pope benedict frailPope Benedict XVI’s unexpected retirement has captured headlines across the world. While this post is in no way going to get into papal politics, a storyline pertinent to the senior care industry is that, as we reach old age, our bodies inevitably become more and more frail — even when you’re the pope.

Shedding light on this matter is an article by Paula Span on The New York Times‘ New Old Age Blog. The Vatican recently revealed that the 85-year-old pope has a pacemaker, signifying “long-standing heart problems,” according to the article. Other reported health issues affecting the pope include difficulty walking even short distances and a recent fall in Mexico, leading Span to ask the simple question — is the now-former pope frail?

But what exactly is frailty? According to the Oxford’s Journals of Gerontology, “Frailty is considered highly prevalent in old age and to confer high risk for falls, disability, hospitalization, and mortality.” Still, a standardized definition of geriatric frailty has yet to be established.

The American Academy of Physical Medicine and Rehabilitation states that a person must meet three of the five following criteria to be considered frail:

    1. Weight loss

 

    1. Exhaustion

 

    1. Weakness

 

    1. Slow walking speed

 

    1. Decreased physical activity

 

As Span notes, trying to diagnose the pope from afar is not the point, rather it’s realizing that frailty is a real concern for elders. Encouragingly, in it’s early stages frailty is a condition that is reversible or can be slowed. In the article, Columbia University’s Dr. Linda Fried recommends key exercises to accomplish this, including regular walking and moving to maintain strength and muscle mass.

While the pope will surely live out the rest of his days comfortably and in the best of care provided by the Vatican, millions of aging Americans face a different reality. One that potentially brings about a national crisis unless a workable and affordable system of long-term elderly care is established. But that’s an entirely different story.

Encompass Senior Solutions “ 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 licensed clinical social workers with no long-term contracts. Contact us today for help with your senior care needs.

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“Encompass Senior Solutions solves the challenges families face in caring for aging parents, with a focus on strategies that keep them in their homes. To learn more about our solutions, visit http://www.encompass-assessments.com.”

Todays post is part of our ongoing series, The Encompass Way. Here, we’ll go over many of the steps involved in setting up a comprehensive care plan, which helps us to provide seniors and their families a complete understanding of the available care options and helps them maneuver through the challenges of the system.

home care omaha dementiaThe following Burden Interview has been specially designed to reflect the stresses experienced by caregivers of dementia patients. It can be completed by caregivers themselves or as part of an interview. Caregivers are asked to respond to a series of 22 questions about the impact of the patient’s disabilities on their life. For each item, caregivers are to indicate how often they felt that way (never, rarely, sometimes, quite frequently or nearly always).

Scoring the test

The Burden Interview is scored by adding the numbered responses of the individual items. Higher scores indicate greater caregiver distress. The Burden Interview, however, should not be taken as the only indicator of the caregiver’s emotional state. Clinical observations and other instruments, such as measures of depression, should be used to supplement this measure.

Norms for the Burden Interview have not been computed, but estimates of the degree of burden can be made from preliminary findings. These are:

    • 0-20 — Little or no burden

 

    • 21-40 — Mid to moderate burden

 

    • 41-60 — Moderate to severe burden

 

    • 61-80 — Severe burden

 

Instructions

The following is a list of statements which reflect how people sometimes feel when taking care of another person. After each statement, indicate how often you feel that way and score accordingly: never (0), rarely (1), sometimes (2), quite frequently (3) or nearly always (4). There are no right or wrong answers.

1. Do you feel that your relative asks for more help than he or she needs?

2. Do you feel that, because of the time you spend with your relative, you don’t have enough time for yourself?

3. Do you feel stressed between caring for your relative and trying to meet other responsibilities for your family or work?

4. Do you feel embarrassed about your relative’s behavior?

5. Do you feel angry when you are around your relative?

6. Do you feel that your relative currently affects your relationship with other family members?

7. Are you afraid about what the future holds for your relative?

8. Do you feel that your relative is dependent upon you?

9. Do you feel strained when you are around your relative?

10. Do you feel that your health has suffered because of your involvement with your relative?

11. Do you feel that you don’t have as much privacy as you would like because of your relative?

12. Do you feel that your social life has suffered because you are caring for your relative?

13. Do you feel uncomfortable having your friends over because of your relative?

14. Do you feel your relative expects you to take care of him or her as if you were the only person he or she could depend on?

15. Do you feel that you don’t have enough money to take care of your relative in addition to the rest of your expenses?

16. Do you feel that you will be unable to take care of your relative much longer?

17. Do you feel that you have lost control of your life since your relative’s death?

18. Do you wish that you could just leave the care of your relative to someone else?

19. Do you feel uncertain about what to do about your relative?

20. Do you feel that you should be doing more for your relative?

21. Do you feel that you could do a better job in caring for your relative?

22. Overall, how burdened do you feel in caring for your relative?

Sources consulted:

    • Brown, JL, Potter JF, Foster BG. Caregiver burden should be evaluated during geriatric assessment. J Am Geriatr Soc. 1990; 38 (4): 455-460.

 

    • Cummings JL, Frank JC, Cherry D et al. Guidelines for managing Alzheimer’s disease: part I. Assessment. Am Fam Physician. 2002; 65 (11): 2263-2272.

 

    • Council on Scientific Affairs, American Medical Association. Physicians and family caregivers: a model for partnership. Council report. JAMA. 1993; 269 (10): 1282-1284.

 

    • Rankin ED, Haut MW, Keefover RW, Franzen MD. The establishment of clinical cutoffs in measuring caregiver burden in dementia. Gerontologist. 1994; 34 (6): 828-832.

 

    • Zarit SH, Reever KE, Back-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980; 20 (6): 649-655.

 

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

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“Encompass Senior Solutions 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.”

senior care omahaIt’s very common for an elderly person to be taking several doses of prescribed medication each day. And the list of drugs seems to only get longer and longer over the years. This makes it increasingly more difficult for someone to properly manage their medication, which is concerning because a missed or wrong dose can have dire consequences.

According to the National Council on Patient Information and Education, around 90 percent of Medicare recipients take prescription drugs, and two out of five reported having to take five or more medications — and many are non-adherent to doctor’s orders. This non-adhereance all adds up to $1 billion annually in hospital costs, according to the New England Journal of Medicine. Meanwhile the FDA figures that more than two million serious adverse drug reactions occur each year, which are responsible for about 100,000 deaths annually.

If your loved one is taking several medications daily, you may want to take the time to help them better organize their pills, especially if they have poor vision and/or cognition problems. Here are some medication management tips via Caring.org.

There are many reminder technologies that can help, including:

Telephone-based reminders

Telephone-based medication reminders have the lowest cost and least intervention, according to Caring.org. Usually for a monthly fee in the $15-$20 range you can subscribe to an automated calling service that calls your loved one each day to remind them to take their medication. If the person doesn’t answer or acknowledge the reminder, the system will notify the designated contact (likely you) by email and/or telephone. No fancy new telephone required.

Another option is the Pill Phone, which is available through wireless carriers like Verizon an AT&T.

Reminders integrated as part of home monitoring or safety devices

Several personal emergency response systems should be available through your local pharmacy. Caring.org notes that these services are often built around wearable products such as pendants or watches. These vary in degrees of sophistication — from programmable medication reminders to a personalized emergency response system.

Electronic pill-dispensing systems

Electronic pill boxes are a small yet advanced way to offer medication reminders. These may be ideal for seniors who can load and count their own pills, or those with regular support from a caregivers. If you can afford it, there are also lockable electronic pill dispenser systems that cost upwards of $1,000.

Which level of intervention depends on your loved one’s ability to independently take medication. When choosing a medication reminder, Caring.org suggests envisioning your loved one’s ever-evolving need for medication management and intervention, taking into account his or her current needs and what those needs might be in the near future.

Encompass Senior Solutions 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 licensed clinical social workers with no long-term contracts. Contact us today for help with your senior care needs.

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“Encompass Senior Solutions 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 omahaA recent study from the National Alliance for Caregiving confirms what many of America’s 65 million caregivers know firsthand — the responsibilities of caring for a loved one brings on stress and lots of it. What’s most concerning is that this stress can lead to an overall decline in health. The study found that 91 percent of caregivers with declining health report depression. Caregivers are also at risk of turning to bad habits such as smoking and alcohol abuse to cope.

Sherri Snelling, CEO of the Caregiving Club, created a “Me Time” plan to help caregivers effectively turn their lives around and deal with stress in healthy ways. Snelling breaks her plan down into three steps:

1. Create a plan. To make sure positive change happens, you need to establish realistic goals. Maybe it’s finding outside help so you can take one day off per week and find time to relax and do the things you love. Snelling suggests seeking out volunteer networks and/or online communities for help. Leaving yourself “Me Time” reminders — like a sticky note in the car — can help make sure you don’t forget.

2. Take baby steps. If you want to run a 5k but are not in shape like you used to be, you have to train slowly, day by day and week by week. The same goes for your “Me Time” plan. If you want a week off to visit your new grandson in Texas, plan it out well in advance and take little steps along the way to make sure it happens.

3. Track and celebrate your progress. Snelling says that tracking your progress will allow you to celebrate it. Pick a day each week and reflect on your recent “Me Time” moments. Having a support network of people who know about your goals can also help immensely. Plus you’ll have someone to celebrate with.

Read more about Snelling’s “Me Time” plan on Huffington Post’s Post 50 blog.

Encompass Senior Solutions 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 licensed clinical social workers with no long-term contracts. Contact us today for help with your senior care needs.

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“Encompass Senior Solutions 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 ongoing series, The Encompass Way. Here, we’ll go over many of the steps involved in setting up a comprehensive care plan, which helps us to provide seniors and their families a complete understanding of the available care options and helps them maneuver through the challenges of the system.

elder fallsThe following test — which we call the “Get Up and Go Test” — is an assessment that should be conducted as part of a routine evaluation when dealing with older persons. Its purpose is to detect “fallers” and to identify those who need evaluation.

Senior care professionals should be trained to perform the “Get Up and Go Test” at check-in and query those with gait or balance problems for falls. Below is what they’ll be looking for.

Initial Check

All older persons who report a single fall should be observed in the following exercises:

    • From a sitting position, stand without using their arms for support.

 

    • Walk several paces, turn, and return to the chair.

 

    • Sit back in the chair without using their arms for support.

 

Individuals who have difficulty or demonstrate unsteadiness performing this test require further assessment.

Follow-Up Assessment

 

In the follow-up assessment, ask the person to:

    • Sit.

 

    • Stand without using their arms for support.

 

    • Close their eyes for a few seconds while standing in place.

 

    • Stand with eyes closed while you push gently on his or her sternum.

 

    • Walk a short distance and come to a complete stop.

 

    • Turn around and return to the chair.

 

    • Sit in the chair without using their arms for support.

 

While conducting the test, pay attention to any abnormal movements. As you observe, answer the questions below.

Follow-Up Assessment Observations

    • Is the person steady and balanced when sitting upright?

 

    • Is the person able to stand with their arms folded?

 

    • When standing, is the person steady in narrow stance?

 

    • With eyes closed, does the person remain steady?

 

    • When nudged, does the person recover without difficulty?

 

    • Does the person start walking without hesitancy?

 

    • When walking, does each foot clear the floor well?

 

    • Is there step symmetry, with the steps equal in length and regular?

 

    • Does the person take continuous, regular steps?

 

    • Does the person walk straight without a walking aid?

 

    • Does the person stand with heels close together?

 

    • Is the person able to sit safely and judge distance correctly?

 

The more you answer “no” to the above questions, the greater your loved one’s risk is for falling.

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

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“Encompass Senior Solutions solves the challenges families face in caring for aging parents, with a focus on strategies that keep them in their homes. To learn more about our solutions, visit http://www.encompass-assessments.com.”

nebraska probateServing as executor of a loved one’s estate is a more difficult job than most people realize. There’s the paperwork, finding an attorney to help with the probate process, following through with the requests in your loved one’s will, paying bills — the list goes on and on.

To help streamline the process, you can refer to the many online guides and checklists out there (or you could always consult with your attorney, who will bill you for the time). Even so, you should consider picking up a copy of the latest edition of the American Bar Association’s “Guide to Will and Estates,” because, as Paula Spin writes in a post for The New York Times’ New Old Age blog, anyone in charge of settling an estate should expect things to be 30 percent more complicated than initially planned.

Spin notes the A.B.A. guide is “written with surprising clarity” (quite a feat for a bunch of lawyers) and offers thorough explanations to common scenarios like divvying up property and real estate between heirs and how to best deal with taxes and trusts. Since you’ll likely be working with an estate lawyer to get things settled, the A.B.A.’s guide will help you better understand what exactly is going on throughout the entire process. And, as many of us have experienced when a loved one’s affairs and assets were disorganized at the end of his or her life, the guide will help you to prioritize getting your own estate in order, something your likely unprepared heirs will certainly appreciate.

You can pick up a copy of the American Bar Association’s “Guide to Will and Estates” at your local bookstore or order it online via Amazon.com.

Encompass Senior Solutions “ 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 licensed clinical social workers with no long-term contracts. Contact us today for help with your senior care needs.

“Encompass Senior Solutions solves the challenges families face in caring for aging parents, with a focus on strategies that keep them in their homes. To learn more about our solutions, visit http://www.encompass-assessments.com.”

Todays post is part of our ongoing series, The Encompass Way. Here, we’ll go over many of the steps involved in setting up a comprehensive care plan, which helps us to provide seniors and their families a complete understanding of the available care options and helps them maneuver through the challenges of the system.

DIY hearing testA third of people older than 60 suffer from hearing loss, making it one the most common conditions affecting older adults (hearing loss in the elderly is especially common, affecting half of people 85 and older). Causes can come naturally with age or be an undesired side effect of excessive noise exposure, trauma or even medication.

If you suspect your elderly loved one is suffering from hearing loss, there’s an easy test you can conduct yourself to help determine if a professional examination is required. The test comes from an Oxford study investigating the reliability of simple free-field voice testing from the book Age Ageing:

Performing the Whispered Voice Test

1. Stand behind the patient’s field of vision. This eliminates the possibility of lip-reading.

2. Gently occlude and rub the external auditory canal of the non-tested ear.

3. Ask the patient to repeat a set of three different random numbers (e.g., 6, 1, 9) presented to the tested ear at four decreasing levels of loudness: conversational voice at six inches and at two feet from the ear, and whispered voice at six inches and at two feet from the ear. Exhale completely prior to testing with whispered voice.

Scoring

A passing score is given if the patient can repeat all three numbers correctly at each level of loudness or achieve greater than 50% success over three successive triplet sets.

Failure to pass at each level of voice testing is considered a positive test for hearing impairment. Failure to hear a whisper at two feet indicates hearing loss and may be the most discriminant test of the set.

Hearing loss diminishes a person’s quality of life, making it hard to understand phone conversations, hear above background noise, converse with more than one person at a time, et al. Just imagine how frustrating it must be to have to continually ask friends and loved ones to repeat themselves. However, if hearing loss is identified, there are treatments that can ease the symptoms, so the sooner you get your loved one tested for hearing loss, all the better.

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

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“Encompass Senior Solutions solves the challenges families face in caring for aging parents, with a focus on strategies that keep them in their homes. To learn more about our solutions, visit http://www.encompass-assessments.com.”

home care omahaMalnourishment effects nearly 3.7 million elderly persons in the United States, according to the American Academy of Family Physicians. The reasons for this are many — from changing taste buds to dental problems to the physical demands of preparing meals. To help bring awareness to the issue, Dr. Lindsay Jones-Born, in conjunction with A Place for Mom, offers the following advice on combating senior malnourishment (via a recent article on Huffington Post).

Start with the basics

Check the food your loved one is eating (i.e., don’t be shy from raiding the fridge and rummaging through the pantry). Throw out any old food you may be suspect of. Other signs that your loved one’s diet lacks proper nutrition is unusual weight loss or weight gain and excessive bruises and wounds that take a long time to heal.

Offer help

Seniors struggling with malnourishment will benefit from education and encouragement, according to Dr. Jones-Born, helping to ensure each meal is packed with essential vitamins and nutrients.

    • Folic acid helps prevent heart disease and boosts red blood cell production. Foods that are rich in folic acid include spinach, asparagus and lentils. 

 

    • B12 helps synthesize protein and aids in mental function. Unfortunately, this process can become compromised with age. Consider adding a B12 supplement to your loved one’s diet or having plenty of foods like turkey, chicken, beef, eggs, milk and salmon in regular rotation on the menu.

 

    • Vitamins C and D are very important to the health of an aging body, so make sure your senior has at least five servings of fruits and vegetables a day (for the vitamin C) as well as foods rich in or fortified with vitamin D (oatmeal, egg yolk, sardines, etc.).

 

    • Essential fatty acids are key to reducing inflammation in the body. A good source is fish, which Dr. Jones-Born recommends seniors eat twice a week. Another rich source of essential fatty acids is flax seeds, which can easily be added to a number of dishes.

 

    • H2O is naturally the best way to keep your loved one hydrated. The article suggests seniors should have nine 8-ounce glasses of water a day.

 

Are there any other ways to help prevent senior malnourishment that we missed? Let us know in the comments or on Twitter.

Encompass Senior Solutions 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 licensed clinical social workers with no long-term contracts. Contact us today for help with your senior care needs.

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“Encompass Senior Solutions 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.”

3817638933_8f6cafda14In 2012, the Center for Disease Control (CDC) reported that one out of three adults 65 and over falls each year. The outcomes of these falls can vary, but they almost always result in decreased mobility for elderly adults and can cause other complications down the road. The CDC also reported that falls are the leading cause of injury death among seniors, so it’s vitally important to make sure your loved one’s home is adequately modified to prevent falls. Below is a checklist to help do this.

All Rooms

    • Use carpet with short dense pile.

 

    • Apply double-sided carpet tape to rugs that can slip.

 

    • Arrange furniture so you can walk easily around it.

 

    • Make sure electrical and extension cords are not in your walking path.

 

    • Make sure you can turn on lights without having to walk through dark areas. Use nightlights, especially in the bathroom.

 

    • Keep exits and hallways clear.

 

    • Use stable chairs with armrests to help you getup.

 

    • Provide bright, evenly distributed light.

 

    • Use window shades that reduce glare.

 

    • Make sure you can easily reach a light switch when you come into a room, and install nightlights.

 

    • Have more than one phone in the house.

 

Stairs

    • Put handrails on both sides of the steps.

 

    • Make sure steps are even.

 

    • Use non-skid contrasting tape, rubber stair treads, or coated skid resistant surface treatment on non-carpeted stairs. Apply tape to dry, clean surfaces at one-inch intervals. Use three long strips of tape on each step.

 

    • Check carpeting to make sure it is firmly attached along stairs.

 

    • Make repairs to worn or loose carpet promptly.

 

    • Select a carpet pattern that doesn’t hide the edge of steps, making you think steps have ended when they haven’t.

 

    • Don’t place throw or scatter rugs at the top or bottom of stairways. All rugs should be secured firmly to the floor.

 

    • Use good lighting (at least 60 watt bulbs) in the stairway. Install on/off switches at the top and bottom of stairs.

 

    • Never leave books, purses, packages, or other objects on stairs.

 

    • Watch out for a single step. People often trip when there is only one step.

 

Kitchen

    • Use sturdy step-stools — preferably with handrails.

 

    • Throw out any step-stools that have broken parts.

 

    • Clean spills immediately to avoid slipping.

 

Bathroom

    • Use rubber bathmats or strips in bathtubs and showers.

 

    • Install at least two grab bars in the bath.

 

    • Clean up water from the floor.

 

    • Use raised toilet seats and/or handrails, securely fastened, if you are at all unsteady.

 

Outside

    • Install handrails along any flight of outdoor steps.

 

    • Spread sand on icy walkways.

 

    • Clean spills or slippery surfaces in garage immediately, before walking on them (especially grease on cement floors).

 

Encompass Senior Solutions “ 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 licensed clinical social workers with no long-term contracts. Contact us today for help with your senior care needs.

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“Encompass Senior Solutions solves the challenges families face in caring for aging parents, with a focus on strategies that keep them in their homes. To learn more about our solutions, visit http://www.encompass-assessments.com.”

As a person ages, it often becomes more difficult for them to maneuver through their home. The culprit may be stairs, excessive clutter, an outdated bathroom and/or kitchen, et al. There are basic home improvements that can enhance the quality of an elderly person’s life and allow them to live independently in their home for as long as possible. Below are some tips and ideas for keeping your loved one safe and comfortable in their own home.

    • Lever door handles and faucet handles that operate easily with a push

 

    • Adjustable closet rods

 

    • A night light in bedroom

 

    • No scatter rugs

 

    • Handrails on both sides of staircases and outside steps

 

    • Brighter staircase lighting

 

    • Large rocker light switches that turn on/off with a push

 

    • Electric outlets 27 inches above floor

 

    • Peephole or view panel in front door

 

    • Walk-in shower with grab bars and portable or adjustable shower seat

 

    • Hand-held adjustable shower head

 

    • Non-skid surface for both tub and shower floor

 

    • Grab bars by the toilet and tub

 

    • Tilting or full-length mirror in bathroom

 

    • Bathroom telephone that is reachable in case of a fall

 

    • Adjustable countertops or lower counter for work space in kitchen

 

    • Rounded kitchen counter tops

 

    • Sliding shelves in cupboards, lazy Susan in corner cabinet

 

    • First floor bedroom and bath allow living entirely on one level if necessary

 

General home safety tips for seniors

    • Consider a medical alert or a buddy system

 

    • Keep a fire extinguisher and smoke detector on every floor

 

    • Use extreme caution when smoking

 

    • Always get up slowly after sitting or lying down

 

    • Wear proper fitting shoes with low heels

 

    • Use a correctly measured walking aid

 

    • Remove scatter rugs and tack down all others

 

    • Remove electrical or telephone cords from traffic areas

 

    • Avoid using slippery wax on floors

 

    • Wipe up spills promptly

 

    • Avoid standing on ladders or chairs

 

    • Have sturdy rails for all stairs inside and outside the house

 

    • Use only non-glare 100 watt bulbs (or greater wattage)

 

    • Make sure that all staircases have good lighting with switches at top of bottom

 

    • Staircase steps should have a non-slip surface

 

Encompass Senior Solutions “ 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 licensed clinical social workers with no long-term contracts. Contact us today for help with your senior care needs.

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“Encompass Senior Solutions solves the challenges families face in caring for aging parents, with a focus on strategies that keep them in their homes. To learn more about our solutions, visit http://www.encompass-assessments.com.”