Category Archives: travel with seniors

Caregiver Tips for travel

Traveling long distances with a person in the early stage of dementia may still be quite enjoyable. As dementia advances, however, traveling becomes unpredictable as the person becomes more confusing. Plan ahead for a trip by gathering important documents: insurance cards, passports, your physician’s phone number, refills on medications and a copy of medical records in case the person with dementia needs to see a physician while away. Make sure you keep track of all the documents and medications. Packing them in carry-on bags so they will not get lost en route is a good idea. Remember to bring sufficient funds or a credit card with you in case you must change your plans suddenly and return home. Also, you may want to bring along a brief letter from your physician to the airline or hotel to expedite a change in plans.

When traveling, try to follow the routine that is followed at home. Even minor changes in routine can be distressing to your loved one, and may cause unexpected delays in the delivery of care. So, be sure to allow plenty of time for everything. Plan for rest periods throughout the day. For example, if you are taking a tour by bus, you may want to remain in the bus so the person can take a nap instead of visiting all the sights.

Remember the person who is at risk of wandering when at home, may also do so in an unfamiliar place. If this is the case with your loved one, try using an identity bracelet or necklace that clearly explains that she has a dementia illness. Put a card with the name and address of the hotel where you are staying in the person’s pocket. You may want to carry a recent photo of the person in case she gets lost.

Traveling may also make the person more anxious. Bring along an anti-anxiety medicine just in case. Toileting is an issue that requires some forethought when you are traveling. If you are driving, stop at the rest-area toilets every couple of hours. If the person needs assistance in the bathroom and you may be in there for a while, bring along an “OCCUPIED” sign for the washroom door. Have on hand a full change of clothing. Be sure to keep the way to the toilet well lighted in hotel rooms, and keep a light turned at night in the bathroom.

A few more travel tips to keep in mind: If you are traveling by car, never leave your loved one with dementia alone in the car. Try to bring along a relative or friend to share in the driving. And if you are traveling by plane, you may want to notify the airline ahead of time, so you can ask for any assistance.

Manual of Caregivers by Rush Alzheimer’s Disease Center

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Filed under adult children of aging parents, Alzheimer's Disease, care giving, dementia, elder care raleigh nc, Geriatric Care Management, long term care planning, NC, Raleigh, senior care, travel with seniors

Summer Travel Plans for Caregivers

Sheryl Leary, caregiver.com

Taking a successful vacation when you are a caregiver requires planning and coordination. Here is some information and questions to consider when planning your time away from home.

Vacationing With Your Loved One
Is the destination accessible for my loved one’s abilities?  Ensure that stairs are kept to a limit that is acceptable and have railings. Are doorways wide enough for a wheelchair or walker? Will the bathroom accommodate your routine?

Are the activities within my loved one’s capabilities? Sometimes less is more. Be aware that your loved one’s abilities may be different when not in the comfort of home. Allow time for recuperation from the travel before activities are planned.

Have you checked the latest security regulations for airlines, trains and buses? It is best to check with your transportation provider prior to your travel about what will be expected for security and/or inspection. Make sure all medications are in their original containers and anything liquid is kept in a clear separate bag and ready for inspection. Check with your doctor to see if your loved one’s pacemaker or implanted medical device can go through the X-ray process or if he or she will need a separate “pat-down inspection.” An excellent source of information for travelers is the Transportation Security Administration (www.tsa.gov). This website has information for travelers with disabilities/medical issues including those with pacemakers, diabetes, mobility and hearing issues.

When going through security at airports, if a separate pat-down inspection is necessary, you may request a private room and caregivers can stay with their loved one.

Alert your travel provider prior to your travel of any special needs your loved one will have. Airlines can provide wheelchairs, or cart transportation through the airport. Special accommodations are also needed for individuals traveling with oxygen.

Remember that elders are more sensitive to extreme heat and more prone to dehydration. Ask your loved one’s doctor about any concerns he may have for fluid intake based on the climate you will be visiting.

Dress in layers to accommodate shifting between air conditioning and the outdoors.

Find the nearest location of an emergency room or urgent care provider in the area you are visiting prior to your trip.

When planning family reunions or large parties, ensure that elders have designated one-to-one time with extended family members. Your loved one may get lost in the hustle and bustle of a large party. Having designated time with your loved one will allow all family members to catch up on the news and events.

Do not compare this vacation with those of the past. When you fall into this pattern of thinking, you often focus on what is different or what you can’t do. Think of each vacation as a new chapter, a new adventure in your life.

Vacationing Without Your Loved One

Make arrangements for alternate caregivers well in advance of your vacation. Do not expect other family members to take on full responsibility for care with only a week’s notice. Ensure substitute caregivers know the dates and expectations for care they will provide.

Have your loved one and the substitute care provider meet before you leave so that they will both be more comfortable together. Ensure that the level of care needed matches the care provider’s abilities.

When using a formal provider for respite care, there are many options. Private home health agencies can provide assistance on an hourly or shift basis. Rest homes, assisted living facilities and nursing homes can often provide care on a short-term respite basis if they have openings. The private care provider will have to decide if your loved one meets the level of care their facility offers.

Have a scheduled check-in time with your loved one or their substitute care provider each day.

Be sure substitute caregivers have access to all information needed including: medication schedule (also be sure to have an ample supply of medication available), all emergency phone numbers including doctor, pharmacy, nearest relative, your contact information, a listing of medical conditions, power of attorney and health care proxy information.

Recognize that both you and your loved one will have a degree of worry and stress because this is a change in the routine. Caregivers often need to be reminded that part of taking care of someone else is taking care of yourself. Recognizing and acting on that need for relief is probably the greatest gift you can give your loved one. It is the gift that will allow you to continue caring.

Life changes and vacations change when you are a caregiver. Caregiving does not mean you have to give up your dreams of travel or your simple desire to “get away from it all.” Caregiving means that you have added a new dimension to your planning and creativity to your schedule, but the dream can still be fulfilled.

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How to Handle Difficult Behaviors Won’t use walker or cane

Almost always, the device makes the person feel old or disabled and is therefore ignored.

What to do:

  • Enlist peer pressure. It works at any age! The more your loved one sees others (especially those perceived as peers or younger) using assistive devices, the more normal they appear. Arrange chance “encounters” with a dapper, active, respected friend of roughly the same age who use a cane. Even watching movies set in locations when canes are commonplace (lots of foreign movies set in Europe, for example) can have a positive subliminal effect.
  • Talk up the benefits. Canes and walkers are seen as symbols of disability. Remind your loved one that they actually promote movement, which will increase the odds of better mobility over time. They also reduce the odds of a fall — which can cause serious injury and further limit mobility.
  • Look for noninstitutional models. Many men prefer a sturdy, stylish wooden cane to an aluminum model, for example. Walkers also come in a variety of types; search online forwalker or look at medical equipment companies.
  • Try compromising. Maybe your loved one will use a walker in certain circumstances (shopping) but prefers to lean on a companion’s arm in others (church).
  • Supply the device wordlessly. Rather than nagging (“Get your cane!”), just provide it.
  • Consider having a third party, such as a physical therapist or doctor, lay out the costs of ignoring a cane or walker.
  • See a physical therapist’s tips for encouraging someone who refuses to use their cane or walker

caring.com

Raleigh Geriatric Care Management:  www.rgcmgmt.com

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Activities for People With Alzheimer’s Disease

It is universally recognized that elderly people with dementia lose their short term memory first and their long term memory last. For example, they often remember people and events from their earlier years, but have difficulty remembering what they ate for breakfast the day before. A short summary of some activities include the following:

  1. Reminisce! Everything you do together lends itself to reminiscing. If the person can still speak fairly well, say, “Tell me about…” If his vocabulary is more limited, you may have to facilitate the story. “Do you remember when…” As you bake cookies together you can talk about residents’ favorite cookies, meals, etc.
  2. Read aloud and use visual aids such as memory poems, family pictures, or stories about “the days gone by” stimulate reminiscences. Ideas include Chicken Soup for the Soul series and Yesterdays by NaDezan, and other short stories
  3. Make music. Sing, hum, whistle, dance. Singing brings oxygen to the brain to help you think more clearly. Dancing exercises other parts of the body. Both increase your own sense of well-being as well as the well-being of the residents! Have music activities and entertainers visit. Choose the residents’ favorite cassettes.

4.  Sensory stimulation activities could include the following:

  • Making lap quilts.
  • Painting.
  • Talking books.
  • Scrap books.
  • Walking!
  • Flower arranging.
  • Tutoring, or visiting with children.
  • Baking.
  • Happy hour with non-alcoholic drinks.
  • Ice cream party.
  • Brushing & fixing a resident’s hair.
  • Manicures.
  • Ladies luncheons.
  • Building with wood (include sanding).

Although these activities are written for residents of a retirement community or a nursing home, they certainly could be utilized for private use as well. Keeping the mind and body active are important for everyone, but especially your loved one with dementia. Do something that is enjoyable for both of you, and it makes it that much easier. Raleigh Geriatric Care Management assists adult children of aging parents. caregiver.com

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Filed under adult children of aging parents, Adult day care, aging drivers, Aging In Place, Alzheimer's Disease, anxiety and the elderly, assessments, care giving, care planning, caregiver burnout, caregiving, caregiving and the holidays, clinical trial studies, dementia, Depression and the elderly, elder care raleigh nc, employee stress, family meetings, Geriatric Care Management, Having a conversation, Long Term Care Insurancee, long term care planning, medication reminders, NC, Nursing Homes, nursing homes and assisted living, paying for home care, Power of Attorney, Raleigh, respite, senior care, Seniors and driving, sibling relationships, support groups, tax tips for seniors, travel with seniors

How to Handle An Aging Crisis

Unfortunately, life isn’t a smooth, straight road as you grow older.

Your husband could break a hip without a second’s warning or your Mom might simply forget to eat one week. Events that throw you into crisis mode happen more and more frequently as you age. But by taking the proper steps and leveraging the best resources, you can prepare yourself to deal with crisis when it strikes and get your loved one’s life back on track.

Below we have compiled some of the more common crisis situations you might encounter and given you the best game plan to resolve these issues:

1) A neighbor found your mother a mile away from her home. She didn’t know where she was, how she got there or how to find her way back.

Now’s the time to get Mom evaluated for dementia. She may need the security of a dementia unit at a skilled nursing facility or a retirement community.

2) When you visit your 90-year-old aunt, who lives alone, you noticed that she hasn’t bathed and her clothes are dirty. The food in her refrigerator is going bad. She may even be forgetting to take her medication.

Home care or an assisted living facility could help your aunt take care of the important activities of daily living that she’s having trouble with on her own. This interaction could also provide socialization she may be missing.

3) Your husband fell and shattered his pelvis. After he’s released from the hospital, he needs regular physical and occupational therapy, but driving him every day will be a hardship for you as well as cause him undue pain.

With a two or three-week stay in a short-term rehabilitation facility, your husband can receive the concentrated therapy and specialized care he needs and return to his regular activities more quickly. This also gives you the time to prepare your home for his return.

4) You live with your Dad, but worry about whether he’s eating right or mobile enough when you have to go to work during the day.

While you’re away, home care can fill your shoes, if your Dad prefers to remain at home, or if he needs the socialization, adult day care may be the right fit.

5) Your children want to take you on a cruise, but your wife, who suffered a stroke, needs your round-the-clock care.

You can feel confident that a respite care facility will take good care of your wife during the 10 days you are gone and you can enjoy a much-needed vacation!

There are a variety of crises that seniors can encounter that will require your immediate and informed response. By checking out the local resources available to you and your loved ones, including geriatric care management (in Raleigh, NC,  Raleigh Geriatric Care Management  home care, skilled nursing facilities, assisted living, hospice, adult day care and respite care, you’ll have solutions—rather than anxiety—should a crisis be around the corner. ~Senior’s Guide

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What are the benefits of hiring a geriatric care manager?

  • Help meet goals of older adult and all involved.
  • A care manager’s knowledge, education, training, and experience can objectively help set realistic expectations while addressing obstacles that might be present.
  • Often families are overwhelmed with the many options presented. A care manager can efficiently streamline decision making.
  • As a neutral third party with knowledge of issues of older adults, a care manager can often help resolve conflicts that a more emotionally involved party can’t.
  • A care manager can often be a cost-effective alternative to families doing it themselves. Knowledge of entitlement programs, the elimination of often hours of research, reduction of time off from work and crisis-based travel can prove to not only provide positive outcomes but save time and valuable financial resources.
  • Avoid problems. The proactive nature of care management can help avoid many of the unfortunate problems that face older adults. Supervising caregivers, home safety precautions, and safe financial management can be vital parts of a care manager’s role.
  • Avoid family conflicts. Having a facilitator to assist with difficult decisions can maintain family stability. Difficult decisions including end of life, driving, and relocation can be addressed in a positive manner.

~~excerpt from caring.com, Brad Prescott

In Raleigh, NC, Contact: Raleigh Geriatric Care Management, http://www.rgcmgmt.com, lwatral@rgcmgmt.com

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Five Myths About Medicaid’s Long-Term Care Coverage

While Medicare gets most of the news coverage, Medicaid still remains a bit of mystery to many people. The fact is that Medicaid is the largest source for funding nursing home care, but there are many myths about exactly who qualifies for it and what coverage it provides.  Here are five myths followed by the real story.

  1. Medicare will cover my nursing home expenses. Medicare’s coverage of nursing home care is quite limited. Medicare covers only up to 100 days of “skilled nursing care” per illness. To qualify, you must enter a Medicare-approved “skilled nursing facility” or nursing home within 30 days of a hospital stay that lasted at least three days. The care in the nursing home must be for the same condition as the hospital stay.
  2. You need to be broke to qualify for Medicaid. Medicaid helps needy individuals pay for long-term care, but you do not need to be completely destitute to qualify. While in general a Medicaid applicant can have no more than $2,000 in assets to in order to qualify, this figure is higher in some states and there are many assets that don’t count toward this limit. For example, the applicant’s home will not be considered a countable asset for eligibility purposes to the extent the equity in the home is less than $536,000, with the states having the option of raising this limit to $802,000 (in 2013). In all states, the house may be kept with no equity limit if the Medicaid applicant’s spouse or another dependent relative lives there. In addition the spouse of a nursing home resident may keep one half of the couple’s joint assets up to $115,920 (in 2013).
  3. To qualify for Medicaid, you should transfer your money to your children. Medicaid law imposes a penalty on people who transfer assets without receiving fair value in return. This penalty is a period of time during which the person transferring the assets will be ineligible for Medicaid, and the length of the penalty period is determined, in part, by the amount of money transferred. The state will look at all transfers made within five years before the application for Medicaid. That doesn’t mean that you can’t transfer assets at all — there are exceptions (for example, applicants can transfer money to their spouses without incurring a penalty). However, before transferring any assets, you should talk to an elder law attorney. 
  4. A prenuptial agreement will protect my assets from being counted if my spouse needs Medicaid. A prenuptial agreement only works to keep property separate in the event of death or divorce. It does not keep your property separate for purposes of Medicaid eligibility.
  5. I can give away up to $14,000 a year under Medicaid rules. You can give away up to $14,000 a year without incurring a gift tax. Under Medicaid law, a gift of $14,000 or any other significant amount could trigger a penalty period if it was made within the five-year look-back period.

Elderlaw News, Mary Markovich

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Filed under adult children of aging parents, Adult day care, aging drivers, Aging In Place, Alzheimer's Disease, anxiety and the elderly, assessments, care giving, care planning, clinical trial studies, dementia, Depression and the elderly, elder care raleigh nc, employee stress, family meetings, Geriatric Care Management, Having a conversation, Long Term Care Insurancee, long term care planning, medication reminders, NC, Nursing Homes, nursing homes and assisted living, paying for home care, Power of Attorney, Raleigh, respite, senior care, Seniors and driving, sibling relationships, support groups, tax tips for seniors, travel with seniors