While providing elderly home care, would you know how to identify
depression in your elderly loved one? Do you know the warning signs of
senior depression? If you answered no to one or both of these
questions, you are not alone. Depression may be described as feeling sad, blue, unhappy, miserable, down in the dumps, or feeling blah. The
common signs of depression can include:

1. Trouble sleeping or excessive sleeping
2. Dramatic change in appetite, often with weight loss or gain
3. Fatigue, lack of energy
4. Feelings of worthlessness
5. Difficulty concentrating
6. Agitation, restlessness, or irritability
7. Withdrawal from once enjoyed activities
8. Feelings of hopelessness or helplessness
9. Recurring thoughts of death or suicide

Depression among seniors is harder to identify than depression among younger adults. Younger adults, and even children, more readily express feelings of sadness or depression that their senior counterparts.
Caregivers providing personal home care and family members of seniors
may not recognize the signs of depression. And if seniors are less
likely to express such feelings, the situation can prove to have
devastating results. Geriatric suicide is a growing concern. Suicide among the elderly is more common that any other age group. One reason for this, is that depression among seniors is often mistaken for other age related problems, or the aging process in general. But remember, depression is not a normal part of aging.
Many seniors are from an era where seeking help for mental health issues carries a negative stigma of being “crazy”. It is important, therefore, for family members and those providing senior in home care to be aware that their senior loved one is less likely to share feelings of depression, and less likely to seek treatment. Seniors often face loneliness, isolation, and grief over the death of a spouse. If you notice signs of depression in your aging loved one, try to reach out and talk about it with them. If you are the caregiver providing personal home care and notice signs of depression, share your concerns with the family members. If the senior is unwilling or unable to open up and share her thoughts, and the depression persists, it’s important
to speak to a medical professional.

Finding care for a parent can present a laundry list of challenges. Perhaps you are suddenly faced with a crisis that requires you to find care for a parent that has become ill, taken a fall, or has become increasingly more confused or forgetful. Where do you begin to find care for a parent?

The first question to answer is what kind of help is needed? Do you need to locate services for short term services such as help following surgery or a rehab center? Or is your parent’s need more long term such as live-in home care following a stroke, or Alzheimer’s? The very first step is to take a deep breath, relax, and make sure you take care of yourself. Without this, you can’t be an effective caregiver.

Regardless of the services your parent needs, you will need to have some general information in order to proceed. Examples of information needed include your parent’s date of birth, social security number, doctor(s) names and numbers, pharmacy name and number, access to or copies of insurance/medicare card(s), and benefits handbooks.

Make a list of all medications your parent is taking, including dosage and frequency. Be sure to include not only prescription medications but over-the-counter drugs such as

aspirin and vitamins. It’s also helpful to create and maintain a list of major illnesses, medical conditions and surgeries. Bring this info with you to all appointments.

Gather family members to discuss your parent’s needs. This meeting is a good opportunity for all family members to express their concerns and facilitate decision making. Be sure your parent’s doctors know who should be the designated contact person.

Find out if your parent has his or her legal documents in order. Has someone been designated to make health care decisions in case your parent is unable to? Has your parent expressed his/her desires for end of live care? These may be difficult topics to broach but can save a great deal of heartache and family turmoil down the road. Some of the documents you want your parent to prepare are a Will, Durable Power of Attorney for finances, and Durable Power of Attorney for health care, and a Living Will. An elder law attorney can help you prepare these documents if they aren’t already done.

You may also find is useful to do a little research on senior care services available. Examples include senior in home care, assisted living, adult day care or long term care. As co-workers, friends and family what are the best around. This will benefit you to familiarize yourself with available services, and will allow your parent a range of options down the road. Gathering information on these services is still useful, even if you are only dealing with a short term crisis. If your parent needs services such as home care or assisted living immediately, you may want to consider hiring a geriatric care manager. This is someone who is licensed and trained in the needs and services related to the geriatric population.

The bottom line advice, become involved. If you are involved in the affairs and care of a parent, you will feel better knowing you are the best caregiver possible because you have done your homework and can advocate with confidence. And don’t forget to take care of yourself!

Sometimes it’s difficult to know when it’s time for you to be thinking about senior in home care for your parent(s). These thirteen signs can be a guideline for you when making that difficult decision.

1. Changes in eating habits or loss of appetite.

2. Spoiled or outdated food in the refrigerator.

3. Difficulty walking, unsteady gait,falls.

4. Poor grooming/personal hygiene.

5.Memory loss, forgetfulness, confusion.

6. Mishandled medications.

7. Persistent fatigue/lack of energy.

8. Personality changes, irritability, mood changes.

9. Diminished driving skills, near misses, accidents.

10. Loss of interest in activities once enjoyed.

11. Reluctance to socialize.

12. Difficulty concentrating, poor judgement.

13. Unopened mail, past due bills, mishandled finances.

14. Poor home maintenance, unsafe conditions.

If you notice several of these warning signs, it may be time to consider some changes. Your options could include an assisted living facility, or perhaps assisted living in home from a home health care agency.

I was talking to a close friend who was very concerned about her mom. She went on to tell me that her mom was starting to develop some health issues and she felt very badly about her living alone in her home.  My friend is newly married and working full time and felt that she could not give her all the care that her parent needed.

We talked about the various types of care that is available.  She began researching both assited living and nursing homes care in nj and the surrounding areas.  Along with the help of some of her family members, she talked to her mom about the costs and advantages of an assisted living facility where she could continue to live independently but also receive the care she needed.

She was able to locate a nearby assisted living facility close to her home.  Her mom has been there for about a year now.  My friend has peace of mind that her mom is receiving the care that she needs but is also enjoying meeting people and getting involved in the various activities that the facility provides.

Sitting down and initiating a discussion with your elderly parents about needing some personal home care can be uncomfortalbe. Many families avoid such conversations about aging, end of life, and finances because they view these topics as private matters. The following tips provide communications strategies that might help with the dialogue of care for parents.

1. Start discussions early-it’s much easier to have these discussions while your parents can be a part of the decision making process, rather than you having to do it for them because of illness or injury.

2. Go in prepared-don’t be surprised to learn that your parents have already thought about the need for personal home care someday. Create a game plan to present to your parents, include siblings and other pertinent relatives, and gather necessary information to share on senior in home care.

3. Explain your purpose-let your parents know you are concerned about them and that your goal is to help them. Your parents will be more responsive to elderly home care if they participate in the dec isions.

4. Take one step at a time-don’t overwhelm your parents by trying to solve too many problems at once. Change comes slowly to many seniors. Tackle the big problems first. Accepting the fact that they need help may take some for your parents to accept.

5. It’s ok to agree to disagree-if your parent’s don’t initially agree with your idea for senior in home care, don’t push too hard. Unless their immediate health or safety are an issue, their wishes should prevail.

6. Don’t give up-if you run into extreme resistance to personal home care on your first attempt…keep trying. Leave some literature for them to read. Be patient and approach the subject again once they’ve had time to disgest the idea.

Home Care: Seniors with complex chronic illnesses such as Alzheimer’s, advanced dementia, congestive heart failure, chronic pain, those who can no longer self-direct etc. can often be well cared for with senior residential care services. Using professionals to asses each individual situation, caregivers can be brought in who understand the special needs of these seniors.  Additionally, there is now new technology such as sensors which detect falls or alert when there are changes in lifestyles which may be a signal of a change in health status and are making an impact in the ability for seniors with complex problems to stay at home.

Seniors needing home care have numerous choices. Selecting an agency which has the right personnel can make a huge difference for children taking care of parents. An agency whose goals are to alleviate the pressure from the children are very aware of the stress and struggles they go through.  They know that care of a parent can be draining. A good agency will address this and look for ways not only to help the senior with their physical care, but also how to help the entire family situation.

When selecting home care for seniors, make sure you look at all the options. Don’t rush into this as the choice you make can greatly affect the way your parents live.

The ideal time to begin talking about housing and seniors care needs is before the need presents itself. The baby-boomer generation is predicted to be one of the most active groups of older Americans. Family members of seniors, recent retirees and baby boomers should be proactive. Become familiar with the risks and specific issues of senior long term care. Then educate yourself on the available resources in your community for seniors care. Some of the local resources for information on resources for seniors include geriatric care managers, occupational therapists, architects, remodeling contractors, home health care companies, insurance companies, reverse mortgage lenders, elder law attorneys, and local public and non-profit organization.

The National Aging in Place Counsel (NAIPC) has announced October 12-18, 2009 National Aging in Place Week. The two main objectives of this week of awareness are to build lasting coalitions of business professionals across the United States to assist homeowners with long term care needs, and to organize educational  activities to highlight transportation and housing that enable seniors to successfully age in place. This awareness week is an opportunity for senior care professionals to educate and it is also an opportunity to seniors as well as baby boomers to familiarize themselves with available senior assistance options.

Locating appropriate senior assistance for your elderly loved one can be a daunting task. This can be especially true when you are not familiar with your care and housing options. It can be overwhelming when you hear senior care related terms such as sub-acute care, independent living, assisted living, residential care, or continuing care facility.

Understanding the variety of senior care options and related terminology can ease your way as you navigate your way. The following are some of the common terms and service options you may encounter and want to become familiar with.

Adult Day Care/Medical Day Care-a protective environment for seniors needing a structured program. Adult day care services vary from custodial care, offering stimulating activities for independent seniors along with meals, to an adult medical day care setting which provides activities to seniors with medical needs. Seniors are usually brought to an adult day care program in the morning and leave in the evening. Often times, transportation to and from the center are available.

Assisted Living- is a combination of housing and personal health support services for seniors. Such services usually include:

• Private or semi-private apartment
• Emergency call system
• Daily meals served in a common dining area
• Recreational and social activities
• Transportation
• Personal care assistance
• Staff available 24 hours
• Laundry and housekeeping services
• Secure unit for memory impaired residents (at some assisted living communities)

Continuing Care Retirement Community (CCRC)- a community that offers multiple levels of assistance to seniors. Levels of care range from independent living apartments, assisted living and nursing home care. A CCRC provides a continuum of housing and health care options on one central campus. Seniors who opt for CCRC living usually sign a long term contract such as the length of the resident’s life. The benefit of this type of care is that it can provide peace of mind that housing and medical assistance will continue to be provided at one site as needs increase.

Home Care- also known as senior in home care or home health care. This type of service provides a range of services that include assistance activities of daily living such as bathing, toileting, dressing, and ambulation. Home care can also include meal preparation, light housekeeping and laundry services. In-home care can be provided for a few hours per day or on a 24 hour basis.

Nursing-Convalescent Home/Skilled Nursing Facility- for those with a need for more acute care, a nursing home provides patients with 24 hours care. This type of facility is generally for patients that will require skilled care ongoing. This type of facility provides medical supervision, rehabilitation as well as bathing, toileting, dressing, and assistance with ambulation.

Many adult children struggle with their concern for their aging parents, especially in regards to driving. For many, seniors independent living includes maintaining freedom, independence, spontaneity, and the ability to stay involved in outside activities. For many, continuing to drive is a symbol of this independence.

For adult children taking care of parents, approaching the subject of when to discontinue driving is a sensitive issue. And while senior drivers are at added risk, many older drivers will place self-imposed limitations on themselves as they age. Many seniors will discontinue night time driving, decrease the speed in which they travel, and  avoid rush hour traffic.

Each family needs to address the issue of when to discontinue driving, but the following 7 tips for older drivers can be a good starting point.

1. Stay physically active-this improves the strength, coordination, and flexibility.
2. Manage chronic conditions-especially those that may affect driving ability such as medications that cause drowsiness or low blood sugar related to diabetes.
3. Schedule regular vision and hearing tests-these are common age related problems that make driving difficult, especially at night.
4. Understand your limitations-for example, if arthritis is a problem, use a steering wheel cover for easier grip.
5. Drive under optimal conditions-avoid nighttime driving and rush hour traffic, or driving when tired.
6. Plan ahead-know the route you plan to take and get directions ahead of time to new destinations.
7. Update your driving skills-local community organizations such as AARP offer refresher courses for older drivers that may even earn an insurance discount.

I recently received a call from Tom in Mt. Laurel NJ asking about home care for his parents. His Mother is 84 years old and Dad is 86.  They live in a lovely two bedroom condo in a retirement community but recent calls by his parents to 911 have signaled to Tom that his parents can no longer live alone.   His Mother has diabetes, needs assistance with medications and due to a recent fall and hospitalization, some help with dressing and bathing. His Dad is more independent, but has macular degeneration and is not able to cope with his wife’s care.  Tom was surprised to learn that the cost of home care was comparable to assisted living costs and scheduled tours at two of the nearby Assisted living communities in Wilmington Delaware.

Assited living is ideal for people needing help throughout the day and want to remain active and independent in an environment that provides around the clock caregivers.  Residents in assisted living are encouraged to do as much as possible on their own and are surrounded by others who are still fairly independent so residents in assisted living tend to remain healthier, more involved and active than seniors who remain isolated in their home with a caregiver who provides a few hours of homecare per day.