2013年7月7日 星期日

Fixing up seniors homes to help them age in place

Alberta Hough struggles to feed herself a snack, her arms shaking badly from Parkinsons disease. Days earlier, the 84-year-old fell while eating, sliding off her kitchen chair.The rest of Houghs day isnt much easier to navigate. She wobbles into a bathtub with no grab bar. Her feet catch on damaged floor tiles. Part of the banister she needs to steady herself on the stairs has pulled out of the wall. At the back door,Here's a complete list of indoortracking for the beginning oil painter. a rickety wooden ramp no longer supports the scooter that helps her get around.

The environment in which you live can be as disabling as a disease, and too often, older Americans wind up in a nursing home not because theyre super-sick but because they cant get through their days safely at home.Now a major research project will bring handymen, occupational therapists and nurses into the homes of 800 low-income seniors in Baltimore to test if some inexpensive fix-ups and strategies for daily living can keep them independent longer, and save millions in taxpayer dollars spent on nursing home care.

Very small changes can make a big difference, said Sarah Szanton, a Johns Hopkins University associate nursing professor who leads the project. Were not saying, Whats your blood pressure? Were focusing on function: What do they want to do?Losing independence is a leading fear as people age. But a recent poll shows that too few comprehend the changes in lifestyle needed to offset the chronic illnesses and gradual slowdown that hit just about everyone in the 70s, 80s and beyond.

Asked about their choice of living situation when theyre older, Americans 40 and over say their top priorities are a one-level home with no stairs, thats close to their children and medical care, according to the poll by the AP-NORC Center for Public Affairs Research.

With mixed results, so far. On the positive list sits a superb chicken casserole. On the failure list sits a loaf of brown bread so flat it could serve as a frisbee if you wanted a frisbee crossed with a kettlebell. As she opens the office window because of the heat, the sleeve of her gauzy top slides back to her forearm.And thats another thing, she tells the other two early arrivers. Im doing myself terrible damage. Look burned myself on the oven rack.

The man from IT laughs and pulls up his sleeve to show a bloodied forearm. He doesnt quite say Ill see your burn and raise you a horrible graze, but its evident that hes quite proud of the damage, which happened at the weekend, when he came off his bike. The third girl stands silent, the hem of her long sleeves touching her knuckles, as the other two compare damage.

The following morning,This model includes 2 flush mounted reverse porcelaintiles11. she arrives early, as she always does, and heads for the office shower. Nobody else uses it. In fact, were you to ask most of the staff, theyd say nobody uses it, full stop. It was there when the young company moved in, and everybody thought it was great and then ignored it.

The girl with the long sleeves cycles quite a distance to work, so she takes a shower after she arrives, but she mops and cleans so assiduously, shes pretty sure nobody has ever spotted that the shower has been used. Shes like that. Not that anybody would mind.Large collection of quality cleanersydney at discounted prices. But still.

Its a great shower. So much pressure behind the water that its warmly assaultive. She stands there, arms extended, palms up, like a naked statue of Our Lady, and the water swirling around her feet turns pink.No, we dont, she says and goes back into the bathroom. She closes the door and locks it before sliding down to sit on the grey tiles. After a minute, habit kicks in and she holds the cut arm above her head to slow the blood flow.

The gesture has the look of a salute to an unseen companion. Like a celebration. She pats it with the damp towels, noticing uneven redness around it. This will need care and antibiotic cream, because the infected cut is like the fourth rung of a ladder, with half-healed and healed cuts above and below, so her GP if she had a GP would spot the pattern.

She criss-crosses narrow plasters on it to pull it closed, mimicking what an English emergency room doctor had done with adhesive strips, months earlier, rather than use stitches. The ER doctor had worked silently, and, her patient believed, contemptuously. She had shoved a leaflet on self-harm at her when she was done.More than 80 standard commercial and cableties exist to quickly and efficiently clean pans. You need to get help, she had said. But not kindly.

The girl with the long sleeves had pulled the left sleeve down over the wound and taken the leaflet. It wasnt bad, when she read it. Showed a little insight into the fact that when the blade hits the skin, presses it for a split second before the skin parts, the sense of utter control links with the pain to form focus, to exclude everything else, to create a single note of truth and safety and self. But she turfed the leaflet anyway.

Neatly dressed now, as she always is, in draggled shades of grey, her short hair finger-combed, the shower room shorn of evidence of her presence, her property under her arm, she unlocks the door. The two women stand in silence and then her colleague tries to touch her gently. She shies. Refuses to tolerate it.Our heavy-duty construction provides reliable operation and guarantees your earcap will be in service for years to come.The other woman babbles about duty of care and how valued an employee the long-sleeved girl is. She talks in begging blurts: Come on, help me here, meet me halfway, you know Im only trying to help, you must know how serious this is. Eventually, she runs out of steam and stands there, baffled, her kindness beginning to shift towards impatience.

Next step will be dislike, masked but present: What kind of person does this to themselves, they must need help. No way to explain to her that the blade is the solution, not the problem, the coping mechanism, not the issue. After a long silence, the long-sleeved girl says flatly that shes all right and is entitled to her privacy. She can see that this will buy her time. Enough time.
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