RESEARCH: Home Assessment Important to Seniors’ Safety

It’s unanimous. 100% of emergency room doctors in the United States and Canada surveyed by Home Instead, Inc., franchisor of the Home Instead Senior Care® network, say it’s important that adult children dedicate one day a year to perform a safety check of their senior loved one’s home. Yet in the last year, less than half (44% in the U.S. and 41% in Canada) of family caregivers surveyed had done so.*

The research suggests a lack of knowledge and attention to potential home safety issues that could lead to danger and the risk of accidents and falls in an older adult’s home. Each year, more than 1.6 million older U.S. adults go to emergency departments for fall-related injuries, according to the National Institutes of Health. The Public Health Agency of Canada reports that falls account for more than half of all injuries among Canadians age 65 and older.

Emergency room doctors are often on the front lines of the action when it comes to senior safety. Dr. David John, co-chair of Emergency Medicine at Johnson Memorial Medical Center in Stafford Springs, Connecticut, and a member of the American College of Emergency Physicians (ACEP), has worked in emergency medicine for more than 20 years. The effects of aging can take a toll, leaving older adults vulnerable to falls doing a variety of everyday tasks, noted John.

A senior's home also can be a safety trap, with the most common issues identified in the research as:
• Throw rugs that pose potential tripping hazards
• No grab bars (e.g. in the shower)
• Kitchen storage that is too high or low

*Home Instead, Inc., franchisor of the Home Instead Senior Care® network, completed 600 telephone interviews in the U.S. (400 in Canada) with seniors age 65 and older, and 600  telephone interviews in the U.S. (400 in Canada) with adult children who have parents age 65 or older. Home Instead, Inc., also conducted five-minute telephone interviews with 100 emergency room physicians in the U.S. and Canada, excluding Quebec.

Seven Tips to Help Boomer Children Communicate With Their Aging Parents

Many adult children of aging adults know how difficult it can be to talk with their parents about certain topics. Following, from Home Instead Senior Care and communication expert Jake Harwood, Ph.D., from the University of Arizona, are tips to help family caregivers communicate with their aging parents on sensitive subjects.

1. Get started. 

If you’re 40 or your parents are 70, it’s time to start observing and gathering information carefully and thoughtfully. Don’t reach a conclusion from a single observation and decide on the best solution until you have gathered information with an 
open mind and talked with your parents.

2. Talk it out. 

Approach your parents with a conversation.Discuss what you’ve observed and ask your parents what they think is going on. If your parents acknowledge the situation, ask 
what they think would be good solutions. If your parents don’t recognize a problem, use concrete examples to support your case.

3. Sooner is best. 

Talk sooner rather than later when a crisis has occurred. If you know your loved one has poor eyesight or has trouble driving at night, begin to address those issues before a 
problem arises. 

4. Forget the baby talk. 

Remember you are talking to an adult, not a child. Patronizing speech or baby talk will put older adults on the defensive and convey a lack of respect for them. Put yourself in your parents’ shoes and think of how you would want to be addressed in the situation.

5. Maximize independence. 

Always try to move toward solutions that provide the maximum amount of independence for the older person. Look for answers that optimize strengths and compensate for problems. For instance, if your loved ones need help at home, look for tools that can help them maintain their strengths. Professional caregiving services, such as those offered 
by Home Instead Senior Care, provide assistance in a number of areas including meal preparation, light housekeeping or medication reminders. Or find friends who can help.

6. Be aware of the whole situation. 

If your dad dies and soon afterward your mom’s house seems to be in disarray, 
it’s probably not because she suddenly became ill. It’s much more likely to stem from a lack of social support and the loss of a life-long relationship. Make sure that your mom has 
friends and a social life.

7. Ask for help. 

Many of the issues of aging can be solved by providing parents with the support they need to continue to maintain their independence. Resources such as Home Instead Senior Care, Area Agencies on Aging and local senior centers can help provide those solutions

Consumer Scam Alert

Seniors should be on the alert for the latest scams against older adults. Phishing emails encouraging seniors to create a “my Social Security” account (used to check out Social Security statements or manage Social Security benefits online) are circulating; however, these emails are a scam, according to the Social Security Administration. Seniors and family caregivers in the U.S. should:

• Not click on links to set up a new account. Even though “my Social Security” is a relatively new service for
the public, the agency is not sending emails to generate enrollment.

• Links to Social Security websites will always begin with www.socialsecurity.gov/.

For additional tips on detecting fraudulent email, visit ssa.gov

Conversation Starters . . . For Sensitive Senior Subjects

To help adult children of older adults know what to say, following are various scenarios of common senior topics. Each is backed by Home Instead Senior Care research conducted in the U.S. Responses were
developed in cooperation with Jake Harwood, Ph.D., communication professor and author from the University of Arizona.

When Health Changes Lifestyles

Your 70-year-old widowed mother has just been diagnosed with macular degeneration, a disease that 
causes deterioration of eyesight. How do you begin a conversation with her about the possible ramifications of this disease on her life?

Many seniors in this situation might begin the conversation with family themselves. If not, then it would be good to think about her personal circumstances and important areas to address. For example, if your
mother lives in a remote area, transportation is probably the most immediate issue. Approach the conversation with the goal of trying to resolve this one issue, rather than multiple issues. Timing is the key. There are rarely urgent deadlines that have to be met immediately – give yourself and your parent time to think about issues. Your mom would likely be receptive to a conversation that begins: “Let’s figure out a plan for how you can get around town if you no longer feel safe driving.”

Did Dad Hit a Light Pole?

A neighbor of your 83-year-old dad has called to tell you he saw your father back his car into a light pole. What do you say?

If the damage is visible, you could ask, “Hey Dad, what happened to the car?” Or you could bring up the phonecall from his neighbor. “Fred from next door called and said he saw you run your car into the light pole.”This is an example of a situation that calls for more general observation. Take the opportunity to drive with your parent. Even a short drive would help you gauge your dad’s skillsand deficits.

For instance, an older adult who consciously reduces driving at night because of vision issues or who drives a little slower to account for reaction time is probably safe. On the other hand, an 83-year-old who insists on driving icy highways at night while doing 75 mph is probably in need of immediate intervention. Then gear your comments accordingly. If you’re concerned that your dad is unsafe on the roads, make his safety and that of others your focus. “Dad, I’m worried that you’re no longer safe on the roads and that others
could be at risk as well.”

You’re Going to Wear That?

You’re planning a birthday party for your 85-year-old mother and she insists on wearing her favorite blue dress. Because her eyesight is poor, she can’t see thatthe dress is stained and worn. What do you do?

It’s important to determine whether this really is an issue – that the stains are worth addressing with your mother. If so, be direct: “Mom, did you know that your party dress is stained?” Then offer to have it
cleaned or, better yet, suggest a shopping trip: “Mom, this is a really special occasion. I’d love to buy you a new outfit. Let’s go shopping.” If she still wants to wear the dress, then a family council or a fight with
your mom is simply not worth it. You may need to figure out a way to overcome any embarrassment that you feel at your mom’s appearance, but ultimately what she wears should be her choice. The embarrassment
that you feel is your problem, not hers. Chances are, though, if she knows you are apprehensive about the dress and willing to help her find a
new one, she will agree.

When the House Is a Mess

You find that your 77-year-old mother’s house is often in disarray when you visit. You believe it’s time for her to make a change in her living arrangement. What do you say? 

Observation and careful attention to the problem should be your first course of action. Avoid diagnosing a problem and deciding on a solution quickly. Approach your mother with a sense of working together
to find a solution rather than telling her what to do. The specific circumstances – such as financial constraints – may be relevant. Is the problem simply that your mother is physically challenged by strenuous housework or is she deteriorating mentally? Does she just need help tidying up around the house or are other aspects of
her personal care, such as bathing, going downhill? Assuming that the problem is physical – where activities such as vacuuming or bending are becoming issues – then begin the conversation with an offer: “Mom, I have some extra cash. What do you say we find someone to help you with the heavy stuff, like vacuuming?
It will be my treat.” Seniors are often very willing to accept help around the house. And most communities have ample resources such as cleaning services and companies like Home Instead Senior Care that can help.

A Senior Moment or Something More?

You've just stopped by your parents’ house and for the second time in a month, noticed that your 70-year-old mother has forgotten the name of a close friend. Is it Alzheimer’s disease or dementia, a senior moment or just a passing phase? More importantly, how do you find out?

Make sure you consider your mom’s history and personality so that you can determine if this
is a change. Some people have always been bad with names, but if your mom is forgetting a close
friend’s name and you notice signs of disorientation, you might say: “Gee Mom, perhaps you should see a
doctor and get checked out. I’m sure it’s nothing, but it would really put my mind at ease if you’d let a doctor make sure your memory is O.K.” Such a conversation starter focuses on the positive not the negative.

Study: Many Colonoscopies for Seniors Potentially Inappropriate

Almost one of every four colonoscopies performed in Medicare beneficiaries 70 years and older in 2008 and 2009 in Texas and across the country was potentially inappropriate, according to age-based screening recommendations or the results of a previous screening.

Kristin M. Sheffield, Ph.D., and her colleagues of the University of Texas Medical Branch, Galveston, said they found the problem when they analyzed Medicare claims data. “Inappropriate use of colonoscopy involves unnecessary risk for older patients and consumes resources that could be used more effectively,” their study concluded.

The background on the study also reports complications from colonoscopy are more likely in those 75 years or older. The study background highlights increasing evidence of overuse of the procedure and that some Medicare patients with negative findings at screening colonoscopy may be undergoing another screening too early.

A colonoscopy repeated within 10 years after negative screening results represents overuse, based on guidelines. A screening colonoscopy performed in the oldest age groups also may represent overuse, according to guidelines from the U.S. Preventive Services Task Force and the American College of Physicians.

The U.S. Preventive Services Task Force recommends against routine screening for colorectal cancer in adults 76 to 85 years of age. There may be considerations that support colorectal cancer screening in a patient, but the U.S. Preventive Services Task Force recommends against screening for colorectal cancer in adults older than age 85 years. 

For more about the study, see http://www.researchgate.net/publication/235905911_Potentially_Inappropriate_Screening_Colonoscopy_in_Medicare_Patients_Variation_by_Physician_and_Geographic_Region?ev=prf_pub.

Scam Phone Calls Continue to Target Seniors

The Home Instead Senior Care^® network developed Protect Seniors from Fraud^SM, a public education program that was conceived to try to prevent criminal acts against the nation’s elderly. Ed Hutchison, director of the Triads and an expert source for the Protect Seniors from Fraud program, states that attempts to steal personal and financial information from seniors is becoming all too common.

Others agree. “America’s rife with health scams,” said James Quiggle, communications director at the Coalition Against Insurance Fraud in Washington, D.C. “Crooks are offering fake health coverage, stripped-down policies masquerading as real coverage.”

Here’s an example of what Quiggle was talking about: An 86-year-old Denver woman recently was sitting in her kitchen when the phone rang. She didn’t recognize the phone number or the voice. “He asked if I was a senior, and he said, ‘We are sending out new Medicare cards and I want to make sure I have all of your statistics correct,’ ” she said.

He recited her address and phone number, “to make sure they were right.” Then he read off a series of numbers and asked if it was her bank routing number. “I didn’t know at the time whether it was or not, so I just said no,” she said. “He said, ‘Could you give it to me so I’ll have it?’ I wasn’t so sure about that, and when he started to say something, I hung up.”

When the scammer tried to call again, she hung up, wrote the number from her caller ID and dialed Medicare to report it.

For more about consumer insurance fraud, see http://www.insurancefraud.org/fraud-why-worry.htm#.UX62-6Kkrl8; to learn how Home Instead is educating about senior fraud, visit http://www.caregiverstress.com/senior-safety/con-cheat-seniors/.