Register today for your 1 hour assessment and instruction in needed corrective exercises to help you achieve your goals of optimal aging.
Click Links Below for Available October & November Dates, Times and to Register
Cost: $75
By Holly Kennedy, PT, ECHM, CAPS, CEAC
Home modifications are changes to the home to make daily activities easier and safer. These changes can help people to stay in their homes and communities after a significant injury/illness that results in a disability and as they age. While many home modifications, such as adding a grab bar and removing clutter, are free or low cost, others, such as remodeling bathrooms for accessibility, can be more expensive.
It is important to start with a consultation with a home modification professional to determine the most effective plan for you and your home. This step is crucial in avoiding mistakes which typically end up adding to overall costs and reducing the efficacy and helpfulness of the renovation.
Determining how to pay for the changes is the second step in the process. Funding sources for home modifications are available but can be difficult to identify and access. In our previous blogs, we discussed the U.S. government funding sources such as the Veterans Affairs and State and Federal Housing and Urban Development programs. Finally, we will share additional resources for you to consider and explore.
Insurance
Other Resources
Non-Profit Organizations
Tax Related https://www.irs.gov
Reference:
National Council on Aging and USC Leonard Davis School of Gerontology
https://homemods.org/wp-content/uploads/2021/06/FundingSourcesforHM.pdf
By Holly Kennedy, PT, ECHM, CEAC, CAPS
Home modifications are changes to the home to make daily activities easier and safer. These changes can help people to stay in their homes and communities after a significant injury/illness that results in a disability and as they age. While many home modifications, such as adding a grab bar and removing clutter, are free or low cost, others, such as remodeling bathrooms for accessibility, can be more expensive.
It is important to start with a consultation with a home modification professional to determine the most effective plan for you and your home. This step is crucial in avoiding mistakes which typically end up adding to overall costs and reducing the efficacy and helpfulness of the renovation.
Determining how to pay for the changes is the second step in the process. Funding sources for home modifications are available but can be difficult to identify and access. In our previous blog, we discussed the U.S. Veterans Affairs housing grants. Today we will share some additional government funding sources you may not be aware of.
National Examples
State Examples
As you can see, there are many resources to explore and access. Follow the link below for additional contact and qualification information. In our next blog, we will share a few non-government sources such as insurance, vocational supports, lending and non-profit organizations. Stay tuned!
Reference:
National Council on Aging and USC Leonard Davis School of Gerontology
U.S. Department of Veterans Affairs
By: Holly Kennedy, PT, CAPS, CEAC, ECHM
So, you’ve decided you’d like to make your home safer and easier to use, but you aren’t sure how to get started and most importantly, how you will pay for it. Home modifications are changes to the home to make daily activities easier and safer. These changes can help people to stay in their homes and communities after a significant injury/illness that results in a disability and as they age. While many home modifications, such as adding a grab bar and removing clutter, are free or low cost, others, such as remodeling bathrooms for accessibility, can be more expensive.
It is important to start with a consultation with a home modification professional to determine the most effective plan for you and your home. This step is crucial in avoiding mistakes which typically end up adding to overall costs and reducing the efficacy and helpfulness of the renovation.
Determining how to pay for the changes is the second step in the process. Funding sources for home modifications are available but can be difficult to identify and access. Over the next few months, we will explore some of these different funding sources to help you know understand what resources are available and if you qualify.
Funding Source: U.S. Department of Veterans Affairs (VA)
The U.S Department of Veterans Affairs offers housing grants for eligible veterans and service members with certain service-connected disabilities so they can buy or change a home to meet their needs and live more independently. Changing your home might involve installing ramps or widening doorways. Below is a list and brief description of common grants offered to Veterans.
Specially Adapted Housing Grant (SAH) This grant helps disabled Veterans and Service members enjoy barrier-free living, for example a wheelchair accessible home. SAH provides up to $101,754 for FY 2022 to construct an adapted home, remodel a home, or apply to a mortgage balance of an adapted home purchased with a VA grant. To apply: https://www.benefits.va.gov/homeloans/adaptedhousing.asp
Special Housing Adaptation Grant (SHA) This grant can be used to increase mobility throughout the residence. SHA provides up to $20,387 for FY 2022 to adapt the home of a Veteran or of a family member with whom the Veteran lives, or to help purchase a home for modification or one already adapted. To apply: https://www.benefits.va.gov/homeloans/adaptedhousing.asp
Temporary Residence Adaptation Grant (TRA) TRA provides a temporary grant to adapt the home of a family member. The maximum grant is $40,983 (SAH) and up to $7,318 for (SHA) in 2022. To apply: https://www.benefits.va.gov/homeloans/adaptedhousing.asp
Home Improvements and Structural Alterations Grant (HISA) HISA funds medically necessary accessibility improvements to entrances, bathrooms, and kitchens; providing Veterans with service-related disabilities up to $6,800 and Veterans with non-service related disabilities up to $2,000. To apply: https://www.prosthetics.va.gov/psas/HISA2.asp
Vocational Rehabilitation and Employment (VR&E) – Housing Adaptation Assistance VR&E may provide home adaptations to individuals who are not currently able to work because of the effects of their service-connected disabilities, or who require adaptations to achieve a vocational goal. The benefits are limited to those required to improve independence at home and/or in the community. • Home adaptations up to $93,356 may be provided as part of an approved rehabilitation plan. To apply: http://www.benefits.va.gov/vocrehab/independent_living.asp
If you have served our country in the military, U.S. Department of Veterans may be able to assist in making necessary home modifications due to a disability. Maximum grant amounts adjust annually, so check the website for updates in 2023. Over the next few months, we will explore a few other funding sources for home modifications. Stay tuned to see if one is right for you!
References: https://www.va.gov/housing-assistance/disability-housing-grants/
By Holly Kennedy, PT, CAPS, CEAC
Many homes have features and barriers that make them more difficult to use. In fact, only 10% of all homes are “aging ready”. Most people know they will need to make some changes to their homes if they lose some of ability to get around due to aging or an injury, but they aren’t sure what changes are most important for their circumstances. Consequently, they put off improvements for another day. However, planning ahead by preparing a home that everyone can use at every stage of life will not only save money, but will bring peace of mind and more comfortable choices down the road. Since most falls happen inside the home, it is important to take steps today to reduce the risk and make them safer and easier to use. Home assessments can provide some direction and help prioritize what the right changes are for your home.
What are some ways to check my home for needed changes?
STEP 1: Check Lists
The simplest, least expensive assessment tools are checklists that help identify common hazards in the home and/or solutions such as this one from the Centers for Disease Control and Prevention CDC Check for Safety Brochure This is a good starting place to address the basics and obtain generalized solutions to common home related problems. Since their content is limited, check lists may overlook some important problems and present only a limited array of possible solutions.
STEP 2: Professional Home Assessment
This is a valuable resource many are not aware of. Specialized occupational and physical therapists (OTs and PTs) can serve as consultants to perform a home assessment and provide recommendations specific to your needs. They are trained to look at both the home and the physical abilities of the people using it. This provides a more comprehensive approach that will address the specific abilities and needs of a person in their home. While assessing the home they may teach skills and techniques that may make a transfer or activities easier/safer to perform. They can instruct care givers; problem solve with the individuals and empower homeowners with a list of options for improvement that will result in the function and safety they need. In fact, the combination of a professional assessment, education and home modifications are shown to be most effective for improving function and reducing falls among community-dwelling older adults.
A professional home assessment will ensure the right things are done for you and your loved ones taking into consideration any diagnosis, prognosis and comorbidities that may impact your current and future home needs. A detailed report filled with options for improvement can then serve as your “road map” to maximizing safety, function and independence in your home today and into the future. A professional home assessment will:
Who would benefit most from a professional home assessment?
Anyone experiencing…
A home assessment could also prove helpful for:
Who is best qualified to perform a Home Assessment?
A healthcare provider such as an occupational therapist (OT), physical therapist (PT), or nurse, all with training in home accessibility. Look for providers with the following credentials:
What does it Cost?
After a phone call to discuss your home and specific needs, the provider will be able to quote a price for your assessment based on complexity/scope and hours estimated (considering travel time, time required on-site time and report time). If you have a tight budget, they can help you prioritize which areas of your home to address first and gradually make strategic changes over time.
When Should I have a Home Assessment Done?
Now! Preparing your home today, sets you up to have more choices in the future and a professional home assessment provides you with directions, a “road map” to refer to as you make changes.
The average cost of assisted living in North Carolina is $4,010 per month, average price for nursing home care is $7,483 (semiprivate) and $8,213 (private room) per month. As you can see, you can invest in considerable home modifications for the amount it would cost to stay a few months in an assisted living facility. It’s important to note that these improvements stay with your home for you to enjoy for years to come in addition to adding value to your home.
Don’t wait, schedule a professional home assessment to ensure you are making the right changes and start enjoying a home that is safer and easier to use today!
What’s next?
If you are in the greater Charlotte area of North Carolina, give us a call at (704) 727-6096 or email Holly@InPlaceWithGrace.org – we are here to help. Others can find local resources through the directory of providers for the designations CAPS, ECHM and CEAC.
Up next, we will be sharing various funding sources for home modifications. Sign up to receive our monthly blog so you don’t miss any of the important information you will need to achieve the goal of creating your “forever home”.
References:
https://www.genworth.com/aging-and-you/finances/cost-of-care.html
Environmental Assessment and Modification as Fall-Prevention Strategies for Older Adults: by J. Pynoos, B. Steinman and A. Nguyen. Clin Geriatr Med. 2010 November; 26(4): 633-644.doi:10.1016/j.cger.2010.07.001.
www.cdc.gov/steadi/pdf/check_for_safety_brochure-a.pdf
By Holly Kennedy, PT, CAPS, ECHM
The Environment is the Problem, Not the People: Many homes have features and barriers that make them more difficult to use. For example, more than ¼ of all U.S. homes are multi-story and lack a bedroom and full bathroom on the first floor. About 1/3 of homes with an adult 65+ have at least one person who has difficulty using some element of the home (e.g. climbing stairs, using bathtub). Only 10% of all homes are “aging ready” with a step-free entry, accessible features in the bathroom and a bedroom with a full bathroom on the first floor. Home modifications are changes to the home to make daily activities easier and safer for everyone. These changes can help people to stay in their homes and communities as they age and after a significant injury/illness that results in a disability. By utilizing Universal Design features, changes can make the home easy to use for all ages and abilities and can be designed with beauty and appearance in mind.
Changing the environment can:
Examples of Helpful Home Modifications:
Take Action: Most people know they will need to make some changes to their homes if they lose some of ability to get around due to aging or an injury. Unfortunately, it is all too easy to put it off for another day and fail to address them until we are forced to. Preparing your home today, sets you up to have more choices in the future. Sometimes life can throw us an unexpected injury, illness, or surgery. That is not the time that you will want to be managing a home modification project. Trying to get a loved one home from the hospital while frantically calling contractors to widen doors and remove tubs adds more stress to an already stressful time. Planning ahead and preparing a home that everyone can use at every stage of life will bring peace of mind and more comfortable choices down the road. It’s difficult to know and prioritize what the right changes are for your home. Having a physical or occupational therapist perform a home assessment can provide a road map of recommendations that will result in the function and safety you need and ensure that important details are not overlooked. Most changes can be done in stages over time to spread out the expense and maintain your budget. Being proactive also provides ample time to find a reputable contractor and even utilize an interior designer to ensure a beautiful outcome that incorporates all the recommendations for functional needs. Having time to shop around and take advantage of product sales, can also save money.
The Cost of Procrastination: Having the option to stay in your home can protect your financial savings as well. The graph below lists annual costs associated with needing to move into assisted living and nursing home environments. Sometimes this is a necessary step but some of these costs below can be reduced and even eliminated if the home enables a person to stay safe and independent in it. Having a home that is easier to use also reduces strain on care givers and adds dignity and more independence for those in need. Besides, most people prefer to stay in their home as compared to moving into an institutional environment. As you can see, you can invest a considerable amount into home modifications for the amount it would cost to stay just a few months in an assisted living facility. These improvements stay with your home for you to enjoy for years to come in addition to adding value to your home. Don’t wait until you are in a crisis, start enjoying a home that is safer and easier to use today!
What’s Next?: Remember, it’s the environment that is the problem, not the people. By removing barriers and hard to use features, you create a home that sets you up for success. In the next few blogs, we will be sharing more about the importance of and what to expect in a home assessment and provide you with various funding sources for home modifications. Sign up to receive our monthly blog so you don’t miss any of the important information you will need to achieve the goal of creating your “forever home”.
References: U.S. Census Bureau, 2020 (Data from American Housing Survey, 2011
MetLife 2011 Market Survey of Long Term Care Costs. https://www.metlife.com/content/dam/metlifecom/us/homepage/ltc/resources/LTC_Resources.pdf
Most Americans do not move enough. The good news is that regular physical activity is one of the easiest ways to reduce your risk of chronic disease and to improve your quality of life. Make physical activity a priority to:
• Improve your memory and brain function (all age groups).
• Protect against many chronic diseases.
• Aid in weight management.
• Lower blood pressure and improve heart health.
• Enhance your quality of sleep.
• Reduce feelings of anxiety and depression.
• Combat cancer-related fatigue.
• Reduce joint pain and stiffness.
• Maintain muscle strength and balance.
• Increase life span.
Physical therapists are movement experts who improve quality of life through hands-on care, patient education, and prescribed movement. PTs treat people of all ages and abilities and empower you to take an active part in your care. After an evaluation, PTs create custom treatment plans for your specific needs and goals.
PTs also play an important role in fall prevention by providing the balance and strength training that is so important in enabling one to do the things they want and need to do. Some PTs are also trained in performing home assessments to maximize your ability to stay living independently in your home as you age. By looking at the functional ability of the person and the physical layout and possible barriers in the home, they can make the appropriate recommendations that will make your home both easier and safer to use.
As October, National Physical Therapy Month, comes to a close – celebrate by making a commitment to adding more activity into each day. If you need help determining what kind of exercise is right for you, find a local PT. They can help you determine the best way to stay active and live a healthy life. Move More!
Resources: https://www.apta.org/national-physical-therapy-month
By Holly Kennedy, PT, CAPS, ECHM
It’s National Fall Prevention Week and we encourage you to take this simple fall risk screen and share it with someone you love. It’s a quick 12 question assessment that provides tips on fall prevention and helps you to see if you’re at risk.
Below you will find a link to the Falls Free CheckUp and some important information found on the National Council on Aging website.
Key Takeaways:
According to the U.S. Centers for Disease control and Prevention, 1/4 of Americans aged 65+ falls each year. Falls have also resulted in more than 3 million injuries treated in emergency departments annually, including over 850,000 hospitalizations and more than 29,000 deaths.
Click here to take the Falls Free CheckUp!
Remember, you can prevent a fall!
References: https://www.ncoa.org/article/falls-prevention-awareness-week-toolkit
Aging can have a bad reputation. But, there is no reason that growing older can’t be a journey full of adventure and opportunities. It can be a chance to live life to the fullest. All you need is proper guidance, proactive steps, and a positive attitude.
And there is proof. Research suggests that improvements in physical function are possible well into older adulthood. It also supports that staying active as you age helps fight cognitive decline. Regular physical activity can benefit your physical, mental, and social health. It can help prevent or improve many chronic conditions, such as heart disease, diabetes, obesity, depression, and some cancers. You can also prevent falling by doing physical activities you enjoy and working with a physical therapist to improve your balance, muscle strength, and endurance.
The following tips can keep you active and independent as you age:
Physical therapists are movement experts who improve quality of life through hands-on care, patient education, and prescribed movement. They can lend expert advice on simple changes that can be made in your home to improve function and independence. You can contact a physical therapist directly for an evaluation or ask your doctor for a referral. To find a physical therapist in your area, visit Find a PT.
References
Stephens C, Breheny M, Mansvelt J. Healthy aging from the perspective of older people: a capability approach to resilience. Psychol Health. 2015;30(6):715–731. Article Summary in PubMed.
Avin KG, Hanke TA, Kirk-Sanchez N, et al. Management of falls in community-dwelling older adults: clinical guidance statement from the Academy of Geriatric Physical Therapy of the American Physical Therapy Association. Phys Ther. 2015;95(6):815–834. Article Summary in PubMed.
Young WR, Mark Williams A. How fear of falling can increase fall-risk in older adults: Applying psychological theory to practical observations. Gait Posture. 2015;41(1):7–12. Article Summary in PubMed.
Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLOS Med. 2010;7(7):e1000316. Free Article.
Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008;56(12):2234–2243. Article Summary in PubMed.
Moreland J, Richardson J, Chan DH, et al. Evidence-based guidelines for the secondary prevention of falls in older adults. Gerontology. 2003;49(2):93–116. Article Summary in PubMed.
House JS, Landis KR, Umberson D. Social relationships and health. Science. 1988;241(4865):540–545. Article Summary in PubMed.
This article is being shared from the American Physical Therapy Association website and the ChoosePT.com/toolkit. Minor edits were made to original article Authored by Joseph V Libera, PT, DPT, MBA, MPH, GCS
By Janet Ceraldi, OTR, CEAC
In this third section of the aging process, we will focus on the skin and the heart. In last month’s blog, we discussed the effects of aging on bones, joints and muscles as well as things we add into our lifestyle to reduce those changes.
Skin: As we go through the aging process, we can see the changes to our skin. How your skin ages depends on factors like your lifestyle, diet, heredity and personal habits. Skin is composed of epidermal cells and dermal cells. Epidermal is the top part we wash. Dermal cells are below where the hair and sweat glands originate. Both types of cells diminish with age as much as 20% in the case of the dermal cells. The blood supply to the skin drops off and wrinkles develop.
The visible signs of aging on the skin are:
The below-the-skin changes in the face:
Interventions: The skin participates in vitamin D production when exposed to strong ultraviolet light. As we age, skin has a limited capacity to initiate vitamin D production.
Cardiovascular Effects of Aging: Some changes in the heart and blood vessels normally occur with age. However; many other changes that are common with aging are due to or worsened by modifiable factors. The heart has two sides. The right side pumps blood to the lungs to receive oxygen. The left side pumps oxygen-rich blood to the body. Blood flows out of the heart through the aorta, arteries which branch out to the tissues and then become capillaries.
Interventions: Effects of aging on the heart include reduced heart rate, physically enlarged heart, and stiffening of the arteries and blood vessels that make it more difficult for the heart to pump blood.
In conclusion, it can be very helpful to add some of these interventions to your daily routine in an effort to mitigate the effects of aging. A healthy lifestyle can be very beneficial in supporting aging gracefully. Remember to consult with your doctor and community resources for help.
References:
By: Janet Ceraldi, OTR, CEAC
Part 2 of this blog on The Aging Process will provide an overview of the effects of aging on different parts of our bodies. As we get older we all can see changes happening. We notice changes in our posture, skin, hair, bones and maybe even in how we walk. There are physiological reasons we feel more stiff, our balance is a bit off and it gets harder to get up out of a low, soft couch. It’s also important to know that there are things we can do to lessen these changes and maintain our function as we age. The areas of focus in this blog will be:
Bones: Even though bones seem to be hard and stagnant, they are in fact, in a constant state of remodeling and undergoing cycles of destruction and rebuilding. Blood vessels are transporting nutrients to working bone cells. The skeleton provides support and structure to the body. As we age, people lose bone mass because the bone becomes thinner. This process accelerates after the age of 50, resulting in a higher susceptibility for fractures. Osteoporosis is a systemic skeletal disorder characterized by low bone mass. This is the most common reason for fractures in the elderly.
The loss of bone density is caused by a decrease in calcium and minerals in the bone. Aging bodies absorb less calcium from the food we eat. Many times Vitamin D decreases which helps the body use calcium. The bones that tend to weaken more than others are the end of the femur (thigh bone), ends of the forearm bones called the radius and ulna (at the wrist) and vertebrae (back and neck bones). A gradual loss in height happens because the discs between the vertebrae lose fluid and become thinner.
Joints: Joints are the areas where bones come together and allow the skeleton to be flexible for movement. They are cushioned by cartilage in the joint and are surrounded by membranes and a lubricative fluid. Cartilage loses water as we age, The cartilage may begin to rub together and wear away. This makes the joint more vulnerable to injury from repetitive movement and stress as it interferes with the ability of the joint surfaces to slide over each other. Osteoarthritis is a common disorder due to damage to cartilage from lifelong use of joints. It is the most common form of arthritis. The disorder causes redness, pain and stiffness in the joints.
Ligaments are tissues that connect bone to bone. Over time, they become less elastic resulting in reduced flexibility. It is the same situation for tendons which bind the muscle to the bone.
Muscle: Muscles provide the force and strength to move the body. Coordination is directed by the brain but is affected by changes in the muscles and joints. Changes in the muscles, joints, and bones affect the posture and gait (how we walk) and lead to weakness and slowed movement. The aging process causes a decrease in strength, size and endurance of muscle tissue. Decreased strength is more often caused by inactivity than aging. However, sarcopenia, the loss of muscle mass, does begin at the age of 30 and continues throughout life. Inactivity may be one reason for shrinkage of muscles. Additionally, levels of growth hormone and testosterone, which stimulate muscle development,decrease with age resulting in decreased muscle mass. Although muscle mass decreases as we age, body fat can often double, causing health problems such as diabetes and sleep apnea.
Interventions in the Anatomical Effects of Aging: So, our bodies change in many ways due to the aging process, but what can we do to reduce negative effects? Being conscientious of our diet and regular exercise can play a huge part in mitigating the effects of aging on our bodies. We can look at some more specific interventions to promote bone, joint and muscle health:
In conclusion, understanding what changes are happening in our bodies can empower us to take steps to lessen the effects of aging. Changes are happening everyday. Taking care of ourselves with proper nutrition and physical activity, will help to mitigate the effects of growing old, prevent disease and extend the warranty of our body.
References:
By Janet Ceraldi, OTR, CEAC
As we get older, the aging process is a complex process that affects the organ systems of the human body in various ways. Everyone will be affected differently, and over the next blogs, we will look at some of the changes and offer a few ideas to counter them. It is believed that aging is the result of the interaction of many influences over the course of one’s life such as heredity, culture, environment, diet, exercise, and past illnesses.
There are different theories that injuries, ultraviolet light, wear and tear on the body are additional factors in aging. Rest assured, there is no single explanation for the various changes people face as they age.
The point at which the various systems of the body begin the aging process is different. Some begin at 30 while others occur later in life.
The ongoing aging process can be defined in different ways:
Let’s take a look at some of the specific body systems. It’s important to recognize the difference between normal functional decline with aging and decline that is part of a disease/disorder process.
Eyes: As we age, typically around age 40, most people develop presbyopia. This is a normal decline caused by a thickening/ stiffening of the lens of the eye which makes it difficult to focus on close objects. As a result, you may need to use reading glasses.
Cells: Cells function declines as they age, and eventually they die in order to make room for other cells. Genetics play a part in programming cells. Cells divide a limited number of times. When a cell can no longer divide, it grows larger till it dies. All of this is part of normal aging. The skin has 2 types of cells: epidermal and dermal. Both types of cells lessen with age. As a result, we see our skin get thinner, increasing our likelihood to bruise.
Organs: Aging cells can cause the organs to not function as well as they did when we were young. Cells are dying and not being replaced so the number of cells decreases. For example, cells of the liver, kidneys, ovaries, and testes decrease as the body ages. When the number of cells becomes too low in an organ, it cannot function normally. The brain; however, is an organ that does not lose a large number of cells in a healthy adult. Most body functions peak at 30 and begin a gradual decline; however, most body functions remain sufficient because most organs begin with more functional capacity than the body needs. Diseases or disorders account for most of the loss of organ function in old age. When one organ declines, it can cause a decline in function of another organ. An example, atherosclerosis (hardening of the arteries) narrows the blood vessels to the liver, the liver will function less well because of the decreased blood flow.
Decline in function: older people are less likely to handle stresses, such as
This is just a small part of how aging can affect the different body systems. We can begin to think about steps we can take to compensate for the normal aspects of aging. Developing a healthy lifestyle of eating nutritious food, starting a consistent exercise program, going to the dentist regularly and doing activities that keep our mind busy are a few suggestions. Research your local community for social activities that will keep you engaged and your mind young. In future blogs, we will continue to look at how the aging process causes changes in the bones, joints, muscle, and skin and strategies to minimize their effects.
References: Jim Belson, MA, PhD – an educator, film/video producer and writer
By Holly Kennedy, PT, CAPS, ECHM
Dementia is a general term for the symptoms of loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life. Alzheimer’s Disease is a specific degenerative brain disease that makes up 60-80% of dementia cases and is the most common cause of dementia. Due to these cognitive changes, individuals with dementia are at higher risk for injury or harm in certain areas of the home. Confusion and memory loss can result in frustration and safety issues. These difficulties can also be compounded by other health conditions that may affect mobility, hearing and vision. Simple changes to create a safe and easy to use environment will help to maximize independence and safety for as long as possible.
Objective: increase safety and improve function
A dementia-friendly environment is one that:
Adjust these 4 key elements to make big impacts:
LIGHT Light helps with orientation, mental well-being and reduces fall risk.
NOISE Overstimulation can cause agitation or distress as it can be overwhelming and difficult to concentrate on more than one thing at a time.
WAYFINDING Signage can help guide a person around their home if they no longer recognize or remember some of the rooms and or where things are stored.
SAFETY Our goal is to encourage independence by creating a safe and comfortable environment to function in.
Consider Memory Aids Everyone needs prompting from time to time but dementia makes cognitive mapping even harder.
It is critical to involve the person with dementia in decisions about possible changes. Make changes slowly so as not to add to confusion and frustration. Protecting a loved one who has Alzheimer’s Disease or another dementia involves taking steps to care for both their physical and mental wellbeing. Implementing some of these suggestions can make a big impact towards your goal of creating an environment that helps your loved one to be as independent as possible for as long as possible. If you would like an in-home or virtual home assessment with our PT/OT team to discuss recommendations specific to your loved one and your home, please call us at (704) 727-6096, we are here to help!
By Janet Ceraldi, OTR
This month we are going to shine a spotlight on occupational therapy. Since April is occupational therapy month, we are going to answer common questions about who, what, when, and why an occupational therapist (OT) can help one become more functional in activities they need to do to take care of themselves and loved ones.
Who are they? An occupational therapist (OT) and an occupational therapy assistant (COTA) are part of a rehabilitation team with physical therapy and speech pathology in many settings. They are skilled health care professionals who use research and scientific evidence to ensure their interventions are effective. OT’s are a vitally important part of the team that help people across the lifespan participate in activities they want and need to do through the therapeutic use of everyday tasks. Evaluations done by OT take into consideration the whole person and customize an approach for interventions to increase independence for:
What is occupational therapy? One of the most common statements OT’s hear is “I don’t need an occupational therapist because I am retired”. This misconception brings a smile to every OT’s face, because the “job” they actually train people for is everyday life. Your life is made up of “occupations” defined as meaningful everyday activities. These occupations may include meal preparer, hair washer, tooth brusher, laundry folder, grocery shopper, shoe and sock donner and so on. Everyone has occupations from child to adult. We don’t think about them till we have trouble completing our tasks due to illness, aging, disease progression or injury. Occupational therapy helps people to become as independent as possible in their daily activities.
Where can I get occupational therapy? OT’s work in a variety of different facilities and settings such as skilled nursing facilities, schools, hospitals, clinics, home health, private practices and community centers.
How do I schedule an occupational therapist? Your doctor will be able to give you a referral for OT services. Look on the computer for private practices in your area.
When do I need occupational therapy? If you or your family member have ever been diagnosed with a new health condition, you can be asking yourself “now what”? How will I get someone to help me? You may have an aging parent who wants to stay in their home and there are concerns of safety, a child with autism who is having trouble in school or someone who had an injury and may face temporary or permanent disability. Occupational therapy can answer the “now what? “ question. An OT will focus and customize their treatment plan on your activities of daily living, your goals and increase independence. In short, occupational therapy can help you live life to its fullest no matter your health condition, disability or risk factors.
Why would I need occupational therapy? Trauma, chronic progressive illnesses, a surgery or mental disorder can make participating in our daily occupations very difficult and interrupt our life and relationships. For example, a stroke can paralyze one side of our body and make walking to the bathroom impossible for a time. Neurological disorders can throw off our balance. Injuries to our arm can make dressing painful. An evaluation of a person’s physical and cognitive abilities will give the therapist the information needed to develop an intervention plan. The OT will always include your input in the treatment plan so you can achieve your goals of getting back to life as independently as possible.
This is why an occupational therapist is an asset on your team and gets center stage this month; they can look at your home environment and your physical ability, and find ways to maximize your safety, function and independence in your home.
References: https://www.AOTA.org>About-Occupational-Therapy
By Holly Kennedy, PT, CAPS, ECHM
It isn’t news that the solution to many chronic diseases and functional problems is exercise. But what is the right exercise for you? It makes sense that how our bodies perform can predict the likelihood of a fall or future disability. But did you know that tight ankles can lead to falls or that your ability to get up out of a chair is an indicator of fall risk? Do you know how you would score against your peers in the areas of strength, balance or flexibility? More importantly, how would you score against normative data that can be used to predict optimal aging? Is your current exercise program leaving you with hidden deficits or imbalances that are setting you up for future injury? Are you getting back into exercise after a year in COVID isolation and feeling unsure about where to start? Let’s explore a non-invasive, pain free screen that can be used to answer all of these important questions.
The Adult Functional Independence Test (AFIT) is a functional assessment for people over age 50 that evaluates 15 performance-based tests administered by an AFIT certified Physical Therapist or Occupational Therapist. These tests provide valid and reliable measures of the 5 key aspects of fitness: posture, strength, balance, endurance, and flexibility.
The Adult Functional Independence Test (AFIT) is a quick yet comprehensive assessment from head to toe. The AFIT is a one hour, one on one evaluation that utilizes research based functional tests. All 15 of the tests use predictive analytics or national norms to calculate an individual’s risk of disability, falls, fractures, and mortality. Upon completion of the assessment, the results and comparisons to norms are discussed. Additionally, evidence-based exercises are given to address the deficits found. So, in this hour,
Knowing exactly where you need to focus your exercise efforts and why adds both motivation and effectiveness into our goals for staying fit and independent. That’s an hour well spent!
“This should be part of my annual physical. I have learned so much about where I am and what I need to work on.”
According to Carole Lewis, the physical therapist who developed the test, “This is the future. I don’t have a single patient who would prefer getting rehab after a hip fracture to avoiding the hip fracture in the first place.” Since healthy living is a moving target, it is important to be reassessed periodically to modify exercises or to address any new issues found. At a minimum, an annual assessment is important for getting a baseline and establishing an exercise plan that is specific to your needs. In the world of exercise, fitness and optimal aging, “one size” does not fit all. At a recent series of AFIT screens, my client said “This should be part of my annual physical. I have learned so much about where I am and what I need to work on.” Take charge now so that you will always be able to what you want to do and feel great doing it. Take the AFIT to be fit!
In the Charlotte, NC area, we administer the Adult Functional Independence Tests with pricing ranging $75-$125 based on number and location of tests performed. Tests can be performed safely given the current COVID guidelines, utilizing masks and social distancing as appropriate. In the Charlotte area, if you would like to arrange for AFIT testing to come to your exercise facility, senior living community, church or physician office please email Holly@InPlaceWithGrace.org
References:
Lewis, Carole B. PT, DPT, PhD, FSOAE, FAPTA Academy of Geriatric Physical Therapy Inaugural Carole B. Lewis Lecture Award Address to the Membership at the Combined Sections Meeting Washington, DC January 24, 2019, Journal of Geriatric Physical Therapy: April/June 2019 – Volume 42 – Issue 2 – p 59-62
www.http// https://greatseminarsonline.com/afit/
Kruk J. Physical Activity in the Prevention of the most frequent common diseases: An analysis of the most recent evidence. Asian PAC J Cancer Prev. 2007 Jul-Sept ; 8(3):325-38.
Sallis RE. Exercise is medicine and physicians need to prescribe it! BR J Sports Med. 2009 Jan;43(1) 3-4.
We are beginning to hear the term “assistive technology” more commonly these days. Technology is advancing by leaps and bounds which makes it difficult to keep up our knowledge.
The definition of assistive technology is an adaptive/assistive device, software or piece of equipment which helps people with disabilities perform everyday functions that may otherwise be difficult or impossible. A person’s functional capabilities can increase or improve with proper equipment. Assistive technology is anything that makes it easier to eat, write, live independently, remember, read, learn, increase mobility or communicate. It can be a s simple as adaptive silverware and as complex as a computer.
Let’s look at some types of assistive technology
Types of Computers
Helpful Features of a Phone/Computer/Tablet:
More examples of Advanced Technology include Alexa/Amazon Echo, Siri Home and Google Now. These devices are virtual personal assistants which listen to your commands and give responses to help with the activities you need done. These personal assistants can control several smart devices using itself as a home automation system. They can do all the features the computers can do and more by using more than one device. Controls can be utilized through an app on your phone or going to the website. Usually you pick a “wake up word” which can be changed to whatever you want through the app or website. For instance you can say “Alexa play country music”. If you have someone in your house named Alexa you can change the name. Another example is “Alexa good night” and you will get a series of lights going off, TV off, security cameras may come on and heat and air conditioning can be controlled. You can customize to your preference. A nice feature is you can ask what the weather, traffic and news is for that day. By setting alarms, it can remind you to take your medicine, check your blood sugar or that it’s time to leave for a doctor’s appointment. Amazon Echo Plus is about $149.99. Siri Home Pod $299 and Mini Pod is $99. Echo Dot is $44.99.
January is often a time when people are ready to take on a project. If your goal is to make your home easier to use and more conducive to Aging in Place we recommend the following:
Step 1: Consult with a Certified Aging in Place designated healthcare professional who can recommend specific changes for your home based on your individual functional abilities. This ensures your project will properly address your needs today and into the future.
Step 2: Once you know what changes are most important for your home, the next step is finding a reputable builder to make the needed changes to your home. Below is a checklist provided by the National Association of Home Builders to help you select a home builder or home remodeler to work on or build your home.
Used with permission from reference: https://www.nahb.org/other/consumer-resources/checklist-for-finding-and-hiring-a-builder-or-remodeler
Are you having trouble finding last minute gift ideas for an elderly loved one who “has it all”? Well here are a few unique ideas aimed at maximizing safety, function and independence in their homes. No gift means more than one that is well thought out and has real benefit.
1.Discreet Grab Bar -In the bathroom, a toilet paper holder that is decorative and rated as a grab bar can add safety without taking away from the beauty of the room.
2. Stand-up Planter – If your loved one enjoys gardening, but painful stooping and unsteady bending has caused them to stop or limit this activity, consider giving an elevated planter box. This is a great option to enable them to safely continue enjoying a hobby they love. Some designs even enable easy access for someone in a wheelchair to use.
3. Apple Watch – If you are thinking of giving an Apple watch to a loved one, make sure you select the model, size and watch band that best suite their needs. Some models have cellular which enables one to make a call from their watch regardless of having their phone in proximity. However, there is an additional monthly fee to your carrier for this service. Recent models feature “Fall Detection” which detects a fall and notifies your emergency contacts, tracks activity/work outs, heart rate and blood oxygen levels.
4. Bidet Seat – This can be added to any existing toilet and can have features such as warm and cold water for cleansing, warm air to dry, and a heated, soft close seat is also an option. Although an unusual gift, it will eliminate the need to stock pile toilet paper during a pandemic while also enhancing dignity!
5. Hidden Night Lights – These great night lights are easy to install, give a nice bright light and are a great safety feature in any room. The best part about these night lights is that they don’t take up a plug in your outlet. Add safety at night without the appearance and inconvenience of having a light plugged into a commonly used socket.
These are few products that make Aging in Place a bit easier. More ideas can be found on our “products” page on inplacewithgrace.org. Enjoy your holiday celebrations, stay safe and healthy. We wish you many blessings in the New Year!
By Holly Kennedy, PT, CAPS, ECHM
We are grateful for all the Caregivers who serve tirelessly and selflessly to help a loved one in need. From dressing, bathing, food prep, house cleaning, shopping, bill paying, helping to transfer into the bed, shower, car, wheelchair: the tasks are endless. Today we will share our Top 5 Tips for Caregivers, our unsung heroes we can’t live without.
1. Take Care of Yourself. Without You, it All Falls Apart!
2. Talk with Others. Don’t go it alone!
Schedule weekly family meetings or phone calls, or if needed, professional counseling. Don’t go it alone.
3. Help Them to be as Independent as Possible. Have Your Home Assessed!
Having an occupational therapist (OT) or physical therapist (PT) perform an in-home assessment can be one of the most impactful things you can do to relieve burden on a caregiver. They can help eliminate barriers in the home that make caregiving more difficult and recommend modifications and products that can make the job easier. OTs and PTs are trained in maximizing independence and function with activities of daily living (ADLs) such as bathing, dressing, grooming and food preparation. They can help your loved one to be as independent as possible, enhancing their dignity and quality of life, and requiring less of you. Create an environment that sets you up for long term success. Look for a healthcare provider with CEAC, CAPS, or ECHM credentials to meet your home assessment needs.
4. Work Smarter Not Harder. Get the Right Tools for the Job!
You may have heard the phrase “Work smarter, not harder” . A small investment in a few helpful products can make your job much easier. The first two products help with transfers out of chairs or bed, the next is a threshold ramp to make navigating through uneven doorways in a wheelchair easier. Grab bars add safety near toilets, showers and tubs and installing taller toilets-18-20 inches tall- can make a toilet transfer a lot easier on everyone. Click on the examples below to learn more:
5. Learn More. Knowledge is Power!
Learning good body mechanics for lifting is essential in avoiding injury to you and your loved one. You’ve likely heard the advice to “use your legs not your back”, but correct technique often requires training and feedback. To maximize safety, it’s best to have a PT, OT or nurse perform a training session of proper lifting and transfer techniques. The therapist can also help to troubleshoot the unique challenges to your situation.
Attend a workshop for family caregivers. The workshop addresses specific needs for caregivers who care for someone with a stroke, dementia, PTSD or any other serious illness or injury. To register, contact your local Area Agency on Aging, https://centralinaaging.org/workshops/building-better-caregivers/
Courses are currently being conducted online due to COVID precautions and a free of charge.
Benefits of Building Better Caregivers:
Remember that taking care of yourself is as important as taking care of someone else. Without you, it all falls apart. Thanks for all you do!
By: Janet Ceraldi, OTR,CEAC
Activities of daily living (ADL’s) such as bathing, grooming, dressing and cooking can become difficult when suffering from disabilities caused by injury, chronic disease, stroke or neurological disorders. Finding the right solution can require some research or even help from an occupational therapist. The good news is there are resources to aid in finding equipment to help with preparing, cooking and serving food. There are also kitchen gadgets that are helpful for low vision users. In this month’s blog, the focus will be on a few examples of adaptive equipment for use in the kitchen.
Kitchen gadgets comprise any tool or product that makes food preparation easier and safer to perform. While any individual can accomplish more by using the right kitchen gadget for the job, people who have lost sight, strength, and coordination due to illness, disability or aging absolutely require specially designed kitchen tools for safer and easier accessibility in the kitchen.
Some of the problem issues people face are:
This cutting board can stabilize vegetables or fruit for cutting if you only have the use of one hand. It can also be used to stabilize a bowl for one-handed stirring.
A rocker knife can be used with the cutting board above to cut food with one hand. The food remains gathered together in the incurved cutting board while cutting is done by rocking the blade with a single hand.
If hands are painful or weak from arthritis or another condition, this cordless can opener can be the solution.
Wider grip utensils can be used when grasp is weak or for deformities in the hands. If you are experiencing difficulties with tremors, as seen with neurological conditions like Parkinson’s Disease, utensils like above can be purchased weighted. The weight helps to decrease the tremor.
This jar opener can be mounted under the cabinet. By securing lids of various sizes in place, it makes opening jars not as difficult. By focusing on only turning the jar, one can open it wiith one or both hands.
Measuring cups for low vision are available with increased font size and color contrast.
High power magnifier enlarges instructions and recipes into large print for easier reading.
The market has many innovations of adaptive kitchen aids designed to not only increase independence with kitchen ADL’s but to make them easier and safer for everyone, especially those struggling with a disability. Hopefully this will help you to enjoy your time in the kitchen. There are a wide variety of tools such as boards/mats for cutting, scissors, knives, slicers, choppers with angled handles, graters, weights and measures, holders and timers and more. There are so many helpful devices available today, with enough investigation, you can find the right tool for you. If you you need additional guidance, an occupational therapist is a great place to get your specific needs and questions addressed.
Resources: www.rehabmart.com >Independent Living Aids
By Holly Kennedy, PT, CAPS, ECHM
Did you know that 1 in 4 Americans aged 65+ falls every year? Falls are the leading cause of injuries for older Americans and they are costly—in dollars and in quality of life. However, falling is NOT an inevitable part of aging. Falls among seniors can be reduced substantially by following these simple tips.
1. Make an appointment with your doctor
Begin your fall-prevention plan by making an appointment with your doctor to address the following:
2. Exercise: Keep Moving!
Physical activity is very important for fall prevention. With your doctor’s approval, consider activities such as walking, senior fitness classes, water workouts or Tai chi. Try to incorporate balance, strength and flexibility activities. Consider attending A Matter of Balance evidence-based balance and fall prevention program. Find something you love, invite a friend and stick with it!
3. Wear sensible shoes
Consider changing your footwear as part of your fall-prevention plan. Wear properly fitting, sturdy shoes with nonskid soles.
4. Make your home safer
Look at your home room by room to find and correct potential hazards. Below are a few simple things you can do to make your home safer:
5. Talk to your family
Include your family members so they can offer support and assistance.
Fall Prevention week is September 21-25. Mark your calendars and use this week to work on your Fall Prevention plan together. Remember, falling is NOT a normal part of aging.
Sources: National Council on Aging https://www.ncoa.org/healthy-aging/falls-prevention/falls-prevention-awareness-week/
By Janet Ceraldi, OTR,CEAC
Low vision deficits are very common in our aging population. In 2011, the first baby boomers turned 65. We now have an increasingly aging population of people being diagnosed with low vision problems, affecting how baby boomers are of thinking about getting older. They want to age in place and stay in their home as long as possible. However, only one in six have made any home modifications to make it safe enough to allow them to do so. The goal of aging in place is to enhance the quality of life of aging adults in their own environment. Staying home not only helps you to be able to participate in the activities you love but also to socialize with the people you enjoy.
Low vision is the term used to refer to a visual impairment that is not correctable through surgery, pharmaceuticals, glasses or contact lenses. It is often characterized by partial sight, such as blurred vision, blind spots or tunnel vision. Low vision can impact people of all ages, but is primarily associated with older adults.
As we age there are a variety of eye conditions that can affect us such as macular degeneration, diabetic retinopathy, glaucoma. Any of these conditions can make activities of daily living (our self care needs- bathing, grooming, dressing, cooking) difficult to complete.
Here are some tips that can help:
Below are a few examples of adaptive equipment or tools for low vision:
Resources: