Assisted Living Activities

Seniors in Assisted Living homes may not be able to do everything a younger and more agile person can do, but they certainly can still be active and not everything has to be done while sitting or lying down.

Activities can be creatively modified to incorporate canes, walkers, slower movement, sitting, etc, but still offer the elderly opportunities for fitness, health, brain activity, laughter, participation and good quality daily living.

Where images of bingo and bridge easily come to mind as activities for assisted living seniors, you should also consider Nintendo Wii, wheelchair races, dress up parties, sing alongs, dances, crafts, cooking, baking and so very much more.

Nintendo Wii can offer bowling, golf and other balance and agility movements that don't have to jeopardize an elderly persons balance and risk of falling. Musical instruments can aid in relaxation, creative expression and group participation as well. Crafts can give the elderly a project that requires some focus, creativity and sense of accomplishment when completed. These can be shown off or given as gifts to their friends or family.

No matter how old one gets the joy of singing and laughing will always leave one feeling happier and joyful. All the more it should be a regular part of the lives of the elderly since they can begin to feel down about their health, distance from family or their simple lack of enthusiasm.

With the availability of CD's and DVD's a senior in assisted living can have a library of old-time TV or radio shows at their disposal such as "The Lucy Show", "Laugh In", "Abbot and Costello", "Perry Mason", "Gunsmoke", "Bob Hope" and many more. Sing along DVD's can be used by one senior, but create a fun atmosphere for many senior citizens to join in together for some much-loved and remembered favourites. Use these during a party and when not dancing to the music, they can all be singing along.

More activities for seniors in assisted living are:

• Gardening
• Computer class
• Pet visits
• Bible studies
• Trivia games
• Vaudeville night
• Movie night
• Pizza parties
• Dance-a-thons
• Wheelchair/walker races
• Costume parties
• Photo sessions
• Barbecues
• Story telling
• Crafts

Aging-in-Place With Universal and Adaptable Design

Homes That Grow Gracefully With You

As we enter into retirement, we begin to face some very difficult questions about the future of our families and our ability to maintain our independence through the retirement years. We have a strong desire to retain our autonomy as long as possible and not rely on family members for assistance with daily living. Universal and adaptable design concepts optimize space in our homes to accommodate a wide range of individuals with varying physical abilities, allow people to stay in their homes longer, and keep families together.

What is Aging-in-Place?

Aging-in-place means living in your home safely, comfortably, and independently, regardless of age or ability level. It allows you to continue living in a familiar environment throughout your maturing years. Aging-in-place is the ability to remain in your home for a lifetime.

Quick Facts...

One-quarter of the U.S. population is over age 50.

From 2000 to 2030 the over 65 population will double.

By 2030, the population of older people will likely increase to over 69 million persons.

By 2050, the U.S. will account for 79 million people over age 65.

The net worth of seniors is five times greater than the average net worth of all U.S. citizens.

What is universal and adaptable design?

Ron Mace, founder and program director of the Center for Universal Design, defines universal design as "the design of products and environments to be useable by all people, to the greatest extent possible, without the need for adaptation or specialized design". For our purposes, we will limit the term "universal design" as it applies to home design and related products.

Adaptable design, on the other hand, allows the easy modification of a space to accommodate a specific need. Where universal design benefits everyone regardless of ability, adaptable design provides access to spaces or products through alteration or the addition of an assistive device that bridges an existing barrier to its use. Adaptable design is defined by ANSI A117.1 (American National Standards Institute) as, "the ability of certain building elements, such as kitchen counters, sinks, and grab bars, to be added to, raised, lowered, or otherwise altered so as to accommodate the needs of either persons with or without disabilities, or to accommodate the needs of persons with different types or degrees of disability".

The differences between universal and adaptable design may be obscure at times. One could consider the installation of grab bars in a shower to be universal as anyone can use the bar for balance or safety. But the installation of the backing (structural support) for grab bars may be considered adaptable if the intent is to install the bars at a future time when needed to provide access to the use of the shower by a person with a disability. It is this obscurity that points to the fact that universal and adaptable design is not a matter of listing items as features; rather, it is a philosophy of design. The philosophy of universal design is summarized by the Principles of Universal Design developed by the Center for Universal Design (see Sidebar).

THE PRINCIPLES OF UNIVERSAL DESIGN

Copywrite 1997 NC State University, The Center for Universal Design

PRINCIPLE ONE: Equitable Use
The design is useful and marketable to people with diverse abilities.

PRINCIPLE TWO: Flexibility in Use
The design accommodates a wide range of individual preferences and abilities.

PRINCIPLE THREE: Simple and Intuitive Use
Use of the design is easy to understand, regardless of the user's experience, knowledge, language skills, or current concentration level.

PRINCIPLE FOUR: Perceptible Information
The design communicates necessary information effectively to the user, regardless of ambient conditions or the user's sensory abilities.

PRINCIPLE FIVE: Tolerance for Error
The design minimizes hazards and the adverse consequences of accidental or unintended actions.

PRINCIPLE SIX: Low Physical Effort
The design can be used efficiently and comfortably and with a minimum of fatigue.

PRINCIPLE SEVEN: Size and Space for Approach and Use
Appropriate size and space is provided for approach, reach, manipulation, and use regardless of user's body size, posture, or mobility.

"The Principles of Universal Design were conceived and developed by The Center for Universal Design at North Carolina State University. Use or application of the Principles in any form by an individual or organization is separate and distinct from the Principles and does not constitute or imply acceptance or endorsement by The Center for Universal Design of the use or application."

What are some applications of universal and adaptable design?

Universal design encompasses a wide scope of home design and modification extending from landscaping and low maintenance exterior and interior finishes to specific features that enhance the use and safety of bathrooms and kitchens. The use of energy efficient building materials and solar design, for example, may be considered universal design criteria because it benefits everyone who uses it.

Some of the major areas we look at, from the perspective of universal design, are entrances and pathways leading to entrances, overall interior accessible features, kitchens, bathrooms, and sleeping areas. Let's take each of these individually and look at ways that we can improve the usability of each.

Entrances and pathways

One of the first things to consider in universal design is how to eliminate barriers to access from a vehicle drop-off point to an accessible entrance. To make a pathway usable for a person using a wheelchair or other assistive device, we need to limit the slope of the walkway to a maximum change of 1 foot for every 20 feet up or down to the entry. We prefer to use earth berms, bridges or retaining walls instead of front ramps that may suggest a vulnerable resident. Anyone moving heavy furniture in or out of the home will love this feature!

The entry itself has many facets to look at in terms of accessibility. These items include providing weather shelter, a no-step entry with a threshold less than ½" high, maneuvering space on both sides of the door, sidelights or "peepholes" to view visitors, and adequate lighting to operate locks and provide security.

Overall features of the home

Here, we are going to explore some universal design features that aren't specific to any one room, but should be considered as general applications.

Whether the home is designed for aging-in-place or simply for visitability, we want to create easy access to the main living areas and facilities. This can be accomplished by providing a minimum clear opening of 32" on all doors to accessible areas and a 40" minimum clear circulation route through rooms and hallways. We also want to provide a minimum of 18" beside the door latch for easy operation for people using assistive devices. Lever handles allow use with an elbow, forearm or wrist for people who have difficulty gripping or twisting a doorknob.

Another consideration would be the placement of electrical outlets, switches and other operable controls. Raised outlets between 18" and 22" above the floor falls within the range of use for a person in a seated position and also aids people who have problems stooping over. Placing light switches and other controls a maximum of 48" above the floor allows their use from a seated position. Children also have an easier time using these switches.

Safety in the home is another big consideration addressed through universal design. Non-slip floor surfaces will help avoid falls and aid in the use of walkers and wheelchairs. Telephones installed in strategic locations, such as bedrooms and bathrooms, will help summon assistance if needed. Also, lowered window sill heights to a maximum of 36" high will enhance the use of windows for egress in case of fire or other emergency.

Kitchens

Kitchens are notorious in excluding their use for a variety of people and there are many universal design "standards" that apply to this area of the home. Even though the application of universal criteria to the kitchen is typically design specific, we will cover some of the more critical design choices.

We first want to be sure we have proper floor space that is suitable for all users, including people who use wheelchairs. Optimally, we would like to see a 5' clear turning radius in the kitchen, but, as a minimum, we want to provide a 30" x 48" approach in front of all appliances. We also want to provide knee space under the sink and cooktop, as well as a lowered counter (also with knee space) at a work area for a person in a seated position. Some adaptable criteria may come into play here with removable base cabinets or doors that swing out for roll-under access.

Continuous counters between work areas may be a universal design consideration. An example would be having a sink and cooktop on the same run of counter so that a heavy object could slide between the two without having to pick it up. Another idea might be to have a sprayer or faucet located to fill coffee makers or pots without lifting.

The selection and placement of appliances need to be considered for ease of use. Controls need to be placed within the range of reach for persons in a seated position. The maximum reach height of 48" for all kitchen controls apply here. Forward reach over obstructions should also be considered, but this is client specific and mathematical formulas are used to determine forward reach ranges. Front mounted controls are easy to use for everyone, but consideration needs to be taken in terms of access to small children. Side-by-side refrigerators are also accessible to everyone.

A raised dishwasher, as well as raised washer / dryer in the laundry room, improves its use for both people using wheelchairs and those having problems stooping over to load the machine. There is also a long list of cabinet features that improve access, such as pull-out shelves, lazy susans, and roll out waste containers. Adequate task lighting is also a major consideration in the kitchen.

Bathrooms

Safety is the number one priority in the bathroom as it is the room with the highest number of accidents in the home. Non-slip surfaces are essential both inside and outside the tub / shower area. As mentioned earlier, grab bars enhance the safety for everyone, but are especially important to people who have an increased risk of falling. They are also very important for people who use wheelchairs to enable transfer to shower seats and toilets. Pressure balanced / anti-scald valves are another safety feature that benefits everyone.

Access for people using assistive devices is critical in the bathroom. Curb-less showers allow people to roll-in or avoid tripping over a curb at the shower pan. (This feature has also spurred some very beautiful bathroom designs!) Dimensions around toilets are critical for access and 30" x 48" minimum approach area in front of all bathroom fixtures is needed. (These clearances can overlap.)

There are many accessories available for shower / tub modifications that improve safety and convenience. Recessed soap and shampoo ledges, various seats and benches, and adjustable height / hand-held shower with slide bars, just to name a few.

Bedrooms

One of the important features we want to look for in the bedroom is that there is adequate clearance for maneuvering around the bed and proper clearances for emergency egress, either at a door or a window with a lowered sill. Proper clearance should be considered for adaptable devices, such as a Med-Pole (a stainless steel assistive device) or Hoya lift. The doorways to accessible areas, like the bathroom and closet, need to be a minimum of 32" wide as mentioned earlier. Adjustable shelves and clothes rods in the closet are very helpful to accommodate a wide range of reach.

Summary

Aging-in-Place means maintaining independence and control of your life. Your environment plays a key role in achieving that goal and steps should be taken to improve the usability, safety and comfort of your home.

This begins with a comprehensive personal assessment and home audit for independence that may be performed by a medical professional or a trained aging-in-place specialist. With this information, solutions for home modification can be developed. Some of these modifications may be done yourself, such as using brighter lighting and slip-free mats. Other modifications will require a trained professional for widening doors and various remodel projects in bathrooms and kitchens.

Whether you are considering remodeling or designing a new home, look for professionals who have the experience to accurately assess your needs and find the solutions that will make your house a home for a lifetime. One resource for finding qualified professionals is the National Association of Home Builders (NAHB). They have created the Certified Aging-in-Place Specialist (CAPS) program to help you identify industry professionals with the skills and knowledge specific to home modifications for aging-in-place.

Learn How to Get Your Fair Share of Assisted Living Veterans Benefits

Many veterans or their surviving spouse don't know about or understand how to go about getting Assisted Living veterans benefits.

The simple truth is that most families think that they need to use a veteran's home or nursing home run by the VA for a place for their aging veteran' care. With this well-kept VA secret now finally beginning to get out among the general population it is important to know that every single Assisted Living facility is an option for your war-time veteran relative or friend.

This VA benefit often provides funds that help the veteran or their surviving spouse pay 50% up to even 100% of the Assisted Living facilities cost. Who knew that you could get paid a benefit from the VA to help you offset these expensive care costs.

For too long it was commonly thought that you needed to be wounded or have an immediate disability incurred during the veteran's active duty.

It was too often understood or assumed that a veteran did not qualify for any VA benefits if their disabilities they face as they grow older did not have it's origin from a documented active duty injury or wound.

This myth has been soundly busted.

WWII, Korean and Vietnam veterans are now beginning to experience normal disabilities due to the natural aging process. Some of these difficulties are due to their active duty but many are not.

The non-service connected disability pension benefit from the VA does not require that the difficulties or disability that you are now experiencing be related to your active duty. Again, to be clear...it does not have to be service related.

What is this little-known VA benefit? It is officially called the "Improved Disability Pension Benefit". Their are three monthly payment thresholds that are defined by:

1. Income and Assets


2. Housebound Status


3. Need for assistance with activities of daily living

The third threshold entitles the recipient to an entitlement commonly called "Aid and Attendance".

A widowed surviving spouse of a qualified veteran (just 90 days of active duty with 1 day during an official stated period of war) is also eligible for this pension benefit.

For widowed surviving spouses it is officially called the "Improved Death Pension Benefit with Aid and Attendance Entitlement".

So, this "new" benefit you may be hearing about called the "Aid and Attendance Benefit" is really either the long-standing VA benefit no one every heard about called either the:

• Non-Service Connected Disability Pension Benefit with Aid and Attendance Entitlement (for veterans)

or the

• Non-Service Connected Improved Death Pension Benefit with Aid and Attendance Entitlement (for un-remarried widowed surviving spouse of an qualified veteran)

Now, here is the best part.

The award amount of this VA non-service connected benefit:

1. A Veteran with a dependent (typically spouse) can get up to $23,388 per year, paid monthly at $1,949


2. A Veteran with no dependents can receive up to $17,728 per year, paid monthly at $1,644


3. An un-remarried widow surviving spouse can receive up to $12,684 per year, paid monthly at $1,057

Assisted Living Veterans Benefits Qualifications

There are five qualification criteria:

1. When the veteran served with at least 90 days of active duty with a least 1 day during a stated time of war. (The veteran does not have to have seen action, serve overseas or be in a combat area to qualify)


2. Must no longer be able to safely drive


3. Must need assistance with activities of daily living


4. Must have liquid assets less than $80 thousand. But, there is no look back if you need to do move assets out of the applicants name to meet this requirement. If you transfer excess assets today you are eligible tomorrow.


5. The actual amount of the veterans benefit you can receive is based on a simple formula.

This last qualification criteria often confuses families looking to get the Veterans Benefits for Assisted Living.

The Truth Behind Aircraft Accidents: Claims and Compensation

Plane accidents do not necessarily equate to those catastrophic scenarios you see on television shows and movies. There are a lot of possible injuries in flight that could affect you and your health and life, temporarily or permanently. You could fall over, hit your head, cut yourself or get food poisoning from what they serve. Or you could get involved in a violent altercation after the airline unwittingly changed your booking or seating without giving you an option or a warning. Sure, you could pass these over as a simple mistake or misunderstanding, but there are grievances that can threaten your life. Small problems, like bumping your head, can become serious issues once they are checked by a physician. Therefore, it may not be wise for you to allow things to slide by. Operators should take responsibility for their faulty procedures, if that is the case, and you may be entitled to receive the aeroplane's accident compensation.

There are several laws governing aircraft accident compensation claims that you can rely on. There is the Montreal Convention which raises negligence during air travel as one of the main types of claims you can pursue. And it offers two vital benefits to those seeking to be compensated subsequent to contracting an illness or injury as a result of or during a flight.

First of all, the air carrier is responsible for any injury caused to a passenger regardless of whether the airline itself caused the injury or was responsible for the passenger's accident. This is an advantage that is solely realized in an aircraft accident claim.

For the most part, finding reasons to compensate for an accident claim is easy. But all the legalities that go along with it may become too overwhelming for the inexperienced. The law is complex. And in such cases, the help of specialized solicitor may be required. You want to find someone who is experienced in the field of holiday accident law to represent you and see to it that he or she is from a credible and decorated firm.

Remember, aircraft accident claims are created to favor the complainants and this makes them the first target of contention. If you want your compensation to push through, you will need the skills of a highly experienced solicitor, specializing in aircraft accident claims, to recover the maximum compensation possible for the damages incurred. There are a number of firms online you could contact for such professionals or, at least, ask advice on related matters.

Common Tricks Insurance Companies Play Claiming Pre-Existing Injuries

One common trick played by insurance companies is to claim that a personal injury victim's injuries were "pre-existing" and therefore, their insured is not responsible for any damages. In truth, there are seldom any true cases involving "pre-existing injuries" when that term is given its plain and ordinary meaning.

A true "pre-existing injury" is one that already exists and was not affected by a new occurrence. Thus, if I already had a fractured leg and was involved in a serious car accident, my lawyer could not claim the fractured leg was caused in the car accident. This is so obvious that it almost never occurs.

Rather, consumers need to understand that simply because they have a past injury it does NOT prevent them from retaining a personal injury lawyer and filing a claim for a personal injury. In fact, it is their right to do so.

Every first year law student learns about the "eggshell plaintiff doctrine" in his or her Torts class. The law recognizes that a pre-existing injury could make you more likely to suffer from an additional injury, even from a relatively mild collision. By law, the victim of an automobile collision must be accepted in the condition they were at the time of the collision. This means the person or people responsible for an automobile collision are fully liable for all injuries sustained by the victim, no matter how unforeseeable such injuries might be. Car accident attorneys refer to this as the "Eggshell Plaintiff" or "Eggshell Skull" principle, based on the idea that a theoretical victim's condition may be so fragile that the slightest contact caused substantial injury to the victim. This concept applies to mental as well as physical injuries such as considering impact of an assault on Vietnam veteran's post-traumatic stress syndrome.

Thus, consumers should know that insurance companies are fully liable for their insured's negligence that causes an aggravation or exacerbation of a pre-existing injury.

Also, the Eggshell Plaintiff principle only pertains to the damages a personal injury victim may recover. The Eggshell Plaintiff principle does not affect the standards for liability when determining fault for the automobile accident.

It is important for your injury attorney to understand your complete medical history to overcome these tricks played by the insurance companies and accurately present your case. Otherwise, insurance company defense lawyers will attempt to distort the record, distort the truth, and avoid taking responsibility for the injuries caused by their clients.

Caring for Seniors Does Not Mean Nursing Homes

As our parents grow older, our relationship with them changes. A role reversal takes place and suddenly adult children become caregivers. This can create stress among both parties. For aging parents, they find themselves losing self-sufficiency and independents. Adult children now have the burden of caring for aging parents.

Whether it is providing transportation to the market, doctors' visits and the pharmacy, cooking meals, managing financial matters or cleaning, the relationship between each party changes fundamentally. In the past, these changes often resulted in the parent moving into a long term nursing home. Today there are many more, and oftentimes better, options available. This essay will look at the two best options.

In Home Care

In home care is growing option. Here, seniors do not need to even leave their own care. Here, caregivers stop by for a few ours or move in to provide care. They are available to drive seniors around to appointments or to the market. They can help cook meals help out around the house. For a senior who is not ready to leave home. This is ideal. By bringing in a part or full time caregiver, adult children are able to help take care of their parent's life without disrupting their own. There is a particularly good option if adult children have moved far away from home. If you are living on the other side of the country, having a set of eyes, ears, and hand you can trust can make all the difference.

Supportive/Assisted Living

Supportive or assisted living is the modern version of the nursing home. However, they do away with the hospital-style wards. Instead, seniors are able to live in their own apartments with a kitchen and their own furniture. Living spaces are designed with limited mobility and medical needs in mind. There is 24 hour staff on hand in case of emergency, daily activities, group dinners, and outing; all of the things that seniors need to thrive. If they want to stay at home and read or play bridge, either option is available. In many cases, if a senior can still drive, they can go out and about to see friends and family. Assisted and supportive living provides seniors with a safety net that their adult children cannot provide. An additional advantage supportive living has, is that they are often times connected to a traditional long term care nursing home. If something does happen, there is a medical team on hand. They are never too far away from their support system.

Why Hospitals and Nursing Homes May Not Mix

You may have heard about some surgical procedures that are considered risky, but did you know that a number of surgical procedures are even riskier for nursing home residents than they are for non-institutionalized older adults? Research reported by Dr. Emily Finlayson, a surgeon at the University of California, San Francisco, and her colleagues in The Annals of Surgery says exactly that. If you are a caregiver to an older adult, particularly one who may now live in a nursing home, you need to be an informed advocate on behalf of that person.

Dr. Finlayson and her colleagues used data reported by Medicare on patients 65 and older to compare surgical patients who lived in institutional settings and those who did not. The samples for each group were impressively large - nearly 71,000 nursing home residents and over a million 65+ year olds who did not live in a facility. The doctor matched both samples on their actual ages and the numbers of other chronic medical conditions they had prior to their surgeries.

Across all surgical categories the mortality of the institutional patients was higher than for their counterparts. For instance, surgery to repair a bleeding duodenal ulcer showed 42% of nursing home older patients dying versus only 26% of their age peers who did not live in nursing homes. For an appendectomy the difference was 12% mortality for nursing home patients against only 2% for the population of older adults at large. Gall bladder surgery was similar with 11 percent of nursing home residents dying compared with 3% of the other population.

And surgery is not the entire story. For institutionalized patients there were proportionately more subsequent interventions than there were for their counterparts. These residents were more likely to need mechanical ventilation to help them breathe, feeding tubes in their abdomens or even venous catheterization to monitor their hearts. Each follow-on procedure introduced more risk on top of what the surgical procedure itself represented.

And as if the story could not get worse, you have to remember that hospitalizations, especially those for surgery, involve a lot of down time. Patients who spend more time in a hospital bed also are likely to be exposed to infections, some of which can lead to pneumonia. For those who dodge that bullet, they will still have their performance status diminished by that time on their backs. The rule of thumb is that for every day in a hospital bed, an older patient will need two days to recover their stamina.

So, the lesson for caregivers is fairly clear based on concrete data: When a provider recommends surgery for the elder in your charge, always ask about non-surgical options. And check out the article in The Annals of Surgery.