“Aging in place” is the mantra of elder care

“Aging in place” is the mantra of elder care, ideally at home or in one facility that will serve your needs forever. It rarely happens. Things change. In the trade, moves are known to cause “relocation trauma,” physically and emotionally, for the frail elderly person, already sick and scared, and for the adult children, who must orchestrate everything. -From The New York Times blog, “The New Old Age”

As part of the community “TimesPeople” I regularly comment on the The New Old Age Blog. Here is what I have to say about their recent article, The Last Place She Expected to Be

These are very significant life-style changes, as they signal a loss of independence. It represents a time when our loved ones lose control over their environment and their health. Restrictive environments like assisted living and nursing homes are increasingly pushing adult children and seniors' specialists to redefine how we look at aging. It can be argued they serve a purpose, but the sentiment of a strong majority of seniors and their adult children (over 85%) is these restrictive envirionments are a destination of last resort on the "way out."

Ten thousand Boomers a day are turning 65. Boomers must not only contend with lifestyle and wellness issues of their own but additionally must focus on the well-being of their aging parents, whose age group at 86 is the fastest growing segment of the senior population. Add to the mix angst over money and you could end up with a recipe for disaster. Showing empathy toward your fellow Boomer by way of your comments carries cathartic and therapeutic benefits. But that's not enough. Life should be about fulfillment, and that happens when you're better prepared. So stay engaged and healthy for a lifetime of independence.

Andy Berger

Andy Berger is the president of Senior Wellness Specialists, a lifestyle and healthcare services company offering Universal Design and Senior Concierge services for all stages of life. 

More Time Spent Talking with Your Doctor Keeps You Healthy and Out of the Hospital

Does your physician give you more than the customary 8-10 minutes to figure out what’s wrong with you?  And in that time-frame can the doctor make an accurate diagnosis and prognosis? Most successful practices have around 7,000 patients and for reasons of efficiency can’t devote any more time than that to a patient. And sometimes this adherence to “time is money” mentality can lead to trouble.

A daughter brings in her 93 year-old frail Mom to see her primary care physician for a persistent cough and congestion in her chest. Doctor listens to her chest, takes her temperature, blood pressure, orders an X-ray and draws some blood. Lab results won’t be back for a few days. Meantime, the X-ray shows the lungs are clear, no presence of pneumonia.  Doctor figures it’s just a bad cold, at worst a slight infection, prescribes a Z-Pac for Mom and instructs both mother and daughter to return for a follow-up in a week or so.

Two days pass and Mom’s condition worsens, she becomes comatose and is ambulanced to the local hospital. Turns out had the doctor spent more time reviewing her medical history and talking with daughter and Mom, he would have discovered Mom had been treated by another physician five years back for an infectious disease called Mercer. He would have also learned that the symptoms Mom displayed at her recent office visit were strikingly similar to those associated with Mercer. If not properly diagnosed, Mercer can be deadly.

That delay, that improper diagnosis lands Mom in the hospital for 10 days. There she receives treatment and is subsequently transported to a rehabilitation center, where she appears confused and is hostile towards employees. The on-staff doctor there sedates the mother. After about 18 hours the daughter gets a call to come and pick up the mother, as the rehab center doesn’t work with aggressive patients. Again, had someone taken the time to check on Mom’s history they would have found she suffers from a form of dementia, which would explain the mood swings.

Nowhere to turn, Mom is once again hospitalized.  And so begins anew the vicious cycle of frustration and anger over a medical system that doesn’t appear to be working optimally.  But there are solutions.

Universal Wellness Insurance, a form of long-term healthcare insurance, provides a boutique-style, concierge oriented approach to wellness. It is an outgrowth of Universal Design that puts more control over your environment and your health, all without time constraints.  So talk to the doc as much as you want. All of our wellness services and programs are personalized and address your ever-changing and discerning lifestyle and wellness needs, which defines who we are and provides a strong foundation for building trusting relationships.

Andy Berger

Andy Berger is the president of Senior Wellness Specialists, a lifestyle and healthcare services company offering Universal Design and Senior Concierge services for all stages of life. 

Senior Citizen Alert: Product Recalls

This week we have recalls on SUVs, cucumbers, disinfecting wipes, snow blowers, lawnmowers and smoked salmon.

Toyota Recalls 308,000 RAV4 and Highlanders for Faulty Air-Bag Sensors
The recall covers about 214,000 RAV4s from the 2007-8 model years and 94,000 Highlander and Highlander hybrids from 2008, the automaker.

Nature's Delight Cucumbers
A North Carolina vegetable and fruit distributor has recalled cucumbers distributed to nine states, including Illinois and Indiana, after some of the vegetables distributed to Florida were found contaminated with salmonella, according to the company.

The bulk cartons are marked Nature's Delight and have lot number PL-RID-002990.

Anyone with questions about the recall can call L&M at 919-981-8003, although the hotline is only staffed Monday through Friday, 7 a.m. to 4 p.m. Central Time. Messages left over the weekend will be returned, according to the company.

Disenfecting Wipes
Since December, Triad Group and its sister company, H&P Industries Inc., recalled a score of alcohol prep pads that it made for companies including Walgreens and CVS. The products were recalled because of potential contamination from bacillus cereus, a bacterium that could cause a potentially serious infection. Consumers who have to take medical injections -- like diabetics -- use prep pads to clean and disinfect their skin before the injections.

Iodine prep pads are also beinf recalled. These wipes are in many first aid kits
http://www.walletpop.com/2011/04/25/medical-disinfecting-wipes-fda-adds-to-the-recall/

Toro Recalls Nearly 30,000 Snowblowers, Lawnmowers (TTC)
Toro power clear snowblowers and the Toro 20" recycler mowers manufactured by The Toro Company, of Bloomington, Minn., and sold at Toro Dealers in the United States and Canada from September 2009 through March 2011.

The Fresh Market Signature Collection: Atlantic Smoked Salmon
Woodsmoke Provisions Voluntarily Recalls 160 packages of 4 oz. The Fresh Market Signature Collection Atlantic Smoked Salmon Due to Possible Health Risk

he 160 packages of product subject to recall were distributed and sold only in a limited number of The Fresh Market, Inc. stores located in AR, FL, GA, IL, KY, MD, NC, OH and TN.

The product being recalled was packaged in 4 oz. plastic packages with the specific lot code 1459/2 which was manufactured January 15, 2010. The item UPC code is 737094000370.

Consumers who have purchased this product from one of the above-mentioned stores with lot code 1459/2 should not consume it, and are urged to return it to the place of purchase for a full refund. Consumers with questions may contact the company at 404-355-5125, Monday through Friday from 9am to 5pm (EST).

Subscribe to the Senior Wellness Specialists Blog to get up-to-date information on product recalls and other information of value, especially to people 55 and older.

Aging in Place

A recent article in The Observer News talks about Aging In Place and how the baby boomers don't even see retirement in the same way as their parents did. Here are my comments on this article.

Clearly money is the driving force behind decisions (both good and bad) being made by both Boomers and their parents, when it comes to aging, their health and wellness. This should be a wake up call for all of us. Making healthy lifestyle decisions and planning for aging has never been more difficult. One generation grew up in or after the Great Depression, and became comfortable saving and making due. One of the negatives to come out of this very disciplined upbringing is its potential for sacrificing the quality of their lives. We see it often with parents of Boomers who place a premium on leaving an inheritance over making their own lives safer. We advise that better planning could save them much heartache and frustration and yes even thousands of dollars.

Boomers on the other hand--until our recent experience with a mini Great Depression-- gained significant wealth and grew very comfortable spending on things that made and still make them feel young and vital. Don't even think about mentioning wheelchairs, canes, scooters, walkers or hospital stays in their company. Boomers don't plan to retire any time soon and don't want to think about the problems associated with aging; many will work from home well past traditionally acceptable retirement age, often giving little or no thought to the hazards present in their home. For Boomers, it's more about satisfying an insatiable appetite for fun and working on their terms. Sidestepping the realities of aging seems to be the answer du jour. It's usually not until an emergency or dire situation arises that they are compelled to take action, and quite often in a panicked state of mind. It doesn't have to play out like that, however. Intelligent solutions to aging are available. For both generations, a healthy lifestyle can mean having FUN and saving money. That's a winning formula.

I Am My Parents’ Keeper

Parents and their adult children are increasingly switching roles. Who’s the child and who’s the grownup? Health and safety are a top priority. But often the parent is in denial that any problems exist, even though their families are aware they exist and bring it to their parents’ attention. As you might imagine, there are consequences to inaction.

Convincing mom and dad you know what’s best for them is no easy task and that waiting until after a terrible illness strikes (a stroke, a heart attack, or Alzheimer’s, etc) to take action is not the way to ensure a long and healthy life. It seems money issues are often at the center of critical decisions that have to be made.

This generation has come to depend on Medicare and other entitlement programs to pay for most of their health needs. Getting them to reach into their pockets to pay for any additional expenses not covered can be frustrating. This reliance on government to take care of all of us will be short lived, as budget cuts force us to consider alternative healthcare programs.

Parents are often less concerned about their own well-being and more interested in not being a bother to their kids and in leaving their family an inheritance. Nevertheless, it somehow falls to Boomer to make sure mom and dad live the second half of their lives with dignity and as independently as possible. So whatever you do to help, try to keep the lid on discussing assisted living and nursing homes. Over 85 percent of seniors prefer staying in their homes. But sometimes seniors who live on their own suddenly find it more difficult to get around the home. Their once easy-to-get-around surroundings and familiar routines can all of a sudden become problematic. Solutions are available.

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Ask your wellness questions on aging. Our panel of experts will answer all questions, from the government's role in taking care of seniors to family and sources to help make the transition. Please send your question to info@seniorwellnessspecialists.com

Product Recalls of interest to Senior Citizens

Every Thursday we bring you the latest recalls posted. Subscribe to our blog to get these weekly notifications and other useful information.

Jonathans Sprouts Recalls Alfalfa Sprouts because they have the potential to be contaminated with Salmonella. Consumers who have purchased Jonathans Sprouts products containing alfalfa sprouts with sell-by date 4/23 are urged to return it to the place of purchase for a full refund. Consumers with questions may contact the company at 508-763-2577. Get more info here.

Ortho-McNeil Neurologics Voluntarily Recalls Two Lots of TOPAMAX®
Ortho-McNeil Neurologics Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc., announced it is voluntarily recalling two lots of TOPAMAX® (topiramate) 100mg Tablets. These two lots were shipped between 10/19/2010 and 12/28/2010 and distributed in the U.S. and Puerto Rico. While the recall encompasses approximately 57,000 bottles of TOPAMAX®, the company believes there are fewer than 6,000 bottles remaining in the marketplace. The recall stems from four consumer reports of an uncharacteristic odor thought to be caused by trace amounts of TBA (2,4,6 tribromoanisole).
http://www.fda.gov/Safety/Recalls/ucm251515.htm

ADP Recalls to Repair Unit Heaters Due to Fire Hazard
Sold at: ADP dealers and distributors nationwide from September 2003 through April 2011 for between $2,700 and $4,200.  Consumers should stop using these recalled heaters immediately. Consumers should contact ADP to schedule an inspection and, if necessary, repair of the heater. For additional information, contact ADP toll-free at (866) 303-8634 between 8 a.m. and 4 p.m. CT Monday through Friday, or visit the firm's website at www.adpnow.com.

Ground turmeric sold under Target's Archer Farms brand name has been recalled nationwide because of elevated levels of lead. The lot numbers and best-by dates involved in the recall are 1740901A, 6/23/11; 2180902A, 8/6/11; 2780906A, 10/5/11; 2920903A, 10/19/11; 3060903A, 11/2/11; and 0071003A, 1/7/12.

Consumers in possession of this voluntarily recalled product may return it to the store at which you purchased it. Consumers or media with questions should contact B&M, Inc. at 1-877-321-5852 (Monday – Friday, 8:30am – 4:30pm CST) or contact Target Guest Relations toll-free at (800) 316-6151. 

Long-Term Care Plan for Aging Americans

A recent article in the US News titled, 5 Reasons You Need A Long-Term Care Plan, talks about aging older Americans' need for long-term care assistance. Here are my thoughts on this matter.

Past marketing efforts by insurers to get people to think about, let alone purchase, long-term insurance have failed miserably; hence, the low number of those who have coverage today. Probably lacking the research to intelligently market to a rapidly growing segment of the population (Boomers who would have been in their 30s, 40s even 50s), they instead focused too much energy on seniors nearing retirement where the payoff for agents was more immediate. But soon insurers found their payouts too often resulting in low profit margins. There are probably fewer than five long-term care companies left. Odds are more will leave the game for reasons of low returns.

Better medicine, more healthful foods and more exercise just make it all that much more urgent to come up with innovative programs and services that will help ease the pain for the next 20 years or so. As a company that deals with issues of wellness and health affecting Boomers and their parents, we at Senior Wellness Specialists have tried to reach out to a rapidly dwindling number of long-term care insurers such as Genworth to get them to consider suggestions that could save the country and individuals millions of dollars and at the same time let them profit reasonably. One such provision would have a much greater percentage of citizens carrying a policy that would allow them to maintain a healthy and engaged lifestyle in the comfort of their home. Universal Design changes are one such option.

Senior Care – Evaluating a Person’s Ability to “Safely Drive”

By Steven E. Reznick, M.D., FACP

Many of my elderly patients seem to take comfort in the fact that they “no longer drive at night,” or “only drive in the community.”  I am not certain that these self-imposed restrictions actually provide any major reduced risk or protective benefits. In Florida, with a lack of public access transportation, giving up your car is giving up your ability to get around.   It’s also perceived by most elderly as giving up their independence.

As part of a routine office visit, I’ll ask my elderly infirm patients “How did you get to the office today”? A common response is that they are still driving independently.  This same patient, who needs assistance getting up the building’s ramp and a 60 minute appointment just to get out of their clothes and into a gown for an examination, is guiding a 5,000 pound vehicle on the roads.

Unfortunately, there’s very little data available that provides guidelines as to when an elderly infirm person should stop driving.  There is even less data supplied by the State of Florida’s Department of Motor Vehicles.

It is clear that after a neurologic event such as a seizure or loss of consciousness there is a state mandated cooling off period before you are permitted back behind the wheel. It is less clear in an individual with diminished hearing, diminished  eyesight  and diminished flexibility whether they should be driving and how much?

Thus, I was pleased to learn that the Florida Department of Motor Vehicles and a local rehabilitation facility run a State supported Senior Adaptive Driving Program. Pine Crest Rehabilitation Hospital in Delray Beach runs a comprehensive driver evaluation and instruction program. It is far more individualized and comprehensive than the programs run for seniors by their auto insurance companies.

In the Program, trained professionals thoroughly evaluate the person’s abilities to safely drive and help adapt the vehicle to assist the senior. If the professionals say you are good to go then you are qualified and capable. If you are not qualified to drive, they begin the process of rescinding your license.

When patients’ children contact me with their concerns about their parents’ driving abilities I refer them for this evaluation all the time. I highly recommend it for those of you questioning your driving abilities or those of your elderly loved ones.

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Steven E. Reznick, M.D., FACP is a board certified internist, with added training in geriatrics, practicing concierge medicine in Boca Raton, Florida since 1979. He has been recognized by his peers as a “Best Doc” as published in Miami magazine and the Miami Herald.  For more info call 561.368.0191 or go to www.BocaConciergeDoc.com.  You can read Dr. Reznick’s acclaimed blog at http://bocaratonconciergedoctor.wordpress.com/.

Health Insurance Can Keep Seniors from Receiving Optimal Care

Consider yourself fortunate if you have Medicare or other non-HMO as your primary insurer. A leading cause of hospitalization of seniors, congestive heart failure (CHF) patients are being discharged before they have fully recovered from the illness. Medicare wants to make sure you stay healthy. It pays for treatments that get you up and functioning as independently as possible. Health Maintenance Organizations (HMO's) usually have provisions in their plans that limit hospital stays.

Sometimes it's more than just the heart and lungs that are affected, other organs like the kidneys are often compromised as well. That's why you have to know what your plan covers and for how long. The course of treatment and its duration are predetermined by an HMO. Statistics and other formulas are used; and very little or no consideration is given to you as an individual with specific needs. So if you don't get better in that time frame, you go home too soon and have to fend for yourself as best you can. Often, the results are tragic.

Many patients soon develop symptoms that got them hospitalized in the first place: water retention and subsequent swelling of body parts, shortness of breath, irregular heartbeat, dizziness, etc. The regimen of pills that are prescribed for CHF often have side effects that can put a senior at risk, as in the case of a fall. For example, Coumadin, given to thin the blood and which has to be monitored regularly, could cause a person to bleed to death. 

The take away is simple: Read your policy and get advice from reputable professionals that work with seniors.  If you have family and friends to check up on you daily, consider yourself blessed.

Senior Citizen Alert: Product Recalls

Pierre Foods’ Jamwich
Pierre Foods announced a company initiated product recall for 320 cases of its Jamwich product. The reason for the recall is the possible contamination of the products by Listeria monocytogenes.

The different types of Jamwich products include peanut butter (crustless), strawberry jam and PB Jamwich. These are packaged in red cartons with the UPC code 7599921368, and Lot number 0068035. The cartons are stamped with a date of sale of March 11, 2011 which can be found on the lower right part of the carton. The products are displayed inside grocery freezers.

The affected Jamwich products were distributed and sold in Giant-Carlisle retail stores in the states of Pennsylvania, West Virginia, Maryland and Virginia.

Consumers who were able to buy the affected product can return it to the store and ask for a refund. For concerns and questions related to the recall, customers may also call the company at 800-982-7091. The company’s operating hours start at 8 AM and until 5 PM, Eastern Standard Time.

Voluntary Recall Of Limited 6.5-Ounce Chopped Clams
The product is mislabeled and may contain tiny shrimp. People who have an allergy or severe sensitivity to shellfish run the risk of a serious or life-threatening allergic reaction if they consume this product. http://www.fda.gov/Safety/Recalls/ucm250479.htm

Cub Cadet Riding Motors
Cub cadet has recalled 4,300 riding mowers that can develop a fuel leak and pose a fire hazard. The recall includes 10 models of zero-turn-radius mowers sold in February and March for between $3,600 and $7,000. see the recall notice for a full list of model numbers. http://www.cpsc.gov/cpscpub/prerel/prhtml11/11733.html

Subscribe to the Senior Wellness Specialists Blog to get up-to-date information on product recalls and other information of value, especially to people 55 and older.

Seniors and Family Need An Advocate When Hospitalized!

Have you or a loved one been admitted to a hospital recently? Chances are that your experience has been anything but pleasant. Our clients increasingly report a lack of communication between doctors and patients when it comes to getting quick and complete information on health issues.  Patients describe their experience as a maze of constant frustration. Sometimes hours pass before medical staff gets back to them. The time constraints placed on physicians between seeing patients at the office and checking on those in the hospital are great. Family members who have flown in to take care of and check on a parent have limited time to navigate the system before heading back to their lives, often in another state.  Those in a hospital without family or kids are especially hit hard. After all, their focus should be on getting better and discharged; unfortunately, their current health status precludes them from advocating effectively for themselves.

There are steps you can take to help you through the process.

The solutions include having a doctor who is immediately available at the first sign of a health issue, services that can be quickly provided, such as an MRI, X-Ray, Lab tests, etc., that can significantly shorten the time it takes to get back to you. We'd like to hear from you. Email your comments on the experience you've had with a hospital--good or bad.

There are many things that consume families with worry and angst while in the hospital. Next we'll address how the type of insurance you have can affect the care you receive from a doctor or hospital and how quickly you get back on your feet.

Caring for Our Aging Parents and Ourselves

A recent article in the New York Times blog talks about long-distance, low-maintenance arrangements between children and aging parents. It is quite common for someone to live in New York, for example, and worry about their parents who are retired and living in Florida. Here is a link to the article and my comments below.

Time for a reality check: The sheer numbers are enough to make all of us anxious--tens of millions, and growing, aging parents and aging Boomers are putting tremendous strain on families and society, and we have only just begun to try to cope with this Tsunami of sorts. And don't look for government to step in with any meaningful solutions--family and friends will, like it or not, be called on to step up and shoulder most of the responsibility.

Starting now and for the next 20 years or so all of us will be put to the test, as your comments have revealed. Do you have what it takes to be an effective caregiver? You'll soul-search about how much or how little you care for your parents. How's your judgment? Will it be clouded by irrational/emotional decisions? Do you have the time, the money and support of family and friends? Do you have the good sense to consult an attorney or expert on aging to prevent panic and chaos? Unfortunately, many problems arise over money and in-fighting among siblings. Issues tend to be about feeling burdened or taken advantage of when it comes to caring for parents. Families squabble over inheritance; how much money mom or dad will go through before they die.

The time to be proactive is now. The aging train will be making many stops. Be prepared. Especially in these tumultuous times, we must keep our sanity.

Don't know where to start? Contact us for a free, no obligation consultation to see if we can help improve the quality of life for your parents and make you rest easier.

Product Recalls of interest to Seniors

Jennie-O Recalls Turkey Burger Product
Willmar-based Jennie-O Turkey Store is recalling nearly 55,000 pounds of frozen raw turkey burger products that may be contaminated with salmonella.

The recall affects four-pound boxes of Jennie-O Turkey Store "All Natural Turkey Burgers with seasonings Lean White Meat." Each box contains 12, one-third pound individually wrapped burgers.

The product has been sold exclusively at Sam's Club stores.

The U.S. Department of Agriculture's Food Safety and Inspection Service says the product is tied to the illnesses of three people in Ohio, Colorado and Wisconsin.

Jennie-O has posted product recall information on its website. A news release from Food Safety and Inspection Services is available here.http://www.hormelfoodsproductrecall.com/

Angiocath Recall Now Class I
The FDA has raised the recall of the Mikro-Tip Angiographic Catheter to class I -- the agency's strongest -- because debris in the device may cause serious injury or death.

In March, Millar Instruments recalled all lots of catheter models SPC-454D and SPC-454F that have expiration dates beyond February 2011, an FDA statement said.

Fresh Express recalls spinach shipped to East Coast
Fresh Express onTuesday announced a precautionary recall of spinach shipped to Ohio and the Northeast after a positive result for salmonella from random sample testing. No illnesses have been reported.

The company recalled 2,939 cases of 9-ounce bag spinach with product codes starting with H081 and H082, UPC Code of 7127913204 and use-by dates of April 6 and April 7.

Consumers who purchased the product should discard it and contact their retailer for a refund.

Those with questions can call the Fresh Express Consumer Response Center at (800) 242-5472, Monday through Friday, 5 a.m. to 8p.m.

The spinach was distributed in Pennsylvania, New York, Maryland, Connecticut, Rhode Island, Massachusetts, Ohio and Maine. It may have been redistributed in New Jersey, Virginia, Delaware, Vermont, New Hampshire, West Virginia and Washington, D.C.

Health and Wellness for Senior Citizens

Baby Boomers and Seniors, ages 51 and older, are more likely to go online to access their Personal Health Records (PHR) than younger adults.

What is a Personal Health Record (PHR)?
From the American Health Information Management Association (AHIMA)

The PHR is a tool that you can use to collect, track and share past and current information about your health or the health of someone in your care. Sometimes this information can save you the money and inconvenience of repeating routine medical tests. Even when routine procedures do need to be repeated, your PHR can give medical care providers more insight into your personal health story.
Remember, you are ultimately responsible for making decisions about your health. A PHR can help you accomplish that.

Important points to know about a Personal Health Record:

• You should always have access to your complete health information.
• Information in your PHR should be accurate, reliable, and complete.
• You should have control over how your health information is accessed, used, and disclosed.
• A PHR may be separate from and does not normally replace the legal medical record of any provider.

Medical records and your personal health record (PHR) are not the same thing. Medical records contain information about your health compiled and maintained by each of your healthcare providers. A PHR is information about your health compiled and maintained by you. The difference is in how you use your PHR to improve the quality of your healthcare.

Take an active role in monitoring your health and healthcare by creating your own PHR. PHRs are an inevitable and critical step in the evolution of health information management (HIM).

The most common health records recorded in a PHR are:

• List of significant illnesses and operations
• Medication Record
• Significant Family History of Disease
• Immunization Record
• Copies of Consent and Authorization Forms

For more information and to set up your PHR go to http://www.myphr.com or contact your doctor to see if they have any plan for helping patients create personal health records (PHR).

Evaluating a Patient’s Ability to Live Independently

By Steven E. Reznick, M.D., FACP

As a geriatrician in a locale with many elderly retirees, I am frequently asked how long mom or dad (or both) can stay in their home and live safely and successfully.  It is clearly a complicated issue even if the individuals involved are cognitively and mentally intact, physically capable and financially able to pay for support and help.
 

There is much to consider. Are the patients physically able to maneuver within their household safely?  If sleep is being interrupted constantly by the night time urge to urinate, can the patient safely navigate the trip to the bathroom without suffering a fall? If they get to the bathroom can they easily manipulate a standard toilet?   If they need to clean themselves and bathe can they get in and out of the shower or bath without falling and injuring themselves? 

Fortunately there are elderly home experts who will travel to the home and evaluate it for safety.  They make an assessment and provide a written report to the patient and the ordering physician. Many of these safety personnel are specially trained home health company nurses sent into the home by the patient’s physician. In many cases, Medicare or the patients’ insurance will cover the cost of the evaluation. Once the evaluation is complete, they will suggest certified and responsible contractors to do the home safety alterations. 

While our goal is always to keep the patient in their home if possible there are many issues other than the safety of the physical plant to consider. One needs to consider how much supervision and assistance the patient needs to perform their normal activities of daily living?  Can they dress and groom themselves independently?  Can they prepare meals for themselves and clean up after them?  Can they get to the store to shop for food and supplies?  Can they get to their doctors’ appointments? What happens if they become injured or ill?  Do they wear a device which allows them to call for help if they are immobile and cannot get to the phone? 

The option of paying someone to care for your elderly loved one is quite expensive. It will cost a minimum of $15 per hour to supply inexpensive help. You may need more than one person so that the staff has time off for their personal needs.  Some families choose to hire a companion who in exchange for room and board supplies help and supervision. This is always risky especially if you don’t/cannot check the background of the individual you are inviting into the home.

If you can afford to pay for help and to alter the home for safety there is always the issue of socialization. Many of my patients who have lost their mates have also lost their friends. They no longer have someone or a group to pal around with.

One particularly spry 93 year old patient was still playing golf, going to the gym and aerobics class three days a week and playing cards regularly. Her golf foursome and card game participants all had passed away or moved closer to their children for support.  Although she had the finances to hire a wonderful aide around the clock she was lonely for companionship despite living in a large country club on a golf course.   She became a wonderful candidate for the correct assisted living facility with a broad range of social activities and residents of a similar age looking for companionship as well.

These are complex issues which require the assistance of the individual’s physician in most cases. It is important for the individual to choose and retain a physician who will take the time to talk to family and professionals involved in the enrichment of their lives.

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Steven E. Reznick, M.D., FACP is a board certified internist, with added training in geriatrics, practicing concierge medicine in Boca Raton, Florida since 1979. He has been recognized by his peers as a “Best Doc” as published in Miami magazine and the Miami Herald.  For more info call 561.368.0191 or go to www.BocaConciergeDoc.com.  You can read Dr. Reznick’s acclaimed blog at http://bocaratonconciergedoctor.wordpress.com/.

PRODUCT RECALLS: Tylenol Recall and Frankly Fresh Seafood Salad Recall

TYLENOL® 8 Hour Extended Release Caplets 150 count
McNeil Consumer Healthcare, Division of McNEIL-PPC, Inc., is recalling one product lot of TYLENOL® 8 Hour Extended Release Caplets 150 count bottles distributed in the United States. McNeil is taking this action as part of our ongoing surveillance and monitoring efforts that identified a small number of complaints of a musty or moldy odor. The uncharacteristic odor is thought to be caused by the presence of trace amounts of chemicals called 2,4,6-tribromoanisole (TBA) and 2,4,6-trichloroanisole (TCA). This voluntary action is being taken as a precaution and the risk of adverse medical events is remote. The product was manufactured at the McNeil Consumer Healthcare plant in Fort Washington, PA prior to the company's voluntary closure of the facility in April 2010.
The lot number for the recalled product can be found on the side of the bottle label.
FULL RECALLED PRODUCT LIST:

Product Name	Lot Number	UPC Code
TYLENOL® 8 HOUR EXTENDED RELEASE CAPLET 150 count	ADM074	300450297181

Consumers who purchased product from the lot included in this recall should stop using the product and contact McNeil Consumer Healthcare, either at www.tylenol.com or by calling 1-888-222-6036 (Monday-Friday 8 a.m. to 8 p.m. Eastern Time) for instructions about receiving a refund or product coupon. Consumers who have medical concerns or questions should contact their healthcare provider.

Frankly Fresh Inc. Voluntarily Recalls Seafood Salad Products Because Of Possible Health Risk

Frankly Fresh, Inc. of Carson, CA. is voluntarily recalling its seafood line of products, because it has the potential to be contaminated with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems.

Although healthy individuals may suffer only short term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.

Product was distributed in the California and Nevada Areas through retail supermarket stores. Products are packed under the Frankly Fresh label in a variety of sizes in plastic containers with safety seals on. The full list of products can be seen here.

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Don't Get Fooled: Frauds Impacting Seniors

There are many scammers targeting seniors with fraudulent claims and offers.

Here are some highlights taken from the FBI webpage on Common Fraud Schemes.

If you are age 60 or older—and especially if you are an older woman living alone—you may be a special target of people who sell bogus products and services by telephone. Telemarketing scams often involve offers of free prizes, low-cost vitamins and health care products, and inexpensive vacations.

Always check out unfamiliar companies with your local consumer protection agency, Better Business Bureau, state attorney general, the National Fraud Information Center, or other watchdog groups. Unfortunately, not all bad businesses can be identified through these organizations.

Be wary of companies that want to send a messenger to your home to pick up money, claiming it is part of their service to you. In reality, they are taking your money without leaving any trace of who they are or where they can be reached.

Always take your time making a decision. Legitimate companies won't pressure you to make a snap decision.

Never send money or give out personal information such as credit card numbers and expiration dates, bank account numbers, dates of birth, or social security numbers to unfamiliar companies or unknown persons.

If you have been victimized once, be wary of persons who call offering to help you recover your losses for a fee paid in advance.

Do not do business with door-to-door or telephone salespeople who tell you that services of medical equipment are free.

Give your insurance/Medicare identification only to those who have provided you with medical services.

Do you have any questions about fraud?