Falls are the leading cause of fatal and non-fatal injuries in older adults. For this reason, a fall risk assessment and home safety evaluation is vital. Falls can not only be deadly to elders, they can forever alter quality of life since falls often lead to nursing home placement and declining health. A professional fall risk assessment is a valuable tool in preventing falls and the accompanying problems. Below we will outline what is involved and how your family can benefit from a fall risk assessment and home safety evaluation, along with sharing falls prevention resources.

When should our family consider a professional fall risk assessment and home safety evaluation?

• As your parents age, their fall risk increases. A home safety evaluation is wise for anyone over the age of 70 and especially those with health problems.
• If your Mom or Dad has ever fallen before, it is vital to ensure the home environment is as risk-free as possible.
• If your elderly parent takes medications or has any chronic conditions, it is wise to get a comprehensive assessment.
• If your aging parents desire to “age in place” at home, a fall risk assessment is one of the best ways to ensure this is possible.
• When your elderly loved one leaves the hospital or has a change in health, it may be wise to review the health and living situation for continued safety.

What is involved in a professional fall risk assessment?

1. Review of the client’s health status (diagnoses, medications, history) and possible risks.
2. Assessment of ADLs and IADLs for potential trouble areas and resources to assist.
3. Home safety evaluation: a thorough review of the home environment to identify fall risks and ways to improve aging-in-place readiness. For some ideas of key areas of the home, check out EasyLiving’s Fall Prevention Checklist (free for you to download to get an idea if your parents’ home may have safety issues).
4. The geriatric care manager writes up their findings and recommendations and reviews this with your family.
5. A geriatric care manager’s assessment is more than just identifying the risks; it comes with personalized recommendations for solutions. So, rather than just saying “the throw rugs are dangerous”, the care manager might offer solutions if the client has a special attachment to the rugs, like non-slip backings or hanging them as wall decoration. For the bathroom, the care manager might recommend someone to install grab bars and provide specific equipment or modification suggestions. Often, the creative solutions make life easier as well as safer. For example, our care manager helped one client rearrange items in the kitchen so key items were within reach and sight. She ended up wasting less food, finding the kitchen more user-friendly and avoided getting on step stools to find items regularly.

How do I approach my elderly parents about a fall risk assessment?

• Take the approach that this is a step to make sure their wishes (such as the desire to remain at home) can be met.
• Explain that the process is collaborative. The geriatric care manager will make suggestions and can offer alternatives if they don’t like some of the solutions (such as the above throw rug example).
• Talk to the care management company about their suggestions if your parents are reluctant. Our care managers are highly experienced working with reluctant clients and often have great success once the clients meet them (daughters and sons frequently tell us they can’t believe Mom agreed to make changes they had been suggesting over and over!).

Resources:

Top Tips for Fall Prevention

Home, Sweet Home: Aging in Place Tips

Contact us about a fall risk assessment and home safety evaluation.

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Gun ownership is a controversial, highly discussed topic. What few people realize is the high number of seniors who own guns and the growing problem of senior gun safety for elders with dementia and diminished mental and physical capacity.

Senior gun safety is one of the trickiest issues our team has come across when working with elders and their families. Although driving safety and falls are probably the top two senior safety issues we encounter, elderly gun safety has come up in a number of cases and there are far too few resources/discussions about it. As shared in a Journal of American Geriatrics Society article*, “Whereas there are well-accepted guidelines for the assessment and counseling of older drivers, there is little to help guide clinicians in their discussions with older gun owners”.

One of the advantages we have in helping families at Aging Wisely and EasyLiving is a great resource network to access knowledge on all types of topics. We were fortunate to welcome Julie Williams from the Largo Police Department to provide continuing education for our eldercare team about senior gun safety. Julie has been with the Largo Police Department 12 years as a member of their Crime Prevention and TACH/SWAT Teams.

Senior Gun Safety Training by Julie Williams, Largo Police Department

Julie started with an overview of general gun safety and firearm information. She talked about the different types of firearms and the importance of safe storage and handling of both guns and ammunition.

She then shared the complex laws about gun safety and firearms. Gun ownership is strongly protected and there are federal and state laws governing firearms. These are covered under U.S. Code U.S.C. Chapter 44 Firearms and Florida Statute 790 Weapons and Firearms. There’s no upper age limit for owning a gun and the law does not routinely address diminished capacity in a person who already owns a firearm. Generally, someone can have a gun at home with no requirement for safe keeping (and can take them many places with them as well). Police can hold a gun temporarily for safe keeping, but this is only a short-term option (they can also advise on safe handling and keeping). Most care facilities have regulations about guns, though they may not be enforceable without the power of the law behind them.

Of course, there are specific issues that apply to aging and homebound clients. Julie discussed in-home care situations involving a gun issue and specific senior gun safety concerns. We talked about a number of cases we have dealt with and our experiences contacting the non-emergency police contacts. Due to the complexities of the law and limitations on police, families and professionals may need to be creative with solutions. The Record of Firearm Transfer form can be used when a client is willing to transfer a gun, for example to a family member.

Care planning can be done to incorporate gun safety and lawyers can even draw up a gun trust (a competent person can execute this, along with other estate planning documents, making the transfer of guns easier. The more proactively we (family and professionals) can address gun safety with seniors, the better. The issues may become more difficult and dangerous over time, especially for someone with dementia.

It is important to evaluate continued client and caregiver safety in relation to gun ownership. This ongoing assessment includes issues such as cognitive status, mental health, and physical abilities. In our discussions with the client, family and allied professionals, we consider the client’s wishes (and why he/she wants the gun–interestingly, nearly a fifth of all guns in the home are not intentionally purchased, but have been given to or inherited by their owners) and others who are coming into the home (providers may have policies about sending employees or volunteers into the home when a gun is present). Julie advised us on alternative safety measures a client might take if their concern is home safety (noise-making devices, pepper spray, securing the home).

One of the big takeaways from our discussions is that this issue needs to be addressed more holistically within communities. Gun issues are controversial generally, and gun rights limit what can be done in these situations. However, as our population ages we’ll need to work together to try to determine more comprehensive gun safety solutions.

What can you do about senior gun safety for your aging parent?

If you’re concerned about an aging parent’s senior gun safety, give us a call at 727-447-5845 or contact our eldercare professionals online (we offer nationwide consultations!). You may also want to check out Elderly Gun Owners and Home Safety Tips. Look for a future post with the Five Things You Need to Do When Your Aging Parent Owns a Gun (you can refresh your browser to initiate our signup box again, if you haven’t signed up for our newsletter yet).

*Pinholt EM, Mitchell JD, Butler JH, Kumar H. “Is There a Gun in the Home?” Assessing the Risks of Gun Ownership in Older Adults. Journal of the American Geriatrics Society. 2014.

Approximately 35% of Americans have a gun in their home. Naturally, some of these gun owners are elders. Gun safety is important for anyone who has a gun in the home, but special issues may arise for elderly gun owners. Here are a few of the considerations regarding gun safety and older adults:

• Cognitive issues (persons with dementia can become paranoid, may have difficulty with complex thinking, and may eventually lack competency in decision making)
• Concerns for caregivers and other helpers/agencies coming in to the home
• Compromised eyesight and hearing (higher chances of inaccurate shooting/accidents)
• Reduced strength and slower reflexes (could make it more likely an intruder could wrestle the gun away and use it on the owner)
• Suicide/depression considerations: Older adults make up 12% of the US population, but account for 18% of all suicide deaths. They have high rates of suicide completion because of methodology (guns being primary) and the highest prevalence of double suicides of partners/spouses.

Addressing gun safety with your aging parents can be a complicated issue. The first step is to open up the discussion (some adult children may not even be aware that elderly parents have guns in the home). You can express your concerns about Mom or Dad having a gun at home and talk about options (selling the firearm or storing it offsite, for example). It is important to know the legalities of transferring the gun…it’s not just as simple as moving it to your home. We’ll have a guest post coming up soon from a police expert, with answers to frequently asked gun safety questions!

If your aging parent claims the gun(s) do not need to be removed, it is important to assess the safety issues. Age is not automatically a reason a person can’t have a gun at home. A professional can help you look at the big picture, assessing the areas mentioned above and other factors.

If the assessment confirms safety problems, the evidence should be presented to the elder. Our experts can help guide that discussion. Many times an outside party can be influential and coming to an agreement is better than having to force the issue. Fortunately, we have a lot of experience with these and other safety discussions, as well as how to approach the whole process in a dignified manner and get the elder’s buy-in.

However, much like with senior driving safety, there are times when the person may not agree and additional steps need to be taken to protect the elder and others. Check out our previous EasyLiving gun safety article and stay tuned for our guest expert post for more!

We write a lot about home safety for seniors here and on our EasyLiving blog. We share checklists that you can use to assess your aging parent’s well-being at home, as well as fall prevention checklists and an array of tips. However, we find that adult children still miss some important considerations when assessing senior home safety. These are often the very important factors that our Care Managers point out when doing a Comprehensive Home Safety Assessment.

Today, we’ll share some of this insight from our experts, on commonly overlooked areas. Don’t miss important warning signs! Contact our team for a full, expert evaluation and recommendations!

1. Are there guns in the home? Is it safe for them to be there, or are additional safety measures needed?
2. Are there other hazardous materials or tools? Is my parent likely to take on potentially dangerous tasks, such as trimming trees, doing roof repairs or attic work in the heat?
3. Is my parent isolated? Are there signs of loneliness and depression?
4. How well can my parent handle tasks requiring complex thinking? Someone with early stage dementia and minor memory loss may be able to function relatively well, especially if the environment is set up in the right way. However, tasks that require higher level executive function (banking, financial transactions, decision making) may cause trouble and leave your parent vulnerable to exploitation or mounting problems.
5. What happens if disaster strikes? Everything might be okay under normal circumstances, but can my parent handle a hurricane or other natural disaster? What if the power or water is out at my parent’s home for a few days? Consider smaller, personal “disasters” as well. Dad is a great caregiver for Mom, but what would he do if she fell? How would Mom handle a pipe breaking in the home or manage a major repair? How well would they do if a serious illness struck?
6. Are there subtle problems building up? What is my parent eating on a day-to-day basis? How accurately is Mom taking her medications? Without a trained eye, it can be easy to miss small problems that can lead to other issues. Aging parents tend to “pull it together” for adult children too, so what you’re seeing may be the best possible scenario.

We’re here to help! Call us at 727-447-5845.

Caregivers: this holiday season, give yourself the ultimate gift. The geriatric care management assessment will save you time, money and a lot of headaches. Why not check into how a geriatric assessment could help you?

 Why is the geriatric care management assessment a gift for the caregiver?

• It gives you the feeling you have a handle on the situation with your aging parent or other elderly loved one. You get a baseline of different aspects of the person’s situation and care needs. This can also be a wonderful tool in discussions (or disagreements) with other family members, professionals, etc.
• You walk away with actionable tips, thus feeling less overwhelmed.
• It offers realistic solutions. The internet and your friends may offer a lot of advice…some of it may or may not be for you. It may be just plain wrong, or just not apply to your loved one. A geriatric care management assessment is specifically built for your loved one’s unique situation.
• The geriatric care management assessment is a plan, built on a thorough analysis of the situation. Having a plan saves you time and minimizes the chances of crisis.
• Rather than having to learn an entire field from scratch (caregiving already feels like getting several Ph.Ds sometimes!), you get an expert who can share their years of experience and knowledge with you. You can quickly gain access to all sorts of resources and information that could take a long time to uncover otherwise. The care manager is hired just to help you…they aren’t a gatekeeper for an organization or focused on one specific program. Care managers can therefore offer you a world of options, so that your loved one gets the best care and you have a smoother journey as a caregiver.

How do I get a care management assessment done on my loved one?

It’s simple, contact us and we’ll set it up. If you aren’t in the Clearwater/St. Pete/Tampa Bay area, we can refer you to a colleague in your area. Worried that your loved one won’t like the idea? We encounter that all the time, so we know how to help. You’ll be delighted by how smoothly things will actually go. We have a dedicated Senior Care Consultant who does complimentary phone consultations and attends the initial face-to-face meeting to ensure everything goes well. She’s an expert in the process and the best approaches for sensitive issues. One of the most frequent compliments our care managers receive is about their ability to handle sensitive situations and guide the family in a dignified approach.

What happens after we get the geriatric care management assessment?

You have an actionable plan with specific resources, so you can follow through or hire our care managers to help guide you. With their help, you can put the suggestions into place with ease. As mentioned, their approach often helps and is especially useful because of the personal separation they have versus family members. It is easy for them to see things objectively and offer your family advice backed up by their deep experience. Depending on the priorities outlined in the geriatric care management assessment, you may hire home caregivers, begin seeking out alternative care arrangements or make some modifications to the home or care situation.

Give yourself the best gift to start 2015 off on the right foot…contact us (phone: 727-447-5845) to discuss getting a geriatric care management assessment done by “your family’s advocate”, Aging Wisely.

In previous posts, we have covered The Benefits of a Geriatric Care Management Assessment and The Nutritional Components of an Elder Assessment.

A major area of any geriatric assessment is a review of the client’s functional status. A functional assessment reviews the client’s abilities to perform daily tasks. These can generally be divided in to ADLs (Activities of Daily Living, such as bathing, dressing, grooming/hygiene, eating and transferring/mobility) and IADLs (Instrumental Activities of Daily Living, such as cooking, household maintenance, driving, using a telephone, shopping, financial management). The assessment also reviews cognitive status and any potential limitations there, which may affect functioning, safety and awareness.

The care manager reviews current daily routines, abilities and challenges with:

* eating
* dressing
* bathing
* hygiene/grooming
* toileting/continence
* mobility & fall risk
* household cleaning & maintenance
* meal preparation
* laundry
* pet care
* transportation

In looking at these various areas, the assessor reviews the person’s:

* cognition (memory, insight, judgment, problem solving)
* psychological well-being(mood, emotions)
* social supports
* sensory systems(hearing, vision)
* physical skills (strength, movement, mobility)
* use of adaptive equipment/environmental safety

The assessment provides an excellent picture of current status, gaps/concerns as well as recommendations to ensure continued safety. By conducting a face-to-face assessment in the home environment, the care manager observes the client’s abilities within the real-life environment. Gathering information from the client, family, and providers as well as careful, expert observation enables the care manager to form a complete picture. The assessment may be conducted over a few visits during different times of day or situations for gathering accurate data.

The findings of the functional assessment result in recommendations for immediately improving quality of life and safety, as well as considerations for the future and issues to anticipate as chronic conditions impact abilities and function. The geriatric care manager may recommend community services, home care assistance, home modifications, technology for aging in place, physical or occupational therapy and other specialty services. The care manager makes specific, easy-to-follow recommendations so that the client and family has a detailed road map for accessing good help, and the care manager can also assist in implementing recommendations if desired.

CONTACT US TODAY for more information or to schedule your geriatric care management assessment. We provide elder assessments in the Tampa, Florida area (Clearwater, St. Petersburg, Pinellas, Pasco and Hillsborough counties) as well as eldercare consultations for families throughout the U.S.