If you are concerned about an elderly driver, closely monitor their driving before deciding whether they need to brush up on their driving skills or give up their driver’s license altogether.
1. Watch for changes in driving habits, general behavior, and health.
2. Encourage a driving evaluation through your local Department of Motor Vehicles, along with refresher driving lessons and the AARP Driver Safety course.
3. Offer some evaluation tools to assess driving risk, or work together on these quizzes.
4. Explore ways to reduce driving, such as making purchases online or through mail-order catalogs. If possible, arrange for home delivery of groceries, and home visits by personal care providers.
5. If necessary, get support from the doctor and other family members.
6. Look into alternative ways of getting around. Maybe your loved one can continue to drive some of the time (such as in the daytime or off the freeway), and alternative transportation can fill the need for rides at other times.
7. If you feel that it is time to talk to your loved one about stopping driving, approach the issue with sensitivity. A driver’s license signifies more than the ability to drive a car; it is a symbol of freedom, independence and independent living, self-sufficiency, being employed, fun and spontaneity, involvement in social and religious activities. Some see the ability to driver as a right; however, it is a priveledge. Understandably, driving is not a privilege that anyone—teenager or elder—wants to relinquish willingly. As important as it is to treat the senior driver with respect and not jump to unjust conclusions, it is also important to help the elderly driver retire from the road.
Start slowly and try to persuade the senior to give up the keys. Some approaches that may work:
Be understanding about resistance. The senior may dismiss you and refuse to listen to you. Emotion may get in the way of a rational decision.
Ask questions, rather than make demands. For example, “Would you consider not driving at night?”
Talk about safety considerations. Many senior drivers who shouldn’t be driving have already had an accident or some close calls. Remind the impaired driver of the danger of serious injuries and that the safety of others is also at risk.
Explain transportation options. Help the senior driver see that living without a car won’t make them permanently homebound. Acknowledge the lifestyle change, but also show them how to continue favorite activities and to remain mobile.
Emphasize financialsavings. The cost savings associated with giving up a car may be a selling point for some older drivers. Costs include insurance, gasoline, maintenance and repairs, and license and registration fees.
Offer rides and visits. Volunteer to come by once a week or to provide rides on a regular basis for things like grocery shopping, library visits, or doctors’ appointments.
Seek their understanding of the situation. Some elderly drivers may be aware of their faltering ability, but be reluctant to give up driving completely. Another person’s concerns may force the senior driver to act. They may even feel relieved to have someone else help make the decision to stop driving.
Friday, October 26, 2007
Should Dad Still Drive?
For many, asking this question is equivalent to opening Pandora's box. It is an issue of independence. While everyone ages differently, many people are able to continue to drive into their seventies, eighties, and even nineties. Some seniors are at higher risk for road accidents. The elderly are more likely to receive traffic citations for failing to yield, turning improperly, and running red lights and stop signs - an indication of decreased driving ability. A person 65 or older who is involved in a car accident is more likely to be seriously hurt, more likely to require hospitalization, and more likely to die than younger people involved in the same crash. In particular, fatal crash rates rise sharply after a driver has reached the age of 70.
If you know an older driver who is experiencing trouble on the road, it is important to carefully monitor the situation. There are physical changes in aging that may affect road safety:
Visual decline
Vision declines with age, which means depth perception and judging the speed of oncoming traffic become more difficult. The eyes also lose the ability to process light, which makes night vision worse and causes more sensitivity to bright sunlight and glare. By age 60, you need three times the amount of light that you did at age 20 in order to drive safely after nightfall.
Hearing loss
Approximately one-third of adults over age 65 are hearing-impaired. Because hearing loss happens gradually, a senior may not realize they are missing important cues when driving, such as honking, emergency sirens, or a child's bicycle bell.
Limited mobility and increased reaction time
With age, flexibility may decrease as response time increases. A full range of motion is crucial on the road. In addition, chronic conditions can limit mobility (rheumatoid arthritis, Parkinson's disease, sleep apnea, heart disease, or diabetes).
Medications
People often take more medications as they age. Certain medications, as well as a combination of medications and alcohol, can increase driving risk. Be particularly careful about medication side-effects and interactions between medications.
Drowsiness
Aging can make sleeping more difficult, resulting in daytime tiredness and an increased tendency to doze off during the day (or while driving). In addition, certain prescription drugs cause drowsiness.
Dementia or brain impairment
Mental impairment or dementia makes driving more dangerous and more frustrating. Brain impairment may cause delayed reactions to sudden or confusing situations on the road.
There are also problems in the driving environment that can affect drivers of any age. If an older adult is experiencing other problems, these challenges can make it even more difficult to drive safely: signs and road markings that are difficult to see or to read, complex and confusing intersections, older vehicles that lack automatic safety features, newer dashboard instrument panels with multiple displays all affect driver safety.
Warning signs of unsafe driving ability:
Abrupt lane changes, braking, or acceleration
More frequent "close calls", or dents and scrapes on the car or on fences, mailboxes, garage doors, curbs, etc.
Failing to use the turn signal, or keeping the signal on without changing lanes.
Drifting into other lanes.
Driving on the wrong side of the road or in the shoulder.
Trouble reading signs or navigating directions to get somewhere.
Missing highway exits or backing up after missing an exit.
Difficulty with Range-of-motion of the neck, affecting the ability to look over the shoulder, turn head, or move hands or feet.
Trouble moving the foot from the gas to the brake pedal, or confusing the two pedals.
Feeling more nervous or fearful while driving or feeling exhausted after driving.
More conflict on the road: other drivers honking; frustration or anger at other drivers.
Oblivious to the frustration of other drivers, not understanding why they are honking.
Reluctance from friends or relatives to be in the car with the senior driving.
Getting lost more often.
Trouble paying attention to signals, road signs, pavement markings, or pedestrians.
Slow reaction to changes in the driving environment.
Increased traffic tickets or "warnings" by traffic or law enforcement officers.
If you would like a free copy of the Driver Safety Rating Form, e-mail Health Calls at: MRadwanski@healthcallshomehealth.com
If you know an older driver who is experiencing trouble on the road, it is important to carefully monitor the situation. There are physical changes in aging that may affect road safety:
Visual decline
Vision declines with age, which means depth perception and judging the speed of oncoming traffic become more difficult. The eyes also lose the ability to process light, which makes night vision worse and causes more sensitivity to bright sunlight and glare. By age 60, you need three times the amount of light that you did at age 20 in order to drive safely after nightfall.
Hearing loss
Approximately one-third of adults over age 65 are hearing-impaired. Because hearing loss happens gradually, a senior may not realize they are missing important cues when driving, such as honking, emergency sirens, or a child's bicycle bell.
Limited mobility and increased reaction time
With age, flexibility may decrease as response time increases. A full range of motion is crucial on the road. In addition, chronic conditions can limit mobility (rheumatoid arthritis, Parkinson's disease, sleep apnea, heart disease, or diabetes).
Medications
People often take more medications as they age. Certain medications, as well as a combination of medications and alcohol, can increase driving risk. Be particularly careful about medication side-effects and interactions between medications.
Drowsiness
Aging can make sleeping more difficult, resulting in daytime tiredness and an increased tendency to doze off during the day (or while driving). In addition, certain prescription drugs cause drowsiness.
Dementia or brain impairment
Mental impairment or dementia makes driving more dangerous and more frustrating. Brain impairment may cause delayed reactions to sudden or confusing situations on the road.
There are also problems in the driving environment that can affect drivers of any age. If an older adult is experiencing other problems, these challenges can make it even more difficult to drive safely: signs and road markings that are difficult to see or to read, complex and confusing intersections, older vehicles that lack automatic safety features, newer dashboard instrument panels with multiple displays all affect driver safety.
Warning signs of unsafe driving ability:
Abrupt lane changes, braking, or acceleration
More frequent "close calls", or dents and scrapes on the car or on fences, mailboxes, garage doors, curbs, etc.
Failing to use the turn signal, or keeping the signal on without changing lanes.
Drifting into other lanes.
Driving on the wrong side of the road or in the shoulder.
Trouble reading signs or navigating directions to get somewhere.
Missing highway exits or backing up after missing an exit.
Difficulty with Range-of-motion of the neck, affecting the ability to look over the shoulder, turn head, or move hands or feet.
Trouble moving the foot from the gas to the brake pedal, or confusing the two pedals.
Feeling more nervous or fearful while driving or feeling exhausted after driving.
More conflict on the road: other drivers honking; frustration or anger at other drivers.
Oblivious to the frustration of other drivers, not understanding why they are honking.
Reluctance from friends or relatives to be in the car with the senior driving.
Getting lost more often.
Trouble paying attention to signals, road signs, pavement markings, or pedestrians.
Slow reaction to changes in the driving environment.
Increased traffic tickets or "warnings" by traffic or law enforcement officers.
If you would like a free copy of the Driver Safety Rating Form, e-mail Health Calls at: MRadwanski@healthcallshomehealth.com
Thursday, October 25, 2007
Minimizing Confusion While Your Loved One is Hospitalized
When an older person is hospitalized, an illness or the change in enviroment can cause confusion, which is usually temporary. Confusion can be a safety concern because the older adult may not think or act as rationally as he or she would normally, and this could result in a fall or injury in the hospital. It is important to plan ahead before a hospital stay to reduce the risk of confusion.
Be prepared in case of a hospitalization. It is important to have this information on the ready at all times:
1. A complete list of all medications (with their dosages), as well as over-the-counter medicines.
2. Prepare a "medical information sheet" listing all allergies, names and phone numbers of physicians, the name of the patient's usual pharmacy and all known medical conditions. Also, be sure all pertinent medical records have been forwarded to the doctors who will be caring for the patient.
If your loved one is hospitalized, there are a few things that you can do to help prevent confusion:
1. Bring glasses, hearing aids (with fresh batteries), and dentures to the hospital. Older persons do better if they can see, hear and eat.
2. Bring in a few familiar objects from home. Things such as family photos, a favorite comforter or blanket for the bed, rosary beads, a beloved book and relaxation tapes can be quite comforting.
3. Help orient the patient throughout the day. Speak in a calm, reassuring tone of voice and tell the patient where he is and why he is there.
4. When giving instructions, state one fact or simple task at a time. Do not overwhelm or over stimulate the patient.
5. Massage can be soothing for some patients.
6. It is always important to have an advocate available for the patient. Stay with the hospitalized patient as much as possible. If your loved one becomes confused, relatives should try to arrange shifts so someone can be present around the clock.
7. If you detect new signs that could indicate delirium -- confusion, memory problems, personality changes -- it is important to discuss these with the nurses and physicians as soon as you can. Family members are often the first to notice subtle changes.
Be prepared in case of a hospitalization. It is important to have this information on the ready at all times:
1. A complete list of all medications (with their dosages), as well as over-the-counter medicines.
2. Prepare a "medical information sheet" listing all allergies, names and phone numbers of physicians, the name of the patient's usual pharmacy and all known medical conditions. Also, be sure all pertinent medical records have been forwarded to the doctors who will be caring for the patient.
If your loved one is hospitalized, there are a few things that you can do to help prevent confusion:
1. Bring glasses, hearing aids (with fresh batteries), and dentures to the hospital. Older persons do better if they can see, hear and eat.
2. Bring in a few familiar objects from home. Things such as family photos, a favorite comforter or blanket for the bed, rosary beads, a beloved book and relaxation tapes can be quite comforting.
3. Help orient the patient throughout the day. Speak in a calm, reassuring tone of voice and tell the patient where he is and why he is there.
4. When giving instructions, state one fact or simple task at a time. Do not overwhelm or over stimulate the patient.
5. Massage can be soothing for some patients.
6. It is always important to have an advocate available for the patient. Stay with the hospitalized patient as much as possible. If your loved one becomes confused, relatives should try to arrange shifts so someone can be present around the clock.
7. If you detect new signs that could indicate delirium -- confusion, memory problems, personality changes -- it is important to discuss these with the nurses and physicians as soon as you can. Family members are often the first to notice subtle changes.
Tuesday, October 23, 2007
How Do I Know if Mom Really Needs Help?
In some cases, the sudden start of a severe illness will make it clear that help is needed. In other cases, your loved one may ask for help. When you don't live with the person you are concerned about, you have to think carefully about possible signs that support or help is needed. You might want to use any time that you are together to take stock.
Some questions to answer during your visit include:
• Are the stairs manageable or is a ramp needed?
• Are there any tripping hazards at exterior entrances or inside the house (throw rugs, for instance)?
• If a walker or wheelchair is needed, can the house be modified?
• Is there food in the fridge? Are there staple foods inthe cupboards?
• Are bills being paid? Is mail piling up?
• Is the house clean?
• If your loved one is still driving, can you assess their road skills?
• How is their health? Are they taking several medications? If so, are they able to manage their medications?
• What about mood: Does he or she seem depressed or anxious?
If you do not see your loved one often, changes in his or her health may seem dramatic. In contrast, someone who is with him or her everyday might not notice such changes, or realize that more help, medical treatment, or supervision is needed. Sometimes a geriatric care manager or other professional is the first to notice changes. For families dealing with Alzheimer’s disease and other dementias, it can be easier to “cover” for the patient — doing things for him or her, filling in information in conversations, and so on — than to acknowledge what is happening.
A few good conversation starters are:
If you thought there might be a change in Aunt Joan’s condition, whose opinion would you seek?
"I didn’t notice Dad repeating himself so much the last time I was here. Do you remember when it started?" Some changes may not be what you think. Occasional forgetfulness does not necessarily indicate Alzheimer’s disease. Before you raise the issue of what needs to be done, talk to your parent and other involved family members about your concerns.
Try not to sound critical when you raise the subject. Instead, mention your particular worry, for example, “Mom, it looks like you don’t have much food in the house — are you having trouble getting to the store?” and explain why you are concerned. Listen to what she says about the situation, and whether he or she feels there are problems.
Discuss what you think needs to be done: “Do we need to get a second opinion about the diagnosis? Can you follow the medication schedule? Would you like some help with housework?” Try to follow up your suggestions with practical help, and give specific
examples of what you can do. For example, you might arrange to have a personal or home health aide come in once a week. You might schedule doctors’ appointments
or arrange for transportation.
In some cases you may have to be forceful, especially if you feel that the situation is unhealthy or unsafe. Do not leave a frail adult at risk. If you have to act against the wishes of your loved one, be direct and explain what you are going to do. Discuss your plan and say why you are taking action.
Some questions to answer during your visit include:
• Are the stairs manageable or is a ramp needed?
• Are there any tripping hazards at exterior entrances or inside the house (throw rugs, for instance)?
• If a walker or wheelchair is needed, can the house be modified?
• Is there food in the fridge? Are there staple foods inthe cupboards?
• Are bills being paid? Is mail piling up?
• Is the house clean?
• If your loved one is still driving, can you assess their road skills?
• How is their health? Are they taking several medications? If so, are they able to manage their medications?
• What about mood: Does he or she seem depressed or anxious?
If you do not see your loved one often, changes in his or her health may seem dramatic. In contrast, someone who is with him or her everyday might not notice such changes, or realize that more help, medical treatment, or supervision is needed. Sometimes a geriatric care manager or other professional is the first to notice changes. For families dealing with Alzheimer’s disease and other dementias, it can be easier to “cover” for the patient — doing things for him or her, filling in information in conversations, and so on — than to acknowledge what is happening.
A few good conversation starters are:
If you thought there might be a change in Aunt Joan’s condition, whose opinion would you seek?
"I didn’t notice Dad repeating himself so much the last time I was here. Do you remember when it started?" Some changes may not be what you think. Occasional forgetfulness does not necessarily indicate Alzheimer’s disease. Before you raise the issue of what needs to be done, talk to your parent and other involved family members about your concerns.
Try not to sound critical when you raise the subject. Instead, mention your particular worry, for example, “Mom, it looks like you don’t have much food in the house — are you having trouble getting to the store?” and explain why you are concerned. Listen to what she says about the situation, and whether he or she feels there are problems.
Discuss what you think needs to be done: “Do we need to get a second opinion about the diagnosis? Can you follow the medication schedule? Would you like some help with housework?” Try to follow up your suggestions with practical help, and give specific
examples of what you can do. For example, you might arrange to have a personal or home health aide come in once a week. You might schedule doctors’ appointments
or arrange for transportation.
In some cases you may have to be forceful, especially if you feel that the situation is unhealthy or unsafe. Do not leave a frail adult at risk. If you have to act against the wishes of your loved one, be direct and explain what you are going to do. Discuss your plan and say why you are taking action.
Monday, October 22, 2007
More Should Get Flu Shot
For the last two years we were in a frenzy over the lack of flu shot availability. This year, there doesn't appear to be a shortage in supply.
Will YOU get your flu shot? It's not just for the elderly, children, and people with chronic illnesses anymore.
Why? Well, what happens if YOU get the flu and pass it on to the person you are caring for? You are not immune to the flu and you can pass it on.
The experts at the Center for Disease Control say that every year in the United States, on average:
5% to 20% of the population gets the flu; more than 200,000 people are hospitalized from flu complications, and; about 36,000 people die from flu. Some people, such as older people, young children, and people with certain health conditions, are at high risk for serious flu complications.
Flu viruses spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose. Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.
Some other good health practices to help prevent the flu from spreading include:
1. Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
2. Stay home when you are sick. If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.
3. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Throw the tissue away as soon as possible to prevent the spread of germs.
4. Clean your hands. Washing your hands often will help protect you from germs. Use warm water and lather with soap. Rub your hands together for 10 seconds, then rinse your hands and dry them. If you aren't able to use soap and water right away, use a alcohol-based waterless hand sanitizer.
5. Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
6. Practice other good health habits. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. These healthy habits will keep your immune system healthy which helps if you are exposed to the flu or other illnesses.
Will YOU get your flu shot? It's not just for the elderly, children, and people with chronic illnesses anymore.
Why? Well, what happens if YOU get the flu and pass it on to the person you are caring for? You are not immune to the flu and you can pass it on.
The experts at the Center for Disease Control say that every year in the United States, on average:
5% to 20% of the population gets the flu; more than 200,000 people are hospitalized from flu complications, and; about 36,000 people die from flu. Some people, such as older people, young children, and people with certain health conditions, are at high risk for serious flu complications.
Flu viruses spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose. Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.
Some other good health practices to help prevent the flu from spreading include:
1. Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
2. Stay home when you are sick. If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.
3. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Throw the tissue away as soon as possible to prevent the spread of germs.
4. Clean your hands. Washing your hands often will help protect you from germs. Use warm water and lather with soap. Rub your hands together for 10 seconds, then rinse your hands and dry them. If you aren't able to use soap and water right away, use a alcohol-based waterless hand sanitizer.
5. Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
6. Practice other good health habits. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. These healthy habits will keep your immune system healthy which helps if you are exposed to the flu or other illnesses.
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