Monthly Archives: June 2012

Disaster Preparedness for Seniors by Seniors

Take responsibility to protect your life! Prepare NOW for a sudden emergency.

Emergencies and disasters can strike quickly and without warning and can force you to evacuate your neighborhood or be confined to your home. What would you do if your basic services—water, gas, electricity or communications — were cut off?
Learn how to protect yourself and cope with disaster by planning ahead. Even if you have physical limitations, you can still protect and prepare yourself.
Local officials and relief workers may not be able to reach everyone right away. You can deal with disaster better by preparing in advance and by working with those in your support network: your family, neighbors and friends as a team. Knowing what to do is your responsibility.
Disasters can happen at any moment. By planning ahead you can avoid waiting in long lines for critical supplies, such as food, water and medicine and you will also have essential items if you need to evacuate.
  • For your safety and comfort, have a disaster supplies kit packed and ready in one place before a disaster hits
  • Assemble enough supplies to last for at least three days
  • Store your supplies in one or more easy-to-carry containers, such as a backpack or duffel bag
  • You may want to consider storing supplies in a container that has wheels
  • Be sure your bag has an ID tag
  • Label any equipment, such as wheelchairs, canes or walkers, that you would need with your name, address and phone numbers
  • Keeping your kit up-to-date is also important: review the contents at least every six months or as your needs change
Check expiration dates and shift your stored supplies into everyday use before they expire. Replace food, water and batteries, and refresh medications and other perishable items with “first in, first out” practices.
Here are some suggestions for building your disaster supplies kit. Include any additional items that you feel might be useful for your particular needs.
Basic Needs and Supplies
  • Three-day supply of nonperishable food. It is a good idea to include foods that do not need cooking (canned, dried, etc.).
  • Three-day supply of water (one gallon per person, per day)
  • Battery-operated or crank-powered radio
  • Flashlight with extra batteries and bulbs (do not use candles)
  • First aid kit and manual
  • Sanitation and hygiene items (toilet paper, feminine products)
  • Matches in waterproof container
  • Cell phone with an extra battery and charger (s)
  • Whistle (to attract the attention of emergency personnel)
  • One change of clothing
  • Blanket
  • Manual can opener
  • Photocopies of personal documents/identification
  • Insurance agent’s name and number
  • Cash and coins (ATMs may not be accessible)
  • Pet supplies (including food and vaccination records)
  • Map of the local area
  • Extra set of keys (car, house, etc.)
  • Plastic garbage bags
  • Family and friends’ emergency contact information
  • Pack of cards to provide entertainment and pass the time
Supplies for Your Vehicle
  • Flashlight with extra batteries and extra bulbs
  • Maps
  • First Aid kit and manual
  • Tire repair kit
  • Jumper cables
  • Flares
  • Bottled water
  • Non-perishable foods such as granola bars
  • Winter: Blanket, hat, mittens, shovel, sand, tire chains, windshield scraper, florescent distress flag
  • Summer: Sunscreen lotion SPF 15 or higher, shade item (umbrella, wide-brimmed hat, etc.)
Make a Plan
The next time a disaster strikes, you may not have much time to act. Planning ahead reduces anxiety. Prepare now for a sudden emergency and remember to review your plan regularly.
Meet With Your Family and Friends
Explain your concerns to your family and others in your support network and work with them as a team to prepare. Arrange for someone to check on you at the time of a disaster. Be sure to include any caregivers in your meeting and planning efforts.
Assess yourself and your household. What personal abilities and limitations may affect your response to a disaster? Think about how you can resolve these or other questions, and discuss them with your family and friends. Details are important to ensure your plan fits your needs. Then, practice the planned actions to make sure everything “works.”
Family Communications Plan
  • Carry family contact information in your wallet
  • Choose an out-of-town contact person. After a disaster, it is often easier to make a long-distance call than a local call from a disaster area
Community Disaster Plans
Ask about the emergency plans and procedures that exist in your community.
Know about your community’s response and evacuation plans (e.g., hurricane, nuclear emergency, severe weather). If you do not own a vehicle or drive, find out in advance what your community’s plans are for evacuating those without private transportation or make arrangements with a neighbor who would drive you.
If you receive home care, speak with your case manager to see what their plan is in times of emergency and how they can assist with your plan.
Escape Routes and Meeting Places
  • Plan the best and quickest escape routes out of your home and evacuation routes out of your neighborhood
  • Decide on a meeting place outside your neighborhood in case you cannot return home
  • If you or someone in your household uses a wheelchair, make sure all escape routes from your home are wheelchair accessible
  • Know the safe places within your home in case you need to shelter during extreme weather events (e.g., tornado)
  • Practice your escape drill every six months
  • Plan for transportation if you need to evacuate to a shelter
Post Emergency Phone Numbers Near Your Phones
Post emergency numbers near all of your phones. Include the numbers of those in your support network. Remember that in some emergencies telephone lines might not be working. Consider having alternative plans for contacting those in your network.
Plan for Those With Disabilities
Keep support items like wheelchairs and walkers in a designated place so they can be found quickly. This step is essential for those who have home-health caregivers, particularly for those who are bed bound.
Plan for Your Pets or Service Animals
Take your pets with you if you evacuate. However, be aware that pets (except service animals) are not permitted in emergency public shelters for health reasons. Prepare a list of family, friends, boarding facilities, veterinarians and ‘pet-friendly’ hotels that could shelter your pets in an emergency.
Talk to your utility company about emergency procedures and know how and when to turn off water, gas and electricity at the main switches or valves. Share this information with your family. Keep any tools you will need nearby. Turn off the utilities only if you suspect the lines are damaged, you suspect a leak or if local officials instruct you to do so. (Note: If gas is turned off for any reason, only a qualified professional can turn it back on. It could take several weeks for a professional to respond. Heating and cooking would need alternative sources.)
Smoke Alarms and Carbon Monoxide Alarms
Test your smoke alarms and carbon monoxide alarms regularly. Consider strobe or vibrating alert systems that might meet your needs. Change the batteries in all alarms at least once a year or according to the manufacturer’s instructions.
Insurance Coverage
Talk with your insurance agent to be sure that you have adequate insurance coverage. Homeowners insurance does not cover flood damage and may not provide full coverage for other hazards.
Vital Records and Documents
Keep copies of vital family records and other important documents such as birth and marriage certificates, social security cards, passports, wills, deeds, and financial, insurance and immunizations records in a safe location, like a fire safe or safe-deposit box.
Hearing Aids/Cochlear Implants
If you wear hearing aids or assistive devices, consider storing them in a bedside container that is attached to your nightstand using Velcro. Some disasters (e.g., earthquakes) may shift items that are not secured, making them difficult to find quickly.
Maintain Your Kit and Practice Your Plan
Every six months:
  • Review your plan with all of your friends and family
  • Check your disaster supplies kit and refresh all expiring items (e.g., food, water, medications and batteries)
  • Conduct fire and emergency evacuation drills on a regular basis with your family. Make sure all your plans “work”
At least once a year:
  • Change the batteries in all essential devices at the same time each year. (e.g., smoke alarms).
Be Informed
Community Hazard Assessment
What hazards threaten your community and neighborhood? Make a list of how they might affect you. Think about both natural (e.g., hurricanes, flooding, winter storms and earthquakes) and human-caused (e.g., hazardous materials and transportation accidents) and about your risk from those hazards. Which of these hazards are most likely to happen in your community?
  • Earthquakes
  • Flooding
  • Hurricanes
  • Toxic Spills
  • Winter Storms
  • Home Fires
  • Tornadoes
  • Wildfires
  • Thunderstorms
Preparing for a hazard that is most likely to happen in your area will help you be prepared for any disaster. Remember, disasters can happen at any time.
  • Do you live alone?
  • Do you drive or own a car?
  • How good is your sense of smell?
  • Do you have any physical, medical, thinking or learning limitations?
  • Has your sense of hearing or vision decreased?
  • Are you reliant upon any medical equipment?
  • Are you reliant upon a caregiver?
Community Warning Systems
 How will you be notified of a possible emergency?
Know how local authorities will warn you of a pending or current disaster situation and how they will provide information to you before, during and after a disaster.
Friends, Family Caregivers and Neighbors
Before a disaster happens it is a good idea to have a conversation with those in your support network: Your friends, family and neighbors. Let them know your needs in an emergency situation; ask them how they could assist with your plan and whether they would be willing to help. Consider that during some emergencies travel is severely limited and they may not be able to get to you.
Local Neighborhood Emergency Teams
Connect with a group in your local neighborhood. Some of these could include CERT (Community Emergency Response Team), neighborhood watch, community block associations, faith-based organizations, etc. Even if you feel you cannot become a member, let them know your needs and ask them how they could assist with your disaster plan. If available, take advantage of advance registration systems in your area for those who need help during community emergencies.
Local Volunteer Fire Departments
Connect with your local volunteer fire department or ambulance and let them know your needs (especially if you live in a rural area). Discuss with them how they might be able to assist in your disaster plan.
Local EAS (Emergency Alert System)
Certain television and radio stations will broadcast emergency messages from local authorities. Find out which stations broadcast on the Emergency Alert System (EAS). NOAA Weather Radio/All-Hazard Alert Radio These special radios provide one of the earliest warnings of weather and other emergencies, and can be programmed to alert you to hazards in your specific area. Call your local National Weather Service office or visit for more information.
Door-to-Door Warning From Local Emergency Officials
In some emergencies local responders may come door-to-door and deliver emergency messages or warnings. Listen carefully and follow their instructions!
Senior Living and Assisted Living Communities
If you live in a senior community become familiar with any disaster notification plans that may already exist. Talk to your community management or resident council about how you can all be more prepared together.
Be Aware—Help Inform Others
There may be people in your community that need extra assistance when a disaster occurs. Consider how you can assist them in their preparedness planning and during an emergency.
Sheltering in Place vs. Staying at Home
In some emergencies such as a chemical emergency, you would need to know how to seal a room for safety on a temporary basis, called “shelter in place.” In the case of a winter storm, you may be told to “stay at home.” This means stay where you are and make yourself as safe as possible until the emergency passes or you are told to evacuate. In this situation it is safer to remain indoors than to go outside. Stay in your home and listen to instructions from emergency personnel. Listen to your television or radio for emergency messages. Be prepared to be on your own and have additional food and water for seven to fourteen days.
If You Need to Evacuate
Coordinate with your family and home care provider for evacuation procedures.
  • Try to carpool, if possible
  • Wear appropriate clothing and sturdy shoes
  • Take your disaster supplies kit – “go bag”
  • Lock your home
  • Use the travel routes specified or special assistance provided by local officials – don’t take any short cuts, they may be unsafe
  • When you arrive at a shelter, notify the shelter management of any needs you may have – they will do their best to accommodate you and make you comfortable
  • Let your out-of-town contact know when you left and where you are going
  • Make arrangements for your pets: take them with you if you leave.
Public Shelters
Relief organizations, like the American Red Cross, may open shelters if a disaster affects a large number of people or the emergency is expected to last several days.
Be prepared to go to a shelter if—
  • Your area is without electrical power
  • Floodwater is rising
  • Your home has been severely damaged
  • Police or other local officials tell you to evacuate
Services Provided at a Red Cross Shelter
  • Food
  • Temporary shelter
  • Basic first aid
All American Red Cross emergency services are provided free of charge. To learn about Red Cross shelters that have been opened in your area, listen to your local media, check with your local American Red Cross chapter or visit
Immediately After a Disaster
  • If the emergency occurs while you are at home, check for damage using a flashlight. DO NOT light matches or candles or turn on electrical switches. Check for fires, chemical spills and gas leaks.
  • Shut off any damaged utilities.
  • Check on your neighbors, especially those who are elderly or have disabilities.
  • Call your out-of-town contacts and let them know you are OK.
  • Stay away from downed power lines.
  • Do not drive through flooded roads.
  • Monitor local broadcasts for information about where you can get disaster relief assistance.
If Electrical Power Is Lost
  • Use a flashlight or battery-operated lantern. Do not use candles.
  • Turn off or unplug all major appliances (e.g., stove, refrigerator, dryer). They could be damaged by the electrical surge when the power is restored.
  • Keep refrigerator and freezer doors closed as much as possible.
  • Use portable generators cautiously. Make sure they are operated only out-of-doors in a well-ventilated area. Refuel a generator only after it has cooled. Do not connect a generator to your home’s electrical system except though an approved transfer switch installed in compliance with the local electrical code.
Financial Exploitation/Scams
Unfortunately, after a disaster there may be some people who will try to take advantage of your vulnerability. Beware of high-pressure sales, disclosing personal financial information (account numbers and credit card information) and services provided with no written contract. For information on scams, go to
Before a Fire
Plan two escape routes out of each room. Choose a place to meet outside after escaping from a fire. Practice your fire escape with everyone in your home every six months. Plan to use the stairs during a fire evacuation, even in buildings with elevators. If you cannot use stairways, make special arrangements for help in advance. Sleep with the bedroom door closed. Install smoke alarms inside and outside sleeping areas to give you warning of toxic fumes. Test your smoke alarm every month. Change batteries on the same day each year. Vacuum it occasionally to remove dust. Replace smoke alarms every ten years—they lose sensitivity over time.
In Case of Fire
  • Remain calm. Drop to the floor and crawl. Most fire fatalities are due to breathing toxic fumes and smoke. The cleanest air is near the floor. Breathing toxic fumes and smoke is more dangerous than the risk of injury in getting to the floor quickly.
  • Feel any door before you open it. If it is hot, find another way out.
  • If your smoke alarm sounds, never waste time to get dressed or collect valuables or pets. Get out of your home immediately.
  • Do not try to fight the fire! Call for help from a neighbor’s phone.
  • Never go back into a burning building for any reason. Get out and stay out!
  • If your clothes catch on fire, drop to the floor and roll to suffocate the fire. Keep rolling (running from the fire only “fans” the flames and makes it worse).
  • If you are in a wheelchair or cannot get out of your home, stay by the window near the floor and signal for help.
Grandparents and Grandchildren
Many children visit their grandparents often; they may even live with you. The following safety advice for children can help grandparents prepare a safe environment at home for children:
  • Store matches and lighters up high in locked cabinets, away from children.
  • Install plastic covers over all exposed electrical outlets.
  • Move cleaning chemicals like cleansers, soap, drain cleaner and other poisons to high cupboards OR install a childproof lock if you must keep these items in low cabinets.
  • Store prescription medicines and over-the-counter drugs like aspirin, cough medicines and stomachache remedies in a cabinet out of reach of children.
  • If children are playing outside or in a pool when skies grow dark or you hear thunder, have them come indoors right away.
Children Can Help Grandparents, Too
Have children test each smoke alarm in your home to make sure it is working by using a broom handle to push the test button. Ask children to draw a floor plan of your home and show two ways out of every room in case of fire. Ask your grandchildren to help you assemble your disaster supplies kit and get them to assemble one for their family at the same time.
Home Caregivers—Special Considerations
Prepare a disaster supplies kit for any family member who cannot do so on their own. If this person receives home care, speak with the case manager to see what the agency’s role would be in case of emergency at home or if evacuation is indicated.
Develop home fire escape and evacuation plans and practice them every month in case of fire and other disasters particular to your area. Enlist the assistance of other family members if possible.
Find out what provisions are available in your area in case evacuation is needed, especially if your family member requires an uninterrupted power source for survival.
Know that you may be directed to a hospital or a medical or functional support shelter and you may need to continue caring for that person during the emergency situation.
Be sure to make your back-up assistants and family members aware of all emergency plans.
Emotional and Psychological Effects
Disasters often cause emotional distress. Being prepared will lessen your anxiety. When an emergency occurs, know that you may experience some emotional, physical, mental and spiritual reactions.
Some typical physical reactions:
  • Stomachaches
  • Difficulty sleeping/fatigue
  • Headaches
  • Appetite disturbances
  • A worsening of chronic medical conditions like arthritis, diabetes or high-blood pressure.
Some typical emotional reactions:
  • Sadness
  • Depression
  • Excessive anxiety
  • Irritability and anger
  • Emotional numbness
Some typical mental reactions:
  • Confusion
  • Disorientation
  • Memory problems
  • Lack of focus and concentration
  • Difficulty making decisions
Some typical spiritual reactions:
  • Anger with God
  • Questioning one’s spiritual beliefs
  • An increase in prayer
  • A need to find spiritual reasons for the disaster
  • A need to be comforted by spiritual leaders
When a disaster occurs, it can remind you of previous events in your life. Remember what you did then to help you get through it and see if it works now.
Sometimes this new disaster seems like the final straw! If you find memories bring up old grief, sadness, fear and anger, it can be distressing. Try to separate your reactions to previous events from what is happening now. Remember that you were able to cope last time and remind yourself you can cope now.
Everyone Is Affected by Disaster—Not Just Seniors
Emotional and other kinds of responses are expected. That’s okay. In a disaster, many people have problems taking care of routine tasks. Be encouraged by a positive attitude, remind yourself of your strengths, and tasks can be more easily done.
Support is most important. And getting help is important. Ask for what you need. If you have family or friends nearby, let them support you. Let the Red Cross or other agencies assist you. Don’t worry about not appearing independent. Everyone needs help when disaster strikes.
Preparation Makes a Difference
When you’re upset or confused, already having your disaster plan in place will allow you to do what needs to be done to take care of yourself. It’s much easier to remain calm when you know what to do.
Summary and Reminders
Take responsibility by planning now.
Listen for information on the radio and TV about hazardous weather and other events, and heed the advice of local officials.
Leave right away if told to do so.
In some communities, people who need help or transportation during an evacuation are asked to register that need with their local government.
Call your local emergency management office for information about what to do during an evacuation. It is important to have alternative plans in case circumstances change.
Gather essential supplies, and be sure to keep a list of medications and their dosage, a copy of your eyeglass prescription and other important papers to take with you if you have to leave your home.
– American Red Cross Mid-Florida Region

Vitamin D

During the summer, the sun shines longer periods and allows us plenty of opportunity to get all the vitamin D we need. But how much time in the sun is okay for our skin? Does vitamin D have to come directly from the sun? Can you overdose on vitamin D? These are all questions that we are here to help you answer. Learn all about vitamin D below!

How Much Vitamin D is Enough?
It is no secret that sun exposure triggers the production of vitamin D3 in our skin. However, geography and skin pigmentation play a significant role in a person’s ability to produce vitamin D. If you can consistently get 15 to 30 minutes of sun exposure over 40 percent of your body two to three times each week (minding the above considerations), you are probably producing adequate levels of vitamin D.

Vitamin D: The Little Powerhouse
From its discovery in the early twentieth century as a cure for rickets, a syndrome characterized by malformed bones, vitamin D was just another vitamin. In 1980 all that changed when Dr. Michael Holick solved the mystery of how this nutrient is produced by our bodies in the skin.Since then, research has expanded our understanding of vitamin D, but the discovery is not yet complete. Hundreds of studies concerning the effects of vitamin D are now released annually.

Healthy Sun Practices
Spending 3 to 15 minutes outdoors for light-skinned individuals and 15 to 30 minutes outdoors for darker skin tones in midday, unobstructed sun with 40 percent of your skin exposed will provide most people with a protective vitamin D level (up to 50,000 IU of Vitamin D in the next 24 hours). The Reference Daily Intake (RDI) however, is only 200 to 600 IU of vitamin D per day.

– Natural Solutions

Do Alzheimer’s drugs really help Alzheimer’s symptoms?

Do Alzheimer’s drugs really help Alzheimer’s symptoms? The daughter of a patient recently asked me a question about Alzheimer’s drugs that families often bring up. She wondered if the medications were still helping her father, who had been taking them for years and was now entering late-stage disease. “I feel guilty to even ask this,” she told me. “But all the many drugs he takes are so expensive, and I’m not sure these dementia drugs are helping. How can I tell if he still really needs them?” When a reader posed a [similar question] ( last summer, many fellow caregivers quickly chimed in with their stories. It’s so common for interest in modern medications to swirl together with doubts about effectiveness, worries about money, and maybe even guilt for even asking the questions. This can be especially true when a dementia such as Alzheimer’s disease has gotten pretty advanced.

I was glad this daughter brought her concern to my attention. The four points below are what we discussed. It’s what I encourage all families in my practice to consider before continuing cholinesterase inhibitors, such as donepezil (Aricept) and memantine (Namenda):

Four things to consider before continuing Alzheimer’s medications

1. These drugs have been shown to slow down the decline caused by dementias such as Alzheimer’s, but only by a little bit. In other words, we think these drugs work, but it’s unrealistic to expect that they will make a huge difference. In studies of people with dementia (which are mostly funded by the drug makers), at the end of the study period, those who take the drugs tend to have lost a little less mental function than those who didn’t take them.

2. Experts continue to debate whether the improvements seen in research studies are really meaningful. Even if researchers find that taking these drugs means better scores on a special mental quiz, that doesn’t necessarily turn into noticeably better quality of life for people with dementia or their caregivers. This could be because the impact of the drugs tends to be small. If you have a loved one taking these medicines, and you’ve found yourself wondering if they’re really helping, you’re not alone. Often families feel that these medicines don’t have much effect, an intuition confirmed by a 2008 evidence review, which described the benefit of these drugs as “marginal”.

3. We don’t know much about how well these drugs work when used for years and years, or in people with very advanced dementia. This is because most of the research is done on people with mild to moderate dementia, and studies almost never last for more than a year. So far, there’s no reason to think that these drugs might work better in advanced dementia, and some experts think they’re less useful.

4. These drugs do seem to help certain people with behavior and function. Although the consensus is that overall these drugs have only a small effect, in some people they seem to make more of a difference. Unfortunately, researchers haven’t yet figured out how we can identify those people ahead of time. For now, the only way to know whether the drugs will help your loved one is to give them a try: You might be one of the lucky ones that then notices an improvement in sleeping or less irritability.

My prescription:

  • Know that these medicines may or may not help, and if they do help, a small effect is much more common than a dramatic effect. The American College of Physicians and the American Academy of Family Physicians have posted a [summary for patients] (
  • Consider a trial period. For a person who’s been taking these drugs for a while, consider asking the doctor to stop them, and see what happens. Often things don’t get any worse, and sometimes a person’s diarrhea or dizziness gets better. If your loved one does seem much worse after you’ve given the medicines a few weeks to wash out, you can always ask to resume the medications.
  • If the cost of medications is an issue, schedule a special visit with your loved one’s doctor, to review the purpose of each medication, and see if any medicines can be eliminated. Don’t feel too guilty if the cost of the medications is the little nudge that results in a trial off drugs like donepezil and memantine.* Taking care of an older person with dementia is difficult and expensive. I wouldn’t be surprised if you find that the money you were spending on dementia drugs ends up better spent on extra help around the house or other things that can more directly improve the quality of life for a family struggling with dementia. Given all the uncertainty about the benefits of medicines like donepezil and memantine, it’s simply smart caregiving to review their use as dementia progresses.** What’s your experience been? Are you wondering about this, too? Are you considering a trial off these medications? Or do you believe your loved one is thriving thanks to the drugs?

, senior medical editor

Genworth’s 2012 Cost of Care Survey

The cost of long-term care varies widely depending on a person’s care needs, location, preferences and the availability of services that meet his or her needs. As you shop for long-term care, you can get an idea about what to expect with Genworth’s 2012 Cost of Care Survey.


The most comprehensive study of its kind, Genworth’s 2012 Cost of Care Survey, conducted by CareScout®, covers nearly 15,300 long-term care providers, across all 50 states and the District of Columbia, in 437 regions and cities nationwide, to help individuals plan with an eye toward costs in their preferred location and preferred care setting. The survey discloses the median annual cost of home care, adult day care, assisted living and nursing home care in 437 regions nationwide, making it the most comprehensive study of its kind!


Here are some highlights from Genworth’s recently released 2012 Cost of Care Survey:


– The cost to receive care in the home remained relatively unchanged from 2011 to 2012. The median hourly cost for homemaker services and home health aide services is $18 and $19, respectively.


– The median annual cost for care in an assisted living facility is $39,600 nationally. This represents an increase of 1.2 percent since 2011 and a 5.7 percent annual increase over the past five years.


– The median annual cost for care in a private nursing home room rose 4.2 percent from 2011 to 2012 to $81,030 nationally, or 4.3 percent annualized over the past five years.


Read More about  Genworth’s 2012 Cost of Care Survey

– CareScout