Promoting Safety and Independence
For Aging Parents

As life expectancy has increased and the growing population of seniors fed by the post-WWII baby boom steadily divides into two subgroups (active seniors and mature seniors), the aging-in-place industry has done much to facilitate the ability of seniors to stay in their homes and retain some degree of independence. With interest rates on the decline and fixed incomes trending downward, aging in place has also become more of a compelling financial option--and an alternative to expensive long-term care facilities.

For seniors who choose to stay in their homes into their eighties and beyond, the key to their maintaining independence is safety, safety, safety. Safely aging in place comprises three basic, commonsense elements: a secure environment; smart, senior-friendly technology; and a pragmatic understanding of the aging process. Your parents’ wellbeing and your family’s peace of mind will in large measure depend on these three proactive fundamentals.

For the purposes of this short article, we will focus only on safety issues regarding the home and touch on each of these key areas. For more information, we recommend that you selectively search the Internet and look for public sources of information, such as AARP, NIH, as well as credible independent resources, such as www.care.com and www.agis.com.

Secure Environment
“Home Modification” is the most commonly used term for altering the physical environment of a home to remove hazards and also provide a functional living space for elderly parents or patients. Common home modifications include the installation of grab bars and no-slip bathmats in the bathroom to prevent falls. More complex and expensive examples include installation of ramps, chair lifts, remote monitoring and even telemedicine technology.

In 2003, more than 1.8 million people age 65 and older were treated in emergency departments for fall-related injuries, and more than 421,000 were hospitalized, according to the Centers for Disease Control and Prevention. Falls are the most common–and preventable–threat to senior independence.

Many such falls occur in the middle of the night while the senior is walking from bedroom to bathroom in the dark. Too often, we hear stories of seniors who, after suffering a broken hip or other injury, end up lying on the floor in pain all night—until help arrives in the morning. Many of these incidents are entirely preventable: with proactive planning, good lighting, clear pathways, proper flooring, and grab bars, these dire situations need never occur again.

Our in-home senior care company, Good Company, considers it a public service to assess the safety of seniors’ homes. That is why we offer our clients a comprehensive complimentary home safety assessment, which takes about 1 - 2 hours. We examine every aspect of the living environment, checking for adequate lighting and night lights, accessibility, doors, windows, locks, furniture placement, television and telephone placement, electrical cords and wires, outlets and switches, smoke and fire detectors, stoves and appliances, rugs, flooring and carpets, plumbing and utilities, toilets, tubs and showers, handrails and grab bars, stairs and ramps, cabinets and shelves, dishes, pots and pans, common household objects, food storage, step stools, toxic products, skid-resistant bathmats, personal care products, exposed pipes, mirror placement, beds and nightstands, bedside lighting, flashlights, driveways and steps, garages, doorbells, slippers, shoes and clothing, and many, many more items. The list is long—by necessity. We’ve learned to look at every detail.

We recommend that our clients protect their elderly parents and ensure their independence by educating themselves and their aging parents about senior safety and home modification. A simple search online will produce a number of senior safety checklists for different purposes. One of the best home safety assessment lists can be found at http://www.agis.com/Document/13/home-safety-and-security-checklist.aspx.

We strongly recommend that you consult with an expert in senior safety and home modification before something happens to your loved one. Too many of us wait until after an incident to take precautions. We urge everyone to be preventive for peace of mind.

Smart Senior-friendly Technology
Even after home modification changes are in place, accidents can still happen. One smart innovation commonly available to seniors to help them in an emergency is an alert device. (Think, “I’ve fallen and I can’t get up,” the well-known Life Alert® slogan.) Seniors carry the alert device on their person, usually in a watch, bracelet or necklace. In the event of a fall or other accident he or she can easily set off the alarm, directly contacting local fire and paramedics. With these devices, help is just minutes away. They save thousands of lives every year.

In recent years, more and more industrial designers and engineers have responded to an aging population with new ideas and devices. They have invested heavily to create all kinds of “assistive technology” for disabled and senior consumers. Good Company Senior Care provides one such simple device to clients with limited range of motion. The Reacher/Grabber helps such seniors securely pick up common household objects from hard-to-reach shelves and storage.

At Good Company we always keep abreast of all the most current developments in assistive technology. It’s exciting to find new ways to protect our clients and support their independence. Here are some recent trends and developments we’ve encountered:

Vibrating insoles that help diabetics and stroke victims stay balanced could also help save elderly people from falls. Random vibrations from the insoles stimulate nerve endings on the bottom of the feet, supplying seniors with direction for maintaining balance. In recent Boston University tests, matures using the insoles were found to stand as steadily as college students.

Granny cams watch over seniors and give relatives peace of mind. More relatives and caregivers are looking into such ‘passive’ monitoring systems to keep a vigilant eye on seniors. Home systems from companies such as Living Independently, Guardian Medical Monitoring, Xanboo and Shell HomeGenie use cameras or sensors to transmit video or data to family and remote caregivers. They’ve also been deployed in homes and long-term care facilities to keep an eye on caregiving staff and prevent abuses. There’s more than a bit of “big brother” in this technology, but it does provide relatives with reassurance—and at the same time addresses the serious problem of elder abuse, which is unfortunately more common than most people realize.

New technology far beyond simple monitoring systems becomes especially useful when caring for patients suffering from dementia and Alzheimer’s. Researchers are enlisting artificial intelligence to create a safe, “intelligent home” for patients experiencing cognitive decline. In some cases, the amenities include bathroom and kitchens with video screens that remind these vulnerable seniors with directions for simple tasks such as washing hands and using the toilet. It sounds elementary, but it’s actually a very empowering tool for such patients.

Telemedicine is an idea whose time should come soon. Intel's Health Guide is a device that lets doctors monitor seniors' health remotely, allowing them to remain in their homes and preventing costly hospital or nursing home stays. Seniors overwhelmingly express a preference to stay in their homes, and healthcare providers acknowledge there are neither the facilities nor the resources to care for the growing mature population. Intel and General Electric will spend $250 million over the next five years developing technology like Health Guide that help manage chronic conditions remotely. Technology that empowers both aging consumers and health providers alike by enabling better care in a preferred environment at lower cost is an easy pill to swallow. As we move into an age of digitized records and virtual medical care, virtual house calls increasingly represent more access and greater flexibility.

User-friendly redesign and innovation is turning even the humble pill bottle into a proactive part of healthcare. The SIMpill bottle takes the guesswork out of medicine schedules, using cell phone technology to alert patients (or their caregivers) when a prescribed dose is missed. Pharmacists program pill-popping times into the dispenser, and if the bottle’s opened too early or too late, SIMpill notifies the patient or caregiver via text message on their cell. If there’s no response, an alert hits the phone of a family member or other designated caregiver. If the pill is taken at the appointed time, there’s no warning—making it a better system than constant alarms, says SIMpill’s inventor, Dr. David Green, because “people get message fatigue.”

Or, alternatively, Sensor-equipped pill necklace keeps forgetful patients in mind, employing technology to fill the medical gap. MagneTrace is a sensor-equipped pill necklace designed for patients who forget to take their medication. In the system, currently in development at the Georgia Institute of Technology, pills are embedded with magnetic sensors that travel through the digestive system. When a pill is not taken as indicated, it sends a signal to alert the patient, doctor or caregiver via phone. MagneTrace is at least one year away from FDA approval. Advocates claim it will ease as much as $100 billion in healthcare costs; skeptics have a lot of questions around safety and versatility. Chronic forgetfulness appears to be a national problem—one in three adults admit they do not follow their prescription drug treatment plans.

Among all the recent innovations, artificial intelligence and tech-equipped homes hold the keys to the future of aging, self-sufficiency and independence.

Knowledge and Awareness
A little education goes a long way. One of the best ways to protect aging parents and support their independence is to tap the knowledge and expertise that’s available at your fingertips—on the Internet. Be sure to educate yourself in the challenges of aging in place and plan for things that may happen, such as common accidents. “An ounce of prevention is worth a pound of cure,” goes the old saying.

Depending on your budget, it also makes sense to tap the expertise of caregivers and home modification companies. After years of service and hands-on experience, these professionals know exactly what to look for, and how to anticipate the challenges your aging loved ones will face. Our professional caregivers can walk into any home and recognize instantly whether it’s a safe environment for seniors, or a potential minefield of accidents waiting to happen.

We have recently written an article you might also find interesting, “Seven Ways to Promote Your Parents’ Better Brain Health". One of the best ways to protect your aging parents is to put in place all the things that support better brain health—from proper diet and exercise, to social interaction and games that stretch the brain’s capacity to think.

Investing time, resources and energy into safeguarding your aging parents’ safety and independence is critically important—and satisfying. Your parents will appreciate it deeply, whether they fully express it or not. You will see the difference in their lives. And, you will always value the good feeling that comes from having contributed to their quality of life.

Jack Merrick is the co-owner and co-executive director of Good Company Senior Care, an independent, in-home caregiver service with offices in Los Angeles and San Bernardino Counties.