Don’t Fall.


The reason for the majority of Emergency Room visits by older adults may surprise you. It’s not heart attacks, or illness, or accidents. It’s falls.

Falls lead to more nonfatal injuries in seniors than anything else, and falls are also the number one cause of injury-related deaths in older Americans.

Almost 15,000 people 65 and older died from falls and about 1.9 million were treated for injuries in emergency rooms.

1 in 3 over 65 have a fall each year, 70% of accidental deaths in people over 75 are caused by falls.

Falls are responsible for over 40% of nursing home admissions.

Injuries from falls in the elderly can include broken wrists, elbows, arms and hips.

Falling can be caused by many factors:
* Internal factors such as slowed reflexes, balance disorders, low blood pressure, visual deficits, etc.
* External factors such as poor lighting, poor room layout, the effects of medications.

What can be done?
* Make an assessment of the risk you have by answering the questions below:
* Add up your score on a separate paper or print this.
* Read information listed at bottom of this page on prevention.

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0-5 = Low Risk
6-8= Moderate Risk
8+ = High Risk

* Tell your doctor about any falls you have taken.
* Talk with your doctor and pharmacist about medications you take.
* Inspect your home for any safety problems such as lighting, flooring, and furniture.
* Make your home safer by installing night lights, bathroom grab bars and slip-resistant floors.
* In addition to strength exercising certain exercises — yoga, tai chi, and trying to balance on one leg with your eyes closed — can help improve balance.

American Academy of Orthopedic Surgeons
National Athletic Trainers’ Association
Centers for Disease Control and Prevention – Injury

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A Solution for Caregiver Shortage: Robots

The government of Japan expects a shortage of 370,000 caregivers for the elderly by 2025, and is will look to robots to help provide care in institutions and at home.

Robots can transfer patients who are unable to move themselves from bed to a wheelchair, or to a bath, for example.

A new robot named Named RIBA (Robot for Interactive Body Assistance) has been developed by RIKEN and Tokai Rubber Industries (TRI). Using the latest sensor, control, information processing, mechanical and materials technology, it is the first of its kind in the world. So far, RIBA can safely lift and move a human patient of up to 61 kg (around 135 lb.).


RIBA’s arms have high-precision tactile sensors and its human-like body has a soft exterior of urethane foam, for patient safety and comfort. Having robots do the lifting will ease the burden on staff, reduce injuries to health care workers, and help patients who want to live at home.

Another use of robot tech is a walking aid that can give a boost when the person is walking uphill and a braking action going down hills. The robot prevents falls and helps the user carry loads safely.

There are monitor systems that collect information aimed at improving nursing care services, and robots that can detect when a patient falls down or needs help. For example, robots are being developed that can predict when a person needs to go to the toilet and guide them there at the right time, helping them with removing clothing and other necessary motions.

In addition to their uses in nursing homes, robots can contribute to self-reliance for people who have some disabilities but want to remain at home.

The Japanese government wants patients to get used to robot helpers, hoping that by 2020, 80% of patients will accept having some of their care provided by robots. Several Japanese government agencies want to encourage businesses to develop care robots, and popularize them.

The RIKEN-TRI Collaborative Center for Human-Interactive Robot Research (RTC), where RIBA was developed, expects to bring care robots to market in the near future.

Priority Areas to Which Robot Technology is to be Introduced in Nursing Care – get information at METI.

For more information on long term care issues, see the Guide To Long Term Care,


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Nursing home patients’ response to music opens new avenues for diagnosis and therapy

A nursing home in California began playing music for residents suffering from dementia, and got responses from patients once considered unreachable.

There are thousands of nursing homes participating in an international music and memory program.

At Villa Coronado, a nursing home in San Diego, 10 residents with traumatic brain injury were given an iPod to listen to music. Over 4,500 residents in 300 California nursing homes are taking part in a statewide experiment. One of the aims of the study is to find out whether music can replace antipsychotic drugs and restraints for agitated patients. With some patients, it seems to work.

This patient population receives little or no therapy, and are mostly bedridden, isolated from the world around them. Researchers are looking to see if the music program can reduce aggressive behavior.

For some people, music brings back memories. It can help dementia patients become more aware of their surroundings. Music will bring a smile to some patients, and can calm those who are agitated. Some patients listening to the music will smile, move rhythmically, and be more responsive to their loved ones.

Music is said to activate more parts of the brain than any other stimulus. New research suggests music therapy could help people in a coma or in a vegetative state.

The patients’ response to music may even help physicians to diagnose consciousness. Studies show there is a high rate of misdiagnosis in vegetative patients, where it is important to determine a patient’s chance of recovery. Observing these patients leads some workers to conclude that rather than a steady state, there is a spectrum of consciousness, and patients drift in and out.

Caroline Schnakers is an associate clinical professor in the Department of Psychiatry at UCLA. Her research indicates there is a 40 to 50 percent error rate in diagnosing a patient’s consciousness. Some patients appear to be unconscious, and yet have some signs of consciousness and awareness of their surroundings.

A patient in a minimally conscious state (MCS) is considered to have more chance to recover than a patient in a vegetative state. If a patient is observed to be sometimes conscious, there is more hope of recovery. The diagnosis of a patient determines medical treatment and end-of-life decisions, so it’s important to diagnose correctly.

Some patients thought to be in a vegetative state are actually in a minimally conscious state, and they respond to the music. One nursing home activities director was excited to see how music affected the residents, saying they just come alive.

Researchers at UC Davis plan to have the initial results of their nursing home study by the end of this year. But regardless of whether music is able to replace medication, it’s worth giving patients music to improve their quality of life.

For more information on the care of dementia patients: Alzheimer’s on Guide To Long Term Care.

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How Innovative Technology Is Changing Long Term Care

There are many challenges of providing long term care to people who need help with activities of daily living, including how to minimize physical limitations, how to assure safety, how to help clients remain as independent as possible, and how to control costs. Inventors have stepped up with some technology solutions to these challenges, which include everything from non-slip socks to high tech robotic technologies.

For example, wearable medical alert pedants have been popular for years, so seniors who might fall can set off an alarm and get quick help. Now there are enhanced alert technologies: motion sensors, bed and chair alarms, and automatic fall detectors the patient can wear. There are sensors that can alert caregivers of changes in sleep quality, or heart and breathing rates. “Smart textiles” have circuitry built into clothing; for example, pants that can tell whether the wearer has fallen; heart monitor shirts; a bowel monitor embedded into clothing that alerts the user to get to a bathroom. A cell phone app gives the user a portable way to track vital signs.

For seniors suffering from memory loss or dementia, wandering can be a problem: radio-frequency transmitters, global positioning systems (GPS), and cellular signal-based systems are available for tracking the patient. A transmitter can be worn in a bracelet or ankle strap, or embedded in clothing. There are shoes that have GPS embedded in the sole.

One of the most advanced devices is the Apple Watch. The Apple Watch is a computer on your wrist and it can do many things. It can track your health with built-in sensors that include heart rate, GPS and accelerometer for fitness workouts. It can remind you to take your medication. It provides hands-free iPhone dialing and it uses Siri for voice recognition (“Call Doctor”).

For Alzheimer’s, there is new technology that addresses the health condition itself: for example, the Ybrain wearable device stimulates brain activity. The device, which can be worn at home, consists of a headband with two sensors in the front that emit electronic signals. Clinical trials indicate that wearing the device for about half an hour a day is 20% more effective than taking oral Alzheimer’s medications. Another possible solution being studied is ultrasound devices for Alzheimer’s treatment.

Digital memory devices include hand-held memory aids which allow the user to record reminders about appointments, tasks, medication, passwords, etc. Another helpful memory aid is automated medication dispensers that alert the user when it’s time to take a pill.

Technologies to facilitate communication are constantly being improved. Alternative communication devices can supplement or replace speech and writing when an individual’s ability to communicate is temporarily or permanently impaired. For the hard of hearing, incoming and outgoing voice amplification can improve telephone calls. Touch screens and graphic interfaces can help those with hearing or vision problems, by using large numbers and icons, voice controls and other innovations.

Computer interfaces can provide social connection and entertainment for long term care patients who might otherwise be isolated. Games can provide mental and physical stimulation and promote fitness.

Electronic health records maintain complete information about patients including their conditions, allergies, medications, needs and preferences, in one place. These systems are designed to reduce medical errors. Electronic medication administration records can be used by staff to document that residents are taking their medications as prescribed.

Long term care staff and caregivers benefit from mobile Internet devices, which provide access to data from anywhere. Because long term care patients often move between hospital, long term care facility, and home care, data sharing can help improve patient care and lower costs.

Telemedicine can improve healthcare by allowing long term care providers to remotely access highly trained clinicians and specialists. Some advantages are the ability to have patient consultations through videoconferencing, the transmission of diagnostic images, and remotely monitoring vital signs.

There are also advances in assistive devices for lifting and transferring patients, bathing, dressing, and wound care, and improvements in mechanical devices such as beds, walkers, and chairs. In the future we will probably see more robotic devices used in care settings.

(more tech innovation for long term care @

One of the difficulties about creating long term care insurance policies is predicting what long term care recipients will need ten or more years into the future. Increasing lifespan plays a part; also medical trends, advances in treatment, and the health issues that come up with people who are living longer and being active longer. Insurers and caregivers must provide appropriate care while managing costs. Creative innovations in technology will help us meet these challenges.

With a 70% chance of needing long-term care it is likely you will need it at some point. The three ways to pay for care are:
1. Self insure, pay out of pocket.
2. State pays, Medicaid only allows you to have $2,000 in cash assets.
3. Long term care insurance. Insurance is always cheaper than paying yourself. Get long term care insurance quotes from multiple companies.



Who Can Qualify for Long Term Care Insurance?

To qualify for a long term care insurance plan, you must be in reasonably good health, within the eligible age range, and not currently in need of long term care.

You must be able to perform activities of daily living such as bathing, dressing, eating and walking; also to handle daily activities such as finances, housework, cooking, shopping, taking medicines and transportation. You should be able to function without help from others or mechanical devices such as a wheelchair. You must have clarity of thought with no memory loss, confusion, or forgetfulness. Some medical conditions are allowed if they are stable and well controlled. If you are anticipating surgery, you would in some cases be able to apply for long term care insurance after recovery from the surgery.

Medical conditions that may make you ineligible for long term care insurance:
    • AIDS
    • ALS (Lou Gehrig’s Disease)
    • Alzheimer’s Disease
    • Cirrhosis of the liver
    • Dementia
    • Diabetes under treatment with insulin
    • Diabetes Type II and heart problems
    • Frequent or persistent forgetfulness
    • HIV
    • Memory loss
    • Metastatic cancer (spread from original site/location)
    • Multiple sclerosis (MS)
    • Muscular dystrophy
    • Organic brain syndrome
    • Parkinson’s disease
    • Senility
    • Stroke
    • Transient Ischemic Attach (TIA) within the past 5 years
    • TIA in combination with diabetes or heart surgery
    • TIA two or more times

In addition to the list above, long term care underwriters will look at the overall health of a person and there may be a combination of health issues that prevent underwriting. It’s important to be aware that a change of health can occur without warning, making you uninsurable – so it’s good to apply sooner rather than later. Another good reason to apply sooner is that some companies have “good health discount” plans for those who qualify.

Normally only a medical records review is required. If it has been more than two years since you saw a doctor, you should get a physical before applying.

What If You Cannot Health Qualify?
For those who can not qualify for health reasons, there are alternatives such as linked benefit plans.