Elder Care Issues

Advice on tackling common health care issues affecting the senior population and resources to turn to for help.

Some Dementia Can Be Treated, But My Mother Waited 10 Years for a Diagnosis

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Pauline Rabin with granddaughters Emma and Aviva Rabin-Court near the C&O Canal in Great Falls, Md. (Photo courtesy of Roni Rabin).

Pauline Rabin with granddaughters Emma and Aviva Rabin-Court near the C&O Canal in Great Falls, Md. (Photo courtesy of Roni Rabin).

By Roni Caryn Rabin March 3, 2015/Kaiser Health News (KHN) is a nonprofit national health policy news service. 

When my mother, Pauline, was 70, she lost her sense of balance. She started walking with an odd shuffling gait, taking short steps and barely lifting her feet off the ground. She often took my hand, holding it and squeezing my fingers.

When my mother, Pauline, was 70, she lost her sense of balance. She started walking with an odd shuffling gait, taking short steps and barely lifting her feet off the ground. She often took my hand, holding it and squeezing my fingers.

Her decline was precipitous. She fell repeatedly. She stopped driving and she could no longer ride her bike in a straight line along the C& O Canal. The woman who taught me the sidestroke couldn’t even stand in the shallow end of the pool. “I feel like I’m drowning,” she’d say.

A retired psychiatrist, my mother had numerous advantages — education, resources and insurance — but still, getting the right diagnosis took nearly 10 years. Each expert saw the problem through the narrow prism of their own specialty. Surgeons recommended surgery. Neurologists screened for common incurable conditions.

The answer was under their noses, in my mother’s hunches and her family history. But it took a long time before someone connected the dots. My mother was using a walker by the time she was told she had a rare

Pauline Rabin surrounded by her grandchildren at her 80th birthday after her operation (Rabin Family Photo).

Pauline Rabin surrounded by her grandchildren at her 80th birthday after her operation (Rabin Family Photo).

condition that causes gait problems and cognitive loss, and is one of the few treatable forms of dementia.

“This should be one of the first things physicians look for in an older person,” my mother said recently. “You can actually do something about it.”

‘Did Mom Tell You? She Fell Again.’

The falls started in 2004. My mother fell in the bedroom of her Bethesda home. She fell in the airport while returning from a trip to see my sister. Sometimes she told me, and sometimes a sibling would call or e-mail. “Did Mom tell you? She fell again.”

Millions of older adults fall every year, but it was my mother’s uneven gait that tripped her up. She was unsteady on her feet; the slightest incline threw her off stride. Sometimes she quickened her pace involuntarily. Sometimes she bent over before straightening back up.

She went to doctor after doctor. “I want a diagnosis,” she would say before the next appointment with a neurologist, geriatrician, urologist or orthopedist. “I’m convinced this is something organic — that it has an underlying biological cause.” Read more


Retirees Rank Home Care No. 1 Way to Meet Long-Term Needs

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New services, technologies and options enable a greater number of people to receive care at home.

New services, technologies and options enable a greater number of people to receive care at home.

Courtesy Home Health Care News/Cassandra Dowell

The vast majority of retirees 50 and older say their top preference for receiving long-term care is in their own home, driving demand for these services, according to a new Merrill Lynch retirement study conducted in partnership with Age Wave. 

Eighty-five percent say, if needed, they would prefer to receive extended care in their home, followed by 10% who said an assisted living facility was their top choice. Four percent said the home of a family member would be their top preference to receive care, and only 1% said a nursing home.

Among people age 85 and older, about three-quarters have difficulties with daily activities, including housework or getting around the home, data show.

New services, technologies and options are enabling a greater number of people to receive care at home, said Ken Dychtwald, president and CEO of Age Wave, during a presentation of the report.

In fact, the number of nursing home residents has declined in the past decade, while at the same time the number of people receiving care at home has increased, data show.

“Another dynamic to those aging is 52% of those 75 and older live alone,” said David Tyrie, head of Retirement & Personal Wealth Solutions for Bank of America Merrill Lynch, noting an increasing need for home health care services. “Today there are 23 million single Baby Boomers, and 15 million that don’t have children.”

Age 55 and older households account for nearly half (47%) of all spending on home renovations, or about $90 billion annually, data show. Of these households spending money on home renovations, 28% are adding safety features to accommodate aging, and 15% are modifying their home to live on one floor should there be trouble with stairs.

In addition, retirees are not just interested in traditional remodeling activities — they’re interested in technologies that can help them improve and monitor their health.

Three-quarters (76%) are interested in technologies to monitor their health at home, such as sensors, alerts, or medication reminder apps, data show. And six in 10 (58%) are interested in technologies to help them maintain their home, such as cleaning robots or heated driveways.

“As people grow into their later years they don’t want to be forced out of their comfortable home,” Dychtwald said. He noted that especially as people age, moving feels “scary, or unpleasant.”

“Today there are more choices to enable people to remain in their homes as they age,” he said.

Access “Home in Retirement: More Freedom, New Choices” here.


Disability Rates Increase Among Older Population

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The most common type of disability was difficulty in walking or climbing stairs.

The most common type of disability was difficulty in walking or climbing stairs.

Changes in population age structure are contributing to a growing number of older people with disability, the U.S. Census Bureau reports, noting that the number of those 85 and older in the United States has increased from 8.8% in 1980 to 13.6% in 2010.

“Given higher prevalence rates among the oldest old, this changing composition of the older population has increased the number with a disability,” the bureau reports.

Those 85 and older had the highest prevalence of disability. While this group represented 13.6% of the total older population, they accounted for 25.4% of those with a disability.

The report covers six types of disability, including difficulty in hearing, vision, cognition, walking, self-care, and independent living, and is based on data from the American Community Survey (ACS). People who reported any one of the six disability types are considered to have a disability.

The most common type of disability was difficulty in walking or climbing stairs, which was reported by two-thirds of those with a disability. Difficultly with independent living, such as visiting a doctor’s office or shopping, was a distant second at 47.8%, followed by serious difficulty hearing at 40.4%, data show.

Where You Live May Affect How Long and Healthfully You Live

The report explains that where one lives in the United States affects how long and how healthfully one lives. Between 2008 and 2012, there were 40.7 million people aged 65 and over in the United States, representing 13.2% of the total population, data in the new U.S. Census Bureau report shows.

The report was commissioned and funded by the National Institute on Aging (NIA) of the National Institutes of Health (NIH). Residents in the South, regardless of race or sex, had lower life expectancy at age 65 than residents in other regions, the report finds.

Almost 16 million Americans 65 and older nationwide report having at least one disability, with about 6.1 million of those Americans residing in the South, data show.

The other three regions each contained about one-fifth of the total elderly disabled population — 3.5 million in the Midwest; 3.3 million in the West; and 2.9 million in the Northeast.

“If the prevalence rates hold, then one would expect the size of the older disabled population living in households will increase, potentially expanding demand for various types of changes in the physical household environment,” report spokesperson Dr. John Phillips told Home Health Care News. Phillips serves as the chief of the population and social processes branch in the Division of Behavioral and Social Research in the National Institute on Aging at the NIH.

“The types of disabilities people have as well as the availability of caregiving will likely affect demand for types of housing, [such as] single story, and physical accommodation, [such as] ramps,” he says. “The data from the Census report shows that difficulties getting around without assistance, or ambulatory disabilities, represent the largest fraction of reported limitations in the 65+ population.”

He says: “Assuming that the prevalence remains roughly the same going forward, there would be a growing need for environments and technologies that assist elders with mobility issues, particularly those living alone and in the community.”

View “Older Americans With a Disability: 2008 – 2012.“

Courtesy Home Health Care News