Whether caring for an aging parent or helping a friend or spouse facing a diagnosis and treatment options, everyone needs an advocate at times. When any person is facing a diagnosis, surgery, or hospitalization, having such an advocate can be invaluable. Even if you are very savvy, there is a lot to absorb and consider in these situations. Here are some tips for you to be a good advocate:

1. Help gather important information. Help your loved one organize their medical records, health history and important documents (advance directives, insurance information).

2. If your loved one has not completed advance healthcare directives and decision making paperwork, encourage them to do so (including Durable Power of Attorney, Healthcare Surrogate/Power of Attorney, Living Will).

3. Help in preparation for the appointment, procedure, hospitalization (as feasible). Prepare purpose of the visit, symptoms, concerns, list of questions. For procedures or treatments, find out what to expect and ask questions. How long will you be there? What do you need to bring? Will the patient need a ride home? Will they need aftercare? While many people don’t need formal aftercare, consider the challenges one ofte faces after a surgery or hospital stay. Often, you can drive the patient home and get them settled, but it may be easier to have additional help as you may need to pick up prescriptions or may not be able to help if the patient is very weak or ill.

4. After an appointment, use your notes to review what was discussed and consider next steps/pros and cons, for example regarding treatment options. It is important to help the patient think through things in a less rushed/stressful manner, when possible. If you are making decisions on behalf of a loved one who cannot do so any longer, have an advocate for yourself…someone you can talk things through with. Sometimes an outside party is best for this and can help you think through all the ramifications, and gain a clearer picture.

5. Help your loved one ascertain second opinions when needed. However, bogging someone down with a lot of information (or misinformation) from the internet, for example, can be less than helpful. It is most helpful to identify the most expert resources and assist in clarifying information and making a comfortable decision feeling informed, not overwhelmed.

6. Review this NY Times article about 6 questions to ask for elderly patients being hospitalized. If you cannot be with your loved one at the hospital or emergency room, it is a good idea to get a friend, relative or geriatric care manager to be there. This is not only for your loved one’s well being, but to ensure the hospital staff gets the accurate information they need to do the best job.

If you need help with eldercare concerns, contact us today.

We can provide advice to you as well as help with an independent assessment of your loved one’s situation. We offer consultations for families and support for the healthcare decision makers. We provide 24/7 emergency on call services so your loved one has an advocate in the E.R. or other crisis situation. We help families in conflict over what is best as well, and help everyone to gain a better understanding of the situation and options. Getting professional input can make a world of difference.

We have a number of checklists for Aging Wisely clients, as well as educational materials to help clients and families as they make their final arrangements. Our team member, Dena Manis, worked for many years in the funeral industry and holds her funeral director’s license. She has been a helpful advisor both in creating these materials for us to use and in working with families when questions arise, or they need some support and consultation during that process.

Here’s one of our checklists on some basics of planning a funeral:

Planning for a Funeral

1. Shop around in advance. Compare prices from at least two funeral homes. Remember that you can supply your own casket or urn.

2. Ask for a price list. The law requires funeral homes to give you written price lists for products and services.

3. Resist pressure to buy goods and services you don’t really want or need.

4. Avoid emotional overspending. It’s not necessary to have the fanciest casket or the most elaborate funeral to properly honor a loved one.

5. Recognize your rights. Laws regarding funerals and burials vary from state to state. It’s a smart move to know which goods or services the law requires you to purchase and which are optional.

6. Apply the same smart shopping techniques you use for other major purchases. You can cut costs by limiting the viewing to one day or one hour before the funeral, and by dressing your loved one in a favorite outfit instead of costly burial clothing.

7. Plan ahead. It allows you to comparison shop without time constraints, creates an opportunity for family discussion, and lifts some of the burden from your family.

Our EasyLiving/Aging Wisely team supports community efforts to reduce falls and their negative effects for seniors. Aging Wisely was a co-founder of the Pinellas Falls Prevention Coalition and our company remains involved in ongoing efforts. Of course, we also work on falls prevention on an individual basis every day in the work we do with clients.

The two major causes of falls are: Health-related changes such as certain medications, slow reflexes, poor eyesight and balance problems and Dangers in the Physical Environment such as slippery floors, poor lighting, electrical wires and cords in pathways, loose rugs, raised thresholds and clutter.

Most falls occur in bathrooms, bedrooms and on stairs. Use this checklist to help minimize the risk of falls in your home:

Approach to House

• Park close to your door.

• Be sure there is a clear pathway from the car to the door.

• Make sure the surface of the pathway is smooth and does not have cracks.

• Make sure there is a good light to show you the way to the door.

• If you have stairs, are the handrails steady and secure?

• Is the door wide enough to get through without straining?

• Make sure the door is easy to open and close.

• Paint the edges of outdoor steps and any steps that are especially narrow or uneven.

Living Room

• Is the seating adequate and safe?

• Can you get in and out of the furniture easily.

• Be sure the pathways are clear of electrical wires, clutter or cords.

• Be sure you have adequate lighting in the room.

• Be sure light switches are easy to reach and are at the entrance to the room.

• Make sure you have the telephone near and access to turn the television off and on without getting up from your chair.

• If you have floor rugs, remove them and wear non-slip, low heeled shoes or slippers with rubber grippers on the bottom. Do not walk around in stocking feet.

Kitchen

• Is the seating adequate and safe?

• Be sure there is good lighting both in the room and in the work areas.

• Move the items you use most often to shelves that you can easily reach without a step stool.

• Do not use a step stool. Ask someone to help you if you must reach for something.

• Are your appliances in good condition and accessible?

Bedroom

• Place a lamp close to the bed where it is easy to reach without getting out of bed.

• Be sure the path from the bed to the bathroom is clear of clutter and is lit by a nightlight.

• Put a nightlight in the bedroom and hallways.

• Remove any floor rugs.

• Have the telephone close to the bed so you can reach it without getting out of bed.

• Have the television remote near the bed to avoid getting up to turn it on and off.

Bathroom

• Clear the pathway to the bathroom of any clutter, wires or cords.

• Be sure to turn the lights on when you enter.

• Do you have grab bars in the shower, tub and toilet areas? If not, have these installed.

• Remove any bathroom area rugs.

• Use non-slip adhesive strips or bath mats with strong suction grip.

• Consider sitting on a chair or stool in the shower.

• Use an elevated toilet seat to make it easier to sit and stand.

• Is there a telephone in the bathroom close to floor or is safety device worn during showering?

Stairs and Steps

• Pick up things on stairs such as books, shoes, laundry or other objects.

• Be sure the stairway is well lit.

• Have glowing light switches installed at the top and bottom of the stairwell.

• Repair any broken or loose steps.

• Repair any broken or loose handrails.

• Paint a brightly colored strip on the top and bottom steps.

General Safety

• Do you have smoke detectors in place (recently tested)?

• Use helping devices such as walkers or canes if necessary.

• Store items you use often on the counter or in an easy to reach drawer.

• Wear skid-free shoes.

• Keep a flash light with a fresh battery in the bedroom, kitchen and living room in case of loss of power.

• Review medications with your doctor or pharmacist.

• Have your hearing and eyesight checked. Inner ear problems can affect balance and vision problems make it difficult to see potential fall hazards.

• Exercise regularly to improve balance, flexibility, strength and overall well-being.

• If you feel dizzy, sit down and allow enough time for the dizziness to clear. Stand up slowly and hold onto something steady.

• If a step stool is absolutely necessary, use one with high and steady handrails. Do not use wobbly stools or chairs to reach things.

• Think about wearing an alarm device that will bring help- in case you fall and can’t get up.

• Be aware that alcohol affects your balance.

There are some great products and services to make the home safer for seniors–everything from in home technologies to aging in place certified remodelers and products to address specific mobility issues. We keep up to date on the latest and greatest, so we can be a resource to you!

If you would like a comprehensive assessment of home safety and custom recommendations for a variety of issues: Aging Wisely’s here to help.

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This is an issue we seem to talk about daily with families. Our care managers regularly coach families on how to approach this, help evaluate the situation, and help go through the process of “ending driving priveledges”. (We invite you to check out our downloadable handout which offers some great tips and resources).

One of the messages we think is important in this process is that individuals can still thrive and live their lives minus a car. But, this requires exploring the options and giving them ways to still get to important activities. Before approaching this issue, take time to learn about transportation options in your loved one’s area (or consult with a care manager on what those are). If your loved one’s lucky enough to live in an urban area with great public transportation, this may not even be an issue in the first place. However, for most of us, that is not the case. However, many aging service organizations offer transportation and there are disabled transportation services via many bus systems.

The option we commonly recommend for clients, in addition or combination perhaps with the above, is to hire a private duty home care company who will provide a homemaker/companion to drive the client. We work out a plan that fits the clients’ needs and schedule. This can not only include transportation to doctors and appointments, but to favorite activities, the hairdresser, dinner dates and more.

This service is often more affordable than people think. According to the Dept. of Labor’s Bureau of Labor Statistics, car ownership costs are the second largest household expense in the U.S. Owning and operating a car costs an average of $8,000/year or about $600/month—which is equal to more than 30 hours of drive time, for example, with our sister company, EasyLiving, Inc. (www.easylivingfl.com).

As you prepare to discuss the “driving issue”, do some homework and learn about the options to help your loved one stay active. For most people, a combination of resources can make this transition much easier. Friends, family and neighbors may be willing to help–but don’t leave the person with that as their only option. That really reduces the person to relying on, and potentially feeling like a burden to others. Your local Area Agency on Aging (www.eldercare.gov) can provide a list of resources, or contact us to discuss options in the Tampa Bay area.