Medic Alert, when and how

When my husband and I were in a motor vehicle accident last summer, the doctor in the Emergency Room (ER) needed to review his medical history in order to be sure that the care he would be providing would not interfere with other care my husband was already getting. Since my husband has an extensive medical history, there were two choices. We tell the doctor my husband’s history and risk forgetting a detail that may be important or the ER staff could access the information in his Medic Alert account which is available on the internet. Since his account is up to date, the quickest and most accurate choice was the Medic Alert account.

Not all Medic Alert bracelets (or necklaces) are created equal. The alert jewelry you can obtain in the drug store or other retail outlet will be able to notify medical providers that you are allergic to a particular medication or may be a diabetic but there are a limited number of messages available for sale at these stores. These are useful if there is only one allergy or the issue about which you are concerned is available.

It is also possible to purchase a bracelet or necklace with the emblem from a good jeweler and have information etched on the back. This is a perfectly good way to customize information that you want emergency workers to know if you are unable to communicate.

The Medic Alert account that my husband uses is significantly more detailed and includes his medical history, surgical history, medication list and contact information for his primary care doctor. This cost a small fee to sign up and a yearly fee of $15 to $20. While this may seem like a great deal of money it can save your life and will allow for individualized care tailored to your specific circumstances.

Our Aging Relative’s Medical History

Do you know your own medical history? Can you list all of the surgeries you have had in your life time? How about what illnesses you have had? Can you give a date when any of this occurred? Do you know the same for your aging relatives?

It is a good idea to make a list of illnesses and surgeries that your relatives have had. This list should include the date, the treatment and the effectiveness of the care. Surgery should also include what other treatments may have been tried before the surgery was performed.  Keep this list available and up to date. When there is an emergency you or your relative may not be able to relate this information in the stress of the moment. Since diagnosis is at least 40 % based on history, this is an important part of helping your relative’s doctor provide the most effective care. This is also why it is important for your relative to have a relationship with a primary care physician who will know your relative’s history and how they respond to treatment.

This history should also include any allergies and how they react to the thing they are allergic to

Aging Relatives - One or Two?

As we age we will lose one parent before the other, most of the time. What will become clear at that time is that there is a different dynamic between caring (providing help) for both parents and providing the same or similar help for the remaining parent.
When both parents are still alive, they will be helping each other and maybe moving into new roles within their relationship. If Mother becomes ill, Daddy may find himself taking on the activities of daily life that she has usually been able to complete. This may be cooking, cleaning and other activities traditionally taken by women. If Daddy is ill, Mother may be taking on (or attempting to take on) maintenance for the house, keeping the car in good condition and any other task that Daddy usually completed. The bottom line is; if one parent becomes ill, the other will probably take on all of the activities of daily life while trying to provide care for the sick person. They will both need help with this, especially if they are still working. Be aware of the need and offer to help support the well parent and maybe take some responsibility for caring for the ill parent. The tricky issue here it to find the right amount of help to give.
After one parent dies, caring for the remaining parent is a different matter. You will be able to be sure that your remaining parent (statistically more likely to be your Mother) is trying to do it all alone. Knowing what part of the day to day tasks have not been easy for the remaining parent will help you to decide what type of help to offer. It is also to be remembered that you are not intruding in a relationship if you are caring for one remaining parent. There is still a dance to do but the steps will change.
These concerns will also apply to other aging relatives. If you are in the position to help other relatives, whether they are single or in a long term relationship your help will need to shift around that relationship.  It is well to have the conversation early and at intervals along the way.

Keeping the house clean for your Aging relative.

Over time even the most meticulous housekeeper begins to have challenges to keeping the house clean. As our vision diminishes, we may miss areas that are soiled or dusty. We may become less able to reach high spots or even bend over to clean lower areas. Admitting that we need help will not come easily. As your relatives age, take note of how clean they are able to keep the house.  In the event there are problems, it never hurts to offer to help or to just pitch in when you are visiting.

One problem that develops over time is the accumulation of “stuff” in the house. This is not always because someone is a hoarder. Things accumulate over time simply because a person lives in a home, 40 or 50 years in the same house will result in many mementos. The best way to address this is head on. “Mom, I am worried that you are unable to do the heavy cleaning and the dust is bothering you.” Offer to assist to organize the rooms that are not being used so much as they used to be. Spend some time sorting through a room or closet to get your own stuff that you left behind when you moved into your own place. Assist to sort through the photos, put labels on the photos and get the stories behind them as you go. If you take it one room, closet or cabinet at a time, things will get sorted.

Valentine’s Day and the Aging

Happy Valentine’s Day! This is a perfect time to spend with your aging relatives to listen to their tales of their dating days. Of course, they may have been walking out, courting or keeping company. The phrases we use to describe that wonderful and exciting time spent getting to know one another change over time but the activity has only had one significant change in the last century. That change was, of course, the acceptance of pre-marital intimacy.

Over the years, here in the US, we have spent a great deal of time and effort on romantic love. We write about it, read about it and it is a major theme in movies, plays and books. No wonder we all look for that one special person. Now is the time to take the opportunity to chat with your relative and listen to their stories. Do you know if your parents ever dated other people? Was their marriage arranged? Was it strongly encouraged or undertaken in defiance of their parents?

If your relatives are members of the “Greatest Generation” there are probably stories to be told about how they managed with the upheaval caused by World War II. Having this conversation will open the doors of communication for all sorts of information exchange concerning how well they are managing to stay connected socially. You may also hear something spicy.

Remodeling to Accommodate the Aging

There are a couple of adaptations for homes that I have not yet mentioned. These require a significant financial outlay as well as substantial changes to a home. Two of these are elevators that use an open chair on the stairwell. These often need a straight staircase or a staircase with one turn. They can be rented or purchased used as well as purchased new. Depending on the staircase, they may need to be made as a custom fit for the house. Costs can range from $2,800 for a standard chair lift up to $15,000 for a custom job. Medicare will not cover the cost so other arrangements will need to be made to set up financing. There may be restrictions due to how steep the stairs are or how narrow the stairwell may be.

Another adaptation that may be made to a home is to install a walk in tub or shower. This can cost from $1.900 to $3,000 depending on the model and what is needed to install this in the home. Consideration needs to be given regarding making this change to the house, especially if there is not another tub.  Some models will also be able to function as a shower as well. Shower stalls with a seat are another option with a price range depending on the cost of the plumber and the other workmen you may need to include to get the changes made.

I would not make either of these adaptations until there was a need. Most of us never need the stair lift or a walk in tub. Change over to a stall shower if you feel it would be helpful when you remodel the bathroom.

Where should the Aging live?

As we approach the end of life, we may find that it is no longer possible to attend to our daily needs without assistance. Sometimes this occurs gradually as we age and sometimes we have an event that creates a significant change quickly. In either case, a decision needs to be made regarding where we will live, in our own home with assistance, with one of our children (or other relative) or in a facility. Each of these options has benefits and drawbacks.

Living in our own home with help has much to recommend it from the comfort point of view. It can also be less expensive or significantly more expensive depending on how the help is supplied. If family members are able and willing to provide the support there are health care professionals available to provide whatever training may be needed. This is the least expensive in terms of money and can be expensive in time and effort of unpaid caregivers. If there are limited financial resources or limited family supports this may be the only long term solution.

Living with children or other relatives can be a solution that appeals to all involved or may be an emotional situation with potholes like a road at the end of a hard winter. Because of the level of mobility in our lives, relatives may not be living near enough to make the move an easy one and we may feel like guests in a new living situation. If there are strong relationships and open lines of communication this can be satisfying for everyone involved. Even if this necessitates a move of a great distance it is possible that this is the best choice for all. Multiple generation living arrangements can be good for all involved with guidance from health care providers as needed.

Living in a facility may be a good choice if there is money enough to pay for the care, particularly if the “ancestral home” can be sold to provide support for part of the cost. There are many facilities that provide effective, safe care as independent living (an apartment with access to a communal dining room), assisted living with a few more services or a complete nursing care facility. Despite fears to the contrary most of these facilities are safe and effective. You need only be observant to be assured that all is well.  

Safety in the home for the Aging – Part 2

When you or your aging relative decide to remodel it takes only a bit of forethought to plan in the safety equipment. If interior doors are being replaced, take the time to change the hardware to levers instead of knobs. Levers are easier to activate as arthritis takes it toll and are a subtle change that makes it easier to remain in the home. Adding railings to steps and walkways outside the home also add stability when someone is traveling the steps. If you take your time and install these before there is an urgent need you will be able to shop for price and a style that will blend in with the house. Placing handrails on both sides of the stairs will not look odd and will make it safer for a frail person to travel up and down.

Safety changes to be made when the need has arisen or seems imminent include grab bars and ramps. Find a contractor who is familiar with ADA (Americans with Disabilities Act) who will also be able to comply with local building codes if you are installing a ramp outside. Keep in mind that the ramp should be 1 foot long for each inch it drops.  Your contractor should also be able to place grab bars appropriately for stability and ease of use. Grab bars should be anchored in the studs and if they are being placed over tile, drilling through the tile to get to the studs is necessary.  Place grab bars in the shower, near the toilet and at transition points like from the front stoop into the house or at the head of the steps if the stairwell is a bit steep. Anywhere more stability is needed is a good place for a grab bar.

Safety in the home for the Aging – Part 1

As we age our mobility often decreases. Sometimes this is related to the wear and tear of time and sometimes as related to a disease or accident. In order to promote safety for our aging relatives as they remain in their own home there are steps to be taken over time to make this possible. There are simple remedies to removing fall risks through a home, some to be put in place when there is remodeling being done, some to be addressed as they are identified and others to install when there is a need.

Flooring needs to be addressed as soon as a problem is identified. Loose floorboards or throw rugs need to be repaired so that the floor is as smooth as may be and to remove the risk of tripping over the edge of a throw rug or an uneven place in the floor. When carpeting is being replaced, take care to be sure that the pile is lower rather than higher. An excessively plush carpet will interfere with walking because it sinks when you walk on it.

Another thought to keep in mind is to be sure that railings are repaired as soon as they are noted to be unstable.  Stair treads need to be tightened as needed and carpeting needs to be lower pile. Railings are often placed on one side of a stairwell, when there is a mobility issue related to traveling steps, it would be wise to install a handrail on both sides to stabilize someone with mobility issues.