Category Archives: caregiving

Don’t Wait for a Crisis: Ways to Create an Aging Plan Now

It’s easy to put off planning for a parent or loved one’s care when that person is still healthy and able to care for themselves. Rather than wait for a crisis to strike, take time to plan for how you can maintain your loved one’s  safety and quality of life. Here are five strategies to keep status quo. 

When An Aging Parent is Fine…Strategies to Maintain Status Quo

by Miriam Zucker, LMSW, ACSW, C-ASWCM – Member of the Aging Life Care Association®

As an Aging Life Care Specialist™, I’m often contacted by family members asking for reassurance that they are not overlooking a need of an aging loved one. Because these are not emergency or crisis calls, these meetings give me an opportunity to discuss current care and future planning.

During a thorough assessment, I evaluate a broad array of areas including medical history, cognitive function, financial status, familial and community supports, as well as status of critical health and legal documents. When these questions don’t raise any red flags, I find myself having to reassure the family that they fortunate. But, at the same time, like a good scout – be prepared and practice prevention.

So just what is it I am telling families? It’s something like car maintenance. No squeaking brakes, or dashboard lights on, but you still bring your car in for maintenance. Some older adults, if you excuse the analogy, are just like that. Blessed with good health – realistic and accepting of their needs – they can remain safely in their homes.

To maintain status quo, Aging Life Care Specialists suggest five strategies:

1. A medic alert pendant or bracelet. Look for a system that has a fall alert built into its sensor. Unlike the commercials, there is no need to dial the phone, the sensor picks up on the fall and calls the designated numbers immediately.

2. Maintain a current list of all medications (and know where to find the list).

3. A notation of any food, medication, or latex allergies .

4. Prominently display a Community DNR (this is different than a hospital DNR).

5. A daily check-in call. Such calls allow for an adult child (or designated caller) to pick up on the slightest of changes in a parent’s cognitive status. Infections in older adults travel at lightning speed with altered mental status as one of the hallmarks that something is wrong. Urinary tract infections are notorious for causing this altered status.

One particular service that facilitates much of the above is Vial of Life . The Vial of Life program helps individuals compile their complete medical information and have it ready in their home for emergency personnel to reference.

These small but essential steps go a long way in helping an aging adult maintain his/her independence while at the same time living safely in their beloved home. Don’t wait for an emergency to seek the help of an Aging Life Care Specialist. Connect with one now to start the assessment process and build a maintenance plan that maximizes quality of life for everyone. Search for an expert at

About the author: Miriam Zucker, LMSW, ACSW, C-ASWCM, is an Aging Life Care Specialist practicing in Westchester County, New York. A social worker by training, she also serves on the faculty of The Brookdale Center for Healthy Aging and Longevity where she helped found the Certificate Program in Geriatric Care Management.

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

How Do You Know It’s Dementia When Dad Can Still Do the Crossword?

The onset of early dementia is not always obvious. Especially when your loved one is smart and can compensate for memory loss, or is clever and determined to hide symptoms, it can be difficult to know whether what seems “off” is really so.

Maybe your dad has always been a dapper dresser, and you notice him wearing a stained shirt on more than one occasion. When you mention it, he shrugs it off and says he’s having his eyes checked next month (despite the fact that he has no trouble surfing the Internet on his smartphone).

Or your mom, ever the vigilant money manager, who always paid bills ahead of time, has some unopened, month-old invoices on her desk. You point them out, and she laughs and informs you she’s now paying online (even though she’s always mistrusted online fund transfers).

Or perhaps your great aunt, the most punctual person you have ever known, comes late to a luncheon date without calling. Once she reassures you that she’s fine, she explains that she misplaced her car keys and also missed the turn for the restaurant (where you always meet).

How Have Things Changed?

For all three scenarios, the explanations may seem logical, possibly true. But if the incidents repeat often enough to indicate a pattern of unusual behavior, it’s time to be more vigilant about the real chance that something more serious is at play.

At the crux of the issue is determining how your loved one’s behavior has changed relative to what has been normal for that individual. For someone who is smart and able, the changes may be subtle. And even if there are notable changes, he or she may be able to compensate creatively and still be able to do the New York Times crossword. Then the question becomes how much loss of ability is too much.

For example:

Can he still manage his own medications? Warning signs include a pill minder box with lids open out of order, pills not taken that should have been, or empty pill bottles that have not been refilled.

Does she leave bills unpaid or stacks of mail unopened? Especially for someone who was once very organized, increased clutter can be a warning flag. Missed payments, tax returns that were never filed, a bank account that hasn’t been balanced in months—all add up to a decline in cognitive functioning.

Is he at risk driving? Aside from slower reflexes, declining sight and increased fatigue—all good reasons to have driving skills evaluated—your loved one may evidence poor judgment, confusion or forgetfulness, all of which could endanger his safety and others on the road.

Has her appearance changed? Again, the standard of comparison is how your loved one normally presented herself to the world. If she always wore meticulously applied make-up, had every hair in place and dressed impeccably, and now seems less attuned to her appearance, she may have decided that she doesn’t want to bother with it all anymore. But she may also be less aware.

What’s at Stake for You?

Recognizing that your loved one is declining brings challenges beyond mere observation. There is a significant emotional hurdle to overcome: recognizing that your aging parent is vulnerable, admitting to yourself that his or her time on earth is limited, accepting that the status quo no longer works. You may have a lot of other demands on your time, and the idea of taking this on can seem overwhelming.

It can also be extremely difficult to confront your loved one with your observations, depending on the history of your relationship. A parent who has always maintained the upper hand, who insists on control, or who is belligerent and critical when challenged can be a nightmare to deal with.

For all of these reasons, if you suspect that your loved one is showing signs of dementia that could put her at risk, consider having an Aging LifeCare Professional® conduct an independent assessment. This information can provide the basis for informed—and mediated, if necessary—discussions with your loved one about next steps. And you may be surprised that you’re not the only one who is relieved to finally address the issue. Your loved one—whether or not she admits it—may be, too.

About the author: President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care® manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Be Prepared: Making a Plan for Winter Weather

2017 has been the year of severe weather , and this winter may bring with it snow, freezing temperatures, ice,  or heavy rains. All of this greatly impacts the safety and well-being of the elderly, especially when weather events strike unexpectedly or with speed. Here are some tips from the experts in aging well to help aging adults get ready for winter weather.

Before a Storm
  • Stay informed and sign up for severe weather alerts through your local city or state resource
  • Refill prescriptions and have an extra supply of other medical necessities
  • Buy extra food, including non-perishables, and bottled water (and don’t forget pet food or supplies if needed)
  • Keep vehicles filled with gas and have tires checked for safety
  • Clear debris from downspouts and gutters
  • Have trees inspected and remove any dead limbs
  • Have evacuation routes planned with identified medical centers
  • Identify an individual or company to shovel snow from driveways, stairs
  • Make sure outside furnace vents are clear and carbon monoxide alarms are working
  • Inspect outside plumbing, insulating any exposed pipes
Prepare for Power Outages
  • If using oxygen, bi-pap, c-pap or other equipment, you will need a generator
  • Purchase battery operated, plug-in lights that automatically turn on when the power goes out
  • Make sure you have working flashlights within reach and extra batteries
  • Keep cell phones charging so you have a full charge at power loss
Plan for Caregivers
  • If you rely on caregivers, consider the following:
  • Arrange for a live-in caregiver
  • Build a relationship with neighbors that may be able to temporarily fill-in
  • Plan temporary or respite stay with a nursing home, assisted living community, or hospice
  • Keep areas around space heaters clear
  • Use space heaters with automatic shut-off
  • Gas stoves or ovens should never be used as a heating source
  • Do not attempt to climb ladders
  • Do not walk on frozen stairs, sidewalks, or driveways

For more winter weather tips and planning, visit the public safety website of Massachusetts – a state very familiar with severe winter weather.

With knowledge of local resources, An Aging Life Care Professional® can  build an emergency weather plan for your aging loved one. Find one to consult at

Moving to a Nursing Home: Making the Right Choice for Your Family

Moving to a long-term care facility or nursing home can be a shock to an individual and to the family. And you’ve probably figured out how expensive it is. With questions ranging from cost to quality of care to food choices, you may feel overwhelmed or trapped. An Aging Life Care Professional™ can help you navigate the nursing home maze and be an extra set of eyes and ears.

Aging Life Care Professionals Know the Ins and Outs of Nursing Home Care

By Suzanne Modigliani, LICSW, CMC – Aging Life Care Association™ Member and
Fellow of the Leadership Academy


 Why Nursing Home Care

There are many reasons someone may be living in a nursing home. After a hospitalization, your loved one may have been placed in rehabilitation; and during that rehab stay, it may have become clear the person can no longer live alone. If finances preclude in-home care, nursing home care can be covered by Medicaid if the individual is clinically and financially eligible. Or if the individual’s needs are so complex that the care of a registered nurse on a regular basis, a nursing home is a practical solution.

Paying for Nursing Home Care

All of a sudden you are told your loved one’s time in rehab is up and that he/she must go home or move to long-term care.  While the rehabilitation stay may have been covered by Medicare, the transition to a long-term care can be confusing. You probably have figured out how expensive nursing home care is. Medicaid will pay for long-term care if the individual meets specific eligibility requirements. There are very specific rules, some depending on if there is still a spouse in the community, as well as others regarding how much money the elder can have spent for certain things. If you are confused or unsure about the Medicaid application process, reach out for professional assistance from an Aging Life Care Professional or even an Elder Law Attorney.

Choosing a Nursing Home

Which nursing home is best for your loved one? A great place to begin your research is with Medicare’s Nursing Home Compare website. Nursing Home Compare allows consumers to compare information based on yearly surveys conducted in person by the Department of Public Health. The website contains quality of care information on every Medicare and Medicaid-certified nursing home in the country – more than 15,000 nationwide.

For information beyond the survey, a local Aging Life Care Professional can offer up-to-date information and insider knowledge based on current or previous experiences with clients at particular facilities. Nursing home staff frequently turn over, so this personal, insider view is invaluable. Aging Life Care Professionals will know the little things like whether all those activities on the calendar actually happen.

Navigating the Maze

An Aging Life Care Professional can be your guide to all things nursing home. Whether you live in the same town or across the country, an Aging Life Care Professional can be your eyes and ears. These experts can also help you answer all of the questions that may be racing through your head, or that may come up along the way such as:

  • Does my relative get to choose a roommate?
  • Can she still have her favorite foods?
  • Who is my contact person at the facility?
  • Who do I tell that my mother never wears her hair that way, or that red lipstick makes her day?
  • Who is responsible for laundry and should clothes be labeled?
  • What if the roommate keeps the TV blasting late into the night?

Though nurses are on staff, the bulk of the care is provided by certified nursing assistants (CNA) who are taking care of a number of people on a daily basis. Forming a bond with the regular CNAs that assist your loved one will help you get timely information and also go a long way towards making sure your loved one is getting the care you hope for.

Nursing homes are required to have quarterly care plan meetings to establish exactly what they are doing for a resident. There need to be goals with progress towards those goals reviewed. Having an advocate attend with you – or in your place – can be invaluable. If the Aging Life Care Professional knew your relative before placement in long-term care, they may have important history to share with the facility staff.

With experience working in and with nursing homes, Aging Life Care Professionals are great partners to work successfully with nursing home staff. Find a local Aging Life Care Expert at

About the author: Suzanne Modigliani, LICSW, CMC is an Aging Life Care™ specialist in Brookline, MA who works with families to find solutions to complicated elder care problems. She has been a leader in the Aging Life Care Association and quoted extensively in the media as seen on her website

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Plan Ahead

Anyone who has been a caregiver for any length of time has learned that it is almost impossible to be prepared for everything that will come along.  Just when you begin to think you have things under control something new pops up unexpectedly with the person you’re caring for.  However, there are some tricks that can help to make these inevitable surprises a little less stressful.

One suggestion is to put together a packet of information that can be kept somewhere where it is easy to grab at a moment’s notice.  This way when a stressful situation arises there will be a few less things to have to remember.  While each person will want some specific things ready to go, here are some ideas of what should be included:

1. Health insurance information, including a copy of any cards.

2. A list of all the medications that they are taking, including names and doses.   This needs to include prescription medications, over-the-counter medications, vitamins, and supplements.

3. A list of medical problems, diagnoses and allergies.

4. Copies of legal documents such as a medical durable power of attorney or a living will.

5. Contact information for all health professionals who have been involved in their care.

This is not an exhaustive list but is a great place to start. Add to this any specific information that pertains to your loved ones condition and circumstances.

Dealing with Hearing loss

Hearing loss can often come on slowly, which makes it easy to miss. It is not uncommon for someone who has started having hearing difficulties to not realize it themselves.  Since often times hearing loss starts with a diminished ability to hear only certain sounds or voices, it is easy to believe that the problem is not with us, but with others. There are some signs that can be clues to hearing loss that we can watch for in others, as well as ourselves.  These can include:

· Always turning up TV or radio volume.

· Problems hearing on the telephone.

· Cupping hand to ear or leaning in close when talking with others

     Hearing loss can be exasperating for all those involved. It can lead to misunderstanding words or saying the wrong thing.  It is not uncommon for people with hearing loss to eventually give up struggling to listen, and those close to them may stop talking to them. Untreated hearing loss can cause isolation and depression. It can also hurt the emotional and physical health of those who are close, particularly a spouse.

     In age-related hearing loss, hair cells in the inner ear that carry sound waves to the brain become less sensitive over time. Sounds become distorted. Certain letters become hard to hear and hard to tell apart, (such as S, T, and P). High-pitched sounds, like a woman’s or a child’s voice, also become harder to hear.

     If you think that you or someone you are caring for might be developing some difficulties with hearing, you should start with a hearing test. Often there are treatable causes for hearing difficulty.  Hearing loss has sometimes even been mistaken for dementia.  A health care professional will be able to let you know the cause of the hearing loss and what the best options are.  While hearing aids won’t be able to restore normal hearing, more than 90% of people with hearing loss can benefit from hearing aids. Hearing aids work by amplifying the sounds that the person is having difficulty with.

     There is also an abundance of devices specifically created to help people with hearing loss.  Telephones, TVs, radios and other amplifying systems can make life much easier.