Your Serenity Care Blog

When Should Mom And Dad Stop Driving?

Driving seems to be one of the hardest of our  freedoms to give up as we get older. Remember when you were so excited to get your license?  It was a taste of independence. You can see why there is a  reluctanceto give it up.  Driving equals independence.  This is why it is so hard for an elderly person to give up their keys.  They feel they are giving up that last shred of independence.   What’s even worse is when your own child is the one telling you that it’s time to give up that independence.

There may come a time when you have to address the fact that your parent is getting too old or too ill to drive their car. What do you do? Here are a few tips to help you recognize the situation and approach the subject:

1. Determine how well your senior is doing behind the wheel.  The best way to do this is to go for a ride in their car with them. This is not driver’s education.   Your job is not to teach them how to drive better. Instead, you are and observer.  You are looking for signs of diminished skills and reflexes such as missing stop signs or not following traffic signals. If they seem nervous or jittery while driving, this can also be a sign of a problem.  Sometimes you will notice that they are driving 10-20 miles under the speed limit.  This can be dangerous.
2. Have your parent’s eyes checked regularly.   Most older people have vision problems and hate to admit it.  This confirms they are getting older.  They usually avoid seeing the eye doctor.  Schedule an appointment for your elder parent. Reassure your parent that they may not need anything more than a new pair of glasses. Seeing the eye doctor does not automatically mean they will lose their license to drive. It may just clear up a vision problem and they’ll be back on the road before they know it.
3. Have a conversation with your parent about driving.  Do they feel that they can still manage?   Are they comfortable out on the highways.  You may get a suspicious look or an argumentative tone, but don’t join in. Remember that you are talking about their independence.  They may feel threatened.  Reassure them you are just checking in to see where they are at with the subject.  Don’t treat your parents like children.  They will usually respond better if you are respectful of their feelings and concerns.  You might be surprised to find out they have been waiting for someone to ask. 
4. Enlist the aid of their doctor to discuss driving with your elderly parent (you will need to attend this appointment to start the converssation). Your parent may not want to hear it from you, but they will listen to their trusted family physician. If your parent is denying they have vision problems or judgment issues and continue to drive, it may result in an accident. For this reason, a visit with the family physician voicing your concerns would be expected. Your parent’s doctor may have to be the one to tell Mom or Dad that their driving needs to be limited or eliminated altogether.
5. Show them how to make their own arrangements for transportation with the local transportation companies.  This will still give them some independence as they will be able to come and go as they please, they will just not be the one driving!

It is never easy losing independence at any age. When safety issues are at stake, you will  have to deal with the fact that your parents are no longer able to drive by themselves. Enlist all the help and support you can get if and when this decision needs to be made.  Always put yourself in their shoes and treat them accordingly.  You can never go wrong with that in mind!

As I sit here and watch Celebrity Apprentice, I am both saddened and appalled at how Gary Busey is being portrayed as some crazy idiot.  I already know what you are going to say….he is on for ratings or it’s all for entertainment purposes.  Well, I think they have gone a little too far and don’t even realize it!  He has a brain injury people!!  I do not believe this has been taken into account by his teammates or by Donald Trump.  Week after week,  I watch as his teammates bully or make fun of him.  He is picked on each time their team goes to the boardroom.  I do not think they realize they are dealing with a handicapped person.  If they thought about it for just a second, they would be ashamed of themselves.  Gary is a textbook, brain-injured patient.  He lacks judgement at times.  He is impulsive.  He has frequent memory lapses.  He lacks the ability to focus. Some of the things he says make no sense at all.   One thing he has been is consistently  graceful.  He is always forgiving of those who are bullying him or making fun of him.  Tonight, he left the show with grace.  Donald Trump, you might want to think about making a public apology for the horrible way Gary Busey was portrayed on your show before running for president!

Yoga is great for the elderly, as long as their physician clears them to do so.  It can help them to stay flexible, strong and give them a tool to use when stressed.  Below is a guide from yoga.com (author unknown).

Yoga Session for the Elderly

Kapalabhati Kapalabhati is a Breathing Technique used specifically for cleansing. If you have a lot of mucus in the air passages or feel tension and blockages in the chest it is often helpful to breathe quickly. This article will introduce you to this breathing techniques and show you its its benefits. Easy Pose (Sukhasana) This is one of the classic Meditative Poses and is usually performed after doing the Corpse Pose. The Easy Pose helps in straightening the spine, slowing down metabolism, promoting inner tranquility, and keeping your mind still. Cat Pose (Bidalasana) The Cat Yoga Pose teaches you to initiate movement from your center and to coordinate your movement and breath. These are two of the most important themes in Yoga practice. Keep in mind that the Cat Pose may not be advisable if you have any chronic or recent back pain or injury. Dog Pose (Adho Mukha Shvanasana) The Dog Pose improves flexibility of your spine, stretches the hips and middle and low back, rejuvenates the body, and helps in preventing back problems. Take note that this Yoga Pose should not be performed if you have serious back pain or injury. Double Leg Raises A Double Leg Raise is similar to a Single Leg Raise, only this time, you will raise both legs. In doing this Yoga Pose, make sure that the full length of your back is resting on the floor and your shoulders and neck are relaxed. This section covers the steps and guidelines on how to do this pose properly. Half Spinal Twist (Ardha Matsyendrasana) If done properly, the Half Spinal Twist lengthens and strengthens the spine. It is also beneficial for your liver, kidneys, as well as adrenal glands. Practice this Yoga Pose under the supervision of a Yoga instructor. In this section, learn how to perform the Half Spinal Twist. Locust Pose (Salabhasana) If the Cobra Pose works mainly on the upper back, the Locust Pose targets the lower part. This posture also strengthens the abdominal area, arms, and legs. Another thing that makes it different from many poses is that it entails rapid movement. Check out how it is done in this section. Wind Relieving Pose (Pavanamuktasana) The term Pavanamuktasana comes from the Sanskrit word ‘pavana’ which means air or wind and ‘mukta’ which means freedom or release. The Wind Relieving Pose works mainly on the digestive system. specifically, it helps in eliminating excess gas in the stomach. Yoga Exercise – Corpse Pose (Savasana) The Corpse Yoga Pose is considered as a classic relaxation Yoga Pose and is practiced before or in between Asanas as well as a Final Relaxation. While it looks deceptively simple, it is actually difficult to perform.  This Yogic exercises schedule is good for aged people. But if you have osteoarthritis at knee joints then please go through the following link to know more about the special exercises to manage your knee pain. http://www.abc-of-yoga.com/forum/general-yoga/pain-at-knees.asp

There was an article published in the Neurology Now magazine by Michael Smolinsky citing that smoking heavily in mid-life may increase the risk of Alzheimer’s and vascular dementia in late life by as much as 100 percent.  The article goes on to say that the risk is probably even greater then we know because of the different factors involved in the studies that were done. 

If you think about it, smoking IS KNOWN to cause heart disease, cancer, lung disease and vascular insufficiency.  Why would it not also cause dementia?  The same mechanism of injury applies…smoking causes an increased heart rate (making your heart work harder), constriction of the blood vessels (making them narrow and hard to get blood through) and lack of oxygen to your vital organs including your brain.  The blood vessels in your brain are very small.  Any insult or injury to these vessels can cause a multitude of problems. 

So if having lung cancer or suffocating because of COPD does not scare you, maybe forgetting who you are or who your family is will.  It is not too late to stop the process of these diseases.  If you quit smoking now, you can stop the on-going damage.  In some instances, you cannot reverse the damages that have already been done.  But below are a few places you can affect:

I am sure many of you did not know this was an epidemic….watch the following video by jlgarris83.

This video really saddened me as I remember the recent murder suicide that took place down the street in a local independent living community. These people were surrounded by friends and family. No one realized or saw the signs. Maybe with more education on what to look for, more of us can look out for our seniors. Our seniors are lonely and feel like a “bother” to their children. I have heard this time and time again. We as a society need to value our seniors. They need love and companionship just like we do. As children, we need to make sure our parents are doing OK and that we do not get caught up in the business of our own lives and forget those that brought us into this world. We may be all they’ve got. Just wanted you all to think about this situation. See how you can intervene in the lives of the seniors around you.

This is an amazing video of another brave elderly women who changed the life of her “would be” attacker.

Would you be calm, cool and collected enough to bear witness to someone who is threatening your life?? I am not sure I could do that on my best day. You can bet I would be praying for divine intervention! I am sure that is what happened here.

Yes, I humbly admit, I should have gotten a flu shot. I am a Registered Nurse, who is deathly afraid of the flu shot. Laugh if you want, but I had a bad experience the one and only time that I did get one. It was not that I got sick, but the Nurse who gave it to me hit my bone with the needle. It was not a pleasant experience. However, neither is having the flu that is going around this season. Being the healthy, young person that I am, I cannot imagine what this flu must feel like to an elderly or immunocompromised person. If you have not gotten the flu yet, let me put it into prospective for you….it starts with a headache. This is not your ordinary headache mind you. It is a headache that not even four Advil will take away. Then you get a fever. Of course, with fever comes the chills. It is a constant cycle of being cold, then hot, then sweaty. Along with the fever comes the achy joints. It feels as though you have been hit by a bus at fifty miles per hour. No bone is spared. Of course there is nausea. Oh and your chest feels like you could breathe fire when you cough. Your face feels like it wants to jump off your body. You cannot get comfortable to sleep, so you are a zombie. Have I said enough? Run to the nearest pharmacy, doctor’s office or where ever they are doing flu shots and get one! You do not want this flu. Also, make sure your elderly neighbor, parents or friends go with you. They cannot afford to get a flu like this!

Adult daycare can be a life saver for both caregivers and elderly loved ones. It allows a person to age at home as they wish while giving the caregiver time to do what they need to do to take care of themselves. This video by PBS39 shows how adult daycare works.

Most adult daycares are flexible with attendance days, hours and times. They provide caregivers with well needed respite for a few hours a day to 8 hours per day. The elderly are provided with much needed socialization and stimulation. This is a win win situation for everyone involved! Contact Serenity Care Senior Health Advisors for more information about adult daycares in your area at info@yourserenitycare.com.

So many times we as Case Managers have our hands tied by bureaucracy, insurance coverage, lack of insurance coverage, too much work and lack of time. How do we meet the needs of our vulnerable patients? How do we spend the time teaching the family what the next steps are? How do we keep our sanity?

We go back to the basics of case management! We do what we can do. The rest will be there tomorrow. If we just take the time initially to assess the situation fully, we will know how to intervene.

• Start by focusing on the one patient you are with at the time. So many times we are so used to multi-tasking that we cannot be effective in any of the things we are doing. See the things you need to do for this patient through. Then move on to the next one.
• Get the patient involved in their own planning. Most of the time they are comfortable allowing others to worry about their lives. They need to take control. Be involved. The sooner they buy into that fact, the easier your job will be with them.
• Communicate! Talk with family members, physicians, facilities and other services. Make sure everyone is on the same page when it comes to this patient. So many times things fall through the cracks because we think the other person got our information, when they did not.
• Follow up! Make sure the patient understands the importance of their follow up visits with their doctors or other services. Make sure the facilities or services you have referred the patient to have received your information and understand the needs of this patient (both short and long term)
• Take breaks! We cannot be effective in our jobs if we are burnt out, tired, overwhelmed etc… Not only should you take a break at work, but take a break from your work. Do things that pamper your soul. Take care of yourself so you can be the best for your patients.
• Have empathy. It is so easy to see our patients as another “task” on our to do list. Reach inside and remember why we do this job. We do it because we want to help people. We care about people. If you find that you don’t, this is not the right job for you!

Now these seniors know how to have some fun!

When I first saw this video, I could not stop laughing. It was so great to see them step out of their element. The looks on some of their faces were priceless. Can you imagine the looks on the kids faces who they were singing for? They did this for a youth camp. This video has over a million hits on you tube. Talk about viral! Is you senior loved one having fun like this? I hope so. Encourage them! Show them what it’s like to be a kid again. We all have a little kid in us…..just waiting to break free. Go! Be a kid as much as you can!!