Preventing Falls

What a Difference a Few Simple Things Can Make

Every day, we look for ways to optimize our efforts. If we can find activities that accomplish multiple goals at once that is even better. This is especially true when it comes to things that benefit our health. For all of us, but especially those over age 60, a significant cause of accidental injuries and death each year are due to falling. Falls often result in expensive emergency department (ED) visits and hospitalizations. Older adults often end up in costly long-term care facilities. The financial cost can be overwhelming. Beyond the initial injuries, a person’s ability to actively engage in life, impacting their physical and emotional health, can be the result.  Wouldn’t it be nice to be able to prevent falls from happening to begin with?

Yes, there is good news! Most risk factors that increase the likelihood of falling can be minimized or eliminated. A few of the most common risk factors and some solutions include:

  • Trip hazards at home and work

Improve lighting, re-route cords across walking paths, remove clutter on the floor, remove or secure loos floor coverings, add non-slip mats to showers/tubs, fix uneven/loose steps and handrails.

  • Inappropriate and poorly fitting footwear

Wear shoes that fit well and provide proper support for activities. Loose-fitting shoes, untied laces or those that hang to the ground, and especially “open” shoes like flip-flops and open-back slip-ons can contribute to falling.

  • Lower body Strength

Don’t be a body builder but ensuring strength and flexibility in our back and legs can mean the difference between a stumble and a fall with injuries.

  • Medication

Many common over the counter and prescription medications can cause issues with balance, reaction time, dehydration, and other contributors to falls. Work with your healthcare team to reduce or change problematic meds.

  • Poor Vision

Wear glasses or contacts that correct your vision as much as possible. (Sometimes we can’t fully correct all vision issues.) In addition, be sure to remove reading and computer glasses, and look through the top part of bi-focals or remove them before walking.

Every one of these risk factors can be identified and most can be completely resolved at little or no cost. At the same time, we can reduce the very significant medical costs of fall-related injuries in Idaho which is more than $253 million each year ($50 billion nationally).

Throughout September, the Idaho Commission on Aging (ICOA) will be presenting free seminars about falls prevention.  Learn more about…

  • The full impact of falls on individuals, families, and Idaho communities in the Why Falls Matter seminar.
  • Performing home and office audits for trip hazards in the Identifying and removing Trip hazards at Home seminar.
  • Simple at-home exercises you can do by watching or following along as a physical therapist demonstrates them during the Simple Steps seminar.
  • Ensuring healthcare students and professionals include assessing fall risk as part of their practice by participating in the “brown bag” Falls Assessment As a Matter of Practice seminar.

View the entire Falls Prevention seminar schedule  and other falls prevention resources: https://aging.idaho.gov/stay-healthy/disease-prevention-health-promotions/falls/

Isn’t it a good idea to take charge of ensuring we, our families, neighbors, and communities can reduce the incidence and impact of falls? Physical and emotional health, loneliness and isolation, financial stability, and the ability to continue to live independently in our communities of choice depend on it.  Together we can learn to reduce and eliminate falls.

Thank you for standing up for Life, Liberty, and the pursuit of happiness for Older Idahoans! Visit the ICOA website for additional information and services to help older Idahoan’s age with safety and dignity.

www.aging.idaho.gov

Emergency Preparedness for Older Adults

Follow these easy steps to make sure you’re protected.

Natural disasters, such as wildfires, floods, and blizzards, may force you to evacuate your home or shelter-in-place at short notice. It is important to know what to do in case of an emergency well before disaster strikes.

If you are an older adult living in the community, you may face some challenges during an emergency. For example, you may have mobility problems, or chronic health conditions, or you may not have any family or friends nearby to support you. Support services that are usually available, such as help from caregivers or in-home health care and meal delivery services, may be unavailable for a period of time. In addition, older adults may experience challenges that come with advanced age, such as hearing or vision problems or cognitive impairment, which may make it difficult to access, understand, and respond to emergency instructions.

You or the person you care for can be prepared for emergency situations by creating a plan, reviewing or practicing it regularly, and keeping an emergency supply kit.

Creating a Plan

The first step in preparing for an emergency is creating a plan. Work with your friends, family, and neighbors to develop a plan that will fit your needs.

  • Choose a contact person who will check on you during a disaster, and decide how you will communicate with each other (for instance, by telephone, knocking on doors). Consider speaking with your neighbors about developing a check-in system together.
  • Create a list of contact information for family members and friends. Leave a copy by your phone(s) and include one in your Emergency Supply Kit.
  • Plan how you will leave and where you will go during an evacuation. If you are living in a retirement or assisted living community, learn what procedures are in place in case of emergencies. Keep a copy of exit routes and meeting places in an easy-to-reach place.
  • Create a care plan and keep a copy in your Emergency Supply Kit. Try out the CDC’s easy-to-use care plan template.
  • If you have medical, transportation, or other access needs during an emergency, consider signing up for SMART911, Code Red, or your local county registry, depending upon which service your area uses to helps first responders identify people who may need assistance right away.

Creating an Emergency Supply Kit

After an emergency, you may not have access to clean water or electricity. Make sure you are prepared with your own supply of food, water, and other items to last for at least 72 hours.

  • Visit Ready.gov for a list of basic items to gather for your Disaster Supply Kit.
  • Medical-Related Items:
    • A 3-day supply of medicine, at a minimum. If medications need to be kept cold, have a cooler and ice packs available.
    • ID band (full name, contact number for family member/caregiver, and allergies)
    • Hearing aids and extra batteries
    • Glasses and/or contacts and contact solution
    • Medical supplies like syringes or extra batteries
    • Information about medical devices such as wheelchairs, walkers, and oxygen including model numbers and vender.
  • Documents (Keep physical copies in a waterproof bag and take photos of each document for backup):
    • Contact information for family members, doctors, pharmacies and/or caregivers
    • List of all medications, including the exact name of the medicine and the dosage, and contact information for pharmacy and doctor who prescribed medicine
    • List of allergies to food or medicines
    • Copies of medical insurance cards
    • Copies of a photo ID
    • Durable power of attorney and/or medical power of attorney documents, as appropriate.

Taking these steps will put you and/or your caregivers in a better position to deal with emergencies that may require you to evacuate or shelter in place.  Contact your local Area Agency on Aging for information on senior services and resources in your area.

Choice and Autonomy

We all Cherish Choice and Autonomy

Every July Americans come together and revel in our freedoms. The freedom to make choices and pursue our own path is celebrated as a fundamental right.

Unfortunately, as we age people lose sight of the fact that we retain our civil rights, and often take away choice and self-determination of older Americans in the name of safety or concern. This is commonly called ageism and is a subtle prejudice we must avoid personally and call out in others when we see it.

It is true that many older Americans need support as they age but this should be done via honest conversation with the elder using a respectful attitude as we explain their options. Yet even today well-intentioned relatives and caregivers are stripping away older and disabled Idahoan’s civil and legal rights, self-esteem, and quality of life by pursuing guardianship with the motivation to keep their older loved ones safe.

Although we applaud the motivation, the Idaho Commission on Aging advocates for older and disabled adults by urging concerned caregivers to consider the multitude of alternatives to guardianship for as long as possible.

What are alternatives to guardianship? Some examples include:

  • Representative payee
  • Durable powers of attorney
  • Health care surrogacy
  • Living wills
  • Trusts
  • Community advocacy systems
  • Joint checking accounts
  • Case management

Power of attorney – A power of attorney is a legal document. The document grants one person, generally called an agent, sometimes known as an attorney in fact, the authority to act on behalf of the person appointing them. The person appointing the agent is called the grantor. To create a power of attorney, an adult must be able to understand they are appointing the agent and understand the kinds of authority they are giving the agent. The scope of the agent’s authority is limited by the terms of the document and by state laws. A grantor with capacity can revoke or modify the appointment of an agent in a power of attorney. Revocation of a power of attorney should be in writing, signed by the grantor, with a copy delivered to the agent and anyone who is likely to be dealing with the agent. In some states, the revocation needs to be recorded in the public records like a deed. A power of attorney is a private agreement and is not subject to automatic oversight by the Courts.

Health care surrogate – A health care surrogate is a person who makes health care decisions for a person, when the person lacks capacity to make health care decisions. This person may also be called a health care agent or proxy. In every state, a person with capacity can appoint a health care surrogate in a durable power of attorney that incudes health care authority. Many states have a short form for naming a health care surrogate. A person has capacity to appoint a health care surrogate if they understand what a health care decision is and can name a person they trust to make health care decisions. If a person does not appoint someone, 45 state statutes give guidance on who can make health care decisions. Generally, statutes turn to the nearest relatives to make health care decisions. Health care decision-making is the only area of decision-making where the law creates a default agent when a person does not name an agent in writing.

The authority of a health care surrogate to make health care decisions does not start until the person loses capacity, or knowingly defers to the agent. The determination of loss of capacity is made by the person’s health care providers. The criteria and documentation for the loss of capacity is based on state law. The scope of the authority is defined in the document and by state law. If the person has capacity, the person can revoke or modify the appointment of a surrogate. Many states have a very low standard of capacity for revocation of an advance directive. Aside from leaving directions on who can make health care decisions, many people leave directions about the health care they want or do not want in the form of an advance directive or living will directive. When making health care decisions for another person, it is helpful to understand their health care values, goals of care, and specific wishes.

Social Security Representative Payee – A Social Security Representative Payee (rep payee) receives the benefits for a beneficiary who has been determined unable to manage money by the Social Security Administration (SSA). Rep payee is specific to Social Security benefits, including Social Security Disability and Supplemental Security Income (SSI). VA pensions and some private pensions have separate payee systems. Social Security will place the benefits in payee status if SSA has reason to believe that the beneficiary is unable to manage benefits. The evidence is either a verification from a physician who has seen the person recently, or evidence in a disability case of serious mental illness or substance abuse. The beneficiary can file voluntarily if they are unable to manage their benefits. The process is entirely administrative. Social Security does not recognize any other agents. Guardians and agents under powers of attorney must apply to Social Security to be recognized as a representative payee.

Someone seeking to be appointed as a rep payee should contact Social Security with the name and identifying information for the beneficiary, the reason the person needs a payee, and name and contact information of a physician who has recently seen the person and may include a proposed payee. Social Security then sends notice to the beneficiary, and a verification form to the physician. The beneficiary has a right to object to the need for a payee, or to the proposed payee. Upon finding of need for a rep payee, Social Security does a basic background check on the proposed payee. The payments must be directly deposited into a separate account, titled “payee as representative payee” for the benefit of the named beneficiary. Most payees file a very basic annual accounting. Representative Payee status can be terminated, at request of the beneficiary, with proof that the beneficiary has regained the ability to manage benefits. If the payee resigns or becomes unable to serve, benefits are held until a replacement payee can be appointed. There is a shortage of reliable volunteer payees and a need for representative payees. All payees are volunteers, with an exception for narrowly defined non-profits who are allowed to receive a limited fee from the benefits. In some states, inpatient residential settings, such as nursing homes, are allowed by state law or regulation to serve as representative payees.

Bank accounts – A common way to manage another person’s finances is to authorize an agent to sign on to that person’s bank accounts. There are two ways to do this: 1) add a person authorized to transact business on the account; or 2) make the bank account a joint account. A joint account creates a presumption of ownership in the account assets and may create inheritance rights. Joint accounts are very helpful for married or committed couples. For more distant family members or friends, joint accounts should be used with great caution. Rather than create a joint account, the bank can authorize someone to sign on the account without creating an ownership interest in the account.

This is commonly accomplished by the bank recognizing the authority granted under a power of attorney. In many states, the banks may insist on a state standard form, or a bank approved power of attorney form. Banks can also authorize signers on accounts without creating an ownership interest; many business accounts are structured this way. Direct deposit and automatic payment for All Social Security benefits and virtually all retirement benefits are paid by direct deposit. Direct deposit eliminates the need to make deposits and prevents lost or stolen checks. Nearly all reoccurring bills can be set up on automatic payment. The combination of direct deposit and automatic payments can help to assure that necessary bills are paid when a person is unable to attend to finances. These arrangements should be monitored to assure that all income is properly received, and automatic payments are correct. Increasingly, financial institutions and utility providers are willing to send copies of invoices and statements to a third party, or to arrange online access for accounts oversight.

This information was supported by a contract with the National Center on Law & Elder Rights, contract number HHSP233201650076A, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201

Additional resources to help concerned family and caregivers support their older relatives without the civil death of full guardianship are:

A Guide to Managing Other’s Money

Supported decision making

A Guide from AARP

Thank you for standing up for life, liberty, and the pursuit of happiness for older Idahoans! Visit the ICOA website for additional information and services to help older Idahoan’s age with safety and dignity.

www.aging.idaho.gov

Elder Abuse Awareness

World Elder Abuse Awareness Day - Building Strong Support for Elders

JUNE IS ELDER ABUSE AWARENESS MONTH

Throughout the month of June, the Idaho Commission on Aging, our statewide partners, and communities around the world will be working to raise awareness about adult abuse, neglect, and financial exploitation.

World Elder Abuse Awareness Day (WEAAD) was launched on June 15, 2006 by the International Network for the Prevention of Elder Abuse and the World Health Organization at the United Nations.

The purpose of WEAAD is to provide an opportunity for communities around the world to promote a better understanding of abuse and neglect of older people by raising awareness of the cultural, social, economic and demographic processes affecting elder abuse and neglect.

In addition, WEAAD is in support of the United Nations International Plan of Action acknowledging the significance of elder abuse as a public health and human rights issue. WEAAD serves as a call-to-action for society’s individuals, organizations, and communities to raise awareness about elder abuse, neglect, and exploitation.

How can you bring awareness?

This month promote elder abuse awareness within your networks and communities. Individual and community prevention efforts and supportive services help keep older adults safe and healthy, to help stop abuse before it happens. 

Access the following information and ideas to help you reach as many individuals as possible.

Share on social media- include one or two recommended hashtags on your posts

  • Sample Social Media Posts
    • Elder abuse is a matter of worldwide concern that demands a global multifaceted response. Take action and be part of the solution. https://eldermistreatment.usc.edu/weaad-home #WEAAD #StopElderAbuse
    • Elder abuse is an injustice with many consequences for our society, affecting everything from our communities’ public health to our economic resources. Working together, we can build the social supports that can prevent elder abuse. https://eldermistreatment.usc.edu/weaad-home #WEAAD
    • June 15th is World Elder Abuse Awareness Day. Older people throughout the United States lose an estimated $2.6 billion or more annually due to elder financial abuse and exploitation. Elder abuse also creates health care and legal costs for our society. However, we can change this. Learn more: https://eldermistreatment.usc.edu/weaad-home #WEAAD
    • We all deserve to lead happy and healthy lives free from abuse as we age, yet older people are mistreated more often than we think. Take action to raise awareness toward prevention on this important social justice issue! https://eldermistreatment.usc. edu/weaad-home #WEAAD #Volunteer
  • Hashtags
    • #ElderAbuseAwarenessMonth
    • #WorldElderAbuseAwarenessDay
    • #WEAAD
    • #StopElderAbuse
    • #ElderAbuse
    • #FinancialAbuse
    • #EveryonesBusiness
    • #Volunteer


Wear purple clothing or a ribbon on June 15!

When someone asks you if purple has special meaning, start a conversation about elder abuse. It’s more common than you think, and rarely discussed socially.


Resources:

Older Americans Month

Age My Way 2022

Older adults play vital, positive roles in our communities – as family members, friends, mentors, volunteers, civic leaders, members of the workforce, and more. Just as every person is unique, so too is how they age and how they choose to do it – and there is no “right” way. That’s why the theme for Older Americans Month (OAM) 2022 is Age My Way.

Every May, the Administration for Community Living (ACL) leads the celebration of OAM. This year’s theme focuses on how older adults can age in their communities, living independently for as long as possible and participating in ways they choose.

While Age My Way will look different for each person, here are common things everyone can consider:

  • Planning:Think about what you will need and want in the future, from home and community-based services to community activities that interest you.
  • Engagement: Remain involved and contribute to your community through work, volunteer, and/or civic participation opportunities.
  • Access: Make home improvements and modifications, use assistive technologies, and customize supports to help you better age in place.
  • Connection: Maintain social activities and relationships to combat social isolation and stay connected to your community.

Idaho includes a growing number of older Americans who contribute their strength, wisdom, and experience to our community.

Communities benefit when people of all ages, abilities, and backgrounds are welcomed, included, and supported.

The Idaho Commission on Aging (ICOA) recognizes our need to create a community that provides the services and supports older Americans need to thrive and live independently for as long as possible.

Idaho can work to build an even better community for our older residents by:

  • Planning programs that encourage independence.
  • Ensuring activities are responsive to individual needs and preferences.
  • Increasing access to services that support aging in place.

This year, the Idaho Commission on Aging is excited to celebrate OAM with our partners in the aging community. Visit the ICOA website for more information on aging resources to help.

Please visit the Michigan Health website for information on “Want to “age in place” someday? Take Action Now” and learn 4 key tips on how to successfully “age in place”.

Diverse communities are strong communities. Ensuring that older adults remain involved and included in our communities for as long as possible benefits everyone. Please join the Idaho Commission on Aging in strengthening our community.

For more information, visit the official OAM website, follow ACL on Twitter and Facebook, and join the conversation using #OlderAmericansMonth.

Boost Your Budget

Millions of older adults are likely eligible for, but not enrolled in, benefits that can help them save money on health care, prescriptions, food, and more. Public benefit programs, such as the Supplemental Nutrition Assistance Program (SNAP), Medicaid, Medicare Savings Programs, and Part D Low-Income Subsidy, help these individuals save thousands of dollars each year by helping with the costs of food, health care, and prescriptions.

However, barriers to enrollment in these programs, i.e., knowledge of programs and how to apply, affect many eligible individuals from not receiving benefits that they need. That is why every April, the National Council on Aging (NCOA), along with its partner network, promotes Boost Your Budget® Week, a targeted campaign that aims to educate older adults about enrolling in public and private benefits that can save them money.

During the weeklong campaign, the aging and disability service network partners work to educate low-income Medicare beneficiaries and their caregivers about benefits available to improve health outcomes and economic security. Those participating in promoting the campaign are also encouraged to connect older adults with online and community resources for benefits screening and application assistance.


What is Boost Your Budget® Week?

Boost Your Budget® Week takes place each year during the second full week of April. This year, the campaign will run from April 11-15, 2022.


What can the aging and disability network partners do to promote Boost Your Budget® Week?

For any community, state, or private organization wanting to promote and be a part of the campaign, some of the things that you can do include:

  • Share information about benefits as part of a food drive, health fair, or tax assistance event
  • Run ads in local newspapers or on social media
  • Invite media, legislators, and the public to tour your facility and learn about the importance of benefits for your community
  • Posting information about the campaign on your website
  • Educate your stakeholders (i.e., staff and clients) during meetings/presentations about Boost Your Budget® Week

What can YOU do to promote Boost Your Budget® Week?

Even if you do not work for an organization whose customers and clients are older adults, you can still do your part to spread the campaign message! Some activities that anyone can do to promote Boost Your Budget® Week can be:

  • Share resources from NCOA’s toolkit about the campaign on your social media
  • Let older adults in your family and social circle know about the campaign, and, if appropriate, let them know where they can find resources
  • Craft a press release and send it to your local newspaper about the campaign

For further information and resources needed to start planning your Boost Your Budget® Week events, please visit the official Boost Your Budget® Week website.

Your efforts can be life changing for low-income seniors or people living with disabilities. Visit the ICOA website to learn more about the MIPPA/MSP programs.

Senior Nutrition Program

Let’s celebrate the 50th anniversary of the Senior Nutrition Program!

According to Feeding America, one in six seniors are considered food insecure. This means about 57,000 seniors in Idaho may be dealing with the issue of food insecurity, which can create negative impact on their health.

In addition to causing a few extra wrinkles and unexpected aches and pains, getting older also impacts metabolism and the body’s ability to absorb nutrients. Because the way the body processes food changes as we age, nutrition becomes vitally important. For older adults, eating the right foods can not only improve health, but also protect against preventable diseases and even enhance quality of life. As with most health-related issues, the first step towards developing better nutrition is awareness.

‘Hippocrates, a famous Greek physician, stated in 440 BC “Let food be thy medicine and let thy medicine be food”. We have finally come to fruition with that fact, 2,383 years after his death.

Each March, the Administration for Community Living (ACL) leads the celebration of the Senior Nutrition Program and the Idaho Commission on Aging promotes its anniversary by celebrating the program’s rich history and tremendous value across the nation with Area Agencies on Aging and meal providers.

The purpose of the nutrition program is to:

  • (1) to reduce hunger, food insecurity, and malnutrition;
  • (2) to promote socialization of older individuals; and
  • (3) to promote the health and well-being by assisting such individuals to gain access to nutrition and other disease prevention and health promotion services to delay the onset of adverse health conditions resulting from poor nutritional health or sedentary behavior.

ACL funds senior nutrition services, including home-delivered and congregate meals. For more resources follow ACL on Facebook and Twitter and join the conversation via #SNP50.

Please join the Idaho Commission on Aging in spreading awareness about malnutrition and food insecurity and help to reduce hunger. Encourage the elders to consider attending a meal at least weekly for healthy benefits for mind and body!

For more information on Congregate Meal Sites and Home-Delivered Meals, please contact your local Area Agency on Aging.

Please join our free educational webinars on March 8th and on March 23rd. For additional nutrition information please visit the ICOA website and follow us on Twitter and Facebook.

See how the healthcare system benefits if seniors eat a nutritious meal at a congregate meal site.

Letters Lift Loneliness

A 2018 study reports that 22% of all adults in the US – nearly 60 million — said they often or always felt lonely or socially isolated (Kaiser Family Foundation) and 45% of seniors (65 and older) feel lonely on a regular basis (HRSA).

Along with the emotional response to feeling lonely comes many health risks that include increased risk of dementia, stroke, and coronary heart disease (CDC). There is no doubt we are a lonely bunch and alleviating loneliness is a public health concern. Over the past two years we have all become masters of zoom, and all things virtual. However, it may be time to set aside our phones, tablets, and computers for an old-fashioned way of alleviating the loneliness – the handwritten note.

Letter writing is tied to our hearts through our inherent drive for social bonds (Janine Ilsley, LMSW). In May of 2020 the United States Postal Service published research stating 65% of people agreed that receiving mail lifted their spirits, with just under 67% stating they have sent or would send mail to family or friends. Many studies have been conducted on the benefits of both the person composing the handwritten sentiments, as well as those receiving the letter.

Letter writing is tied to our hearts through our inherent drive for social bonds.  Studies prove letters bring us closer together.  The letter recipient will feel special and appreciate the thoughtful effort invested into physically writing, addressing, and mailing a letter.  This sends the message to the recipient that they are important to the sender (Janine Ilsley, LMSW).

When we think about an idea or concept, we can get stuck looking at it one way, but when we actually put pen to paper, a different part of our brain begins to examine the idea, opening new doors.  The repetitive nature of writing gives us the option to focus on what we are writing and the physicality of the act of writing, working on different aspects of our brain. (Erin Miers, Psy.D.). When reading books from the past we often hear of letters from past love saved in a box, or letters from family someone holds dear and rereads when they feel a need for comfort.  There is something about a handwritten note that touches our heart in a way lacking in today’s fast-paced world of electronic communication. 

So, pick up your favorite pen and share your heart with your grandma far away, or your neighbor down the street and always remember the words of Soraya Diase Coffelt, “Letter writing can be seen as a gift because someone has taken his/her time to write and think and express love.”


Write a Letter to Lift Loneliness! If you want to bring joy to someone you don’t even know consider writing a letter to a resident of a local nursing home or assisted living center.  Simply address the letter to “Any Resident”.  Staff will forward it to a resident that has few visitors or correspondence, and it is guaranteed it will make their day!


End Loneliness Campaign

The End Loneliness Campaign supports volunteers, professionals, elected officials, and concerned citizens to end loneliness in Idaho. This campaign is modeled after the End Loneliness UK campaign that has had decades of success in multiple countries around the world. Find the free “Let’s End Loneliness” training course on the Commission on Aging’s website.

Help is Close When You Need It

Caring for someone with Alzheimer’s and other dementias can be a rewarding experience, it can also be demanding and challenging.  Caregivers for people with Alzheimer’s and other dementias are two and half times more likely than caregivers with other conditions to need help with emotional or mental challenges and nearly four time as likely to assist with behavioral issues (Alz Association, 2018). 

About one in three Alzheimer’s caregivers report their health has gotten worse due to care responsibilities, compared with one out of five caregivers or older adults (National Alliance for Caregiving, 2017).

Luckily help is available within the local area where the caregiver or the person with Dementia are living.

Caregivers usually do not know what they are seeking when calling an agency, so The Idaho Commission on Aging in partnership with six Area Agencies on Aging staff can aid caregivers to explore a spectrum of issues so the caregiving family can make informed decisions in their situation. There are 6 AAAs located throughout the state and each are experts on resources available in their communities.

Area Agencies on Aging (AAAs) are trusted sources of information and assistance, where older adults can turn to find specialized information, supports and service options in their area.  AAAs also play a crucial information and referral role, connecting families with local providers who can help them create a caregiving plan, address specific challenges, or identify support services.

In addition to Information and Assistance, each local AAA also offers support groups, Powerful Tools for Caregiver workshops, and respite.

The Commission on Aging’s website has free education and training resources found on the Idaho Commission for Aging’s website.  Further, the Idaho Chapter of Alzheimer’s offers “Know the 10 Signs” and “Understanding Alzheimer’s and Dementia” and many other webinars.  Look out the January schedule of educational webinars here.

References:
Alzheimer’s Association. (2018) Alzheimer’s disease facts and figures. Alzheimer’s Dementia 2018;14(3).  Available at alz.org
National Alliance for Caregiving in Partnership with Alzheimer’s Association. Dementia caregiving in the U.S Bethesda, MD: National Alliance for Caregiving: 2017.

You Can Provide Comfort and Joy This Holiday Season

My favorite definition of loneliness comes from Britannica:   A distressing experience that occurs when a person’s social relationships are perceived by that person to be less in quantity, and especially in quality, than desired.

It is common when people think of loneliness to think of the emotional response to a situation.  We’ve all felt lonely at some point in our lives, often in a room full of people.  Sometimes we don’t even recognize it as loneliness, we just realize we are not connected to anyone around us.

But, did you know that loneliness is much more than an emotional state?  It is a health epidemic costing Medicare 6.7 billion dollars a year? (AARP)

Loneliness is equivalent to smoking 15 cigarettes a day, being obese and having a sedentary lifestyle. (Julianne Holt-Lundstad) 

Nearly 40 percent of seniors feel some level of loneliness on a regular basis. (UCSF) and there is no doubt the holidays can be a difficult time for this generation stressed by the pressure of holiday expectations and the sadness of holiday memories.

What can we do to help those we care about?

Listen

That may seem simple, but when you have heard a story many times, make sure to listen again.  Especially about holiday memories.  If your loved one is hard of hearing or is developing dementia prepare ahead of time on how to best communicate.

Focus on the true meaning of the season

If they are no longer able to prepare the traditional holiday spread, or able to shop for gifts, make modifications. 

Simplify the meal

One month after my mother had major surgery my family went from a full holiday meal on Christmas afternoon to a simple morning brunch.  Each adult child arrived at my parent’s home with the food prepared and set it on the table immediately.  This made for a quick and easy meal that emphasized family time and created little work for any one person.  It has worked so well we’ve continued and made it our new tradition.  My parents still feel involved because it is in their home, but they do not have the pressure of preparing the meal. You can also leave them the leftovers!

Simplify the gift giving

Ask older people in your life to give you the gift of their memories.  In writing if they are able, or verbally, and you can record them.  Another idea is to let them know that spending time together is the greatest gift. This year I am giving my mother a few 300 large format piece puzzles (available on Amazon for less than $10.00) with a certificate for puzzle day. When she turns in a certificate my daughter and I will show up with a few snacks and visit while we complete the puzzle.

Holidays are unfortunately a trigger for loneliness; however, our goal is to ensure the older people in our lives feel noticed and included not only during the holiday season, but each and every day.

Join the campaign and visit the ICOA website “Stay Educated” page to increase your knowledge about loneliness by taking our six module course, browse the tools and resources, and reach out to your local Area Agency on Aging to get involved.

Idaho Celebrates Family Caregivers

Being a family caregiver isn’t uncommon, in fact, more than 53 million people provide a broad range of assistance to support the health, quality of life, and independence of someone close to them, but it is crucial. In fact, millions of older adults and people with disabilities would not be able to live in the community without that support and replacing it with paid services would cost an estimated $470 billion each year.

Providing support is rewarding, but it can be challenging when family caregivers do not have training or support, needed for the growing complexities of care, or opportunities for rest and protecting their own well-being. At the Idaho Commission on Aging, we believe that caring shouldn’t hurt.

The Idaho Commission on Aging’s core duty is planning a network of services that help older Idahoans to live safe, healthy, and self-directed lives in their communities of choice. One of the most important services is the Idaho Family Caregiver Support Program offering:

  • Information Services
  • Help accessing services and supports
  • Support groups, training, and counseling
  • Respite, or a short break from caring
  • Supplemental Services for individuals aged 60 years or older

This month ICOA encourages all Idahoans to recognize and thank family caregivers. If you are a family caregiver celebrate the important job you perform, but don’t forget to also prioritize the interests and passions that enrich your life and recognize the essential component of self-care.

Ten Caregiving tips for you and your family:

1. Seek support from other caregivers. You are not alone!

2. Take care of your own health so that you can be strong enough to take care of your loved one.

3. Accept offer of help and suggest specific things people can do to help you.

4. Learn how to communicate effectively with doctors.

5. Caregiving is hard work so take respite (rest) breaks often.

6. Watch out for signs of depression and don’t delay getting professional help.

7. Be open to new technologies that can help you care for your loved one.

8. Organize medical information so it’s up to date and easy to find.

9.  Make sure legal documents are in order.

10.  Give yourself credit for doing the best you can in one of the toughest jobs there is!

Visit the ICOA Website for Caregiver information

Contact your local Area Agency on Aging for programs and services

For free education on healthy caregiving topics visit the Idaho Commission on Aging’s Caregiving Education webpage.

Family Advocacy in Long-Term Care

The decision to move into a long-term care or assisted living facility is one that requires thought and preparation. Taking steps to choose the facility most likely to meet your loved one’s needs, is necessary work for a positive long-term care experience. 

Necessary work includes acts of advocacy done in preparation for long term care placement, and while your loved one is residing in long-term care.

The three stages of long-term care family advocacy are

Stage 1:  Advocate by assisting loved ones, as they wish, to take the steps to choose a facility that meets their needs and preferences.
  • Assist  your loved one as needed to call and request facility information to better narrow down the options.
  • Together as appropriate, review basic amenities, cost, staffing ratio, dining, resident rooms, does facility accept Medicaid if needed in the future or long-term care insurance? Can you stay at the facility should you transition to Medicaid, and would you have to share a room once on Medicaid?  Does the facility allow visitation, or compassionate caregivers. 
  • Encourage your loved one to choose 2-3 facilities to visit.  Assist to set appointments and walk through the facility, schedule to eat a meal, visit with the staff and meet the administrator.  The administrator sets the atmosphere for the facility.  Listen to the volume level of the facility, does the facility have strong unpleasant odors?  Is the facility clean and orderly and are the staff friendly and welcoming or rushed and inpatient?
  • Discuss with your loved one what they liked and did not like in each facility.  If one of the facilities appears to meet their needs and preferences and they are willing to accept your assistance, then assist them to choose a facility.


Stage 2: Advocate for and create a positive move-in experience.
  • Plan ahead to create a more orderly experience.
  • Visit the new room prior to move-in day.
  • Make the room homelike and comfortable for your loved one.  Having some personal belongings, they would like around them can make the transition a more pleasant experience.
  • Introductions to staff assisting with the move-in and to those who  will be working with your loved one is important.
  • Assist to inventory all items being brought into the facility to include hearing aids, dentures, jewelry, clothing—everything.
  • Offer to assist your loved one to get settled or if they are tired, set a time to come and assist to organize their things at a later time.
  • Request a locked drawer if your loved one has items they would feel better having locked up.
  • Learn when Resident Council and Family Council Meetings are and where they are held.

Stage 3:  Be actively involved with your loved one during their stay in the facility of their choice.  Residents whose family are involved receive better care.
  • Know your loved one’s rights and educate them so they will be able to voice expectations for care with informed confidence.
  • If the facility is not allowing visitation due to an outbreak of infection request to visit with your loved one via, zoom, even if it is just to lay eyes on them and let them know you care.
  • Participate in Family Council and if one is not formed in the facility speak with your loved one and with their support create  a council in their facility.  Ombudsmen are willing to assist in the development of councils.
  • Know who your advocates are and how to contact them- Ombudsmen are formally trained advocates that can help when family efforts aren’t enough.

Visit the Idaho Commission on Aging website for additional information and services to help older Idahoan’s age with safety and dignity.

Falls Aren’t Always Funny

We have all seen the video where a person trips or stumbles over something and falls. When mixed with a few good sound effects, they are often humorous. It’s OK to be able to laugh at life sometimes but falls are more often than not a life-changing event, especially for older adults.

Falls are an important health concern. They often result in injuries more severe than just a scraped, bruised body and bruised ego. Falls are the #1 cause of accidental injury and death in people age 65+. Even what seems like a simple fall can lead to a trip to the emergency room or call to 9-1-1. Bone fractures and head injuries are common. Most of us are aware of the costs associated with an ER visit and other treatments but the full cost is far-reaching.

Accidental falls kill about 158 Idahoans each year at a cost of $164 million. We can easily calculate the cost from medical bills but what about lost productivity? What about the cost to have someone who takes time off work so they can take someone to medical appointments? What if that person had to hire someone for childcare while they provided transportation or in-home care? These are just the financial impacts of a fall. It is impossible to quantify loss of functionality, independence, and quality of life.  For the 1 in 5 Idahoans who experiences a fall that results in significant injury, there is nothing funny about it.

These are certainly sobering statistics for those age 65+ but falling is not limited to older adults. They can happen to any of us.  Are you ready for some good news? All falls are preventable. Fortunately, there are simple steps we can take to reduce the risk of falls. Invest the time now to learn how to reduce fall risk and become fall-free.

Idaho celebrates Fall Prevention Awareness Month each September!


Review and register for the four fall prevention seminars in September:

  • The Importance of Fall Assessment as a Matter of Practice
  • Why Falls Matter and How to Prevent Them
  • Recognize and Remove Hazards at Home
  • Simple Steps to Improve Balance and Prevent Falls

Descriptions, dates and registration available on the Commission for Aging website.

Take Action to Prevent Falls

It only takes a few simple steps to dramatically reduce our risk of falls. We can easily encourage others to do so as well.

  1. What is YOUR fall risk? Answer 12 yes/no questions to find out and get resources to help you reduce your risk.
  2. Are there hazards in your home? Do a safety check with this checklist to identify where to look for trip hazards and resolve them.
  3. Can you recover from tripping or losing balance? Stay active to maintain balance, strength, and flexibility by doing simple movements each day. Watch our Simple Steps seminar to learn more.
  4. Do your medications put you at more risk for falls? Ask about interactions and side-effects that may make you more prone to falling.
  5. Are you more likely to fall because you can’t see well? Check your vision and get correction (and wear your glasses) or learn skills to reduce misjudged steps and tripping on unseen obstacles.

Other than on TV and the movies, falls aren’t funny. Avoid the physical, mental, and financial impact of falls. Take charge of getting fall-free this fall!

The Dog Days of Summer Can Bite You!

How to Prepare for Power Outages

You know the feeling, and it’s a bad one. Suddenly everything in the house goes silent and dark. Power’s out. You run outside to see if it’s just you and check your breaker box. Meanwhile you are wondering: How long is it going to be out? (Did I charge my phone?)  A few minutes is one thing. A few hours, even. But if you’re without electricity for days— or longer — real harm can result for both you and especially elderly shut ins.

We tend to take the power grid for granted, until it fails us. Based on demand, rolling blackouts are more common in summer. So, sooner or later chances are you may be facing an eerily quiet, dark house. What now?

The first action you should take is notifying your utility. Do not assume your neighbors have done it — besides, the more people that report an outage, the better they can pinpoint the problem. After critical care community services (like hospitals and airports) have power restored, utilities generally look to areas that can bring lots of customers back at one time.  So, you cannot over-report.

However, don’t wait until the lights go off. It’s best to do research ahead of time to know what tools and resources your utility offers. Most utilities have methods of reporting outages via text message, dedicated phone app, or websites.  Sign-up to receive outage updates on your cell. Do yourself a favor and set this up before the next outage.

If your provider is Idaho Power, input these phone numbers into your contacts to be prepared.

REPORT AN OUTAGE

  • By Phone
    • Treasure Valley: 208-388-2323
    • Outside Treasure Valley: 1-800-488-6151
  • By Email

If you, or especially your elderly family or neighbors rely on electrically powered medical equipment, be sure to notify both your local fire department and utility company.

What if it’s going to be an extended outage?

No matter the emergency, be ready with a disaster supplies kit like that detailed on ready.gov. That should include water, at least a three-day supply of non-perishable food, and things like manual can openers, flashlights and extra batteries (including for your cell phone). It is a good habit to keep all important prescriptions filled, and medical supplies well stocked.

Before deciding to stick it out, listen to authorities. If the outage is the result of a natural disaster or other calamity, it may be that you need to evacuate.  But if you stay, take note of the time. When the outage strikes, the clock is ticking on the food in your refrigerator and freezer. The USDA says food in a fridge will stay safely cold for four hours if the door isn’t opened and a full freezer will maintain temperature for about 48 hours (if it’s half full, that’s 24 hours) as long as you keep the door closed. Don’t rely on just looking — and certainly not on tasting — to see if the food’s safe. Instead, keep appliance thermometers in the fridge and freezer. You want to see 40°F or below in the fridge and 0°F or lower in the freezer. When in doubt, take individual foods’ temperature with a food thermometer.

Even as we continue to move past a world-wide pandemic, it’s the common stuff, like power that can cause the most significant, instantaneous disruption to our daily activities.

Make sure to check in on your older loved ones or neighbors. It may be necessary to temporarily move them into your home or another safe living location until power is reestablished.

To learn more and be prepared follow the links provided in the resources.

Resources:


Please visit the ICOA website at aging.idaho.gov for more great information on aging services.

Independence for Older and Disabled Adults

In July we celebrate liberty and justice for all. Sadly, as we age well intentioned fellow Americans often chose to curtail older or disabled Americans’ inalienable rights.

Overprotection may appear on the surface to be kind, but it can be really evil. An oversupply can smother people emotionally, squeeze the life out of their hopes and expectations, and strip them of their dignity.

Robert Perske

Is there such a thing as too much protection? Yes! Older and disabled adults deserve the right to make decisions about their own life that could expose them to potential harm. It is called dignity of risk, and it is an essential human right. The term, dignity of risk, was first coined in 1972 by Robert Perske in reaction to over-protective safeguards and a paternalistic manner by direct care staff toward elders in institutional settings, which he argued, was patronizing and diminished a person’s freedoms and self-esteem.

Today the term dignity of risk refers to the concept of affording a person the right (or dignity) to take reasonable risks, and that the impeding of this right can suffocate personal growth, self-esteem and the overall quality of life (Ibrahim & Davis 2013).

Yet even today well-intentioned relatives and caregivers are stripping away older and disabled Idahoan’s civil and legal rights, self-esteem, and quality of life by pursuing guardianship with the motivation to keep their older loved ones safe. Although we applaud the motivation, the Idaho Commission on Aging advocates for older and disabled adults by urging concerned caregivers to consider the multitude of alternatives to guardianship for as long as possible.

What are alternatives to guardianship? Some examples include:

  • Representative payee
  • Durable powers of attorney
  • Health care surrogacy
  • Living wills
  • Trusts
  • Community advocacy systems
  • Joint checking accounts
  • Case management

Power of Attorney

A power of attorney is a legal document. The document grants one person, generally called an agent, sometimes known as an attorney in fact, the authority to act on behalf of the person appointing them. The person appointing the agent is called the grantor. To create a power of attorney, an adult must be able to understand they are appointing the agent and understand the kinds of authority they are giving the agent. The scope of the agent’s authority is limited by the terms of the document and by state laws. A grantor with capacity can revoke or modify the appointment of an agent in a power of attorney. Revocation of a power of attorney should be in writing, signed by the grantor, with a copy delivered to the agent and anyone who is likely to be dealing with the agent. In some states, the revocation needs to be recorded in the public records like a deed. A power of attorney is a private agreement and is not subject to automatic oversight by the Courts.

Social Security Representative Payee

A Social Security Representative Payee (rep payee) receives the benefits for a beneficiary who has been determined unable to manage money by the Social Security Administration (SSA). Rep payee is specific to Social Security benefits, including Social Security Disability and Supplemental Security Income (SSI). VA pensions and some private pensions have separate payee systems. Social Security will place the benefits in payee status if SSA has reason to believe that the beneficiary is unable to manage benefits. The evidence is either a verification from a physician who has seen the person recently, or evidence in a disability case of serious mental illness or substance abuse. The beneficiary can file voluntarily if they are unable to manage their benefits. The process is entirely administrative. Social Security does not recognize any other agents. Guardians and agents under powers of attorney must apply to Social Security to be recognized as a representative payee.

Someone seeking to be appointed as a rep payee should contact Social Security with the name and identifying information for the beneficiary, the reason the person needs a payee, and name and contact information of a physician who has recently seen the person and may include a proposed payee. Social Security then sends notice to the beneficiary, and a verification form to the physician. The beneficiary has a right to object to the need for a payee, or to the proposed payee. Upon finding of need for a rep payee, Social Security does a basic background check on the proposed payee. The payments must be directly deposited into a separate account, titled “payee as representative payee” for the benefit of the named beneficiary. Most payees file a very basic annual accounting. Representative Payee status can be terminated, at request of the beneficiary, with proof that the beneficiary has regained the ability to manage benefits. If the payee resigns or becomes unable to serve, benefits are held until a replacement payee can be appointed. There is a shortage of reliable volunteer payees and a need for representative payees. All payees are volunteers, with an exception for narrowly defined non-profits who are allowed to receive a limited fee from the benefits. In some states, inpatient residential settings, such as nursing homes, are allowed by state law or regulation to serve as representative payees.

Health Care Surrogate

A health care surrogate is a person who makes health care decisions for a person, when the person lacks capacity to make health care decisions. This person may also be called a health care agent or proxy. In every state, a person with capacity can appoint a health care surrogate in a durable power of attorney that incudes health care authority. Many states have a short form for naming a health care surrogate. A person has capacity to appoint a health care surrogate if they understand what a health care decision is and can name a person they trust to make health care decisions. If a person does not appoint someone, 45 state statutes give guidance on who can make health care decisions. Generally, statutes turn to the nearest relatives to make health care decisions. Health care decision-making is the only area of decision-making where the law creates a default agent when a person does not name an agent in writing.

The authority of a health care surrogate to make health care decisions does not start until the person loses capacity, or knowingly defers to the agent. The determination of loss of capacity is made by the person’s health care providers. The criteria and documentation for the loss of capacity is based on state law. The scope of the authority is defined in the document and by state law. If the person has capacity, the person can revoke or modify the appointment of a surrogate. Many states have a very low standard of capacity for revocation of an advance directive. Aside from leaving directions on who can make health care decisions, many people leave directions about the health care they want or do not want in the form of an advance directive or living will directive. When making health care decisions for another person, it is helpful to understand their health care values, goals of care, and specific wishes.

Bank Accounts

A common way to manage another person’s finances is to authorize an agent to sign on to that person’s bank accounts. There are two ways to do this: 1) add a person authorized to transact business on the account; or 2) make the bank account a joint account. A joint account creates a presumption of ownership in the account assets and may create inheritance rights. Joint accounts are very helpful for married or committed couples. For more distant family members or friends, joint accounts should be used with great caution. Rather than create a joint account, the bank can authorize someone to sign on the account without creating an ownership interest in the account.

This is commonly accomplished by the bank recognizing the authority granted under a power of attorney. In many states, the banks may insist on a state standard form, or a bank approved power of attorney form. Banks can also authorize signers on accounts without creating an ownership interest; many business accounts are structured this way. Direct deposit and automatic payment for All Social Security benefits and virtually all retirement benefits are paid by direct deposit. Direct deposit eliminates the need to make deposits and prevents lost or stolen checks. Nearly all reoccurring bills can be set up on automatic payment. The combination of direct deposit and automatic payments can help to assure that necessary bills are paid when a person is unable to attend to finances. These arrangements should be monitored to assure that all income is properly received, and automatic payments are correct. Increasingly, financial institutions and utility providers are willing to send copies of invoices and statements to a third party, or to arrange online access for accounts oversight.


This information was supported by a contract with the National Center on Law & Elder Rights, contract number HHSP233201650076A, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201

Additional resources to help concerned family and caregivers support their older relatives without the civil death of full guardianship are:

Thank you for standing up for life, liberty, and the pursuit of happiness for older Idahoans! Visit the ICOA website for additional information and services to help older Idahoan’s age with safety and dignity.

www.aging.idaho.gov