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ElderCare Solutions of MI

Archive for 'Aging Well'


The older we get, the more doctor appointments we seem to need.  It is not uncommon for the average baby boomer or older adult to see a cardiologist, a neurologist, perhaps even a rheumatologist, pulmonologist or gynecologist!  But amidst these many appointments there is one that often gets forgotten…an annual physical with a primary care physician.

Why is it important to keep up with your primary care doctor if you’re seeing all these specialists?  That’s a frequently asked question among our clients.  And the answer is a timeless metaphor…to be sure the right hand knows what the left hand is doing, and vice versa! Most specialists will only diagnose, treat, and prescribe medications for illnesses that fall under their own area of specialization.  So problems that come up may not be addressed outside of a primary care physician’s office.  For example, you’ll routinely have your blood pressure checked as part of an office visit with a pulmonologist, rheumatologist, or gynecologist, but it will not likely be addressed or treated, even if it is elevated. That’s also true if your labs show elevated cholesterol levels.  Instead you’ll be referred to primary care.  Also, routine general preventive care and screening will not be done by specialists, who need to use the appointment time to focus in-depth on the condition they are treating.

So, as much as you would love to eliminate another appointment, call your primary care doc, and schedule your annual appointment.

Getting out my calendar,


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While many of you were hopefully enjoying some fun in the sun on this 4th of July weekend, my family’s weekend was bustling with indoor activity because my much loved niece got married on Saturday.  The festivities spilled over into the entire weekend.  It was absolutely heartwarming to see so many familiar faces again, all in one room.  And as we made our way from table to table, gathering snippets of conversation as we went, I think we were all experiencing a myriad of thoughts and feelings.  Some heartwarming, “Where has the time gone?”, others silly “Look who asked who to dance…”, but I was surprised at the direction my own thoughts were taking.

I was struck by something altogether unexpected, namely the fact that there were many older adults in the room from both the bride and groom’s sides of the family, and absolutely none of them appeared to have any type of dementia!  Given the work that I do, all too often I see the way dementia robs older adults of their independence, their relationships, and often their peace of mind.  I see it so often that somewhere along the line a part of me began to accept it as a consequence of growing older.  But seeing this vital, thriving group of seniors actively engaged and enjoying this phase of life, reminded me that it doesn’t have to be that way.  Whether the causes are due to genes, lifestyle, luck or a combination of factors, clearly the quality of life implications are impossible to overstate, and deserve our time and attention, as well as ways to prevent and treat this challenging disease.

Relishing my memories,


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The 4th of July is just a few days away, and families across the country are planning picnics, barbeques, and other celebrations.   If you are having an older adult join you and your family this year, here are a few things to consider in order to help them have as much fun at the outing as you do.

Heat: If you’re planning an outdoor function remember that older adults are more sensitive to heat, and because of that are more susceptible to heat stroke.  If possible, choose an area with some shade, or if that’s not possible, bring a canopy or sun umbrella from home.

Dehydration: Be sure to have a selection of non-carbonated cold drinks available to help ward off dehydration.  Water, lemonade, and Gatorade are great choices.  Popsicles work well this time of year too.

Balance: Because the ground outdoors is often uneven, and patio chairs can be slightly unsteady, balance issues can become a concern.  In order to reduce the risk of a fall, pick a level spot to put your sturdiest chair, and save that seat for the older adult in your life.  It’s helpful to minimize the amount of walking to get to the food as well.

Dementia:  If one of your loved ones has dementia, an afternoon celebration might be easier for them than an evening one.  Often times people with dementia can become more confused during the evening hours.  A smaller crowd is also less overwhelming for people with dementia.  For more tips on how to customize family gatherings for relatives with dementia, please refer to my former blogs on the topic.

A little bit of thought up front can lead to a great time for all!  Happy 4th everyone!

Firing up the grill,


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Living in a time where celebrating your 100th birthday is no longer uncommon, the cost of long term care is often on the minds of older adults, their families, and senior service professionals.  How will we pay for it, should the need arise?  Next week, the Elder Care Chat debuts, and may have an answer for you.

Hosted by Christopher J. Berry, Certified Elder Law Attorney and Veterans Accredited Attorney, the Elder Care Chat is a weekly call and webcast Mondays at 2:00pm, that addresses topics of interest to both those who need elder care services, such as caregivers, as well as those who provide them, such as home care providers, social workers, elder care communities and other senior service professionals.  Chris will  lead the calls each week and will also occasionally feature other experts who work with older adults and their families.  You can join him on the web at,  using the event ID 42786354, or dial (206) 402-0100, and enter ID 670087#.
This Monday, June 24th at 2:00PM,  Chris will give an overview of the 6 ways to pay for long term care, followed by a brief Q & A.  As he is fond of saying, “This is the cheapest time you’ll ever spend with an attorney”!
Putting it on my calendar,
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Now that spring has arrived and summer is around the corner, I often find myself refilling my water bottle several times throughout the day.  And unlike me, my clients usually don’t have a water blottle with them when we’re out and about.  As we get older we become less aware of thirst, so I thought this beautiful weather week would be a great time for a quick dehydration reminder.  Many times dehydration is caused by inadequate water intake, but that’s not the only cause.  Other culprits include medication side effects, sweating or diarrhea.  

If you’re not sure of the signs of dehydration, here is a list from The Mayo Clinic:

  • Dry, sticky mouth with thick saliva
  • Sleepiness, weakness or a general feeling of being unwell
  • Decreased urine output with a dark or deep yellow color
  • Dry skin
  • Headaches
  • Constipation
  • Feelings of dizziness or lightheadedness
  • Sunken eyes
  • Cramping in the limbs
  • Breathing faster than normal
  • Low blood pressure
  • Acute confusion

While water is the best option for hydration, here are other ways to increase fluids in the body:

  • Fruits and vegetables
  • Flavored gelatin
  • Watered down juices
  • Sparkling or flavored water
  • Soups
  • Ice pops
  • Limit salt intake
  • Avoid alcohol
  • Minimize the number of beverages with caffeine.

The goal is not to change your loved one’s behavior, but to be creative in finding ways to keep them hydrated.  As they say, timing is everything.  It is best to drink often instead of in large amounts.  After a trip outdoors, during meals and with snacks are all good times to offer a beverage.  While most older adults may not think to  ask for a drink, if you offer them one while getting one for yourself they’ll most likely agree, and remember, every sip counts! 

Don’t forget, if you have questions, concerns or suspect dehydration be sure to check with their doctor.

Refilling already,


Contributing author Christie Schoenwald

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There are so many conversations we’d rather avoid than have…conversations about finances or about someone’s inability to drive to name just a few.  But by far the most universally avoided topic has got to be end of life wishes.  On the surface this seems like such a silly problem.  I mean, most of us do truly know that someday we will die.  But do our children know our wishes?  Do they know the specific interventions we do and don’t want?  Have we given anyone the legal power to make medical decisions for us if we are unable to do so ourselves?

Clearly not, because statistics show that 70% of people wish to live out their lives and die at home, yet 70% of all deaths occur in hospitals.  The good news, however, is that there are tools available to help us navigate this potentially difficult topic.  There is a website, that has a free downloadable starter kit to help you start thinking about what is important to you regarding end of life care.  Unpleasant topic? Perhaps, but at least it’s free!

Downloading as we speak,


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The theme for this week is Falls Prevention.  Over the last 2 weeks I fell tripping over power cords, a colleague of mine slipped in her home, and we received several calls from new clients who were asking for help because they are recovering from…you guessed it, falls!

I think most of us think about falls prevention reactively, meaning it becomes really important to prevent another fall, after we’ve fallen at least once.  Prior to that we feel pretty much invincible.   But the truth is, it takes a long time to recover from that first fall if it was a bad one, so the time to think about falls prevention is now!

There are several different reasons people fall.  The most common causes are poor balance, clutter on the floor, inadequate lighting, wet/slippery floors, and neurological causes.  Luckily, the following preventive suggestions are helpful in most cases:  

  • Install grab bars in bathrooms
  • Pick up or tape down all throw rugs
  • Remove clutter from the floor
  • Install additional lighting if necessary
  • Be conscious of where you step on slippery surfaces
  • Work with a physical therapist to improve balance

Whether you put all of these steps in place, or only the one or two critical for you, protecting your quality of life is well worth the investment.

Measuring my bathroom for grab bars,


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Doctors…the average older adult sees many different medical specialists.  So why is it often a good idea to switch from an internist or family practice doctor to a geriatrician?  And the answer, of course depends! 

A geriatrician is a physician who specializes in treating older adults. Many of us took our children to a pediatrician when they were young, because we recognized that the very young need specialized care.  Well, the same concept applies to older adults.  Our physiology changes as we age, including the way we metabolize medications.  In fact, many commonly used medications have a different set of side effects when taken by older adults.  Geriatricians are generally more aware of what medications to use (or not to use) when treating older adults.

Another difference you can expect to see is that geriatricians usually schedule fewer appointments each day, so they are able to spend more time with each patient.  They are also likely to screen for cognitive changes, depression and anxiety on a routine basis.  But perhaps the biggest difference is that geriatricians will often tackle difficult topics outside the scope of a traditional appointment including driving, moving to a more supportive environment, and bringing help into the home.

If an older adult and their family feel that all their needs are being met by their current physician, then there is no need to make a change.  But all too often I hear stories from clients who feel that their doctor is too busy to be able to spend as much time with them as they would like.

Passing this on to my in-laws,



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If we were compiling a Top Ten list of things we put off, discussing our wishes for end of life care would probably be number one on the list.  Whether it is the expense involved with having legal documents drawn up or our own sincere desire to believe we have no need to think about it yet, too many of us have not put our wishes in writing.  That leaves our loved ones in the unenviable position of having to decide what types of treatment they think we would want.

However, the 5 Wishes program takes some of the sting out of this most important topic.  According to the Aging with Dignity website, the 5 Wishes program lets you notify your doctor and hospital:

  • Who you empower to make health care decisions for you if you are unable to do so yourself
  • What kinds of medical treatment you do or don’t want
  • What comfort measures you want
  • What information you want shared with your loved ones

The form is free, can be completed online and then printed out, or a soft-bound version can be ordered.  It is currently recognized as a legal document in 42 states including Michigan, and is written in plain, easy to understand language. 

For more information visit

 Downloading as we speak,


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I’ve spoken with several older adults and their families last week where eating was a concern, so I’m reposting this blog on the topic…I hope it helps!

There is nothing that is more basic than eating. We have all been eating every day of our lives AND we so often take this for granted…shopping, cooking, broiling, serving, clearing, refrigeration, fiber, grilling, paper or plastic, calories, pot roast, pureeing, dessert, local, organic, food groups, turnips, pleasure. There’s a lot to it! As we get older, getting the right nutrition can become a concern.  I’ve been hearing more and more stories about older adults missing meals…not because they can’t afford to buy food, but because they’re too tired to eat.  By the time they get up, get dressed, eat breakfast, run an errand, and put their packages away, they sit down on the couch for a few moments and end up falling asleep for a few hours.  There goes lunch.  

There are several different alternatives for seniors who might not get the right nutrition (whether it’s because they are too tired or any other reason):

  1. Meals on Wheels: Several local community organizations have their own Meals on Wheels programs that deliver daily meals to their clients (  Kosher Meals on Wheels are also available through Jewish Family Service.
  2. Select restaurants and smaller grocery stores will deliver to seniors’ homes.
  3. Finding a caregiver who can cook meals for an older adult may also be the answer. 

Here are a couple of links:

The joy of eating well and aging well –

Senior health: How to detect and prevent malnutrition –




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  • Does an older adult's family live out of town?
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ElderCare Solutions of Michigan is a division of Jewish Family Service of Metropolitan Detroit, a non-sectarian not-for-profit organization that has served the metro Detroit area for more than 80 years.