Aging in Place

The choice to age in place rather than in an institutional setting and the tools to do it successfully.

Home-Based Dementia Care Offers Support to Caregiver

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Caregivers of patients with dementia claimed greater caregiver satisfaction when using geriatric care programs that included care management strategies.

Caregivers of patients with dementia claimed greater caregiver satisfaction when using geriatric care programs that included care management strategies.

If you care for a loved one who has dementia, you may have some new caregiver support tools to help better care for your loved one and delay their move to a nursing home.

In a randomized controlled trial, trained non-physician managers used evidence-based protocols to educate and offer support to caregivers through a telephone-based assessment and care management program.

Medscape Medical News reports:

In their study, lead investigator Joshua Chodosh, MD, from the UCLA Health System in Los Angeles and his team randomized 242 patient–caregiver dyads to the dementia-care management program and 256 dyads to usual care.

Care managers were trained social workers, nurses, and nurse practitioners.

Greater Caregiver Satisfaction

All caregivers were surveyed at baseline and at 9 and 18 months.

At 18 months, satisfaction with healthcare was rated higher, on a 100-point scale, by caregivers in the intervention group than in the usual care group (89.6 vs 86.3; P = .06). When caregivers rated confidence in their abilities, scores in the intervention group were 5.6 points higher than scores in the usual care group (P < .05).

The unadjusted rate of nursing home use during the intervention period, documented in patients’ medical records, was lower in the intervention group than in the usual care group (7.6% vs 17.5%; P = .042).

Improvements from baseline were seen for nearly all process measures in both group, but most between-group differences were not significant.

During the first 2 months of the study, the health plan referred 75% of members in the usual care group to geriatric care programs that included care management strategies, which were likely influenced by the intervention, Dr Chodosh reported.

In addition, most patients had moderate-severity dementia. At that stage, patients tend to need more care and are more likely to benefit from care management than those at an early stage

American Geriatrics Society (AGS) 2015 Annual Scientific Meeting: Abstract P1. Presented May 15, 2015.


6 Ways You Can Prepare to Age Well

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Think ahead about how you might get help in the event you needed services like meal preparation, transportation, or housecleaning.

Think ahead about how you might get help in the event you needed services like meal preparation, transportation, or housecleaning.

Seniors have more options than ever when it comes to where and how they want to spend their “golden” years. To ensure a quality lifestyle as the years progress, it’s important to eat healthy, stay active, get recommended health screenings, quit smoking, and control stress. It also helps to prepare for future health issues that may coincide with aging, reports Harvard Medical School in its special health report “A Plan for Successful Aging.”

Here are 6 tips Harvard Medical School offers in its report:

  1. Adapt your home. Stairs, baths, and kitchens can present hazards for older people. Even if you don’t need to make changes now, do an annual safety review so you can make necessary updates if your needs change.
  2. Prevent falls. Falls are a big deal for older people – they often result in fractures that can lead to disability, further health problems, or even death. Safety precautions are important, but so are exercises that can improve balance and strength.
  3. Consider your housing options. You might consider investigating naturally occurring retirement communities (NORCs). These neighborhoods and housing complexes aren’t developed specifically to serve seniors – and, in fact, tend to host a mix of ages – but because they have plenty of coordinated care and support available, they are senior-friendly.
  4. Think ahead about how to get the help you may need. Meal preparation, transportation, home repair, housecleaning, and help with financial tasks such as paying bills might be hired out if you can afford it, or shared among friends and family. Elder services offered in your community might be another option.
  5. Plan for emergencies. Who would you call in an emergency? Is there someone who can check in on you regularly? What would you do if you fell and couldn’t reach the phone? Keep emergency numbers near each phone or on speed dial. Carry a cellphone (preferably with large buttons and a bright screen), or consider investing in some type of personal alarm system.
  6. Write advance care directives. Advance care directives, such as a living will, durable power of attorney for health care, or health care proxy, allow you to explain the type of medical care you want if you’re too sick, confused, or injured to voice your wishes. Every adult should have these documents.

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