• Remaining independent in my own home.
• Maintaining good health and receiving adequate health care.
• Having enough money for everyday needs and not outliving my income.

Although seniors are definitely concerned about the need for long term care it is not high on the list of concerns. And yet, to address these concerns or wishes and maintain the quality of life wanted in their senior years, it simply takes a little pre-planning.

Unfortunately, as a rule, that is not happening.

For seniors, the need for home care or assisted living is one of the most catastrophic unexpected events that could happen to them. Why? Because the need for care typically removes any level of security an older person may have with the three major lifestyle concerns mentioned above.

With the need for long term care the older person fears:

• Losing their independence
• A decline in their health
• Depleting their assets sooner than expected.

No other late-life event can be as devastating to the lifestyle seniors are so concerned about maintaining. No wonder many seniors who lose their ability to care for themselves withdraw, become angry, and suffer from severe depression.

Ironically, many older people painstakingly scrape together $100-$200 a month to buy Medicare supplemental insurance to cover a risk which is about equal to their yearly premiums. Or, they will go without the things they need, and sacrifice food, recreation and activities in order to hold on to the last few dollars in their savings accounts.

Yet very few seniors spend money or time to plan for the event of long term care. It seems a paradox that someone would be more concerned about buying insurance for a home fire when the risk of needing home care help is 600 times more likely. Or what about the cost of insuring for an auto accident when the risk of long term care is 120 times more likely and is potentially 20 times more expense? Or why the overwhelming concern to buy Medicare supplement insurance when, without it, Medicare would still cover the bulk of their health needs after deductibles and co-pays? And please understand … I’m not recommending going without insurance coverage.  I’m simply using it as an example of how people refuse to deal with the issue of long term care.

No one knows why people beyond age 65 are not more concerned about preparing for long term care needs. Perhaps they mistakenly think the government will take care of them. Or, they are assured that family and friends will provide the care when needed. Whatever the case, without proper planning, the need for care services can result in the one of the greatest challenges in a person’s senior years.

In addition, this lack of planning will always have an adverse effect on the older person’s family. It usually results in great sacrifice or financial burden on the part of the spouse or children. Or, for those with no immediate family, long term care can be a burden to extended family members, neighbors and friends.

I would urge anyone reading this column, who are planning for retirement, or are now in their retirement years, and who has not prepared for long term care, to at least do some research, seek professional guidance, look at the options, and give this matter some careful attention.

As Benjamin Franklin so aptly put it “an ounce of prevention is worth a pound of cure.”

Carl R. Johnson
Certified Senior Advisor (CSA)®
Community Relations Director
Abiding HomeCare
Silverdale, WA

Tiredness

Is the client tired for a good reason? Perhaps they overworked themselves during the day, have been suffering from insomnia due to certain medications, or are readjusting to being out of the hospital. Are they able to catch up on their sleep and seem rested enough during the day that they aren’t taking frequent naps? If they seem tired, it’s important to know how long it has been going on.

Withdrawn

Does the senior suddenly have no desire to interact with people that they once liked spending time with? Do they tend to keep to themselves more and more often? It is important to note what the senior’s disposition is normally. If they are naturally shy or soft spoken, not wanting to draw attention to themselves or interact with people, this may be a harder call to make.

Sadness

Is the client experiencing prolong bouts with sadness? Do they have a reason to be sad, such as the recent loss of a beloved pet or dear friend? Do they seem sad because of something specific or melancholy in general? Are they making progress in dealing with their sadness such as grieving for their losses? Or do they seem to be taking the loss very hard and unable to cope?

The key to picking up on and alerting a senior’s health care professional to the potential onset of depression is being intimately familiar with the client on a variety of levels. As a caregiver having a true understanding of the senior’s moods, attitudes, and outlook on things will make changes in these characteristics easier to pick up on.

Any frequent and constant changes that a family member or caregiver notices in an elderly individual should be discussed with their doctor at the first opportunity. The sooner depression is diagnosed in the client, the better the prognosis and treatment will be.

Some of the ways the elderly may express anger are:

• being combative
• breaking things
• cursing
• shouting 
• name calling
• withdrawing

Caregivers have to take the time to sit down with an angry senior and find out the source of their anger. Family members and friends can help caregivers with the senior to work through the issue and redirect their anger toward more productive things.

Some of the ways a senior may express feelings of sadness are:

• crying
• withdrawing
• losing interest in things or activities
• sleeping a lot

It’s very important that family members and caregivers find the source of the client’s sadness. Making repeated efforts to lift the client’s spirits is essential to deterring the onset of mental illnesses such as depression.

Some of the ways a senior may express feelings of anxiety are:

• shaking
• trembling
• trouble concentrating
• wringing hands
• decreased appetite
• insomnia
• crying

Because the continued presence of anxiety can lead to more serious conditions such as panic disorder, it is very important that caregivers and family members find effective ways to soothing an anxious client. Talking to them to find out exactly what they are nervous or anxious about can lead to the creation of a plan to effectively put the worries to rest.

The most important thing to remember is to address a senior’s feelings and emotions with dignity, respect, and compassion. Seniors may not know how to communicate their feelings, even if they have an audience to share them with. Careful and considerate methods of helping the senior cope with their emotions should be employed by everyone who comes in contact with the senior to reinforce the idea that whatever they may be feeling is okay and that they are entitled to feel any way they want to feel. Ensuring that the senior has a dependable group of supportive people can and will make all the difference in the world.

The following activities are possible in a home care environment due to the ease they can be carried out and the little space, time and cost in setting them up.

Painting

For seniors who have trouble communicating due to speech impediments or dementia, painting can be a wonderful new way of expressing. They can paint out their feelings in bright shades that can depict any number of emotions or messages that they may want to convey. Displaying their creations in a prominent place in the home can instill a sense of pride in the client, which goes a long way in combating mood issues like depression. Optionally, a client can give their creations to friends or family members as gifts, which can provide them with a level of self-confidence as well.

Scrapbooking

Scrapbooking is an ideal activity to promote and maintain long-term memory. Seniors can sift through cherished photographs of their loved ones while creating the perfect page to display them upon. Looking through the photographs will trigger memories of the people depicted in them so that the seniors do not lose the ability to recognize the important people in their lives. As with the paintings, seniors can choose to give away their creations to family members as treasured heirlooms to be passed down for generations to come.

Photography

Taking up photography as a hobby can motivate the elderly to remain active and interested in their surroundings. It can encourage them to get outside and get involved in the world around them, which is very important in maintaining social skills. Further, photography can instill an interest in the outdoors in a senior as they may want to photograph local flora and fauna. The benefits of this can be two-fold as they are both interested in something and able to get fresh air and exercise in the process of pursuing that interest.

If you would like to share with us your ideas for exercising the mind whilst receiving home care please leave a comment below.

Foods that contain ‘empty calories’

Because seniors are less active than the younger population, their bodies require less food, whose calories are later turned into energy for activities. Junk foods should be avoided because of their high fat, calorie, and sugar content – also known as ‘empty calories’. Empty calories are calories that have no nutritional value.

Foods with a high sodium content

Even if they are not on a restricted sodium diet, seniors should avoid foods with a high sodium content due to the increased risk for elevated blood pressure and the host of maladies that can accompany it. Caregivers should also be aware of foods with hidden sodium content. These foods are foods that one doesn’t normally consider as ‘salty’ – such as certain types of breads.

Fried foods

Fried foods contain high levels of LDL or ‘bad cholesterol’. An elevated cholesterol level can present a host of health problems in the elderly and make them susceptible to strokes and heart attacks.

Raw or undercooked foods

This doesn’t mean to just thoroughly cook a senior’s foods. There are a number of foods that aren’t supposed to be cooked that can lead to a variety of food borne illnesses due to the presence of germs and bacteria. Some common food products where bacteria is prevalent are:

• soft cheeses such as feta, Brie, and Camembert
• egg products like cake batter, cookie dough, sauces, and eggnog
• raw fish products such as sushi
• hot dogs 
• non-pasteurized milk, milk products, and juices
• fresh vegetables and fruits that have not been thoroughly cleaned

The reason that raw or undercooked foods pose a health risk in seniors is because a reduction in stomach acid occurs as the body ages. Instead of being broken down by the stomach acid, the bacteria is able to reach the small intestine where most gastrointestinal issues occur.

It should be easier for a senior receiving home health care to eat a healthy diet due to the experience, mobility and motivation of the caregiver.

However, there are a number of ways that care providers and family members can lift the spirits of their elderly loved one and maintain their emotional health in the process. Here’s a look at some of the techniques that can be implemented to ensure a senior’s emotional well-being.

Talking

Talking to the client about a variety of topics. Tell them about news or current events that they might not be aware of. Talking about recent episodes of their favorite television programs. Discuss the day to day activities and goings on within the home or family. All of these are good topics to strike up a conversation, but they are only a drop in the bucket.

Listening

Listening to the client is also very important. Being attentive and interested while the client speaks makes them feel important and valued. Listen to them talk about anything that comes to their mind. Maybe they want to reminisce about the good old days or maybe they’re upset over something they saw on television. Perhaps they need to bounce some ideas off of someone or share their opinion on things that matter to them. No matter what it is, care providers and family members should always be respectful and attentive when the senior is speaking. Otherwise, they may feel like no one cares what they have to say, which could cause them to withdraw all together.

Reminders

Everyone likes to be reminded of how special they are. Care providers and family members should always remind their elderly loved ones how special they are to them and how important they are in their lives.

Reassurance and Positive Reinforcement

Sometimes an elderly person may feel like they are helpless or not good for anything due to the constraints and ill effects that aging can often bring. Care providers and family members alike should make conscious efforts to praise any and all accomplishments that a senior makes over the course of the day. They should encourage the senior to try new things and to complete simple task. This can be very beneficial to the client by reestablishing their sense of self-worth and value.