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Aging Wisely September 2012 - Aging Wisely

Eldercare Advice: Downsizing a Lifetime of Belongings


Several personal experiences got me thinking about downsizing and the many emotional and practical components involved in “getting rid of stuff” which often happens during major life changes such as an elder moving to a retirement community. 

I can vividly recall the process as my grandparents prepared for their move to a retirement community a number of years ago.  My grandmother was an avid collector and the process certainly had stressful moments, though I think it was much easier being that it was a proactive choice they were making on their own.  Even then, it is not easy to decide which of your precious belongings to take and what to do with those you choose not to take.  Many of the clients we work with are facing a transition due to health or care needs, and while we may encourage their participation in the process, the feelings about the transition are generally more ambivalent than were those of my grandparents. 

Facing a major life transition of my own, I have recently experienced what many of our clients have…going through an estate sale, deciding on a small portion of belongings to keep and facing the emotional and practical issues of downsizing a lifetime of belongings.  My situation may be quite different, and my “lifetime” shorter in years of collecting, but it did give me a different perspective on the process (and greater insight in to how it all works).

estate sales downsizing pictures

It is important to acknowledge the emotions involved in these major life transitions, especially for our elderly relatives who may not be making the move solely out of choice.  These emotions take time to process.  Unfortunately, we don’t always have the luxury of time.  If a health crisis precipitates the need to move to assisted living, for example, family members may need to make quick arrangements.  As a family member, you may feel pressure of time while trying to balance helping your loved one with your job and other obligations.  Take a step back when possible and think about ways things can be accomplished to perhaps slow the process.  Consider hiring help to allow you time to spend with your loved one and reduce time on certain tasks to allow more time for others.  Think about your loved one’s perspective when you feel frustrated.

There are many resources to help with transitions such as moving to assisted living, moving an elderly relative in to your home or even assisting after a loved one dies.  A geriatric care manager can help you coordinate the transition, locate reliable helpers and professionals of all types, and provide recommendations and tips such as choosing the best assisted living options or making changes needed to health insurance if your loved one is moving to your state.  A care manager can also be an invaluable resource in helping your family through the emotional issues and making suggestions to ease the transition–before, during and after. 

Estate sales companies can put on a professional estate sale, helping with everything from pricing items and staging to advertising and managing the sale. You might also want to sell specific items separately, through such online sales options as EBay or Craigslist or by taking items to a local purchaser or pawn shop.  Do some homework on the best ways to sell items and consider the value of your time as you determine how much effort you want to put in to certain items.  You may want to have a professional appraiser value items, especially collectibles, art and other items that might have significant value.  If you aren’t sure about an item, it is better to use a professional for valuation.  You should consider seeking advice from a qualified attorney as you deal with selling items, managing an estate and related financial and legal ramifications.

Moving companies can help with various aspects of the move and there are now senior move managers who specialize in this area.  A senior move specialist will usually be: 1. sensitive to the emotions of transitions and how to handle more than just the practical aspects 2. knowledgeable about moves involving downsizing so they can help with looking at what to take, layng out the new floor plan, etc.

We will continue highlighting issues, tips and resources for transitions and downsizing in our blog so check back for more! 

Need help planning for a transition or eldercare advice on any topic? Looking for resources to assist?  Call us any time at 727-447-5845.

Have you been through helping a loved one downsize?  What was the hardest part?  How did everyone decide what to keep or “who gets what”?  Did you get any helpful eldercare advice as you went through the process?

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Fall Prevention in the Comprehensive Geriatric Assessment


Fall is upon us and the first day of fall is used to create awareness for falls prevention and home safety.  It is a great time to download a Falls Prevention Checklist and review it with your older loved ones.

Falls Prevention Awareness

Some of the statistics about falls and seniors from the CDC clearly illustrate why this is such an important issue for seniors and their families, and why we at Aging Wisely are so passionate about it.  Take a look:

  • 1 in 3 older adults (65+) fall each year (but less than half talk to their healthcare provider about it).
  • Falls are the leading cause of injury death among older adults.
  • The direct costs of falls (2010) was $30 billion.
  • Falls are the most common cause of Traumatic Brain Injury.
  • People age 75 and older who fall are four to five times more likely than those age 65 to 74 to be admitted to a long-term care facility for a year or longer.

Clearly, falls are a serious concern for older adults and are not only dangerous, but can seriously impact quality of life.  Many older adults who fall and do not have a serious injury develop a fear of falling and therefore limit their activities, further exacerbating fall risks due to lack of activity/exercise and affecting quality of life in other ways.

In addition to seeing how falls can negatively impact elder clients over the years, we are passionate about this issue because there are so many available prevention steps.  A key aspect we want to emphasize here is recurrent prevention–that is, taking preventative steps after minor falls to prevent further falls and serious injury.  We know individuals often do not think about this issue until a fall has occurred.  If every senior who fell talked to their healthcare provider and took preventative steps after a minor fall, we could prevent many of the extreme statistics we see above.  Our experience tells us that when a senior lands in the hospital or suffers serious consequences, he or she has usually had numerous minor falls beforehand.

How can a healthcare professional help you with falls prevention (or “recurrent prevention”)?  What factors might contribute to fall risk that can be modified to reduce risk?

  • A professional can assist with an environmental review and complete a home safety assessment like the one above, but also providing solutions and resources for you to make it easy to make changes.  A geriatric care management assessment also helps the elder client and family to understand how such changes will help and to find creative ways to make changes without necessarily feeling the home has been “medicalized”.
  • Physical factors may need to be evaluated, such as balance issues, eyesight, and muscle weakness.  Is the fall related to a medical condition or do glasses need to be adjusted?  A care management assessment can pull together information from your various medical specialists and help you identify risk factors.
  • Medications can play a significant role.  Your care manager can help you ascertain a medication review from your doctor or pharmacist (including specialty geriatric consultant pharmacists) and talk with your providers about possible solutions.
  • Exercise is a key tool in preventing falls.  How can you incorporate exercise and modify it to your physical abilities?  Your assessment may include a recommendation and coordination with your doctor for a physical or occupational therapy evaluation.  You might benefit from specialists such as a personal trainer who works with older adults (we love In Home Fitness and have recommended them to a lot of our clients!) or a Tai Chi or senior exercise class.
  • A professional assessment can provide well-rounded recommendations on a variety of aspects and may uncover things you would not have.  Issues that could impact fall risk include nutrition, foot issues, mobility aids, socialization/loneliness.  A geriatric care management assessment can focus on specific areas of concern, but also look at the “big picture” and help provide you with proactive steps for good health and future planning.
  • A comprehensive geriatric assessment can offer specific recommendations for solutions along with costs and programs to assist with care needs and help with any financial concerns.

Need help today?  Want to schedule a comprehensive geriatric assessment or a care consultation?  Contact our Senior Care Consultants at 727-447-5845.

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Getting Good Information: Caregivers, Sundowners Syndrome, Dementia


We read a lot of forums, websites, books and articles about all matter of topics related to aging and elder care.  With the explosion of information available on the web and, in particular, social media and forums for comments and feedback, there are many caregivers benefiting from sharing information and connecting with others in similar circumstances.

However, the downside to the information superhighway is that it can take you on a lot of wrong turns.  We all know the stories of ways the internet has been used by con artists for scams, but another less obvious concern is filtering through information to ensure you are getting accurate information or advice.

caregiver seeking information on sundown dementia

Both online and offline, we see a lot of misinformation about dementia and related terms like sundowners syndrome, Alzheimer’s disease and memory loss.  It is not uncommon when a family comes to see us to hear that they have not been able to get specific answers about what is going on with a loved one who is having cognitive issues.  Sometimes this is due to fear and no one wanting to seek a specific diagnosis, other times certain assumptions have been made (the symptoms are just “old age”) and occasionally the family has gotten blatently incorrect information.

Here are some words of advice for seeking information as a caregiver, whether on issues like sundowners syndrome, dementia, caregiving or preparing for eldercare:

  1. Seek expert sites on the specific topic.  Start with sites such as disease-specific organizations and trusted resources with long histories. 
  2. Find out who is providing the information and review their “about us” closely.  What are the academic backgrounds and qualifications of the people writing the information?  If you cannot locate an “about us” page, you should probably seek information elsewhere.
  3. The best information to get from other caregivers is support and ideas on how they have handled situations.  When it comes to diagnoses, care planning and choosing specific resources, a professional opinion usually serves you better.  Here are some areas where we see particularly bad (or just misguided) information being shared: legal advice, qualifying for benefits/programs and how to do so, diagnosis and treatment information, terminology and resources.  Many times it is not that the information is purposely harmful, it just doesn’t necessarily apply to your situation.
  4. Stay away from judgmental or negative commentary.  It is the last thing you need as a caregiver.  If you review a Facebook group or forum site and notice people sharing strong opinions of what a caregiver should or should not do, this may not be a supportive atmosphere for you.  Negativity (and even things like political ranting) can cause you greater anxiety.
  5. Just like with other aspects of caregiving, strategize which ways the internet and technology can help you most.  For example, reading too much about a relative’s diagnosis might be scary at first.  Instead, seek information on which physicians or hospitals specialize in treatment or who offers local support groups.  Setting up an online personal health record or using a communications system/online community can be very helpful to caregivers.
  6. Use a combination of information sources to seek resources/care providers.  When you are trying to find options such as in-home care, assisted living, and benefit programs, you may be best served by having professional help in pulling together a care plan.  This can save you a lot of hours of research and heading down the wrong roads.

More specifically, when it comes to dementia concerns, here is some specific advice we offer to caregivers who may be seeing signs of sundowning or cognitive changes:

  1. Make a list of symptoms, concerns, and behaviors.  When did you notice symptoms? Have their been medical or other changes? How are symptoms affecting functioning?
  2. Get past “terminology confusion” by understanding the basic terminology related to memory loss and dementia–check out our dementia fact sheet which you can download at the bottom of this post for a concise overview.
  3. Seek a diagnostic workup from a memory clinic, geriatric specialist, or neurologist.  A complete workup will serve to rule out reversible causes and include a case history (benefiting from the information collected above) and evaluation of symptoms.
  4. Find a support group, online or in person, that fits you.  There are groups for various stages and situations, as well as groups for both caregivers and the person who is diagnosed.
  5. Seek out books and fact sheets from the disease-specific organization.  The Alzheimers Association has great information on an array of topics, which you can get online or at a local office.  Aging Wisely has a page of some recommended reading for dementia caregivers as well.
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Navigating Assisted Living Facilities with a Geriatric Care Manager


elders in an assisted living facility activityWhen your elderly loved one needs help, you might start to consider what type of senior care assistance is best…home health care, community support services, assisted care facilities…it is a lot to navigate.  We speak to a lot of families who are considering options, or have decided it is time to consider an assisted living facility, but do not want to make the wrong decision.  Here are just a few of the many factors and questions that might play in to the decisions:

  • What level of care does the elder need?  How much home health care or assisted living support would be needed?  Which type of agency or assisted living facility could manage the care? 
  • What does all the terminology mean? What levels of care does the state offer and how are these providers regulated?
  • What are the costs involved in senior care?  What is included in various rates?  What insurance or benefits programs assist with costs, and how does my loved one become eligible?
  • Which senior care providers do a good job?  What is the history of the provider or facility?  What kind of care will they provide to my dear loved one?
  • What factors should we consider in the decision and how important are each of these: location, appearance/layout of apartments, activities, food, additional care levels/services available, etc.?

This is just a quick snapshot of the factors to consider in the assisted living decision, to say nothing of the very personal process involved and the challenges of making the transition.  If you are somewhere in this process, you might want to check out our Choosing a Senior Care Facility guide which lays out some important steps to take as you consider your options. 

This list of questions alone points to why having a professional geriatric care manager help with the process can be so valuable.  Here are some additional reasons why a geriatric care manager, specifically, should be first on your list of calls when your family is considering assisted living options:

  1. A geriatric care manager is an independent consultant hired by you, to help you.  Geriatric care management’s code of ethics outlines important guidelines such as the role of the care manager and business relationships.  Other professionals may be available to help, but may be paid by certain facilities (i.e. a referral fee, typically how “placement services” work) or may be associated with a particular program or unable to provide opinions on quality of care or other specific issues.  An Aging Wisely care manager, on the other hand, works for the client/family system directly in this role.
  2. A professional care manager is an expert in aging and the services to support families as they face aging issues.  This simplifies your life, by offering you one point person who can answer questions on a wide variety of issues and help you navigate all types of options.
  3. Care managers’ expertise and sensitivity uniquely qualify them to help your family with the many dynamics and emotions of the transition process.  We get letters all the time from family members saying the care manager turned what seemed like it was going to be a negative process in to a positive one in which the client was an active part of the process.
  4. A care manager’s role is to give you their opinion and input, so that you can make the decisions you feel are best for you.  A care manager won’t decide anything for you, but empower you to make a fully-informed decision.  So many times in eldercare, families are given a list of options which feels meaningless.  A care manager can tell you about quality of care at specific facilities, pros and cons of certain options and pitfalls to consider.  As you navigate options together, the care manager might point out things you hadn’t considered or help you “pull back the curtain” to see the factors that will impact the outcome of your decisions.

Most care managers offer flexible options for how you use their services.  You might start with a care consultation to gather some information ahead of time, or hire a care manager when a loved one is in the hospital and you need an assessment and advice on where to go next.  Other families will use the services of a geriatric care manager for everything from selecting an assisted living facility to monitoring care on a regular basis and serving as a local liaison. 

Want to talk to someone about how a geriatric care manager could help you in determining the best senior care options?  Want to get some information on assisted living facilities or other resources in Florida?  Call us at 727-447-5845.

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Payment Concerns
Not sure how you are going to pay for elder care?

Is the Time Right?
Find out if its time to seek help for your loved one.

Aging in Place
How to keep a loved one safe at home, and when it may be time to consider assisted living.

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Mission Statement

Our goal is to enable every individual we work with to live the most fulfilling life possible, with utmost dignity, focusing on their physical, mental, spiritual, family and financial wellbeing.