Prevent falls; manage changes

Fall Changes, Falls, and Your Changes

Prevent falls; manage changes
Physical changes can increase risk of falls.

In Maryland, the leaves are turning beautiful fall colors. The air is crisp more often, and that fuzzy blanket feels good at night! The move from summer to autumn makes itself known in obvious and in subtle ways.

Throughout life, your body makes changes, too. Some are obvious. Some are subtle.

Many of these changes increase your risk for falls and/or injury with a fall.

Obvious changes

  • Joints get stiffer
  • Lung capacity gradually decreases – you might get short of breath easier
  • Skin gets drier as overall body water content decreases
  • Vision changes, especially your ability to see up close
  • Skin and tissues get looser

Subtle changes

These changes are usually caught when your doctor monitors your labs, your urine, or does a physical exam.

  • Kidneys slow down
  • Liver slows down
  • Bones get less dense (hard)
  • Reflexes aren’t as quick
  • Risk for urinary track infection goes up
  • Hormone production changes – for men and women

Association with falls

As we move slower, have more joint pain, lose some of our range of motion, and reflexes slow, the risk of falls goes up. As senses such as vision, hearing, touch, smell, and even taste change, these also increase the risk of falls.

The kidney and liver changes are especially important as we think about the impact on how our body handles medications. The liver is the key organ that breaks down medicines in our body. The kidney is one of the primary ways they are then removed. So, as our kidneys and liver slow down, for many medicines, we need lower doses. Sometimes, at some point in the decline of kidneys or liver, some medications should NOT be used at all.

Falls can lead to losing your ability to walk, run, climb stairs, and be as active as you would like to be.

Remember, with accumulated years we also grow in wisdom, in maturity, and learn to count the blessings in our lives! Graceful aging is a beautiful thing. I just don’t want you to fall!

Call us at Meds MASH for a thorough assessment of your current changes, your medications, and ways to decrease your risk of falls. This is one of our specialties! Michelle is one of the creators of a comprehensive falls risk assessment.

You can reach Michelle at michelle@medsmash.com; 410-472-5078; www.medsmash.com/contact.

BIBLICATION APPLICATION

Our bodies aren’t the only things that change with time. Our Christian walk is also a journey with twists and turns. Ideally it is an uphill climb to more maturity. But without practice and several bumps in the road, it can be a very flat journey.

Ephesians 4:14-15 ESV

So that we may no longer be children, tossed to and fro by the waves and carried about by every wind of doctrine, by human cunning, by craftiness in deceitful schemes. Rather, speaking the truth in love, we are to grow up in every way into him who is the head, into Christ,

Growing, learning, and changing take effort and dedication. Practice makes perfect. I don’t expect any of us will reach perfect until Heaven, but practice can certainly help us with improvement.

Hebrews 5:12-13 ESV

For though by this time you ought to be teachers, you need someone to teach you again the basic principles of the oracles of God. You need milk, not solid food, for everyone who lives on milk is unskilled in the word of righteousness, since he is a child.

To grow and change, we take risks, learn from our mistakes, and gain confidence as God sees us through each obstacle.

James 1:1-27 ESV

James, a servant of God and of the Lord Jesus Christ, To the twelve tribes in the Dispersion: Greetings. Count it all joy, my brothers, when you meet trials of various kinds, for you know that the testing of your faith produces steadfastness. And let steadfastness have its full effect, that you may be perfect and complete, lacking in nothing. If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him. …

Romans 5:3-4 ESV

More than that, we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope,

Rather than avoid the changes that include hardship, know that God will get you through them, and you will grow and change in beautiful ways with each piece of the journey.

Blessings,

Michelle

Advertisements
support for the sandwich generation

Are you the meat in the sandwich – for those caught in the middle

support for the sandwich generation
Support is available while you are the meat in the sandwich between children and aging parents

Have you heard of the ‘sandwich generation’? Are you the meat in the middle – still finishing the child raising and caring for aging parents? This sandwich generation is now different than it has ever been before. It is the older Generation X and the younger Boomer generation now in this position. This means this sandwich generation has more dual career couples, more divorces, and generally more independent people juggling the younger and older generations.

Certainly you are blessed when you have children who are nearly or newly on their own AND you still have your parents. So many of us miss that opportunity.

If you do have this opportunity, it can be very challenging. Typically there are several other things happening around the same time.

Other changes while you’re the meat in the sandwich

The sandwich phase usually comes while in your late 40’s through your 60’s. During this time some other commonalities are:

  • You’re at the peak of your career
  • Friendships/relationships are no longer made through your children’s activities
  • Your own health is changing
  • If you’re a woman, you’re somewhere near menopause which brings its own health changes
  • You’re thinking about your ‘bucket list’

Tips for you to be the best ‘meat’ possible

It is so easy to get caught up in the needs of your parents and children and to forget about you in the process. If you fall ill, get injured, or burn out, then everyone loses. I don’t mean to add to your pressure. I just want to encourage you to take care of yourself as the caregiver.

  • Sleep to maintain clear thinking and patience
  • Exercise to stay healthy and stay strong
  • Healthy diet with fruits and vegetables vs grab-n-go fast food
  • Time off to maintain your mental health

Resources to help you

There are many resources available to help you as you help your aging parents. With the aging of the population, the numbers and types of resources are rapidly increasing.

Medications are often involved when someone reaches a point where they have difficulty living without assistance. That is our specialty at Meds MASH. Over 80% of people we see have a specific medication issue that we work with you doctor to address to help you stay safe at home. For 100% of all people we have seen, we have provided important education about medicines and how to get the most from healthcare visits.

There are several types of services that can assist with safely aging at home or in a place designed for safe aging. There are homecare services that can provide someone to help with tasks such as companionship, housekeeping, bathing, cooking, driving, and more. There are independent living communities with assisted living options when needed. There are assisted living facilities at many sizes, price ranges, and amenities.

If your parents’ home would be safer with some modifications, look for a contracting that is a certified aging in place specialist. You can learn more at http://www.nahb.org/en/learn/designations/certified-aging-in-place-specialist.aspx

A certified aging life care manager is an expert on your local resources that can assist with healthy aging. I think of these people as one-stop-shopping for many of your questions and needs. You can learn more at http://www.aginglifecare.org.

Legal and financial questions can be complex. These are elements that are easiest to address while your parents are still fully in command of their own finances. That is a good time to plan for the future in case you, your siblings or other friends/family will assume control of those key areas of your parent’s life. Decisions about advanced directives, power of attorney, and memorial wishes are easiest to make while your parents are fully able to make their own decisions. However, even if you miss that window, these resources (elder care attorney and financial advisor) can help guide you through each step. Here is a resource that can help you find an eldercare lawyer http://www.naela.org/findlawyer.

This is a very brief overview of the many resources that exist to help you and your parents navigate this sandwich time of life. We are glad to help you navigate this complex time and to identify these helpful resources. Please don’t hesitate to contact us at 410-472-5078 or www.medsmash.com/contact.

BIBLICAL APPLICATION

This blog has acknowledged how difficult and consuming this time of life can be – in the phase of supporting children and aging parents. Resources and tips for self-care have been provided.

Another essential aspect for all of the complex phases of life is an awareness of the sufficiency of God.

2 Corinthians 12:9 ESV

But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me.

As in this verse, Paul is very clear that he was weak and unable to do what God called him to do. But, God was more than sufficient to get Paul through the many struggles, the imprisonment, the rejection, and the difficult travel.

To further understand that verse, let’s put it in perspective. Paul describes a health problem he had that he asked God to remove. Here is the response:

2 Corinthians 12:7-10 ESV

So to keep me from becoming conceited because of the surpassing greatness of the revelations, a thorn was given me in the flesh, a messenger of Satan to harass me, to keep me from becoming conceited.  Three times I pleaded with the Lord about this, that it should leave me.  But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me.  For the sake of Christ, then, I am content with weaknesses, insults, hardships, persecutions, and calamities. For when I am weak, then I am strong.

Paul further encourages us that Christ can sustain us through all of the highs and lows.

Philippians 4:12-13 ESV

I know how to be brought low, and I know how to abound. In any and every circumstance, I have learned the secret of facing plenty and hunger, abundance and need.  I can do all things through him who strengthens me.

We try and try to do it all ourselves. And, have you noticed how that doesn’t work?

2 Corinthians 3:4-5 ESV

Such is the confidence that we have through Christ toward God. Not that we are sufficient in ourselves to claim anything as coming from us, but our sufficiency is from God,

So, as you work through this complex time as the meat in the sandwich, remember the source of your strength. No, you can’t do it alone. So remember, you are NEVER in this alone.

Psalm 73:23 ESV

Nevertheless, I am continually with you; you hold my right hand.

Blessings,

Michelle

Image source: <a href=”http://cliparts.co”>Clip arts</a>

Senior Service Providers – a huge network of resources

occupational_therapist
There are many types of senior service providers for you to research in your area.

Our population is aging! And there is a rapidly growing network of Senior Service Providers to help promote healthy, safe aging. I was first introduced to this ever expanding network about a year and a half ago.

So I want to introduce you to the many resources available to you, to your aging loved ones, and to anyone you know who is anxious to stay as healthy as possible.

I don’t think it would be possible to make a list like this complete. So know if you have a specific need not listed, search for what you need. I’m fairly certain someone has thought of that need and designed a solution. At the end of this blog I’ll point you toward a think-tank of even more innovative solutions being pursued.

Senior Service Providers to seek in your area

  • Aging-in-Place/Home Safety
  • Assisted Living Placement Services
  • Assistive Technology Devices
  • Certified Care Management
  • Computer & Technology Services
  • Daily Money Management
  • Estate Liquidation & Cleanout
  • Financial Services & Insurance
  • Fitness and Balance Classes
  • Home Modification and Repairs
  • In-Home Primary Care Provider
  • Legal Services
  • Licensed Massage Therapy
  • Medicaid Planning
  • Medical Alert Systems
  • Medication Management
  • Mortgage & Reverse Mortgage
  • Move Coordination from your home
  • Nutrition
  • Occupational Therapy
  • Personal Historian
  • Physical Therapy
  • Private Duty & Home Care
  • Real Estate
  • Senior Living Communities
  • Transportation

Ways to find senior service providers

Again, this is not an exhaustive list. If you want to modify a home to make it safer, there are specialists that can help you. Look for the ‘Aging in Place’ certification. If you want to know what resources are available in your particular community, find a local Lifecare Manager at www.aginglifecare.org. If you are faced with downsizing, moving from home to assisted living or in with children, or arranging for someone to move in with you, there are a host of specialists to help. There are realtors specialized in homes designed for safe aging; mortgage and reverse mortgage specialists to help find the best rates, companies that specialize in helping you sort through your belongings and sell those you don’t plan to keep to convert them to cash; and companies that specialize in sorting through horded materials. There are companies that will pack you, move your belongings, and unpack them so that they are right where you want them.

There are lawyers specializing in the sensitive needs of older adults making financial and legal decisions. You can find specialists that will manage your bills and finances for you in your home – http://aadmm.com.

Note, some of these services are covered by insurance while others are out-of-pocket. Be sure to ask about costs as you research your options.

And, as promised, I want to tell you about Aging 2.0. This organization is pulling together innovative people with any kind of solution that will enhance healthy aging. It gives those innovators a platform to share their innovation, perhaps find funding, and network with other providers so they can collaborate and offer a more robust service. You can learn more at https://www.aging2.com/about-us/.

I have been amazed at all of the available resources. I hope you find hope in the many kinds of senior service providers that can help you in your quest for healthy aging. For more information about options, please contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

As Christians, we have a lot of resources at our disposal, too. Within the body of believers we have every kind of gift and skill. In Acts the believers supported each other and shared everything. We don’t do that, but we can use our gifts to help each other in whatever God is calling us to do.

Acts 4:32-37 ESV

Now the full number of those who believed were of one heart and soul, and no one said that any of the things that belonged to him was his own, but they had everything in common.  And with great power the apostles were giving their testimony to the resurrection of the Lord Jesus, and great grace was upon them all.  There was not a needy person among them, for as many as were owners of lands or houses sold them and brought the proceeds of what was sold and laid it at the apostles’ feet, and it was distributed to each as any had need.  Thus Joseph, who was also called by the apostles Barnabas (which means son of encouragement), a Levite, a native of Cyprus, sold a field that belonged to him and brought the money and laid it at the apostles’ feet.

The messages about helping each other are found in the New Testament and the Hebrew Bible.

Hebrews 13:16 ESV

Do not neglect to do good and to share what you have, for such sacrifices are pleasing to God.

Philippians 2:4 ESV

Let each of you look not only to his own interests, but also to the interests of others.

It is through going to Church, being part of small groups, participating in Bible studies, and other times of fellowship that we can find out about the needs. Then, as we consider our own gifts, we can align ourselves with the needs where we can be of assistance. We can also help connect those with needs to those with matching gifts among our Christian community. It is so beautiful when those matches come together!

Blessings,

Michelle

Image source: National Eye Institute, National Institutes of Health, U.S. Department of Health and Human Services

When the Rules Don’t Quite Make Sense

Airplane ors.od.nih.gov
Interpretation of rules has created an airplane that has launched with no plans to build the runway in healthcare.

To finish a thought from last week’s blog, sometimes the rules create their own problems. The Centers for Medicare and Medicaid (CMS) created a new risk-sharing payment strategy with hospitals. If someone has health insurance through Medicare, and if they are readmitted to the hospital for the same condition within 30 days, then the hospital will not be paid for the second admission. (Of course it’s a bit more complex than that, but this is the gist).

This ruling has created a whole new ‘market’. A group of very smart technology experts and entrepreneurs have identified this as a place to create new ways to keep people healthy at home. Tools and solutions are created that help people be successful at home after being in the hospital.

  • Patients benefits by having new resources to help them maneuver their care at home and stay at home.
  • The hospital benefits by losing less money on readmissions within 30 days.
  • The new companies, technology gurus, and entrepreneurs make money by being paid through the hospital’s cost savings.

Rules (and solutions) – make sense?

These are the parts that are missing, in my opinion.

  1. Once we determine how to keep people home safely for 30 days, I anticipate CMS will expand the time window to 60, 90, or more days. So short–sighted solutions will not survive.
  2. What happens after 30 days? Many of these new solutions involve technology. Who pays for the technology and the monitoring after the 30 days? Will it just be removed from the person’s home? Then what happens? Is that cost effective? Does it even make sense?
  3. What about people who are fearful of technology? Again, most of the solutions I’m hearing and reading about are based on technology. What if the person doesn’t have internet access or land-line phone access? What if the person has no interest in learning how to use the technology? What if the person just can’t get the hang of the technology?
  4. As I mentioned last week, I am finding very little data on what users/people with chronic medication conditions want. Solutions are being developed with little to no input about whether people will actually want or use the solutions.

For some of these issues the answers I’ve received are that there will always be exceptions. Those will be dealt with one by one. The goal is to find solutions for the majority.

It was funny, in one of these conversations we likened the current technology solutions boom to the airplane that’s in the air but no one has thought yet about the runway. That seems like a fitting analogy to me right now.

Hope

There is hope. I talked yesterday to a company taking a MUCH broader view of helping people stay healthy in their homes. They are not even thinking about the 30 day readmission rules. They are looking at long-term solutions that are created and maintained around the person that is using them. I know that company is not alone. I’ll put my hope in these types of companies!

For more information about new technologies in healthcare, please contact us at www.medsmash/contact.

BIBLICAL APPLICATION

Do you ever feel like the ‘rules’ of Christianity don’t make sense? Are you left wondering why the Christians around you are doing things a particular way? Have you been instructed to do something that doesn’t make sense?

In these instances, I encourage your FIRST question to be, ‘Is it Biblical’?

1 John 4:1 ESV

Beloved, do not believe every spirit, but test the spirits to see whether they are from God, for many false prophets have gone out into the world.

2 Peter 2:1 ESV

But false prophets also arose among the people, just as there will be false teachers among you, who will secretly bring in destructive heresies, even denying the Master who bought them, bringing upon themselves swift destruction.

I’m not saying every pastor or spiritual leader who says something that is not Biblical is a false prophet. People, even pastors, do make mistakes. But we have A LOT of examples of people adding rules to what is in the Bible. These ‘human’ rules are just that. Each denomination has their ‘way of doing things’. Even these are often the result of people trying their best to understand and interpret the scriptures. So see if the item that you question is from people or from God.

Your SECOND question should be, ‘Did I understand correctly’? Never hesitate to ask clarifying questions. We are all guilty of making assumptions about the other person’s knowledge when we answer a question. This often leads to complete misunderstanding.

Proverbs 18:13 MSG

Answering before listening

    is both stupid and rude. 

1 Timothy 6:20-21 MSG

And oh, my dear Timothy, guard the treasure you were given! Guard it with your life. Avoid the talk-show religion and the practiced confusion of the so-called experts. People caught up in a lot of talk can miss the whole point of faith.

I encourage your THIRD question to be, ‘Does it glorify God?’ By this I mean, does it promote the type of life and interaction we are called to live?

James 3:17-18 MSG

Real wisdom, God’s wisdom, begins with a holy life and is characterized by getting along with others. It is gentle and reasonable, overflowing with mercy and blessings, not hot one day and cold the next, not two-faced. You can develop a healthy, robust community that lives right with God and enjoy its results only if you do the hard work of getting along with each other, treating each other with dignity and honor.

The real ‘rules’ and instructions are in the Bible. The rest are interpretations, good/spot on and sometimes misguided. So discernment helps us sort them out. I know I have trouble sorting through it all on my own. Bible reading, study, trusted people to talk with, and prayer help me through.

Blessings,

Michelle

Image source: Office of Research Support; National Institutes of Health; U.S. Department of Health and Human Services.