Aging/Gerontology, Health Conditions/Diseases, Healthcare, Humanity, News, Social Work/Helping Profession/Mental Health

Rapid assessment and frailty — British Geriatrics Society

This is awesome news and more hospitals should do this! Care beds for older adults and rapid assessment and treatment. Thoughts?

 

Beverley Marriott is a Advanced nurse practitioner working in the Birmingham community healthcare foundation trust. She is also a King’s College Older Person Fellow. There continues to be a growing emphasis on older people and emergency hospital admissions, with Frailty often used as a ‘wrap’ around term for ‘older people’. Older people with multiple complex […]

via Rapid assessment and frailty — British Geriatrics Society

Aging/Gerontology, Education, Healthcare, Humanity, Social Work/Helping Profession/Mental Health

Change for Older Adults is Needed!

As my clients are aging, I see the challenges they face and what is lacking in the current healthcare system.  This has led me to End-of-Life issues, Palliative Care and an interest in healthcare.  I have come to see that there needs to be a shift and focus on allowing seniors to ‘age in place’ and the services must expand in order to do so.   Expansion obviously requires money from the government, both on a federal and provincial/state level.  Healthcare needs to shift to a Patient-Centered approach with professionals available to the patient in either a facility, clinic or in their home in the community.  There is also a need for case managers to oversee the patients with chronic and complex health issues while coordinating with the professionals that need to be involved in the patients overall care.

I have realized much with the work that I have been immersed into for many years now.  For one, end-of-life needs to become less taboo and society needs to realize that in the cycle of life-there must be death; to be born, one must die.  I feel that we need to let individuals die with dignity and at home if that is what they choose while having the necessary professionals and services in place.  As a society we need to lighten up, reduce stress levels and find what makes us happy in life.  Again, a shift is needed and I believe this will happen; with less focus on materials things and more focus on human relationships, quality not quantity.

I feel it is important that every professional re-evaluate their interests and find their passion, their niche population, their niche demographic.  As professionals, we should also advocate within our profession for any needed updates or changes. 

There are many of us out there working with seniors/older adults in many different ways. We are on the front lines, we see what is happening, and see what needs to change. It is our role as professionals to advocate for that change.

What are you going to do today to make that change occur? How can you force the change? Who do you speak to? Write to? 

These are all things to think about and dwell on and when the timing is right-creativity will emerge along with action!

Aging/Gerontology, Education, End-of-Life, Humanity, Social Work/Helping Profession/Mental Health

Social Isolation Amoung Seniors….

As a case manager that works with older adults/seniors in a private community centre, my role is different than a social worker or case manager in a government system.

People choose to be involved with our agency in some way whether through the Wellness Centre, taking courses, volunteering, playing cards, socializing in the cafeteria, attending a group or being involved in the Social Services department.

I have approximately 75 older adults that I personally work with. My contact with them can be only at the centre, through home visits, phone calls, visits in the hospital or rehabilitation, meetings, case conferences, etc.

I also co-facilitate a group for seniors each week and the group’s participants are Holocaust Survivors.

Some of my clients are very private, withdrawn while others are social, active in the centre where I work, volunteer and have more energy than I do! (That is how I want to be when I get older!)

For those that choose to be private, have only a few close friends or for those that have no where to go and are isolated-their life is very different.

This article resonates with me as this should not happen!!

What happened to neighbors saying hi to one another, being friendly, checking up on one another? What happened to the communities of long ago where the younger generations looked out for the older generations!

No one should die alone. No one should lie dead for a month in their home before someone notices!

When I first moved to Canada and my then-husband and I lived in a small upper duplex. We had a senior woman living below us who was extremely private and in the 4 years we lived there, I think I physically saw her in person maybe 3 times.

I heard her, I smelled the cigarettes she smoked and I heard her TV blaring.

One day I realized it was quiet in her apartment; no TV, no radio, no smell of cigarette smoke.

I knocked on her door-no answer. I tried this for 2 days and then being a social worker, professional instinct kicked in, and I went to the janitor of the small apartment complex. The police were called in. Her door had to be broken down and guess what? She was dead. She had fallen and hit her head on the side of her dresser. She had no family that I knew of. No visitors. She had her food delivered as she was not very mobile.

To me that is wrong on so many levels, but if I had not noticed the absence of smoke, no TV-how long until someone else noticed……

Please as a personal plea from me, be aware, notice when a senior is not seen or heard from, get to know your neighbors. Rebuild that sense of community from long ago…….

 

http://www.cbc.ca/news/canada/montreal/quebec-coroner-report-senior-social-isolation-1.4200146

Aging/Gerontology, Health Conditions/Diseases, Healthcare, Humanity, Social Work/Helping Profession/Mental Health

Attitudes and opportunities: Medical students’ and doctors’ attitudes towards older patients — British Geriatrics Society

Another article I have to share as I have worked with older adults/seniors for 17 years. My past work was with youth and families and adults with mental health issues, but my passion is older adults!

This is a great article with excellent information-take a look!

 

 

Dr Rajvinder Samra is a Chartered Psychologist working as a Lecturer in Health and Social Care at The Open University. She enjoys researching the influence of attitudes and personality in medical settings and tweets at @RajvinderSamra Read her Age and Ageing Paper. Social psychologists have been interested in attitudes for about 90 years now. Debate […]

via Attitudes and opportunities: Medical students’ and doctors’ attitudes towards older patients — British Geriatrics Society

Aging/Gerontology, News, Social Work/Helping Profession/Mental Health

Theatrical Presentation on Elder Abuse: Arm Yourself with Knowledge

I attended a play on Elder Abuse this past weekend titled: “Grandpa Is Not a Cash Cow & Grandma Won’t Take Any Bull” organized by Seniors Action Quebec. It was excellent! The cast, except for 3, were all seniors. Le Theatre La Belle Gang presented. The play was written by Francois Jobin and directed by Marie-Claude Henault.

Issues of financial, emotional, verbal abuse, and psychological abuse were addressed in vivid, humorous, and easily recognizable vignettes. Physical abuse and sexual abuse were not outwardly addressed, but these are a bit harder to portray within a play.

Examples of the vignettes are: adult children (sisters) discussing placement while older adult present (recently suffered a stroke), but not including her in the decision-making. A grandchild that approaches her grandfather seeking money for a class trip and this was suggested by the adult child (grandpa’s daughter), an adult daughter who is verbally abusive towards her mother and demanding a check supposedly to be used to pay the mother’s bills, residents in a senior residence sitting around talking and waiting for their Sunday visitors that might show (children and grandchildren), an adult son talking on the phone to a friend saying that if his mother, who baby sat his sister’s kids, will not take his 2-year-old daughter for the weekend, she will see the granddaughter much less often, and the infamous scam of a ‘company’ coming to a senior residence and promising the world, taking the residents money, and giving nothing in return. Another scene was of a ‘doting’ niece who started paying extra special attention to her aunt when the uncle died and suggested that her aunt update her will.

Getting older is not easy, but it does not have to be negative. There may be more dependence on others for IADL’s, Instrumental Activities of Daily Living; cleaning, meal preparation, shopping, transportation, finances, medical appointments, medication management, communication and/or ADL’s- Activities of Daily Living; bathing, toileting, dressing, feeding, ambulating (mobility), cognitive issues, auditory or visual challenges, and fewer socialization opportunities. Household management becomes more difficult and often adult children and grandchildren live out-of-town and a senior has to rely on the community, friends, and agencies or organizations for assistance.

Possible Abuse: What to Look out for and What to Do:

Potential Signs of Abuse:

  • They criticize me
  • They ignore me
  • They isolate me from others
  • I am dependent on others
  • They take control of my affairs, i.e. finances, medication, medical appointments, hiring of homecare assistance, etc.
  • They boss me around
  • They raise their voice to me and at me
  • I am lonely
  • I am depressed
  • I cry often
  • They ask me for money all the time
  • I have no decision-making power

To Counter the Possible Abuse:

  • Say no! Assert yourself to family members, friends, and acquaintances.
  • It is your life and you should be able to go out and do as you please without approval.
  • You can call or talk to whomever you want.
  • You have socialization activities whether playing cards, exercising, attending a social group or meeting friends for lunch to keep you busy.
  • Call your local, provincial or state Elder Abuse Hotline for information, clarification, with specific questions. Arm yourself with knowledge!

Some Resources:

  1. HelpGuide.org
  2. CSSS Cavendish in Cote St. Luc, Quebec- http://www.cssscavendish.qc.ca/   or 514-484-7878.
  3. http://maltraitanceaines.gouv.qc.ca/en/
  4. http://www.aqdr.org/ (French)

By Victoria Brewster, MSW

Aging/Gerontology, Book Review, End-of-Life, Grief/Grieving/Bereavement

What to Do about Mama?- Book Review

Book Review- What to Do about Mama? By Barbara G. Mathews and Barbara Trainin Blank

What I like about this book is the different perspectives on caregiving as there are many contributors. This provides any individual or professional reading the book with different scenarios, which include common situations and feelings.

The authors also describe their own care giving experiences. For Barbara Matthews, she became a caregiver for her mother-in-law. Ten years after her father-in-law died, her mother-in-law came to live in her hometown. At first, the response was no, but as health problems began to appear, the move happened. A family meeting with all helped “seal the deal” for her to relocate and be closer to family to have assistance as needed.

Another health crisis occurred creating a cycle of hospitalizations and rehabilitations. She then moved in with Barbara and her husband on the first floor of their house. Increasing assistance was added as her mother-in-law required it. Eventually, hospice services were put into place which also gave Barbara a break (respite) from providing total care.

For Barbara Trainin Blank, she was the caregiver for her mother who lived quite a distance away.  After her father’s death, her mother began presenting with forgetfulness which progressed. Her mother did not want to go to a nursing home or residence and Barbara did her best to honor this by having assistance come to her mother’s home environment. She became a long distance caregiver, an advocate, an organizer, and in some ways an unpaid care manager-organizing all the details of her mother’s life from medical appointments, to home care workers, arranging transportation, etc.

Caregiving itself has a different definition for each individual providing it. It is hard work from what I have read in the book and witnessed myself in interactions with clients and family. While I have children myself, caregiving for an adult is very different.  The needs of a child can be more or less than the needs of an adult and much easier to carry/lift a child than an adult! Also, as Barbara pointed out to me, for her an important difference between caregiving for children vs. care giving for older adults is that the first is a hopeful process preparing the child for a good future and the second is a process of trying to make life as comfortable as possible for the aging adult as they proceed toward the end of life.

Some common themes in the book are:

Care giving responsibilities:

Local or long distance caregiving?

Alone in acting as a caregiver or shared responsibility?

Potential tasks: financial care, physical care, respite, paid caregivers, volunteers, professional assistance.

Caregiving profiles:

Some quit their jobs to provide caregiving to a spouse or other family member. Some are trying to balance work with raising a family and caregiving (sandwich generation), some are alone in their caregiving role while others have siblings or other family member’s support/assistance. Some are caregiving locally and some long distance.  It is difficult to watch a parent, spouse, child or friend deteriorate and age, just as it is difficult for the person this is happening to, to admit they are aging and deteriorating, and need help.

Roles and Responsibilities:

If you can, define what the person needs assistance with: IADL’s Instrumental Activities of Daily Living; cleaning, meal preparation, shopping, transportation, finances, medical appointments, medication management, communication and/or ADL’s- Activities of Daily Living; bathing, toileting, dressing, feeding, ambulating(mobility). Determine who is assisting with what and whether the individual in question will allow the assistance.

Caregiver emotions and need for self-care:

This to me should be a no brainer; everyone needs some help and should be open to accepting and asking, but it is not easy for everyone to do so.

Self-care should be regularly scheduled as much as possible into the daily and weekly routine.

  • Arrange or accept assistance from family, friends, agencies/organizations, paid companions or homecare workers, and perhaps volunteers.
  • Take vacations or days off if you cannot go away on vacation (financial reasons, other commitments)
  • Give yourself a night off every once in a while.
  • Schedule your own appointments and keep them for medical reasons and check-ups, beauty salon appointments, to go grocery shopping, etc.

Regarding emotions and support for the caregiver:

  • Look into support groups whether run by professionals or volunteers.
  • Seek assistance of a counselor or therapist if you think it would help.
  • Call or schedule coffee breaks or lunches out with friends to talk.

Family Relations:

Communication is important between family members, between professionals and family, between other caregivers, and one person needs to be the designated person as the main contact. As a professional, I can state it is easier to have one family member to talk to, to share information with. If a phone call will not work or is not possible, then a group email addressed to the main contact with the other family members cc’d is another option. This way everyone is in the loop and aware of what is happening and the information is written.

Each caregiver or main contact has their own definition of “doing one’s part.” Caregiving one’s parent(s) is not easy and can be difficult at times as the child-parent dynamic changes. It is reverse roles and now the adult child is parenting the adult parent!

I have worked as a case manager with older adults for 14 years and fortunately I have known most of my clients for that length of time. It is hard to watch someone become frailer. I imagine it is more difficult and more emotional for a family caregiver re: a parent, child, spouse or other family member.

Barbara Matthews shared with me that over the past year of working on her social media sites, this “caregiving in a nutshell” definition has evolved:

Caregivers get involved with care giving to meet a need, solve a problem, or deal w/ a crisis.  The situation often improves—for a while.  Many times caregivers do not take into account the process of aging cannot be controlled, needs will increase—sometimes over many years, or how heavy the burden can/will become.  Therefore, it is important:  to have realistic expectations about care giving, to be prepared for the unexpected, to communicate expectations clearly to the “others” and to develop a care giving contract of shared responsibility to be signed-off on by all.

The book is worth reading and is very comprehensive.

By Victoria Brewster, MSW

Aging/Gerontology, Social Work/Helping Profession/Mental Health

Interview with Patrick Roden, RN, PhD, Certified Aging in Place Specialist

Aging and seniors/older adults are ‘hot topics’ right now due to the aging of our population. Is society prepared?  No. Many more services and innovations are needed to assist older adults while they age. For those that choose to remain at home for as long as possible, services must be bought to the home environment.

Below is an interview I conducted with a professional who has a passion for working with older adults.

What is your background?

I began my life crawling around the floors of a nursing home run by my Irish grandmother who was a nurse in Astoria, Oregon. This must have imprinted me for my life’s mission.

My Catholic upbringing taught me to come from a place of contribution in this life, so I too became a nurse. I worked my way through nursing school employed in a nursing home in Eugene, Oregon, then transferred to Linfield- Good-Samaritan School of Nursing in Portland, Oregon. I completed my Bachelor’s degree in nursing in 1985, applied for a critical care internship, and was awarded a position as a graduate nurse.

I’ve invested over two decades in acute care nursing; trauma center, coronary care, ICU, and recently working part-time for the last five years in post-surgical recovery. I also was a YMCA Cardiac Therapy volunteer in Portland for 10 years, helping people with heart conditions return to health through prescriptive exercise. This was my most positive nursing experience.

Along the way I’ve earned a graduate certificate in Gerontology and a Master’s degree in Adult Education from Portland State University–as well as a Master’s degree and PhD in Social Gerontology from Fielding University.

I enjoy speaking to business and civic groups on issues re: successful aging, aging and creativity, and aging in place. My volunteerism focuses on: Portland Marathon, Meals-on-Wheels, Habitat for Humanity, Central Oregon: Ramp-a-Thon, Relay for Life, and helping seniors in my community.

Why did you create the website; Aging in Place?

I created the website as a concept in the late 1990’s; I was studying environmental gerontology and the term “aging in place” was showing up in all the literature. I knew that someday soon this would be a MEGA trend. It has been said that if you want a BIG opportunity–find a BIG problem; aging in place was both! I knew this would be my life’s work after ICU nursing. And it has become a Magnificent Obsession. Home is fundamental to who we are; home-as-self, if you will. I saw first-hand what institutional settings did to the soul; the mind numbing routines that are essential in places where efficiency is required and accommodation of individual rhythms and needs can’t co-exist. I wanted to do what I could to keep people in their homes.

What is your mission?

The best definition of “healing” I’ve ever heard is: Healing is evoking the will to live in others. The home environment does that…To keep people home by choice; that’s my mission.

Why is a focus on aging and older adults important to you?

My focus on aging and older adults is important to me because as Stephen Covey once said: “What’s most personal is most universal–and most important (paraphrase)…If we are lucky, we will all age, it’s not guaranteed to anyone” God willing, I wanted to help create a more fulfilling future to grow old in. You might call it enlightened self-interest.

Aging in Place.com website is pretty impressive and covers a wide array of services, products, and information. Aging in place tips, resources, design trends, products to assist older adults for the ADL’s, along with a newsletter, and blog.

Aginginplace.com is a friendly, easy to use website dedicated to providing relevant information about the mega-trend of keeping baby boomers and older adults in their homes as they age; the term used worldwide for this is “aging in place.” When visiting the web site you will find out the What, Why, and How.

What: We answer the question; “What is aging in place?” by defining, explaining, and giving you the key ingredients.

Why: We provide insights on why aging in place is important for successful aging by giving both the emotional and practical reasons.

How: We give concrete information on the how-to of home modification and where to find help if needed.

Our blog is focused on entertaining and delighting you while keeping you informed on topics about aging in place and successful aging.

A special thank you to Patrick for agreeing to the interview and keep up the good work that you do!

By Victoria Brewster, MSW