Help Parents Age Well and in Place: Old Bathrooms. Old Parents. New Shower Fittings for a 97-year-old Woman–Update: Now 100, Still in Her Home

IMG_0971Search engines connect to countless websites offering renovations to help aging parents and others remain in their homes when muscles, joints, and limbs become “ify.” Mobility problems may instantly flash “candidate for assisted living” in the minds of many and rightly so.

The flip side for others, however, is the cost (literally and emotionally) of moving vs. remaining in one’s home. Clearly, if mental capacity has become impaired, remaining at home is risky. When aging parents still have a “good head on their shoulders” and are adamant about remaining in their home, values and a philosophy of life come into play. And so it was for Sr. Advisor R, now 99.

Readers know she still lives, without daily help or a companion, in the 1-story home she and her husband built in the mid-1940’s. From the minute she left the hospital after surgery for a broken hip two years ago (she lost her balance and fell after making a quick turn to straighten out a picture her cleaning woman had turned around), going home was her only goal. After 4 months “of very hard work” (she’ll tell you) in a rehab center, she went home alone, refusing all offers of anyone’s staying there with her. But she couldn’t go home without a physical therapist visiting her home and making specific recommendation to make her home as accident proof as possible.

R is smart, reads widely, orders through catalogs, and had already taken the initiative to have some of the usual grab bars, easier-to-grip handles for faucets etc. installed well before breaking her hip. She was limber enough before her fall to get in and out of a bath tub with help from the grab bars. But after hip surgery a shower became an easier option. That entailed updating her previously not-often-used shower.

IMG_0964The shower is about 4′ x 6′ and grab bars were installed on 3 walls: 2 horizontal and 1 vertical.  Looking in one sees a high step up. A vertical grab bar is unseen on the right wall, just as you step in (or out) and a left horizontal bar above the bench is easily grabbed when stepping into the shower. The 2nd horizontal bar plus a soap dish are within easy reach. Turning the corner, the shower control comes into view. The tile floor is from the ’40’s and would not be recommended today because of its somewhat slippery finish. R is very careful. Doesn’t stand to shower and doesn’t do much walking in the small confines.

Next, the shower control (on the wall opposite the bench) and the long metal shower hose hanging down for the hand-held sprayer attachment (there’s no shower head–only a vertical bar the sprayer could be attached to if used as a shower head, which it isn’t). The sprayer faces the shower controls but actually fastens into a holder on the 4th wall abutting the shower door and near grab bar.  R. says the sprayer attachment is heavier than she would have liked but, she says, “I wasn’t consulted.”

I have a Kohler spray attachment that I love. (Check it out, [e-faucets was least expensive a year ago]); I researched well before getting it. It’s as powerful as the big ones–good for a female, someone with small hands, or someone who wants/needs something relatively light and small. No doubt we’ll make that a gift (Mother’s Day will be here before we know it), but we will check with R first to make certain she’d like it.

The 4th wall, to which the sprayer head is attached, has the vertical grab bar that’s unseen in the photo.

Having a small bathroom and small shower made this “update” simple, but “expensive–around $1,000″–according to R. Moving to assisted or independent living would have been quite expensive. Much more money for much less space. Plus, she’d be leaving a home and neighbors that have been–and are–an important part of her life.

As long as R’s mind continues to be good, she will call the shots (and enjoy her refurbished shower). To do otherwise would be to undermine all that she has done to remain independent. As we try to help parents age well, we stop and ask ourselves: Is it easier/better for us or easier or better for them?”

Related: Bathroom Safety Checklist: http://afriendlyhouse.com/17/Safety-checklist–Bathroom/  I found this article several months after writing this post. R’s hands have no problem with the dial shower control mechanism.

Changing weekly: “Of Current Interest”(right sidebar). Links to timely information and research from top universities, plus some free and some fun stuff–to help parents age well.

Cell Phones vs. Alert Pendants if Seniors Should Fall

Help! I’ve Fallen! 

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Are cell phones and alert pendant equally effective in getting help when an older person falls? We had that discussion the other night at dinner with friends. We remembered that 97-year-old Senior Advisor, R, had neither cell phone nor pendant and spent the better part of 3 hours trying to crawl and drag her body about 40 feet to a phone, then figure out how to get the phone down so she could call 911. We agreed: the quicker the response that sends appropriate help, the better.

Facts:

>My “best cell phone for seniors” post has been read well over 34,290 times*–many more times than the two carefully researched posts on Alert Pendants. 
>Falls are a leading cause of mortality and morbidity among adults age 65 and older:” Oregon Research Institute Study 2008
>Every 18 seconds an older adult is in the emergency room because of a fall:” Center for Disease Control and Prevention.
>1 in 3 adults over 65 will fall every year.
>falls cause 300,000 hip fractures a year.

As if confirming the above–two far-away-living friends recently fell and broke their hips. One, an accomplished equestrian just over 65 who still jumps competitively, was rushing to leave home, arms loaded with stuff, and tripped over their old dog who was lying in an unexpected place. The other, an active 71-year-old,  wrote: “I was stopped in my rushing-about tracks when I fell and broke my hip in early June…I am now driving.”

Judging from the # of views plus the comments on my “best cell phones for seniors” post, children and grandchildren see cell phones as especially valuable for older people in emergency situations. But how effective are cell phones (even with the recommended ICE or an emergency button) in getting timely help if someone is alone and falls?

  • Most older people don’t carry cell phones everywhere with them (ie. at home– to the bathroom where many falls take place).
  • A cell phone in a pocket or purse may be unreachable.
  • Older (as well as younger) people can forget to recharge cell phones.
  • If one falls and is unconscious how is help alerted?

While cell phones have wonderful advantages for aging parents and make great gifts, if we want to give older people the most protection if they should fall, the alert pedants’ technology is superior–having none of the problems just listed, assuming one wears the pendant or bracelet. (If Tiffany made alert pendants would people be more inclined to buy–and wear–them?)

When there’s a risk of falling because of age, I–for one–would certainly prefer to know who was orchestrating my rescue (the alert pendant company’s trained responders) as opposed to leaving it to chance.  That said, for the benefit of aging parents and grandparents, check out the two posts featuring “alert pendants.” Older people tend to get them after they’ve fallen or a good friend has fallen and “converts” them….after the horse is out of the barn so to speak. Why wait?

Check out “Newsworthy” (right sidebar). Links to timely tips, information and research from top universities and respected professionals–to help parents age well.

*statistic updated 1/11/13


 

Broken Hip: 97-year-old’s Fall, Surgery, Rehab, Amazing Recovery Chronicled–Part 2

Rehab–Attitude and Reality

A broken hip makes one helpless.  Can’t move, can’t get up and do what you and I take for granted daily.  Excellent doctor, successful surgery, excellent rehab facility selected. Yet as R lay flat on her back in a hospital bed after admission to the rehab center, we realized there would be “down days” and physically-challenging work ahead.

The importance of attitude: loomed front and center.  First concern–whether a proud, successfully independent 97-year-old woman would have the will to endure, and recover from, almost complete dependency accompanied by the pain remaining after surgery and accompanying the physical therapy.

Control and Empowering: We couldn’t control much, but wanted R to feel empowered, not like a helpless little old lady.  She’d never considered herself that way, that would be so undermining. To this end, we immediately requested that the staff call her by her first name, never “honey” or “sweety” (or any other too familiar or what she might consider a diminishing pet name so commonly used in care facilities).

Next, we asked R to give us orders–where to put things, what things she wanted us to bring her from home, what we could do to make the room more user friendly for her etc. etc. That gave her a smidge of control. Within a week, she also tried to control what little she could.  “Pick the dead leaves off that plant, she would instruct.  “I don’t want to look at dead leaves,” she’d emphasize.” “I don’t want clutter in this room,” she’d say. We complied with any “orders”.  Her mind worked, we didn’t question even seemingly unnecessary (to us) “orders.”

Adjustment: The first week in an institutional setting is similar to a child’s going to school for the first time: unfamiliar routines, new people, different food, expectations, and disappointments. When we don’t feel good, we’re weak, we lack energy and we’re not mobile, we may not feel much like adjusting.  We may be cranky or worse.  Understandable, isn’t it? Here’s where focusing on the big picture helps.

What’s the goal? Always keeping the goal in mind applies equally to helping aging parents and their children. This helps ward off the disappointments, insults, and temporary setbacks. The goal in R’s case was to be able to walk again, regain independence and not need a wheelchair. But R had an intermediate goal because of her surgeon’s instructions to the rehab center: “no weight on the left leg for 90 days,” then an x-ray to be certain the hip was healed, before weight-bearing exercises could begin on that leg.

Patience: Unbeknownst to us, until she told us she had passed the 45 day, half-way mark, R was mentally crossing off the days until her return to the surgeon and an x-ray showing the femur had healed…..    To be continued on next post 1/22/11.

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Note: An RN in the family was emphatic that once R began the weight-bearing exercises on the leg with the broken femur, she should never use a wheel chair. Why? Because the unused leg needed every chance to strengthen and using the wheel chair eliminated precious time exercising that leg. Indeed she said using a wheel chair instead of making oneself walk at every opportunity while doing rehab, is a reason old people who break a hip will become confined to a wheel chair, never to walk normally again

Click Tab Above For All Broken Hip Recovery Posts 

Note: Newsworthy (right sidebar) for current research and information from highly respected sources–to help parents age well.

Broken Hip: 97-year-old’s Fall, Surgery, Rehab, Amazing Recovery Chronicled–Part 1 (of 4)

97-year-old Recovers and Regains Independence After Fall and Broken Hip–Part 1

For everyone fearful of…caring for…or recovering from…a broken hip,  Help! Aging Parents chronicles Senior Advisor R’s fall, her “rescuers,” surgical considerations, rehab highlights and insights, and lastly her preparation for returning home.  She will go home with an alert pendant, a cane, and a walker for going out when anticipating a great deal of walking. No caregiver.

What follows may repeat snip-its from earlier posts.  But the chronology and additional information make it hang together better.  A recap of R’s experience is also a helpful frame of reference for those going through this not-for-sissies/prima-donnas experience.

Part 1: The Fall, the Rescuers (911 and doctors)

R. didn’t have an alert pendant. In late September as she walked from her bedroom to the kitchen, she noticed her twice-a-month cleaning help had moved something on the desk she was passing. She reached around to reposition it, realized she was losing balance, grabbed the nearest chair, but it wasn’t heavy enough to support her weight, and they both fell on the carpet.

R recalls she grabbed at a table leg thinking she’d pull herself up. One side of her body would not move. She knew immediately she couldn’t get up. That ad, “Help, I’ve fallen and I can’t get up,” for the first time resonated, R, said.

The next 3 hours were spent inching her way back 31 feet to the bedroom, and a telephone.  She rolled over on her stomach and with her arms in front “kinda pulled her knees and body along.” Her knees sustained carpet burns, one of which is still not completely healed.

The phone, on a table, was too far to reach from the floor, but there was a waste basket nearby.  R grabbed it, was able to reach up and, after repeated attempts, knocked the phone out of the cradle. “Very hard work,” she says. She phoned a nephew, who drove to her home, called the doctor, got the answering service, who told him to call 911.

Paramedics came immediately. First 2, then more to make certain her condition was stable then to place her on the gurney and transport her to the hospital designated by her primary care doctor (who by this time had been contacted).

Now in the “right” hospital, the next step was the “right” surgeon, for this 97-year-old, with a broken femur. R’s primary care doctor was insistent on one particular orthopedic surgeon who had “technical excellence” and “good hands.”  Why? “Surgery is a trauma to the body. It is not tolerated as well in the elderly as in the young,” according to R’s highly regarded doctor.  “It’s important to get in, get out, do a quick job with less anesthesia, less blood loss, less time in the operating room.  That means less trauma.”

Clearly these early steps cleared the way for R’s ultimate excellent recovery and gave us far-away-living children (one of us was out here almost all the time) confidence that–in terms of helping parents age well–we were on the right track. To be continued on next post 1/18/11.

Help! Aging Parents is again a finalist in  the “Best Senior Living Blogs by Individuals.” Thanks to all who voted. Click 2014 badge at right to see and link to all finalist blogs. 

 



Smart Elders Who Reject Alert Pendants, Thinking They’re Careful and Won’t Fall–Wrong, sadly!

Independence vs. Broken Hip

We try to help parents age well and we’re aware of the statistics.  After 65 the chances of a fall increase; ditto the damage which  increases as people’s bones become more  brittle.  Down the line we realize that many people age, and suddenly look more fragile.

So I write yesterday’s planned post today, from a rehab center where my 97-year-old mother-in-law and a senior advisor, R, is recovering after falling 10 days ago in her home and having surgery to put a pin in her broken hip.

R. (hover over senior advisor tab above for her “bio”), like many older people fortunate to have (as she calls it) “a good brain,” values her independence above all. She took precautions to prevent falling in her home and has never hesitated to gracefully ask for help (your arm) when she feels unsteady.  She never dreamed she would fall in her home and thus, rejected the idea of a pendant that would alert someone she needed help.

The result: she fell in her living room, while walking to the kitchen, having noticed a decorative object on a desk had been moved by her every-other-week cleaning person.  She reached to move it, lost her balance, and grabbed a nearby chair.  But it wasn’t heavy enough to hold her. Both fell on the carpet. The next three hours were spent pulling her body with her arms across the carpet to a telephone; she called a nephew; he called 911.

I share R’s experience to help aging parents and others who live alone and resist “alert button” bracelets or necklaces. While they don’t prevent falls, they do prevent skinned knees from carpet burns, pain, and possible further hip damage from trying to get to a telephone…and worse. And they needn’t be worn all the time.

Indeed, a woman in her mid-80’s who shares an apartment with her son in the northeast, only wears the bracelet when she enters her Florida apartment–where she live alone in the winter.  She says she leaves the bracelet near the door and puts it on the minute she enters that apartment.

While we do our best to help our aging parents, the odds can catch up with even the most smart, independent and remarkable seniors….evident from the older people with broken hips in this rehab center.  We can only try to reduce the damage. Perhaps R’s experience can provide an opening for discussion with older parents who live alone and refuse–or don’t use–those “alarm button” pendants.


Aging Parents–Fall, Broken Hip, Post Delayed

Sorry–Still away and unable to write a substantive post.  It’s especially frustrating because senior advisor, R, less than a week ago fell, broke her hip, had surgery and is now in a care facility for two weeks of rehab, as I understand it.

You know from reading about her (click Senior Advisors tab; see sidebar), that she’s my mother-in-law and is remarkable.  Although I’m presently on the West Coast, I’m flying out to help her tomorrow and will relate her experience.

It’s instructive, which is the purpose of this blog.  There’s also a definite tie-in to last week’s posts that I want to share as soon as I’m certain I have correct details and dependable internet access.

Until Saturday, when I should have internet access—-