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Tips for Transitioning Senior with Cognitive Disorders

 Posted by Regina Hileman on March 2, 2015 at 1:01 PM

Tips for Transitioning Senior with Cognitive Disorders

By Chris Seman, President, Caring Transitions (as seen on The Caregiver’s Voice)

There comes a time when our elder loved ones need to consider a home transition–whether it’s relocating to a smaller home or downsizing to an independent assisted living community. Late-life transitions are often perceived as a negative aspect of aging and can be rather stressful on relocating seniors and their loved ones.

Transitioning seniors experiencing cognitive disorders, such as dementia or Alzheimer’s, will experience even greater stress than those without an illness. This is because removing a person with dementia or Alzheimer’s from a familiar place can cause feelings of disorientation and confusion.

In general, our homes are our most recognized places. As the caregivers of seniors in transition, especially those with cognitive disorders, it’s important to understand how moving or making a major change to a home environment can cause seniors to lose not only their sense of place, but also their sense of self.

By following the tips below, caregivers can make the transitioning process easier for their loved one and for themselves.

  1. Reinstate a sense of control.
    People often experience stress when they feel things are out of control.
    Caregivers can lessen the stress of transitioning by reinstating a sense of order and control to the events their loved ones find stressful. Offering choices helps the senior maintain his/her sense of self in the midst of chaos.
    It’s important to understand that when we remove someone’s ability to make decisions on his or her own behalf, we also remove an essential practice that would otherwise help a senior maintain a sense of control over unfamiliar situations.
  1. Give seniors a voice.
    With cognitive issues present, it becomes difficult for older adults to voice their fears and opinions.
    Caregivers can give their loved one a voice by offering a few simple options with outcomes that are always acceptable.
    For example, asking something as simple as, “Would you like to explore three assisted living communities or just two?” presents an outcome favorable to both parties, while allowing the older adult to make his/her voice heard.
    When caregivers present options for discussion, their loved one develops a sense of being important to the relocation process.
  1. Use outside resources.
    Caregivers and their elders should not feel they have to handle every detail of a late-life transition, alone.
    Using dedicated professional resources helps relieve the stress of dealing with the nitty gritty details of relocating and instead, allows caregivers to focus on their loved ones. For instance, Caring Transitions gives families peace of mind by managing and supporting transitions; initially, with sorting personal belongings, and then packing, shipping, and selling items to the final clearing and cleaning of the property.
  1. Practice “Mirror Placement™.”
    As seniors settle into a new home or an assisted living community, it’s important to help them maintain or regain their sense of place as well as their sense of self.
    Surrounding loved ones with familiar things helps them to assimilate to a new environment more quickly. Caregivers can create familiarity by practicing “Mirror Placement™,” thus duplicating the furniture arrangement and location of objects to mimic that of the original home setting. Caring Transitions uses specially designed technology to ensure their new space is mirrored as closely as possible.

By establishing processes where transitioning seniors, even those living with dementia or Alzheimer’s,  can express their concerns, regain some control and focus on the road ahead, caregivers can help their loved ones and themselves turn a late-life home transition into a meaningful life experience with less stress and more positive outcomes.

Care Transitions and Caring Transitions®

 Posted by Regina Hileman on February 4, 2015 at 6:30 PM

Care Transitions and Caring Transitions®

By Nan Hayes

Individuals with chronic health conditions often require a variety of care services provided by multiple practitioners. Typically, each provider of services operates in a unique setting. For instance, as a patient’s needs change, they may transfer from their home setting to a hospital, then from hospital to a rehabilitation center or nursing facility, then perhaps return home where they receive additional care. The patient may also schedule office visits with primary care and specialty care physicians.

Each of these changes in practitioner or healthcare setting is called a “Care Transition.”  Traditionally, providers in each of the care settings operate individually, with little or no knowledge of what services or information was given to the patient by any of the other providers. Among providers it is known that poorly managed transitions can diminish health and increase healthcare costs. The lack of coordination among care services may also lead to poor clinical outcomes, dissatisfaction by patients and their families and even readmissions to the hospital.

According to the Centers for Medicaid and Medicare Services (CMS) nearly one in five Medicare patients discharged from a hospital, or 2.6 million seniors, are readmitted within 30 days, at a cost of over $26 billion every year. Clearly this indicates room for improvement in care transitions. In addition to readmission, patients may suffer other complications due to unclear discharge instructions, conflicting instructions from different providers and medication errors, such as dangerous drug interactions or overdose due to duplication of prescriptions.

On the other hand, when care transitions are managed optimally, quality of care is increased and readmission of a patient can be reduced. According to the American Geriatrics Society, good transitional care is based on a comprehensive plan of care, as well as the availability of health care practitioners who are trained in chronic care and have current information about the patient’s goals, preferences, and clinical status.

Good transitional care will also include these 6 principles:

  1. Planning and logistical arrangements
  2. Use of technology to promote the exchange of information
  3. Education for the patients, their families and caregivers
  4. Support assessments and service referrals
  5. Patient follow up
  6. Performance standards, measurements and reporting

At Caring Transitions®, we understand the value of these care transition principles and apply them to other areas of late life transition, such as “home transition.”   While clearly different from health transitions, “home transitions” encompass the changes to an individual’s living environment. In later life, home transitions typically include a move from the family residence to an assisted living community, nursing care or a rehabilitation center.  Additional changes to home environment may include downsizing, decluttering or modification to an existing residence to improve comfort and safety.  And lastly, a home transition may be the transfer of an estate to a trustee, who is then responsible for the management or liquidation of the estate.  In all cases, Caring Transitions® provides the necessary transitional planning and services to help assure the best possible outcomes for the client.

Please join our blog and newsletter over upcoming weeks as we explain “What Families Should Know” when it comes to transition services and standards.

©Caring Transitions 2015. No reprint in part or entirety without permission.

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Assessing Parents’ Well-Being

 Posted by Regina Hileman on December 23, 2014 at 10:21 AM

Assessing Parents’ Well-Being

When you visit family this year, you may notice some changes in mom and dad’s home and environment. The following is a list of significant changes which may indicate your parents may need additional support such as home care, companion or financial services or assisted living:

  • Difficulty keeping up with finances. Observe stacks of unpaid bills or late notices.
  • Changes in personal hygiene or housekeeping that indicate parents are having trouble with personal grooming or housework.
  • Your parent repeats themselves often in the same conversation, seems confused, highly emotional or exhibits unusual paranoia. This could be caused by medications or other more serious cognitive issues.
  • Excessive shopping through TV or online outlets, or an unusual interest in online sweepstakes that require their personal information, phone numbers, addresses, social security or banking information.
  • Your parent is extremely isolated due to loss of a spouse or loss of personal mobility.
  • Numerous safety concerns in the home, such as heat, air conditioning, leaks, crumbling plaster, trip and fall hazards, steep stairways, loose carpeting and outdated electrical.
  • Health concerns: disorganized medications, spoiled food in the home, lack of healthy food items, infestations or mold

Even when concerns about your parents’ lifestyle are minor, you can still provide support during the holidays in a number of ways such as:

  • Give useful gifts such as gift certificates for needed services such as home delivery for groceries, transportation, housekeeping, laundry pick up, exterminators or lawn service.
  • Purchase a few hours of time from a downsizing expert or professional organizer to help with clutter and disorganization.
  • Help mom decide which items may make great holiday gifts for children, grandchildren, nieces and nephews. If she has been holding on to jewelry, china or collectables, this may be the year she can enjoy gifting them to others.  Help her pack and ship items. Be sure to include a note with each that describes origin or significance of the item within the family.
  • Research the value of family heirlooms online
  • Purchase photo digitizing services that allow parents manage old photographs, slides or movie reels and share them with the entire family.

Most importantly, take this time to improve communications. Taking the time to call or visit more often isn’t always possible, but try your best. Frequent communication promotes honest conversation and can help you adjust to the many changes that take place as our parents grow older.

Home for the Holidays

 Posted by Regina Hileman on December 8, 2014 at 10:09 AM

Home for the Holidays

Going home for a holiday visit can provide an opportunity to observe what may be changing in our parents’ lives. Sometimes the changes are good: dad has started a low sodium diet, mom is having her eyesight addressed and the roof is being replaced after 30 years. Other times, we may be dismayed by what we find:  dad can no longer keep up the yard work, furnishings and flooring look stained, dingy and dusty, food is in the pantry or refrigerator is outdated and the furnace does not seem to be working properly.

Once we notice things that make us worry or uncomfortable, we have a tendency to step in and immediately tell our parents what we think they should do. Sometimes that advice is not entirely welcome. Our parents may perceive our advice as criticism and productive conversation may shut down. Of course, if you feel there are immediate health and safety issues in the home, the only responsible action is to try and open a dialogue with your parents regardless of how difficult. However, if you find you are truly uncomfortable with the changes you notice in your parents’ home, a more thoughtful, more respectful approach will yield better results.

During your visit, make a private list of concerns, but do not address them during your holiday weekend. Instead, use the holiday time to enjoy your family and continue observing their overall health, physical and mental abilities. Chances are mom and dad may even raise some concerns on their own.  Like most of their generation, aging parents want to appear capable and independent and often have difficulty letting us know when they need help.

Once the holidays are over, review your list of concerns with siblings, friends, a social worker or care manager.  This may serve as a “reality check” for your own level of concern. Remember, just because our parents have changed the way they live, it does not mean they are incapable of living on their own.

Eventually discuss your more serious concerns with your parents, not as criticism, but as observations. The “Parent Care Conversation”  by Dan Taylor, is one of many books that may help you talk to your parents.

“Do’s” and “Don’ts” of an Estate Sale

 Posted by Regina Hileman on November 3, 2014 at 6:24 PM

“Do’s” and “Don’ts” of an Estate Sale

One of the challenges consumers face when moving to a smaller space is trying to determine what to do with their downsized possessions.  Today there are more options than ever, including charitable donations, live auctions, online auction sites, tag sales, traditional garage sales and Estate Sales.

For people who have a fair amount of valuable inventory but not a lot of time, an Estate Sale can be a very positive experience.  Estate Sales are run by professionals, who, for an administrative fee and/or a percent of total sales, manage everything for you, including decluttering, home inventory, heavy lifting, pricing, advertising, marketing, and set up. After the sale, qualified experts such as Caring Transitions can also help with move management or help organize clean up, donations, transport or shipping and reconciliation of sales receipts.

DO follow these guidelines

  • Ask for references from any company you employ. You may even want to attend another sale they are holding and see how smoothly it runs. Always use a professional company who is in the business of running Estate Sales.
  • Ask if the company carries liability insurance for business operations and the merchandise they sell, as well as personal injury liability coverage and importantly, workers compensation for employees.
  • Hire the specialist you feel you can trust and discuss payment methods before the contract is signed. Some specialists charge an administrative fee or “minimum” to prepare the sale and others include those same fees in their commissions.
  • Understand that choosing a lower commission percentage does not necessarily mean you will make more money. A skilled professional, with a list of buyers, may make you more money even while charging a higher percentage.
  • Understand it can take days or even a couple weeks to prepare for a sale. Preparation includes, sorting, cleaning, pricing, tagging, merchandising the sale, advertising, arranging for labor and security and selling.
  • Be sure you receive an itemized list of the items in the sale and items sold, after the sale.
  • Discuss the specialist’s process for turning over hidden valuables or personal items found during the sorting process.
  • Allow the specialist to clean the items. Some items are delicate and cleaning may result in damage to valuables.
  • Understand that age does not always equal value in an item. Authenticity is the true guide to value and the item also has to hold its value in today’s market. Your specialist has many resources to help them determine value of special items.
  • Be sure to reserve the items your family wishes to keep and make sure everyone has a list of those items so they are not included in the sale or sales contract.
  • DON’T allow inexperienced or unprofessional people run your sale. This rarely, if ever, produces optimal results and may cost more in the long run as they will have to purchase materials and displays, buy extra advertising, purchase signage and take the time to research prices. The result is usually something like a failed garage sale, leaving you with a lot of unsold items and very little to show for the items that did sell.
  • DON’T be discouraged if an Estate Sale isn’t right for you! Caring Transitions can offer many options to help liquidate, sell, and auction your belongings!

You may also like: Decluttering: Let it Go!

Decluttering: How to “Let it Go!”

 Posted by Regina Hileman on October 3, 2014 at 2:20 PM

Decluttering: How to “Let it Go!”

At Caring Transitions, we believe “Rightsizing is the art of downsizing with a purpose™”

When you “rightsize” before you move to a new residence, your entire move will progress more smoothly. Your new home will be less cluttered and your current home is more likely to sell.

The point of Rightsizing is to create a new living environment that reflects a meaningful, comfortable lifestyle for the years ahead. Personal possessions that have purpose and meaning are honored and preserved for the new home, while those that have lost their purpose or meaning are respectfully disposed of via sale or donation.

The steps to effective Rightsizing are as follows:

  • Determine the space requirements (via floor plan) for the new residence.
  • Decide what items are actually NEEDED for living safely or comfortably. This includes necessary items such as a bed, place for clothes, eating utensils, and so forth.
  • Add items that we LOVE to the space plan. These are meaningful items that define us as individuals.
  • Choose from what we WANT from the remaining possessions and decide which are most important. Make sure they will fit into the space plan.
  • Review and revise the space plan as necessary.
  • Establish action for selling items of monetary value, gifting those of sentimental value, then donating or disposing of the rest.

The following is a list of items to typically “let go” when you are Rightsizing.

  • Dispose of broken, outdated electronics
  • Reduce items that have too many “multiples.” For example, if you have four 1-quart casserole dishes, release 3. If you have 6 umbrellas, release 4. If you have 3 pair of worn out red wool gloves, you may choose to release them all!
  • Get rid of things that belong to others. For instance, your 40-year old son’s high school project or the heirloom desk you agreed to store for your cousin…10 years ago.
  • Release items you have kept out of guilt or fear. For example, you may have that box of multi-colored knitted scarves that you never wore, but your grandma made, so you just cannot bring yourself to let them go. Now is the time.  Or perhaps you are afraid your neighbor will notice the ant-shaped napkin holder she gave you 15 years ago is now included in the garage sale. In that situation you may wish to donate it instead, but either way, let it go.
  • Finally, donate all the cloths, shoes and coats that never fit, don’t fit or have simply been taking up space for years.
  • Find out of that “special collection” was really worth all the time and energy you once put into it and place it on the market.
  • Sort the linen closet and get rid of everything that doesn’t match, is worn or stained.
  • Give up the many books and magazines that you haven’ read in ages.  In most cases you can rely on digital options or the good old-fashioned library if you ever really wish to read them again.
  • Dump your outdated spices.
  • Do the same with all that accumulated junk mail or newspaper and magazine clippings. Again, the internet provides easy access to all of that information should you ever decide you need it.
  • Find safe outlets for your outdated medications and over the counter products. Most police stations and pharmacies sponsor “take-back” programs.
  • If moving to an apartment or condo, it’s time to sell or donate your lawn , garden and home maintenance items
  • Dump the entire contents of the “junk drawer” (none of it is worth paying a mover to move it!). Keep the car keys and money of course!
  • Reduce your inventory of seasonal décor items.  Try to keep only those that are space efficient or have tremendous sentimental value.

Sometimes “rightsizing” is easier said than done and in those instances, our professional staff is here to help; coast to coast!

Relocation Resources for Older Adults

 Posted by Regina Hileman on August 1, 2014 at 12:44 PM

Relocation Resources for Older Adults

When it comes to moving an entire home and all its contents, there is good reason to worry about scam artists and rip offs.

Caregivers and adult children of aging parents find themselves in a position to locate qualified resources to help with a pending move and it is often challenging to find truly professional service providers. This is particularly true when trying to help a parent who lives out-of-state.  Fortunately, there are a growing number of professionals who have taken steps to better serve the senior market; improving their skills through national affiliations, training and certification programs.

Realtors:

The National Association of Realtors developed the Senior Real Estate Specialist (SRES®) Program in 2006. There are currently about 20,000 SRES® Realtors in the U.S. You can recognize an SRES® by the designation that follows their name, or you may locate one at the SRES website.  Above and beyond regular board certification, this subset of Realtors have been trained to understand the specific needs of older adult clients including housing options, transition resources, financing and other issues facing a later life move from a family home.

Movers:

In conjunction with government agencies, the American Moving and Storage Association (AMSA) launched their Pro Mover program in 2009 to help the consumer identify and steer clear of moving imposters, known within the industry as “rogue operators.”  The Pro Mover designation gives consumers an easy way to separate reputable, professional movers from con artists out to make a quick buck at their expense. Individuals can determine if their interstate mover has been qualified by looking for the distinctive Pro Mover “M” logo on their business materials and website. The Pro Mover logo is only issued to companies that meet AMSA standards. You may also be contacted directly by a Pro Mover by using AMSA’s mover referral service.

Many state movers’ associations also have their own local programs to help qualify local movers. For more information contact your local mover’s association.

Full-Service Senior Relocation and Estate Liquidation Professionals

Caring Transitions® is the nation’s largest network of full-service relocation, move management and household liquidation professionals.

The organization was founded in 2007 and currently boasts nearly 200 independently-owned offices, serving over 500 U.S. markets. Every Caring Transitions® office has been fully vetted, trained and is industry Certified. Each fully-insured office is staffed with its own W2 employees, who also undergo background screening.

Caring Transitions complete menu of services includes relocation and space planning, sorting, organizing, downsizing, packing, unpacking and household goods liquidation, in the form of professional estate sale or online auction.

Within their expanded network, Caring Transitions® is also able to support families relocating coast-to-coast as easily as those moving within their own zip code. They also are able to coordinate the services of other professionals mentioned above, as well as financing services and VA benefits.  You may find a Caring Transitions® office near you at the company website, www.CaringTransitions.com.

Clearly, as our society changes and the older generations grow even older, there is an important responsibility to establish qualified providers and specialized services to support them.

©Caring Transitions 2014. All rights reserved.

Managing Your Move to Senior Housing

 Posted by Regina Hileman on June 16, 2014 at 9:38 AM

Once you’ve made a decision to take charge of your own health, safety or social needs by moving to a Senior Living Community,

1. Prepare in advance

Whether choosing to move now or later, you should start putting your home in order today. Begin by evaluating what you really need to keep and then start to downsize, clear out clutter, plan an Estate Sale or make major home repairs. It is a proven fact that homes will sell for a higher price if they are “market ready”, or “Staged”, at the time of listing. (See more about Home Staging) link to BLOG

2. Establish a plan

A good plan can save time and but a professional, well structured plan can help alleviate stress and save money. Establish a relocation timetable as best you can and gather advice from qualified professionals such as movers, realtors, financial advisors and estate sale professionals. You may consider hiring a move manager such as Caring Transitions, who will establish a team approach to ensure a successful senior home transition.

3. Establish a timeline

Start with the date of your intended move and then schedule everything from that time back to present day.  Set some realistic steps and goals for moving forward and don’t try to do everything at once. It can be overwhelming. Establish definitive dates for having meetings, hiring resources or completing projects.

4. Space Plan

Very few moves can be successful without an accurate space plan, especially when moving to late life housing, which is typically much smaller than traditional family homes.  Those who chose to move without a plan are often distraught by the end of a move when they realize their new apartment is cramped and uncomfortable due to too much furniture or poorly planned storage. Professional organizations such as Caring Transitions work closely with clients to understand what is meaningful and important among their possessions. They utilize accurate 3-D space planning tools that help create ideal new environments   and help clients feel at home while saving them the expense of moving unnecessary items.

5. Downsize

Downsizing goes hand-in-hand with space planning for a smaller home, yet it is sometimes the most difficult part of “senior move”.  Many people find it daunting to sort through a lifetime of possessions in order to narrow down the selection of items they will move to a new home.  To help older adults who struggle with those decisions, Industry expert Nan Hayes has spent years teaching companies such as Caring Transitions how to help clients “rightsize” their possessions. Rightsizing helps individuals focus on what is necessary and important to their daily, care, comfort and personal identity and places less importance on sheer “volume” of possessions. In other words, helping clients identify what is personally, but not necessarily materially, valuable.

Many items fall by the wayside  during this rightsizing process  and those that  hold sentimental value are best  given to other as legacy gifts and those that hold material value are best  awarded as inheritances or liquidated through  auction, estate sale or online auction.

6.  Seek support

There can be no doubt that late life home transitions are complex and stressful. You should always seek both personal and professional support throughout the process. Be sure and discuss plans with trusted friends and relatives who have a history of supporting your decisions. The right personal support system can help you evaluate information gathered from professional advisors and create a good sounding board for reviewing choices and making decisions.

Above all, remain focused on what is important for your health, welfare and safety. As long as your medical and financial circumstances allow time to plan, seek the advice and support needed so you can remain in control of this next step in your life.

©Caring Transitions 2000-2014

Just For Seniors: Moving vs. Aging in Place

 Posted by Regina Hileman on May 15, 2014 at 9:20 AM

Establishing short term and long term housing goals can help families plan ahead for large moving or remodeling projects. It is best to consider changes to home and housing as early as possible in order to avoid situations where last minute decisions may wreak havoc on financial and emotional stability.

Today, individuals are fortunate to have many housing choices, including independent living, assisted living, active adult communities and the ability to continuing living at home with assistance and safety modifications. Reorganizing, remodeling and redesign may also serve to make existing home environments comfortable for years to come.

Moving

While a change in an individual’s functionality often initiates a senior move, many folks simply decide they no longer want to stay in a home that is too large or requires  a great deal of maintenance. Increasingly, older adults choose to move to a residential setting designed exclusively for seniors. This lifestyle choice provides a number of benefits such as safety, security, meal plans and health care services.

Regardless of these benefits, many individuals are overwhelmed at the thought of moving in late life. Fortunately, companies such as Caring Transitions work with closely with Senior Living Communities to help manage the entire move process from start to finish.  A wide range of services are available including space planning, sorting, downsizing, packing, unpacking, plus van line and real estate referrals, as well as liquidation of personal property through professional estate sale and online auction.

Staying at Home

According to AARP, over 85% of older adults prefer to age in their own homes. Today, there are more agencies and tools available that can make your “stay at home” choice a safer and more achievable reality.

Just as with our moving options, older adults need to evaluate their real needs, finances and community/caregiving resources and then formulate a “stay at home” plan.

If you or an older relative decides to stay in his/her own home or apartment but finds household tasks too overwhelming, or needs assistance with personal or health care issues, an array of home care support services are available in most communities. Contacting your local Area Agency on Aging or home health care agencies can help you obtain access to these services.

©Caring Transitions 2000-2014

Five Tips for Family Caregiving

 Posted by Regina Hileman on May 1, 2014 at 10:56 AM

As the Baby Boomer generation moves into their 60’s and their parents move into their 80’s and 90’s,   more attention has been given to the role of the family caregiver.  An increased number of resources are available in communities and online and within that data, it is evident most experts agree on the basic tools adult child require to help them gain control over stressful family situations.

1. Assess the Situation: You can find out how your parents feel about their changing health and household needs by asking simple, open-ended and non-threatening questions. “How was your last visit to the doctor?”  Parent Conversations are important and you adult children should listen to what parents have to say and gauge their response carefully, so not to patronize or antagonize the older adult.

As you learn more about the situation, consider these three primary areas which may require third-party professional assessment: 1. medical concerns, 2. cognitive concerns and, 3. assessment of functional abilities or “Activities of Daily Living” (ADL’s). This last group includes items such as socialization, personal hygiene and the ability to prepare meals, take medications and manage finances.

2. Organize Information: Family members should discuss the location of important medical, legal and financial documents with parents and determine if they willing to release copies of information. If the older adults prefer to keep paperwork in the hands of legal or financial representatives, that is their prerogative.

3. Gather Support: Long Distance Caregiving often involves a team approach. Resources will vary for every family, and may involve medical professionals, social services, care managers, home care providers, attorneys, financial advisors and more. Additional support for parents is available in the form of relatives, close friends, neighbors, religious leaders and other associates.

4. Establish a Plan: As the conversation progresses, you may discuss short and long term options with your parents. Take into account the advice of professionals along with your parents’ personal wishes. Once areas of necessary support have been identified, communicate with local care givers and/or other family members to make sure things are progressing as planned.

5. Recognize Your Limitations: Frequent travel to visit parents can be stressful and creates difficult situations for jobs and immediate family. Budget your travel funds and set up a network of support through family, friends and child care services to help support your new role. Don’t overlook signs of stress, which are quite common for care givers.

As our parents live longer, many of us will need to develop an entire new caregiving skill set. Fortunately, supportive technology, services and professional resources are developing at rapid pace.

©Caring Transitions 2000-2014

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