Curbing Driving Due to Age is Hazardous to Health

Curbing Driving Due to AGE is Hazardous to Health

There are many reasons to take away driver's licenses. They all have to do with physical and mental skills and abilities. They do not have a thing to do with "old age."

A safe driver must have and be able to use whenever needed, a set of often taken for granted, but very "complicated skills and abilities". The most critical abilities that have been shown to be the strongest predictors of crash risk among older drivers are:

1. General mobility (how easily the body is able to move about in the car)

2. Head/neck flexibility (how easily the head and neck can move)

3. High- and low-contrast visual acuity (how good is vision in all sorts of lights, darkness;
can things be distinguished from each other, like the curb from the pavement)

4. Leg strength

5. Working memory (of all the rules of the road, how to use the car, etc.)

6. Visualization of missing information (see a ball, but no child, so your mind thinks a child
might be close by, so the body reacts just in case a child is there)

7. Visual search (scanning ahead and near)

8. Visual information processing speed (how quickly a person can see something, understand the meaning of what was seen, and react and safely respond)

The CAR is the STAR in TRANSPORTATION

The lucky folks in places like Washington, DC, New York and Boston have great transportation systems in place that don't require a car. But in most parts of the USA, the car is the pre-dominant form of transportation. People go to the doctor, the grocery store, church, social events, leisure activities, and work using the car. They vacation, help others out, visit, shop, and sight see using the car.

It concerns me to see so many states interested in curbing the older driver based on age. To take the keys to the car away from an individual can be hugely traumatic and life changing. It can also be hazardous to health. It is demoralizing and to some it is humiliating. Imagine World War II Veterans, Viet Nam and Korea War Veterans; and so many other people who have led productive, independent, energetic and involved lives, suddenly told their driving privileges have been revoked.

This can cause isolation, dependency, poor eating habits, malnutrition, poor personal health care, lack of interest in the outside world and embarrassment. It can lead to depression as well as other forms of ill health, and can increase symptoms of conditions that were formally controlled.

This is a big deal!

Prolong Safe Driving Skills for As Long As Possible

It is unfortunate, that as a nation, we seem to react to the few really horrible cases that involved older drivers (that have been sensationalized in the media) in a punitive way, rather than getting to the real reason why people crash.

People crash because under the circumstance, a driver, all the drivers, some of the drivers, did not or could not do something that needed to be done at the precise moment of the confluence of events. This comes down to function,….not age.

We do need to prevent unsafe drivers from getting behind the wheel. This is easier said than done, because so many do not recognize the many red flags that can indicate an unsafe driver. When we do come to a realization that a parent is driving unsafely, and is unwilling to stop, it is time to take personal responsibility, and get involved. This will save lives and heartache.

We also have an obligation to help our older drivers prolong safe driving skills for as long as possible. (That can be well into the nineties and even 100+)

Proactive Approach to Optimize Driving Skills & Safety

People don't know what they don't know. So it is often really hard to recognize "red flags" if you don't know what they are!

A proactive program approach to optimize driving skills and safety would be educational, positive, and preventive in nature.

Goals should be to optimize driving skills and prolong driving safety. The marketing approach should be focused on boomers and healthy seniors in a positive manner. It should be offered in
community environments such as the following:

• shopping malls
• condominium association meeting places
• senior living communities
• theaters and concert halls
• public meeting places
• restaurants, etc.
  

PROLONG DRIVING SAFETY : PROGRAM FEATURES

Programs should include the following features:

1. Fitness programs to maintain or enhance the body's abilities

a. flexibility

b. strength

c. balance

d. range of motion

2. Fitness activities to keep the mind sharp

3. Vision screening opportunities

4. Review of highway rules and regulations

5. Assessments of how well the car fits the person (see CARFIT.ORG)

6. Demonstration of assistive devices that can be used to enhance lossed or reduced physical abilities
7. Information about nutrition

8. Information about the effects of medications and alcohol on driving and the older body.

9. Screenings to determine need for customized health program

10. Information about normal age related changes that can occur

Medicare and Insurance Company Support

If I could wave my magic wand, I would immediately make car insurance programs offer a discount or a stipend or reimbursement, to any senior who participates in such a program. Such a program should:

1. Increase awareness of the skills needed to drive

2. Increase personal responsibility (for one's skills and abilities)

3. Increase desire to stay or get fit

4. Enhance quality of life

5. Delay dependency

6. Save loads of money

7. Prevent injuries and accidents

8. Improve the ability of people to recognize their own driving risk factors

9. Prolong safe driving years

For more information, please take a look at the following Internet resources.

Internet Resources: http://www.safeaging.com/newsletter/Feb06newsletter.pdf

http://www.safeaging.com/newsletter/Feb2005newsletter.htm

http://www.tfhrc.gov/pubrds/06jan/04.htm

Have a safe and happy day.
Dr. Vanessa M. Dazio

Who Provides Guidance to Boomers or Aging Seniors Living At Home

Occupational Therapists: Aging in Place Consultants

The other day, I just had to respond to an article written in USNEWS.COM directed toward boomers who have aging parents. The article was about tips to help aging parents (presumably) of boomers, to age in place.

(If interested, here is the link. http://www.usnews.com/blogs/the-best-life/2009/07/13/tips-to-help-parents-who-want-to-age-in-place-.html)

The public and the media do not seem to be aware of the great resource they have in occupational therapists (OT). OT's are available as consultants to anyone who wish to be as productive in living as they can be. Now, a huge focus is on aging, because guess what, our boomer population is getting older.

Aging can cause physical, cognitive, and sensory changes to people. There are no specific guarantees when aging causes loss of standing balance, or vision loss, or strength loss, etc. But, all can happen, and when they do, a house that has been easily lived in for years, can slowly and subtly become hazardous, and user UN-friendly! This means the house is no longer a good fit for the occupants, and danger lurks around every corner.

HOW OT's CAN HELP HEALTH SENIORS AT HOME

Here are some things OT's can do to help older adults make home adjustments as needed:

1. Identify specific skills, abilities and challenges of the occupants, then develop safe solutions.
2. Identify potential home hazards or personal risks that could cause injuries or accidents in the home.
3. Identify useful assistive products that could improve abilities and safety in the home.
4. Recommend changes in room arrangements that could make life easier or safer.
5. Recommend changes based on a wide range of health, personal, design, financial factors etc.
6. Recommend health promotional plans to optimize personal skills needed for health and safety, such as balance, range of motion, and flexibility.
7. Collaborate with family members to develop the most cost effective strategies based on the specific needs of the occupants
8. Consult with architects, builders, realtors, other family members, other health care professionals, even attorneys and financial advisors (depending on the need)
9. Recommend outside consultations with the appropriate people.
10. Be a health advocate!

HEALTH CARE PROBLEM

People seem to recognize they have to pay the fees for a visiting plumber, a contractor or an electrician. People pay some pretty hefty fees for car repairs, computer repairs, financial consultants, too.

Then, why is it, when it comes to pay for the service of a skilled health care professional coming to the home, the very idea is often met with complete resistance or disinterest (unless of course, "INSURANCE PAYS.")

A visit or a few visits from an OT could save thousands of dollars a month in unnecessary expenditures such as a premature move to an adult living facility or nursing home. An adult living facility may charge $3000 a month, and a nursing home may be as much as $6,000 a month. Just think of the cost savings, if a person were to be able to remain living at home for another 6 months, 12 months, a year or even 5 years.

The cost of the OT consultation, and maybe the cost of some products installed for safety, and maybe some slight changes in the homes are minor when compared to $3000 to $6000 monthly for other residential options.

I don't mean to demean nursing homes or adult living facilities, both are perfect in the perfect situations. But, for the many people who think they have no other options, and unhappily and prematurely move from home, because they were unaware of other options, isn't this a terrible loss?

So, why not ask your insurance company to send an occupational therapist to your home for a home and personal assessment? If they won't help, consider this an investment in your health and safety,...and do it before you get hurt, fall, or find the home you have lived in for years is no longer comfortable.

Need more information about occupational therapy, check out www.aota.org, or my web site at www.safeaging.com/ Go to the links, or the newsletters or the learning centers.

That's it for now.
Have a happy and safe and comfortable home.
Dr. Vanessa

WISE AGING: Personal Fall Risk Factors and Strategies to Prevent Them

What are Personal Fall Risk Factors?

Fall risk factors are conditions that increase the chance or likelihood of a fall happening that could result in harm, disability or even death.

Combinations of personal risk factors increase the risk (chance) of falling. (harm is always a threat)

Below is a basic explanation of personal fall risk factors, as strategies to reduce them.

Personal Fall Risk Factors List

1. Muscle weakness: limited leg/arm/hand strength
2. Unsteadiness: Standing or walking balance is unsteady
3. Walking difficulties (either with or without additional support such as a cane or walker)
4. Vision loss or decline (vision isn't as good as it was; vision problems despite the use of glasses; things look different, but eyes haven't been checked in long time)
5. Decline in independent ability to do basic daily life activities (such as bathing, dressing)
6. Stress/anxiety/depression: Being distracted is often cited as a cause for falling
7. Medications:

a. Certain types of medications can increase the risk of falling, such as those that cause drowsiness or sleep; affect coordination or balance.

b. Take multiple medications: There is an increase of falling risk when taking multiple medications. (That is why it is important to have all medications reviewed to make sure side effects are not hazardous)

Increased Fall Risk with Multiple Risk Factors

The more personal fall risk hazards there are, the greater the chance of a fall with injuries.The good news is there are preventive steps that can be taken to reduce personal fall risks.

Here they are:

Stratagies to Reduce Fall Risks

Falls can be prevented. There are strategies that can be chosen and used in daily life to reduce such risks.

1. BE FIT! Muscle strength and flexibility are a key in preventing falls. Normal age related changes or medical conditions can decrease strength over time. The best thing to prevent falls is to BE FIT!

If you aren't fit, GET FIT. Get involved in some regular physical activities such as walking, bicycling, swimming, hiking, rowing a boat or canoe, gardening, dancing,tennis, ....pick a sport you like.

The object is to improve muscle strength, flexibility and joint range of motion. A person is NEVER too old to increase all of these. That's right. A 95 year old person could improve all of these vital abilities, even at such an age.

So, it is never too late to start working on muscle strengthening. (PRECAUTION: TO BE SAFE, BE SURE TO GET DOCTOR'S APPROVAL BEFORE BEGINNING A HOME PROGRAM)

USE COMMON HOME PRODUCTS FOR CHEAP WEIGHTS

STEPS TO FITNESS

1. See doctor: If you need to get fit, start by getting an appointment with your physician.

2. Make a plan: Discuss a good plan for you to begin getting fit.

3. Start slow, build up gradually: Sometimes, to gain strength, starting at the beginning means just doing an activity. When the activity gets easier, you can add some resistance (add some weights) to build strength and endurance. Always starting with a small amount and build up.

CREATIVE AND CHEAP WEIGHTS

Over the years, as an occupational therapist offering home health therapy services, I had to be creative to help people use what they had to help themselves. Often cost was a limiting factor for many people. "I/we can't afford to buy expensive weights" was something I commonly heard.

The good news was then and is now, ....you don't have to spend money on buying weights! I have suggested using all of the following items found in kitchen pantries or garages to use as weights, such as the following:

1. 8 ounce box of spaghetti
2. 8 ounce can of soup (vegetables, pie filling,...whatever is on hand)
3. 1 pound of rice: TIP: Put the pound of rice in another bag or a sock (in case of breakage)
4. 3 pounds of onions
5. 5 pounds of potatoes
6. A large box of washing detergent
7. A container of CRISCO
8. A pocketbook filled with golf balls (worked great for leg strengthening activities, and also for people who could not hold weights due to painful arthritic joints.
9. a bag of oranges (increase or decrease the weight as able)
10. a broom handle
11. a copper pipe
12. you get the idea, right?

A really funny story happened a long time ago when I had a patient who had a Yorkie. Yorkies love to stick their little noses into their master's business. Anyway, a patient of mine had a Yorkie, who weighed about 3 pounds. Her little Yorkie would not let her alone when she was doing her weight lifting. One day, my patient got the bright idea if the little boy Yorkie wouldn't let her alone, she would use him for the weight lifting!

As it turned out, the Yorkie loved it! He pestered her every day to do her exercises. His tail wagged the whole time she did her routine with him, and they both had fun while she got stronger.Such is working in home health rehabilitation. Use what you can! You never know what will work for someone.

Let me know what works for you.

Tomorrow's blog will be on a few more strategies to reduce personal fall risk factors.

Internet resources for today's blog:

SAFE Aging Newsletter: http://www.safeaging.com/newsletter/May2005newsletter.htm#fallriskfactors

http://www.cdc.gov/ncipc/duip/preventadultfalls.htm

Stay healthy, be SAFE.

Dr. Vanessa

Vanessa M. Dazio, OTD, OTR/L

www.safeaging.com

www.medictag911.com

www.safeaging.blogspot.com

WISE AGING: Tips to Reduce Bathroom Falls Risk

Many falls resulting in serious injuries such as fractures and brain injuries, happen in the bathroom. Reasons often cited are slippery tub/shower, wet floor; loss of balance with slippery floor surface.



Think about it. Bathing and showering is a daily activity that increases the risk of falling due to the conditions. (wet and slippery) People even in the best of condition have slipped in the tub and fallen.



There are some really simple things that can be done to reduce fall risks. These tips work well for everyone. I heartily recommend the following:



THINGS TO DO! FOR EVERYONE



1. Install safety rails: I think the single most important purchase you can buy for bathroom safety is safety rails for the tub or shower. No home should be without them. I wish it was a universal requirement.



2. Add non- slip strips or a safety matt to the tub/shower floor.



3. Install a phone in the bathroom.


4. Install a night light in the bathroom. (I like the automatic night lights that turn on whenever they detect movement.



5. Keep floors dry at all times.



THINGS TO DO: IF UNSTEADY BALANCE



1. Use a shower chair (rather than standing to shower)



TIP: There are many types of shower chairs or transfer tub seats. It is important to get the best one for your specific circumstances. I have used and recommended using molded outdoor plastic chairs. They generally cost about $6-$10 and usually fit in most tubs or showers, depending on how the base of the legs are designed.



2. Do not bend or twist while standing. (These are awkward postures that change the center of gravity, and further reduce balance.



3. Install a handheld shower attachment with extra long hose (this makes it alot easier to get to all the places that need to be washed without having to bend and twist)


4. Use safety rails (AKA grab bars) for additional support when bathing (washing legs, lower back, upper back, hair, etc.)



5. Use soap on a rope, to prevent the possibility of dropping the soap and having to chase it.



TIP: Soap on a rope can be easily made at home. (Here's how: Take a skewer and make a hole through the soap. I usually put the hole closer to the middle. Then tie a piece of rope on it. Usually 4 feet long, but you decide how much rope you need.

Oh, some soaps are better to do this with than others. Creamier soaps are better than flakier soaps.)



6. Organize useful things within an easy reach. (Avoid storing anything above the shoulders or below the knees.)



WHAT NOT TO DO!



1. Never lock the bathroom door.



2. Never, ever, ever use a towel rack, soap tray, shelves or other attachments not anchored in the wall, as a support for body weight.



3. Never turn suddenly while washing in shower.



For more detailed information, please take a look at my newsletter articles.



http://www.safeaging.com/newsletter/Aug2006newsletter.htm



http://www.safeaging.com/newsletter/Nov2004newsletter.htm

Be wise, stay safe,
Dr. Vanessa

Vanessa M. Dazio, OTD, OTR/L
SAFE AGING
www.safeaging.com
www.medictag911.com

WISE AGING: TIPS to Reduce Falling Risks at Home

Falls with injuries happen alot at home. Sometimes, they aren't because of a home hazard, such as a slippery or damaged floor, or tripping over the dog. The following is a common scenario often repeated as a reason for injuries that happened to patients seen in rehabilitation programs.

Scenario: Person is sound asleep. Doorbell rings. Person jumps up quickly to answer the door. Person felt dizzy, then fainted, falling to the floor. Person wakes up, lying on the floor in a lot of pain. Oops, a broken hip, leg, arm,...etc. What the heck happened?

There is a logical reason for fainting in this manner. In a "nutshell," time is needed for the heart to adjust for increases in blood pressure, caused when the body quickly moves from lying down to sitting or standing. Basically, the heart needs a moment to readjust it's pumping action.

WISE AGING TIP: How to REDUCE RISK OF FALLING DUE TO POSTURE CHANGES

Prevent the risk of falling due to rapid posture changes by taking a few minutes to

A. Slowly rise to a sitting, up right position.

B. Then sit still (on edge of bed, couch, etc) for another minute or two.

C. Do this simple act to reduce the risk of falling due to postural changes after sleeping.

That's it. Just take an extra couple of minutes to let the heart adjust it's pumping action. If this can be added every time to the routine of getting up from the bed or couch, a lot of falls can be prevented.

CAUTION! There can be many other reasons for fainting, besides getting up too quickly. Fainting should be reported to your doctor immediately to determine the cause.

If you want more info about fainting, here is a link about fainting. falling.http://www.cdc.gov/ncipc/factsheets/fallcost.htm#how%20big%20is%20problem

Be wise, be safe, be healthy,

Dr. Vanessa

Vanessa M. Dazio, OTD, OTR/L
SAFE AGING
www.safeaging.com

WISE AGING: 4 Major Tips to Reduce the Risk of Falling

Falls are Preventable

Falls are accidents, and accidents can be prevented. It only takes one fall to cause:

• a dis-abling injury
• loss of independence
• severe financial difficulties
• major change in lifestyle
• intense suffering and/or
• death
  

General Statistics About Falls

Some people really like statistics to back up statements, so, here are a few. If you want more, check out the references listed at the bottom of this article.

• "One in three adults 65 and older falls each year."

• "Of those who fall, 20% to 30% suffer moderate to severe injuries that make it hard for them to get around or live independently, and increase their chances of early death."

• "Every 18 seconds, an older adult is treated in an emergency department for a fall, and every 35 minutes someone in this population dies as a result of their injuries."

• " Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes."

An Occupational Therapists Role in Fall RIsk Reduction

Over the years, as an occupational therapist, I worked with many people who fell, broke bones, and got to meet me in the hospital, nursing home and adult living facilities, as a result of their injuries.

In those settings, my task was to train the person to compensate for their functional losses (caused by their fall) so they could do their basic daily life activities as independently as possible until they did heal, then go home.

This was almost always a process that included other family members, friends or neighbors so they could learn how to help the injured person. Falls rarely affected just the person who broke the bone(s).

My favorite work was always in the home. If the injured person was able to return home, it was my job to identify home hazards, barriers or problem actions that could promote accidents.

Then, I educated the person and their family about risk reduction. I identified their home hazards, barriers or unsafe actions, and educated the injured person and their support system, on actions that could be done to reduce the risks of injury.

Let me say this, over 25 years of practice, and I am still amazed at some of the unbelievably unsafe situations people have at home.

The Costs of Falls


The costs can be staggering financially, personally and socially. Here are a few more statistics to back up my topic today.

Amazing Statistics from the US. Center of Disease Control

Average cost: By 2020, the annual direct and indirect cost of fall injuries is expected to reach $54.9 billion (in 2007 dollars).

• ".....(In a study of people age 72 and older, the average health care cost of a fall injury totaled $19,440 (this included hospital, nursing home, emergency room, and home health care, but not doctors’ services.)
  

WISE AGING TIPS:

4 Major things a person or family can do to prevent falls.

1. Get fit: Maintaining muscle strength, joint flexibility and complete joint range of motion increases the ability to quickly recuperate from a loss of balance.

2. Review all of your medications with doctor or pharmacist: REASON: Check for medication side effects that could cause dizziness, lightheadedness, excessive sleepiness, etc.

3. Get a yearly eye exam: REASON: Vision does decline with age. Annual eye exams detect early vision changes or loss. Often vision loss can be corrected with eyewear, or other medical help, including medications, and preventive or corrective surgery.

4. Make your home safer: REASON: Home hazards are often cited as the cause of a fall. Eliminate the hazards, and fall risk is reduced.

WISE AGING's BLOG

Tomorrow's blog will include some other details about falling, and what actions you can take to reduce fall related risks.

Resources for statistics were retrieved from the Internet on April 1, 2009



http://www.cdc.gov/ncipc/factsheets/fallcost.htm#how%20big%20is%20problem

http://www.nlm.nih.gov/medlineplus/ency/article/003093.htm


http://www.cdc.gov/ncipc/duip/preventadultfalls.htm

http://www.safeaging.com/information/ReduceYourRiskofFalling.pdf

http://www.cdc.gov/ncipc/factsheets/fallcost.htm#how%20big%20is%20problem

http://www.nlm.nih.gov/medlineplus/ency/article/003093.htm

Be wise, stay safe and have a healthy day.

Dr. Vanessa

Vanessa M. Dazio, OTD, OTR/L

Prolong Driving Safety: Care for Yourself Like You Care for Your Car

It really is possible to prolong safe driving years. If you care for yourself like you care for your car (assuming you are doing a fine job of caring for your car!) you can prolong your safe driving years.

The Most Important Tip: Schedule Preventive Maintenance

1. Get routine scheduled preventive check ups with your doctor. (like your car gets with the mechanic)
Regular physicals that include all of the following:

• Get an annual eye exam (Like checking your lights)
• Get all the required medical screenings (To make sure everything is OK)
• Keep your body well lubed ( Eat good nutritious food and drink plenty of water)
• Keep your muscles (Like the belts in your car) flexible and in good condition
• Stay fit or get fit (A good routine maintenance program)
• Wear good shoes (Like good tires, they are the basis for your ride and help with balance!)
• Keep your mind in excellent condition (Just like your car engine)
• Be aware of medications that cause fatigue, sleepiness, visual, physical or mental changes (Like additives in a car, you have to know what happens when you use them)

Next blog will include details to explain the "how" of this section, then more tips.

Be WISE and healthy.

Dr. Vanessa M. Dazio