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Helping your parents stay out of the nursing home

Aging parents and their children sometimes disagree over the issues of safety versus independent living. Here are steps you can take to make your parents’ home safer.

By Karen Ravn, Special to the Los Angeles Times

February 6, 2012

 

 

Your parents say they couldn’t bear to lose their independence. Their hearts are set on staying in their own home for the rest of their days. And you understand. It’s what you’d like for them too. But they’re not as young as they used to be. Not as strong and on top of things. And you can’t help wondering if their plan is really wise, or even feasible. So you worry.

The question of what’s best for mom and/or dad is one that bedevils many children with aging parents, says Dr. David Reuben, chief of the geriatrics division in UCLA’s Department of Medicine. “One of the things older people want most is to stay in their own homes. But there’s always a tension between autonomy and safety. Children may want to err on the side of safety, but parents may want to err on the side of autonomy.”

Of course, the time may come when physical or cognitive limitations make independent living impossible. But until then, there are steps you can take to make your parents’ home safer, their lives in it easier — and your concerns about them a little less daunting.

To make a home more elder-friendly, a safety assessment is a good place to start, says Myra Hyatt, a specialist clinical social worker at the Landon Center on Aging at the University of Kansas Medical Center in Kansas City. That means having an occupational therapist inspect your parents’ home for safety concerns and suggest ways to deal with them. These are some of the main issues that often come up in such assessments.

Stuff happens, so be prepared. If they have a personal emergency response system, your parents can call for help, 24/7, with only a push of a button. Newer systems can detect when a person has fallen down, so even if they’re too injured to push the button, the system will automatically alert an operator, Hyatt says.

Being prepared can prevent stuff from happening. An emergency response system is a very fine thing, but in the long run it’s more important to create an environment where such a system is needed as rarely as possible, says Linda Ercoli, director of geriatric psychology at UCLA. “If you fall and break your hip, you might be able to push a button and get help, but the fact remains that you’ll have broken your hip.”

Indeed, your parents’ home may be booby-trapped with all sorts of falls waiting to happen — including slippery showers or tubs (add grab bars), slide-prone throw rugs (get rid of them or tape them down) and fate-tempting steps and stairs (consider installing ramps or even chairlifts). Poor lighting is another open invitation for your parents to take a tumble or bang their heads or stub their toes. With brighter, better-positioned lights, you’ll be sure they can see what they’re doing and where they’re going.

Be an alarmist. Smoke and carbon monoxide alarms should be standard in every home. But your parents might also benefit from other, more specialized alarms, Hyatt says — for example, an alarm that goes off if a pot has been left unattended on the stove for too long, or one that reminds them to take their medications (and alerts someone else if they don’t).

Life-simplifying devices. Clothing that fastens with Velcro — instead of buttons or zippers — can make a welcome difference for fingers stiff with arthritis. And for backs no longer terribly keen on bending, an extra-long shoehorn can be a real blessing. Speaking of recalcitrant backs, a handy-dandy reacher/grabber allows for bend-free retrieval of items that fall on the floor as well as stretch-free retrieval of objects from high shelves.

Staying connected. Isolation can be a problem for seniors, especially as they become less mobile. If their hearing has also gone downhill, talking on the phone may be difficult. But a phone with amplified speakers can help, Hyatt says. And if their eyes aren’t so sharp anymore, big buttons can help too. So can email with big fonts.

Senior centers and adult day care are other good options for those who can get to them — as are pets, at least in the right circumstances. “They make great companions,” Reuben says. “People relate to them exceptionally well.” On the other hand, he warns, “if your parents can’t walk very well themselves, they obviously won’t be able to walk a dog. And pets can get underfoot.” Tripping over a leg-rubbing cat or toy-chasing dog can cause falls. Think goldfish?

Food. Nutrition can be problematic for seniors, Ercoli cautions. “Will they eat right — or even at all?” Perhaps your parents are eligible for Meals on Wheels services. Also, senior centers often offer no- or low-cost lunches. You might even hire someone to shop for groceries and prepare meals.

Professional services. Staying in their own home can be a lot easier for your parents if they don’t need to worry about keeping it clean or keeping the yard looking good. You can hire professionals to do those and almost any other chores your parents might no longer feel up to.

Taking care of business. Maybe it’s time for you to take charge of your parents’ finances — pay their bills, balance their checkbook. And it’s important for them to consult an elder law specialist, Hyatt says. How they handle their assets can have big-bucks repercussions down the road, affecting their eligibility for programs like Medicaid, to name just one example.

Take care of yourself too. Worrying about and caring for your parents can wear you down, Hyatt says. “You can become isolated yourself and find yourself thinking, ‘I want my life back.’ Part of the challenge is the guilt you feel.” That’s where caregiver support groups come in, she says. You can be open and frank there, even about the feelings you’re least proud of. “Everyone there will get it,” she says. “They won’t think you’re a monster.”

Resources. Countless agencies and organizations are dedicated to providing invaluable — but often free or low-cost — senior services. Information about many of these is available from your local Area Agency on Aging, which in Los Angeles County can be reached at (800) 510-2020 or css.lacounty.gov (click on the “Programs” tab). There you can find help with many of these issues, as well as others. Also, for a thorough “Housing Safety Checklist for Older People,” visit and click on the “Housing” tab.

“Find help,” Hyatt says, “because it’s out there. And it can mean you stay the course and keep your parents at home as long as you can.”

health@latimes.com

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