Learn About Alzheimer’s: Spring 2014 Workshops in Central Massachusetts

January 22, 2014

A diagnosis of Alzheimer’s for a loved one can seem overwhelming and devastating. But there is a great deal of support and information available to ease the journey.

The following Central Massachusetts programs, offered by the Alzheimer’s Association Massachusetts/New Hampshire Chapter , are presented by trained Alzheimer’s Association staff and volunteers. Workshops are free and open to the public. Group size may be limited.

Descriptions are from the Chapter Calendar of Events . For more information or to register for these and other Chapter programs throughout the region, please call 617-868-6718

The Basics:  Memory Loss, Dementia and Alzheimer’s Disease

Wednesday, March 26 — 1:00 to 2:00 p.m.
Gardner Senior Center, 294 Pleasant Street, Gardner

Monday, May 19 — 10:00 to 11:00 a.m.
Grafton Senior Center, 30 Providence Street, Grafton

Alzheimer’s disease is not a normal part of aging. This program provides information about the disease and related dementias, the benefits of early detection, causes and risk factors, treatment, and services offered by the Alzheimer’s Association.

Conversations About Dementia: Tips to Help with Family Conversations

Thursday, May 1 — 5:30 to 7:00 p.m.
Clinton Hospital, 201 Highland Street, Clinton

How to have honest and caring conversations about some of the most difficult topics when you are caring for someone with memory problems: the importance of going to the doctor for a diagnosis or follow-up, concerns about driving and making legal and financial plans for the future. You’ll hear from actual family caregivers about these challenging issues via video as well as recommendations for what to do next.

Essential Skills for Family Caregivers (3-part series) – It Starts with Communication, Understanding Behaviors, Safety at Home

Tuesdays, April 2, 9, and 16 – 10:00 a.m. to 12:00 p.m.
Alzheimer’s Association Worcester Office, 128 Providence Street, Worcester

Provides education and practical tools to those caring for someone with dementia. Improved day-to-day living and overall quality of life for the person with dementia and the caregiver is the goal.

This series is also offered in Spanish via conference call on Thursdays, February 13, 20 and 27, from 7:00 to 8:30 p.m. and Thursdays, June 5, 12, and 19 from 7:00-8:30 p.m.

Estrategias básicas para cuidar a un familiar con demencia- Conferencia telefónica

Jueves, 13, 20, 27 de febrero, 2014 – 7:00-8:30 pm

Aprenda cómo comunicarse con su ser querido para evitar discusiones, cómo manejar las conductas difíciles y qué precauciones se deben tomar en el hogar.

¡Participe por teléfono desde cualquier lugar!

Para registrarse llame al 617-393-2086. NOTA: Es necesario registrarse para recibir los materiales y la información de cómo participar.

Legal and Financial:  Issues and Answers

Wednesday, February 12 — 10:00 to 11:30 a.m.
Alzheimer’s Association Worcester Office, 128 Providence Street, Worcester

Many families wait until it’s too late to learn about legal and financial concerns. This presentation by an elder law attorney provides information about wills, durable power of attorney, protection of assets, health care proxy, and what Medicare and Medicaid do and do not cover. While this program is not intended to substitute for a personal appointment with an elder law attorney, you will have the opportunity to hear about typical issues and problems that can be avoided or reduced by adequate planning.

The following programs are for persons with Alzheimer’s Disease and related dementias and their family members and friends:

Coping with Early Memory Loss

Wednesday, June 11 — 10:00 a.m. to 12:00 p.m.
Alzheimer’s Association Worcester Office, 128 Providence Street, Worcester

Fill in the gaps since your diagnosis of Mild Cognitive Impairment, Alzheimer’s disease, Vascular Dementia, Frontal-Temporal Dementia, or other related disorders. Medical and non-medical treatments will be discussed, and resources available to help will be explored.

Living with Alzheimer’s:  For People with Alzheimer’s

Thursdays May 1, 8 and 15 — 3:00 to 5:00 p.m.
Worcester Senior Center, 128 Providence Street, Worcester

Interactive three-part program where you will have a chance to hear from others who have been where you are. We will discuss what you need to know, what you need to plan and what you can do to navigate this chapter of your life. Participants are encouraged to invite family members or friends to attend the program with them.

Topics covered will include:

  • Understanding Alzheimer’s disease and memory loss
  • Partnering with your medical team
  • Effective communication and telling others about the diagnosis
  • Coping with changes, making decisions and planning for the future
  • Daily strategies and safety issues
  • Opportunities for supporting research
  • Resources for people with early-stage Alzheimer’s disease

President of Deborah Fins Associates, PC , since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified geriatric care manager. Drawing on more than 30 years of professional experience in geriatric care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsGCM.

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Staying Safe While Aging in Place: Why You Need a Home Safety Assessment

December 17, 2013

“Aging in place.” It’s the ideal we all hope for, the ability to remain in our own homes as we grow older—safely, securely, for as long as possible.

But aging often brings a range of physical and cognitive challenges that can make living at home risky and, all too often, an unsafe option without adapting the home environment to accommodate disabilities.

That’s where a home safety assessment by a licensed occupational therapist can make the difference between continuing to live at home and having to move to assisted living or other adaptive setting.

Home Safety Assessment Goal: Simple, Cost-Effective Solutions

The home safety assessment involves a room-to-room review; our goal is first to find the simplest, most cost-effective solutions to any potential problem. Among the most common, affordable adaptations are the following:

  • Remove scatter rugs to prevent accidental falls, especially for persons using canes and walkers, or for those with neurological disorders that affect coordination, such as Parkinson’s.
  • Ensure that paths are clear of objects that could make maneuvering with a cane or walker difficult, or that could cause falls.
  • Add grab bars near the shower and toilet for ease of movement.
  • Add a raised toilet seat to facilitate sitting and rising.
  • Use a shower or tub seat. We favor stable, elongated models that reach over the edge of the tub onto the bathroom floor, making it easier to sit and “scoot” into the tub or shower stall.
  • Attach a telescoping or hand-held shower head to be able to direct water flow.
  • Add a “kill switch” or knob guards to oven and stove if the individual struggles with dementia and is at risk of leaving on burners.
  • Wrap a towel around a refrigerator door handle to make it easier to grab and open.
  • Use a plate guard to prevent food from falling on the floor.
  • Use reach extenders to get objects on high shelves.
  • Add a U-bar to a bed, to make rising and sitting down safer and easier.
  • Install a ramp to facilitate entering and leaving the house with a wheelchair.
  • Add a stair lift to ease climbing and descending staircases. These can be rented for short-term use or purchased.

These are just a few examples of the kinds of creative solutions an occupational therapist may recommend. The best plan is tailored to the specific needs of the individual.

Adaptations Tailored to the Needs of the Client

Cost is always a factor in any plan. Our goal, as occupational therapists, is to fit the solution to the client’s needs and pocketbook.

The following websites give a good overview of the variety of adaptive equipment that’s available. They are also easy to navigate:

For family members who are handy with home improvements, we often recommend reviewing adaptive equipment on these types of sites and then visiting Amazon or Home Depot’s websites to find equivalent, less expensive products that can be used to create the same adaptive benefits.

For more complicated and extensive adaptations, such as restructuring kitchens to accommodate wheelchairs or building customized ramps, we recommend a consultation with a qualified contractor who has experience in this field.

A registered and licensed occupational therapist and certified geriatric care manager with Deborah Fins Associates since 2000, Susan Ritz works directly with elders and their families and provides administrative support to our practice. Her professional training in occupational therapy informs her detailed functional assessments and home safety evaluations, and she has extensive experience working with clients who have Parkinson’s Disease and other neurological disorders.

Drawing on more than 30 years of professional experience in geriatric care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

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Should Your Aging Loved One Still Drive?: Five Steps to Safety

December 9, 2013

For most teens, learning to drive is a major step toward becoming independent. Recognizing the need to give up the keys as we age can be a real blow to self-esteem and self-reliance.

Whether we want to admit it or not, aging is inevitable, and with advanced age, our ability to drive safely can be affected by changes in our physical, emotional, and cognitive health.

When your aging loved one begins to have difficulty driving safely, here are five steps to take, recommended by the American Occupational Therapy Association (AOTA):

1. Identify Changes That Can Affect Driving

Although changes are a part of normal aging, they occur individually and at different rates and times. Just as we plan for retirement, it’s important to plan for transportation needs. Proactive, early planning is paramount to continued independence and safety. Occupational therapy practitioners address driving as an essential activity of daily living and can help older adults maintain their driving safety and community mobility despite age-related changes.

The Massachusetts Registry of Motor Vehicles (RMV) offers this Safe Driver Checklist ; if your loved one experiences any of the issues on the list, it’s time for an evaluation.

2. Have a Supportive Family Conversation

One of the first steps in addressing older driver safety is having a nonthreatening conversation with your loved one. Family and friends play a major role in discussions about older driver safety, and it’s better to start the conversation early, allowing time for planning and the exploration of options long before the crisis or accident.

It’s best NOT to have this conversation in the car, when your loved one is driving. Pick a non-threatening time to sit and have an honest talk. Share your concerns without being critical. You might use a news report of a car accident involving an older driver as a starting point, or discuss future plans, such as how your loved one might get to the doctor if she or he were no longer able to drive. Some families find it helpful to identify one person as a driver advocate who rides with your loved one and offers supportive advice, while keeping track of any driving weaknesses for pro-active problem-solving.

3. Screen and Evaluate With Help from an Occupational Therapis t

You or your loved one may decide that it’s time to get a check-up on his or her driving fitness. But the services described as “driving fitness evaluations” may seem confusing, as they range from self-assessments (useful education tools to help identify potential challenges) to a professional, comprehensive driving evaluation from an occupational therapy driving rehabilitation specialist. It’s important for you and your loved one to understand the driving service you are getting, so you can act on the results in a meaningful way.

For an evaluation to be useful, there should be no changes in your loved one’s normal routines, medication or other factors that could affect the outcome. You’ll have a clearer sense of recommendations if an adult family member comes along for the evaluation.

A professional safe driving assessment by an occupational therapist will provide the following information:

  • Identify driver’s strengths and any changes in vision, physical ability, and/or cognition that may pose a risk for driving safely.
  • Recommend how driver might strengthen skills, compensate for weaknesses and develop a relationship with the driving specialist to work together to explore every option.
  • Prioritize goals to continue driving safely, but recommend a plan to stop driving now or in the near future if changes in the driver’s skills and abilities are too severe, placing your loved one or others in your community in harm’s way.
  • Remain focused on transportation and participation in your community. The occupational therapy professional will work with the driver to identify the alternative modes of transportation that would work best and provide the needed support.

4. Identify Equipment That Can Empower Drivers

Driving intervention is based on a plan drawn up between your loved one and the occupational therapist. The goal of intervention is to explore ways for your loved one to drive safely for as long as possible. Occupational therapy practitioners trained in driving rehabilitation can suggest a broad range of solutions, tailored to the individual driver. These suggestions sometimes include adaptive equipment. Occupational therapy practitioners can work with older drivers in their vehicles to see which types of equipment, if any, are necessary to help them remain comfortable and safe on the road.

5. Take Changes in Stride

When your loved one discovers the need to make adjustments to drive safely or can no longer do so, family and friends can help him or her take these changes in stride. To do so, all of you need to know about resources for independent community mobility before driving cessation occurs. Losing the ability to drive, limiting the amount of driving, or changing the way one drives does not have to mean losing independence, and your loved one may have options to continue to stay involved in her or his community.

Content for this article was adapted from AOTA’s thoughtful information for Older Driver Safety Awareness Week .

For resources in Massachusetts, visit the Massachusetts RMV’s resource page for Mature Drivers .

For information about driver evaluations in Central Massachusetts, see Deb’s post, When Is It Time to Take Away the Car Keys?

President of Deborah Fins Associates, PC , since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified geriatric care manager. Drawing on more than 30 years of professional experience in geriatric care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

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DFA Fall 2013 Update: Debbie Fins Elected to NAPGCM Board of Directors

November 8, 2013

An active member of the National Association for Professional Geriatric Care Managers (NAPGCM) at both the regional and national level, Debbie Fins, LICSW, CMC, was recently elected to NAPGCM’s national Board of Directors for a two-year term, beginning January 1, 2014.

Debbie has been a member of NAPGCM since 1996, when she opened her care management practice in Worcester, Mass. She currently serves as President of the organization’s New England chapter. She has chaired or co-chaired numerous chapter committees, helped to plan the national NAPGCM conference in 2007, and serves on the National Standards Committee and Chapter Presidents Committee.

“We have many strengths—a committed Board of professional GCMs and a terrific professional leadership team,” says Debbie. “I am proud to join the National Board to help move us forward as the leading elder consultation resource.”

NAPGCM, a non-profit association, represents more than 2,000 members nationally. The organization was formed in 1985 to advance dignified care for older adults and their families in the U.S.

November 20 NAPGCM-New England Mini-Conference
GCM’s and Guardians: Who’s on First? Protecting Our Clients, Protecting Ourselves
8:00 a.m., Cornerstone at Milford, 6 Birch Street

Debbie joins a panel of professional experts to discuss key elements of working together in guardianships: Attorney Elizabeth Baum; Neuropsychologist Elizabeth Nasser, PhD; and moderator Kate Granigan, LICSW, C-ASWCM.

The program begins at 8:00 a.m. with a continental breakfast and registration, and visits with vendors; panel discussion from 9:00 a.m. to Noon. $35 GCMNE/MGA Members; $45 Non-Members.

Approved for 3.0 CEUs for Social Workers; Nursing Certificate of attendance for all others.

Space is limited: Registration deadline is Wednesday, November 13. Click here for details and registration form .

Team DFA on the Move Raises Over $6,000 for Alzheimer’s Research

Far exceeding her team goal of $3,500, Debbie is proud to announce that Team DFA on the Move has raised $6,200 for Alzheimer’s research at this fall’s annual Worcester County Walk to End Alzheimer’s Disease on September 30.

“I’m grateful to everyone who has supported our efforts to find a cure for this devastating disease,” says Debbie. “Alzheimer’s touches so many and is now the sixth leading cause of death in the U.S. One in three seniors dies with Alzheimer’s or another form of dementia. We can’t rest until we find a cure.”

There’s still time to contribute! Deadline is November 15: Please click here.

President of Deborah Fins Associates, PC , since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified geriatric care manager. Drawing on more than 30 years of professional experience in geriatric care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

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Can We Talk? How to Open Up the Conversation as Loved Ones Age

October 30, 2013

As adults, we all want to stay independent as long as possible, in our own homes, living our lives without someone looking over our shoulders. At least, that’s the cultural bias among many Americans.

But the aging process all too often compromises independence. When you’re beginning to struggle on your own due to physical or cognitive impairment, it can be incredibly hard to admit that you need help.

Likewise, as the adult child of an aging, ailing parent, you may find it incredibly hard to open up a conversation with your parent about the need for help. According to a 2009 Pew Research Center survey, only 55 percent of adult children have talked to their parents about what to do if the parents can no longer live on their own.

Sometimes the communication barriers are built up over years of difficult interactions; other times, adult children think they know what their parents want, or they simply don’t want to deal with the possibility of their parents’ decline. Aging parents may be reluctant to share their fears and appear weak to their adult children, or they may fear becoming a “burden.”

The problem is this: Frequently, that reticence to discuss what’s really happening can result in no planning or preparation for the inevitable crisis—a fall, a stove left with the burner on, a medical emergency precipitated by forgetting to take medications, a neglected cold that morphs into pneumonia and a hospital stay.

Here are some tips for how to open up the lines of communication. You may both find it helpful to include a trusted third party, such as clergy, another family member or an elder care professional, to add balance and an objective viewpoint to the conversation:

For Parents

  • Let’s face it: Aging happens. There’s no escaping it, and we all go through it. You and your adult children will benefit from sharing your concerns and planning together, rather than waiting for a crisis to force the issue of your need for additional support.
  • Your children are no longer little kids. They are adults, too. Treat them as partners in this discussion. You can guide the conversation, but don’t dictate.
  • Be honest and realistic about your wishes. Any plans you devise together will only work for you if you are clear about your needs and priorities.
  • Be open about finances, healthcare and legal planning. This can be a very sensitive area, but the only way to create a realistic, workable plan is with all the facts on the table.

For Adult Children

  • Watch for openings, such as your parent’s expression of concern about eyesight, an issue with a friend, worry about ability to drive at night, and so on.
  • Give your parents a list of questions and schedule a meeting. Don’t spring the conversation on them, which can make your parents feel more vulnerable and defensive.
  • Respect your parents’ feelings, but push if you feel that their health or safety are at serious risk.
  • Start from a loving place. Assure your parents that you want to support their independence as long as possible.
  • Ask your parents what they would want if they needed help. Try to draw out their thoughts and feelings about what’s happening as they age.
  • Share your feelings about their aging. This can be one of the hardest pieces, but if you’re able to be honest with your parents, you’ll have a better chance of reaching a good solution—and possibly find a new, closer dimension to your relationship.

What to Talk About

These are the key points to cover:

  1. Safety at Home —any modifications needed to the house or apartment for mobility; who lives nearby and can help in an emergency
  2. Everyday Activities —do they need help with chores, preparing meals, grooming, managing medications
  3. Transportation —is it still safe for them to drive; what alternatives are available
  4. Health —contact information for all physicians, list of current medications, releases to allow medical professionals to speak with designated family members
  5. Finances —information about bank and other accounts, monthly income, other assets
  6. Passwords —all accounts, including computer, email, Facebook, online banking or bill payment, etc.
  7. Health Insurance —location of policies, long term care insurance, other relevant coverage
  8. Estate Planning —key documents include a will, durable power of attorney, healthcare proxy and HIPAA release

For more ideas about having “The Talk,” listen to Deb’s radio interview .

President of Deborah Fins Associates, PC , since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified geriatric care manager. Drawing on more than 30 years of professional experience in geriatric care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

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