Hoarding and the Elderly: How to Help


We inherit a lot from our parents, their traits, their looks and even their stuff -- perhaps too much of their stuff.

Clutter is a growing problem today among all populations, including the elderly. To help your parents pare down, downsize, create more room in their home and/or make it safer to age in place, it is important to note the difference between hoarders and clutterers. Hoarders are obsessive about their stuff and will often need a trained professional specializing in obsessive compulsive disorder to let go. Clutterers, the more common type, are more apt to let go with a little encouragement and support.

Dr. April Benson, the founder of stopovershopping.com, says that "letting go reminds them that they are closer to the end of their lives and many older people want to hold on. Explaining that letting go does not always signal loss but can also mean making space for something, is a good way to ease anxiety."

Keeping in mind that items people don't want to let go of represent history and legacy, you can try the following suggestions to get people to part with them:

  • Find out how much the heirlooms are worth. Consult a local antique dealer. For the money motivated, resale can be a great inducer to declutter the home. A common mistake is that just because something is old, people assume it is "Antique Road Show" quality, so be prepared for some disappointments.
  • Be satisfied with slow, steady progress. Rome was not decluttered in a day. Even though you are dealing with their things objectively, your parents may not be. For many, starting is the hardest step, so be prepared to put in the extra time.
  • Consider hiring an objective third party. You might be too close to help. An professional organizer or housekeeper might be more effective at navigating the emotional terrain. Consult the National Association of Professional Organizers to find one near you.
  • Get family support. Letting family members take a remembrance or keepsake is a great way to preserve the legacy, especially if the elder family member can see something valued and put to use.
  • Make a list. A good way to start for the very clutter challenged is with a small step in letting go, such as making a list of whom they want to give their things to when the time comes.

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How to Protect Your Loved Ones - Scams That Target Elderly Seniors

While it seems unconscionable to most, unscrupulous men and women often target senior citizens for devious scams to rob them of their money or identities. When scammers know how to confuse and gain the trust of the elderly, they have virtual free reign of bank accounts, personal information, and even assets.

If you’re concerned about the well-being of a senior in your life, or if you’re a senior who wants to protect yourself, learn about common risks and scams. Then, if someone approaches you or your loved one with a potential investment or opportunity, it will be easier to determine the legitimacy of the offer.

Here are some of the most common schemes – and why they’re especially dangerous for seniors:


1. Prescription Drug Scams

Seniors often take a myriad of prescription medication, which can be quite expensive. Sure, Medicare helps with the costs, but some seniors are still left paying hundreds of dollars per month for prescriptions. It’s no wonder that seniors are likely to fall for online schemes that promise deeply discounted prices on medication. But once shoppers hand over a credit card number, their money is taken – and they’ll never receive any medication.

2. Investment Scams

Plenty of seniors are eager to multiply their nest eggs to provide for a more comfortable retirement. And if they’ve already saved a tidy sum, they may have a little with which to take some risk. That makes seniors easy prey for fake “investment opportunities” that don’t really offer a return. Whether it’s plowing money into a fledgling or even fictional business, or buying vacation property that doesn’t exist, investment scams can deplete seniors of their savings in the blink of an eye.

3. Internet and Email Scams

The Internet can be a confusing place for seniors who haven’t had much experience with technology. A Pew Research Internet use study found that many adults over the age of 74 use the Internet solely for health information, news, and buying products, and are not as savvy when it comes to email, social networking, and online safety.

When a senior receives an email promising big returns for a small investment, it can be easy to become excited. Even if you can spot an Internet or email scam from a mile away, an unsuspecting senior might hand over his or her personal information without a second thought.

How many times have you received a message in your inbox notifying you that you’re the winner of a lottery in Nigeria, or some other faraway country? Savvy Internet users know the old tricks, but less-confident seniors often fall prey to the claim that they’ve hit it big. Usually, lottery schemes operate by asking the target to pay a certain amount to redeem the cash prize, or to pay for the “shipping and handling” to receive other goods. They might also ask for bank routing and account numbers and other highly personal information, which is then used for theft.

4. Reverse Mortgage Scams

Reverse mortgages have made it possible for some seniors to have a more comfortable retirement by turning their home equity into a reliable stream of income from the bank. Even a legitimate reverse mortgage, however, should be considered carefully, as in many cases, you must eventually turn your deed over to the bank. In other words, the bank – and not your heirs – could get your home when you pass away.

Unfortunately, not all “financial institutions” are the real deal. Seniors can fall prey to a scam artist who proposes a reverse mortgage – and then steals the equity. It’s one of the most complicated scams, but it also yields some of the highest returns for scammers.

5. Charity Scams

Scammers posing as charity workers contact seniors and offer up a sad story which, of course, concludes with a plea for funding. Seniors are taken in by the tale, and send along money to help. Charity scams often carry a note of urgency – a telemarketer might note that money has to be given now, or ask that a credit card number be given in lieu of a mailed check. This gives a senior virtually no time to investigate the supposed charity and contemplate whether they should give. Such a scam takes advantage of a senior’s compassion, which can make it especially hurtful.

6. Check Scams

Check scams involve a con artist offering to buy an item from a seller (often an item that has been put up for sale online through Craigslist) using a cashier’s check, which is made out for an amount that is greater than necessary. The scammer then asks that the check be cashed, and the excess funds returned. Of course, the check is fraudulent, but if the money is returned before the seller realizes this, they have lost the funds – as well as the item they put up for sale. Since cashier’s checks are usually as good as gold, some seniors don’t ask questions and are taken in by the opportunity to sell quickly.

7. Help Scams

This is a scam that often confuses the elderly, as it causes them to panic and act without calmly considering the situation. A scam artist calls up the unsuspecting target, and with some basic information convinces the senior that he or she is a grandchild in a dire situation. Then, the scammer asks for financial help because of an accident or other emergency. The scammer then has money wired directly into his or her hands. Of course, the real grandchild is perfectly fine, oblivious that his or her name has been used to execute a scam.


Protecting the Elderly

While it’s important to be aware of the scams that senior citizens most often fall prey to, it’s even more important to know how to prevent being a victim. Take the time to explain the possible scams to your loved ones, and suggest the following techniques to help them avoid potentially devastating thefts:

  • Be Suspicious. If you or a loved one is generally trusting, being skeptical can be difficult. However, being generally suspicious of cold calls and unsolicited letters and emails that promise huge benefits is an effective way to stay protected.

  • Ask Questions and Get Information. Before you or your loved one does business with a new company, obtain a name, address, phone number, and website for the person you’re talking to. Just asking a few questions can be enough to scare some con artists away.

  • Become Familiar With Online Safety. Surf only reputable websites, adjust email spam settings to the highest level, and never share personal information like Social Security numbers with anyone online – even if it seems as though your bank is requesting it. Call the bank first.

  • Never Give Personal Information Online. An investment company or charity will never ask for a Social Security number via email. If you or your loved one receive an email requesting personal data, bank routing numbers, or other private information, it’s probably a scam.

  • Don’t Make Hasty Decisions. If a telemarketer pressures you to make an immediate decision, hang up the phone. Never make a decision to hand over money until you’ve had time to do careful research.

  • Check the BBB. The Better Business Bureau is a fantastic tool for confirming the legitimacy of financial institutions, charities, and other organizations. Always check with the BBB before offering up funds. If a company isn’t registered with the BBB, it could be fraudulent. A quick Internet search might also turn up information from people who have been scammed by a similar scheme.

  • Invest Carefully. The most fool-proof investments are done with the assistance of a financial advisor, not a random acquaintance or someone who cold-calls your house. It takes only a few minutes to contact your bank or planner, and it could save hundreds or even thousands of dollars. Find a planner or counselor you can trust, and run all investment ideas by him or her first.

  • Don’t Pay to Play. Never provide money to gain a prize. When someone asks for a routing number to deposit funds, or for shipping and handling charges for a “free” prize, it’s a clear sign that it’s not legit.

  • Protect Others. If you think you or a loved one has been the victim of a scam, contact your local police department to file a report. You can also let the FBI know about the scam artist by submitting your information to the FBI tips website. 

Final Word

You can’t always protect your loved ones from unpleasant experiences, but you can reduce the likelihood that they will become victims of a scam. Remember, if an offer seems to good to be true, it probably is. And though it may feel wrong to be suspicious of a charitable organization or a family member’s request for money, it’s always in your best interest to verify the identity and legitimacy first. Always confirm who you’re sharing your personal information with or providing money to before you go through with it.

How to Protect Elders From Frigid Winter Weather



Chilling temperatures and treacherous snow and ice can terrorize the elderly and their caregivers during the winter months.

Here are a few things to keep in mind to help keep seniors safe during the frigid season approaches:

Hypothermia
Each year, half of Americans who die from hypothermia are at least 65 years old. The elderly are particularly susceptible to becoming dangerously chilled because they have less fat, slower circulation and a more sluggish metabolism. A senior can even become hypothermic while indoors, so the thermostat should never be set below 65 degrees for a person who is 75 or older. Make sure that an elderly person is warmly dressed when inside the house as well as outside.

Dehydration
Seniors are especially prone to becoming dehydrated simply because they eat and drink less than younger people, thus they consume less water. In general, people also feel less thirsty during the winter and so are more prone to not drinking enough as they should. Make sure your elderly loved one is drinking consistently.

Ice and snow
Sidewalks slick with ice and snow pose a serious falling hazard for an elderly person. Make sure that the porch, driveway, sidewalk, etc. of the senior has been thoroughly cleaned. Try not to let them do it themselves—bring a shovel or hire an outside service. To maximize a senior's stability, be sure that they have rubber-soled shoes and new treads on their walker or cane.

Disaster kit
Winter storms can be fierce enough to knock down power lines and forcibly confine seniors to their homes. It is essential to make sure a senior is equipped with a disaster kit to help them get through these times. Each kit should include enough food and water for several days (at least 3 gallons of water per person per day), a few days-worth of medication for the senior, a flashlight, a weather radio, extra batteries, and first-aid essentials.

Space heaters
While they can provide an elderly person with some much-needed warmth during the colder months, precautions need to be taken so these sources of heat don't become health hazards. If the heater is gas powered, make sure the senior has a fully-functional carbon monoxide detector. If the heater is electric, make sure the cords aren't damaged or fraying. Keep all heaters away from flammable materials such as cloth and paper and make sure the smoke detector is working properly.

Clothing
Mittens, scarves, sweaters, hats, and coats are a few of the must-have articles of clothing for seniors living in colder climates. Even when an elderly person is indoors, they should be dressed in warm layers so they can take clothes off if they are too hot, or put more on if they are too cold.

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Managing Sundowning and Dementia


For most of us, sunset is an occasion we celebrate. It's a time of transition from the often frenetic energy of the day to the more subdued and relaxing nature of evening. But for many elderly people who suffer from Alzheimer's disease or other forms of dementia, it can be a time of increased memory loss, confusion, agitation and even anger.

For family members who care for those with dementia, witnessing an increase in their loved one's symptoms of disorientation at sunset can be nothing short of troubling, if not also painful, frightening and exhausting.


Common Sundowning Triggers

  • Too Much End-of-day Activity: Some researchers believe the flurry of activity toward the end of the day as the facility's staff changes shifts may lead to anxiety and confusion.

  • Fatigue: End-of-day exhaustion or suddenly the lack of activity after the dinner hour may also be a contributor.

  • Low Light: As the sun goes down, the quality of available light may diminish and shadows may increase, making already challenged vision even more challenging.

  • Internal Imbalances: Some researchers even think that hormone imbalances or possible disruptions in the internal biological clock that regulates cognition between waking and sleeping hours may also be a principle cause.

  • Winter: In some cases, the onset of winter's shorter days exacerbates sundowning, which indicates the syndrome may have something to do with Seasonal Affective Disorder, a common depression caused by less exposure to natural sunlight. 


Managing Sundowning Symptoms

The treatment of Sundowner's Syndrome, just like its cause, is not well established. But there is hope in a number of approaches that have helped calm down sufferers of the condition in the past.

"It's not like treating blood pressure where you just give a blood pressure medicine," says Rabins. "It's hard to generalize about it because there's not one treatment approach, but I think often when you focus on the individual you can find things that are more likely to work with one person than another."

Some of the more successful approaches to managing sundowning behavior include:

Establishing a Routine
Routines help sundowners feel safe. Routines minimize surprises and set up daily rhythms that can be relied on. Without a routine that fits your loved one's need for regular activity and food, he or she may remain in a constant state of anxiety and confusion, their limited cognitive abilities unable to deal with the unpredictability of the day. Schedule more vigorous activities in the morning hours. Don't schedule more than two major activities a day. As much as possible, discourage napping, especially if your loved one has problems sleeping.

Monitoring Diet
Watch for patterns in behavior linked to certain foods. Avoid giving foods or drinks containing caffeine or large amounts of sugar, especially late in the day.

Controlling Noise
It may be helpful to reduce the noise from televisions, radios and other household entertainment devices beginning in the late afternoon and early evening. Avoid having visitors come in the evening hours. Activities that generate noise should be done as far away from your loved one's bedroom as possible. 

Letting Light In
Light boxes that contain full-spectrum lights (light therapy) have been found to minimize the effects of sundowning and depression. As the evening approaches, keep rooms well-lit so that your loved one can see while moving around and so that the surroundings do not seem to shift because of shadows and loss of color. Night lights often help reduce stress if he or she needs to get up in the night for any reason. 

Medicating
In some cases of sundowning, especially when associated with depression or sleep disorders, medication may be helpful. Consult a physician carefully, for some medications may actually disrupt sleep patterns and energy levels in a way that makes sundowning worse, not better.

Taking Supplements
A few over-the-counter supplements may be of some benefit. (Remember to consult with your loved one's doctor before giving him or her any dietary supplement.) The herbs ginkgo biloba and St. John's Wort have assisted people with Alzheimer's and dementia in the past. Vitamin E has also been found to minimize sundowning in some cases. Melatonin is a hormone in supplement form that helps regulate sleep.

Looking for Behavior Patterns

Sundowners Syndrome is a condition most often associated with early-stage Alzheimer's, but has been known to affect the elderly recovering from surgery in hospitals or in unfamiliar environments. Occasionally, the syndrome will affect people in the early morning hours. While the symptoms and causes of Sundowners Syndrome are unique to the individual, researchers agree that it occurs during the transition between daylight and darkness, either early in the morning or late in the afternoon. But the precise cause of sundowners, like the cause of Alzheimer's disease, remains elusive.

"There is not a clear definition of what sundowners syndrome means," says Dr. Peter V. Rabins, professor of psychiatry in the geriatric psychiatry and neuropsychiatry division of Johns Hopkins University School of Medicine. "It's a phrase. Some people would only include agitation in the definition. It is a range of behaviors-something that is not usual for the person. That can range from just being restless to striking out."

While some with Alzheimer's express their dementia throughout the day, the behaviors encountered in sundowners syndrome are often more severe and pronounced, and almost always worsen as the sun goes down and natural daylight fades. While one person may express several of the behaviors at the same time, another may exhibit only one of them. Symptoms include rapid mood changes, anger, crying, agitation, pacing, fear, depression, stubbornness, restlessness and rocking, according to Rabin.

Occasionally you will find your loved one "shadowing" you closely from room to room. They may ask you questions and interrupt you before you can answer them. They may ask these questions more than once, but it is important to realize they have no recollection of ever asking them before. They are not purposely trying to aggravate you. They simply do not remember.

The more severe symptoms of Sundowners Syndrome are also the most difficult to manage for those who care for Alzheimer's patients and may also put others at risk: hallucinations, hiding things, paranoia, violence and wandering. Wandering, especially, is dangerous, besides also being frustrating. Not only can the person not control these behaviors or conditions, if they wander, they often do not know they are wandering and they often do not know how to return home. While it may sound rather indiscreet, it is often a good idea to give your loved one an identification bracelet and even go so far as to lock doors and fence yards with locked gates to keep him or her safe during unsupervised hours. It is never a good idea to leave a loved one with sundowners alone in a car or in a public place while you are shopping or running errands.

According to Rabins, it is not inevitable that a person with Alzheimer's disease will also develop Sundowners Syndrome. And it is also important to note that Alzheimer's specifically and dementia in general are not the only precursors to the condition. As mentioned above, it is not uncommon for perfectly healthy elderly people to behave strangely when recovering from surgeries in which anesthesia has been administered, or during protracted hospital stays. These event-oriented psychoses are usually temporary. It is only when a pattern in behaviors at sundown is noticed that a syndrome may be developing.

"When there's a pattern to it," says Rabins, "it's important to look for triggers or something in the environment. Is there something in the patient's medication? Are their fewer activities? Is there less staffing? There might be things in the environment that may change or things in the patient: biological changes, sleep-wake cycle, hormone secretion problems. There may be things that can be done, for example, to increase the stimulation for some people, but for others it might be decreasing it. Does it happen every day, how long does it last, how severe is it?"

Because it is common, many professional caregivers who care for Alzheimer's patients are experienced with its range of symptoms and trained to deal with them appropriately.

It is important to remember that Sundowners Syndrome in your loved one is not something he or she can help. They are not purposely becoming agitated or angry or afraid as the afternoon leads to evening. Remaining calm will help you and your loved one get through these sometimes stressful moments.


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