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Driving Concerns – How to Know When to Put the Brakes On Elderly Drivers

Driving skills vary from one person to another, and one age bracket to another. However, as people age, their driving does decline, but it doesn’t always mean that across the boards all elderly people will become worse at driving.

Noticing the early warning signs is important. One of the biggest early warnings is getting lost.

If not addressed early enough, it can become dangerous for not only your loved one to be on the road, but also for other drivers and families out there.

First it is important to look at the cause of your parent getting lost. Sit down and talk with your parent about the situation that occurred.


  • Did something along the way distract him/her while driving? Is this the first time it has occurred and was just due to something unusual that day?
  • Find out if they have noticed other moments of forgetfulness that are of concern – greater than not knowing where they put the car keys?
  • How does your parent feel about driving? Does it feel stressful to them? Can they easily see traffic lights and street signs? Or do they find themselves driving closer and closer, slowing by the sign to see it?
  • If your parent is on more than one consistent medications check with their doctor to see that those medications are not interfering with each other and causing other side effects. Certain medications or combinations of medications can affect senses and reflexes.


Ensuring regular doctor check-ups is important. Getting their eyes, hearing and reflexes checked is vital. Another area of concern could be sleep. Anyone, no matter their age, can appear to be intoxicated when poor sleep is involved. Have their doctor help them establish healthy nighttime sleep conditions to ensure proper rest when driving.

If all of the above has been done and your loved one still gets lost frequently or has other issues when driving, it’s time to make the difficult decision of putting on the brakes and having them turn in their keys.

AAA has a Senior Drivers Program where you can get driving fitness tips, videos and more, including state License Policies and Practices. They also help with planning for continued mobility (post driving), which is extremely helpful.

Visit: http://www.seniordrivers.org/home/ for more information.

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10 Signs Indicating an Aging Loved One May Need Help

10 Signs Indicating an Aging Loved One May Need Help

1. Mail and bills are left to pile up. The simple act of opening and filing mail becomes overwhelming. Managing a checking account can also become too much for a parent to handle.

2. The house is cluttered or unkempt. This is especially troubling if a parent has always been neat and orderly.

3. Food in the refrigerator is uneaten or spoiled. Shopping, cooking, and cleaning become too much trouble. A parent might eat just enough to get by, but suffer nutritionally. Losing weight can be another sign that a parent is not eating a nutritious diet.

4. Signs of scorching on the bottoms of pots and pans. A result of short-term memory loss, this is a dangerous sign that parents are forgetting about pots left on the stove, causing a fire hazard, and threatening both the individual’s and the surrounding neighbor’s safety.

5. The parent wears the same clothing over and over again and has other personal hygiene issues. Doing laundry has become physically challenging, particularly if the washing machine is in the basement. Or there may be a fear of falling in the tub or shower.

6. Missed doctor’s appointments. Sometimes this is simply a product of not having transportation and not knowing how to access ride options.

7. Repeated phone calls at odd hours. When a parent telephones friends or family at odd hours, it may be a sign of memory loss, or a cry for help– a sign of depression or isolation. Arranging for a daily check-in phone call, a regular volunteer visitor, or getting involved with a local senior center, could make all the difference.

8. Forgetting to take medication. A sign of short-term memory loss or depression, this isn’t just a quality of life issue, but a real risk factor.

9. Inappropriate behavior, clothing or speech. You may hear about this from a neighbor, someone who has noticed that your parent is not dressing appropriately for the weather, for instance. That’s a sign that he or she might be confused.

10. Symptoms of depression. A frequent problem for many older people, who feel isolated and alone, like a prisoner in their own homes, depression causes marked changes in behavior and routine. Feelings of hopelessness, lack of interest in once pleasurable activities, crying, listlessness, and not wanting to get dressed can all be indications of a problem.

Once adult children decide that a parent needs assistance, the next step is determining what kind. The following are a few options to consider:

1) Geriatric Care Managers – These highly trained professionals can assist in determining the appropriate type of care. They are generally licensed nurses or social workers that specialize in geriatrics. To locate a care manager contact the National Association of Professional Geriatric Care Managers.

2) Emergency Response Devices – Almost 5,000 seniors die from falls in the home. Investing in a home emergency response device can offer everyone peace of mind.

3) Non-Medical In-Home Care – Services range from companionship, light housekeeping, grocery shopping, meal preparation, bill paying, and transportation to appointments. Assistance with bathing, dressing, grooming, and toileting are also provided. Most are bonded and insured and perform multiple background checks on caregivers.

4) Tax Credit Senior Apartment Communities – Unlike most publicly subsidized housing programs designed to assist the elderly, the housing tax credit program does not provide tenants with governmental rent subsidies, but rather provides for a more affordable monthly rental rate. The advertised term “affordable” is the term to look for. Income restrictions apply.

5) Residential Care Assisted Living Homes – Offer a more home-like setting than nursing homes. They typically provide meals, laundry, housekeeping, medication supervision, assistance with activities of daily living (for most types) and an activity program. Other amenities such as transportation may also be offered in some facilities.

7) Elder Law Attorneys – Elder law spans and encompasses elder care planning issues, estate planning, long-term care needs, planning for incapacity and other needs. Attorneys are members of the National Academy of Elder Law Attorneys.

8) Respite Care / Spousal Care Giving – Respite care provides time off for family members who care for someone who is ill, injured or frail. Caregivers face many challenges. Contact the National Respite Care Locater for assistance. The Well Spouse Association is a non-profit organization that also offers support for spousal caregivers.

Ensure your parents needs are being met by knowing what to look for, who to call, and how to locate needed services.

Call a trusted resource and we will work together to build long term plan.

Amy Burfitt, Eldercare Consultant LivHOME, Inc. 619-544-1622 aburfitt@livhome.com

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Tomorrow is National Family Health History Day!

Family health history is extremely important as it helps with preventive care, diagnosis, and treatment for a range of disorders and diseases.

Family Health History
Family health history is recognized as an integral component in medical care. Knowledge and documentation of family health history can assist in extending the quantitative and increasing the qualitative elements of life, not solely for the elderly, but for the entire family.

There are numerous health conditions that people are predisposed to. Having knowledge of these disorders can help medical professionals design an effective preventive care plan. Simply altering a few habits may prove to be extremely valuable. Such alterations include include dietary intake, physical activity, and routine medical visits.

Crucial Considerations
Initiating the discussion about family health history is quite simple, especially during the holidays. It’s important to phrase questions gently as this topic may be painful. Have a journal handy during these discussions to jot down notes. It’s a good idea to compile a list of questions in advance. If seniors seem emotionally distressed, try discussing at a different time and be sure to pay close attention to their feelings.

There are several questions that should be asked about seniors’ family health history. These include causes of death in the immediate family, birth defects, and the existence of disease. Keep in mind this will not only help the elders of the family, but also the younger relatives as well. Some specific conditions to inquire about are:


  • Certain types of cancer
  • Diabetes
  • Arthritis
  • Stroke
  • Heart disease
  • Osteoporosis


There are also some risks factors to include:


  • Specific combinations of disease
  • Premature disease
  • Multiple immediate relatives with the same condition
  • Disease that affected uncommon members i.e. men diagnosed with breast cancer


Helpful Hints
There are a number of ways to document this vital information. Approximately 33% of all Americans have a documented family health history. There are many ways you can get started today. Consider these options:


  • There are numerous websites which offer family health history documentation tools for free.
  • Many common computer programs have templates to document family health history which are print friendly.
  • The app market provides a number of applications at no cost to document this history as well as some that are more sophisticated for a nominal charge.
  • The My Family Health Portrait Tool is offered on the web in four languages.


Be sure to print and distribute this information to other family members and health care providers involved and keep several copies available for future requirements.

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Thanksgiving Activities to Do with Family

Thanksgiving is typically thought of as a familial time of year, and unfortunately, the elderly are often left out. Occasional, families feel as though their elderly family members are unable to take part in the holidays or that they are simply disinterested. In many cases, these reasons could not be further from the truth. There are a number of interesting activities that the elderly can and want to take part in.

Yule Prep
One traditional Thanksgiving idea is to draw names for a Secret Santa party. Drawing names around Thanksgiving gives participants time to plan. The elderly, just as many others, cannot afford to buy everyone a gift, and Secret Santas allow them to take part in gift giving on a budget!

Crafty Cards
The elderly generally enjoy making crafts and contributing in decorating for the holidays. Consider asking them to help make dinner place cards. There are several inexpensive craft ideas for making place cards and the Internet is a wonderful tool to research ideas.

Dinner Prep
Many older adults also enjoy planning and cookin and would love to contribute to meal preparation. Ask them which foods they would like to cook as well as which foods they enjoyed at past Thanksgiving dinners. Use the Internet it to find suitable recipes to accommodate their preferences and nutritional requirements.

Holiday Memoirs
One of the greatest gifts that the elderly give the rest of the world is wisdom and one of their favorite pastimes is sharing memories. Choose a time, perhaps after everyone has finished eating, to ask them about their favorite holiday memories. This is a wonderful activity as it creates a time of bonding for the entire family!

Helping Hands
Consider volunteering with an elderly friend this holiday season. The holiday season is an extremely difficult time of year for those less fortunate. Consider heading over to a Soup Kitchen or hosting a gift drive with a senior friend. Research your options through your town or church’s website!

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Holiday Travel with Senior Loved Ones

Holiday travel can present a challenge for anyone, but this can be much more difficult when traveling with an elder loved one. This is even truer, if the elder is suffering from any type of negative health condition. There are a few items to keep in mind to make the entire process not only simpler, but much more fun.

Predetermine Travel Objectives
They elderly often cannot simply hop into the family van or on an airplane and hit the road like younger relatives. Remember to think critically before packing and it may be prudent to create a list. This ensures important, but often forgotten, items such as maps, travel documents, and important medications are not left behind. It may be a thought to research travel insurance just in case.

Examine Travel Choices
This may be a delicate subject in some cases; however, there are many senior discounts to investigate for travel. There is nothing wrong with saving money and many seniors are happy to lend a hand in the travel experience. The funds saved may be required for some unforeseen emergency. It is also good practice to create a travel budget ahead of time.

Planning is Prudent
Make a plan, print or write it out, and try to stick as close to it as possible. Be sure to ask if there is anything that he/she wants to take with him/her, perhaps a book or favorite robe. Be extra careful to make sure all medical documentation that may be needed is packed and secure. This includes medical insurance cards as well as history, if it is available. Be sure to put a first aid kit in the car which includes not only emergency medical supplies, but minor provisions as well. This may include antacids, pain relief, and allergy medicine.

Do not forget plants and animals. Ask a family member, or hire a reliable professional, to care for pets, indoor plants, and gardens during the vacation. Perhaps notify the local police department and neighbors that no one will be home for a period of time. This way they know they should keep an eye on suspicious activity around the property. Do not forget to tell them of any caretakers that will be visiting. Notify any delivery services and mail persons about the absence. They will most likely be happy to hold services until someone is home again.

Last Minute Tips
Keep all documentation handy and make sure it is in the vehicle before leaving. Be sure to revisit all plans and lists throughout the entire planning process and especially just before departing. Check items off to make note of what has been accomplished. As mentioned previously, include the elderly in the planning process. Being a senior does not always mean disabled or disinterested. They may actually enjoy being include and appreciate being considered. This last piece of advice may actually be the most crucial. It may be somewhat more challenging to travel with seniors; however, it can also be exciting for the whole family. Relax and have a good time.

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The Five Biggest Mistakes Boomers Make When Enrolling in Medicare

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Finding the right Medicare plan matters. With hundreds of policies to choose from, and so much information to understand, many people guess when choosing a policy and end up paying too much for a plan that doesn’t cover what they need.

Open enrollment period for Medicare begins October 15. Here are the five biggest mistakes one should watch out for when enrolling in Medicare:

Mistake 1: Signing up too early or too late for Medicare and its parts
If you are aging into Medicare, your initial enrollment period is based on your 65th birthday. To avoid long-term penalties, make sure you know what you have to choose—and by when. If you or your spouse are still working when you turn 65 and your insurance meets certain requirements, it may make sense for you to delay enrollment in Parts A, B, and D. On MyMedicareMatters.org, you can take a free, confidential Medicare QuickCheck™ and receive a personal report with your initial enrollment period, or special enrollment period if you or your spouse are still working, and recommendations about when you should sign up for which parts of Medicare.

Mistake 2: Not understanding the difference between a Medicare Supplement and a Medicare Advantage policy
If you are new to Medicare, you have a fundamental choice to make: enroll in original Medicare or opt into a Medicare Advantage plan. It is very important that you understand the pros and cons of both types of coverage.

Original Medicare is a fee-for-service program. Most consumers supplement the government benefit with a private Medicare Supplement (also called Medigap) policy as well as a Part D plan for their prescription drugs. A Medicare Supplement policy may cover some services that are not included under the standard Medicare Parts A and B as well as some out-of-pocket costs such as co-insurance costs for care at skilled nursing facilities, the Part A deductible, and foreign travel emergency care. If you choose a Medicare Supplement policy, you will pay an additional monthly premium. You won’t need prior authorization to use specialists or to get second opinions.

A Medicare Advantage Plan (Part C), on the other hand, takes the place of original Medicare Parts A and B. These plans work more like group insurance. They are sold through approved, licensed insurance companies and may have an additional monthly premium. Often, Medicare Advantage plans include prescription drug coverage as well as services that original Medicare does not such as health/wellness programs and vision care. However, a Medicare Advantage plan may also limit a person’s ability to use doctors and hospitals, and also require prior authorization to use specialty services.

During open enrollment, you have the option of changing from one type of plan to another if your needs have changed.

Mistake 3: Guessing when picking specific plans
It can be very difficult and time-consuming to compare all of the plans that are available to you. Many people try to do their homework, get frustrated, and then “give up and guess.” Choosing a Medicare plan is too important to leave to guesswork. Take the time to review your health insurance needs before your first—and every subsequent—enrollment period. Think about:


  • Do you have health insurance from another source?
  • Do you have any chronic conditions?
  • Which doctors and hospitals do you use?
  • Which prescriptions do you need and what pharmacies do you get them from?


You don’t have to do this on your own. You can get help from a trusted source that can help you think through your options and compare plans. If you’re unsure about your choices, start with a Medicare QuickCheckTM to get a personalized report on your options and use that to start a conversation with a licensed benefits advisor.

Mistake 4: Not applying for extra help
Millions of older adults are eligible for billions of dollars in programs that can help them pay for their prescriptions and health insurance premiums, deductibles, and coinsurance. If your income in retirement is modest, you should find out if you qualify for assistance. NCOA also offers a free online BenefitsCheckUp® where you can see if you’re eligible and apply online for Extra Help or Medicare Savings Programs. Or, contact your State Health Insurance Assistance Program (SHIP) to see what’s available to you.

Mistake 5: Not re-evaluating your coverage every year
Unfortunately, choosing health insurance is no longer a one-time decision for most Medicare beneficiaries. Insurance companies can make changes to policies every year. Just because your doctor and medications are covered this year doesn’t automatically mean they will be covered in the coming year. Research studies show that the average consumer could save $300 or more annually if they review their Part D coverage. Make sure to confirm cost, copays, coinsurance, covered providers, and prescription drugs. Here are a few things to consider:


  • Has your health changed in the last year?
  • Is your current plan still meeting all of your health needs?
  • How much have you paid out-of-pocket in the last year—and for what?
  • How is your plan changing for the coming year? How will that affect your out-of-pocket costs?
  • Are there better options available to you now?


Learn more at https://www.mymedicarematters.org/

Contact your LivHOME Care Manager if you have questions or need assistance in making a decision during Medicare Open Enrollment. If we don’t know the answer, we can refer you to someone who does.

323-933-5880

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Lung Cancer Awareness

November is the official month for Lung Cancer Awareness. It was originally a single day when it began in 1995. Both the community and the movement for Lung Cancer Awareness have grown exponentially. They have evolved into an entire month in which the community is dedicated to bringing awareness to this serious disease.

Lung Cancer Prevalence
Lung carcinoma remains the number one cause of death due to cancer in the United States. This applies to men and women. It exceeded breast cancer in female deaths in 1987. The next three most deadly cancers are breast, colon, and pancreatic. Lung cancer kills more individuals each year than these combined. The elder community within the U.S. is disproportionately affected by lung cancer.


  • It has been projected that by the end of 2014 159,260 cases of lung cancer will result in death. This portion will then equal 27% of total cancer deaths.
  • Between the years 1999 and 2010 lung cancer death tolls rose by 4.3%; this is from 152,156 to 158,318 deaths.
  • The gender relationship in 2010 was 87,740 deaths in men and 87,740 in women.
  • One study released a short number of years ago showed that an estimated 40% of lung cancer cases are diagnosed in individuals who are aged 70 or older.
  • Another report published in 2013 stated that two thirds of cancer cases were diagnosed in those aged 65 or older.


Lung Cancer Causes and Symptoms
Smoking is thought to be one of, if not the, number one cause of lung cancer. This is smoking cigarettes or a pipe; however, the risk is dramatically increased with cigarette smoking as opposed to pipe smokers. The risk also increases with pack-year smoking history. The lung cancer risk from secondhand smoke rises 24% over incidents related to non-exposure.

Those who have worked with asbestos, but have never smoked, have an increased risk of lung cancer. The incidence in individuals who smoked as well as worked with asbestos rises by anywhere from 50 to 90 times. Lung cancer and mesothelioma have both been directly linked to asbestos exposure.

There are also individual genetic predisposition factors to take into consideration. Those whose relatives were diagnosed with lung cancer are more susceptible to this type of cancer regardless of whether they smoke or not. Medical researchers believe that a specific gene, human chromosome number 6, indicates a susceptibility to lung cancer in smokers.


  • Coughing that worsen with time or simply cannot be cured, particularly if accompanied by hoarseness, is a sign of lung cancer.
  • Coughing that expels bloody or rust tinted phlegm is of great concern.
  • Chest pain, especially that worsens when breathing, laughing, and/or coughing is also a concern.
  • Loss of appetite and/or weight often accompanies lung cancer.
  • Feeling weak and/or tired are symptoms of lung cancer.
  • Reoccurring or on-going infections such pneumonia and bronchitis are also signs that may indicate lung cancer.


Lung Cancer Treatment
An oncology surgical team decides between four basic courses of treatment of lung cancer. A thoracic surgeon generally leads this team. The options are chemo; radiation therapy; surgery, and/or targeted therapy. This decision is greatly impacted by the stage and form of cancer; associated side effects; current health condition; and patient preferences.

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National Healthy Skin Month

November is the nationally recognized month for healthy skin making it the perfect time to prepare elderly patients for the coming colder seasons. The colder and much dryer whether can exacerbate skin conditions. It often affects most everyone’s skin. There are several ways to help protect the elderly and their delicate skin.

5 Tips for Keeping Elders Skin Young and Healthy
  1. One of the most crucial aspects of skin care for all ages that is often forgotten in wintertime is sunscreen. An SPF of at least 30 is recommended by skin care professionals and dermatologists. It is believed that this strength will absorb about 97% of skin damaging UV rays. Remember these sun rays are dangerous in winter and can travel through both glass and clouds. Be sure to reapply sunscreen often and especially after patients have bathed or sweated.
  2. Look for shaded areas for seniors to sit while they are outside, particularly when the sun is intense. Keep in mind that the AAD, or American Academy of Dermatology, has determined the sun to be most intense between 10 am and 4 pm in the northern American continent. There is also apparel now hitting the market which can effectively assist in skin protection. Another innovative invention today is laundry detergent with added ultraviolet protection. Remind the elderly to dress in sun protective accessories such as sunglasses, hats, and long sleeves. Suggest woman carry a parasol or men take an umbrella along.
  3. Be cautious and examine all of the literature that accompanies both over the counter and prescription medications. Many of these intensify the effects of sun exposure and make the skin extremely sensitive to UV rays. Neglect can result in skin damage such as blistering, sunburn, and inflammation. Sun exposure has also been medically linked to melanoma.
  4. Skin care for the elderly is not limited to during time spent in the sun. Remind seniors to cleanse their skin on a daily basis. Help them ensure they use only moderately heated water as well as gentle soap when bathing. It is best to always dry the skin thoroughly and moisturize before dressing. All of these steps promote healthy skin which in itself is a sun protectant.
  5. After sun exposure and care is just as crucial as before and during. The first step to proper after sun skin care is appropriate skin care in general. As mentioned above the skin should be cleansed and protected through an everyday regimen. Healthy supple skin as well as proper dietary nutritional intake promotes overall positive health. The body is able to protect itself to a certain degree when is in good condition.

After being outside, or exposed to UV rays at all, moisturize the skin. The best moisturizers provide vitamins for the skin such as Vitamin A and E as well as plant extracts like Aloe Vera and Coconut. Coconut oil contains a natural amount of SPF of anywhere from 4 to 8 depending on how it was manufactured. It is a good idea to practice all of these tips, including after sun care, each day regardless of the amount seniors are exposed to ultraviolet rays.

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Ways to Combat the Flu Season

It is widely known that individuals aged 65 and older are at a much higher risk of severe complications due to the influenza virus than any other age group. It has been estimated that about 90% of flu related deaths are among this age range. Between 50% and 60% of hospital stays due to flu complications occur within the senior group in the United States. As individuals age, their immune system begins to weaken making influenza a very serious threat. There are several steps that seniors and caregivers can take to combat the flu season. Anyone who presents with flu like symptoms should immediately consult a health professional.

Influenza Vaccines
Once the immune system begins to weaken individuals become extremely vulnerable to the flu virus. It is crucial to ensure those aged 65 or older receive their flu vaccines. There are currently two options for this. One vaccine is a normal dose and the other is considered a high does flu vaccine. It is important to consult a medical professional when deciding which is best. Most communities have flu vaccines available around the month of October. The best bet is to get it as soon as possible.

Practice proper Hygiene
Everyone should practice proper hygiene including not only the elderly, but caregivers and little ones as well. This is one of the single most effective ways to combat the flu season.


  • It is extremely important to keep hands cleansed. This may be done with soap and warm water. Wash the hands for at least 20 to 30 seconds before rinsing. Be sure to dry with a clean cloth afterwards. If there is no soap and/or water present, use an alcohol based hand sanitizer.
  • Cover the nose and mouth every time a cough or sneeze threatens, if possible. Cleanse or sanitize hands immediately after each and every sneeze or cough.
  • Try to make a conscious habit of not touching any of the orifices of the face. This include the eyes.
  • Try to keep counter tops and surfaces in all rooms clan sanitized, especially if anyone present is sick.
  • Wash clothes including towels and wash cloths on a regular basis. It is a good idea to wash bathing items and clothes used by sick individuals immediately after use.
  • A couple of other good health habits are try not to be in close proximity to individuals who are known to be sick and all individuals who are sick should stay at home.
  • Try to avoid allowing sick persons to visit until they are well to prevent the flu from spreading. Small children often are not old enough to be completely conscious of all good hygiene habits and may spread the virus unintentionally.


Important Note
Do not get the influenza virus confused with the avian flu virus. Avian flu is widely publicized; however, it is very rare for a human to contract this disease. Humans must come into direct contact with contaminated surfaces or infected poultry to contract it. There are no vaccines available for the avian flu, but they are currently being developed.

It is extremely rare for humans to contract the H1N1 swine flu as well. In many cases, even when humans are exposed to infected hogs, they still do not contract the H1N1 virus. There is an H1N1 swine flu vaccine available; however, many medical professionals believe it is unnecessary as it is very rare for humans to contract it.

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The Mindful Caregiver

How to Be an Effective Advocate When an Elder is in the Hospital


You get the call you have always hoped you wouldn’t get: your 80-year-old father has fallen, broken a hip, and will need surgery. Unfortunately, a sudden change in health status among elders occurs far more frequently than most people expect. Falls are one of the most common reasons elders end up in the hospital. Other reasons include pneumonia, heart attack, and stroke. However, be aware that a urinary tract infection or dehydration can be serious for the elder and be a need for hospitalization. And more times than not, the event that caused the hospitalization can lead to a whole series of events, which could require rehab, in-home care, nursing home or assisted living care and in some circumstances hospice care.

Over the years, my clients have shared that the hospital experience was one of the worst experiences they have had to face with their loved one. Being an advocate for your family member can help ensure that this does not happen to you. Hospitals can be scary places for elders, and especially so for individuals with major health issues or dementia. Depending on their medical situation, surgery or new medications can complicate their hospital stay. The following are tips to help you advocate for your loved one.

The ER can be a busy, noisy, and crowded environment. This unfamiliar and over-stimulating atmosphere can cause an elder to experience confusion, agitation and even combative behavior. It can be even worse for a family member with cognitive impairment. If this is happening or you’re concerned it could happen, be assertive and ask the ER staff if he could go into a room instead of sitting in the waiting room.

If your elder family member is hospitalized, make sure you find out if her status is considered hospital admission or observation. Observation is classified as outpatient. Many families have been confused by this, as they report their loved one was “in the hospital.” Your loved one can receive medical services, lab tests, X-rays, and even spend the night at the hospital. But if the doctor hasn’t written an order to admit her to a hospital as an inpatient, she will be considered outpatient. Keep in mind that Medicare and many insurance policies reimburse differently for observation verses in-patient hospitalization. Plus, if your loved one requires rehab care after his hospital stay, he must be admitted and have a three night in-patient stay in order for Medicare to pay for his rehab care.

If your loved one is admitted, designate one family member to communicate with the hospital staff. This decreases confusion and misinformation and helps to ensure that family the elder’s care is properly coordinated. If there is a Power of Attorney (POA) for health care, I usually suggest that person be the designated advocate.

Another area to be mindful has to do with medication management while your elder loved one is in the hospital. Most elders are on an average of 4-6 medications before they even enter the hospital. Whenever possible, bring a list of your loved one’s current medications. Once hospitalized, an elder’s medications may be changed, stopped or added to. If any medications were changed during the hospital stay, ask the hospital nurse why and ask what medications should be continued, stopped or changed after discharge. Compare the new medication list with the old one and make sure you understand what has changed and why.

Many of my clients have reported that their elders were given psychotropic medication to calm down anxiety, confusion or agitation. If your elder family member is placed on psychotropic medication, ask why he is being prescribed the medication, what is the dose, and how long will they keep him on it. I prefer that they be used as a last resort, as my clients and I have seen that these medications can sometimes cause more problems.

As surprising as it may sound, plan for the discharge to begin as soon as your elder loved one is admitted. First, ask to speak to the social worker or discharge planner assigned to your family member. Ask how long your loved one will remain in the hospital. Keep asking until you know the discharge day. Then find out what care is needed or recommended. If your loved one is going home, make sure that everything is in place for a safe return home. If your loved one needs a rehab care center, don’t rely just on the discharge planner’s suggestions. I strongly encourage that you visit the facilities, check them out and ask questions. On the day of discharge, ask for a discharge summary, any discharge prescriptions and a copy of discharge medications.

There is no doubt that the hospital experience can be stressful. My hope is these tips will be helpful and can at least ease your way.

Please send your questions, ideas and topics of concern to this paper. I will do my best to respond to the most common questions and issues posed. You can also visit my Geriatric Consulting Services website at www.nancykriseman.com, my Facebook page, or follow me on twitter @GeriatricMSW.

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