4 Aging in Place Challenges Your Parent May Face at Home

Is your aging parent dealing with worsening health, mobility, or cognitive issues? If the answer is yes, it’s natural to be worried. And if your mom or dad lives alone, then your worry probably takes up a good deal of mental energy.

Today, many older adults who face aging-related challenges are choosing to continue living independently. There’s a term for this phenomenon: aging in place.

Of course, it’s important to watch for signs that your parent who’s aging in place is no longer coping. But a move to assisted living isn’t always the best solution. Comfort, safety, and dignity are important to us all. It may be that a few lifestyle or environmental modifications will allow your parent to continue maintaining this balance at home.

That said, there are bound to be challenges. In this post, we’ll look at four areas of difficulty your loved one is likely to encounter—and what you can do to help.

1) Completing activities of daily living

Eating, bathing, toileting—most of us engage in these activities, commonly referred to as the activities of daily living (ADLs), without incident. But for many older adults who are aging in place, the difficulties they pose are significant.

From compromised mobility to poor eyesight, there are a whole host of physical challenges that can get in the way of basic self care activities.

In many cases, tweaks to a living environment can make all the difference. Kitchen appliances can be set out in ways that reduce physical strain. For example, keeping a microwave at or below counter height can make bending and reaching less stressful on the body.

Bathrooms can be remodeled to make bathing simpler for those with mobility issues. Lever controls are easier to use than knob-shaped faucets, and portable shower chairs are good for those who have difficulty standing for long periods of time.

2) Avoiding falls

For many older adults, completing the activities of daily life—or simply moving around the house—comes with safety risks. Falls are one of the most worrisome, since they can lead to head injuries, hip fractures, and many other serious or debilitating injuries.

We’ve already discussed ways to make bathing more comfortable, but it’s also important to recognize the hazards it can pose. Walk-in bathtubs can make bathing much safer and less stressful.

Of course, bathrooms aren’t the only places where falls can occur. Luckily, a few modifications—such as removing scatter rugs and ensuring adequate lighting—can make every room in your parent’s home safer.

Technology can also provide peace of mind—for you as well as your mom or dad. Fall detection systems save lives, and they don’t have to be obtrusive. A lightweight bracelet that senses falls is a good option for those at risk, whatever their activity levels may be.

3) Accessing transportation

Aging in place allows older adults to remain where they’re most comfortable—in their homes. That said, getting out of the house is an important part of living independently. Often, it’s an absolute necessity.

Maybe you can’t always be there to drive your mom to the grocery store. Perhaps your dad’s medical appointments conflict frequently with your work schedule. In these situations, how can you ensure that your parent is able to get around safely?

Fortunately, there are affordable transportation options for older adults in cities across Ontario.

Some services are offered for free, while others provided for a fee. For example, Toronto Ride, a transportation network comprised of thirteen agencies, charges a maximum of $17 each way.

Many vehicles can accommodate wheel chairs, walkers, and other equipment, and escorts are often permitted to come along.

4) Social isolation

One of the most unrecognized problems among older adults who are aging in place is social isolation. If you live too far away from your parent to visit regularly, you may be worried about whether they’re engaging in enough (or any) social contact. If the answer to this question is no, your concern is warranted.

Social isolation can have negative physical, psychological, and cognitive health impacts. Studies show that having a limited social support network is linked to a 60% increase in the risk of dementia and cognitive decline.

It goes without saying that increasing in-person contact is best. If regular visits from loved ones aren’t realistic, you might consider asking a friendly neighbor to check in every now and then.

In many cases, mobile technology can also help. The right videoconferencing app can connect you and your parent face-to-face—at any time. You can also rest easy knowing that your mom and dad can get in touch with you whenever they need to.

Of course, many older adults are reluctant to reach out. The reasons for this hesitation can range from the fear of being a burden to mobility challenges that make operating a phone difficult.

Downloading an app on a tablet for your parent demonstrates your desire to keep in touch and encourages them to make the call. And with the right app, calling you will be is as easy and intuitive as tapping a picture on a tablet screen.

Feature image courtesy of Lucy Lambriex

 

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COPD Education – Onboarding

Objective

To complete a thorough needs assessment / initial evaluation for a COPD patient of an outpatient clinic

Actors
Patient, Educator (Nurse, RT, the Physician could also be the educator)

Timelines
One 60-90 min session with the Educator

Description
  • This protocol should be established for all COPD patients from a given clinic, independently of whether they are new patients or they are known to the clinic. This protocol is the basis to engage the patient into other protocols such as education, exacerbation follow-up, etc.
  • We need to identify patient goals/concerns to guide the interventions
  • A thorough evaluation is carried on, with the objective of understanding where the patient is on their disease journey and follow-up treatable traits: dyspnea, exacerbation or dyspnea and exacerbation.
  • It includes the use of objective questionnaires such as the mMRC, CAT, HADS, Frailty Scale, etc.
  • Identify if the patient needs to be referred to other resources (e.g. Physiotherapist, social worker, occupational therapist)
  • Once Onboarding is completed, the patient continues to the COPD Education workflow
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COPD Education – Continuous Maintenance

Objective 

To cover in depth all the necessary elements of self-management education as per the LWWCOPD, with priorities based on patient goals and identified treatable traits

Actors
Patient, Educator (Nurse, RT or Physician)

Timelines
A number of “Core” educational modules have been identified which cover the basic COPD education from the LWWCOPD program. Additionally, optional modules can be used to respond to patient needs. The timeline (frequency, number of modules to be covered at a given education session) is fully customizable, although we recommend to have education sessions every 2-weeks during the “active” phase of education. Once this is completed, the patient continues to the Maintenance Mode (see below).

Description
  • Launched at the onboarding protocol
  • Provide basic overview of COPD self-management based on LWWCOPD (medication adherence, inhaler techniques, PLB technique & energy conservation) up to the development of an Action plan for early exacerbation recognition and management.
  • Prioritize self-learning by the patient (e.g. watching videos, reading educational materials, completing homework) in addition to live sessions with the Educator. Educational materials are sent to the patient directly via the platform, and become the patient’s own library. The Educator can customize which “homework” the patient receives.
  • Educators have access to “User guides” to standardise their educational intervention. These user guides include: objectives, interventions, suggested questions, evaluation of self-efficacy, and learning contracts for each module.
  • Once the core education is completed, the patient can continue to the Respiratory Status Follow-up Workflow (run in parallel)

The Maintenance Mode
  • As soon as the maintenance mode is engaged, the frequency of visits Educator/Patient is reduced to once every 6 months.
  • During the Maintenance Mode sessions, the educator has access to all the education modules and can choose any piece of content that needs to covered with the patient. 
  • A streamlined evaluation (similar to the initial eval.) is done during each “maintenance” visit to identify any substantial changes on the patient’s needs that will require some adjustment. The patient could come back to an “active” education mode (more frequent education sessions, e.g. every 2 weeks).
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COPD Respiratory Status Follow-up

Objective

Monitoring of stable patients from a clinic in order to identify early any aggravation of symptoms (exacerbation) and implement an action plan

Actors
Patient, Educator (Nurse, RT or Physician)

Timelines
Scheduled regular automated follow-up to the patient symptoms. Intensity/Frequency can be adjusted by the Educator depending on patient needs (e.g. daily, every week, etc.). Ongoing through the year.

Description
  • Launch: Patients who have completed the Core Educational including setting-up an action plan.
  • Regular automated questions allow to identify any change in patient’s symptoms and severity.
  • If an exacerbation is detected the patient gets a reminder to engage their self-management strategies while waiting for the Educator to call back.
  • An alarm is generated for the Educator, so they immediately call back the patient. At this call they will evaluate any further intervention required and schedule additional follow-up.
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