Falls Don't Have To Be A Part Of Aging: How To Stay Safe

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If you are concerned about falling, whether it is for yourself or someone you care about, you are in the right place. As we age, sooner or later, the topic of falling comes up. We understand all the negative and painful consequences that a fall can bring. And we worry. At the same, we cross our fingers and try not to think about it. Is that because, in a way, we think that there is nothing that can be done about it anyway?

As someone who specializes in fall prevention, I can tell you that there is a lot that you can do to keep yourself or your loved one from falling at home. But before we talk about strategies for preventing falls, we will go over how and why falls happen in the first place. Once you understand what contributes to falling, the approaches for preventing falls will make sense to you.

 

How a fall happens

A fall is a single event that consists of many factors. Most of the time, a fall is not “just an accident.” Most people don’t realize the complexity of what happens during a fall and how various factors interact and lead to a person falling. It gets even more complicated when you consider that each person has their own combination of risk factors that is specific to them, their medical condition, physical and cognitive abilities as well as their physical environment.

So, let’s break it down…

Here are 3 main points that you need to know in order to understand how a fall happens:

1.     A fall is a result of inability to maintain balance. If we can’t keep most of our weight over our feet, gravity does its’ job and we fall.

2.     There are 2 main types of risk factors, or reasons, that contribute to falling: personal and environmental.

-         Reasons that are specific to the person are called personal (or internal) risk factors. Examples of personal risk factors are aging changes such as slowing down of reflexes or reduced vision, medical conditions such as diabetes or high blood pressure, side effects of medications, muscle weakness, balance or gait issues, pain, arthritis, cognitive impairment such as dementia, and previous falls.

-         Reasons that are specific to the environment are called environmental (or external) risk factors. Examples of external factors are poor footwear, improper use of assistive devices such as walkers or canes, absence of grab bars in the bathroom or other areas, toilet seat or other seats that are too low, wet or slippery floor in the bathroom, clutter on the floor that presents a tripping hazard, stairs inside or outside the home, a bed that is too low or too high etc.

3.     A fall occurs when personal factors and environmental factors interact in a way that causes a person to lose their balance, with inability to recover.

 

Let me give you an example.

John is 87 years old and walks with walker. He has some balance issues due to a previous hip fracture. He hasn’t been feeling well for the last few days, feeling a little weak and sometimes dizzy. His toilet in the bathroom is regular height, about 16 in and has no grab bar next to it. Before going to bed that night, John went to the bathroom and found himself unable to get up from the toilet. He made several attempts and on the last one, he was able to partially lift himself up, but in the process lost his balance and fell. He was later found to have dehydration, a urinary tract infection, and an arm fracture from the fall.

Do you see how John’s personal factors and the environment came into play here? His personal factors were poor balance, obvious weakness in his legs, oncoming dehydration and a new infection. His environment had a low toilet seat and no grab bar to hold on to. As a result, a fall happened. This fall could’ve been avoided if the environment was more appropriate and accommodating to his balance and strength issues. He could’ve made it back to bed safely and called his doctor or a family member the next morning.

 

What you can do next

Now that you understand how a fall happens, and how personal and environmental reasons come into play, it’s easy to see that as we identify and reduce the risk factors for a fall, the likelihood of a fall would also go down.

Although we can’t prevent all falls from happening, there are numerous ways to reduce the chance of falling for you or your loved one.

You can start with some general tips and ideas like:

-         Staying active and exercising regularly.

-         Checking vision at least once a year and updating the lenses in your glasses.

-         Making sure that the footwear fits properly and has a non-slip sole.

-         Reviewing your medications and their side effects with your doctor.

-         Using a basic home safety checklist like this one, for ideas on how to make the home safer and more accessible. https://www.cdc.gov/HomeandRecreationalSafety/pubs/English/booklet_Eng_desktop-a.pdf  

Although all of the above strategies are helpful in reducing the likelihood of a fall, the most effective approach to fall prevention is to conduct a professional safety assessment of the home and to develop a personalized fall prevention plan for yourself or your loved one.

This way you can focus on the approaches and solutions that are most relevant to your situation and implement strategies that will have the most impact on keeping you or your loved one safe.

Here is another good resource on fall prevention for you to review, from the Center for Disease Control and Prevention.

https://www.cdc.gov/steadi/pdf/steadi_olderadultfactsheet-a.pdf

If you are ready to take a more customized and more effective approach to fall prevention, contact us here to schedule a Home Safety Audit. As part of our service, we can also help you create a Personalized Fall Prevention Plan.

Thank you for reading!

Product Review: The Best Senior-Friendly TV Remote

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Does your elderly parent often complain that their “TV is not working”? Are they pressing the wrong buttons on the remote control and end up getting to the wrong screen? Sounds like a lot of wasted time and frustration for both of you. This big button TV remote could be a perfect solution.

Below, I will go over it’s features, pros and cons, and some of the other comparable products, and explain why the Flipper Big Button Universal Remote is my best pick for your senior parent.

Features:

  • Has only 6 buttons: On/Off, Mute, Vol(+), Vol(-), Ch(+), and Ch(-).

  • Controls 2 devices like TV and cable (or satellite)

  • Works for all major TVs

  • Buttons are large, raised, color-coded, and stand out well against the white background

  • Has a hidden locked panel that allows you to program up to 25 channels

  • 100% money back guarantee as well as 1-year manufacturer’s guarantee

Pros:

  • Very few buttons >> no more confusion and no more pressing the wrong button

  • Buttons are easy to locate by touch >> good for someone who has numbness in their hands

  • Buttons are easy to see and have good contrast against the background >> good for someone with low vision

  • Larger in size than comparable remotes >> easier to use for someone with arthritis

  • Easy to set up >> won’t take a lot of time out of your day

  • Takes place of both TV and cable remotes >> less remotes means less confusion

  • Programmable >> don’t have to click through all the channels

  • Lock on the programming panel >> no more pressing the wrong button

I love this remote! It obviously solves a lot of problems.

But nothing is perfect. The only downside that I found was its price. It costs $29.95, more than other comparable devices.

I will mention 2 of these devices and some of their features/differences below:

1.     Universal Big Button TV Remote by Continu.us

  • Only works for 1 device/TV

  • Has a wrist strap

  • Has back-lit buttons

  • Not programmable, have to go up and down all channels

  • Costs $15.95

2.     Large Button TV Remote Control by Tel Pak

  • Only works for 1 device

  • Has back-lit buttons

  • Not programmable

  • Costs $19.99

Both of these devices might be a good option for someone who lives at an assisted living facility, where there is no separate cable box and not that many channels to go through.

Otherwise, my top pick is the TV remote by Flipper. Even though it’s a little more expensive, the price is definitely worth all the extra features and ease of use compared to the other senior-friendly TV remotes available on the market.

Thank you for reading!

 

Disclosure: please note that the links above are affiliate links and that I will earn a small commission if you decide to make a purchase after clicking through the links.

How To Get The Most Out Of A Doctor's Visit: Things To Do Before, During, And After

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An appointment with a doctor is an important meeting that you should properly prepare for. When you walk into the doctor’s office, you should have clear goals and be able to have an informed conversation with the doctor about your or your loved one’s condition.

During the appointment, it’s important to clarify everything that you are confused or uncertain about. At the end of the visit, you should have a better understanding of what causes the symptoms, a clear picture of the treatment options, and an agreement on a treatment plan that you are comfortable with. The treatment plan should make sense to you and be acceptable to you.   

I know, this sounds like you might have to be a real pain in the..... Well, if you have to, then so be it. This is about you, your body, your health, and you are the one who has the most to lose if the wrong decision is made. So, speak up, be the best advocate for yourself or your loved one if you are a caregiver. And if you have a good doctor, he or she will understand your concern and support you in making the right decision.

Below, I listed lots of tips and ideas for you. Go through them and take note of the ones that you think would be the most beneficial to you. Write them down and use them to prepare for your next appointment.

Before the appointment:

  • Get the medical records organized. If you are going to a new doctor, put together your medical history, including all hospitalizations, surgeries, diagnoses, family medical history, and a list of other doctors/specialists who are treating you. Bring any changes to the medical record since the last appointment, like new medications prescribed by other physicians or new test results.

  • Do your homework. Do your research about the medical condition, symptoms, and treatment options, so you can have an informed conversation with the doctor.

  • Make a list of questions and concerns. Arrange the list from the most to the least urgent. Ask other caregivers about new issues, changes, or concerns.

  • Make a list of all medicines and their schedule. You can also bring all pill bottles (prescription, over-the-counter, and supplements) in a zip-lock bag.

  • Think about and write down your goals for the visit. What would you like the doctor to address, for example, adjust or review medications, get pain or other symptoms under control, make a referral, order additional testing or preventive screening, coordinate care with other doctors/specialists.

  • Keep a record of symptoms, vital signs, or changes. Document the intensity or frequency of new or ongoing symptoms, such as blood sugar, blood pressure measurements, severity of pain, side effects etc. The doctor needs to know if the treatment is effective or the details of new symptoms.

  • Bring a family member or a friend. They will be your advocate and will help you make sure that all the questions are addressed.

During the appointment:

  • Take notes. You might not remember everything that the doctor said, but you will have your notes to refer to.

  • Ask all the questions from your list. Check them off as you go through them.

  • Speak up. Don’t be afraid to clarify information, ask additional questions, or express concerns. Ask a question more than once, if you are still confused about the explanation that the doctor provided.

  • Call during the appointment to talk to the doctor, if you are a caregiver and can’t make it to the appointment.

  • Ask about potential side effects and interactions, if the doctor is prescribing any new medications.

  • Ask to explain the reasoning behind any new treatments that the doctor prescribes. Ask if there are alternatives.

  • Find out when the doctor wants to see you again.

  • If the doctor refers you to a specialist, ask the receptionist to schedule the appointment for you. You might get in a lot sooner.

  • Ask how to get in touch with the doctor if you have any additional questions after the appointment.

After the appointment:

  • Go through your notes. Make sure you understand everything that was discussed, call back if you are not sure you understand any instructions or what to expect next.

  • Schedule any tests or appointments that were ordered by the doctor.

  • Pick up new medications from a pharmacy.

  • Update other caregivers on any changes.

  • Review doctor’s recommendations with your loved one.

  • Keep a journal of symptoms, vital signs, ongoing changes, so you will be prepared for the next visit.

What to do next:

Get organized and come up with a system that would make sense for you, would be easy to find information in, and easy to update. Whether you decide to use an old-fashioned notebook or keep records electronically, make sure that your system is easy for you to use. You might have to tweak it over time, if you find that it takes you too long to find information you are looking for.

If you have your own tips or advice on preparing for a doctor’s visit, leave them in the comments section below.

Thank you for reading!

Why Adapt The Home For Aging?

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We’ve heard so many times that most people want to remain at home as they age. Whether you are thinking about your own future or caring for an elderly loved one, being successful at living at home in the later years requires thought and preparation.

Most homes have been built for healthy, able-bodied people. No one has given any thought to whether these homes would need to accommodate people in their 80’s and 90’s. But the fact is that our bodies change as we age, but our homes don’t.

At some point, the place that’s supposed to provide safety, comfort, and security, does not feel that safe and comfortable any more. I’ve seen people stuck in a single room with a half bath just because they are unable to access other areas of the house any longer. Neither can they get in or out of their house unless a rescue squad comes in with a stretcher. Can you imagine how depressing this might be? Are you thinking: “prisoner in their own home?”

In a lot of ways, we take our homes for granted. We think they will always feel as comfortable as they have been for years. But the future comes. Our bodies change. And it’s up to us to decide whether our homes will support or aggravate these changes. It’s up to us to do something about it and to plan well. While we can’t control everything, we can dramatically increase our chances of having a better life for us and our aging loved ones.

So, where do you begin? Start with walking through the house and looking at it with a fresh pair of eyes. Think about an elderly friend or a relative who uses a walker or a wheelchair. Do they have poor balance, low vision, pain and limited motion from arthritis? Would you be concerned for them to use stairs by themselves? Or get into the shower? What about reaching into a closet? Or cooking a meal?

This should give you an idea about some of the areas of the house that might present a fall hazard or limit independence. Start with that. Become more aware of how the home environment might present mobility challenges and hidden dangers.

Whether you are planning for yourself or helping an aging relative, there are some important questions you need to ask yourself before adapting the home to support present or future needs. Answers to these questions will point you in the right direction and help you determine your starting point as well as clarify your goals and priorities for making an age-friendly home.

Pick up this guide that I have created for you, “3 QUESTIONS TO ASK YOURSELF BEFORE ADAPTING THE HOUSE FOR AGING” so you can start thinking through the options that would best suit your or your loved one’s needs.

If you have any questions or comments, contact me here. I value your feedback and respond to all emails.

To learn more about our services, please visit our homepage.

The Medical System vs Common Sense

 
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The new movement in medicine is towards patient-centered care. This trend acknowledges the sad reality of how far away we must be from what really should be a standard. Isn’t patient-centered care just common-sense care? And what is at the center of medical care now if it’s not the patient?

Our medicine is focused on treating diseases, and we have doctors for each body part. We understand the physical aspect of the disease so much better than 10 or 20 years ago. But we are not just physical beings, and a human is more than a sum of its’ parts. Being unwell or ill is a deeply personal experience that involves more than just physical symptoms. It’s an emotional and often spiritual experience that changes how we view ourselves and the world; it’s an experience that could change the rest of our lives.

When we become seriously ill, we might have to deal with hope and disappointment, fear of the unknown, and coping with pain. We might have to deal with the loss of our former healthier selves and the loss of a habitual lifestyle. The disease might make us dependent on others and strain personal relationships. There are also decisions that we have to make along the way, about treatment options and their implications for our lives and well-being.

For each person, this experience is unique. Yet solutions offered by our medicine are generic, and the personal aspect of being sick is often overlooked. Patient-centered care means taking time to listen and respect each patient’s goals and preferences. It also means discussing how different treatment options could affect their quality of life. This approach to medical care would lead to medical decisions that are in the best interest of the patient and reflect the patient’s experience, values, and lifestyle. Hopefully, patient-centered care gains momentum and becomes the new normal. Because it’s really just common sense!

- by Nina Rubinstein

The Medical System: Are You Falling Through The Cracks?

 
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Have you ever tried counting all the cracks and holes in our medical system? I’ve tried and to be honest, I’ve lost count. I’ve lost count of all the instances of poor care after years of working as an occupational therapist, hearing my patients’ stories, and going through medical events with my own family members.

“I can write a book!” one of my patients told me. She had enough stories for a book, just from her own experience! That’s astonishing to me!

In healthcare, we talk about “readmission risk,” “quality measures,” “patient satisfaction,” “utilization of services.” There are positions and departments devoted to improving all these measures. So, how come so many things still get missed? Behind all these metrics are real people who might’ve suffered more than they had to, or got sicker because someone was not paying attention.

What about the pain that the person goes through when their pain pills arrive 2 days after their admission to a rehab facility? What about treatment and diagnosis mistakes that are caused by doctors not communicating with each other about a patient? And how about sending someone home with a new cast or a brace, or right after surgery with no follow-up at home at all?

We can work on improving quality indicators and it will fix some of the problems. But we can’t regulate paying attention and taking time to listen to the patient’s needs. There isn’t a way to manage human touch, kindness, and compassion.

I don’t pretend to have an answer on how to fix all the cracks in our medical system. But seeing a human being who is going through a difficult time in their life instead of “the next patient” might be a good place to start.

- by Nina Rubinstein

Let Me Introduce Myself!

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When I was little I used to say, “when I grow up, I will invent a medicine so people will  not die.” I don’t know where the idea came from at such a young age. We had no doctors in our family. I don’t remember any conversations about “old age” or “dying” either. So, I am still wondering how a small child could come up with such an aspiration. I don’t think I will ever know… But I like to think that maybe this idea was the seed for the journey that is now starting to take shape in my life.

I am translating this childhood dream into today’s language. Of course, I know it’s impossible to invent such a medicine. Today my dream is no longer about the medicine. It’s about people who are getting older and going through health-related challenges. It’s about living well and enjoying life despite those challenges.

Over the years I have discovered that helping people persevere through life’s transitions is my true aspiration and starting my own business (and this blog!) is a way to do just that. Following my own values while improving people’s lives and discovering my own authentic voice while serving others – that’s where my journey is taking me!

- by Nina Rubinstein