Depression Is Not a Normal Part of Aging

“Lorraine’s” at-home caregiver always arrived on time and ready to perform her homemaking tasks, but Lorraine could never decide what she wanted her caregiver to do. Lorraine couldn’t make any decisions about what she needed help doing, so she’d go into the kitchen and make breakfast, leaving her caregiver alone in the living room to figure out what to do with her time. When Lorraine would finally give direction, she would then inevitably change her mind. Her caregivers, of which there were several, felt like they could never please Lorraine.

In addition to her indecisiveness, Lorraine had a flat affect and reported vague physical complaints which were not of concern to her medical doctor. Her physician had been telling her for many, many months that she was suffering from depression. Unfortunately, Lorraine refused to seek help for her depression. Because or her religious beliefs, she was waiting for “God to make it better,” even though her care management nurse, her physician, and her home care nurse each had recommended a trial of antidepressant medication. I also did my best to convince Lorraine to try an antidepressant but to no avail. After three years, Lorraine was still waiting for God to heal her depression. It was affecting her relationships and, unfortunately, she eventually lost her elderly home care service as well. It was just too frustrating for caregivers to work with Lorraine. They felt helpless.

What exactly is depression? According to the Mayo Clinic, it is a “medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too.” People with depression tend to isolate themselves. They lose interest in life and usually have sleeping and/or eating problems, two of the most common symptoms of depression. Not having an appetite, weight loss, weight gain, and eating too much can all be symptoms. Not being able to get to sleep, awaking in the middle of the night, or not being able to sleep at all can also be symptoms, as well as wanting to sleep all of the time. It is estimated that 5-6 million people over the age of 65 have depression. One study indicated that as many as 25% of the elderly are depressed.

When we think of depression, we associate it with a dictionary definition characterizing it as “extreme gloom, feelings of inadequacy, and an inability to concentrate.” While depression may manifest itself in typical ways—having “the blues,” crying, or exhibiting a feeling of hopelessness—according to Kay King of NAMI Minnesota, depression sometimes comes out sideways. Other common symptoms of depression include (but are not limited to):

Anger/Irritability
Poor Concentration
Sleep Disturbances
Self Doubt
Pessimism
Forgetfulness
Mood Swings
Tearfulness
Vague Physical Complaints
Fear
Ruminations
Frustration
Feelings of Guilt
Fatigue
Feelings of Helplessness
Lethargy
Lack of Energy
Loneliness
Overeating
Weight Loss or Gain
Inactivity
Under eating
Indecisiveness
Helplessness
Isolation
Suicidal Thoughts
Confusion
Feeling Overwhelmed
Boredom
Apathy
Decreased Cognitive Function
Obsessive thoughts

If you are taking care of elderly parents and find they have been experiencing several of these symptoms for 2-3 weeks or more, you should definitely have them evaluated for clinical depression.  While most everyone experiences “down” periods at certain times in their lives, real depression is more than an occasional period of feeling blue.  It is an ongoing medical condition that people cannot choose to control, stop, or “snap out of.”

In addition to common physiological and environmental causes, depression in seniors can also be caused by side effects of prescription drugs, thyroid issues, and even some medical procedures.  It is not uncommon for a cerebral vascular accident, for example, to bring on depression after the stroke.  Additionally, chronic illnesses, such as diabetes, cancer, or heart disease, can also bring about depression.  While coping with a chronic illness is always difficult, it is not normal to become clinically depressed.  Treatment for depression, in some cases, may actually improve symptoms of other conditions.  Other contributors to depression in the elderly are grief, loss, loneliness, chronic pain, memory loss, alcoholism, boredom, and feeling that life no longer has purpose or meaning.

If you suspect the senior in your life is experiencing depression, it’s important to take your concern seriously and to intervene as quickly as possible.  Not only will depression affect quality of life, but white men over the age of 85 are at the greatest risk for suicide of all age-gender-race groups, 2.5 times higher than the rate for men of all ages.  Depression is not a normal part of aging, and fortunately, it is a treatable medical condition.

Unfortunately, those who are now seniors grew up in a time when there was much more stigma around mental illness.  They are terrified by any suggestions of mental illness, fearing they’ll be “locked up.”  They come from an era when people were ashamed to admit they had family members with mental illness for fear of being called “crazy.”  If someone had depression, it was kept hush-hush. We now know that depression is a treatable medical condition just like high blood pressure, diabetes, or asthma.

If you suspect the seniors in your life are suffering from depression, please take your concern seriously.  Encourage them to talk to their doctor or a licensed mental health professional.  The best treatment for depression is a combination of anti-depressant medications along with professional counseling (psychotherapy).  Nonmedical interventions, such as having regular family visits, regular exercise, senior companion care services, hobbies, as well as increasing social activity and having something meaningful to do, can also be helpful.  Most people who have depression, with the right treatment, can live much more meaningful and quality lives.  There is no need to suffer.

Paul R. Blom, Owner/CEO
Right at Home

P: 952-854-6122

pblom@rah-tc.net

Rightathome.net/twincities/
CaregivingCompanion.com



Maintenance Therapy – The Best Kept Secret in Senior Care!

By Above & Beyond Senior Services

Have you ever needed physical or occupational therapy (PT/OT)? Conditions that cause decreased strength, range of motion, balance deficits, difficulty with walking and memory issues are leading reasons seniors might need therapy. Most therapy is based on a model that requires patients to meet certain qualifying criteria. Typically, a person must demonstrate measurable, skilled progress or the therapy provider is required to discharge. Over the course of the last decade, a new option for wellness and exercise has become increasingly available to Minnesota seniors!

Maintenance therapy is the same PT/OT that you are familiar with, but with a few differences:

  • Starts after traditional therapy ends.
  • Has no requirements for frequency or duration of service.
  • Can continue on a long-term basis.Comes into the home, while allowing freedom to be active throughout the community.

Let’s meet Mary:

Mary had a massive stroke at 68. She was left with an inability to walk, difficulty with speaking, and decreased movement on the left side of her body. After completing rehabilitation in the hospital, then a care facility, she was able to return home with her husband, Ed. She also qualified for Medicare home therapy. When Mary was no longer considered homebound, she transitioned to an outpatient clinic. Mary was very motivated to get better, but this proved more difficult than imagined. It was hard to be disciplined in completing the home exercises her therapists assigned. Ed began to notice declines, despite Mary going for therapy twice a week. They were disappointed in her regression. It was time for a change. She wanted home therapy that focused on the tasks and activities that were important to her and allowed them to be in control of her rehab. Thanks to a recommendation from a trusted health care worker, Ed inquired about direct-pay, maintenance therapy.

The maintenance therapists helped discover Mary’s abilities and limitations. The couple’s therapy goals were set collaboratively. These weren’t goals for the purpose of insurance coverage, but the goals that were important to both of them. They were finding their “new normal”. Her desire to maximize her mobility, strength and balance was met by creative exercise instruction from her therapists. Over time, with PT/OT each week, Mary had many successes. Eventually she was able to walk throughout her home, enjoy her swimming pool and an adaptive horse-riding program! Her quality of life was significantly improved as she met her goals of participating in community activities and going out to dinner with Ed. She felt empowered, engaged and happy about her accomplishments.

While many people desire and achieve goals of improvement, maintenance therapy also understands that sometimes, true “maintenance of ability” IS the goal. Many seniors get caught in a cycle of decline which leads to hospitalization and rehab. Once home again, it’s difficult to maintain exercise programs independently. Lack of adequate maintenance leads to progressive decline and the cycle begins again. Introducing maintenance therapy can be a life changer for a senior.

When a client has ongoing, one-on-one therapy, they are able to maintain their physical abilities. This makes the difference between staying at home vs. moving to assisted living or nursing home. A benefit of maintenance therapy is the same therapist can continue with clients if they change the place they call home.

If you are a senior who wants to either regain or maintain your quality of life through wellness and exercise, maintenance therapy may be the missing link that you have been searching for.

Allison Bakke, OTR/L
Above & Beyond Senior Services

www.aboveservices.com
allison@aboveservices.com
612-965-5122

Life Insurance with Long Term Care Riders

As conventional LTC policies grow costlier, alternatives have emerged.

The price of long term care insurance is really going up. If you are a baby boomer and you have kept your eye on it for a few years, chances are you have noticed much costlier premiums for LTC coverage today compared to several years ago. For example, in 2015 the American Association for Long-Term Care Insurance found that married 60-year-olds would pay $2,170 annually to get a total of $328,000 of coverage.1

As CNBC notes, about three-quarters of the insurers that sold LTC policies ten years ago have stopped doing so. Demand for LTC coverage will only grow as more baby boomers retire – and in light of that, insurance providers have introduced new options for those who want to LTC coverage.1

Hybrid LTC products have emerged. Some insurers are structuring “cash rich” whole life insurance policies so you can tap part of the death benefit while living to pay for long term care. You can use up to $330 a day of the death benefit under such policies, with no reduction to the cash value. Other insurance products are being marketed featuring similar potential benefits.2

This option often costs a few hundred dollars more per year – not bad given that level annual premiums on a whole life policy with a half-million or million-dollar payout often come to several thousand dollars. The policyholder becomes eligible for the LTC coverage when he or she is judged to require assistance with two or more of six daily living activities (dressing, bathing, eating, etc.) or is diagnosed with Alzheimer’s disease or some other kind of cognitive deficiency.2

This way, you can get what you want from one insurance policy rather than having to pay for two. Contrast that with a situation in which you buy a separate LTC policy but die without requiring any long term care, with the premiums on that policy paid for nothing.

The basics of securing LTC coverage applies to these policies. As with a standard LTC policy, the earlier you start paying premiums for one of these hybrid insurance products, the lower the premiums will likely be. You must pass medical underwriting to qualify for coverage. The encouraging news here is that some people who are not healthy enough to qualify for a standalone LTC insurance policy may qualify for a hybrid policy.3

These hybrid LTC products usually require lump sum funding. An initial premium payment of $50,000 is common. Sometimes installment payments can be arranged in smaller lump sums over the course of a few years or a decade. For a high net worth individual or couple, this is no major hurdle, especially since appreciated assets from other life insurance products can be transferred into a hybrid product through a 1035 exchange.1,3

Are these hybrid policies just mediocre compromises? They have detractors as well as fans, and the detractors cite the fact that a standalone LTC policy generally offers greater LTC coverage per premium dollar paid than a hybrid policy. They also cite their two sets of fees, per their two forms of insurance coverage. While it is possible to deduct the cost of premiums paid on a conventional LTC policy, hybrid policies allow no such opportunity.3

Paying a lump sum premium at the inauguration of the policy has both an upside and a downside. You will not contend with potential premium increases over time, as owners of stock LTC policies often do; on the other hand, the return on the insurance product may be locked into today’s (minimal) interest rates.

Another reality is that many middle-class seniors have little or no need to go out and buy a life insurance policy. Their heirs will not face inheritance taxes, because their estates aren’t large enough to exceed the federal estate tax exemption. Moreover, their children may be adults and financially stable themselves; a large death benefit for these heirs is nice, but the opportunity cost of paying the life insurance premiums may be significant.4

Cash value life insurance can be a crucial element in estate planning for those with large or complex estates, however – and if some of its death benefit can be directed toward long term care for the policyholder, it may prove even more useful than commonly assumed.

Provided by Candido Palomarez of Candido, Inc.

Phone: 763-428-1000

Website:  www.CandidoInc.com

 

This material was prepared by MarketingPro, Inc., and does not necessarily represent the views of the presenting party, nor their affiliates. This information has been derived from sources believed to be accurate. Please note – investing involves risk, and past performance is no guarantee of future results. The publisher is not engaged in rendering legal, accounting or other professional services. If assistance is needed, the reader is advised to engage the services of a competent professional. This information should not be construed as investment, tax or legal advice and may not be relied on for the purpose of avoiding any Federal tax penalty. This is neither a solicitation nor recommendation to purchase or sell any investment or insurance product or service, and should not be relied upon as such. All indices are unmanaged and are not illustrative of any particular investment.

Citations.
1 – cnbc.com/2015/08/07/fer-more-products-that-cover-long-term-care-costs.html [8/7/15]

2 – consumerreports.org/cro/news/2015/04/get-long-term-care-from-whole-life-insurance/index.htm [4/16/15]
3 – tinyurl.com/o3ty2j3 [5/4/14]
4 – marketwatch.com/story/hedging-your-bets-on-long-term-care-2013-11-06 [11/6/13]

The Dangers of Hypothermia

The cold weather is upon us! While some people enjoy the snow and cold and others can’t wait for summer to return, none can deny that winter can produce some dangers, especially for older people. Not only are there slippery sidewalks to contend with, but also the possibility of hypothermia.

Hypothermia is a drop in body temperature that is caused by staying in a cool place for too long. This may bring to mind images of someone who is lost outside in a blizzard, but hypothermia can strike a person in their own home where the heat is turned down too low. A body temperature below 96 degrees can cause an irregular heartbeat leading to heart problems and even death, if not treated promptly. Hypothermia is especially dangerous because it happens gradually and affects your thinking. You may not even realize you need help!

As caregivers, it important to be aware of the symptoms and risks of hypothermia as people with advanced age are especially vulnerable. When checking in on your relatives, friends or neighbors, be especially aware of the symptoms of hypothermia.

  • Confusion or sleepiness
  • Slowed, slurred speech or shallow breathing
  • Weak pulse or low blood pressure
  • Cold, pale skin
  • A lot of shivering or stiffness in the arms or legs
  • Chilly rooms or other signs that they have been in a cold place
  • Poor control over body movements or slow reactions

If you think someone may have hypothermia, take his/her temperature and if it doesn’t rise above 96 degrees, call 9-1-1. Then keep the person warm and dry by moving them to a warmer place, wrapping the person in blankets or coats or using your own body warmth by lying close to them. Do not rub their arms or legs as this can result in skin tears. Once at the emergency room, the doctor will verify the diagnosis and then warm the person’s body from the inside out. It is very important that a person with hypothermia is treated by a physician.

Sometimes people are tempted to turn their thermostats down too low as a way of saving money on their energy bill, but this can result in a dangerous situation. It is essential for people keep their home warm, especially on those days and weeks where the temperatures stay near zero. To be safe, your thermostat should be set for at least 68 degrees. Even temperatures between 60 and 65 can lead to illness.

There are some things you can do to keep yourself warm and cut down on heating costs. First, you can get ideas on reducing your heating bill by calling your power or gas company for information on weatherizing your home. Ideas such as closing vents and doors to rooms you are not using can cut your energy usage. Also, wearing several layers of loose clothing will keep you warmer while tight clothing can keep your blood from flowing freely. And lastly, eating enough food to keep up your body weight can also keep you warmer.

Jane Mahoney
Older American’s Act Consultant
Greater Wisconsin Agency on Aging Resources

Submitted by:
Tammy Sullivan
Home Care Solutions
952-924-0677
caremaster25@gmail.com
HomeCareSolutionsMN.com

Finding EXCELLENCE in Senior Healthcare

As a health care professional for the past 15+ years I’ve always felt pretty confident I could find a good doctor, pharmacist, caregiver, physical therapist, or nurse if the time ever came that I needed one…especially in a crisis. I was recently put on the caregiver side of the health care equation – nothing earth shattering, but my son broke his leg and it came with a unique set of circumstances. Lost dreams of a summer soccer season, bike riding and swimming with friends, and a choir trip to Alaska were all things that suddenly seemed very much shattered. As his mom and caregiver I found myself wondering about all these things and a hundred others. I was squarely in a situation that was out of my control to direct. We were at the mercy of whatever orthopedic doctor the scheduler assigned to us.

I imagine this is how family members feel when a senior in crisis is referred to a nursing home for rehab or to a home care agency for on-going care. How do I know I’m going to like the person that is assigned to me? Will they take enough time for me? Will they answer my questions? Are they any good at what they do? Do they provide quality care? How do I know that what they are telling me is correct? How do I know what I don’t know?

What happened next on our broken leg journey was nothing short of anxiety inducing. The doctor we saw didn’t have time for us, he couldn’t relate to my son, and looked at me like I was crazy when I asked about pain control. We left his office without any instructions on my son’s restrictions or care. We also left with newfound gratitude for my profession as an occupational therapist; we would have been totally lost otherwise. What I realized after the shock of the appointment wore off was this: a broken bone had become routine to this doctor. It was a mechanical issue that needed repair – there was no passion for the care of the patient. To my son and our family a broken bone was anything other than routine; it was a loss of some short-term hopes and dreams. This is no different for a senior who sustains a fall, has a heart attack, or develops dementia – plans are changed, dreams are shattered, lives are disrupted…that IS NOT routine. How do you find an individual provider or senior care agency that will help you compensate, adapt, and be compassionate around these issues?

Here are a few ideas:

Read More»

Resource for Alzheimer’s/Dementia: MEternally

MEternally is who you are, where you come from, what may not be seen but is still there. We believe that connections can be made between those with dementia and those who love and care for them through pictures of things that they love and identify with. These same pictures can provide comfort and promote reminiscence.

What started as a college class project has turned into a business dedicated to create comfort, promote connections, and inspire reminiscence. Below is an article that was written which actually gives a very good history of how it all came about. Snap of the past, connects to today – Alzheimer’s and Dementia

Through our software and DVD products we provide collections of common and creative themes and continue our progress towards custom and deeply meaningful products at reasonable prices for those affected by dementia. The first DVD in the series (Favorite Things – Nature Collection) is ready to ship with others scheduled throughout the year. We also have an active software pilot which we offer through our website, in exchange for feedback on how we can make our product better. People can sign up to participate in the software pilot, purchase DVDs, or find out more about us on our website. MEternally.com

Review in Alzlive.com