Defining Home: Housing Alternatives for Elders

As a big proponent of “aging at home,” I have worked with many families, including my own, over the wrestling of options when “home” needs to be redefined for aging parents and relatives. Sometimes “staying at home” is not viable, even when care it taken to build in all the modifications, supports and assistance necessary to consider it seriously. And, as in the case of a dear friend, sometimes it is the parent who firmly decides that finding a safer, friendlier, smaller space in the company of others would be preferable to the loneliness of long days and nights alone in what was once the bustling family home.

While alternatives abound, theoretically, the slog through options often reveals major flaws that must be understood and overcome in order to make not only a coherent decision, but the “right” decision for the individual concerned. The option to buy into assisted living communities has grown over the past decade as one that continues to create equity for the elder. It is no surprise, however, to learn that in today’s rough economy with home values and assets of nearly every type losing value that many families are rethinking this decision.

It is not uncommon that entrance fees for many retirement communities run into six figures. Typically, once the family and individual settle on the community with the right fit, a significant amount is put on the table as a down payment, often 10% or higher. Next steps include selling the primary home to get the rest of the cash to buy into the community fully. Often the fine print includes options to dissolve the relationship, generally dependent on the management of the facility selling that “unit” and returning a certain percentage to the individual or heirs. The previously growing trend for seniors to pay $200,000 or more to become part of an established community with a continuum of care from independent living to assisted living to full nursing care is now taking a sharp nosedive.

As personal incomes and investments have diminished during this worst of economic times, individuals and their families are rejecting these options perceived as unrealistically expensive. With devalued homes the problem takes on even more seriousness as people want to hold on longer to their properties in the hope the values will return. Of concern, too, is that buying into a retirement community will also lose its value. Handing over $200,000 today is no guarantee that in a few years when a change might be needed that unit will have retained enough value to make the “buy back” viable. Letting the retired living company have the full benefit of someone else’s savings strikes many nowadays as foolhardy. Some, such as Spectrum Retirement Communities offer monthly payment plans as an alternative, but this trend is slow to develop across the industry. Such an approach compromises the funding of building new communities, a practice that is leading some of the biggest names in the business into deep financial problems.

Running retirement communities is a costly venture and some of the well-known players in the industry are showing signs of stress, if not outright despair. Erickson Retirement Communities, one of the nation’s largest, filed for bankruptcy protection under Chapter 11 on October 19, 2009. One of the outcomes of this restructuring will be a separation of the real estate side of the business from the retirement community management side.

While these economic realities add another set of issues to the debate about aging at home, defining “home” will continue to be one of the most personal matters we and our families face.

Read more about aging in place

Resource for pricing home safety modifications

Five Reasons for Health Insurance Reform

Somewhere during the summer, health “care” reform switched to health “insurance” reform, and the debate came alive in new ways. While our system of health care itself is worth questioning, in fact vigorously by some, including Michael Moore in his award-winning film, Sicko, what makes a lot of sense now is challenging the way we package health care, pay for health care, withhold health care, dole it out. And, when looked at in that light, “insurance” is definitely the aspect of our health system that needs reforming.

As we make changes to Capabilities, separating ourselves from selling products, while highlighting still the importance of access to products and services that promote independence, the voice I use in this blog will change sometimes. Ever interested in putting a whole picture on the table, I have particular experiences that do shape my perspectives and beliefs. I am not always neutral on these matters of great importance.

To insist that our health care insurance options today should be the choices of tomorrow ignores some realities that are out there, maybe not for all of us, but for enough of us Americans to take notice. I have five situations (at least) that make me believe that the time is now to change some fundamentals about health care and health insurance. I have changed the names to protect privacy. The situations are real, though, and some version of these situations presented themselves on a nearly daily basis.

1. Mike, a 40-something, has a debilitating disease made all the more complex by premature arthritis that causes severe spinal and hip pain. He lives on SSI disability income and Medicaid. In this case, he has options that some others do not. Medicaid has paid for a wheelchair, a patient bed and equipment for the bathroom. He cannot sit or stand for any period of time, however, and he needs a chair, a reclining lift chair. Medicaid will pay for one of those, too. The approved one. Mike has tried that chair under several conditions and it causes him excruciating pain. He has found the one that works for him. Medicaid will not approve this chair; they approve the other chair and deliver one to him. He does not use it. They will not take it back. He called to tell him he just cannot sit in it.
2. At 84, Margaret could no longer manage her day-to-day activities in her home. After discussion, her family and she decide that if she had a power wheelchair to get around the house, she could stay at home longer. Margaret and her family worked with one of those dealers advertised on TV, who made it easy for her to get approved, advising her how to work with her own doctor or providing one in their networks. They sent her a chair. It was too big for her home and for Margaret. Her family tried to work things out with the dealer, but to no easy avail. Margaret passed away a few months later. The family now has a big power wheelchair. They are trying to sell it. “It’s a $6000 chair,” they say in the ad. Everyone knows they did not pay a penny. Medicare footed the bill for something that proved useless for Margaret.
3. Gloria is barely 50. She lost her job with the downturn. She has fibromyalgia, a syndrome that causes myriad physical problems, including mobility issues. She also lost her insurance coverage because the COBRA payments were too high for her to continue the coverage as properly offered by the company. Within a few months, with still no job prospects, Gloria’s condition worsens. She needs a walker to get around the house and something more powerful when she goes out to look for work. She cannot afford even the basic one. She spends her time looking for a donation and applying for grants at local churches. Her job search falls by the wayside.
4. Jose became an American citizen years ago and worked diligently to provide for his family. He paid his insurance premiums faithfully. At age 60 and a widower, he struggles with COPD, diabetes and congestive heart failure. He cannot work anymore and after the COBRA coverage ran out, he tried to buy individual coverage. Because he has pre-existing conditions, he is not insurable. Luckily, he had savings. They are used up now, so he sold his home to be sure he can buy oxygen, a must-have to get through his days.
   Jim and Alice are about to bring Alice’s mother in to live with them. She has advanced macular degeneration leaving her nearly blind. Her children want very much to find her some tools to help keep her active. A CCTV costing about $1700 would give her enough independence during the day while Jim and Alice work to read, do her needlework and write checks to pay her bills. Surely, insurance will help cover this needed tool that will give Alice’s mother some quality of life? Jim and Alice get very angry when they learn that neither Medicare, nor the high priced supplemental insurance she has, will pay anything towards vision tools, other than corrective lenses, exams and surgeries.
   
   I have seen hundreds of people disappointed, angry, frustrated and despairing when they find that “after all these years of paying into insurance” they are left to handle the situation themselves. Of course, health insurance does pay for certain procedures and pieces of equipment. And for those who have great coverage, the complaints are few. But, there are things so necessary, so vital to quality of life, to mobility, to independence, to comfort, to managing pain that individuals pass up every day, or sacrifice even more to get. In more certain times, adult children, grandchildren, nieces, nephews have taken up the slack, filling in the gaps to ensure the right thing happens. In these difficult economic times, everyone thinks twice before opening a wallet, including loving and caring family members.
   
   Reason tells us that we cannot as a country satisfy every need and comfort. After these years of working with honest, hard-working families who face physical challenges that may lie just around the corner for every one of us, I am more persuaded that there is a place for oversight and regulation of health insurance at the very least, and perhaps even a greater role for government to ensure that the list of health care basics for every American gets redefined.
   
   One interesting idea is to shape the health insurance industry after the public utility model. While privately held companies can compete to deliver electricity, for example, there are guidelines and regulations that ensure a modicum of fairness in access to the utility, pricing and safety.
   
   What do you think? What gets under your skin about health care and health insurance? What do you like about the way things are? Please post your comments here or email.

Fountain of Youth?

Time magazine published an article this spring (3/23/09) titled, "10 Ideas Changing the World Right Now." There were the usual references to "green" initiatives and technological advances. And then came #5, "Amortality." Author Catherine Mayer coined the phrase as she wrote about how aging Boomers are changing the paradigm of growing older. She notes that the number of cosmetic surgeons in this country, for example, has tripled since 2003. Here's how Ms. Mayer describes her newly minted term. Amortality is more than this ripple effect of aging Boomers' resistance. "Amortality is a stranger, stronger alchemy, created by the intersection of that trend with a massive increase in life expectancy and a deep decline in the influence of organized religion - all viewed through the blue haze of Viagra." Her tongue-in-cheek remarks give way to serious paragraphs revealing this "trend" driven not only by dreading the aging process, but outright denying it through physical interventions, including surgery, and scientific explorations going beyond the temptations of cryogenics into "radical life-extending and life-enhancing technologies." These potentially life-shifting perspectives and discoveries challenge the common wisdom that "aging is a natural thing that is going on independently of disease." Dr. Aubrey deGrey, a Cambridge university gerontologist quoted in this article calls this so-called everyday knowledge "nonsense." His research is focused on stopping aging altogether.

"Amortality" is a boon to the economy, Ms. Mayer argues, touching every arena from music to clothing, to vacations to drugs (note how much Viagra and Cialis have become household words), to gadgets and foods. So, what does this trend really mean for those of us who may be more accepting, shall we say, of the fact that aging is a part of life. Surely the boundaries of aging have expanded over the years. And the recent film, "The Curious Case of Benjamin Button," turns the framework upside down with the worst effects of old age appearing right at the beginning of life bringing this boy man into ever-strengthening youth, ending finally when he becomes a tiny baby again.

As I work with individuals and families every day facing the challenges of aging, I see the insistence on independence and creating quality of life, the willingness to push and pull and do what it takes to stay alive and able to make decisions about how to live life as fully as possible. Don't only think replacement hips, knees, and Lasik surgery. Consider the proliferation and accessibility of products to make home safe and manageable, stairlifts, easy-to-access tubs, and power vehicles.

So maybe the word "amortality" is a new one, but this so-called "trend" of extending life and living it to the fullest is in fact as old as the hills, or at least as old as Plato, who wrote first about "aging backwards." Ms. Mayer concludes that if this trend does not sound so revolutionary, "it's only beause amortality has already revolutionized our attitudes toward age."

What are your thoughts about "amortality?" What are your tips for living fully and endlessly? What else changes when we think about ourselves as "amortal?" Share your ideas in a post or email me.

Low Vision August Event Postponed

Please note that we have cancelled the August 3 low vision event featuring Dr. Paul Cutarelli and Ron Demske, our Eschenbach expert. We plan on rescheduling the event once our expert consults his schedule. Please stay tuned for more details shortly.

Health Care From Our Perspective

The health care debate can stir passions in a heartbeat! As President Obama tries to tackle this thorny topic, we hear about how the House and Senate debates are going. We hear, too, from insurers, businesses and individuals as all wrestle to find common ground. Unless you are in the durable medical equipment (DME) or home medical equipment business (HME), the ordinary person does not get a view from this perspective.

While we do not solely identify ourselves as DME or HME, we clearly have products that fall into those categories. We also spend our days working with individuals and families who face situations that they expect qualify for help from private or government insurance plans. As business owners in this field, Pam and I are often the messengers of bad news. In so many cases, neither government sponsored or private insurance companies cover what the ordinary, everyday person considers a "must have." Sometimes the response is an angry one, as if we, ourselves, have orchestrated events so as NOT to provide coverage. Other times, we see resignation as folks hear the same story over and over again that a particular product is not covered, or that their own eligibility for that product does not hold up under the scrutiny of insurers. And then there are those who fight, who take their case to those in high positions, who push the envelope, who insist that their case be considered. While these types are few and far between, we know they exist. We often do not hear the outcome, though.

So, our story as a business owners is a mixed one. We offer a store full of an array of practical products (and a bunch of unique ones, too) that people might find in five or six different venues, including online stores. We love that we can contribute to someone's independence or a family's set of potential solutions for a loved one in this very tangible way. On the other hand, we all too often have to deliver the unpleasant news that Medicare, or some private payer, will either not cover the item, or will not let us be the provider because we are still an emerging business.

This debate is surely a hot one now in our country and it is anyone's guess how it will play out. What is certain is that not everyone will be satisfied, including those of us in this DME and HME business. We are looking to make a living. Individuals are looking to get what they need at a minimal cost given the years of contributions they believe they have made. Private insurers want profits. The government wants to keep its promise that affordable health care is possible for every American. Good luck on this one! Pleasing so many disparate parties will be a miracle.

What are your thoughts on the health care debate? Post your comments below or email your perspectives. For updates on various health care proposals you can check the government's official site or read the Kaiser Family Foundation's summaries. This site offers a side-by-side analysis of the various proposals in Congress.

Got Squabbles? Conversations With and About the Elders in Your Life

If you are a Boomer, chances are you have already experienced or are about to experience some difficult conversations with the aging relatives in your life. Or, you may be on the verge of becoming the elder in your family with whom others will one day face a similarly challenging conversation. Whether it is about when to hand over the keys, or the checkbook, or when living alone in the family home is no longer safe, the list can be endless when strong wills face each other on the question of personal independence.

We are delighted that our colleagues, Debbie Reinberg and John Rymers, are hosting a forum where families and individuals can speak openly about some of these difficult conversations. On August 10, Debbie and John will be at Capabilities, listening and offering important tips and advice. Skilled mediators, they operate a business called ELDEResolutions in metro Denver, offering their talents and experiences to families facing sometimes one of their most difficult chapters.

As our guest blogger this week, Debbie tells us more about why family meetings are so essential. You can contact Debbie and John at ELDEResolutions.com or at 303/268-2282.

Facing an Elder Crisis: Consider a Family Meeting

Some families are able to share emotions and ideas and develop a plan of action, without assistance. A good family meeting creates a process for members to share their personal observations and concerns. And, it also provides a mechanism to march forward, defining roles and expectations clearly.

My family is such a family – most of the time! When my mother started showing signs of cognitive decline (in her mid-60’s), my three sisters and I were each concerned about what that really meant – for my father, my mother and for us. We live in four different time zones and the closest sister to my parents was 300 miles away. So, we started talking. First, it was two people at a time, by phone. Then, we started to use Instant Messaging to have “joint” conversations. Amazingly, Dad started to join us for some of those internet discussions. And, we were able, as a group, to gently share our sorrow and our concerns with him. He really appreciated the emotional support and continued to let us know that the “practical” things were taken care of. As a devoted spouse and a rather young and able caregiver, he readily rejected most of our concerns and did a pretty good job of caregiving. We continued, of course, to worry about his well-being (he had several serious health care alarms during his caregiving years), yet we agreed to trust his judgment and his role as master decision-maker.

And, we still worry. Now that there is no “young and able” spouse/caregiver to make decisions, we worry about Dad’s physical and cognitive health. He certainly likes to control his own life, but he doesn’t seem to be doing activities that truly benefit his wellbeing. Although he moved to be close to one daughter, he often refuses her invitations to join their family for events. He stays close to home. He complains that he doesn’t like to cook, but rejects most offers to join others. He is usually home, alone (unless he is doing a quick errand.)

My sisters and I have been talking. We’re all going to be together for the weekend for a family event. Hoping to have a family meeting – WITH Dad – to share our concerns and help him develop a plan. None of us are typically “bold” enough to just tell him what we think (we tend to be reluctant to “make waves”.)

Perhaps it would be helpful for a professional facilitator to help us get to the next step. A neutral professional could free everyone up to talk openly, in a safe environment - even my father! We could all rely on the facilitator to keep us on track with the important topics and help us actually address the issues that need to be tackled. An impartial neutral could also help ensure that we find the common ground necessary to make the right decisions, as a family.

Sometimes, families just can’t get where they need to be without an extra push.

StrokeLink: A Resource for Survivors of Stroke and Their Families

We are pleased to connect you to the regular publication of Rocky Mountain Stroke Center called StrokeLink. As you know we are big fans of the services that RMSC offers to those in the metro Denver area. We also offer our Capabilities community room weekly for professionally led physical therapy sessions and the aphasia support group.

In the most recent edition of StrokeLink you will find the latest information about support groups and educational seminars in the metro Denver area as well as information about stroke-related vision issues. Find a list of Behavorial Optometrists who specialize in vision therapy throughout Colorado.

Contact RMSC if you or someone you love is living with stroke. Please consider making a donation to this extraordinary organization. As you might imagine, the economic situation facing everyone is especially challenging for non-profit organizations.

Bones, Joints, Muscles, Ligaments

Operating Capabilities gives us a unique view into the lifestyles of so many people. While a number of our customers are "seniors," people over age 65, we see very many folks of ages across a wide spectrum. Just the other day I worked with an 11-year old who took a tumble a few months ago and is still trying to figure out what is going on with her ankle. We have one of the few pediatric and youth lines of orthopedic supports in town.

Summer is a big time for broken bones, sprained ankles and wrists, twisted knees and torn ligments. Some folks go see a doctor or PT immediately, others try self-treatments first. We, of course, are not MDs or certified health care specialists, but we do know our way around orthopedic braces and supports and potential tools to help when life gets too rough.

Two weeks ago I heard about a condition that was brand new to me. After nearly four years, I keep thinking I have heard just about every version of what can happen to people, but that is what makes this life choice so amazing. There is always another story waiting for me the next day. I received a call inquiring about leg splints of a certain type. When I began to ask some questions, I learned that "Joe's" family was on the hunt for this type of splint because Joe had been diagnosed with "compartment syndrome" and recently underwent surgery. He would be okay, but recovery required a few supplies. While on the phone, I quickly googled the condition to learn some amazing things.

1. Compartment syndrome can exist in acute or chronic forms. The acute condition can be fatal.
2. It is a fairly rare condition but can occur as a result of surgery, a crushing injury to a large limb or surface of the body, or repetitive and extensive muscle use. The leg is one of the common sites.
3. Acute cases can only be treated surgically. Chronic cases can be treated with rest, elevation of the limb, anti-inflammatory medications, and manual decompression or massage, although surgery is often indicated in these case, too.

Because high levels of compression inside the fascial "compartment" of the area can cause nerve or muscle damage, paying attention to symptoms is crucial. Necrosis or death of tissue is one of the dramatic possible outcomes of compartment syndrome. Extreme deep, severe and consistent pain, more intense than the visible injury seems to suggest, is one of the most significant symptoms. This type of pain will not be quieted with medications, OTC or prescribed. The sensation of "pins and needles" is also common. Swollen and shiny skin is also common with this condition. Full paralysis is a late symptom as is a lack of pulse. Measuring pressure subcutaneously is a relatively easy procedure nowadays, so consulting medical professionals immediately is advised.

As I have said many times, Capabilities brings us so close to challenging situations that are part of people's lives everyday. These experiences not only expose us to conditions and circumstances we would not otherwise know about, but it gives us the opportunity to be part of finding solutions, whether directly or indirectly. We are always grateful to be invited to participate in the ways we can.

Contact us first when you are on the hunt for products and solutions to help you and those you love face an ordinary situation - a sprain or pulled muscle, or something extraordinary like compartment syndrome.

Independence and More

According to Visualthesaurus.com, independence is a word not only about freedom, but about victory and triumph, a successful ending or conquering of a struggle. In our world at Capabilities we meet people everyday who fight for their independence, who conquer the challenges life hands them, who exult in the victories, big and small, that keep them not only alive, but thriving. Our hats off to them and to everyone who stares fear in the eye and does what has to be done. We appreciate the opportunity to work with you and families, providing or helping you find the tools that will help you focus on independence.

Speaking of independence, try out the newest product on the market that combines a rolling walker and a transport chair. Medline has just released its Translator, a lightweight combo unit that transforms easily and effortlessly from one piece of mobility equipment to another. Imagine a day at the zoo with your grandchildren. You start out early in the day with your 4-wheeled walker with a seat, stopping here and there to admire the animals and other attractions. Sometime after lunch you feel quite exhausted and ordinarily would have to stay put or go wait in the car, prompting your family to pack up and leave. With the Translator, you can simply flip over the backrest and pull the footrests from the side of the walker and voila! you have a great wheelchair to sit in while your family pushes you. You can enjoy the rest of your time easily.

Come by our showroom for a test drive or take a closer look at this terrific product.

Read Kathryn's reviews of three combo walkers/transport chairs on the market today in Examiner.com.

Featured Event: A Place for Your Stuff, All of It!

Is your stuff taking you over? Are you thinking of "right-sizing" but do not have the faintest of idea of where to begin and how to tackle it? Has a loved one been gathering "stuff" for years and you find the task hard now to convince him/her to make decisions about what is essential and what not?

Sally Allen, President of A Place for Everything, joins us again on July 21,2009 at 3 p.m., offering her expertise and practical approach to right-sizing. Read an earlier blog about Sally's work with a client and some of Sally's tips. Learn some basics from this workshop and find out more about Sally Allen's approach to projects big and small. RSVPs are highly encouraged for this popular event.

Guest Blogger: Sally Allen of A Place for Everything

We are pleased to present Sally Allen, President of A Place for Everything. As a Certified Professional Organizer and a Certified Relocation & Transition Specialist, Sally knows what to do with stuff. She also knows that a person's "stuff" holds memories, emotions and sometimes the very soul of an individual. Handling those treasures carefully and thoughtfully differentiates these services from those of more traditional moving companies. Sally writes about a situation that might sound familiar to many of you. Please join Sally on July 21 at 3 p.m. at Capabilities for her free workshop.

After reading the story about "Where the Journey Takes you Next", I thought about the trip I just made to CA to help guide the journey for 86 yr. old Aunt Sue from Independent Living (she definitely stayed independent way too long) into assisted living in CO to be near her daughter, Mary. I had never met Mary or Sue and was looking forward to meeting and providing assistance with the transition/move management process.

Two days before her departure from CO, Mary had a lively and spirited phone conversation with Sue. The day I arrived at the Independent Living community in CA, I found Mary sitting at the head of Jane’s bed holding Sue in her arms and trying to feed her. Sue could not sit up, nor keep her eyes open, nor feed herself, nor speak in sentences. One day before our arrival Sue had a very significant drop in physical ability. She had been sent to the hospital and with no significant findings she was sent back to her apartment. Mary and I realized that Sue was in no condition to be at home and called First Responders. Sue was returned to the hospital.

I have never before walked into the "crisis" environment while attending to the letting-go and relocation process. This was a first for me, and took me places I never expected to go. I was reminded how important it is to get your house in order before the crisis sets in. I truly understood the language of tears.

Mary spent the rest of her visit with Sue at the hospital while I researched and organized our next steps. I realized that there was an abundance of sorting and editing that needed to be done regardless of Sue’s whereabouts. I called in another organizer who lived in the area and fortunately was also a Certified Relocation and Transition Special (CRTS).

We dug through the art room and the craft room that had paintings and projects that were started and not completed. We collected boxes of fabric that were going to be used “some day”. We consolidated Sue’s clothes so that Mary could make better decisions about what to leave behind and what Sue needed and could fit in her small closet at destination. We found vital documents and financial papers scattered throughout the apartment.

We checked with Mary as to what was important to her and Sue, and encouraged Mary to make some ruthless decisions about what Sue needed to surround herself with in assisted living. We took three vanloads of “give aways” to the art institute and to the quilting center the first day. We returned to continue the sorting and editing and categorizing for another day and took one more vanload of items to charity.

In the meantime the search was on for new accommodations for Sue in CO as it was obvious that she would not be accepted in assisted living at this time, and would need to be in a skilled nursing and memory care community. Through my contacts and senior care associations I was able to find a bed for Sue in a skilled nursing community near Mary in CO. This brought up some major new decisions about what stayed behind and what would be shipped to Sue’s, one room, smaller quarters in skilled nursing.

Ten days later Sue was finally released into skilled nursing in CA and the caregivers were desperately trying to get her stable enough to fly to Colorado. Let us not forget that during Sue’s days in the hospital we were frantically proceeding with sorting, editing, identifying (while loading up the car van) what must be packed and shipped and what must stay. Originally, the transporting of Sue’s belongings to CO was thought to be a shipment too small for a moving company. I found a pack and ship company that could handle the transport. As the chaos continued, it became evident that neither Mary nor Sue would be able to make many of those ruthless decisions about letting go and saving only the treasures that would fit into the new apartment The transport of Sue’s, larger than expected, shipment to CO was still up for grabs and was in process.

Our next concern was if, and how, Sue would get to CO. Again, though my contacts in NASMM (National Association of Senior Move managers) I was able to find a company in Chicago that is dedicated to giving peace of mind when transferring an ill, injured or elderly relative by air. Their Registered Nurses fly for a living. They accompany travelers on commercial flights, but also have experience with patients on air ambulances, as well as arranging for and attending to the needs of those on charter flights. I am reminded through this whole process that it takes a “team” to get you to the “village”.

Two weeks later, Sue became stable enough to be released for transport and was transported successfully from CA and settled into skilled nursing in CO.

Several days later I visited Sue in her new environment and was totally taken aback at how she had transformed herself into a perky, feisty, and full of smiles “young” lady. She is adorable.

Just last week the skilled nurses reported to Mary that Sue could move from skilled nursing into her own apartment in memory care. Mary proceeded to visit the memory care unit and was extremely despondent with the level of activity and awareness of the residents living there. After much discussion and sole searching, Mary went back to the original assisted living community to ask them to visit Sue and make an assessment of her abilities to live in the assisted environment. They gave us the thumbs up and we are now in the process of relocating Sue to her new home.

My concern is that Sue may truly not be able to stay assisted, but Mary has made the determination that if Sue only lasts in assisted living for even 2-3 months, at least she will have lived a more energetic life for a bit longer, and Mary is ready to move Sue again if necessary. I asked myself….how can I argue with that reasoning?

Now all we need is for the shipment to arrive so that we can make Sue’s apartment into her new home. The decision has been made to ship everything and sort, edit, and find storage in Sue’s new, larger apartment during the settling-in process. As an organizer, we would suggest to those of you reading this blog, to ruthlessly sort and edit before the move to save money (you pay to pack, load, unload, your clutter) and precious time at destination. In this case the crisis had set in and became the dominant factor in the relocation process.

We know that every nook and cranny holds memories. The thought of leaving them behind is overwhelming. Look at it this way; you are making choices of what physically goes with you and what mentally stays with you. Planning ahead is crucial. Remember that the letting-go process does not get better with age, and the greatest legacy you can leave your family is to have your house in order before the crisis sets in.

In retrospect, one wonders if, subliminally, the 86 yr old body went into toxic stress due to the upcoming journey. Relocation stress is defined as a state in which an individual experiences physiological and/or psychological disturbances as a result of transfer from one environment to another.

We are ready and eager to create a new home for Sue, full of her treasures.

Post Script: Sadly, Sue passed away a few weeks ago. Our thoughts are with her and her family.

Summer Doings at Capabilities

While summer is generally a quieter time for seminars and workshops, we find ourselves this year with a terrific line up of special events in July and August. Of course, you can always check our the latest in our Events section of the website, but we thought we would give you a teaser on a few of the headliners coming up.


July 21 features Sally Allen, our guest blogger this week. Sally offers a free workshop on how to manage your "stuff," keeping in mind just how precious all that stuff really is.


On July 29 our space fills with a group of Denver area psychics who offer readings for the low price of $5. They used our space in April and June to see what kind of "energy" they would find here. We are happy to report they called it "fabulous," and are meeting here on a more regular basis. Come in for a terrific evening! And consider holding your meetings here in our great "energy" space.


August 3 brings another low vision seminar to Capabilities, one of our most popular events. Dr. Paul Cutarelli of Cutarelli Vision, brings his expertise as a corneal and cataract surgeon to the table. He also will discuss non-invasive treatments for dry eyes, a common issue as we age. Immediately following the event, Ron Demske, the vision expert from Eschenbach, the worldwide manufacturer and distributor of high quality magnification, will meet with individuals to explore magnification solutions. This segment is by appointment only, so be sure to make your reservations to meet with Ron.


On August 10 our colleagues, Debbie Reinberg and John Rymers of ELDEResolutions in Denver, host a workshop for families to help ease the difficult conversations they have with and about elders. Watch for Debbie's blog on Resolving Family Issues coming up in our next newsletter!


And on August 18, Bonnie Price, Founder of Silvervixens.com, a community for and about women of a certain age, comes to Capabilities to speak about reinventing instead of retirement. A reception with libations and other treats follows her presentation. This has the makings of a great summer evening out! By the way, I write for Silvervixens.com. Read my articles on caregiving.

July Is UV Safety Awareness Month

Ultraviolet rays (UV) are everywhere! The American Academy of Ophthalmology (AAO) has named July as UV Safety Awareness Month. Exposure to the sun intensifies in the summer as we spend more time outdoors and expose ourselves to reflected UV rays while playing in the water, on sand, and walking or riding bikes on pavement. The AAO recommends that you:

• Wear sunglasses or solar filters that screen UV-A and UV-B rays. Your eye doctor can check your sunglasses to be sure they offer protection from both types of rays.
• Wear a wide brimmed hat to offer additional protection from the sun's rays.
• Wear goggles while swimming. Pools, ponds and lakes have plenty of bacteria that can enter under eyelids and contact lenses. Wash your eyes after swimming.

In spite of the body's resilience to sunburn, damage to the eyes can occur even with one serious exposure. Like sunburn, the outer effects may disappear, but the effects can be devastating over time. Age-related macular degeneration can be traced to over-exposure to the sun. Cataracts are a major cause of vision problems with older people.

At Capabilities we carry a line of solar filters developed by our primary vision supplier, Eschenbach. Available in a number of tints - amber, yellow, orange, polarized gray, plum -, each designed to help control a different type of issue, all Eschenbach solar filters provide protection from all UV rays. There are options to wear over eyeglasses and those to wear alone if no eyeglasses are necessary.

Do you wear solar filters or sunglasses? Post your comments and questions about protecting your eyes from UV damage.

Incontinence Overstock Sale

We have more adult briefs and pads than we know what to do with! Help us out by taking some off our hands. It happens! People ask us to stock a certain brand, and their needs change. Or, their loved one moves to a nursing home or passes on. We are offering Tena and Dignity brands at 40% off regular price to reduce this inventory. Come by or contact us. We ship!

Tubs Galore

Our Home Safety Day and Tub Fest on June 20 offered education and plenty of ideas for transforming an ordinary home into one safe for elders and others with physical and mental challenges. Many thanks to our partners, JRDSteam, Total Long-Term Care, and Medline for providing product, refreshments, good company and great information to our customers. Our tub distributor, JRDSteam, brought a number of easy-to-access tubs for customers to step into and see for themselves how easy these tubs are to use. Capabilities now has access to 20 different models of tubs. When looking for the right tub for you or a loved one, consider some of these basic features.

• The door. You can find doors that swing in and those that swing out. This feature is more than just a question of taste. Consider whether the individual might feel trapped while soaking in a tub. If so, you will want a door that swings out, even though s/he should be encouraged to leave the door closed until all the water has drained before opening. Or, perhaps the individual experiences forgetfulness and might mistakenly open the door while soaking. In this case, you would want to get a door that swings in and cannot be opened while filled with water. Doors that swing out generally offer more comfort entering and exiting the tub.
• Jets. Many models have jets as a standard feature. Whether water or air, jets keep the water moving and, in many cases, offer a therapeutic massaging effect. There are instances, however, where the individual may prefer a tub without jets, especially if s/he has fragile skin and cannot tolerate the pressure of water jets, in particular.
• Seat. Most easy-to-access tubs offer a seat as a standard feature. Be aware of whether the seat complies with ADA standards, raised at least 17 inches from the ground. The design of some tubs allows for easy transfer from a scooter or wheelchair. Others require a step into the tub, so look for lower heights for those who will be stepping into the tub.
• Handheld shower. Most models come equipped with a handheld shower. In some cases the design of the tub allows for mounting a shower head so users can stand or sit. Other models do not offer this feature.

Capabilities provides a free in-home evaluation to discuss easy-to-access tubs with you and your family. We also provide installation at a fixed price in most cases. Contact us today to discuss your need for an easy-to-access tub or shower.

Home Safety and Peace of Mind

Most falls happen at home, a place which quickly becomes an enemy as we age or when we experience physical illness or injury. We hear stories everyday from children and grandchildren living in fear and worry about their aging parents who still live in their homes. We hear from individuals themselves who know they should not be climbing stairs or getting into the old bathtub anymore, but want so much to stay independent and in their own homes.

On Saturday, June 20, we are hosting a home safety day with product demonstrations and lots of information. We have teamed with JRD STeam, a Denver-based distributor of walk-in tubs and showers, Medline, a family-owned distributor and manufacturer of medical and home care products, and Total Long-Term Care, Colorado's first PACE provider (Program of All-Inclusive Care for the Elderly) to ensure a day-full of rich experiences for participants. Our event is open to the public and starts when our doors open at 9 a.m. A number of walk-in tubs will be on display and experts on in-home care assistance on site until 3:00 p.m. Capabilities is open until 5 p.m. on Saturday.

Register for prizes and enjoy refreshments provided by Capabilities and Total Long-Term Care.

On Being the Denver Examiner for Mobility Products

As we mentioned last month, Examiner.com selected me to be the Denver Examiner for Mobility Products. After nearly a month, I have a few reflections. On the one hand, I love writing so I appreciate any opportunity to do so. Writing about mobility has become one of the topics I enjoy, of course, because it relates so directly to what I do every day at Capabilities. My knowledge of products and relevant solutions grows every day as I work with the most amazing people as our customers and suppliers.

I like taking a slightly different take on things as I write for the Examiner, a view that steps outside of my role as founder and President of Capabilities. Relating the story of the evolution of a product, perhaps focusing on its inventor, or taking one aspect of a piece of mobility equipment to highlight, such as the joystick and tiller, for example, not only pleases me, but focuses the reader's attention differently and heightens awareness. At least, I hope all this happens for readers.

On the other hand, Examiner.com is a business and like all businesses the motivation for the folks who run that business is to generate readership, measured in website "hits." The Examiner team stay in touch with us examiners, providing tips and ideas to improve not only our writing, but our ability to draw readers. When you go to my home page, for example, you have many options besides reading my articles. You can choose to subscribe to mine and others' articles on a variety of topics, receiving them immediately when we publish. You can also choose me as one of your "favorite" examiners (which I hope you will do!). And, you can advertise on my pages. As you know, internet advertising is nearly outpacing traditional advertising now as a preferred advertising approach. You will see that some big internet companies already appear on my mobility pages through their Google ad buys.

So, as with most things in life, our choices are generally more complex than we think at first blush. I have a great new forum for my writings that I enjoy and use to bring awareness of Capabilities and our expertise, and I have another responsibility to the organizers of that forum to help bring awareness and traffic to their business endeavor. I hope you will take a closer look at Examiner.com, especially my pages.

Let me know what you think and be sure to send me any suggestions or questions you might have that would be informative subjects for my blog or my Examiner articles. Thank you, as always, for your support of Capabilities and for me and Pam.

Guest Blogger: Laura Hansen, Owner of Always Best Care Senior Services

This week we are pleased to introduce you to Laura Hansen, owner of Always Best Care Senior Services. Laura's Denver metro based organization provides assistance with housing placement AND non-medical home care. For those of you giving care to aging relatives, or those of you facing decisions about your own care, you know how hard it can be to find services that are right for you and your family. Laura writes about some important considerations to keep in mind as you think about the next steps for you or your loved one. To schedule a free consultation to ask your questions and get what you need, call Laura at 303-952-3060, or visit her website at InHomeCareLittleton.com.

There comes a time when most seniors need to look at housing alternatives but making a decision can be overwhelming. In addition to researching the many types of housing – from Independent Living to Skilled Nursing and everything in between – you will need to understand the many housing communities in your area so you can make an informed decision.

Here are just some of the questions you need to answer:

• Which type of housing will best meet my needs?
• What should I look for in a new community?
• What questions do I need to ask?
• Where do I turn for help figuring all of this out?

Sound overwhelming? Unless you work in the senior housing industry, it can be nearly impossible to sort through all of this information by yourself. Thankfully, you don’t have to. By contacting a Senior Housing Specialist (also known as referral or placement agencies), you can work with someone who not only understands the types of housing, but also has visited, and knows the details about, many of the local communities.

And the best part? It’s free!

Working with a Senior Housing Specialist is similar to working with a Realtor. Just as a real estate agent receives a commission from the home seller, she receives a referral fee from the communities.

Finding a new place to live
When you meet with your Senior Housing Specialist, you will begin by discussing your needs and desires as well as your budget and location preferences. Once you have narrowed your list of possible places to live, she will take you out to tour those properties. He or she will be at your side as you talk with the community’s admissions coordinator to help with questions and ensure you understand the process.

In addition to helping you find a place to live, Senior Housing Specialists can refer you to other businesses that provide specialized senior services. These services may include elder law attorneys to draw up wills and set up estates and trusts, real estate agents to help you sell your home, Veteran’s benefits specialists, moving/downsizing services and more.

Staying at home
What if you would rather stay at home? Some Senior Housing Specialists can help you find a new home or give you the care and support you will need to stay where you are. By using a business like this, the same person who helped you evaluate your housing options can also provide the non-medical home care you will need. Non-medical home care includes things like stopping by on a regular basis to see how you are doing, fixing a meal, doing light housekeeping and laundry, running errands, providing transportation to medical – or other – appointments and helping you with Activities of Daily Living such as meals, dressing, bathing and medication monitoring.

Deciding on the best living situation for your needs can be a daunting task. By working with a Senior Housing Specialist, you will be able to make an informed decision as well as have access to the additional help you may need. With their understanding of senior housing, plus their connection to other senior service providers, Senior Housing Specialists are the people to turn to for the assistance you need to stay as independent as possible.

Balancing Act

Among the many remarkable feats of the human brain, the ability to balance is one to marvel at. But balance is not a feature of the brain alone. When you think about just how many parts of our bodies are at play when we stay in balance, the awe increases. Proprioception refers to the vast network of inner regulators that allow us stand upright and stay balanced while doing so. These signals cue muscles, ligaments, nerves to do their job at just the precise moment, generally in response to external factors. Couple this ability with the organs and nerves of the inner ear and receptors that are located inside our muscles of our joints with the brain and the outcome is this incredible ability to move and balance ourselves. This vast communication system involves both large organs and the tiniest of nerve endings throughout the human body.

Maintaining balance through the aging process requires attention. While some changes are subtle and others occur perhaps through genetic fate or natural aging, there are steps you can take to ensure that your body's network stays as healthy as possible. Tending to the ongoing maintenance of core muscles, for example, is one way to help joint muscles work productively and continuously. Practicing various exercises with regularity help strengthen and stretch core muscles. For example, standing on one foot, using a balance board, standing on an air disc, stretching the foot, ankle, and leg muscles all contribute to developing core muscle strength. The recent introduction of Wii virtual sports and fitness games have added a whole new dimension to strength training and exercise for people of all ages. Many assisted living residents now engage in Wii bowling and golf and compete against each other.

Playing sports and games that help develop hand-eye coordination are also part of the approach one can take to help ward off ill effects of aging. Humans often follow the path of least resistance, especially during the aging process. Staying focused and attentive help not only preserve many of the body's amazing abilities, but contribute, too, to overall brain fitness.

If you suffer from chronic imbalance, see your physician. This could be the sign of serious conditions. If you are feeling unsteady, perhaps a little practice will help.

Share your favorite exercises and tips for balance.

Page Magnifiers: Debunking the Myth

At least once a week, I encounter someone who is looking for "a large magnifier to lay over the newspaper" for ease of reading. Generally, this person is a Boomer son or daughter trying to help out mom or dad, or a loving adult grandchild who is on the hunt for products to get grandparents involved again. Occasionally, it is the individual him- or herself, struggling with the changes brought about by macular degeneration or some other condition that affects vision. They all want the page magnifier to do the trick.

The page magnifier is a useful tool, but only under certain circumstances. If you have generally good eyesight and are just at the early stages of "presbyopia," the natural aging of the eye muscles that causes many in their 40s and 50s to require reading glasses, a page magnifier may help deliver just enough magnification to ease the strain. However, because large-size page magnifiers are developed using the "fresnel" process, named for the French physicist and engineer, Augustin-Jean Fresnel, their ability to provide distortion-free viewing is compromised. Fresnel processing allows for the production of inexpensive lens or magnifying surfaces, stamped from sheets of transparent plastic. It offers an alternative to the complex and detailed work typically involved with grinding lenses for correction or magnification of eyesight.

The fresnel process does not use the mathematics of lens production either, which dictate that the greater the level of magnification, the smaller the lens. This phenomenon confounds and disappoints many who enjoy using handheld magnifiers, but just want one that has a bigger field. So, the request for something large that also magnifies to a greater degree is ubiquitous among older folks especially, but difficult to deliver in the world of good quality glass magnifiers. With Fresnel quality lenses, one can get the size and some level of magnification. That's the good news. The bad news is that there is often lots of distortion, causing for a blurred image. One has to be prepared to fiddle quite a bit with the magnifier, too, to alter the lighting and the distance to see clearly.

This solution is simply not the right one for those with macular degeneration or other conditions affecting vision. If eyesight is already compromised by one of these conditions, the eye's ability to adjust to distortions of any kind is extremely difficult.

So, while page magnifiers seem to hold the promise of a larger field of vision and greater levels of magnification, it is best to invest in a high quality magnifier or a video magnifier for better results. For example, this around the neck magnifier offers magnification at 2x, but a fairly large field of vision. With the correct lighting, it can be a terrific solution for reading the paper or a book. It is especially great for needlework, tying flies, examining coins, or any close work.

If you are in the greater Denver metro area, stop by our showroom and try out a selection of magnifiers to make the best choice for you. Our trained staff will work with you individually to be sure you are satisfied before you purchase.

What works for you? If you have low vision or know someone who does, sign up for our invitations to low vision seminars held regularly at Capabilities flagship location in the Denver metro area.

Osteoporosis: Tackle It Before It Tackles You

Osteoporosis is accelerated bone loss. Most of us Boomers know by now that the natural aging process causes many changes, among them some bone mass loss. More prevalent in women after menopause, the process of aging in general diminshes the efficiency of how bones "remodel" in the body. The typical process for remodeling bone, including mineralization, takes about eight months. As our bones become less effective at maintaining themselves, we experience greater risk of osteoporosis.

Because it is a "silent" disease without symptoms for a long period of time, many do not even realize they are losing bone density. There are easy tests available today to measure bone density through physicians and other health care professionals. Diet and exercise play significant roles in the prevention of osteoporosis, as does the restriction of certain prescription and over-the-counter medications, especially those for arthritis symptoms. As the body produces fewer hormones (e.g., estrogen in women and androgen in men), the body's ability to create new bone and to absorb properly "old" bone during the process of remodeling has a profound impact on susceptibility to osteoporosis. Scientists have not conclusively eliminated hereditary factors from playing a role with this disease.

With sustained bone loss over time, the risk of falling increases. And with falling, comes the serious potential outcome of broken bones. Fifty-five percent of elders who fall do so at home. We have written in this blog previously about fall prevention and treatment. Enhancing balance and strengthening core muscles are important for overall health and essential for strengthening bones. Use an exercise ball, sitting disc or balance board as a regular part of your fitness routine.

Losing some bone as we age might be a normal part of the process, however if you focus on these few simple ideas and have a routine check of bone density, you are likely to tackle this disease before it tackles you and brings you down.

Do you have osteoporosis? If so, what are you doing to stay on top of it? If not, have you have a bone density test? Tell us about it. Post a comment to this blog now.

Elder: A New Old Word

We have written before of the dilemma we sometimes find ourselves in here at Capabilities. We are a store for mobility and comfort and serve people along the whole age and abilities spectrum. Needless to say, we serve a large number of older folks as they and their families address the physical needs that emerge during the aging process. We have fought against the word, senior, and its many (sometimes perjorative) connotations. We use "older" quite a bit and refer, too, to the generational monikers of WWII Generation, the Silent Generation, and Boomers as means of conveying certain age groups. Occasionally, we use "elder," full with its original meaning of someone with experience who has a place of respect in a community. Its early usage often denotes someone who was connected with a church or religion, a tribe or community.

The word elder is making a comeback, we notice. For a while, it was rare to find the service or book, article or organization that used the word in its title. You might have found it in a subtitle or description of services. Lately, we see it emerging again. Dr. Marion Somers, for whom we have great respect, has a great book, Elder Care Made Easier, with tips and simple steps for caring for aging relatives and other loved ones. Her work centers on ensuring that we care for our elders in a most respectful and thoughtful way, while not burning out during the process.

We see new organizations sprouting and old ones getting makeovers, transplanting "senior" with "elder." As Boomers step now into the next decade of life, getting closer to those we used to think "old," resisting labels and notions that have perhaps summed up others, but not ourselves, our culture seems ready to find new words, or refurbish old ones, to speak about certain realities. For a culture that usually wants nothing to do with aging, the inevitable is upon us. The largest generation for decades will become society's oldest members within fewer years than most of us like to think. Will we be its elders, too?

What's your reaction to words like "senior" and "elder?" Is there another one you prefer? Does it really matter in the end? Weigh in. Post your comment below or email us.

Capabilities Out and About

We often wonder where on earth Pam's travels around metro Denver take her on behalf of Capabilities. Pam fills us in with her blog on some of the details on the who, what, where and how of her recent days. She brings back valuable information that informs our product selections and helps each of us bring better service to our customers and colleagues in the health care world. Staying connected to the many who serve our elders and those with disabilities, as well as communicating and meeting customers and would-be customers every day, keeps all of us at Capabilities so clear about our purpose. We are here to be part of something bigger, to help solve life's challenges. For me and the staff, we are so grateful to Pam for her huge network of colleagues, her affable ways that make meeting new people easy for her, and her passion for the mission that is Capabilities.

We talk so much about our great store that sometimes we forget to mention how much of a community presence we have! It is very important for Kathryn and me to show our support for all the wonderful communities and groups that help support us.

For example, over the past two months, I have been busy presenting topics of interest to our colleagues at retirement communities. Along with Mary Lilley from Right at Home, I talked to a group of residents at St. Andrew’s Village, an independent living retirement community in Denver, about home safety and what to look out for to avoid accidents. Mary brought ice cream, an inducement that I’m sure attracted many. She then hosted a wine and cheese social a few weeks later for the assisted living group at St. Andrew's where I had the chance to speak to a different group on these important topics.

In April I brought our traveling Capabilities' collection of products to the Resource Fair co-hosted by Home Instead, an in-home care company, and Columbine West residential community for their residents. Since I always take a variety of interesting gadgets for people to look at, my table is usually crowded. How else will people find out what is out there to make their life more comfortable! Thanks to Amy Santorelli from Home Instead for inviting Capabilities.

I exhibited at the Talk Yourself into Action Vision Fair held by Center for People with Disabilities in mi-May in Boulder. The day was a combination of speakers and resources. As usual, our table was a hit with the variety of gadgets and assistive aids we show. An event like this draws many individuals (and their families) who experience low vision as a result of macular degeneration, cataracts, or other situations that cause low vision. Macular degeneration is especially prevalent in those over age 75.

On Saturday, May 30, the National Federation of the Blind of Northern Colorado held their Vision Fair in Greeley. It was great to be able to join other vendors and meet the chapter members of the NFB. They provided the seniors in the area with food, drink, door prizes and awards. Our collection of low vision products is among the largest in the greater metro area. As you know, we also sponsor regular low vision seminars throughout the year, featuring experts in the many fields of vision and related diseases, as well as the latest products available.

Next week we will again be providing the wheelchairs for Salute To Seniors, an annual event hosted by the Colorado Gerontological Society, held this year on June 3, with performances by Shirley Jones. The theme for the day is the ‘50s so if you are attending, check out the costumes and booths. Stop by our booth and say hi and have some chocolate.

Occasionally, my travels take us to celebrate with a competitor! Kathryn and I were pleased to participate in annual festivities celebrating Accessible Systems, a company that specializes in home modification. The company has its walk-in storefront and offices in a house in a Littleton neighborhood. While we do compete with this company for some business, we also refer to them for projects too big and extensive for our growing business. It is a delight to be part of a community of so many caring people who share so much in common with us about the greater good.

As you can tell by my busy schedule, we are always eager to display, attend events, and support our colleagues in the industry. Let me know if you would like to offer any of our presentations to your groups. Kathryn and I both love to do that! And, take it from the many who flock around our table, we do have some of the coolest stuff around!

The Green House Project

The Green House model is to create "small intentional communities of elders and staff." Finding its roots from the Eden Alternative approach, founded by Dr. Bill Thomas, Green House homes are intended to be a viable alternative to traditional nursing homes. Imbedded in neighborhoods, Green House homes are not only architecturally part of the neighborhood, looking just like every other home, but they integrate the goings-on of a neighborhood, including opening their doors to local residents. Designed to house and care for six to ten elder residents, Green House homes are organized around a self-manged team of individual workers and leaders who all share in the tasks involved in caring for the residents - everything from housecleaning and cooking to medication management, delivered in ways completely different from those in an institutional setting.

Dr. Thomas has led innovation for over a decade in the reimagining of elder care. He speaks often about the lack of respect towards elders in our culture, including the institutionalization of our citizens as we age. Struck by the loneliness affecting a vast majority of aging Americans, he set out years ago to find suitable alternatives to the high cost of "at home" care and the cold stark environment of nursing homes. His Eden Alternative approach has been adopted by many traditional nursing homes, creating smaller "residences" within larger facilities. For example, if there are large populations of a particular ethnic group inside a nursing home, that facility might organize a unit around the residences, providing ethnic foods and traditions to ensure comfort and familiarity to those elders.

In 2001, Dr. Thomas received a grant from the Robert Wood Johnson Foundation to take things to the next level. He piloted the idea of the Green House. He then partnered with NCB Capital Impact, a national nonprofit group that provides capital to underserved communities. Since then there are 18 cities and towns participating in the Green House project. With 16,000 nursing homes in the United States, Green House homes have a ways to go. Their influence is growing on traditional nursing homes, in just the ways that the Eden Alternative has affected many across the country.

I have a lot of respect for many traditional nursing homes. My own mother was in one during the last months of her life and I spent a lot of time sitting by her bed, observing the hustle and bustle of staff as they care for large numbers of residents. I remember thinking about the demands on a staff to provide this kind of care. I also saw many a resident who looked lost and lonely. With the creativity of Dr. Thomas and those behind the Green House project, we can all envision a time when choices for living as we age will be as abundant as the choices we experienced at other stages in our lives.

For a local flavor to this news, consider the work of Washington Park Cares (WPC), which we have written about previously in this blog. Taking inspiration from Beacon Hill Village, our Denver-based WPC, offers services and companionship in a neighborhood setting so that those who prefer to stay at home as they age can do so with a local support system to rely on. NCB Impact has played a role helping Beacon Hill Village emerge as one of the pioneering neighborhood "villages" across the country. WPC, Beacon Hill Village and other pioneers in this field, present a regional workshop on June 15 from 9 a.m. to 4 p.m. at the Hyatt Denver Convention Center. Get details about this event or register now.

Celebrate the one year anniversary of the launch of WPC on Wednesday, June 3, 2009 at picnic area #3 at Grasmere Lake near the Franklin St. entrance to Washington Park in Denver. The festivities start around 4 p.m. For more information, visit WPC.

Featured Product: Tena Protective Underwear for Men

"At last!" I hear some of our customers breathely a sigh of relief. While everyone wrestles with the emotional and physical impact of incontinence, there are some men who fight with their loved ones helping them find solutions. And, to be fair, some of the traditional briefs and protective underwear available, is generic, not providing protection in the "right" places for men. Tena has long been a leader of specialized incontinence products. They introduced Men's Guards a few years ago; that product has become one of our most popular. Shaped specifically to the male anatomy, the guards offer extra protection exactly where it is needed.

And now Tena introduces Protective Underwear for Men which combines a style more suitable to men along with the extra protection of the Men's Guard. Find out more about this great product or purchase now.

Featured Event: Home Safety Day and Tub Fest at Capabilities

On Saturday, June 20, 2009 we are planning a festive and interesting day full about ideas and state-of-the-art products to make home safe, especially for aging relatives and those with illnesses or injuries that increase risk of falls. We will feature an array of easy-to-access tubs along with our local supplier, JRD Steam, experts in walk-in tubs and roll-in showers. We will have a number of models on hand all day that you can sit in, compare and get detailed information, including installation costs from our specialists who install.

See our price calculator to help you weigh the costs for modifying the home as you consider alternatives to living at home. Sometimes "aging at home" is the best approach and the most cost-effective.

You can also browse our large showroom and try out a stairlift, automatic door opener, adjustable cabinets and cook surfaces, lift chairs, not to mention the hundreds of smaller items designed to ensure safety and comfort in the home.

Since we are always up for a party, there will be plenty of food and prizes, too. Consider another great way to welcome summer. And perhaps you will find something just right for dad or grandpa. Don't forget that Father's Day is Sunday, June 21!

Catheters: Internal and External

In this business we handle all kinds of situations and hear about the many challenges that people face every day. We have written about incontinence previously in this blog. Today, we want to take a look at another of the many options as folks handle temporary or permanent incontinence, catheters.

Most of us unfamiliar with the world of incontinence might only associate catheters with the use of them in a hospital situation. If you have been in the hospital for an inpatient procedure of some kind, you might find that a catheter has been inserted to make you more comfortable as you recover. While generally comfortable when inserted while you are under anesthesia, inserting an internal catheter yourself can take a bit of getting used to.

Essentially, there are two types of catheters available to men - internal and external. For women, there is only the internal catheter option. There are several internal styles designed for self-insertion, the Foley catheter, straight, or coude tip. The circumference of a catheter is measured using the "French" system, typically 14FR, 16 FR, 18FR, and so on. Specialists often recommend using the smallest French possible, which they can help you determine. Catheters are attached to a bag that collects the urine, unless an individual inserts a catheter for immediate relief of a temporary condition and can direct drainage directly into a toilet or other receptacle. Leg bags strapped to the upper leg are typical for catheter users who continue their everyday activities. For those who are not ambulatory, there are bags of a larger capacity that attach to wheelchairs or beds.

• The Foley catheter is a thin sterile flexible tube that is inserted into the bladder to drain urine. Because it can be left in place for a period of time it is often referred to as an indwelling catheter. There is typically a balloon at the end inflated with sterile water to help keep the catheter in place.
• A straight catheter is designed for insertion into the urethra and features an opening at the inserted end. It is a straight flexible tube with a rounded end to prevent any trauma to the tissue.
• Coude tip catheters feature a slight bend at the tip, generally making it easier for some men to slip the catheter past the prostate. This type of catheter is also recommended for those with a narrowing of the urethra or a urethral blockage.

Insert catheters under the most sterile of conditions, including the use of gloves, to avoid risk of infection. Lubricants are also recommended to assist with insertion. Training and practice will provide more comfort to the person inserting the catheter, generally the individual him/herself.

Men also have the option of using an external catheter which operates like a condom. The external condom catheter, sometimes called a Texas style catheter, comes in small, medium or large sizes designed to slip over the penis. A drainage tube at one end connects to a bag that collects the urine.

Speak with a health care professional if you believe your condition could benefit from the use of a catheter. At Capabilities, we have trained professionals who work with individuals having a range of conditions with incontinence as a key symptom. We keep a selection of typical catheters on hand and can order specialty catheters upon request. Please contact us for more information on catheter types and availability.

Memorial Day Reflections

Pam and I come from families that have served our country. Pam's grandfather, Claude, died fighting in WWI. My uncle John went missing in hostile waters during WWII. My father, who became a citizen of this country from Canada, served in the U.S. Navy during WWII. My three brothers served, each in a different branch of the military during the 50s and 60s, and Pam's two brothers also gave years of service during the Vietnam era.

Since we opened Capabilities nearly four years ago, we are honored that so many of our customers are veterans. It is striking how much pride there is with older generations who want to tell us about their experiences and how grateful they are to have been part of the greatest military force around. Many of the men will still use their rank when they give us their contact information or write a check for their purchases. Their pride of having achieved the rank of Captain or Lieutenant Colonel swells as they walk back in time to days of heroism and competence, qualities many struggle to find in their everyday lives marked by so many of the challenges of aging.

The women are quieter about their service, although occasionally a story will spill out revealing that Mary reached the rank of Lieutenant or Captain serving in the Army, or Alice went on to play a leading role in the U.S. Navy after enlisting in the early days of the Korean War. A recent customer stationed at the Air Force Academy in Colorado Springs was on her way to a new assignment in California. She wears compression stockings for her long days of work.

Our work with the VA and other organizations that support our veterans introduces us to both the tales of glory and satisfaction as well as those of pain and suffering. Younger veterans returning now from their mid-east assignments speak to us most often of head injuries and trauma. Their limbs may be intact, but their battles now are with memory and emotional balance.

We recently featured John Garrett and Inga Tomasino who work with veterans and others addressing PTSD (post traumatic stress disorder), an ever-present outcome for so many returning from war zones. The national organization, Easter Seals, is teaming with one of our favorite suppliers of products, Posit Science, to help veterans address the more temporary, but confounding, affects of head trauma, especially the impact on long- and short-term memory. Using the Brain Fitness program to retrain the brain's ability to product essential neurotransmitters for memory and recall, Posit Science and Easter Seals contribute greatly to rehabilitation efforts of veterans.

As Pam and I honor our families and customers who have served our country so selflessly, we reflect, too, on the challenges for veterans returning from their tours of duty today. Some of our family members were killed during war, but happily our brothers all returned safe and sound. If any of them suffered from PTSD, we never knew it. Perhaps they never knew it, since in their day no one spoke of such a diagnosis. We are fortunate to be part of a culture that now has so many alternatives for respecting our veterans and helping them get back on their feet, literally and figuratively.

Thank you to all who have served to protect our country and freedoms. We appreciate you and your families very much.

Grab Bar Tip

When you are installing grab bars, be sure to work with the individual using them first to understand exactly the most comfortable way of reaching and grabbing for that person. What? you say. Imagine someone who has weak wrists trying to pull against a horizontally positioned bar. Try it and see how the wrist bends when you use a pulling action. Or for someone with weak fingers, imagine trying to grip a vertically placed grab bar. It won't work. They need something they can lean on or place a whole hand behind for leverage. Placing a bar on an angle can be helpful for someone who wants to use two hands in a climbing motion as they sit or stand in the shower or tub. If you experiment first with watching how the person you are assisting reaches and grips, the odds will be greater that s/he will actually use the grab bar.

For more on grab bars, see Kathryn's article in the Denver Examiner.

Retirement Homes Are Murder

"Remembering nothing from the day before, crotchety octogenarian Paul Jacobson must become an amateur sleuth to clear himself as a murder suspect when he finds a dead body in the trash chute of a retirement home. As Paul’s snooping and short-term memory loss get him in trouble with the local police, his new friends and granddaughter Jennifer help him solve an expanding list of crimes. Paul finds romance as he struggles to escape a murderer intent on a repeat performance."

Boulder author, Mike Befeler, launched his debut novel, Retirement Homes Are Murder, in 2007 to critical acclaim. As part of the sub-genre, "geezer lit," this book comes on the scene just as Boomers glimpse their own retirements just over the horizon.

Capabilities is proud to announce that Mike Befeler will join us for a reading and book signing on June 4 at 6:30 p.m. at our location in Westminster, CO. Come meet this author, enjoy snippets from his first novel and his most recent novel, Living With Your Kids is Murder, released in April 2009. Ask questions and offer your own "geezer" stories over refreshments.

RSVP highly suggested for this entertaining evening. You may purchase Befeler's books at Capabilities.

June is Great Outdoors Month

As we celebrate Memorial Day, we also usher in the spirit of summer. While summer officially comes later in the month, we all start imagining the fun and relaxation so associated with this great season. Getting out and about is what we do. There are many, though, whose situations keep them inside, who itch to get out, who might consider going out if they could figure out the best ways to do this. Help someone get mobile this month. Offer a hand, a ride, a wheelchair, a scooter, or a ramp! Let Capabilities help you and those you care about enjoy the summer. We have dozens of affordable ideas.

We also have rental equipment. This helps you and those you care about try things out first, or dip the proverbial big toe in the great outdoors without investing too much. We have a huge fleet of wheelchairs, walkers, scooters, ramps and RollerAids, the terrific knee walker that you can use as an easy alternative to crutches.

Happy Memorial Day!

What are you up to this summer? Share your ideas and suggestions. Post a comment at the end of this blog.

Featured Product: Nuwati Teas Iced

It is warming up rapidly here in the Rocky Mountain State as it is in so many places. I have great memories of Aunt Emily's iced tea, brewed on the back porch in the sun with plenty of lemons. Aunt Emily used the popular black tea in bags so common to many of us Boomers. I have learned a lot about tea since those delightful and carefree summer days of long ago. And, while I still enjoy a tall glass of regular old iced tea now and again, I especially am fond of iced herbal teas. We have written in this blog of the healing effects of tea, of the many types of tea we carry at Capabilities, of the terrific suppliers we have partnered with to ensure a rich and interesting mix of teas on our shelves. But it is nearly summer again and I am drawn to tell you about a few of my favorite Nuwati tea selections that work especially well over ice.

Cloud Walking Tea: Enjoy this yummy brew when you are feeling especially anxious or worried. Sip it before you wind down at night, or on a Sunday afternoon when you don't have to drive anywhere or mow the lawn. Created from eleven herbs and roots, including catnip (!), a glass or two of this iced tea will calm even the jitteriest among us.

Laughing Coyote Tea: This is one of the newer additions to the Nuwati collection, mixed to ensure a mood enhancing experience. Maybe it's the stevia or rooibos or the incredibly unique combination of over 20 herbs, roots and fruits that makes you happy, but make no doubt, Laughing Coyote Tea makes you happy!

The Healer Tea: This is the most popular of the Nuwati collection. You can use this tea in two ways. Shake the bottle and sniff. Wow! Talk about clearing your sinuses. Then you can make some (hot or iced) to sip on. This combination of herbs not only helps the immune system, but you can use it effectively to combat headaches. Some folks even mix it with favorite foods and drinks. Dr. Pepper?!

Learn more about Nuwati teas or make a purchase.

Four Companies Work Together to Give Back to Senior Community

Capabilities, Interim HealthCare Inc., Elder Wellness LLC, & Colorado Seniors Resource Connection have developed a quarterly health educational series that provides a valuable benefit for the communities they serve and is consistent with their common commitment to consumer education. They believe education is a valuable part of their mission to improve people’s lives.

The first of these health educational seminars will be held on Thursday, June 11th at
5:30 p.m. The seminars will be held at Capabilities located at 6805 W 88th Ave. (at Pierce St.) in Westminster. This event is free and open to the public. Refreshments will be served. The highlight of the seminar will feature a key note guest speaker. Yvonne Baca, President of the Board, Rocky Mountain Stroke Association will talk about education, awareness and living with stroke.

“A stroke is a very serious medical condition that can make life difficult for everyone involved” said Interim HealthCare Inc. program manager Jake Rankin. “Our hope is to get involved in the communities and create awareness for many of the medical conditions that face people today. Thankfully the healthcare community here in the Denver area is the best and most caring group of people I have ever seen”.

For additional information, please contact us. You can call us at 720-214-0339.

Kathryn Arbour Selected as Denver Mobility Products Examiner

Have you seen http://examiner.com/ yet? If you are on the hunt for information on just about any topic, you won't be disappointed on this website. Organized by city, category or topic, the site is fueled by writings from "Examiners," folks who apply as experts in the various fields represented. In my case, I suggested the field of expertise since Examiner had not yet created this category of Mobility Products Examiner. My job is to write about mobility equipment and tools for independent living, areas I know about through our wonderful experiences here at Capabilities. Check out my very first article posted just this week. Please comment and pass around to those who might find the information useful. If there are specific topics you would like to read about or have discovered a "not to miss" product, be sure to contact me. And, if you would like more information about how to become an Examiner yourself, I would be happy to give you the details. Send me a note and some contact information and I'll be in touch.

Risers: A Simple Solution to a Challenging Problem

In the past couple of months we have seen a number of families struggling with conflicting realities. A loved one needs some additional assistance, but the budget is shrinking and money has to go further. We recently worked with two families whose loved ones can no longer get up from a seated position very easily. Once in a chair or on the couch, they usually stay there until it's time to go to bed. This creates all kinds of issues, slightly different for each one, but worrisome nonetheless.

The simplest solution in these cases is a reclining lift chair. In these times, however, it is not always the least expensive approach. Capabilities, however, is offering affordable lift chairs in its newest spring collection. Be sure to stop by if you are in the Denver metro area to check them out. When the lift chair is beyond the budget, however, there is another approach - risers.

Available in different sizes, risers give you the flexibility to raise furniture to different heights, creating the same effect as a lift mechanism in a chair. Often by raising the back of the chair several inches higher than the front, you give the individual in need the height needed to lift more easily and gently from the chair. You can anchor the feet of the furniture to the risers for extra safety and protection. Risers can also be used to lift a bed to a height suitable for caregiving.

There are also portable lifting mechanisms you can purchase to put on a chair or sofa that are sized by weight. These are available in hydraulic or electric versions.

Capabilities offers an array of choices for most situations. Please consider us first as you look for a partner in solving some of life's challenges with you or your loved ones. Tell us about some of your favorite products for caregiving or coping. We love sharing good ideas or letting others know about the ones to avoid.

Lifting Solutions For Caregivers

You already know how many potential pitfalls there are when caring for someone, whether by profession or as a family member. You usually stumble into most of them if you are not a caregiver by profession. Even professionals come upon some surprises.

One of the big issues to confront as a caregiver is lifting, especially if the individual under your watch is not ambulatory. However, some of the more serious injuries occur with individuals who have some ambulation; it is easy to let your guard down as a caregiver when you believe that someone can usually make a transfer from one location to another fairly easily.

Of course, preventing falls to the individual under your care is essential. Your own health and safety are also of primary importance. Keeping those outcomes foremost in our minds, let's look at various options for assisting with a lift or lifting the individual.

For assisting with transfers from one location to another consider these common, but essential tools:

• grab bars and other support poles that can be placed around the home


• transfer boards, benches and disks that allow the individual some control over his/her movements and are typically used for bathing, moving into or out of vehicles, chairs or beds


• gait belts which can be placed around the individual to provide a wide, safe area to grab onto and hold while someone is trying to walk; handles are available to use with the gait belt to make the process even easier for the caregiver; vests and other devices are becoming more common to ensure even more support while assisting an individual to a standing position

For lifting someone who is not ambulatory, it is prudent to use one of the following types of patient lifts:

• "Hoyer" so named for the company that first manufactured the lift that was patented in 1955 by R.R. Stratton as "floor crane with adjustable legs." The patent uses the analogy of an automotive crane used to lift engines. This type of lift uses a sling (often the sling used depends on the physical situation of the individual needing it, for example, an amputee sling, or the reason for the usage, such as a "toileting" sling that has an opening to allow the individual to be lowered onto a commode or toilet.


• Stand-assist lift, which cradles the back with a sling and provides reinforcement and padding at the legs and knees while the caregiver pulls the individual forward into a standing position. The advantage of this lift is for those who cannot bend easily, or who have an adverse reaction to be lifted in a seated position as happens with the "Hoyer."


• Easy-Pivot lift, which we have blogged about previously. Developed by a Coloradoan who became a quadrapeligic as a young man and resisted what he called the indignities and discomfort of the "Hoyer" for both himself and his caregiving wife. This lift works with an individual already in a seated position, requiring a sling beneath the buttocks and around the knees. The individual "drapes" over a padded front piece and is safely lifted and moved to another seated position. It works well for those with little to no leg movements or strength so cannot easily be lifted to a standing position.


• Ceiling lifts have become increasingly more popular as individuals are cared for in the home. The other lifts mentioned above have wide (mostly adjustable) bases that can be altered somewhat to fit around chairs, beds and commodes. However, they are often too wide for use in a home, especially a smaller home, and cannot be used effectively to transfer someone to most bathtubs. Ceiling lifts can be mounted in every room of the house, including some that offer a track to connect through doorways. The patient or caregiver controls the movement of the lift along the track with a remote.


• Freestanding overhead lifts offer a more convenient and often less expensive way to provide some of the same advantages of a ceiling lift. This A-framed mechanism is placed over a bed or between transferring locations. It is most useful for lifting and transferring individuals who are not moved among widely divergent places in the home since the frame has limitations.

Caregiving is hard, and sometimes dangerous, whether you do this work professionally or as a family member or friend. Please remember to honor the two key principles of preventing falls and further injury to the individual you are caring for AND preventing injury to yourself. Be smart about lifting and consider using some of these tools. Let Capabilities help you assess the situation. We do free home assessments to work with you and your family on what solutions might be best. Contact us for more information. Please post your ideas on caregiving and tools you have used using the link provided below or sending us an email.