Cheat Sheet

Navigating Your Later Years For Dummies Cheat Sheet

From Navigating Your Later Years For Dummies

By Carol Levine, AARP

People are living longer and healthier lives than ever before. How will you stay independent and in control? With a bit of forethought and a little investigation, you can break down the big picture into more manageable segments. Discover how to compare online information, get ready to set in motion an advanced directive plan, find what types of benefits are available to older adults, quickly identify warning signs for older drivers, and handle safety issues in order to prevent falls for older adults.

Comparing Online Information about Healthcare

Websites offer comparative rankings and user reviews of everything from restaurants to electronic products to colleges. Similarly, dozens of sites offer comparisons of hospitals, nursing homes, and doctors. But how much weight should you place on any of these sites? And how do you compare the comparisons? What are their strengths and what do they lack?

The website of the Informed Patient Institute (IPI) can help. IPI is an independent, nonprofit organization created to provide unbiased information about healthcare quality online report cards from both governmental and private sources. It doesn’t rate individual healthcare providers. The ratings are based on 15 criteria in six areas: the site’s content, timeliness, presentation, ease of use, information to help make decisions, and special features.

IPI rates websites for nursing homes, hospitals, and doctors. The ratings range from “Recommended,” including A (Outstanding), B (Very Good), and U (Recommended for Unique Content). Sites that are designated “Use with Caution” are ranked as C (Fair) or D (Poor). Finally, the really bad grade of F is “Not Recommended” or “Not Worth Your Time.”

Start by entering your state and the type of provider you’re investigating. For example, you live in Colorado and are looking at nursing homes. Six websites are rated, with rankings from B to D. Each rating has sections called “What we like” and “What we don’t like” and a link to each website so you can make your own judgment.

The website also has a series of tip sheets for handling quality problems in selected states. The first states on this list are California, Connecticut, Maine, New York, Pennsylvania, and South Carolina. And there are links to news reports about report cards, quality measures, and other topics, as well as a list of other resources.

Planning Ahead for Your Healthcare

Planning ahead for your healthcare is one of those topics that tends to get postponed until there is a crisis in your later years, when the planning is no longer “in advance” but “right now.” It’s difficult enough to do without placing all the emphasis on a single momentous conversation. A study by Terri Fried and colleagues at Yale University School of Medicine found that many people go through several stages of change on the path to actually taking action to complete an advance directive and name a healthcare proxy. These stages are precontemplation (“I’ve never thought about it”) to contemplation, preparation, action, and maintenance (reviewing plans).

Using this framework, Rebecca Sudore and colleagues at the San Francisco VA and University of California, San Francisco, Division of Geriatrics, developed a website called PREPARE for Your Care to guide older adults and their families through these stages.

The tool guides users through the process of choosing a decision maker (a healthcare proxy), deciding what matters most in life, choosing flexibility for your decision maker, telling others about your wishes, asking doctors the right questions, and making a plan.

The type is large and each screen has one idea. Each stage of the process includes videos and stories about how individuals have made different choices. You can stop the process at any stage, save the information, and come back to it at a later date.

How to Find Benefits for Older Adults

Many adults in their later years are unaware that they may be eligible for a range of benefits, and it’s not easy to find them one by one. BenefitsCheckUp, a free tool from the National Council on Aging, is a good place to start. The website asks questions about you (or the person for whom you are seeking assistance) and then directs you to the agencies in your community that may be able to help. Some of the services include help paying for medications or food, legal advice, utilities, housing, in-home services, taxes, transportation, or employment training.

After you complete the survey, you’ll receive a written report and you can take the next steps by applying online or in person.

Identifying Warning Signs for Drivers in Their Later Years

For older adults and their families, driving is often a flash point. When is it time to give up the keys? Waiting until there is a serious accident is not advisable. Most drivers in their later years are safe drivers, but some monitoring and caution are appropriate. Here are some warning signs for older drivers from “We Need to Talk: Family Conversations with Older Drivers,” produced by The Hartford.

The driving behaviors listed by The Hartford could cause safety problems. They are ranked from minor to serious. Many of the less serious issues may be overcome with changes in driving behavior or physical fitness, while the more serious behaviors may require your immediate action. Since driving ability seldom changes drastically in a short time, you should be able to track changes over time to get a clear picture of overall driving ability.

Preventing Falls at Home

Preventing falls is critical. Falls are not only harmful in themselves but also often lead to declines in independence and function. Most falls happen at home, so that’s where you should start.

Falls are often due to hazards that are easy to overlook but easy to fix. The following tips are from the Centers for Disease Control and Prevention’s checklist for preventing falls at home. Use this checklist to help you find and fix those hazards in your (or your loved one’s) home.

The checklist asks about hazards found in each room of the home. For each hazard, the checklist tells you how to fix the problem.

Floors

Look at the floor in each room.

Q: When you walk through a room, do you have to walk around furniture?

Ask someone to move the furniture so your path is clear.

Q: Do you have throw rugs on the floor?

Remove the rugs or use double-sided tape or a nonslip backing so the rugs won’t slip.

Q: Are there papers, books, towels, shoes, magazines, boxes, blankets, or other objects on the floor?

Pick up things that are on the floor. Always keep objects off the floor.

Q: Do you have to walk over or around wires or cords (like lamp, telephone, or extension cords)?

Coil or tape cords and wires next to the wall so you can’t trip over them. If needed, have an electrician put in another outlet.

Stairs and steps

Look at the stairs you use both inside and outside your home.

Q: Are there papers, shoes, books, or other objects on the stairs?

Pick up things on the stairs. Always keep objects off stairs.

Q: Are some steps broken or uneven?

Fix loose or uneven steps.

Q: Are you missing a light over the stairway?

Have an electrician put in an overhead light at the top and bottom of the stairs.

Q: Do you have only one light switch for your stairs (only at the top or at the bottom of the stairs)?

Have an electrician put in a light switch at the top and bottom of the stairs. You can get light switches that glow.

Q: Has the stairway light bulb burned out?

Have a friend or family member change the light bulb.

Q: Is the carpet on the steps loose or torn?

Make sure the carpet is firmly attached to every step, or remove the carpet and attach nonslip rubber treads to the stairs.

Q: Are the handrails loose or broken? Is there a handrail on only one side of the stairs?

Fix loose handrails or put in new ones. Make sure handrails are on both sides of the stairs and are as long as the stairs.

Kitchen

Look at your kitchen and eating area.

Q: Are the things you use often on high shelves?

Move items in your cabinets. Keep things you use often on the lower shelves (about waist level).

Q: Is your step stool unsteady?

If you must use a step stool, get one with a bar to hold on to. Never use a chair as a step stool.

Bathrooms

Look at all your bathrooms.

Q: Is the tub or shower floor slippery?

Put a nonslip rubber mat or self-stick strips on the floor of the tub or shower.

Q: Do you need some support when you get in and out of the tub or up from the toilet?

Have a carpenter put grab bars inside the tub and next to the toilet.

Bedrooms

Look at all your bedrooms.

Q: Is the light near the bed hard to reach?

Place a lamp close to the bed where it’s easy to reach.

Q: Is the path from your bed to the bathroom dark?

Put in a night-light so you can see where you’re walking. Some night-lights go on by themselves after dark.