You have one tool as a caregiver that is most effective to consistently improve the quality of the life of those you are caring for. It can be used in any situation and costs nothing. It has been shown to improve your quality of life as well. It’s a smile!

As cheesy as this sounds, there are many tangible as well as intangible benefits of smiling. As caregivers, our feelings and emotions are very often relayed to those we are caring for. If we are feeling anxious, angry or frustrated, subconsciously that is communicated to Mom. This will increase her own frustrations and anxieties, or reduce her previously good mood without knowing why. But if you are able to set these things aside and choose to be in a better mood for Mom, your smile will convey happiness and security. Even when we don’t feel like smiling, choosing a smile, produces the release of endorphins from the brain. This thought to be caused by the position of the facial muscles and the brain can tell the difference between a fake and real smile and releases the endorphins anyway. This also suppresses the release of cortisol or the stress hormone.

Making it a habit to smile with each interaction, will very often produce a smile in the one you are caring for and then you both get the benefits of a smile which include:

This is especially helpful as mom gets older or if her memory is becoming an issue. With a decline in cognitive function, it becomes much harder to process information quickly. Because she recognizes her child, she will immediately look to you to determine if everything is OK or if she needs to be ready for a “fight or flight” scenario. The initial, calming smile you give, will go a long way to help her feel at ease.

If you are not the primary caregiver or are entering a new situation for the first time, it will take more than just an initial smile to see the benefits. When you are new, nearly constant and genuine smiles may be necessary. You often may have to explain who you are every so often and give details that reassure them they are in safe hands. “Mrs. Smith, I am here to assist you while your daughter Carol is at work. We spoke to her this morning and she will be calling at lunch to check on us.” In time, hopefully Ms. Smith will recognize you and this will not be needed nearly as often.

There is a lady, we will call her Pearl (not her real name) who lived in a nursing home. She was in late stage 5 of dementia. She was walking and talking, but often would experience sundowning and become increasingly agitated, confused and anxious. She did not need physical therapy when I met her. Even so, I made it a point to say “Hello Pearl,” look her in the eye and smile every time I passed her in the hallway. After about 2 weeks (and about 30 repetitions of this) I heard her tell a friend that “me and him are kin.” While that is not an accurate statement, it does show the bond that we had formed with the simple repetition of a smile and acknowledgement. When she did eventually have a fall and require PT services, I had much less trouble than other staff who had not previously formed this bond. She would follow directions, participated well with me and was able to get back to her normal routine relatively quickly.

Your smile should be your first tool out of the bag and most used tool as a caregiver. Costs nothing and the benefits are priceless!

That’s all for today.

Take care, be safe and have a great day!

Winn

As our parents age, a decline in balance is natural. Often this can be reversed with physical therapy, but eventually an assistive device is likely to be required for safety.

How do you know when mom needs a cane or walker? Are there different types and which would be best for mom? Below is a description of common assistive devices and who they would be a good fit for. An evaluation by a licensed Physical Therapist may be needed for specific recommendations for your loved one. 

CRUTCHES

It is NEVER a good idea to let mom use crutches. They are unnatural to use, increase fall risk in all but the most athletic 20 year olds, and can cause upper extremity nerve damage if her arms are not strong enough for them to be used correctly. I have seen way too many significant injuries (broken bones, traumatic brain injuries etc.) from someone given crutches who does not have the strength, balance and coordination to safely use them. Use a cane instead of 1 crutch or a walker instead of 2 crutches.

CANES

Before I was a physical therapist, I thought of canes as 3 foot long shepherd’s hooks intended for shaking and the neighbors kids (often me) while telling them to get out of the flower bed. While cane’s can be used to make your point from across the yard, they also serve another purpose, to assist with balance. There are many different types and styles of canes. Each with their own pro’s and con’s. 

Single point cane: The traditional wooden, hooked handled cane mentioned above or some of the newer adjustable, aluminum canes with a single rubber stopper on the end. This device is for someone with a slight unsteadiness to their walk. The small single point of contact is just enough to provide increased stability and positional awareness to improve balance. Single point canes may be a good idea on an uneven (outdoor) surface who has no difficulty getting around their home. Someone who cruises (touching walls or furniture as they walk in the home) may benefit from the assistive device within the home.

Quad Cane: There are 2 sizes of bases for quad canes. Large base (approximately 12” x 6”) and small base (approximately 7”x4”). This assistive device is for someone who needs much more stability than a single point cane can provide. Often they are unable to walk short distances safely without it.  The size of the recommended base would depend on the amount of stability required. A quad cane can allow you to weight bear through it, but is not as cumbersome as a walker. This cane is often appropriate for someone who has had a stroke affecting one side of their body.

Hurry Cane: This unique device is most similar to a single point cane, but has a larger base and a joint between the base and the shaft which allows it to adjust to uneven surfaces and provide more stability than a single point cane but is much lighter and more convenient than a quad cane.

WALKERS

Much like canes, there are different types of walkers. Each with varying degrees of stability vs. mobility.

Standard Walker: The traditional four legged assistive device with Rubber stoppers on each leg. This is the most stable of the walker when it is on the ground, but the least mobile. To walk with this device, it has to be picked up, moved forward and then stepped into. This process repeats itself until the destination is reached. It is slow and methodical. This is rarely recommended for home use as it has to be lifted off the ground to be advanced thus eliminating the benefit of 4 stable legs on the ground. 

Rolling Walker or Two-Wheeled Walker: This is the most stable device when walking. The two wheels on the front eliminate the need for it to be lifted off the ground as it slides forward with little difficulty improving balance by increasing the base of support. The two legs on the back allow for your entire body weight to safely be put on the walker if needed. This can be required after an amputation or while non-weight bearing on one lower extremity following a fracture. 

Rollator or Four-wheeled walker: This assistive device is the most mobile of the walkers and the least stable. Its four wheels make it a breeze to glide around and it will provide some balance assistance. That being said, you need to have pretty good balance to safely use a rollator. It is often best for people with minimal balance difficulty who have trouble with activity tolerance and need to take seated rest breaks every so often. Make sure the brakes are locked prior to sitting. Also this is not a wheelchair. It is not safe to scoot around sitting on a rollator or to push mom while she sits on this four-wheeled walker. A light weight transport wheelchair would be the safe option for moving about while seated.

It is important to have an assistive device that is the right size and type for the person using it. In other words, it’s not a good idea to let mom use dad’s old walker just because it's still in the attic. While it's a good idea to reuse some durable medical equipment, make sure to have it evaluated and fitted by a licensed physical therapist to make sure it is right for mom. 

That’s all for today.

Take care, keep mom safe and have a great day!

Winn

Keep mom safe at home is an idea built around the concept of aging in place. It is a simple concept, live at home. But in practice, it becomes more and more difficult as we age.

Ninety percent of those born before 1965 state that they would like to stay in their own homes as they age. But the everyday tasks and chores which used to be part of the routine can become exhausting requiring planning and energy conservation for mom to get through the day. Shopping and meal preparation may begin to require assistance to ensure she is eating well. Fall risks within the home is another topic but one that often leads to an inability to age in place. So for mom to be able to stay at home longer, there are many factors to consider. 

Before we decide to commit to Aging in Place, we need to know what the other options would be. 

STEP UP IN CARE MODEL

If not aging in place, then what? The alternative would be the step up in care model. In this alternative the first step when leaving home would be to transition to an independent living facility (ILF). This is a group living environment where mom would have her own apartment, but some services such as housekeeping, meals and laundry could be provided for additional cost. She is free to come and go as she pleases and would have her own parking spot if she is still driving. Often there are daily activities for the residents which can be quite stimulating and create needed social time. 

If/when the time comes and mom needs additional care, transition to the assisted living facility (ALF) would be the next step up in care. This increase in care comes with increased cost. Care services provided for the additional expense include: meal preparation, housekeeping, laundry, utilities, and maintenance. Additional care services such as medication management and assistance with bathing and/or dressing can also be provided. 

The last level of care in the step up model is the Skilled Nursing Facility (SNF). This level of care is needed when IV medications, wound care or other nursing concerns are present. 

Here, your mom will have nursing staff available around the clock as well as a therapy to provide physical, occupational or speech therapy as needed. Many people at this level will need total care, but there is also a percentage that are relatively independent. Daily activities, games and events help provide needed stimulation and socialization.

The step up in care can also be a temporary solution to a recent decline in independence following a hospital stay. People often leave acute care and transition to a SNF or ALF for short term rehab to allow for return home or to one of the lower levels of care. 

AGING IN PLACE VS. STEP UP IN CARE

Important to consider pros vs. cons when considering aging in place.

Pros of aging in place

Con’s of aging in place

ILF/ALF/SNF Pros

ILF/ALF/SNF Cons

The goal is to keep mom safe at home forever, or until a time when that is no longer an option and a decision needs to be made about the next level of care. Often the need for more care is thrust upon mom and primary caregivers after an illness or an injury that exposes the difficulties she was having at home. If we know what to look for and plan ahead, we can keep mom safe at home as long as possible. 

That is all for today.

Take care, keep mom safe and have a great day!

Winn

How can you tell if your parents need Geriatric Physical Therapy (PT)?

The most common way physical therapy is prescribed is after an injury or hospitalization.

Did mom fall and break a bone? Get sick and spend 2 weeks in bed at the hospital? Is she now very weak and unsteady with her movement?

At this time it is obvious that therapy is needed. And extensive therapy may be required to return to function. 

Today, we'll talk about how geriatric physical therapy can benefit your aging parents the most.

WHAT IS GERIATRIC PHYSICAL THERAPY?

Our bodies degenerate over time.

As we grow older, we become more susceptible to frailties, conditions, and other age-related conditions.

Most of the time or limbs, arms, and hands suffer the brunt. It makes them weak and prone to injuries. Think arthritis, osteoporosis, joint issues, balance, and even incontinence.

Geriatric physical therapy becomes all the more important as people we age.

It's specifically targetted to help improve mobility and flexibility. Therapy also helps reduce pain, inflammation, and other potential challenges for the elderly.

Age-related diseases are among the biggest challenges of taking care of the elderly. That's why we also need to focus on their physical well-being, flexibility, and mobility.

This way it will minimize any health risk that can complicate keeping mom safe at home.

FOUR TYPES OF GERIATRIC PHYSICAL THERAPY FOR SENIORS

There are four types of physical therapy dedicated towards the elderly.

  1. Geriatric Physical Therapy - Puts emphasis on aging adults. This is focused on treating conditions like arthritis, osteoporosis, cancer, joint replacement, and balance disorders. These treatments are designed to alleviate pain, restore and improve mobility, and increase fitness levels in seniors.
  2. Orthopedic Physical Therapy - This is focused on the musculoskeletal system and is designed for those who need recovery from orthopedic surgeries. Its ultimate goal is to restore functions to muscles, joints, tendons, and ligaments.
  3. Cardiopulmonary Physical Therapy - This is designed specifically for the elderly who recently suffered a heart attack. It is also for those who have cardiovascular or pulmonary conditions. The goal is to help the patient increase mobility, endurance, and functional independence.
  4. Neurological Physical Therapy - This is focused on the brain and body. Those who suffer from neurological conditions like Alzheimer's disease, ALS, and Parkinson's' disease benefit most from this. People who have gone through brain injury also benefit from this. The goal is to help them adapt to visual, mobility, balance, and muscle loss impairments.

DOES MY AGING MOM NEED GERIATRIC PHYSICAL THERAPY?

Some things are out of our control and we have to roll with the punches.

But there are also many risk factors that can be identified beforehand and specifically addressed to reduce the risk of future falls and injury or hospitalization.

What should you look for to know if your family is at increased risk? There are 3 things to look for when deciding if someone is at increased risk of falls. 

  1. Strength
  2. Gait Speed
  3. Balance

First, their strength, specifically quadriceps strength.

This is the large muscle on top of your thigh. It is the largest power generator for standing and is a stabilizer when walking.

A healthy aging adult should have the strength to stand from a chair without using their arms to assist.

If you notice mom is now rocking before standing or using her arms to begin standing, this is a sign of decreased strength and increases the likelihood of future fall and injury.

The second sign to look for is decreased gait speed.

This means she is walking more slowly than normal. There can be lots of reasons for this.

But decreasing gait speed is a good indicator of future falls. Slower speeds show decreased steadiness and confidence when walking.

The third is decreased balance.

Identifying declining balance early can be difficult at home. It is often not noticed until the result is a fall or a series of falls.

Look for increased veering when walking (not staying in a straight line), cruising (touching the backs of chairs, walls, or furniture for support when walking around the room), or a wider than normal stance at rest (look for feet just wider than shoulder-width or shoulder width with one foot more forward than the other). 

If you notice any of these changes, it is a good idea to go see a physical therapist. Depending on direct access in your state, this may require a referral from your doctor. Call your local physical therapy office and they will be able to tell you if a referral is necessary. And how to schedule the appointment.

An evaluation by a licensed physical therapist should assess each of the three factors listed above.

Full disclosure, I am a Doctor of Physical Therapy and believe that most PTs are pretty great.

This evaluation will help identify if your loved one is at increased risk of falls. If the answer is yes, at least we identified a potential problem before it became a much bigger and more costly injury. An ounce of prevention is worth a pound of cure.

Changes in strength, gait speed and balance are normal parts of aging.

This is true, but physical therapy along with a home wellness program can reverse some losses caused by decreased activity and exercise over the years.

And slow down future declines. After all limited mobility is the number one reason people are no longer able to live independently in their homes.

The longer mom can keep up her strength, speed, and balance, the longer she can live where she wants to live with limited assistance. Let's help mom stay independent, active, and living her best life!

That's all for now. Take care, be safe and have a great day!

Winn

Is a minimalist lifestyle a better fit for your aging parents?

Are you worried about the sheer volume of things in your aging mother’s house?

This is a common problem for those with aging parents.

Most of the time we don't understand why they keep trinkets and things around. But in reality, it might be their way of keeping the memories alive.

This article will discuss it is important to start a minimalist lifestyle as soon as possible.

This is not a solution for significant hoarders.

If your parent falls into the category 2-5 of hoarding listed here, professional help is needed.

See if her primary care physician can refer to someone who specializes in dealing with that. We can help reduce the normal accumulation of items over a lifetime to improve her safety within the home. 

So, is a minimalist lifestyle the best for our aging moms?

Truth is, she doesn’t need to free herself of all worldly possessions and completely change who she is.

But it's always a good idea to declutter and clear away what she doesn't need.

Stuff, junk, clutter, knickknacks, and heirlooms tend to accumulate as we age.

It is usually due to one feeling that an item is valuable or will be needed in the future.

And most of the time, getting rid of them is also an emotional process.

As we age, we begin to outlive relatives. Many of whom have left their heirlooms and trinkets to us.

This may be when you see items within the home becoming excessive.

Often your mother will feel a responsibility to her family to keep the items they felt were important or worth saving. This is the time to step in. If Mom’s home is already full of furniture, suggesting a one piece in, one piece out (donated) is a good policy. 

A minimalist lifestyle is a safer option for our parents aging in place

WHY CHOOSE A MINIMALIST LIFESTYLE

A quick story first.

I was working with a man one time who was in need of physical therapy before returning to his home.

Due to his significant COPD, he was unable to walk around his home without being very short of breath.

Because there was so much clutter in the home, he was unable to use a walker or a wheelchair.

He bought a “shop stool” and was using this to scoot around his home. This very unsafe behavior eventually resulted in a fall off the stool and a broken hip.

Try not to let the clutter reach the point of significant danger.

There are many reasons to reduce the amount of items in one’s home.

As furniture begins to take more and more floor space, the pathways for walking become more narrow.

While mom can navigate these narrowing pathways now, what happens when she steps off a curb wrong, twists her ankle, and requires a walker to get around.

If she can't use the walker at home, she is likely to try cruising (touching the walls and furniture for support) which increases her chance of another fall and more significant injury.

As furniture blocks wall space, electrical outlets are more difficult to access. The fix often used is an extension cord.

While this will solve the issue of inaccessible outlets, it creates a separate risk of tripping.

In addition, more furniture and more stuff leads to more lamps and electronics each needing to route cords across the narrowing walkways 

HOW TO HELP MOM REDUCE CLUTTER?

If she is hesitant but not outright resistant, suggest starting with one item she can find that she thought she might need months or years ago, but no longer needs this item. Give it away. There are many organizations such as Goodwill or the Salvation Army that gladly accept donations. Give her a day to reflect on the “loss”. Once she realizes, it was not really that difficult, suggest finding 5 things to donate.

If this goes well, suggest a room to clear and declutter. Maybe a small guest bedroom or dining room. Let her know you appreciate the effort it takes, and encourage her that personal safety is a top priority. Point out how nice the room looks and how free and open it feels. Give her time to begin to adjust. Change is uncomfortable and even more so as we age. Once she has adjusted, help her move to the next room.

If she is unwilling to participate in improving the safety of her home by starting to declutter, it may be necessary to remove visible fall/fire risks without permission. Start slowly. Unplug one cord to an appliance or lamp that is seldom used. If there is one that crosses a walkway, move the cord to behind the piece of furniture it was sitting on, don’t plug it back in. See if this is noticed. If it is not, try another one or remove the item altogether. If she does notice, express your concern regarding her safety and see if yall can find a compromise where another item is removed or a pathway is cleared. 

Be sure to be understanding during this process, and to give time for the benefits to become apparent. She may feel attacked and hurt if the situation is not described in a way she will see the need for change.

In the long run, a minimalist lifestyle will have more perks that she will eventually love.

Change is difficult, but when we choose to change it becomes empowering. 

That's all for today.

Need more tips on how to keep mom safe at home? Check out the full guide for aging in place here.

Take care, keep mom safe and have a great day!

Winn

You might be wondering what the best exercises for seniors at home are.

Of course, you'd want your parent to be as strong as possible. But the question is, are you giving them the right exercise to keep them healthy and strong?

It is a good idea to check with her primary care physician prior to beginning a new exercise routine. Her doctor may have a specific guideline related to her medical history or current medical status. Most likely though, she will be given the green light to begin an exercise program. 

Mom may be resistant to exercise, after all, she never needed to exercise before.

This is quite common among our aging mothers.

According to the CDC, by age seventy-five, 33% percent of men and 50% of women engage in no physical activity. But the benefits significantly outweigh the risks for her to start exercising. Start slow and encourage building exercise into her routine. This will help build progressively. 

BENEFITS OF EXERCISE IN THE ELDERLY

Exercise has been shown to reduce the risk of dying from heart disease, becoming diabetic, hypertensive or developing colon cancer.

And the best exercises for seniors at home also reduces blood pressure in certain people with hypertension.

Though chronic and disabling conditions may make starting an exercise program seem more difficult, it has been shown to help with the management of these conditions such as arthritis.

Daily exercise has been shown to help our parents live independently longer with reduced risk of fall and serious injury.

It also has been linked to improved mental well being with reduced symptoms of anxiety and depression. Reduces the pain and joint swelling associated with arthritis.

These benefits and much more information is given by the CDC here.

RISKS ASSOCIATED WITH EXERCISE

Dehydration, overuse injuries, muscle strains and extreme fatigue are possible negative outcomes associated with exercise in the elderly. These risks are most likely to result from excessive high intensity exercise. This is unlikely to be a concern with a proper progressive light to moderate intensity exercise program. Even building up to some high intensity activity is a good thing, but start slow. Progressing slowly will limit the soreness that can appear after increasing intensity too quickly.

HOW TO GUIDE MOM TO BEGIN AN EXERCISE PROGRAM

It is plain to see that the benefits of exercise outweigh the potential risk, but how do you convince mom to give it a try?

Participate in the activity with her, or encourage her to join a friend to increase the social aspect of exercise.

Another option is to explain all the benefits such as living independently longer, or improved physical fitness and link this to something she finds highly valuable.

Suggesting she will be able to spend more quality time with the grandchildren or great grandchildren may be enough of a motivator.

Another way to get her buy in is to ask what she is having difficulty with and tailor the activity towards that challenge. This can improve her quality of life in a way that is apparent to her, making her more likely to want to continue.

best exercises for seniors at home: walking

CHOOSING THE BEST EXERCISES FOR SENIORS AT HOME

For those who have not been regular exercisers in the past, start with 5-10 minutes of light walking.

Start at home.

This way mom is comfortable and this reduces the barriers to begin an exercise program. She knows it is a climate-controlled environment, she knows where to find places to rest as needed, and the restroom is near.

Tell her to take a break when she is starting to lose her breath, or if talking while exercising is difficult. This will make sure mom doesn’t overdo it initially.

Once she is able to walk and talk for 15 minutes with minimal difficulty, it is safe to increase the intensity, add a new exercise or take the walk outdoors.

Slowly build up to 30-60 minutes of moderate-intensity daily exercise.

Some of the best exercises include chair yoga, resistance bands, and pilates.

Here's a quick list of the best exercises for seniors at home, and a few you would need to avoid.

WHEN TO STOP EXERCISING

If mom experiences any of these symptoms when she is exercising, it is best to stop and consult her doctor before continuing with the exercise routine. 

WRAPPING UP

The benefits of exercise significantly outweigh the risks associated with exercise. Participate with her or encourage her to exercise with a friend. Start slowly and build up to 30-60 minutes of daily exercise. Stop exercise and check with you physician if you experience the above symptoms when exercising. 

That is all for today.

What are your recommendations for the best exercises for seniors at home?

Don't forget to share!

Take care, keep mom safe and have a great day!

Winn

Aging in place can be challenging for the elderly and the caregiver.

There are many things to consider when you and your family would choose this option.

These may include personality traits, geographical considerations, and even the layout of the elderly's home.

So today, I'll be sharing a great guide to help you and your mom make aging in place much easier.

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And a free copy of the Static Balance Home Exercise Progression.

Aging in Place: A Complete Guide for the Family

PERSONAL FACTORS

Temperament: Mom’s personality and how she interacts with the world can demonstrate if aging in place in her home is a good fit for her. The first thing to consider is how does she handle being alone? If she needs some amount of alone time and uses it to recharge, aging in place may be a good fit. Does she enjoy reading, crosswords, knitting or have other productive hobbies that help pass the down time? On the other hand if mom recharges best by being around lots of people and always enjoys having something going on, aging in place may not be the best idea. The increased isolation at home can lead to loneliness, anxiety and depression. Though it is common to want to remain at home, these extraverts tend to thrive in more communal living environments. Looking into an active seniors community or apartments may give mom another setting to age in place in and set her up to thrive. 

Cognition: Mom’s mental capacity is a major factor in her ability to safely remain at home. There are normal cognitive declines that occur with aging such as increased word finding difficulty or forgetfulness. While these can be frustrating for mom and those around her, this does not indicate that she is unsafe at home. Using lists and written reminders can be good tools to help her operate safely at home. If larger cognitive problems occur, such as getting lost while driving somewhere familiar, leaving the stove/oven on or an inability to maintain proper hygiene, she may need help. This help can be as simple as having someone around to assist with light household duties and keep an eye out for safety concerns. This family member, friend or sitter can provide stimulating companionship while assisting with supervision and routine chores.

Aging in place guide

Fitness: There are two parts of fitness to consider; health and activity level. Health concerns related to aging in place can be thought of as how many medical conditions does mom have that need to be managed by a doctor? If the answer is none, that's awesome! It is still a good ideal to routinely have a physical to check for underlying conditions before they become medical complications. This preventative approach will give mom the best chance to avoid serious health issues. If mom has multiple comorbidities and takes 5+ medications to manage them, her need for quick access to healthcare may be a concern. Activity level is the next part of fitness and it is closely correlated to ability to age in place. The more active a person is, the more likely they are to be able to safely get around their home to perform activities of daily living. This will keep mom safe at home longer. Increasing activity level is a good idea for those who are currently minimally or moderately active. This exercise has been shown to help maintain a healthy body weight, increase/maintain bone density, improve cardiovascular function, increase strength and improve cognition. Is there a neighborhood recreation center close by where classes, hobbies, and activities can be enjoyed with others?

Finances: This is an important factor to consider when looking at aging in place. Mom may be on a fixed income without much in savings. There may be ways to supplement retirement income with additional funds from non traditional measures. Utilizing the equity in your home is one example. It is a good idea to speak to a fee only fiduciary financial planner. This will be someone who charges you for their time, but is not commission based. They can be valuable teammates when assessing/planning for financial concerns. The XY Planning Network is a great place to find this person who can help.

GEOGRAPHICAL CONSIDERATIONS: LOCATION AND SUPPORT NETWORK

Location: The most difficult thing to change about mom’s home is the location. While it is possible to pick up some smaller homes from their foundation and transport them to a new location and hook them back up, it is fairly expensive to move an entire home. Not impossible, but definitely impractical so let’s assume the house remains in place. The location of the home will determine many things such as access to medical care. Is there a hospital nearby? How difficult is it to get to her primary care physician’s office? Are there specialists around if needed? Are home services provided in this area? Access to transportation can also be related to location. If mom can no longer drive, is family close to assist with transportation needs or are there rideshare services available such as lift, uber or gogograndparent?

Aging in place: geographical location

Support Network: Who is around to help mom age in place? Friends and family nearby make all the difference in quality of life. A trip to the grocery store, cooperating with making a meal, or a game of cards with a friend can be a great way to have some fun and strengthen quality relationships. Other parts of a support network would include the availability of community services. Churches and nonprofit organizations can at times assist with transportation, caregivers, meal delivery and or housekeeping and cleaning. Seeing what is available for mom locally can help her stay safe at home longer!

HOME SETUP AND LAYOUT

Many of the homes lived in by the aging population were built 40+ years ago. Very often a house built in the late 40’s or 50’s (post world war two) is still where mom calls home. She has lived there for what feels like forever and intends to remain there no matter the consequences. 

Is there a way to make this home more suitable for aging in place? Yes! But even a minor bathroom or kitchen remodel can seem exceedingly expensive. A thirty to fifty thousand dollar remodel can feel astronomical to someone who remembers buying the entire home for less than $10,000. Even if mom has no intent to move, it is likely a good idea to show her the cost of newer construction homes geared towards the 55+ community and built with universal design. This serves two purposes, first, it will show her the cost of a newly constructed home. Those built for aging in place can be 5 to 10x more costly than even a large remodel. Second, it can give her ideas for changing the layout or function of her home to incorporate universal design.

Another way to present the affordability of a home remodel is to compare its cost to the cost of living somewhere such as an independent living facility, assisted living facility or skilled nursing facility. The median semi-private room in a skilled nursing facility costs nearly $75,000 per year and that average price is increasing year over year. Be careful using this tactic, as it can come across as a threat if not properly worded. Try: “You can potentially avoid hundreds of thousands of dollars in costly care with this bathroom remodel”. Avoid: “You will be paying $75,000 per year when you slip and fall and end up in a nursing home!” 

When it is decided that a remodel is necessary and agreed upon, the next step is to determine what needs to be changed to improve safety within the home. The bathroom is usually a great place to start. This is where the most injurious falls occur when home. The tub/shower combo usually needs to go. It is dangerous to step over a 12 to 18” tub wall, especially when wet. A standup shower with a bench or a chair and a low profile entrance or a seated walk in tub are much safer options. Preference for soaking vs. aesthetics of a tile shower can help make this decision. The height of the toilet can also be improved to reduce difficulty and improve safety. Older homes were built with very short (often 14”) toilets. This can lead to an uncontrolled lowering (last few inches of sitting) or need for momentum to get off/on the commode. Neither is safe and can be fixed with a new raised toilet and a grab bar or 3-1 bedside commode which can be used as a frame to raise the seat height and provide chair style arm rests for standing. Good lighting is needed in every room, but can be forgotten about in the bathroom. The more well lit the room is, the less chance of an unnoticed tripping hazard.

The next place to consider changes to improve safety and accessibility is the kitchen. Mom’s height and ease of working overhead vs. below her hips will determine how to best utilize the space. The counter height should be a comfortable level for her to be able to reach the back, while preventing the need for bending over to reach items. Rearranging the storage, cabinet and counter space is also a good idea to have her most used utensils and appliances within easy reach. The microwave should likely be on the counter if it is difficult for her to reach above the stove. The oven may need to be installed in a cabinet to be easily accessible for mom and prevent the need for bending and reaching to retrieve all those tasty hot baked goods! Good lighting is essential for this room as well to reduce risk of tripping.

Make aging in place normal by considering the house's layout

There are two other items of note to consider when making the home as safe as possible for our aging parents. The first is consistent flooring throughout the home. If possible, this eliminates doorway transitions which can be tripping hazards due to the change in height of the floor. Sunken rooms, and unmarked steps should be removed if at all possible. Obviously carpet in bathrooms and kitchens is a bad idea, and it's not easy to have a single type of flooring throughout the entire home, but anywhere a change in level or surface can be eliminated is a step in the right direction. The other item to consider is widening doorways. Bedroom and especially bathroom doors in older houses can be exceedingly narrow. Often a walker or wheelchair may not fit through this door. This can lead to someone who is rushing to the toilet leaving behind a necessary assistive device. Which will lead to greatly increased risk of fall and injury.

Check local prices for the work needed to be completed and be sure to get multiple bids and check a few references from each contractor or company. The quality of the team you hire can prevent many headaches down the line, even if they seem more expensive upfront.

That's all for today.

Do you have any tips to make aging in place easier for moms? Share it with us below.

Take care, keep mom safe, and have a great day!

Winn