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family issues

Medical Alert Devices – Too Little, Too Late

An older woman cries out pleading for help from the bottom of a stairway in a large and empty house, and we are led to the conclusion that if only she had a medical alert device worn around her neck she could have emergency first responders there in minutes.

But what then…? How does the second half of this supposedly “averted” tragedy play out?

As reported by the Centers for Diseases Control and Prevention (CDC)*:

“In 2010, 2.3 million nonfatal fall injuries among older adults were treated in emergency departments and more than 662,000 of these patients were hospitalized.”

“People age 75 and older who fall are four to five times more likely than those age 65 to 74 to be admitted to a long-term care facility for a year or longer.”

So instead of lying on the floor for hours or days incurring additional life threatening conditions or worse, our female victim is whisked to the hospital and most likely will be treated and then discharged to a long-term care facility, either an assisted living or a skilled nursing facility for a year or more or until the end of her life.

The ability to lie on the floor and push a button may provide some level of comfort and security to seniors and their families yet when the fall has already occurred and resulting injuries sustained, the reality is your parent is lying there just pushing a button for help.

Now, a life will change in ways not to be desired by anyone. He or she will most likely be shuttled into a vast medical system to wind up in a bed that is not theirs and to no longer live in their own home.

This is the real fear older people live with. The fear of losing their independence and being institutionalized needlessly or prematurely.

If only the family had pushed beyond the simplistic notion that technology and telecommunications were all that was needed to keep mom or dad safe. If only our fear-based advertising could help us consider what happens after that last ditched effort is activated. Then, we could achieve compassionate aging for everyone concerned, senior and family caregiver alike.
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Like the CDC states*:

“Each year, one in every three adults age 65 and older falls. Falls can cause moderate to severe injuries, such as hip fractures and head traumas, and can increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable.

Geriatric case managers are qualified professionals to identify and evaluate many safety risks based upon mobility, vision and other physical deficits, environmental factors around the home, medical and behavioral conditions. By providing comprehensive assessments including balance and gait and home safety assessments, appropriate provisions and safeguards can be allotted and falls and many other unrealized dangers can be truly averted.

Medical alert products and services are worthwhile, but they are the very last line of safety. If they are to provide comfort and security, they should be part of a much more comprehensive approach to an elder’s care – one where that button need never be pressed.

© Anthony Antoville 2014

Anthony Antoville is Care Manager, Certified and COO of Champion Advocates LLC in Portland, Oregon providing geriatric case management services. He is a recognized expert in eldercare and home safety, internationally published with The Edwin Mellen Press.

*The Centers for Diseases Control and Prevention (CDC) Website “Home and Falls Among Older Adults: An Overview” Last Updated: 9/20/2013

 

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Disney’s “Maleficent” is a Tale of Forgiveness

Maleficent, Disney’s recent blockbuster release, reveals an unusual way to express the timeless message of forgiveness to its viewers, young and old alike. The tale of the formerly evil villainess in the classic Sleeping Beauty is provided a much needed backstory in this updated version to explain what has led her to unleash such hatred against the newly born babe, Aurora.

We learn that a great violation has been committed upon Maleficent by Aurora’s soon to be father, Stephan. This would be the mutilation and stealing of her faerie wings through deception and manipulation by Stephan to gain favor and the eventual kingship from the dying human king. A new war ensues between these two worlds and the innocent on both sides are made to suffer. All of this for the sake of the old king’s desire to destroy the faerie realm and plunder its coveted wealth of unimagined riches.

Yet, the innocent Aurora shows Maleficent the path back toward compassion and healing as only a child will. Through the years that lead up to Aurora’s fateful 16th birthday, Maleficent slowly rediscovers her own love of the natural world and a shared awe of wonder as expressed in Aurora.

Eventually, Maleficent strives in vain to reverse her dreaded spell that she had cast upon Aurora, and is left with but one final measure to cure the girl of the forever deathlike sleep. She must travel into the human kingdom, enter King Stephan’s castle and face his knights who are armed with weapons of deadly iron.

Forgiveness is a cornerstone of compassionate aging. Several times and in many ways, this compassionate message is conveyed.

Stephan as a young boy and would-be thief is forgiven by a young Maleficent and her faerie co-beings of his original trespass; the three tiny pixies repeatedly tussle and argue with one another to remain each others faithful companions over the years; Maleficent again forgives Stephan later as a grown man who had abandoned her to pursue his ambition among men, and Aurora forgives Maleficent of casting the doom-filled spell upon her.
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But most dramatically, Maleficent, in the heat of battle and clearly in a position to defeat King Stephan, gives him quarter and is willing to spare his life. It is only Stephan who chooses to cling to a hardened and merciless heart, thus seeking final vengeance.

By the re-vision of this tale, we are shown that forgiveness begins when we strive to rise above an insult, a trespass, a wound, an injustice.

Forgiveness is ultimately realized, when we knowingly attempt to break a painful or disastrous cycle in favor of reaching a new state of awareness within ourselves and in others. This process is one that can occur naturally over time as memories fade, the mind weakens and the ego-driven self slowly diminishes. Or, we can consciously decide which aspects of our lives that we wish to truly cherish and nurture through our remaining years.

© Anthony Antoville 2014

Anthony Antoville, CMC is Care Manager, Certified and COO of Champion Advocates LLC in Portland, Oregon. For more than 20 years, he has professionally served hundreds of families in addressing family relations and other elder issues.

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Are You Your Parent’s Secret Emergency Plan?

Recently, I received a call from a gentleman in his early eighties, who was caring for his wife with dementia.

He told me, “I’m calling you, because I need an emergency plan if anything happens to me. I need someone who will come in and handle my affairs and my wife’s issues at a moment’s notice. Then my kids, who live in another state, will come and take care of my wife.”

I asked him, if his adult children were aware of this plan he had. No, he hadn’t actually discussed this plan with them, but he was sure it would be fine.

I asked why he thought it was a good plan to wait until an emergency situation to happens, before he could ask for help or let his children know of basic issues in advance. He said bluntly, “Look, I know what I need! I only want someone to be able to come in on a moment’s notice, then my kids will take care of everything.”

This exchange illustrates a common and complex issue that is happening across the country for many families with aging parents. A spouse caring for another spouse who suffers from dementia or another chronic condition will often become fatigued, burned  out and develop their own health problems brought on by stress and overwork, thus putting both elders at risk.

Often, the senior providing care will refuse help or underestimate the amount of help that is actually needed.

The adult children are often kept in the dark, while simultaneously being made part of a secret emergency plan that no one has actually examined. The secret plan is revealed only once the crisis hits, and the adult children are caught in a web of issues that are usually serious, intricate and deteriorating rapidly.

For the family members trying to help, coming in at this stage of the crisis can result in significant stress, significant time commitments and significant financial cost. It can negatively impact employment or business and overwhelm personal relationships.

Waiting to respond until a crisis hits almost always results in substantially reduced options for the aging parents and for the family caregiver. Reacting is never planning!

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Open up the conversation with your aging parent sooner than later! Chances are, you already have a feeling that something is going wrong.

Ask your parent how things really are with questions that elicit more than simple “yes” or “no” answers. Ask how tired, stressed or overwhelmed is the parent who is providing care? What are the health and household issues? How much time, energy and work can be realistically expected of other family members, if help is needed?

How do you respond to this information and what are the next steps?

As a geriatric case manager, I highly recommend having a family meeting with a geriatric case manager. Geriatric case managers are aging professionals with broad expertise and knowledge. We can perform assessments based on multiple issues and coordinate planning and services to meet goals for the entire family. Best of all, a geriatric case manager can continue to work with the family and the senior over a period of time, providing continual monitoring, oversight, coordination and support as needed.

© Anne Conrad-Antoville 2014

Anne Conrad-Antoville is a geriatric case manager with Champion Advocates LLC in Portland, Oregon. She has spent the past 15 years of her professional career successfully troubleshooting complex issues for seniors and their families.

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