Choosing a Caregiver – Agency vs. Private

When choosing a caregiver, you must decide between an agency caregiver and a private caregiver.  There several things you should consider.

Private caregiver

Employee of the client, they are not a 1099 contractor

Client is responsible for employer’s share of social security, unemployment insurance and worker’s compensation

Client is responsible for federal and state tax deposits based on the caregiver’s pay

Client is responsible to background check the caregiver(s)

If a caregiver calls off, the client must coordinate for another caregiver to cover

Agency caregiver

Employee of the agency

Agency pays taxes, unemployment insurance and worker’s compensation

Agency is responsible for background check of the caregiver

Agency has multiple caregivers and can cover when a caregiver calls off

Agency has liability insurance to cover the caregiver for theft or damage

Although a private caregiver may have a cheaper hourly rate than an agency caregiver, when the added cost of unemployment insurance and worker’s compensation are added to the cost, it may end up being more expensive to have a private caregiver.

Are You Prepared For An Emergency?

In the past, most Americans lived their lives without any emergency plans.  After 9/11, many people began to think about what they would do if there was a catastrophic event or terrorist attack in their town.  These contingency plans included having food and water, batteries and other emergency gear.  Families planned where they would meet and who would get the children.  These plans have become necessary due to the current world culture.  Although many of us have these plans in place for catastrophic events, most of us do not have contingency plans in place for the more common crisis in our lives.

What would those who depend on you do if you got hit by a bus, or had a stroke?  What would you do if your parents were unable to take care of themselves?  These situations happen every day and most of us do not have a plan in place.  Unfortunately, without a plan, these events often become a crisis and families end up making rash decisions to deal with the crisis.  Those who do have a plan in place are usually able to make better decisions because they have more time, information and resources.  

All of us have preferences for handling emergencies, our finances, medical decisions, legal matters and end of life choices.  The problem is that we often do not discuss them with anyone.  It can be difficult to discuss these issues with our families, so often we just avoid the topic.  Unfortunately, if we don’t discuss these topics, we won’t have the information necessary to make a well informed decision.  If you are having a difficult time getting your loved one to talk about these issues, consider having an independent third party talk to you and your loved one.  Sometimes a physician, attorney or an Aging Life Care Professional can be more effective in discussing these topics because they are considered to be a professional and there is no emotional history to overcome. No matter who leads this discussion, the focus should be on your loved one and how they would like these preferences carried out.  It is important to get specific information now so if the time comes, there will be no question what your loved one wants you to do.  Some of the topics you should address include:

1.          Medical

a.          Current medical providers – name and phone number

b.         Current medical conditions

c.           Current medication(s)

d.         Allergies

2.          Legal

a.          Power of Attorney

b.         Living Will – give a copy to your physician

c.           Will

d.         Trust

e.          Location of legal documents

f.            Verify the people appointed in legal documents have a copy

3.          End of Life

a.          Feelings about death

b.         Is it important to die at home?

c.           Burial or cremation preferences

d.         Funeral/Memorial preferences – be specific!

4.          Emergency Assistance

a.          Who will be called first/second in the event of an emergency?

b.         Is there someone local who can assist if family lives far away?

5.  Financial

a.          Location of bank/investment accounts

b.         Location of safe box and keys

c.          Location of financial documents

d.         Who is monitoring bank & credit card statements

Statistically financial fraud is becoming more prevalent.  Anyone who has a mailbox, writes a check, or has a credit card is a potential victim.  To protect yourself, review your bank and credit card statements when they come in and report any unrecognized activity.  Since elder adults are particularly vulnerable, it is a good idea to have the person who is nominated as Financial Power of Attorney or Successor Trustee to monitor these statements as well.  Financial fraud comes in many forms, so keep track of your finances and be careful who has access to your financial information. 

Once you have the information, share it with anyone who could be responsible for making these decisions.  If you are geographically distant from your loved one, look for a local resource to be available for emergencies.  A local Aging Life Care Professional can be an invaluable resource in putting together a contingency plan.  The Life Care Professional not only knows the local resources, but often can be available on an emergency basis to get things stabilized while family is in route.  The Life Care Professional can also take a proactive roll, making recommendations to help prevent potential crisis or monitoring unstable situations.

Whether you work with a Life Care Professional or do it yourself, take the time to put a contingency plan in place.  It will give you and your loved one a peace of mind knowing you have a plan in place for an emergency.  You may never need it, but it is good to know it is there if you do!

What Level of Care Does Your Loved One Need?

When looking at a facility option in Arizona, there are many types of facilities to choose from.  The type of facility required is based on the physical and functional needs of the resident.  Below is a breakdown of the facility types available and what they offer. Your Care Manager or Aging Life Care Professional will be familiar with the best care solutions in your area and provide the advice you need to make the best decisions for your loved one.

Independent Living in Arizona

These communities are geared for the independent senior.  They often have organized activities/outings for the residents.  Many have a clubhouse and a pool on the property as well as other amenities.  The residents either own their home and are responsible for the maintenance or they rent their living space like a traditional apartment.  These properties are not appropriate for a person who needs assistance with their activities of daily living.

Assisted Living in Arizona

The Assisted Living Federation of America (ALFA) defines an Assisted Living residence as a combination of housing, personalized supportive services and health care designed to meet the needs – both scheduled and unscheduled – of those who require assistance with activities of daily living.  In Arizona, the Department of Health Services (DHS) licenses Assisted Living homes and centers.  Assisted Living homes are licensed for ten (10) or fewer residents and residents usually have either a private or a semi-private bedroom.  Assisted Living centers are licensed for eleven (11) or more residents and usually are set up as apartments.  Assisted Living residences typically charge a monthly rent.  Additional charges may be added to cover the cost of services required by the resident.  There may also be a one-time, non-refundable facility fee due at time of move in.

In Arizona, there are three levels of care available in Assisted Living homes and centers and many facilities offer more than one level of care:

1. Supervisory Care Services – general supervision, including daily awareness of resident functioning and continuing needs, the ability to intervene in a crisis and assist in the self-administration of prescribed medications.
2. Personal Care Services – assist with activities of daily living that can be performed by persons without professional skills or professional training, and includes the coordination or provision of intermittent nursing services, and the administration of medications and treatments by a licensed nurse.  Must meet all the requirements also of the Supervisory Care Level.
3. Directed Care Services – programs and services, including personal care services, provided to persons who are incapable of recognizing danger, summoning assistance, expressing need, or making basic care decisions.  Must meet all requirements of Supervisory Care and Personal Care levels.

Most Assisted Living communities provide the following either as part of the monthly rate or for an additional charge:
• A minimum of one meal per day, many provide all three
• Housekeeping services
• Transportation
• Social and recreational activities
• Medication management
• Laundry services
• 24-hour security and staff availability
• Emergency call systems for each resident’s room
• Assistance with eating, bathing, dressing, toileting, and walking
• Access to health and medical services

Facilities licensed by the state should be checked out for deficiencies (enforcement actions).  This can be done by contacting the Arizona Department of Health Services or going to their website http://azdhs.gov/licensing/medical-facilities/index.php.

Memory Care in Arizona

Memory Care centers are a specialty form of Assisted Living designed for the person suffering from a memory disorder.  The physical environment and the programs provided in a Memory Care setting are specifically tailored to the individual, with the goal of nurturing independence while maximizing quality of life.  Memory Care settings are a secure environment to protect those who wander.  In addition the staff at these facilities have had additional training in the care of persons with dementia.  In Arizona, Memory Care centers are licensed as Directed Care.

Skilled Care in Arizona

In Arizona, Skilled Nursing Facilities are also licensed by DHS.  Licensed nursing care facilities provide the highest level of medical care for persons who are not able to perform their activities of daily living.  The care is provided by nursing professionals under the direction of a physician.  Skilled Nursing care is often used for acute, short stay care after hospitalization.  These stays may be covered by Medicare after discharge from a hospital.  Long-term care in a skilled setting is reserved for those who need nursing care on a regular basis but do not require hospitalization.  These stays are not covered by Medicare, although Medicaid (if eligible) and long-term care insurance will often cover part of these costs.  Often these facilities also provide services such as speech therapy, physical therapy and occupational therapy.

Continuing Care Retirement Communities in Arizona

Continuing Care Retirement Communities (CCRC) usually provide independent, assisted and skilled levels of care in one community.  Some CCRCs also offer Memory Care.  This type of community offers a contract that secures living accommodations and services over the long-term.  These communities are designed to provide services over the life of the resident.  There are three common types of contracts used in CCRCs:

• Extensive – covers shelter, residential services, amenities, and unlimited skilled nursing care with little or no increase in the usual monthly payments.  Due to the nature of this contract, the fees are usually higher



• Modified – covers shelter, residential services, amenities and a specified amount of Skilled Nursing Care.  Any additional Skilled Nursing Care required beyond the specified amount is the resident’s financial responsibility.

• Fee-For-Service – covers shelter, residential services and amenities.  Skilled Nursing Care is paid for by the resident as it is used.

Most CCRCs also require a one-time entrance fee in addition to the monthly payments.  Examine the refund policy on the deposit.  There should be a pro-rated refund available based on the length of residence.  Finally, inquire into the financial stability of the CCRC.  Some unlucky families put down a deposit only to find out that the company is on the verge of bankruptcy and the deposit is lost.  Due to the complexity of these arrangements, it is wise to have an attorney review the contract prior to signing.  You can also obtain information on CCRCs from The Continuing Care Accreditation Commission at www.ccaconline.org.

Choosing an appropriate facility can be a challenge.  There are many levels of care and dozens of facilities which offer one or more level of care.  When it is time to look for a facility option, engaging an Aging Life Care Professional (www.aginglifecare.org) can make the process easier.  The Life Care Professional can assess the proposed resident’s needs and then guide the selection process, making the process easier and less stressful.

Make sure to consult an Aging Life Care Professional in Arizona.

Should Mom Still Be Driving?

Whether or not an aging parent should be driving is a question we are frequently asked.  It is a very touchy subject and most children do not want to force the issue with their parents.  Getting a drivers license is a rite of passage that most teenagers look forward to.  Having to give up that license can be very difficult.  It affects a person’s sense of independence.  Once a person surrenders their driver’s license, they are suddenly dependent on others to get around.  Going to the grocery store, going to the doctor and even going out with friends can become difficult without transportation.

There are several warning signs to look if you are concerned about a loved one’s safety behind the wheel.  If you notice any of the following 17 warning signs, it is time to evaluate whether your loved one should continue driving.

1. signaling incorrectly
2. trouble making turns
3. changing lanes improperly
4. confusion at highway exits
5. difficulty parking
6. stopping inappropriately in traffic
7. confusing the brake and gas pedals
8. driving too fast or slow
9. hitting curbs
10. failing to notice stop signs or traffic lights
11. reacting slowly to traffic situations
12. failing to anticipate potential dangers
13. getting lost in familiar places
14. scrapes or dents on car, house, garage, etc.
15. traffic violations
16. near-misses
17. accidents

There are several options for driving evaluation.  One option is to have an evaluation through a driving evaluation center.  Although there are companies that offer these services, many of these programs are offered through larger rehabilitation centers as well.  Another option is to have a physician write a letter to the Department of Motor Vehicles (DMV) expressing their concern about their patient’s driving ability.  Once the DMV receives this letter, they will send out a letter to your loved one either revoking their license or requesting them to come in for a written test and/or an on the road driving test.  Successful completion of the testing is necessary for the license to remain valid.

It can be hard for family members to address the topic of driving safety with their loved one.  Involving the primary care physician in this process can be helpful because it takes the role away from the family.  Another option is to consult with a Certified Care Manager or Aging Life Care Professional.  These care management specialists are typically well versed in the resources to evaluate driving and can facilitate not only the testing, but also put a plan in place to address the need for transportation once the person stops driving.  Again, involving an independent third party takes the pressure off the family and takes some of the emotion out of the situation.

Addressing driving concerns with your loved one can be stressful and very difficult.  It is an emotional topic with significant consequences.  Having a plan to both evaluate your loved one’s driving and to accommodate their transportation needs if they stop driving will help make this difficult task somewhat easier.

Are Your Affairs In Order? It’s Time to Talk…

“My mother didn’t want to put a Power of Attorney document in place because she didn’t want anyone to make decisions for her.”  “My father doesn’t have a Living Will because he wasn’t comfortable talking about end of life issues.”  These comments are common.  Making decisions about who we want as our decision maker if we can’t make our own decisions is difficult.  No one wants to think that they won’t be able to make their own decisions.  Most people do not feel comfortable talking about end of life issues, death or dying.  As difficult and uncomfortable as they can be, these conversations are necessary.

Before you are unable to make decisions, you can empower a person of your choosing with the authority to act on your behalf under a Power of Attorney.  A Power of Attorney documents is a legal form in which you nominate someone else with the authority to make certain decisions and act on your behalf.  The person to whom you give these powers is called an “agent” and you are called the “principal”.

If you do not choose an agent under a Medical Power of Attorney and you need a medical decision maker, you may end up with a Guardian.  The Guardian is appointed by a judge and may or may not be the person you would have chosen to be in that role.  The Guardian may not know what decisions you would have made if you had the ability to make them.  The same is true for your finances.  If you do not choose an agent under a Durable Power of Attorney and your need someone to handle your financial affairs, you may end up with a Conservator.  The judge will select a person to serve as Conservator.  This person may or may not have been the person you would have chosen to be in that role, and they may not know how you would handle your finances if you had been able to do so.
Equally important is the Living Will.  This document directs the medical providers and your medical decision maker how you would like your end of life issues to be managed.  The document can be as detailed as you like and give instruction on anything you think is important regarding your care and end of life decisions.  Although an attorney can draft your Living Will, you can also use a form such as Five Wishes to make you desires known.  No matter how you do it, make sure that your family knows your wishes and make sure you write it down.

It’s important that your chosen loved ones have the authority to make decisions in your behalf when the time comes. You definitely don’t want the courts deciding who will choose your Care Professional. A trusted, Life Care Professional can help you or your family get the best care and quality of life possible.

Sandwich Generation Stress: 6 Ways to Cope While Raising Kids and Caring for Elderly Parents

by Paula Banks, LSW, CMC 

“My boss yelled at me for missing my third day of work in two weeks, but I had to go help Dad. What choice did I have? His dementia is getting worse and he keeps forgetting to take his medication. Last night the neighbors found him wandering around in his pajamas. Two hours after I checked on him, my teen's assistant principal called to tell me my daughter is being suspended for skipping school again. On top of all that, my husband is traveling a lot for work, the house is a mess, no one is paying attention to the dog, I've put on 25 pounds and I can honestly say that I haven’t had one day of fun in the past three years. I feel like I’m going to disintegrate if something doesn't give soon.”

In families where there are tremendous competing needs (like kids and aging parents) these crises can become a self-perpetuating situation.

If the above scenario sounds familiar, welcome to the “Sandwich Generation.” There’s almost nothing more draining, stressful, emotional and guilt-inducing than caring for an elderly parent or relative while raising kids. I know what this is like because I’ve been there myself—and my life’s work has been devoted to helping people who are caring for elderly or sick relatives. If you are in this situation right now, you’re probably feeling pretty overwhelmed and alone. I want to tell you that regaining some peace and order in your life is possible. You can learn how to handle the obstacles and difficulties that arise—and you can also let go of some of the guilt, stress and other energy-draining emotions that pull you down and make you feel defeated and exhausted.

Related: How to stay sane while caring for your parents and raising your kids 

I understand how alone, frightened and unsure you can feel—and how cheated, as well. Maybe this is that time in your life when you thought all your hard work raising a family and advancing your career would have paid off. Instead, your life feels out of control, your family is a mess, your marriage is on the rocks and you are very close to losing your job. Well, let me tell you, you are not alone! There are approximately 20 million women in this country between the ages of 45 and 56—and a whopping 10 percent of them are members of the Sandwich Generation. The numbers of hours and dollars they spend in the care and support of their children and parents are into the billions. (While we have many more men than ever before stuck in the Sandwich Generation, the burden still falls to women in most cases.)
It’s no surprise how this has evolved over the past 20 years, given the demographic changes in this country. We have more women in the workforce, increased life expectancy, couples having children later in life and smaller families—meaning fewer siblings are available to share in the caregiving for their elders. And for parents stuck in the Sandwich Generation, the stress can be extreme. It’s no wonder that marriage and family therapists often refer their clients to geriatric care managers for support.

Related: Kids acting out while you try to take care of your elderly parents? 

My Mother Fell Down Again—and My Kids Are Constantly Acting Out. Help! 

Children often act out when their parents are under extreme pressure from the numerous responsibilities of taking care of elderly or sick relatives. Acting-out behavior might occur if your child is:
• Anxious about what's going on within the family
• Sad about the changes their grandparents/relatives are experiencing
• Feeling ignored because your attention is elsewhere
• Scared of what's going to happen

Your child might also just be plain angry and feeding off the stress in your household—a house that might feel as if it’s frequently in crisis mode. If this is the case, it’s important for you to step back, take a deep breath, evaluate what's going on in your home and make a plan to take back control of your situation. Preparing by creating a plan will help make you feel stronger and more empowered in your life—and less like you're living from crisis to crisis.

What does this plan look like?

1. Stop the “Screech”…and Breathe. When it comes to crises, I ask my clients all the time, “Is someone in immediate or imminent danger of death or injury? If the answer is “no” then I tell them it is not a crisis. It may be a major issue or major concern but not a crisis. What happens in families where there are tremendous competing needs (like kids and aging parents) is that these crises just become a self-perpetuating situation. Everyone is meeting “screech with screech” and there is simply no need for it. I advise my clients to take four very deep breaths, clear their head and slow down that “fight or flight” response. Take a step back and then begin. They can teach their kids to do this also by simply refusing to go to screech.

Your parent's crisis might have come before your child's or vice versa. One may be feeding the other. If you step back, take a look and stop reacting all over the place you can break it down to understandable, manageable pieces. I can’t say it enough: Breathe. It sounds silly, but studies show that people who are under tremendous stress often forget to breathe. Steady, mindful breathing calms us down and gets crucial oxygen to our brains. That clarity will help you make better decisions.

Related: How to maintain your sanity while you care for your parents and raise your kids.

2. No More “Shoulda, Coulda, Wouldas” I always say that guilt is one of the most useless emotions—and the most embraced one in the world! We humans are great at feeling guilty for everything. It takes a lot of work to let go of guilt, especially for those of us in the Sandwich Generation. Because you are caring for kids, your aging parents, your spouse, your home, your community and your job, you probably feel like you have a million masters and can never please any of them. I believe this is where we must understand and tell ourselves daily that anything and everything we are doing is helping and that it matters. Identify where you might need some support or assistance, but don't get stuck in the constant “coulda-shoulda-woulda's” because it is just counter-productive.

3. Ask for Help…And Say “Yes” to It When someone offers to help, say, “Yes!” And sometimes you will need to ask for help as well—don’t hesitate. My clients are always amazed at how many people will pitch in if you ask. If you’re raising kids and caring for an elderly or sick relative, it’s also important for you to know that there is help for you—both for dealing with your children and your aging parents. The key is to know how to access that assistance.

For some, that assistance is as close as your child's school. School social workers and guidance counselors can be a good resource for finding assistance and services for your child and family. Often, people around you are dealing with aging relatives as well. Try reaching out—what’s the worst that could happen? And don't forget your faith community. Talk to your clergyman and ask him or her to send word out that you need some help with chores, respite, sitting with your elder or meals. People love to help and will do so if asked. The Area Agencies on Aging (in almost all communities) can help with resources as well. Go to www.n4a.org to find one in your area.

4. Include your child in the family plan. I am a big fan of intergenerational learning—and there is nowhere better to start than your own family. No matter their age, ability, maturity or behavior, all children can help their parents care for their elderly relatives. Whether it’s your five-year-old son bringing Nana a cup of juice, your teen visiting with Grandpa and helping him walk out to the sun porch, or your 23-year-old driving Aunt Rose to her doctor's appointments, all kids can help in some way. Helping others makes us feel needed and wanted—and that we matter.

I think it’s also important to share with your kids about the changes that are happening within the family and with your aging parent. When kept “age appropriate,” the information will actually decrease your child's fear, anxiety and acting-out behaviors. For example, if you have a grandparent who has suffered a hip fracture and is going to be staying with you for a while until they heal, you might tell a 4-year-old, “Nana has a boo-boo on her leg. We are going to help her feel better." You can give your 14-year-old more information:  “Nana fell in the driveway and broke her hip. She's in a lot of pain and needs our help right now. She’s going to be staying with us for a while until she feels better. We really need you to sit with Nana after school and help her out until we get home from work." Keep it age appropriate but do share—it’s important for kids to feel needed and respected.

Related: Doing too much for your kids—and everybody else?

There is very little we should not involve our kids in when caring for aging parents. Your kids always know more than you think they do! And if they are too young to understand it, they still know something is happening and changing. Even death, one of the scariest words in the world for us humans, is something kids can be part of. Because it is part of the circle of life, kids should know that it happens, is part of the life cycle and not a silent subject.

While it is important to keep things age appropriate when it comes to any issue of aging, there are teachable moments everywhere. So, for instance, while it is unpleasant for a child to see a grandparent who is agitated due to their dementia, you can learn how to decrease the agitation, have the child see the grandparent when they are most calm, and explain that their dementia causes them to act differently than they used to but they are still the same Nana who always loved them. There are many resources out there, including www.alz.org, where one can learn about dementia, behaviors and coping strategies.

5. The 3 R’s:  Respite, Respite and Respite. When you’re sandwiched in between all this stress, it’s crucial to take some time for yourself. Schedule “respite” into your calendar. Meet a good friend for coffee if you can, or call someone to talk. Take a book to the beach, take a walk around your block, go shopping and do something fun for you. Build this into your plan of action because by doing so, you will be healthier physically and emotionally—and prepared to keep going.

This may seem impossible because you may be thinking, “Who will watch Mom when she can’t be left alone?” The answer is easy: You can ask a friend to sit with her—or even offer to pay for their time. Also, home care agencies have people trained to care for your loved one. They can provide respite so you can get out for a while. Most have two hour minimums and cost about $25 an hour. If you can afford it, do it! It is worth every penny to help you get refreshed and keep you sane—and to give your mind and body a break from caregiver mode.

Related: How to stop living in “crisis mode” with your elderly parents.

6. Stay in touch. One of the tough things about being caught in the Sandwich Generation is that between caring for your kids, trying to keep your job and caring for aging parents, you have little to no energy left for socialization with peers. Socialization is critical to all of us for emotional and physical health—so reach out. Talk to family and friends, your faith community and try to reconnect with the groups or clubs that used to interest you. These are critical connections that will sustain you. Don't let them drift away. Feeling isolated and alone is one of the worst parts of caring for others, and is also one of the hardest aspects of elder care. If you simply don't have time or energy for these things at present, make it a goal for the near future. And if you have no one to talk to, there are many caregiver support groups throughout the country. Go to www.n4a.org to find one near you.

I always say that “action equals strength!” By creating a plan to handle the situation of being caught in the Sandwich Generation, you will be able to take control of the chaos you are swimming in. You will be able to breathe, calm your house down, look at and separate the issues of your children, aging parents, marriage and yourself. You owe it to your physical and mental health to understand what is going on and how to get the assistance needed to make a plan that will benefit everyone in your family.

Website Reference: http://www.empoweringparents.com/sandwich-generation-stress-6-ways-to-cope-while-raising-kids-and-caring-for-elderly-parents.php#

Exercise for the Arizona Elders

Everyone wants the benefits of exercise throughout their life. But we often wonder if it is safe for seniors to exercise. According to the American Academy of Family Physicians almost all older people can benefit from additional physical activity. With regular exercise an healthy elder can be protected from chronic disease, improves mood and can lower their chance of injury.

As the body ages, it takes a little longer to repair itself, but moderate physical activity is good for people of all ages and of all ability levels. Truth be told, the benefits of your elderly parents exercise program highly outweighs the risks. Even elderly people with chronic illnesses can exercise safely. Many medical condition such as Alzheimer's and dementia, heart disease, diabetes, colon cancer, high blood pressure and obesity can be improved with an exercise program.

In fact, elders who regularly exercise can see an improvement in their health to include improvements in blood pressure, diabetes, lipid profile, osteoarthritis, osteoporosis, and neuro-cognitive function.

A regular exercise program can improve:

Immune Function – A body can fight off infection and sickness and recover more quickly less strenously when healthy instead of stealing energy from the body.

Cardio-Respiratory and Cardiovascular Function – The risk of heart disease and high blood pressure is lowered with regular physical activities. If the elderly person has hypertension, exercise will lower blood pressure.

Bone Density/Osteoporosis – Exercise protects against loss in bone mass and will reduce the risk of osteoporosis and lowers risk of falling and broken bones because of better bone density.  Research shows that strength training can dramatically reduce the loss of bone mass, help restore bones, and contribute to better balance and less fractures.

Gastrointestinal Function – Regular exercise promotes the efficient elimination of waste and can improve digestive health.

Chronic Conditions and Cancer – Regular physical activity lowers risk of Alzheimer's disease and dementia, diabetes, obesity, heart disease, osteoporosis, colon cancer and can help in the management of high cholesterol and arthritis pain.

Regular physical activity is also associated with decreased mortality and age-related morbidity in older adults. In addition, a study by the Journal of the American Geriatrics Society examined exercise in the elderly and found that exercise training led to improvement in functional reach, balance and fear of falling.

Often, frail elderly people are unable to maintain an aerobic exercise routine on a regular basis due to lack of endurance. Age-related changes in the cardiovascular system have significant effects on cardiac performance, it has been estimated that 50% of endurance loss can be related to decreased muscle mass.

The best exercise program for the elderly consists of three components: aerobic exercise, strength training, and balance and flexibility. To learn more about how your parents can improve their health with a care manager contact Desert Care Management by visiting their website or calling at 480-804-7200.