Mission: To educate and improve the experience of aging for mature adults and their caregivers.

In-Home Care

Drowsy Driving Spells Danger

Tuck Sleep took on drowsy driving as a part of our larger initiative to increase sleep awareness worldwide. Our aim is to provide the most comprehensive sleep portal available online that covers everything from sleep disorders to sleep product information and we certainly had to cover this topic given the impact it has on society and the lack of quality coverage and information available online.
Some of the key takeaways from the piece include:
  • Young adults ages 18-29 have the highest likelihood of being involved in a drowsy driving accident but everyone is impacted
  • Driving with at least one other friend or occupant in the car dramatically reduces the risks of drowsy driving incidents
Check out the piece here and pay close attention to the drowsy driving prevention tips as well as the driver resources towards the bottom of the piece.

Agnes Green is a researcher for the sleep science hub Tuck.com. She holds two masters degrees in the social sciences from the University of Chicago and Northwestern University. She sleeps most soundly after a kettlebell workout in Portland, Oregon.

PO Box 61293 | Seattle, WA 98141-6293

Tuck Sleep Foundation is a non-profit community devoted to improving sleep hygiene, health and wellness through the creation and dissemination of comprehensive, unbiased, free web-based resources. Tuck has been featured on NPR, Lifehacker, Radiolab and is referenced by many colleges/universities and sleep organizations across the web.

Diane’s comment:  Older adults dealing with chronic conditions and taking multiple medications will want to be especially careful. Anyone with sleep apnea will be at risk. Sleep is the state that restores the body so a nap in the afternoons for even 15 minutes helps to reset the brain so it will be more efficient. Driving for long periods of time without stretch breaks is a bad idea for seniors as circulation is affected which impacts the brain and driving decisions.

Homebound Services Offered by the St. Louis Library

In home caregiverHomebound Services Offered by the St. Louis Library

The St. Louis Library offers many programs available to homebound seniors. If a person is unable to visit the library due to illness, age or disability or other extenuating circumstances, the library will mail materials. They might include the latest fiction, classics or cookbooks, music, movies and more. This service is also available to the caregivers of someone who is homebound. The items will arrive in a zippered bag with a label for returning materials to the library when finished.

The Homebound Service staff will call and discuss what interests you. You may choose your material or have them selected by the staff. Items must be returned after 4 weeks. There are no overdue fines for Homebound Service users.

To sign up, call the Outreach Dept. at 314-994-3300, ext. 2333 or fill out an online request form at www.slcl.org/outreach/homebound_service. You will receive an application to confirm eligibility. You will need a library card. If you don’t have a library card, the Outreach Dept. staff will be happy to assist you in obtaining one.


Other Services Offered to Seniors at the St. Louis Library System.

Book A Librarian – This program allows a senior to bring in their laptop or ipad and in a 30-60 session, the librarian will show them how to download e-media in the library. If the person is in a senior living facility, they can contact their Activities Coordinator to arrange a session. Otherwise, call 314-991-3300, ext 2050 to set an appointment.

Book Discussion Kit – For residents in a senior living community, the library will send book discussion kits to their facility. Each kit will contain books on CD, and large print books. Call Outreach at 314-994-3300, ext. 2333 for more information.

Bookmobile Service – Bookmobiles will visit senior living facilities. To schedule a visit, email at outreach@slcl.org or call 314-994-3300, ext. 2333.

Special Programs – A Senior Programming Specialist presents programs for resident of nursing facilities, independent and assisted living centers, adult day centers and other qualified organizations. They are designed to stimulate social interaction based on life experiences using audio, tactile and video materials. To schedule a visit from a Senior Programming Specialist, call 314-994-3300, ext. 2335.

Call the Outreach Department staff to learn more about senior programming.

The Most Important Quality in a Caregiver

In home caregiverWhat is the Most Important Quality in a Caregiver?

If you are a caregiver of an aging parent, the most important quality you can have is the ability to be observant. As a caregiver you observe subtle changes in condition, unmet needs and unexpressed wishes so that you can make changes to ensure a greater quality of life for the person for whom you are caring. Some caregivers will come and sit with their charge watching TV and getting meals. Others will anticipate activities that will stimulate memories, enhance brain function and keep the body active so that they are able to maintain their charges mental and physical well-being. That can only happen when the caregiver is observing and being proactive about the person’s needs. When they are observant, they can see changes in behavior or condition that may initiate a visit to the doctor and allows them to provide a verbal dialogue about changes they have seen.

Activities to Enhance Body and Spirit

What are some of the activities that enhance body and spirit? Enjoy nature together in a park or preserve even if it is only sitting on a bench watching squirrels, birds and other animals. Play board games or think of words starting with a particular letter; read the paper or a joke book. Review photo albums from earlier in the person’s life and ask them to tell you what it was like growing up at that time. Write a memoir for the person telling stories that they want to share about their life. Take a video of them telling a story. Sing songs or play music that they like. Dance or have them show you a dance that they did when they were younger. Do a project together like bake cookies or craft a poster with pictures taken from magazines about an ideal vacation. Then have them talk about their favorite vacation. Ask the person what they like to do. Plan to visit sites of interest in the town in which you live. Find out where free concerts are being given. Put together a picnic. These are just a few ideas of ways to increase reasons for enjoying life.

An older adult may require more down time so you will have to tailor activities to their abilities and energy levels. Listening, showing interest in what they have to say, and demonstrating they mean something to you will enhance your relationship, validating them and their purpose for being here. Encourage them to do as much as they can by themselves. Offer choices between several options so that they feel that they have some power over their own life. Ask for their preferences and opinions as often as possible.

Being observant and proactive will forge a trust and build a relationship that will more than pay back your efforts.

How Much Can A Fall Cost You?

Falls Carry a Heavy Cost for Seniors

Mrs. M. was carrying a basket of laundry down to the basement. Her foot slipped on the steps and she went head-first landing at the bottom of the staircase on the concrete. She had broken her leg and hip and could not move. She laid there for a day and a half before someone found her. As a result, she is now in an assisted living center. Mr. V. fell in his bathtub and lay on the bottom for two days before EMS came. He had severe pressure sores, hypothermia and never recovered from his fall. Here are some famous people who died from falls:  George Burns, David Brinkley, Katherine Graham and David Atkins. Despite wealth and being famous, a simple fall brought them down. It is no wonder, many seniors have a fear of falling.

Let’s review some of the statistics about falling?

  • The mortality rate from falls has been deterCOPD Patientmined to be 67% when lie times were more than 72 hours as opposed to 12% when lie times were less than one hour.
  • Of the patients who were found alive, 62% were hospitalized and approximately half required intensive care.
  • Over 13.3 million people 65 years and older will fall this year…that’s every 2.3 seconds on average.
  • About half of older adults cannot get back up without help.
  • Falls account for over 60% of all nonfatal injuries in the ER in the 65+ group
  • This group is 3 times more likely to required hospitalization than a younger person.
  • Fall risk is highest during the first two weeks after discharge from the hospital as compared to three months later.
  • Older adults with diabetes have a higher rage of falling than the general population.
  • Of all nursing home admissions, 40% are related to falls
  • Of those who break a hip:
            •      – 90% were caused by a fall
            •      – 50% will become dependent upon a cane or walker
            •      – 40% will require nursing home admission
            •      – 20% will die in one year

**These statistics were taken from The American Academy of Orthopedic Surgeons website.

What are the risk factors for a fall?

  • History of falls
  • Arthritis, Diabetes, Parkinson’s
  • Problems with gait & balance
  • Visual deficits
  • Incontinence
  • Osteoporosis
  • Environmental causes
  • Medications (4+)
  • Familiar behaviors that are now unsafe

What can a person do to counter their possibility of falling?

Falls can be prevented by initiating a fall prevention program. Some of the elements of this program address:

1.  Balance problems

2. Mobility issues

3. Multiple medications

4. Low blood pressure

5. Sensory deficits

6. Home hazards

Ask yourself these two important questions:

1. If you were to fall tonight, would you be able to get up?

2. If you were injured and couldn’t get up, how would you get help?

 What You Can Do:

There are many things that you can do to prevent falls.

  • Exercise 3-4 times per week using a mix of low-impact, weight lifting and core building, and stretching.
  • If you have had a fall, consider getting an emergency response system that will allow you to obtain help if you need it. There are systems that will detect falls whether you can press the button or not.
  • Do a home safety check and remove items that could pose a fall hazard. i.e. loose throw rugs, stacks of items on the floor, cords in traffic patterns, etc.
  • Get physical therapy if you notice your gait changing. Gait is predictive of future mobility problems.

You can be proactive in avoiding unnecessary falls and preserve your independence and autonomy.

How to Select an In-Home Agency

In home caregiverHere are a few steps to selecting an In-Home Agency

When you have determined that your loved one needs help in the home or perhaps they are coming home from the hospital and can not manage things by themselves for a few weeks while they recover, here are a few tips  in making a selection. Determine what services you need before calling the in-home agency.

  1. How long have they been in service?
  2. Are they a companion or medical company?
  3. Are they an agency or registry? Agencies screen, train and supervise the aide while Registries screen, train and place a caregiver who contracts directly with the family or patient.
  4. How are aides paid?  Who pays the taxes? Who carries liability insurance?
  5. How are caregivers screened?
  6. What kind of training do they receive?
  7. What kind of supervision?
  8. What happens if there is a caregiver that does not work out?  Can you get a replacement?
  9. What are the basic services they provide and what services incur additional charges?
  10. Do they provide transportation to necessary appointments?
  11. Ask for references from clients.
  12. What is the backup plan if someone can not make it to the client?

Never place a home care company in charge of paying bills.  That can set up an unhealthy situation fraught with abuse. Don’t expect home care workers to do extensive housekeeping.  They are there for light housekeeping and overseeing care of your loved one.  Ask the aide to write down what happens every day in a nurse’s notebook. Then you will have historical data regarding habits and health.

My Gluten Allergy Experience

WheatDiane Keefe shares her personal experience with gluten allergies

Recently I discovered that I had a gluten allergy.  It came about when my daughter was diagnosed with Celiac’s disease – that is the more extreme form of the allergy.  When my daughter explained that it is genetically based so it had to come from one of her parents, it became clear it was me.  I am gluten intolerant.

Those with Celiac’s disease have problems with cross-contamination meaning that if their food comes in contact with surfaces where wheat has been present, it causes a reaction in them.  They are likely to experience extreme fatigue, depression, diarrhea for weeks at a time and brain fog.  They must take supplements because their bodies have been malnourished due to the gluten inflammation in the intestines of their body.

My symptoms of gluten intolerance were mental fogginess in the mornings; frequent fatigue, pain in the entire body, extreme cravings for food, and intermittent diarrhea.  I thought it was just part of the process of aging.  I was wrong.  My other daughter told me about the ‘whole 30 diet’ or ‘caveman diet’ that she and her co-workers were on.  They were allowed to eat vegetables, fruits, meats, fish, poultry and nuts..  It was suggested that they limit caffeine to one a day and avoid corn, potatoes, dairy, sugar and other high starch items.Fruits and vegetables

Here’s what happened.  After 30 days of eating that way, my body became very purified and I was encouraged to add foods back one at a time to find out to which foods I was allergic.  What I found was that I no longer was tired all the time; my cravings (even to chocolate) had disappeared.  I had had incredible cravings during the day causing me to eat every couple of hours or my blood sugar would drop too low.  Now I could go longer periods of time without eating. In fact, my body pain had diminished significantly; 17 pounds fell off my body and I was not hungry as I could eat as many vegetables as I wanted.  My brain was clearer than it had been in years…no more morning fogginess!  I was more flexible and felt like exercising more.  My body seemed to reshape and I no longer had a big belly.  Suddenly, I was feeling better about myself.

One of the reasons that wheat has become such a problem and that we will be hearing much more about it in the future is that it has been so genetically modified that it no longer resembles the original wheat kernel and it passes the blood brain barrier!  In an effort to feed the world’s population, scientists made a wheat kernel that could provide greater yield.  It created a greater yield in humans as well in the way of bigger bodies.  By passing the blood brain barrier, it created debris on the brain and interferes with brain processing.

When I have accidentally eaten something with gluten, the next morning, my brain will be in a fog and processing very slowly.  I get agitated easily if I feel like I am being pressured or pushed to move quickly.  Sound familiar?!  My mother had Alzheimer’s and many of the Alzheimer’s behaviors are similar in that they do not like to be pushed or pressured and have limited ability to cope.  They no longer think clearly.  We are just now beginning to understand how gluten is affecting the brain.  In my parents’ generation, it was not recognized as a condition and, frankly, people were not living as long.  However, we are now living longer but not necessarily better if our brains are not able to process well.  We may need to do more research on how our food is affecting our health and quality of life.

I challenge all readers to go on a cleaner diet and stay away from packaged foods…especially wheat containing foods.  Find out what your body needs and then follow that diet.  We are not all a standard unit…our bodies are different and we need to explore what they need to perform well.

In the St. Louis area, you can find many restaurants now offering gluten free menus.  However, if a person has Celiac’s, they are advised to avoid restaurants that are not totally gluten free because chefs and servers often do not understand the gluten cross-contamination issues.  I have discovers, Andrea’s Online, New Dayon Manchester Rd. in Ellisville, Wolf’s Restaurant on Clayton Rd. and there are more.  We need to spread the word to increase the number of places where you can eat out.  A point of caution:  the best practice is to eat at home.

To find out more:  http://celiac.org/

‘Whole 30’ diet   www.whole30.com

Finding the Right Diet for Stroke Prevention

Fruits and vegetablesFinding the Right Diet for Stroke Prevention

Written by M. Ferdinand, writer for DrugNews.net.

For those who have suffered a stroke, preventing another is top priority. A diet full of healthy foods can help control blood pressure, body weight, and many other risk factors. When choosing a diet beneficial to stroke prevention, keep the following information in mind:

What to Avoid

Cutting the following items completely out of your diet is inadvisable, as both cholesterol and sodium are required for your body to function correctly. However, limiting them is one of the best ways to control cholesterol levels, high blood pressure and weight.

Saturated Fats

A diet high in saturated fats may cause high cholesterol and an increased risk of cardiovascular disease. Saturated fats are:

  • Often solid at room temperature
  • Found in animal products such as meat, cheese, egg yolks, butter, and ice cream
  • Found in some vegetable oils such as palm, palm kernel and coconut oil

Trans Fats

A diet high in trans fats is also associated with high cholesterol and increased risk of cardiovascular disease. Food products containing partially hydrogenated vegetable oils should also be avoided.

Trans fats are found in:

  • The majority of fried foods
  • Stick margarine
  • Anything made with partially hydrogenated fats
  • Vegetable shortening


Another important step in controlling high cholesterol is watching the cholesterol content in your diet. Here are seven great ways to do just that:

  • Cut back on how often you consume meats, poultry and other animal-derived foods
  • Limit meat portion sizes to 3 ounces
  • Trim the visible fat from meat
  • Remove the skin from poultry
  • Choose nonfat or low-fat dairy foods
  • Limit butter
  • Eliminate lard


Many of us eat far more sodium than we need. Too much sodium can cause an increase in blood pressure as well as fluid retention. Limiting sodium intake can be achieved by:

  • Not adding salt to foods at the table
  • Substituting herbs and spices for table salt
  • Using fewer processed and canned foods
  • Choosing snack foods wisely

Potentially dangerous medication

If you are at risk for stroke, chances are you’ve been prescribed a blood thinning medication. Pradaxa is one of these blood thinners facing lawsuits for dangerous side effects such as internal bleeding resulting in unprecedented deaths (due to the lack of a reversal agent). Make sure you stay informed, and avoid dangerous medications like this one.

What to Enjoy

Prevention diets aren’t all doom and gloom. There are tons of delicious, healthy foods available for your enjoyment!

Foods Rich in Fiber

Fiber is perfect for stroke prevention as it can reduce cholesterol and your overall risk for cardiovascular disease. High fiber intake can also help control blood sugar, promote regularity, and prevent gastrointestinal disease. Try the following foods to up your fiber consumption:

  • Whole grain cereals and breads
  • Whole wheat pastas
  • Oatmeal
  • Raspberries, pears and apples
  • Barley
  • Bran
  • Brown rice
  • Beans
  • Almonds, pistachios and pecans
  • Artichokes
  • Peas
  • Broccoli
  • Brussels Sprouts
  • Sweet Corn
  • Carrots

Foods Loaded With Potassium

Recent studies show that reducing sodium intake and increasing potassium rich foods in your diet can reduce high blood pressure. Furthermore, there are some really tasty options when it comes to getting your daily dose of potassium.

Try the following foods:

  • White Beans
  • Spinach
  • Potatoes (with skin)
  • Dried Apricots
  • Baked Acorn Squash
  • Yogurt (Plain, Skim/Non-Fat)
  • Salmon
  • Avocado
  • White Mushrooms
  • Bananas

Foods Stuffed With Magnesium

Another study found that increasing magnesium intake by 100mg per day can reduce your risk of stroke by 8%. You can find a high concentration of magnesium in the following foods:

  • Halibut
  • Mackeral
  • Boiled spinach
  • Bran breakfast cereal
  • Almonds
  • Cocoa
  • Bran breakfast cereal
  • Almonds
  • Cashews
  • Pumpkin seeds

Foods Bursting With Omega-3 Fatty Acids

Eating more fish is a great way to cut down on consumption of red meats and poultry, which is helpful in controlling your cholesterol. Besides the aforementioned benefit, fatty fish are chock full of omega 3 fats which improve blood flow by reducing inflammation in the arteries and making blood less likely to clot.  Here are some great sources of omega-3 fatty acids (even some non-fishy ones):


  • Salmon
  • Halibut
  • Sardines
  • Scallops
  • Shrimp
  • Flax Seeds
  • Walnuts
  • Soybeans
  • Tofu

Foods Packed With Antioxidants

Antioxidants benefit the circulatory system by reducing inflammation, preventing plaque build-up in the arteries, and improving blood flow by helping blood vessels dilate.  These delicious fruits are loaded with antioxidants:

  • Blueberries
  • Cranberries
  • Blackberries
  • Raspberries
  • Strawberries
  • Cherries
  • Prunes
  • Plums
  • Apples

Taking the appropriate steps to control your cholesterol, blood pressure and other stroke risk factors isn’t always easy. However, when the end result is a longer, fuller life, the price is a small one to pay.

Caring for Parents Together



Madeline Ferdinand is a writer for DrugNews.net. She likes to play card games and go on walks with her mother who had a stroke two years ago.

Transport Options in St. Louis

St. Louis Transport Options:

  • Mobility 4 U     Mike Flotken   Mike@Mobilityforu.com      www.MobilityforU.com     (314) 873-6814   (rental vehicles with side ramps)
  • OATS Transportation Service   636-441-0898   www.oatstransit.org
  • American Cancer Society   314-286-8100    (cancer related treatments and appointments only)
  • EMT   314-781-6400    www.express-medical.com   (Automobiles, stretchers and wheelchair accessible vans)
  • Continuum    314-863-9912   (24 hour advance notice required)
  • Mideast Area on Aging  314-615-7418  CORE  Transportation Program
  • St. Louis Area Agency on Aging – 314-612-5900   SeniorCenter Transport Program
  • Disabled American Veterans (DAV) 314-289-6443
  • Medicaid Non-Emergency Transportation 1-866-269-5927
  • Most hospitals and some medical offices provide transportation to doctor’s appts.
  • Seniors on the Fly, Vicki Fieman, 314-591-9911, Website: seniorsonthefly.com.  She charges $15 per hr with a two hr min. 2nd person add’l $5 per hr. utilizing a 4 door Sedan. Easy access. She stays with the client during the call.
  • OASIS  314-539-4555  (They offer Stretcher van, Paralift or Van)
  • Metrolink  314-231-2345
  • Point of Change Ministries Transit Services   Norma Brooks, Exec. Dir,Eric Harris, Dir. Of Transit, 314-863-6484   Available M-F  7 a.m. to 6 p.m. and Sat. 9 a.m. to 1 p.m.  No Sundays.
  • Dave Harris, CNA and Missouri Class E Chauffer License 314-721-7464  (Charges $20/hr with a minimum of 2 hours.  Honda Odyssey 2007 Mini Van, Living centrally in Clayton/University City area; will travel a 25 mile radius of home. Will stay with the client until finished
  • Mary Go Round, Don Rose, 636-207-8743, cell:  314-223-6327,  ridemgr@gmail.com.  Provides transport to medical appts.
  • St. Louis Cab Company  314-993-8294   ($2.50 first 1/10th mile; 17 cents each additional mile; $2.00 fuel surcharge.  $22.00/hr waiting time)
  • Some communities offer transportation.  Check with your city government
  • Some churches provide transportation if you are a member and most senior resident facilities offer transportation.

Compliments of Caring for Parents Together, 314-484-8623


Verify these charges before making transportation arrangements as they may not be current.  However, I did call most of these numbers to make sure they were still active.

Brain Health

View this video for Tips to Better Brain Health!

How to Assist Your Aging Parents Without Intruding

Notice That Your Parent Is Not Quite Together?

As you sit around your family table during the holidays, you may observe that your parent is just not operating the same way they used to. Maybe they are more forgetful or rattled. You may notice mail stacking up or the house isn’t as clean as it used to be. Ask yourself, ‘Are they safe at home alone?’ You may conclude that you should offer to help but before you start to take over their affairs, consider getting the situation assessed by a professional. Ask your parents if there are some things that you could do to help. Suggest that it is alright to hire some of the tasks out now. In fact, volunteer you and your children to come over once a week to visit and help out. This not only gives the children a sense of being helpful and needed but also provides time with an older adult for some intergenerational bonding.

Fear of Losing Independence and Autonomy

Older adults are afraid of losing their independence and autonomy. They are fearful that if someone notices that they are not able to handle their own affairs, their children will take over and they will no longer have any control. Their fears are not unwarranted. Many children will come in and just take over. This makes an older adult feel helpless and unneeded. They need a sense of purpose. What can they do now with changing conditions? Sometimes, just having supports put in place can make a difference.

Lack of Visitors

Many older adults have few visitors. The people they have associated with in the past are aging too and may not drive any longer. Just one visitor a week can make a difference and give them something for which to look forward. I can remember visiting an elderly neighbor when I was a child. She would set out magazines for us to cut pictures and make collages and posters. We would have a creative afternoon with her with cookies and KoolAid. It was fun for us and she looked forward to it as well. As I have moved around the country with my family, the substitute grandparents made a big impact on my children. Older adults have much to offer and stories to tell. Teens will often bond with an older adult when they are at odds with their own parents. Set up regular visit times so they have something to look forward to doing.

Job Jar

If you truly want to help, ask them to make up a list of things that would be a big help to them. Then choose the tasks that you can do and make a set time when you can do them. Some tasks that may have been easy in the past are no longer easy for your parent such as cleaning out gutters; raking the lawn in the fall; trimming trees and completing some repairs. Keep them involved as much as possible and allow them to do as much as they can. Treat them with the same dignity and respect that you would want.

Fear of Driving

As adults age, they may not feel as comfortable driving in inclement weather but still may need to make that trip to the drug store or grocery store. There are many places that deliver now. Check to see what is available in their area. Offer to take them where they need to go or hire someone to do it. This may be a way to earn money for a grandson or granddaughter who has not had their license that long and needs the experience of driving. They will be less likely to drive recklessly with an older adult in the car.

Concerned But Don’t Live Close By?

If you don’t live close, hire a Geriatric Care Manager who lives in their area and knows all the resources. They will conduct an assessment and give you an accurate picture of how things are working out for your parents as well as what they will need from you. You can then decide how to proceed. You may also want to pick up a copy of the local Older Adult Resource Guide. The Area Agency on Aging or United Way will know where to find this information.

Stay Connected

Diane is currently available for speaking engagements. For fees and scheduling, call 314-484-8623. To send an email, please click here.


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Alton Heart/Stroke Fair

Feb. 4th, Saturday 8:30-noon, Alton Memorial Hospital

May 17th, Caregiver Support Group Presentation, Chesterfield Villas

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