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

1. Memory loss.
2. Difficulty performing familiar tasks.
3. Problems with language.
4. Disorientation to time and place.
5. Poor or decreased judgment.
6. Problems with abstract thinking.
7. Misplacing things.
8. Changes in mood or behavior.
9. Changes in personality.
10. 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