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Vital Talks to Have Before an Aging Loved One Is Admitted to the ER

A 79-year-old man is involved in a serious car accident. He’s not able to breathe on his own, so a breathing tube is inserted to help him. An 80-year-old woman living alone falls at home but isn’t found until the next day. She has suffered trauma to her brain and can no longer speak coherently.

[See: 14 Ways to Protect Seniors From Falls.]

As a trauma surgeon, I’ve met hundreds of these types of patients. When I do, I already know I am at a disadvantage. These emergency room patients likely have more than one chronic medical condition and take more than one medication. But they are often unable to articulate any of this.

I’ve spent hours trying to gain information from aging spouses and family members, who don’t know what medical problems their loved one has, and can’t remember the names of their loved one’s medications or doctors. Hours are spent calling pharmacies, digging through old records and checking labs just to gain the most basic of health information. And what if the patient’s condition does not improve? What are his or her wishes in this situation? As the treating emergency physician, how am I going to find that out, in order to honor those wishes? Does the family even know?

The U.S. aging population is growing. In fact, more than 1 in 10 Americans is over age 65, and that number is expected to almost double in the next 20 years.

For those of us with loved ones in this age group, that’s great news — we can expect to have them with us longer. It also means that now, more than ever before, we need to know how to help our aging parents and family members have the healthiest golden years possible.

[See: 14 Ways Caregivers Can Care for Themselves.]

Unfortunately, in my line of work, I too often witness accidents that could have been prevented and wishes that could have been honored, if families had been prepared. The truth is, it’s only a matter of time before falls and accidents affect the majority of our aging loved ones. Every 11 seconds, an aging adult is evaluated in an emergency department because of a fall, according to the National Council on Aging. And almost 650 aging adults are injured in car accidents daily.

Here’s how you can better prepare for these incidents with the aging loved ones in your life:

1. Know your loved one’s health history. This is one of the most helpful things you can do to care for your aging loved one. While you may not be able to join every doctor’s appointment, make sure you know the name of your loved one’s primary care physician. Additionally, know which pharmacy he or she uses to fill prescriptions. Having a list of your loved one’s medical conditions and current medications is optimal, but knowing these basics is incredibly helpful for emergency health care providers.

2. Take a ride. If your loved one still drives, when was the last time you rode along? The idea of losing driving privileges is scary for aging adults, but having conversations about driving is extremely important. As much as it would hurt you to have your loved one injured because of an accident he or she caused, it hurts even more when you realize someone else was injured, too. Try and arrange a time for your loved one to drive you, so you can observe firsthand his or her ability to adapt to other drivers on the road and changing road conditions. If you don’t feel safe riding with your loved one, it may no longer be safe for him or her to drive. Taking the time to ask your loved one his or her perspective on the matter is an excellent way to broach this tough topic.

3. Discuss living independently. Similarly to driving, the choice to continue living independently is a hot-button topic for most aging adults. However, family members should know what safety measures are in place, in case of a fall. If a loved one cannot call for help, consider an alarm service or a check-in protocol with neighbors. If bedrooms are not located on the first floor, think about moving the bedroom to limit the use of stairs. If stairs are necessary, make sure they are in good repair and that the handrail is secure. In the case of many falls, a small amount of prevention and preparation can go a long way toward improving your loved one’s quality of life.

[See: 14 Ways Alcohol Can Affect the Aging Process.]

4. Know who’s in charge. When aging adults are injured, they are often unable to communicate effectively with their health care team. Every adult should have a health care power of attorney and a living will. If no power of attorney is documented, some states have a defined default process. In other words, if no paperwork is present, the spouse assumes that role by default. If no spouse is available, then it would be an adult child and so on. However, in some states there are no legal defaults for health care decision-making and any family member can have an equal say in the care of your loved one. In other words, a second cousin twice removed, who has only visited twice in the past 50 years, can have just as much say in the health care of a loved one as a spouse of 50 years. In order to prevent this potentially fraught situation, it’s crucial to have this discussion and have it legally documented.

5. Discuss the “what if” scenarios. Not only should every adult have a living will to guide their medical care, but close family members should be familiar with a loved one’s wishes. For example, if your loved one is involved in a fall or accident and suffers a traumatic brain injury, would he want his life extended by a breathing machine or feeding tube? Would she want CPR? Although these are very specific examples, being able to guide the doctors caring for your loved one — and doing everything in your power to give your loved one the care he or she wants — is priceless.

More from U.S. News

7 Surprising Things That Age You

Easy Ways to Protect Your Aging Brain

11 Things Seniors Should Look for in a Health Provider

Vital Talks to Have Before an Aging Loved One Is Admitted to the ER originally appeared on usnews.com

Don’t Settle for Student Loans to Pay for Online Education

Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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