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Aging-in-Place Newsletter #10

Reminiscence

1. Last month, I did a 45-min. reminiscence session at a local assisted living facility. They invited me to do another one this month. I think because baseball season is starting later this month, that memories of baseball would be a good topic. Questions like “Did they play baseball?”, “Who were they favorite players?”, “Favorite teams?”.
It would:

  1. Give residents, etc. a chance to be heard
  2. Help promote cognitive stimulation and social connection (the participants could talk about this later with other residents).
  3. Give younger baseball fans a chance to hear some cool stories.

I’ll report how it goes next month. I’d like to see something

Shopping carts

2. Especially for older people, shopping carts are a stability and mobility device. The other day I saw an elderly lady walking very slowly and unsteadily to the store with two canes, one with 4-prongs. I asked her if she would like a shopping cart. She said ‘yes” and I quickly got her one. She put both canes in the carts and proceeded more confidently to the store. The ADA requires handicapped parking but doesn’t say anything about placement of cart corrals which are often far from the handicapped parking spaces. For some time now, I’ve seen shopping carts left haphazardly in or near the handicapped parking spaces. The stores know this is a problem but they need some encouragement to find a low-cost solution. What I don’t want to do is make it into a government mandate. What I’m looking for is low-cost, simple, easily understood, and tidy. I’ll be talking to the local director of the Area Agency on Aging and others this week. I think a pilot project can happen soon.

Sleep

3. There are plenty of sites about the importance of sleep for senior adults even if they are not nearly as active as when they were younger. I’ll include a few below. I’ve found that sleep isn’t as easy as it used to be. Getting to sleep and staying asleep is often a challenge. A few things I do is try not to go to bed early. Keep room dark and cool. I once tried a weighted blanket for a few days but it didn’t seem to help. Maybe I’ll try it again someday. I often listen to the same boring, audio book. I think that does help. And try for the same bedtime and wake time, every day, even on weekends. I think the important thing is for messages and routines that relay “It’s time to go to sleep now”.

Perhaps the most helpful thing I’ve found is having a good day and looking forward to the next day. Sleep doesn’t come easily if things are bothering you.

Some other links:

Aging in Place isn’t just about home modifications. It’s about what kind of community you want to live in.

4. While home modifications (ramps, lighting, wider doorways) are essential, the community context is a key element of quality of life. Here are some critical “Macro-Environment” factors for successful aging-in-place.

Can the resident reach basic needs without a car? As driving becomes more difficult, the “15-minute neighborhood” becomes a lifeline. Is there a pharmacy, a grocery store, park, or a library within a safe, flat walking distance or on public transportation ? Are the sidewalks well-maintained and wide enough for a walker? Are they well lit at night? Are there frequent “resting benches” along the route? Are there opportunities facilitate “accidental” social interactions? Religious institutions  they are comfortable with.

Communities that house both young families and seniors tend to be more vibrant. A community that offers roles for seniors (volunteering at schools, mentoring, or leading reminiscence groups) provides the “Sense of Purpose” required for longevity. Are there opportunities for seniors to serve on local government or non-profit boards?

Are there nearby medical services nearby? How secure are the public utilities?

More senior adults are living alone

5. 15 million people aged 65 and older live alone in the United States. This represents about 28% of the total 65+ population. Women are much more likely to live alone than men. Nearly 44% of women aged 75 and older live alone, compared to only about 21% of men in the same age bracket. Many of the same safety features apply whether they live solo or not. Keeping your phone on you or close by is a key element. Even people living with someone doesn’t mean that someone is always in the home. Having a regular check-in to ensure things are OK is a good idea. Even people in good physical and cognitive health can have a sudden health problem.

Allow family members or trusted neighbors to have a “digital key” or a regular key so they can enter in an emergency without breaking down the door. Devices like Alexa can be used to call for help if the resident cannot reach a phone.

“Check in” service providers can improve safety and delay institutionalization

6. The “Village” Model (The U.S. Grassroots Leader)

The “Village” movement, starting with Beacon Hill Village in Boston consists of self-governing, non-profit organizations where neighbors help neighbors. Members pay a small annual fee. In return, they get access to a network of vetted volunteers who do check-ins, grocery runs, and simple home repairs.  It creates a “safety net” without relying on government or insurance.

CAPABLE (Johns Hopkins Model) This is a highly successful program now being adopted by many insurance companies and state health departments. It consists of a nurse, an occupational therapist, and a handyworker, who visit the senior’s home over several months. They don’t just “check-in”; they modify the home and the senior’s habits to prevent the #1 cause of institutionalization-functional decline.
Support and Services at Home (SASH) – VermontVermont is a leader in this area. Their SASH program places a “Coordinator” and a “Wellness Nurse” in affordable housing complexes for seniors.  They check on every resident regardless of health status, coordinating with their doctors to ensure no one “slips through the cracks.”

Companies like Papa (often called “Grandkids on-demand”) or CareLinx partner with insurers to send “Pal” companions to do light housework, tech help, or just provide a social check-in.