Anderson: A proactive approach to aging's challenges

Challenges bring out the best in most people, and aging is one of the most onerous challenges we face.

We are all aging each day. Add enough days together and we will see our 80s, 90s or even 100s.

A common theme among seniors is a desire to continue to care for themselves, not perceive themselves as becoming a burden on loved ones. Fortunately, remaining independent at home, at least for an extended period, is attainable for most seniors.

However, it takes a proactive approach to maintaining health and a willingness to address problems head on. And even then, there are issues that come up frequently, thus need to be anticipated.

Considerations often start with children.

Some adult children are willing and able to provide care for parents in their advanced years. Others are not.

If your children have always been busy and independent, don’t expect them to change. Accept them as they are.

Involve them in communication so they are aware of your wishes and decisions can be made on what they can and can’t provide. Then make your own arrangements for needs outside their capabilities.

That might mean hiring in-home care, and eventually moving to an independent living or assisted living community.

Many adult children are stressed by the idea of becoming a caregiver to a parent. 

The personal care element can be particularly problematic for parent and adult child. Daily dressing, showering, medication management can overwhelm even the most dedicated family caregiver.

If you or a loved one would like an assessment to determine an appropriate care level, and provider for that care, seek one out. You may need to develop an independent plan for elements in the personal care realm.

Many people develop knee or hip pain and reduce activity to minimize pain. Depending on the cause of that pain, it may continue to worsen and reduce activity further.

But the old saying, “Move it or lose it,” is true. We see the results of these choices as people gradually become less able to walk and care for themselves over time.

As we age, strength and mobility are much easier to maintain than regain.

I’ve had the honor of caring for hundreds of Yamhill County seniors in their homes, so I know from long experience. Members of my team and I care for many people who qualify for physical therapy in their homes, and we are pro-active in seeing that they get it.

Contact your doctor and ask about in-home physical therapy options.

Therapy can help you get moving again. It can also arm you with new strategies for pain reduction.

Please avoid hospitalization if you can.

Take care of problems early. See your doctor before getting sick enough to be admitted to the hospital.

When you are hospitalized, you spend most of the time lying in a bed. It’s noisy at night and resting is difficult.

Sometimes a condition known as delirium develops. You may become confused, requiring introduction of powerful medications to help manage your symptoms.

What’s more, the combination of bed rest and medications can cause weakness, increasing your risk of suffering falls. And that can lead to more hospitalizations.

Medicare does not pay for assisted living or in-home care. These services are paid privately by the person or family.

So if you see the potential for such needs looming, it pays to plan ahead.

Long-term care insurance is one option, as it can cover these types of care. If you already have such a policy, you should find out what it covers and how to access the benefits in the event they become needed.

We sometimes discover from families we work with that they have policies that have cost them tens of thousands of dollars, but those policies have gone unused because of confusion about what is covered and how to tap into benefits.

If you rely on a neighbor or relative for basic daily care, you should have an alternative caregiver plan, known as an ACP, in place. The pandemic caused many disruptions in care, and they hit seniors depending on a single caregiver hardest.

If that person tested positive for COVID, was hospitalized with complications or, worst case, passed away unexpectedly, there was no one prepared to quickly step in.

Without their regular caregiver, some seniors developed severe health problems. Sometimes they spent weeks in the emergency room waiting for a bed to open up at a care facility, as they could not safely return home.

We also advise building a network of friends. We are amazed at the cohesion of friendships and the dedication people show to each other when the need arises.

One good route is seeking out opportunities to be of service. That way, when you need a hand yourself, someone you’ve worked with will be there to provide it.

Churches and the senior center are good places to start expanding your social network. 

In our experience, we have seen the support of friends and neighbors play a key role in staying safe and happy at home longer. The less isolated you are, the less likely you are to fall victim to health or nutritional challenges.

If possible, blend in group activities like walking or swimming. Aging bodies are unpredictable, and having a steady support group can buffer the winds for you.

You should also talk with your emergency contacts about your wishes with regard to lifesaving treatment. And you should share your care directions widely in your family so everyone is aware.

To plan ahead for emergencies, keep a signed physician’s order for life-sustaining treatment, known as a POLST, posted on the fridge. This makes it easy for paramedics to locate in an emergency.

A POLST is a single bright-pink document printed on card stock, which makes it instantly recognizable. A living will or advance directive is helpful, but may contain several pages of directions, thus be harder to find and follow in a moment of crisis.

An easy-to-find POLST makes it simple for first responders to provide the right care for you.

You should also understand the medications you are taking, and why.

Talk with your doctor about any medications that may be reduced in dose or discontinued. Some medications are necessary lifelong, but others need to be taken only until a health condition resolves.

All medications have side effects, and aging can magnify them, as it changes how our bodies process and excrete active ingredients. Also, the need for oral diabetes or blood pressure medications can increase or decrease based on lifestyle choices.

You might also consider asking for a referral to a dietitian — someone who can help you develop a plan to improve your health with wise food and activity choices.

Stroke is the No. 1 cause of disability in the U.S. Know the signs of a stroke, and set about calling 911 and getting to the hospital immediately if such signs surface.

The faster you get to the hospital, the more brain tissue may remain viable. Speed to treatment is the key to optimal recovery.

FAST is an acronym you can use to check for symptoms. It stands for:

Face drooping on one side, becoming lopsided smile. Arms — one, the other or both — drifting when you attempt to raise them. Speech becoming unusual or slurred, perhaps accompanied by confusion or difficulty understanding instructions. Time being of the absolute essence once stroke is suspected, as restoring circulation to the brain quickly is critical to the potential for recovery.

Nurses have a saying, “Time is brain.” That’s because it can’t go long without oxygen.

Healthcare is complicated. There are many variables. Those mentioned here are only a few of those that might arise.

As people age, their care becomes more complex. That makes care management an ever-growing task.

By default, managing appointments, therapies and medications often falls first on family members. But eventually, they may become overwhelmed and professionals may need to step in.

This does not have to be a negative development.

As a partner in a firm dedicated to providing that kind of care, I lead a compassionate team of care providers helping people stay safe and healthy at home as long as possible. In the process, we get to know not only seniors in need, but also their friends, relatives and support networks.

Relationships may span months or years, instead of hours or days, so we have the opportunity to learn something new from each person we help. Sometimes it’s an example of how to live, other times a cautionary tale.

Nurse care managers are skilled at identifying the risks for poor health and making recommendations to head off disaster. They can provide a bridge serving to extend the feasibility of home care.

A good manager can create a customized plan of care to help people age where they choose, with a safe and appropriate level of support. Local doctors and clinics can provide recommendations if you think that might work for you.

Guest writer Helen Anderson owns HelloCare, a McMinnville provider of senior home care and day care services, with fellow nurse Kristy Runge.  She holds a B.S. in nursing, an M.S. in nursing education and board certification in gerontology nursing. During a career that began in 2004, she has devoted herself to caring for seniors in acute care as well as community-based settings.