Recognizing and Responding to

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• Recognizing and Responding to
• Older Adult Behavior

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Learning objectives purpose of this seminar
Through this session you will be able to

• Recognize characteristics of normal aging
• Identify behaviors that may indicate problems
• Know techniques for dealing with older adults
• Identify resources

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Demographics The Graying of America

• Fastest growing population group is older
  Americans
• Most rapid growth is among people 85 with the
  majority being females
• In 2005 the first of the Baby Boomer generation
  turned 60
• By 2030, one of every five Americans will be 65
• Nearly 25 of US households (more than 22
  million) have at least one adult who has
  provided care for an elderly person at some
  point in the previous 12 months

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Aging in America

• Impact on communities and families
• Myths

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What is normal aging?

• Differs for every individual
• Aging does not cause illness illness does not
  cause aging
• Normal slowing down is normal and most, but not
  all, older adults experience decline in senses
  (taste, touch, smell, hearing, sight)

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What is normal aging? 2

• However not true for every older adult and the
  changes are caused by disease not aging
• Vision problems in people in children and teens
• Hearing loss caused by loud noises
• Sports injuries at any age
• Myths about aging

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Secret to Happiness

• Something to do
• Someone to love
• Something to look forward to
• What happens to an older adult
• with chronic illness?

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Behaviors

• Personality does not change as we age unless
  there is dementia or Alzheimers disease or some
  disease that affects the brain
• Whatever we are we are just older versions of
  ourselves magnified through stress and illness
• People who are easy going when they are younger
  and more likely to be that way as they age
• People who dont like change or who are
  pessimistic and demanding are likely to become
  even more so as they age and lose their health
  and independence

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What is dementia?

• Dementia is a loss of mental skills that affects
  daily life caused by disease
• Can cause problems with memory and how well a
  person can think and plan.
• Usually dementia gets worse over time.
• Progression is different for each person.
• Some people stay the same for years. Others lose
  skills quickly.
• Not curable or reversible medications help slow
  symptoms and can help control some of the
  behaviors

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Dementia and Alzheimers www.alz.org

• Alzheimers disease is a form of dementia about
  60 of people with dementia have Alzheimers
  disease
• Not everyone who has dementia has Alzheimers but
  everyone with Alzheimers has dementia
• Age 85 person is at 50 risk of developing
  Alzheimers
• Dementia symptom can be experienced by people
  with Parkinsons disease, result from strokes,
  and other illnesses

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10 warning signs of Alzheimer's disease

• Memory loss.
• Difficulty performing familiar tasks.
• Problems with language.
• Disorientation to time and place.
• Poor or decreased judgment.
• Problems with abstract thinking.
• Misplacing things.
• Changes in mood or behavior.
• Changes in personality.
• Loss of initiative.

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Emotions depends on the basic personality and
health

• Fear
• Denial
• Depression
• Anxiety
• Loss of self image, identify and purpose
• Loss and grief from death of spouse, adult
  children, friends
• Loneliness
• Suspicious and paranoid

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Evaluation for Heath and Safety

• Medical evaluation and ongoing medical care by a
  qualified physician who is board certified as a
  Geriatrician or is an internist with training and
  experience with geriatrics
• You are doing pretty good for your age is not
  an acceptable statement
• It is not okay to be depressed at any age
• At the least get a second opinion and consider
  changing to a physician specializing in treating
  older adults
• Chau Pham, DO, Geriatrician, Keller
• Gerontology Assessment Planning Clinic (GAP) at
  University of North Texas Health Science Center
  in Fort Worth 817-735-2200

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Causes of usual or difficult behavior how to
deal with it

• Medical problems
• Medication interactions especially
  polypharmacology
• Urinary Tract Infections
• Dehydration
• Depression and anxiety chronic or short term
  due to illness, grief, or fear of losing
  independence

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Staying active

• Many older adults are active, healthy, and eager
  to learn something new
• Ask what they want
• Ask them about interests they have had in the
  past
• Help them find activities that are related to
  what they have done in the past

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Staying active, 2

• Many are intimidated and insecure about new
  technology remind them that the fastest growing
  group of users for computers and internet are
  older adults
• Really listen and assure them that they can learn
  new skills
• Give options for print or online form

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Responding

• Empathize walk a mile in their shoes
• Observe behavior
• What is changing in their normal behavior
• Listen
• Focus on health concerns
• Try to avoid telling them what they should do

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Tips for communicating

• Show basic courtesy and treat them with dignity
  and respect.
• Value their age and wisdom
• How do they want to be addressed? Dont assume
  older persons want to be called by first name
  ask them
• Good morning, Mr. Jones?
• Shall I address you as Mrs. Smith or Emily?
• Use normal tone of voice increase volume only if
  they dont respond just because they are old
  does not mean they are deaf

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Tips for communicating, 2

• Ask dont tell How can I help you today?
  What do you want?
• Ask questions in a normal tone of voice avoid
  baby talk.
• Help them identify what they want
• Stay aware of what they may need and make
  appropriate referral to family members and
  community providers such as the senior center

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Tips for communicating, 3

• Ask about family members who may need to be
  contacted for help or to discuss what you observe
  
• Encourage them to stay active by walking, going
  to senior center, staying in touch with family
• Tell them that you have noticed CHANGES and
  encourage them to see a doctor because I want
  you to have the best health care possible

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Special needs and emergencies

• Encourage anyone with special medical needs to
  let the local fire department know
• Education your peers and first responders

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Who is a caregiver?Anyone who helps an older
adult in these and many other ways
   

• Driving to and from doctor and other health care
  appointments
• Helping manage medications
• Communicating with health care professionals
• Assisting someone to pay their bills

• Helping someone clean their home or arranging
  for housecleaning
• Assisting someone or arranging for home repairs
• Helping arrange for home health care or hospice
  services

? _____________________? Caregiver Continuum
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Elder care and independence

• The health of older adults can be unpredictable
  with many older adults remaining healthy
• A slip, fall or diagnosis of a chronic illness
  can quickly and dramatically change the life of
  an entire family
• As health declines older adults move toward
  dependence

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Caregiving is a family affair

• 80 of all eldercare is provided by family
  members
• One of every four households provides help to an
  older person
• Most caregivers
• Are reluctant to ask for or use formal help
• Continue to provide care with little support
• May experience consequences to their own health
  and well being
• Use formal services only as a last resort

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The vast majority of long-term care is provided
informally and privately, at no public cost

• 2003 Updated information for working caregivers
• 56 are women
• 44 are men
• Source National Alliance for Caregiving and the
  Center for Productive Aging (2003), Sons at Work
  Balancing Employment and Eldercare

American Society on Aging, 2000
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Elder care and the workforce

• 62 of elder caregivers are working part-time or
  full-time
• Up to 25 of employees report having caregiver
  responsibilities
• The average family caregiver is a middle aged
  female
• In the last 3-5 years the number of sons,
  husbands, and other male relatives providing
  elder care has grown significantly
• 40 or 7 to 10 million adult children are caring
  for their parents from a long distance
• 44 of Americans between the ages of 45 and 55
  have aging parents or in-laws as well as children
  under 21
• American business is losing between 11 and 29
  billion per year because of the direct and
  indirect costs of elder caregiving

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Caregivers checklist

• Assess the situation What are the needs?
• Thorough recent medical examination
• Functional assessment by an occupational
  therapist, social worker, home health, or other
  (ask doctor to prescribe)
• Complete Family Caregiver Assessment
• Use Long Distance Assessment, as needed
• Prioritize needs
• Organize important information
• Find out about and use resources
• Take care of yourself

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Help older adults by

• Helping maintain independence and
  self-sufficiency
• Reducing risk
• Using health care, family and community support
• Increasing knowledge of illness or disability
• Reinforcing a sense of productivity and
  involvement
• Helping make choices to determine the course of
  his/her own life
• Being supportive
• Bringing a positive attitude

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Resources For Caregivers

• Call
• 2-1-1 throughout Texas. Provides information and
  access to health and human service information
  for all ages
• 1-800-252-9240 to find local Texas Area Agency on
  Aging
• 1-800-677-1116 - Elder Care Locator to find help
  throughout the United States
• Online
• Family Caregivers Online www.familycaregiversonlin
  e.net
• Online education, resources, links, frequently
  asked questions
• Benefits Check-up www.benefitscheckup.org for an
  online way to determine benefits for which
  someone qualifies.
• To schedule a caregiver presentation for your
  church, business, library, civic group, or other
  location, call your local area agency on aging or
  send an email from www.familycaregiversonline.net

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What Assistance is Available Through the Area
Agency on Aging (AAA)?

• Services for persons age 60 and older
• Benefits counseling
• Ombudsman - advocacy for those who live in
  nursing homes and assisted living facilities
• Home delivered meals
• Congregate meals
• Light housekeeping

• Caregiver Services
• Information and referral
• Caregiver education and training
• Caregiver respite
• Caregiver support coordination
• Case management
• Transportation assistance

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• Written by Zanda Hilger, M. Ed., LPC, Family
  Caregiver Education, Area Agency on Aging,
  Revised 2009.
• Go to www.familycaregiversonline.net for more
  information about this and
• Other training programs internet links
  frequently asked caregiver questions legal
  forms phone numbers fact sheets and more