How to Keep Tabs On An Elderly Parent

By Jim Miller

Dear Savvy Senior,

My 80-year-old mother lives alone about an hour from me and I worry about her health and safety. Outside of the telephone, what types of care giving devices can you recommend that can help me keep tabs on her?
—Concerned Son

Dear Concerned,
There are many different tools and technologies available today that can help adult children keep tabs on aging parents when they can’t be there. Here are some popular options and new products to check into.

Senior Help Line
One of the biggest concerns among families that have an elderly parent or relative living alone is them falling and needing help. For this, a “personal emergency response system” or PERS is the most affordable solution. For about $1 a day (available through companies like lifelinesys.com, lifealert.com and lifefone.com) you can rent the equipment which includes a small transmitter (SOS button) that your mom would wear, giving her the ability to call for help any time she needs to. The drawbacks, however, are that many seniors forget to wear their SOS buttons regularly, and if they do have it on and fall, they still have to be alert enough to actually push the button.

Fall Detection
If you’re willing to spend a little more (around $50 a month), there are several more sophisticated PERS on the market. One of them is Wellcore (wellcore.com), a new device that has fall detection sensors in the SOS button that can automatically summon help without the user having to press a button. Plus, it will beep to remind your mom to put it on, and if she doesn’t, it will notify you. And, when paired with a compatible cell phone, it can even be used outside the home. Halo Monitoring (halomonitoring.com) also offers fall detection products, as does Philips (lifelinesys.com), maker of the popular Lifeline Medical Alert Service.

Home Monitoring
Another more expensive option for keeping tabs on your mom is with a “home monitoring system.” These systems come with sensors, placed in key areas of your mom’s home that learn her daily patterns and notify you if something out of the ordinary is happening. The great thing about this type of system is it requires no input from your mom, and you can check in on her anytime through a password-protected website. You can find these systems at companies like GrandCare (grandcare.com), Healthsense (healthsense.com), and CloseBy (closebynetwork.com), with prices ranging from several hundred to several thousand dollars, depending on the options you choose.

Medication Management
If you’re worried your mom is not keeping up with her medications, there are a wide variety of pill organizers, medication dispensing and alarm systems (see epill.com) that can help. One of the best new systems on the market is TabSafe (tabsafe.com). A home-based device that dispenses medicine on schedule, providing reminders to ensure she takes it on time, and will notify you or other caregivers if her pills aren’t taken.
Medication reminding services like OnTimeRx (ontimerx.com) or Check-in Friends (checkinfriends.com) can also be helpful. For a small fee, these services will call your mom to remind her to take her medication. Pillphone.com offers a similar service for wireless phones only.

Communication
Videophones have become an increasingly popular tool for keeping in touch with older loved ones from afar. If you’re not familiar with them, videophones are like a telephone with a built-in camera and video screen that gives you the ability to see the person you’re talking to in real time. Two of the best on the market today are the “ASUS Videophone Touch” that works with Skype (skype.com), and the “ACN IRIS 3000” (myacn.com). Both require a high speed Internet connection and are simple to use. Or, if your mom and you, both have a computer and a Webcam you can video chat online.

Association Develops Test for Home Care Workers

The National Private Duty Association (NPDA), a non-profit organization comprised of home care agencies, recently announced that it has developed a unique caregiver testing program to measure the knowledge and preparedness of home care workers. The new testing program sets NPDA member agencies apart as the preferred provider of choice for consumers.

Developed by the NPDA’s Standard and Ethics Committee, the testing program will allow the association’s members to evaluate caregivers before they are placed with a client, giving supervisors an opportunity to assess skill level and possible need for additional training.

“We based this program off the Levels of Care guidelines we already have in place,” said Gloria Horton, executive director of Visiting Nurse Plus, Inc., and chairman of the NPDA’s Standards and Ethics Committee. “By administering the testing procedures, NPDA members will be able to determine if their caregivers are ready to be placed with clients.”

Testing is broken down into three areas, based on the three levels of care provided by most NPDA member companies. The Level One test is for homemaker companions, Level Two is for personal care assistants and Level Three is for home health aides. All three tests focus on core areas such as communication, observation, reporting/documentation, behavioral and physical changes, maintenance of the environment and nutrition.
“As the level of care changes, so does the structure of the test questions,” Horton said. “We patterned the tests after what caregivers should know.” For example, the level one test is based on the fact these caregivers will not be providing any hands on care. The level three test, on the other hand, focuses on skills such as reading and recording vital signs, personal care and safe transfer techniques.

“Families making home care choices face very important decisions,” Horton said. “They deserve the peace of mind that their caregivers have been trained  and tested.”

Advisor, Counselor and Healer Eases Life’s Transitions

By Phyl Newbeck

Jeannie Lynch of South Burlington hopes people can distinguish between her “left brain” job and her “right brain” calling. By day, the trim, 47-year-old professional runs the Key 4 Women program at Key Bank in Williston. But every Wednesday night, she devotes her intuitive energies to guiding those seeking assistance with life’s transitions, free of charge.

Lynch prefers not to put a label on her right brain activities, but accepts “healer” as the closest to conveying the work she performs. Her calling started with a tragedy. On January 20, 2005, Lynch’s eight-year-old daughter Ila was killed in a car accident. A month later, Lynch pulled herself together enough to stop in at work to see her coworkers. Checking her e-mail she saw a message regarding the yet-to-be launched Key 4 Women program asking who would replace her as the program’s Vermont representative. As Lynch tells it, her daughter’s spirit coursed through her arms and propelled her fingers to the keyboard to respond that she would be back at work to take charge of the program. Speaking of Ila, Lynch said, “my daughter drew the line in the sand. She was so clear what my mission had to be.”

The first person to contact Lynch for her healing work was the mother of Sam Cohn, a Richmond teenager struck and killed by a car while on vacation in Florida. Lynch said Cohn’s mother kept track of how many times she heard Lynch’s name mentioned and by the thirteenth time, she decided to give her a call. Lynch is convinced that the grief she has experienced in her own life –the death of two children and several boyfriends – prepared her to help others. “I went through all these key lessons,” she said. “I felt it was my goal to teach.”
According to Lynch, being happy is both a choice and a skill. She has faith that she has the capability to get people through their grief. “I believe I am intuitive enough to get the words to help them through,” she said, noting that it is impossible to compartmentalize grief as those who counsel the seven stages would suggest. After two years of helping the grieving, focusing initially on mothers who had lost children, Lynch expanded her practice to include those in any kind of transition, be it a relationship, a family issue or a job. Even though she generally sees each individual only once so as to encourage them to find their own strength and power from within, Lynch is booked through next January. Although she takes great pains to separate her job and her calling, she does pray that she will continue to be successful in her work at Key Bank so that she can continue to help people for free. She estimates she has held almost 500 two-hour sessions with individuals from all walks of life. Her goal for 2010 is to help people realize they have their own gifts and don’t need her at all. “It would be great if nobody needed my work,” she said.

Lynch’s day job as the Vermont representative for the Key 4 Women program is also the result of a leap of faith on her part. Her 20-year job at Grand Union had come to an end due to cutbacks so Lynch impulsively went to visit Key Bank, which held her mortgage. “I’ve got 20 years cash management experience,” she recalls telling the bank manager. “I’m going to be paying you back somehow, so you might as well hire me.”

He did, and despite her lack of a college degree, Lynch has spent the last 20 years in banking. As the Key 4 Women representative, her job is to support women in business. “I meet people when the idea is in their head,” she said, “and I help get it to the table.”

In addition to assisting start-ups, Lynch helps existing businesses grow, and aids those who are nearing retirement in figuring out their next step. Pulling out an enormous tray of business cards, Lynch explains how she is able to create a network of people, introducing her clients to others who can provide assistance. “I’m the connector,” she said.

Lynch invites visitors to a room in her home filled with a mural of the outdoors and a ceiling painted to look like the sky. A portrait of her daughter is part of the artwork. “I’m only as successful as the people I’ve helped,” she says. This maxim is true for both facets of Lynch’s existence, since her job is based on the success she helps others create in the business world.

When people visit Lynch she feels as though she has the ability to see and hear what their guides and spirits want for them. “I call it ‘close to the veil’,” she said. It is then her job to determine what people need to have filtered from their thoughts, including limiting beliefs or past situations that didn’t honor them. Lynch uses herself as an example. “I used to believe that everything I love, I lose and that became a self-fulfilling prophecy,” she said. When Ila died, Lynch initially thought this just proved her theory, but soon the loss of her daughter taught her that she had been so concerned with death that she had been afraid to live. Instead, Lynch now believes that “everything you love lives on.”

Further, she believes that everything that happens has a purpose. “That’s an innate truth,” she said, “and the way I feel about that innate truth is what changes my experience.”

Despite the tragedy in her life, Lynch describes herself as “very much at peace.”  Her life is built around “believing, trusting and receiving.”

Lynch describes heaven as a place of acceptance and hell as a place of resistance. “My life is heavenly,” she said. “I accept everything that comes my way with open arms.”

Want To Make Your Parents Healthier? Get Them a Pet!

By Dr. David Lipschitz

One of the worst parts of advancing age is the gradual loss of contact with those we love. As baby boomers, many of us first lose our children to college, then to spouses and ultimately to grandchildren.

As we age further, some of us will become frail, dependent on others for transportation and might need help with the simple tasks of daily life. One thing leads to another, and it becomes increasingly difficult to avoid loneliness and isolation. For many — myself included — it is vitally important to fill the empty nest with the unconditional love of a pet.

My wife and I are already empty nesters, and our beautiful French bulldog, Iggy Pup, has moved squarely to the center of our household. Iggy is a constant companion. We walk him, feed him, cuddle him and endlessly dote all over him. When I go on vacation, I miss Iggy almost as much as I miss my children! He is truly an integral part of my life. I have no doubt that Iggy’s unconditional love and the affection I shower on him assure me a better, less stressed and more healthful life.

The link between pets and health promotion is very clear. Many research studies show that contact with animals powerfully assists in improving the health of nursing home patients and hastens the recovery of hospitalized patients. Studies on individuals of all ages clearly show that 15 minutes of direct contact with a pet reduces stress, lowers blood pressure, slows heart rate, improves sleep and reduces the risk of depression.

For men and women, interacting with a pet fosters nurturing, rapport, socialization, entertainment and exercise. Recent studies show that people who walk with dogs exercise more consistently and experience bigger fitness results than those who walk with a two-legged friend. Dogs are more reliable, walk faster and can often be more convincing enthusiasts for the regular walk.

But the most important health benefit of a pet’s companionship is the physical contact and touch. Contact with a dog or a cat is safe, soothing and nonthreatening. One stroke of a cat’s back or the touch of a cold puppy nose, and out of nowhere, unhappy patients smile, unwind and feel a deep sense of gratitude and contentment.

Pets of all kinds are particularly important to older people who live alone or who reside in nursing homes. Published in Occupational Therapy International, recent research showed that contact with pets and the resulting companionship and sensory stimulation improved the ability of nursing home residents to socialize while decreasing stress, anger and disruptive behavior. In addition, pet therapy decreased the need for sedatives or medications to prevent agitation. Self-esteem, patient independence and increased responsibility were also noted.

Occupational and physical therapists found that pet therapy had many physical benefits for patients. Muscle strength and range of movement improved, and pain management was more successful. Pets also reduced blood pressure and slowed heart rate.

As the healthful benefits of pets become more clear, many apartments, condominiums and assisted-living facilities are accepting animals. And the demand for “pet-friendly” establishments will only grow as the baby boomer generation marches past 65. Luckily, most long-term care facilities, hospitals and health clinics already have programs in place for animal-assisted therapy. There are training programs available to teach volunteers how to facilitate interactions between patients and a pet. Individuals who are interested can find local community programs, often through animal-training associations, to certify their pets as therapy animals.

For adults who volunteer in pet-therapy programs, the health benefits are doubly strong! Not only do you get to care for and interact with your animal, but you also get the fulfillment of seeing others benefit from your pet.

If your parents are older and live alone, I would urge them to get a pet. Whether it’s a dog, cat, bird or even an iguana, a pet can be an amazing addition to their lives. The unconditional love we give and receive from a pet doesn’t only improve health, but it also fulfills a critical need in our lives.

Gaining Wisdom, Growing Older: A Guidebook to the Future

Aging is inevitable, no matter how hard people try to stop or turn back the clock. This fact of life has become problematic for governments and citizens around the world as each struggles to provide care for their aging populations. In his book, “A New Wrinkle,” Dr. Eric Shapira prepares his readers for the future and what to expect.

“A New Wrinkle” serves as a guide for those who similarly find themselves caught between their parents and their children, on the horizon of both taking care of their parents and continuing to raise their own children.  The book encourages readers  to conquer life’s challenges by learning from the personal stories of others. Everyone will deal with the effects of aging in their lifetime and many will be forced to make decisions on the care of their loved ones. Dr. Shapira advises his readers on how to examine their own lives and strategically plan and confront any challenge at hand. It is a perfect guide for anyone handling a life-changing transition, facing the aging process or caring for elderly family members.

Visit Dr. Shapira’s Web sites www.agingmentorservices.com and www.newwrinklebook.com for more information.

Economy Is Down, So Homesharing Is Up

With the economic downturn, many more people are turning to homesharing to help make ends meet.

In the past year, HomeShare Vermont saw a 39 percent increase in people needing an affordable place to live. The local non-profit agency also saw more homeowners who needed financial assistance with rent or utilities to be able to stay at home. In the past, most homeowners were looking primarily for services and help to stay at home, but now help with rent is a greater need.

The average rent for new homesharing matches this year was $164/month. While still affordable, that is up from previous years.

HomeShare Vermont has noted a real difference between the rural and urban towns in its three-county service area. In Chittenden County, for example, there are many more people looking for a place to live than there are homes available. In Grand Isle and Addison counties, volunteers have done a great job encouraging folks to open their homes, but are finding fewer people wanting to live in the more rural areas. Despite these imbalances, HomeShare Vermont saw a 39 percent increase in placements over the previous year.

The services offered by HomeShare Vermont focus on recruitment, screening and matching and are are customized to the individual. HomeShare Vermont provides comprehensive screening including five different background checks, and requires at least three positive references including landlord references. In homesharing, participants are able to choose who to live with based on who is most compatible. HomeShare Vermont staff and volunteers stay actively involved in all matches to help with changing needs or any issues which may arise.

Homesharing is an old fashioned bartering arrangement where someone with a spare room in the home needs a little help, such as companionship, help with meals or simply a protective presence in the home, and is matched with someone who is looking for an affordable place to live and can offer an average of ten hours a week of service. An affordable rent or help with utilities can also be part of the exchange.

For more information, visit www.HomeShareVermont.org or call 863-5625.

Defining Vermont’s Senior Housing Options

By Don Manders

Six levels of senior housing are available in Vermont, categorized by the type of accommodations they offer. They range from totally independent living communities to continuing care retirement facilities, and there is a legal definition of some, particularly if personal assistance is required for residents.

• Independent Housing offers private residential units with kitchen and dining areas, bedroom(s), bathroom(s), and living areas. These are barrier-free with emergency call features, are complemented by housing management and maintenance services, and are geared toward independently functioning people. These facilities usually don’t offer regular meals, housekeeping, or home health services.

• Congregate Housing offers private apartments in a complex that contains central dining and other common areas. This type of facility is for those who want or need some supportive services including dining, housekeeping, home health and other assistance.

• Assisted Living offers private living units and bathing facilities in a complex with common dining and activity areas. Facilities are geared toward those who have difficulty functioning independently and who often require oversight. These residences provide an array of services, including 24-hour staff, full meal plans, transportation services up to three times per month, nursing assessment, care planning and oversight, medication management, as well as organized activities programs. The Vermont Department of Disabilities, Aging and Independent Living licenses and regulates these residences.

• Shared Homes offer private bedrooms and either private or shared bathrooms, with common living, dining, and kitchen areas. Geared toward seniors wanting a home-like setting, shared housing offers support services such as daily meals, service coordination, and light housekeeping. Residents can bring in hospice care, but these homes are not designed for those with intensive medical needs.

• Residential Care Homes (RCHs) are licensed and regulated by the Department of Disabilities, Aging and Independent Living. There are two categories of RCHs in Vermont – Level III and Level IV. Unlike Assisted Living residences, RCHs are not required to be barrier-free or to offer private accommodations and baths, although many do. Both levels of licensure provide general supervision, personal care assistance, organized activities and transportation services up to three times per month. Level III RCHs also provide nursing oversight, medication management and 24-hour staffing, while Level IV RCHs do not.

• Continuing Care Retirement Communities (CCRCs) combine independent housing, congregate housing, and assisted living with the availability of nursing home care. These communities require a significant upfront investment, and residents also pay a monthly fee. CCRCs serve the entire older population and offer individual residents the benefit of remaining in their community as care-level needs increase.

Veda Lyon, Manager of the Community Development Unit for the Vermont Department of Disabilities, Aging and Independent Living, contributed to this story.

Book Urges Caregivers to Care for Themselves

To Weep for a Stranger: Compassion Fatigue in Caregiving” by Patricia Smith is a guide for caregivers to understand and address compassion fatigue, a secondary traumatic stress syndrome that results in providing care without practicing authentic, sustainable self-care.

Written from the perspective of a compassion fatigue survivor, the book offers an explanation of the phenomenon and features personal anecdotes and observations, tips and techniques, a comprehensive quality of life self-test, a life stress test and a list of suggested workbooks and training materials for caregivers.

Local Caregiver Resources

Armistead Caregiver Services             Shelburne     288-8117     www.armisteadinc.com

Converse Home                                     Burlington     862-0401     www.conversehome.com

Ethan Allen Residence                         Burlington     658-1573     www.ethanallenresidence.com

Home Care Assistance                          Burlington     735-1290     www.homecareassistance.com

Living Well ResidentialCare Home   Bristol     453-3946     www.livingwellcarehome.org

Starr Farm Nursing Center                 Burlington     658-6717     www.starrfarmnc.com

The Arbors at Shelburne                     Shelburne     985-8600     www.seniorforliving.com

VT Assembly of Home Health Agencies     Montpelier     1-800-HOMECARE
(466-3227)     www.vnavt.com

Financial Help for Family Caregivers

Dear Savvy Senior,
Q. I’ve been taking care of my elderly mother for nearly a year now and it’s wearing me out both physically and financially. Is there any way I could get paid to be her caregiver?

A. To get paid as your mother’s caregiver there are several possibilities you should check into, and a variety of support services that can help, too. Here’s what you should know.

Caregiving for Pay

Is your mom on or eligible for Medicaid (health insurance for low-income folks)? If so, you may be able to get paid a small amount by the government. In some states, Medicaid offers a Cash and Counseling program that provides direct financial assistance to their beneficiaries, and that money can be used to pay in-home caregivers. A few other states have similar programs for low-income seniors, even if the person receiving care doesn’t quite qualify for Medicaid. To find out about these options contact your local Medicaid office or visit www.benefitscheckup.org – an online service that helps seniors and their families find and enroll in federal, state, local and private benefit programs.

Other Options

If your mom has financial resources of her own, find out if she can afford to pay you herself. If she agrees, it may be a good idea for both of you to draft a short written contract detailing your work and payment arrangements. Or, if your mom has long-term care insurance that includes in-home care coverage, in some cases those benefits can be used to pay you.

Tax Breaks

The IRS may be able to help you out as well if you can show that you pay at least half of your mother’s yearly expenses, and if her annual income is below $3,650 (not counting Social Security). If so, you can claim her as a dependent on your taxes, and reduce your taxable income by $3,650. Your mom doesn’t have to live with you to qualify as a dependent. IRS Publication 501 has a worksheet that can help you with this (www.irs.gov/pub/irs-pdf/p501.pdf).

If your mom’s income however is over $3,650, you can’t claim her as a dependent. But if you’re paying at least half her living expenses, you can still get a tax break if you’re helping pay her medical and long-term care costs and they exceed 7.5 percent of your adjusted gross income. See the IRS publication 502 (www.irs.gov/pub/irs-pdf/p502.pdf) for details.

Support Services

If you don’t qualify for caregivers pay or a tax break, you can still get some financial relief through the Family Caregiver Support Program (FCSP). This is a federally funded program that provides aid for specific caregiver needs like respite care or adult daycare to give you a break, counseling and support groups, and supplemental services including the purchase of medical supplies, SOS emergency response systems and even home modifications. In addition to the FCSP, you should also check into home delivered meal programs, volunteer companion programs, and even home and personal care services. These too can lighten your load. To locate all the various programs and support services near you, contact your Area Agency on Aging. Call the Eldercare Locator at 800-677-1116 to get your local number or visit www.eldercare.gov.

Savvy Tip:

The best Web resource to search for caregiver support services and programs in your area is the Family Caregiver Alliance at www.caregiver.org. When you get there, click on “Family Care Navigator: State by State Guide.”

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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