The Retirement Cruiser

As our regulars know, I often write about different and innovative retirement living options. I'm always interested in what's current and where things seem to be going when it comes to seniors housing. The other day I read about a man who has taken something that until now, I considered a 'chain email' concept, and turned it into his reality. I'm certain many of our readers have received that email that talks about how its cheaper to live on a cruise ship than in a retirement home .... it shows up in my inbox at least once a year .... well, there is a fellow who decided to make a cruise ship home more than a dozen years ago. He is mentally alert, fairly healthy, in his 90's, widowed and almost fully blind. He has a home in Florida which he uses to store his belongings but rarely goes there. He spends his days cruising around and staying on the ship with staff who know him well and cater to all of his needs. The article didn't indicate the cost involved or how the cruise company agreed to this arrangement (or if there is a 'out-clause' if his needs exceed what they are able to do) but it did get me thinking about the viability of such an arrangement.
Clearly, it only works because he is independent. Like most retirement homes, he gets his meals, housekeeping services and entertainment. He mostly interacts with staff who attend to him as required. But beyond them, he has no lasting relationships. His kids visit when he docks in their city's port but he doesn't have an opportunity to socialize with people of his age and stage. If he gets too sick to be looked after by the crew, he will have to be relocated. I do wonder how that scenario would play out.
As someone who loves cruising, I understand the desire to vacation on a cruise ship. However, after a week on board, maximum 10 days, I am anxious for land, and home. I cannot understand, wanting to retire full-time on a boat, cut off from everyone but the crew. From a practical perspective, or maybe its a social work perspective, I see red flags everywhere in a situation like this and I remain convinced that a retirement home is a far better setting for someone in their 90's who needs a bit of assistance. And as a family member, I would not want an elderly loved one, at sea for years. I wonder what led him to make this choice and why he considers it preferable to living in a retirement setting with the potential for more amenities and care and in close proximity to his friends and family. I suspect there is more to this story than the brief interview I read and am left with more questions than answers to this retirement option.
As our readers know, there are many different housing opportunities for seniors  - and many new and innovative ones coming soon - but I hope living on a cruise ship is one that will not become popular anytime soon. I think, in retirement, one needs to consider several things when making decisions around relocation including proximity to health care and hospitals, family and friends and amenities and care required, now and in the future. And I know that there are many retirement settings that can provide a much better quality of life than living on a ship. In fact, there are many people I have talked to who have described a retirement home as a 'cruise ship on land'.
So, if you are an avid cruiser and are considering this option when you get that chain email in your inbox, before really considering it, check out a retirement home; go for a visit, try a meal, stay for a week and see if you like it. Consider your proximity to family and friends, the care you will get now and what you can get in the future if your needs change. I hope you will look at the many options out there in your community and beyond before making a cruise ship your permanent retirement destination..........

Where do you want to live at 80 or 90?

Many people, simply do not think about what they want for themselves when the time comes that they cannot live alone. For many, moving into a care home becomes something that happens in a crisis when options are limited and in some cases, when someone else decides for you. People rarely think about one day needing care or support. And few people choose to relocate to a care setting when they are healthy  and/or young seniors. So, I'm always fascinated when I read about people who think outside the box when it comes to senior housing and what they want for themselves 20 or 30 years down the road.

A few days ago a read about two couples (who are in their 50's/60s) in Toronto who decided to create their own co-housing opportunity to share with a few other couples. Intent on aging in place and avoiding loniliness, isolation and potentially, institutionalization, these two couples have bought a house they are renovating that will house up to 12 people with private space for each and shared common areas. They have legally incorporated their company, created rules for their living situation and thought through the financial implications for those wishing to buy in to their venture. They even hosted a workshop to explain their concept to interested and potential house-mates.

The idea of co-housing is not new. It's popular in parts of Europe and the USA. There are a few communities in Canada (primarily in BC) but Ontario has been slow to follow. That being said, in the next several years, it will be interesting to see how the concept develops and moves throughout the country as our aging poplulation starts looking for alternatives to institutionalization and our public system has trouble coping with the increasing need for seniors' housing.

Co-housing fosters interdependence, a caring support network and a shared-care opportunity decreasing the burden on a stressed public system. As the boomer generation starts thinking about how they want to live during their senior years, after witnessing their parents generations' options, I do believe that innovation will be rampant and we will start seeing more viable and beneficial housing options (like this one) for seniors come to fruition.

The Forever Bond

Childhood memories vivid but fleeting….

The warmth of her embrace.

The sound of her laughter.

Her full-body ‘giggle’.

The smell of her cooking,

mingled with cigarettes.

The hunch in her back.

The touch of her hands,

crippled with age.

Daily visits…..

watching soap operas;

eating soft-boiled eggs for breakfast,

and spumoni ice cream for dessert;

April Fool’s jokes;

stories from The National Enquirer;

and our annual viewing of the Wizard of Oz.

A constant through childhood.

A safe haven in her arms.

When did it begin?

She looked the same but really wasn't.

When was…..

the moment that her memories began to fade;

the hour when no one was familiar;

the day when she ceased to be the person I knew.

Was there fear? Anguish? Or passive acceptance?

If I knew then, what I know now…..

Would it have made a difference?

Would I, or she, have done things differently?

Or said things left unspoken?

An unconditional acceptance and love like no other,

gone over time and in an instant.

© Esther Goldstein, 2018

Planning Ahead

     If you are a regular reader of this blog, you will know that the key to maximizing your choices as you get older, is being proactive. It is far too common for people to wait for a crisis or significant hospitalization before considering issues around care and relocation. For many, this constitutes 'waiting too long' and they end up in a situation or place they would not have chosen. Often, if they had taken the time to discuss options well in advance and preplan, their transition from independent to requiring care, would have been easier and far less stressful for everyone involved. 

    For many, there is a stigma mixed with denial when it comes to discussing aging and the need for support and care. Most do not consider what they would want in an 'ideal world' or what they will need financially when the time comes. It is always the hope that we won't need care and can live in our homes unassited until the end. Unfortunately, this is rarely the case. 

    For those independent seniors who have not thought about these important issues but wish to be  proactive, there are questions you may want to consider to help you determine if you need to start thinking about options. 

• Are there stairs in your home (either inside or to get inside)?
        • If yes, are you having difficulty with going up or down the stairs?

• Do you need help with any household tasks (laundry, cleaning, shopping, etc.)?

• Do you or your spouse need help with any personal care (bathing, dressing etc.)?

• Are you able to prepare nutritious meals for yourself?

• Do you have a yard/yard work/outside maintenance?

• Who does your repairs inside/outside your house?

• Do you have people who can assist you with any of the above issues now or in the future or, if you do not, can you afford to pay people to assist with any personal care or household tasks?

• If you already have people assisting you:

     • Are you happy with the service they are providing?

     • Do they provide enough to meet your needs?

     • Can they provide more if you need it?

     • Is the cost affordable?

• Are you on a lot of medications?
        • If yes, are you able to keep track of when you need to take them?

• How do you get around (drive, cab, transit, family assistance)?

• Are you walking distance to important amenities (doctor, dentist, pharmacy, grocery store, etc.)?

• Do you require any assistive devices to help you to function?

• Do you have any safety concerns?

• Has your family indicated that they have concerns about your living situation/safety?

• How is your hearing?

• How is your sight?

• Are you forgetful?

• Do you have any significant medical issues which require assistance or may in the near future?

• Do you feel isolated/lonely or scared at certain times of day/night?

• Do you get out every day/almost every day or are you always home?

• Do you have hobbies? 

• Are you able to manage your finances?

• Do you ask for help when you need it?

• Do you have a support network, friends or family nearby and available?
        • If not, would you like to move closer to family/friends?

      Answering these questions honestly can serve as a ‘conversation starter’ as they will help you to focus in on the type of support you might need currently or, in the near future. While a few potential or minor issues may not be problematic, several might be, and may suggest a need to begin considering resources.

     If, after thinking/talking about your current situation and (potential) concerns with your loved ones, it seems that in the somewhat near future, you might need either additional help in your own home or to relocate to a place where there are more supports to enable you to remain independent, it may be time to start looking at the options available to you based on your current financial, physical and social situation. Discuss any concerns you have with your family and your doctor, so they can assist you in locating supports in your area. It is better to begin doing your research and discussing what your desires are with your family before you need the help and most certainly, before a crisis forces the issue and limits available options. 

Caring for the Caregiver

Our ever-changing world has altered the way we do so many things – including caring for our elderly. For many families, children live great distances from their parents. Most women work in jobs outside of the home and even in cultures where the custom of the past had been to have multi-generational families living under one roof and caring for each other, this is becoming less feasible. Caregiving for elder loved ones is something many people now do from a distance or among several other daily responsibilities. The ‘sandwich generation’ is common place with many caring for both parents and children at the same time. Caregiving can be so overwhelming at times that it can negatively effect one’s emotional and physical well being which in turn impacts the care of the senior in need.

Without doubt, the key to avoiding such difficulties is for the caregiver to ‘care’ for themselves as much as their loved ones. This, of course, is much easier said than done. How do you do this when you feel as if you are being pulled in a million different directions?

If you are in this situation, there are several things you can do that may help you navigate and cope with this often unexpected and somewhat daunting role:

1. Communicate – make sure you speak to medical personnel about concerns or issues. Ensure you have the facts. Create a support network of family, friends and others that you can talk with about your feelings and needs. Remember – avoiding or negating problems does not make them go away – it only compounds them. Let you employer know your situation as well. There may be available support groups, Employee Assistance Programs or paid family leave options available to you.

2. Educate yourself – knowledge can only empower you. Fear is often based on not knowing. Ask questions so you can understand the situation. With the technological tools of the 21^st century, finding out information is as easy as sitting in front of your computer. Seek out information about your loved one’s medical condition and the options available. This will aid you in planning for the future as much as possible. Know your rights and theirs. If you are providing physical care, ensure you learn how to do this safely.

3. Ask for and accept help – sharing responsibilities is often difficult but extremely necessary for the caregiver as much as the recipient of care. Use available community resources – there may be day programs, respite care options, homemaking and a host of other services available to you.  Good care can be provided by others besides the immediate family and getting this important relief is often as simple as asking for help. Keep in mind that people don’t know what you need unless you ask for it. Learn to delegate tasks to those willing to assist be it family members or friends.

4. Stress Management – acknowledge your feelings. It is okay to feel overwhelmed, sad, anxious and a host of other emotions. Learn to recognize the things that trigger a stress reaction in you and what that reaction is. It’s important to keep in mind that while you may not be able to change a situation, you can decide how you will react and respond to it. Learn the signs of ‘caregiver burnout’ and if you think you might be experiencing it or if your physical health or functioning is being affected, speak to your doctor or a trained mental health professional as soon as possible. Learning relaxation techniques may be helpful as well.

5. Life Balance – prioritize, prioritize, prioritize! Organization is the key to feeling a sense of control over your situation. Accept the good with the bad. Look after yourself. Eat properly, exercise, sleep and take breaks when needed. It’s okay to do things for yourself. Don’t self-medicate. Learn to say ‘no’. Don’t expect too much of yourself. Caregiving is a learning process so allow yourself to make mistakes. Know your limits and deal with stress before crisis hits. Seek medical attention if you are ill. Consider joining a support group for those with similar struggles. You may hear valuable helpful information from others who have been where you are but also, knowing that you are not alone can help you cope.

As difficult as caregiving can be, it also has the potential to be very rewarding. How it impacts us has everything to do with our ability to deal with the ups and downs of daily life and our attitude. Finding the ‘silver lining’, having realistic goals, sharing special moments and finding enjoyment in simple pleasures can contribute tremendously to how we cope and manage what can be one of the more challenging roles in our lives.

GUEST POST - 6 Ways Technology Helps Family Caregivers

The wealth of online resources makes it possible for almost anyone to gather a great deal of information about medical problems and treatment on her own. Pew reports that just under 3 out of 4 caregivers conduct their own health research online and over half engage in health-related social activity online.

It’s clear that the transformative power of technology in health care extends beyond high-tech hospital settings to include everyday senior and hospice care. Read on to learn about 6 tech trends that help family caregivers support the health and quality of life of seniors and others under their supervision.

1.   Med Monitors

A number of digital tools, such as MedMinder and TabSafe, are designed to remind seniors and caregivers to take or administer prescription medication. And the same functionality is available on the go with apps for iPhone and iPad like MedCoach.

2.   Wireless Safety Nets

Another way to monitor a senior’s health and wellness status, while helping them lead active and independent lives, is via sensor-based home monitoring systems like Canary Care and TruSense. These and similar systems alert caregivers or emergency personnel when warning signs, such as long periods of inactivity by a senior at home, arise.

3.   (Virtual) Fellowship

Loneliness and social isolation are particularly acute risk factors for elderly folks given their greater likelihood of reduced mobility and loss of loved ones. In-person interactions are ideal, but when they are not possible, email and video correspondence can be helpful stopgaps. Indeed, encouraging research has shown that social media use is associated with reduced loneliness and improved mental and physical health outcomes.

4.   Picking up the Pace

Like anyone, seniors need regular exercise to reach their full potential for living capably and independently. Technology can help put them in motion and keep them active. Wearable fitness trackers help seniors and their caregivers mark progress toward wellness goals and document encouraging results.

5.   “Telehealth”

Thanks to the emerging tools of telemedicine, obtaining professional consultations no longer requires leaving the comfort and security of home. Senior and hospice patients can arrange virtual visits with physicians and other healthcare professionals. In discussion with U.S. News & World Report, Medical Director of Telemedicine at the University of Pittsburgh Medical Center Dr. Andrew R. Watson emphasized telemedicine’s positive impact on health outcomes and patient engagement.

The benefits of telehealth tools for patients and healthcare providers include reduced costs, fewer hospital readmissions, improved diagnosis and treatments, and stronger relationships between doctors and patients, especially in rural areas.

6.    Brain Benefits

Finally, it turns out that healthy amounts of screen time don’t rot your brain. On the contrary, internet browsing and even video games, the brain decay boogeyman of yesteryear, increase elderly brain function and help reverse the bad mental effects of aging. The takeaway here is that, quite apart from the other benefits we’ve discussed, technology offers direct cognitive advantages to senior and hospice patients.

Digital tech is not the most critical line of defense against health setbacks for the elderly and hospice patients, let alone a cure-all. But as we have seen, it provides a wealth of resources supporting family caregivers in their efforts to promote the best possible outcomes for those in their capable hands.

Contributed by: Christian Golden, PhD
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Christian Golden, PhD, writes about tips and trends in digital marketing and social media for TrustRadius. He is a philosopher by day who loves teaching and digging into the big questions. His extracurricular interests include making music, reading comics, watching (really old) movies, and being in the great outdoors. 

GUEST POST - Planning and Paying for Long-Term Care: A Guide for Seniors and Caregivers

Regardless of age, preparing and planning for long-term care isn’t something most people think about. But, for a person over the age of 65, it’s an important conversation to have. There is a 52 percent chance that they will need long-term support and services. That means it is never too soon to start planning how you want to handle that situation—for yourself and for loved ones.

Planning for long-term care is one step, deciding how to pay for it is another. For seniors, preparing for this is crucial to enjoying your golden years with independence and dignity. For family members, planning for long-term care can help you understand your role as a caregiver. In 2013, unpaid caregivers — mostly comprised of family members — spent 37 billion hours providing long-term care. Being a caregiver is rewarding, but can often be stressful and physically draining.

“Being a kind, compassionate caregiver is one of the greatest gifts you can give to a senior loved one,” says June Duncan, co-founder of Rise Up for Caregivers and author of the upcoming book The Complete Guide to Caregiving: A Daily Companion for New Senior Caregivers. While family caregivers play an essential role in our society, they often do so without much-needed support and guidance. June’s book fills that gap by offering a helping hand on everything from how to assess your loved one’s medical needs to how to work self-care into your busy days.

Self-care is just one aspect of planning for long-term care. Planning out the potential steps can be a huge benefit to seniors and their loved ones, even if they don’t wind up needing care at all. You can plan for long-term care by:

●       Assessing the likelihood you or a loved one will require long-term care. There are a few reasons long-term care could be in your future. For example, if someone in your family suffered from hereditary illnesses such as Alzheimer’s, you may be at a higher risk. Be sure to plan for in-home care or pick out an assisted living facility to help care for your needs.

●       Making lifestyle choices to reduce the risk of injury or onset of illness. Regular exercise, a good diet and consistent good sleep are three lifestyle choices that are critical for healthy seniors. From prolonging the onset of dementia to promoting healthy knees, hips and joints, all three impact your physical and mental health. Start walking, join a gym or sign up for yoga classes.

●       Plan for future home modifications you need to make. Most seniors want to age in-place, meaning they want to stay in their homes for as long as possible. Planning for long-term care means planning for independence and safety. If the house is two-story, consider moving all essential rooms to the first floor. Install non-slip flooring in bathrooms and kitchens. These modifications will prevent accidents that could make long-term care a reality, as well as create a home environment that supports independent living.

Planning for long-term care also involves insight into the costs involved. Some ways to pay for long-term care include:

●       Retirement options. If you can, consider postponing retirement and staying on at work for another year to boost up your savings. You can also take out an additional retirement policy specifically to cover potential health care issues.

●       Purchasing long-term care insurance. Many insurance companies offer special long-term care insurance policies. Keep in mind— the younger and healthier you are when you purchase this type of insurance, the lower your premiums will be.

●       Selling a life insurance policy. Selling a life insurance policy can help pay for daily living expenses and medical care. This can give you cash in hand to cover the costs of an in-home caregiver, home modifications or medical equipment you need that Medicare doesn’t cover.

Planning for long-term care is not a simple conversation to have, but it doesn’t have to be too complicated if you start talking about it now. Make sure your family and friends know your wishes, so that, if the time comes, you’ll receive the care you want and deserve.

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Contributed by: Marie Villeza, ElderImpact. 

Marie Villeza is passionate about connecting seniors with the resources they need to live happy, healthy lives. So she developed ElderImpact to provide seniors and their caregivers with resources and advice.