treats Shaw. “Anyone at risk for neuropathy, including diabetics, alcoholics and some chemotherapy patients, should see a foot and ankle surgeon early and at least once every year, even if they are considered low risk.”
ACFAS surgeons know that monitoring for changes in the foot is the single most important factor in prevention. Dr. Schade continues, “Anyone who notices a difference—discomfort, unexplained swelling or redness, or changes to the shape of the foot—should seek care right away.”
As for Shaw, who was able to avoid amputation, she now spends much of her time advocating for greater awareness of Charcot foot, informing and educating at-risk patients and the general public. “If I can save even one person from the pain of surgery or amputation by raising awareness of Charcot foot, I’ll have done my job,” Shaw continues. “People spend so much time and money worrying about aging and maintaining beauty, when really they should spend time caring and worrying about their feet!”
For more information on Charcot or other foot and ankle health information, visit the American College of Foot and Ankle Surgeons’ patient education website at
Source: The American College of Foot and Ankle Surgeons, a professional society of over 7,000 foot and ankle surgeons. Founded in 1942, the College’s mission is to promote research and provide continuing education for the foot and ankle surgical specialty, and to educate the general public on foot health and conditions of the foot and ankle through its patient education website

Saturday, October 31, 2015

When a Loved One with Dementia Loses Their Spouse

Americans are increasingly challenged by the need to communicate difficult information to aging family members with dementia. According to the National Institutes of Health, as many as 5 million of the 43 million Americans age 65 and older may have Alzheimer’s disease, and another 1.8 million people have some other form of dementia. According to the Alzheimer’s Association, the number of Americans with Alzheimer’s disease and other dementias will escalate rapidly in coming years as baby boomers age. In the absence of medical breakthroughs to stop or slow the disease, by 2050, the number of people age 65 and older with Alzheimer’s disease may more than triple, from 5 million to as many as 16 million.
The Aging Life Care Association (ALCA) released the results of a 2014 survey to help American families who face one of the most difficult of these challenges. ALCA (formerly known as the National Association of Professional Geriatric Care Managers) polled 288 professional aging life care professionals, also known as geriatric care managers, from across the country, asking them to identify the most effective strategies for helping a loved one with dementia cope with the loss of their spouse. The top six strategies identified by the aging experts are:
  1. Remember there are many different stages of dementia. Your loved one’s capacity for understanding, coping and grieving can be very different depending on their stage of dementia. (Identified by 96% of survey respondents)
  2. If your loved one’s response to reminiscing about their spouse is positive, share old photos and memories. (88%)
  3. Make sure the surviving spouse is not socially isolated. Schedule visitors on a regular basis and help them keep up with any normal social routines they have. (85%)
  4. Reassure them there are people who care about them and will care for them. (84%)
  5. Don’t rush big changes. It may make sense for them at some point to move to a facility, or closer to family. But, if possible, give them time to adapt so there aren’t too many major life changes at once. (81%)
  6. If they choose to be included in mourning rituals for their spouse, make sure there is someone overseeing this so if the situation becomes too stressful they can leave. (78%)
“With the rising rates of Alzheimer’s disease and dementia, families are increasingly confronted with this difficult challenge,” said ALCA past-president Emily Saltz. “Our survey shows that knowing your loved one’s stage of dementia and respecting individual differences are key.”
Many of the aging life care professionals surveyed expressed strong views about the need for tailoring your response to the individual, both in terms of their stage of dementia and their personality. Some individual comments included:
  • “As each person is unique, each person with dementia is unique. Recognize your loved one’s values, personality and culture.”
  • “There are varying types of dementia, some affecting short-term memory more than others and each type has a different appropriate response.”
Other aging life care professionals surveyed by ALCA shared additional tips, including:
  • “Do not underestimate their ability to understand, at an emotional level, what they cannot express verbally.”
  • “Take cues from the affected person. If they are not aware or focused on the loss, do not remind or instigate a conversation about the loss.”
Source: The Aging Life Care Association (ALCA), formerly known as the National Association of Professional Geriatric Care Managers, was formed in 1985 to advance dignified care for older adults and their families in the United States. Aging Life Care Professionals have extensive training and experience working with older adults, people with disabilities, and families who need assistance with caregiving issues. They assist families in the search for a suitable nursing home placement or extended care if the need occurs. The practice of Aging Life Care and the role of care providers have captured a national spotlight, as generations of Baby Boomers age in the United States and abroad. For more information or to access a nationwide directory of Aging Life Care Professionals, please

Sunday, October 25, 2015

Protecting Our Bones Throughout Life

Osteoporosis is a painful, often debilitating, disease that causes the bones to become weak and puts us at higher risk of fractures as we grow older. Nutrition plays a big role in bone health, but the sad irony is, once we realize our bones have become brittle and porous, we’ve already passed our optimum years for building bone density.
For this year’s World Osteoporosis Day, held on October 20, experts from the International Osteoporosis Foundation (IOF) released a report that emphasizes the importance of lifelong, age-appropriate nutritional emphasis, from before birth through old age.
Published in the journal Osteoporosis International, the study summarized the latest findings on the bone-protecting nutritional needs of mothers, children, adolescents, adults and seniors. With an emphasis on calcium, vitamin D and protein, the study showed that the goal in childhood and adolescence is to build the best bone mass we can, given our genes. In adulthood, the goal is to avoid premature bone loss. And for seniors, preventing and treating osteoporosis is the focus.
“This new report shows just how important nutrition is for our bone health throughout life,” said Professor Cyrus Cooper, chair of the IOF Committee of Scientific Advisors. “In fact, nutrition plays a key role in the development of a healthy skeleton even before birth. Healthy maternal diets as well as adequate vitamin D levels are associated with greater bone mass in the offspring.”
The study authors reported that many children fail to get enough calcium and vitamin D. Adults, too, may be deficient, and many make lifestyle choices that lead to lower bone density, such as smoking, drinking too much, and being too overweight or underweight. Seniors in particular may be suffering from malnutrition.
We can expect to see more osteoporosis in the near future. Said Professor Bess Dawson Hughes of Tufts University’s Human Nutrition Research Center on Aging, “The baby boomer generation is aging and, as a result, age-related musculoskeletal diseases are imposing an increasingly costly burden on society and healthcare systems worldwide. This report shows how we can tap the potential of healthy nutrition within a systematic life-course approach to support osteoporosis and fracture prevention.”
The study authors say that improving the diet of seniors, along with exercise and in some cases medication, can reduce the risk of debilitating falls and fractures. They have created a free consumer booklet based on the study findings,  Healthy Nutrition, Healthy Bones, which covers the various life stages and ways older adults can avoid falls and fractures. The booklet is available in nine languages, which you can find here.
Source: IlluminAge AgeWise reporting on materials from the International Osteoporosis Foundation.

Monday, October 19, 2015

Choosing a Long-Term Care Facility

An Informed Decision
Are you considering a move to a long-term care facility for yourself, or for your spouse, parent, other family member or friend? If so, you will feel more confident in your choice if you know about your options and what you and your family can expect after the move.
Whether you are considering just one long-term care facility, or are trying to choose from among several facilities, your decision should be an informed one. This means understanding what level of care is needed in your particular situation and making sure the facility you are considering is a good fit.
You might start by using the Nursing Home Compare tool on the website. A geriatric/aging life care manager, hospital discharge planner or social worker can also help with the decision. But nothing takes the place of an in-person visit. Taking the time to visit, observe, and ask questions not only lets you make the best selection, but also prepares you and your family to take full advantage of everything the care facility you select has to offer.
Level of Care
The level or levels of care a facility offers is the first thing to ask about. A person about to be discharged from a hospital and admitted to a nursing facility for a short period of recovery before returning home has one set of medical, therapy, and social needs. A frail or chronically ill person who requires ongoing, around-the-clock nursing and personal care has another set of needs. Someone with severe dementia has yet another. Ask whether the facility you’re looking into offers the level of care appropriate for the situation of you or your loved one.
Paying for Care
Another thing to check on is cost and who will pay. The rates facilities charge their residents vary, and it may be important for you to know which services are covered in a basic daily or monthly rate, and which ones have to be paid for as extras.
Not all facilities participate in Medicare and Medicaid. So, if one of these programs covers you or the person you are helping, it is important to verify that the facility you have in mind is certified to receive that type of payment.
Similarly, a growing number of managed care plans, like HMOs, have payment contracts with particular long-term care facilities. It is worth asking about this, as well. If you have long-term care insurance, check your policy’s payment provisions to see what is covered.
Things to Watch For
Visiting a facility you are considering is always a good idea. While you’re there, these are some of the important things to look for:
Do the residents appear comfortable and well cared for? Are they appropriately dressed and well groomed?
Do the facility’s employees seem knowledgeable and well organized in the tasks they are performing? Are they courteous and attentive to the residents (for example, knowing and using a resident’s name, and knocking before entering a resident’s room)? Are they wearing name tags? Are they groomed appropriately? Do they seem happy and engaged in what they are doing?
Resident Rooms
Are the residents’ rooms clean and comfortable? Do lighting, ventilation, and space seem adequate? Are the bathrooms equipped with non-skid surfaces and grab bars? If rooms are shared by two or more people, is privacy respected as much as possible?
What is the dining room like as a meal is being served? Do things seem calm and organized? Is the food appealing? Is it served hot?
Social Activities
Does the facility offer a variety of activities and outings? Does it keep residents informed and personally active as much as possible? Are calendars, posters, and photographs displayed?
Building and Grounds
Is the facility well maintained? Are there walkways or a courtyard for outdoor visits in good weather? Do stairways and hallways have safety rails?
More Questions to Ask
Many important characteristics of a facility are not immediately apparent. Don’t be reluctant about asking more questions. For example:
Choice of Doctor
Does your regular doctor see patients at this facility? If not, which doctors do?
Admission Agreement
What sort of written contract does the facility use? Ask to see a copy.
Family Involvement
Find out about visits, availability of support groups, and participation in care conferences and care planning.
Survey Results
All long-term care facilities are regularly inspected (“surveyed”) as part of their license renewal or in conjunction with their certification as a participant in Medicare or Medicaid. The facility’s most recent survey results are always available for you to see. Were there any major problems?
Facility Policies and Procedures
What does the facility ask of each resident—its “rules and regulations”? What is the policy on smoking? On noise? On protection of resident belongings?
Long-Term Care Selection Checklist
Here is a checklist you can use as you consider the merits of a particular facility:
  • Services and capabilities match needs
  • Participates in Medicare and/or Medicaid
  • Rates are competitive
  • Residents appear to be well cared for
  • Staff appears to be knowledgeable and dedicated
  • Residents’ rooms are comfortable
  • Residents’ rooms have adequate light and ventilation
  • Activities programs are interesting and varied
  • Meals are appetizing and served in a comfortable setting
  • Building and grounds are well maintained and functional
  • Admission agreement is reasonable and easy to understand
  • Family involvement is encouraged and supported
  • Recent survey results show no major problems
  • Facility policies and procedures protect quality of life
  • Facility policies and procedures protect privacy

Friday, October 16, 2015

Distracted Driving Videos Contain a Laugh … and a Lesson

Distracted driving is a growing cause of automobile accidents in the U.S.  With cars, bikes and pedestrians sharing our congested city streets, and with more vehicles zooming along on our highways, you would think drivers would want to operate at 100 percent attentiveness! And yet, how often do we see a driver furtively (or openly) texting, putting on eye makeup, or eating a messy burger? The problem is so serious that there is now an official government website to address the problem,
If you are guilty of distracted driving, or if you know someone who is, check out these new consumer education videos from Decide to Drive, a joint project between the American Academy of Orthopedic Surgeons and the Alliance of Automobile Manufacturers. While the short spots might make you laugh, the message they convey is not so humorous: the U.S. Department of Transportation says that close to 500,000 people are killed or injured in distracted-driving crashes each year.
The videos focus on common distractions such as shavingputting on makeupeatingdrinking hot beverages and the all-too-familiar taking a selfie.
Decide to Drive also provides the “wreck-less checklist” of ways to avoid distracted driving:
  1. Put on any accessories you may need, such as sunglasses or Bluetooth earpieces before you start driving.
  2. Adjust seats, head rests, vehicle controls and mirrors. And don’t forget to fasten your seat belt.
  3. Move all reading material away from easy reach. Pre-load mp3 playlist or CDs and adjust volume level so your music does not mask the sounds of emergency sirens.
  4. Enter an address in the navigation system before you depart or review maps and written directions before you drive.
  5. Stop your car in a safe area before attending to a child or a pet, or having an involved discussion.
  6. Driving is not the time to apply makeup, groom, polish your nails, or change clothing.
  7. Do not eat or drink while driving.
  8. Do not text, make a call, take selfies or make vlogs while driving. Just put the phone away.
  9. At all times while operating your vehicle, keep your eyes on the road and hands on the wheel.
Source: IlluminAge AgeWise reporting on news release from the American Academy of Orthopaedic Surgeons (

Monday, October 12, 2015

Learning About Hospice Should Begin Long Before You Are Sick

By Caroline E. Mayer, Kaiser Health News
As a consultant who counsels families on end-of-life care management, Johanna Turner often shares the story of her mother’s final days 21 years ago. Thanks to the skilled and loving care provided by a local hospice, Turner was able to keep her promise to let her mother die in their Oakton, Va., home.
“She had the best of care for five months,” says Turner, a District of Columbia resident. “A hospice licensed practical nurse came first thing in the morning to help change complex dressings, a primary nurse visited several times a week, there was an on-call nurse to help address pain-control questions in the middle of the night, plus a social worker and a chaplain. It took all of us to get through those weeks.”
Still, Turner tells families, she had to bear much of the caregiving, even taking a leave of absence from her job. “I treasured that time, but it was physically and emotionally exhausting. Hospice made it doable, but the truth is, it was still a lot of hard work.”
Some families, she says, may not be able to bear that burden, certainly not without hiring extra help. But, she says, “the hospice gave me the skills and confidence to do what I wanted so badly to do for my mother. I will always be grateful.”
Introduced to the United States in the 1970s, hospice care is becoming an increasingly common treatment. Last year, 1.65 million people received hospice care, up from just more than 1 million in 2004, according to the National Hospice and Palliative Care Organization. In addition, there were more than 5,500 programs in the U.S. last year, compared to 3,100 in 2000.
Although the growth in hospice programs has given patients and their families more choices than ever, a recent Washington Post investigation into the industry found widespread concerns about the quality of care. The Post cited numerous complaints, noting that although hospices are supposed to provide continuous nursing care to patients whose pain or symptoms are out of control — commonly called “crisis care” — one in seven do not.
Unfortunately, there is no federal rating system — as there is for hospitals and nursing homes — that can help consumers make educated choices about the hospice they select.
For many families, hospice is an unfamiliar concept that prompts fear and questions, including where, why and even when someone should receive hospice care. To help patients and their caregivers, here are some hospice basics:
What Is Hospice Care?
Hospice is not a particular place, like a hospital, but a service that provides end-of-life care and support to the dying and their families, most often in a patient’s home. By signing up for hospice, patients generally agree to stop all disease-fighting treatments, such as chemotherapy and radiation, although some hospices allow such therapy if it is to help manage symptoms, such as pain or problems breathing.
One of the hospice’s primary goals is to alleviate pain. Through a team of caregivers — doctors, nurses, social workers, grief counselors, spiritual counselors, home health aides and volunteers — the hospice provides comprehensive care, including drugs, medical supplies and equipment. It instructs families on patient care and even provides special services such as physical therapy and psychological counseling.
“If we can manage and alleviate pain, we can help reinvigorate patients to help them accomplish whatever it is they want to do in their remaining days, whether it’s making peace with an estranged sibling, attending the wedding of their grandchild — or just going out to eat or fish,” says Malene Davis, president of Capital Caring, one of the first hospices in the Washington area. It now cares for about 1,200 patients a day.
How Much Care Does Hospice Provide?
Comprehensive care generally does not mean around-the-clock service, although many hospices provide 24/7 care when the patient is in crisis or near death.
“The hospice will teach families how to care for a patient, address their concerns and answer questions, but it does not take over the caregiving,” says Dale Lupu, an associate professor at George Washington University’s Center for Aging, Health & Humanities. “Someone on the hospice staff should be available by phone 24/7 in case there’s a crisis. But for hour-by-hour, day-to-day care, the family has to figure out a way to be involved,” even if it means hiring a private nurse or home health aide.
That’s one reason why hospice care may not be for everyone. “Families have to look within themselves and ask if they are comfortable being part of the dying process,” says Linda Kunkel, director of marketing and business development for Care Options, a Northern Virginia care-management firm. “It can be very gut-wrenching and, for some people, very hard.”
Who Pays For Hospice Care?
Medicare covers most hospices for its beneficiaries. Private insurance plans and HMOs also generally pay for hospice care, but they may have a preferred provider. Check with your insurer before you begin your hospice search.
In some cases, a small co-pay — such as $5 or 5 percent — may be required for medication, inpatient facility care and/or respite care.
Additionally, most hospices offer financial help for families in need. So make sure to discuss any financial concerns in your initial meetings.
If Hospice Is Not A Place, Where Do I Get Hospice Care?
Nearly two-thirds of hospice patients die at their homes, a nursing home or an assisted-living facility.
For patients who can’t be cared for at home — perhaps they live alone or have complications that can be treated only at a health-care facility — some hospices have inpatient facilities in freestanding centers or specially designated sections in hospitals or nursing homes.
Why Would I Want Hospice Care? Can’t My Doctors And Local Hospital Adequately Meet My Needs?
Surprisingly no, hospice experts say.
“The traditional medical approach is cure, cure, cure; but when a person is dying, he or she may need a different approach,” says Linda Adler, head of Pathfinders Medical, a California health-care advocacy firm that helps patients with complicated medical diagnoses. “The patient needs someone who’s willing to move the conversation from finding a cure to having best quality of life in the midst of an illness, someone who’s not afraid to talk about the end of life and provide compassion in the final days. Most physicians aren’t trained to do that.”
Hospice caregivers also have in-depth training and experience in palliative treatments for pain management. “Most doctors are not adequately trained in pain management, and the quality of pain control in hospitals and nursing homes is very uneven,” says Naomi Naierman, who was the president of the American Hospice Foundation before it closed last year.
When Should I Start To Think About Hospice?
Most hospices require an order from the patient’s physician as well as approval from the hospice medical director. Both must certify that the patient has six months or less to live if the illness runs its normal course. However, if a patient outlives that time, he or she can be “recertified” to continue receiving hospice care.
But experts in end-of-life care say most Americans need to start thinking about hospice long before the final six months is near. As the American Cancer Society notes on its website: “One of the problems with hospice is that it’s often not started soon enough. Sometimes, the doctor, patient, or family member will resist hospice because he or she thinks it means you’re ‘giving up,’ or that there’s no hope. This is not true. If you get better or the cancer goes into remission, you can leave hospice and go into active cancer treatment.”
Indeed, hospice experts say many people leave hospice, a situation that the late humorist Art Buchwald made famous when recounting his own discharge from a hospice. Patients can then be readmitted to hospice when their conditions deteriorate again.
J. Donald Schumacher, president of the National Hospice and Palliative Care Organization, says patients should discuss hospice options as early as they are diagnosed with a potentially fatal disease. “Don’t wait for the doctor to begin the conversation. Even if you agree to aggressive therapy, ask what are the plans if you don’t return to your optimum health.”
Are All Hospices The Same?
No; they vary greatly.
An increasing number of hospice organizations are for-profit, a distinct change from the early days of the hospice movement when they were mostly nonprofit. Today, 65 percent of hospice organizations are operated as for-profit companies, up from 34 percent in 2000.
Being a for-profit company is not inherently bad, but many of the complaints about substandard service have been leveled at for-profit hospice firms, The Post investigation found. The Post reported that the typical for-profit spent less on nursing and was less likely to have sent a nurse in a patient’s last days of life.
Still, Adler of Pathfinders Medical says consumers shouldn’t necessarily refuse to use a for-profit concern. “There are bad hospices, just like there are bad doctors” in both for-profit and nonprofit organizations, she says. “There are also great hospices in both kinds of groups. That’s why people need to do their homework.”
How Do I Find A Good Hospice?
First, seek recommendations from healthcare providers and specialists such as geriatric care managers. Ask which hospice they would use for themselves or a loved one.
Next, call the recommended hospices and ask questions about the issues that matter most to you, such as:
— How often do their caregivers come to visit? (A nurse’s aide should visit about three times a week and a nurse or doctor once a week, Naierman says.)
— Are their doctors and nurses certified in palliative care?
— Is there crisis care? How fast can a caregiver get to your home in case of a crisis? Will they come at any time, even 3 a.m. Saturday?
— Will the patient’s primary doctor still be involved in the medical care?
— Will a nurse or clinician be in the home when the patient is actively dying? (“The answer should be yes,” Naierman says. “If it is anything but yes, run, don’t walk, away.”)
— Is there an inpatient facility if the patient needs extra care? Is it conveniently located?
— Are there limits on radiation and chemotherapy, even if it’s to control pain? What about IVs, dialysis or blood transfusions?
— How does the hospice handle new health problems that are curable, such as urinary tract infections or pneumonia?
— What is expected from family members? What will they be required to do? Give medicine, including shots? Bathe the patient?
— Is respite care – providing relief and time off for caregivers – offered?
“Having a conversation with the hospice admission people helps you get a feel in advance on how receptive they will be to your needs,” says Naierman, who helped develop 16 key questions to ask a hospice.
Are There Any Other Criteria To Judge The Quality Of A Hospice?
Yes. Here are some details to look for:
— Accreditation status. Three organizations — the Joint Commission, the Accreditation Commission for Health Care and the Community Health Accreditation Program — inspect and approve hospice programs.
“I would always lean toward an accredited program when available because it speaks to a program’s willingness to open itself to review and, hopefully, improvement,” says Lupu, who notes that only 40 percent of hospices are accredited.
— Age and patient load. “Experience — gained over time and gained over a number of cases — usually helps build both individual clinician expertise and organizational/team expertise,” Lupu wrote in a recent post on Pallimed, a blog about hospice and palliative medicine. “Very new and very small hospices are unlikely to have the breadth of experience and the depth of resources to assist with challenging or unusual circumstances.” She suggested that patients should generally lean toward an organization with at least five to 10 years of experience that handles at least 80 patients a day.
— “Live discharge rates,” which is the proportion of people who leave hospice care before dying. A large number of departures may signal that patients were unhappy with care and services. “I’d select a hospice with a live discharge rates in the 10 to 20 percent range,” Lupu says.
Where Can I Go For Additional Help?
There is a lot of information on hospices on the Internet, including:
This article was produced by Kaiser Health News with support from The SCAN Foundation.
Source: Kaiser Health News (, a nonprofit national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.