It’s something I think about all the time – could my elderly father be victimized by a scam. Maybe it comes in a phone call to his apartment in a continuing care retirement community. Or through the mail. Thank goodness at least he doesn’t use email!

Now this investigation by the Orlando Sentinel proves my concerns are valid. The first sentence reads, “If your parents are 60 or older and live near here, chances are they’ve been scammed.”

That’s a scary thought, but one we should all be aware of. The full Orlando Sentinel article offers helpful information.

GPS-fitted shoe by Aetrex & GTX

We hear about it far too often- an elderly person with Alzheimer’s or dementia who is missing. In the past few days, I’ve come across these news stories online:

• Virginia State Police are searching for a woman with early stage Alzheimer’s who wandered away from her Eastern Shore home overnight…
• Police are looking for a Georgia woman with Alzheimer’s disease who went missing Saturday afternoon in New Orleans…
• Authorities asked for the public’s help in locating an elderly Millard County man with Alzheimer’s Disease…
• Search is on for woman, 87, with mild dementia…

It’s a frightening situation for caregivers, and an unsafe and sometimes tragic one for the patient. But recently I heard about a new device that could truly be a lifesaver: a shoe outfitted with a GPS tracking system that can locate the wearer instantly.

According to the Alzheimer’s Association, as many as 5.3 million people in the United States are living with Alzheimer’s. Patients of Alzheimer’s, the leading cause of dementia, can easily become confused or disoriented, and it’s common for them to wander from their home or senior living facility and not be able to find their way back. The tracking device in this shoe is intended to be totally unobtrusive. In addition to providing real-time information on the elderly person’s location, caregivers will also have the option to subscribe to a GTX service that automatically alerts them when the wearer of the shoe leaves a designated boundary.

Of course one of the stumbling blocks here is whether your loved one is willing to wear such shoes. There are all sorts of issues of privacy and consent. No one is more stubborn than my elderly father. He still lives independently in a continuing care retirement community, but in recent years  I have noticed that he is more accepting of his limitations and maybe even a little scared at times. As I’ve written before, he suffered a terrible fall in his apartment last September and nearly 32 hours passed before he was found. He is now fully recovered, but that tragedy scared him into agreeing to wear an “alert” necklace that he can use to signal if he is ever incapacitated in the future. I’d like to think that if he started to develop dementia, he might be willing to wear a shoe such as this, if not out of concern for his own safety than maybe out of concern for my peace of mind.

Of course, my husband reads this and his first thought is, “Can’t we get those shoes for our daughters?” That’s a topic for a different blog!

The shoe is a collaboration between GTX Corp., a firm that specializes in miniaturized GPS tracking devices, and footwear company Aetrex. Details are still being worked out, but GTX expects the shoe to retail for around $200 to $300 and be available some time next year.

For this week’s Friday’s Featured Facility- a community that may represent a trend in senior living. Oak Hammock at the University of Florida in Gainesville is the only university-based retirement community in Florida and one of only a handful across the country. But these types of senior living facilities are attracting attention and popularity among boomers who appreciate the vibrant educational, cultural and social offerings that a university setting can offer.

Oak Hammock’s 136-acre facility is a continuing care retirement community (CCRC), meaning it offers a range of options – everything from independent living to assisted living to memory care and skilled nursing. For a one-time entrance fee, ranging from  $147,500-over $500,000 – Oak Hammock residents are guaranteed long-term care at a significantly reduced rate. There are also monthly fees ranging from $1800-5000 to cover everything from utilities to social activities and some meals.
What makes Oak Hammock unique is its integration with the University of Florida. Star Bradbury, Director of Life Planning at Oak Hammock, told me that the community would not exist without the University. Oak Hammock’s board is appointment by UF’s president, and the school’s deans and staff provide input for the community’s activities. Among the benefits listed on Oak Hammock’s website are:

• Because our 22,000-sq.-ft. Fitness Center is affiliated with UF’s College of Health and Human Performance, attention has been paid to the smallest detail – from installing the right equipment to calibrating the ideal temperature for the swimming pools. 
• The College of Dentistry staffs an on-site, full-service dental hygienist suite.
• The College of Veterinary Medicine operates a Veterinary Clinic at Oak Hammock, providing routine wellness care. Pet sitting is also offered.
• The College of Fine Arts provides performance venues and schedules on-site recitals.
• The College of Medicine provides a Mini-Medical School series.
• The College of Pharmacy provides weekly consulting services with members
• Liberal Arts and Sciences presents educational programs in a wide range of disciplines.
• Oak Hammock members serve as mentors, lecturers and volunteers in the University’s many academic programs. 
• Because Oak Hammock is directly affiliated with the University of Florida, members have campus privileges similar to those of University faculty – with access to sports, performing arts events, library and research facilities, and more.

Oak Hammock is home to approximately 400 people. Most live in independent living apartments or freestanding homes. The facility also has a capacity for 42 people in its assisted living unit, 42 in skilled nursing and 24 in memory care. Oak Hammock currently has a waiting list, but if you are interested, you can secure a spot on that list for a fully-refundable $1500 deposit.

To learn more about Oak Hammock at the University of Florida, visit www.oakhammock.org.

I’m starting a new segment on the Florida Senior Living Advisor blog today called “Friday’s Featured Facility.” Every Friday I’ll tell you about one of the more than 3700 senior living facilities in Florida, everything from assisted living facilities, to nursing homes, continuing care retirement communities, hospice, skilled nursing units and adult day care centers. If you’d like to recommend a facility for me to feature, send it to me at mitra@flseniorlivingadvisor.com.

The inaugural “Friday’s Featured Facility” is Guardian Home Health in Spring Hill, Florida, about 60 miles north of Tampa. This is actually an assisted living facility, but the name “home health” refers to the fact that it is located in a single-family home. The facility is licensed to care for six residents. Of the nearly 3,000 assisted living facilities in Florida, about half have a capacity of less than 10.

Owner Elaine DeCiutiis runs Guardian Home Health, along with her husband Frank and daughter, Paulamarie Aurigemma. DeCiutiis and Aurigemma are both certified nursing assistants and have backgrounds in health care administration. They opened the home last October, with the goal of providing very personalized care to each elderly resident.

“When I’ve gone to big nursing homes, I see people just sitting there and doing nothing,” says DeCiutiis. “We try to keep them active. We play cards.  We discuss current events. We go to the movies or out to lunch.”

DeCiutiis also tailors each meal to the residents’ taste as much as possible.

“You could say we spoil them,” she says with a laugh. “But at their age, they deserve to be spoiled.” Residents are also offered a shower every day, a service that is often not possible in larger facilities where there may not be enough staff to accommodate residents in this way.

For more information on Guardian Home Health, you can visit their website at www.guardianhomehealth.org. You can also call 352-688-8832 or send an email to edecuitiis@tampabay.rr.com.    

Our regular Sunday night dinners with my elderly father and his friend Ginny always include a drink with our meal. Usually it is red wine, although sometimes, particularly if we go out to eat, they opt for a vodka martini (with an olive AND a twist please). At ages 84 and 90, respectively, I figure they can do what they want. And after all, we provide the ride to and from their Florida continuing care retirement community, so no worries there.

But it never occurred to me that those drinks might actually be helping them. That’s right. According to a new study one or two alcoholic beverages a day may reduce a senior citizen’s risk of developing dementia by almost 40 percent. The study was presented this week at the International Conference on Alzheimer’s Disease, currently being held in Vienna, Austria.

These “moderate drinkers” who are 75 years of age or older had a lower risk of developing dementia than people who had more than two drinks a day and also a lower risk than those individuals who abstained from any alcohol completely, Dr. Kaycee Sink and her colleagues found. For the study, they asked more than 3,000 adults how often they drank and examined them every six months for up to six years for signs of memory loss or mental decline.

The findings aren’t a free pass for drinking among the elderly, the results showed. People who were already showing signs of memory problems deteriorated significantly faster if they drank alcohol, and the more they consumed the worse the symptoms became. Heavy drinkers, defined as those consuming more than 14 drinks a week, were almost twice as likely to develop dementia, researchers said.

“If you’re already drinking, you don’t need to cut back if you’re cognitively healthy, but we don’t have enough information to recommend you start drinking,” Kaycee Sink, assistant professor of medicine at Wake Forest University School of Medicine in Winston-Salem, North Carolina, said during a press conference. “The benefits increase as people move from mild to moderate levels of drinking, and then start to decline.”

Maybe this study will convince the folks in charge of senior living facilities to add a regular happy hour to their activity calendars!

I suppose these results also have implications for me and my fellow 40-something friends. We’ve known for a long time that a glass or two of red wine is good for our hearts. Now to think it can also stave off dementia is reason to celebrate – with a toast!

Lately, whenever I put on a pair of shoes, I think about my elderly father. As I stare at my choices – high heel, low heel, sandal, sneaker, black, white, pink or blue – I think about him putting on the same pair of brown fisherman sandals day after day, month after month. He only has one pair; not because he’s particularly picky, but because we have not been able to find another pair that meets his needs for comfort and function. Like a lot of senior citizens, his feet appear slightly swollen most of the time. Not enough to cause concern but enough to make it difficult to find suitable shoes. He needs them to be wide; he needs them to have a high rise (the opening from the sole to the top of the shoe); he needs them to be easy to put on; and most importantly, he need them to be safe. When he first moved to Florida about a year ago to move into a continuing care retirement community, he primary footwear was a pair of slip-on sandals. They met all the criteria except the most important one – safety. Without any support around his heel, the shoes forced him to walk in a shuffle, not really picking his feet up and often snagging on carpet.
 
Last September, he took a fall (unrelated to his choice of shoes), that forced him to spend several weeks in the nursing home section of his ccrc. Upon his release back to his independent living apartment, I decided it was time to get him new and better shoes. The pair we selected is a leather fishermen’s sandal with one very helpful feature- a velcro closure strap. At 84 years old and having had double hip replacement surgery several years ago, my father’s mobility is limited. There’s no way he could bend down long enough – and steady enough – to tie shoelaces. But he also can’t wear slip-on shoes that can’t be opened and then closed; they are just too tight for him to get on. So these fishermen sandals have been the perfect solution. He can sit in his chair, position the shoes just in front of his feet, and with some patient wiggling, get his feet in. Then he slowly reaches down and closes the velcro. The holes in the sides of the shoe also offer much-needed ventilation.

I tell you all this because it has only recently hit me how something that I take largely for granted – the ability to wear whatever shoes I want – can become a huge issue for senior citizens. Shoes that seem sturdy may actually contribute to falls for the elderly, according to a study by Dr. Carol Frey, an orthopedic surgeon. Dr. Frey studied 185 men and women. Among those who fell and were injured during the year of the study, 28% said that the shoes they were wearing had caused the fall. Sixty percent of those wearing sneakers said they fell because their shoes caught or dragged on the floor.

Here are some safety tips from orthopedic experts:

• Never wear shoes with slippery or worn outer soles. Also avoid shoes with smooth leather or plastic soles, which can be slippery on carpets, wood and tile floors, and wet surfaces. Some athletic shoes made with synthetic soles, which may be ideal for exercising in a gym, can be extremely slippery on a damp or wet surface.
   
• Avoid wearing shoes and slippers that are loose or ill-fitting.
   
• When walking on carpets, avoid wearing shoes with heavy rubber lugs that can catch on carpets, especially when they are worn by people who barely pick up their feet when they walk (exactly my father’s problem). The rubber tips on the toes of running shoes can also cause a stumble on a carpeted surface.
   
• For an all-around shoe, consider walking shoes, which provide good traction and support but do not have heavy soles or rubber over the toes.
   
• Although shoes with a lot of cushioning can make you feel as if you are walking on air, they can also make an older person unstable and are best avoided.
   
• Shoes that tie are safer than shoes that slip on the feet. Laced shoes can be adjusted to accommodate orthotics, braces and swelling of the feet. For those who lack dexterity, consider replacing cloth laces with elastic ones that hold the shoe firmly on the foot, but stretch enough to allow shoes to be slipped on and off without tying or untying the laces. (I am planning to have my father try out this type of laces on his next pair of shoes.)
   

I am currently talking to some companies that sell shoes specifically for the elderly about advertising on my Florida Senior Living Advisor website. Stay tuned for more on that.

Last night, like most Sunday nights, my 84-year-old father came over for dinner. And as is usually the case, he was accompanied by his girlfriend  Ginny, an amazing 90-year-old woman who lives in his continuing care retirement community. We all have different ideas of what constitutes “old age” or “elderly”. Ask my young children, and they would probably tell you old age starts in your 50s. Most of my 30- and 40-something friends would probably say anyone 75+ falls in that category. But there would be little  debate that a woman of age 90, like Ginny, is elderly. After spending nearly every Sunday evening with her for the past eight months, I am here to tell you otherwise.

Ginny is a vibrant, fit, sharp-minded woman who exemplifies everything I hope to be if I am fortunate enough to live that long. And I’ve finally figured out her secret. Ginny has discovered the Fountain of Youth. It’s not a place, and it’s not in a cream or an injection or a surgical procedure. The Fountain of Youth is in her head – and in all of our heads if we allow it to be.

Ginny is always “up.” Everything is wonderful in her world. Every week when she comes over, she gushes about how the meal is the best she’s ever had (even when I opt not to cook and order take-out), my children are amazing (as she listens to my three girls argue over the Wii), the weather is beautiful (not the word I’d use on a sticky hot Florida summer night), etc. Her favorite phrase is, “This is such a treat” – and she uses it often. Last night as she was saying good-night, she touched my arm and said, “This is really heaven in this home. Your kids, your family, it’s just heaven.” She verbalizes positive thoughts and she says them with sincerity. I believe her optimism is the secret to her youthfulness, and it’s starting to rub off on the rest of us as well. When we first started hosting my father and her for dinner, I think we thought of it more as a favor to them, to give them a chance to get out of their continuing care retirement community and have a change of scenery and food. Now I realize that my husband and I are the ones reaping the benefits.

What Ginny has taught us – or at least reminded us – is that there really is power in focusing on the positive. She has had her share of heartache, outliving three husbands, her first who died fairly young. Through it all, though, she has never lost her love of life and living. She has held interesting jobs, traveled the world, and continues to seek out new experiences (she is currently trying to convince my father that they should take a trip to Key West). Until recently, Ginny was an avid swimmer; now she stays fit by using the equipment in her senior facility’s exercise room. According to this article from WebMD, exercise is a key to staying sharp in old age.

Thanks to Ginny, I have clear evidence that I don’t need to buy into the fancy creams and procedures to retain my youth. Those are only superficial treatments (and one way or another – by 90, the wrinkles are there). The real secret to a vibrant, youthful life comes from within, from fostering a positive  attitude and mental acuity. The Fountain of Youth is much closer than I ever thought!

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For a comprehensive online database of senior living facilities in Florida, visit Florida Senior Living Advisor.

I’ve been a fan of online shopping for years. I was what you’d call an “early adopter” – back when friends and family were still too scared to think about submitting a credit card number online, I jumped right in with enthusiasm. I love the convenience of being able to shop when I want (often late at night) and where I want(comparing several different stores and products without spending a dime on gas). So I was thrilled to learn about a new shopping website that is unlike any other I know of – Alice.com.

Alice carries all the common household items we all need – things like laundry detergent, shampoo, toilet paper and deodorant – that we buy again and again. Once you set up your free account, the site walks you through the process of selecting your favorite items and brands. You can search by product name, price or even find out which items have coupons available. Here’s the best part: shipping is free. And you can set up your account so Alice will remind you when to re-order; for example, toilet paper once a month, band-aids every three months, etc. The website says that it offers savings comparable to the big-box stores, because it allows manufacturers to sell directly to consumers, eliminating the middleman. I need to spend some more time comparing prices on my favorite items, but I have to say that from what I’ve seen so far, I’m impressed. (And remember  – no gas money spent.)

I’m telling you about Alice.com not just because I like the service for myself, but because I think it could turn out to be a great resource for the elderly and all users of Florida Senior Living Advisor. For example, my father lives in a continuing care retirement community. The facility provides weekly van trips to a local grocery store, but the residents are responsible for carrying their own items up to their apartments. I know it would make it easier for my dad if he didn’t have to worry about hauling things like toilet paper and laundry detergent, and he could focus on buying his favorite food items. I think Alice.com could also be a helpful service for folks living in assisted living, although maybe not as much for people in nursing homes, where most of these types of products are provided. My father is not what you would call computer savvy, so I’ll manage his online account and do his ordering for him. This would be a great way for family members who live far away to be able to help their loved ones in senior living facilities with a necessary task.

So check out Alice.com and let me know what you think. You can also enter to win a $250 gift certificate to Alice.com by visiting Five Minutes for Mom.

Well this is encouraging. On Friday the Centers for Medicare and Medicaid Services - the federal agency that sets quality standards for nursing homes – issued new guidelines for nursing home surveyors that emphasize the importance of “resident quality of life” and “homelike environments.” CMS says the goal is to get nursing homes to focus on resident-centered care. It’s about time, don’t you think? And just what have they been focusing on prior to this decision? Profit margins?

Last fall my father had to spend several weeks in the nursing home that is part of his Florida continuing care retirement community. He had fallen in his apartment, received treatment at a local hospital and then was discharged to the nursing home for rehabilitation and physical therapy. To be blunt, initially it was a terrible experience. When we arrived at the nursing home, they assigned my father to a room and then left us to fend for ourselves for what felt like an eternity. How wonderful it would have been to have someone – a nurse, an administrator, anyone -  take a few minutes to welcome him, explain his daily schedule, meal options, etc. Yes, I understand that he was just one of many patients they had to deal with. But a little warmth and time spent in his admission would have gone so far in starting things off on the right track. Instead I left the nursing home that afternoon with a knot in my stomach, with no confidence in the care he would receive. It certainly did not feel like a “homelike environment.”

One of the other points in Friday’s CMS report is that nursing homes should start to pay “close attention to resident’s preference for his or her own daily schedule.” I know this will be a difficult task, but how wonderful it will be for the residents in nursing homes that can fulfill this suggestion. My father prefers to eat his dinner later in the evening, 6:30 at the earliest. While he was in the nursing home, he had to eat at 5pm. That may seem like a minor issue, but to anyone who has dealt with a family member in this situation, you know that it has a big impact on their attitude and sense of dignity. One of the things that upset my father the most while he was in the nursing home was that he was dependent on the nurses and CNAs just to use the bathroom. He would have to ring the call bell and then wait, and wait, and wait, for someone to come into his room to help him up to the bathroom. As you can imagine, at 84-years-old, this was often an urgent issue for him.  But most of the nursing staff seemed to exhibit total disregard for this.

I believe that part of the problem initially was that my father was placed on a floor where most of the other residents were much more incapacitated that he was. So I think the staff was a bit slack – it is tempting to not be “resident-centered” if the resident doesn’t know the difference, and can’t even articulate any frustration. He was also placed in a corner room at the end of the hall, a bit of the “out of site, out of mind” phenomena. After my sister and I raised a fuss, he was transferred to a different floor and that’s when things turned around. He was surrounded  by more active residents, and more engaged staff members. I recall the dining supervisor found out that he had been asking for honey to go with his hot tea (which was usually served lukewarm, by the way). Just when he had given up on ever getting honey, she arrived with several small packets  delivered personally to his room. A small gesture that made a big impression.

I’m sure there are nursing homes in Florida and the rest of the country that already focus on “resident-centered care” and “homelike environments.” But there are far too many that don’t. This won’t happen overnight. But I have hope that these new survey guidelines will at least get these important issues on the table and create greater accountability for nursing homes. If you’d like to learn more about the CMS guidelines, visit http://www.cms.hhs.gov/transmittals/downloads/R48SOMA.pdf

For a searchable database of nursing home in Florida, visit Florida Senior Living Advisor.

I just learned that a nursing home in West Palm Beach has been fined $16,000 after a patient was found on the floor with maggots crawling out of his leg cast. An August 2008 report by state regulators determined that Azalea Court Nursing Home failed to provide necessary care to the resident, who had a cast on his lower leg, leading to the infestation of maggots. The patient’s broken leg was supposed to be treated every three days, but the facility could only document weekly treatment.

In April 2008, just four months before the above-mentioned incident report, inspectors cited the 120-bed facility for a series of isolated events that it said “put the health or safety of residents in immediate jeopardy.” The nursing home was put on a “watch list” and given just one out of a possible five stars as its overall inspection grade, including just one star for quality of care and quality of life measurements, according to the Florida Agency for Health Care Administration. State regulators gave Azalea Court a “J” grade for protecting residents from mistreatment and having policies to prevent abuse. That grade means there was “immediate jeopardy” to resident’s health or safety for isolated violations. You can find Florida’s watch list and get other state ratings of nursing homes here. Azalea Court has appealed the penalty.
 
I can’t help but wonder if the resident in this case has any family members nearby who oversee his care. I know that when my father fell last fall while living in his continuing care retirement facility, I was there every day afterward to check on his care and rehabilitation at the on-site nursing home. This shouldn’t be necessary – a resident in a senior living facility should get quality care whether there is a relative or friend watching or not; but I can’t help but think that in reality – at least in some senior living facility – it does matter.

What is particularly appalling about this story is the paltry size of the fine – $16,000??!! I’d like to know how state regulators came up with that amount. And more importantly, when the appeals process is complete, will the facility face any fine??