What is Personal Care?

Personal care refers to a range of personal daily living tasks that keep a person clean and comfortable. These tasks involve private hygiene such as bathing, toileting, and oral care. Additionally, other activities include dressing, eating, and ensuring medication is taken appropriately. An individual’s personal care requirements can differ depending on their overall health and level of mobility. Some older adults may require assistance with these tasks because they have problems with their joints, and strength, or have other health issues. For example, they may need help getting out of bed and into a chair or assistance with a bath or shower.²

Why is Personal Care so Important?

Personal care is key in promoting the overall well-being of elderly individuals. By engaging in personal care routines, individuals can experience a heightened quality of life empowering them to maintain their independence, health (physically, mentally, emotionally, and socially), and overall happiness.³

• Independence benefits – an individual’s personal care routine can be adapted to their specific needs so that their independence can be maintained in a comfortable and safe environment. Support for physical mobility enables them to continue living in their familiar environment and allows them to move around more safely, reducing the risk of falls and injuries. Assistance with outings ensures that a person can participate in social activities, continue their connections, and enjoy life beyond their home setting. Assisted Living care facilities can offer transportation when needed and senior transportation services are available.
• Physical health benefits – showering, dressing, and grooming are essential for maintaining physical health. Maintaining personal hygiene reduces illnesses and the spread of infection. It can also help certain health issues from worsening or reoccurring, such as skin conditions or urinary tract infections. Oral hygiene, including regular teeth brushing and denture care, prevents dental diseases and promotes overall health. Clean, appropriate clothing contributes to overall comfort. Maintaining a healthy diet, getting proper sleep, and obtaining adequate physical activity all play an important role in a person’s physical well-being.⁴
• Mental and emotional health benefits – by optimizing a personal care routine, a person feels better, looks better, and has more energy. This self-care is linked to enhanced mental health, resulting in greater self-esteem and self-worth, increased optimism, and lower levels of anxiety and depression. A warm bath and the use of scented products at the end of the day can help a person feel relaxed and ready for bed. Proper nutrition and sleep are additional aspects of self-care that contribute to mental well-being.
• Social health benefits – living alone can cause feelings of isolation and have serious health consequences. It is crucial to have a good social life to maintain overall wellness. Provided personal care support, such as what is available through an assisted living facility, offers an opportunity where an individual can form a genuine bond with their caregiver and gain companionship.
• Quality of life – when an older adult is caring for themselves and maintaining their overall health, they’ll be better equipped to live their best life. With proper physical health, the body will run more efficiently. There’s a strong connection between the body and the mind, so when caring for the body, one will think and feel better as well. Health problems, even relatively minor ones like aches, pains, fatigue, and indigestion impact people’s happiness and stress levels. Health problems can also make daily tasks more challenging. Poor health habits can add stress to an individual’s life and interfere with daily living. Therefore, maintaining healthy habits is extremely important for overall health. When daily tasks are managed and a healthy personal care regimen is in place, people can focus on activities they enjoy. Additionally, feeling well-cared-for increases happiness, life satisfaction, and psychological well-being, resulting in a higher quality of life.⁵

While personal care routines can differ for older adults, it’s important to recognize an individual’s specific needs. Prioritizing an appropriate routine is a vital aspect of care for seniors. It empowers them to maintain their independence, overall health, and increased happiness. When ensuring personal care for a senior has become challenging or too costly, or social isolation is a concern, consider the benefits of an assisted living environment and call CarePatrol Baltimore for guidance and recommendations.

References:

¹ Verywell Mind https://www.verywellmind.com/self-care-strategies-overall-stress-reduction-3144729

² National Institute on Aging (NIH) https://www.nia.nih.gov/health/aging-place/aging-place-growing-older-home

³ Psychology Today https://www.psychologytoday.com/us/blog/a-deeper-wellness/202302/understanding-the-mental-health-and-self-care-connection

⁴ Verywell Mind https://www.verywellmind.com/self-care-strategies-overall-stress-reduction-3144729

⁵ Verywell Mind https://www.verywellmind.com/how-to-maintain-a-high-quality-of-life-3144723

Artificial intelligence (AI) is the theory and development of computer systems capable of performing tasks that historically required human intelligence, such as making decisions, solving problems, and identifying patterns. AI encompasses a wide variety of technologies that control many of the services and goods we use in everyday life, including machine learning, deep learning, and natural language processing (NLP).  AI has shaped opportunities to advance on real-world problems concerning health, education, and the environment. In some cases, artificial intelligence can do things more efficiently or precisely than human intelligence.¹ In healthcare, AI is used to mimic human analysis, the understanding of healthcare data, expedite clinical workflow, and identify health problems efficiently.² AI algorithms are helping healthcare providers and public health officials to detect and diagnose chronic diseases earlier, personalize treatment plans, monitor patients remotely, and predict the spread of these diseases in the population.³

AI in elderly care
Caring for our seniors is essential to our sense of community. It is essential to civil society. Not to mention that we all want to be cared for as we ourselves age. In a time when chronic diseases are on the rise, people are living longer, and where the healthcare provider shortage continues to strain our care resources, it is comforting to know that artificial intelligence (AI) powered software and technologies are providing necessary solutions. These solutions extend care and help to support the elderly in a variety of ways including providing a better quality of life, promoting independence, monitoring health, and enhancing social interaction.⁴

• Promoting independence

AI-powered applications and tools can help the elderly perform daily tasks, such as medication management, fall detection, and navigation, allowing them to live independently for longer. Smart home systems integrated with AI can adapt to seniors’ daily routines and preferences. Voice-activated technologies like Amazon’s Alexa or Google Assistant can assist with various household tasks such as turning on lights, adjusting room temperature, or ordering groceries.⁵ AI-powered home monitoring systems can ensure safety by detecting falls or accidents and notifying emergency services if needed. These systems can send real-time alerts to the family, care facility, or medical agent that something abnormal has been detected. AI-driven wearable devices can monitor vital signs and activity levels, promoting a lifestyle that is healthier and more independent. These advancements empower seniors to comfortably live independently while providing an added layer of security.

• Monitoring chronic diseases

Chronic diseases such as diabetes, heart disease, and cancer are some of the leading causes of death and disability around the world. By analyzing vast amounts of data quickly and accurately from sources such as wearable devices, genetic testing, and electronic medical records, AI algorithms can identify patterns and risk factors for chronic diseases, allowing for early detection and diagnosis. For example, AI-enabled diagnostic tools can analyze medical images such as X-rays, MRIs, and CT scans, detecting abnormalities that could be missed by human radiologists. AI also has the capability to personalize treatment plans using one’s individualized characteristics and medical history including factors such as age, sex, genetics, lifestyle, and environmental exposures. Using this data, AI algorithms can determine the most effective and targeted treatment plans for an individual, reduce the risk of complications, and improve outcomes. Another AI component in the role of chronic disease prevention and management is the use of AI-powered remote patient monitoring devices. These devices use sensors and wearables to collect data on one’s vital signs, activity levels, and other health indicators, transferring the information to healthcare providers in real-time. AI is also being used in public health surveillance to analyze and predict the spread of chronic diseases. With data collected from electronic health records, social media, and other sources, AI algorithms can recognize patterns and risk factors for these diseases, allowing for targeted public health prevention strategies. For example, AI-powered predictive models can pinpoint communities at high risk for diabetes, enabling targeted public health campaigns to promote healthy lifestyle behaviors and reduce the risk of developing the disease.3

• Assistive robots and physical support

AI empowered robotic systems equipped with sensors and actuators can offer physical assistance with mobility support, household chores, and personal hygiene. These robots can be programmed to adapt to individual needs, granting personalized and responsive treatment. Robots with a mind are being developed to assist elderly patients in hospitals with their therapy. With physical touch, these robots can affect the patient’s emotional, physical, and social well-being in a positive way.

• Social robots and social interaction

Social interaction is a key factor in promoting mental well-being and combating social isolation in the elderly. With their companionship and engagement, social robots provide emotional support and cognitive stimulation. These AI enhanced robots can engage in conversations, play games, and even assist in reminiscence therapy, improving overall quality of life.

AI’s power to impact and improve human health is why Johnson & Johnson, and many other leading healthcare companies are actively using the technology in different ways, from speeding up the process of discovering new medicines to helping surgeons analyze the results of procedures. “There’s a deep demand for solutions in the healthcare space,” says Shan Jegatheeswaran, Global Head of MedTech Digital, Johnson & Johnson. “But it’s important to remember that the most sophisticated thing in the clinical workflow is still the human brain. The role of AI is to augment a human decision or action in a way that improves speed, quality, or both.”⁶

References:
¹ Coursera https://www.coursera.org/articles/what-is-artificial-intelligence 
² MindSea https://mindsea.com/ai-senior-care/
³ iMeetify https://imeetify.com/blog/how-ai-is-helping-to-predict-and-prevent-chronic-diseases/
⁴ National Institutes of Health https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10474924/#REF1
⁵ Senior Helpers https://www.seniorhelpers.ca/blog/how-ai-technology-can-improve-the-lives-of-the-elderly
⁶ Johnson & Johnson https://www.jnj.com/innovation/artificial-intelligence-in-healthcare?utm_source=bing&utm_medium=cpc&utm_campaign=BI-USA-ENG-PS-Corporate+Equity-GP-PH-RN-NB_STORIES_ARTIFICIAL+INTELLIGENCE&utm_content=AI+-+Healthcare&utm_term=ai+in+healthcare&gclid=dee70dd8770f14e16fe268ab2a583e70&gclsrc=3p.ds&msclkid=dee70dd8770f14e16fe268ab2a583e70

At CarePatrol of Baltimore, our Certified Senior Advisors have extensive experience helping families understand when it’s time for senior care. Let’s take a look at some of the signs that it’s time to think about care planning, and how to start the conversation with your loved one.

Top Signs That It’s Time to Consider Elderly Care Services

Changes In Mobility and Safety

If your loved one is having trouble getting around, it may be time to consider a senior living community that offers assistance with activities of daily living (ADLs). This could include help with bathing, dressing, eating, and using the toilet.

What These Changes Could Look Like

• Bruises that can’t be explained
• Struggles to stand from a seated position
• Walking, balance, and mobility difficulties
• Scratches or dents in their car
• Change in household cleanliness (piles of dirty laundry, severe clutter, etc.)

Changes in Hygiene and Personal Care

If your loved one is not taking care of themselves as well as they used to, it could be a sign of a larger problem. They may be struggling with depression, dementia, or another health condition.

What These Changes Could Look Like

• Noticeable body odor
• Less frequent bathing or showering
• Urine odors in the home
• Marked differences in personal care and grooming habits
• Failure to throw away spoiled food

Changes in Lifestyle or Household Habits

Changes in lifestyle or household upkeep could also signal a need for senior care. As an older person faces changes in cognition and mobility, they may have trouble keeping up with their bills, household chores, or hobbies they were once active in.

What These Changes Could Look Like

• Forgetting to check or open the mail (stuffed mailboxes, stacks of letters, etc.)
• Past-due bills or lapsed responses to time-sensitive communication
• Lack of interest in once-loved hobbies or activities
• Mood changes, especially extreme mood swings
• Unexplained weight loss or failure to maintain a healthy diet

Signs of Dementia

If your loved one is experiencing memory loss, confusion, or changes in personality, it is important to get them evaluated by a doctor. Dementia is a progressive condition that can make it difficult for people to live on their own. The most common cause of dementia is Alzheimer’s disease, but there are other forms as well.

According to a 2022 study, 1 in 10 Americans over 65 has dementia, and about twice as many have mild cognitive impairment. The earlier you can get a person with dementia the extra care and support they need, the greater their chances for positive outcomes and quality of life.

What These Changes Could Look Like

• Missing a lot of appointments or difficulty keeping track of time
• Changes in the ability to express oneself clearly or concisely
• Skipping medications or taking the wrong dose
• Forgetfulness that interferes with daily life
• Feeling lost or “out of sorts” when doing things they used to do easily

How to Start the Conversation

If you have noticed any of these signs, it is important to start a conversation with your loved one about senior living. If you’ve noticed 10 or more of the above signs, we recommend speaking with a Senior Care Advisor for personalized advice as soon as possible.

Tips for Talking to Your Loved One About Elderly Care Services

Broaching the subject of elderly care can be a difficult conversation, but it is important to be honest and open about your concerns. A senior living community can provide your loved one with the care and support they need to live a happy and fulfilling life.

• Choose a time when you are both relaxed and have some time to talk
• Start by expressing your love and concern for your loved one
• Share your observations about the changes you have noticed
• Be clear about your reasons for bringing up the topic of senior living
• Listen to your loved one’s concerns and answer their questions honestly
• Be patient and understanding. This may be a difficult decision for your loved one to make.

How to Find the Right Senior Living Community in Baltimore

Once you have started the conversation with your loved one, you can start looking for the right senior living community. Here are some things to consider when choosing a community:

• The level of care your loved one needs
• The size and location of the community
• The amenities and activities offered
• The cost of the community

It is important to visit several communities before making a decision. This will give you a chance to see the facilities, meet the staff, and talk to other residents.

Talk to a Senior Care Advisor

If you are still unsure whether a senior living community is right for your loved one, talk to a senior care advisor. We can help you assess your loved one’s needs and recommend the best senior living options for them. The earlier you can get started planning for senior care, the better the experience will be.

Whether you’re ready now or are just beginning to think about elderly care, CarePatrol of Baltimore can help! We begin with a comprehensive evaluation of your loved one’s needs and personal preferences. And we do more than hand you a list of communities—we curate recommendations, connect you with resources, and act as a true partner every step of the way.

Get Help from Your Local Baltimore Senior Living Expert

Making the decision to move a loved one into senior living is a big one, but it can be the best decision for all. By following these tips, you can make the transition easier and ensure that your loved one is getting the care they need. When you need an expert on your side to help you navigate your options and make the perfect decision for your loved one, contact CarePatrol of Baltimore!

Choose CarePatrol: Your Senior Living Consultant Serving Baltimore, MD

At CarePatrol of Baltimore, we’ve performed extensive research on hundreds of our area’s residential assisted living, memory care, retirement communities, and more. In fact, we have personally visited all of the communities to which we refer our clients. At no cost to you, our team is ready to help your family find the highest quality senior care option for your loved one. Get free senior care planning assistance today—call us at (410) 844-0800 or reach out online.

Follow Public Health Guidance
Travelers, especially those over 50, should be aware of travel alerts and possible health implications.² Always consult medical professionals if there are any concerns prior to traveling. Additionally, the CDC has a wealth of travel guidance, including frequently asked questions and tools for gauging COVID-19 risk by destination at cdc.gov/travel.³

Know the TSA Rules
The Transportation Security Administration (TSA) has important guidelines for those with disabilities or medical conditions. TSA usually allows those 75 or older to go through the security pre-check line, which means it’s not necessary to remove shoes or separate laptops or liquids from carry-ons. Other travelers under 75 can leverage the TSA Precheck or Global Entry program to avoid the lines. For domestic flights, use TSA Precheck and for international flights use Global Entry. Each program has a non-refundable application fee and requires travelers to apply for the program well in advance of travel. But if approved, the status lasts for five years.^1,4

Prevent Fall Hazards
It’s important to keep in mind the surroundings during travel in order to help prevent falls. Seniors are at higher risk of falls and higher risk of injury from falls. Seniors should wear the right shoes by finding a pair that won’t slip. Encourage an elderly traveler to use railings and grab bars to help them navigate. Request non-slip mats in the bathtub or shower. A gentle exercise that involves slow and graceful dance-like movements, such as walking or water workouts can reduce the risk of falls by improving strength, balance, coordination and flexibility⁵.

Pack Wisely
Once the  travel destination has been chosen, and lodging and transportation have been planned, strategize to pack key essentials, such as medications, sunscreen, toiletries, comfortable footwear and clothing. About 1-2 weeks prior to travel, take inventory of any medications needed during the trip and upon return. Have a backup plan. Be flexible and use it if something goes wrong. Pack additional medication in case of travel delays. Make sure to take a list of medications, doctors, and the location of a pharmacy covered by insurance (or Medicare) at the destination.⁶ If the medication is a liquid and requires syringes, pumps, freezer packs, or IV bags, the TSA will allow it to be carried on the plane. Before packing, check the TSA’s rules on how to pack medications appropriately.⁷ Always pack medications in carry-ons where they can be  accessed easily, and can’t be lost or delayed in transit.

Remember, packing light is key. The less there is to carry, the less there is to worry about and manage.  Seniors should pick a lightweight suitcase. Wheels, and a manageable size will help prevent strain or difficulty. The lightweight suitcase should be resilient and have secure locking systems, providing peace of mind⁸ See what The Green Voyage recommends for the 11 Best Lightweight Luggage For Seniors & Older Travelers (2023).

Stay Active and Hydrated
During the trip, encourage seniors to engage in light physical activities if they have the mobility, like walking and swimming, to counteract the long periods of sitting on a plane or automobile and to help maintain good health⁹. It is important for seniors (and everyone) to use their sunscreen¹⁰ for protection and keep water handy. According to the NIH, hydration is paramount, especially for seniors¹¹. Proper hydration can be troublesome any time of year but especially  in the hotter summer months. Know the surroundings, so that if water supplies run low, it is easy to identify where to quickly stock up. Take regular breaks. Enjoy the new surroundings, rest and relax throughout outings, and find appreciation at a slower pace.

Protect Skin from the Sun
The fatty layer below the skin gets thinner with age, allowing UV light to penetrate more deeply, causing more vulnerability to skin damage and ultimately increasing the risk of getting skin cancer. Skin cancer is one of the most preventable forms of cancer. Protect skin every day by following these handy guidelines:¹²

• Pay attention to the time. The sun’s UV rays are the strongest between 10am – 4pm. Try to schedule time outside in the early morning or afternoon. Otherwise, stay in the shade.
• Use the right sunscreen. Choose a sunscreen that is SPF 15 or higher. Look for “blocks UVA and UVB” or “broad spectrum” identified on the label.
• Use sunscreen correctly. Sunscreen should be applied 20 minutes before being in the sun and then reapplied every two hours. Be sure to reapply immediately after swimming or heavy sweating.
• Wear protective clothing. Wearing protective clothing like a wide-brimmed hat, a long-sleeved shirt, and long pants can protect against the sun’s harmful rays. Wear clothing specially designed to filter UV rays. UV-filtering sunglasses are equally important¹³.

Taking the time to plan ahead can ensure a relaxing and enjoyable time for the whole family. Enjoy!

References:
^{1, 2, 4, 6, 7}National Council on Aging, NCAO https://ncoa.org/article/safe-travel-tips-for-older-adults

³CDC https://wwwnc.cdc.gov/travel

^{4, 7}Transportation Security Administration https://www.tsa.gov/precheck

⁵Mayo Clinic https://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/fall-prevention/art-20047358

⁸The Green Voyage https://thegreenvoyage.com/best-lightweight-luggage-for-seniors/

⁹Optimal Senior Care Solutions https://optimalseniorcaresolutions.com/summer-travel-tips-for-seniors/?utm_source=rss&utm_medium=rss&utm_campaign=summer-travel-tips-for-seniors#:

¹⁰Skin Cancer Foundation https://www.skincancer.org/skin-cancer-prevention/sun-protection/sunscreen/

¹¹The National Heart, Lung, and Blood Institute, NIH https://www.nhlbi.nih.gov/news/2023/good-hydration-linked-longevity#:~:text=Adults%20who%20stay%20well-hydrated%20appear%20to%20be%20healthier%2C,National%20Institutes%20of%20Health%20study%20published%20in%20eBioMedicine

^{12, 13}Cigna Healthcare https://www.cigna.com/knowledge-center/uv-safety#:~:text=What%20are%20some%20UV%20safety%20tips%20for%20older,two%20hours.%20…%204%20Wear%20protective%20clothing.%20

Memory care is specialized care designed to enhance the lives of people with dementia. In Baltimore, these programs may be offered in continuous care retirement communities, assisted living communities, or residential assisted living communities. Whether you’re just starting your search or have been researching for a while, this guide will help you make an informed decision that will give you peace of mind and ensure your loved one receives the care they need.

Staffing and Training

One of the most important factors to consider in your search is the people who will care for your loved one. After all, these caregivers will shape the quality and safety of your loved one’s days. The more you know about the staff, the better equipped you’ll be to make a decision.

• Staffing ratios: Ask each community about its staff-to-resident ratio. The lower this number, the more attention a caregiver can give your loved one. A ratio of about 1:8 is average for the best memory care communities.
• Specialized training for dementia care: Caregivers should be trained in how to manage challenging behaviors, promote well-being, and engage people with dementia in meaningful activities for their cognitive health.
• Experience and qualifications of staff: In Maryland, seniors with dementia are generally required to enroll in programs with Level 3 licensing. Both the community itself and the individual staff members should provide their qualifications when asked.

Safety and Security

Everyone wants to know that their loved one is safe and protected where they live. Because seniors with dementia often experience confusion, changes in vision and depth perception, and mobility issues, they may be particularly vulnerable to falls and wandering behaviors.

• Safety measures for wandering and falls: Check for features like gated outdoor areas, keypad-coded entrances, and other monitoring technologies.
• Emergency protocols and response times: Make sure the community has 24/7 staff coverage as well as emergency buttons or call systems in each room. Ask about the average response time to an emergency situation.
• Accessibility and mobility features: Walkways should be clear, and it should be easy to navigate between rooms and common areas. Bathrooms should be equipped with grab bars and other non-slip, non-trip features.

Activities and Programs

Research shows that familiar pastimes, emotionally meaningful experiences, and predictable routines can reduce depression and behavioral issues in people with dementia. Take time to explore each community’s offerings and care philosophy!

• Cognitive and physical activities: Seniors should have the opportunity to participate in a range of activities that are both meaningful to them and focused on their well-being.
• Social events and community involvement: Loneliness is a risk factor for dementia, and can aggravate cognitive decline. Healthy social engagement should be part of any memory care program.
• Individualized care plans: If a person was never interested in cooking, then a cooking class won’t be especially meaningful for them. Ask the community how they personalize activity plans for seniors based on their interests, preferences, and abilities.

Environment and Amenities

Touring a community is incredibly important, as it allows you to get a firsthand look at the environment. Use your senses while you tour a community, and make sure to explore as many amenities as you can.

• Cleanliness and upkeep of facilities: Take into account your immediate experience of the environment (its smell and appearance) and ask questions about health and safety protocols.
• Private vs. shared spaces: Some memory care programs are part of larger assisted living facilities, while others are standalone memory care facilities. Residential assisted living facilities may have both private and shared rooms. Make sure you understand the community’s layout, level of occupancy, shared amenities, and more.
• Amenities such as outdoor spaces and therapy rooms: Every memory care community is unique! Ask what special amenities are available at each location.

Communication and Family Involvement

The best dementia care involves families, operating with full transparency and an inviting atmosphere. If you get a feeling that the administration isn’t forthcoming or is trying to rush through your interview, that should be a concern.

• Communication with family members: Ask how often you’ll hear from the care team and what channels of communication are available.
• Family involvement in care plans and decision-making: Make sure you’ll have a say in the important things. Ask how often you’ll be asked for feedback and invited to collaborate.
• Support for families of residents with dementia: Ask if the community has any resources to help you and your family cope, connect, and find comfort.

Get Help from a Senior Living Advisor in Baltimore

CarePatrol has vetted Baltimore’s memory care communities, compiling in-depth reports on the safety, security, activities, and amenities of each. When you partner with us, you’ll receive a curated list of communities that best fit your loved one’s needs and preferences. We’ll then help you set up tours, accompany you on most visits, and be there to guide you as you make your decision. Best of all, we provide these services at no cost to you!

If you’re not quite sure whether or not you’re ready to start the process, take our quick assessment to find out what level of care your loved one needs. We’ll be here to help whenever you need us!

CarePatrol: Find High-Quality Memory Care in Baltimore County

The team at CarePatrol of Baltimore is committed to finding the best senior living option for your loved one. We’ve evaluated over 400 communities in the area, and have the tools and expertise to help you narrow down your search. Let us take the stress out of finding quality care. Call us today at (410) 844-0800 or reach out online to speak to a senior care advisor today!

The good news is there are many resources available to help families manage this phase of life. From books to consultants to tried and true best practices, the information below will help get you and your family started on a peaceful path in supporting aging parents.

Our population is tipping into their senior years faster than ever before. Baby Boomers, the second largest generation, born between 1946-1964, are rapidly flooding society with senior citizens. The older Boomers are well into their 70s today and all of the youngest Boomers will have reached the age of 65 by 2030. This aging of America elevates the need for caregiving of aging individuals like never before (U.S. Census Bureau, 2022).

Here is where the trouble begins. Folks fortunate enough to have multiple offspring with concerned opinions on their wellbeing may be surprised to find themselves the center of what can end up as heated debates or full-on family feuds. Childhood rivalries and resentments are reborn in the context of caring for mom and dad. The emotions are real, the opinions are strong, and the viewpoints are varied. How are well-intentioned but stubborn family members supposed to come to an agreement on things as important as where will mom live? Who will be the primary caregiver now that dad has dementia? When is the right time to provide assisted living arrangements?

When a family discussion veers off track and emotions are elevated, take a moment to remember why you are there, for the best care of the parent(s). Recognize old emotions or resentments for what they are, old, and move past them. Strive to view each other as the adults you have become. With a fresh approach, focus on each other’s strengths and capabilities.

Have a meeting and make a plan. A family meeting should involve any medical assessments on the parent(s) to clearly identify physical or cognitive limitations and the progression of any health issues. This step will help identify necessary accommodations and support and allow for future planning.  If an agreement is not readily available on who will do what or strong differing opinions exist concerning the overall plan, consider leveraging an outside expert like CarePatrol.

Bringing in an outside mediator ensures the focus stays on Mom and Dad. This person could be a social worker, a family counselor or someone trusted outside of the immediate family such as a member of the church or a close friend or neighbor.

Even more definitive are advance directives and power of attorney documents. These are valuable tools to help guide families in decision-making. Ideally, these are prepared before there is a need and the family can reference the documents to guide care decisions as pre-defined by the parent.  We gave a good overview of these documents in a recent blog post.  Having these documents removes some of the decision-making and ensures access to important accounts and information such as health care decision making, and financial accounts should a parent become disabled.

Communication is key, for all parties. Never assume someone is “fine” with how things are going. Check-in frequently! If you are the one doing the most caregiving, ask for the help you need. If you want to be more involved, offer tangible ways you can be supportive. Bills need to be paid, laundry and grocery shopping need to be done, social and emotional support is required, and medical appointments and coordination must be managed.  There’s more than enough to do and one person can’t be expected to shoulder it all.

When necessary, use outside support! Everything from meal delivery, grocery delivery, cleaning support, transportation, virtual health visits, and even social interactions can be outsourced! Many services exist through community-based senior centers. Modern services like Uber or Lyft, GrubHub, restaurant delivery services, and meal preparation and delivery can be used to give caregivers a break. Some seniors will qualify for programs like Meals on Wheels.

Take advantage of available technology. Apps like SignUpGenius or CaringBridge help organize support including meals or visits. Apps exist for medication management and reminders, and virtual family visits. Many helpful technologies exist for aging well and keeping family members on the same page. Here is a recent blog that highlights solutions that may be useful for families caring for seniors.

Additionally, in-home care, or assisted living facilities can take on most if not all of the day-to-day care provision. Utilize extended networks of friends and family to check in on seniors as well as caregivers to make sure everyone is staying well and staying connected. Remember to consider the best options for the parent across care, emotional support, health, and financial management, and build a plan that works for you and your family, together.

Books:

The ElderCare Ready Book by Start Furman, Esq.

Retooling for an Aging America 

They’re Your Parents, Too! How Siblings Can Survive Their Parents’ Aging Without Driving Each Other Crazy by Dr. Francine Russo

Organizations:

Adult Children of Aging Parents 

info@ACAPcommunity.org
Toll-free 1-877-599-ACAP (1-877-599-2227)

Family Caregiver Alliance
National Center on Caregiving
(415) 434-3388 | (800) 445-8106
Website: www.caregiver.org
E-mail: info@caregiver.org
FCA CareNav: https://fca.cacrc.org/login

Resources:

Caregiving with Your Siblings – Family Caregiver Alliance. (2014).

PBS NewsHour. (2014, November 28). A sibling’s guide to caring for aging parents.

U.S. Census Bureau. (2022, February 25). 2020 Census Will Help Policymakers Prepare for the Incoming Wave of Aging Boomers. Census.gov.

The first step of medication management is talking to your parent’s doctor. Bring them a complete list of all the medications they are taking and ask them about their effectiveness. Many medications are prescribed by specialists, without oversight from a primary physician, and could react negatively when combined. Also ask what each are for, and if they are absolutely necessary. Overprescribing is also a common in health care.

If your loved one is struggling to take the right dosages, explain the situation to the doctor and ask if there is a better system. Can they take them all at once to make it simpler? Or is there another brand that can be taken less often?

For many seniors, the struggle to remain organized with medications is an everyday problem. You’ve probably seen the infamous plastic pill boxes many seniors use. These boxes are a good idea but often fall short for people who are easily confused. Many pill boxes aren’t clearly labeled, and its’ still easy to forget if you’ve already taken a dosage.

One option for effectively managing medications is creating a medication routine. If the pills need to be taken three times a day, suggest your dad take one with breakfast, lunch and dinner. Combining habits is a helpful way to remember. Make sure to check with their doctor first.

You can also do something as simple as marking it on a calendar or logging it on a mobile app. There are also alarms on phones, computers and watches that indicate when it’s time to take medicine. Some apps and watches feature helpful information, including the name of the drug, the amount to take, and the doctor’s name for questions. These may not be good fit for someone who struggles with technology or is frightened by beeping or loud sounds. If it leads to more stress, it’s not a good solution.

One of the more helpful and affordable solutions is asking for medication blister packs. Talk to your pharmacist about the situation and request that your mom’s weekly medicines be sealed in blister packs. You have probably seen these before; they are the metallic-looking packs that antibiotics arrive in. Caregivers can also purchase blister pack kits to sort and pack themselves. The labels are usually clearer, and the empty space of a taken dose is an effective visual it’s already been completed.

If your loved one is still struggling with the usual options, it’s time to get more help. After all, their safety is the goal. A medication reminder service may be a good option for you. MyMedChecks is a program of the senior housing referral company CarePatrol and offers a free 30-day trial. You don’t need to use a credit card to sign up. After the trial, continued use of one call per day costs $19.95 per month. Two calls costs $29.95 per month, and three calls per day costs $39.95 per month. For more information, visit http://mymedchecks.com.

This information is provided by CarePatrol of Baltimore, a senior housing placement agency that serves the Baltimore city and county areas. If you or your loved one need to find a new home, consider talking to a CarePatrol housing placement specialist. They will sit down with you, assess your needs and financial situation, and offer the best options they can find. They are also available for tours and guidance during your final search. You can contact a specialist at (410) 844-0800, CarePatrolBaltimore@CarePatrol.com or www.carepatrolbaltimore.com. You can also find them on Facebook at www.facebook.com/CarePatrolBaltimore.

Sadly, 5 million people over the age of 60 experience abuse every year. Roughly 1 in 10 senior adults. Worse, 93% of elder abuse goes unreported.¹ If you are in contact with a senior, be mindful of the indicators of abuse. We all have a role to play to protect vulnerable adults.

Any strange or sudden changes to an older adult’s behavior is a warning sign. Changes in a senior’s mental state, physical appearance or capability, or unusual financial changes are worth investigating. If you uncover abuse, take immediate action.

Elders often fall prey to mail solicitations and fundraising efforts. While not necessarily illegal, it’s not unusual to find out that your family member has been sending out hundreds of dollars a month in charitable donations or magazine orders. Other types of money “lending” may trip into an abusive situation.

Neglect can take the form of dehydration or missed medications. Poor nutrition or skipped meals, leading to weight loss or health problems is also problematic. These situations, if caught early, can help an elder from further spiraling into anxiety or depression because of the abuse.

In the state of Maryland, it is required to report suspected abuse to the office of social services (DSS) or by calling 1-800-332-6347 ². Much like laws protecting children, our vulnerable adults need protection through legal recourse as well. Professionals such as the police, medical providers, and human service workers must report suspected abuse. Abuse can come from many sources, it’s not always a care provider, or a family member causing the abuse, and the abuser may not be aware that what they are doing constitutes abuse, especially in the area around neglect.

Fortunately, good tools have been developed to help families and friends identify signs and symptoms of elder abuse.

Use this checklist “Suspect Neglect of an Older Adult: What to do?” from the NCEA​ and the National Adult Protective Services Association (NAPSA).³

Indicators of elder abuse:

1. Emotional & Behavioral Signs
   • ​Increased fear or anxiety
   • Isolation from friends and family
   • Unusual changes in behavior or sleep
   • Withdrawal from normal activities
2. ​​Physical Signs
   • ​​Dehydration or unusual weight loss
   • Unattended medical needs
   • Unexplained injuries, bruises, cuts, or sores
   • Unsanitary living conditions, poor hygiene, or torn or bloody underclothing
3. ​Financial Signs
   • ​​Fraudulent signatures on financial documents
   • Unusual or sudden changes in spending patterns, will, or other financial documents
   • Unpaid bills

In addition to staying observant, there are other things individuals and families can do to prevent abuse from occurring. Here are five core recommendations from Maryland Department of Aging: ⁴

• Listen to older people and caregivers to understand their challenges and provide support
• Educate one another about the signs of abuse and how to get help
• Report suspected abuse or neglect as soon as possible
• Build a community that fosters social connections and supports
• Reach out to professional services for support where available

So, while we may think our favorite people are cared for and secure, there are many ways for them to suffer or be exposed to abuse. Stay mindful. Helping to build a community of social connections and support is something we can all do.

Resources and References:

1. Maryland.Gov https://aging.maryland.gov/Pages/elder-abuse-prevention.aspx

Adult Protective Services
2. https://dhs.maryland.gov/office-of-adult-services/adult-protective-services/

3. NCEA: “Suspect Neglect of an Older Adult: What to do? https://ncea.acl.gov/NCEA/media/Publication-4.0/NCEA_NAPSA_CGchecklist.pdf

National Adult Protective Services Association (NAPSA):  https://www.napsa-now.org/

4. Maryland Department of Aging https://aging.maryland.gov/Pages/elder-abuse-prevention.aspx

The result of the aging Baby Boomer generation combined with advances in medicine that are allowing people to live longer lives, is slated to impact everything from healthcare to the housing market. This rolling influx of seniors, known as the “Silver Tsunami”, may be seen as a boon for some industries, but equally raises the alarm for others.

More people with multiple chronic conditions like diabetes, and heart disease, or asthma and gastrointestinal disorders, mean more doctor visits, more medications, and higher levels of required care. Add to these chronic conditions the increased levels of Alzheimer’s disease and other dementias that accumulate with age, and it is apparent that the nation is going to be in a complex and demanding period where heavy resources are needed to meet the health needs of our aging population. The generations following the Boomer generation have fewer people, affecting availability of both family care and professionals providing care.

Managing high levels of need with fewer individuals available to provide care is already changing how we do things. We’ve gotten better at disease management in certain conditions such as diabetes, and high blood pressure. And by leveraging the use of new technologies such as monitoring devices and tracking apps, and adding telemedicine visits into follow up care, patients may live with more independence whether they are at home or in a care community. By placing emphasis on prevention through healthy lifestyles we can mitigate some of the multi chronic disease problem since so much of it is driven by healthier behaviors. This will help to meet some of the challenges presented by an aging population. Reduce care demands by reducing disease and allow people to live more healthily not just longer.

There is a lot of funding and research going into things like Alzheimer’s treatments and prevention, new adaptive technologies that support seniors, and new medications and vaccinations that may one day eliminate entire diseases.  These are good things. But as 40 million more people are aging into Medicare, hopefully aging well, we will still see pivots in how society works to meet their needs and desires. ¹

Think downsizing. As this wave of seniors retires, and contemplates downsizing, the market expects an increased demand for senior living community, multi-generational housing (apartments and condos), and assisted living communities. Research shows this generation prefers urban living with access to travel and community-based activities such as parks and libraries, cultural attractions and shopping and dining options. They also prefer communities with lots of amenities! ²

As technologies advance from on body wearables to in home sensors and connected devices that can do things like collect data on weight, walking gait to detect certain orthopedic problems, and medication adherence, or even order groceries when the refrigerator determines it is low on a staple, we will be able to assist seniors in their daily living needs. Whether they choose to and are able to age at home or choose a community.  However, there are many ways these coming advances in smart homes will still fail to meet the needs of individuals with more limiting health concerns. “They can’t replicate the kind of oversight that a nursing facility offers,” says writer Ruth Reader in Fast Company. She goes on to say that for aging in place to be a viable solution in the U.S., nursing care at home needs to be affordable and accessible and that’s just not the case currently. ³

We will continue to see more options come online as the Boomer generation ages over the next 3 decades. Innovation such as robots providing care (an initiative being tested out in Japan),  and more integrated facilities such as nursing homes or senior facilities built out with assistive technologies incorporated right from the design phase will continue to provide solutions to living well as we age. Another trend prediction is for “home as a service” or said another way an “ageless home” according to Joseph Coughlin, director of the Massachusetts Institute of Technology AgeLab. Meaning the innovations coming along will be wanted by everyone. ³

As we enter this age of “age”, we will certainly see breakthroughs in health care solutions and treatments, and advancements in assistive technologies. But the number of aging seniors is so utterly significant that it is an all-hands-on deck situation. We will need the support of all care givers, all educators, all planners, and all senior living communities to manage the coming wave of care. When you or a loved one finds yourself in need of something a little more sophisticated than a Roomba and a smart refrigerator, please reach out to us. We have decades of experience finding the right care for seniors.

References:

1. Rx The Quiet Revolution, What the ‘Silver Tsunami’ Means for U.S. Health Care: An Interview with Thomas Gill of the Yale Center on Aging https://rxfilm.org/problems/silver-tsunami-united-states-healthcare-thomas-gill-yale-center-on-aging-interview/ 
2. Leon, Joe. THE SILVER TSUNAMI AND CRE: WHAT YOU NEED TO KNOW. 10/17 2021 https://voitco.com/the-silver-tsunami-and-cre/ 
3. Reader, Ruth. ‘The silver tsunami is coming’: Inside the quest to help seniors age at home 4/29/21 ‘The silver tsunami is coming’: Inside the quest to help seniors age a (fastcompany.com)
4. Geber, Sarah Zeff .  The New Silver Tsunami, 11/2020 The New Silver Tsunami (forbes.com)

A Johns Hopkins Medicine lead research study identified four primary behaviors that contribute to a significant reduction in death from all causes over the research period by an astonishing 80%! (Smith, Johns Hopkins Center for Behavior and Health). In order – the biggest impact drivers to living a long and healthy life are: 1.) Do Not Smoke 2.) Maintain a healthy weight 3.) Move your body (30 minutes a day) 4.) Make healthy food choices. 1

All of these are within our control. It is ok to start with baby steps, just get moving in the right direction. Smoking is clearly the most detrimental behavior to overall health. Affecting coronary arteries, lungs, and increasing the risk of cancer and stroke – smoking is the number one bad habit to give up. 2

There are many articles out there on good habits that help you live longer, everything from drinking coffee or tea (for the antioxidants), getting good sleep, meditating (mindfulness), and eating a Mediterranean diet. Equally important for longevity is a good social network for emotional health and the connective layer it provides to better overall health. 3

People who have strong social connections are more likely to follow up on annual physicals, take medications as prescribed, and have higher levels of happiness than those who don’t have a good network. Social networks are important in health recovery as a part of disease management or recovery from surgical procedures and research has shown that individuals with a strong social network are more likely to adhere to their medications and recovery programs. Social networks also step in to provide support for smoking abstinence or cessation, moderation in alcohol consumption, and other healthy behaviors. 4

Interestingly, even before COVID’s impact, the U.S. has been experiencing declining longevity rates as compared to similar countries, specifically skewed to lower social-economic groups. Factors such as holding a college degree, higher levels of income, and your zip code (access to healthcare, support networks, and an indicator of socioeconomic status) are impact areas for building longevity. Higher economic groups are experiencing higher longevity rates, while lower economic groups are experiencing declining rates.  So, while socio-economic indicators are connected to longevity, it is the behaviors themselves that are driving it. 4

Communities will benefit as they are able to reach out and lift the overall availability and access to care and raise the health literacy levels of the whole community so that the leading good habits may be embraced by every economic level. The burden of chronic disease in the US is a heavy one, with 90% of the country’s 3.8 trillion-dollar annual health care total being driven by people with chronic disease and mental health conditions. 5 As one famous well-wisher put it “live long and prosper,” however it is more aptly put “prosper and live long.”

At any age, and at any level of health, taking the initiative to work on the four key factors of not smoking, maintaining a healthy weight, moving your body daily, and eating a healthy diet will add years to your life. Additionally, people who practice these good habits tend to feel better and enjoy a more mobile and active life with a reduced burden of disease and other health-related problems. Longevity is within everyone’s reach! And today’s modern technologies are making it easier to stay connected, stay on target and manage health in new and meaningful ways.

1. https://www.hopkinsmedicine.org/health/wellness-and-prevention/4-top-ways-to-live-longer
2. Johns Hopkins Health – Transform Your Life in Four Simple Steps (hopkinsmedicine.org)  

&. https://www.hopkinsmedicine.org/health/wellness-and-prevention/its-never-too-late-five-healthy-steps-at-any-age 

3. https://www.kingsfund.org.uk/projects/improving-publics-health/strong-communities-wellbeing-and-resilience
4. https://jamanetwork.com/journals/jama/article-abstract/2776338
5. Chronic Diseases Are Main US Public Health Concern (medscape.com)

COMAR, is the official compilation of all administrative regulations issued by agencies of the state of Maryland. The COMAR regulations are reviewed and updated frequently. The following regulations apply to all assisted living and memory care communities and are the key points to look for when evaluating facilities:

1. Licensure requirements and procedures. Make sure the facility is licensed in the state of Maryland, by the Office of Healthcare Quality.
2. Uniform disclosure statement. A document that explains exactly the amenities and care abilities of the community. Review this – it includes the details about what services the facility can provide, what care ability they are authorized to perform (i.e., lifting, sliding scale insulin, catheter).
3. Quality assurance program. All RALs need to have this in place. It is a requirement for assisted living communities to have a quality assurance program, including how to use incident reports for accidents such as falls.
4. A staffing plan and defined rules. All RALs need to have their plan documented, i.e., for when an awake caregiver is needed at night, or having a care provider on premise 24/7. For example, dementia patients require awake care 24/7.
5. Requirements for staff training. Trainings such as CPR, medication management, and dementia training are critical for competent staff and compliance.
6. A delegating nurse. Every RAL must have a registered nurse staff member who will complete a resident assessment upon admission and at least every 45 days for each resident or when a resident’s condition changes, such as in declining health, running a temperature, or developing a new cough.
7. A preadmission requirement. RALs in Maryland must require a few things of each new resident prior to move in: A physician pre-check/Doctors orders called Healthcare Care Practitioner Assessment Form, an advanced directive in the Maryland form (MOLST), a TB test, AND NOW A COVID Vaccine or negative covid test.
8. Clients plan of care guidance.  Every resident must have a specific plan of care, which the caregivers must follow. An example of a “plan of care” is what kind of diet is medically needed or the need for oxygen and how often.
9. Meal standards. Each RAL must meet requirements for meals that are balanced & nutritional and planned in advance. The plan must be posted for the whole month, and must include protein, fruit, and vegetables. The Maryland Office of Healthcare Quality will audit the facility for this requirement.
10. Medication management. Medications must be managed and given to residents by a licensed medication technician. In most cases the residents medical list must be reviewed quarterly by a pharmacist.
11. Resident record requirements. There must be established protocols on how the facility must chart the health needs for each resident. Each resident has a health record or log which is stored in a locked cabinet.
12. Resident rights documentation. COMAR requires each RAL to post necessary documentation about resident rights. These rights include the right to be treated with respect, dignity, consideration, and full recognition of a resident’s human dignity and individuality.
13. Smoking rules must be posted. Smoking is only allowed outside in a designated area.
14. Bathroom minimums. Each RAL must have one bathroom per every 4 residents.
15. Posted Emergency Plans. Facilities must have a posted emergency preparedness plan and additional safety measures in place. For example, they are required to have accessible fire extinguishers, and smoke alarms.
16. Residential agreements. All residents must be provided for signature a residential agreement.

Maryland COMAR rules apply to all RAL communities, from those that are large and have 200 residents to communities that are small and have only 3 residents. The above regulations are those most relevant to consider when evaluating a residential facility. They provide a clear picture of the type of care, official safety measures in place, and establish clear guidelines for consistency and professionalism. The goal of the COMAR regulations is to keep residents healthy, happy, and well cared for.  CarePatrol will have this information for you and make this process very easy for you to chose a RAL.