Showing posts with label isolation. Show all posts
Showing posts with label isolation. Show all posts

Monday, May 5, 2025

Aging in Place Planning: Groundbreaking Study- Take Charge of Your Cognitive Health with Simple Lifestyle Changes


As we age, the risk of stroke, dementia, and late-life depression threaten our independence, decision-making, and financial health. The consequences of these conditions threaten our families with burden, cost, and concern. These conditions change how we live, make decisions, and plan for the future. But here’s the good news: a groundbreaking new study from Mass General Brigham, widely covered by CNN, The New York Times, and Fox News, suggests that simple everyday steps can lower our risks.

By making small changes now, we can protect our brains, stay independent longer, and make life easier for ourselves and our loved ones. From the perspectives of estate planning, elder law, and aging in place planning, the findings offer critical insights into preventive health strategies that can enhance quality of life, reduce care giving burdens, and inform legal and financial preparations for aging. This article dives into what the study found, why it matters for planning your future, and how you can start today.

What the Study Says

The Mass General Brigham study, looked at tons of research to identify 17  modifiable risk factors shared by stroke, dementia, and late-life depression (LLD), things we can change to lower our chances of suffering from these conditions. These aren’t complicated medical fixes—they’re things like eating better, staying active, or even spending more time with friends. 

High blood pressure and kidney problems have the most profound impact, but staying active and keeping your brain engaged can make a significant difference in cutting your risk. The study found that improving just one of these areas—like going for regular walks—can help protect against all three conditions. They even created a tool called the Brain Care Score to help you track your progress. For example, boosting your score by 5 points could cut your risk by 27% over 13 years. That’s something to get excited about!

The reason that the study is groundbreaking is that these conditions, which contribute significantly to stroke, dementia and depression, share vascular and small vessel pathologies, making their overlapping risk factors critical. The 17 modifiable risk factors common to at least two of the three diseases are: blood pressure, kidney disease, fasting plasma glucose, total cholesterol, alcohol use, diet, hearing loss, pain, physical activity, purpose in life, sleep, smoking, social engagement, stress, body mass index (BMI), leisure time cognitive activity, and depressive symptoms. Among these, high blood pressure (hypertension ≥ 140/90 mm Hg) and severe kidney disease (estimated glomerular filtration rate < 30 mL/min/1.73 m²) had the greatest impact on disease incidence and burden, while physical activity and cognitive leisure activities were associated with the most significant risk reduction. The interconnected nature of these risk factors means that improving one—such as increasing physical activity—can positively impact others, like blood pressure, sleep, and social engagement.

Why This Matters for You and Your Family- Aging in Place, Estate Planning and Elderlaw Implications

As we get older, we want to stay in control of our lives—living in our own homes, making our own choices, and not leaning too heavily on our kids or loved ones. Stroke, dementia, and depression can make that harder, affecting everything from your health to your finances. This study gives us a roadmap to fight back, and it’s especially important if you’re thinking about aging in place, planning your estate, or  protecting your future.

Staying in Your Home (Aging in Place):
Most of us want to stay in our own homes as we age,  surrounded by our friends, family, memories, and comfort. This study says you can make that more likely by moving your body, sleeping well, and managing stress. Here’s how to make your home work for you:
  • Make It Health-Friendly: Add a place for stretching, a blood pressure cuff, or even smart lights to help you sleep better. These little changes support the habits the study recommends.  
  • Fix Hearing Loss Early: Your home should not be a prison. Untreated hearing loss can make you feel isolated and raise your dementia risk. It makes you less likely to leave your home, and more likely to isolate. Get a check-up—it’s a small step with big payoffs.
  • Get Family/Friends Involved: Ask your kids or grandkids to join you for walks or game nights. Invite friends over for a sports event or movie. It's fun, keeps you social, and lowers your risk of depression.  
  • Use Tech: Set up reminders on your phone for meds or try a sleep-tracking or exercise app to stick with healthy habits.  Schedule Zoom or Facetime calls with families and friends to talk. Consider my article regarding the use of technology to reduce dementia risk and age in place.
Planning for Your Future (Estate Planning): Nobody wants to think about losing the ability to make decisions, but stroke or dementia can make that a reality. By taking steps like managing your blood pressure or quitting smoking, you can keep your mind sharp longer, which means you’re more likely to stay in charge of your money, your home, and your care. Here’s how you can plan smarter:
  • Set Up a Routine Healthcare Plan: Work with a doctor, physicians assistant, personal trainer, deploy an online health app, and/or work with family and friends to improve your health, increase activity, and spend more active and engaging time with family and friends.  Design these around things you already enjoy or like.  Set goals, and work towards them to create a routine. 
  • Advance Directives: Engage a lawyer to create a healthcare proxy and living will that says what you want if you become sick. Avoid simple minimalist forms, and actually state your intentions regarding long-term care (e.g., "if I need care I want it to be in my home," or "I do not want to burden my children financially, but hope they will provide time and support when needed").  Mention your current routines and plans (e.g., "monitor my blood pressure a few time a day," or "continue my selected supplements as they have demonstrated success" or I might qualify for Aid and Attendance because your father was a wartime vet, talk to the VA if I need help at home"). 
  • Pick Someone You Trust: Choose a family member or friend to handle your finances and/or health decisions if you can’t. Make sure they know your goals, like staying healthy to avoid nursing homes and direct them to take advantage of your existing plan (e.g., if my Medicare benefit runs out, use my MA plan's "hospital at home" benefit, or pay for home care using my long-term insurance policy/short- term disability policy).   
  • Deploy Trusts: Consider establishing trusts to fund healthcare needs, including home modifications or caregiver support, to facilitate aging in place, and/or to protect assets from long-term care spend down in the worst case.
  • Save for Care: Set up a trust or savings to cover things like home modifications (think grab bars, ramps, a hospital bed at home, or a simple blood pressure monitor) so you can live independently longer.
  • Financial and Insurance Planning: Consider aging in place planning when making other financial, insurance, or investment decisions. Consider, for example a Medicare Advantage Plan with home health care benefits, or a life insurance policy that is convertible to lifetime long-term care benefits.
Protecting Your Rights (Elder Law):  Elder law is fundamentally about making sure you’re taken care of as you age, whether that’s qualifying for Medicaid or finding community support. This study shows that simple changes—like joining a book club or getting your hearing checked—can keep you healthier, which means less stress on your wallet and your family. Here’s what you can do:  
  • Stay Social: Loneliness can lead to depression, so find a local senior center or volunteer opportunity to stay connected. It’s good for your brain and your mood.  More, it protects your decision-making by providing interactions with people who know you and can alert you or your family if there are changes and/or help you if a predator or scammer attempts to take advantage of you.
  • Plan for Medicaid: If you’re worried about long-term care costs, talk to an elder law attorney about protecting your savings while staying healthy to delay those costs.  
  • Guardianship Protection: Implement a plan to protect you and your assets from guardianship.  Even a simple revocable trust can, in many states, be crafted to remove or frustrate guardianship control of the trust assets.
Easy Steps to Start Today

The study calls these 17 factors a “menu of options,” meaning you don’t have to do everything—just pick what works for you. Here are some ideas to get going: 
  1. Check Your Blood Pressure: Get a home monitor and aim for under 120/80. Cut back on salty snacks, eat more fruits, and talk to your doctor if you think you need meds.  
  2. Move More: Walk around the block, try chair exercises, or join a local tai chi class. It helps your heart, brain, and even your mood.  
  3. Quit Smoking: If you smoke, call a quitline or ask your doctor for help. It’s one of the best things you can do for your brain.  
  4. Stay Connected: Call a friend, join a hobby group, or volunteer. Feeling connected keeps depression at bay, and keeps you active.  
  5. Challenge Your Brain: Do crosswords, read a new book, or learn a skill like painting or a new technology or device. It’s fun and keeps your mind sharp. 
  6. Sleep and De-Stress: Try a bedtime routine or a quick meditation app to relax. Good sleep and less stress are brain boosters.
The Brain Care Score is a great way to see how you’re doing—just answer questions about your habits, and it’ll show you where to focus. The study says they’re working on more ways to use this tool, so keep an eye out!

How They Did the Study (And Why It’s Solid)

The researchers looked at 182 big studies from 2000 to 2023, narrowing it down to 59 that really dug into what causes these conditions. They focused on things you can actually change, like how much you exercise or how you manage stress, and figured out which ones matter most. They then employed a statistical analysis to compare how much each factor affects your risk, so you know where to put your energy.

This approach is strong because it pulls together lots of research, not just one small study. But it’s not perfect—they might’ve missed some things specific to depression, for example, and they can’t say for sure that changing these habits causes less disease (it’s more like a strong hint). Still, it’s a reliable guide for making smart choices.

What Else We Learned (And Why People Are Talking)

This study’s a big deal because it shows you don’t need a magic pill to protect your brain—just small, doable changes. People are excited about it—CNN called it a “hopeful message,” and experts say it’s empowering to know we can take control. It’s also a wake-up call: with dementia cases expected to skyrocket and strokes hitting even younger folks, starting now is key. Plus, things like finding purpose or staying social remind us that aging well isn’t just about your body—it’s about your heart and soul too.

One cool takeaway? The study’s Brain Care Score is like a personal coach for your brain. It’s already helping people, and researchers want to test it more to make it even better. For now, it’s a simple way to see what you’re doing right and where you can improve.

Wrapping It Up

Growing older doesn’t have to mean losing your independence or worrying your family. The Mass General Brigham study shows that by making small changes you can lower your chances of stroke, dementia, and depression. That means more years in your own home, more control over your future, and less stress for everyone. Whether you’re planning your estate, talking to a lawyer, or just want to age on your terms, these steps are a powerful way to take charge and implement a plan. So grab a friend, take a walk, and start building a healthier, happier future today.

Wednesday, April 30, 2025

Hearing Loss Linked to Nearly One-third of Dementia Cases in Older Adults- What it Means


A recent article, "Hearing loss linked to nearly one-third of dementia cases in older adults" from McKnights, references a study published on April 17, 2025, in JAMA Otolaryngology-Head & Neck Surgery. Let’s break down the study’s claims, assess its implications, and explore actionable steps for seniors and their families.

Analysis of the Study

The study, conducted on 2,946 older adults with a mean age of 75, found that nearly one-third (32%) of dementia cases at a "population level" could be attributed to hearing loss, as measured through audiometric testing. This figure is derived from the population attributable fraction (PAF), a statistical measure estimating the proportion of a disease (dementia, in this case) that might be prevented if a specific risk factor (hearing loss) were eliminated. 

Notably, the study found no significant association between self-reported hearing loss and dementia risk—only audiometrically confirmed hearing loss showed this link. The association was stronger in women, those over 75, and white individuals.

Does Hearing Loss "Cause" Dementia, or Contribute to Faster Onset?

The study does not claim that hearing loss directly causes dementia. Instead, it highlights a correlation, suggesting that hearing loss may contribute to dementia risk at a population level. The article and related sources  emphasize that if the relationship is causal, addressing hearing loss could potentially delay or prevent up to 32% of dementia cases. However, causality is not proven here. Several mechanisms are proposed to explain the link:
  • Cognitive Load Hypothesis: Hearing loss forces the brain to expend more energy on processing sounds, leaving fewer resources for memory and cognitive functions, potentially accelerating cognitive decline.
  • Social Isolation: Hearing loss can lead to social withdrawal, which is a known risk factor for dementia due to reduced cognitive stimulation.
  • Brain Atrophy: Some research suggests hearing loss may cause faster brain shrinkage in areas related to memory and cognition.
The study’s language—“could be attributed to”—indicates an association, not causation. It aligns with prior research, such as the 2020 Lancet Commission on Dementia, which identified hearing loss as one of 12 modifiable risk factors, estimating it contributes to about 8% of global dementia cases.  Similarly, isolation has been associated with a 28% higher risk of developing dementia over nine years, regardless of race or ethnicity, according to a study in the Journal of the American Geriatrics Society This new study’s higher estimate (32%) reflects a focus on older adults with clinically significant hearing loss, but it doesn’t confirm that hearing loss directly triggers dementia. Instead, it suggests hearing loss might accelerate the onset or progression of dementia symptoms in those already at risk.

Limitations and Critical Examination
  • Correlation vs. Causation: The study relies on observational data, which cannot establish causality. Other factors, like shared underlying causes (e.g., vascular issues affecting both hearing and cognition), might explain the link.
  • Self-Reported vs. Audiometric Data: The lack of association with self-reported hearing loss raises questions. It could mean many older adults are unaware of their hearing loss, or that self-reports are unreliable, potentially skewing the perceived impact.
  • Demographic Bias: The stronger link in women, white individuals, and those over 75 might reflect demographic differences in the study population rather than universal truths. For example, women tend to live longer, increasing their dementia risk overall.
  • Interventional Evidence: While the study suggests treating hearing loss might delay dementia, it doesn’t provide direct evidence. Related research, like the 2023 ACHIEVE study, found that hearing aids slowed cognitive decline by 48% in high-risk older adults over three years, but this also isn’t definitive proof of dementia prevention.
  • Meaning of "Population Level" Relationship: When a study finds a correlation "at a population level," it means the relationship between two variables (e.g., hearing loss and dementia) is observed across a large group of people, typically representing a broad population. This correlation reflects a general trend or pattern in the data when averaged over the entire group, but it doesn’t necessarily apply to every individual within that population. For example, a study might find that higher coffee consumption is correlated with increased anxiety at a population level, meaning this trend holds true when looking at the group as a whole.
  • Meaning of "Individual Level" Relationship: The alternative is finding a correlation "at an individual level," where the relationship between variables is examined for specific individuals rather than the group. This approach looks at how changes in one variable correspond to changes in another for each person. For instance, a study might track an individual’s coffee intake and anxiety levels over time to see if they rise and fall together for that person.

Comparison:

    • Population-level correlations are generally more reliable for understanding broad trends because they are based on larger sample sizes, which reduce the impact of outliers and individual variability. They’re useful for making generalizations about a group, but they can mask individual differences. For example, a population-level correlation might show that smoking increases lung cancer risk, but some individuals who smoke might never develop cancer due to other factors like genetics.
    • Individual-level correlations can be less reliable for generalizing because they’re based on fewer data points (just one person or a small group) and are more susceptible to noise, such as random fluctuations in the data or unaccounted variables. However, they’re more precise for understanding a specific person’s experience, which can be critical in personalized medicine or tailored interventions.
    • Merits of Both:  In short, population-level correlations are more reliable for broad insights but less precise for individuals, while individual-level correlations are more specific but less generalizable. The choice depends on the study’s goal—general trends versus personalized understanding.
What the Study Actually Tells Us

The study tells us that hearing loss, when confirmed through objective testing, is strongly associated with dementia risk in older adults, particularly those over 75. It estimates that addressing hearing loss could theoretically reduce population-level dementia risk by 32%, but this is a hypothetical projection, not a guaranteed outcome. The findings underscore hearing loss as a significant, modifiable risk factor, but they don’t confirm it as a direct cause of dementia. Instead, hearing loss likely interacts with other risk factors, potentially hastening the appearance of dementia symptoms in vulnerable individuals.  In making individual health decisions, it is just one of several variable that may factor in health care decisions.

Actionable Steps for Seniors

Based on the study’s findings, seniors can take proactive steps to potentially reduce their dementia risk:
  • Get Regular Hearing Tests: Since the study found a link only with audiometrically confirmed hearing loss, seniors should prioritize objective hearing assessments, especially if they’re over 60, as one-third of this age group experiences hearing loss. Regular testing can catch issues early.
  • Use Hearing Aids if Needed: If hearing loss is detected, using hearing aids may help. The ACHIEVE study suggests hearing aids can slow cognitive decline in high-risk individuals. Even if they don’t prevent dementia, they can improve quality of life by enhancing communication and reducing social isolation.
  • Stay Socially Engaged: Hearing loss can lead to isolation, a known dementia risk factor. Seniors should maintain social connections, whether through community activities, day centers, or family interactions, to keep their brains active.
  • Monitor Overall Health: Hearing loss is one of many modifiable risk factors for dementia. Seniors should also address other risks, like high cholesterol, physical inactivity, and depression, as outlined in the 2024 Lancet Commission Report, which identifies 14 such factors (action items for all 14 risk factors are outlined at the end of this article).
  • Advocate for Accessibility: Hearing aids can be expensive, and access varies. Seniors should explore subsidies or programs that make hearing aids more affordable, as equitable access is crucial for widespread impact.
How Family Members Can Help

Family members can play a critical role in supporting seniors to act on this information:
  • Encourage Hearing Tests: Family members can gently encourage seniors to get their hearing checked, especially if they notice signs like difficulty following conversations or frequent misunderstandings. Offering to accompany them to appointments can make the process less daunting.
  • Support Hearing Aid Adoption: If hearing aids are recommended, families can help seniors adjust to them. This might involve researching affordable options, assisting with fittings, or providing emotional support, as some seniors may resist using hearing aids due to stigma or discomfort.
  • Facilitate Social Interaction: Families can help combat isolation by organizing regular visits, outings, or activities that keep seniors engaged. For example, involving them in family events or community programs can provide cognitive stimulation.
  • Monitor for Cognitive Changes: Since hearing loss may accelerate dementia symptoms, families should watch for early signs of cognitive decline, like memory lapses or difficulty with tasks. If noticed, they can encourage cognitive screening, as suggested by related research on falls and dementia risk.
  • Advocate for Holistic Care: Families can ensure seniors see healthcare providers who take a comprehensive approach, addressing hearing loss alongside other dementia risk factors like diet, exercise, and mental health.
Conclusion

While the study highlights an important link, it’s worth questioning the narrative that hearing loss is a primary driver of dementia. The 32% PAF figure is striking, but it’s a population-level estimate, not a personal risk prediction. Other factors, like genetics or socioeconomic barriers to healthcare, might play larger roles for some individuals. Additionally, the focus on hearing loss shouldn’t overshadow other modifiable risks—like vision loss, isolation, or smoking—which also appear to contribute to dementia rates. Seniors and families should view hearing loss as one piece of a larger puzzle, addressing it within a broader strategy for brain health.

In summary, the study suggests hearing loss is a significant risk factor that may hasten dementia onset, but it doesn’t prove causation. Seniors should prioritize hearing tests and interventions like hearing aids, while families can support them through encouragement, social engagement, and advocacy for comprehensive care. This approach can potentially delay cognitive decline, though it’s not a guaranteed shield against dementia.


The 14 Risk Factors identified by Lancet

  1. Ensure good quality education is available for all and encourage cognitively stimulating activities in midlife to protect cognition.
  2. Make hearing aids accessible for people with hearing loss and decrease harmful noise exposure to reduce hearing loss.
  3. Treat depression effectively.
  4. Encourage use of helmets and head protection in contact sports and on bicycles.
  5. Encourage exercise because people who participate in sport and exercise are less likely to develop dementia.
  6. Reduce cigarette smoking through education, price control, and preventing smoking in public places and make smoking cessation advice accessible.
  7. Prevent or reduce hypertension and maintain systolic blood pressure of 130 mm Hg or less from age 40 years.
  8. Detect and treat high LDL cholesterol from midlife.
  9. Maintain a healthy weight and treat obesity as early as possible, which also helps to prevent diabetes.
  10. Reduce high alcohol consumption through price control and increased awareness of levels and risks of overconsumption.
  11. Prioritize age-friendly and supportive community environments and housing and reduce social isolation by facilitating participation in activities and living with others.
  12. Make screening and treatment for vision loss accessible for all.
  13. Reduce exposure to air pollution.
  14. Considerations for People with  Dementia:
    • Interventions after diagnosis help people to live well with dementia, including planning for the future. Multicomponent coping interventions for family carers and managing neuropsychiatric symptoms are important and should be person-centred.
    • Neuropsychiatric symptoms should be treated, and clear evidence exists that care-coordinated multicomponent interventions are helpful. Activity interventions also reduce neuropsychiatric symptoms and are important to maintain enjoyment and purpose for people with dementia. There is no evidence for exercise as an intervention for neuropsychiatric symptoms.
    • Cholinesterase inhibitors and memantine should be provided for people with Alzheimer's disease and Lewy body dementia. These drugs are cheap, with relatively few side-effects; attenuate cognitive deterioration to a modest extent, with good evidence of a long-term effect; and are available in most high-income countries, although less so in low-income and middle-income countries.
    • There is progress in and hope for disease-modifying treatments for Alzheimer's disease, with some trials of amyloid-β-targeting antibodies showing modest efficacy in reducing deterioration after 18 months of treatment. However, effects are small and drugs have been trialled in people with mild disease and people with few other illnesses. These treatments have been licensed in some countries but have notable side-effects, with few data about long-term effects. The expense of these treatments and the precautions that must be taken, which have resource implications for staff, scanning, and specialist blood testing, could limit their use and be challenging for health systems. We recommend that full information is shared broadly about the unknown long-term effects, the absence of data about the effects in people with multimorbidity, and the scale of efficacy and side-effects, particularly for APOE ε4 genotype carriers. We recommend that people on amyloid-β-targeting antibodies are carefully monitored.
    • Cerebrospinal fluid or blood biomarkers should be used clinically only in people with dementia or cognitive impairment to help to confirm or exclude a diagnosis of Alzheimer's disease. Biomarkers are only validated in largely White populations, limiting generalizability and raising health equity concerns.
    • People with dementia who become acutely physically unwell and need to be admitted to hospital deteriorate faster cognitively than others with dementia. It is important to protect physical health and ensure that people have help if needed to ensure that they eat and drink enough and can take medication.
    • COVID-19 exposed the vulnerability of people with dementia. We need to learn from this pandemic and also protect people with dementia as their lives and wellbeing, and that of their families, have been valued less than that of people without dementia.


Thursday, April 24, 2025

Frequent Use of Technology Slows Cognitive Decline: Empowering Seniors to Thrive in a Digital Age


A recent Newsweek article boldly declared: "[o]lder adults who frequently use digital technology may experience slower rates of cognitive decline." The article continues, "sweeping new analysis challenges previous research that has suggested digital technology could reduce cognitive function as we age and instead suggests that use of technology may be linked to lower rates of cognitive decline in older adults."  

Far from being a hurdle, technology equips seniors with tools to improve health, safety, security, dining, and social connections, fostering independence and vitality. Below, we'll explore practical ways seniors can leverage technology in these areas, including passive fall detection and alert systems alongside active solutions, inspired by the study’s call for balanced tech adoption.

Health: Proactive Wellness with Digital Tools

Technology empowers seniors to monitor and manage their health effectively. Wearable devices like Fitbit or Apple Watch track heart rate, sleep, and activity, alerting users to potential concerns. Apps like MyFitnessPal support nutrition tracking, while telehealth platforms like Teladoc offer virtual doctor consultations, minimizing travel. 

Medication management apps, such as Medisafe, send timely reminders for prescriptions. Seniors can begin with one tool, like a wearable, and consult their healthcare provider to align it with their needs, ensuring a proactive approach to wellness.  Seniors can also share their technology experiences, and results, with others, helping foster a sense of community. 

Personal Safety: Enhanced Protection with Passive and Active Systems

Smart technology bolsters personal safety for seniors living independently. 

Passive Fall Detection:  Systems, integrated into devices like Apple Watch or specialized sensors from companies like SafelyYou, automatically detect falls and alert emergency contacts or services without requiring user action—ideal for those at risk of falls, or proactice seniors wanting a robust sense of safety.

Passive Alert Systems:  Embedded in smart home hubs and security systems, these applications monitor daily routines and notify caregivers if unusual patterns (e.g., prolonged inactivity) are detected. These systems work without the necessity of a user pushing a button, or remembering to wear a device or operate it properly. Working autonomously and "in the background," they offer comfort and saferty to both the healthy and well-oriented and the impaired or disabled.  

Active systems: Life Alert, Medical Alert, Lifeline, and others, allow seniors to press a button  to summon help instantly, or in the cases of voice activated home applications like Alexa, Siri, and Google Home, summon help verbally. 

Additional tools, such as motion-sensor lights and smart doorbells with cameras (e.g., Ring), reduce fall risks and enhance home safety. Seniors can start with a single device, like a smart speaker or fall detection wearable, and gradually build a comprehensive safety net.

Personal Security: Safeguarding a Senior 

Security systems and cameras are pivotal in supporting seniors who wish to age in place, offering safety, independence, and peace of mind for both the seniors and their families. These technologies enable adult children to remotely monitor their parents’ well-being and home security without being intrusive, leveraging advancements in smart home systems, AI, and connectivity.  These offer family members opportunities to support an independent senior, conveniently and capably. .  

Remote Monitoring for Safety and Well-Being: Modern security systems and cameras allow adult children, and grandchildren to check on their parents from anywhere—home, work, or on the go—using smartphones, tablets, or computers. This is facilitated by cloud-based platforms and mobile apps that provide real-time access to camera feeds and system alerts.
  • Non-Intrusive Observation: Cameras with two-way audio and motion detection (e.g., Ring, ADT, Vivent, Arlo, Google Nest) can be placed in common areas like living rooms or kitchens, allowing children to "drop in" virtually without disrupting their parents’ routines. For example, children can view live feeds to ensure their parent is active or safe without needing to call or visit. Systems like Amazon’s Echo Show or Google Nest Hub also enable video calls where seniors can accept or decline, preserving their autonomy and privacy.
  • Health and Activity Monitoring: Some security systems integrate with wearable devices or smart sensors (e.g., FallCall or GrandCare) to detect falls or unusual inactivity. If a senior hasn’t moved past a motion sensor in a set period, an alert can notify children to check in. This is discreet, as it doesn’t require constant video surveillance.
  • Privacy Considerations: To avoid intrusion, cameras can be set to record only when motion is detected or during specific times. Privacy-focused systems allow seniors to disable cameras or set “do not disturb” modes. Clear communication about where cameras are placed and their purpose ensures seniors feel respected.
  • Convenience and Accessibility for Remote Monitoring:  The design of modern security systems prioritizes ease of use for both seniors and their children, ensuring monitoring is seamless and non-disruptive.
  • Mobile Apps for Remote Access: Systems like Vivent, ADT, Blink, Wyze, or Eufy offer user-friendly apps that let children check camera feeds, review recorded footage, or receive alerts from anywhere with an internet connection. For example, a child at work can quickly open the  app to confirm their parent answered the door safely or check if a package was delivered.
  • Customizable Alerts: Families can set up notifications for specific events, such as motion in the backyard at night or a front door left ajar. This reduces unnecessary interruptions while ensuring critical events are flagged. For instance, SimpliSafe allows users to prioritize alerts (e.g., “urgent” for a door alarm, “informational” for a delivery).
  • Voice-Activated Systems: For seniors, voice assistants like Amazon Alexa or Google Assistant can control cameras or locks hands-free, reducing the need to interact with complex apps, devices, or keypads.  With many, a smartphone or doorbell can be linked to voice or facial recognitions so that  a senior can verbally open a door.  Children can also use these platforms to drop in via voice or video, making check-ins feel like a casual conversation.
Security Alarms and Fraud Prevention: Security systems are critical for protecting seniors from external threats, such as break-ins or fraudsters, while also monitoring home safety issues like doors left open. These systems provide real-time alerts to both seniors and their children.
  • Doorbell Cameras for Fraud Protection: Video doorbells (e.g., Ring, Nest Doorbell) allow seniors to see and communicate with visitors without opening the door. Adult children can receive notifications when someone rings the bell and view the feed to identify potential scammers or unrecognized visitors. For instance, if a fraudster poses as a utility worker, children can intervene by calling their parent or contacting authorities. AI features in some doorbells can detect suspicious behavior, like loitering, and send alerts.
  • Door and Window Sensors: Smart security systems (e.g., Vivent, SimpliSafe, ADT) include sensors that automatically lock doors, notify users if a door or window is left open, or is tampered with. This is particularly useful for seniors with memory issues who might forget to lock doors or secure windows. Children can receive these alerts via an app and remind their parent or take action remotely, such as locking a smart door lock
  • Integration with Smart Locks: Smart locks (e.g., those with security systems, or stand-alone products from August, Schlage) allow family members to lock or unlock doors remotely if their parent is unable to do so or if a caregiver needs access. This ensures security without requiring the senior to manage physical keys.

Additional Benefits of Technology for Aging in Place: Beyond monitoring and security, these systems enhance seniors’ independence and quality of life:
  • Emergency Response Integration: Many security systems connect to 24/7 monitoring services that can dispatch emergency responders if a fall or intrusion is detected. Children are notified simultaneously, ensuring rapid response even if they’re far away.
  • Smart Home Integration:: Cameras and security systems often pair with other smart devices, like smart lights or thermostats, to create a safer environment. For example, motion-activated lights can prevent falls at night, and children can adjust settings remotely if needed.
  • Data-Driven Insights: Advanced systems use AI to analyze patterns, such as a senior’s daily routine, and flag anomalies (e.g., no activity in the kitchen by noon). This helps children intervene proactively without constant monitoring.
Challenges and Solutions: While security and safety systems are powerful tools, there are challenges to consider:
  • Technology Adoption: Some seniors may resist or struggle with new technology. The solution is to choose, at least initially user-friendly systems with simple interfaces (e.g., Ring’s plug-and-play cameras) and provide training or involve tech-savvy grandchildren to assist.  Don;t forget to encourage seniors that using tech may help them retain cognitive capability! 
  • Privacy Concerns: Seniors may feel "watched" or "dependent."  Use cameras with clear indicators (e.g., lights when active), limit their placement to non-private areas, and involve seniors in setup and deployment decisions.
  • Cost: Systems can be expensive, with cameras costing $50–$200 each and monitoring services adding monthly fees. Opt for affordable options like Wyze or Blink, which offer robust features without subscriptions, or prioritize key devices like a video doorbell and door sensors. Another strategy is to spend the money for a high-end system from a good security system provider (ADT, Vivent), take advantage of discounts, and terminate monthly monitoring as soon as possible. Having their tech supoport later may be worth the investment. 
Real-World Examples:
  • Home Security: A senior’s Ring Doorbell detects a stranger at the door. The adult child, at work, receives an alert, views the feed, and uses two-way audio to deter the visitor, protecting their parent from a potential scam.
  • Arlo Cameras with Motion Detepreventing a security riskction: Motion sensors in an Arlo system notice no activity for several hours, sending a notice to all users. A child checks the camera feed, and sees their parent on the floor, calling emergency services while heading to the home.
  • Apple Watch Passive Fall Detection: A senior falls walking to the bathroom in the middle of the night.  The watch detects the fall, and notifies an emergency contact and local emergency services.  After the child rushes across town, she arrives to find that EMT has treated the parent and preparing for a trip to the local hospital yo make sure no injuries are severe.
  • Life 360 Collision Detection: A senior is involved in a single car accident travelling from an event in the late evening. Life 360 detects the collision and notifies the family group and emergency services. 
  • Door Sensors: A senior forgets to close the back door. The child gets an alert after 15 minutes, checks the parent's safety on a camera, and calls the parent to remind the senior to close the door, preventing a security risk  The child can lock the door remotely via a smart lock.
Security systems and cameras empower seniors to age in place by enhancing safety and enabling discreet, convenient monitoring by their children. Video doorbells, door sensors, and smart cameras provide real-time insights into home security and potential threats like fraudsters, while motion detectors and fall alerts ensure well-being. By prioritizing user-friendly, privacy-respecting technology, families can balance independence for seniors with peace of mind for themselves, all manageable from any location. For optimal use, families should select systems that align with the senior’s comfort level and involve them in the setup process to foster trust and autonomy.

Financial Security: Safeguarding Privacy and Finances

Cybersecurity is vital as seniors embrace technology. Password managers like LastPass securely store credentials, while apps like LifeLock monitor for identity theft. Seniors should activate two-factor authentication on banking and email accounts and explore free cybersecurity workshops through libraries or AARP to navigate the digital world confidently. These tools ensure personal and financial security without overwhelming users.

Food and Dining: Simplifying Nutrition and Social Engagement 

Technology streamlines meal planning and dining. Grocery delivery services like Instacart,  Amazon Fresh, or Uber Eats Delivery, bring ingredients to the door, while meal kit services like Blue Apron provide pre-portioned recipes tailored to dietary preferences. Apps like Yummly generate recipes based on available ingredients, and smart kitchen devices, such as Instant Pots, simplify cooking. Seniors can discover local dining deals via apps like OpenTable or join virtual cooking classes to make meal prep a social experience, fostering both nutrition and enjoyment.

 Avoiding Isolation: Fostering Connections Digitally

Social isolation is a pressing concern for seniors and their families, but technology can help bridge the gap. Video call platforms like Zoom or FaceTime connect seniors with loved ones, while social media like Facebook builds community ties. Online groups on platforms like Meetup offer virtual book clubs or hobby classes, and apps like SilverSneakers combine fitness with social interaction through virtual classes. Seniors can start with a weekly video call or join one online group, gradually expanding their digital social network to stay engaged and connected.

Getting Started: A Balanced Approach

To avoid cognitive overload, as cautioned in the Newsweek study, seniors should adopt technology incrementally. Begin with one tool—perhaps a passive fall detection device, an active alert system, or a video call app—and master it before adding others. YouTube tutorials or local senior center classes offer beginner-friendly guidance. Setting screen time limits and balancing tech use with offline activities, like reading or walking, maintains well-being. Family members can assist by setting up devices or teaching basic functions, ensuring seniors feel confident and supported. Tech-savvy grandkids can help teach grandparents and demonstrate technology and apps, fostering engagement, respect, and nurturing family bonds.  
  
Conclusion

Technology is a powerful ally for seniors, enhancing health, safety, security, dining, and social connections. From passive fall detection and alert systems to active Life Alert solutions, smart home tools, and virtual communities, seniors can live more independently and joyfully. The Newsweek study emphasizes mindful adoption, and by starting small and balancing digital and offline life, seniors can unlock technology’s full potential. Whether monitoring health, securing the home, or connecting with friends, technology empowers seniors to thrive in the digital era and age in place.


*For more on the study, visit [Newsweek’s article](https://www.newsweek.com/technology-reduced-digital-dementia-study-2058511).

Wednesday, July 21, 2021

Pandemic Pets, Pet Companionship, and Estate Planning Considerations

Pet companionship took on new meaning and importance during the pandemic as lock-downs, quarantines, social distancing, and social isolation impacted nearly everyone. For many, life trapped in a home would be unbearable and unthinkable without pet companions.  This blog has previously discussed how important pets are to some, and how important it is to consider pets in estate planning

An unanticipated effect of the pandemic has been a surge in interest for fostering and adopting abandoned pets. Although unanticipated, this effect is not surprising given the lack of social human interaction during stay-at-home orders, and subsequent social distancing. Regardless, the renewed focus on pets and pet companionship is welcome and important. 

There are at least seven quantifiable benefits to pet owners, including aging owners and owners with special needs:

  1. Reducing Isolation and Loneliness; 
  2. Lowering Stress and Anxiety; 
  3. Improving Fitness; 
  4. Increasing Social Interaction and Connection to the Community;
  5. Improving Cardiovascular Health; 
  6. Reducing Depression Risk, and;
  7. Providing Routine and a Sense of Purpose.

Isolation

Isolation and loneliness are among the considerations for those planning to age in place. Seniors and persons with disabilities may experience feelings of isolation and loneliness if they spend a lot of time at home, sometimes because they lack mobility, security, or just comfort leaving home.  Isolation and loneliness are major risk factors for depression and increase the risk of heart disease, arthritis, diabetes, and dementia. 

Experts at the Centers for Disease Control and Prevention (CDC) agree; pet companionship eases loneliness and isolation. 

Stress and Anxiety

Relieving feelings of loneliness and isolation are not the only emotional and mental health benefits of pet ownership.  Research has shown that simply petting a dog lowers the stress hormone cortisol , while the social interaction between people and their pets actually increases levels of the feel-good hormones oxytocin and serotonin.  Oxytocin is the same hormone that bonds mothers to babies.   A University of Utah study found that even spending time near a pet can reduce stress levels and nervousness. 

The companionship of a pet can be particularly beneficial for reducing anxiety for a persons with disabilities or impairments.  In fact, an astonishing 84 percent of post-traumatic stress disorder patients paired with a service dog reported a significant reduction in symptoms, and 40 percent were able to decrease their medications, according to a recent survey.

Fitness

A pet increases opportunities for exercise. A daily exercise routine and physical activity can improve mobility the ability to perform activities of daily living.  Shelter dogs have been used for animal-assisted therapies to encourage physical activity for residents of nursing homes and assisted living facilities. A study published in Clinical Nursing Research found that people who walked with shelter dogs were more likely to go for a walk than those who walked with a human companion and even walked faster and for longer distances! 

Community

Programs that allow residents of assisted living facilities to spend time with a pet encourage interaction among the residents and give them something to look forward to.  

Pet care offers opportunities for  interaction with others, such as vets, groomers, pet care retail staff, and other pet owners.  Most folks that serve in the pet care industry are, themselves, pet lovers, which creates a community that is naturally sharing, caring, and helpful.  Pet walkers often follow a regime which affords them  insight into the routine of other owners.  A pet owner may notice that another pet owner is suddenly absent, or might observe another owner struggling physically and offer help.  

Pets can help persons with autism improve social skills by facilitating social connections with others, inspiring the person to work harder on communication skills and teaching compassion.

Cardiovascular Health

According to the American Heart Association, pet ownership is associated with lower blood pressure and lower heart rate during mental stress. A University of Utah study found that just the presence of a companion dog is associated with lower cardiovascular responses during stress. The CDC lists decreased blood pressure and reduced cholesterol levels as two benefits of pet ownership. 

Depression

The Research Center for Human/Animal Interaction has found that dog owners are less likely to suffer  depression. Animal-assisted activities and therapy have been used successfully with patients struggling with depression, loneliness, and mental illness and can reduce the symptoms of depression. The effects are particularly apparent with seniors.

Purpose

Pet care invites structure and scheduling, establishing a beneficial routine, and lots of older adults who own a pet say that their pets provide a sense of purpose and help them enjoy life.

For more information how to incorporate pet care into your estate plan, consider the following article:  Ohio Pet Trusts.



Source: Rebecca H. Miller, Pandemic Pets and Pet Companionship: Seven Benefits/Considerations for Care Coordination and Estate Planning, Chambliss Law, May 5, 2021. 

Friday, July 9, 2021

Isolation Impact: Death Rate Higher for Institutionalized Residents in Socially Isolated Neighborhoods

Nursing home residents in socially isolated neighborhoods are at an increased risk of mortality according to findings from a new study published in JAMA.

A recent analysis conducted by a Boston-based research team found that long-term care residents in facilities located in areas with high levels of social isolation have higher mortality rates than residents in facilities in places that have more social contact. Findings showed residents entering facilities in neighborhoods with the highest levels of social isolation among older adults had a 17% higher risk of mortality compared with those in neighborhoods with the lowest levels. 

Social isolation among seniors has been an ongoing topic among the long-term care industry due to the COVID-19 pandemic and it’s connection with depression, anxiety and cognitive decline among nursing home residents.  Isolation impact is not well known or studied, though it is addressed elsewhere in this blog (here and here, the latter being a collection of articles tagged with the topic "isolation" meaning that the subject was mentioned).   

Researchers said the findings suggest the need for operators to place special attention and strategies to keep long-term care residents connected to their friends and family for optimal health: 

“Such measures could eventually contribute to improved health trajectories in the US population that is increasingly aging and at growing risk of entering LTC facilities.”

For those interested and/or committed to aging in place, the findings provide additional justification for avoiding institutionalization, to be sure sure, but they also underscore the importance of planning and implementing a rigorous social plan, including and incorporating family, friends, and fraternal organizations and associations.  For secular and non-secular organizations serving the needs of seniors, the findings of the study underscore the importance of outreach and involvement, for example, by ensuring transportation for seniors otherwise unable to travel. 

Friday, June 4, 2021

Deaths from Nursing Home Neglect Surged Amid the Pandemic

As more than 180,000 of the nation’s long-term care residents and staff died of COVID-19 in a pandemic that has pushed staffs to the limit, advocates for the elderly say a tandem wave of death separate from the virus has quietly claimed untold tens of thousands more The most common causes included neglect occasioned by overburdened workers unable to provide necessary care.

Matt Sedensky and Bernard Condon, writing for the Associated Press (AP), told the soul wrenching story of David Wallace: 

"When COVID-19 tore through Donald Wallace’s nursing home, he was one of the lucky few to avoid infection. He died a horrible death anyway."

Hale, hearty, and reportedly happy before the pandemic, the 75-year-old retired Alabama truck driver became so malnourished and dehydrated that he dropped to 98 pounds.  His son reported that he looked like he’d "been in a concentration camp."  No wonder: septic shock suggested an untreated urinary infection, E. coli in his body from his own feces hinted at poor hygiene, and aspiration pneumonia suggested that  Wallace, who required assistance with meals, had  choked on his own food.  All of these conditions developed while Wallace was under the control, custody, and care of a nursing home.  

Kevin Amerson, Walace's son indicted the institution:

“He couldn’t even hold his head up straight because he had gotten so weak. They stopped taking care of him. They abandoned him.”

According to the AP, as nursing homes were opening up to family visitations nursing home watchdogs were being flooded with reports of residents kept in soiled diapers so long their skin peeled off, left with bedsores that cut to the bone, and allowed to wither away in starvation or thirst.

Beyond that, AP interviews with dozens of people across the country reveal swelling numbers of less clear-cut deaths that doctors believe have been fueled not by neglect but by isolation.  The AP described a common mental state plunged residents into despair as a result of prolonged isolation.  The AP noted that many residents cause of death as reported on death certificates was simply “failure to thrive.”

A nursing home expert who analyzed data from the country’s 15,000 facilities for the APs investigation reportedly estimated that for every two COVID-19 victims in long-term care, there is another who died prematurely of other causes. Those “excess deaths” beyond the normal rate of fatalities in nursing homes could total more than 40,000 just since between last March and November.

The industry's record was not stellar prior to the pandemic; studies have indicated that one 

These extra deaths are roughly 15% more than you’d expect at nursing homes already facing tens of thousands of deaths each month in a normal year.

“The healthcare system operates kind of on the edge, just on the margin, so that if there’s a crisis, we can’t cope,” Stephen Kaye, a professor at the Institute on Health and Aging at the University of California, San Francisco, who conducted the analysis, told the AP. “There are not enough people to look after the nursing home residents,” he admitted.

Comparing mortality rates at homes struck by COVID-19 with ones that were spared, Kaye also found that the more the virus spread through a home, the greater the number of deaths recorded for other reasons. In homes where at least 3 in 10 residents had the virus, for example, the rate of death for reasons besides the virus was double what would be expected without a pandemic.

That suggests the care of those who didn’t contract the virus  suffered, possibly  as healthcare workers were consumed attending to residents ill from COVID-19 or were left short-handed as the pandemic infected employees themselves.

Chronic understaffing at nursing homes has been one of the hallmarks of the pandemic, with a few homes even forced to evacuate because so many workers either tested positive or called in sick. In 20 states where virus cases are now surging, federal data shows nearly 1 in 4 nursing homes reported staff shortages.

The nursing home trade group American Health Care Association disputed that there has been a widespread inability of staff to care for residents and dismissed estimates of tens-of-thousands of non-COVID-19 deaths as “speculation.”

Dr. David Gifford, the group’s chief medical officer, said the pandemic created “challenges” in staffing, particularly in states like New York and New Jersey hit hard by COVID-19, but added that, if anything, staffing levels have improved because of a drop in new admissions that has lightened the patient load.

“There have been some really sad and disturbing stories that have come out,” Gifford said, “but we’ve not seen that widespread.”

Another industry group, LeadingAge, which represents not-for-profit long-term care facilities, said staffing challenges are real, and that care homes are struggling in the face of federal inaction to provide additional stimulus money to help pay for more workers.

“These incidents, stemming from the challenges being faced by too many committed and caring nursing home providers during this pandemic, are horrific and heartbreaking,” said Katie Smith Sloan, LeadingAge’s president. “I hope that these tragedies will wake up politicians and the public.”

When facilities sealed off across the country in March, advocates and inspectors were routinely kept out too, all while concerning reports trickled in, not only of serious injuries from falls or major medical declines, but of seemingly banal problems that posed serious health issues for the vulnerable.

Mairead Painter, Connecticut’s long-term care ombudsman, said with dentists shut out, ill-fitting dentures went unfixed, a factor in mounting accounts of malnutrition, and with podiatrists gone, toenails went untrimmed, posing the possibility of painful conditions in diabetes patients.

Even more widespread, as loved ones lost access to homes, was critical help with residents’ feeding, bathing, dressing and other tasks. The burden fell on aides already working tough shifts for little pay.

“I don’t think anyone really understood how much time friends and family, volunteers and other people spent in the nursing home and supplemented that hands-on care,” Painter said.

Strict rules barring in-person visitation persisted in many homes, but as families and advocates have inched back inside, they’ve frequently been stunned by what they found.

The AP shared the  story of June Linnertz, who, when she returned to her father’s room at Cherrywood Pointe in Plymouth, Minnesota, for the first time in three months, she was struck by a blast of heat and a wall thermometer that hit 85 degrees. His sheets were soaked in sweat, his hair was plastered to his head and he was covered in bruises.  Linnertz would learn these bruises came from at least a half-dozen falls. His nails had been uncut so long, they curled over his fingertips and his eyes crusted over so badly he couldn’t get them open.  

Linnertz father, 78-year-old James Gill, was found screaming, thinking he had gone blind, and Linnertz grabbed an aide in a panic. She snipped off his diaper, revealing genitals that were deep red with skin sloughing off.

Two days later, Gill died from Lewy Body Dementia, according to a copy of the death certificate provided the AP. Linnertz told the AP that she always expected her father to die of the condition, which causes progressive memory and movement loss, but she never thought he would end his days in so much needless and avoidable pain and suffering.

“What the pandemic did was uncover what was really going on in these facilities. It was bad before, but it got exponentially worse because you had the squeeze of the pandemic,” Linnertz said. “If we weren’t in a pandemic, I would have been in there... This wouldn’t have happened.”

The assisted living facility’s parent company, Ebenezer, told the AP: “We strongly deny the allegations made about the care of this resident,” adding that it follows “strict regulatory staffing levels” required by law.

Cheryl Hennen, Minnesota’s long-term care ombudsman, said dozens of complaints have poured in of bedsores, dehydration and weight loss, and other examples of neglect at various facilities, including a report of a man who choked to death while he went unsupervised during mealtime. She fears many more stories of abuse and neglect will emerge as her staff and families are able to return to homes.

“If we can’t get in there, how do we know what’s really happening?” she said. “We don’t know what we can’t see.”

The nagging guilt of unnecessary death is one Barbara Leak-Watkins understands. It was just in February that her 87-year-old father, Alex Leak, went for a check-up and got lab work that made Leak-Watkins think the Army veteran, contractor and farmer would be with her for a long time to come.

You’re going to outlive all of us,” Leak-Watkins remembered the doctor saying.

As nursing home outbreaks of COVID-19 proliferated, Leak-Watkins prayed that he be spared. The prayer was answered, but Leak was nonetheless found unresponsive on the floor at Brookdale Northwest in Greensboro, North Carolina, his eyes rolled back and his tongue sticking out.

After he arrived at the hospital, a doctor there called Leak-Watkins with word: Her father had gone so long without water his potassium levels rocketed and his kidneys were failing. He died two weeks later of lactic acidosis, according to his death certificate, a fatal buildup of acid in the body when the kidneys stop working. For a man whose military service so drilled the need for hydration into him that he always had a bottle of water at hand, his daughter had never considered he could go thirsty.

“The facility is short-staffed...underpaid and overworked,” Leak-Watkins said. If they “can’t provide you with liquids and fluids to hydrate yourself, there’s something wrong.”

The daughter is considering filing a lawsuit but a North Carolina law granting long-term care facilities broad immunity from suits claiming negligence in injuries or death during the pandemic could stymie her efforts. Similar laws and executive orders have been enacted in more than two dozen states.  Critics say the laws are a free pass for neglect.

The owner of the father’s facility, Brookdale Senior Living, said it couldn’t comment on individual cases but that “the health, happiness and wellbeing of each of our residents will always be our priority.”

Around the country, the heartache repeats, not only among families who have already buried a member, but also those who feel they are watching a slow-moving disaster.

In Hendersonville, Tennessee, Tara Thompson was able to see her mother for the first time in more than six months when she was hospitalized in October. The 79-year-old had dropped about 20 pounds, her eyes sunken and her legs looking more like forearms. Doctors at the hospital said she was malnourished and wasting muscle. There were bedsores on her backside and a gash on her forehead from a fall at the home. Her vocabulary had shrunk to nearly nothing and she’d taken to pulling the blankets over her head.

The facility Thompson’s mother lived in had been engulfed in virus outbreaks, with more than half its residents testing positive and dozens of employees infected, too. She never caught it, but shaken by the lack of care, Thompson transferred her mother to a new home.

“It has nothing to do with the virus. She’s declined because she’s had absolutely no contact with anybody who cares about her,” she said. “The only thing they have to live for are their families and, at the end of their life, you’re taking away the only thing that matters to them.”

“Failure to thrive” was among the causes listed for Maxine Schwartz, a 92-year-old former cake decorator whose family had been encouraged prior to the lockdown by how well she’d adjusted to her nursing home, Absolut Care of Aurora Park, in upstate New York. Her daughter, Dorothy Ann Carlone, would coax her to eat in the dining room each day and they’d sing songs and have brownies back in her room. Several times a week, Schwartz walked the length of the hallway for exercise.

When the lockdown began March 13, Carlone feared what would happen without her there. She pleaded to staff: “If you don’t let me in to feed her, she won’t eat, she will starve.”

On March 25, when a staffer at the home sent a photo of Schwartz, Carlone was shocked how thin she was. Carlone was told her mother hadn’t been eating, even passing up her favorite brownies.

Two days later, Carlone got an urgent call and when she arrived at the home, her mother’s skin was mottled, she was gasping for breath and her face was so drawn she was nearly unrecognizable. An hour later, she died.

Dawn Harsch, a spokeswoman for the company that owns Absolut Care, noted a state investigation found no wrongdoing and that “the natural progression of a patient like Mrs. Schwartz experiencing advanced dementia is a refusal to eat.”

Carlone is unconvinced.

“She was doing so good before they locked us out,” Carlone said. “What did she think when I wasn’t showing up? That I didn’t love her anymore? That I abandoned her? That I was dead?”

Before the lockdown, Carlone’s mother would wait by an elevator for her to arrive each day. She thinks of her mother waiting there when her visits stopped and knows the pain of the isolation must have played a role in her death.

“I think she gave up,” she said.

You should never give up.  Plan to age in place.  Learn what aging in place planning entails, develop a plan, and then implement the plan. If you won't for yourself, do it for those whom you love, who may be ravaged by the consequence of there being no plan when it is needed.    

Source: Sedenski and Condon, "Not just COVID: Nursing home neglect deaths surge in shadows," AP NEWS (November 19, 2020) (last accessed 4/15/2021). 

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