HealthDay
Sat Nov 28, 11:47 pm ET
SATURDAY, Nov. 28 (HealthDay News) -- For many seniors, the holiday season can trigger melancholy as they think about lost loved ones, struggle with health issues or worry about money problems, according to the American Geriatrics Society.
To help overcome the seasonal blues, the AGS Foundation for Health in Aging offers the following advice:
* Get out and socialize or invite family and friends over. Those who find it hard to get around should ask relatives and others for help traveling to parties and events.
* Volunteering can help improve mood. Contact the United Way or call local schools or religious organizations to ask about opportunities nearby.
* Don't drink too much alcohol because it can actually lower your spirits.
* Accept the fact that many people feel blue during the holidays and there is nothing wrong with not being "merry."
* Talking to someone about your feelings may help you understand the reasons why you feel sad.
* Watch for warning signs of depression. While holiday blues are temporary and mild, depression is more serious. Signs of depression include: persistent sadness; lack of interest; frequent crying; changes in appetite, weight or sleep; constant feelings of fatigue, restlessness, worthlessness, or guilt; suicidal thoughts.
* If you're depressed, contact your health-care provider. Depression is treatable.
The AGS Foundation for Health in Aging also offers tips for people with older loved ones who experience sadness during the holidays:
* Invite them out and to gatherings. Remember to take into account their needs, such as transportation or special diets.
* Lend a hand by offering to help with shopping and preparations for get-togethers in their homes.
* Encourage them to talk about their feelings. Acknowledge their sadness, including a sense of loss if family or friends have died or moved away.
* Suggest your loved one talk with a health-care provider. Many older people don't realize when they're depressed. Let your loved one know depression is a medical illness and there's no shame in having it.
More information
Mental Health America has more about holiday depression and stress.
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
Monday, December 7, 2009
Monday, November 30, 2009
Elder care added to UAB medical school curriculum
November 27, 2009 By The Associated Press JEFF HANSEN (The Birmingham News)
Quick Summary
Growing older population causes UAB to add elder care to medical school curriculum
BIRMINGHAM, Ala. - BIRMINGHAM, Ala. (AP) — With a ballooning population of older people, the UAB School of Medicine is changing its curriculum to ensure every medical student learns about caring for the elderly.
Historically, the University of Alabama at Birmingham and other medical schools have failed to give broad training in geriatrics, the area of medicine that focuses on diagnosing and treating diseases and problems particular to older people.
UAB has now joined 39 other medical schools to correct that, with the help of $80 million of funding from the Donald Reynolds Foundation. Reynolds was a media tycoon who built a fortune in newspapers, radio, television and outdoor advertising.
UAB got its $2 million, four-year grant last year and is spending it to improve education for its 875 medical students, as well as for 350 residents and numerous faculty and community physicians.
"There has been a huge gap in geriatrics training," said Dr. Christine Ritchie, director of palliative and supportive care in the UAB Division of Gerontology, Geriatrics and Palliative Care, and director of the new program.
Some parts of the new Alabama Reynolds Program for Care of the Complex Older Adult are under way.
Internal medicine residents are now required to spend one month in geriatrics training in settings that include acute hospital care for the elderly, a long-term care facility, outpatient clinics and home care visits.
Medical students have started a senior mentoring program in which older people from the community talk to the students. Other parts of the program will be added over the next two years.
Ritchie and others are systematically working to increase geriatric education in all four years of the medical school curriculum.
They are also developing interactive, online training modules with 10 different virtual patients. In one, an older man and his adult daughter come to see the doctor, with the daughter explaining that her dad has become very withdrawn. The modules will be tested in collaboration with the University of South Carolina, the University of Arizona, Emory University and Vanderbilt University.
Ritchie and other physicians are also developing special geriatrics training for residents in internal medicine, family medicine, emergency medicine and pediatrics.
"Why pediatrics?" said Ritchie. "What we're seeing is multigenerational caregivers, where a grandparent is the caregiver."
She has one simulation in which a young child comes in after overdosing on his grandmother's blood pressure medicine. "The pediatrician has to figure out what's going on with the grandparents - what do you have to be aware of when you have an older caregiver?" Ritchie said.
Geriatrics presents some special problems.
One great danger that older patients face is transitions, when they move from one care setting, say a hospital, to another, such as home or a nursing home.
"It's very hazardous for patients, because balls get dropped," said Ritchie.
One study in the New England Journal of Medicine this year found that 30 percent of Medicare patients who had been hospitalized for a medical condition were readmitted to the hospital within 60 days. The cost of those potentially preventable hospitalizations may be as high as $12 billion a year.
To avoid transition problems, doctors have to make sure medications are managed properly during the change, that a follow-up outpatient appointment has been set, and that patients and caregivers know the "red flags" of their illnesses that require quick attention. Patients and families also have to be able to take charge of the health care plan.
Older patients can face multiple chronic conditions.
Dr. John Burton, a geriatrics expert at Johns Hopkins University, has said the average adult has two to three chronic medical conditions by age 75, and some have as many as 10 or 12 conditions. And he has said that just as doctors do not treat a child and a middle-aged adult the same way, there are remarkable differences in the medical treatment of a 50-year-old and an 85-year-old.
Geriatric doctors also have to understand the patient's family system and the culture they come from.
"People's caregiver support is highly variable," Ritchie said. "In the past it was sort of 'don't ask, don't tell.'"
This improved training at UAB comes at a point when people 85 and older are the fastest-growing group in the United States. It also comes just as the baby boomer generation starts to reach Medicare age. The demand for geriatric care will only increase.
Dr. Mustafa Ahmed, an internal medicine resident who went through medical school in England, will finish his UAB geriatrics rotation next week. Ahmed said he was surprised by the lack of geriatrics training in America - especially since so many of the patients that internists see are older.
"In England, there is a heavy emphasis on geriatrics training," he said. "It's essential for our training."
Ritchie believes the UAB changes will improve the quality of medical care that patients and families receive.
"I hope it means that the future care of them or their loved one is more clued in to the various complex issues that surround the care of older adults," she said.
Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
Quick Summary
Growing older population causes UAB to add elder care to medical school curriculum
BIRMINGHAM, Ala. - BIRMINGHAM, Ala. (AP) — With a ballooning population of older people, the UAB School of Medicine is changing its curriculum to ensure every medical student learns about caring for the elderly.
Historically, the University of Alabama at Birmingham and other medical schools have failed to give broad training in geriatrics, the area of medicine that focuses on diagnosing and treating diseases and problems particular to older people.
UAB has now joined 39 other medical schools to correct that, with the help of $80 million of funding from the Donald Reynolds Foundation. Reynolds was a media tycoon who built a fortune in newspapers, radio, television and outdoor advertising.
UAB got its $2 million, four-year grant last year and is spending it to improve education for its 875 medical students, as well as for 350 residents and numerous faculty and community physicians.
"There has been a huge gap in geriatrics training," said Dr. Christine Ritchie, director of palliative and supportive care in the UAB Division of Gerontology, Geriatrics and Palliative Care, and director of the new program.
Some parts of the new Alabama Reynolds Program for Care of the Complex Older Adult are under way.
Internal medicine residents are now required to spend one month in geriatrics training in settings that include acute hospital care for the elderly, a long-term care facility, outpatient clinics and home care visits.
Medical students have started a senior mentoring program in which older people from the community talk to the students. Other parts of the program will be added over the next two years.
Ritchie and others are systematically working to increase geriatric education in all four years of the medical school curriculum.
They are also developing interactive, online training modules with 10 different virtual patients. In one, an older man and his adult daughter come to see the doctor, with the daughter explaining that her dad has become very withdrawn. The modules will be tested in collaboration with the University of South Carolina, the University of Arizona, Emory University and Vanderbilt University.
Ritchie and other physicians are also developing special geriatrics training for residents in internal medicine, family medicine, emergency medicine and pediatrics.
"Why pediatrics?" said Ritchie. "What we're seeing is multigenerational caregivers, where a grandparent is the caregiver."
She has one simulation in which a young child comes in after overdosing on his grandmother's blood pressure medicine. "The pediatrician has to figure out what's going on with the grandparents - what do you have to be aware of when you have an older caregiver?" Ritchie said.
Geriatrics presents some special problems.
One great danger that older patients face is transitions, when they move from one care setting, say a hospital, to another, such as home or a nursing home.
"It's very hazardous for patients, because balls get dropped," said Ritchie.
One study in the New England Journal of Medicine this year found that 30 percent of Medicare patients who had been hospitalized for a medical condition were readmitted to the hospital within 60 days. The cost of those potentially preventable hospitalizations may be as high as $12 billion a year.
To avoid transition problems, doctors have to make sure medications are managed properly during the change, that a follow-up outpatient appointment has been set, and that patients and caregivers know the "red flags" of their illnesses that require quick attention. Patients and families also have to be able to take charge of the health care plan.
Older patients can face multiple chronic conditions.
Dr. John Burton, a geriatrics expert at Johns Hopkins University, has said the average adult has two to three chronic medical conditions by age 75, and some have as many as 10 or 12 conditions. And he has said that just as doctors do not treat a child and a middle-aged adult the same way, there are remarkable differences in the medical treatment of a 50-year-old and an 85-year-old.
Geriatric doctors also have to understand the patient's family system and the culture they come from.
"People's caregiver support is highly variable," Ritchie said. "In the past it was sort of 'don't ask, don't tell.'"
This improved training at UAB comes at a point when people 85 and older are the fastest-growing group in the United States. It also comes just as the baby boomer generation starts to reach Medicare age. The demand for geriatric care will only increase.
Dr. Mustafa Ahmed, an internal medicine resident who went through medical school in England, will finish his UAB geriatrics rotation next week. Ahmed said he was surprised by the lack of geriatrics training in America - especially since so many of the patients that internists see are older.
"In England, there is a heavy emphasis on geriatrics training," he said. "It's essential for our training."
Ritchie believes the UAB changes will improve the quality of medical care that patients and families receive.
"I hope it means that the future care of them or their loved one is more clued in to the various complex issues that surround the care of older adults," she said.
Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
Tuesday, November 17, 2009
Sources: Senate weighs long-term care program
By RICARDO ALONSO-ZALDIVAR, Associated Press Writer
WASHINGTON (AP) -- Senate health care legislation expected this week is likely to include a new long-term care insurance program to help the elderly and the disabled avoid going into nursing homes, Democratic officials say.
Senate Majority Leader Harry Reid, D-Nev., is expected to incorporate the voluntary program in legislation to be unveiled as early as Wednesday, said the officials, who spoke on condition of anonymity because a final decision has not been made.
Known as the Community Living Assistance Services and Supports Act, or CLASS Act, the program was a top priority for the late Sen. Edward M. Kennedy, D-Mass. It would begin to close a gap in the social safety net that's received little attention in the health care debate.
Fiscal conservatives and government economists have questioned whether the program would be financially sustainable over the long run, and insurance companies are lobbying to strip it from the health care bill.
Nonetheless, the House included the program in its health care legislation, with the approval of the Obama administration. In the Senate, the Health Committee bill had included it, but the Finance Committee omitted it. The approach Reid is considering in a combined bill would address the objections of fiscal conservatives by stipulating that premiums from the program could not be counted in offsetting the cost of the broader health care bill. Reid's office had no comment on Tuesday.
The cost of nursing homes averages $70,000 a year, and a home care attendant runs about $29 an hour. Medicare only covers temporary nursing home stays. Middle-class households have to exhaust their savings before an elder can qualify for nursing home coverage through Medicaid. Continue readinghttp://www.ksdk.com/news/local/story.aspx?storyid=189903
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in the Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
WASHINGTON (AP) -- Senate health care legislation expected this week is likely to include a new long-term care insurance program to help the elderly and the disabled avoid going into nursing homes, Democratic officials say.
Senate Majority Leader Harry Reid, D-Nev., is expected to incorporate the voluntary program in legislation to be unveiled as early as Wednesday, said the officials, who spoke on condition of anonymity because a final decision has not been made.
Known as the Community Living Assistance Services and Supports Act, or CLASS Act, the program was a top priority for the late Sen. Edward M. Kennedy, D-Mass. It would begin to close a gap in the social safety net that's received little attention in the health care debate.
Fiscal conservatives and government economists have questioned whether the program would be financially sustainable over the long run, and insurance companies are lobbying to strip it from the health care bill.
Nonetheless, the House included the program in its health care legislation, with the approval of the Obama administration. In the Senate, the Health Committee bill had included it, but the Finance Committee omitted it. The approach Reid is considering in a combined bill would address the objections of fiscal conservatives by stipulating that premiums from the program could not be counted in offsetting the cost of the broader health care bill. Reid's office had no comment on Tuesday.
The cost of nursing homes averages $70,000 a year, and a home care attendant runs about $29 an hour. Medicare only covers temporary nursing home stays. Middle-class households have to exhaust their savings before an elder can qualify for nursing home coverage through Medicaid. Continue readinghttp://www.ksdk.com/news/local/story.aspx?storyid=189903
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in the Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
Wednesday, November 11, 2009
Home Health Care for Your Elderly Parents
When a nursing home doesn't feel like the right move, home health care can be a good option. Here's how to make your decision
By Beth Piskora
Your mother doesn't see as well as she used to, and sometimes has trouble walking. You wonder if it's a good idea for her to stay alone in that house, or if there is a better option for her. But you just can't stomach the idea of putting mom in a nursing home.
You're not alone.
According to the National Academy on Aging Society, there are 8.5 million people over age 70 in America with limitations in walking, dressing, bathing, shopping, paying bills, and preparing meals. This number will increase dramatically in the future, perhaps to 21 million in the next quarter century, according to estimates. In addition, the National Association of Home Care & Hospice Care reports the number of home-care agencies has increased to 17,700 in what has become a $53.4 billion industry. Readhttp://www.businessweek.com/investor/content/sep2008/pi20080910_761489.htm
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in the Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
www.linkedin.com/in/liacald4773
www.merchantcircle.com/.../Home.Care.Charlotte.NC-I.Care.For.You.Home.Care.L.L.C..800-383-0520
http://www.facebook.com/home.php#/pages/Charlotte-NC/I-Care-For-You-Home-Care-LLC/82169019227?ref=ts
http://twitter.com/vcaldwell773
By Beth Piskora
Your mother doesn't see as well as she used to, and sometimes has trouble walking. You wonder if it's a good idea for her to stay alone in that house, or if there is a better option for her. But you just can't stomach the idea of putting mom in a nursing home.
You're not alone.
According to the National Academy on Aging Society, there are 8.5 million people over age 70 in America with limitations in walking, dressing, bathing, shopping, paying bills, and preparing meals. This number will increase dramatically in the future, perhaps to 21 million in the next quarter century, according to estimates. In addition, the National Association of Home Care & Hospice Care reports the number of home-care agencies has increased to 17,700 in what has become a $53.4 billion industry. Readhttp://www.businessweek.com/investor/content/sep2008/pi20080910_761489.htm
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in the Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
www.linkedin.com/in/liacald4773
www.merchantcircle.com/.../Home.Care.Charlotte.NC-I.Care.For.You.Home.Care.L.L.C..800-383-0520
http://www.facebook.com/home.php#/pages/Charlotte-NC/I-Care-For-You-Home-Care-LLC/82169019227?ref=ts
http://twitter.com/vcaldwell773
Thursday, November 5, 2009
The Anti-Aging Diet
Can what you eat help you age gracefully?
By Kathleen M. Zelman, MPH
WebMD Weight Loss Clinic-Feature
Reviewed by Louise Chang, MD
It seems we're all trying to find the "magic bullet" that delays the natural aging process. Put an antiaging label on most any product, and it flies off the shelves.
Yet if you're trying to look your best without going under the knife, a secret ingredient might be right under your nose. Some experts say one answer to aging gracefully can be found in the grocery store -- in fruits, vegetables, green tea, and a host of other healthful foods that are rich in antioxidants and other potentially age-deterring compounds.
What Is Aging?
Of course, the signs of aging include not only wrinkles, but also memory loss, decreased brain function, and an increasing risk for chronic diseases such as heart disease, osteoporosis, and cancer. Healthy aging is also defined as living a longer, healthier life. And many studies have documented the link between a healthy diet and prevention of age-related or chronic diseases.
Adopting a healthy lifestyle that includes regular physical activity, adequate rest, avoiding tobacco, and a diet full of healthy foods and beverages can be the best defense against aging.
"Dietary choices are critical to delay the onset of aging and age-related diseases, and the sooner you start, the greater the benefit," says Susan Moores, RD, a spokesman for the American Dietetic Association.
Antioxidants and Inflammation
Some foods and beverages contain powerful substances called phytonutrients that some believe are capable of unlocking the key to longevity. Phytonutrients, which are members of the antioxidant family, gobble up "free radicals" -- oxygen molecules that play a role in the onset of illnesses such as heart disease, cancer, osteoporosis, and Alzheimer's disease. Read morehttp://www.webmd.com/healthy-aging/guide/anti-aging-diet
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in the Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
By Kathleen M. Zelman, MPH
WebMD Weight Loss Clinic-Feature
Reviewed by Louise Chang, MD
It seems we're all trying to find the "magic bullet" that delays the natural aging process. Put an antiaging label on most any product, and it flies off the shelves.
Yet if you're trying to look your best without going under the knife, a secret ingredient might be right under your nose. Some experts say one answer to aging gracefully can be found in the grocery store -- in fruits, vegetables, green tea, and a host of other healthful foods that are rich in antioxidants and other potentially age-deterring compounds.
What Is Aging?
Of course, the signs of aging include not only wrinkles, but also memory loss, decreased brain function, and an increasing risk for chronic diseases such as heart disease, osteoporosis, and cancer. Healthy aging is also defined as living a longer, healthier life. And many studies have documented the link between a healthy diet and prevention of age-related or chronic diseases.
Adopting a healthy lifestyle that includes regular physical activity, adequate rest, avoiding tobacco, and a diet full of healthy foods and beverages can be the best defense against aging.
"Dietary choices are critical to delay the onset of aging and age-related diseases, and the sooner you start, the greater the benefit," says Susan Moores, RD, a spokesman for the American Dietetic Association.
Antioxidants and Inflammation
Some foods and beverages contain powerful substances called phytonutrients that some believe are capable of unlocking the key to longevity. Phytonutrients, which are members of the antioxidant family, gobble up "free radicals" -- oxygen molecules that play a role in the onset of illnesses such as heart disease, cancer, osteoporosis, and Alzheimer's disease. Read morehttp://www.webmd.com/healthy-aging/guide/anti-aging-diet
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in the Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
Wednesday, November 4, 2009
Thursday, October 29, 2009
Limited Mobility of Another Sort
By Paula Span
In theory, the continuing care retirement community, or C.C.R.C., makes great sense: build different types of senior housing on a single campus, or even in a single building, so that as residents need more care, they can transfer within the facility — from independent living apartments to assisted living units to a nursing home — instead of being uprooted from familiar surroundings. More than a half-million older Americans find this an attractive idea and have moved into such a retirement community.
Yet ever since reporting a few years ago in an assisted living facility in Bethesda, Md., and hearing about a resident who pushed the wrong elevator button and then screamed in horror when the doors opened onto the nursing home floor, I have wondered how these transitions work in practice.
Tetyana Shippee, a research associate at the Center on Aging and the Life Course at Purdue University, chose an unorthodox way to learn more. Ms. Shippee, then 21, moved into a C.C.R.C. in a Midwestern town and, for two years, observed, ate with, got to know and interviewed its residents.
Ms. Shippee’s findings, recently published in The Gerontologist, show how elusive the aging-in-place ideal remains, even in a facility expressly set up to foster it.
People liked their independent living apartments just fine, Ms. Shippee discovered, but were often reluctant to move to assisted living when their health and mobility declined. “There was a certain level of stigma involved,” she said. It was not that the assisted living units and nursing home, with their separate dining room, were particularly far away; they were just a seven-minute walk from the independent living apartments. “Mostly,” she explained, “there are social boundaries.”
In Ms. Shippee’s facility, where introductory tours often bypassed the assisted living/nursing wing altogether, the health and vigor required for independent living had become an important source of status. To leave an independent living apartment meant not only losing one’s home and social network, but also a part of one’s identity. Friendships often did not survive the move; visits became more like duties or favors than part of reciprocal relationships. Small wonder, then, that Ms. Shippee observed anger, stress and a keen sense of loss when residents were faced with moving.
It is possibly different in other facilities. At least, said Steve Maag of the American Association of Homes and Services for the Aging, a C.C.R.C. allows for the possibility of continuing social connections, so much harder to maintain across geographic distances. Mr. Maag pointed out, too, that C.C.R.C.’s were adapting to these unexpected social wrinkles, adding home care programs to accommodate residents who did not want to move.
But wasn’t the ability to move within the facility — with the assurance that as one needed more help one could remain socially connected — the whole point of selecting a continuing care community?
The prospect of an involuntary move led Sally Herriot, who cherished her cozy independent-living apartment in Palo Alto, Calif., to make a federal case of the issue — literally. Mrs. Herriot already employed private aides and had agreed to increase their hours, but in 2006, when C.C.R.C. administrators told her she would have to move into assisted living anyway, she filed suit in federal court and charged that forcing her to move was a violation of the Fair Housing Act. “It amounted to a loss of control, a lack of privacy and dignity,” her son Robert Herriot said.
A judge sympathized but ruled that state law permitted the C.C.R.C. to make such decisions. Mrs. Herriot, represented by AARP lawyers and by Relman & Dane, a civil rights firm in Washington, has appealed the verdict; meanwhile, Mrs. Herriot, 91 and very frail, remains in her apartment with her helpers.
Could C.C.R.C.’s improve the situation by promoting more interaction, with less physical and social separatism, among residents who require different levels of care?
“Independent living residents don’t like that,” Ms. Shippee pointed out. “They view themselves as healthy and active. If you try to integrate them with people in wheelchairs who have problems, they will object.”
In the dining room, she added, “they want to feel like they’re in a nice restaurant, conversing with friends; they don’t want to be faced with those in declining health.”
Mr. Herriot has heard of residents who have gone so far as to conceal their health problems, fearing that they will be the next ones moved.
So much for theory. Most C.C.R.C. residents who are told to move will comply, but having to leave a home is disruptive and distressing, it seems, whether you are moving 7 minutes or 70 miles away.
Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in the Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
In theory, the continuing care retirement community, or C.C.R.C., makes great sense: build different types of senior housing on a single campus, or even in a single building, so that as residents need more care, they can transfer within the facility — from independent living apartments to assisted living units to a nursing home — instead of being uprooted from familiar surroundings. More than a half-million older Americans find this an attractive idea and have moved into such a retirement community.
Yet ever since reporting a few years ago in an assisted living facility in Bethesda, Md., and hearing about a resident who pushed the wrong elevator button and then screamed in horror when the doors opened onto the nursing home floor, I have wondered how these transitions work in practice.
Tetyana Shippee, a research associate at the Center on Aging and the Life Course at Purdue University, chose an unorthodox way to learn more. Ms. Shippee, then 21, moved into a C.C.R.C. in a Midwestern town and, for two years, observed, ate with, got to know and interviewed its residents.
Ms. Shippee’s findings, recently published in The Gerontologist, show how elusive the aging-in-place ideal remains, even in a facility expressly set up to foster it.
People liked their independent living apartments just fine, Ms. Shippee discovered, but were often reluctant to move to assisted living when their health and mobility declined. “There was a certain level of stigma involved,” she said. It was not that the assisted living units and nursing home, with their separate dining room, were particularly far away; they were just a seven-minute walk from the independent living apartments. “Mostly,” she explained, “there are social boundaries.”
In Ms. Shippee’s facility, where introductory tours often bypassed the assisted living/nursing wing altogether, the health and vigor required for independent living had become an important source of status. To leave an independent living apartment meant not only losing one’s home and social network, but also a part of one’s identity. Friendships often did not survive the move; visits became more like duties or favors than part of reciprocal relationships. Small wonder, then, that Ms. Shippee observed anger, stress and a keen sense of loss when residents were faced with moving.
It is possibly different in other facilities. At least, said Steve Maag of the American Association of Homes and Services for the Aging, a C.C.R.C. allows for the possibility of continuing social connections, so much harder to maintain across geographic distances. Mr. Maag pointed out, too, that C.C.R.C.’s were adapting to these unexpected social wrinkles, adding home care programs to accommodate residents who did not want to move.
But wasn’t the ability to move within the facility — with the assurance that as one needed more help one could remain socially connected — the whole point of selecting a continuing care community?
The prospect of an involuntary move led Sally Herriot, who cherished her cozy independent-living apartment in Palo Alto, Calif., to make a federal case of the issue — literally. Mrs. Herriot already employed private aides and had agreed to increase their hours, but in 2006, when C.C.R.C. administrators told her she would have to move into assisted living anyway, she filed suit in federal court and charged that forcing her to move was a violation of the Fair Housing Act. “It amounted to a loss of control, a lack of privacy and dignity,” her son Robert Herriot said.
A judge sympathized but ruled that state law permitted the C.C.R.C. to make such decisions. Mrs. Herriot, represented by AARP lawyers and by Relman & Dane, a civil rights firm in Washington, has appealed the verdict; meanwhile, Mrs. Herriot, 91 and very frail, remains in her apartment with her helpers.
Could C.C.R.C.’s improve the situation by promoting more interaction, with less physical and social separatism, among residents who require different levels of care?
“Independent living residents don’t like that,” Ms. Shippee pointed out. “They view themselves as healthy and active. If you try to integrate them with people in wheelchairs who have problems, they will object.”
In the dining room, she added, “they want to feel like they’re in a nice restaurant, conversing with friends; they don’t want to be faced with those in declining health.”
Mr. Herriot has heard of residents who have gone so far as to conceal their health problems, fearing that they will be the next ones moved.
So much for theory. Most C.C.R.C. residents who are told to move will comply, but having to leave a home is disruptive and distressing, it seems, whether you are moving 7 minutes or 70 miles away.
Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in the Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
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