The Sure Foundation Upon Which I Stand

“The sure foundation upon which I stand

turns out to be the center from which I seek.”

– Chögyam Trungpa Rinpoche

What you can do for an older relative you take to an emergency room

Here’s a link to an interesting article on NextAvenue.com (see link below) about the debate over whether Senior-focused Emergency Rooms are a good thing and necessary. Or whether MD’s and nurses just need a lot more training in geriatric care.

“Nationally, there are probably fewer than two dozen senior emergency rooms, says Sue Penoza, director of strategic planning at Trinity Health of Novi, Mich., one of the largest Catholic hospital systems in the United States.

All take older patients, generally anyone 65 and older, who aren’t experiencing potentially life-threatening traumas, like heart attacks or strokes, based on findings from an initial evaluaton in the regular ER. Common conditions seen by the medical staff in these special emergency rooms include falls, hip fractures, generalized weakness, abdominal pain and non-urgent chest pain.

The impetus is a growing understanding that older adults have unique medical needs and vulnerabilities that often aren’t very well served in traditional emergency rooms.”

Whether the Senior ER phenomenon will be a growing trend is unknown. In the meantime, this article describes some simple and important ways that family members can advocate for their loved ones in the ER’s to help make sure they receive better care.

What you can do for an older relative you take to an emergency room: 

Make sure you bring your relative’s glasses or hearing aids to the hospital. Once the medical staff in the general ER rule out a life-threatening medical problem, ask if there is someone trained to work with older adults, or if the hospital has a senior ER. Ask nurses and doctors attending to the person what the plan of care is. Ask the medical staff if your relative can have food and water and make sure this happens, if appropriate. Speak up if the person’s needs aren’t being met. Be alert to signs of sudden confusion or disorientation that arise in the ER — these can signal the potential onset of delirium — and let medical staff know if this occurs.

Cornell Legacy Project 

The Cornell Legacy Project has systematically collected practical advice from over 1500 older Americans who have lived through extraordinary experiences and historical events. They offer tips on surviving and thriving despite the challenges we all encounter. The project is based on the work of Cornell University gerontologist Karl Pillemer.

The interviews are focused on “lessons for living”.  You can watch some of the wonderful, short video clips with some very wise and insightful octogenarians and nonagenarians on YouTube HERE.

With elder abuse on the rise, as is all domestic violence in this stressful time of financial struggle, there have been almost no shelters available for elder abuse victims in the entire country. The first elder abuse shelter in Ohio has just launched at Cedar Village Retirement Community.

“For decades, many communities have had shelters for victims of domestic violence. But those shelters do not fully meet the needs of older adults who are victims of abuse, even though the issues may be similar. About a half-dozen shelters for elderly abuse victims exist in nursing homes around the country—including in Connecticut, New Jersey, Rhode Island and Atlanta. The first opened six years ago in New York City.

Research indicates that more than one in ten elders may experience some type of abuse. Only one in five cases is reported. Annual estimates range from 700,000 to 3.5 million victims in the U.S. Elder abuse is defined as intentional or neglectful acts by a caregiver or “trusted” individual that lead to, or may lead to, harm of an elder. Abuse includes physical abuse, neglect, emotional or psychological abuse, verbal abuse and threats, financial abuse and exploitation, sexual abuse and abandonment. “

To read the rest of the article, click here  Ohio’s First Elder Abuse Shelter   .

Marin County is the oldest county, population-wise, in California. It is also the fastest aging county in the state.

• Currently 1 in 4 people in Marin are 60 years old or older.

• In about 15 years, it is projected that 1 in 3 people will be 60 or older.

• The change in 60+ population from 2000 to 2010 has been a 41% increase.

• The projected change in 60+ population from 2010 to 2020 will be another 27%.

• The median age in Marin is 45; in Boca Raton it is 43. In Scottsdale, the US city with the oldest median age, it’s 46.

• In 11 areas in Marin, the average age is 51. Dillon Beach has the oldest median age at 58 years old.

The myth is that everybody in Marin is wealthy and well taken care of. This is not true. Many thousands of people in Marin live below the Federal Poverty Level and many more below the Adjusted Elder Index.

Many older people in Marin moved here and bought their homes many years ago when real estate was affordable. Now, they are “house rich and cash poor”. Some choose to sell their homes and move to new, more affordable locations. Some who love their communities in Marin, opt to stay and, if they reject reverse mortgages, are struggling to have enough money for food and medications.

The “silver tsunami” has arrived and is growing larger in Marin. Here is a link to the disturbing Marin County Grand Jury report from 5 years ago that accurately predicted what we see happening now. Aging in Marin – An Essay in Uneasiness .

I have long found this list of emotions – nouns and adjectives – very helpful. So many of us were not brought up to give our emotions much attention let alone encouragement to describe or communicate about them.

It can be evocative to have a list of a full palette of feelings with which to develop a more finely tuned thought process, ability to understand ourselves and ability to communicate.

For instance, here are the “A”‘s through “B”‘s:

• absorbed
• abusive
• accepting
• accommodating
• accomplished
• adaptable
• adversarial
• aggressive
• agreeable
• alert
• altruistic
• analytical
• angry
• annoyed
• antagonistic
• anxious
• approved of
• arrogant
• ashamed
• authentic
• balanced
• beautiful
• belligerent
• bereft
• bitter
• bored
• brave
• broken down
• bullied

Click here to see the rest Emotions & Feelings – A List of Choices

Recently I discovered a remarkable new online tool for locating and matching the best Marin senior housing options for each individual. It’s called Lucille’s List.

Lucille’s List was started by two partners, Tia Small and Hilary Parkhill, who had experienced their own personal struggles with finding the best housing options for their loved ones. It was such a frustrating experience for them that they began to realize that “something better could be done for all people looking for senior housing.”

In 2009, the two women joined forces to found “Lucille’s List”. They have spent countless hours researching and organization the latest information on resources available to older adults in Marin.

Lucille’s List is committed to:

• helping seniors find appropriate living situations,
• listing housing options regardless of socio-economic status, and
• providing the most comprehensive listings of senior communities.

This is a free and user-friendly service. The initial version of Lucille’s List has information and photographs on all:

• 55+ Active Adult communities,
• Senior Apartments,
• Senior Mobile Home Parks,
• aging in place Villages,
• Continuing Care Retirement Communities,
• Low-Income/Subsidized options,
• Assisted Living, and
• Skilled Nursing Facilities inMarin County,CA.

Soon to follow will be the entire San Francisco Bay Area

What a welcome and valuable addition to tools for older adults and their families in MarinCounty!

BABY BOOMERS & OLDER ADULTS – WORKING LONGER

More and more older people are continuing to work. In the last 4 1/2 years, the number of people 65 and older who are working has increased by 1.4 million – a huge increase of 25%. People are staying healthier longer – Americans reaching age 65 can expect to live to an average of 83 for men and 85 for women. So, people are working longer partly because they want to and partly because they feel financially squeezed since the Great Recession. Read this very interesting and informative essay from the NY Times: “Working Late, By Choice or Not”.