Monday, 29 January 2018

The Future Planning Talk

When I first started working as a hospital social worker many moons ago, it was not uncommon for people to ask that we complete nursing home papers for a loved one without their knowledge. It seemed as if there was a role reversal in play - the child had suddenly become the parent and thought they knew what was best. They believed that if they raised the issue of moving to a long-term care home with their parent, there would be disagreement and a negative reaction. This was a very short-sighted request and I have no idea how they expected to deal with a move to long-term care if it came as a surprise to their loved one. For those who are wondering, unless the person was incompetent, this was not something I would ever do or suggest to a client.
When CCAC created a standardized form, it became easier to deny this request - if someone was competent, they would have to sign the form and accept the bed. While there was 'push back' from many families, there was nothing they could do about it.
In all my years at the hospital, I don't think there was ever a situation where a senior or their loved one told me they had discussed future planning with each other.
Years later when I left the hospital setting and began giving workshops and lectures, I came to understand that healthy seniors often did want to talk about future planning with their kids but felt a resistance from the kids - the same resistance the adult children would tell me they faced. I developed a theory that most families considered that very difficult conversation taboo, and both sides were afraid to discuss it yet, if they did, they would see how freeing it was and made things so much easier when decisions did needed to be made.
This weekend I read an article that reminded me of all of this. Essentially, the article was about dictating lifestyle changes, like diet, for seniors in the interest of better health and living longer. Let's be honest here - how many 80 year old's are willing and able to change their diet when they have been eating a certain way for all their lives? Is it really something we can force anyone to do, regardless of their age? Ultimately, the answer to this question and the one so many children of seniors asked me so long ago is this - people have the right to live the way they want, even if it's in a situation we deem 'risky' as long as they are mentally competent. Present the information and then listen to what they want. I know when I am 90, I don't want my kids to decide anything for me if I am still able to decide for myself. What's important is that we have the difficult conversations before crisis hits; talk over time, when the person is healthy, about what they want. When the time comes, it's far easier to make a decision when you have talked about it, and perhaps even planned for it.

Friday, 19 January 2018

GUEST POST - Motivational Tips for Senior Wellness

If it’s true that age is just a number, someone should inform the wrinkles. In fact, physical appearance and gray hair are not the only lovely attributes that broadcast the effects of age. As time ticks forward, our whole body gets a makeover one grueling second at a time. We suddenly experience pain in parts of the body we didn’t know existed, and naps feel like mini vacations. We can’t always remember what we had for dinner last night, and wonder if our hearing is going or if the kids are creating the next slang word. Don’t you wish there was a cure for the inevitable aging process?

While no one has perfected an anti-aging solution, there are plenty of ideas surrounding the concept of maintaining physical and mental wellness as we grow older. Some effects of our age are unavoidable, but most of the extenuating issues like disease, illnesses, and muscle weakness can be prevented, if we learn how and why to take care of ourselves. It’s as simple as maintaining a little self-discipline and setting a few healthy goals. At the end of the day, your overall health depends on how well you manage it. You may want to research some inspirational tips to keep you motivated. In fact, here are just a few to get you started:

Your limitations don’t have to determine your health.
Your mind and your physical limitations do not have to dictate your overall health. Sure, there may be a few extenuating circumstances, and cautionary tips from you primary care doctor. Those are important things to consider, but don’t let what you can’t do stop you from doing what you can do. Try to accomplish a weekly activity that still challenges you to become healthier, without risking your wellness. Your goal might simply be to walk down the street in your neighborhood twice a week. Or to work out at home with a treadmill, exercise ball, modified strength training exercises such as push-ups or wall sits, or even light cleaning activities that get your heart rate up. Those are all really great in-home exercise routines that don’t have to cause serious strain to your muscles. Sometimes we just need someone to tell us we are capable to fulfill the goals we have set for ourselves. If that applies to you, you can do this!

Start chasing your passion now.
How does passion relate to total wellness? A study was conducted regarding the effects of intentional activities on psychological wellness. It revealed that those who participated in activities they enjoyed, or ones that peaked their interest, had a healthier overall well-being. It might sound obvious, but if you chase after your passions (no matter your age), you will likely improve your well-being. Mentally, you will be challenged. Emotionally, you will feel satisfied in your accomplishments. And physically, you will increase your level of activity, while you chase your dreams. And, you avoid many potential pitfalls that other seniors are facing: the rate of addiction, suicide and depression is up among seniors - by making good choices for your mental health, you put yourself in the best possible position to avoid such negative issues and enjoy only positive ones.

It's never too late to begin a healthier lifestyle.
It's true that as we age, it becomes more difficult to lose weight or see significant physical gains from exercise, but that shouldn’t stop you from living healthier. The purpose of healthy living is to improve your quality of life. It’s been proven that people who exercise more and eat healthier, actually live longer. Today is the best day to begin managing your physical activities, diet plan, and sleep schedule. No matter your age, you can still benefit from new healthy choices.


What can you do to maintain a thriving lifestyle? You are always one healthy decision away from enjoying a life of improved wellness. Choose today to change an aspect of your life that will positively affect your well-being tomorrow. 

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.

Friday, 5 January 2018

GUEST POST - The Wonderful Benefits of Aging in Place


The decision to age in place or enter a care facility is a deeply personal one, and a decision most seniors would prefer not to make. Unfortunately, a lack of preparation leads many elderly people to end up in a nursing home, assisted living facility, or continuing care retirement home when they become ill or injured. However, with some planning, many seniors can remain in their homes and enjoy the multitude of benefits that aging in place can bring.

Big Savings


The cost of living in a nursing home is high and rising. In 2013, a private room averaged $1,995 per month, or more than $23,000 annually; if you are in a larger city such as Ontario, you can expect to pay a minimum of  $1,819.53 per month (for basic accommodation), or close to $22,000 annually (based on rates as of July 2017). The current ceiling cost for a private bed in a newer long-term care home is $2,599.11 per month or close to $32,000.00 per year. Pair the cost with the fact that seniors now outnumber children, and the reality is that demand increasing at a much larger rate than supply. With some seniors remaining on waiting lists for years or more, the option to age in place becomes one that should be seriously considered in order to provide seniors with the immediate care they need.

Retained Independence


Staying independent is a big motivator for many seniors who wish to age in place. A senior who is accustomed to following her own schedule may experience significant emotional blowback when forced into the regimented meal times and social activities of a care facility. Maintaining a sense of autonomy can keep the elderly active and energized well into their twilight years.

A Familiar Environment


Seniors who have to move into a care facility must part with most of their possessions in order to adapt to a smaller living space. This can be upsetting for older people who have spent many years in their home, and may disorient seniors experiencing cognitive decline.

Community Connections


One of the greatest benefits of aging in place is being able to stay in a beloved community. Social isolation is one of the biggest threats to senior well-being, and has been correlated with  depression, cognitive decline, and repeated hospitalizations. When senior citizens age within their community, they retain access to existing social networks and support systems.


Aging at home also means that seniors are free to have visitors at their own discretion. Care facilities, on the other hand, often limit the hours that residents can have visitors as well as how long visitors can stay.

Cherished Companions


Pets offer valuable companionship to seniors, especially those who live alone, as they help keep them active and can even reduce depression. While some assisted living and continuing care retirement communities may allow small pets, most nursing homes do not. Having to part with a cherished pet can be emotionally devastating for older people and contribute to isolation and depression.

Reduced Illness Risk


Care facilities inevitably expose seniors to germs and illnesses not encountered at home. And since immune systems weaken with age, the elderly are more likely to face permanent disability or death from an infection or illness. While care facilities have on-site staff to deal with sickness, staff members may not necessarily be licensed nurses, and low staffing levels can lead to inadequate care. When a senior ages in place, home health aides can be brought into the home to provide one-on-one assistance in times of illness or disability.


While aging comes with a number of challenges, losing independence doesn’t have to be one of them. Many nursing home residents could be aging in place if only they had adequate supports at home and in the community. With proper planning, an accessible home, and health and social support networks, seniors can stay safe and comfortable in their homes longer than ever.

Post submitted by: Marie Villeza, Elderimpact.org
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.

Friday, 22 December 2017

Staying Together

Many years ago, as a new social worker in a large hospital, an elderly couple came in together with two different issues and were admitted to my floor. They had been married well over 60 years and had never spent time apart. The husband had dementia but knew his wife. In the day they found each other but they were in separate rooms and the staff were faced with a problem every night when he would wander the halls and climb into bed with other female patients. We realized that he was looking for his wife at bedtime. I began to advocate to allow them to share a room and was faced with opposition as this was not something the hospital had ever done or entertained. Unfortunately, they each had different medical issues and could not return home.
I was reminded of this story this week when I read of the New Brunswick couple, separated after 69 years of marriage because his dementia had worsened and he was deemed to need a level of care not offered in the home he and his wife lived in. 
My story had a bittersweet ending - after many calls and much advocacy, I found a place that would take our couple on the same day. They would be in different areas of the residence but staff would do their best to bring them together as often as possible so they could visit. Not ideal but at least an understanding that for whatever time they had left, they needed to be together as much as possible. 
For the New Brunswick couple, this understanding was clearly not there. Separated this week, the family resorted to calling the press to share their story. 
I am sad that this many years later, with more couples aging together, we don't have a proper mechanism in place to ensure that at this last stage of their lives, they remain under the same roof regardless of differing care needs. As our health care system continues to evolve, this is definitely something that should be added to the list of 'must haves'. We need to find ways to allow couples at different levels of care to stay together and live out the remainder of their days in each other's company. 

Friday, 8 December 2017

Hiring Help

For most people 'there is no place like home' and so, for many who have difficulty managing at home, prior to considering relocation, they consider/investigate hiring extra help in the home. For some, adequate help can be found through their local LHIN where costs are covered by OHIP. For others, if funds permit and the care available through the LHIN is not enough for them to feel safe, they investigate hiring through a private agency. As with any private care service for a vulnerable population, one is wise to do their homework prior to hiring anyone. Senior care is the new up and coming field with many new companies who may or may not have adequate training and experience. One needs to ensure that whomever they hire is reliable, trustworthy and able to provide exactly what they promise. As with any private service it is always best to contact more than one company and interview both the agency and the care providers before they begin working for you. It would be best if you have a written list of questions to ask each company/provider prior to speaking with them. As well, ask to see a copy of the client contract in advance and ask if they can provide references.
Some suggested questions to consider when interviewing an agency to purchase services from include:
• How long have they been in business?
• What sort of memberships/licenses/accreditation do they have?
• What qualifications do employees have?
• Do they do background/criminal checks and reference checks for all new staff?
• Are staff trained to manage cognitive impairment, behavioral issues, vision issues and hearing issues?
• How do they monitor their staff & track hours?
• Are there surprise visits by a supervisor?
• Are staff licensed, insured and bonded?
• Will the same staff person visit your loved one every time or will there be different people providing service?
• What is the cost of services required?
• Is there a minimum number of hours required for a client to commit to?
• How often do they increase fees & how much notice do they give you before an increase?
• Are staff protected by the Workplace Safety and Insurance Board (WSIB)?
• What is the procedure if a caregiver is sick?
If there are specific needs your loved one has, do include that in your list of questions as well as anything else you think is important to know when you hire someone to provide care. 

Friday, 24 November 2017

Aging with Confidence: Ontario's Action Plan for Seniors

A couple of weeks ago the Ontario government announced a new document and with it, their commitment, to helping seniors age well. Entitled Aging with Confidence: Ontario's Action Plan for Seniors the document outlines "Ontario's vision [to] help seniors remain independent, healthy and active, safe and socially connected." Using different sources of a data as well as a survey of seniors, the government has created a plan aimed at encompassing the changing needs of seniors as the population become more diverse and lives longer. There are several "guiding principles" at the report's core - Inclusion, Diversity, Choice and Self-Determination & Safety and Security.
With this goal, the province hopes to support seniors regardless of their age or stage, health or income, and physical needs.

An all-encompassing website for seniors has been created at Ontario.ca/AgingWell. It has information on health, transportation, housing, activities and financial assistance. While many of the initiatives are encouraging to consider (education, consumer protection, helping with technology, etc.) what is most interesting from my perspective, given the issues I hear about most, are those related to housing.... I do want to see more age-friendly communities, I do want to know that seniors will get more home support to live independently in their own homes for as long as possible, I want to read about more naturally occurring communities where there are many seniors and supports are sufficient, I want to know that there is more supportive housing for those on limited incomes, and I want to know about better long-term care - less wait times, more support, more staff, more innovation, more protections, more homes for those with cultural needs and more modern homes. Ultimately, I want to see the end to the big black hole in senior care - I want to be able to help people like the man who called me today who is on a limited income but needs a retirement home. I want to be able to tell him that our government has a solution for his situation.

The vision is a good one. The initiatives are encouraging. I hope getting to the reality is not too many years in the making. 

For more information on the Aging With Confidence document visit: https://www.ontario.ca/page/aging-confidence-ontario-action-plan-seniors

Thursday, 9 November 2017

GUEST POST - The Importance of Staying Active in Your Golden Years

So you haven’t exactly found hitting the big 6-0 to be motivation for improved fitness. The good news is, there’s still time. If you haven’t been practicing healthy eating and living a healthy active lifestyle, you can still improve your health by starting now.

The science of aging works a bit against us in our golden years. As we age the correlation between our body fat and our lean body mass changes, and it isn’t for the better. So, instead of muscle working to raise our metabolism and burn fat, there’s far less muscle to do the job. This means as we age we must work hard to follow a low calorie diet, and harder at following an exercise plan to go with it.

According to the American Journal of Clinical Nutrition, several population studies among the older generation (65+) found that following a healthy nutrition plan, along with a healthy lifestyle plan: 1) reduces the risk of cancer by one third, and 2) decreases the risk of cardiac events by as much as 45%.

In addition to decreasing physical health, the older population also faces significant mental health issues. The World Health Organization reports that 20% of world’s elderly population, 60 and over, suffers from a mental or neurological disorder. They further recommend “optimizing physical health” as one of the most important components of intervention.

It’s time to get motivated with these easy tip.

Strength Training. To build more muscle mass as you age, start with strength training. Stronger muscles make day-to-day activities much easier. A study by The US National Library of Medicine National Institutes found that, “muscle mass can be increased through training at an intensity corresponding to 60% to 85% of the individual maximum voluntary strength.”

If the idea of strength training at a gym is intimidating, consider creating your own home gym with a few select pieces of equipment. Read about proper form to avoid injury and find a free online weight training program that’s best for you and that can be done from the comfort of your own home. Remember: doing something is better than nothing, so allow yourself to ease into it and work your way up when you’re ready.

Get Moving. Like strength training, a good walk can increase muscle mass, but walking also has so many other benefits:

·        Weight control
·        Improve balance and coordination
·        Keeping joints flexible
·        Lowers your risk for heart disease
·        Improves your energy
·        Decreases depression and anxiety

Consider purchasing a Fitbit. The Fitbit, worn around your wrist most commonly, tracks your daily steps via a pedometer. Keeping yourself accountable for moving so much each day, and increasing your efforts, will motivate you to move more. Consider competing with a friend for most steps in a day. The American Heart Association recommends 10,000 steps a day as a goal for improving health and lowering your chances of heart disease. As always, start with a small goal and work your way up.

Try Yoga. Numerous studies have shown that yoga has many health benefits, particularly in the 50-plus age group. Here’s a few of them:

·        AARP published a study suggesting that the slow, controlled breathing required for yoga leads to a decrease in hypertension and stress, and may lead to a decrease in medication use.
·        The American Osteopathic Association reports that yoga “creates mental clarity and calmness; increases body awareness; relieves chronic stress patterns; relaxes the mind; centers attention; and sharpens concentration.”

Head to your local retailer, and purchase a yoga mat for as little as $15. These mats can be used for yoga, as well as for your home strength training.

Easy home exercises. Start working on easy home exercises that will help you build your strength and coordination.

Remember, a sedentary lifestyle can lead to numerous diseases of the mind and the body. Find fun ways to incorporate daily exercise into your life, and sooner than you know it, the ole 5-0 will feel more like the younger 3-0. 


Post Submitted by: Marie Villeza, Elderimpact.org

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.