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Tag Archive for: Aging In Place

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Aging in Place: Making the “Stay or Go” Decision

This great resource provides some helpful advice to seniors that face the difficult decision to “stay or go” when it comes to housing as they age:

McMaster Optimal Aging Portal: Should I stay or should I go? Factors influencing older adults’ decisions about housing

The “Bottom Line” as outlined in this link is helpful, but I have added some other thoughts relating to the important “stay or go” decision:

The Bottom Line

Older adults’ loss of independence and declining capacity often lead to a decision to move to safer housing where care will be provided.

It is true that one of the most important factors in staying or going from the home includes the ability to get care.  Homecare from the public sector is not usually sufficient and private care is costly.  Friends, family and neighbors can only do so much.  But what if there was a way to delay the need for care by being proactive and addressing declining health actively by making changes to promote safety and independence BEFORE care needs become significant?  Occupational therapy can help people to be safer and more independent at home, and should be one of the first people you consult with if you are facing declining function.

The most important factors when making this decision are usually social and psychological considerations, not merely practical or economic considerations.

This is also true.  Isolation and reduced ability to self-motivate, engage and activate important self-care and home tasks greatly impact if someone can manage with or without supports.  Often the loss of a spouse or partner creates isolation and quickly forces people to have to adapt to a new way of living and managing alone.  This can often be the catalyst that determines if a home is too much to manage, or if a person can remain where they are.  Many seniors have the economic resources and family support to make changes to their home or living situation, but often they resist using these resources to manage their own needs.

Having a better understanding of the range of factors influencing older adults will help family members and professionals better support them in the decision-making process.

Also a great point.  However, I would argue that solving issues related to senior housing and living needs to be a customized approach.  “Understanding seniors” does not create a roadmap of how to help people through their unique challenges.  There is no cookie cutter solution and getting input and help at the actual home (i.e. not in an office or clinic) is the ideal approach to develop the most appropriate solutions.

Consider occupational therapy if this can help you or a loved one to stay home safely, independently and for as long as possible.

Learn more about factors to consider when looking to Age in Place in our post, Occupational Therapy and Aging in Place.

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The A to Z of OT: A is For… Aging in Place

Occupational therapists are trained to assess the person, their environment and the tasks they need to complete in the places they live and work.  Therefore, when it comes to helping older adults make the decision to age in place or move, Occupational Therapists are the experts. 

Learn some of the ways occupational therapy can be involved in the aging well and aging in place process in our post, Occupational Therapy and Aging in Place.

 

October is Occupational Therapy Month and to celebrate we will be sharing a new series called the A to Z of OT.  In our attempts to further educate the public about what Occupational Therapists do we will be highlighting twenty-six of the awesome ways OTs provide Solutions for Living.  

We encourage you to follow along with The A to Z of OT and to add to the discussion by highlighting other awesome things OTs help with for each corresponding letter!

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Senior Safety – Occupational Therapy Can Help!

Canada’s population is aging. In 2015, there were almost 6 million seniors over the age of 65 – that is nearly 1 in 6 Canadians. As we grow older, we face increasing risk of falls, accidents, disabilities, and illnesses.  As a senior how can you stay safe and healthy?

Why is Older Adult Safety Important?

Older adult health and safety is important for maintaining our ability to age in place of choice.  Statistics Canada has highlighted the following safety risks for older Canadians:

·        89% of Canadian seniors had at least one chronic health condition. Arthritis and rheumatism were the most common.

·        25% of Canadian seniors reported having 2 or more list of chronic conditions such as high blood pressure, arthritis, back problems and diabetes.

·        63.7% of Canadians reported to be injured in a fall

·        There are 3.25 million people aged 65 and over in Canada who have a driver’s licence.

·        92.1% of seniors live in private households

These statistics demonstrate the increased risk to seniors for health and other safety concerns.

Occupational therapists can help!

Occupational Therapists (OT) are trained professionals who address aspects of getting people back to doing things they want to do, need to do, or have to do, but may be experiencing challenges when doing so.  Occupational Therapists can support older adult’s health and well being through providing supports for seniors to maintain active social connects, manage changes in health conditions, and to continue engaging in activities that provide them with meaning and joy.

These are the following areas that an OT can help keep seniors safe and healthy!

Fall Prevention 

Falls are the leading cause of injury among older Canadians with 20-30% of seniors experiencing one or more falls each year (Statistics Canada).

Occupational Therapy can help seniors prevent falls by assessing their functional status and reviewing the hazards in their environment that may put them at risk for falling. Strategies to prevent falls can be discussed, such as:

·          General Education on how to do activities differently to stay safe

·          Equipment and devices to assist

·          Home modifications such as lighting, flooring, organization and layout

Aging in Place

Canada’s Population Is Aging!  In 2011, 92 % of all seniors ages 65 + lived in private homes, and over 10 million seniors are living with a chronic condition (Statistics Canada). Older adults also have disproportionally higher rates of unmet care at home (Turcotte, 2014). Thus, ensuring these individuals function safety and independently at home is a high priority!

Occupational Therapy can help by assessing the home and the homeowner to ensure a proper fit between the person and environment to promote overall health and safety.

An OT can prescribe the proper assistive devices, education and help people plan ahead so they can “ age in place” without being at risk.

Keeping Senior’s Active

Remaining physically active as you age can help reduce, prevent or delay diseases and can help to manage stress, improve mood and boost cognition! 57% of Canadian seniors consider themselves physically inactive (Statistics Canada).

Occupational Therapy can help seniors remain physically active by:

·          Creating Custom Activity Plans based on health and abilities

·          Helping seniors create a daily schedule that includes physical activation

·          Helping seniors to find appropriate facilities and groups to join or other productive and meaningful activities.

Sleep

Sleep is important for recovering from illness and injury, staying healthy, and ensuring people have sufficient energy during the day to accomplish life roles. Difficulty sleeping is a common and detrimental issue for people in various life stages.

Occupational Therapy can help seniors reduce sleep problems by:

·          Reviewing sleeping positions and patterns to suggest improvements for both comfort and quality of sleep

·          Assessing the bed, mattress and pillows to ensure the body is sleeping in the optimal position for comfort

·          Prescribing assistive devices to improve sleep positioning, bed transfers and bed mobility

·          Helping people to implement a new sleep routine that will improve your sleep quality and duration!

Cognitive Impairments

According to the Alzheimer’s Society of Canada as of 2016, there are an estimated 564,000 Canadians living with dementia – plus about 25,000 new cases diagnosed every year.

Occupational Therapy can help people with dementia or who have altered/declining cognition by:

·          Educating people and loved ones on how to maximize function while still promoting independence and safety in the completion of activities of daily living.

·          Assessing cognition, abilities and environment to make suggestions on ways to compensate for declining cognitive skills through direct therapy or environmental modification

·          Developing routines and schedules that promote independence and eases the role and need for a care giver

·          Prescribing safety equipment and devices to optimize function

Transition Stages

Occupational Therapy can play a crucial role in helping seniors through live transitions this by:

·         Identifying, planning and helping people engage in finding new meaningful occupations outside of work

·         Providing education on role changes, spending time with family and friends, healthy lifestyles and choices

·         Helping discover new ways to occupy their time, participate in leisure activities and find new interests

·         Improving quality of life through promotion of independence and pain management strategies

 

Check out our infographic on how OT works for seniors and stay tuned to our blog next week for our post on how OT’s can help older adults be safer on the road.

 

Resources

http://www.statcan.gc.ca/pub/11-402-x/2012000/chap/pop/pop-eng.htm?fpv=3867

https://www.tc.gc.ca/media/documents/roadsafety/cmvtcs2013_eng.pdf

Turcotte, M (2014). Canadians with unmet homecare needs. Statistics Canada report. http://www.statcan.gc.ca/pub/75-006-x/2014001/article/14042-eng.pdf

http://www.caot.ca/default.asp?pageid=1454

http://www.caot.ca/default.asp?ChangeID=1&pageID=621

http://www.caot.ca/default.asp?pageid=1501

 

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Aging in Place

Co-written with Claire Hurd

If you are an “empty nester” you may start to think how this phase in your life relates to your home and ongoing need for a larger space that previously accommodated a growing family.  Or, for some with kids out of the house, married and with their own families, they want to start spending time in a warmer climate, or want to move closer to their grandchildren.  Some will even consider moving in with their children to help raise the next generation, or because financially this is the most suitable option.  Whatever the reason, housing can be a massive contributor to function as we age, and there are several things to consider.

Universal design:
Universal design, or inclusive design, has the goal of maximizing usability for all, without sacrificing aesthetics when possible. You have probably seen universal design in many public spaces, but it can be incorporated into homes as well.  Examples of this may include lever door handles rather than knobs, raised outlets and lowered light switches, and large flat panel switches rather than small toggle versions. Many new homes are being designed to be “visitable,” with a basic level of universal design, including a smooth, ground level entrances without stairs, a wheelchair accessible main floor bathroom, wide doors, and wide hallways with room to maneuver a mobility device. When touring a potential new home, see if principles of universal design have been included. If you are renovating, consider including universal design elements in layout and fixtures.

Layout:
Bungalows and condos are usually the most accessible options. Stair lifts are expensive, and the more landings or turns there are, the more they cost. It is also difficult to install them on curved staircases. Some side split designs may be conducive to elevator installation, but side or split-level homes are more difficult to accommodate in the event of mobility decline.

Bathrooms:
Bathrooms should have room to maneuver a mobility device. “Comfort height” toilets are a few centimetres taller than standard toilets, more like a standard chair, and make sitting down and standing up easier. A walk-in shower, or, better yet, a roll-in shower with no ledge to step over, will be accessible by family members and guests who may have temporary or more permanent mobility challenges.

Kitchens:
If possible, have variable counter heights in the kitchen, to make food preparation easier for taller adults, shorter children, and individuals who need to sit. Recessed areas underneath countertops and appliances can accommodate mobility devices or chairs. Ensure that lighting is good in all task areas. Rounded corners prevent injuries. Casement windows are more readily opened than the traditional double-hung styles.

Outdoors:
Gardening is a great activity for mind, body, and soul, but bending and kneeling on the ground can be difficult for many people. Raised flower beds and container gardens are a great solution.

Location, location, location:
Even if a house or apartment is otherwise perfect and accessible, if it’s in the middle of nowhere or in a neighbourhood that feels unsafe, it may not promote its occupants’ wellbeing. Proximity to services, such as grocery stores and public transportation, not only prevents social isolation, but may decrease potentially unwanted dependence on others.

Accessibility can benefit health, wellbeing and safety for anyone – regardless of physical or cognitive limitation. If you have more specific questions about how you can help yourself or others age comfortably in place, consider consulting with an occupational therapist.  Occupational therapists are trained to assess the person, their environment and the tasks they need to complete in the places they live and work.  So, before you make potentially costly mistakes in planning how you can better manage the “job of living”, give an OT a call.

 

For more information on Aging in Place and other helpful topics for Senior’s please visit our Senior’s Health page.

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Occupational Therapy and Aging in Place

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

Being proactive with your health is one of the best strategies for preventing future problems.  This is in contrast to being reactive which would involve trying to address a problem AFTER it has happened.  Much like putting a grab bar in the bathroom AFTER a fall caused hip fracture, the better strategy would have been putting in the bar BEFORE, while you are well, to prevent the fracture in the first place. This is what “aging in place” is all about.

As the population continues to age, more and more people are opting to stay in their homes.  In fact, in Ontario, 60% of people over 75 still own a home.

Harvard Health Publications compiled a list of “6 Ways You Can Prepare to Age Well” and in reading this we identified that 5 of the 6 strategies related to occupational therapy!  So, we have adapted this to show the top 5 ways occupational therapy can be involved in the aging well and aging in place process:

1.       Space Modification:  An occupational therapist is trained to provide solutions for the “occupations” of daily living.  The home you occupy may need to be slightly adapted, or more extensively modified, in order to ensure it will meet your needs as your physical abilities change.  An occupational therapist can help by assessing your current space, your physical concerns, and will develop a plan for any current or future adaptations you may require.  Common areas OT’s consider in the home include the bathroom, kitchen, flooring, entry ways and stairs.

2.       Fall Prevention:  As people age, the dangers of falling become heightened.  An occupational therapist can help by assessing your home to look for any existing dangers that may lead to falls.  Common areas considered include flooring, transitions, layout and home organization.  Check out our video on “fall prevention” to learn more about how OT can help to reduce your risk.

3.       Is a Move Necessary:  Although many are hoping to live in their current home as long as possible, at some point people often have to make the difficult decision to relocate.  If the layout of your home is not suitable for your aging in place plan, it may be necessary to look to move to a more suitable home, such as something that is one level or has less maintenance.  Alternatively, many seniors look to downsize into senior friendly neighbourhoods or villages where care might be onsite if needed.

4.       Plan Ahead for Assistance:  Do you have someone reliable who is willing to assist and care for you in your later years?  An occupational therapist can help you to plan for the assistance you may need – such as help with activities of daily living, finances, meal preparation, transportation and home maintenance.  It’s best to discuss with loved ones early on if they are able to help with any of these tasks, and if not, an OT can help you to find this assistance in the community.

5.       Emergency Preparation:  As you age, the likelihood of an emergency is heightened.  Emergencies could include a fall, health crisis, problem with your home, or medical condition that worsens overtime causing you to need 24 hour care.  An occupational therapist can help you to develop an emergency plan, or to have the supports in place so you can get support when it is needed.

It is important to remember that people will age differently, and no two people will have the same experience with the changes that occur as we all get older.  I know a lady at my gym who is 75 and can run circles around most 30 year olds.  A unique and custom approach is the best strategy for ensuring that you get the help you need, based on your own abilities and the environment in which you live.   It is just important to develop your plans early and proactively, instead of reactively trying to develop solutions after something has happened.  Seek the services of an occupational therapist for input on how to “age well” and “age in place”.