Paid in- Home Care: More and Better Care for Seniors

Paid In-Home Care: MORE CARE &
BETTER CARE FOR SENIORS
A WHITE PAPER FROM HOME INSTEAD SENIOR CARE

Section I

ABOUT HOME INSTEAD SENIOR CARE

®

H

Franchise offices are located throughout the United States and in Canada, Australia, Austria, Finland, Germany, Ireland, Japan, New Zealand, Portugal, Puerto Rico, South Korea, Switzerland, Taiwan and the United Kingdom.

Home Instead franchise offices employ more than 65,000 professional, trained CAREGiversSM who, in 2010, provided more than 40 million hours of elder care services through more than 60 home-care activities. In situations in which a client has aging-related medical needs beyond the capabilities of non-medical home-care workers, referrals can be made to Home Instead’s partners in the healthcare industry.

Home Instead was founded by Paul and Lori Hogan in 1994 in Omaha, Nebraska, and began franchising in June 1995. It was Paul’s own family experience caring for his grandmother for 12 years that influenced his realization of the need for non-medical home-care and elder-companionship services to help seniors live independently at home.

By 1998, the Home Instead Senior Care network had grown to 99 franchise offices and was recognized by Entrepreneur magazine as one of the 100 fastest-growing franchise companies in the United States. In 2000, Home Instead began international expansion by establishing a partner relationship with Duskin Co. in Osaka, Japan.

The Home Instead Senior Care Foundation was created in 2003 to further the philanthropic mission of franchisees. The foundation’s objective is to provide financial assistance to non-profit organizations specializing in projects that improve the quality of life for seniors.

Home Instead has been cited for its business success by the International Franchise Association and by several publications including TIME, The Wall Street Journal, The New York Times, Entrepreneur and Franchise Times. Company Founder and Chairman Paul Hogan has also taken on several advisory roles on aging issues, including serving as an at-large delegate to the White House Conference on Aging.

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Section II

METHODOLOGY

This Home Instead Senior Care-commissioned research project—entitled the "Value of Caregiving at Home" study—examined the perceptions and experiences of U.S. caregivers for seniors by conducting a survey among adults (aged 18 and older) who were providing and/or arranging care for an older adult (aged 65 or older).

To ensure the integrity, independence and validity of this paper, an expert panel composed of medical professionals and academics, as well as senior-care and research experts, guided and approved both the methodology and survey instruments. Additionally, both methodology and survey instruments were reviewed and approved by the Western Institutional Review Board, a fully-accredited commercial institutional review board that reviews health and healthcare-related research projects according to FDA regulations and ICH guidelines.

Two separate samples were used: one involving caregivers whose care recipients were receiving paid in-home non-medical care; and a second group of caregivers whose care recipients were not receiving this care. The data was collected using a national panel of more than three million consumers who have agreed to take part in surveys conducted by professional researchers.

A detailed screening procedure identified qualified respondents, who then participated in this survey voluntarily. To be eligible, respondents had to be responsible for providing and/or arranging care (either totally or partially) for someone aged 65 or older who was not capable of complete self-care; and who was not living in a nursing home, assisted-living facility, or group home. After qualifying as a caregiver, respondents were then appropriately classified into "paid in-home non-medical care" or "non-paid in-home non-medical care" groups.

The definition of "non-medical care" was stringent, to include no registered or certified medical professionals whatsoever. For the purposes of this report, "medical professionals" will be thus defined as physicians; physicians’ assistants (PAs); nurse practitioners (NPs); registered nurses (RNs); licensed practical nurses (LPNs); licensed vocational nurses (LVNs); physical therapists (PTs); occupational therapists; or any other registered therapists. Some respondents were using both medical and professional, in-home non-medical care; however, those relying solely upon professional medical care were excluded from this study.

The online survey instrument consisted of three component questionnaires designed to be administered sequentially. These questionnaires contained sections that allowed the following: demographic profiling of care recipients and caregivers; identification of the types of care provided; detailed description of the health status of the care recipient and the caregiver; assessment of the quality of life of both the care recipient and caregiver; and the collection of data related to caregiver employment.

Six-hundred and ninety-seven caregivers with paid in-home non-medical care completed all three surveys, along with 934 caregivers who were not using paid in-home non-medical care—yielding a total of 1,631 study respondents. Only those participants who completed all three surveys were retained in the survey-analysis process. Data collection occurred throughout January 2010.

 

Section III

THE GRAYING OF THE BABY BOOMER

The nation’s population of senior citizens is about to rise to historic levels. In 2011, the first of the Baby Boomers – the 78 million men and women born between 1946 and 1964 – will begin turning 65 at a rate of more than 8,000 per day. By year’s end, the nation’s senior population will have increased by almost 3 million, to nearly 49 million. By 2025, the U.S. senior population, which was 35 million in the year 2000, will have more than doubled to 72 million.

As these older adults continue to age, many will experience various health problems such as impaired mobility, strokes, Alzheimer’s disease and other dementias, to name just a few.

Some ailments will be long lasting, and some will occur in combinations. Indeed, 80 percent of the nation’s current seniors have one chronic health condition, and 50 percent have at least two.

1

The challenge confronting the nation is how to care for these millions of seniors, many of them afflicted with

 Typically, about 90%

 

Section IV

PART OF THE SOLUTION: PAID IN-HOME NON-MEDICAL CARE

One potential solution to this challenge is the use of paid in-home non-medical care. Recent academic research commissioned by Home Instead Senior Care indicates that paid non-medical workers can be an integral part of the in-home care continuum for seniors, including those who also receive treatment from medical professionals. This is especially true for those seniors who are older or need more-intensive levels of care.

In fact, the Home Instead Senior Care research uncovered an association between the use of paid in-home non-medical care and a lower number of visits to doctors by care recipients.

The reason for this may be that the use of paid in-home non-medical care results in more hours of care – and presumably better care – for older adults. What’s more, the benefits of paid in-home non-medical care extend not just to seniors, but also to the people who most often are caring for them: their family members and friends.

A Supplement to Medical Care

This Home Instead Senior Care study strongly suggests that for seniors across the country, paid non-medical care is rapidly establishing itself as a supplement to the healthcare services they receive in their homes.

Thirty-five percent of the seniors studied were being cared for not only by clinical professionals (physicians, registered nurses, licensed practical nurses, home-health nurses, or physical or occupational therapists), but also by non-medical personnel who worked in collaboration with these providers.

The following results reflect in-home healthcare usage in this group of seniors over a 12-month period:

o

60 percent used home-health nurses.

o

59 percent used physical therapists.

o

32 percent used occupational therapists.

o

37 percent had at least one in-home visit from a physician’s assistant or nurse practitioner.

o

17 percent had an in-home visit from a physician. 6

In addition, 17 percent of those with paid in-home non-medical care had used adult day-care, as opposed to just 4 percent of those without such services. (Adult day-care centers are similar to senior centers in that they are designed to help keep seniors in their homes by providing them with a wide range of day-time activities. But unlike senior centers, they have the staff and equipment to serve seniors who have greater needs, including those suffering from dementia.)

The remaining 65 percent of the older adults in the study were using only paid in-home non-medical services to meet all their care needs. This suggests that paid in-home non-medical care is increasingly functioning as a "jumping-off" point from which seniors access more formal medical care as the need develops.

Help for Those with Intensive Needs

This Home Instead Senior Care study found that the U.S. seniors with the greatest need for medical care are also making extensive use of paid in-home non-medical care.The recipients of this combination of non-medical and medical in-home care tended to be older. According to the research, 75 percent were at least 80 years of age.

And these care recipients were often sicker or otherwise more limited in their daily routines:

Both the seniors who use paid in-home non-medical care, and their families and friends, recognized it as a vital supplement to clinical medical care for those who wanted to stay in their homes but had chronic health problems, or who presented demanding caregiving challenges.

Section IV
Part of the Solution: Paid In-Home Non-Medical Care (Continued)

61%

had mobility problems.

29%

had Alzheimer’s disease.

43%

were suffering from other types of dementia.

22%

were contending with the after-effects of stroke.

48%

were dealing with "frailty," which is defined by the American Geriatrics Society as a condition characterized by "three or more of the following: muscle weakness; slow walking speed; exhaustion; low physical-activity levels; or unintentional weight loss."2 7

Fewer Doctor Visits

The Home Instead Senior Care research found that the use of paid in-home non-medical care is associated with a lower rate of in-office doctor visits, thus helping to improve seniors’ quality of life while helping them save on healthcare expenditures.

Overall, the study found that on average, caregivers for seniors in the group using paid in-home non-medical care reported that those seniors had about 25 percent fewer doctor visits each year (12.5) than the older adults who did not have such care (16.6 visits).

The following results, which cover a 12-month period, are for less-healthy seniors whose caregivers rated their conditions as "worse than [those of] others of the same age":

Thus, it appears that having paid in-home non-medical care helps reduce the need to make inconvenient and potentially expensive visits to a doctor’s office.

o

Among care recipients with heart disease/stroke, caregivers told us that those with paid in-home non-medical care had 18.5 visits to a doctor compared with 23.5 visits for those without such care.

o

For those with arthritis, the numbers were 19.7 doctor visits for those in the first group versus 22.2 for those in the second group.

o

Among those with Alzheimer’s or other dementias, the difference was 10.2 doctor visits for those with paid in-home non-medical care versus 19.2 visits for those without. 25% fewer doctor visits 8

More Care, Better Care

The Home Instead Senior Care research found that per week, recipients of paid in-home non-medical care typically receive more overall hours of care (both paid and unpaid, medical and non-medical) than older adults who do not use such services.

In fact, the comparison is startling. The seniors in the study with paid in-home non-medical care received an average of 87.9 hours of care per week, compared with 35 hours for those without. Put another way, in any given week, older adults who use paid in-home non-medical care will receive about two-and-a-half times as much total care as the seniors who do not.

Interestingly, while the first total includes an average of almost 48 hours of paid in-home non-medical care delivered "over the last week," it also reflects the fact that seniors in this group are likely to receive care from family and friends first, and then from paid professional in-home non-medical care.

What were the most important services offered by paid in-home non-medical care providers? According to the research, the seniors who had such care made extensive use of it in transportation (often a problem for older adults) and housework. In addition, paid in-home non-medical care proved useful in grocery shopping and meal preparation, both critical activities in helping older adults remain healthy and independent.

Thus, paid in-home non-medical services are able to complement the care provided to seniors by their medical professionals and their family and friends – resulting in more care, and more diverse care.

Caregivers Recognize This

The caregivers who participated in the study supported this conclusion when they were asked to use a 1-to-5 scale to rate the overall quality of in-home care being received by their seniors.

Seventy-eight percent of the caregivers for older adults whose "bundles" incorporated paid in-home non-medical services rated the overall quality of care as a "4" or "5" – "very good" or "excellent." In contrast, 70 percent of caregivers for seniors not using paid in-home non-medical services assigned a "4" or "5" to the quality of care.

In summary, more care appears to also mean better care for seniors who, as a result, should remain healthier and happier in their own homes, and in the company of family and friends.

87.9

35
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Section V

CONCLUSION

The Home Instead Senior Care research found that in-home non-medical care for seniors is frequently part of a larger protocol of care involving medical professionals and family members and friends – a combination designed to help older adults remain in their homes as long as possible. And the use of paid in-home non-medical care can help families provide more and better care for their seniors.

As the number of older Americans rapidly expands, paid in-home non-medical care can play a vital role in ensuring that seniors receive necessary and appropriate care even though the U.S. healthcare system is stretched thin in funding and staffing – a problem that likely will become more pronounced in the coming decades.

In an especially significant finding, the study indicates that on average, seniors receiving paid in-home non-medical care experience fewer doctor visits each year. This has major financial implications for seniors and their families, the healthcare system, and the federal budget.

The use of paid in-home non-medical professionals has a major impact not only on the quality of care that seniors receive, but also on the number of hours per week of care that they receive.

Finally, the use of professional in-home non-medical care may help delay or even prevent the need for more formal medical care, thus taking significant pressure off the country’s resource-strapped healthcare system – especially hospitals and nursing homes.

The contributions of paid in-home non-medical workers become even more significant in light of society’s move away from institutionalizing seniors in favor of helping them remain healthy and independent in their own homes.

Consequently, it will be an important policy-level imperative to determine at which points on the evolving senior-care continuum that paid in-home non-medical care can best augment clinical care – or in some instances, delay or even prevent the need for it.

 

Section VI

RECOMMENDATIONS

Given the growing importance of paid in-home non-medical services and their potential to improve the quality of senior care while saving the nation significant sums, a series of steps to encourage their growth and development is in order:

Sources:

1.Online at http://www.cdcfoundation.org/healththreats/aging.aspx. 2. Online at http://www.healthinaging.org/agingintheknow/research_content.asp?id=12.

o National Senior-Care Policy – Establish a comprehensive national senior-care policy to provide optimal care for seniors and ensure good stewardship of the limited human and financial resources available to provide care to an aging population. o An Educational Campaign – Develop a continuing nationwide program to educate seniors and their families about the choices that are available along the healthcare continuum, and how to go about making the best decisions at each stage of the aging process – for example, providing non-medical care in the senior’s home rather than institutionalizing him or her in a nursing home. The campaign could be mounted by a coalition involving public senior-service agencies and the private-healthcare community.o Tax-Policy Changes – Create a national study commission to review the impact of the current tax code on senior-care decision-making and recommend adjustments to the code which would encourage home care and personal responsibility for senior care.o A Youth Corps – Create a corps of young volunteers who would be trained to work for, say, three years as in-home non-medical workers, perhaps using reductions in college-loan debts as an incentive. o A Senior Corps – Often, some of the best in-home non-medical workers are seniors themselves. Social policies should be developed to encourage this trend.o New Senior-Care Options – Offer federal grants to test innovative new programs in senior care, especially programs that will enable older adults to age at home, a choice nearly 90 percent say they prefer.11 NOTES12

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10 Seniors Using Paid In-home Non-medical Care Seniors Not Using Paid In-home Non-medical Care

Hours of care per week.of American seniors say they want to remain in their own homes for as long as possible. 5

The situation is complicated still further by the fact that in study after study, about 90 percent of American seniors have said they want to remain in their own homes for as long as possible. Their desire is both sensible and understandable, but how can so much care be delivered to so many individuals living in so many neighborhoods across the nation?

chronic conditions. The challenge is complicated by the fact that the U.S. medical community is facing a serious shortage of clinicians trained to work with older adults.

4 ome Instead Senior Care is a U.S.-based international franchise network that provides high quality, non-medical home care for older adults. The Home Instead Senior Care network consists of more than 900 independently owned and operated franchise offices that help seniors and their families through the home-care stage of aging.

The 50/50 Rule: Helping Siblings Overcome Conflict While Caring for Aging Parents

A long-time employee of an accounting firm, Mary has been waiting for this promotion for years. “This job is just what I’ve dreamed about all my life,” she excitedly told her best friend. But then Mary’s mom fell and broke her hip. As the youngest in the family and her mom’s presumed favorite, Mary suddenly is thrust into the role of family caregiver and is struggling to keep up with the demands of her new job. “I hate the feeling that I have to choose between caring for my mom and a new job all because my siblings won’t help.”

Situations like this are among the family conflicts that caregivers encounter each day while caring for aging parents. Caregiver stress, life-and-death medical crises, financial problems and property disputes often become part of the ongoing saga of a family’s caregiving story. Relationships between adult brothers and sisters can suffer as a result.

That’s why the local Home Instead Senior Care^® office has launched the 50-50 Rule^SM, a program that offers strategies for overcoming sibling differences to help families provide the best care for elderly parents.

“Any family that has cared for a senior loved one knows that problems working with siblings can lead to family strife,” said Bob Vielee, owner of the local Home Instead Senior Care^® office serving Lackawanna, Monroe, Pike, Wayne and Wyoming counties.“Making decisions together, dividing the workload and teamwork are the keys to overcoming family conflict.”

The 50-50 Rule refers to the average age (50) when siblings are caring for their parents as well as the need for brothers and sisters to share in the plans for care 50-50. Research conducted for the Home Instead Senior Care^® network reveals that an inability to work together often leads to one sibling becoming responsible for the bulk of caregiving in 43 percent of families. And that can result in the deterioration of relationships with brothers and sisters.

“If you’re 50, have siblings and are assisting with the care of seniors, it’s time to develop a plan,” Vielee said. “This program can help.”

At the core of the 50-50 Rule public education program is a family relationship and communication guide of real-life situations that features practical advice from sibling relationships expert Dr. Ingrid Connidis from the University of Western Ontario. She says that relationships among siblings should be protected.

“Like all relationships, siblings have a history,” Connidis noted. “Whatever happened in the past influences what happens in the present. Regardless of their circumstances, most siblings do feel a responsibility to care for parents that is built from love. And that’s a good place to start – optimistically and assuming the best.”

Even the best of circumstances, though, can cause a strain for a family dealing with the issues of an aging parent. That’s where the free 50-50 Rule guide of family situations will help brothers and sisters struggling with any number of topics from trying to divide care and work better as a team to dealing with end-of-life issues. In the guide, Connidis addresses situations, like the one described at the beginning of this release, with practical advice.

The guide and a website at www.solvingfamilyconflict.com will offer a variety of additional tips and resources for siblings. For more information, visit the site or contact your local Home Instead Senior Care franchise office at 570-586-3135.  “Sometimes problems can be alleviated with a little extra home care for seniors and respite for family caregivers,” Vielee said.

The extra effort will be well worth it, Connidis explained. “Siblings are sometimes the only family relationships that endure. After parents, siblings are the ones we’ve known the longest. So there is a depth of empathy we can tap into that goes back to that relationship. When I look at my brother, I still see that little boy playing in the back yard.  And I can still remember caring for my little sister. Those memories are what motivate us to care for our parents and each other. It’s what keeps us connected, even when we’re different. That sibling relationship will continue after parents are gone; research suggests that siblings don’t want to harm their relationships with each other.” 

Home. There's no place like it.

It's a place to feel safe and warm surrounded by the memories that make up a lifetime. Home is the foundation of our lives. A symbol of our families and friends. It's a personal sanctuary of comfort and familiarity. Home is the one place we can truly be ourselves.

Young and old, we all understand the importance of home. And especially as we age, home is where we want to stay. Time passes and calendars change, but inevitably the moment comes when you start to wonder:

Can Mom stay home and stay safe without me? Who will help Dad with his groceries when I'm not around? How can I even start this conversation?

These are all valid concerns that Home Instead Senior Care can help you address. Now you can feel secure knowing your loved one can stay in the place they call home. If you need help today or you are planning for the future, call us at 570-586-3135.

Home Instead Offering Free CEUs

Home Instead Senior Care has teamed up with the American Society on Aging to present a series of six webinars that address pertinent caregiving issues. This family caregiver support webinar series features a variety of topics that will help caregivers navigate the many issues that arise while caring for an older adult.

Continuing education is available at no cost to attendees. This series is the ideal opportunity to earn CEUs while gaining valuable information that will help you in your work with older adults- all without leaving your desk. It's convenient and it's FREE!

Each webinar will be recorded and available for viewing for up to 90 days after the live presentation. Preregistration is required to attend the live webinars. Mark your calendar so you don't miss this great webinar.

OCTOBER 27, 2010: "Recognizing the Signs of Aging and Need for Care"

Register by going to https://www3.gotomeeting.com/register/382087790 .

For more information, please call Home Instead Senior Care at 570-586-3135 or visit homeinstead.com/nepa.

Our Solutions for Your Worries

Mom always forgets to take her medications.

Our Solution: Medication Reminders

Home Instead CAREGivers will remind your mom to take the prescribed dosages of her medications at the correct times. No need for you to worry whether she has taken them or not.

Mom isn't cooking. She barely eats and her fridge is either bare or stocked with expired food.

Our Solution: Errands, Meal Preparation, and Clean Up

Home Instead CAREGivers will do grocery shopping for your mom. Our CAREGivers are able to prepare and serve nutritious meals for your loved one. Also, they will prepare meals that are easy for mom to reheat on her own. CAREGivers will also make sure to discard expired or spoiled food. You'll be comforted knowing she has healthy meals easily available to her whenever she's ready to eat.

Mom's house is a mess. My visits are spent cleaning, not spending quality time with her.

Our Solution: Light Housekeeping, Taking Out Garbage, and Laundry

Home Instead CAREGivers will make sure mom's house is kept tidy... and safe. Our CAREGivers will perform duties that your Mom is unable to accomplish. Such duties include vaccuming, dusting, and taking out garbage. Laundry will be washed, dried, folded, and put in its proper place. You won't have to spend any more time doing chores while visiting mom. Your time can be spent enjoying each other's company.

Mom is at home recovering from a broken hip. I'm afraid she'll fall again.

Our Solution: Personal Care

Home Instead CAREGivers will assist your mom with mobility, dressing, tolieting, and showering. Our CAREGivers recieve Personal Care training; they know the proper way to help your mom so she doesn't hurt herself and make sure activities, such as tolieting and showering, can still be discreet. We'll be by your mom's side when you can't be there yourself.

Your parents want to stay in the place they call home. We can help.

She sang you to sleep, taught you how to tie your shoes, made chicken soup when you were sick and cheered you on at the game. You knew she was there for you, no matter what. Now you want to be there for her. Whether you’re caring for your mom, your dad or both parents, we’re here to help. There’s no place like home, and Home Instead Senior Care® was created to help seniors remain safely in the comfort of home and to provide support to the family and friends who love them. Since 2002 our local office has been here to address your concerns and provide the non-medical services you need, whether it’s companionship while you’re at work, assistance with a shower, support with incontinence, help with groceries and errands, a helping hand with household chores or a simple reminder to take medications. With the help of our compassionate CAREGiversSM, you can stop worrying and enjoy your time with your loved one.

Please call us at 1-888-294-6785 to schedule a free, no-obligation consultation or visit homeinstead.com/nepa for more information.

Activities for the Mind, Body, & Soul

Both seniors and adult children agree: staying physically active is a major challenge for older adults, according to research conducted for the Home Instead Senior Care network.* But what does that mean to a senior’s everyday life and to family caregivers looking to help and motivate their loved ones?


For many older adults, inactivity is the first step down a road that leads to frailty and decline. Family caregivers as well as seniors want to do everything possible to keep that from happening. The National Institute on Aging says that seniors are more likely to stay active if they:

1. Think they will benefit from activities

2. Participate in activities they enjoy

3. Believe the activities are safe

Keeping an older adult’s mind, body and social life active can prevent or even reverse frailty, experts say. Family caregivers assisting seniors are in a unique position to help them figure out what activities will work best, according to Stephanie Studenski M.D., M.P.H., an authority and researcher of mobility, balance disorders and falls in older adults, who serves as director of clinical research for the University of Pittsburgh Institute on Aging.

*The Boomer Project (www.boomerproject.com) completed online interviews with 523 seniors and 1,279 adult caregivers, ages 35-62, with a parent, stepparent or older relative for whom they or someone in their household provides care.

Dr. Studenski says, “A key is simple activities that seniors find pleasurable or enjoyable. If possible, engage frail older individuals in what they’d like to do. And don’t separate the mind, body and soul activities. Seniors need to stay active doing things they find meaningful and helpful to others, even if they can no longer get out of the house.”

The National Institute on Aging Exercise and Physical Activity Guide points out that regular exercise and physical activity are important to the physical and mental health of almost everyone, including older adults. They can help maintain and improve endurance, strength, balance and fitness; help improve the ability to do things; help manage and prevent diseases like diabetes, breast and colon cancer, osteoporosis and heart disease; and help reduce feelings of depression. Being active may also help improve mood and may maintain some aspects of cognitive function, such as the ability to shift quickly between tasks. Emerging data also suggests that engaging in social and productive activities may help maintain well-being.
ON CALL

Many older adults have a telephone that is programmed with the numbers of family and friends. So all they have to do is hit a speed dial button to make that important connection. A senior can attempt to recall all of the numbers in the telephone directory and make a list.

A senior may want to think of a different telephone number each day this week that she might need and memorize that number. At the end of the week, review all the new numbers.

Incorporate this new skill by asking your loved ones to try to remember the ingredients and directions of a favorite recipe. (Your loved one might want to double check the cookbook to see how well she did.) Or think about a hobby he or she hasn’t done for a long time. Suggest they remember the steps and write them down.

CHANGE DIRECTION

If a senior has a regular route through the grocery store or to the mailbox, she may want to try a different route. Research has revealed that such a technique exercises the brain.

Or, if an older adult can’t leave the house, help your senior break a routine. Drink tea in the afternoon instead of coffee in the morning. If he reads the newspaper in the morning and watches television in the afternoon, suggest that he try switching that around. Make a note of what she likes and doesn’t like about the new order.

While she is going about her day, ask your mom to use her opposite hand to open doors and brush her teeth. Or suggest to dad he wear his watch on the opposite wrist. These activities will help their brains re-think daily tasks.


CRAZY 8s

Cards are a great form of socialization that may help improve a senior’s overall sense of well-being. How about a game of “Crazy 8s?”

1. The basic game of Crazy 8s uses a standard 52-card pack.

2. The dealer deals (singly) five cards to each player (seven each if there are only two players).

3. The un-dealt stock is placed face down on the table, and the top card of the stock is turned face up and     placed beside the stock to start the discard pile.

4. Starting with the player to dealer’s left, and continuing clockwise, each player in turn must either play a legal card face up on top of the discard pile, or draw a card from the un-dealt stock.

5. If the top card of the discard pile is not an eight, play any card which matches the rank or suit of the previous card (for example if the top card was the king of hearts you could play any king or any heart).

6. An eight may be played on any card, and the player of the eight must nominate a suit, which must be played next.

7. If an eight is on top of the pile, you may play any card of the suit nominated by the person who played the eight.

The first player who gets rid of all their cards wins, and the other players score penalty points according to the cards they have left in their hands. Remember that meaningful conversation while playing can boost a senior’s outlook as well.

MEMORY LANE

Remembering and memorizing song lyrics is a great way to keep the mind active. How about “Moon River,” the hit made popular in the 1960s by legendary crooner Andy Williams. If you don’t know the tune, Google it, or let your senior teach you how it goes.

Here are a few others from the 1940s, ‘50s and

early ‘60s that your loved ones might remember:

“Chances Are” (Johnny Mathis)

“Blueberry Hill” (Fats Domino)

“When You Wish Upon a Star” (Cliff Edwards)

“You Send Me” (Sam Cooke)

“Wake Up Little Susie” (The Everly Brothers)

“Sentimental Journey” (Doris Day)

“Fly Me to the Moon” (Frank Sinatra)

Ask a senior to remember and sing other songs as he or she is going about the day.

POWER GRIP

Having the strength to grip can impact the everyday lives of seniors. Seniors can do this squeezing exercise with a tennis ball while watching TV:

1. Hold a tennis ball or other small rubber or foam ball in one hand.

2. Slowly squeeze the ball as hard as you can and hold it for 3-5 seconds.

3. Relax the squeeze slowly.

4. Repeat 10 - 15 times.

5. Repeat 10 - 15 times with the other hand.

6. Repeat 10 - 15 times more with each hand.

Encourage your senior to incorporate this skill by opening a jar of pickles or olives. Or suggest playing fetch with the dog before naptime. Keep hands and fingers limber by folding towels or the laundry.

Source: National Institute on Aging

WALKING STRONG

The Leg Curl is designed to help make walking and climbing stairs easier for a senior:

1. Stand behind a sturdy chair, hold on for balance. Lift one leg straight back without bending your knee         or pointing your toes. Breathe in slowly.

2. Breathe out as you slowly bring your heel up toward your buttocks as far as possible.

3. Bend only from your knee, and keep your hips still.The leg you are standing on should be slightly bent.

4. Hold position for 1 second.

5. Breathe in as you slowly lower your foot to the floor.

6. Repeat 10 - 15 times.

7. Repeat 10 - 15 times with other leg.

8. Repeat 10 - 15 more times with each leg.

Source: National Institute on Aging

THIS IS YOUR LIFE

Why not check out those old photo albums while you take a trip down memory lane. Going through the pictures will undoubtedly jog a senior’s memory and prompt a few stories.

While you’re looking through those old pictures, let your senior’s imagination and memories run wild. Do those old photo albums need a face lift?

Tackle one of those projects today. Why not write down all those stories next to the photos. You’ll treasure them in years to come.

START A COLLECTION

Think about items of interest that have been collected through the years. Many seniors have stashed away old coins or stamps or baseball cards. How about costume jewelry from the 1940s or ‘50s?

Perhaps pieces of the collection are scattered around the house. Make it a treasure hunt of sorts.

Next, decide where you would store this collection. Depending on what you have gathered or decided to collect, you may need a lot of room or a special place that will help preserve the items you are collecting. Think about different ways you could display these treasures. If you decide to collect valuable items, such as baseball cards, consider a safe deposit box at the bank.

Or you could begin a collection that a senior would pass down through the family. Need help? Start collecting by visiting garage sales, looking for the items while traveling or researching on the internet.