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One Step in Marietta Changed Everything

Wed, 29 Apr 2026 22:09:54 GMT

It only takes one moment.

A step into a shower.

A loss of balance.

And suddenly, everything changes.

We recently worked with a client in Marietta who experienced a fall stepping over the threshold of her walk-in shower. There were no grab bars—nothing to steady herself.

She broke her hip.

After surgery and several weeks in rehab, the question became:

“How do we make sure this doesn’t happen again?”

Before she returned home, we were able to make several important home modifications to improve home accessibility and create a safer environment:

• A zero-threshold shower for easy, safe entry

• Properly placed grab bars for stability

• A handheld shower and built-in shower seat

• A comfort height toilet with additional grab bars

• A widened doorway for better wheelchair access

• A portable ramp in the garage for safe entry

While she may eventually transition from a wheelchair to a walker, her home is now prepared to support her every step of the way.

This is what aging in place should look like.

Creating safe homes for seniors and individuals who are physically challenged isn’t just about construction— It’s about restoring confidence, safety, and independence.

And moments like this remind us why this work truly matters.

Helping People Stay Where Life Happened

Thu, 23 Apr 2026 00:27:56 GMT

A home is more than a structure—it’s where life happened.

Where routines were built.
Where memories were made.
Where comfort became familiar over time.

That’s why the conversation around aging in place is not just about safety…
It’s about connection.

For many seniors and individuals who are physically challenged , the idea of leaving home isn’t just a practical decision—it’s an emotional one.

I’ve seen families face this moment.

Trying to balance safety with familiarity.

Independence with peace of mind.

The good news is—there’s another way to look at it.

Through thoughtful home modification and improved home accessibility , it’s often possible to create safe homes for seniors without losing what makes a home feel like home.

Features like:
• Accessible bathrooms with zero-threshold showers
• Properly placed grab bars
• Wheelchair accessible ramps and improved entryways

These changes aren’t about altering the home—they’re about supporting the people who live in it.

Because sometimes, the goal isn’t just to make a home safer…

It’s to help someone continue aging in place —
right where life happened.

Your Home Might Be Your Most Overlooked Health Risk

Wed, 08 Apr 2026 06:05:41 GMT

Most people think of their health in terms of doctor visits, medications, diet, and exercise.

But there’s one critical factor that is often overlooked…

The home environment.

Over the years, we’ve seen a consistent pattern:

Health issues are not always caused by illness alone—they are often made worse by the home itself.

A small step into a shower becomes a fall risk
Poor lighting increases instability
Narrow doorways limit mobility
Everyday tasks become physically demanding

What starts as a minor inconvenience can quickly become a serious safety concern.

The reality is this:

A home that is not designed to support you can quietly work against your health every single day.

On the other hand, a properly designed, accessible home:

Reduces fall risks
Supports mobility and independence
Eases the burden on caregivers
Encourages confidence in daily living

This isn’t about major renovations in every case.

Sometimes, small, thoughtful changes can make a meaningful difference.

As more individuals choose to remain at home longer, it’s time to expand the conversation:

�� Health isn’t just managed in hospitals—it’s lived at home.

These Tiny Changes Might Lengthen Your Life

Sat, 04 Apr 2026 20:37:29 GMT

This is an excerpt from an article in The Washington Post written by Gretchen Reynolds

A recent study highlighted by The Washington Post reveals something both encouraging and practical:

You don’t need dramatic lifestyle overhauls to improve longevity.

Researchers found that just:

5 additional minutes of sleep
2 minutes of added physical activity
A modest improvement in nutrition (like an extra serving of vegetables)

…can add a year or more to your life.

Even more compelling, these small improvements—when combined—create a powerful synergy between what researchers call:

Sleep, Physical Activity, and Nutrition (SPAN).

Together, they significantly improve both lifespan and overall health.

But There’s a Missing Piece in the Conversation

While these findings focus on personal habits, there is another critical factor that determines whether individuals can actually maintain these improvements:

�� Their home environment

You can have the best intentions—eat better, move more, rest well—but if your home is not designed to support those actions, consistency becomes difficult… and sometimes dangerous.

This is where home modifications and home accessibility play a vital role.

How Home Accessibility Supports Longevity

A well-designed, accessible home directly supports the very habits this study highlights:

Sleep (Safety & Confidence at Night)

Proper lighting reduces fall risks during nighttime movement
Safe, accessible bathrooms eliminate hazards
Clear pathways provide peace of mind

Physical Activity (Daily Movement Without Barriers)

Open layouts encourage mobility
Widened doorways accommodate walkers and wheelchairs
Wheelchair-accessible ramps eliminate obstacles

Nutrition (Easier Access = Better Habits)

Accessible kitchens with lowered counters
Pull-down shelving and reachable storage
Functional layouts that reduce strain and fatigue

Real-Life Impact for Seniors & the Physically Challenged

For many individuals—whether seniors, those with chronic illness, or those facing mobility challenges—these small daily habits are not just about longevity…

They are about maintaining independence.

Features like:

Zero threshold (curbless) showers
Grab bars for stability and fall prevention
Widened doorways and hallways
User-friendly kitchens
Safe entry and exit solutions

…transform a home into a space that promotes:
✔ Safety
✔ Confidence
✔ Daily consistency
✔ Long-term independence

The Bigger Picture

Longevity is not just about living longer—it’s about living well.

This study reinforces that small, manageable changes can have a profound impact on health.

But to fully benefit from those changes, your home must work with you—not against you.

A properly designed, accessible home makes it easier to:

Stay active
Maintain healthy routines
Reduce fall risk
Age in place with dignity

Final Thought

You don’t need to change everything overnight.

Start small.

But also take a step back and ask:

�� Does my home support the life I want to live as I age?

Because while small habits may extend your life…

A safe, accessible home will help ensure you can truly enjoy it.

What I Wish Every Daughter Knew About Her Mother's Bathroom

Mon, 30 Mar 2026 18:29:47 GMT

I've walked into hundreds of homes over the course of my career as an occupational therapist and Certified Aging in Place Specialist.

I've sat at kitchen tables with worried adult children, I've held the hands of seniors who felt embarrassed by their own vulnerability, and I've stood in more bathrooms than I can count, assessing, recommending, and sometimes arriving just a little too late.

If you're reading this because you're concerned about your mother, I want you to know something first: the fact that you're thinking about this already puts you ahead of most families.

You're not overreacting. You're not being alarmist. You are paying attention, and that is an act of love.

The Bathroom Is the Most Dangerous Room in the House, and the Most Private

Here's what I know after more than two decades in this field: the bathroom is where falls happen . Not on the stairs. Not in the driveway. In the bathroom, where the floor is wet, the surfaces are hard, and your mother is alone.

The statistics are sobering, falls are the leading cause of injury-related death among older adults , but statistics aren't what keep me up at night. What I remember are the stories.

The woman who fell getting out of the tub on a Tuesday morning while her daughter was at work twenty minutes away. The man whose wife had no idea anything had happened for three hours.

I'm not telling you this to frighten you. I'm telling you because understanding the risk is what allows us to do something about it.

Your Mother Isn't Going to Bring This Up Herself

This is the part that surprises most families. You might assume that if there were a real problem, Mom would say something. She wouldn't.

Not because she's hiding things from you, but because the bathroom is deeply personal territory. Bathing, toileting, managing her own body, these are the last frontiers of independence for many older adults.

To acknowledge that the tub has become difficult, that she sometimes grabs the towel bar to steady herself, that she waits until she's absolutely sure she can make it, that feels, to her, like the beginning of the end.

So she stays quiet. And you don't ask, because you don't want to embarrass her. And in that silence, the risk grows.

What I've learned is that the conversation goes better when it comes from curiosity rather than alarm.

Not "Mom, I'm worried you're going to fall", but "Mom, I was reading about some of these new grab bars and honestly they look pretty sleek. Can I show you?" You're not taking something away. You're offering something.

Small Changes Make an Enormous Difference

One of the most reassuring things I can tell you is this: bathroom safety doesn't have to mean turning your mother's home into a clinical facility. The modifications that matter most are often simple, affordable, and surprisingly attractive.

A well-placed grab bar by the toilet, installed properly into the wall studs, gives her something solid to push up from. A handheld showerhead means she can bathe seated if she needs to, without it feeling like a defeat.

A shower bench, a non-slip mat, adequate lighting, a raised toilet seat, none of these are dramatic interventions. They are quiet, practical acts of respect for a body that has worked hard for decades and simply needs a little more support now.

What I tell families is to think of these not as accommodations for decline, but as good design for real life . Plenty of people in their forties and fifties would benefit from a grab bar after surgery, or a handheld shower during an injury.

The difference is that for your mother, the need is ongoing, and the stakes of ignoring it are higher.

You Don't Have to Figure This Out Alone

A CAPS-certified professional can walk through your mother's home, and her bathroom specifically, and give you a clear picture of what's working, what's risky, and what can be done about it.

This isn't a sales pitch or a scare tactic. It's an assessment, grounded in clinical knowledge and a genuine understanding of how older adults move through their own spaces.

Often, families tell me afterward that they wish they'd done it sooner. Not because something had gone wrong, but because they finally had language for what they'd been quietly worrying about. The uncertainty lifts. There's a plan. That's worth something.

The Conversation Is an Act of Love

I want to leave you with this: bringing up bathroom safety with your mother is not about taking over or taking charge.

It's not about preparing for the worst. It's about saying, in the most practical terms possible, I want you to be here. I want you to be safe. I want you to stay in this home you love, for as long as you possibly can.

That's the whole point. That's always been the whole point.

And she may not say so, she may bristle a little, or change the subject, or tell you she's perfectly fine, but somewhere underneath all of that, she knows you're saying I love you.

And that lands, even when the grab bars don't go in right away.

If you'd like guidance on next steps, whether that's a home safety assessment, specific product recommendations, or simply knowing what questions to ask, check out the professionals on the Aging in Place Directory

Getting Better With Age Is Possible

Sat, 28 Mar 2026 14:02:33 GMT

This is an excerpt from an article in the Washington Post, written by Maggie Penman, March 25, 2026

Research shows that aging does not always mean decline. In fact, studies have found that nearly half of adults over age 65 improve physically, mentally, or both as they grow older. A positive outlook plays a major role, but another factor is often overlooked — the environment a person lives in.

Examples of people accomplishing great things later in life remind us that aging is not a one-way path. Researchers studying thousands of older adults found that those who believed aging could still be a time of growth were more likely to stay active, socially engaged, and physically strong.

However, the ability to stay active often depends on whether the home allows a person to function safely and independently. When a home becomes difficult to navigate, people may begin avoiding everyday activities. Over time this can lead to less mobility, less confidence, and reduced independence — not because of age itself, but because the home no longer fits their needs.

Homes designed with accessibility in mind can help support the positive cycle of aging.

Features such as:

Zero-threshold showers, grab bars, better lighting, wider doorways, ramps, lifts, and user-friendly kitchens allow individuals to move safely and remain engaged in daily life. These improvements make it easier to stay active, socialize, and maintain a sense of purpose.

Experts often say that people who thrive later in life usually have something that keeps them moving forward — family, hobbies, volunteering, travel, or community involvement. A safe and accessible home makes it easier to continue those activities.

Aging is not just about years. It is about mindset, activity, and environment working together.

When a home supports independence instead of limiting it, people are more likely to stay confident, active, and involved — and that can make the aging process far more positive.

Planning ahead and creating a safer, more accessible home can help ensure that life does not slow down with age — it can continue to get better.

Accessible Living Atlanta has been making homes accessible for over 20 years. We not only create a more accessible home, but also help you in supporting a healthy, positive attitude.

I want to avoid the ‘aging mistakes’ my parents made. I’ve got work to do.

Sun, 22 Mar 2026 22:26:38 GMT

Twenty years ago, I started a list of what I considered “stupid things” that people do as they age. Now, I’m seeing my life, and my list, in a different light.

Wow, time flies. Nearly 20 years ago, soon after my 50th birthday, I started making a list of what I considered mistakes my parents (and many of their generation) had made as they aged — and that I swore I would not repeat. Some of the items were silly (“I won’t color my hair anymore”), but most of them had substance (“I won’t limit myself to friends my own age” and “I won’t worry about what I can’t control”), and a few took the needs of family into account (“I won’t keep driving when I become a threat to others” and “I won’t deny the fact that I need hearing aids”).

Now, in the penumbra preceding 70, I’m seeing my life – and my list – in a new light.

I wrote about the list for the first time in 2017, after my parents had died. Born of the frustration I felt witnessing the price Mom and Dad paid for their stubbornness, my tally had reached more than 100 items, and I hoped to hold myself accountable by going public with my promises.

ARCHI — The Structure Behind Safe Aging

Fri, 20 Mar 2026 16:05:37 GMT

The word ARCHI comes from the Greek meaning “chief,” “principal,” or “foundational.” It is the root of words like architecture and hierarchy —both of which play an important role in how we think about aging safely and independently.

When it comes to growing older, the structure of the home matters more than most people realize . Many houses were built for convenience when we were younger, but not necessarily for the mobility and safety needs that can come later in life.

That’s where thoughtful planning and home modifications make all the difference.

At Accessible Living Atlanta , we help families create the right structure for safe aging , through solutions such as:

Zero-threshold showers
Grab bars and safer bathrooms
Wheelchair and walker accessibility
Ramps and safer entrances
Improved lighting and wider pathways

These changes are not just renovations—they are structural solutions that allow people to remain safely and comfortably in the homes they love.

Safe aging doesn’t happen by chance.

It begins with the right structure.

�� 770-301-8165 �� www.alatlanta.com

Aging-in-Place Remodeling Is Growing, So Why Are Many Aging-in-Place Professionals Struggling to Find Clients?

Wed, 18 Mar 2026 21:35:53 GMT

Over the past several years, I’ve heard the same concern from many aging-in-place professionals.

They say something like this:

"Everyone says aging in place is a huge opportunity… but I’m not seeing the clients."

If you’re feeling that way, you’re not imagining it.

The reality is that aging-in-place remodeling is growing rapidly , but the work is not always flowing to the professionals who specialize in home safety assessments.

Instead, much of the demand is going directly to contractors and remodelers .

Let’s take a closer look at the numbers and the reasons behind this disconnect.

The Aging-in-Place Remodeling Market Is Growing

First, the data does show strong growth in the remodeling industry.

In the United States, homeowners spend hundreds of billions of dollars every year on home improvements .

Recent research shows:

U.S. home improvement spending reached about $534 billion in 2024
Experts project it will grow to over $680 billion by 2033

Remodeling has also become a much larger part of the housing industry.

In 2007, remodeling made up about 33 percent of residential construction spending .

Today, that number has grown to about 44 percent .

This means homeowners are spending more money upgrading existing homes instead of moving or building new ones.

A significant portion of remodeling spending is driven by the needs of older adults, with industry surveys showing that over 70 percent of aging-in-place modification requests come from homeowners age 65 and older. ( NAHB )

The Aging Population Is Driving Home Modifications

The reason is simple.

Most older adults want to remain in their homes.

Research consistently shows that:

Nearly 90 percent of adults over age 65 want to age in place
About three-quarters of adults over 50 say staying in their home is their goal

At the same time, most homes were never designed for aging .

Some estimates suggest that only about 10 percent of homes are aging-ready .

This creates a large gap between what people want and what their homes can safely support.

That gap is driving a growing market for aging-in-place remodeling.

Some estimates place the aging-in-place renovation market at over $74 billion today , with projections exceeding $100 billion within the next decade .

Remodelers Are Seeing the Demand

When researchers ask remodelers about aging-in-place projects, they consistently report growing demand.

Surveys show:

More than 70 percent of remodelers say requests for aging-in-place features have increased ( eyeonhousing.org )
Over half of remodelers are already completing aging-in-place modification projects ( housingwire.com )

Common projects include:

Walk-in or curbless showers
Grab bars in bathrooms
Ramps and step-free entrances
Wider doorways
Non-slip flooring
Improved lighting

These modifications make homes safer and easier for older adults to navigate.

So yes, the demand for aging-in-place improvements is real.

But here is where the story gets more complicated.

Why Contractors Often Get the Work Instead of Assessors

Even though aging-in-place professionals specialize in home safety assessments, many homeowners never hire one.

Instead, they go directly to contractors.

There are several reasons for this.

1. Homeowners Do Not Know Home Safety Assessments Exist

Most people simply do not know that aging-in-place assessments are a service.

When a homeowner begins searching online, they usually type things like:

“Bathroom remodel”
“Grab bar installation”
“Walk-in shower”
“Wheelchair ramp”

They rarely search for:

“Home safety assessment”
“aging-in-place evaluation”

Because of this, contractors become the first professionals they find.

2. Contractors Sell a Visible Solution

Another reason is psychological.

Contractors sell a clear, visible solution .

A contractor might say:

"We can install a walk-in shower and grab bars."

An assessor might say:

"We will evaluate your home and provide recommendations."

To many homeowners, the first option feels more concrete.

They see a product or improvement right away.

3. Insurance Rarely Pays for Assessments

Financial factors also play a role.

Most aging-in-place assessments must be paid out of pocket .

Insurance rarely covers them.

However, home modifications are often paid for through:

Home equity loans
Remodeling budgets
Renovation financing

Because of this, homeowners sometimes skip the assessment and go directly to the renovation.

4. Contractors Often Do Informal “Assessments”

In many cases, contractors end up doing the evaluation themselves.

The process often looks like this:

A homeowner calls a remodeler
The remodeler walks through the home
They recommend safety improvements

From the homeowner’s perspective, the assessment has already happened.

So they never seek a separate professional evaluation.

Why This Is a Problem

From a clinical perspective, this approach can miss important issues.

A proper aging-in-place assessment looks at much more than home design.

It should consider:

Mobility and balance
Vision changes
Cognitive function
Caregiver needs
Future physical decline
Daily routines inside the home

These factors help ensure that modifications truly support long-term independence.

Without this deeper evaluation, homeowners sometimes make renovations that solve today’s problem but not tomorrow’s.

The Opportunity for Aging-in-Place Professionals

Even though contractors currently receive much of the work, the opportunity for aging-in-place professionals still exists.

But the opportunity may depend on working alongside remodelers instead of competing with them .

Many successful professionals build partnerships with:

Contractors
Remodelers
Occupational therapists
Home care agencies
Senior service providers

By collaborating, they help ensure that home modifications are based on both safety and function .

The Bottom Line

The aging-in-place market is real.

Demographics, housing trends, and homeowner preferences all point to growing demand for safer homes.

However, much of the current demand is flowing through remodeling companies rather than assessment professionals .

Understanding this reality can help aging-in-place specialists rethink how they position their services and how they connect with homeowners.

Because when safety, accessibility, and independence are done right, aging in place becomes much more than a remodeling project.

It becomes a plan for living well at home.

Mobility Changes — Your Home Should Change Too

Fri, 13 Mar 2026 20:59:44 GMT

Serious mobility loss can happen gradually — or instantly.
Conditions such as ALS, MS, Muscular Dystrophy, Parkinson’s disease, stroke, and traumatic injuries often change a person’s ability to move safely inside their own home.

The type of home modifications needed depends on the stage of the condition.

In the early stages, a few small changes may be enough.

As mobility becomes more limited, additional accessibility solutions are often required to maintain independence and safety.

Over the past 20+ years, Accessible Living Atlanta has worked with individuals and families throughout every stage of mobility loss, providing customized home modifications designed for real-life needs.

Examples of modifications may include:

Ramps or vertical platform lifts for safe entry
Doorway widening for wheelchair access
Zero-threshold showers and accessible bathrooms
Comfort-height toilets and grab bars
Ceiling lifts for bed-to-chair transfers
Lowered kitchen cabinets and roll-under sinks
Improved lighting for safety
Elevators for multi-level homes

Every situation is different. Every home is different. Every client has different goals.

Our experience allows us to recommend the right solution at the right time — helping individuals remain safely at home with greater independence and a better quality of life.

�� 770-301-8165

�� www.alatlanta.com

Accessible Home Modifications

Thu, 12 Mar 2026 18:59:16 GMT

Although home modifications to improve accessibility have been around for decades, many people across the country are still unaware that their homes can be adapted to meet changing physical needs.

Home accessibility is not just for seniors.
It benefits individuals of all ages who may be living with mobility challenges, chronic illness, birth defects, injuries, or other physical limitations.

For thousands of families, simple modifications have made the difference between moving out… and staying safely at home.

Accessible home modifications may include:
✔ Barrier-free showers
✔ Wheelchair ramps & lifts
✔ Wider doorways
✔ Grab bars & safety rails
✔ Stair lifts
✔ Accessible kitchens & bathrooms
✔ Zero-step entrances
✔ Improved lighting & safer flooring

These changes allow people to live with greater independence, dignity, and safety in the place they know best — their own home.

Across the country, more families are discovering that the right modifications can extend independence for years and prevent unnecessary moves to assisted living or nursing facilities.

Home accessibility is not a trend.
It is a proven solution that has helped thousands — and will help thousands more in the years ahead.

Aging in Place Isn’t Just for Seniors: Why Planning Ahead Matters

Wed, 11 Mar 2026 19:43:34 GMT

Serious mobility loss can happen gradually — or instantly.

Conditions such as ALS, MS, Muscular Dystrophy, Parkinson’s disease, stroke, and traumatic injuries often change a person’s ability to move safely inside their own home.

The type of home modifications needed depends on the stage of the condition.

In the early stages, a few small changes may be enough.
As mobility becomes more limited, additional accessibility solutions are often required to maintain independence and safety.

Over the past 20+ years, Accessible Living Atlanta has worked with individuals and families throughout every stage of mobility loss, providing customized home modifications designed for real-life needs.

Examples of modifications may include:

Ramps or vertical platform lifts for safe entry
Doorway widening for wheelchair access
Zero-threshold showers and accessible bathrooms
Comfort-height toilets and grab bars
Ceiling lifts for bed-to-chair transfers
Lowered kitchen cabinets and roll-under sinks
Improved lighting for safety
Elevators for multi-level homes

Every situation is different. Every home is different. Every client has different goals.

Our experience allows us to recommend the right solution at the right time — helping individuals remain safely at home with greater independence and a better quality of life.

770-301-8165

www.alatlanta.com

How to Implement ADA Requirements in Your Home — And Why We Go Beyond Them

Sat, 28 Feb 2026 15:35:56 GMT

When preparing a home for aging in place or accommodating mobility challenges, many families ask:

“What standards should we follow?”

The Americans with Disabilities Act (ADA) provides important guidelines for accessibility — including:
✔ 32” minimum door widths
✔ 36” hallway clearance
✔ 30” x 48” wheelchair floor space
✔ Proper sink and countertop heights
✔ Grab bars and handrails
✔ Lever-style handles

But at Accessible Living Atlanta , we don’t just “meet code.”
We design homes that promote true independence, dignity, and long-term safety .

For over 20 years, we’ve specialized in:

Barrier-free and zero-threshold showers
Wheelchair-accessible kitchens
Custom ramps and entry modifications
Grab bar and safety installations
Whole-home accessibility audits
Universal design solutions

ADA guidelines are the starting point.
We carry that theme through everything we do — creating homes that are safer, more convenient, and built for real life.

If you or a loved one is planning ahead, now is the time to evaluate your home.

770-301-8165
www.alatlanta.com

Aging in place isn’t just possible — it can be done safely and beautifully.

What Is Meant by “Modify”?

Fri, 27 Feb 2026 07:19:09 GMT

Modify means to make partial or minor changes to something — typically to improve it.

But in the world of home modifications, “minor changes” often create major life impact.

For seniors, individuals living with chronic illness, physical challenges, or mobility limitations, a modification might look like:

✔ Converting a traditional shower into a zero-threshold shower

✔ Installing strategically placed grab bars for fall prevention

✔ Widening doorways for wheelchair accessibility

✔ Adding ramps for safe entry

✔ Improving lighting for visual safety

✔ Integrating smart-home features for independence

Most homes were not built with aging in place in mind. A simple step at an entryway. A narrow bathroom door. A high bathtub wall. These design elements can quietly limit independence.

Through thoughtful universal design , we modify the environment — not the person.

At Accessible Living Atlanta, our goal is simple:

Make homes safer.

Make daily living easier.

Make independence possible.

Sometimes the smallest modification changes everything.

�� 770-301-8165

�� www.alatlanta.com

The Rise of Solo-Agers Is Changing How We Think About Aging at Home

Wed, 25 Feb 2026 05:01:45 GMT

Nearly one-third of older adults in the U.S. now live alone — and that number continues to grow. These “solo-agers” often don’t have a built-in support system to help manage safety risks, home maintenance, or sudden health changes.

This is where home accessibility modifications become more than convenience — they become a lifeline.

Features like:

• Zero-threshold showers

• Grab bars and safe flooring

• Wider doorways for mobility access

• Ramps and step-free entries

• Smart lighting and fall-prevention upgrades

These solutions allow individuals aging alone to remain independent, safe, and confident in their homes — without relying on emergency decisions after a crisis.

For over 20 years, Accessible Living Atlanta has helped individuals of all ages, including many living alone, transform their homes into spaces designed for long-term independence.

As the solo-aging population grows, proactive planning and accessibility design will be essential — not optional.

�� Independence shouldn’t mean isolation. It should mean living safely on your own terms.

Helping People Stay Where They Feel Most Comfortable — At Home

Fri, 20 Feb 2026 16:11:34 GMT

Over the years, we’ve had the privilege of speaking with support groups across the greater Atlanta area, including individuals and families affected by ALS, MS, Parkinson’s, Muscular Dystrophy, Dementia, brain injuries, and stroke.

These conversations are more than presentations — they’re opportunities to listen, understand, and provide guidance during life-changing circumstances. As a result, many families turn to us when they need help making their homes safer and more accessible.

We’ve modified hundreds of homes to help individuals remain living independently rather than transitioning prematurely into assisted living or nursing facilities. Every project is unique because every journey is different. The stage of a condition often determines the type of solutions needed — whether that’s:

Barrier-free showers and bathroom safety upgrades
Ramps and zero-threshold entries
Wider doorways for mobility equipment
Stair lifts or vertical platform lifts
Kitchen modifications for accessibility
Improved lighting and fall-prevention improvements

At Accessible Living Atlanta, our goal goes beyond construction — it’s about preserving dignity, independence, and quality of life. Helping someone remain safely in the home they love is one of the most meaningful outcomes we can achieve.

We are grateful to partner with the many support organizations that allow us to share this mission.

How are we going to pay for this?

Sat, 14 Feb 2026 18:50:06 GMT

The good news is — funding may be available.

Beyond the VA, several programs can help homeowners offset the cost of accessibility improvements:

Federal Programs

• U.S. Department of Agriculture – Rural Housing Repair Loans & Grants (for very low-income homeowners age 62+)

• U.S. Department of Housing and Urban Development – FHA 203(k) Rehabilitation Loans

• Administration for Community Living – Resources for seniors and people with disabilities

State & Local Resources

• Medicaid Waiver Programs

• State Housing Finance Agencies

• Local Community Development Grants

Non-Profits

• Rebuilding Together

• National Multiple Sclerosis Society

• USAging

At Accessible Living Atlanta, we regularly work with families who need:

✔ Barrier-free showers

✔ Wheelchair ramps

✔ Wider doorways

✔ Safer bathroom layouts

✔ Improved entry access

We also collaborate with Occupational Therapists to help provide the documentation often required for grant applications.

The need for accessibility is growing. The funding options are out there. The key is knowing where to look — and having the right team to guide you.

The resources shown in this post are certainly not all that may be available. For additional information, please call us at 770-301-8165 , or email at info@alatlanta.com .

If you serve seniors, individuals with mobility challenges, or families navigating discharge planning, we’re happy to be a resource.

�� 770-301-8165 ��

www.alatlanta.com

Underpaid and under pressure: The eldercare workforce leading America's job growth

Fri, 13 Feb 2026 14:00:04 GMT

The fastest-growing U.S. jobs are in homes and nursing facilities, caring for an aging population. But worker shortages and policy threaten the pipeline.

The U.S. added 130,000 jobs in January, according to federal data released this week. But a closer look shows that the lion's share of this growth came from one specific task: caring for older Americans.

Grouped under the formal categories of "social assistance" and "healthcare," at-home care services, hospitals and long-term care facilities added 124,000 positions.

Much of this expansion was among the tens of thousands of aides and assistants who help elderly and disabled people bathe, dress, eat and manage their daily lives. Their work is essential — and booming — but it is also physically demanding and often modestly paid.

The trend underscores a broader shift underway in the American labor market. While recent headlines suggest that employment in the U.S. is resilient, much of today’s job growth is not in the corporate offices or on the factory floors that have traditionally powered economic expansion. It is concentrated instead in labor-intensive care and service-based roles.

As the country ages, demand for long-term care is projected to keep rising. At the same time, immigration restrictions, falling birth rates and sweeping Medicaid funding cuts are narrowing the pipeline of workers willing, or able, to fill these roles.

Low pay, high demand

Health care spans some of the highest-paid professions in the country. Surgeons can earn more than $450,000 annually , data from the federal Bureau of Labor Statistics shows. But physicians are not the people driving the surge in health care work that amounted to more than 700,000 new jobs last year.

Nationwide, nearly 4 million people, most of them women, work as home health or personal care aides, per the BLS. Another roughly 1.5 million work as nursing assistants.

Pay for many of these roles remains modest. Home health and personal care aides earn a median of about $16.82 an hour, or roughly $35,000 a year. By comparison, the federal poverty level for a family of four is $32,150.

Nursing assistants earn a median of about $19.84 an hour, or roughly $41,000 annually. Both figures sit well below the national annual median wage of $49,500.

“When we talk about the direct care workforce, we’re talking about people who are providing typically long-term care services to older adults and younger people with disabilities,” Priya Chidambaram, senior policy manager at KFF , a nonpartisan health policy research organization, told NBC News in an interview.

The direct care workforce is overwhelmingly female, about 87%, and more than a quarter are immigrants. Roughly 11% are noncitizen immigrants and 17% are naturalized citizens, according to KFF’s analysis of federal data. About 40% of workers are at least 50 years old. Care at home is even more dependent upon immigrants, with around 1 in 3 home health workers foreign-born.

Many enter the field after caring for a family member at home.

“We see some people entering the workforce just from their own personal experience,” Chidambaram said. Others want to work in health care, but encounter financial or educational hurdles that make a shorter certification program for a direct care role more attainable than a nursing degree.

Training requirements vary by state. Nursing assistants typically complete certified nurse aide training, while home health and personal care aides often take short certification courses. Roughly half of direct care workers have a high school education or less.

Despite relatively low educational barriers, the work itself is anything but easy.

“It’s emotionally and mentally and physically demanding work,” Chidambaram said. “The financial benefits associated with the work don’t meet up with the demands of the work itself.”

Alyssa Crockett, a licensed practical nurse (LPN) currently working in long-term care, described the reality on the ground in a social media post: “We cannot do everything. It’s so messed up. My 12-hour shift? I get 25 minutes per person. … How is this possible?”

“I’m truly at the point of realizing that I’m going to lose my nursing license working in long-term care,” she continued, “which sucks, because it’s my entire heart. We need to do better.”

Not surprisingly, turnover within the profession is high. Studies show annual turnover among nursing assistants can approach 100%, and home care roles see turnover rates of around 75% , reflecting both burnout and unstable hours.

An aging population

The strain on this workforce is building at the very moment the country needs it most.

The share of Americans ages 65 and older is projected to reach over 20% by 2035 , meaning roughly 1 in 5 Americans may require some form of care. Baby boomers are moving deeper into their 70s and 80s , and more older adults say they want to age at home rather than in institutional settings.

“All these things are combining to create this inevitability that there will not be enough of a workforce to meet the demands of an aging population,” Chidambaram said.

Immigration policy adds another layer of uncertainty. Visa categories typically used by highly specialized workers, such as H-1B, are less common for these roles. Instead, employment-based immigrant visas and temporary protected status (TPS) holders are more likely to be represented, though detailed visa breakdowns are not publicly available.

The Trump administration has tightened pathways for legal immigration , including pausing or restricting some employment-based immigrant visas and ending TPS designations for several countries that have historically been the source of large numbers of care workers in American facilities.

This raises questions about how future staffing needs will be met: “This workforce will be heavily impacted by federal policy as a result of immigration changes,” Chidambaram said.

Medicaid, which pays for the majority of long-term care services in the United States, also plays a central role. Cuts to the program — including approximately $1 trillion in reductions passed in recent legislation — could ripple through agencies that employ aides and nursing assistants.

Reduced funding would likely squeeze the workers themselves. The most probable outcome is that “direct care workers are going to be paid less somehow,” said Chidambaram.

While some economists have questioned whether an economy so dependent on elder care could eventually face a demographic drop-off once the baby boom generation passes, researchers say the more immediate risk is the opposite: not having enough workers to meet the coming waves of demand.

“We have this growing demand, and it sounds like the supply is going to reduce pretty significantly over the next few years,” Chidambaram said, noting that the workforce serves not only aging Americans but also younger people with disabilities who rely on long-term care.

It’s a strain that’s already building — and one that will not fade quickly. As Chidambaram put it: “It’s going to impact us for the next 30 years.”

Home Accessibility is Not Just About Seniors

Sat, 07 Feb 2026 17:42:50 GMT

When people hear “home accessibility,” they often think it’s only for older adults.

But the reality is — accessibility supports people of all ages .

Every day, we help individuals and families navigating:

✅ Injuries from accidents or work-related incidents
✅ Chronic illness that affects strength, balance, or stamina
✅ Neurological conditions impacting mobility or coordination
✅ Temporary mobility challenges after surgery or hospitalization

Accessibility isn’t about age — it’s about function, safety, and independence.

Here’s what thoughtful home modifications can provide:

✔ Safer bathrooms with zero-threshold showers and grab bars
✔ Smooth flooring and zero-threshold transitions for easier movement
✔ Accessible entryways with ramps or lifts
✔ User-friendly kitchens with reachable cabinets and layouts
✔ Reduced fall risk and daily strain

At Accessible Living Atlanta, we design safe, accessible, user-friendly homes that support recovery, independence, and aging in place — whether needs are temporary or long-term.

Accessibility doesn’t label people. It empowers them.

Why Home Accessibility + Occupational Therapy Is a Powerful Partnership

Sat, 07 Feb 2026 15:48:19 GMT

When families explore home modifications, they aren’t just comparing services.

They’re looking for reassurance, safety, and confidence .

That’s where collaboration with an Occupational Therapist (OT) makes a meaningful difference.

At Accessible Living Atlanta, we believe home accessibility works best when clinical insight meets construction expertise .

Here’s why this partnership matters:

✅ OTs evaluate how people actually live in their homes — not just floor plans
✅ They assess balance, strength, cognition, and daily routines
✅ They help identify fall risks before they become emergencies
✅ They guide solutions based on real functional needs

This allows us to design safe, accessible, user-friendly homes that truly support:

✔ Aging in place
✔ Recovery after injury
✔ Independence and dignity
✔ Long-term safety

Working alongside an OT also builds trust with families and referral partners because it shows:

�� Evidence-based decision making
�� Safety-first planning
�� Respect for professional expertise

The result? Fewer mistakes, better outcomes, and homes that genuinely work for the people living in them.

Home accessibility and Occupational Therapy aren’t separate services — they’re a perfect partnership .

Here’s a proven way to slow aging. Any volunteers?

Thu, 05 Feb 2026 19:31:33 GMT

New research shows that you can lengthen your own life by improving someone else’s.

https://www.washingtonpost.com/health/2026/01/30/seniors-volunteering-health-benefits/

6 Daily Habits for Aging Well — and How Your Home Can Help

Wed, 04 Feb 2026 20:55:57 GMT

Harvard neurologist Rudolph E. Tanzi emphasizes six daily habits that support brain health and slow aging:

sleep, stress management, social connection, exercise, learning, and healthy eating.

What’s often overlooked?

Your home environment plays a powerful role in supporting every one of these habits.

Here’s how home accessibility connects the dots:

�� Better sleep starts with safer bedrooms and bathrooms (zero-threshold showers, good lighting, reduced fall risk).
�� Lower stress comes from a home that’s easy to navigate — no steps, tight doorways, or daily obstacles.
�� Social connection is easier when entryways are accessible and guests can visit comfortably.
�� Exercise & movement improve when flooring is smooth, transitions are zero-threshold, and stairs are addressed with ramps or lifts.
�� Learning new things happens best in spaces that feel safe and supportive.
�� Healthy eating is more achievable with user-friendly kitchens , including lowered cabinets and accessible layouts.

At Accessible Living Atlanta, we see every day how thoughtful home modifications support aging in place, independence, and dignity — not just safety.

Because accessibility isn’t just about construction.

It’s about creating an environment that supports healthy living at every stage of life

Why Working with an Occupational Therapist Sets Us Apart

Tue, 27 Jan 2026 21:22:22 GMT

At Accessible Living Atlanta, home modifications aren’t just construction projects — they’re personalized solutions designed around how people actually live.

One of the ways we deliver better outcomes for our clients is by working closely with a consulting Occupational Therapist (OT) who supports many of our projects.

This partnership provides a powerful advantage that many contractors simply don’t offer.

Here’s why it matters:

�� Professional Functional Assessments – An OT evaluates how clients move through their home, identifying risks and opportunities for improvement that may not be obvious to families or builders alone.

�� Client-Centered Design – Recommendations are based on real-life activities such as bathing, cooking, dressing, and mobility — ensuring modifications support independence and dignity.

�� Fall Prevention & Safety Planning – The OT helps prioritize solutions that reduce fall risk and improve long-term safety.

�� Better Outcomes – By combining clinical insight with construction expertise, we create homes that truly work for each individual — not one-size-fits-all solutions.

�� Peace of Mind for Families – Clients know their home modifications are guided by both healthcare and construction professionals.

This collaborative approach allows us to design safe, accessible, user-friendly homes that support aging in place , recovery after injury, and long-term independence.

It’s not just about modifying homes — it’s about improving lives.

Accessibility Is About Everyday Living

Tue, 27 Jan 2026 19:52:45 GMT

When people hear “accessibility,” they often think of ramps or grab bars.

But true accessibility is much more than that.

It’s about how easily someone can move through their day.

It’s the little moments that matter most:

�� Reaching kitchen cabinets without strain

�� Entering the home safely and confidently

�� Showering without fear of slipping or falling

�� Moving from room to room without obstacles

�� Preparing meals comfortably and independently

These everyday activities shape quality of life. And when they become difficult, independence starts to fade.

�� Where Homes Commonly Fall Short

Many homes—especially older ones—were never designed for aging, recovery after injury, or mobility changes. Over time, families discover challenges like:

• Narrow doorways that restrict movement

• Bathrooms that feel unsafe

• Kitchens with counters and storage that are hard to reach

• Flooring transitions that create trip hazards

• Entryways with steps that become barriers

These aren’t flaws in the home. They’re signs the home needs to evolve with the people living in it.

��️ Turning Barriers Into Everyday Comfort

At Accessible Living Atlanta , we focus on real-life usability through thoughtful home modifications , including:

✔ Zero-threshold showers with grab bars for safer bathing

✔ Ramps and stairlifts for easy entry and multi-level access

✔ Hardwood flooring with smooth transitions for mobility devices

✔ Lowered kitchen cabinets for comfortable reach

✔ Wider doorways for walkers and wheelchairs

Each modification supports safety, dignity, and independence — while helping families continue aging in place .

�� Accessibility Means Freedom at Home

Accessibility isn’t about changing who you are.

It’s about changing the home to support your life.

With the right modifications, homes become safe, accessible, and truly user-friendly — empowering seniors and individuals with mobility challenges to live comfortably, confidently, and independently.

Sometimes the biggest transformation doesn’t come from one large project — but from many small improvements working together.

�� If you or someone you care about is beginning to notice everyday challenges at home, now is the perfect time to explore your options.

Because accessibility isn’t about construction —

it’s about everyday living .

Before You Modify: Questions to Ask First

Fri, 23 Jan 2026 18:40:28 GMT

Not every home modification project starts with construction — it starts with the right questions.

Before making accessibility changes, it’s important to understand the person, not just the home. At Accessible Living Atlanta, we guide families through thoughtful planning by asking:

�� What daily activities are hardest?

Is it bathing, entering the home, moving between rooms, or preparing meals?

�� What’s temporary vs. permanent?

Are these challenges due to surgery or injury recovery — or part of long-term aging or mobility changes?

�� What matters most to the client?

Independence? Safety? Privacy? Comfort? Remaining at home?

By starting with these questions, home modifications become personalized solutions, not one-size-fits-all fixes.

The result is a safe, accessible, and user-friendly home that supports dignity and independence — now and in the future. We listen to help you answer your questions. Reach out to us at 770-301-8165 , or info@alatlanta.com

What Most Homes Were Never Built For

Tue, 20 Jan 2026 01:43:48 GMT

Many of the homes we live in today were designed decades ago — for a very different stage of life. As a result, they often fail to support aging in place , mobility changes, or recovery after injury.

Here’s what most older homes were never built for:

�� Narrow doorways that can’t accommodate walkers or wheelchairs
�� Steps everywhere , from entryways to sunken rooms and stair-only access
�� Bathrooms designed for younger bodies , with tubs, low toilets, and slippery surfaces

These design limitations don’t mean a home is “bad” — they simply mean it needs to evolve with the people living in it.

At Accessible Living Atlanta , we specialize in home modifications that transform older homes into safe, accessible, and user-friendly spaces — without sacrificing comfort or dignity.

Accessibility isn’t about changing who you are — it’s about changing the home to support independence at every stage of life.

This Ramp Helped a Tucker Resident Remain Safely at Home

Wed, 14 Jan 2026 23:14:22 GMT

After a fall at work, a Tucker resident faced surgery, rehabilitation, and a difficult reality: returning home to a house he could no longer safely enter.

Steps at the front door became an immediate barrier. What should have been a moment of relief—coming home after rehab—was instead filled with frustration and uncertainty.

Our team at Accessible Living Atlanta designed and installed a custom ramp , restoring safe and reliable access in and out of the home. But accessibility didn’t stop at the front door.

To support long-term independence, we also completed key interior modifications:

A safer, user-friendly bathroom with improved access and stability
Bedroom modifications that supported mobility and daily routines
Kitchen adjustments that allowed him to prepare meals comfortably and independently

The result was more than a ramp — it was a home that worked with him, not against him.

This project is a reminder that home modifications are about restoring dignity, independence, and confidence — especially after life-changing injuries.

Preventing Hospital Readmission Starts at Home

Tue, 13 Jan 2026 12:00:01 GMT

Many hospital readmissions don’t happen because recovery failed — they happen because the home environment wasn’t ready.

After discharge, patients often return home with:

Reduced strength or balance
Temporary or permanent mobility challenges
New medical equipment
Increased fall risk

Quick, targeted home modifications can make a critical difference, including:

Grab bars and handrails
Temporary ramps or threshold solutions
Improved lighting and clear pathways
Bathroom safety upgrades

These timely changes help reduce falls, increase confidence, and support safer recovery — often preventing an unnecessary return to the hospital.

At Accessible Living Atlanta , we work with families and healthcare partners to create safe, user-friendly homes that support healing, independence, and dignity

Myths of Home Modification: What Families Should Know

Thu, 08 Jan 2026 06:42:42 GMT

There are many misconceptions around home accessibility and modification — and these myths often prevent families from planning ahead.

Here are a few of the most common myths we hear:

�� Myth: Medicare pays for home modifications
✅ Reality: Medicare generally does not cover accessibility upgrades.

�� Myth: Home modification is for everyone
✅ Reality: While it can be life-changing for many, some individuals simply don’t need it.

�� Myth: Renters can modify without approval
✅ Reality: Landlord consent is typically required.

�� Myth: Modifications look institutional
✅ Reality: Today’s designs are safe, discreet, and beautiful.

�� Myth: You should wait until there’s a crisis
✅ Reality: Proactive planning reduces risk and stress.

At Accessible Living Atlanta , we believe education is the first step toward independence and dignity at home.

Sometimes, the most meaningful construction projects don’t just change a house — they change a life.

Tue, 23 Dec 2025 20:48:04 GMT

At Accessible Living Atlanta , we recently worked with a client whose world changed overnight after a serious injury. What was once a comfortable, familiar home quickly became a place filled with obstacles and uncertainty.

�� The Challenge

After the injury:

Steps at the front door became a daily barrier
Narrow doorways made mobility equipment difficult to use
The bathroom — once routine — felt unsafe and stressful
Simple daily tasks began to require assistance

The biggest concern for the family wasn’t just convenience — it was whether their loved one could continue living at home at all .

��️ Our Approach: Thoughtful, Purpose-Driven Modifications

Rather than a one-size-fits-all solution, we focused on safety, independence, and dignity .

Here’s what we implemented:

✔ Zero-threshold shower with seating and strategically placed grab bars
✔ Widened doorways and pathways for smooth wheelchair navigation
✔ A custom entry ramp , eliminating dangerous steps
✔ Design elements that blended seamlessly into the home — not institutional, but comfortable and welcoming

Every modification was intentional. Every detail mattered.

�� The Result: More Than Accessibility

The transformation went far beyond construction.

�� Independence was restored
�� Confidence returned to daily routines
�� Caregiver stress was reduced
�� Peace of mind replaced worry

Most importantly, the home once again felt like home — not a limitation, but a place of possibility.

�� Why This Matters

At Accessible Living Atlanta, we believe:

Accessibility isn’t about giving something up —
it’s about gaining freedom, safety, and dignity.

Every ramp, every grab bar, every widened doorway is a pathway back to independence.

�� If you know someone struggling to remain safe at home, we’d be honored to help them explore solutions that support aging in place — comfortably and confidently.

When the Holiday Visit Becomes a Wake-Up Call

Tue, 23 Dec 2025 05:33:34 GMT

Holiday gatherings often bring more than memories.

For many adult children, they quietly reveal challenges Mom or Dad may be facing every day — alone.

During visits, families often notice:
✔ Difficulty stepping into the shower
✔ Hesitation on stairs or entryways
✔ Dim lighting and hidden fall risks
✔ Narrow doorways and cluttered walkways
✔ A parent working harder just to stay independent

These signs are easy to miss from a distance — but impossible to ignore in person.

�� Here’s the good news:
Home modifications can dramatically improve safety, independence, and peace of mind — without requiring a move.

✔ Zero-threshold showers
✔ Grab bars & safer bathrooms
✔ Improved lighting
✔ Wider, safer pathways
✔ Easier home entry access

The holidays often spark an important realization:
A safer home can help loved ones continue aging in place — confidently and with dignity.

Nearly 1 in 4 Americans Say the U.S. Health Care System Is in Crisis — and the Home Is Becoming a Safer Haven

Wed, 17 Dec 2025 13:45:54 GMT

Nearly one-quarter of Americans say the U.S. health care system is in a state of crisis , according to a recent Gallup poll, with high costs cited as the most urgent national health concern. The perception spans party lines, with majorities of Democrats and Republicans agreeing the system has serious problems.

While many Americans technically have health insurance, affordability remains a major barrier. Rising premiums, deductibles, and out-of-pocket expenses are forcing people to delay or avoid care , increasing the likelihood that manageable conditions turn into serious medical emergencies. For many families, a single fall, injury, or unexpected illness could result in overwhelming medical bills.

As concerns about cost and access continue to grow, more Americans are looking for ways to reduce health risks before medical intervention is required. One increasingly important solution is creating a safer home environment .

Home modifications can reduce health-related risks by helping prevent falls, injuries, and accidents—some of the leading causes of emergency room visits among seniors and individuals with mobility challenges. These preventive measures often cost far less than hospitalization, rehabilitation, or long-term care.

Simple improvements such as zero-threshold showers, grab bars, wider doorways, improved lighting, and safer entrances can make everyday activities safer and more manageable. These changes allow individuals to age in place , maintain independence, and rely less on an already strained and expensive health care system.

In a time when Americans increasingly view health care as costly and uncertain, the home is emerging as a critical part of the solution—offering safety, independence, dignity, and peace of mind when it matters most.

Caregiver Spotlight: Supporting Independence Through Accessibility

Thu, 11 Dec 2025 08:53:45 GMT

Caregivers play a crucial role in helping seniors and individuals with mobility challenges remain safe and independent at home. And while home modifications benefit the person living there, they also make life safer and less stressful for caregivers.

Thoughtful accessibility features — wider doorways, zero-threshold showers, ramps, grab bars, non-slip flooring, and even smart-home tools — lighten the physical and emotional load placed on caregivers every day.

At Accessible Living Atlanta , we see firsthand how the right modifications:

�� Reduce lifting and strain for caregivers

�� Improve safety for everyone in the home

�� Support independence and dignity for loved ones

�� Create smoother daily routines for families

A safer home doesn’t just empower the individual — it empowers the entire care network that supports them.

�� We’re proud to partner with caregivers, families, and healthcare professionals to make aging in place possible.

Technology & Accessibility: How Smart Homes Support Independence

Tue, 09 Dec 2025 01:05:27 GMT

Smart home technology is transforming how seniors and individuals with mobility challenges live safely and independently. When paired with professional home modifications , these tools create a powerful system for aging in place with confidence.

Key examples include:

�� Voice assistants that control lights, thermostats, and devices hands-free

�� Motion-sensor lighting that automatically illuminates halls and bathrooms to prevent falls

�� Video doorbells & smart locks that enhance safety and allow remote access for caregivers

These technologies reduce reliance on others, improve daily safety, and provide peace of mind for families and caregivers.

At Accessible Living Atlanta , we design safe, accessible, and user-friendly homes that integrate both traditional accessibility solutions and modern smart technology .

#TechnologyAndAccessibility #SmartHome #AgingInPlace #HomeModifications #AccessibleLiving #SafeHomesForSeniors #MobilitySolutions

Workers’ Compensation & Home Accessibility: Planning for Safety After an Injury

Mon, 08 Dec 2025 07:21:32 GMT

When someone is injured on the job, the focus is often on medical recovery — but what happens when returning home brings new challenges?

For many, workers’ compensation benefits can help cover essential home modifications that restore safety, accessibility, and independence.

These upgrades may include:

�� Zero-threshold showers for safe, independent bathing.

�� Ramps or platform lifts for easy access to entries and exits.

�� Wider doorways and open floor plans for wheelchair navigation.

�� Grab bars, handrails, and non-slip flooring for fall prevention.

A work-related injury can change how someone moves through their home — but with the right support, it doesn’t have to limit how they live.

At Accessible Living Atlanta , we’ve helped many families work with insurance and workers’ comp programs to create safe, user-friendly homes that promote healing, comfort, and confidence — inside and out.

�� If you know someone adjusting to life after an injury, we can help them explore how workers’ compensation may fund the modifications they need.

Emergency Exits Save Lives — But Are They Accessible?

Wed, 03 Dec 2025 06:29:03 GMT

When a fire or emergency strikes, seconds matter. For someone who is wheelchair-bound, uses a walker, or struggles with mobility , getting out of the home can become nearly impossible without proper planning and modification.

In Georgia, building codes require at least one operable emergency exit , and most homes include two egress points so one can serve as a backup if the other is blocked.

But here’s the challenge:

If both exits have steps…
If doorways are too narrow…
If there’s no clear, safe path outside…
If the threshold is too high for a wheelchair…

Those exits aren’t truly accessible.

✔ Common Barriers We See:

High thresholds
Narrow doors
Multiple steps at all exits
No ramp access
Obstacles in the egress path
Heavy exterior doors difficult to operate

✔ Home Modifications That Change Outcomes:

Zero-threshold exterior doors
Ramps or modular ramp systems
Widened doorways
Smooth, slip-resistant paths to safe areas
Vertical platform lifts (when terrain prevents ramp installation)
Reinforced grab bars at exit points

An emergency is not the time to discover a home’s limitations.

Planning ahead means safety, dignity, and peace of mind for families and caregivers.

�� 770-301-8165 | �� www.alatlanta.com

FROM GARDEN TUB TO TRUE INDEPENDENCE – Woodstock, GA Renovation

Tue, 02 Dec 2025 07:35:53 GMT

This client in Woodstock, GA became wheelchair bound and could no longer access her traditional garden tub . Bathing safely was impossible — until we stepped in to redesign the space for safety, mobility, dignity, and future care planning .

�� Key Project Modifications:

✔ Removed the full garden tub
✔ Installed a zero-threshold / barrier-free shower
✔ Created additional open floor space for wheelchair maneuverability
✔ Added built-in shower seat & handheld shower attachment
✔ Installed multiple grab bars , including front-wall placement
✔ Used non-slip flooring throughout
✔ Modified the cabinet & sink for roll-under wheelchair access
✔ Widened the powder room door to allow easy entry
✔ Expanded the overall bathroom layout for future caregiver assistance
�� Outcome:

The client can now bathe independently, safely, and without assistance. The bathroom is also now designed to accommodate a caregiver in the future , ensuring long-term accessibility and dignity.

“I never thought I’d be able to bathe on my own again — this changed my life.”

�� 770-301-8165 | �� www.alatlanta.com

Room of the Month Spotlight – Exterior Home Access

Wed, 26 Nov 2025 04:48:12 GMT

The entrance to a home sets the tone for safety, dignity, and independence.

As mobility changes, steps and narrow entryways become major barriers — but with the right home modifications, safe entry can be restored without relocation.

�� Exterior Access Solutions

Ramps & step reduction
Vertical platform lifts
Stair lifts on sloped entries
Widened entry doors
Non-slip walkways with handrails

�� Ideal for:

Seniors aging in place
Wheelchair & walker users
Balance or mobility issues
Stroke & injury recovery
Caregivers who assist with daily access

At Accessible Living Atlanta, we create safe homes for seniors and individuals with physical challenges — starting right at the doorstep.

One Small Change — Who Benefits Most?

Tue, 25 Nov 2025 07:27:20 GMT

Even a single modification — a grab bar, roll-under sink, or zero-threshold shower — can dramatically impact someone’s ability to live safely and remain independent.
The people who benefit most are:
�� Seniors choosing to age in place
�� Individuals using mobility devices
�� Adults recovering from stroke, injury, or surgery
�� People with arthritis, neuropathy, Parkinson’s, or balance issues
�� Caregivers who need safer environments to provide support

Thoughtful home modifications promote confidence, dignity, safety, and long-term independence.

At Accessible Living Atlanta, our mission is simple:
Make homes safer so people can live better.

Adult Child Worried About Their Parent

Thu, 20 Nov 2025 17:12:07 GMT

“I’m starting to worry about my mom more than she knows. She still wants to live at home and stay independent — but I’ve noticed small things… she holds the wall when walking down the hall, steps very carefully into the tub, and avoids the stairs when she’s alone. I know she wants to age in place — but I need to know she’s safe.

That’s why we’re looking into home modifications. A zero-threshold shower, grab bars, widened doorways, better lighting — these changes may seem small, but they mean everything when it comes to safety, dignity, and independence.

I just want her to feel confident at home — without losing the place she loves the most.”

At Accessible Living Atlanta , we help families create safe homes for seniors with accessible bathrooms, zero-threshold showers, roll-under sinks, fall prevention solutions, and thoughtful aging in place strategies.

Because home should be a place of independence — not worry. ��

Long-Term Care Insurance: An Overlooked Resource for Home Modifications & Aging in Place

Tue, 18 Nov 2025 04:51:35 GMT

For individuals planning to age in place , Long-Term Care Insurance (LTCI) can play a critical role in maintaining safety, independence, and quality of life.

While many assume LTCI only applies to nursing homes, most modern policies offer significant benefits for:

• Home modifications (zero-threshold showers, ramps, grab bars, accessible bathrooms)

• In-home care services

• Assisted living options

For adults in their mid-50s , exploring LTCI is particularly beneficial. This age range often offers the best combination of lower premiums and good health — increasing the likelihood of approval.

At Accessible Living Atlanta , we routinely work with families using their LTCI benefits to fund modifications that reduce fall risk, enhance accessibility, and extend independence.

LTCI is more than a policy — it’s a long-term investment in safety, dignity, and the ability to remain in the home you love.

Universal Design: Built for Everyone, Benefiting Everyone

Mon, 17 Nov 2025 01:06:44 GMT

The term “ Universal Design ” might sound technical — but its purpose is simple: to make life easier, safer, and more independent for everyone, regardless of age or ability.

From zero-threshold showers to wider doorways, accessible vanities, and smart lighting , Universal Design creates spaces where you can move freely, live confidently, and age in place gracefully.

At Accessible Living Atlanta , we apply these principles in every project — helping seniors and those with physical challenges stay independent and thrive in their own homes.

�� Safety. Comfort. Dignity. Independence.

�� (770) 301-8165 | �� www.alatlanta.com

Aging and Independence: What Home Modifications Can Do

Wed, 12 Nov 2025 04:10:49 GMT

For most older adults, the greatest fear of aging isn’t the number of candles on a cake — it’s the loss of independence.

Driving, bathing, cooking, and moving freely are daily activities that define confidence and self-worth. But without proper accessibility, those same activities can become stressful — or even dangerous.

That’s where home modification meets empowerment .

From zero-threshold showers and widened doorways to accessible kitchens and grab bars , today’s design solutions make it possible for seniors to remain at home longer — safely, comfortably, and with dignity.

At Accessible Living Atlanta , we specialize in creating functional, beautiful spaces that allow people to age in place without compromise.

✅ Safer mobility for walkers and wheelchairs

✅ Bathroom and entryway accessibility

✅ Smart design for long-term independence

Let’s make every home a place where aging means thriving.

�� www.alatlanta.com | �� (770) 301-8165

What to Know Before Moving An Aging Relative Into Your Home

Sat, 08 Nov 2025 15:11:03 GMT

If you have an aging relative, particularly a parent or parents, you might consider whether or not it’s the right time to have them move in with you. Having your parents move in can give you peace of mind, help keep them from feeling lonely, and if you have children, they might also be able to help with their care.

At the same time, it’s not without possible pitfalls. As people age, they’re more prone to slip and fall accidents, so you may have to make modifications to your home. You also have to consider whether you’re ready for such a long-term commitment, which would undoubtedly be a lifestyle change for your family.

The following are considerations to keep in mind before you make this big decision.

Checklist for Moving Elderly Parents Into Your Home

What Level of Care Will Your Aging Parent Need?

If your parents are in their 60s or even their 70s and relatively healthy, they might be able to come into your home and contribute to how things operate from day to day. However, if your parent is older or struggling with a mental or physical health condition, you’ll have to think about the level of care they might need and whether you’re able to provide that.

If you work full-time, having someone move in who’s entirely or nearly wholly dependent on you may not be feasible. You might have to manage medications, help them with daily tasks like bathing or getting dressed, and take them to and from appointments.

Are you able to manage your parents’ physical limitations or chronic illnesses? How much assistance can you realistically provide?

What’s Your Relationship with Your Aging Parents Like?

If you have a strained relationship with your parents, you may think having them move in with you now that they’re older could help things. The reality is that’s not always the case.

If you don’t get along well with your parents, or you often have conflicts when you’re together, this will not only affect you but also other people who live in your home, including your children.

Your mental wellness and your spouse and children are essential, even if you feel obligated to have your parents move in. Be honest with yourself about whether or not you can live together peacefully.

Preparing for Elderly Parent to Move In

Even relatively healthy older people may be more likely to fall and get into accidents around the house. If you have stairs, how would that affect your aging parents?

Would you have to make modifications to make your home livable for your parents now or in the future? If so, how will you cover those costs?

If you’re going to give your parents a bedroom in your home, is it accessible based on their mobility needs? Is there a bathroom nearby? Would this force someone else in your family to give up their space? How much privacy could you all have?

Managing Expenses

An inevitable part of this conversation is how you’ll manage expenses. If both parents move in, you’re bringing one or two more people into your home—which is costly.

Statistics indicate families spend more than $10,400 a year on care for older parents when they live with them. Additionally, more than 70% of caregivers miss time from work, which can financially impact you.

Can your parents contribute to expenses? Do you have other relatives who can help with the cost of care?

How Does the Rest of Your Family Feel?

From your siblings to your spouse and children, how does everyone feel about a potential move for your aging parents? Try to talk to everyone one-on-one.

A big priority will be how your kids feel—if they’re apprehensive or unsure, listen to why. Is your spouse supportive? What is their relationship like with your parent? Is this something your parent is even open to?

Overall, being a caregiver can be challenging, as can living in a multigenerational household in general. You will have to weigh many factors, but be truthful with yourself about what the situation might entail instead of only painting a rosy picture in your mind.

Designing Multi-Generational Homes: Accessibility for Every Age

Sat, 25 Oct 2025 14:01:56 GMT

Today’s families are changing — more generations are choosing to live to gether under one roof. Whether it’s parents moving in with adult children or families supporting loved ones who are physically challenged, designing homes that are both beautiful and functional has never been more important.

At Accessible Living Atlanta , we specialize in home modification that blends style, home accessibility , and long-term safety. Our multi-generational designs support comfort for everyone — from to ddlers to grandparents — by including features like:
�� Step-free entries and wider doorways
�� Accessible bathrooms with zero-threshold showers
�� Subtle grab bars that match modern finishes
�� Smart lighting and non-slip flooring
�� Flexible kitchen designs for seated or standing use

Creating safe homes for seniors and accessible spaces for those who are physically challenged doesn’t mean sacrificing beauty. It means planning for independence, safety, and aging in place — while keeping your home’s aesthetic intact.

�� Accessible Living Atlanta – Designing homes where all generations feel at home.

Designing for Dignity: Accessibility That Looks Beautiful

Fri, 17 Oct 2025 04:20:30 GMT

When many people think of home modifications, they picture bulky ramps, hospital-style grab bars, or clinical spaces. But modern accessibility has evolved. Today, it’s about designing for dignity —creating spaces that are functional, beautiful, and inviting.

At Accessible Living Atlanta , we understand that your home reflects your personality, comfort, and pride. We also know that at some point, you may wish to sell your home. With that in mind, our goal is to design modifications that have the “wow factor” —so that future buyers see both the functionality and the beauty of your space.

Our barrier-free showers, low-profile ramps, stylish grab bars, and open, well-lit layouts are crafted to complement your home’s architecture while improving accessibility for years to come.

Because accessibility should never look out of place—it should enhance your home’s appeal, safety, and long-term value. ��

�� Accessible Living Atlanta – Where safety meets style, and design meets dignity.

Hidden Barriers in the Home You Might Not Notice — Until You Need To

Wed, 15 Oct 2025 18:22:28 GMT

For many homeowners, safety hazards aren’t always obvious. But for seniors, individuals with mobility challenges, or those recovering from surgery or injury, the smallest details can become major barriers.

At Accessible Living Atlanta , we often find that “hidden obstacles” are the very things that cause the most difficulty — or lead to falls — such as:

�� Narrow doorways that restrict wheelchair or walker access

�� Poor lighting in hallways or bathrooms

⚡ Outlets or switches placed too low or too high

�� Showers with a small step-over lip that can cause tripping

�� Low toilets or chairs that make standing difficult

These are things most people overlook until mobility changes make them impossible to ignore.

A home doesn’t have to look unsafe to be unsafe. A few thoughtful modifications can eliminate those hidden barriers — and restore comfort, confidence, and independence.

��  Accessible Living Atlanta – Helping families discover and remove the hidden barriers that stand between them and safer living.

Preparing the Home Before Surgery or Rehab: Planning Ahead for Safety and Independence

Sat, 11 Oct 2025 14:47:42 GMT

Preparing the Home Before Surgery or Rehab: Planning Ahead for Safety and Independence

Recovering from a surgery—such as a hip or knee replacement—or returning home after rehab can be a major adjustment. The good news is that much of the stress can be reduced with proper home preparation ahead of time.

At Accessible Living Atlanta , we often meet families after a fall or hospital stay, but we want people to know— home modifications are most effective when done before the need becomes urgent.

Here’s what pre-surgery planning might include:
✅ A zero-threshold shower to prevent tripping or loss of balance
✅ Grab bars near the toilet, shower, and bed for stability
✅ Ramps or stair lifts for safe access in and out of the home
✅ Wider doorways and open pathways for walkers or wheelchairs
✅ Proper lighting to eliminate shadows and hazards

By addressing these areas before returning home, recovery becomes smoother, safer, and less stressful for both patients and caregivers.

Because when the home is ready, recovery feels possible. ��

�� Accessible Living Atlanta – Preparing homes for safer, easier recoveries across metro Atlanta.

The Psychology of Home Accessibility: Beyond Safety, Toward Peace of Mind

Wed, 08 Oct 2025 17:48:21 GMT

When we think about home modifications, most people picture ramps, grab bars, or wider doorways. Those are all important features—but the real transformation happens on the inside.

Accessibility isn’t just about preventing falls or creating convenience. It’s about restoring confidence, reducing fear, and nurturing emotional well-being for seniors and their families.

We’ve seen this time and again at Accessible Living Atlanta. When a senior feels anxious about moving through their home—worrying about each step or struggling to get into the shower—it impacts their independence and quality of life. Once those barriers are removed, something powerful happens: peace returns.

Home modifications give back control, dignity, and comfort.

A bathroom designed for safe entry. A kitchen that allows easier reach. A hallway that’s bright and open. These changes allow individuals to relax and enjoy daily life again without fear.

It’s not just about building accessibility—it’s about rebuilding confidence.

Because a truly accessible home provides more than safety—it offers peace of mind, freedom, and the ability to keep living life on one’s own terms.

�� Accessible Living Atlanta – Creating homes that support independence, comfort, and dignity for over 20 years.

Taking the Stress Out of Home Modifications

Tue, 30 Sep 2025 18:54:40 GMT

For many senior citizens and their adult children, the idea of home modifications can feel overwhelming. Health challenges and mobility concerns are already stressful enough, and the thought of making changes to the home can seem like one more burden. But the reality is—home modifications don’t have to be stressful.

At Accessible Living Atlanta, we’ve designed our process to be simple, transparent, and focused on your needs. Here’s how it works:

Step 1: A Free Home Assessment

With just a phone call or email, we’ll schedule a convenient time to visit your home. During this FREE assessment , we evaluate your living space and identify changes that can make your home safer, more comfortable, and easier to navigate.

Step 2: A Personalized Proposal

After the assessment, we create a custom proposal based on your specific needs. Whether it’s a zero-threshold shower, widened doorways, ramps, or other modifications, our recommendations are tailored to help you stay independent and safe in your own home.

Step 3: Moving Forward—Only If You’re Ready

If you approve the proposal, we schedule the work at a time that fits your needs. If you choose not to move forward, there’s no obligation . The decision is always in your hands.

What to Expect

Some modifications are quick and straightforward. Others may be more complex and take longer. In every case, we work as efficiently as possible while keeping quality our top priority.

Throughout the process, our focus remains on your comfort, safety, and satisfaction . We strive not just to meet your expectations, but to exceed them.

The Goal: A Home That Works for You

Whether you’re a senior adjusting to new mobility challenges or an adult child helping a loved one, our goal is to make the home more “user-friendly.” These changes don’t just improve safety—they enhance quality of life , reduce daily stress, and allow you or your loved one to remain in the comfort of home for years to come.

�� Accessible Living Atlanta – Helping you stay safe, independent, and comfortable at home.

Technology & Accessibility: Smart Solutions for Aging in Place

Wed, 17 Sep 2025 08:44:01 GMT

Technology is no longer a luxury or a trendy upgrade — it’s becoming one of the most powerful tools for helping seniors and those with physical challenges live safely and independently in their own homes.

At Accessible Living Atlanta, we see every day how traditional modifications—like zero-threshold showers, widened doorways, and ramps—are even more effective when paired with the right smart-home technology. Here are a few of the solutions making the biggest impact:

�� Voice-Activated Assistants & Smart Speakers – Simple voice commands can turn on lights, adjust thermostats, or lock doors. For someone with limited mobility or arthritis, this means more independence and less reliance on caregivers for everyday tasks.

�� Motion-Sensor Lighting – Hallways and bathrooms automatically light up when someone enters, dramatically reducing the risk of nighttime falls.

�� Video Doorbells & Smart Locks – Whether it’s a caregiver arriving or a package delivery, residents and family members can see who’s at the door and unlock it remotely, providing both security and convenience.

�� Telehealth & Remote Monitoring – Wearable devices or smart sensors can alert family members or healthcare providers if a fall occurs, or even track vital signs for ongoing health management.

When thoughtfully integrated, these tools create a living environment that is not only safe and functional, but also empowering. Aging in place should mean living with dignity, and technology—when combined with our carefully planned modifications—makes that possible.

�� Which smart-home upgrade do you think would make the biggest difference for your family or clients?

Aging with Dignity: More Than Just Home Modifications

Sat, 30 Aug 2025 17:53:07 GMT

As we grow older, our homes should continue to be a source of comfort, safety, and independence. Yet, for many seniors and individuals with physical challenges, the home they love can become a place of worry and limitation. That’s where thoughtful home modifications come in.

At Accessible Living Atlanta, we believe accessibility is not just about functionality — it’s about preserving dignity and independence.

A grab bar in the bathroom isn’t just a safety feature; it restores confidence, removing the constant fear of slipping or falling.
A zero-threshold shower isn’t only a construction upgrade; it allows someone to bathe independently, maintaining privacy and daily routine.
A widened doorway isn’t simply about mobility; it ensures no one feels restricted from moving freely in their own home.
An accessible kitchen isn’t just cabinetry and design; it gives back the joy of cooking and gathering with family.

For over 20 years, our team has been creating solutions that are functional, safe, and beautiful. We understand that dignity is found in the little things — being able to dress without help, prepare a meal, or welcome friends at the front door.

Aging in place should not mean giving up comfort or independence. It should mean living fully, with confidence and peace of mind.

�� If you or someone you know is exploring ways to remain at home safely and gracefully, we’d be honored to be your trusted resource.

Best regards,

Creating Inclusive Homes: The Importance of Home Modifications for Seniors and Physically Challenged Individuals

Sat, 23 Aug 2025 15:54:51 GMT

As our population ages and awareness of accessibility grows, more families are looking for ways to make their homes safer, more comfortable, and more inclusive. For seniors and individuals with physical challenges, even the smallest obstacle—like a single step at the front door or a narrow bathroom doorway—can become a major barrier to independence.

That’s where home modifications come in. These changes, which can be as simple as adding grab bars or as comprehensive as redesigning entire spaces, transform houses into homes that support both safety and dignity.

In this article, we’ll explore why home modifications are so important, how they improve daily life, and how Accessible Living Atlanta has been helping families create safe, functional, and beautiful homes for over 20 years.

For individuals who use a wheelchair, the home should be a place of comfort, independence, and safety. Yet many houses are built with narrow doorways, high counters, steep steps, and other barriers that make daily life more challenging than it needs to be. At Accessible Living Atlanta, we believe those barriers can — and should — be removed.

We’ve spent over 20 years working with clients in the Atlanta area to transform their homes into spaces that work with them, not against them. The right modifications don’t just make a home more functional — they restore independence, reduce risk of injury, and give peace of mind to both the homeowner and their loved ones.

Below, we’ll explore how thoughtful, professionally designed modifications can make every room in a home wheelchair-friendly.

Enhancing Independence

Independence is one of the most valued aspects of life, especially as we age. Home modifications help preserve that freedom.

Ramps and lifts eliminate barriers at entrances, allowing wheelchair users or those with walkers to come and go freely.
Barrier-free showers with handheld showerheads and built-in seating make bathing a safe and private activity.
Wider doorways give mobility devices easy access to every room, so no part of the home feels “off limits.”

For many, these adjustments mean the difference between relying on constant assistance and enjoying everyday routines independently.

Promoting Safety

Falls are one of the leading causes of injury for older adults. Safety-focused home modifications address these risks head-on.

Grab bars in bathrooms and hallways provide stability where it’s needed most.
Non-slip flooring reduces the chance of slips in high-risk areas like bathrooms and kitchens.
Good lighting ensures stairs, hallways, and outdoor paths are easy to navigate.

These updates don’t just reduce accidents—they also provide peace of mind for family members who may worry about their loved one’s safety at home.

Supporting Aging in Place

Many seniors wish to remain in their own homes as they age, a concept known as “aging in place.” But doing so requires a home that can adapt to changing physical needs.

Strategic modifications—such as comfort-height toilets , zero-threshold showers , and accessible kitchens —make it possible to live safely and comfortably in a familiar environment for years to come.

Improving Caregiver Support

Home modifications also benefit caregivers.

A ceiling lift reduces the physical strain of transfers from bed to wheelchair.
An open floor plan makes it easier to maneuver equipment.
Accessible bathrooms allow for more independence, easing stress for both the caregiver and the individual receiving care.

These thoughtful updates foster healthier, more sustainable caregiving relationships.

Boosting Mental and Emotional Well-Being

When people feel safe and independent in their homes, their emotional health improves too. Modifications help reduce stress, anxiety, and frustration, and create an environment where individuals feel:

Confident in moving about their home.
Connected to family and community.
Positive about their ability to remain active and engaged.

Increasing Property Value

Accessible homes often appeal to a broader range of buyers. Features like ramps, widened hallways, and barrier-free bathrooms make properties more marketable.

Additionally, grants, veterans’ benefits, and insurance options may help offset the cost of modifications, making them a smart financial choice as well as a lifestyle improvement.

Customized Solutions for Every Home

No two people—or homes—are the same. That’s why modifications should always be tailored. An occupational therapist and accessibility professional can evaluate the home and recommend the best solutions, ensuring modifications are both functional and aesthetically pleasing.

Accessible Living Atlanta: Your Partner in Creating Inclusive Homes

For over 20 years, Accessible Living Atlanta has been helping families across the metro Atlanta area create homes that are not only functional but also welcoming and beautiful.

Our team specializes in:

Bathroom Modifications: Zero-threshold showers, grab bars, comfort-height toilets, and slip-resistant flooring.
Entry & Mobility Solutions: Wheelchair ramps, vertical platform lifts, widened doorways, and barrier-free entryways.
Kitchen Adaptations: Lowered cabinets and counters, accessible appliances, and layouts designed for seated use.
Whole-Home Accessibility: From hallways to bedrooms, we ensure every part of the home supports independence and safety.

What sets us apart is our experience and certifications . Co-owner Dennis Lippy, with over 40 years in construction and more than 20 years focused on accessibility, is CAPS (Certified Aging-in-Place Specialist) and CEAC (Certified Environmental Access Consultant) certified. Co-owner Trent Zumbrun brings deep expertise as a fourth-generation construction professional and serves as our senior project manager, ensuring every project runs smoothly from start to finish.

At Accessible Living Atlanta, we believe modifications should never feel clinical or institutional. Every change we make is designed to blend seamlessly with your home’s style while giving you the functionality you need.

Conclusion

Home modifications are about more than construction—they’re about creating inclusive living spaces that support safety, independence, and peace of mind.

Whether it’s a ramp, a zero-threshold shower, or a complete home redesign, these changes allow seniors and physically challenged individuals to thrive in the comfort of their own homes.

Accessible Living Atlanta is here to guide you every step of the way, from consultation to design to completion. Together, we can create a home that works for you—today and for years to come.

�� If you or a loved one is considering home modifications, reach out to us. Let’s create a safe, comfortable, and beautiful home that meets your needs

How Home Modifications Support Both Homeowners and Caregivers

Wed, 20 Aug 2025 09:05:47 GMT

Caring for a loved one is one of the most meaningful roles someone can take on. But it’s also one of the most physically and emotionally demanding. While much attention is often given to how home modifications benefit the person living with mobility challenges, what is often overlooked is how these changes can also make life significantly easier for caregivers.

At Accessible Living Atlanta, we’ve seen firsthand how thoughtful home design not only promotes independence for homeowners but also relieves stress, reduces physical strain, and provides peace of mind for the people who care for them.

Below, we’ll explore how thoughtful, professionally designed modifications can make every room in a home wheelchair-friendly.

Bathroom Modifications: Safer and Easier for All

Bathrooms are one of the most common areas where accidents occur—and one of the most challenging spaces for caregivers. Without modifications, assisting with bathing or toileting can require awkward lifts, balancing, or constant worry about falls.

With improvements such as curbless showers, strategically placed grab bars, and comfort-height toilets, everyday routines become safer and less stressful. These features mean fewer heavy transfers for caregivers and more dignity and independence for homeowners.

Entryways and Ramps: Removing Daily Obstacles

What seems like a small barrier—a step into the home—can actually be one of the biggest sources of stress for caregivers. Helping a loved one in a wheelchair or walker navigate stairs is physically demanding and potentially unsafe.

Ramps and zero-step entries remove that daily struggle. Instead of lifting, balancing, or worrying about trips and falls, caregivers can focus on simply getting in and out of the house with ease.

Room-by-Room Accessibility: Reducing Strain and Stress

The layout of a home plays a big role in the caregiving experience. Narrow doorways, tight hallways, or poorly placed furniture and appliances can make daily care exhausting.

By widening doorways, creating open layouts, and ensuring smooth transitions between rooms, caregivers spend less time straining and more time focusing on what matters most, supporting their loved one’s quality of life.

The Shared Benefits of Accessibility

When a home is designed with accessibility in mind, everyone benefits. Homeowners gain safety, independence, and confidence. Caregivers gain relief, reduced physical risk, and the freedom to focus on meaningful time together instead of constant physical strain.

At Accessible Living Atlanta, we believe that home modifications should be both functional and aesthetically pleasing—creating spaces where safety and dignity are built into the environment itself.

Home modifications aren’t just about the homeowner. They’re about creating a supportive, sustainable environment for caregivers, too.

If you’d like to learn more about how we can help transform your home into a safe and supportive place for you and your loved ones, reach out to Accessible Living Atlanta today.

Creating a Home Without Limits: How Home Modifications Support Wheelchair Users

Fri, 15 Aug 2025 06:12:14 GMT

Below, we’ll explore how thoughtful, professionally designed modifications can make every room in a home wheelchair-friendly.

Quick Reference: Wheelchair-Friendly Home Checklist

Kitchen: Lower counters, pull-out shelves, side-opening ovens, reachable appliances
Bathroom: Zero-threshold shower, grab bars, roll-under sink, non-slip floors
Bedroom: Wide doorways, smooth floors, reachable closet storage, accessible switches/outlets
Living Spaces: Open layouts, lever handles, reachable controls, clear sight lines
Entrances: Ramps, lifts, widened doors, automatic openers

1. The Kitchen – Cooking Without Constraints

For many, the kitchen is the heart of the home. But for someone in a wheelchair, standard designs can make cooking, cleaning, and even reaching a cup from a cabinet difficult.

Some solutions we create include:

Lowered countertops and sinks so work surfaces are within comfortable reach.
Pull-out shelves and drawers to make every inch of storage usable without bending or straining.
Side-opening ovens and accessible cooktops to improve safety and mobility.
Strategically placed outlets and appliances so that using them doesn’t require stretching or risky movements.

A well-designed accessible kitchen keeps everything within reach, promotes independence, and allows wheelchair users to continue preparing meals with confidence.

2. The Bathroom – Safety Without Sacrifice

Bathrooms are often the most dangerous room in the home for someone with mobility challenges due to slippery floors, tight spaces, and hard surfaces.

We focus on:

Zero-threshold showers that allow smooth, unobstructed entry, whether rolling in or transferring from a chair.
Grab bars placed strategically for stability during transfers or standing.
Roll-under sinks and vanities so grooming and handwashing can be done without strain.
Non-slip flooring to prevent falls.

These changes not only make bathing and personal care safer, but also more private and comfortable.

3. The Bedroom – Rest Made Accessible

The bedroom should be a place to recharge, not a daily obstacle course.

Modifications can include:

Wider doorways to accommodate wheelchairs without scraping knuckles or wheels.
Smooth, continuous flooring for easy movement around the bed.
Accessible closet systems with lower rods, shelves, and drawers.
Positioning of light switches and outlets so they can be reached from bed or chair.

This ensures that getting ready for the day or settling in for the night is a smooth, stress-free process.

4. Living Spaces – Freedom to Move

Common areas like living rooms and dining rooms often have furniture or layouts that unintentionally block a wheelchair user’s path.

We design for:

Open floor plans that allow free, comfortable movement.
Lever-style handles instead of round knobs for easier door and cabinet operation.
Lowered or reachable controls for lighting, blinds, and thermostats.
Clear sight lines to make socializing and watching TV more enjoyable.

These adjustments keep living spaces both functional and welcoming.

5. Entrances – Coming and Going with Confidence

If the home’s entryway is a barrier, independence is instantly limited.

We provide solutions such as:

Ramps designed for both safety and curb appeal.
Vertical platform lifts for homes with higher entry points.
Automatic door openers for hands-free access.
Widened exterior doors to improve maneuverability.

Safe, secure entrances make leaving and returning home simple and dignified.

Beyond the Basics – Why Design Matters

It’s important to remember that accessibility doesn’t mean sacrificing beauty. At Accessible Living Atlanta, we balance function and aesthetics , ensuring that modifications blend seamlessly with your home’s style.

We also take the time to listen — to understand daily routines, personal preferences, and caregiver needs. Many of our projects are done in collaboration with occupational therapists, so every change is tailored to the person’s specific abilities and goals.

The Benefits at a Glance

Independence : Navigate your home freely without relying on others for simple tasks.
Safety : Reduce risks of falls, strains, and injuries.
Convenience : Make everyday activities — from cooking to bathing — easier and more enjoyable.
Peace of Mind : Families and caregivers know their loved one is in a safer environment.
Longevity at Home : Stay in the place you love longer, without the need for costly relocation.

A Partner You Can Trust

With over two decades of experience and certifications in CAPS (Certified Aging-in-Place Specialist) and CEAC (Certified Environmental Access Consultant), our team at Accessible Living Atlanta has the expertise to transform any home into a wheelchair-friendly haven.

Your home should give you the freedom to live life on your terms — and we’re here to help make that possible.

Ready to get started?

Call Accessible Living Atlanta today for a personalized home assessment, and let’s talk about how we can make your home work with you.

Work injuries can change everything — including how someone moves through their own home.

Fri, 25 Jul 2025 19:21:13 GMT

For individuals receiving workers' compensation, Accessible Living Atlanta provides expert home modifications to restore safety, accessibility, and dignity. From bathroom conversions to wheelchair-accessible entryways, we tailor each solution to fit the individual’s condition and needs.

�� Let us help create a home environment that supports healing and independence

#AccessibleLiving #HomeModifications #AccessibleDesign #BarrierFreeLiving #SafeAtHome #MobilitySolutions #DisabilityAwareness #AdaptiveLiving #AccessibleLivingAtlanta #IndependenceAtHome

Shower Safety for Seniors: The Essential Checklist to Prevent Falls and Protect Your Loved Ones

Thu, 19 Jun 2025 05:21:18 GMT

When my mom slipped in the shower a few years ago, my sister (her caregiver) froze. She was lucky, no broken bones, just a bruised hip and a frightened daughter.

That moment made my sister realize how dangerous a shower can be for seniors, and how most bathroom accidents are preventable with a few simple changes.

If you are here, you probably worry about your parent, spouse, or yourself. You know a shower can be slippery and hard to use. You want clear, easy steps to keep everyone safe.

That is why I wrote this checklist, using terms like grab bars, non-slip flooring, and independent living. My goal is to help you take action now before something happens .

Hidden Dangers in the Bathroom ��

Showers look safe, but for seniors they pose big risks:

Wet floors become slippery fast (non-slip mats help)
Tight spaces hinder movement (mobility aids need room)
Stepping over tubs feels like climbing (walk-in showers are safer)
Poor lighting hides hazards (nightlights and pathway lighting help)
Hot water can burn (thermostatic valves stop this)

I have seen patients struggling just to get into the tub. One misstep and they could have fall hard. It only takes 1 second for an injury to occur. If you see your loved one grabbing walls or moving slowly, do not wait, they may need help now.

Who Needs This Checklist? ��

Adult children caring for a parent
Caregivers helping clients stay safe
Seniors living independently who want to stay safe
Aging-in-place specialists and therapists doing home assessments

Safety tools, like grab bars, anti-slip flooring, and reachable storage, help seniors stay independent longer.

The Complete Shower Safety Checklist ✅

Print this checklist and use it while walking through the bathroom:

1. Grab Bars & Safety Rails

Install them near the shower entrance, side wall, and controls. They should be 1.25–1.5 inch bars that support 250+ pounds. Use studs or proper anchors, no suction cups. These provide stability and fall prevention.

❓Are suction-cup grab bars safe for seniors?

�� Suction-cup grab bars are not recommended for seniors. They can lose suction over time and may not hold in an emergency. Permanent grab bars anchored into wall studs provide reliable support.

2. Non‑Slip Flooring, Mats & Adhesive Strips

Remove loose rugs. Use textured flooring , non-skid tiles , adhesive strips , or secure mats . This adds grip to prevent slips.

3. Decluttered Bathroom & Reachable Storage ��

Store shampoo, soap, and towels on wall-mounted caddies or shelves at shoulder height. Avoid bending or reaching. I personally use a soap/shampoo dispenser near my shower seat!

4. Shower Chair, Bench or Transfer Bench

A shower chair or transfer bench allows sitting while bathing, lowering fall risk. Choose non-slip feet and back support. Built-in benches work well if space allows.

❓Should I hire a professional to install safety equipment?

��Yes, for most installations, especially grab bars and transfer benches that require secure mounting. A professional ensures that everything is anchored properly, reducing the risk of equipment failure during use.

5. Walk‑In Shower or Low‑Threshold Entry

Replace tubs with barrier-free or step-free entry showers . They reduce tripping hazards and let seniors step in easily.

❓What is the safest type of shower for a senior?

�� The safest option is a walk-in or barrier-free shower with a low-threshold entry. These allow easy access without needing to step over a tub edge. Adding grab bars, non-slip flooring, and a shower bench makes the space even safer.

6. Shower Door Safety

Pick tempered safety glass . These reduce injury if bumped.

7. Proper Lighting & Pathway Nightlights ��

Install overhead, glare-free lighting in the bathroom. Add motion-sensor nightlights along the path from bedroom to bathroom, to prevent late-night trips.

8. Water Temperature Control

Fit anti-scald valves or thermostatic mixing valves. Keep water under 120°F. Always test before stepping in.

9. Easy‑Turn Fixtures

Use lever-style handles and ADA-compliant faucets. A handheld showerhead with a long hose lets you shower while seated.

10. Bathroom Layout & Mobility Aid Space

Keep pathways clear and ensure door width allows walkers, rollators, or wheelchairs. Clutter-free flooring and open space reduce tripping hazards.

11. Emergency Call & Alert Devices ��

Install a waterproof call button or alert device in the shower. These offer fast help if a fall happens. I personally like an Alexa device in the bathroom so that a call for help can be made just using your voice.

12. Raised Toilet Seat & Toilet Grab Bar

Add a raised toilet seat to make sitting and standing easier. Install grab bars next to the toilet for support. Of course, a tall toilet will also work and may look better in your bathroom.

13. Regular Maintenance & Safety Checks

Check grab bars, mats, and fixtures monthly. Look for loose bars, worn mats, mold, or uneven flooring. Securing everything helps avoid future risks.

❓How often should I inspect the bathroom safety equipment?

��Check all safety items monthly. Look for loose fittings, worn-out mats, and mold or mildew. Regular maintenance ensures that everything stays secure and functional.

Safety in Rentals and Apartments ��

❓Can I make these changes in a rental or apartment?

��You may wonder: Many safety upgrades can be done in rentals. Portable shower chairs, non-slip mats, and nightlights do not require permanent changes. For grab bars, check with your landlord, as some will allow installations if done professionally.

Handling Resistance or Cost Concerns

“It looks too clinical” : You can choose stylish grab bars and fixtures that match your décor. Ponte Giulio makes some beautiful adaptive products .
Worried about cost? Start with grab bars and non-slip flooring, these give big safety gains for low cost.
“They say they are fine alone” : Gently remind loved ones these tools help them stay independent.

Emotional Support & Peace of Mind

The night after my mom’s fall, I could not sleep. I feared she might be seriously hurt. After we made safety changes, I finally slept again. She felt more confident taking showers, and I felt less worry.

You deserve that peace of mind, and so does your loved one. You are not just installing equipment, you are protecting dignity and independence ��

Professional Help is Available

You do not have to do this alone. Occupational therapists, aging-in-place specialists, and home modification contractors can help assess what you need. On AgingInPlaceDirectory.com, you can find professionals who understand your needs and your budget.

Time to Take Action Today ��

Thousands of seniors get hurt in bathroom falls each year. You can stop that. Use this checklist now, walk through the bathroom, and make the changes that suit your situation. Even one small change can save someone from injury or a hospital stay.

If you don’t feel comfortable doing this then please contact an aging in place specialist in your area. If you have trouble finding one – just let me know – I’ll check for you and email you a list of the ones that I find in your area.

You have the power to help. So begin today.

Is Medicine a Job or a Calling?

Sat, 15 Feb 2025 18:27:04 GMT

Is Medicine a Job or a Calling?

— Reflections on the "c-word" as a symbol of the generational divide

Recently, my colleague Lisa Rosenbaum, MD, and I led a series of interactive grand rounds titled, "Is Medicine a Job or a Calling?" These conversations were inspired by our own angsty discussions about shifting expectations in our teaching and observations of often divisive social media threads. Rosenbaum has thoughtfully explored the origins and implications of this generational divide in her New England Journal of Medicine series and podcasts

, which should be required for every physician -- young and old.

In our presentations, we relay our own unsettling experiences and exposit the extremes -- from "In my day, it was a privilege to be a doctor," to "My demanding job is a means to earn a living and pay my debts, and life is what happens outside of work." Then we turn to the audience for their lively feedback. Predictably, the front row (boomers) responds first, and the back rows (in training or recently trained) wait patiently before adding their equally heart-felt perspective. Consistently, the word "calling" becomes a generation-dividing fulcrum

The front-row doctors reminisce nostalgically about their treasured memories caring for patients and families in their most desperate hour, and the trust they earned; these physicians then point to the essential medical and life lessons learned over exhaustively long hours of dedication. They recall their pride in supporting the hospital's mission to care selflessly for the most vulnerable.

From the rear, we hear versions of, "my job doesn't love me, why should I love my job?" Rather than sensing appreciation for the value of their sacrifice, they report feeling like widgets in a huge, inefficient, possibly unsustainable and rarely patient-focused health industry, whose mission seems to have become making money.

Changing Times, Changing Perspectives

A calling refers to a vocation or way of life that ministers to (cares about) others. Implicit in this definition is selflessness and uncompensated or undercompensated service. Clergy remain the most prominent example of a calling.

For my generation (graduated medical school in 1991), caring was our central professional identity, but it came with unwritten expectations and privileges. Medicine offered fewer therapeutic options; less regulation and billing rules; more continuity with hospitalized patients and their families over the ebbs and flows of their illnesses; and assuredly more time in the hospital. With the predominance of white men in my cohort, fewer of us were expected to play large roles at home and in child rearing, sadly.

In 1938, Rufus Cole, MD, lightheartedly summarized

the intern's assignment: "During your intern days the hospital should be your home, your workshop, and your playground... Learn to shun outside affairs that will complicate your life...rejoice if you are too poor to own an automobile...avoid the movies, you will find sufficient tragedy as well as comedy close at hand. Above all, avoid like a plague entangling affairs of the heart...I am still convinced of the soundness of Dr. Osler's advice to 'put your affections in cold storage during your intern years.'"

It was a simple calculus -- we trusted that our hospitals and program directors had our backs and that our long hours would lead to respected careers and a comfortable lifestyle.

Young physicians today are equally talented and dedicated and generally have mastered a broader bag of medical and sociological tools based on amazing scientific and therapeutic advances, increased cultural awareness, and access to ever-expanding on-demand knowledge. They are certainly just as caring as their senior colleagues, but the landscape of what that means has shifted. Young physicians (including my son, 2022 graduate) have a very different view of the job-calling divide.

Recently minted doctors often carry huge medical school debt Their friends who chose different paths are raising families and building equity, while young physicians have little control over their assignments and schedules. Those schedules are increasingly dictated by hospital fiscal needs determined by executives with seven-digit salaries while physicians in training earn minimum wage or less . With the evolution of electronic medical records designed as a billing capture accelerator, a very heavy portion of their time is spent in front of computer screens .

Meanwhile, they are acutely aware of the conflicting priorities and high cost of care. Primary care is under-supported and overwhelmed; residents routinely report that they must write prescriptions for each other because they cannot find a primary care doctor or don't have time to see one. So-called "not-for-profit" teaching hospitals -- built on the model of charitable care -- increasingly focus their growth strategy on lucrative procedures at the expense of less flashy primary care, especially among vulnerable communities.

Rather than as a point of pride, at our presentations and in online forums, young doctors view the word "calling" as a code-word for "being taken advantage of."

The Way Forward

"The c-word" has emerged as a potent symbol of the generational divide in medicine. In both camps, the c-word encodes dissatisfaction and disappointment. Senior physicians lament the devolution of professional commitment that some see as lacking. Younger physicians march to unionization as a means of assuring work-life balance and a seat at the healthcare decision-making table.

As a training director for a quarter-century and a proud father of a decidedly modern and skeptical young physician, I see opportunities for common ground: lowering the barriers to physician agency and restoring meaning by making "care" the central determinate of physician training assignments.

We should recognize that professionalism -- and judgement about adherence -- requires a broader context, emphasizing the ability of providers to deliver the highest level of another c-word -- care -- to all patients. Of course, this is a high bar within our often-dysfunctional and overly complex systems. Rather than a checklist of arbitrary or subjective attributes, such as hours in the hospital or sacrifice, the relevant measure of professionalism should become the quality of care, as measured by metrics meaningful to patients such as timely access, affordability, respect, and peace of mind. This conversation can promote a productive realignment between disaffected learners and their curmudgeonly teachers; and more importantly, between citizens and their industrial-sized health systems.

This shift will require radical redesign of the medical school and residency curricula, including by creatively extracting trainees from their data-entry, cut-and-paste roles in favor of experiences that assure meaningful and longitudinal time with patients and families. Educational programs that connect students with the most experienced physicians can enrich learning. Such changes will require increased flexibility and individualization to accommodate diverse (e.g., age, backgrounds, trajectory) trainees, which stands in stark (and wonderful) contrast to the vanilla white "good old days."

These changes will invariably conflict with financial optimization. To be sustainable and impactful, such change will require inviting medical trainees (and other staff) into the boardrooms for bidirectional and difficult conversations about what the real hospital mission is and the consequences of derivative fiscal choices.

My son is unconvinced by my pollyannaish speculation. He (and presumably others in his generation) thinks that redefining medical school curricula to be more focused on care sounds great, but he is skeptical that the incremental changes I suggest will counter a hospital's inevitable attraction to fiscal expedience through consolidation, targeting high-return procedures over preventative care, and private equity quick-fixes, for example. As a resident physician, he sees a bloated healthcare industry serving its own stakeholders' interests over patients' care. He thinks a more caring healthcare system is probably only possible through large-scale reform. If a national political solution is off the table, and his generation can't improve the cost-to-quality equation and increasing access barriers from within, then fiscal strain and social unrest will follow. If his generation can't say "no," then he predicts the market will say "no."

So, while we may never agree on the "calling" versus "job" debate, at the end of the day, young and older physicians can agree that our current overpriced, too often inaccessible, and inefficient system is sorely in need of an overhaul for our patients' and our nation's wellbeing.

Acknowledgement: I appreciate the helpful contributions of Andriana Friel, APRN, and Daniel Katz, MD.

Joel T. Katz, MD, MACP, is an infectious diseases physician, senior vice president for education at the Dana-Farber Cancer Institute, and associate professor of medicine at Harvard Medical School in Boston.

Across the South, Rural Healthcare Has Become 'Trendy.' Medicaid Expansion Has Not.

Tue, 11 Feb 2025 04:25:07 GMT

— Ten states haven't fully expanded Medicaid coverage with federal money available under the ACA

WALHALLA, S.C. -- Nestled in the foothills of the Blue Ridge Mountains, a small primary care clinic run by Clemson University draws patients from across the region. Many are Hispanic and uninsured, and some are willing to travel from other counties, bypassing closer healthcare providers, just to be seen by Michelle Deem, the clinic's bilingual nurse practitioner.

"Patients who speak Spanish really prefer a Spanish-speaking provider," Deem said. "I've gotten to know this community pretty well."

Clemson doesn't operate an academic medical center, nor does it run a medical school. Arguably, the public university is best known for its football program. Yet, with millions of dollars earmarked from the state legislature, it has expanded into delivering healthcare, with clinics in Walhalla and beyond. School leaders are attempting to address gaps in rural and underserved parts of a state where health outcomes routinely rank among the worst in the country.

"Some of these communities have such high need," said Ron Gimbel, PhD , director of Clemson Rural Health, which operates four clinics and a fleet of mobile health units as part of the university's College of Behavioral, Social, and Health Sciences. "They have so many barriers that impact their ability to be healthy."

Clemson Rural Health is one of several programs attempting to meet this need in the state.

"Rural health is trendy," said Graham Adams, PhD, CEO of the South Carolina Office of Rural Health .

State lawmakers nationwide are spending millions of dollars to address a rural healthcare crisis long in the making. For more than a decade, though, Republican-controlled legislatures in most Southern states have refused billions in federal funds that would provide public health insurance coverage to more low-income adults. These are the same states where racial health disparities and health outcomes are often worse than in other regions.

Nearly every state has extended Medicaid coverage for women in the months after they give birth. But 10 states haven't fully expanded Medicaid coverage with federal money made available under the 2010 Affordable Care Act (ACA). Seven of these states -- Alabama, Florida, Georgia, Mississippi, South Carolina, Tennessee, and Texas -- are in the South. With few exceptions, adults without children in these states don't qualify for Medicaid coverage, regardless of their income level.

Georgia Gov. Brian Kemp and South Carolina Gov. Henry McMaster, both Republicans, recently announced plans to expand Medicaid in limited ways to include some parents. The South Carolina plan would impose work requirements on some of these newly eligible Medicaid beneficiaries, while the Georgia plan would allow some parents of young children to skirt the state's existing Medicaid work rules. Both plans require federal approval.

Jonathan Oberlander, PhD, a professor and health policy scholar at the University of North Carolina, said he doesn't expect to see any of the remaining states rushing to fully expand Medicaid. Before Donald Trump took office on January 20, Republicans in Washington had already expressed their intention to dramatically cut spending for Medicaid , which covers 72 million people at a cost of nearly $900 billion.

"There's a large gray cloud hanging over Medicaid expansion right now, and that's because there's so much uncertainty about what the Trump administration and congressional Republicans are going to do," Oberlander said.

Even so, in South Carolina this year the advocacy group CoverSC plans to lobby the General Assembly to pass a bill to adopt Medicaid expansion, said Beth Johnson, regional government relations director for the American Cancer Society Cancer Action Network and a CoverSC board member. The state's legislative session began January 14.

If such a measure were approved, the federal government would cover 90% of the state's Medicaid expansion costs and South Carolina would be expected to pay 10%, or an estimated $270 million during the first year, according to a 2024 report by the Milken Institute School of Public Health at George Washington University.

Across all 10 non-expansion states -- which, outside the South, also include Kansas, Wisconsin, and Wyoming -- about 1.5 million people fall into a coverage gap, according to 2024 estimates from KFF , the health information nonprofit that includes KFF Health News. That means they do not qualify for Medicaid coverage or financial assistance to buy insurance through the federal marketplace.

Many of the people who would qualify for Medicaid if these states were to expand eligibility are gig workers, Johnson said. They play music, drive for Uber, or deliver pizza, and they typically don't qualify for health insurance through their jobs.

"They are providing services that we all appreciate," she said. "And they simply can't afford health insurance." In some South Carolina communities, Clemson Rural Health attempts to fill this gap by providing primary care, cancer screenings, nutrition education, and diabetes management for uninsured patients free of charge or at reduced rates. Only about half of the patients seen by Clemson Rural Health have health insurance, Gimbel said, compared with 92% of the U.S. population.

During the current state fiscal year, Clemson Rural Health has been underwritten by a $2.5 million contract, its largest source of funding, from the state Department of Health and Human Services, which administers Medicaid in South Carolina and operates with a budget approved by state lawmakers.

That's a relatively small amount of money compared with the $47.5 million the state legislature has given to the Medical University of South Carolina (MUSC) in recent years to move into rural communities. MUSC has served Charleston for most of its 200-year history, but since 2019 it has expanded across the state by purchasing, building, or partnering with seven rural hospitals -- some on the brink of closure -- and one freestanding emergency department. MUSC is set to open an additional rural hospital this year.

Other states have made similar investments. The University of Georgia, for example, has established a new medical school, partly to send more physicians into underserved and rural areas. The Georgia General Assembly kicked in half the cost of a new $100 million building for medical education and research in Athens.

Meanwhile, the Tennessee General Assembly passed a budget last year that included $81 million for a variety of rural health initiatives.

Outside the South, state legislatures in Colorado, Nevada, West Virginia, and elsewhere have made recent investments in rural health, in addition to expanding Medicaid eligibility.

Some of this spending has been prompted by a wave of rural hospital closures -- more than 100 since 2010, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina.

It's not yet clear what long-term impact some of these initiatives will have -- for instance, whether the Clemson program will "reduce premature mortality, decrease preventable hospitalizations, and improve overall quality of life," as it aims to do, according to its website . Some public health experts point out that bolstering the number of rural clinics, hospitals, and doctors in the South won't matter much if patients can't afford to make an appointment.

"Lack of ability to pay is one of the greatest barriers," said Adams, the Office of Rural Health chief.

Oberlander said conservative lawmakers often consider projects such as building new rural clinics more politically palatable than expanding Medicaid coverage.

"The further away you get from the ACA, the less polarized the politics of healthcare," he said.

South Carolina Senate President Thomas Alexander , a Republican who lives in Walhalla, said the General Assembly is willing to invest in some rural health initiatives to improve healthcare access.

"Just because you expand Medicaid doesn't mean you've expanded access to the services," Alexander said. "I want to focus on expanding access to the services."

Gimbel would not comment on Medicaid expansion in South Carolina, and he said it's too soon to know how federal Medicaid changes under the Trump administration might affect funding for Clemson Rural Health, which currently receives money from the state's Medicaid agency. But making the Clemson program financially solvent might take several more years, he said."If rural health was profitable," he said, "we wouldn't have a rural health problem." KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF -- an independent source of health policy research, polling, and journalism. Learn more about KFF .

Source: https://www.medpagetoday.com

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Can Medical Schools Funnel More Doctors Into the Primary Care Pipeline?

Sat, 01 Feb 2025 18:18:43 GMT

Many start out interested in primary care, but often end up chasing higher-paying specialties

Throughout her childhood, Julia Lo Cascio dreamed of becoming a pediatrician. So, when applying to medical school, she was thrilled to discover a new, small school founded specifically to train primary care doctors: NYU Grossman Long Island School of Medicine.

Now in her final year at the Mineola, New York, school, Lo Cascio remains committed to primary care pediatrics. But many young doctors choose otherwise as they leave medical school for their residencies. In 2024, 252 of the nation's 3,139 pediatric residency slots went unfilled and family medicine programs faced 636 vacant residencies out of 5,231 as students chased higher-paying specialties.

Lo Cascio, 24, said her 3-year accelerated program nurtured her goal of becoming a pediatrician. Could other medical schools do more to promote primary care? The question could not be more urgent. The Association of American Medical Colleges projects a shortage of 20,200 to 40,400 primary care doctors by 2036. This means many Americans will lose out on the benefits of primary care, which research shows improves health, leading to fewer hospital visits and less chronic illness.

Many medical students start out expressing interest in primary care. Then they end up at schools based in academic medical centers, where students become enthralled by complex cases in hospitals, while witnessing little primary care.

The driving force is often money, said Andrew Bazemore, MD, MPH, a physician and a senior vice president at the American Board of Family Medicine. "Subspecialties tend to generate a lot of wealth, not only for the individual specialists, but for the whole system in the hospital," he said.

A department's cache of federal and pharmaceutical-company grants often determines its size and prestige, he said. And at least 12 medical schools , including Harvard, Yale, and Johns Hopkins, don't even have full-fledged family medicine departments. Students at these schools can study internal medicine, but many of those graduates end up choosing subspecialties like gastroenterology or cardiology.

One potential solution: eliminate tuition, in the hope that debt-free students will base their career choice on passion rather than paycheck. In 2024, two elite medical schools -- the Albert Einstein College of Medicine and the Johns Hopkins University School of Medicine -- announced that charitable donations are enabling them to waive tuition, joining a handful of other tuition-free schools.

But the contrast between the school Lo Cascio attends and the institution that founded it starkly illustrates the limitations of this approach. Neither charges tuition.

In 2024, two-thirds of students graduating from her Long Island school chose residencies in primary care. Lo Cascio said the tuition waiver wasn't a deciding factor in choosing pediatrics, among the lowest-paid specialties, with an average annual income of $260,000, according to Medscape .

At the sister school, the Manhattan-based NYU Grossman School of Medicine, the majority of its 2024 graduates chose specialties like orthopedics (averaging $558,000 a year) or dermatology ($479,000).

Primary care typically gets little respect. Professors and peers alike admonish students: If you're so smart, why would you choose primary care? Anand Chukka, 27, said he has heard that refrain regularly throughout his years as a student at Harvard Medical School. Even his parents, both PhD scientists, wondered if he was wasting his education by pursuing primary care.

Seemingly minor issues can influence students' decisions, Chukka said. He recalls envying the students on hospital rotations who routinely were served lunch, while those in primary care settings had to fetch their own.

Despite such headwinds, Chukka, now in his final year, remains enthusiastic about primary care. He has long wanted to care for poor and other underserved people, and a 1-year clerkship at a community practice serving low-income patients reinforced that plan.

When students look to the future, especially if they haven't had such exposure, primary care can seem grim, burdened with time-consuming administrative tasks, such as seeking prior authorizations from insurers and grappling with electronic medical records.

While specialists may also face bureaucracy, primary care practices have it much worse: They have more patients and less money to hire help amid burgeoning paperwork requirements, said Caroline Richardson, MD, chair of family medicine at Brown University's Warren Alpert Medical School.

"It's not the medical schools that are the problem; it's the job," Richardson said. "The job is too toxic."

Kevin Grumbach, MD, a professor of family and community medicine at the University of California San Francisco, spent decades trying to boost the share of students choosing primary care, only to conclude: "There's really very little that we can do in medical school to change people's career trajectories."

Instead, he said, the U.S. healthcare system must address the low pay and lack of support.

And yet, some schools find a way to produce significant proportions of primary care doctors -- through recruitment and programs that provide positive experiences and mentors.

U.S. News & World Report recently ranked 168 medical schools by the percentage of graduates who were practicing primary care 6 to 8 years after graduation.

The top 10 schools are all osteopathic medical schools, with 41% to 47% of their students still practicing primary care. Unlike allopathic medical schools, which award MD degrees, osteopathic schools , which award DO degrees, have a history of focusing on primary care and are graduating a growing share of the nation's primary care physicians.

At the bottom of the U.S. News list is Yale, with 10.7% of its graduates finding lasting careers in primary care. Other elite schools have similar rates: Johns Hopkins, 13.1%; Harvard, 13.7%.

In contrast, public universities that have made it a mission to promote primary care have much higher numbers.

The University of Washington -- No. 18 in the ranking, with 36.9% of graduates working in primary care -- has a decades-old program placing students in remote parts of Washington, Wyoming, Alaska, Montana, and Idaho. UW recruits students from those areas, and many go back to practice there, with more than 20% of graduates settling in rural communities, according to Joshua Jauregui, MD, MHPE, assistant dean for clinical curriculum.

Likewise, the University of California Davis (No. 22, with 36.3% of graduates in primary care) increased the percentage of students choosing family medicine from 12% in 2009 to 18% in 2023, even as it ranks high in specialty training. Programs such as an accelerated 3-year primary care "pathway," which enrolls primarily first-generation college students, help sustain interest in non-specialty medical fields.

The effort starts with recruitment, looking beyond test scores to the life experiences that forge the compassionate, humanistic doctors most needed in primary care, said Mark Henderson, MD, associate dean for admissions and outreach. Most of the students have families who struggle to get primary care, he said. "So they care a lot about it, and it's not just an intellectual, abstract sense."

Establishing schools dedicated to primary care, like the one on Long Island, is not a solution in the eyes of some advocates, who consider primary care the backbone of medicine and not a separate discipline. Toyese Oyeyemi Jr., MPH, executive director of the Social Mission Alliance at the Fitzhugh Mullan Institute of Health Workforce Equity, worries that establishing such schools might let others "off the hook."

Still, attending a medical school created to produce primary care doctors worked out well for Lo Cascio. Although she underwent the usual specialty rotations, her passion for pediatrics never flagged -- owing to her 23 classmates, two mentors, and her first-year clerkship shadowing a community pediatrician. Now, she's applying for pediatric residencies.

Lo Cascio also has deep personal reasons: Throughout her experience with a congenital heart condition, her pediatrician was a "guiding light."

"No matter what else has happened in school, in life, in the world, and medically, your pediatrician is the person that you can come back to," she said. "What a beautiful opportunity it would be to be that for someone else."

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF -- an independent source of health policy research, polling, and journalism. Learn more about KFF .

The baby boomer effect is hitting the housing market hard

Wed, 15 Jan 2025 15:28:55 GMT

Baby boomers continue to dominate the national housing market.

The outsized homeownership share held by one generation creates downstream problems that might not go away anytime soon, experts say.

By Andy Medici – Senior Reporter, The Playbook, The Business Journals

Source: www.bizjournals.com

Local nonprofits Shepherd Center, ACE will celebrate anniversaries with growth pushes in 2025

Fri, 03 Jan 2025 17:57:04 GMT

Jamie Shepherd, president and CEO of Shepherd Center, stands in front of the new Marcus Center for Advanced Rehabilitation behind him. The new facility is set to open this spring.

Bita Honarvar

New CEOs of the Shepherd Center rehabilitation hospital and the Access to Capital for Entrepreneurs are marking their organiz ations' milestone birthdays with expansion and fundraising efforts.

By Crystal Edmonson – Senior Editor, Atlanta Business Chronicle

Source: www.bizjournals.com

Patients Are Relying on Lyft, Uber to Travel Far Distances to Medical Care

Fri, 25 Oct 2024 10:37:33 GMT

Some are calling for states to subsidize the expensive trips for rural residents

When Lyft driver Tramaine Carr transports seniors and sick patients to hospitals in Atlanta, she feels like both a friend and a social worker.

"When the ride is an hour or an hour and a half of mostly freeway driving, people tend to tell you what they're going through," she said.

Drivers such as Carr have become a critical part of the medical transportation system in Georgia, as well as in Washington, D.C. , Mississippi, Arizona , and elsewhere. While some patients use transportation companies solely dedicated to medical rides or non-emergency ambulance rides to get to their appointments, the San Francisco-based ride-hailing companies Uber and Lyft are also ferrying people to emergency rooms, kidney dialysis, cancer care, physical therapy, and other medical visits.

But Georgia ride-hail drivers aren't only serving patients living in Atlanta or its sprawling suburbs. When rural Georgians are too sick to drive themselves, Uber or Lyft is often one of the only ways to reach medical care in the state capital.

Rural hospital closures in Georgia have meant people battling cancer and other serious illnesses must now commute 2 or more hours to treatment facilities in Atlanta, said Bryan Miller, director of psychosocial support services at the Atlanta Cancer Care Foundation , a medical practice offshoot that seeks to alleviate financial burdens for cancer patients and their families.

From April 2022 to April 2024, Lyft drivers completed thousands of rides that were greater than 50 miles each way and that began or ended at Atlanta-area medical treatment centers, including the Winship Cancer Institute of Emory University and Emory University Hospital Midtown, according to Lyft.

While 75% of those trips were under 100 miles, the company said, 21% of them were between 100 and 200 miles and 4% were over 200, showing that even Georgians who live hours away from metro Atlanta rely on the ride-hail platform to reach medical care there.

Uber Health global head Zachary Clark declined to provide comparable ridership data. Uber Health is a division of Uber that organizes medical transportation for some Medicaid and Medicare recipients, healthcare workers, prescription drug delivery, and others seeking reimbursement for medical-related Uber rides, according to Uber's website .

Lyft also has a healthcare division, offering programs such as Lyft Assisted and Lyft Concierge to coordinate rides for patients.

Nationwide, some insurance companies and cancer treatment centers, plus Medicare Advantage and state Medicaid plans, pay for such ride-hailing services, often with the goal of reducing missed appointments, according to Krisda Chaiyachati , MD, MPH, an adjunct assistant professor at the University of Pennsylvania medical school.

In 2024, 36% of individual Medicare Advantage plans and 88% of special needs plans offered transportation services, said Jeannie Fuglesten Biniek , PhD, associate director of Medicare policy at KFF, the health policy research, polling, and news organization that includes KFF Health News. A special needs plan provides extra benefits to Medicare recipients who have severe and chronic diseases or certain other healthcare needs, or who also have Medicaid.

And Medicaid -- the federal-state government safety net insurance plan for those with low incomes or disabilities -- paid for up to 4 million beneficiaries to use non-emergency medical transportation services annually from 2018 through 2021, according to an HHS report. Patients residing in rural areas used ride-hailing and other non-emergency transportation providers at the highest rates, the report said.

The estimated total federal and state investment in non-emergency medical transportation was approximately $5 billion in 2019, according to a study by the Texas A&M University Transportation Institute.

Even with some insurance covering trips or charities offering ride credits, social workers say, many ailing patients are still left without a ride. Nationwide, 21% of adults without access to a vehicle or public transit went without needed medical care in 2022, according to a study by the Robert Wood Johnson Foundation. People who lacked access to a vehicle but had access to public transit were less likely to skip needed care.

The data analytics company Geotab ranked Atlanta as tied for second worst in the nation when it comes to the accessibility of its public transportation network.

"The ability to get to a doctor's appointment can be a barrier to care," said Rochelle Schube, a cancer support group facilitator in Atlanta. "If I give a patient $250 in Uber cards and they live far away, that gets spent quickly."

The fact that Uber and Lyft are harder to come by in rural America compounds the lack of medical access in those areas. "When you move to rural areas -- which you could argue have a higher need -- you see fewer services," Chaiyachati said.

Finding drivers who are able and willing to provide medical transportation can be a challenge. The Atlanta-based start-up MedTrans Go connects patients and healthcare providers with vetted drivers, many offering wheelchair or stretcher rides, in Georgia and 16 other states. Many of its drivers have medical training, walk patients to and from medical facilities or their homes, and can handle complex situations for vulnerable patients, said Dana Weeks, the company's co-founder and CEO.

The company's app can also dispatch directly to Uber or Lyft for patients who do not need specialized assistance, she said.

Uber and Lyft trips can save patients and insurers money, costing a fraction of the typical fee for an ambulance ride, said David Slusky , PhD, an economics professor at the University of Kansas who has studied the impact of ride-hailing services on medicine.

But instead of all of that, argued Timothy Crimmins , PhD, a history professor emeritus at Georgia State University and a former director of the school's neighborhood-studies center, the best solution would be for Georgia to expand Medicaid , so more rural hospitals would be able to remain open and Georgians could seek medical care close to home.

The decision by Georgia lawmakers to not accept a federally funded expansion of Medicaid has left more than 1.4 million Georgians without health insurance, according to KFF -- and that hurts rural hospitals when those patients use the medical facilities and cannot pay their bills. In Georgia, 10 rural hospitals have either closed or ceased their inpatient care operations since 2010, according to a 2024 report from healthcare consultant Chartis, and 18 more are in danger of shuttering.

Until more patients are insured, Crimmins said, the state should subsidize Uber and Lyft trips for less prosperous Georgians who need help reaching medical care in Atlanta. "We might be talking about $100 to $150 round-trip," he said. "That can be subsidized."

Still, ferrying around patients is not for every ride-hail driver. Damian Durand said his Chevrolet Equinox SUV is large enough to accommodate a medical passenger requiring a wheelchair, but he isn't paid extra to transport those with medical needs. He said some of his recent passengers in Atlanta have been Medicaid recipients with mental health conditions or disabilities.

"It can be stressful," he said. "I do feel like Uber and Lyft are trying to catch me off guard. When I can see that the ride is going to the hospital, I try to avoid or cancel the ride."

While Durand's experience with medical transport has been mostly negative, Carr loves the work and appreciates being able to help older Georgians, who she said often tip her well. For her, ride-hail work remains a good option even when it entails medical calls.

"It's not stressful for me," she said. "I worked a good 20 years in customer service. For me, human connection is important. I tried to work from home, and I really didn't like it. I prefer this because I can connect with people."

Doctors Cut Back on Seeing Medicare Patients as Another Pay Cut Looms

Fri, 04 Oct 2024 14:47:35 GMT

Those still seeing Medicare patients struggle to stay in private practice

Will his independent practice be able to survive another Medicare payment cut? That's what Terre Haute, Indiana internist Pardeep Kumar, MD, wonders each day as the next round of cuts looms.

"We have to see," Kumar said in a phone interview. "We have around 40% of the population of patients that are on Medicare ... Our overall ability to sustain as a private practitioner is significantly under distress because of these cuts."

Can We Stay in Business?

Kumar and his wife, who is also an internist, are in private practice together , and each has taken on outside work at various points in order to keep the practice viable, he said. "I used to be the director of a hospice company outside the practice, and I also [work at] another hospital for geriatric psychiatric patients. I go and see them so that we have additional revenue to sustain our practice."

CMS is proposing a 2.8% cut in the Medicare fee schedule for the 2025 fiscal year, which would, if approved by Congress, come on top of a 1.69% cut in 2024. Often, Congress reverses the cuts, although this year they did so only partially. The cut is currently in limbo -- along with the rest of the federal budget -- now that Congress has passed a short-term budget deal keeping the government funded at current levels through mid-December, after the election.

Doctors' groups such as the American Medical Association, to which Kumar belongs, argue that instead of cutting doctor pay, CMS should adopt an inflation-adjusted reimbursement model. "When the cost of living goes up, there should be some [similar] adjustment in the physician reimbursement model," Kumar said. "That will provide sustainability, especially for the private practice."

Helping private practices stay in business, rather than forcing doctors to close their private practices and work for hospital systems, "will actually eventually lower the cost of care ... because reimbursement in private practice is relatively lower than hospital-based [reimbursement] so there's a cost saving for health insurers," including Medicare, said Kumar.

Although there is some movement in Congress toward site-neutral payment, in which hospitals would get the same pay as private practices for providing the same outpatient services, "hospitals are fighting that, because they are saying that they are employing more and more physicians now ... They're getting site benefit from that, and they're able to pay the physicians to keep them employed," he said. "I also sit on the hospital board here, and they are saying their margins are very shrunken and they will not be able to sustain or at least employ as many physicians if they [institute site-neutral payment]."

Primary Care Shortage Persists

Donaldo Hernandez, MD, a hospitalist in Santa Cruz, California, has seen first-hand how continued Medicare payment cuts are keeping patients from getting care. "Central and northern California can be somewhat expensive places to conduct healthcare business for a number of reasons," Hernandez said during a telephone interview at which a press person was present. "Even prior to the pandemic ... it was really the commercial marketplace that allowed medical practices that have enough money to invest in staff and all the other things that they do to maintain themselves."

"As we emerged from the pandemic, with the inflationary pressures exerted by the pandemic and the ongoing issues with hiring staff and sundry other things that occurred -- such as increases in the cost of electricity, for example, from Pacific Gas & Electric -- those pressures really were exerted on medical practices to a much greater extent," said Hernandez, who is immediate past president of the California Medical Association.

Doctors "really want to see this Medicare population, and yet the economics really forces physicians into sort of a Sophie's Choice between, 'Do I see these patients because I want to, and I know they have a need, or do I save my practice from financial uncertainty and the challenges that exist in me being able to hire MAs [medical assistants], back office people and [deal with] all the administrative burdens that are inserted on all medical practices?'" he said.

Hernandez recalled a recent patient he had seen at his hospital for a severe hypoglycemic episode; the patient -- who had recently moved to California from Oklahoma to care for her ailing father-in-law -- had been in 2 weeks before for a myocardial infarction. "That was treated, managed, and she was placed on some new medications in order to manage that particular medical problem, and was told to follow up with her doctor," he said. "Well, it turns out she really didn't have a community doctor that was managing her problems. There was nobody managing those [medication] alterations in an effective way in the outpatient setting ... As a consequence, she took her diabetes medications erroneously, and ended up having low blood sugar."

"The challenge for me was that day and the following day was to try to find her someplace that she could get follow-up," said Hernandez. "I had two social workers working on it for 48 hours to try to find her a medical home, including within our safety net system, who at this time isn't taking you Medicare patients because they're at capacity." He finally called in a favor with a doctor he knew personally, and was able to get the patient into that practice.

"That's what we're seeing throughout the state, is physician practices are just not able to take these new patients on," he added. "With every subsequent cut or pullback ... It continues to be, in my opinion, an ongoing risk factor for these patients moving forward."

A Personal Effect of the Shortage

For Rene Bravo, MD, a 65-year-old pediatrician in San Luis Obispo, CA, the cumulative effect of the previous Medicare cuts hit him very personally. He had had private health insurance for himself and had gotten care without a problem, "and I finally went on Medicare and tried to find a physician," Bravo said in a phone interview. "I couldn't find one -- they were all either full up or not available ... I finally found an internist who took Medicare, but I had to pull some strings."

"If I have trouble finding a physician, what's going on for other folks in the population?" he said. "The fact that these reimbursement cuts are coming -- everybody is aware of these things, and it just creates a profound amount of insecurity in the system."

"This has got to be fixed once and for all," Bravo said. "The Medicare payment system needs to be significantly revamped because this is creating a lot of stress on healthcare provision for seniors. There's nothing about this that is right."

Should We Attribute Patients' Conditions to 'Old Age'?

Fri, 13 Sep 2024 17:02:06 GMT

#homeaccessibility#homemodification#homehealthcare#aginginplace#aginggracefu
lly#caregivers#disability#disabilityawareness#wheelchairuser#wheelchairacces
sible#spinalcordinjury#physicallychallenged#safetyathome#elderlycare#graytsu
nami#healthylifestyle#accessiblematters#userfriendlyhome

"I can't tell my patients the truth any longer because they get upset, as if I were insulting them."

This is what a colleague of mine said after his 85-year-old patient, whom I will call Kathy*, expressed dissatisfaction with the office visit. Attributing her knee pain to degenerative joint disease and explaining that this is a common occurrence "later in life" was apparently perceived as a slight. The x-ray report, clearly documenting the changes of arthritis, was not enough to satisfy Kathy who, reportedly, could not understand why her symptoms or condition should be attributed "just to old age." She was tired of hearing that so many of her ailments were part of the aging process.

I'm not foreign to this type of interaction, where patients seem to reject that physical and cognitive decline are expected with aging. Perhaps they are just in profound denial regarding the effects of age. Although the aging process differs significantly from person to person, it seems disingenuous that our patients could believe that age will have little to no effect on their functional abilities. "No one wants to admit they're old," my colleague concluded.

So, what's the best way to communicate with older adults about their age-related health conditions?

Reconciling a History of Ageism With an Aging Population

Society and nature are not kind toward elderly people. Ageism is a reality. Suffice to mention the recent dispute ignited by President Joe Biden's performance at the presidential debate with former President Donald Trump. Although some concerns were certainly legitimate, there is no doubt in my mind that the controversy was also spurred by the many prejudices against older adults.

The term "ageism" was coined in 1969 by Robert Neil Butler, MD, to describe discrimination against seniors. In a society obsessed with youth and beauty, ageist beliefs against older adults are commonplace, leading to derogatory attitudes, rejection, and isolation.

Long lives are our new normal, thanks in large part to modern medicine, with all the advancements in therapeutics and technology and improved living conditions. But long lives are not necessarily happy and fulfilling lives. A dear patient of mine, who was in her mid-80s and lived at home with her 93-year-old husband, always used to say, "The Golden Age is not so golden."

The optimistic scenarios of pro-aging writers, although inspiring, often don't account for the progressive and unpredictable nature of human frailty. Aging is a complex biological process caused by many co-conspirators: nuclear and mitochondrial DNA damage, progressive telomere shortening, defective DNA repair pathways, and cellular senescence, leading to unavoidable tissue and organ atrophy, with resulting loss of function. Many factors, including lifestyle, can have a positive or negative impact on biological aging. But the bottom line is that the depredation of age cannot be avoided, unless people die young.

Help Patients Navigate, Not Deny, Their Age

How can we reconcile our desire to live longer with the challenges brought on by aging and by society's treatment of older people? Between the threat of ageism on one hand and the many betrayals of the golden years on the other, is anyone surprised that some people might oppose the suggestion that they are losing physical and cognitive capabilities due to old age?

I am not anymore. I used to be puzzled by what I perceived to be a lack of common sense, a form of unreasonable denial, and a bold disregard for the truth despite all the available evidence. I'm not puzzled any longer. I am concerned.

I have seen too many of my patients, including family members, launching into exhausting and wasteful quests to find answers to their ailments that do not include the word "age." Being labeled with a specific disease seems to provide some people with a more palatable and more socially acceptable excuse for their decline.

"They will keep on changing doctors until they hear what they want to hear," another colleague commented when his 84-year-old patient consulted several neurologists to find the answer to his declining motor skills. Eventually, an expert in the field told him that although nothing was found on physical exam, "You might have a mild case of Parkinson's disease. If you feel like the medications help you, take them." Aging wasn't mentioned at any point in time during the office visit.

The problem is that, far from providing psychological relief, these alternative diagnoses might eventually result in more anxiety and depression, an endless sequence of time-consuming tests and doctors' appointments, hence a diminished quality of life, not to mention escalating medical costs. These "maybe" diagnoses, made with a cavalier attitude, might even prompt families to push their loved ones toward alternative living arrangements and nursing home placement, and not always in good faith. Family dynamics and societal expectations are very complex. A neurodegenerative disorder might be seen as a socially more acceptable reason to put "pops" away than just old age.

We should never forget that we are our patients' best advocates. This requires an honest and objective assessment of our aging patients, and frank, realistic conversations with both the patients and their families. Aging can be a messy business and there is not a lot of grace in it. People can choose to ignore it and look for answers elsewhere, but we, as physicians, should not become part of the problem. Fueling the denial comes at a great cost to our patients and society.

Let us instead help our patients navigate older age with sound medical advice and great compassion.

*Patient's name has been changed for confidentiality.

Fabrizia Faustinella, MD, PhD, is an internist and faculty member at Baylor College of Medicine in Houston. She is also a Doctors for America A. Gene Copello health advocacy fellow.

Up to 1 in 5 Dementia Cases May Be Attributable to Vision Impairment

Sun, 08 Sep 2024 22:16:00 GMT

Up to 1 in 5 Dementia Cases May Be Attributable to Vision Impairment

— Contrast sensitivity impairment showed the strongest relationship

https://www.medpagetoday.com/neurology/dementia/111827

Outsized Death Risk for Women With Afib After Heart Surgery

Fri, 30 Aug 2024 04:01:57 GMT

After cardiac surgery, women were particularly vulnerable to poor outcomes in the long run if the most common procedural complication had occurred, according to a large retrospective study from two tertiary care centers.

Although postoperative atrial fibrillation (poAF) was less likely to occur in women than in men after adjusting for patient and surgery-related risk factors (OR 0.85, 95% CI 0.79-0.91), there was a significantly stronger association between poAF and subsequent mortality for women.

Compared to those without, men with poAF had a 17% higher mortality hazard (HR 1.17, 95% CI 1.11-1.25) versus women with poAF who had a 31% higher mortality hazard (HR 1.31, 95% CI 1.21-1.42), reported a group led by Sergey Karamnov, MD, of Brigham and Women's Hospital and Harvard Medical School in Boston in JAMA Network Open

"Our findings suggest that women may have protective factors against the development of poAF. However, once poAF takes place, women may be more vulnerable to the associated long-term morbidities," they concluded.

Prior work has already linked poAF to increased risks of stroke, morbidity, and mortality atop higher healthcare utilization costs.

The majority of the present study cohort had at least 10 years of follow-up, during which 50.4% women and 48.9% men with poAF died, compared with 49.6% and 51.1%, respectively, among non-poAF peers.

"The observed elevated risk of long-term mortality in women with poAF underscores the need for refined approach to postoperative management, continuous cardiac monitoring, regular follow-ups, and proactive interventions in this patient population," Karamnov's team stressed.

Mariana Fragão-Marques, MD, PhD, MBA, of the University of Porto in Portugal, suggested that potential sex disparities may lie in long-term postoperative care areas such as surveillance and access to medical treatments.

"At the heart of this study lies the recognition that poAF, traditionally viewed as a largely self-limited event, may have long-term implications that extend beyond the immediate postoperative period," she wrote in an accompanying editorial . "By highlighting the disproportionate impact of poAF on long-term outcomes in women, the study underscores the need for a more nuanced and personalized approach to postoperative care delivery."

Study authors cited genetic, cardiac structural, hormonal, socioeconomic, and psychosocial risk factors as potential mechanisms underlying their findings.

"This observed sex disparity in the association between poAF and long-term outcomes clarifies previous conflicting results reported in the literature and underscores the need for a deeper understanding of the underlying mechanisms driving these differences," according to Fragão-Marques.

The retrospective cohort study was conducted from data at two tertiary care centers in Massachusetts.

Included were adults who had presented in normal sinus rhythm and undergone coronary artery bypass graft surgery, aortic valve surgery, mitral valve surgery, and combined procedures with cardiopulmonary bypass. Procedures took place from 2002 to 2016, and patients were followed up to 2022 with supplementary longitudinal data from the Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Approximately 75% of the sample was censored or deceased at 10 years, authors noted.

Out of 21,568 people with poAF data (mean age 66.5 years), poAF was detected in 40.8% of women and 38.8% of men.

By predicted probabilities, men had a 40.5% chance of experiencing poAF, while women had a 37.0% chance of developing poAF.

Notably, these researchers had defined poAF as any atrial fibrillation (Afib) detected on ECG during the index hospitalization. Other research has shown that people may need to undergo continuous rhythm monitoring after cardiac surgery to catch any late poAF.

Karamnov and colleagues acknowledged the potential for residual confounding despite efforts at statistical adjustment in the retrospective analysis. Additionally, the data were geographically limited, with low representation of certain age and race groups.

The investigators noted that people with persistent or longstanding Afib and those not in normal sinus rhythm within 7 days prior to surgery had been excluded from the report. So were patients with pacemakers, those with prior or intraoperative pulmonary vein isolation, Maze, or left atrial appendage occlusion, and those who underwent reoperations within 1 year.

Who are the beneficiaries of home modification to create a more user-friendly home?

Tue, 27 Aug 2024 16:05:42 GMT

Home modifications to create a more user-friendly environment primarily benefit several groups:

Older Adults and Seniors: Aging individuals often require modifications to maintain independence and safety in their homes. This includes installing grab bars, stairlifts, ramps, and widening doorways for wheelchair access.
People with Disabilities: Individuals with physical, sensory, or cognitive disabilities benefit from modifications like accessible bathrooms, lower countertops, adapted lighting, and voice-activated technology.
People Recovering from Injury or Surgery: Those recovering from surgeries or injuries may temporarily need home modifications to navigate their living spaces more easily. This can include temporary ramps, shower seats, and handrails.
Caregivers: Family members or professional caregivers who assist individuals with mobility issues, disabilities, or chronic illnesses benefit from modifications that make caregiving tasks easier and safer, such as walk-in showers and adjustable-height counters.
Families with Young Children: Childproofing the home, with features like safety gates, corner protectors, and secured cabinets, creates a safer environment for young children.
People with Chronic Health Conditions: Those with conditions like arthritis, heart disease, or vision impairment may need modifications to reduce strain and increase safety, such as lever-style door handles, non-slip flooring, and improved lighting.
Individuals Planning for Future Needs: Homeowners who anticipate future mobility issues or are planning for "aging in place" might modify their homes proactively to accommodate potential future needs.

Overall, home modifications enhance safety, accessibility, and comfort, improving the quality of life for a wide range of individuals.

Does the Private Sector Help, or Hinder, Life Expectancy?

Tue, 20 Aug 2024 17:07:42 GMT

Does the Private Sector Help, or Hinder, Life Expectancy?

— Analyzing the impact of the "commercial determinants of health"

by N. Adam Brown, MD, MBA, Contributing Writer, MedPage Today,

August 13, 2024

Earlier this year, the CDC announced that life expectancy in the U.S. had risen to 77.5 yearsopens in a new tab or window. Of course, that number is just an average. If you grew up in Mississippiopens in a new tab or window, you're not expected to live to see 72. Meanwhile, the average life span for residents of Hawaii is 80.

Many Americans now understand that social determinants of health (SDOH) -- where a person lives, their education and income, and even ease of access to transportation -- can affect longevity.

While these factors remain crucial in shaping health outcomes, a growing body of evidence suggests private companies play an equally significantopens in a new tab or window, and maybe more insidious, role in determining health outcomes for individuals and communities. These companies control the commercial determinants of health: actions, policies, and practices executed by private-sector entities that directly or indirectly influence public health.

What Are Commercial Determinants of Health?

Unlike SDOH, which are generally the result of government policies and priorities, family legacy and background, and economic pressures, commercial determinants of health (CDOH) are driven by the decisions made by private enterprises. They encompass a wide array of business considerations, including the desire to attain a certain profit margin, the durability of supply chains, labor conditions, product design and packaging, research funding, lobbying, and marketing practices.

CDOH can have both positive and negative effects, shaping the social, physical, and cultural environments in which people live. The choices made by companies in the production, pricing, and marketing of products like ultra-processed foods, tobacco, and sugar-sweetened beverages have been linked to an increase in noncommunicable diseases such as cardiovascular disease, type 2 diabetes, and certain cancers, for example.

The aggressive marketing tactics employed by these companies, especially when targeting young people, exacerbate these health issues. Advertising fast food to teenagers, for instance, taps into the highly sensitive and still-developing pathways in their brains, making them more susceptible to unhealthy eating habits that can lead to obesity and related health problems. Similarly, the promotion of alcohol and tobacco through celebrity endorsements and social media influencers often glamorizes these products, encouraging consumption among impressionable audiences.

The Hulu series Dopesickopens in a new tab or window, which explores the origins and causes of the opioid epidemic, and the 2006 movie Fast Food Nationopens in a new tab or window both examine how commercial decisions affect health -- but the impact of CDOH extends far beyond these well-known examples. The environmental consequences of commercial activities like mass deforestation to meet global demand for commodities -- like timber, tobacco, and coffee -- can lead to outbreaks of vector-borne diseases such as malaria and chikungunya.

According to a 2020 articleopens in a new tab or window published in Nature, up to 20% of malaria risk in deforestation hotspots can be attributed to international trade. And, of course, as the American Hospital Associationopens in a new tab or window has pointed out, "Many commercial health insurance policies and practices often disrupt, delay and deny medically necessary care to patients."

On the flip side, pharmaceutical companies play a crucial role in increasing the availability of essential medicines and health technologies, and improving access to high-quality, safe, and effective medical products. The reformulation of goods and products to reduce harm is another area where commercial entities have made significant strides. For example, the introduction of seat beltsopens in a new tab or window by the automotive industry (an invention from the 1880s), efforts to reduce salt contentopens in a new tab or window in food production, and the elimination of trans fatsopens in a new tab or window from the global food supply are all examples of how private sector initiatives benefit public health. Admittedly, while public outcry, laws, and regulations hastened some changes, others have been quickly recognized as a public good.

How the Private Sector Can Leverage Commercial Power to Address SDOH

Commercial determinants of health do not exist in a vacuum; they interact with and often exacerbate the effects of SDOH. Ultra-processed foods are more likely to be consumed by individuals living in economically disadvantaged communitiesopens in a new tab or window, for example, where access to healthy food options and healthcare services is limited. Young people are particularly vulnerable to the influence of marketing and advertising, making them more susceptible to the allure of harmful products.

The fact that social and economic inequities can be worsened by the effects of CDOH underscores the importance of government regulation of the commercial activities that target vulnerable demographics, as well as the need for public health campaigns that balance these influences. It is essential that lawmakers create a regulatory environment that encourages responsible corporate behavior while holding companies accountable for the negative impacts of their actions. Lawmakers also should consider incentives for companies to invest in health-promoting activities and products.

The private sector also must police itself. In 2018, just days after a mass shooting in Florida, the CEO and largest shareholder of Dick's Sporting Goods decided that his company would no longer sell guns (following an initial scale back in 2012 following the Sandy Hook Elementary School shooting). As CNN explainedopens in a new tab or window, the company started slowly, first announcing it would stop selling semi-automatic weapons, and then pulling firearms and hunting accessories from 10 stores as a test.

The decision was the right thing to do for public health -- and for the bottom line. At those 10 stores, "Overall sales increased." The last quarter of 2023opens in a new tab or window was Dick's Sporting Goods' most profitable 3 monthsopens in a new tab or window in the company's history.

Corporate policies that promote living wages, paid parental leave, sick leave, and access to health insurance also can significantly improve health outcomes, particularly for vulnerable populations. These positive effects of CDOH highlight the potential for the private sector to be a force for good, provided that there is a commitment to prioritizing public health over profit.

While the commercial market has the potential to contribute to improved public health, it also poses significant risks, particularly when profit motives overshadow public health considerations. As we continue to address the social determinants of health, it is imperative that policymakers and the healthcare industry also focus on the commercial determinants, holding the private sector accountable for the role it plays in promoting the health and well-being of all people. By doing so, we can create a healthier, more equitable society where the pursuit of profit does not come at the expense of public health.

8 Ways to Keep From Going Broke in Retirement

Sat, 17 Aug 2024 19:03:47 GMT

No matter how diligently you’ve been saving for retirement , it’s hard not to worry about outliving your money. But you can take several steps to contain your expenses, manage your nest egg and invest wisely to help keep your savings from running dry.

1. Be realistic about expenses

“A lot of people are not honest with themselves about how much they will spend in retirement,” says Linda Bentley Gillespie, founder of Real World Financial Planning in Newton, Massachusetts.

To get a general estimate, add up your regular expenses, like rent or mortgage payments, utilities, taxes and insurance, then figure out your variable spending. Sarah Behr, an investment adviser at Simplify Financial Planning in San Francisco, suggests adding up your costs for things like dining out, groceries, gas and vacations over the last six months, and calculating a monthly average. Using a spreadsheet or a budgeting app can also help you track those expenditures.

Be sure to factor in new expenses that might pop up in retirement, and any costs that might go away, Behr says. Will you be traveling more? Will you and your spouse still need two cars if you’re not commuting anymore? Will your mortgage be paid off ?

2. See where you can save

Look for ways to reduce spending on the things you don’t really need so you will have enough to do the things you love in retirement.

For example, if your home is becoming too difficult to maintain, consider downsizing . Pay off high-interest debt, like credit cards and auto loans, and shop around for things like cheaper auto insurance. The little things add up, so examine your day-to-day costs as well. Maybe you can cancel one or two of your streaming services , or go out to dinner a few times less a month.

Even if you’ve been frugal over the years, think twice about any big splurges . Retirement may seem like the perfect time to hit the road in an RV or get a boat for your lake house, but big-ticket items like these — and the cost of maintaining them — can dig a deep hole in your savings.

3. Figure out the right withdrawal rate

Once you reach retirement age, odds are good that you’ll live another 20 years or more. You need to find the right balance between drawing down your savings for income and making the money last.

One long-standing rule of thumb is the 4 percent rule, which recommends withdrawing up to 4 percent of your investment portfolio in the first year of retirement, then adjusting the amount for inflation every year after that. So, if you retire with $1 million saved, you could take out $40,000 in the first year. The next year, if the inflation rate is 3 percent, you would withdraw $40,000 plus 3 percent, or $41,200.

A November 2023 Morningstar study found that a retiree following this method at an initial withdrawal rate of 4 percent or less had a 90 percent probability of having funds left after 30 years, assuming a balanced portfolio (such as 40 percent stocks and 60 percent bonds and cash) and returns that follow historical norms.

The 4 percent rule is a good starting point, but it’s important to stay flexible. “No one spends in a straight line,” Behr says, noting that retirees generally spend more at the beginning and the end of retirement, and less in the years in between.

4. Play catch-up

While it’s always best to start saving for retirement when you’re young, it’s never too late for older workers to play catch-up. Starting when you turn 50, the IRS lets you make larger “catch-up contributions” to retirement accounts. Doing so can significantly bulk up your nest egg, says Greg McBride, chief financial analyst at Bankrate.

For 2024, workers under age 50 can put up to $23,000 into a workplace retirement plan such as a 401(k) or 403(b), but those who are 50-plus can contribute up to $30,500. For an individual retirement account (IRA), the standard limit is $7,000, but 50-plus workers can make catch-up contributions of up to $1,000, for a total of $8,000.

5. Be strategic about Social Security

If you can afford to hold off taking Social Security until you reach age 70 (or at least your late 60s), your monthly checks will be appreciably bigger.

Retirement benefits are reduced if you take them before full retirement age (between 66 or 67, depending on the year you were born). That’s when you qualify to claim the full benefit calculated from your lifetime earnings record . If you can delay past that , you get an extra two-thirds of 1 percent per month, or up to 8 percent a year, until you hit 70.

“That is a benefit that is 24 percent higher than if you claim it at age 67,” McBride notes. So, if your full benefit would be $2,000 a month, claiming at 70 makes it $2,480. That’s an extra $5,760 a year (plus cost-of-living adjustments, or COLAs ) for life.

6. Stay on top of your investments

When it comes to investing for retirement, you can’t just set it and forget it. “People should, over the course of their life spans, be reevaluating and making adjustments,” says Tyler Bond, research director at the National Institute on Retirement Security, a nonprofit research organization.

The conventional wisdom is that the older you get, the less risk you should take on, because you’ll have less time to recover if the market goes south . This means reducing your exposure to riskier assets, like stocks, in favor of more conservative assets, like bonds or cash .

Target date funds (TDFs), which rebalance your portfolio as you near retirement age, were created to help investors navigate these adjustments. But do your research before investing in one. “Not all target date funds are created the same,” says McBride. “Some are more aggressive, while some are more conservative.”

Also, steer clear of annuities and investment funds that charge high fees, Behr suggests. You can check fees for individual funds on the Financial Industry Regulatory Authority (FINRA) Fund Analyzer , which calculates how much fees and expenses will affect the value of a certain fund over time and allows you to compare the cost of owning different funds.

7. Don’t forget about health care costs

The average 65-year-old will need to devote roughly $165,000 of savings to health care expenses in retirement, according to a 2024 Fidelity study . A couple who are both 65 would need approximately $330,000.

One way to keep these costs from breaking your bank: Don’t retire until you’re eligible to enroll in Medicare at age 65. Staying on your workplace health plan (or your spouse’s) instead of relying on COBRA or buying private coverage could mean significant savings, McBride says.

During your working years, you may also be able to put funds into a tax-advantaged account like a health savings account (HSA). “You get a tax deduction on the money you put in while you’re working, the money grows without being taxed, and, when you withdraw it for health care-related expenses, you don’t pay taxes on the withdrawals,” McBride says.

The drawback to an HSA is that it often requires you to enroll in a high-deductible health plan. “That may be unaffordable for some people, or it may not be offered by your employer,” McBride says.

8. Consider a side hustle

One of the best ways to help ensure your nest egg will last as long as you do is to keep working. But hanging on to a full-time job well into your 60s or 70s is not always realistic, or particularly desirable.

To bring in extra income and let your investments keep growing, consider getting a part-time job doing something you enjoy. Not only will it keep money flowing in; it will also help you stay active and engaged.

If you want even more freedom and flexibility, consider a side hustle, says Robert Holzbach, a fee-only certified financial planner at Red Kennedy Financial in Littleton, Massachusetts. “An extra $10,000 a year can go a long way because you aren’t touching $10,000 in retirement savings, and you’re letting it compound.”

Holzbach suggests a few creative ways to make money, including hosting an exchange student, pet sitting or renting out your home on a site like Vrbo or Airbnb. Plus, you can often deduct the expenses for some of the income you bring in, he says.

“You can visit your grandkids for two weeks, rent out your home, and then you’re getting paid to play with your grandkids,” he says.

A Recession Survival Guide for Retirees

Wed, 14 Aug 2024 06:04:22 GMT

Economic downturns are inevitable. Here’s how to protect your retirement nest egg

Is the U.S. in a recession? The media is filled with speculation after the stock market’s recent nosedive . But the official arbiter of recessions, the National Bureau of Economic Research (NBER), says it’s too soon to tell.

Still, sooner or later, the economy will fall into a recession, because that’s the nature of the economy: Busts follow booms. For many retirees, the biggest challenge is the investment volatility that typically accompanies a recession. For those who haven’t retired yet, the biggest worry tends to be job loss. If you know what to expect in a recession, however, you’ll know how to survive it. Let’s take a look at what recessions are and how to prepare for them.

What’s a recession?

Most retirees have lived through several recessions and know that it’s not pleasant. Typically, you’ll see a recession described as “two consecutive quarters of negative economic growth.” In other words, gross domestic product (GDP), adjusted for inflation, has to fall for at least six months. But that’s not a terribly accurate description.

The NBER is a private nonprofit made up of economic researchers. Its Business Cycle Dating Committee — the official recession scorekeeper — uses several indicators to determine when a recession starts and ends. GDP is just one of those indicators. The committee also weighs employment trends, industrial production and retail sales, among other factors.

The NBER’s broad definition of a recession is that it is “a significant decline in economic activity that is spread across the economy and that lasts more than a few months.” In practical terms, a recession is a period of increasing unemployment, business failures and general economic distress. A recession is not solely defined by the ups and downs of the stock market.

Since 1857, the U.S. has had 34 recessions, lasting an average of 17 months, according to NBER. Recessions have been fewer and shorter since 1945, lasting an average of 10.3 months. The recession of 1873 was the big daddy of misery: It lasted 65 months.

What causes a recession?

A recession typically is caused by an overheated economy. Rising demand for goods roars past industry’s ability to produce them; that, in turn, results in rising prices. Low unemployment means that workers can command higher wages, which results in further economic overheating.

How does that turn into a recession? High consumer demand in a ripsnorting economy usually translates into higher interest rates. Rising rates mean businesses have to spend more to borrow money, which reduces corporate earnings. For retirees, higher mortgage rates make it harder to sell a house, and the rates on credit cards and auto loans become more expensive. If businesses and consumers feel the economy is slowing, they reduce spending and, eventually, the economy stops expanding. Inflation cools and sometimes the economy falls into recession, as it did in 1981, for example.

At times, an overheated economy leads to enormous run-ups in financial assets — stocks in 1929, tech stocks in 2000 and housing prices in 2006.

Other times, recessions are sparked by unexpected events, such as the onset of the COVID-19 pandemic in 2020, which triggered the shortest recession on record — and one of the sharpest. GDP contracted at the fastest quarterly rate ever in the United States. “We shut down,” says Mark Zandi, chief economist for Moody’s Analytics.

Most important for retirees and pre-retirees, a recession means that financial markets often crumble, forcing people to delay retirement — or return to work — in reaction to their shrinking nest eggs. During the Great Depression, stock prices plummeted 86 percent and didn’t recover until 1954. More than 9,000 banks failed, 4,000 in 1933 alone, because the federal government didn’t guarantee bank deposits as it does now.

Recession or depression?

The old joke among economists is that a recession is when somebody you know gets laid off; a depression is when you get laid off. (That’s why you find economists at the NBER and not at the Improv.)

In general, the difference is a matter of degree. A depression is the grizzly bear of the economic world. In the Great Depression, unemployment climbed to nearly 25 percent. The Great Recession of 2007–2009 saw unemployment rise to 10 percent and GDP fall 4.3 percent, adjusted for inflation. The most recent recession, sparked by the COVID-19 pandemic, has been the most severe since the Great Depression, although it was much shorter. In just two months, GDP plunged 19.2 percent and unemployment spiked to 14.7 percent, an all-time high.

One other thing: Because the Great Depression was so terrible, economists have basically stopped using the word “depression.” “We have come up with more targeted terms for the bigger events in history, and so I think the word ‘depression’ has been largely reserved, at least until now, for the Great Depression,” says Mike Englund, chief economist at Action Economics, a consulting firm in Boulder, Colorado.

“With the housing collapse earlier this century, we coined the ‘Great Recession,’ ” Englund says. “If we have another big adverse economic event, I think the incentive is high for the media to come up with a new clever name again.”

Will we have another recession?

Absolutely. Someday. But the U.S. economy is not currently in a recession.

In response to worrisome inflation levels, the Fed typically raises short-term interest rates to slow the economy and — at least officially — tries to keep the U.S. out of recession. Sometimes, however, a recession is the only way to tame inflation, as the nation learned in the 1981–1982 recession, when the Fed, under chairman Paul Volcker, raised short-term interest rates to 15 percent.

More recently, Jerome Powell, the current Fed chairman, spearheaded a series of rate hikes in 2022 and 2023 to rein in soaring prices. The tactic was successful in taming inflation. Now, with the job market softening and the economy slowing, Powell is widely expected to shift gears and start cutting the Fed’s benchmark rate in September.

One thing is certain: Sooner or later, the economy will sink into recession, and if you’re retired — or planning to retire soon — you should be prepared for it.

How retirees and retirement savers can prepare for a recession

1. Save. “Avoid risk if you think a recession is around the corner,” says John Lonski, president of Thru the Cycle, an investment advisory firm. The biggest risk for pre-retirees: losing your job. If you’re working, be sure you have an emergency fund you can tap if the paychecks stop. Financial planners often recommend that you have three to six months’ worth of expenses in your emergency fund.

2. Pay down debt. The money you save in interest can be used to build your emergency fund. And, all things being equal, paying off a credit card that charges 16 percent interest is the same as earning 16 percent on your money.

3. Keep a cash stash. Retirees who are taking withdrawals from their savings should keep about a year’s worth of expenses in cash in their retirement account. (If you’re not taking withdrawals, it’s generally best to wait it out.) Bear markets in stocks typically last about a year. You don’t want to sell stocks when the market is falling unless there’s no other option. If your stocks are down 10 percent and you withdraw 5 percent, your stock portfolio is down 15 percent.

4. Stay safe. Most cash options pay little to nothing in interest. Money market mutual funds, a typical cash option in brokerage accounts, currently pay 1.41 percent in interest, the Federal Deposit Insurance Corporation reports. That’s not much, but it’s better than a 20 to 30 percent loss from stocks in a bear market. If you take cash withdrawals from your retirement account during a bear market, you’ll give your other, riskier investments time to recover.

5. Sit tight. Sooner or later, you’ll be tempted to buy stocks while they appear to be cheap. Take your time going back in. Keep in mind that by the time the NBER has officially declared a recession has started, it’s probably near the end. After all, economic data usually lags, particularly GDP. The average recession lasts about 10 months, and the NBER typically needs about nine months to collect all the data it needs to declare that a recession has started.

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Death Is Inevitable. It's Time We Learned to Talk About It.

Tue, 13 Aug 2024 20:05:21 GMT

Years ago, in a busy emergency department, I found myself joining my mentor at the bedside of an elderly man experiencing chest pain. After completing the physical exam, the doctor unceremoniously changed gears to abruptly ask our patient, "If your heart were to stop beating, do you want us to do everything ?"

Between the stress of the situation and the vague and awkward delivery of the question, our patient seemed (understandably) overwhelmed. So was I.

I wish I could say this clumsy navigation of a conversation relating to medical decision making and end-of-life care was a one-off. However, I've observed similarly worded interactions far too often. In healthcare, a field dealing with life and death every day, it's surprising how little we talk about death.

Of course, in a profession that celebrates life, triumphs over disease, and seeks cures, mortality can seem like a failure. Advanced directives demand a grappling with the uncertainty surrounding health outcomes and the potential need for decisions to be made in unforeseen circumstances. It can be challenging to balance the desire to assert control over one's medical destiny with the humility to acknowledge the limits of that control.

Yet, morbidity, mortality, and the many grey zones in between are ever-present in healthcare. As a medical student, I believe it is crucial to equip future physicians with the skills to navigate these conversations, especially in acute situations where time is limited and patient capacity for decision-making can quickly change over the course of their hospital stay.

End-of-life conversations can feel like a "word soup" of sorts. Between numerous provisions -- from advanced directives to powers-of-attorney to living wills and informal verbal instructions -- it is easy for patients and providers alike to feel lost. In addition, decisions on how to die are incredibly personal to each patient and family. Providers must also consider the nuances of cultural attitudes towards death; the location and family arrangements surrounding a person at the end of life; and the varying emotional responses and feelings of decision paralysis surrounding how one dies and how one feels about dying. Unfortunately, these feelings of disorientation can often cause the most harm in acute care settings like emergency departments.

Multiple studies have highlighted the positive impact that early exposure to palliative care and communication of end-of-life goals can have on patient satisfaction at the end of life. In the context of a rapidly aging population -- both in the U.S. and abroad -- elderly and terminally ill adults often present to emergency departments several times in the last 3 to 6 months of their lives. These visits provide opportunities for healthcare professionals to listen to patients and enable them to share and communicate their goals of care, as well as to assume some agency over their healthcare choices concerning end-of-life care.

For older adults with serious illness, studies demonstrate that conversations about end-of-life care planning are associated with improved quality of life and a greater likelihood of health wishes and directives being communicated and followed. For families, early end-of-life conversations are associated with reduced distress and discomfort related to medical decision-making, and improved bereavement adjustment.

In a recent study by Alice Chang, DO, et al. , 88% of medical residents agreed that palliative care literacy was a critically important skill for emergency medical providers; however, up to 46% reported having minimal knowledge or training in this area. Beyond arming emergency medical providers with the medical skills to recognize and manage patients at the end of life, it is equally important to empower emergency physicians with the skills to navigate and engage their patients through end-of-life care conversations.

In addition to greater training for emergency physicians, all clinicians should gain some literacy in communicating choices about end-of-life care and shed the all-too-common clinician awkwardness around death and dying. While my own medical school curriculum included one or two lectures on palliative care and navigating the end of life, the bulk of my experience comes from self-learning and actively seeking experiences in the palliative care field or being thrust into situations on the medical wards.

It is not fair to patients who may already be disoriented to make them interact with similarly disoriented doctors who navigate end-of-life care ineptly. Like all aspects of care, navigating end-of-life care and building literacy in this field is a skill that must be developed through ample practice.

End-of-life care is not a sideline issue but a core component of compassionate, patient-centered healthcare. By improving palliative care literacy among medical professionals, we can ensure that patients receive the support and respect they deserve in their final days. This extends beyond medical care, and refers to the ability to communicate with empathy and clarity, guiding patients and their families through some of the most challenging decisions they will ever face.

As providers, our goal should be to create a healthcare environment where conversations about death are not avoided but instead are approached with sensitivity and competence. This approach can improve outcomes for patients and families, reduce the emotional burden on healthcare providers, and ultimately reflect a more holistic and personalized approach to medical care.

Death is an inevitable part of life, and our healthcare system must be better equipped to handle it. By fostering open, honest, and compassionate discussions about end-of-life care, we can provide patients with more dignity throughout their experience. Or, at the very least, we can meet patients at the bedside with tact and grace when supporting their wishes and needs near the end of their lives.

Nidhi Bhaskar is a third-year medical student at the Warren Alpert School of Medicine at Brown University in Providence, Rhode Island, and a member of MedPage Today's advisory board, The Lab. An alumnus of Brown University and the University of Oxford, she hopes to bridge her background in medical anthropology with the practice of medicine to shape global health interventions and public policy.

Older Adults Most Concerned About Healthcare Costs Ahead of Election

Tue, 13 Aug 2024 16:28:53 GMT

— Of healthcare-related concerns, costs of long-term care rose to the top

by Sophie Putka, Enterprise & Investigative Writer, MedPage Today

August 14, 2024

Ahead of the 2024 election, five of the top six health concerns of adults 50 years and older were related to costs of healthcare and health insurance, a nationally representative survey found.

For the top spot, 56.3% (95% CI 53.7%-59%) reported being "very concerned" about the cost of home care, assisted living, and nursing home care, John Ayanian, MD, MPP, of the University of Michigan in Ann Arbor, and co-authors reported in JAMA .

Cost of medical care, cost of prescription medications, financial scams and fraud, cost of health insurance and Medicare, and the cost of dental care rounded out the top six, ranging from 56.2% (95% CI 54.3%-58.1%) to 44.6% (95% CI 42.9%-46.3%).

"Adults 50 years or older cast more than half of all ballots in the 2020 U.S. election," Ayanian and colleagues wrote. "Issues related to health and healthcare are often key factors for voters, particularly for older adults who typically have greater health needs than younger adults."

Adjusted analyses showed significant differences between certain groups of adults who reported they were "very concerned" about medical care costs:

Women vs men (59.3% vs 54.1%, P=<0.01)
Liberals vs moderates (68.2% vs 56.4%, P<0.001)
Moderates vs conservatives (56.4% vs 51.4%, P<0.05)
Those ages 50-64 vs 65-101 (59.6% vs 53.4%, P<0.001)
Those in nonmetropolitan vs metropolitan areas (61.7 vs 55.9%, P<0.05)

"It really is striking that so many of those issues are top concerns and worries for people," Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care in Washington, D.C., who was not involved in the study, told MedPage Today. "It goes to the need to ensure that people have good options for retirement planning, or end of life planning, or planning for care in their future. People need quite a bit of support, and our policies need to reflect that."

Like all healthcare, "the costs are just tremendous, and they rise significantly every year. So unfortunately, it's the way our health system operates, and long-term care has been a part of that, and has been very, very costly," Smetanka said. With an increasingly older population, and with people living longer overall, there is more need for medical services.

Smetanka emphasized that these concerns are relevant not only to older adults, but to families that the costs and care often fall to. It's not unusual, she said, for people to leave their jobs and move back home to care for older adults, use money saved for their own retirement on medical expenses, or even deplete all their resources in order to qualify for Medicaid, which offers a nursing home care benefit. More support for care at home or community-based settings is needed, she said.

Of those running for office, she said, "How will the policies that they promote best support families and family caregivers so that people have choice and access ... but also support the families that are providing so much of that uncompensated care?"

"Those are really important elements that we need to be asking our candidates and our policymakers as we move forward in this election," she said.

The authors wrote that in order to "engage older voters, candidates for president and Congress should prioritize communicating their plans for controlling healthcare costs."

The study was part of the larger National Poll on Healthy Aging, a recurring survey which uses a probability-based sample of the U.S. household population. It was conducted online and by phone from February 22 to March 12, 2024 with a stratified random sample of adults ages 50 to 101 years. In total, 2,576 of the 3,626 invited adults completed the survey. The mean age was 65.2, 53.1% were women, and 77.1% of participants were white, non-Hispanic.

Based on focus group and pilot testing, a research team designed 26 health policy-related issues and participants were asked to rate their level of concern on each as "very," "somewhat," or "not concerned." Other issues included access to home care, assisted living, or nursing home care; healthcare quality; health misinformation; access to affordable healthy foods; poverty; neighborhood safety; and social isolation or loneliness, among others. Researchers calculated weighted percentages for participants who reported being "very concerned" about each issue.

Study limitations included a lack of data on personal health concerns and non-health issues that could influence older voters' preferences.

5 Health Conditions Linked to Poor Sleep

Thu, 08 Aug 2024 19:03:54 GMT

If you feel like your sleep isn’t what it used to be, you’re probably right. Even healthy aging is associated with changes in sleep patterns like shorter sleep duration, less deep sleep and more frequent awakenings throughout the night.

But it’s not all bad. In fact, despite these typical shifts, healthy older adults tend to report fewer sleep problems than younger generations. Put another way, the older you are, the less likely you are to be bothered by an imperfect night’s sleep, says Michael Grandner, a clinical psychologist and director of the Sleep and Heath Research Program at the University of Arizona.

That could help explain why, despite a recent AARP survey showing that 70 percent of adults 40 and older reported having sleep difficulties, another study, published last month by Saatva, showed that only 20 percent of boomers said they always or often struggle to get up in the morning. That’s compared to 43 percent of millennials and 48 percent of Gen Zers — even though the older cohort didn’t report that their sleep was any more restful.

“Part of it might be resilience; part of it might be changing expectations; part of it might be perspective and ability to cope,” Grandner says.

But if you’re not coping well with sleep issues in your 50s, 60s and beyond, it could be a sign of a health condition that deserves medical attention — and treatment.

“The important thing to remember is if you’re getting older and you feel like your sleep is a problem, if it’s not really interfering with your ability to function, maybe that’s more the normal aging side,” Grandner says. “But if it is actually becoming a real problem, don’t let your doctor just say, ‘Eh, this is just part of aging.’ There might be a solution for this.”

Here are five conditions other than insomnia that may be leading to poor sleep — and how better sleep can help fend off disease in the first place.

1. Sleep apnea

If you keep waking up unrefreshed even though you seem to be doing everything “right,” there may be a relatively straightforward explanation: sleep apnea . The condition, which causes you to sporadically stop breathing throughout the night, is widely overlooked, with about 85 to 90 percent of people with sleep apnea unaware that they have it , the Cleveland Clinic says. Sleep apnea is especially common in older people, affecting 17 percent of men and 9 percent of women ages 50 to 70.

So while it might be tempting to look for an explanation other than a sleep disorder to explain your unsatisfying z’s or daytime fatigue, often a sleep disorder is at least partially to blame.

“A lot of times, this kind of thinking — that something else is causing the sleep issue— only delays treatment for the sleep problem, when treating the sleep issue first can often resolve other issues,” says Shelby Harris, a clinical psychologist who is board certified in behavioral sleep medicine and serves as a clinical associate professor at Albert Einstein College of Medicine.

The top-line treatment for sleep apnea is positive airway pressure (PAP), which describes a range of devices that help prevent the throat from closing by increasing air pressure in the airway.

2. Congestive heart failure

While heart problems seem distinct from breathing (and therefore sleeping) problems, the cardiovascular and pulmonary systems are intricately linked.

That’s why, in broad terms, upwards of two-thirds of people with heart failure (when damage to your heart prevents it from pumping enough blood effectively) also have sleep apnea, says James Rowley, M.D., a pulmonologist and the program director of the Sleep Medicine Fellowship at RUSH University Medical Center.

Often these patients have central sleep apnea, when the brain fails to tell the lungs to breathe, rather than obstructive sleep apnea, the more widely known type in which a mechanical issue in the throat blocks air from reaching the lungs.

As a result, your sleep is erratic, which puts more stress on the heart, which exacerbates both conditions. “If you don’t treat the sleep apnea, [patients] are not gonna feel better — even if you’ve been treating the congestive heart failure,” says Rowley, the immediate past president of the American Academy of Sleep Medicine. “And then there’s also evidence that treating the sleep apnea helps the congestive heart failure.”

Managing heart failure can include lifestyle changes like salt reduction and medications like those that help open up the blood vessels.

3. Menopause

Hot flashes and night sweats are stereotypical menopausal symptoms for a reason, with some research showing that as many as 87 percent of midlife women experience them. So it’s no wonder women going through menopause often struggle to get high-quality sleep.

It’s not just the symptoms of menopause that can interrupt solid shut-eye during this transition — so, too, can stressors like caring for aging parents or menopause-adjacent mental health conditions like depression. And some research suggests about half of menopausal women have an underlying sleep disorder independent of their life stage.

“It can be hard to tease apart, but it is always a discussion to have with your gynecologist, especially one who is very knowledgeable about menopause treatments,” Harris says.

Those treatments may include hormone therapy (which can help reduce hot flashes and night sweats) or nonhormonal meds like benzodiazepines (which can help reduce anxiety). The gold standard, though, is cognitive behavioral therapy for insomnia , Harris says.

“This approach works on limiting naps during the day, creating a more appropriate sleep-wake schedule, working on any thoughts about sleep that might be interfering with the ability to sleep (‘I must sleep or else XYZ will happen tomorrow’) and improving sleep hygiene, movement and light exposure during the day,” she says.

4. Dementia

The term “ dementia ” encompasses a range of conditions, from mild to severe, Grandner says. “But they all have to do with what’s called neurodegeneration, which means that areas of the brain start losing function and breaking down. And it’s not just the cells themselves dying; it’s also the connections between them that are altered,” he says.

Sleep disturbances frequently accompany that process, with about 25 percent of people with mild to moderate dementia and 50 percent of people with severe dementia facing them, according to the Mayo Clinic.

More specifically, people with Alzheimer’s — the most common type of dementia — may experience “sundowning,” which often starts around dusk but can last into the night. It can include agitation, anxiety, disorientation and pacing throughout the night, according to the Alzheimer’s Association. Dementia’s effect on melatonin production can also disrupt a person’s internal body clock and make it difficult to sleep.

“I don’t think there are any neurodegenerative disorders that don’t have a significant impact on sleep-wake regulation,” Grandner says.

The reverse is true too: Poor sleep can raise the risk of developing dementia in the first place. One 2023 study looking at 10 years of data from U.S. adults over age 64 found that sleep-initiation insomnia (the type where it’s hard to fall asleep) was associated with a 51 percent increased risk of dementia , and using sleep meds was linked to a 30 percent increased dementia risk.

No matter which comes first — poor sleep or dementia — supporting better sleep can include lifestyle adjustments like maintaining a routine and avoiding daytime napping, as well as treatments like melatonin supplementation and light therapy, the Mayo Clinic says.

5. Parkinson’s disease

Parkinson’s disease — a progressive brain disorder that is marked by movement challenges like stiff muscles and tremors in the hands and legs — makes it hard to feel comfortable. So people with it often “don’t sleep well because of the rigidity aspects of the disease,” Rowley says.

But there’s more to it than that. Recent research showed that even among people with early-stage Parkinson’s who aren’t yet impaired by motor issues, 71 percent had at least one type of sleep disturbance, like insomnia or excessive daytime sleepiness, and about half had multiple disturbances. That’s likely related to chemical changes in the brain, Parkinson’s medications and other factors that scientists are still studying, the researchers say.

Here, too, it’s key to address both issues. Just treating the Parkinson’s “doesn’t necessarily mean that the insomnia will improve,” Rowley says. “[Patients] should still see the sleep doctor and have cognitive behavioral therapy or sometimes medication.”

Prioritizing sleep to help prevent disease

If you’re currently disease-free, maximizing your sleep quality can help you stay that way, a new study in the journal Nature Medicine shows.

To see how sleep quality and duration affected people’s likelihood of developing all sorts of conditions, researchers looked at data from nearly 7,000 adults who wore activity and sleep trackers over the course of a median of four and a half years. They then squared that data with the participants’ electronic medical records.

Unlike most sleep studies, which either analyze one night of an individual’s sleep or review a population’s sleep as it relates to a particular disease, this one looked “across the entire spectrum of human diseases that show up in people’s electronic medical records,” says the study’s corresponding author Evan Brittain, M.D., a professor of medicine at Vanderbilt University Medical Center. “We were able to take a really unbiased view at what associations with sleep were more important.”

The researchers found that the less rapid eye movement (REM) and deep sleep the participants got, the more likely they were to develop atrial fibrillation, or an irregular heart beat. And the more inconsistent their sleep schedule, the greater their odds for obesity, hyperlipidemia, hypertension, depression and generalized anxiety disorder.

One of the takeaways, Brittain says, is that going to bed and getting up at the same time every day seems to be more important than getting the oft-recommended eight hours. In fact, seven hours of sleep was the median — not minimum — number of hours people with good health outcomes got.

“I think that finding is a hopeful thing for patients because it’s hard for me to say, ‘You need to get more REM sleep, you need to get more deep sleep,’ and patients can’t do anything with that information,” Brittain says. “But saying, ‘It’s really helpful if you go to bed and wake up at the same times each night; that’s really important for your health’ — that’s something that’s easily digestible.”

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Coffee-Dementia Link Continues to Unfurl

Tue, 06 Aug 2024 19:47:32 GMT

— Two studies hint at protective relationships for some coffee and tea drinkers

by Judy George, Deputy Managing Editor, MedPage Today ,

PHILADELPHIA -- Coffee and tea intake were associated with long-term cognitive changes in older adults, two prospective studies presented at the Alzheimer's Association International Conferenceopens in a new tab or window (AAIC) suggested.

Among 6,001 Health and Retirement Study participants in the U.S., drinking two or more cups of coffee a day was associated with a 28% lower risk of dementia over 7 years compared with drinking less than one daily cup (P<0.05), reported Changzheng Yuan, ScD, of the Harvard T.H. Chan School of Public Health in Boston and the Zhejiang University School of Medicine in China, in a poster presented at the meeting.

Moderate tea drinking -- up to two cups a day -- was also associated with a lower dementia risk compared with no tea consumption (P<0.05).

When total caffeine intake derived from coffee and tea was calculated, participants in the highest quartile of caffeine consumption had a 38% decreased risk of dementia (P=0.032), Yuan and co-authors said.

In another study presented at AAIC, researchers showed that among 8,451 U.K. Biobank participants, daily coffee and tea intake predicted the slope of fluid intelligence decline.

Decline in fluid intelligence was slower among older adults who had moderate coffee consumption (one to three cups of coffee a day) and those who never drank coffee, compared with those who drank four or more daily cups, said Kelsey Sewell, PhD, of Murdoch University in Perth, Australia. This suggested an upper limit to coffee intake, she observed.

Tea drinking, however, showed a different pattern. U.K. Biobank participants who never drank tea had a greater decline in fluid intelligence compared with those who had moderate (one to three daily cups) or high (four or more cups per day) tea consumption.

Both coffee and tea contain bioactive compounds , including caffeine. Prior work has suggested that coffee may have a protective role in Alzheimer's and Parkinson's disease .

In an earlier study of 227 cognitively unimpaired older adults in Australia, "we found that greater coffee consumption was associated with slower cognitive decline and slower accumulation of brain beta-amyloid," Sewell noted.

The U.K. Biobank analysis evaluated cognitively unimpaired older adults who were followed for an average of 8.8 years. Coffee and tea intake were self-reported at baseline. Cognitive assessments throughout the study incorporated pairs-matching, reaction time, numeric memory, and fluid intelligence tests.

Most of the cohort (60%) were women. Mean age was 68 years, and nearly all participants (97%) were white.

At baseline, nearly half (47%) of U.K. Biobank participants reported high tea consumption, drinking four cups a day or more, while 38% were moderate tea drinkers, and 15% didn't drink tea.

In contrast, only 18% of the U.K. sample had high daily coffee consumption; 58% were moderate coffee drinkers, and 25% didn't drink coffee at all.

The results "support the hypothesis that both coffee and tea intake may have a protective factor against cognitive decline, particularly for maintaining fluid intelligence," Sewell said.

Given the dose-response relationships seen in the study, "caffeine may be a potential mechanism here," she suggested.

The analysis may be subject to measurement error or recall bias, she noted. The researchers didn't have information about coffee or tea drinking in midlife, the types of coffee or tea that older adults consumed (green vs black tea, for example), or how coffee and tea were prepared.

"Further studies are required to elucidate the neuroprotective mechanisms of coffee and tea compounds," Sewell said. "Coffee and tea intake could contribute to the development of safe and inexpensive strategies for delaying onset and reducing incidence of Alzheimer's disease."

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The Shocking Truth About ‘Sitting Disease’

Tue, 06 Aug 2024 16:17:20 GMT

Kelli Bloomquist, 45, spent up to 10 hours a day sitting at her desk in her home office. That, plus ending her day with family couch hangs, left the media executive with very little time on her feet. “My legs were always falling asleep. I’d have to stand up just to get feeling back into my legs and butt,” she recalls.

During a doctor’s appointment, Bloomquist learned she was prediabetic and had an array of autoimmune issues, largely as a result of her inactive lifestyle. So she purchased a treadmill and stand-up desk and now challenges herself to hit a daily 10,000 steps. “I’ve lost weight; I’m no longer prediabetic,” she says. She’s also focusing better at work.

Bloomquist had what doctors refer to as “sitting disease” — a term for the negative effects of being too inactive, which experts warn is becoming all too common these days. It’s often said that “sitting is the new smoking,” but in recent years, more research has shown just how unhealthy our sedentary lifestyles are. Here’s what you need to know.

You’re probably sitting a lot more than you think. “On average, U.S. adults are spending 11 to 12 hours per day sedentary, which represents three-quarters of their waking day,” says Keith Diaz, associate professor of behavioral medicine at Columbia University Medical Center in New York City.

Consider our most popular leisure activity, especially among older adults: watching TV. People 65 and older watch it for an average of 6.4 hours a day, while essentially enlisting technology to be active for us.

“While you’re watching TV, a microwave could be cooking your food, a dishwasher could be washing your dirty dishes, a laundry machine could be washing your soiled clothes, a vacuum could be self-cleaning the floor,” says Diaz. And many of us who still work are doing it from home — and hence not getting up to walk over to coworkers or into meetings.

Sitting is worse for you than just about any other position. Researchers broke a 24-hour day into five core behaviors: sleeping, sitting, standing, light activity and moderate-vigorous activity. Moderate to vigorous exercise — running, cycling and more — was found to be best for your heart. Next came lighter activity (like walking), followed by standing, then sleeping. They were all better for you than sitting, says lead researcher Jo Blodgett, a senior research fellow at University College London.

Sitting diminishes your brain. People who sit for more than 10 hours a day are at greater risk of developing dementia. Prolonged sitting can also worsen symptoms of depression and anxiety.

Sitting impacts your longevity. A 2016 review of 13 studies found that sitting for eight hours a day with no activity puts you at a similar risk of dying as smoking and obesity. Too much sitting leads to an increased risk of diabetes, heart disease, blood clots and certain cancers.

Sitting damages your fitness and mobility. “Anytime you spend a lot of time in one position, your muscles adapt to that position, which makes it so that you’re less flexible; it’s harder to get the full range of motion when you’re doing an activity,” says Claire Morrow, a physical therapist with Hinge Health in San Francisco.

You can’t fully undo the damage by exercising. “The more time you spend sitting, the greater risk you have for most chronic diseases, independent of whether you exercise or not,” says Diaz. “This notion that ‘I exercised today — check off my box for moving and I’m done’ is not enough. For ideal health, we need to move throughout our day, not just in one bout of exercise for 30 to 60 minutes.”

“I used to tell people you need 30 to 40 minutes of exercise at one time. I was wrong,” says Barry Franklin, director of preventive cardiology and cardiac rehabilitation at Corewell Health William Beaumont University Hospital in Royal Oak, Michigan. He now tells patients that even one to two minutes of movement every hour, throughout the day, has a big impact. “So over 16 hours, if you’re doing two minutes every hour, you’re getting more than 30 minutes,” he explains.

Moving every half hour for five minutes has substantial, positive effects on blood sugar levels, Diaz says. Getting up after a meal, even for a slow walk, is enough to reduce blood sugar spikes by 60 percent — equivalent to the effects of medication, he says. And moving every hour for just one minute provides a reduction in blood pressure comparable to what you’d experience from exercising daily for three to six months.

In a perfect world, you’d log at least 8,000 steps per day, says Edward Coyle, a professor in the department of kinesiology and health education with the University of Texas at Austin. Eight thousand is the number his team found was key to a healthy fat metabolism. But any amount helps. “If you are inactive, for each 1,000 steps you take, you lower your risk of dying and having heart disease by 15 percent,” he says.

Even seconds of activity throughout the day have immense benefits. Coyle’s team had people hop on an exercise bike for quick sprints and found that if they did this for 20 seconds every hour, they maintained a healthy fat metabolism.

The bottom line? Now that you’ve finished reading this article, get up and walk around for just two minutes. It could improve your life.

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Tiny Houses Can Help Reduce a Huge Affordable-Housing Shortage

Tue, 23 Jul 2024 18:10:30 GMT

Council on Aging of West Florida is often contacted by or on behalf of older residents in desperate need of housing and asking for help. In most cases, all the Pensacola, Florida-based agency can do is tell people to get on the region’s waiting lists for senior housing.

In 2022, the agency chose to address the housing problem directly by using its AARP Community Challenge grant for a housing-related demonstration project. “Housing is the biggest need,” explains Emily Echevarria, and it has the potential for the “biggest impact.”

Because the organization's staff didn’t have experience in the housing space, it reached out to local developers and one put them in touch with Rick Dye, a retired bank president who volunteers as an affordable housing consultant in the Pensacola community.

“Rick was gung-ho about doing something with tiny houses,” says Echevarria. He connected Council on Aging of West Florida to Randy Jones of Incredible Tiny Homes in Newport, Tennessee. The agency contracted with the company to build two 128-square-foot tiny houses.

Tiny house rules vary by city and county. In the Pensacola area, tiny houses, which are built on pier foundations or flatbed trailers so they can be moved at a later date, are classified as recreational vehicles so are allowed in mobile home and RV parks.

The homes built by Jones are a model he calls the Incred-I-Box. Measuring 8-feet wide by 16-feet long, the Incred-I-Box home currently lists for $25,000 and has electricity, a hot water heater, plumbing, a full bathroom and a kitchen sink. Heating and air conditioning can be achieved with the addition of a mini-split or window unit. Carpentry students from Pensacola State College built the homes’ stairs and shelving. Volunteers from Pensacola Habitat for Humanity painted the houses.

Two local women experiencing housing emergencies were selected by Council on Aging of West Florida to become the tiny house owners. Beverly (pictured) had been living in a vermin-infested mobile home. The other woman had been living out of her car for 10 months when she was selected to receive a new home. In 2022, the average monthly rental cost of a one-bedroom apartment in Pensacola was $900. Both women pay $350 a month to cover the mobile home lot fee and they pay for their electricity.

One of the homes was used as a showcase model to introduce the tiny homes concept to the Pensacola community.

PHOTO COURTESY COUNCIL ON AGING OF WEST FLORIDA

An interior view of a tiny house showing the entrance and living-sleeping area

“Tiny homes are a little bit stigmatized around here,” says Echevarria. “People worry that, if tiny homes are allowed, people will just put up any little, ramshackle structure and call it a tiny home. We’re trying to show people that tiny homes are a viable housing option, especially for people who are older or are at risk of homelessness.”

“Any type of residential housing that is not the traditional site-built home must be built to a community's local building code and be located on an acceptably zoned lot,” adds Dye. “So, when you talk about a tiny home which, for affordability and transportability, often looks like a box, people compare it to a mobile home but it's not. When built as a modular in a factory, a tiny house is comparable to a traditional site-built home, just smaller.”

PHOTO COURTESY COUNCIL ON AGING OF WEST FLORIDA

An interior view of a tiny house showing the entrance and living-sleeping area

Results

The house tours given to local leaders were instrumental to beginning the educational process of gaining community acceptance of tiny homes as an affordable housing option.

In addition, the Council on Aging of West Florida was invited by the new mayor’s transition team to participate in a roundtable discussion about housing. Representatives from the Florida Blue health insurance company traveled to Pensacola from Jacksonville to see the tiny house, after which they invited the agency to submit a proposal for $500,000 in grant funding to lead a similar project.

PHOTO COURTESY COUNCIL ON AGING OF WEST FLORIDA

The bathroom and kitchen counter in a tiny house under construction

Lessons Learned

Seek Out Expertise: “Have great partners that fill any gaps in your knowledge,” says Echevarria. “Rick Dye knows a lot about the current state of homelessness, housing and zoning ordinances and laws. We have a board member who worked at Habitat for Humanity and is very knowledgeable about what’s happening behind the scenes at various county and city boards.”

Don’t Be Shy: “Talk about the project wherever you go,” advises Echevarria. “I was doing a presentation at Pensacola State College about guardianship education when the facilitator mentioned that the school’s carpentry program always needed projects.”

It Takes a Village: “Delegate as much as you can,” says Echevarria. “Sometimes I thought I could handle things by myself. One day, because we were under a time crunch, our CEO was crawling under the tiny home hooking up the sewage and I was connecting the waterline. When I turned the water on, it spurted from every connector.” Lesson learned? “Collaborate, make partnerships, make friends, tell everyone about the project and see if anyone raises their hand and says, ‘Hey, I can help.’”

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No, Social Security Beneficiaries Are Not Getting a Fourth Stimulus Check

Sat, 20 Jul 2024 14:09:59 GMT

No, Social Security Beneficiaries Are Not Getting a Fourth Stimulus Check

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A wave of website headlines, videos and social media posts are spreading misinformation about a supposed "fourth stimulus check" headed to older Americans or people with disabilities. Don't believe the hype — there's no fourth stimulus going out, to anyone.

“We’ve paid out all the Economic Impact Payments,” IRS spokesman Anthony Burke says, using the official term for the three rounds of federal stimulus payments sent to more than 160 million U.S. taxpayers as part of the COVID-19 relief measures Congress passed in 2020 and 2021.

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The IRS says people who missed a stimulus payment or received less than they should have can still try to claim the money by applying for a Recovery Rebate Credit (see below). “People should go to IRS.gov as the definitive source of information," Burke says.

More than three years after the third and final federal pandemic payment went out, claims that new ones are on the way are due in part to the growth of generative artificial intelligence (AI) in creating content, says McKenzie Sadeghi, AI and foreign influence editor for NewsGuard, a company that monitors misinformation in online media.

Imminent stimulus checks are a staple of “content farms,” she says — supposed news sites that regurgitate dubious information and often rely on AI-generated articles with little or no human oversight.

“We’ve seen this claim come up regularly on these websites — that you can get a fourth stimulus check,” Sadeghi says. “It's very in line with the type of content that we see from them, which are hoaxes aimed at generating clicks and getting people to the site.”

Seeking clicks

The latest round of stimulus stories tease possible payments of up to $2,600 for older Americans or assert outright that the payments have been “confirmed” by authorities and will go out in July. Similar claims have made the rounds of suspicious sites in recent months and have cropped up on social media, too.

Late last year, social media posts asserting that older residents of 10 states would be getting new stimulus checks Nov. 30 went viral, the Associated Press reported . Purportedly finance-focused YouTube channels with thousands or even hundreds of thousands of subscribers regularly post videos touting imminent extra payments to Social Security recipients or low-income Americans.

The distribution of legitimate, congressionally approved relief payments in 2020 and 2021 was accompanied by a raft of related scams , with robocalls , emails , text messages and social media posts promising to deliver faster or bigger stimulus checks if you paid a fee or provided personal information.

The questionable websites and social media posts this time appear to be mostly focused on attracting eyeballs. Sites and videos reviewed by AARP use a common search term such as “stimulus check” but apply it to a mash-up of claims — that the IRS is about to send out fresh payments (false); that multiple states are offering tax credits or rebates (true but unrelated to stimulus payments); or that Congress is going to increase Social Security benefits (highly speculative; such bills have been filed but have not made it out of committee).

The goal is to “rank high in search results in some way and attract viewers to their site,” Sadeghi says.

These sites are often “saturated in advertising,” placed by automated buyers “without much regard to the quality or the nature of the source,” she says. “By bringing viewers and readers to their sites, they are hoping that people will, in turn, click on these advertisements and they will gain financial revenue.”

As of mid-July, NewsGuard’s AI Tracking Center had identified nearly 1,000 purported news and information sites operating with little or no human oversight. The number is “growing on a weekly basis,” Sadeghi says, but the tracker count is likely “just scratching the surface.”

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Spotting signs of AI

The stories most often peddled by content farms are “fake death hoaxes about celebrities,” Sadeghi says, “but the one about stimulus checks is one that hasn’t really gone away.” Whether AI-generated or not, such sites pick up on “an uptick in search results for something” and publish content related to that search term, leading others to follow suit, she says.

Sadeghi recommends readers who aren’t sure about a news site’s quality or veracity look for these signs of unreliable, AI-generated content:

Inconsistent information. AI-generated articles “often contain contradictions or conflicting info,” or even error messages, Sadeghi says.
Repetition. Content farm articles will often repeat a key phrase like “stimulus checks” dozens of times.
No attribution . “We’ll see a lot of missing citations,” Sadeghi says. “None of the information is credited anywhere.”
Lack of transparency. Does the story have a byline or any way to verify the writer’s identity? Does the site disclose information about who is behind it?

How to recoup a missed stimulus payment

The IRS sent Economic Impact Payments of $1,200, $600 and $1,400 to tens of millions of Americans in 2020 and 2021 under three rounds of federal COVID-19 relief legislation. If you did not receive one of those payments, or got less than the full amount, you may still be able to claim the money via a tax credit.

To claim this Recovery Rebate Credit, you must file (or refile) a tax return for the year of the missed payment. The deadline to file a new or amended 2020 tax return to claim one or both of that year’s stimulus payments has passed, but taxpayers have until April 15, 2025, to claim the credit for the 2021 stimulus.

The Recovery Rebate Credit page on the IRS website has more information on eligibility and instructions for filing.

Andy Markowitz covers Social Security and retirement for AARP. He is a former editor of the Prague Post and Baltimore City Paper.

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8 Early Warning Signs of Parkinson’s Disease Initial symptoms can be mistaken for other illnesses

Mon, 08 Jul 2024 16:19:32 GMT

Most of us can recognize some signs of Parkinson’s disease, such as tremor and trouble walking. But signs that can appear a decade or more before the disease presents in more obvious physical forms are often mistaken for something else — including normal aging.

Common problems among older adults, such as trouble sleeping , constipation, muscle stiffness and increased anxiety and depression , are related to early-stage Parkinson’s. So is loss of smell, a well-established symptom of COVID-19 .

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Experiencing them doesn’t mean you have Parkinson’s disease , but they are worth discussing with your doctor, especially if you have several of them at the same time.

“The early signs are normally not problems that bring anybody to the doctor,” says Michele Tagliati, M.D., director of the Movement Disorders Program and vice chair of the department of neurology at Cedars-Sinai Medical Center.

That’s because the effects of Parkinson’s, a neurodegenerative order, are far-reaching and often lead to changes long before a tremor appears. Twenty-five percent of people with Parkinson’s may not even develop a tremor, research shows. Though there is no cure for Parkinson’s, medications can treat the symptoms, lifestyle changes can help manage the disease, and an early diagnosis can ease planning. Here are eight things to look for.

1. Restless sleeping

Talking in your sleep, sleepwalking and/or acting out your dreams, also known as REM sleep behavior disorder, can be early warning signs of Parkinson’s. “We are supposed to be completely still and paralyzed” during sleep, Tagliati says, but for someone with Parkinson’s, the “mechanism in the brain that oversees this phase of sleep is somewhat defective.”

One sign of this problem is falling out of bed. If you live with someone, they might see or hear you acting out your dreams. Sometimes people even kick or punch in their sleep or jump out of bed suddenly. If you live alone, you may wake up with twisted sheets or jar yourself awake yelling, says Camilla Kilbane, M.D., a neurologist and movement disorder specialist at University Hospitals Cleveland Medical Center.

2. Loss of smell

Losing your sense of smell, or hyposmia, is a well-known symptom of COVID-19 and other viral infections.

Researchers aren’t quite sure why it’s associated with Parkinson’s, Tagliati says, but this symptom appears in 90 percent of early-stage Parkinson’s cases.

Like sleep problems, issues with smell are easy to brush off and attribute to something else. But loss of smell shouldn’t be ignored, especially in the presence of other symptoms.

3. Constipation

Parkinson’s affects the autonomic nervous system, which controls bodily functions we don’t normally think about, such as going to the bathroom. Parkinson’s might also affect the gut microbiome , according to a study published in the journal Neurology, which in turn affects how your digestion system functions — or doesn’t.

Parkinson’s doesn’t hit each gastrointestinal system the same way. A change in how often you have a bowel movement — or other digestion issues such as bloating , nausea and general discomfort — could be an early warning sign that should be investigated. A third of U.S. adults over age 60 report having constipation , so if you have this condition, mention it to your doctor, but there’s no reason to panic.

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4. Anxiety/depression

Parkinson’s harms the brain’s ability to create serotonin and dopamine, two chemicals that affect mood. Changes in the levels of neurotransmitters can lead to increased anxiety and depression. According to the Parkinson’s Foundation, patients can experience depression or anxiety for two to five years before diagnosis.

Parkinson’s-induced mood disorder isn’t typically drastic, like major depression, Kilbane says. But a spouse or family member might notice a change — for example, when a normally happy person becomes a worrier.

“It’s so subtle that people may not go to the doctor,” she says.

5. Soft voice

According to the Parkinson’s Foundation, 89 percent of people with Parkinson’s will have speech and voice disorders. That often shows up first in their voice’s volume. A person may speak more softly without realizing it, Kilbane says, and a spouse, friend or family member has to ask the person to speak up and/or repeat himself.

6. Masked face

Parkinson’s affects muscles in the face, which experience the same gradual stiffening as the rest of the body. People with Parkinson’s will have “less facial mimicry and less spontaneous smiling,” says Kilbane, who calls this condition “poker face.”

People might think you’re angry or upset because your positive emotions are less likely to translate into a smile or other facial cues that show joy or appreciation.

7. Stiffness and gait problems

It’s common for undiagnosed Parkinson’s patients to view stiffness and gait problems as part of aging, Kilbane says. “You anticipate as you get older that you may slow down a bit in your movements, you might be a little stiffer and might shuffle a bit,” she says.

Stiffness from Parkinson’s can be mistaken for arthritis , but it will appear in the muscles, not the joints. It can be hard for a person to make that distinction without medical guidance, Kilbane says. Gait problems can show up in someone who has trouble keeping up with their peers on a walk or getting in and out of a car — again, something that might be attributed to old age. But both are signs of potential Parkinson’s.

8. Resting tremors

Shaking in the hand, foot or leg is often the first obvious visual sign of Parkinson’s, Tagliati says. By the time Parkinson’s affects muscles in this way, most patients have already experienced early signals such as sleep, smell and digestion problems — sometimes for years.

Involuntary movements are typically on one side of the body — not necessarily the dominant side — and occur when the limb is at rest. “Normally, when you use the hand, the tremor goes away,” Tagliati says. “Many people put [their] hand in [a] pocket, and nothing really happens.” A tremor in the chin is also common in Parkinson’s and should be investigated.

Editor's note: This story, first published May 4, 2022, has been updated to include new information.

Jen A. Miller is a contributing writer and author of Running: A Love Story. Her work has appeared in The New York Times, The Washington Post, Self, Vox and BuzzFeed, among other publications.

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What Is ALS?

Wed, 05 Jun 2024 14:35:09 GMT

This neurodegenerative disease has been getting some much-needed research focus

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Remember the Ice Bucket Challenge? It’s been 10 years since social media feeds were saturated with videos of people willingly having large buckets of ice water dumped over their heads to raise money for ALS research.

More than 17 million people took the challenge in 2014 to speed research on amyotrophic lateral sclerosis, or ALS, helping raise $115 million for the ALS Association. The viral fundraiser nearly doubled the association’s annual research funding, expanding support to more than 500 research projects around the world.

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ALS is a progressive disease with no cure. It is also rare: About 30,000 people in the United States have it. Conditions that affect so few people seldom get that kind of public attention, or that kind of money. The Ice Bucket Challenge “brought a lot of attention to a rare disease and to the gaps that existed,” says Kuldip Dave, senior vice president of research at the ALS Association. “It brought focus to a disease that was, frankly, unknown.”

What is known about ALS? And has the Ice Bucket Challenge made a difference?

What is ALS?

You might know ALS as Lou Gehrig’s disease, named for the New York Yankees first baseman who retired after developing the disease in 1939 at age 36.

In ALS, nerve cells in the brain and spinal cord that control muscle movement and breathing deteriorate and die. Those cells, called motor neurons, can no longer send messages between the brain and the muscles, so the muscles weaken, start to twitch and waste away, or atrophy. Eventually, the brain cannot control voluntary muscle movements such as walking, talking, chewing and, eventually, breathing.

“These motor neurons start slowly dying. That’s why you slowly get weak. It doesn’t happen abruptly, like with an acute injury. But why these cells start dying? Honestly, we don’t fully understand,” says Jeffrey Rothstein, M.D., director of the Robert Packard Center for ALS Research at Johns Hopkins Medicine.

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What are the symptoms of ALS?

Weakness in an arm or leg, trouble swallowing or slurred speech are the most common first symptoms. The weakness may be preceded by twitching or cramps in the arms, shoulders, legs or even the tongue. But these aren’t the only possible early symptoms. The way ALS first shows up varies a lot from one person to another.

Symptoms of ALS

Weakness, muscle atrophy, twitching or cramps in muscles of arms or legs
Slurred speech, difficulty chewing or trouble swallowing
Trouble walking or doing daily activities
Tripping, falling or clumsy movements related to the hands or feet
Laughing, crying or yawning at inappropriate times

“For some people, it might be only their arms that are weak for years before the legs get weak,” Rothstein says. In others, he says, muscles used for breathing, chewing and speaking are damaged early on, and the arms are affected very slowly.

ALS usually doesn’t affect the senses, including the ability to taste, smell, touch and hear. People with ALS usually remain able to reason, remember and understand, which means they are aware of the progressive loss of function. Less often, people with ALS experience changes in their behavior or the way they think or act. This happens to some degree in about half of people with ALS, according to the most recent diagnostic criteria for the disease. These changes are often mild. About 8 to 9 percent of people who experience these cognitive changes will develop dementia and no longer be able to make decisions about their care.

Who gets ALS?

An estimated 5,000 people are newly diagnosed with ALS each year in the United States. Even though it’s not clear what causes ALS, certain people may be more likely to get it.

A small proportion of the people who get ALS — about 1 in 10 — were born with a gene mutation that caused the disease. Their children run a 50-50 chance of having this mutation, too. In most cases, just inheriting the gene from one parent is enough to ensure that a person will develop what’s called familial, or genetic, ALS.

About 25 to 40 percent of people with familial ALS have defects in a gene called C9orf72. Another 12 to 20 percent of familial cases have ALS due to a defect in a gene called SOD1. People who have C9orf72, the most common inherited gene mutation for ALS, may be at higher risk for a form of dementia called frontotemporal dementia (FTD). The same gene mutation in a family can cause ALS, FTD or both. “You can have a sister with ALS and a brother with FTD,” Rothstein says. “We don’t think of ALS as a dementia disease, but sometimes you can have a very severe dementia with it, which is usually because of that gene mutation.”

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The vast majority of people with ALS — 9 in 10 — did not inherit a gene from a family member and have no family history of the disease. They have what’s called sporadic ALS. Age and, to a certain degree, sex are the only known risk factors for sporadic ALS. The age at which the disease is most often diagnosed is between the 50s and mid- 70s. Familial ALS may develop much earlier, around age 45 or younger.

Before age 65, ALS is a little more common in men than in women. After age 70, rates are the same for both sexes.

Aside from these known risk factors, smokers may be more likely to develop ALS, as are people who’ve been exposed to environmental toxins, such as lead or certain chemicals, research suggests. For some reason, perhaps due to toxic exposures, people who have served in the military seem to be at higher risk.

Is there treatment for ALS?

There’s no cure for ALS. People who have it will eventually die from the condition. Three medications approved by the U.S. Food and Drug Administration may slow the progression of the disease. Additional medications are used to treat symptoms and prevent complications to make patients comfortable and live as well as possible with ALS.

Kuldip Dave of the ALS Foundation recommends patients receive treatment at a multidisciplinary clinic “to interact with a team of health care professionals, not only a neurologist or ALS specialist, but also a physical therapist, pulmonologist, respiratory therapist and nurse coordinator.” Speech therapists, dietitians and social workers may also be part of the team. “Multiple publications show that people with ALS [who attend] a multidisciplinary clinic have at least a 10- to 18-month increased survival,” he says.

What can you expect with ALS?

ALS eventually weakens the muscles used for mobility, breathing, speaking and swallowing. You may need technology, devices and eventually professional care to help with each of these. For some people, ALS can progress to this point very quickly, and for others it can take years. Doctors typically won’t be able to let you know how fast the disease will progress.

No matter how quickly or slowly, ALS does progress over time. Eventually, people with this condition need more care than a spouse or adult child alone can provide. “Home caregivers are very common for ALS patients somewhere in the course of the disease, and, of course, at the very end, there can be hospice,” Rothstein says.

A variety of assistive devices are available to help people with ALS move around their homes, speak, breathe and carry out other tasks of daily living as the disease progresses. Assistive technology is also an area of active research in ALS to bring more effective tools to patients.

Though currently available drugs may slow the progress of ALS by a few months, they won’t cure it, halt it or reverse the damage. But scientific understanding of ALS — expanded in part by the Ice Bucket Challenge — has advanced in recent years.

For one, researchers have made some headway in treating familial ALS. There are around 40 known genes that cause genetic ALS. In 2023, the Food and Drug Administration approved Qalsody (tofersen), the first drug to target one of those genes, SOD1, believed to be mutated in 1 to 2 percent of people with ALS.

In a clinical trial, when people with ALS due to SOD1 mutations received Qalsody intraspinal injections (three loading doses every two weeks followed by five monthly maintenance doses), levels of a protein called neurofilament-light (NfL) that is elevated in people with ALS began to drop. The drug received accelerated approval because of the need for effective therapies, and the reduction in NfL is considered a predictor of patient benefit. Researchers will continue to study the drug to see if it actually has an effect on the progress and symptoms of the disease.

Medications for ALS

Available treatments for ALS do not reverse damage or provide a cure. They may slow disease progression, extend survival and improve quality of life.

Qalsody (tofersen): given by spinal injection in the 1 to 2 percent of ALS patients with a mutation in the SOD1 gene. It may decrease neuron damage.
Radicava (edaravone): an antioxidant given orally or intravenously that may slow functional decline.
Rilutek (riluzole): an oral medication that may reduce damage to motor neurons by reducing levels of glutamate, a chemical messenger between nerve cells. In clinical trials, riluzole prolonged survival in people with ALS by a few months. It’s available in thickened liquid form (Tiglutik) or as a tablet that melts on the tongue (Exservan).
Nuedexta: an oral medication that treats involuntary outbursts of crying or laughing in people with ALS and other neurological disorders.

Sources: National Institute of Neurological Disorders and Stroke and the ALS Association

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“The important thing is that they were able to develop a therapy that went straight for that gene and repaired it,” Dave says. He’s optimistic that the same approach can be used to mute the effects of other genes gone awry in ALS: “Now we have the formula to do this for the other 39 genes.”

NfL is the focus of other ALS research, beyond those people with familial ALS. Researchers are getting closer to understanding how to use this protein as a blood biomarker for the disease in all patients. This could lead to earlier detection and, potentially, drugs that target the protein directly as a way to stop the disease.

The last 10 years of extra support for ALS research have led to a larger-than-ever diversity of research. More than 35 clinical trials are recruiting U.S. patients affected with ALS to test new therapies. Promising work is underway in the following areas:

Repurposing anti-inflammatory drugs. It’s known that inflammation underpins neurodegenerative diseases, including ALS. A growing number of drug companies are taking an interest in ALS and testing the impact of existing anti-inflammatory drugs for people with ALS.
Correcting defects in TDP-43. This protein in the nuclei of cells in the central nervous system plays a crucial role in their function. But in ALS, a specific defect puts TDP-43 outside the nucleus of motor neurons. Researchers are testing a drug that moves the protein back in place, and they are now in the early days of developing ALS treatments based on this concept.
Using brain-computer interfaces (BCI). An implantable device in the brain would allow people with ALS to use their thoughts to control computers, equipment and devices such as wheelchairs and breathing and speech assistance.

“For a rare disease like ALS, having that many opportunities is a good thing,” Dave says. “We don’t know where our next home run is going to come from. The fact that we have multiple ways to go after this disease is really exciting.”

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How will AI impact the growing need for accessible homes?

Thu, 30 May 2024 19:55:26 GMT

AI is poised to significantly impact the growing need for accessible homes in several key ways:

1. Design and Customization

Automated Design Tools: AI can assist architects and designers in creating accessible home designs quickly and efficiently. By analyzing a set of accessibility guidelines, AI can generate plans that include wider doorways, ramps, and accessible bathrooms.
Personalization: AI systems can customize home designs to cater to individual needs, taking into account specific disabilities and preferences. This ensures that the design is not only compliant with general standards but also tailored to the user.

2. Smart Home Technologies

Voice-Activated Systems: AI-powered voice assistants (like Amazon's Alexa, Google Assistant, and Apple's Siri) can control home environments, making it easier for people with mobility impairments to manage lighting, temperature, security systems, and appliances without physical effort.
Predictive Automation: AI can learn the routines and preferences of residents and automate tasks accordingly. For example, an AI system might automatically adjust the height of countertops or shelves based on the needs of the person using them.
Assistive Robots: AI-driven robots can help with daily tasks such as fetching items, cleaning, and even providing companionship for individuals with disabilities or the elderly.

3. Health and Safety Monitoring

Fall Detection and Prevention: AI systems can monitor residents for falls and provide immediate alerts to caregivers or emergency services. They can also predict and mitigate fall risks by analyzing movement patterns.
Health Monitoring: AI can integrate with wearable devices to track vital signs and health conditions, alerting residents or healthcare providers to any anomalies.
Emergency Response: AI can improve emergency response by recognizing distress signals and automatically contacting emergency services with relevant information.

4. Accessibility in Smart City Infrastructure

Integration with Urban Planning: AI can help urban planners design smarter, more accessible cities. This includes ensuring that public transport, sidewalks, and public buildings are accessible to everyone.
Data-Driven Insights: By analyzing data on accessibility issues, AI can provide insights and recommendations for improving accessibility in both new constructions and existing structures.

5. Cost Reduction and Efficiency

Optimizing Resources: AI can optimize the use of materials and labor in construction, reducing costs and making it more feasible to build accessible homes on a larger scale.
Energy Efficiency: AI can enhance the energy efficiency of homes, which is particularly beneficial for individuals with disabilities who may have specific temperature control needs.

6. Enhanced Communication and Advocacy

Awareness and Education: AI can help raise awareness about the importance of accessible homes by analyzing and presenting data on the impact of accessibility on quality of life.
Advocacy Tools: AI can support advocacy efforts by providing tools that allow individuals to report accessibility issues and suggest improvements, ensuring that their voices are heard and considered in the planning process.

Conclusion

AI has the potential to transform the landscape of accessible housing by making it easier to design, build, and maintain homes that cater to the needs of individuals with disabilities. Through smart home technologies, health monitoring, and cost reduction, AI can contribute to creating inclusive living environments that enhance the quality of life for everyone.

#homeaccessibi lity #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

Staying Connected is a Key to Healthy Aging

Mon, 13 May 2024 17:02:12 GMT

May is Older Americans Month, first designated as such by President John F. Kennedy more than 60 years ago. It is a time to remind ourselves of the indispensable contributions that our growing 50-plus population has made and continues to make to the progress and vitality of our nation.

The U.S. government made “Powered by Connection” the theme for this year’s Older Americans Month to call attention to the profound link between staying in touch with other people and emotional and mental health.

At AARP, we couldn’t agree more that connection is an essential part of aging well.

But recent data suggests that America is in danger of becoming a nation of loners. A 2023 advisory report by U.S. Surgeon General Vivek Murthy revealed that America is in the throes of an epidemic of isolation that imperils both the health of our people and the future of our democracy. He cited research showing that roughly one in two adults in America “reported experiencing loneliness.”

Dr. Murthy called social isolation an “underappreciated” public health crisis associated with a 29 percent increased risk of heart disease, a 32 percent increased risk of stroke and a 50 percent increased risk of developing dementia for older adults. He warned that if we continue to “splinter and divide,” our communities will face dire consequences.

AARP has long taken a deep interest in keeping people connected, as part of our core mission to promote happier, healthier lives as we get older.

jo ann jenkins chief executive officer of a a r p

TIMOTHY GREENFIELD-SANDERS

That’s why we seek to empower more older Americans to get up, get out and get active in their communities through fun and fulfillment activities and digital connections.

Technology is an essential part of living, but many older people have a hard time staying on the cutting edge and accessing the fastest internet connections. We set out to change that when Older Adults Technology Services (OATS) became an AARP affiliate. OATS’ mission is to harness the power of technology to change the way we age. Through its flagship program, Senior Planet from AARP, OATS works closely with older adults in community settings to create extraordinary experiences in person and online.

AARP also brings hundreds of thousands of older Americans together through our Virtual Community Center (VCC). The center is a place to find online concerts, cooking classes, yoga sessions and other fun and educational events to share with like-minded people. Since its inception during the pandemic, the VCC has attracted more than 5 million unique visitors 50 and older.

Our bodies, minds and communities are only as strong as the ties that bind them.

Connecting with others in your community, online or in person, is a great way to prevent loneliness, stay healthy, promote social cohesion and bring joy to yourself and others. Check out what AARP offers to help you achieve those connections.

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disab ilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

Older adults have more control over their aging than they think

Wed, 08 May 2024 20:18:51 GMT

Psychologists are tackling negative stereotypes about aging and helping older adults embrace healthy attitudes and behaviors

For many, getting older is rewarding—adults tend to experience more well-being, life satisfaction and emotional stability as they age—and a growing body of research shows that a healthy lifestyle can slow and even reverse cognitive and physical decline. But most people still hold negative views of aging.

“ Optimizing Aging: A Call for a New Narrative ,” published in the May/June issue of American Psychologist, tackles that disconnect by refuting the major misconceptions about aging and outlining how psychologists can help reframe the conversation (Diehl, M., et al., American Psychologist , Vol. 75, No. 4, 2020).

“Aging is a much more plastic process than was previously thought,” says psychologist Manfred Diehl, PhD, director of the Adult Development and Aging Project at Colorado State University and lead author of the paper. “That means middle-aged and older adults have more control over the way they grow older than they believe.”

Along with his co-authors, psychologists Chandra Mehrotra, PhD, of the College of St. Scholastica in Minnesota, and Michael Smyer, PhD, of Bucknell University in Lewisburg, Pennsylvania, Diehl hopes that shifting the narrative can help adults embrace the power they have over their own aging. Not only will this improve individual lives, he says, but it can also benefit society through lower health-care costs and increased productivity if adults stay healthier for longer.

“Our society has a long-standing history of ageism,” says Katherine Ramos, PhD, an assistant professor of psychiatry and behavioral sciences at Duke University and a member of APA’s Committee on Aging, who was not involved with the paper. “What this article highlights is a call to action to change how we think and talk about growing older.”

Challenging negative stereotypes

Ageism at the societal level can lead to overt discrimination, for instance in biased hiring and termination practices. At the individual level, negative stereotypes about aging can prevent people from engaging in preventive health behaviors, which can ultimately decrease life expectancy.

Perhaps the most pervasive misconception about aging is that growing older mainly involves loss and decline. In fact, research suggests that for most mental abilities, statistically reliable age-related decline does not occur before age 60, and most adults do not experience noticeable ability declines until the late 60’s or early 70’s (Schaie, K.W., Developmental Influences on Adult Intelligence: The Seattle Longitudinal Study , 2nd ed., Oxford University Press, 2013). Moreover, emotional well-being and life satisfaction tend to improve as we get older (Carstensen, L.L., et al., Psychology and Aging , Vol. 26, No. 1, 2011).

Another widely held belief is that changes associated with aging are largely outside of our control.

“Many people think the way we grow older is genetically determined,” Diehl says. “That misconception is dangerous because it prevents many adults from taking action that could help them age in a more positive way.”

Studies show that lifestyle factors—including alcohol and tobacco use, physical activity and cognitive engagement—can account for as much as 70% of the variance in age-related memory and cognitive changes (Tucker-Drob, E.M., & Briley, D.A., Psychological Bulletin , Vol. 140, No. 4, 2014).

New evidence also suggests that older adults’ cognitive losses, as well as physical problems such as osteoporosis, can be reduced, delayed or even reversed with early intervention.

Changing the narrative

A further problem with the way we view aging—one that’s been amplified by the COVID-19 pandemic—is the tendency to describe older adults as a single homogenous group: in this case, a group that’s highly susceptible to disease and death.

“Older adults are actually the most diverse age group, but they are often seen as unilaterally frail, vulnerable or even expendable,” says Diehl. “The COVID-19 crisis is further reinforcing those existing stereotypes.”

In fact, adults who are 65 to 74 years old, 75 to 84 years old, or 85 and over face different risks. And like the rest of the United States population, older adults are diverse in race, ethnicity, socioeconomic status, immigration status, gender identity, sexual orientation, religious affiliation, and rural/urban location. Those characteristics interact in complex ways as individuals age, says Mehrotra.

“Let’s not think about older adults through this arbitrary 65-and-older category—lumping everybody together as if their experiences are the same, when we know they’re not,” Ramos says.

The new narrative on aging should reflect that diversity, say Diehl and his co-authors, and focus on challenges and opportunities rather than loss and decline.

The Gerontological Society of America’s Reframing Aging Initiative , for example, conducts research on healthy aging and offers resources to inform and engage professionals who work with older adults.

Other avenues for change include addressing ageist media portrayals of older adults, which often depict the group as a burden on society (Löckenhoff, C.E., et al., Psychology and Aging , Vol. 24, No. 4, 2009). In fact, many older adults are productive workers, frequent caregivers of grandchildren and adult children with disabilities, and active volunteers in their communities.

The authors suggest directing messages toward middle-aged adults, who can be encouraged to ramp up preventive health behaviors as they age. Workplace-based health and wellness programs are one key channel they identify for disseminating information about healthy aging to middle-aged and older adults. Other ways to spread such messages include mass media and public information campaigns.

Psychologists' role in making changes

Psychologists have already played a key role in debunking misconceptions about aging by studying behavioral and neural plasticity, socioemotional development over the life span and the negative effects of ageism. They’ve also developed theories and techniques of behavior change, such as self-regulation, that can be applied to help optimize aging.

Moving forward, the authors of “Optimizing Aging” encourage psychologists to take an increasingly active role in disseminating those findings and strategies to the public.

“In addition to publishing research papers, we should move toward translating evidence in a way that communities can understand and implement,” says Mehrotra.

Convincing people to change their behavior is a tall order, but an intervention Diehl developed shows promise. Eight weeks of education on age stereotypes, goal setting and plasticity—along with a structured exercise program—reduced negative views on aging and increased physical activity levels in adults ages 50 to 82 (Brothers, A., & Diehl, M., Journal of Aging and Physical Activity, Vol. 25, No. 3, 2017). Last year, Diehl launched a large randomized controlled trial to test a modified version of the program.

“Our biggest challenge now is to convince the person on the street that they have more control over their own behavior and aging than they know,” he says. “That’s what our field should focus on next.”

8 Ways Baby Boomers Become Poor in Retirement

Thu, 02 May 2024 02:59:56 GMT

Commitment to Our Readers

As the baby boomer generation enters retirement, a growing number of them face unexpected financial challenges that threaten their retirement security.

Even those who have worked hard and saved their whole lives may find themselves losing spending power and sinking into poverty after they retire.

It can be disheartening for that to happen. If you are nearing or in retirement, look out for these pitfalls to remain as financially secure as possible.

Even falling into one or two of these traps can lead to financial trouble.

Carrying a Balance on Credit Cards

Carrying a balance on credit cards can quickly and easily get you further in debt. It means paying interest and, therefore, more money than you should.

Plus, as baby boomers transition from a steady paycheck to a fixed income, paying off interest can become more difficult. The interest accrued can snowball, quickly depleting their savings during retirement.

“Work to pay down high-interest debt as quickly as possible and pay your credit card balance in full each month to avoid interest charges,” said Ashley Rittershaus, a CFP and founder of Curious Crow Financial Planning .

“Credit card debt can also be an indication of living beyond your means, so you’ll need to address any overspending issues as well.”

Collecting Social Security Too Early

While you can start collecting Social Security benefits as early as age 62, collecting too early can significantly reduce your monthly payout. Baby boomers may be eager to enjoy retirement and think they should receive Social Security as soon as possible. However, waiting until full retirement age or even later will actually result in higher monthly payments.

For example, if you file at age 62, you will lose 30% of the full Social Security benefits you would have received at age 67. If you file at 64, you will only lose 20% of the full benefits. This continues until age 67, when you receive the full benefits you are entitled to based on your lifetime earnings history.

Every month you wait between the ages of 67 and 70, your benefit amount will increase. If you wait until 68, you will receive 108% of your Social Security benefits. This increases by 8% each year until the age of 70.

“Optimizing when you begin collecting Social Security can make a big difference in the total lifetime amount you receive,” Rittershaus said. “The optimal strategy depends on your specific situation, but for some, this may mean waiting until age 70 to begin collecting Social Security.”

Selling Investments When the Market Drops

Fluctuations in the market are an inevitable part of investing. However, some people may panic during a downturn and sell their investments before they had planned.

This can be especially bad for retirees because they don’t have the benefit of time on their side. Baby boomers who liquidate their investments when the market takes a hit may lock in losses and miss out on potential future gains. A well-diversified portfolio and a long-term investment strategy can help ensure a more stable retirement income.

“Working with a financial advisor on an ongoing basis can be beneficial if you need help determining your asset allocation and staying invested when times are tough,” Rittershaus said.

Paying Too Much in Housing Costs

Housing is a significant expense no matter what stage you are in life, but it can be especially difficult during retirement. This is when some baby boomers who own homes may find themselves house-rich but cash-poor.

Maintaining a large house with high property taxes, utility bills and maintenance costs can strain limited retirement resources. Downsizing or exploring cost-effective housing options can free up funds for other essential needs.

Having an Unrealistic Budget

Some baby boomers enter retirement with unrealistic expectations about their spending habits. Failing to create a detailed budget that aligns with their fixed income can lead to overspending and financial stress. Establishing a realistic budget that accounts for essential and discretionary expenses is crucial for maintaining financial stability in retirement.

Not Having a Plan

Not having a clear plan for managing expenses, investments and unexpected costs can lead to poor decision-making and financial instability. Seeking advice from financial professionals and creating a comprehensive retirement plan can provide the guidance needed to navigate the complexities of retirement.

“Develop a long-term retirement plan that includes your income sources (like Social Security and pensions), portfolio assets, and expenses,” Rittershaus said. “People tend to forget about the impact of inflation and taxes, so be sure to account for those, too. It may be helpful to create a retirement ‘paycheck’ for yourself, using automatic monthly transfers into your checking account for spending needs.”

Waiting Too Long To Adjust a Plan

Even if you have a retirement plan, it may require adjustments over time. Make sure to periodically reevaluate your plan to account for changes in health, market conditions or unexpected expenses.

Baby boomers must be proactive in regularly reviewing and adjusting their financial plans to ensure they remain on track for a secure retirement.

Not Planning for the Unexpected

In retirement, unexpected expenses, such as medical bills, procedures or emergency car or home repairs, will occur. Taking these into account ahead of time can help you plan for them in your budget. If baby boomers don’t have room in their budget for these unexpected expenses or don’t have an emergency fund to cover them, they could have to rely on credit cards or personal loans to pay for them, putting them into debt.

The Bottom Line

Retirement should be a time of relaxation and enjoyment, but financial pitfalls can turn it into a time of stress and uncertainty. Baby boomers can safeguard their financial well-being by avoiding these common things that cause retirees financial issues.

By adopting prudent financial habits, seeking professional advice, and remaining flexible, baby boomers can improve their chances of a comfortable and secure retirement. It’s never too late to take control of your financial future and ensure the golden years are truly golden.

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The difference between a heart attack vs. cardiac arrest?

Tue, 30 Apr 2024 07:55:44 GMT

When Nicole Smith went to visit her 83-year-old father in the hospital last fall, she never imaged she’d become a patient, too. But that’s exactly what happened to the Fort Lauderdale, Florida, resident after she suddenly collapsed in the cafeteria.

“I woke up and I was in the intensive care unit,” says Smith, 53. The diagnosis: sudden cardiac arrest. With no known heart risks or warning signs, she never saw it coming. “This was the furthest thing from my mind that something like this could happen,” she said.

While often confused with a heart attack, cardiac arrest is a completely different health emergency — and it’s one that requires prompt recognition and response.

Here’s what you need to know about each of the two conditions and what to do if you suspect someone is experiencing a serious heart event.

Cardiac arrest

What is cardiac arrest? Cardiac arrest is when the heart suddenly stop pumping, depriving the body and brain of oxygen-rich blood.

The impact is immediate: Breathing stops and the person loses consciousness. “If somebody has a cardiac arrest, it’s not subtle. They are on the ground, and they are not responding to you,” says Gregory Katz, M.D., a cardiologist at NYU Langone and an assistant professor in the Department of Medicine at NYU Grossman School of Medicine.

What causes cardiac arrest? Cardiac arrest is caused by irregular heart rhythms, called arrhythmias, that cause the heart to stop working properly, says the National Heart, Lung and Blood Institute (NHLBI).

Many health conditions that are common among older adults can disrupt the heart’s rhythm and increase the risk of cardiac arrest, including coronary heart disease , a prior heart attack, atrial fibrillation , heart inflammation, cardiomyopathy (an enlarged heart), and leaky or narrow heart valves. Still, the NHLBI says about half of cardiac arrests happen to people who did not know they had a heart problem, as was the case with Smith.

Sometimes heavy alcohol use or drug use can trigger cardiac arrest. So can severe stress , a blow to the chest (this is what recently happened to NFL player Damar Hamlin) and respiratory arrest, or when a person stops breathing.

Are there warning signs and symptoms of cardiac arrest? Unlike many other health issues, there aren’t usually any signs or symptoms to warn an individual that cardiac arrest is imminent, though some people may experience chest pain, nausea, vomiting or shortness of breath before losing consciousness. “People may get no warning whatsoever,” Katz says.

What should you do? If you see someone in cardiac arrest, “the immediate thing that you do is you start chest compressions, and you call 9-1-1,” Katz says. Starting CPR — which helps keep blood flow active until emergency responders arrive — “really is the difference between somebody having a good outcome versus a tragic outcome,” he says. About 350,000 people die from cardiac arrest every year in the U.S., and less than half of people who experience cardiac arrest outside the hospital receive the right care from bystanders.

The American Heart Association says anyone can perform CPR with hands-only chest compressions (no need for mouth-to-mouth unless you’re trained and feel comfortable doing it). Push hard and fast in the center of the chest to the beat of “Stayin’ Alive” by the Bee Gees or another song that is equivalent to about 100 to 120 beats per minute. And if an automated external defibrillator (AED) is available, use it. These portable devices that can often be found in public places such as airports and malls can stimulate the heart to resume beating.

Smith considers herself fortunate that her cardiac arrest — which her doctor says was possibly caused by a ventricular fibrillation, or an irregular heartbeat, and may have been brought on by stress — occurred inside a hospital. She now has a small device known as an implantable cardioverter-defibrillator in her chest to detect and correct any irregular heartbeats that could cause this to happen again.

Heart attack

What is a heart attack? Unlike with cardiac arrest, the heart is still pumping when a person has a heart attack; it’s just that the heart is under stress, says Mistyann-Blue Miller, M.D., a cardiologist with Cleveland Clinic in Vero Beach, Florida. And that’s because blood flow to the heart is being blocked. If this blood flow is not restored quickly, the oxygen-starved heart muscle will start to die.

Heart Attack vs. Cardiac Arrest

A quick way to remember the difference:

Cardiac arrest is an “electrical” problem

If you see someone going into cardiac arrest, call 911 and start CPR right away.

Heart attack is a “circulation” problem

If someone is having a heart attack, call 911.

Source: American Heart Association

What causes a heart attack? Most heart attacks are caused by coronary artery disease, according to the NHLBI, or plaque buildup along the walls of the arteries that supply blood to the heart. Cholesterol and other fatty substances can lead to this buildup.

A number of modifiable factors can increase your risk for coronary artery disease, including physical inactivity, unhealthy eating, smoking and being overweight , according to the Centers for Disease Control and Prevention. Other risk factors include a family history of heart disease.

Are there warning signs or symptoms of a heart attack? Also different from cardiac arrest is that many people who have a heart attack experience symptoms. For some, they can start slowly and be mild. For others, symptoms can come on suddenly and be severe.

“I describe it to patients that it can be anything weird between your chin and your belly button,” Katz says. And those odd or uncomfortable feelings typically gets worse with physical activity. “The idea that everyone has an elephant sitting on their chest as their heart attack symptom is just not borne out in the real world,” he adds.

Heart attack symptoms can include:

Chest pain or discomfort
Pain or discomfort in the arms, back, shoulders, neck, jaw and stomach (above the belly button)
Shortness of breath
Sweating
Fatigue
Nausea and vomiting
Lightheadedness or dizziness
Rapid or irregular heartbeat

Women tend to have more “nonspecific” heart attack symptoms that are easier to attribute to other things , such as stress, Miller says. “That can be a dull, achy feeling between the shoulder blades, maybe fatigue, decreased exercise tolerance,” she explains. “If something doesn’t feel right, definitely report that to your doctor.”

Katz says older adults are also less likely to experience the classic heart attack symptoms.

What should you do? If you suspect a heart attack, call 9-1-1 right away. CPR isn’t necessary unless the person isn’t breathing or you can’t find a pulse. “You really need to go to an emergency room,” Katz says, where doctors can quickly locate and address the blockage. The longer the heart goes without oxygen, the more likely a person is to experience permanent damage, even death.

Rachel Nania is an award-winning health editor and writer at AARP.org, who covers a range of topics including diseases and treatments.

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Federal Nursing Home Staffing Standards to Increase Care Hours for Residents

Thu, 25 Apr 2024 00:53:04 GMT

A new rule also requires registered nurses to be on site around the clock.

The Biden administration has set minimum staffing levels for nursing homes for the first time under a rule announced Monday, which establishes comprehensive staffing requirements and requires facilities to have a registered nurse on site at all times.

The announcement, made by Vice President Kamala Harris, comes in response to concerns about the adequacy of care in nursing homes in general as well as about 188,000 nursing home resident deaths since the COVID-19 pandemic. The pandemic also exacerbated long-standing staffing shortages in nursing homes.

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The new rule, which was proposed in September by the Centers for Medicare & Medicaid Services (CMS), requires that nursing homes that receive funding through Medicare and Medicaid provide the staffing equivalent of at least 3.48 hours of nursing care per resident, per day. That includes 0.55 hours of care from a registered nurse and 2.45 hours of care from a nurse aide each day, according to a White House fact sheet.

A registered nurse also must be on site 24 hours a day, seven days a week, to provide skilled nursing care at the facilities, which are home to about 1.2 million people nationwide, according to the new rule.

Requirements for additional hours of nursing care will prevent workers from being “stretched too thin” and bar nursing homes from understaffing sites, the White House noted.

“When facilities are understaffed, residents may go without basic necessities like baths, trips to the bathroom, and meals – and it is less safe when residents have a medical emergency,” the White House fact sheet noted.

Minimum staffing requirements will “help protect the basic rights of residents to live in dignity” and is long overdue, especially for facilities that are funded through taxpayer dollars, Nancy LeaMond, AARP’s executive vice president and chief advocacy and engagement officer, said in a statement.

“Far too many residents and families have experienced tragic consequences because of poorly staffed facilities,” LeaMond said in the statement, adding that “ensuring nursing homes are adequately staffed will improve the quality of care residents receive and can give family caregivers peace of mind, knowing their loved ones are living with the quality of life they deserve.”

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More staff likely needed

Many nursing home facilities will need to hire staff to meet the new requirements, the White House said, noting that a facility with 100 residents would need two or three registered nurses and at least 10 or 11 nurse aides, as well as two additional nurse staff, who could be registered nurses, licensed professional nurses or nurse aides, per shift to meet the new standards.

President Joe Biden pushed for minimum staffing levels in nursing homes in his 2022 State of the Union address. The COVID-19 pandemic highlighted long-term problems in nursing homes, including the decline in staffing, issues regarding infection control deficiencies and inadequate oversight.

Current law requires facilities to have licensed nursing services around the clock that are “sufficient” to “maintain the highest practicable physical, mental, and psychosocial well-being of each resident.”

Nursing home industry groups said the new rule and requirements will be hard to meet because of staff shortages.

The American Health Care Association (AHCA), a national lobbying group representing more than 14,000 long-term care providers, issued a statement calling the rule “an unreasonable standard.” The group said the new staff requirements could lead to nursing home shutdowns and the displacement of residents.

“Issuing a final rule that demands hundreds of thousands of additional caregivers when there’s a nationwide shortfall of nurses just creates an impossible task for providers,” the AHCA said in a statement. “This unfunded mandate doesn’t magically solve the nursing crisis.”

The new staffing requirements will be introduced in phases, with rural communities given a longer time to comply, according to the White House. Limited, temporary exemptions also will be available for the around-the-clock nurse requirement and the staffing standards in areas where there are workforce shortages and a good faith effort to hire.

The announcement Monday comes one month after a federal government report highlighted lessons learned from the pandemic for nursing homes and found that CMS should do more to prevent staffing shortages in nursing homes and strengthen infection controls to better protect residents after the COVID-19 pandemic.

Toby Edelman, a senior policy attorney at the Center for Medicare Advocacy, a legal nonprofit working to advance access to health care coverage, said the new rule doesn't end the discussion of staffing levels. Each facility must annually conduct an assessment to determine the nursing needs of its residents and to ensure it has enough staff with the skills to meet those needs.

"Properly implemented and enforced, the facility assessment process will require many facilities to implement higher staffing levels than the minimums announced today," he said in a statement.

Maura Kelly Lannan is a writer, editor and producer for AARP who covers federal and state policy. She has worked as a reporter for the Associated Press, the Chicago Tribune and the Waterbury, Connecticut, Republican-American. She also has written for Bloomberg Government, The Boston Globe and other publications.

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Are the Last Boomers Ready for Retirement?

Fri, 19 Apr 2024 20:34:06 GMT

‘Silver tsunami’ reaching age 65 lack savings, will largely rely on Social Security, new study says

The last and largest cohort of boomers is rolling into their retirement years, but nearly two-thirds will struggle to meet their financial needs once they get there, according to new research on the so-called peak 65 surge.

Over the next several years, more Americans than ever before will reach the traditional retirement age of 65 — an estimated 4.1 million a year, according to the Alliance for Lifetime Income (ALI).

More than half — 52.5 percent — have less than $250,000 in retirement assets and will have to “rely primarily on Social Security as a source of income,” according to “ The Peak Boomer Impact Study ,” commissioned by ALI’s Retirement Income Institute and released April 18. Another 14.6 percent of this group, with assets between $250,000 and $500,000, “will strain to meet their financial needs” over the course of retirement, the report says.

The average expected Social Security benefit for these “peak boomers” is about $22,000 a year, the study says.

“America has never seen so many people reaching retirement age over a short period, and well over half of them will find it challenging to meet their needs through their retirements, let alone maintain their current standard of living,” Robert Shapiro, a former U.S. undersecretary of commerce and lead author of the study, said in a statement. “They lack the protected income that many older boomers have from solid pensions or higher savings.”

Women, Black and Hispanic retirees in this group face the most acute shortage, Shapiro and coauthor Luke Stuttgen write in the report. Shapiro is the chairman and Stuttgen a senior analyst at Sonecon, a Washington, D.C.-based economic advisory firm.

The boom’s last wave

ALI, a financial-industry education organization that promotes annuities as a source of regular income for retirees, coined the term “peak 65” to represent this last wave of boomers, born from 1959 to 1964. The oldest boomers were born in 1946.

According to the study, this group, which has also been dubbed the “silver tsunami,” had median retirement assets of just under $225,000 as of 2022. Those assets primarily come from workplace retirement plans and individual retirement accounts (IRAs) but can also include bank accounts, pensions, annuities and nonretirement account investments in stocks, bonds and other vehicles.

In addition, peak boomers have median home equity of $156,000 and expected annual Social Security benefits of $22,342. Sixty-four percent plan to be fully retired by 2030, when they will range in age from 66 to 71, the study found, based on analysis of data from the University of Michigan’s 2022 “Health and Retirement Study.”

Financial advisers generally estimate that retirees need to replace 70 percent to 80 percent of their working income to maintain their lifestyles in retirement, and Social Security is only designed to replace about 40 percent, noted Jason Fichtner, chief economist at the Bipartisan Policy Center and executive director of the ALI's Retirement Income Institute, at an April 18 forum on the findings in Washington.

While their home is “the single largest asset for most people,” it plays a limited role in retirement finance, Shapiro said at the event. “Seniors don’t want to sell their homes. They prefer to stay in place,” he said, and very few take out home equity loans . “So, the largest asset is not available as a source of income.”

The report “certainly shows that the median retirement assets, with Social Security, are not adequate to maintain the peak boomers’ preretirement level of living,” Shapiro said.

Big gaps by gender, race, education

The report also found wide disparities in peak boomer retirement readiness along gender, racial and educational lines:

Men in this group had median retirement assets of $269,000; women had $185,000.

Median retirement assets were $299,000 for whites, $123,000 for Hispanics and $49,000 for Black peak boomers.

The widest gaps were by education, with college graduates having median retirement assets of $591,000 compared to $75,000 for high school graduates and $7,000 for those without high school diplomas.

The median assets for Black workers and those without degrees “are sufficient to support people for a couple of years” in retirement, said Shapiro. He called the extent of those disparities among peak boomers, whom the study found to have less higher education than the population at large, “one of the two or three major findings of this analysis.”

“The data suggests — though I hav en’t thoroughly investigated this — that retirement increases inequality,” he said. “The differences in retirement assets based on education and race are much greater than the differences in income across society based on education and race.”

One reason for the wide gaps is the decline of “defined benefit” pensions as a regular feature of U.S. working life, Shapiro said. About a quarter of peak boomers have such plans, which provide former workers with a fixed monthly check based on their past earnings and which covered about two-thirds of private-sector workers in 1980. They have been largely supplanted by “defined contribution” savings plans such as 401(k)s , in which employees make contributions and manage withdrawals in retirement.

“Defined-benefit pensions were the great leveler in retirement income,” Shapiro said. “Disparities based on race and education and gender are much less with respect to defined-benefit plans than with respect to defined contribution plans.”

Repairing the three-legged stool

Pensions were long regarded as part of the “three-legged stool” of retirement income, along with Social Security and withdrawals from savings . With that leg removed for most workers, much of the discussion at the forum focused on developing different income streams to sustain aging Americans through retirements that, based on actuarial data, will last an average of 20 years or more.

For many peak boomers, the third leg will be continuing to work. According to survey data, “20 percent of peak boomers do not plan to retire, even by 2034,” when they will be 70 to 75 years old, Shapiro said. “This is a reflection, again, of how unprepared large numbers of people are to retire.”

ALI has supported proposals to integrate income annuities into workplace retirement plans, giving employees an option to convert their savings into a regular, pension-like payment.

Panelists at the forum noted that many workers shy away from annuities because they underestimate how long they will live and are wary about tying up a large chunk of their assets in a long-term income plan.

“It’s tricky because you don’t want to automatically annuitize all of somebody’s wealth,” said William Gale, a senior fellow in economic studies at the Brookings Institution. “In six months they might figure out they didn’t want to annuitize all their wealth and it’s too late. You can’t undo that.”

How workers, employers, financial firms and policy makers address those income challenges will reverberate far beyond the peak boomers’ retirements, Fichtner said. “We’re also now in a peak millennial moment. The largest generation is millennials,” he said. “The problems we’re seeing today with retirement income challenges for current retirees and near retirees will be magnified for those who are coming up 30 years behind. If we don’t do something today to help them, it’s just going to be worse.”

Andy Markowitz covers Social Security and retirement for AARP. He is a former editor of the Prague Post and Baltimore City Paper.

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilit yawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

What are the Benefits of a Barrier-Free Shower?

Tue, 16 Apr 2024 04:42:55 GMT

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

Making Your Town Better

Mon, 08 Apr 2024 01:14:03 GMT

Residents enjoy the saturday morning Farmers Market on the square in downtown Fayetteville, Arkansas.

As we emerge from the chill of winter into the bright, warm days of spring, many Americans are getting outside, fixing up their homes and working with neighbors to improve their communities.

Some people 50 and older may be asking themselves deep and important questions: How can I make my house safer and more comfortable for the years ahead? Do I need to move? Is this the best place for me now? What could make it better? Are there cities that would be a better fit as I age?

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We created the AARP Livable Communities initiative to help people answer these questions. We started by asking what makes a community “livable.” Our research shows that it is one that provides safe, walkable streets; age-friendly housing and transportation options; access to needed services; and opportunities for all ages to participate in local life.

One of the most important choices people make is where they want to live, in terms of both their home and their community. We know that the vast majority of people want to stay put as they age. Yet as we grow older, many of us look around at our homes and find they’re no longer a good fit.

AARP has ideas to help. We have long advocated universal design elements that accommodate the needs of people of all ages, making homes more flexible and a place to age safely and comfortably.

That’s just part of the challenge. It’s great to have a grocery store, a favorite restaurant, a pharmacy, doctors, cleaners and a place of worship nearby, but it doesn’t mean much if your community has not fixed the impediments to getting around.

Far too often, communities that aren’t planned with older people in mind have built-in barriers that cause people to become isolated. Such obstacles contribute to sedentary lifestyles and ultimately force residents to make changes they don’t want to make.

We created the AARP Livability Index platform to help people find a place that meets their needs. This interactive tool measures every town and neighborhood in the U.S. for quality of life in areas including housing, transportation, health, environment, social engagement and economic opportunity.

The score produced from the index helps people identify benefits and challenges in their own town, as well as learn about a new neighborhood where they might relocate.

TIMOTHY GREENFIELD-SANDERS

We have partnered with the National Association of Realtors to integrate the Livability Index tool into the Realtors Property Resource website and mobile app. This allows more than a million Realtors across the country to view the Livability Index data for a property and share that information with their clients. As a result, more homebuyers can factor livability into their decisions.

Since 2017, AARP has invested $16.4 million in nearly 1,400 community challenge grants to nonprofit organizations and governments to support community improvement projects focused on public spaces, transportation, housing, health and food access, and more.

Spring is the season of change. By working together, we can bring positive changes and greater livability to every community.

#homeaccessibility #h omemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

Beginner’s Guide to Retirement Investments: Simplifying Your Choices

Wed, 03 Apr 2024 13:28:02 GMT

If you want to make a retirement investment then it’s important to look at the options you have. Many people recommend saving up to 15% of your income, but some savers fall out of this range. If you have concerns regarding your trajectory then it’s helpful to use a retirement calculator so you can conduct a pressure test. After establishing how much you need to save, it’s then a good idea for you to start building your retirement portfolio.

Target-Date Funds

One very effective and low-maintenance way for you to maintain asset allocation would be for you to go with a target-date fund. With this, you will pick the right target date, which is the time you’d like to retire, and the investment company will adjust your allocation over time.

Diversification Funds

Diversification is so important. It helps you to limit risk while also increasing the potential for your return. Index funds, mutual funds and ETFs will pool investment money into a pool of different securities. This gives you the chance to diversify without having to manage a lot of securities.

Mutual Funds

For years, mutual funds were actively managed by experts. Teams of portfolio managers would manage, analyze and then select certain stocks that they thought would outperform. In recent years, passive funds, such as index funds, have gained traction. A lot of this comes down to the fact that they’re easier to manage.

Exchange-Traded Funds

ETFs are very similar to mutual funds, but there is a difference. You can trade them throughout the day, like bonds and individual stocks. ETF prices tend to be lower than the minimum that is required for comparable funds, which allows investors to attain a lot of exposure for an affordable price.

Individual Stocks

Some investors prefer to research and then buy individual stocks and bonds. This can take a lot of time and knowledge. Dividend stocks can also provide you with a regular source of income, and they can also help you manage your interest rate risk while maintaining steady cash flow.

Annuities

Another option would be annuities. Some people sleep better knowing that their base expenses are covered by the income streams that they can’t outlive. Purchasing an annuity means you will have a source of income for life. They can be costly though, so make sure that you only buy the features you need because if you don’t then you may end up throwing money down the drain.

How does it Fit with your Portfolio?

When choosing an investment product, you need to keep the bigger picture in mind. You need to think about your risk tolerance, time horizon and goals. Together, these factors will help you to take advantage of optimal asset allocation for your total investment portfolio.

Retirement accounts should be a major part of your portfolio because they have the longest time horizon. In some accounts, you will smooth your entry into the market over a long period by taking advantage of dollar averaging. Retirement accounts are a great place for you to trade often and to be more active. You will not pay any taxes into a traditional IRA or a 401(k) until you make a withdrawal.

Aggressive Allocation with Your Retirement Accounts

If you want to balance a more aggressive allocation with your retirement account then you need to be conservative with your taxable brokerage account. Accounts like this are going to be used first so that any short-term goals can be satisfied. Remember that the asset allocation and the underlying investment of your account should not be static. You will need to be more conservative with your investment as time goes on, so you can set up for withdrawing your funds as you approach the age of retirement.

Which Retirement Account Should You Use?

Now that you are familiar with some of the top retirement accounts, which one should you use? Some of the best options would be employer-sponsored plans, pension plans, IRAs and profit-sharing plans. By doing this, you can then make retirement planning easier, while safeguarding your financial future. If you’re not quite sure how to go about monitoring your investments or if you want to make sure that you get the most out of the money you have then one thing you can do is hire a financial advisor. This, when combined with an investment advisor, can help you to not only invest the right amount of money but also in the right stocks and accounts.

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disabil ity #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

What Does Retirement Even Look Like?

Wed, 27 Mar 2024 08:15:24 GMT

For older parents of adult children with disabilities, focus stays on caring for kids

Jeanne Piorkowski looks forward to having more time in retirement to navigate the dense bureaucracy of forms, benefits and programs she can already rattle off like an expert.

But she doesn’t expect to have much time to do new things, see new places or generally just relax.

Piorkowski, 64, of Newton, New Jersey, is among the hundreds of thousands of older Americans who have adult children with disabilities living with or dependent on them.

“Being retired would enable me to do more for Ray,” she says, referring to her 30-year-old son, who has Down syndrome. “But on the other hand, I don’t foresee being able to travel very much or doing the things that other retirees enjoy.”

More than 1.1 million adults receive Social Security benefits due to a childhood disability, and nearly 345,000 of them have parents receiving retirement benefits, according to Social Security Administration data.

There are probably far more families in this situation, as these numbers only include families receiving Social Security payments. And the challenges are becoming increasingly urgent as more Americans reach retirement age and their children with disabilities live longer.

Ray gives his mom a hand making breakfast. Jeanne says they often prepare meals together.

PHOTOS BY ELINOR CARUCCI

“This is a really big issue and we’re right on the cusp of it becoming a much bigger problem,” says David Goldfarb, director of policy at The Arc, a national nonprofit that advocates for people with disabilities and their families and provides services through a network of state and local chapters.

“I would expect these issues to grow exponentially as the decade moves forward,” Goldfarb says. “Because society is getting older, we have more individuals that are going to need more supports and services.”

'Those families are really stretched thin'

The challenges begin well before retirement. Because of the time they must devote to caregiving, these parents often seek work that gives them flexibility to stay home with their children or to take them to activities or medical appointments, or they take part-time jobs without retirement plans. That can limit career prospects and economic horizons.

Ray gets a piano lesson from music therapist Julianna Altonjy as his mother, Jeanne, looks on.

Those with full-time jobs may forgo promotions that require moving to another state, since disability benefits differ from state to state and moving can mean starting the application process again from scratch, says Nancy Murray, former president of The Arc’s Pittsburgh-area chapter.

When Tamara Rampold and her husband retired, they and their youngest son, Shawen, who is 26 and has Down syndrome, moved from Illinois to Knoxville, Tennessee, to be closer to another of their three sons, who had just had a baby.

“We had barely gotten services in Illinois, then we had to start over in Tennessee,” says Rampold, 67. Her son’s state-provided Medicaid was interrupted for two months.

Tom and Tamara Rampold with their youngest son, Shawen, at their home in Knoxville, Tennessee, where they moved after the couple retired in 2022.

PHOTO BY WILLIAM DESHAZER

AARP research shows that caregiving disproportionately falls to women, and a February 2023 Urban Institute report prepared for the U.S. Department of Labor found that women earn $237,000 less, on average, over their working lives because of time they take off to raise children or provide care to parents or spouses. Mothers of children with disabilities often must step away from their careers for even longer, meaning they earn still less.

Because future payments from Social Security and workplace retirement accounts are tied to earnings, that lost income can “reverberate into retirement” and “jeopardize financial security in old age,” the Urban Institute study notes.

By retirement age, parents of children with disabilities have incomes nearly 25 percent lower than other parents and have saved less, according to a September 2023 report from the University of Wisconsin-Madison’s Center for Financial Responsibility on retirees with adult children with disabilities. Facing higher costs for things like medical care, home health aides and transportation, they’re likely to have trouble affording food, rent and utilities.

“They’re having to make all these trade-offs,” says Lisa Klein Vogel, a University of Wisconsin research scientist and a coauthor of the study. “Those families are really stretched thin.”

Health care costs can also cast a long financial shadow, says Staci Alexander, vice president for thought leadership at AARP and the parent of a 19-year-old daughter with autism and cerebral palsy.

“Many parents, even if their children are Medicaid-eligible and/or have private insurance, have been paying out of pocket for physical therapy, speech therapy and other services for years, due to provider shortages and the fact that many don’t accept any form of insurance,” she says. “This is money that could have gone towards retirement savings.”

Shawen dances to music in his living room. His parents had to reapply for Medicaid and other benefits after the family moved from Illinois to Tennessee.

Benefit rules and red tape

Benefits programs haven’t kept up — one limit on personal assets that affects how much federal assistance people with disabilities can receive hasn’t been updated in decades — and the process to qualify for them is a tangle of red tape. Minors with disabilities qualify for one kind of benefit, for instance, but in most cases, when they turn 18 they must qualify again for adult disability benefits.

“This paperwork is so daunting, and people are afraid of the penalties for getting it wrong,” Goldfarb says. “All of these benefits have different rules, and then you might need to appeal [after an initial rejection] to get these services. There is an enormous amount of complexity. It’s preventing people from getting benefits and getting the services they need.”

For example, Supplemental Security Income (SSI), a Social Security-administered program that provides monthly benefits for people with disabilities and limited financial resources , requires that individual recipients have no more than $2,000 in assets such as bank accounts, a cap that hasn’t been raised in 35 years and leaves little room for beneficiaries to save for emergencies or future needs.

“There hasn’t been a political will, I think, to increase benefit amounts, so they’ve just stayed low,” says Molly Costanza, coauthor of the University of Wisconsin study and a former research analyst at the Social Security Administration.

AARP has endorsed the SSI Savings Penalty Elimination Act , bipartisan legislation introduced in Congress in 2023 that would raise the individual income cap to $10,000 and index it to inflation.

There are tools parents can use to build greater financial security for children with disabilities without risking loss of benefits, Alexander notes. She cites Achieving Better Live Experience (ABLE) accounts , which allow people with disabilities to save up to $100,000 that is not counted against the SSI asset cap. The Arc chapters in many states operate pooled special needs trusts that similarly allow families to set aside money for future needs while protecting benefit eligibility.

But federal assistance is only part of the equation. There are nearly 700,000 people, including many with disabilities, on state waiting lists nationwide for services such as home health or adult day care and nonmedical transportation, according to the health policy research organization KFF (formerly the Kaiser Family Foundation). In some areas, particularly rural regions, such services aren’t available at all, the University of Wisconsin study says.

“There’s a huge lack of direct-support professionals, so even if they’re able to get off these wait-lists, there’s not enough individuals to provide the service, let alone the additional hours they might need,” Goldfarb says.

Handling such responsibilities becomes increasingly difficult for parents as they age, he adds. “They’re less able to handle certain tasks themselves — getting people out of bed or feeding them. They may not have the strength or the energy to do that.”

Shawen uses colored pens and notecards to keep track of different seasons of his favorite TV shows.

‘Retirement doesn’t mean the same thing’

Piorkowski hopes to retire at 67 from her paying job as an executive assistant at an insurance company. Until then, caring for Ray is like a second job, she says.

“I figure out his schedule, keep the budget, hire aides. If a person can’t make it or an activity is changed, it becomes a Rubik’s Cube. I’m trying to shift things around. It’s always shifting, always thinking.”

Now that she’s been doing it for so long, “it’s just life,” Piorkowski says. “I can imagine someone who doesn’t have the time and the resources could be missing out on a lot that their child is entitled to.”

Many parents of children with disabilities take a similar view. “I’m just kind of like, oh, OK, this is what we’re going to do,” says Rampold. “Millions of people have done this, so I can do it.”

That doesn’t make it any easier. “I don’t know how they get up in the morning and face another day,” Murray says of parents caring for adult children with disabilities.

Murray, who is 70 and newly retired, speaks from experience: As part of a host home program in Pittsburgh, she and her husband, Joe, took in three children with Down syndrome — one abandoned, one orphaned and one from an underdeveloped country. Now in their 50s, they ended up becoming family. (“They adopted us,” Joe quips.)

Friends of the couple “have moved south, they’ve moved to Florida, they play golf every day, they go out for dinner whenever they want,” Nancy says. “When you have an adult child with a disability, that’s just not your life.”

As they age, these parents often find themselves serving as dual caregivers. “It’s hard enough [caring for an adult child with a disability] when you have a spouse and a partner that are with you, but then all of a sudden your spouse or partner may die or become incapacitated themselves because of illness,” Nancy says. “Then you might have Mom who is now caring for the adult child with a disability and a husband with dementia.”

For these retirees, “the word ‘retirement’ doesn’t mean the same thing. You can’t just go to Mexico and chill out on the beach,” Vogel says. “What does retirement even look like when you’re giving up so much of your life?”

Many confront another responsibility: planning for what happens when they die. “If you were to ask any parent what their main concern is, probably most would tell you, ‘Who will take care of my child after I’m gone?’ ” says Piorkowski.

On that score, she is relatively lucky: Her other son, Calvin, is Ray’s coguardian.

“I’ve heard from some older parents the saying, ‘I pray to live one day longer,’ ” she says. “Meaning, we can’t bear to think of what will happen to our children without us. But nor do we want to live without them, because we love them so much.”

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physic allychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

Adult Day Care: What Family Caregivers Need to Know

Mon, 25 Mar 2024 18:33:21 GMT

Adult day care programs can provide caregivers with a needed break while giving older people a chance to socialize with their peers and alleviate the isolation and loneliness that many experience.

Although traditional community senior centers can be a great place for relatively healthy older people to exercise or take classes, adult day care centers serve those with physical or cognitive disabilities who may need more supervision and services. More than half of older attendees at adult day care facilities have cognitive impairment, such as dementia , according to the National Adult Day Services Association (NADSA), an industry group.

Evidence shows that older people who attend these centers have a better quality of life. A 2017 review of research on adult day care programs, published in The Gerontologist, found the centers provide health-related, social, psychological and behavioral benefits for participants, particularly those with dementia and other cognitive impairments.

Arranging for a loved one to spend time in adult day care can also be beneficial to a caregiver’s well-being . Both dementia patients and caregivers slept better, with fewer disturbances, on the nights before patients attended adult day care, according to a 2021 study published in the journal Aging & Mental Health. Other research has shown that using adult day care has a positive impact on dementia caregivers’ mood, health and relationships and reduces their sense of “role overload,” according to a 2017 review by a researcher at the School of Social Work at St. Catherine University in Minnesota.

Who provides adult day care?

In 2020, the most recent year for which figures were available, about 4,100 adult day care centers in the U.S. served more than 257,400 participants, according to the National Center for Health Statistics (NCHS).

About half of adult day care centers are nonprofit, according to the NCHS. The remainder are for-profit businesses. The nonprofit operators include local governments, universities, hospitals, national groups (such as Easterseals and the Alzheimer’s Association), religious organizations and Native American tribes.

Adult day care services are regulated by the states, which generally require operators to obtain a license or certification, to maintain a minimum staff-to-participant ratio and to provide a baseline set of services, including monitoring clients’ health and assisting them with activities of daily living. Requirements in areas such as specialized services and staff training vary from state to state, with some having specific provisions for serving people with dementia.

Adult day care services available

Adult day care centers vary in their programs and services, NADSA says, but most offer therapeutic exercise, brain stimulation for clients, social activities appropriate for their condition and help with personal care, such as grooming and using the toilet. Facilities often provide meals and snacks, including special diets for those who need them, and door-to-door transportation.

Some focus on specific areas of care.

Social centers concentrate on meals and recreation while providing certain health-related services.
Medical/health programs provide more intensive health and therapeutic services as well as social activities.
Specialized centers accept those who have only a particular condition, such as dementia.

Adult day care centers normally operate on weekdays, during regular business hours, though some offer weekend or evening services.

Adult day care costs

Prices can vary, depending on factors such as geographic region and range of services. The median cost across the U.S. is $1,690 a month, or $78 per day, according to the 2021 Cost of Care survey from long-term care insurance company Genworth.

While Medicare generally doesn’t cover the fees, financial assistance may be available through other government programs, like Medicaid, the Veterans Health Administration and state agencies. Thus, adult day care may be a more affordable option for caregivers seeking help and respite than hiring an aide or companion to provide in-home care.

When to consider adult day care

NADSA suggests that caregivers look into day care when they start seeing signs that an older loved one:

Is unable to structure his or her daily activities.
Feels isolated and lonely and wishes for interaction with other older people.
Experiences anxiety or depression and needs social and emotional support.
Has difficulty starting and focusing on an activity, whether it’s conversation, reading or watching TV.
Seems not to be safe on his or her own or feels uncertain and anxious about being alone.

Family caregivers also should consider adult day care services when they need to work or be away from home for most of the day or if they are experiencing negative effects like anxiety, frustration, depression or other health problems.

Finding and evaluating programs

To find adult day care programs in your area, type your zip code into NADSA’s searchable directory or contact your local Area Agency on Aging, which you can find via the federal government’s Eldercare Locator or by calling 800-677-1116.

Once you identify a center that seems to meet your loved one’s needs, the next step is to visit the facility. NADSA recommends asking some basic questions, such as:

How long has the center been in operation?
What licenses, certifications and accreditation does it have?
What’s the ratio of staff to attendees (the lower the better), and what kind of training do employees receive?
What days and hours is it open?
What’s the policy on late arrivals or pickups (if you won’t be using transit services that the center provides)?

You’ll also want to explore the facility’s full range of services. Does it offer physical, occupational and speech therapy? (Nearly half of centers do.) Does it have specialized care for conditions such as memory loss?

Ask whether the center creates individual service plans for attendees, how often those plans are updated and whether you can provide input.Spend some time simply observing the center itself.

Does it seem clean and generally pleasant?
Is the furniture comfortable and sturdy, and is the facility wheelchair accessible?
Is there a quiet area where your loved one can relax if he or she needs a break?
Are the restrooms conveniently located and outfitted with grab bars and space for wheelchairs?

Pay attention, too, to how the staff and clients interact and whether they seem comfortable with one another.

Helping your loved one adjust

The transition to adult day care can be stressful for an older person with dementia. The Alzheimer’s Association suggests a gradual approach.

Once you’ve vetted a center, take your loved one there for lunch or an activity. Then start using its services a couple of times a week, for a month or so, before making a final decision about enrolling.

Your family member may resist adult day care at first, but participants often warm to it after several weeks and begin looking forward to seeing other people at the center and engaging in activities, NADSA says. If the program doesn’t seem to be working for your family member, you might remove them from it and reintroduce them to it at another time.

Editor’s note: This article, originally created in 2012, has been updated with more recent information.

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

Dementia vs. Alzheimer’s: Which Is It?

Wed, 20 Mar 2024 15:00:26 GMT

The terms “dementia” and “Alzheimer’s” have been around for more than a century, which means people have likely been mixing them up for that long, too. But knowing the difference is important.

In the simplest terms, one is broader than the other. If the two were nesting dolls, Alzheimer’s would fit inside dementia, but not the other way around. While Alzheimer’s disease is the most common form of dementia (accounting for an estimated 60 to 80 percent of cases), there are several other types.

The second most common form is vascular dementia, which is caused by decreased blood flow to the brain. Other types of dementia include Lewy body dementia and frontotemporal dementia. In addition, certain medical conditions can cause serious memory problems that resemble dementia.

A correct diagnosis means the right medicines, remedies and support. It could also impact clinical trial eligibility and participation.

What it is

Dementia

In the simplest terms, dementia is a decline in mental function — thinking, remembering and reasoning — that is usually irreversible. It’s a syndrome, not a disease, notes neurologist Ron Petersen, M.D., director of the Mayo Clinic Alzheimer’s Disease Research Center and the Mayo Clinic Study of Aging in Rochester, Minnesota.

The catchall phrase encompasses several disorders that cause chronic memory loss, personality changes or impaired reasoning, Alzheimer’s disease being just one of them, says Dan G. Blazer, M.D., a psychiatrist and professor emeritus at Duke University School of Medicine.

To be called dementia, the disorder must be severe enough to interfere with your daily life, says psychiatrist Constantine George Lyketsos, M.D., director of the Johns Hopkins Memory and Alzheimer’s Treatment Center in Baltimore.

What it’s not? Typical mild forgetfulness that sometimes accompanies aging — say, having trouble remembering the name of an acquaintance who comes up to you on the street.

In fact, the earliest stage of dementia, known as mild cognitive impairment (MCI), is considered “forgetfulness beyond what is expected from aging,” Petersen says. With MCI, a person is still functioning normally — paying her bills, driving well enough, doing his taxes — though performing some of those tasks may take longer than they used to. When someone starts to need regular assistance to do such daily activities, “that gets into the dementia range,” Petersen says.

Alzheimer’s

Alzheimer’s is a specific brain disease that progressively and irreversibly destroys memory and thinking skills. Age is the biggest risk factor for the disease. Eventually, Alzheimer’s disease takes away the ability to carry out even the simplest tasks.

To help determine whether patients have this particular brain disease, doctors talk to the patients and their close family members about any recent challenges or changes in behavior or memory. They also administer a mental status exam in an office setting, and possibly do a short neuro-psych evaluation.

While a cure for Alzheimer’s remains elusive, researchers have made some progress when it comes to finding treatments that may be able to slow the progression of the disease. So far, two drugs have received accelerated approval from the Food and Drug Administration.

How it’s diagnosed

Dementia

A doctor must find that you have two cognitive or behavioral areas in decline to diagnose dementia. These areas are disorientation, disorganization, language impairment, mood change, personality change and memory loss. To make an evaluation, a doctor (often a specialist such as a psychiatrist, neurologist or geriatric medicine physician) typically takes a patient history and administers several mental-skill challenges.

Thanks to growing medical consensus that irritability, depression and anxiety often flag dementia before memory issues do (and official changes to the diagnostic criteria to reflect this), doctors also ask more about changes in mood or personality, Lyketsos notes.

To check for cognitive decline, a doctor will ask whether a patient is experiencing just forgetfulness or, potentially more indicative of dementia, also having trouble figuring out calculations such as a restaurant tip, Petersen says. A physical exam can be important for flagging something like specific types of dementia caused by vascular disease (strokes) or Parkinson’s disease.

Next, a standard and fairly brief round of memory and thinking tests is given in the same office visit. In the Hopkins Verbal Learning Test, for example, you try to memorize and then recall a list of 12 words — and a few similar words may be thrown in to challenge you. Another test — also used to evaluate driving skills — has you draw lines to connect a series of numbers and letters in a complicated sequence.

Alzheimer’s

Doctors use several different methods to determine if an individual has Alzheimer’s disease, according to the National Institute on Aging. Physical and mental evaluations are often part of this process. Memory and problem-solving tests are also used.

With Alzheimer’s in particular, the progression and timing of symptoms is important. To identify this degenerative brain disease, doctors are looking for “a gradual, insidious onset that is slowly getting worse,” Petersen says.

Until fairly recently (before the early 2000s), a conclusive diagnosis was not possible until an autopsy was performed and the brain examined for the physical hallmarks of the disease — beta-amyloid and tau, proteins that look like plaques and tangles in the brain.

Now, a patient can get a PET scan or cerebrospinal fluid sampling that can show, with high accuracy, whether such plaques or tangles are present. But a high percentage of patients never get such a test, doctors say. For one, these tests are invasive. They’re also expensive and typically are not covered by insurance, though this could change in the future as more Alzheimer’s treatments become available.

Researchers are hopeful that faster, less-expensive tests will be available soon, like a blood test to diagnose the disease in the doctor’s office, or even to identify someone at high risk for developing Alzheimer’s.

#homeaccessibility #h omemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

Home Accessibility is no Longer Just a Luxury, it’s Become a Necessity

Mon, 18 Mar 2024 15:06:00 GMT

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

How Pressalit bathroom products & designs can benefit those who are physically challenged

Wed, 13 Mar 2024 23:30:48 GMT

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

'Older And Wiser Now Means Being Richer' — Baby Boomers Own 72% Of Nation's Wealth, But Gen X And The Younger Generations Trail Far Behind

Wed, 13 Mar 2024 17:23:10 GMT

The economic divide between generations is becoming increasingly pronounced, with older Americans amassing a significant portion of the nation’s wealth. A Fox News video titled "Baby Boomers' Wealth Bursts As Gen X and Younger Lag Behind" opens with the observation that “being older and wiser now means richer.”

This report reveals that Americans older than 55 control 72% of the nation’s wealth, highlighting a major contrast with the financial realities facing those younger than 55, who see little to no growth in their financial assets. This wealth concentration among older generations raises important questions about economic equity and the financial prospects of younger Americans.

According to the video, a Fox News poll highlighted a shift in political allegiance among voters younger than 30, showing former President Donald Trump leading President Joe Biden by 13 points in this demographic. The economy emerges as a major concern for these voters, who seem to adopt a different perspective toward the presidency and, by extension, their economic future.

The report elucidates the generational wealth divide: Americans 70 and older own 30% of the nation’s wealth, while those between 55 to 65 control 42%. In contrast, households aged 40 to 54 hold 20% of the wealth, and those younger than 40 possess less than 7%. This disparity is not merely a reflection of current economic conditions but also the result of decades-long trends in stock investment and home ownership that have favored older Americans.

Younger Americans face myriad economic challenges, including high college costs, rising interest rates and soaring housing prices. Unlike their predecessors, who navigated through six recessions and faced mortgage rates as high as 18%, younger generations have not had the same opportunities to build wealth through home ownership or stock market investments.

The conversation around this wealth gap also touches on changing attitudes toward work and savings. For instance, younger generations’ spending habits, characterized by daily indulgences such as $7 Starbucks coffees and frequent online purchases, contrast with the financial prudence historically practiced by older generations.

It's not just the millennials and Gen Z struggling to save. The New York Post reports that the more than 65 million Americans in Generation X, ranging in age from 43 to 58, face the largest wealth gap of any generation. This exacerbates the challenges highlighted by Schroders’ 2023 U.S. Retirement Survey . According to the survey, Gen Xers anticipate needing over $1.1 million for retirement but expect to have only $660,000 by the age of 67. This projection leaves them $440,000 short of their desired retirement savings and a significant $1 million less than what the average adult in this generation currently has saved. The National Institute on Retirement Security (NIRS) found that the average Gen X household has even less set aside for retirement, with savings amounting to just $40,000.

This generational wealth disparity, coupled with evolving economic and social attitudes, underscores the complex interplay between age, wealth and political preferences in the United States. As the country navigates these changing dynamics, the impact on electoral outcomes and broader economic policies remains a subject of keen interest and debate.

Consulting a financial advisor is not just beneficial; it’s a strategic move for anyone looking to navigate the complexities of today’s economy. Whether you’re trying to build your wealth from scratch or manage an existing portfolio, a financial adviser can provide the guidance needed to make informed decisions. This step is crucial for younger generations facing economic challenges and equally important for those in higher wealth brackets aiming to preserve and enhance their assets. In essence, seeking financial advice is a proactive step toward achieving financial stability and growth, regardless of your economic standing.

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #di sabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

8 Ways Middle-Class People Become Poor in Retirement

Tue, 12 Mar 2024 14:18:29 GMT

After working for most of your adult life, the last thing you want to do is stress about your finances and paying the bills in retirement. You want to enjoy your golden years after committing to a career and waiting so long to exit the workforce.

Underestimating Retirement Expenses

“Many middle-class individuals may underestimate how much money they’ll need in retirement,” said Taylor Kovar, a Certified Financial Planner (CFP) as well as the CEO and founder of 11 Financial .

“They might prioritize immediate expenses or simply not have enough left over to save for the future,” Kovar added.

Do your research and consider working with a financial professional to ensure you’re prepared for your various expenses. You don’t want to be surprised when you see just how much money you’re spending

Not Saving Enough For Retirement

“Unexpected financial setbacks like job loss or medical emergencies can eat into savings, making it difficult to build a substantial retirement nest egg,” warned Kovar.

One of the biggest issues with retirement planning is not saving enough to cover expenses for the remainder of your life.

“Many individuals do not save enough for retirement due to high living expenses, debt, or underestimating the amount of money they will need,” explained Liam Hunt, director at SophisticatedInvestor.com .

Hunt added, “Without adequate savings, retirees may find their funds depleting faster than anticipated, especially as life expectancies increase.”

If you don’t have sufficient funds to cover your expenses, you could risk feeling poor as you struggle to get by.

Not Diversifying Their Income

According to Kovar, “Relying solely on one source of income, such as a pension or Social Security, can be risky because these sources might not provide enough to cover all expenses in retirement.”

You’ll want to diversify your income streams with investments, rental income or even a part-time gig to have more stability in retirement.

Unexpected Healthcare Costs

With age, the cost of healthcare only becomes more expensive. Regular and unexpected visits can quickly drain your savings if you’re not prepared.

“Without adequate health insurance or a plan to cover medical costs, retirees may find themselves struggling to afford necessary treatments and medications, leading to financial hardship,” warned Kovar.

While predicting future health concerns is difficult, you want to do your best to ensure you have the funds to cover medical bills. If you don’t factor in medical costs, they’ll eat away at your nest egg.

Market Volatility

While investing in the stock market can provide high returns over time, Kovar warns that it also comes with it’s share of inherent risks, such as market volatility and economic downturns.

“Middle-class individuals may not have the knowledge or resources to navigate these risks effectively,” Kovar continued, “leading to losses in their retirement portfolios…”

Depending on your retirement portfolio and external economic factors, you may face financial hardships due to unforeseen circumstances. While you can’t control the market, you can control how you invest.

Poor Investment Choices

“Poor investment choices and the lack of a diversified portfolio can expose retirement savings to unnecessary risk,” said Hunt.

While a higher risk tolerance is expected at a young age, older adults should focus on mitigating risk. Bad investments in retirement can leave you feeling poor and stressed about covering your expenses.

It’s important to be mindful of investment scams as well. As the old adage goes, if something sounds too good to be true, it probably is. If you find yourself in a situation like this, seek out advice from a trusted financial expert to avoid putting your life savings in the wrong hands.

Not Planning For Inflation

"Another significant issue is the failure to account for inflation and the rising cost of living,” explained Hunt.

“What may seem like a robust retirement fund now can lose its purchasing power over time,” Hunt continued, “reducing the retiree’s ability to maintain their standard of living. This is particularly concerning for fixed-income sources that do not adjust or keep pace with inflation.”

As we’ve all noticed in the last few years, inflation can increase the prices of everything around us. When you create a retirement budget, you must consider that prices will increase over time and adjust your budget accordingly.

Not Creating a Comprehensive Spending Plan

Without a retirement plan that includes a budget, withdrawal strategy and consideration for taxes, Hunt said that it’s easy for “individuals to overspend in the early years of retirement, leaving them financially vulnerable later on.”

A comprehensive plan ensures you’re able to fund your retirement lifestyle without sacrifice. Taking the time to create one before retirement gives you more time to adjust and change as your life dictates.

“Addressing these issues requires early and careful planning, education on financial management and, most importantly, consulting with financial advisors to create a tailored retirement strategy,” concluded Hunt.

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

OTs and CAPS Can Make a Home a Good Fit

Tue, 05 Mar 2024 16:00:28 GMT

Sometimes it's handy to call in the pros — specifically an Occupational Therapist or Certified Aging-in-Place Specialist

AARP Livable Communities

Whether you've recently relocated or have lived in the same home for years, it can be hard to figure out the most efficient use of your living spaces, or know which furnishings and housing features provide the best comfort, safety and ease-of-use.

For those reasons and others, it may be helpful to bring in a professional, such as an Occupational Therapist (frequently called an OT) or a Certified Aging-in-Place Specialist (commonly identified by the acronym CAPS). Or, you can even assemble a team that includes an OT and a design-build CAPS professional.

What's a "CAPS"?

The National Association of Home Builders (NAHB), in collaboration with AARP and other experts, developed the Certified Aging-in-Place Specialist (CAPS) designation, which is achieved through training and testing during a multicourse educational program.

A Certified Aging-in-Place Specialist understands the unique needs of the older adult population and is knowledgeable about, aging-in-place home modifications, common remodeling projects and solutions to common barriers. CAPS designees are often remodelers, but designers, OTs, architects and others frequently achieve this designation as well.

A Certified Aging-in-Place Specialist can:

Recommend updates that will help a person live independently in his or her own home
Work with an OT to develop a home modification or build plan based on the safety and functional needs of an individual or household
Collaborate with a licensed contractor or interior designer about building and design strategies and techniques for creating attractive, barrier-free living space.
Provide information about building codes and standards, useful products and resources, and the costs and time required for common remodeling projects

CAPS remodelers and design-build professionals are not medical or health care professionals. They are generally paid by the hour or receive a flat fee per visit or project. To find a Certified Aging-in-Place Specialist in your area call the NAHB at 800-368-5242 or visit its directory page "Find a Certified Aging-in-Place Specialist" at nahb.org .

What's an "OT"?

Occupational therapists (OTs) are licensed health professionals who understand the health and disability issues people face over a lifetime and know how to match the abilities of an individual with needed supports.

OTs are skilled at performing home assessments that identify a person's daily routines and activities and the barriers that impact performing them. An OT then works with the individual, the family and others to identify solutions for achieving the desired goals.

An OT has a strong understanding how an individual functions in her or his space, which is essential in making recommendations that will enhance function and safety in the home environment. This person-centered focus helps ensure that any modifications made to a home will meet both current and future needs. Such assessments save money in the long run by helping to avoid mistakes in product selections and design solutions.

All OTs have training in basic home assessments, and some have additional training or certifications including Specialty Certification in Environmental Modifications (known as SCEM) through the American Occupational Therapy Association (AOTA), the Executive Certificate in Home Modifications (ECHM) or the CAPS designation.

An Occupational Therapist can:

Assess an individual’s abilities, challenges and needs. (This is often done by asking questions, such as: Do you have medical conditions that impact your daily life? What activities are painful or difficult for you to do?)
Provide a home evaluation and recommend changes to increase safety and ease of use
Identify furnishings, equipment and techniques that can help with activities
Suggest and demonstrate techniques that can make essential activities possible or easier
Collaborate with a home improvement contractor to develop a modification or build plan that will meet the needs of an individual or household

Work with clients after the modifications, equipment or specialized products have been installed in order to ensure safe usage

Occupational therapists are generally paid a flat fee per visit and their services may be covered by health insurance. (Check with your insurance provider.) To learn more about occupational therapists, visit AOTA.org . To find an OT, check with your physician, health insurance provider or local hospital or seek recommendations from family and friends, or even age-friendly builders.

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

8 Ways Baby Boomers Become Poor in Retirement

Thu, 29 Feb 2024 17:36:06 GMT

As the baby boomer generation enters retirement, a growing number of them face unexpected financial challenges that threaten their retirement security.

Even those who have worked hard and saved their whole lives may find themselves losing spending power and sinking into poverty after they retire.

It can be disheartening for that to happen. If you are nearing or in retirement, look out for these pitfalls to remain as financially secure as possible. Even falling into one or two of these traps can lead to financial trouble.

Carrying a Balance on Credit Cards

Carrying a balance on credit cards can quickly and easily get you further in debt. It means paying interest and, therefore, more money than you should.

“Credit card debt can also be an indication of living beyond your means, so you’ll need to address any overspending issues as well.”

Learn: 5 Bills You Start Paying When You Retire

Collecting Social Security Too Early

Selling Investments When the Market Drops

Fluctuations in the market are an inevitable part of investing. However, some people may panic during a downturn and sell their investments before they had planned.

“Working with a financial advisor on an ongoing basis can be beneficial if you need help determining your asset allocation and staying invested when times are tough,” Rittershaus said.

Paying Too Much in Housing Costs

Having an Unrealistic Budget

Not Having a Plan

Waiting Too Long To Adjust a Plan

Even if you have a retirement plan, it may require adjustments over time. Make sure to periodically reevaluate your plan to account for changes in health, market conditions or unexpected expenses.

Baby boomers must be proactive in regularly reviewing and adjusting their financial plans to ensure they remain on track for a secure retirement.

Not Planning for the Unexpected

The Bottom Line

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disab ilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

How to Be an Effective Advocate for Aging Parents

Tue, 20 Feb 2024 14:11:43 GMT

6 skills that will help you care for the ones you love

As family caregivers, we play many roles: scheduler, money manager , house cleaner, health aide, nurse, navigator, nurturer and more. Perhaps the most important role is advocate, as we ensure the best possible care for our loved ones when they are vulnerable.

That includes understanding and respecting their goals and wishes for their care and quality of life, and ensuring their wishes are carried out. It means helping them manage financial and legal matters . And it means ensuring they receive appropriate, high-quality services and treatments when needed. We are their voices when they are unable to advocate for themselves.

If the thought of being an advocate for others seems overwhelming , relax. You probably already have the skills to be effective; you just need to develop and apply them in new ways. Here are the six attributes I think are most important:

1. Relationship-building abilities

Getting things done often depends heavily on our relationships with the people involved . When advocating for our loved ones, our job is not to be best friends with the health care providers and others we interact with as caregivers. But having respectful, pleasant relationships can sometimes help you get the response you need.

How to be a better relationship builder:

Be calm, confident and assertive without being aggressive.
Create allies, not adversaries. Approach with a collaborative attitude — “we’re all in this together,” rather than “you are my enemy.”
Build empathy. Validate others’ limitations and concerns while sharing your pertinent details, perspectives and requests.
Show appreciation. Thank people for a job well done.
Apologize. Don’t hesitate to say “I’m sorry” when it’s appropriate.
Establish a personal connection. This is best done right off the bat, before a need to advocate arises.

2. Strong observational skills

Caregivers are often too busy or exhausted to notice small changes, but the slightest shift in our loved ones’ abilities, health, moods, safety needs or desires may indicate a much larger medical or mental health issue. Catching those changes early can make all the difference in alleviating the problem.

Equally crucial is keeping a close eye on the services they receive and adjusting any subpar care. Whenever possible, we must try to accompany loved ones to the hospital and visit them in their homes or wherever they reside, such as an assisted living or long-term care facility.

How to be more observant:

Practice noticing the subtle details. We are often so busy that we move through life quickly. Try to become more observant of the emotions of people around you, the clothing they are wearing, and changes in your home environment.
Listen carefully. Whether you are interacting with coworkers, a clerk in a store, your family or those you care for, taking time to really listen can help you be more in tune with changes.
Develop observational skills. Mindfulness and meditation can help you become more aware and fully present in the current moment. Practice in a class, through yoga instruction or with a mindfulness app.
Get adequate sleep. The key to a clear and focused mind is prioritizing your rest .
Document your observations. Keeping notes about your loved ones, including dates and details, can help you track changes. If in-person interactions are limited, enlist staff or neighbors who see them regularly to report back to you, preferably in writing.
Use technology. Phone calls help, but video calls via apps such as Zoom, Skype or FaceTime can tell you more about subtle changes in a loved one’s physical appearance and abilities. Try a remote monitoring system to track their movements at home and detect changes in routine, such as staying in bed longer.

3. Ability to organize despite constant change

It can be tough to stay on top of a caregiving plan, with its many moving parts. As an advocate, you’ll need to manage your loved one’s caregiving team, make task lists and organize the mounds of paperwork associated with health, legal and financial matters. You'll want to make sure you can easily access all legal documents (such as powers of attorney for finances and health care) when you need them.

How to get better at organization:

Sign up for a class. Consider taking an organizing course to improve your skills.
Get outside help. When I was caring for my parents and my sister, moving and starting a new job all at once, I consulted a professional to develop an organizational plan for the paperwork, tasks and physical setup of my work area. You can make this option more affordable by implementing the plan yourself, as I did, or by tapping friends and family for their systems and suggestions.
Create a to-go folder. Keep this by the door, so you can easily grab it when headed to a doctor appointment or hospital. Include medical history, a current medication list, insurance information and a list of key health care professionals.
Turn to tech. There are numerous apps that centralize and organize medical information, caregiving tasks and appointments , as well as communication with the care team.
Make digital copies of documents. Make PDFs or take photos of medication lists , medical history, powers of attorney and living wills, so you can access them on the go from your phone or tablet.

4. Excellent communication skills

This is key for building relationships with those who help care for our loved ones, from family members to lawyers, doctors and more. Most family caregivers are not experts on medical, legal or financial matters, which can make some topics challenging to discuss.

Caregiving can be a very emotional experience , and emotions can affect our communication styles and skills.

How to communicate more effectively:

Be respectful. Try to set your feelings aside when you are advocating for a loved one. Remember that to communicate effectively, listening is just as important as speaking. It’s critical that we ensure our message has been received and give feedback to those we speak with so they are sure their message has come across correctly as well.
Show up prepared. Do your homework before meetings with lawyers, medical professionals and other providers, and have notes and questions ready. Be clear, concise and get to the point. Try to prioritize your top three questions.
Find the key people. To ease communication with busy professionals, find out who in their office handles matters such as appointments and billing, and build relationships with them. Get to know how they prefer to communicate (phone, email, text, patient portal, etc.) and the best time of day to reach them. Always express appreciation.

5. Curiosity and a questioning mind

Dad, a former professor, used to have a sign in his office that read, “Question everything.” As I advocated for him for 12 years while he lived with Alzheimer’s, I often thought of that message. My family’s doctors and service providers could attest that I ask plenty of questions! Remember — there is always more to learn, and there is often another way to get things done.

Don’t be satisfied with feeling in the dark about your loved ones’ situation. As a caregiver, it’s part of your job to gather information — this is not the time to be shy. It never hurts to ask, and many times you’ll miss something if you don’t. All too often, busy professionals will not offer critical information; they need to be asked.

How to feel comfortable asking questions:

Learn as much as possible. Dig in to your loved one’s health conditions, finances and legal affairs, so you can identify concerns and ask pertinent questions.
Be gracious. Always be polite and appreciative, regardless of whom you ask or their position in the organization.
Consider alternate approaches. If you hit a roadblock in arranging care or services, try to think of other paths toward your goal. Sometimes, getting questions answered is all about asking the right person, be it a doctor, lawyer, accountant or member of their staff.

6. Tenacity

Someone said my role when caring for my parents was “chief bulldog.” I guess that’s true.

As their advocate, I had their best interests at heart, and I took that job seriously. Facing a fragmented and frustrating health care system and trying to do more with less money can be discouraging. Being tenacious means being determined and not giving up easily. I did my best, and I never gave up until I found the best possible solution.

Honestly, I didn’t take no for an answer when it came to my family; I could almost always find a way to get them what they needed.

How to be more tenacious:

Be clear about goals. And believe there are solutions.
Focus on the end result. After you’ve figured out what you want, be flexible and adaptable about how to get there.
Surround yourself with supporters. Find encouraging people who will pick you up and cheer you on when you feel like giving up.
Follow other caregivers’ stories. You’ll hear about the triumphs as well as the challenges.
Remember why you are a caregiver. You may be driven by love, a sense of responsibility or duty, or a desire to do the “right” thing in your view. Whatever your reason is, when you feel like giving up, allow it to motivate you and propel you forward.
Have a positive mindset. This is crucial. When caregiving knocks you down, get back up . Resilience is success!

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

20 Popular Jobs for Older Workers

Thu, 15 Feb 2024 15:05:50 GMT

These positions value experience and some even offer flexibility and remote work

While you can be successful in a career at any age, there are certain occupations that attract higher shares of older workers. Whether it’s because the job offers flexible hours and the opportunity for remote work or because the position requires skills and experience that take years to build, some jobs are just more popular with older adults.

AARP examined U.S. Bureau of Labor Statistics (BLS) data to identify 20 occupations that had workers who were an average of at least 49 years old. The following list is ranked in order of the total number of workers age 45 and older in each field, from the most workers to the fewest. All wage data is from the BLS. Clicking on the link below each entry will take you to a list of all current postings nationwide for that occupation on the AARP Job Board.

These 20 jobs are the most popular for older workers.

1. Chief executives

Median age: 52.2 years
Total workers age 45 and older: 1,260,000
Average wage: $91.12 per hour
Find chief executive jobs

CEOs aren't limited to the Fortune 500. Smaller businesses and organizations need leaders, too, which explains why there are so many chief executives in the BLS tally. It’s no surprise that many businesses turn to older workers – and their lifelong experience – to fill this role.

2. Bookkeepers, accountants, and auditing clerks

Median age: 49.2 years
Total workers age 45 and older: 720,000
Average wage: $22.05 per hour
Find bookkeeping/accountant jobs

Among the jobs on this list, bookkeeper and accountant are perhaps the roles that offer the most work-from-home opportunities. These positions also tend to offer contract positions and other kinds of flexibility.

3. Real estate brokers and sales agents

Median age: 50 years
Total workers age 45 and older: 632,000
Average wage: $25.02 per hour
Find real estate jobs

Only 6 percent of members of the National Association of Realtors say real estate was their first career, making these jobs good fits for career switchers. “We see that there’s a very diverse background of members who are coming from other industries and starting in real estate,” the association tells AARP.

4. Postsecondary teachers

Median age: 49.5 years
Total workers age 45 and older: 630,000
Average wage: $38.86 per hour
Find teacher jobs

The most familiar workers in this occupation are the professors at colleges and universities across the nation. Another place to find these teachers are in technical and professional schools that award certificates for various careers.

5. Farmers, ranchers and agricultural managers

Median age: 56 years
Total workers age 45 and older: 613,000
Average wage: $36.42 per hour
Find agriculture jobs

This profession has the highest average age of all the jobs on this list. Among all industries, these careers also offer the highest levels of happiness and meaning, according to a Washington Post analysis of BLS data.

6. Home health aides

Median age: 49.1
Total workers age 45 and older: 345,000
Average wage: $14.51 per hour
Find home health aide jobs

The BLS projects that the number of jobs in this field will grow by 22 percent over the next eight years. If you have experience as a family caregiver or you volunteer to help older family and friends, this job could be a good fit for you.

7. Public transit bus drivers

Median age: 52.8 years
Total workers age 45 and older: 203,000
Average wage: $24.47 per hour
Find bus driver jobs

According to the American Public Transportation Association, 96 percent of transportation agencies reported a shortage of bus drivers in 2022. The job can be stressful in some cases, but there’s steady demand for workers.

8. School bus drivers

Median age: 55.5 years
Total workers age 45 and older: 159,000
Average wage: $19.84
Find bus driver jobs

The unusual schedule suggests why this occupation tends to favor older adults. Working a couple hours in the morning and a couple hours in the afternoon is a better fit for retirees than for most other types of workers.

9. Aircraft pilots and flight engineers

Median age: 49 years
Total workers age 45 and older: 125,000
Average wage: $101.82 per hour

Soaring through the wide blue yonder can lead to sky-high salaries. Pilots earn the prize for the highest salaries on this list.

10. Facilities managers

Median age: 53.6 years
Total workers age 45 and older: 110,000
Average wage: $48.98 per hour
Find facilities manager jobs

From handling renovations to hiring janitorial staff, facilities managers are responsible for keeping buildings ready for workers and their clients. The role requires both good people skills and knowledge of how to keep a building’s infrastructure up-to-date.

11. Sewing machine operators

Median age: 52.1 years
Total workers age 45 and older: 90,000
Average wage: $15.26 per hour
Find sewing machine operator jobs

This blue-collar job is more like a manufacturing role within the apparel industry. Most jobs in this field do not require a degree or certificate to get hired, opting instead for on-the-job training or previous experience.

12. Payroll clerks

Median age: 49.5 years
Total workers age 45 and older: 79,000
Average wage: $23.86 per hour
Find payroll jobs

Before you receive your check, the payroll department has to tally your hours and calculate your benefits, taxes and other deductions. Clerks are the workers that help get that process started.

13. Property appraisers/assessors

Median age: 53.2 years
Total workers age 45 and older: 70,000
Average wage: $29.60 per hour
Find real estate jobs

If you like the real estate industry but aren’t comfortable with the responsibilities of being an agent or broker, a property appraiser is an interesting alternative. Most cities or states will require you to complete a short training program and pass a licensing exam before you can begin working.

15. Shuttle drivers/chauffeurs

Median age: 54.3 years
Total workers age 45 and older: 52,000
Average wage: $15.77
Find shuttle driver jobs

Flexible schedules and part-time shifts are part of what make these jobs attractive to older adults. And years of personal experience driving in a city or region is a valuable skill these workers bring to the role.

16. Judges

Median age: 53 years
Total workers age 45 and older: 51,000
Average wage: $72.61 per hour
Find lawyer jobs

Many judges are either elected or appointed to their positions, a condition that could give an edge to people with years of experience and larger professional networks. Many states, however, do have mandatory retirement ages (typically 70 years old) for some judge positions, according to the National Center for State Courts.

17. Firefighting supervisors

Median age: 52.1 years
Total workers age 45 and older: 39,000
Average wage: $38.53 per hour
Find firefighter jobs

While firefighters in general are an average of 38.5 years of age, their supervisors are significantly older, according to the BLS. Experience is a highly valuable skill in this high-stakes profession, it seems.

18. Legal secretaries/administrative assistants

Median age: 53.9 years
Total workers age 45 and older: 38,000
Average wage: $23.45
Find secretary jobs

While these secretaries tend to have some knowledge of and experience with the particular needs of a law office, they typically don’t perform legal research or other duties that paralegals fulfill. The secretaries instead schedule meetings, support clients and lawyers, and perform other administrative duties.

19. Crossing guards

Median age: 55.8 years
Total workers age 45 and older: 36,000
Average wage: $16.05 per hour
Find crossing guard jobs

Perhaps the most common place to find these workers on the job is in intersections near elementary schools. That means an early start to work, a few hours to yourself midday, and a few hours of work mid-afternoon – a schedule shared with school bus drivers.

20. Tailors and dressmakers

Median age: 49 years
Total workers age 45 and older: 30,000
Average wage: $16.48 per hour
Find tailor/dressmaker jobs

These days, you might be likely to find more people at a Taylor Swift concert than you are to find people employed as a tailor, but it’s still a fun, fulfilling job. Not every dress or suit ends up on a stage, but a good tailor or dressmaker can still make your outfit sparkle.

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

Should You Modify Your Current Home for Accessibility, or Move Into a More Accessible Home?

Wed, 07 Feb 2024 21:15:32 GMT

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

What to do, (or Not do), When Someone is Having a Stroke

Wed, 07 Feb 2024 15:17:59 GMT

A stroke is a sudden, potentially catastrophic event. In the blink of an eye, a clot can block a blood vessel that feeds brain tissue, or a blood vessel in the brain bursts. Either way, brain cells are starved of nutrients and oxygen, or damaged by pooling blood, and begin to die. And they go fast — at a rate of about 2 million per minute.

That dying tissue can show up as a facial droop and weakness, often on just one side of the body, or speech and balance problems, among other symptoms. These signs are important to recognize, because if any of them are present, what you decide to do next could be the difference between recovery and severe disability or death.

“It used to be that you couldn’t do much about stroke. But nowadays we can,” says David Miller, M.D., an interventional radiologist and codirector of the Comprehensive Stroke Center at the Mayo Clinic in Jacksonville, Florida. “We can actually do a lot for stroke if we get people to help in a timely fashion.” He says this is particularly true for ischemic stroke, which accounts for about 87 percent of strokes, according to the Centers for Disease Control and Prevention (CDC).

If you think someone is having a stroke

Call 911 immediately. The goal is speed, not only because the brain is rapidly dying but also because the window for certain stroke treatments is narrow. “As soon as you cut the blood flow off to the brain, the clock starts ticking,” Miller says.

Calling 911 does two crucial things: It brings help to your door, and it primes the entire medical system and the nearest stroke team for action. “When you dial 911, you activate a series of protocols that have been created across the United States to shave down treatment time,” says William “BJ” Hicks II, M.D., a vascular neurologist and codirector at the Riverside Methodist Hospital Comprehensive Stroke Center in Columbus, Ohio.

While you wait for the paramedics to arrive, get the person to the floor or the ground, so they can’t fall, and try to keep them calm until help arrives. Some stroke patients will pass out, but many do not, Miller says. “They are just very confused and unable to grasp what’s going on.”

Once the person is safe, write down the following information to give to the paramedics when they arrive:

The time you first noticed the stroke symptoms. Doctors need to know when the stroke occurred to decide how to treat the patient. “We often play detective,” Hicks says. “The real information … that we search for is: When were they last seen normal?”

Any medications you know the patient is taking, and if you believe they have taken them as prescribed. Some medications interact with certain stroke treatments.

Your contact information. The stroke neurologist at the hospital may want to call you to confirm the times the medics give them.

Here’s what NOT to do

Do not drive the person to the hospital yourself. You might hit traffic, and there will be no sirens to clear the way. You might have to park the car, too. And when you do walk in the door, instead of the patient getting whisked into a room, you will first need to explain to the emergency room staff what you think is going on, and it’s possible they won’t agree. “There’s inherent delays that people don’t always appreciate when taking a private car,” Hicks says.

You might even drive to the wrong hospital. Only designated “stroke centers” have the expertise to treat acute stroke, Miller says. Emergency medical personnel have a list of these centers, and they are trained to take potential stroke patients to them. It’s a good idea to find out where the nearest stroke centers are, just in case the first responders aren’t aware.

Stroke centers offer the best, speediest care. “When I first started working on acute stroke, and we were forming a stroke center, we looked at everything that we did,” Miller says, “including moving where we kept the janitorial supplies in the emergency room to clear space and to make a shorter path for us to evaluate patients and get them into the [CT] scanner.” The scans can reveal bleeding in the brain or damage to brain cells so doctors can identify the type of stroke.

Why the need for speed?

The need for speed comes in large part from the fact that the main drug treatment for ischemic strokes, the kind caused by clots, must be given within 4.5 hours of stroke onset, and sooner in some cases. Ideally, doctors give the patient this drug — called tPA for tissue plasminogen activator — within an hour, Hicks says. But any time up to 90 minutes provides “a strong chance we will have minimal symptoms three months from now.” For people in rural areas that don’t have stroke centers, hospitals have begun to use telemedicine to “bring in” help from stroke center specialists via digital cameras and internet connections to more quickly diagnose and get treatment to patients.

If more time passes, there are other options. Up to 24 hours after a stroke, doctors can thread tiny catheters into the brain and either remove the clot with suction or push small metal mesh cylinders called stentrievers into the clot to snag it and pull it out. The technique is standard care for patients who have blockages in large vessels — for which tPA alone is unlikely to work — or for people in whom clot-busting drugs are unsafe for various reasons. In stroke centers, doctors may be aided by artificial intelligence programs that create a map of the brain after doctors inject a patient with a dye and make an image using a CT scanner, Miller says.

In some parts of the country, stroke care comes with the 911 call. Mobile stroke units (MSUs) patrol almost two dozen urban centers. These ambulances carry a portable CT scanner, which can reveal a clot or a bleed. Remote doctors read the scan via telemedicine, and if there is a clot, medics can deliver a clot-busting drug such as tPA on the spot. If the scan shows a bleed, paramedics can, say, lower the patient’s blood pressure and perhaps offer an experimental treatment for hemorrhagic stroke.

For example, a clotting compound called factor VII is being tested as a treatment for this type of stroke in a large nationwide clinical trial called FASTEST (for rFVIIa for Acute Hemorrhagic Stroke Administered at Earliest Time). “That is a groundbreaking study that we’re very excited about that we are doing on both the mobile stroke treatment units and we are doing in the emergency room,” Hicks says.

This treatment’s time window is tight: within two hours of when the stroke presumably struck. One more reason to call 911.

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

A Blood Test for Alzheimer's Disease?

Tue, 06 Feb 2024 14:44:08 GMT

https://www.aarp.org/health/conditions-treatments/info-2024/blood-test-for-alzheimers.html

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

How Does Healthcare for Seniors Compare With 20 Years Ago?

Wed, 24 Jan 2024 20:47:15 GMT

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

What kitchen modifications can create more accessibility for those with challenged mobility?

Wed, 24 Jan 2024 08:56:52 GMT

Kitchen Modifications

Struggling with high countertops, hard-to-reach appliances & cabinets, or inaccessible sinks? We design custom kitchens that accommodate your needs, ensuring comfort and ease of use.

#AccessibleLiving,#HomeModifications,#AccessibleDesign,#BarrierFreeLiving, #SafeAtHome,#MobilitySolutions,#DisabilityAwareness,#AdaptiveLiving, #AccessibleLivingAtlanta,#IndependenceAtHome

How Can an Overhead Ceiling Lift be Beneficial to Someone That's Wheelchair Bound?

Mon, 22 Jan 2024 21:23:21 GMT

An overhead ceiling lift can offer several benefits for someone who is wheelchair-bound. Here are some key advantages:

Improved Mobility and Independence: Overhead lifts provide a safe and efficient way for individuals to transfer from their wheelchair to other surfaces, such as beds, chairs, or bath areas. This promotes greater independence and mobility.
Reduced Physical Strain: Using an overhead lift reduces the physical strain on both the caregiver and the person with limited mobility during transfers. This is particularly important for individuals with conditions that affect strength or stability.
Enhanced Safety: Overhead lifts are designed with safety features, such as emergency stop buttons and secure harness systems, reducing the risk of accidents or injuries during transfers. This is crucial for maintaining a safe environment.
Comfort and Dignity: The smooth and controlled movement of an overhead lift ensures a comfortable and dignified transfer experience. It minimizes the discomfort that may be associated with manual transfers.
Space Efficiency: Overhead lifts take up minimal floor space compared to floor-based lifts or other transfer aids. This is advantageous in smaller living spaces, allowing for more flexibility in room design and layout.
Versatility: Overhead lifts can be installed in various areas of a home, including bedrooms, bathrooms, and living rooms. This versatility makes it easier to facilitate transfers across different environments within the home.
Time Efficiency: Using an overhead lift can significantly reduce the time required for transfers. This efficiency can be particularly beneficial in situations where quick and frequent transfers are necessary.
Adaptability: Overhead lifts can be adapted to suit the specific needs of the individual, including height adjustments and customized sling options. This ensures a personalized and comfortable transfer experience.

It's important to note that the suitability of an overhead ceiling lift depends on individual needs, the layout of the living space, and other factors. Consulting with healthcare professionals and occupational therapists can help determine the most appropriate assistive devices for a person with limited mobility.

#homeaccessibility #homemodification #homehealthcare #aginginplace #aginggracefully #caregivers #disability #disabilityawareness #wheelchairuser #wheelchairaccessible #spinalcordinjury #physicallychallenged #safetyathome #elderlycare #graytsunami #healthylifestyle #accessiblematters #userfriendlyhome

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