Senin, 14 Juli 2008

Scaling Down (Almost) Painlessly

Moving to a smaller house or apartment in a retirement community almost always involves a certain degree of trauma, both for the elder who's moving and for family members. However, by planning ahead you can reduce the discomfort involved and turn what might well become a nightmare into a pleasant event.

Begin by Planning for the Move

Where is the elder moving? Go to the actual house or apartment with tape measure, pad and pencil and write down measurements. Floor space is important, but don't forget about ceilings. Many elders own large pieces of furniture that may not fit into rooms with low ceilings. Your work here will determine which pieces can move with your elder.

And while you're at the actual location, talk to several other elders who already live there. What is their life style? Do they go outside the property on frequent trips? How do they dress? Casual lifestyles will require an entirely different style of dress than more formal ones.

Gather Supplies and Contact Helpers

Having all the supplies you will need in one place will speed your task. You'll want a number of storage bins; five or six should be sufficient to hold sorted items. Plastic bags can be used for discarded belongings and as a container for articles to be donated to charities. Packing boxes and supplies such as padding materials and wide sealing tape are must-haves. Labels and dark marking pens are essential to ensure that boxes go to their intended location.

While you're in the gathering stage, begin to contact helpers you'll need. Among these may be:





estate sale professionals



certified appraisers



moving companies



house cleaners



repair specialists (electricians, plumbers, carpenters, painters)





Ask friends, relatives, and senior real estate specialists for recommendations. Also, check with the Better Business Bureau to ascertain whether problems have been reported about particular companies or individuals.

Approach Your Task One Room at a Time

Who should help? The elder and one family member should assume responsibility for sorting all items and some packing. Do not include everyone in the family if you want to make the job quick and easy because distractions increase in geometric proportion to the number of persons doing the sorting.

Sort all the items in one single room at once, beginning and ending in the kitchen. Why start there? Because kitchens in small houses and apartments typically are short on storage space, and the elder needs time and experience to determine which items are true necessities, and which may never be used. If you reduce kitchen items to a bare minimum at the beginning, your elder can determine what's needed and what's not by living with them ahead of time. After living with fewer items, your elder may find that items once thought essential may not be needed. Complete work in the kitchen at the very end of your tasks.

Even though you intend to stay in only one room, distractions will occur. Resist them by stacking items that belong in another room at the door. A bin or box placed just inside the door can contain all the items that have homes elsewhere.

Make your motto One Thing at a Time; One Time for each Thing. Once you've picked up an item, decide then and there what its fate should be. Place it in one of the bins you've labeled:





Discards



Donations



Distribution to Relatives



Keepers



Uncertainties





Large collections of books may require their own bins. You might have bins for Collectors' editions, books to be stored, books to be sold to book dealers.

When you have finished categorizing all the items in the room, start the packing process. Items in the Uncertainties bin can be packed for storage.

If an unbreakable item is to be moved only a short distance, don't waste time on elaborate packing and padding. Items like crystal and china, however, require excellent packing, regardless of the distance they will be moved. If you can't do a great job, leave packing fragile items to professionals.

Mark boxes as you go.

Mark boxes as you go.

Mark boxes as you go.

Nothing is more frustrating than finding that you've shipped your elder's bed linens to Aunt Minnie and kept a silver salver you meant to send your nephew.

Don't try to do everything at once. Do only one room on any given day, and take the time to enjoy reminiscing as you sort items.

This is also the perfect time to have a certified appraiser come in to appraise items that may be of significant value. Very expensive items may be auctioned at an auction house such as Christy's or Sotheby's. Less expensive items can be sold to local antiques dealers. By having an idea of their value before going to dealers, you reduce the chance that dealers can scam you.

You could also consider selling items through an on-line auction. If you do so, remember that you will be responsible for shipping items and ensuring their condition to successful bidders.

Distribute Items to the Intended Recipients

Schedule a single day for distribution of items. In-town relatives can come to pick up items intended for them; they may also be helpful by taking bags to charities, books to resellers, boxes to storage, and trash to dumps.

Use this day for shipping as well. Small items can be shipped via UPS or FedEx; large pieces of furniture and antiques may require special handling by movers. Once you've finished distribution, you should have a considerably reduced pile of boxes and furniture. These boxes should contain only items to be moved to the elder's new residence or to storage. Remaining items should be those to be sold in an estate sale.

Move the Elder to His New Residence

Will the mover actually show up on time? Will the mover actually show up at all? Increase the probability of a good outcome for the move by contacting the mover to confirm arrangement a week ahead and the day before the actual move is scheduled. Of course, missed appointments may still occur, but if you've checked out the company with the Better Business Bureau and reminded the company of your appointment, the chances are good that the move will go as planned.

Accompany your elder to his new residence and help him with the moving-in process. Even if not all boxes can be emptied in a single day, he will feel more comfortable if a few items that are meaningful to him are unpacked and placed where he can find them.

Hold an Estate Sale

Once the movers have left the premises, the estate sale professionals should come in to evaluate and price items for the estate sale. Give them a key to the house, and then get out of their way. If you have chosen well, these professionals can do a great job of pricing items to sell and clearing the house of whatever remains. They will take a percentage of the sale receipts as compensation.

The days of the sale are good days to keep your elder busy elsewhere. A tearful elder does nothing to help sales.

Schedule a professional cleaning service to clean the house once the estate sale is over. When that has been completed to your satisfaction, turn the keys over to your senior real estate professional and give yourself a big pat on the back. You're done!

Click here for a checklist to help you through this process. Or copy this address into your browser address bar.


By Phyllis Staff, Ph.D.


Why Everyone Over 50 Should be Training for the Senior Games

by Phil Campbell, M.S., M.A., FACHE
Senior Games participant and author of
Ready, Set, GO! Synergy Fitness - 2nd Edition

New biomedical research proves why everyone over age 50 should be training for the Senior Games.

Research discoveries in 2002 show that we can unleash the most powerful body fat-cutting, muscle-toning, anti-aging substance known to science, naturally, with specific types of exercise, and the workouts necessary in training for many of the Senior Games events do the job.

The American Heart Association recently cited research showing that high-intensity exercise can significantly lower the risk of heart disease. Simply, as exercise intensity goes up, the risk of heart disease goes down.

The researchers compared the impact of different levels of exercise intensity on men with an average age of 66. The subjects in the high-intensity exercise group produced a 31 percent risk reduction for heart disease, which was 14 percent better than those who performed less intense exercise.

"The harder one exercises ... the lower the risk of heart disease," says lead researcher Dr. I-Min Lee, associate professor Harvard Medical School.

Anti-aging exercise

Anaerobic exercise (as contrasted with aerobic exercise) involves short, high-intensity sprint training, rather than endurance training.

Researchers show that high-intensity anaerobic workouts that include the short-burst get-you-out-of-breath sprinting types of exercise make your body release significant amounts of growth hormone (Impact of acute exercise intensity on pulsatile growth hormone release in men, 2000, Pritzlaff).

As children, growth hormone (HGH) makes us grow taller, but when we reach our full height, this hormone actually changes roles. When we're adults, increasing HGH reduces body fat and trims inches. Growth hormone actually becomes the "fitness hormone" for middle-aged and older adults.

New studies show that HGH can be increased by as much as 530 percent with the anaerobic exercise of sprinting, (The time course of the human growth hormone response to a 6s and a 30s cycle ergometer sprint, 2002, Stokes).

Anaerobic sprint workouts can be involve many sports, including running, swimming, cycling, cross-country skiing, and all these are Senior Games events.

Whatever you do, don't do this!

Don't jump in, ease in to anaerobic exercise. Anaerobic fitness training is clearly the most productive, but it's also the most dangerous. Hamstring pulls are a painful potential injury, so flexibility training is essential to every fitness plan.

Everyone, especially those with heart conditions or medical problems, should get physician clearance before performing anaerobic exercise. Even young athletes should progressively ease into high-intensity anaerobic workouts.

Older adults get results with less effort

When you see an 80-year-old participant running a 10-K or working out in the gym, don't think that it's unfortunate that she can't run as fast or lift as much as her 60-year-old counterparts. It's easier for her to reach higher intensities.

The American Heart Association study proves that exercise intensity is relative to a person's age and fitness level. In other words, an older person can reach high-intensity levels with an effort level that might be considered low-intensity for a young athlete.

The new study confirms the need for higher intensities, but it also shows that beginners and older adults reach the more productive levels of exercise intensity with less effort than a triathlete, for example.

Newcomers to high-intensity exercise may initially get great results by performing the anaerobic training with power walking, but a fine-tuned triathlete may need more work for the same results.

If you're over age 50, get physician clearance first, select a Senior Games event or two and get started with a gradual buildup training program.


If Using The Stairs Has Become A Daily Struggle, A Stair lift Could Change Your Life

Using stairs is an everyday nightmare for many people. As we grow older the stairs in our home can become more of a struggle due to mobility problems associated with old age, an accident or illness. Often when out shopping or in a public place an alternative can be found such as a lift or escalator, but the stairs at home can become a daily challenge. Many people who experience difficulty climbing the stairs come to dread having to use them. For people whose bathroom or toilet is upstairs it can be even more of an issue.

When faced with the challenges that limited mobility brings to the home, there are several options. An expensive and disruptive choice is to move into a bungalow, which can be very stressful, especially if the move is away from family and friends. Some people are forced simply to live downstairs. This can lead to a fall in their standard of living, from lack of space and privacy. Another option is to extend the living space downstairs, which can be costly and disruptive and may not be worth the effort when it comes to selling the house. Other people do nothing at all and continue to struggle on a daily basis, increasing their risk of injury from falling.

But there is really no need to continue to live in dread of the stairs or make drastic decisions such as to move. Having a stair lift installed has made life easier for thousands of people with limited mobility. Buying a stair lift can really improve quality of life for someone who wants to stay independent in their own home. The initial cost may be daunting but that needs to be weighed up against the alternative costs and inconvenience of moving to a bungalow or extending the downstairs.

There are many advantages of choosing a stair lift. Out of all the options mentioned above, having a stair lift installed causes the least disruption. In fact, after an initial visit from a representative of the stair lift company to take measurements of the staircase, a stairlift can be installed within a day. The color and upholstery can be chosen especially to blend in or compliment the existing d├ęcor. Stair lifts are safe and very easy to operate. And above all for a person with limited mobility a stair lift can give them some freedom and allow them to remain in their own home.

By Caroline Smith



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Solitary Confinement -- for Life

Sixty-five year old Arthur Jones served a self-imposed life sentence - in his own home.

Arthur lived in a high crime neighborhood, so he built iron cages around his outside doors and installed bars on all the windows. No one could find it easy to break in to Arthur's house!

I met Arthur a few years ago, although you would hardly call our interaction meeting. When I arrived to deliver his meal, as part of the Meals-on-Wheels program, Arthur barely cracked open his front door even though his cage clearly protected him. He refused to open the cage door at all, so, to give him his meal, I had to angle the box through the bars. Without doubt, this maneuver scrambled the hot contents of his boxed meal, but Arthur would have it no other way. He clearly feared me, a 100-pound woman, and everyone else.

I wish I could say that Arthur's family came to his rescue, finding for him the medical and emotional treatment he needed. I cannot. Arthur's depression and paranoia compounded relentlessly, killing him at far too young an age.

Many elders live like Arthur, holed up in their own homes, barricaded against the world. Who cares? Family and friends must care, and they must assume the primary responsibility, acting before their elder's condition rivals that of Arthur. We cannot shift this burden to our government. We cannot wish it away. Those among us lucky enough to have elders in our lives must shoulder the responsibility of seeing that they do not succumb to depression.

At this holiday season, many elders experience transitory depression, as celebrations bring memories of friends and loved ones who have died. Decreased hours of sunshine may add to their depressed feelings. How do you know if your elder suffers from serious depression? And, if you suspect depression, what you should do? Here are a few tips.

What signs should lead you to suspect serious depression?





Lethargy and or refusal to get out of bed;



Changes in Sleep Patterns, such as sleeping all morning



Unusual Complaints



Memory loss and loss of ability to concentrate



Frequent sighs or weeping if unusual for the sufferer



Feeling fear and loneliness;



Thoughts of death



Refusal to eat



Refusal to take prescribed medications



Thoughts or talk of suicide (remember, the notion that suicides do not signal their plans is a myth!)



Significant changes in personality



Irritability





What Can You Do?

A few simple steps may improve their condition rapidly:





Call more often than usual.



Take your elder for outings away from the house.



Schedule a medical appointment to confirm or deny your suspicions, and be the one to take your elder to that appointment. Depression often accompanies the early stages of Alzheimer's disease and other dementias.



Check bottles to be certain that your elder is actually taking prescribed medications at the recommended dosages. Too many or too few pills in the bottle can warn you of problems. If you find evidence that medications are not taken as prescribed, gently probe to see if you can learn why.



Include the elder in parties and holiday festivities, but keep the duration of their participation at a level they can handle comfortably.



Drop in more often than usual on homebound elders.





You don't have to be a doctor or social worker to recognize the signs of depression. Take action now to protect those who protected you.


By Phyllis Staff, Ph.D.


When Assistance with Long Term Care Becomes Necessary

According to the Administration on Aging, it is estimated by 2030, the older population will more than double to approximately 71.5 million. It is also estimated that between 39 to 49 percent of people will use nursing home services during their lifetime. Unfortunately, there may come a time when your loved one may require assistance with long term care. The following is a list of warning signs one should be aware of when evaluating your loved one's situation. If the senior exhibits two or more of these signs, assistance is likely required:

? When your loved one or their spouse can no longer provide care due to debilitating health conditions

? When your loved one experiences difficulty with walking, or is unsteady when standing

? When your loved one's safety is compromised due to hazards in the home such as stairs, poor lighting, cluttered walkways, and dangers in the kitchen or bathroom

? When your loved one needs assistance with daily activities such as bathing, dressing, and meal preparation

? When your loved one becomes confused about taking their medications

? When your loved one is afraid of falling or being alone

? When your loved one exhibits changes in personality or has sudden mood swings

? When your loved one is no longer able to manage their finances and requires assistance with administering their monthly household expenses

If you feel assistance with long term care may be necessary, have a discussion with your loved one and talk to them about their concerns and desires. It's important to help your loved one maintain their independence for as long as possible. Your loved one should be involved in the decision making process as long as their decisions do not negatively impact their health and safety. Talk with other family members and get their input as well. If necessary, discuss your concerns with your loved one's physician, attorney or financial advisor, and make sure all aspects of their long term care needs have been met. It's never too early to be concerned about your loved one's long term care needs. Being aware of their needs and continually reevaluating their situation will help ensure the long term needs of your loved one will be met.


By Torey L. Farnsworth, CSA


Arizona Assisted Living Homes -- The Alternative to High Priced Senior Care

The cost of skilled nursing care is slowly rising. Currently, the average cost of care in Arizona ranges from $3,500 to $4,500 per month. Skilled nursing facilities are great for seniors who require skilled nursing care by medical professionals such as registered nurses or physicians. However, is skilled nursing care appropriate for those who only require assistance with their activities of daily living (ADLs) such as bathing, dressing and going to the bathroom? Is it realistic for someone to pay $3,000 to $6,000 a month for skilled nursing care when their only requirement is assistance with their ADLs? Believe it or not, there are many seniors who do not require skilled nursing care and remain in nursing homes due to their lack of knowledge of the options available to them. There are affordable alternatives to nursing home care. When a senior requires long term care without 24 hour medical supervision, the preferred alternative is Assisted Living Homes.

You may ask, "What is an Assisted Living Home?" In Arizona, an Assisted Living Home is a regular home located within a residential neighborhood and licensed by the Arizona Department of Health Services to provide assistance 24 hours a day to those who need care outside of their own home. Assisted Living Homes are licensed for up to 10 residents. There are three levels of care an Assisted Living Home can be licensed for: Supervisory, Personal and Directed. Every Assisted Living Home is licensed for one or more of these levels of care. In sum, Assisted Living Homes are homes licensed to provide care for seniors who are no longer able to live alone, and do not require skilled nursing care.

What are the benefits of an Assisted Living Home? An Assisted Living Home gives residents a feeling of being at home instead of an institutionalized setting. Each caregiver and manager is required to become certified, and often times the caregiver or manager lives in the home full time. Each home provides 24 hours of care, 7 days a week. Many homes offer hospice care, respite care, Alzheimer's/Memory Care, incontinence care, and therapeutic services under the direction of a physician. In addition, three nutritious meals are prepared for the residents along with snacks throughout the day, as well as daily activities as required by law. Both private and semi-private rooms are available for residents to choose from. As a result, there are many benefits available when residing in an Assisted Living Home.

Why is an Assisted Living Home unique? An Assisted Living Home provides care in a home setting, and because there is a limit of up to 10 residents in each home, the ratio of caregiver to residents is such that the care provided is very individualized as opposed to larger facilities. Monthly costs for Assisted Living Homes range from $1,500 to $3,000, allowing for an affordable option compared to the cost of nursing home care. Private pay may be the only option currently offered by the majority of Assisted Living Homes. However, the facilities that do accept different payment sources such as ALTCS (Arizona's Medicaid Program referred to as Arizona Long Term Care System), usually require a resident to private pay for a certain period of time before they allow government benefits to begin. Bottom line: Assisted Living Homes are less expensive and provide more individualized care in a home-like setting.

Finally, when living at home is not an option and skilled nursing care is either out of one's budget or not the right option based upon one's level of care, Assisted Living Homes are the affordable alternative senior housing choice.

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By Torey Farnsworth