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Tag Archive for: Senior Safety

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Pedestrian Safety for Older Adults

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

The other day I was driving through a busy parking lot.  I noticed an elderly man who parked his car, got out, and proceeded to walk through the parking lot without ever surveying his surroundings.  He did not see my vehicle approaching him, and did not appear to notice the other cars that had to stop to let him pass.  The other drivers looked both annoyed and perplexed that he could be so clueless.

According to the CDC Increasing frailty may leave the elderly more vulnerable to being hit by traffic. Age-linked declines in mental function, vision and physical disabilities might place older adult pedestrians at greater risk for being struck by a vehicle.

With this man, what I noticed was quite telling.  He was looking at his feet.  Many seniors do this when walking.  Why?  Because they are afraid to fall.  With a decline in physical ability comes problems negotiating uneven terrain.  Parking lots and sidewalks are full of holes, stones, and cracks that could be problematic for someone with declining mobility.  So, they stare at the ground to avoid falling, the entire time being unable to also look around at other risks in the environment.  And when you combine this with reduced peripheral vision, they may not notice vehicles approaching. 

Society expects seniors to “know better” in that they have been trained, over a lifetime, about the perils of traffic.  With children, we don’t expect them to know better because they are carefree and often move before thinking.  As driver’s, we watch for children and take extra care when we see them around roads or in parking lots.  We also tend to take the same precautions when we notice someone who is more visibly disabled using a wheelchair, or white cane.  But disabilities are not always visible and we have to be careful to not make assumptions – especially with seniors who may have an unnoticeable visual, cognitive, physical or auditory problem.  

My message here is that drivers should be cautious with all pedestrians, but need to be especially mindful of seniors – much like they are with children or other people with visible disabilities.  Seniors deserve our patience and the extra time it might take to help them safely go about their day and negotiate the sometimes challenging outdoor environment.

Previously posted July 2013

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Community Safety for Alzheimer’s Disease and Cognitive Impairment

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

In recognition of Alzheimer’s Awareness Month, I wanted to touch on the important topic of helping people with Alzheimer’s disease (or cognitive impairment) to be safe in the community.

A few months back I received an email from a friend. She wanted to “pick my brain” about a problem they were encountering with her father who has Alzheimer’s disease. She mentioned that he enjoys spending time in the community on his own, but the family was growing increasingly concerned about his safety. She was wondering if I had any suggestions on how they could monitor his community activities, and be able to locate him should he not return home when expected.

My experience working in brain injury has had me looking for such solutions in the past. Some people, with behavioral or cognitive impairment, are at risk in the community because they become disoriented, confused, lose track of time, or are not attentive to traffic. There is such a loss of independence for people to be told they cannot leave the home alone, and some become agitated or angry when people try to supervise their activities. Yet, even a familiar route can become a problem for people if their cognitive status changes or deteriorates, and what is manageable one day may become problematic the next. Part of my role as an occupational therapist when dealing with cognitive impairment is to problem solve with the client and family the ways we can help them to pursue their goal of independence outside the home, while also ensuring their safety and easing the mind of the care provider. There are several ways to do this, and the list below is not exhaustive by any means.

  1. Consider the local Police Departments. These often have programs and ways to track people at risk of wandering. It is also helpful to notify the police about a potential wanderer so this is in their records should their help be needed.
  2. The S-911 bracelet has multiple features that allows health care workers and families to GPS locate anyone that may have wandered off, or who is in the community unsupervised. There is a monthly and yearly fee for this device.
  3. The Loc8tor is another option and notifies a care giver (or parent of a child for that matter) if the person wearing the device has wandered up to a certain distance away. The Loc8tor is also useful for helping people to find those items that tend to get misplaced – such as keys, wallets and cell phones.
  4. Smartphones have GPS detection capabilities such as the “Find my Friends” application for the iPhone. With this, both users can locate the other person, but it does require the person to be carrying the phone, and the phone to be charged and on. This can be a problem for people with cognitive impairment as they may not always remember to take the phone with them when out, may not understand how to turn this on and / or to check and see if it is charged.
  5. There are home monitoring systems that can notify family when people are coming or going, or even bed alarms if people leave the bed at night. Motion sensors in the home can also help to notify family if someone is wandering or moving between locations indoors. While these don’t work to locate or ensure someone’s safety outside the home, they are a way to give family members piece of mind to go about business inside the home without always needing to provide the person with cognitive impairment constant supervision.

Remember that Occupational Therapy is about helping people to solve the problems that arise when physical, emotional or cognitive abilities change rendering daily activities to become a struggle. In all cases, because disability is experienced differently by everyone, the solution for one person may not be the solution for another – even when dealing with the same diagnosis. So, consult an OT if you have a functional problem to solve!

Previously Posted September 2014

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O-Tip of the Week: Safer Transitions

Our O-Tip of the week series we will be providing valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living. 

For the month of November, Fall Prevention Month, our O-Tip series will concentrate on preventing falls at home and in the community.

Falls are the leading cause of injury among older Canadians with 20-30% of seniors experiencing one or more falls each year (Statistics Canada).  With seniors most falls often happen when someone is just trying to go about their day by having a shower, coming down the stairs, or taking a leisurely walk.

This week’s O-Tip of the Week returns to the bathroom, which can be the most dangerous room in the home, especially for seniors.  Transitions into and out of the tub or shower are often the cause of falls in the bathroom.  The installation of grab bars in the tub or shower can greatly reduce this risk.  An Occupational Therapist can help by assessing the older adult’s functional status and reviewing the hazards in their environment that may put them at risk for falling.

Learn more helpful fall prevention tips for older adults from our infographic:  An OT Knows How to Help Seniors Age in Place.

 

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Falls Are a Leading Cause of Injury- Let’s Talk Prevention

Did you know that in Canada falls are the leading cause of injury amoung older Canadians?  And that 20-30% of seniors experience one or more falls each year? Falls are also the number one cause of both brain and spinal cord injury in seniors.

November is Fall Prevention Month and we want to share with you some of the ways an Occupational Therapist can work with seniors to help prevent this danger.

In the following episode of our OT-V video series we discuss some ways to reduce the risk of falls and help keep you and your loved ones safe.

Learn more about safety for seniors on our Healthy Seniors page.

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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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Tough Conversations

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

My grandmother always used to say “once an adult, twice a child”.  She was referring to the fact that we start life dependent, and through the aging process, tend to end our life that way as well.  So, what happens when the grown-up “child” needs to become the caregiving adult in a relationship with an aging parent?  It leads to many tough conversations about some pretty big topics.  Recognizing that some conversations are not only difficult, but could cause relationship-changing outcomes, I wanted to give you some pointers for handling the big ticket items adult children might encounter with their aging parents:

Driving

We all have a societal obligation to ensure that the roads are safe.  Just like a parent not giving the keys to a teen that has not demonstrated adequate driving skills, adults need to look for this in their older parents too.  While some seniors self-retire their license when they feel they are unsafe, some are not as willing, or able, to make this decision.  I remember my grandmother stopped driving when one day behind the wheel she “woke up and the light was green”.  While we joked about this as a family, we applauded her for making a responsible decision.

Making sure your parents are able to drive safely is important for them, and the general public.  So how do you manage this?  Next time you are out with your parent drive separately and follow them, or get them to drive with you in the car.  Watch for the following:

  • Are they driving to slow or too fast?  Note that driving too slow can be just as dangerous as driving too fast.
  • Are they obeying the traffic signs?
  • Do they have the range of motion to look both ways and check blind spots?  Are they looking around at stop signs, when merging lanes?
  • How are they negotiating directions, are they getting lost frequently?
  • Do they seem to be driving aggressively, or do they seem oblivious to other drivers, cyclists or pedestrians?
  • Do they obey right of ways, manage one-way streets, can they park the car safely and easily in a lot or on a side-street?

If you have concerns about any of the above, you have a moral obligation to bring your concerns to their attention, or to the attention of their treating physician.  If you choose to have this discussion with them directly, be caring and compassionate, but direct.  Tell them about your concerns but instead of just telling them they shouldn’t drive, suggest the involvement of a professional like their doctor, an occupational therapist, or driving assessment.  If you are not comfortable having this conversation with them, bring your concerns to the attention of their treating physician so they can do their own assessment.

Home Modifications

Most seniors want to remain in their own home as long as possible.  Many recognize that some small changes to the home could have a big impact on their safety and function, and some are very hesitant to consider modifications.  I remember I once had a call from a physician who was calling about his own parents, expressing concerns about his mother and how she was managing at home.  We talked about the value of OT and he agreed that a home assessment would help her.  He then asked “so, what should I say to her to get her to agree to this”?  I found that surprising as even as a physician who is required to have difficult conversations with people all the time, he struggled to know how to approach his mom.  I suggested he tell her that he recognizes it was very important to her to stay at home as long as possible, and that he is concerned that if she falls, staying home might not be an option.  I told him to tell her that he wants to have an occupational therapist come and talk to her about her safety to make sure they are doing everything possible to keep her living at home for as long as she can.  He called his mom, and like a kid planning a sleepover, called back and said “it worked, she said yes”!

I think it is important for adults of aging parents to demystify the home modification process and stress to their parents that most changes are minor, removable, or will actually increase the value of their home, while keeping them there for as long as possible.

But honestly, the best approach is usually letting a professional explain to the aging parent what can be done, and what they should consider either now, or in the future, to ensure their home continues to work for them.  In that case, the difficult conversation is more getting the professional in the door, instead of trying to convince the parent of the changes that you feel (without full knowledge of the options) might be needed.  Occupational therapists are great at getting a sense of what people need, explaining the options, and coming up with a plan.  I always chuckle when I meet with seniors and the first thing they say is “I know my son says we need X, Y and Z, but just so you know we are not doing that”.

Relocation

There may come a time when being the primary caregiver of an aging parent who is trying to live at home, may become too much. Caregiving is a difficult task that often requires time, knowledge or a level of commitment that a working adult-child who might have children of their own, just does not have. Having a discussion with your parent about the need to relocate to get access to skilled or more available care, is difficult.  Like the other conversations, tell your parent that their safety is your primary concern and that you are willing to do all you can to help them get the care they need.  Remind them of your own capabilities and the other responsibilities that you are also trying to balance.  Framing your conversation this way will go a long way to show them you are being supportive, and not just trying to tell them what to do or how to do it.

In the end, yes these conversations will be difficult, but your parents need your love, support and guidance as they navigate the aging process.  I remember having a difficult conversation with my grandmother about her decision to use a walker instead of her wheelchair, when the wheelchair was much safer for her.  She was giving me a hard time and I reminded her that she taught us to care about each other so the fact that I care about her safety was actually her own fault.  She laughed and we had a great conversation about her fears about declining mobility and reducing independence.

I wish you the best as you navigate these difficult conversations with your parents.  But remember, sometimes involving a professional (like an OT) who can assess the situation, come up with solutions, and develop a plan may go a long way to maintaining the parent / adult-child relationship, while keeping the parent safe at the same time.

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Fall Prevention For Seniors

Did you know that in Canada falls are the leading cause of injury amoung older Canadians?  And that 20-30% of seniors experience one or more falls each year?  Falls are also the number one cause of both brain and spinal cord injury in seniors.

November is Fall Prevention Month and we want to share with you some of the ways an Occupational Therapist can work with seniors to help prevent this danger.

In the following episode of our OT-V video series we discuss some ways to reduce the risk of falls and help keep you and your loved ones safe.