There are more 65+ Seniors in the US than ever before!

 

Washington (CNN) — The Census Bureau released data Wednesday that shows there are more people 65 and older than ever before in the United States.

According to the 2010 numbers, there are 40.3 million people age 65 and older, an increase of over 5 million since the 2000 Census. The older population grew at a faster rate than the population as a whole.

But the best news might be for older males.

“Males show more rapid growth in the older population than females over the decade,” said Carrie Werner, a statistician at the Census Bureau. “While females continue to outnumber males in the older ages, males continued to close the gap over the decade by increasing at a faster rate than females.”

The 2000 Census showed that there were just over 88 men to every 100 women age 65. In 2010, there were just over 90 men to every 100 women at that age.

Geographically, the South has more people 65 and older, followed by the Midwest. On the state level, only Rhode Island experienced a decline in population of the 65 and older set. The District of Columbia also experienced a decline.

The 2010 Census also showed a jump in the number of centenarians in the United States. There were 53,364 people who were 100 years or older in 2010, an increase of 5.8 percent since the 2000 count.

As the Baby Boomers reach retirement age, the numbers of older men and women should continue to go up, according to Werner.

“Future growth of the older population is both highly probable and unprecedented in the United States,” she said.

8 Tips for The Long-Distance Caregiver

Caregiving is never easy, but there are several steps we can take to make it less burdensome and more rewarding. I asked Marion Somers, Ph.D. (Dr. Marion), a geriatric care manager with 40 years experience under her belt, for some advice—particularly for those who care for someone who lives some distance away. Dr. Marion is the author of Elder Care Made Easier as well as a suite of free iPhone apps for caregivers.

1. Be realistic. Before you take on the role of primary caregiver, you need to determine how much time, energy, finances and emotional resources you can afford to give. “Some caregivers also have children at home or a sick husband,” advises Dr. Marion. “They have to be careful not to overcommit.”

It helps to have a heart-to-heart with the person you’ll be caring for—assuming, of course that they are competent to have such a discussion. Find out what level of support they think they need.

2. Accept your role. A lot of us are caregivers and don’t know it. Or rather, we may know it somewhere deep down, but we’d rather not think about it, according to Dr. Marion. If anyone asks, we’ll say, “Well, yes, I’m kinda responsible for my aunt Zelda,” but we don’t quite want to take the mental leap and say, “Yes, I’m her primary caregiver.”

“People need to wake up to the facts. Only when you wake up can you take charge of the situation,” says Dr. Marion.

What are the facts? Back to Aunt Zelda for a moment. Is it the same Zelda who lives three states away, but whose doctors’ appointments you schedule, whose neighbors you’ve organized into a support brigade, and who calls you every day when she wakes up (at 6:38 AM)? Do you have responsibility for her finances? For seeing that her house gets cleaned? Look in the mirror. You’re her primary caregiver.

What does acceptance of your role do? For starters, it helps you get results. “In a crisis, professionals in the field will defer to someone who identifies themselves as the primary caregiver,” says Dr. Marion. “They’ll listen to you. That’s a term that has meaning in the profession. Calling yourself the neighbor, the friend, even the relative, won’t get you the same treatment or the same access.”

3. Don’t neglect your own needs. Caregivers have a higher rate of illness, depression and dementia than the population at large. The burden is huge, and it takes its toll.

“Before they took on this responsibility, caregivers had full lives,” says Dr. Marion. “Maybe they had a book club, maybe they exercised regularly. But now, they stop doing the things that support them and provide them with psychological wellbeing. With all that energy going out, that means they’re not replenishing themselves. Think about it. If they get sick, that’s a double whammy for the person they’re caring for.”

The solution is to find some backup help so you can schedule regular breaks for yourself. Rejoin that book club; take a vacation; join a card game. The person you’re caring for will be better off for it.

4. Get regular feedback. “It’s essential that whenever you make suggestions, you check in first and ask, ‘What do you think? How do you feel about this?’” says Dr. Marion.

She describes a classic example of not getting feedback: A caregiver who lives two hours away from the person she’s caring for knows the person is running low on groceries. So she drives two hours to the supermarket, takes them to the person’s house and loads up the refrigerator. Then, pressed for time, she jumps back in the car and drives two hours home. Now she’s spent four-plus hours getting groceries and the person she’s bought them for is acting resentful. What went wrong?

“Sure, you did a wonderful deed,” says Dr. Marion. “But maybe you bought the wrong brand of cereal. Maybe you put the milk on the top shelf and she always puts it on the bottom shelf.”

This common conundrum is easy to prevent. All it takes is asking some questions before you do the shopping. “If you simply barge in and stack the groceries willy nilly in the ‘fridge, the person is not going to be grateful to you for devoting the better part of a day to helping them. Instead, they’re going to think you aren’t very considerate.”

5. Help maintain a familiar routine. Similarly, should you need to hire a caregiver or a health aide, make sure you tell them the routines the person likes to follow. Does she like to shower at night or bathe in the morning? What does she like to eat for breakfast? “If you ignore these basic preferences, and let outsiders set up their own schedules, the person feels diminished,” says Dr. Marion

6. Use the “I” word. When important decisions are being made, it’s critical to get the person’s buy-in. “Never just tell someone that you’ve decided to do something, whether it’s hiring an aide or making a doctor’s appointment,” says Dr. Marion. “Ask them what they think. Then be sure to say how you feel as you explain your point of view. For example, ‘I’m really worried about you and I’d like you to consider having someone come in to help with the washing/cooking/cleaning.’ The ‘I’ word is vital to expressing empathy and getting buy-in.”

7. Encourage outings. As people get older, they start limiting social activities, because they feel it’s too exhausting. But once they get out of the house, they interact with other people. “That’s very important. It keeps them intellectually and emotionally stimulated,” says Dr. Marion.

Yes, it’s complicated to help them out of the house, but worth the effort. “Their social life can’t be just doctor visits,” says Dr. Marion. “Take them to the senior center. There are games, conversation, snacks, plus they have to dress up a bit.”

8. Don’t try to “parent.” This is a big one, and it flies in the face of instinct. Here you are, taking responsibility for a person’s life. It feels a little like the parenting you did when your children were small. But there’s a big difference. “These are adults. They have lives,” says Dr. Marion. “You cannot go in and take over another person’s life. Even when what you’re trying to do is for their benefit, they’re going to look at you as a busybody, and they’ll resent it.”

What it all boils down to is respecting a person’s needs, life experience and habits. Taking a little extra time to make sure the person you’re caring for feels engaged and in control of his or her life will pay back rewards many times over in terms of cooperation and positive feeling.

–Steve Slon

Steve Slon is a writer specializing in health and aging. He is the former editor of AARP The Magazine.

Caring for the Combative Client

Who is the “Combative” Client?

Combative or aggressive behavior may include verbal attacks, such as yelling, cursing, and making threats. Non-verbal or physical behaviors may include hitting, pinching, spitting, pushing, kicking, or throwing things. Often, a fairly predictable progression of behaviors can be seen. For example, the client may start by becoming tense and irritated, followed by verbal complaints, such as “You’re always after me to take a bath!” This may progress to cursing, threatening (“Get away from me or I’ll hit you.”), and finally to physical forms of aggression, such as hitting or kicking.

Preventing and Managing Combative Behavior

The best way to manage combative behavior is, of course, to prevent it. While this is not possible in every case, proper client management can often significantly decrease aggressive incidents. If you are working with a client who has a history of aggressive behavior, get as much information as you can.

• What triggers the aggressive behavior?
• What early signs of aggression does the client display?
• Does the client’s behavior progress to physical violence?
• What helps the client to calm down?

When working with your clients, maintain a constant awareness of their mood and affect. Even subtle reactions, like a stiffening of the body or clenching fists when you perform certain actions, can give you clues that they may have difficulty coping. Watch for these early signs of possible aggression:

• increased activity, such as pacing
• a frightened or angry look in the eyes
• tensing of the body, such as clenched fists
• increased respirations
• flushed face

The Caregiver’s Role

Your behavior toward clients can greatly reduce the risk of aggression. The vast majority of our communication with others, about 93%, occurs nonverbally. This means that our messages to others are conveyed mainly by factors such as our appearance, body language and tone of voice.

• Act in a kind, calm, manner toward your clients
• Handle them gently, and speak in a calm tone
• Avoid hurrying or pressuring clients, or appearing impatient or annoyed, as these behaviors may trigger a combative reaction
• Provide a predictable, calm environment
• Make sure that the client’s needs for food, rest, comfort, and social interaction are met
• When working with clients who have dementia, tell them frequently who you are, to avoid fear and possible mistaken identity.

Managing a Combative Situation

If a client you are working with becomes combative, your goal in this situation is de-escalation— attempting to reduce or “bring down” the client’s reaction. Verbal and non-verbal de-escalation techniques can be very effective in reducing agitation. Non-verbally, your goal is to project a calm, yet attentive, facial expression. Excitement is contagious, and the client is likely to become more agitated if you react by becoming agitated yourself.  Here are some tips on how to de-escalate a situation:

• Keep your body loose
• Avoid aggressive signals such as clenching your fists or crossing your arms
• Maintain caring eye contact, but don’t stare aggressively at the client.
• Remember to breathe slowly and deeply, as this will help you to relax
• Stand with your body at a slight angle, rather than fully facing the client. This not only puts you in a better position if you need to exit quickly, but protects your chest and abdomen if the client suddenly hits or kicks
• Stand at least two arm lengths from the client, so that he doesn’t feel as threatened by you and cannot hit or kick you
• Always keep the nearest door open, and position yourself between the client and the door, so that he is not blocking your exit if you need to leave quickly
• If possible, position yourself so that there is a piece of furniture between you two, for further protection
• Speak to the client in a firm, calm voice. Watch the tone and volume of your voice. Keep it low, as most people tend to raise both their tone and volume when excited or threatened, resulting in high-pitched yelling
• Say something that helps the client to know that you understand his feelings… “Mr. Jones, I can see that you’re very upset, and I want to help.”
• Treat the client with dignity and respect,
• Never threaten or belittle him for his behavior
• Do not argue or try to reason with the angry client, such as saying, “I do not always forget your coffee.”

If possible, try to “undo” whatever has made the client agitated. For example, if combative behavior resulted when you approached the client to give him a bath, back off and leave him alone for awhile. If the client has dementia, distracting him with a favored activity can also be effective… “Mr. Jones, your favorite TV show is on now—would you like to watch?” When trying to de-escalate a client’s it is helpful if only one person talks, to avoid confusing or frightening the client.

Proper Procedure

Safety is the top priority when dealing with a combative client. If your safety is threatened, leave the area immediately, and get any other persons to safety if needed, and immediately call for assistance. As always, be familiar with and follow agency policy in dealing with emergency situations. If the situation is extreme enough that you cannot effectively handle it, the police should be promptly called to assist.

By acting in a caring and compassionate manner, and staying attuned to your client’s reactions, you can help to prevent and effectively manage combative behavior..

Once the incident is over, be sure you document it in a clear, objective manner. Also, it is very important to report any type of combative behavior, as this may be a sign of illness or medication reaction.