Maximizing the Quality of Life for Families with Special Needs

As the name of our company suggests, most of Elder Care Guides’ clients are older adults who access our professional care management and in-home support services to improve their quality of life and maximize safety while living as independently as their situation allows. But through the years we’ve seen an increase in the number of families caring for a loved one with a developmental disability who come to us for support. Within these aging families, many parents are wondering who will take over the care of their adult child when they themselves are no longer able to do so. Will they have access to the kind of care they would want for their son or daughter?

In order to better serve these families, I recently attended a Special Needs Trust presentation by the CELA Certified Elder Law Attorney Phil Lindsley. He has been involved with the special needs community for over 30 years and is the senior attorney at the San Diego Elder Law Center.

Anyone with even a remote knowledge of this area of the law knows that things get complicated very quickly. A lot of important information was covered during his two-hour presentation, and below I’ve provided a brief summary of my key takeaways. Continue reading “Meeting the Needs of Families with Special Needs”

Suicide: Older Adults at Risk

September 12, 2014

National Suicide Prevention Week

This week is National Suicide Prevention Week, an opportunity to discuss a subject that is too often considered “taboo.” According to the most recent statistics released by the Centers for Disease Control, the suicide rate in the United States is climbing, despite the efforts of public health and mental health advocates to raise awareness and encourage people to seek help.

The most recent statistics from the CDC (from 2011) reveal that U.S. national suicide deaths rose slightly for the fifth year in a row from 12.1 per 100,000 in 2010 to 12.3 per 100,000 in 2011 (rates are per 100,000 individuals). Data from 2012 and 2013 have not yet been released.

Older men are particularly at risk for self-harm. While the risk of suicide declines for women with advancing age, statistics show that men’s risk increases as they get older. Older men die by suicide at a rate that is more than seven times higher than that of older women. White men aged 85+ die from suicide at a rate four times higher than the average rate of suicide nationally. Firearms are the most common method of suicide in older adults (67%), followed by poisoning (14%) and suffocation (12%). Continue reading “Suicide: Older Adults at Risk”

Yesterday I went to see a new doctor. As we were talking during the appointment, he asked me about my work. When I explained my social work background, and the care management and home care services we provide to older adults, he responded, “Wow, I bet that’s depressing.”

This, I have found, is a pretty common response when people hear that I work in geriatrics. It amazes me each time I hear it, especially from a doctor, because it is so far from the truth.

What is it about getting older that inspires such fear and loathing? Why is growing old necessarily equated with sadness and isolation? Is there another way to conceptualize the process of aging?

For each of us, the answer to these questions is different, and certainly dependent on our personal experience. Some of us have positive memories of fun times with very active grandparents, while others have seen their older relatives suffer from chronic conditions that have impaired their quality of life. In my case, my mother died in her early 40s. Like many whose parents or grandparents have died young, I look at aging as a gift. So many people don’t get the chance to have a 50th or 60th birthday, let alone a 90th.  So, you might accumulate some spots and saggy areas along the way; it is truly better than the alternative.

Learn to see aging as a gift.
Learn to see aging as a gift.

Working with older adults, for me, is a privilege. Each client I have known has been an individual, with his or her own strong points, flaws, and particular sense of humor. When I learn about the losses they have suffered, their accomplishments, their goals, and their fears, I am struck by each person’s uniqueness and value.

I did my best to share with my doctor the perspective that aging isn’t so bad. In fact, it is to be celebrated. Wouldn’t it be great if we could spread that idea, one person at a time?

Prescription drug abuse is on the rise in the older adult population.
Prescription drug abuse is on the rise in
the older adult population.

Prescription drug abuse has become a dramatic public health concern in the United States, and it is not limited to “young people.” Mental health providers, physicians, and government agencies are noting increasing problems with the misuse and abuse of prescription medications amongst older adults, including the Baby Boomers. While there have not been many studies on the subject, some research shows that up to 26% of people over the age of 65 misuse or abuse their prescription drugs.

Why are so many older adults misusing or abusing their medications?  Older adults who have cognitive decline, including dementia, may experience confusion about how and when to take their medications. Pain, anxiety, depression and sleep problems are common in the elderly, and the medications prescribed for these conditions can lead to abuse or dependence. Some older adults on limited incomes may “borrow” or share medications. In most cases, the abuse or misuse is not intentional, and the medication is obtained legally, by prescription.

Older adults face some particular risks if they misuse their medications. According to The Substance Abuse and Mental Health Services Administration (SAMHSA), older adults are more vulnerable to this problem because as a group they use more prescription drugs than younger adults. Due to the slowing metabolism and elimination associated with aging, even small amounts of medication can impact older adults in dramatic ways. Many older adults take multiple medications, increasing the likelihood of medication interactions. The abuse or misuse of “psychoactive drugs” taken for depression, anxiety, and insomnia is of particular concern as these drugs act on the central nervous system. If used inappropriately, or mixed with alcohol, these medications can cause sedation, memory problems, functional impairment, and/or falls.  Those older adults most vulnerable to psychoactive medication abuse are socially isolated women with histories of substance abuse and mental health problems, especially depression.

What can older adults and their families do to avoid prescription drug misuse and abuse?

  • Read and follow prescription drug usage instructions and ask your health care provider for information on side effects.
  • Do not rush to increase the strength of your medication, especially pain medication. Talk to your doctor if your symptoms are not improving, and explore non-prescription methods to address your symptoms (such as massage, acupuncture or stretching/exercise). For depression and anxiety, consider talk therapy as well as medication therapy.
  • Let your doctor and pharmacist know about every medication you are taking, prescription and over-the-counter, including supplements.
  • If you are taking more than five medications, it is likely you will experience some drug interactions. Consider working with a senior care pharmacist to review your medication list and identify possible changes to discuss with your doctor.
  • Never use another person’s medications. If the cost of medication is a concern for you, ask your doctor for samples and talk to your pharmacist about medication assistance programs.
  • If you suspect you may have a problem with prescription drug abuse or misuse, know that you are not alone and help is available.  Talk to your doctor, mental health professional, or geriatric care manager for local resources.

Information gathered from fact sheet from SAMHSA: