1 THE DOWNWARD SPIRAL Greg Dodd Member, Society of Certified Senior Advisors® SENIORS HELPING SENIORS® - NORTHWEST DALLAS

2 THE DOWNWARD SPIRAL  A combination of negative conditions can drag the physical, mental, and emotional health of a senior into a downward spiral.  The consequences at or near the bottom of the spiral can be severe: › Injury › Illness › Depression or Dementia › Fraud and Other Abuse

3 NEGATIVE CONDITIONS  These conditions can create a downward spiral.  Isolation  Inadequate Nutrition or Hydration  Inadequate Home Organization or Sanitation  Improperly Taking Medication

4 REFERENCE  Some of this presentation is based on  information in Social Isolation Among Seniors:  An Emerging Issue, An Investigation by The  Children’s, Women’s, and Seniors’ Health  Branch, British Columbia Ministry of Health  (2004).

5 ISOLATION  Defined as: limited social interaction and a small social network  Objectively observable  Usually develops gradually  Caused by: › External factors (e.g., lack of transportation or funds) › Medical conditions, causing inability to socialize › Psychological conditions, causing unwillingness to socialize

6 INADEQUATE NUTRITION OR HYDRATION  Inability or unwillingness to socialize can lead to:  Lack of adequate food supplies in the home  Lack of a balanced diet  Relying on easily prepared or ready-to-eat foods  A diet that aggravates existing medical conditions  Eating at times that are not consistent with medication requirements (e.g., taking medication before a meal, instead of after)  Dehydration

7 UNSAFE OR UNSANITARY HOME CONDITIONS  Isolation and inadequate nutrition or hydration  can lead to:  Inadequate housekeeping  Unsanitary food preparation  Spoiled or tainted food  Inadequate personal hygiene  Hazards from excessive clutter in the home  Inadequate home maintenance and repairs  Inadequate personal security

8 IMPROPERLY TAKING MEDICATION  Isolation, inadequate nutrition or hydration, and  unsafe or unsanitary conditions can lead to:  Failure to renew prescriptions on time  Failure to obtain new prescriptions when needed or maintenance medications  Failure to take medications as prescribed  Interactions between medications and foods or herbal supplements  Undetected medication side effects or drug interactions

9 POTENTIAL CONSEQUENCES  Isolation, inadequate nutrition/hydration, unsafe  or unsanitary conditions, and taking medication  improperly can cause a downward spiral,  resulting in:  Injury – from falls, cuts, burns  Illness – skin and eye infections, UTIs, stomach and intestinal infections  Untreated and Aggravated Medical Conditions – diabetes, hypertension, pulmonary disease  Onset or Acceleration of Dementia and Depression  Fraud or Other Abuse

10 WHO IS MOST AT RISK?  Factors that increase the risk of a downward spiral:  Gender – Women can be more susceptible to isolation, partially because they typically live longer.  Death of a Spouse – grief; forced self-sufficiency  Living Alone – often an abrupt change after death of a spouse  Reduced Social Network – illness or death of friends; recent move to a new location  Loss of Ability to Drive – especially if forced

11 PREVENTION  What can be done to prevent a downward spiral?  Some seniors recognize the risk and take preventive actions on their own. They are the exceptions!  Medical or mental conditions can make it impossible for the senior to recognize the risk.  Family members, neighbors, friends, church members, and/or social organizations must then act to prevent or reverse a downward spiral.

12 WHAT CAN PREVENT OR REVERSE A DOWNWARD SPIRAL?  Family, friends, and/or church members must take the initiative to increase their interaction with and help for the senior at risk  Identify and engage technology to help the senior at risk  Identify and engage charitable and/or government services for the senior at risk  Identify and engage in home help for the senior at risk

13 FAMILY, FRIENDS, CHURCH MEMBERS  Typically, there will be significant resistance from seniors at risk when they think people are “taking over”. Be prepared for it. Be politely persistent.  Coordination is essential among those interacting with the senior at risk. Without it, the resistance will only increase.  Even distant family members can help, with financial arrangements, internet-based research and resources, emotional support and encouragement, and PRAYERS for all involved!

14 SOCIAL SERVICES  Local church ministries  Regional faith-based services  Secular private charitable service organizations  City, county, and state entities  Charitable and government entities often  have need-based requirements that must be  met before they can provide services.

15 TECHNOLOGY  Emergency Response Equipment and Services  Medication Management Equipment  Mobility Assistance Equipment  Equipment for the Hearing Impaired  Equipment for the Visually Impaired  Video Monitoring Equipment

16 IN HOME HELP  Varies widely in breadth of service, delivery method, quality, and cost.  Home Health Care – usually only post- hospitalization, very short visits, specific tasks; Medicare can pay  Companion/Homemaker/Personal Assistance -  available any time, any duration, broad tasks; private pay (including Long Term Care Insurance and Veterans Benefits)

17 IN HOME HELP – Individual or Agency?  Individuals hired directly: › Not required to be licensed, insured, or “bonded” › Background reports must be obtained › No backups or replacements for time off or illness › Can be slightly lower cost  Service from an Agency: › Licensed for Personal Assistance, insured, and “bonded” › Background reports obtained on each worker › Readily available backups and replacements

18 SENIORS HELPING SENIORS® All helpers are seniors themselves – active, healthy, dependable, compatible The helpers’ maturity and their experience with other seniors gives them added understanding, compassion, and patience The dependability of a business service, from helpers carefully selected to have the “heart of a volunteer” Competitive rates, with only a 3-hour minimum visit Individually owned and operated Part of a nationwide franchise network

19 Greg and Katie Dodd Seniors Helping Seniors® - Northwest Dallas