Homes That Grow Gracefully With You

As we enter into retirement, we begin to face some very difficult questions about the future of our families and our ability to maintain our independence through the retirement years. We have a strong desire to retain our autonomy as long as possible and not rely on family members for assistance with daily living. Universal and adaptable design concepts optimize space in our homes to accommodate a wide range of individuals with varying physical abilities, allow people to stay in their homes longer, and keep families together.

What is Aging-in-Place?

Aging-in-place means living in your home safely, comfortably, and independently, regardless of age or ability level. It allows you to continue living in a familiar environment throughout your maturing years. Aging-in-place is the ability to remain in your home for a lifetime.

Quick Facts…

One-quarter of the U.S. population is over age 50.

From 2000 to 2030 the over 65 population will double.

By 2030, the population of older people will likely increase to over 69 million persons.

By 2050, the U.S. will account for 79 million people over age 65.

The net worth of seniors is five times greater than the average net worth of all U.S. citizens.

What is universal and adaptable design?

Ron Mace, founder and program director of the Center for Universal Design, defines universal design as “the design of products and environments to be useable by all people, to the greatest extent possible, without the need for adaptation or specialized design”. For our purposes, we will limit the term “universal design” as it applies to home design and related products.

Adaptable design, on the other hand, allows the easy modification of a space to accommodate a specific need. Where universal design benefits everyone regardless of ability, adaptable design provides access to spaces or products through alteration or the addition of an assistive device that bridges an existing barrier to its use. Adaptable design is defined by ANSI A117.1 (American National Standards Institute) as, “the ability of certain building elements, such as kitchen counters, sinks, and grab bars, to be added to, raised, lowered, or otherwise altered so as to accommodate the needs of either persons with or without disabilities, or to accommodate the needs of persons with different types or degrees of disability”.

The differences between universal and adaptable design may be obscure at times. One could consider the installation of grab bars in a shower to be universal as anyone can use the bar for balance or safety. But the installation of the backing (structural support) for grab bars may be considered adaptable if the intent is to install the bars at a future time when needed to provide access to the use of the shower by a person with a disability. It is this obscurity that points to the fact that universal and adaptable design is not a matter of listing items as features; rather, it is a philosophy of design. The philosophy of universal design is summarized by the Principles of Universal Design developed by the Center for Universal Design (see Sidebar).

THE PRINCIPLES OF UNIVERSAL DESIGN

Copywrite 1997 NC State University, The Center for Universal Design

PRINCIPLE ONE: Equitable Use The design is useful and marketable to people with diverse abilities.

PRINCIPLE TWO: Flexibility in Use The design accommodates a wide range of individual preferences and abilities.

PRINCIPLE THREE: Simple and Intuitive Use Use of the design is easy to understand, regardless of the user’s experience, knowledge, language skills, or current concentration level.

PRINCIPLE FOUR: Perceptible Information The design communicates necessary information effectively to the user, regardless of ambient conditions or the user’s sensory abilities.

PRINCIPLE FIVE: Tolerance for Error The design minimizes hazards and the adverse consequences of accidental or unintended actions.

PRINCIPLE SIX: Low Physical Effort The design can be used efficiently and comfortably and with a minimum of fatigue.

PRINCIPLE SEVEN: Size and Space for Approach and Use Appropriate size and space is provided for approach, reach, manipulation, and use regardless of user’s body size, posture, or mobility.

“The Principles of Universal Design were conceived and developed by The Center for Universal Design at North Carolina State University. Use or application of the Principles in any form by an individual or organization is separate and distinct from the Principles and does not constitute or imply acceptance or endorsement by The Center for Universal Design of the use or application.”

What are some applications of universal and adaptable design?

Universal design encompasses a wide scope of home design and modification extending from landscaping and low maintenance exterior and interior finishes to specific features that enhance the use and safety of bathrooms and kitchens. The use of energy efficient building materials and solar design, for example, may be considered universal design criteria because it benefits everyone who uses it.

Some of the major areas we look at, from the perspective of universal design, are entrances and pathways leading to entrances, overall interior accessible features, kitchens, bathrooms, and sleeping areas. Let’s take each of these individually and look at ways that we can improve the usability of each.

Entrances and pathways

One of the first things to consider in universal design is how to eliminate barriers to access from a vehicle drop-off point to an accessible entrance. To make a pathway usable for a person using a wheelchair or other assistive device, we need to limit the slope of the walkway to a maximum change of 1 foot for every 20 feet up or down to the entry. We prefer to use earth berms, bridges or retaining walls instead of front ramps that may suggest a vulnerable resident. Anyone moving heavy furniture in or out of the home will love this feature!

The entry itself has many facets to look at in terms of accessibility. These items include providing weather shelter, a no-step entry with a threshold less than ½” high, maneuvering space on both sides of the door, sidelights or “peepholes” to view visitors, and adequate lighting to operate locks and provide security.

Overall features of the home

Here, we are going to explore some universal design features that aren’t specific to any one room, but should be considered as general applications.

Whether the home is designed for aging-in-place or simply for visitability, we want to create easy access to the main living areas and facilities. This can be accomplished by providing a minimum clear opening of 32” on all doors to accessible areas and a 40” minimum clear circulation route through rooms and hallways. We also want to provide a minimum of 18” beside the door latch for easy operation for people using assistive devices. Lever handles allow use with an elbow, forearm or wrist for people who have difficulty gripping or twisting a doorknob.

Another consideration would be the placement of electrical outlets, switches and other operable controls. Raised outlets between 18” and 22” above the floor falls within the range of use for a person in a seated position and also aids people who have problems stooping over. Placing light switches and other controls a maximum of 48” above the floor allows their use from a seated position. Children also have an easier time using these switches.

Safety in the home is another big consideration addressed through universal design. Non-slip floor surfaces will help avoid falls and aid in the use of walkers and wheelchairs. Telephones installed in strategic locations, such as bedrooms and bathrooms, will help summon assistance if needed. Also, lowered window sill heights to a maximum of 36” high will enhance the use of windows for egress in case of fire or other emergency.

Kitchens

Kitchens are notorious in excluding their use for a variety of people and there are many universal design “standards” that apply to this area of the home. Even though the application of universal criteria to the kitchen is typically design specific, we will cover some of the more critical design choices.

We first want to be sure we have proper floor space that is suitable for all users, including people who use wheelchairs. Optimally, we would like to see a 5’ clear turning radius in the kitchen, but, as a minimum, we want to provide a 30” x 48” approach in front of all appliances. We also want to provide knee space under the sink and cooktop, as well as a lowered counter (also with knee space) at a work area for a person in a seated position. Some adaptable criteria may come into play here with removable base cabinets or doors that swing out for roll-under access.

Continuous counters between work areas may be a universal design consideration. An example would be having a sink and cooktop on the same run of counter so that a heavy object could slide between the two without having to pick it up. Another idea might be to have a sprayer or faucet located to fill coffee makers or pots without lifting.

The selection and placement of appliances need to be considered for ease of use. Controls need to be placed within the range of reach for persons in a seated position. The maximum reach height of 48” for all kitchen controls apply here. Forward reach over obstructions should also be considered, but this is client specific and mathematical formulas are used to determine forward reach ranges. Front mounted controls are easy to use for everyone, but consideration needs to be taken in terms of access to small children. Side-by-side refrigerators are also accessible to everyone.

A raised dishwasher, as well as raised washer / dryer in the laundry room, improves its use for both people using wheelchairs and those having problems stooping over to load the machine. There is also a long list of cabinet features that improve access, such as pull-out shelves, lazy susans, and roll out waste containers. Adequate task lighting is also a major consideration in the kitchen.

Bathrooms

Safety is the number one priority in the bathroom as it is the room with the highest number of accidents in the home. Non-slip surfaces are essential both inside and outside the tub / shower area. As mentioned earlier, grab bars enhance the safety for everyone, but are especially important to people who have an increased risk of falling. They are also very important for people who use wheelchairs to enable transfer to shower seats and toilets. Pressure balanced / anti-scald valves are another safety feature that benefits everyone.

Access for people using assistive devices is critical in the bathroom. Curb-less showers allow people to roll-in or avoid tripping over a curb at the shower pan. (This feature has also spurred some very beautiful bathroom designs!) Dimensions around toilets are critical for access and 30” x 48” minimum approach area in front of all bathroom fixtures is needed. (These clearances can overlap.)

There are many accessories available for shower / tub modifications that improve safety and convenience. Recessed soap and shampoo ledges, various seats and benches, and adjustable height / hand-held shower with slide bars, just to name a few.

Bedrooms

One of the important features we want to look for in the bedroom is that there is adequate clearance for maneuvering around the bed and proper clearances for emergency egress, either at a door or a window with a lowered sill. Proper clearance should be considered for adaptable devices, such as a Med-Pole (a stainless steel assistive device) or Hoya lift. The doorways to accessible areas, like the bathroom and closet, need to be a minimum of 32” wide as mentioned earlier. Adjustable shelves and clothes rods in the closet are very helpful to accommodate a wide range of reach.

Summary

Aging-in-Place means maintaining independence and control of your life. Your environment plays a key role in achieving that goal and steps should be taken to improve the usability, safety and comfort of your home.

This begins with a comprehensive personal assessment and home audit for independence that may be performed by a medical professional or a trained aging-in-place specialist. With this information, solutions for home modification can be developed. Some of these modifications may be done yourself, such as using brighter lighting and slip-free mats. Other modifications will require a trained professional for widening doors and various remodel projects in bathrooms and kitchens.

Whether you are considering remodeling or designing a new home, look for professionals who have the experience to accurately assess your needs and find the solutions that will make your house a home for a lifetime. One resource for finding qualified professionals is the National Association of Home Builders (NAHB). They have created the Certified Aging-in-Place Specialist (CAPS) program to help you identify industry professionals with the skills and knowledge specific to home modifications for aging-in-place.

Thomas Hewitt is a Certified Aging-in-Place Specialist, home designer and President of Falcon Homes, Inc., Albuquerque, NM. For more information on Falcon Homes, Inc., visit their website at http://www.falconhomesinc.com or call Thomas at 505-323-5361.

This article gives ten ways to help achieve a safe and joyful air travel experience with your elderly parent. This is based on personal experience with my own 91-year-old mother. After having some rather stressful trips with my mother, I have made conscious efforts to create more joy in our travels. My goal was to reduce the frustration for my mother and for myself.

1. Include your parent in the planning stage of making reservations for rooms.

Some parents prefer having a separate room. Others like the security of sharing a room.

2. Review procedures for closing out their residence prior to leaving. Stop paper, mail, etc. Make sure there are no appointments lined up for the time period of the trip.

3. Plan to travel on a day ahead of the main activities of the trip.

This time gives space for transition to the new environment and rest from the trip.

4. Arrange with the hotel/motel for adjoining rooms if you are in separate rooms.

This gives you the opportunity for easy connecting. Even keeping the key for your parent could be helpful. Doors are usually very heavy and are not easy to handle. Better to have your parent wait in the room until you are with them.

5. Go over the procedures for contacting the front desk so that the security of having help nearby is there.

Caution against opening the door thinking it could be family. Rely on the phone for connection if you don’t have the key to their room.

6. If agreeable for your parent, arrange ahead of time for a wheelchair.

Distances in the airport are LONG and there is so much confusion everywhere. Being in the wheelchair takes away that stress for your parent. AND you can zip through the security lines when you are with a wheelchair passenger!

7. Take along extra reading material for your parent to make the waiting time go faster.

Something you have may be more interesting since it is different from what your parent usually reads.

8. Take along a nightlight so that there is safety at night for going to the bathroom.

So many elderly people have falls which lead to inactivity which leads to degeneration of the body. Having light at night is a great safety precaution against falls.

9. Be careful not to pack the schedule too tight.

Leave room for naps when necessary. Take along plenty of reading for yourself so that you are not impatient waiting.

10. When returning home, check over their residence to make certain all is in shape for reentry.

Make certain lights are working. Check for any leaks in water lines. Ask if there is anything that you can do for them before you leave. Coming home after a trip is another important transition.

Suzanne Holman,MAEd works with successful professional baby boomers who want to use their brains not only for financial abundance but for bringing more JOY to their lives!

Visit Suzanne Holman’s website, http://www.suzanneholman.com for a complimentary Exuberance E Course and Assessment.

Is anybody really ready for their lives to be turned upside down, when parents need help and the adult child steps in?

My memories of my grandparents are very vivid. They were wonderful grandparents but one day life took a slide backwards and age catches up.

My grandparents who lived in their own home and maintained all the aspects of their lives were one day uprooted and moved to their daughter’s home.

My grandparents were still very much in control of their own lives, in some areas but in others, not anymore.

My mother, as their loving daughter, their roles became reversed. She was not ready for this change. Suddenly, my mother became the parent and they became her trusting children.

NOW MY MOTHER HAD TO SET THE RULES AND BOUNDARIES FOR HER PARENTS EVEN WHEN IT WAS HARD FOR HER.

When my grandparents argued with my mother, such as, about them wanting to use their own sheets, blankets, and bedspread on their new, adopted bed, poor mom, she could not understand why. They were perfectly good sheets and blankets already on the bed but what they needed, was something familiar. My mother came to understand that, eventually.

But how do you prepare yourself for the day your life turns upside down? Now your parents are your children and you have to take care of their personal needs.

There were no such classes, thirty five years ago when all this happened. You just had to wing it as you went along.

My mother was confused and definitely not ready for this change. Now she was the CARE GIVER, FINANCIAL ADVISOR and the one IN CHARGE.

My grandparents migrated from Wilno, Lithuania before the First World War on a cattle boat. They were happily married for approximately seventy-five years. I loved to listen to them argue. Never fight. Just pick, pick, pick.

They always did everything together. My grandmother cooked while my grandfather helped and they both made their bed every morning.

Thankfully, they were both in good health up until the end. They always were coherent and never violent. They both lived into their late 90’s.

My mother was lucky she had family which lived close by to help. But my grandparents, as they came to rely on my mother, would not accept help from other family members. They were more comfortable with my mother.

Obviously, this put a huge burden on my mother. She was working full time while making sure her parents were comfortable and safe. She could not travel or leave home for longer than a weekend.

Towards the end of my grandparent’s lives they could not walk and as a result, their care became to physically demanding. My grandfather ended up in the hospital. He was so upset with having been placed into the hospital without his permission; he never spoke to my mother again.

My mother was a special person. She loved and kept her parents comfortable and safe until they both passed away. I never heard her complain.

Today when the grandparents are living with family members, it is rare. Many are sent to nursing or convalescent homes.

To make that heart wrenching decision is very difficult on the family but sometimes it is the only option.

As I am getting older, it scares me to think, that someday my children will have to do for me what my mother did for her mother. I hope I don’t fight them on this matter. Nobody can predict the future.

Let me hear from you about your experiences on this article or about any of my articles.

Copyright 2006 Linda Meckler

Linda was very lucky she had the love of her grandparents throughout her lifetime. She remembers these years her mother became the parent of her own parents.

Currently she is the author of "Ghost Kids Trilogy," three books in one book. CHRISTY 12, AND HER BROTHER BRAD, 16 MOVE INTO AN OLD HOUSE ON TOP OF A MOUNTAIN AND MEET TWO GHOST KIDS. Meet a Magical Blue Vase. Join Christy and Brad on a Pirates’ Treasure Hunt. ADVENTURE/MYSTERY Love, Family Values and Charity burst off the pages. Visit my website at http://www.lmeckler.com my email lmecky@tns.net. Order my book at http://www.amazon.com or http://www.buybooksontheweb.com With an order of 5 books = 40% discount. An order of 20 books free shipping and handling. ISBN 0-7414-2273-5.

There are a couple of things in life that we know, at some stage, we will be worried about. Growing old certainly seems to be one of them. More and more, our culture is becoming obsessed by the cult of youth. Not only are film stars and musicians young and beautiful, but increasingly, politicians and newsreaders are getting younger also. Add to this the extraordinary lengths to which the not so young among the elite are going to maintain their youth and appear young and you will quickly see why so many people are becoming distressed about growing old.

There is one thing that people have known, at varying levels, for centuries however. This is that old age is a state of mind. Therefore, the secret to staying young lies also in the mind and not in the body. When someone mentions Madonna, we don’t think about old age or an elderly woman, but is this because she still looks quite young, or because she is as active and controversial as ever, releasing hit albums and doing what she has always done? In many senses it is a combination of the two, but I would propose that it is the young mind that keeps the body young rather than the other way around.

There are many things that you can do to keep your mind young and active. One is to keep up the old hobbies and pastimes that you have enjoyed for your whole life. Try to keep physically active. Consider walking and swimming which are less stressful on joints and bones than some other activities.

At the end of the day, it is not such a young person’s world out there. The charity. Help the Aged, defines the elderly as anyone above the age of 50. There are many 50 year olds around who would defy this but the fact is that many people, by this age, are already preparing for retirement. Age discrimination has also been recognised by the government who in 2006, will bring into force the age discrimination act that outlaws discrimination on the basis of age in the workplace.

Also, the over 50 age group is not only the fastest growing segment of the population, but 80% of the nation’s wealth is owned by the over 50s. They are also one of the freest and least tied down segments of the population. As society’s attitudes change towards old age, perhaps the time is coming to let loose and enjoy old age for all the potentialities it provides.

Joseph Kenny is the webmaster of the insurance site http://www.insure121.com/ where you will find information, news and links to the leading providers of insurance in the UK. If you found this article interesting you may find more articles of the same nature in the insurance guide located on site.

Q. When do you need a care facility?

A. A residential care facility should be taken into account when at least one of the following circumstances happens:

- Your elderly relative requires and demands twenty four hour of continuous care and attention.

- Your elderly relative can not anymore cope up with the activities of day-to-day living such as eating, bathing, using the toilet, changing etc.

- Your elderly relative is more likely to have either physical or verbal violent out burst and is a threat to himself and to others.

- Your elderly relative has wandered off from the safety of home.

- The caregiver’s physical condition and welfare is harmfully affected.

Q. What out of home choices for the elderly are available?

A. A variety of choices are available, and it is an important decision, so choose wisely.

1. Residential care facility.

For the elderly that is no longer able to live alone however does not require skilled nursing attention and care. Assistance is given in grooming, bathing and other daily activity as well as care and supervision for temporary illness.

2. Assisted living facility.

Granting independence to the elderly who are moderately healthy and active. An impaired spouse and a healthy spouse may live together in an assisted living facility, where most include apartment style of living with separate kitchens, twenty for hour security, social and recreational programs.

3. Skilled nursing facility.

Also known as nursing homes, wherein patients are given continuous nursing services and assistance from a licensed vocational or registered nurse. Skilled nursing facility provides extensive and broad services and help, such as medication, injections and constant monitoring of blood pressure as well as support for patients with ventilators. Compared to residential care facility and assisted living facility, skilled nursing facility provides the much needed medical care of patients.

4. Others. There are special care centers that offer and give special attention to certain medical conditions like dementia or Alzheimer’s disease. Psychiatric facilities are an option for the elderly that displays violent behaviors.

Q. What qualifications should I look for in a primary care physician? A. A primary care physician should be competent, well trained and has concern for and about the elderly. Ask these questions to guide you in choosing the right one for your relative:

- Does the physician practice as part of a group or does he practice on his own?

- Does the physician accept patients with Medicare?

- Is the physician’s clinic accessible from where you live?

- Are you comfortable with him?

- Where does he treat his patients? At which hospital?

- Can he explain to you things clearly? Can you easily understand his explanations?

- Does he readily listen to you and to his patient?

- Does he show concern when communicating with you?

- What is his policy and guidelines about following up patients with regards to patients that has moved to a residential care center?

Q. What should I consider when choosing an elder care facility?

A. Carefully consider the following areas: services, facility, staff, rooms, respect, and medical considerations

1. Services

- What are the care services that the facility provide? Do these satisfy your needs?

- What accommodation choices do they offer?

- What items from your home can you bring in the facility? What items are not allowed?

- Can you have your own car on the grounds?

- What are their policy regarding visitation?

- Is it licensed by the State?

- Is there a balance of social and recreational activities?

2. Facility:

- Is it well kept and sanitary?

- Are the safety measures such as fire exits should be clearly marked, hallways should be well-lighted and bathrooms should have grip bars appropriately set up?

- Is it located in a convenient and safe location?

- Does it have a twenty four hour security?

3. Staff:

- Are they friendly, approachable and respectful?

- How many are assigned per shift?

- What are the staff’s credentials?

- What medical services (physician, physical therapist, nursing, respiratory care, etc.) do they specialize in?

4. Rooms:

- Are the rooms bright and airy? Are they arranged in a cheerful manner

- Does it permit privacy?

- Does the room offer a view? Does it have wide windows?

- Is the dining room clean and spacious, in such a way that one can move around easily?

- Is the kitchen clean, organized and sanitary?

5. Respect:

- Does the facility clearly state the rights and responsibilities of patients?

- Are the staff well trained, so as they treat each elder with respect and dignity?

- With regards to the patient’s care plan, do they encourage family members to get involved?

6. Medical considerations:

- When emergency arises, is there always a physician available?

- Is the personal physician of the elder permitted to follow up the patient or does the facility appoint a resident physician to each elder?

- In cases of emergency, does the facility have arrangements with a hospital nearby?

- Is there always transportation that is available at all times?

Now you are prepared to plan out the elder care for yourself or a relative! I hope you have found this article useful.

For more great elder care related articles and resources check out http://eldercare.goldenhq.com

As baby boomers watch the years fly by, one of their biggest concerns is sorting through the many problems of caring for their elderly parents. When is it no longer safe for our elderly parent to stay home alone? How can we maintain our jobs, our home, our children, and care for our parents all at the same time? What resources are available to help? How do we approach the subject with them? How can we help them keep their independence and dignity? How do we deal with the stress of it all?

As our parents age, we need to stay diligent and aware of changes in their mental orientation and ability to care for themselves. Are they just a little forgetful at times, or is it something more worrisome than that? If they are able to take their medications without being reminded, bathe alone, dress without assistance, prepare meals every day, and they are not experiencing frequent falls or sudden illnesses, they are probably safe to be at home alone. There are monitoring systems and personal emergency alert systems that can provide added security by making help available to them in the event of an accident or sudden illness.

However, if you notice that your parent’s health is declining, that they have increased weakness or weight loss, if they have had frequent falls, if they are not taking their medications, not eating properly, and not able to do their personal care without help, it may be time to look into other options. Sometimes the increased care is all they need to regain their strength and be able to continue living at home, avoiding placement in a nursing facility or some other major life change.

Finding the help you need is another obstacle. Knowing who to go to for help may seem to be an overwhelming task, but there are many resources available to seek information and counsel. Private duty organizations, home health agencies, and hospices are all viable places to start if you want to help your parent stay at home.

The Indiana Association for Home Care and Hospice (IAHHC) has a listing of all local agencies, both for private pay and agencies that accept Medicare and/or insurance payor sources. You can find them on their web site: www.ind-homecare.org.

When investigating which private agency to use, make sure they are licensed appropriately and that they do criminal background checks on all their employees. Their staff should be bonded and insured, and you should not have any of the burden for carrying worker’s compensation, tax liabilities, or social security. A new law beginning in January of 2006 requires all private duty, non-medical services to be licensed through the state of Indiana. Make sure the agency you choose has gone through this licensing process, and you will be safer in trusting that they have taken all the appropriate steps in ensuring good care for your loved one.

There are many financial resources available to help pay for private duty care, such as reverse home mortgages. The Veterans Administration can give you valuable information on benefits for veterans who need care at home and have served at least one day in the service during war time. These benefits are also available for spouses of veterans. Look on the web for more information regarding financial concerns; there’s plenty of information available. You can also contact private duty agencies and request assistance in finding funds that are available.

Private duty agencies can provide any kind of non-medical care needed to assist the client in staying at home. They will provide personal care assistance, medication reminders, cleaning, cooking, laundry, running errands, and transportation to appointments, and a variety of other services. They are usually available twenty four hours a day, including holidays and week ends, and do not require any doctor’s orders to initiate the care.

Home health care requires a doctor’s order for services to begin, and the patient must be certified to be on "home bound status". This means that they can only leave home to visit the doctor, go to church, or to the beauty or barber shop. A nurse will visit on a regular basis, and a home health aide will assist with personal care. Some home health agencies also provide physical therapy, social services, speech therapy, and occupational therapy as well. Most home health care agencies are not available in the evening hours, on week ends, or on holidays. The majority of home health agencies accept insurance and Medicare payments.

Hospice care also requires a doctor’s order, and the patient must have a life-limiting disease with expectations of six months or less to live. Patients can be re-certified for hospice every sixty days, and may live much longer than six months and still be in hospice care. Hospice care also provides nursing and home health aide services, along with extra support to the family and patient during this difficult time. Comfort measures are a priority in the plan of care, and they have a variety of services such as social services, pastoral care, and volunteer services as well. Medicare and insurance usually are accepted. There will always be a hospice nurse on call twenty four hours a day to assist with any emergencies or special problems during times when the office is closed.

Sometimes the best plan is a combination of home health or hospice along with private duty care. Many seniors are resistant to accepting any kind of help at first, and will require continual reassurance effort to help them maintain as much independence as possible.

When addressing these issues, never "speak down" to your loved one. Remember, even though roles are changing, they still deserve to be honored and respected. Sometimes calling a care giver "the maid" or "the butler" rather than a "caregiver" or "home health aide" will help them accept the situation with a little less anxiety. It’s all in the attitude that it’s presented to them - help them feel a sense of control in the situation whenever possible. Try to help them understand that these changes are happening in their home because you love them and want them to be able to stay at home as long as possible and not have to live in a facility to get the help they need.

Don’t forget to schedule time for yourself during this intensely demanding season of your life. By succumbing to false guilt or unreasonable demands, you may be setting yourself up for a disaster later. Take time to enjoy your immediate family, your hobbies, and leisure time as well. Join in with other caregiver groups for extra support - you can find them at churches or on the web. You’ll be safeguarding your own ability to handle this long term role as a caregiver with a healthy mind, body, and spirit.

Jo Nelson is a registered nurse and co-owner of Servant’s Heart Homemaker Services located in Logansport. Servant’s Heart provides companion services for the elderly in their homes.

For more information contact Jo at servantsheartservices@yahoo.com or call 574-739-1776.

Assisted living is simply finding help in the form of a care giver or a family member assigned to assist an elder who with illness or diminished mental ability is no longer capable of living an independent life. Depending as to the circumstances involved, an elder may also be sent to a nursing home or a community of professionals wherein she can be well taken care of.

As an elder, know how to decide between assisted living in your children’s home or in a residential home. Ask these questions:

- Is there a spare room available for you?

- Is your lifestyle and the lifestyle of your children compatible?

- Does your children really do want you stay with them? Or are they obligated to take you in?

- Will they be able to provide you with all the care you need?

- Will my presence in their home interfere with them providing for the needs of their own children?

- Can I be of help to my children rather than a burden?

- Do I have resources so that I can afford living in residential care?

1. How to choose the right nursing home for you:

- Consider how much care you need.

- Get referrals from friends and relatives.

- Make a list of all the referrals and visit each one.

- Make sure that the location is near the home of the person that you have chosen and assigned to manage your dealings when you can not.

- Inspect the facilities and the grounds of the home; make sure that it is well maintained and preserved.

- It is best to review a home without any appointment. Just drop by and have a look at everything.

- Are the residents in the home happy, friendly and contented?

- Scrutinize all the rooms, even the ones that they don’t lead you to.

- Request their latest newsletter to see what activities they have that might interest you.

- Inquire and find out how they hire their employees and staff.

- Ask for a written description of the care that they offer and how much do they ask for all their services.

- Ask if they could let you stay for two or three nights so you can get a feel for the place. While you are there, talk to at least three residents and get their opinion on the place.

How to decide if you or a relative is a candidate for assisted living can be easy. It all starts with taking a realistic and a sensible look at your financial status. Four years from now, will you still be able to afford assisted living? Years from now, expenses as well as your medical needs will increase. Will your assets cover everything? Next, carefully weigh the method that a facility cares for their elders. Is the facility caring and sensitive enough in addressing to your loved one’s needs? After you cover these two basics, the rest is up to you.

While determining your own care may be straightforward, you should take additional matters into consideration when providing care for a relative. Be certain that it is clear to them what the facility can as well as can not do. Be sure that the facility should help you look for other ways to provide care in case they are unable to provide support for residents with disorders or disabilities. Consider Section 202 housing if your relative has low income. Put their name on the waiting list at a facility located in your area. Will assisted living improve the quality of life of your loved one, impart camaraderie, and provide plenty of activities to keep them in good health?

2. What questions should you ask yourself when choosing an assisted care facility for your loved one?

- Is the management of the facility experienced?

- Are the residents and their families happy and contented?

- What is the ratio of the staff to residents?

- Does the staff express concern to all the residents? Are they friendly and caring?

- Is there a sincere concern and reverence to the elders?

- Is the facility hygienic and comfortable?

- Do they serve a well balanced meal? Are the meals tempting and attractive?

- Do they offer health and wellness services?

- What are the activities planned for the residents?

- Will your relative like their activities?

- Will your relative like and enjoy the daily life offered in this facility as compared to other options?

- Do the services that they offer as well as the living quality of the facility live up to your standard?

- Does the facilities standards and services worth the cost?

- Is this the type of place that children would love to pay a visit?

- Is the location accessible and convenient enough for family and friends to visit?

For more great Assisted Living related articles and resources check out http://assistedliving.goldenhq.com

There are many things to consider before you purchase a wheelchair. Regardless of whether you want a manual or powered chair, consider the following:

1. Folding or rigid frames?

On manual chairs, folding frames are the usual conventional type having an X brace in the center allowing the frame to be folded sideways. Folding is simple, but a chair of this type tends to be bulky as well as quite heavy. New versions of lighter materials are now available, but regardless of this point because folding frames involve many parts, it is heavy compared to a rigid frame. Rigid frame joints are welded and a lightweight aluminum material is used, enabling one to transfer the wheelchair into the car without help.

2. It’s all about comfort: get the footrest angled perfectly

An angle footrest is measured from the horizontal or is regarded from the side, whereas tapered footrests are regarded from the front, and joins both feet at the bottom, providing more clearance when turning. However, if you have limited hip and knee joint flexibility, this can be uncomfortable.

3. Don’t overlook the handrim

Note that the overall diameter of a handrim will affect its propulsion. This means that having a large diameter climbs will be easier and with a diameter that is much smaller, it brings about a lot of speed on a flat surface.

4. It’s all about the wheels

While spoked wheels are lighter, they require extra maintenance with continued use. Composite wheels on the other hand usually wear out at the bearing escalations. Then, the zero camber gives a slender wheelchair measurement. When the camber is increased, the measurement at the wheel’s botton is also increased and the measurement at the top is decreased, providing steadiness and turning can be done with ease.

5. Wheel locks

These are of two types namely the under-seat and the side mounted. The side mounted type provides easy operation, though one has to be careful when pushing as thumbs can easily be caught in the wheel lock. Whereas the under-seat type can pas up to this problem, it is much difficult to use since it calls for reaching under the seat.

6. Front and back balance

Check the balance well - as if the rear wheels are very much far forward to the frame, the user can tip backwards. Also, the chair will be hard to push if the wheels are put too far backwards.

Wheelchair safety measures:

- Always make sure that your wheelchair is in good condition all the time.

- When using a power wheelchair, be certain to turn the power off when leaving it at a slope or inclined place.

- When pushing a patient, inform her first before you move the wheelchair.

- When not moving, use brakes.

- Do not attempt to go up or to go down on steep slopes.

- When pushing a patient on a manual wheelchair, be sure that your speed should not exceed that of brisk walking.

- When transferring a patient to a wheelchair, be sure to raise the footplates before doing so. Then lower the footplates after and place the patient’s feet onto the footplates.

- Avoid passing through grassy or pebbled plains.

- When crossing the street, be sure to stop, look and listen.

Safety on power wheelchairs:

- Choose a type with mechanical brakes that can be released or set by the user.

- For outdoor use, a power wheelchair must have power large wheels at the front and never free swinging casters.

- For the user with an impaired hand or arm, install an orthotic elbow or arm support so as to aid the hand when operating the controls.

- Shut off breaking sensors can detect when a wheelchair is moving out of control and quickly shut off the power.

- Mechanical brakes can bet set by the user with normal hand functions.

- Check the batteries before you go out that they are fully charged, every time.

- Always keep a cell phone handy. You’ll never know emergencies might happen.

- A power wheelchair has many of the same parts as a car. Have it checked by a professional every three months for safety, and check it daily yourself.

Are you at risk?

1. Paraplegics

Fit & active individuals are on the average the safest users of a manual, power-assisted, and fully powered wheelchair. They are at very low risk.

2. Amputees

Individuals with missing arms or legs, having active upper bodies are generally safe power wheelchair users. Although it depends on the type of control device that is used, but when used and executed properly, they are at low risk.

3. People having weak upper bodies like people with Cerebral Palsy, Multiple Sclerosis, Parkinson Disease, and many other conditions A standard joystick is used to maneuver power wheelchairs. These disorders cause slowed reflexes, impaired eyesight, or impaired judgment. All must be carefully screened for their functional insufficiency. They are at moderate risk.

4. Individuals with little or no upper body movement

Individuals who uses a mouth a puff & sip breathe control, mouth joystick, or gyroscopic (inertial) wheelchair controls. They are at high risk.

5. Paralyzed individuals and children.

Children as well as very small adults that are using special seats need a power wheelchair, mostly with significantly paralyzed bodies. Depending on the mechanical operation, the individual’s ailment, and personalized progress and safety instruction, these individuals are at high risk.

For more great wheelchair related articles and resources check out http://wheelchair.goldenhq.com

On the evening of Saturday 4th February 2006, my wife and I went out with a couple of our friends to our local Pizza Express. Anyway, over dinner they were telling us the shocking and scandalous story about how an elderly couple was forced to sell their homes when the husband developed an illness requiring long term care.

Apparently, these two individuals have worked hard, paid their taxes and with prudence have accumulated assets of more than £12,250. Ok, let’s face it, that is not a fortune these days. Sadly, enough for their access to care to be means tested.

It turned out that these two frail individuals were means tested and were found to own assets at well over £12,250. Consequently, the wife was evicted and their property was sold to pay for his care.

I was disgusted. I could not understand how the establishment can treat its senior citizens so callously in our so-called civilised society. How can people who have led a productive and prudent life be penalised for having built a modest buffer. More importantly, was there anything that could be done to help others avoid this awful trap?

I heard how a retired businessman stumbled across this same problem and how he invested a lot of his time and money to do something about it. I acquired details of his research and findings which, incidentally, concluded that if you own your property jointly with a spouse or partner, you are a sitting duck for the eviction squad.

My wife and I, like most people who are married or live together, own our house jointly because it is the right and responsible thing to do. Big mistake! Unfortunately, in law, when you own a house jointly with your spouse/partner, you own it jointly and severally. Basically, you both own the whole of the house - not half each, but both 100%. What this means is that if the house is assessed to pay for residential care, the portion of the house that the person needing the care owns is what’s taken into account. And how much do you think that is?

Well, it is 100%, ALL OF IT! So, if you or your partner needs long term care, you’ll be forced to sell up if you don’t have the cash to pay - and the remaining partner will be left effectively homeless.

Frightening, disgusting, but absolutely true.

There is a simple solution, but hardly anyone knows, or thinks about it. By the way, although my wife and I are in our fifties, we are utilising this simple solution to remove the risk for us. You too can do the same, to find out how you can get this solution for FREE you need to visit http://hope4life.vipinfoweb.com

"In our way of life, in our government, with every decision we make, we always keep in mind the Seventh Generation to come. It’s our job to see that the people coming ahead, the generations still unborn, have a world no worse than ours - and hopefully better. When we walk upon Mother Earth we always plant our feet carefully because we know the faces of our future generations are looking up at us from beneath the ground. We never forget them."
OREN LYONS

This article is supplied by Abi Motala, the CEO of Vista Information Publishing Ltd. Articles written by Abi have been published in both business and IT magazines. You can visit him at http://www.vipinfoweb.com.

This is the day you thought would never happen. Your roles in life are reversing. Your trying to make decisions for yourself and your Aging Parent. What will be best for them without altering your life too drastically. How do you keep up the pace and ultimately please everyone around you? You are not alone in life, you have a family, significant other, a career to think about. You want to balance everything to keep everyone happy and life as normal as possible. Think again! Those once a week visits or daily phone calls aren’t enough anymore. Your parent needs care, the real kind.

The care includes making sure they eat, that they take their meds, that their money isn’t being floundered away on TV shopping. You have siblings that think Assisted Living or Nursing Facilities are awful and they don’t want to put Mom or Dad in one even though they also don’t want to help out. How do you cope? How do you deal with this situation without alienating every member of your family?

First understand, it’s not about you. What I mean by that statement is that it is not about guilt and what some think is the “Right thing to do”. It’s not about hanging on to someone that they used to be. They are an elderly person in need of constant care and attention. If you need a dose of growing up, this situation will make it happen whether your ready or not!

Start with their doctor. Have an appointment to discuss the faltering health of your beloved parent. You can also check into the hospital that their health care is associated. Every hospital has an elder care group of some type. The medical coverage will also have affiliations with elder sourcing. Between the doctor and the medical coverage group, you may be able to determine the types of help and living style your parents current status requires. Keep asking until you have the best situation for all concerned. It may be as simple as an Aide visiting once or twice a day to help with showering, dressing, meals and meds. Their health may need more than that and the visiting nurse or doctor’s office is the place to apply the concern. The best word to learn to help an elder parent is the same as if your infant child were being cared for and that is SAFETY. If safety is not at the level necessary, keep pushing until you get the help you need.

It may take you time to uncover everything available to your parent to help with this care process but trust me, it will be worth it in the many years elder care can stretch out to be. It is best to discuss with them all their health and medical, financial and personal situations before that day arrives. When they are older the best thing you can give them is you. Spend quality time instead of stress time. Have them over for a day and dinner instead of needing to pawn them off on someone else. The resentment builds if you do this alone and there are many really good care facilities to take that burden off your shoulders.

Safety and honesty is what makes those later years a good memory for your aging parent!

More from this author, Marge Pickering-Picone can be found at http://www.aging-baby-boomer-guide.com More on the above article http://www.aging-baby-boomer-guide.com/agingparents.html