Celebrating National Family Caregiver Month

November is a time to celebrate the many caregivers providing care for older adults and individuals with disabilities in the community. It is estimated that around 44 million Americans provide 37 billion hours of unpaid care for adult family members and friends. Let's all take the time this month to thank a caregiver we know. If you are a caregiver take time this month to reward yourself for all of your hard work!

Be sure to check out our helpful resource page Helping an Older Adult: A Caregiver's Journey. If you are taking care of anyone in your life be sure to take the caregiver stress assessment. You can also visit this page to learn about the many useful resources for caregivers and older adults in the area.

The Passing of the Greatest Generation 
 The National WWII Museum 

Approximately every two minutes a memory of World War II – its sights and sounds, its terrors and triumphs – disappears. Yielding to the inalterable process of aging, the men and women who fought and won the great conflict are now in their 80s and 90s. They are dying quickly – at the rate of just over 600 a day, according to recent US Veterans Administration figures. 

Honoring the 20th-century veterans’ sacrifice before they pass from the scene, is at the forefront of everything we do at The National WWII Museum – from our exhibits, to oral histories, to the Museum’s $300 million expansion, a lasting tribute to the Greatest Generation.

“There’s no time to lose,” said Dr. Gordon H. “Nick” Mueller, President and CEO of the Museum. “We want to be able to finish and dedicate our expansion while we still have members of the Greatest Generation to thank for their sacrifice and service to the nation and to show the world what they mean to the principle of freedom.” 

To read the entire report on WWII Veteran Statistics Click Here! 

National Prescription Drug Take Back Day Saturday October 26th from 10am – 2pm

This event aims to provide a safe, convenient and responsible means of disposing of prescriptions as well as educating the public about the potential abuse of medications.

Below find collection sites in the area.

Participant’s Name	Collection Site
Ashby Police Department	Ashby Police Department 893 Main Street Ashby, MA 01431
Ayer Police Department	Ayer Police Department 54 Park St Ayer, MA 01432
Blackstone Police Department	Blackstone Town Hall Senior Center 15 St Paul Street Blackstone, MA 01504
Charlton Police Department	Charlton Police Department 85 Masonic Home Rd Charlton, MA 01507
Douglas Police Department	Douglas Police Department 29 Depot St Douglas, MA 01516
Dudley Police Department	Dudley Police Department, Municipal Complex 71 West Main St Dudley, MA 01571
Fitchburg Police Department	Fitchburg Police Department 5520 Lacy Rd Fitchburg, MA 01420
Gardner Police Department	Price Chopper Supermarket 560 Main St Gardner, MA 01440
Grafton Police Department	Grafton Police Department 28 Providence Rd Grafton, MA 01519
Groton Police Department	Public Safety Building 99 Pleasant St Groton, MA 01450
Holden Police Department	Holden Police Department 1370 Main St Holden, MA 01520
Lancaster Police Department	Lancaster Police Department 153 Main St Lancaster, MA 01523
Leicester Police Department	Leicester Recycling Center 200 Mannville St Leicester, MA 01524
Leicester Police Department	Leicester Police Department 90 South Main St Leicester, MA 01524
Lunenburg Police Department	Lunenburg Police Department 655 Massachusetts Ave Lunenburg, MA 04162
Milford Police Department	Senior Center 60 North Bow St Milford, MA 01757
Millbury Police Department	Millbury Police Department 127 Elm St Millbury, MA 01527
Northbridge Police Department	Northbridge Police Department 1 Hope St Whitinsville, MA 01588
Pepperell Police Department	Pepperell Police Department, Public Safety Complex 59 Main St Pepperell, MA 01463
Princeton Police Department	Princeton Police Department 8 Town Hall Dr Princeton, MA 01541
Rutland Police Department	Rutland Police Department 242 Main St Rutland, MA 01543
Shrewsbury Police Department	Shrewsbury Senior Center 98 Maple Ave Shrewsbury, MA 01545
Southbridge Police Department	Southbridge Police Department 1 Mechanic St Southbridge, MA 01550
Townsend Police Department	Townsend Police Department 70 Brookline Rd Townsend, MA 01469
Webster Police Department	Webster Police Department 57 Thompson Rd Webster, MA 01570
West Boylston Police Department	West Boylston Police Department 39 Worcester St West Boylston, MA 01583
Westminster Police Department	Westminster Police Department 7 South Street Westminster, MA 01473
Worcester Police Department	Senior Center 128 Providence St Worcester, MA 01608

For more information and to search for other collection sites www.deadiversion.usdoj.gov/drug_disposal/takeback

Care To Ask

Lessons I Learned from Being a Caregiver
Cameron Von St. James
When someone you love has a serious illness, such as Alzheimer’s, dementia or cancer, taking on the role of a caregiver is challenging. It most cases, it happens suddenly and unexpectedly, and you find yourself completely unprepared. In my case, I was in one of the best times of my life as I had just spent three of the happiest months with my newborn daughter, Lily, when my wife found out she was seriously ill. She had malignant pleural mesothelioma, a form of rare cancer that is caused by being exposed to asbestos.
I had to swiftly take on the role of main supporter and caregiver to my wife. Something, at the time, I felt I was incompetent to do. Those were some of the most difficult and trying times I’ve ever faced. Although my wife beat the cancer and seven years later, she is still well, it took a lot of effort to get here. We have been through so much that made us stronger, and lessons that taught us to never lose faith, and to keep on going no matter what. I feel this has left me with a lot of experience that would be valuable to other caregivers.
I am able to share this experience and pass on helpful tips to other caregivers and their families by being an advocate for the Mesothelioma Cancer Alliance. There are a few questions that I am asked the most, and I am sharing the answers I give, which are based on the lessons I learned from my own experience and from other caregivers.

1. Take care of your emotional and physical well-being. This is really essential as you need to feel good in order to keep a positive atmosphere around the home. If you fall apart, then that will make the situation much worse, and it will make the person you are caring for feel guilty that they have put you in this situation. They do not need that. So, for their sake and yours, make sure you get enough sleep, good food and exercise. These simple things will prevent ‘caregiver burnout.’
   
2. Prioritize everything you need to do. This is key to being able to get everything done. Make a list of things that are important and prioritize them in order of urgency. Also, make lists of things that are not so important and that perhaps someone else could do. If you also have to take care of children and need to continue working, then taking the time to do this will be a big help to your day-to-day activities.
   
3. Use whatever tools you are comfortable with to help you with prioritizing and organizing everything you need to do. A pad of paper and a pen, laptop, iPad or any other way you may prefer can help you keep track of appointments, medications, and the hundreds of other things you need to see to. Keep all your medical and insurance papers well organized so you can get the information you need quickly.
   
4. Learn all you can about the illness your loved one is fighting. I became an expert on mesothelioma after my wife was diagnosed. The more you know the better you will be able to care for them. You can recognize what they are going through, anticipate how they will feel and understand the side effects they have to the treatment. This will give you confidence, and it will enable you to be a stronger caregiver.
   
5. Do not hesitate to ask for assistance when you need it. It is easy to get wrapped up with your own problems, and feel as if it is all up to you. However, try not to let this happen. Stay closely connected with family and friends, and any other social activities you normally participate in as this will keep you in touch with other people. It is normal to have moments when you feel you can’t handle things anymore, but what you need to do is ask for help. Wouldn’t you help someone else in your situation? Remember that everyone around you feels the same way, and they are willing to help; you just need to let them know. Even if it is just a small errand, it will be one less thing that you have to remember.
   

Being a caregiver is a great challenge, but it can also be one of the most rewarding jobs a person can have. There is no greater act of love or devotion than being a caregiver to a sick loved one. I hope that these tips will help you be the best caregiver you can be.

Author
 
Mesothelioma

Care To Ask

This month’s questions comes from someone who is wondering how social day care and adult day health programs differ.

Remember if you have caregiving questions email them to CareToAskCMAA@gmail.com.

Q. I am currently taking care of my uncle and I think he would benefit from some sort of a day program to socialize and be with others during the day while I am at work. Currently he is at the house all day by himself and he complains he is bored. I am confused on if we should look into social day care programs or adult day health programs. What is the difference between these two programs?

A. Social day care and adult day health programs are extremely valuable and important programs. These programs allow older adults to continue to reside in a community setting while allowing the informal caregiver to have a break during the day. There are differences between the care provided at social day care and adult day health programs. The level of care the older adult needs will determine which program is the best for them.

Both programs are offered during the day Monday-Friday, with some now offering extended evening and/or weekend hours. Most programs prefer that a person attend at least 2 days per week so the participant and staff get to know each other. Both programs offer socialization activities as well as nutritious meals and snacks. Transportation may be provided to and from the center.

Social Day programs, which may also be called Adult Day Care, focus on the socialization of the older adult allowing them to maintain structure and focus in their day. This type of program is best suited for the older adult who is still independent and does not require hands on assistance with any of their activities of daily living (ADLs), such as bathing, dressing, toileting and transferring, but require more supervision and structure than is provided at the local senior center. Social day care is not appropriate for those who need medication administration, wander or require constant redirection during the day. It is appropriate for the person who can take their own medications after a reminder is given or needs occasional redirection or cueing during the day.

If your uncle needs more care that what can be offered at a social day care program you should look into an adult day health program. These programs have registered nurses (RNs), certified nursing assistants (CNAs) and licensed practical nurses (LPNs) on site and can provide hands on assistance to participants. They can also bring other health care professionals, including podiatrists, eye doctors, dentists, physical, occupational and speech therapists onsite. Adult day health programs are best suited for the older adult who requires medication administration and/or assistance with any ADLs such as feeding, dressing, bathing, toileting or transfers. These programs are secure so they provide a safe environment for someone with dementia. They are not appropriate for someone who needs constant one on one attention or is combative.

Social day and adult day health programs are great programs for older adults and their caregivers. Social day care programs are less expensive than adult day health programs and have a lower staffing to participant ratio. It is important to make sure that the program, whether a social day program or adult day health program, is a good match for the older adult. Programs may have different populations that they focus on such as younger individuals with mental health or developmental disabilities. It is a good idea to visit the center and make sure it is a good match for the older adult. Many centers offer a free one day trial visit so the family and older adult can decide if a particular center will be a good match. Any center you and your uncle are interested in will conduct an assessment to be he is an appropriate fit for their site.

A very big thank you to Lisa Pontbriand, from St Francis Adult Day Health, for helping to answer this month’s question. For more information about the Adult Day health program at St Francis please visit www.saintfrancisrehab.com.

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What You Should Never Say To Someone Over 50

The Huffington Post

There are just some things that are best left unsaid, especially when you're talking to someone over 50. A seemingly innocent enough observation -- "Hey, you look tired!" -- can be an unexpected and at times unpleasant reminder of one's age.

The Huffington Post asked their fans what were some things one should never say to someone over 50, and the answers came pouring in.

Add your comment below.

To read the entire article, Click Here!

Helpful Technology For Caregivers & Older Adults

 Lately, it’s hard to imagine a world without blogs, iPhones, tablets and the seemingly endless list of apps. But to many older adults who never had access to these developments before, the thought of using them now is overwhelming. Studies suggest that, “a lack of awareness of what is available and the knowledge of how to access it, are two of the main obstacles preventing people using technology” (University of Sheffield, 2013). There is a widespread perception that technology is too complex for those above a certain age, however this is simply not true! Once introduced to these resources, older adults often find them to be extremely useful.  Using technology is a great way to develop new ideas, save money, and connect with loved ones from all over. Check out the following websites, devices, and apps:

Websites:
Groupon and other coupon sites allow you to customize searches to find deals on activities and products that directly relate to your interests. Find deals on exercise classes, restaurants, home goods, trips and more!

Pinterest is a great site for gathering ideas for the home, recipes, crafts, and do it yourself products.

Photosharing sites like dropbox and shutterfly allow you to choose who you share pictures with. Shutterfly can even organize photos into an album or gift that you order. Sharing photos is a great way to continually see what friends and family are up to in between visits!

Online calendars, like Google Calendar, are another wonderful resource. You can make multiple calendars for different types of events, which you can then choose to combine or separate. You can add other people to view or edit the calendar. This is especially useful for caregivers near and far to help keep track of an older adult’s schedule!

Apps:
Dragon Diction is an app that enables users to vocalize emails, text messages, status updates, etc and view them immediately before publishing. This is a great app for people who have difficulty with seeing small print on a smartphone, tablet or computer.

Apps like Viber, TextPlus, and Whatsapp are all communication applications that allow you to call or text people who also have the app for free! This is useful for contacting people in other countries.

Red laser is an app that compares the prices of a good among stores in your area. Find out where to get things for the cheapest price and save money!

Pill Reminder apps keep track of the valuable information associated with medication management. According the Guardian, the Pill Reminder Pro asks users to “enter in the name of your pill, dosage, frequency, and what time(s) of day, and Pill Reminder sends a message via PUSH alert” (Guardian, 2013).

Devices:
For older adults that live far away from loved ones, one of the best investments to make is in a webcam. Aging can sometimes be a lonely process but chatting through Skype or Google can allow you to regularly keep in touch with family or old friends.

As many people age, they have difficulty reading the small print found in newspaper or books. Many E-readers provide the same publications in larger print. For example, Kindle users have access to a wide range of books and newspapers through the online bookstore. E-readers are also useful because they conveniently store everything in one place. Tablets like the iPad, Kindle Fire or Samsung Galaxy Note act as E-readers while also providing the internet and wide selection of apps to their users. Tablets are easy to travel with allowing users to bring book collections, music, pictures, movies and more with them wherever they go!

Fitbit is a device that is similar to a pedometer, except that it is synced to your computer. You can keep track of how many steps you take each day and compare to friends!

The WII is a user friendly gaming system that provides a lot of entertainment and fitness options. It is interactive so it allows you to actually play sports like bowling, tennis, and golf indoors. You can buy different games that suit your interests. You can also download Netflix onto your WII. This is a great way to stream favorite movies and television shows from home for a relatively low monthly cost.

There are many options available. Many senior centers can provide information on how to use these devices and websites. Technology stores like Apple and Windows can offer tutorials on how to use their products. Several senior centers and libraries offer free courses on how to use the internet, which provides its students with opportunities to ask specific questions.

Resources:
Horton, Clare, and Mark King. "10 of the Best Apps for Older People." The Guardian. Guardian News and Media, Media, 21 September 2011. Web. 12 July 2013.

"Older People Have a Thirst for Technology." University of Sheffield News Releases. N.p., 22 May 2013. Web. 12 July 2013.

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Care To Ask

Summer is in full swing and that means that wedding season is here. This month’s Care to Ask comes from a caregiver who would like to travel to his niece’s wedding but is concerned about who will care for his mother while he is away.

Remember if you have caregiving questions email them to CareToAskCMAA@gmail.com.

Q. My Niece in California, who is also my godchild, is getting married in September. Since my brother’s passing, she has looked to me as her dad, and has asked me to walk her down the aisle. I really do want to do this, but my Mom lives with us. Mom is homebound, and cannot make the trip. What kind of help is available so that my wife and I can go to Cali, and yet still be sure my Mom is safe and cared for?

A. The service that can best meet your needs in this situation is called respite. Respite can best be described as a short term service that provides care to an individual when the caregiver is not available. This service can be provided in a number of settings including in home, out of home or a combination of both.

Using in home services means that your mother can stay in the comfort of her own home. Depending on the level of care your mother needs you can arrange for someone to stay with her 24/7 or during certain times of the day. If your mother needs help showering, being put to bed and/or staying overnight and individual could be hired to come for only those times of the day.

Out of home services can be provided in facilities such as nursing homes or assisted living residences, or in a community based day program. Respite in a facility is for overnight stays and is usually provided on a space available basis. The facility may also have minimum or maximum length of stay requirements.

Day programs include Adult Day Health and Social Day programs. An assessment will be done to determine the appropriate program. Your mother would be transported to the program in the morning and return home later in the day, usually late afternoon. In home services can be used for the night, overnight and weekend hours.

Depending on the level of care your mother needs and the amount of time the service will be utilized respite may be costly. Respite services are usually on a private pay basis unless your mother is fortunate enough to have long term care insurance that covers this service. There may be assistance in paying for a portion of these services through your local Family Caregiver Support program, which in Massachusetts is a program of the local Aging Service Access Point (ASAP).

If you live in Massachusetts, you can find the appropriate service agency by going to www.800ageinfo.com.

For those individuals that live outside of Massachusetts you can find local resources by using Elder Care Locator at www.eldercare.gov or call 1-800-677-1116.

If possible, you should begin researching options and putting a plan in place as soon as possible. It is also important to have a conversation with your mother about your plans, the services that you have arranged so that she will be safe and well cared for while you are away. If appropriate it is always good to have your mother participate in the planning to the best of her ability. By planning in advance, you may be able to arrange for you and your mother to meet anyone that will be providing in home services and/or to visit any out of home programs that she will be participating in.

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CARE TO ASK

Q. How will I know if my loved one is out patient or admitted status at the hospital?

A. Understanding whether or not you are considered a hospital 
inpatient or outpatient is very important for Medicare beneficiaries. It determines what and how much Medicare will pay for during and after your hospital stay. Even if you stay in the hospital overnight you may not be considered to be inpatient. Below please find the alert from the Medicare Advocacy Project on this subject. You can also read a Medicare document on this same issue here: www.medicare.gov. 

  

Medicare Beneficiary Alert:

Are You a Hospital Inpatient?

If you are a Medicare beneficiary, Medicare can pay for up to 100 days of care in a Skilled Nursing Facility (SNF) such as a nursing home.  Unless you are in a Medicare Advantage plan which allows otherwise, to qualify for Medicare coverage, among other criteria, you must have a qualifying hospital stay of 3 consecutive days or more and need doctor-ordered skilled care or therapy on a daily basis.  However, a three-day hospital stay is not a guaranty that Medicare will pay for SNF care.  The stay must be considered an inpatient hospitalization.

Recently it has come to the attention of the Medicare Advocacy Project that some Medicare beneficiaries have been admitted to a hospital for days, if not weeks, at a time, while during that time their hospital considered them as under “observation status.”  If a person is in a hospital under observation status, instead of as an inpatient, those days in the hospital will not count as part of the 3 days hospital days needed before Medicare will cover care at a Skilled Nursing Facility.  Not only does your inpatient or observation status impact whether Medicare will pay for your SNF stay, but also it can change the amount you will pay for the services and medications you receive while in the hospital.

Medicare beneficiaries should take the following steps to protect their right to appropriate Medicare coverage:

• Make sure to ask your doctor or other hospital staff whether you are considered an inpatient or under observation status.  Be aware that some hospitals change a person’s status during the course of his or her stay, so make sure to ask this question multiple times when you are in the hospital.  If possible, ask for a decision in writing.

• Review any notices you receive carefully.  Some hospitals and SNFs will issue “Advanced Beneficiary Notices” or “Notices of Exclusion from Medicare Benefits” which may explain when Medicare coverage is and is not available.

• If you think you should be an inpatient, or that Medicare should cover your SNF stay, explore your appeal rights.  If you disagree with a Medicare claims or services decision, you can file an appeal.

---

The Medicare Advocacy Project (MAP) is devoted to assisting people who may have been wrongfully denied Medicare.  If you have questions about your Medicare claims or need legal advice, contact your local MAP office via Greater Boston Legal Services at 1-800-323-3205.  For Worcester County residents, contact Community Legal Aid at 1-855-CLA-LEGAL.

For those individuals that live outside of Massachusetts you can find local resources by using Elder Care Locator at eldercare.gov or call 1-800-677-1116.

photo credit: MTSOfan via photopin cc

Care To Ask

Q. How will I know if my loved one is out patient or admitted status at the hospital?

A. Understanding whether or not you are considered a hospital inpatient or outpatient is very important for Medicare beneficiaries. It determines what and how much Medicare will pay for during and after your hospital stay. Even if you stay in the hospital overnight you may not be considered to be inpatient. Below please find the alert from the Medicare Advocacy Project on this subject. You can also read a Medicare document on this same issue here: www.medicare.gov/.

    Medicare Beneficiary Alert:
Are You a Hospital Inpatient?
If you are a Medicare beneficiary, Medicare can pay for up to 100 days of care in a Skilled Nursing Facility (SNF) such as a nursing home. Unless you are in a Medicare Advantage plan which allows otherwise, to qualify for Medicare coverage, among other criteria, you must have a qualifying hospital stay of 3 consecutive days or more and need doctor-ordered skilled care or therapy on a daily basis. However, a three-day hospital stay is not a guaranty that Medicare will pay for SNF care. The stay must be considered an inpatient hospitalization.

Recently it has come to the attention of the Medicare Advocacy Project that some Medicare beneficiaries have been admitted to a hospital for days, if not weeks, at a time, while during that time their hospital considered them as under “observation status.” If a person is in a hospital under observation status, instead of as an inpatient, those days in the hospital will not count as part of the 3 days hospital days needed before Medicare will cover care at a Skilled Nursing Facility. Not only does your inpatient or observation status impact whether Medicare will pay for your SNF stay, but also it can change the amount you will pay for the services and medications you receive while in the hospital.

Medicare beneficiaries should take the following steps to protect their right to appropriate Medicare coverage:

• Make sure to ask your doctor or other hospital staff whether you are considered an inpatient or under observation status. Be aware that some hospitals change a person’s status during the course of his or her stay, so make sure to ask this question multiple times when you are in the hospital. If possible, ask for a decision in writing.
  
• Review any notices you receive carefully. Some hospitals and SNFs will issue “Advanced Beneficiary Notices” or “Notices of Exclusion from Medicare Benefits” which may explain when Medicare coverage is and is not available.
  
• If you think you should be an inpatient, or that Medicare should cover your SNF stay, explore your appeal rights. If you disagree with a Medicare claims or services decision, you can file an appeal.
  

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The Medicare Advocacy Project (MAP) is devoted to assisting people who may have been wrongfully denied Medicare. If you have questions about your Medicare claims or need legal advice, contact your local MAP office via Greater Boston Legal Services at 1-800-323-3205. For Worcester County residents, contact Community Legal Aid at 1-855-CLA-LEGAL. For those individuals that live outside of Massachusetts you can find local resources by using Elder Care Locator at eldercare.gov or call 1-800-677-1116.

photo credit: MTSOfan via photopin cc

Care To Ask

Long Distance Caregiving

This week’s Care To Ask comes from a daughter who is caring for her parents who live in another state. Caregiving is stressful and living far away can make it difficult to provide the care older adults need.

Don’t forget that if you have a caregiving question email us at CareToAskCMAA@gmail.com



Q.

I live in Massachusetts but my parents, who are in their mid 80’s, live in North Carolina. I am only able to visit 2-3 times a year but I do speak with them at least 1 time a week. Although they keep telling me everything is OK, I am beginning to notice an increasing frailty in their voices. There are no family members in their area to help them out. Recently one of their neighbor’s called and expressed concern that they may be having difficulty caring for the house and themselves, including proper nutrition. I do not know where to start looking for help for them or even what might be available. I am also afraid that they will not let anyone in the house to help them.

A. Being the primary caregiver for parents or other loved ones is a stressful time. This stress is increased when one is trying to provide caregiving from a distance. All of the United States, including territories and Native American reservations are covered by an Area Agency on Aging. One of the functions of these agencies is to provide information about and referral to programs and services in their service area.

You can find the Area Agency on Aging in their community by contacting the ElderCare Locator at www.eldercare.gov. You can contact them by phone or live online chat or by the search feature. The phone line and online chat are available Monday-Friday between 9:00 am-8:00 pm the website search feature is available 24/7.

Once you have an understanding of what services are available, it is best to have a conversation with your parents before starting any service. It is important that they understand that any service you contact is committed to helping older adults remain in their own home as long as possible. It is often helpful to the older adult if a trusted family member or friend is present during the initial assessment for services.

You should also plan a visit to go see your parents as soon as you can. On your visit make a point to meet all of your parent’s friends and neighbors; share contact information with these people. You can ask these friends and neighbors to check in on your parents when you are not in town. When visiting your parents it will be important to assess their current level of need. This would mean taking notice of how they are doing with grocery shopping and preparing meals, their driving ability, safety in the home, medication management and their emotional and physical health conditions. It will be important to reassess these needs each time you visit.

It will be important to talk with your parents about the aspects of their care. Make sure you are aware of all important legal and financial documents they have and where they are located. It may be helpful to make copies of these documents. Also have contact information for your parent’s physicians and care providers.

Being a long distance caregiver can be exhausting. Make sure that you are taking care of yourself during this time as well. You can also use the ElderCare Locator to find caregiver support services, such as support groups or counseling, in your area.

Have any of the readers deal with long distance caregiving before? What worked for you? What did not?

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ElderCare Raffle Winner

Our ElderCare 2013 raffle winner is Ann Klump!

Care To Ask?

Answering Your Caregiving Questions
Question

My 77 year old uncle is having some issues with his driving. He is very persistent about driving and says he is not willing to give up his keys yet. My brother and I have found a few dents and scratches on his car and feel it is time he stop driving all together. Right now he has stopped driving at night and only drives short distances but I feel this isn’t enough. How do I get my uncle to give up the keys? What options does he have for transportation when he does? Any help would be great!

Answer

It is easy to understand why someone would not want to stop driving. Our society is centered around the private vehicle and being able to go where we want when we want. Think about how your uncle will feel needing to ask for a ride every time he wants to leave his house. That being said there is a time when an older adult may not be able to safely drive anymore. First, suggest that your uncle have a medical exam including vision and hearing as his driving issues may be related to something that can be corrected. Next, you may want to propose your uncle partake in driving assessments whether online or with a driving specialist. Having an impartial evaluation of his driving ability may be helpful for all of you. A driving specialist may be able to suggest vehicle adaptations that can help his driving.

If you do have to have a conversation with your uncle about giving up the keys it may be helpful to present him with the options for transportation that are available in his community. You can check with the local senior center to see if they offer any transportation. The senior center and/or council on aging may also be able to give you information on private and volunteer transportation programs in the area. Also if there is public transportation available in his community this may be an option for him. Some transportation authorities offer a travel training program to teach individuals how to use the fixed route bus service. If you think your uncle may have problems utilizing the fixed route service due to a disability there are ADA paratransit services available. The paratransit service offers curb to curb transportation. The person must be able to independently or with his or her own companion make it to the curb to wait for the ride. The ride must be scheduled in advance and may involve wait times. Once you have fully researched all of the transportation options available you can present these to your uncle to help calm his fears or giving up his keys.

You should also give your uncle a list of family and friends who would be willing to give him rides. Specify the times they are available for him to call. Offering multiple names may make your uncle more likely to utilize the list because he won’t feel that the burden is on one individual. When talking to your uncle, be sure you respect him and are empathetic to the situation, this is a hard transition.

Have any readers dealt with this situation? Share your experience in the comment section below.

Care To ASK?

Answering Your Caregiving Questions

Question:

My mother recently fell and suddenly needs a lot more help then she has ever needed. I have been going over to her house everyday to help her get dressed in the morning, make her meals and clean her house. It is absolutely exhausting. On top of that I bring her to her appointments and any errands she has. It has starting taking all of my time just helping her. My husband is getting frustrated because I am not home in the evenings to help with dinner and the kids homework. The kids are also getting upset because I’m not able to be around like I used to. Just last week I missed my daughter’s chorus concert because Mom had a doctor’s appointment. I just feel like I can’t do this anymore. I am frustrated that my mother keeps asking for so much help. This is horrible! What daughter feels like this? I just want help and advice on how to make this situation better. I feel like there are no solutions and I have no clue where to turn!

Answer:

First thing; this is more common than you think. You are trying to juggle so much of course you are tired and stressed. Caregiving is stressful, tiring and yet can be an extremely rewarding role. First thing you need to do is not be so hard on yourself and realize that you can’t do it all.

It may be helpful to bring in help to dress your mother, prepare her meals and provide other assistance around the home. If your mother is currently not receiving services through an Aging Service Access Point (ASAP) or Independent Living Center (ILC), I would suggest you speak with an Options Counselor. This person can meet with you, your mother and any other interested individuals to discuss the different types of services available in the area. To find an Options Counselor in your area contact your local ASAP or ILC. A list of state agencies can be found at www.800ageinfo.com.

There are home care services available by private pay but there are also State funded programs offered by ASAPs. State home care fees are on a sliding scale based on your mother’s income. Be aware the State funded programs may have wait lists to receive services. If your mother is already receiving services through a local ASAP it will be important to discuss any changes with her case manager to determine if she is eligible for additional services.

Another option would be to look into an Adult Day Health or Social Day Care program. Your mother would receive meals, snacks, medications as well as the opportunity to participate in social activities. An Adult Day Health program would be able to monitor your mothers ongoing health needs as well as offer physical and occupational therapy if needed.

Do either of your parents have military experience? If so, your mother may be eligible for services through the VA even as she surviving spouse. For more information you can contact the VA Benefits line at 1-800-827-1000 or go to this website www.va.gov/GERIATRICS

Also do you have other family in the area or does your mother have friends in the area? If so ask these people to help you! Any amount of assistance they are willing to offer will be of help to you. Be specific about what assistance you need. You need to take time for yourself and your family. Bringing in extra help, whether paid or by family and friends will ease your stress.

Finally I would suggest visiting Central Massachusetts Agency’s on Aging’s website. A new section Helping An Older Adult: A Caregiver’s Journey, offers supportive resource materials for caregivers just like yourself. There is also a caregiver stress survey which may be helpful to take to assess your stress levels. Feel free to look over the entire webpage as there is an online searchable database available, a digital copy of the Caregiver’s Guide, articles written by community experts and chats facilitated by professionals. It would also be helpful to join a caregiver support group to talk with other family caregivers about your current situation.

Mema's Cold Weather Tips

Continue to be aware of extreme weather conditions by monitoring Media reports.

• Make sure you always have a well-stocked Winter Home Emergency Supply Kit that includes flashlights, portable radio, extra batteries, a first aid kit, bottled water, non-perishable food and a manual can opener.
  
• Minimize outside activities, particularly the elderly and very young. Also, consider your pets.
  
• Dress in several layers of loose-fitting, lightweight clothing, rather than a single layer of heavy clothing. Outer garments should be tightly woven and water repellent. Wear a hat, mittens and sturdy waterproof boots, protecting your extremities. Cover your mouth with a scarf to protect your lungs.
  
• Excessive exposure can lead to frostbite, which is damaging to body tissue that is frozen. Frostbite causes a loss of feeling and a pale appearance in extremities, such as fingers, toes, ear lobes or the tip of the nose. If symptoms are detected, seek medical help immediately.
  
• Hypothermia can occur in extreme cases. The warning signs are uncontrollable shivering, memory loss, disorientation, incoherence, slurred speech, drowsiness and apparent exhaustion. If the person’s temperature drops below 95 degrees, seek immediate medical care.
  
• Ensure you have sufficient heating fuel, as well as emergency heating equipment in case you lose electricity.
  When utilizing alternate heating sources, such as your fireplace, wood stove or space heater, take the necessary safety precautions. Keep a fire extinguisher handy; ensuring everyone knows how to use it properly. Test smoke alarms and Carbon Monoxide (CO) detectors.
  
• If you lose your heat, seal off unused rooms by stuffing towels in the cracks under the doors. At night, cover windows with extra blankets or sheets.
  
• Food provides the body with energy for producing its own heat.
  
• Be a good neighbor. Check with elderly or relatives and friends who may need additional assistance to ensure their safety.
  
• To keep pipes from freezing, wrap them in insulation or layers of newspapers, covering the newspapers with plastic to keep out moisture. Allow a trickle of warm water to run from a faucet that is farthest from your water meter or one that has frozen in the past. This will keep the water moving so that it cannot freeze. Learn how to shut off your water if a pipe bursts
  
• If pipes freeze, remove insulation, completely open all faucets and pour hot water over the pipes or wrap them with towels soaked in hot water, starting where they are most exposed to the cold. A hand-held hair dryer, used with caution, also works well.
  
• Have a well-stocked Winter Home Emergency Supply Kit that includes flashlights, portable radio, extra batteries, a first aid kit, bottled water and non-perishable food.
  
• Make sure your car is properly winterized. Keep the gas tank at least half-full. Carry a Winter Emergency Car Kit in the trunk including blankets, extra clothing, flashlight with spare batteries, a can and waterproof matches (to melt snow for drinking water), non-perishable foods, windshields scraper, shovel, sand, towrope and jumper cables.
  

Continue to follow MEMA updates on Twitter at www.twitter.com/MassEMA; on Facebook. Download the free ping4alert! app to your Smartphone to receive important weather alerts and emergency messages from MEMA. Easy instructions are available at www.mass.gov/mema/mobileappp.

News From SHINE!

Help!..My new Part D Plan doesn’t cover all my Medications!!”

If you have a new Medicare Part D plan and have just found out that your new plan does NOT cover a drug you have been taking, you should know about transition refills. Transition refills may give you temporary coverage (one-time, 30-day supply) for a drug that is not on your new plan’s formulary OR that has restrictions (prior authorization or step therapy).

It is important to understand that a transition refill is only a temporary solution. You need to call your doctor right away to talk about switching to a drug your plan does cover OR filing a request with your Part D plan for a "formulary exception" (which may or may not be approved).

A transition refill is not for new prescriptions. You can only get one if you were already taking the drug before you signed up for the plan. Also, a transition refill does NOT apply to drugs that Medicare doesn’t require Part D plans to cover (like Valium and Ativan).

If you are in the same plan as last year, you may still be able to get a transition refill if your plan removed a drug you had been taking in 2012 from its 20123 formulary, for reasons other than safety.

Not all pharmacists know about transition refills. Ask your pharmacist to call your Part D plan for special instructions.