A recent study by the Journal of the American Medical Association reported that upwards of 40 percent of colonoscopies performed on seniors between 76 and 85 years of age may be inappropriate under current guidelines. Even though a colonoscopy is a routine procedure every five to 10 years for many adults over 50, another study by the Annals of Internal Medicine found that those over 80 were at 50 percent greater risk for developing colon-related complications than those aged 60 to 69, as reported by the AARP.

But the question on the minds of many here is whether the uncomfortable procedure is worth it for those over 75. One example would be if colon cancer is detected, the surgery to treat it is painful and could lead to other complications, especially if an elderly person already suffers from other terminal conditions. When someone is nearing the end of their life, it’s important to remember it’s OK to say no to certain treatments. Of course, have thorough conversations about the subject with physicians and family before making any rash decisions.

Colorectal cancer stats (via the CDC)

• • Colorectal cancer is the second leading caner-related cause of death among men and women in the United States and the third most common cancer among men and women in the U.S.

2009 numbers (most recent that are available):

• • 136,717 people were diagnosed with colorectal cancer in the U.S. (70,223 were men and 66,494 were women).

• • 51,848 people died from colorectal cancer in the U.S. (26,806 were men and 25,042 were women).

On the encouraging side of things the death rate from colorectal cancer has been dropping for more than 20 years, according to Cancer.org, and there are currently more than 1 million survivors of colorectal cancer living in the U.S. today. This is likely due to factors such as screenings that allow more cancers to be found earlier (when it’s easy to cure) and recent advancements in treatment.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system. All Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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“Physicians Choice Private Duty solves the problems families face in finding home health care providers they can trust. Providers who will focus on strategies that keep parents in their homes. To learn more about our health care services, visit http://www.encompass-home-health-care.com.”

Caregiving responsibilities are often blurred in blended families. For example, the husband of an aging couple is diagnosed with Alzheimer’s. The wife needs help with her husband’s care but when she reaches out to her now grown children from a previous marriage, they are reluctant in offering much help in overseeing the care of their stepfather. Likewise, the husband’s children are hesitant to offer help as well, as they assume their father’s new wife will take on most if not all caregiving responsibilities.

This topic was the focus of a recent article on The New York Time’s New Old Age blog, which revealed that the boomer generation — the generation most likely to have step children — will likely find themselves in scenarios very similar to the example above. Pew research backs this up. A study found that 42 percent of the 2,700 people surveyed had at least one step-relative.

Atlanta-based clinical social worker Moira Keller told the Times that the lines are blurry who’s going to do what. For one, most grown children don’t have much history with their parent’s new spouse and thus don’t feel obligated to intervene or help out when a step parent becomes ill. Another possibility is that it’s often unclear who even has decision making authority — children or the new spouse.

The article noted that there are other situations that can lead to a stepchild’s lack of participation in caregiving. Research has shown that the obligation to become a caregiver is weaker in stepchildren than in biological children, who naturally feel the need to reciprocate the care they received from their parents who raised them. More dubious factors such as money can enter into the equation as well.

So what should older couples who remarry do? Discuss what will happen when illness or dependence strike, however difficult a subject it might be to talk about.

“Who’s going to take care of you if you become sick? Talk about that while you’re still healthy, Keller told the Times.If I could yell one thing from a mountaintop it’s to talk about this stuff.”

What roles should stepchildren play in caregiving? Let us know in the comments or on Twitter.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system. All Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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“Physicians Choice Private Duty solves the problems families face in finding home health care providers they can trust. Providers who will focus on strategies that keep parents in their homes. To learn more about our health care services, visit http://www.encompass-home-health-care.com.”

Today’s post is part of our series, The Encompass Way. Here, we’ll go over many of the steps involved in setting up a comprehensive care plan, which helps us t provide seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system.

Physicians Choice Private Duty professionals conduct a comprehensive in-home assessment for each of our clients. Each assessment looks at a client’s current psychological, environmental, functionality and medical status, helping us develop a written plan of care and coordinate the health care providers and family members who are responsible for the execution of the plan of care.

Part of determining a client’s functionality status is to use the Instrumental of Activities of Daily Living (IADL) scale. Although IADLs are not essential for fundamental functioning, they do allow a person live a more independent and fulfilling life.

Below is an adaption of of M.P. Lawton and E.M. Brody’s IADL scale via the Abrams Center.

Index of Activities of Daily Living

INSTRUCTIONS

Circle the scoring point for the statement that most closely corresponds to the patient’s current functional ability for each task. The examiner should complete the scale based on information directly from the patient, the patient’s family and any other caregivers and recent records.

ACTIVITY

Ability to use telephone

• • 0 = Does not use telephone at all

• • 1 = Dials a few well-known numbers

• • 1 = Answers the phone, but does not dial

• • 1 = Operates telephone on own initiative

Shopping

• • 0 = Completely unable to shop

• • 0 = Needs to be accompanied on any shopping trip

• • 0 = Shops independently for small purchases

• • 1 = Takes care of all shopping needs independently

Food preparation

• • 0 = Needs to have meals prepared and served

• • 0 = Heats and serves prepared meals, or prepares meals but does not maintain adequate diet

• • 0 = Prepares adequate meals if supplied with ingredients

• • 1 = Plans, prepares and serves adequate meals independently

Housekeeping

• • 0 = Does not participate in any housekeeping

• • 1 = Needs help with all home maintenance tasks

• • 1 = Performs light daily tasks but cannot maintain acceptable level of cleanliness

• • 1 = Performs light daily tasks such as dishwashing and bed making

• • 1 = Maintains house alone or with occasional assistance

Laundry

• • 0 = All laundry must be done by others

• • 1 = Launders small items

• • 1 = Does personal laundry completely

Mode of transportation

• • 0 = Does not travel at all

• • 0 = Travel limited to taxi or automobile when assisted/accompanied by another

• • 1 = Arranges own travel, but does not otherwise use public transportation

• • 1 = Travel independently on public transportation or drives own car

Responsibility for own medications

• • 0 = Is not capable of dispensing own medication

• • 0 = Takes responsibility if medication is prescribed in advance in separate dosages

• • 1 = Is responsible for taking medication in correct dosages at correct time

Ability to handle finances

• • 0 = Incapable of handling money

• • 1 = Manages day-to-day purchases, but needs help with banking, major purchases, etc.

• • 1 = Manages financial matters independently (budgets, writes checks, pays rent, pays bills, goes to the bank, collects, keeps track of income, etc.)

Related

Index of Activities of Daily Living

Currently serving Omaha and surrounding areas, all Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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A recent study suggests that family caregivers who use positive coping strategies could be slowing the progression of dementia in the loved ones they’re caring for. This research comes from Utah State and Johns Hopkins University, which assessed more than 200 demintia patients and their caregivers twice a year over a six year span, reported the AARP.

With an aim to measure genetic and environmental factors that might affect the rate of the progression of dementia, patients were given brief exams which measured cognitive abilities such as attention, memory, language and orientation. The research found that caregivers who took a problem-solving approach to coping saw slower rates of decline in care recipients with dementia than caregivers who did not take a problem solving approach as often.

So what exactly is this problem-solving approach to coping? The article describes it as those with good social support who count their blessings, i.e., those apt at “changing how [they] look at a situation and focusing on the positive rather than trying to tackle the problem itself.” Another bonus of these positive coping strategies is that they lead to less caregiver stress, according to the study.

Utah State professor JoAnn Tschanz, the study’s lead author, offered the following strategies for caregivers, adapted below.

• • Avoid arguing or correcting your loved one with dementia as the disease may limit his or her ability to see things from separate points of view.

• • Your loved one’s abilities may vary depending on whether he or she is having a good or bad day. Try to figure out patterns to the bad days as to identify trigger behaviors.

• • Don’t forget to take time for yourself. You need it and deserve it.

• • Do your homework so you know how dementia progresses. This helps you be prepared to seek professional help when the time comes.

Do you think the results of the study are credible? Let us know in the comments or on Twitter.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system. All Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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“Physicians Choice Private Duty solves the problems families face in finding home health care providers they can trust. Providers who will focus on strategies that keep parents in their homes. To learn more about our health care services, visit http://www.encompass-home-health-care.com.”

Music has the power to act as therapy for people with special needs of all ages and abilities. With more than 6,000 music therapists currently operating in the United States (certified through the American Music Therapy Association), you should be able to find someone in your area if you believe music may help your aging loved one’s condition.

So what’s music therapy used for? Well, just about everything. Health workers currently use music to treat a wide range of conditions — from depression, brain injury and Huntington’s disease to Parkinson’s disease, stroke and cardiac disease, according to the AARP. It’s even being used for pain management during cancer treatments.

Even so, you don’t have to be a health care professional to reap the benefits of music. Below are a few tips on incorporating music into your everyday life from veteran music therapist Amy Goyer via the AARP caregiving blog.

• • Keep a CD or mp3 player nearby your loved one’s favorite spot to sit outside. This can turn solitary time into a relaxing and stimulating experience as your mother enjoys her favorite tunes — from big band swing to classical to contemporary favorites.

• • Watch a lot of musicals. Not only are the plots easier to follow, as Goyer notes, you can even get up and dance and sing along with your loved one.

• • Try mixing music and physical activity. Take a walk with your elderly father and sing songs he remembers (you might be amazed at what he does). Goyer calls this “a golden combination for brain stimulation.”

Of course, caregivers can benefit from a little music therapy as well. When you need to unwind, listen to music to help you calm down and relax.

If you’d like to learn more, you can join Goyer for an online webchat on Tuesday, March 19 from 3 to 4 p.m. ET.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of the available care options and helps families maneuver through the challenges of the system. All Encompass services are directed by registered nurses or social workers with no long-term contracts. Contact us today for help with your senior care needs.

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“Physicians Choice Private Duty solves the problems families face in finding home health care providers they can trust. Providers who will focus on strategies that keep parents in their homes. To learn more about our health care services, visit http://www.encompass-home-health-care.com.”