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.    

It’s no surprise that elderly couples that have been together for decades can take on each other’s traits – developing similar political views, taste in food and music, sense of humor and even physical appearance. But a recent study suggests something remarkable – spouses of people with dementia are at substantially increased risk of developing dementia themselves.

No, dementia is not contagious. Rather, researchers say that the stress involved in caring for a person with this condition is huge and stress is a known risk factor for dementia. In addition, people who are stressed are less likely to eat a healthy diet and exercise, both of which are critical to brain health.

The study was presented at the Alzheimer’s Association 2009 International Conference on Alzheimer’s Disease.

Researchers followed more than 1,200 couples for 10 years. They found that wives who cared for husbands with dementia were nearly four times more likely to develop dementia than wives of men who didn’t have the condition. Husband caregivers were almost 12 times more likely to develop dementia than husbands of women who were cognitively healthy.

Why are male caregivers at greater risk of developing dementia than female? Researchers say it’s because elderly men tend to rely on their wives to keep up social ties with relatives and friends. Also, men often fail to go to the doctor without some nudging from their wives, according to the study. This places them at higher risk for high cholesterol, high blood pressure, and other conditions that may raise the risk of dementia.

Researchers offer this advice for adult children of people with dementia:

• Visit frequently and relieve the caregiving parent from his or her duties so he or she can get some rest.
• Make sure the healthy parent gets out and engages in social activities.
• Ensure both parents get to the doctor regularly.

These are good reminders for all senior citizens, not just those caring for someone with dementia.

Adult day care centers are an option for some families caring for a relative with dementia. These facilities offer a respite for caregivers. Most operate during normal business hours Monday-Friday, although some do offer evening and weekend hours. For a complete list of adult day care centers in Florida, visit Florida Senior Living Advisor.

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.

There are two things I know my 84-year-old father will always have in his pocket: a toothpick and a wad of bills. Like many elderly people who grew up in a different era, his preferred form of payment is cold hard cash. Over his lifetime, he has used credit only sparingly and I don’t think he has ever had a debit card (no matter how hard I try to explain that it is like using cash, he doesn’t buy it). Since he moved into a Florida continuing care retirement community about a year ago, I have been a little concerned about him keeping too much cash on hand. Thankfully his building has a Bank of America branch right in the basement. Not only does it give him peace of mind to know that he has easy access to his money, but I think it also helps preserve his sense of independence and dignity, especially since he no longer drives. 

I got to thinking about this after reading last week that an employee of a West Palm Beach nursing home has been arrested for stealing more than $2300 from an elderly resident. The employee, Natasha Petit-Homme was an admissions clerk at Woodlake Nursing and Rehabilitation Center in West Palm Beach.  According to Florida Attorney General Bill McCollum, Petit-Homme gained access to the victim’s checkbook, wrote herself a check for $2,341 and deposited the funds into her personal checking account. Petit-Homme is charged with one count of exploitation of an elderly person, a third-degree felony. She faces up to five years in prison and a $5,000 fine if convicted.

I don’t know anything about this victim’s capabilities or her situation, but I have to wonder why a nursing home resident is keeping a checkbook. These are sensitive issues, I know. As I have seen with my father, control of one’s finances is an important part of maintaining dignity and holding on to some independence. And as I have also seen with him, things can change rapidly for the elderly. Someone who is sharp-minded and on top of things today can go downhill in a matter of weeks or even days. Maybe the best we can do for our loved ones who are in senior living facilities is to be aware of these issues, discuss personal security with them and look out for changes in their mental abilities that may warrant a change in their responsibilities.

The arrest in this case resulted from an investigation by the Attorney General’s Medicaid Fraud Control Unit’s Patient Abuse, Neglect and Exploitation (PANE) team. According to their website, the AG’s Medicaid Fraud Control Unit investigates fraud committed by health care providers, and it also investigates the abuse, neglect and exploitation of the elderly, ill and disabled residents of long term care facilities such as nursing homes and assisted living facilities. If you want to report fraud or abuse, you can call the statewide hotline number or contact the Medicaid Fraud Control Unit nearest you:
The statewide hotline number is 1-866-966-7226

Tallahassee (850) 414-3300

Orlando (407) 999-5588

Tampa (813) 287-7940

Ft. Lauderdale (954) 712-4600

Miami (305) 377-5441

Jacksonville (904)-858-6919

Ft. Myers (239) 338-2442

West Palm Beach (561) 837-5000

Pensacola (850) 595-6057

While I was on the AG’s website, I noticed that they also provide a link to a new brochure, “Smart Consumers Can Stop Fraud: A Guide for Seniors.” The information in the brochure provides valuable guidelines and steps for consumers to take to protect their interests, as well as information on tools designed to save money, especially in the important area of prescription medication.