Source: SeriousIllness.org

Technologies abound to help us stay connected with loved ones. There are also many options to support your relative in living independently. Here are some options in the areas of safety and health.

Personal safety and home security

• Personal medical alert: Wearable devices that call for help. Most require the push of a button. Some can detect a fall automatically. Others can be used even when away from home.
• Fall detection: Video systems that scan the bottom 12 inches of a residence. This protects privacy but reveals if a person has fallen to the floor.

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Soure: Winston-Salem Journal

By Annette Fuller
Published: February 09, 2011

Doctors’ busy schedules are no excuse for them not taking the time to discuss end-of-life care options with their patients, said Dr. William Blackstock, program director of the Comprehensive Cancer Center at Wake Forest University Baptist Medical Center.

“Some of my colleagues do a fabulous job of discussing these issues with their patients,” Blackstock said. “But too many of my colleagues almost never have these discussions until the patient is seriously ill. At that point, they may be taking pain medication that can confuse them. We need to have these conversations sooner than that.”

And it’s not just an issue of doctors not having enough time, he said.

“There is a skill set to this,” Blackstock said. “We are not trained to do this. It’s not something that we emphasize during residencies or fellowships.”

That’s why Blackstock is glad that the American Society of Clinical Oncology recently published a 24-page booklet, available online, that advocates for more involved conversations between patient and doctor earlier in the process about the patient’s choices for care and treatments during his or her last few months of life, if treatments are not successful.

Cancer patients are “at different places” when doctors first bring up this topic, Blackstock said.

“Some want these discussions early; some want it later,” he said. Even if the patient puts off the topic, due to fear, “it is still the doctor’s responsibility to engage the patient in this discussion. It’s part of taking care of them, just as much as the medical treatment.”

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Driving performance, not age, dictates when it’s time to curtail driving. If your parent is showing problems with driving, it could be time for “that” conversation.

Ideally, you’ve set the stage through candid discussion over the past months or years. Perhaps you’ve even talked about how others have handled this phase-of-life issue. Sensitivity to your own emotions can help guide you when you talk with your loved one. It’s better to acknowledge the sadness than avoid the conversation and risk an accident.

- Consider who should deliver the news. It’s typically best received from a trusted family member or a health professional. Choose someone who can be supportive and empathetic. If Mom is able, have her talk to Dad, or vice versa. If it’s your role, go easy. Expect to have several conversations. Show your concern for maintaining your parent’s ability to get around and participate in life activities.

- Practice using alternatives. Work toward zero driving. Have family members and friends provide rides more often. Make it natural by saying, “Let’s go shopping together today.” Join Mom in trying public transportation. Arrange for home delivery of goods and for automated bank deposits/payments.

- Work with resistance. If Dad doesn’t follow through with promised changes, you need to take further action. See if the doctor will set limits. Remind Dad his behavior puts others at risk. Impose family restrictions, such as telling him he can no longer drive when the grandkids are in the car.

- Be firm. If all else fails, contact your state department of motor vehicles and find out how to report an unsafe driver. This will trigger a driver evaluation. If the license is revoked but your parent continues to drive, consider disabling the car or “losing” the keys.

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Don’t be surprised if your aging parent reacts with some defensiveness if you raise the topic of driving skills. No one wants to have their independence snatched away! Make it obvious from the start that it’s a mutual goal to keep your loved one safely on the road. And that it’s not an all or nothing situation.

Here are several options for supporting your parent’s continued safe driving:

- Mature driver refresher classes. These classes are often sponsored by AARP or a local AAA club (American Automobile Association). Classes offer practical information on easy ways to accommodate the natural changes of aging[link back to natural changes of aging article]. They tend to be informal and include a lot of group discussion. Plus, persons over 55 may qualify for a discount on their car insurance! Online classes cost less than $20 and are offered by both AARP and AAA. Or, contact a professional driving specialist for a personalized, behind-the-wheel evaluation.

- Staying physically flexible. Being able to turn to look behind you is critical to safe driving. Encourage your loved one to practice simple flexibility exercises.

- Maintaining car fitness. Make sure the car is properly adjusted for your parent. Especially important is the ability to see clearly in all directions. The addition of wide-angle mirrors, for instance, can help reduce blind spots. Be sure the wipers are in good shape. Maintain the car for road safety, too. Tires should be properly inflated and have adequate tread. And don’t forget to have the brakes checked regularly.

- Improving driving habits. A few simple changes can greatly reduce the chance of problems. Suggest Mom reduce or avoid driving at night or in bad weather. Stick to routes and times with less traffic. Make fewer left turns. (Three right turns are much safer!) And practice extra caution in parking lots and when changing lanes.

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Some people maintain strong driving skills as they age. But over time, most of us lose physical abilities that are key to safe driving. Indeed, only teens have more accidents per mile than do adults over age 65.

Advanced years alone are not a reason to stop driving, however. Health, fitness, and thinking power, not age, determine a person’s ability.

Following are signs of possible problems:

- Trouble with vision or hearing. Watch for problems seeing lane lines or pedestrians, overlooking stop signs, or judging the speed of oncoming traffic. Other signs include discomfort with glare or driving at night.

- Inability to twist or turn easily. Arthritis and stiff muscles can make it painful to turn and look when needed. This can lead to trouble when backing up, changing lanes, or merging with traffic.

- Medication use. Many medicines can slow thinking and response time. Drugs for depression and anxiety can do this, as can sleeping pills and medicines for heart conditions, colds, and allergies.

- Dementia. At “early” stages, many individuals can still drive safely. Talk to your loved one’s doctor about a driving skills evaluation.

- Two or more recent tickets. Consider tickets a yellow, warning light. Common infractions include poor parking, running a stop sign, or going the wrong way.

- Two or more recent accidents. Parking lot and sideswipe accidents indicate driver error. Poor depth perception also causes seniors to have a very high rate of left turn accidents.

Take regular ride-along outings. Notice your loved one’s skill level and confidence level. Ask for input from friends and neighbors.

It is important to approach this subject with sensitivity. In the meantime, you may want to explore self-assessments your loved one can take privately, at home. These two were created by the American Automobile Association’s Foundation for Traffic Safety.

AAA Roadwise Review (30-minute multimedia screening tool measuring specific mental and physical capabilities)

AAA Drivers 55 Plus: Self-Rating Form (15 multiple choice, text-based questions)

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