A Golden Opportunity

The age distribution of the American public is changing. Healthier lifestyles and medical innovations have increased the longevity of the American population. Our citizenry now includes not only higher percentages of senior Americans, but greater numbers of elderly members who are living well into their 80s and 90s.

Unfortunately, medical technology and healthier lifestyles have not solved all the problems related to longer life. Many who reach significant seniority find that they need various degrees of assistance and companionship in their daily activities. The growth of the nation’s elderly population has coincided with an increase in dual-career and single-parent households. In the past, grown children would absorb aging parents into their households. More recently no such households exist. If an adult child and his or her spouse both work outside the home, no one is left at home during the day to care for the aging parent. If a single adult child raises a family, he or she cannot stay home to watch over an elderly mother or father. As a consequence, seniors become isolated in their own homes, or in some situations, spend their days in adult day-care facilities. The caregiver roles once played by family members are now assumed by paid and volunteer staff at service organizations, including those who staff day-care centers, deliver meals, or simply make periodic visits to interact with the elderly service population.

Staff members who engage the elderly on a daily or weekly basis become the seniors’ link with the outside world. This role affords staff a tremendous, if not unique, opportunity to protect the elderly from many of the risks that accompany the aging process. Staff members are often the first and sometimes the only ones to spot signs of trouble, including elder abuse, physical disability, medication problems, self neglect, depression, and household hazards. Paid and volunteer staff members have become the new front line in senior risk management. Their interaction and willingness to help may prevent injury and stop problems from escalating.

These staff should not be expected to face these newfound responsibilities alone. Proper training, screening and supervision can help service personnel assess a situation, decide when or whether to report an incident, and choose the methods and personnel needed to assist them. Nonprofit organizations must teach their staff the signs and symptoms of problems and the appropriate methods to improve a situation without making matters worse. In essence, these frontline caregivers will take on risk management roles, as well.

The first tenet is that the term “seniors” comprises people of many ages, with varied mental and physical capabilities. One definition definitely does not fit all. Within the category, each person ages differently. Outward changes can occur, which alert caregivers that alterations need to be made in the person’s life. Medications, furnishings, exercise or diet regimens are a few of the areas affected. An alert staff member who knows where to report what he or she observes provides a service to the service recipient as well as the organization.

Basic principles of risk management woven into staff training protect the staff member, the organization and the service recipient from harm. For instance, a person hired or volunteering to deliver meals to seniors’ homes needs to be educated how to maintain proper temperature of the food, to deliver the food within a specified time period, and to serve the meal immediately or store it appropriately. A service recipient who contracts food poisoning from food delivered by your staff person will put the staff member, the organization and the recipient at risk. At the same time, this staff member needs to clearly recognize the job’s parameters and not offer to provide services (such as transportation or housekeeping) outside the job description’s scope of work. Again, no matter how well-meaning the action is, it can put everyone at risk.

Health-related risks including physical, psychological and financial abuse; self abuse; and neglect need to be addressed with staff serving senior recipients. Provide staff with a working knowledge of the symptoms of stroke, dementia and delirium, diabetes, heat stroke, falls, depression and suicide, physical incapacities and diminished mental capacities. They also need to know to whom to report these symptoms to in order to assist their charges without jeopardizing themselves or the organization.

Other issues that pose risks common to seniors include transportation, crime and confidentiality. Suggest appropriate methods to control, reduce or alleviate risks to seniors, without invoking consequent risks to staff or service organizations, or frightening elder residents into recluses.

Paid and volunteer staff members who have chosen to work with seniors need your support to handle the new responsibilities that come with the territory. The senior service recipients need service providers who are trained and prepared to handle the problems that accompany the aging process. Help make risk management a golden opportunity for both the organizations and the seniors who look to them for service.

Checklist

(Write Yes or No for each item)

Four Areas of Safety Concern for Communal Residences

1. Crime and Victimization

Agency raises the senior residents’ level of consciousness about victimization and fraud.

Agency limits access and solicitation to residents.

Agency promotes technology and Internet use among seniors.

Agency distributes safety information to senior residents.

Agency creates continuous, highly creative linkages between various community providers and their senior residents.

Agency provides advanced training for staff on the victimization of senior residents.

2. Quality of Life

Agency provides a sustained commitment to enhancing the quality of life for its senior residents.

Agency creates champions to sustain effective programs for seniors.

Agency seeks out key service providers willing to help increase seniors’ quality of life.

Agency matches the ongoing needs of senior residents with free services and service providers.

Agency includes exercise rooms or physical fitness areas in facilities where seniors live.

Agency engages local colleges and universities in designing and delivering health and wellness services and programs for seniors.

Agency deploys properly structured resident patrols in facilities where seniors reside.

3. Seniors’ Involvement in Protecting Their Safety

Agency develops programs that emphasize senior-resident empowerment.

Agency creates programs that directly involve residents in decision making about their personal safety.

Agency devises creative methods for getting safety information to senior residents.

Agency uses elected representatives to give seniors a voice.

Agency communicates key messages over and over again.

Agency evaluates every effort to engage seniors in their personal safety.

Agency fosters and/or strengthens a circle of caring and compassion among neighboring seniors.

Agency educates seniors how to recognize and report their own victimization.

Agency includes seniors in the formulation of policies concerning their safety.

Agency structures meetings, briefings and safety education programs that respect physical and language challenges of seniors.

4. Interior and Exterior Safety Equipment and Facility Design

Agency evaluates the suitability of existing policies in the face of new needs, changing dynamics, population shifts and external events.

Agency emphasizes the importance of “target hardening.”

Agency uses a master contractor for all sites in the community housing’s portfolio.

Agency installs house telephones in facilities housing seniors.

Agency installs pull cord-type emergency systems in every unit designed for use by a senior.

Agency ensures that appropriate material is used to carpet new units built for occupancy by seniors and replaces carpets in existing facilities to be occupied by seniors.

Agency integrates rest areas into the design of new facilities or the renovation of existing facilities that will house seniors.

Agency furnishes common areas in buildings serving seniors with “senior-friendly” furniture.

Agency researches and explores the feasibility and applicability of integrating the principles of “universal design” into community housing construction and renovation.

This article is excerpted and adapted from information in A Golden Opportunity, Managing the Risk of Service to Seniors, published by Housing Authority Insurance Group and the Nonprofit Risk Management Center, which will be available soon. Click here for more information.