Waiting for a crisis - one thing we'll all do sometime

Speaking with a friend last night I realized that there is one basic thing that nearly all of us share when it comes to dealing with elderly family  - that is the waiting for some crisis event which forces a change for our loved one.  We wait for the fall that puts mom or dad in the hospital and then the nursing home.  It's the stroke or heart attack that signals the start of their decline.   Or, it's the car accident that means the loss of a drivers license and cancellation of insurance.

Elder care professionals call these "sentinal events" - some event that is often a tragedy and that means a big change in the living conditions of our loved one.   Most often the outcome of these events means drastic change or a tragic outcome  Think of the stories we read of elderly people found wedged for days between their toilet and the wall or someone who's fallen and never got up.  After waiting for so long we can only react to the circumstance; there are only a few options left by the time an event occurs.

Why do we end up waiting?  It's because we have no other option.  The parent/elder is not sick enough to be hospitalized or might have a chronic condition.  She or he might be right-minded enough to say "leave me alone" or there just are no funds to help provide any assistance to prevent the incident.   We WANT to respect our elders so we respect their need for independence. We don't want to hurt their feelings or pride or our relationships so we let things be.  We know something will happen, it's usually only a matter of time.  We wait and wait then deal with the outcome.

The waiting is hard.  We see the decline, the weakness, the potential; we know something is coming but we don't know what or when.  We grow anxious, we get stressed, angry or frustrated but there's nothing we can do.    In some ways the waiting is easier because if we let things go long enough the options for our elder are limited.  Their condition may be such that a nursing home or hospice is the only option.  I have to ask myself if this is so bad.   We might do things that prolong the life of our elders but what about the quality of that life?  For me, I'm glad my Mom was in her home for years and admitted to a nursing home late in life.  She was surrounded by her family, her favorite sentimental things, her own roses and friendly neighbors.   The house didn't get as clean as I'd like, the lawn was under-watered and the flowers often gangly but she didn't care. She was simply happy to be there.   So I had to be satisfied that she was content and worry less about the time she had left.  We chose to put her immediate happiness first.  It was hard and I often worried but looking back, I'd do it again the very same way.
What is a sentinal event , when should I move mom dad , mom doesn't want to ove what do i do , dad doesn't want to move what do i do ,dad won't stop driving what do i do 

The catalog every caregiver needs....

Need things that make your elders life easier?  There is a one-stop shopping location: Gold Violin.  They have all kinds of things  - from clothing to safety items to transport chairs with wheels - that make your elders life easier and safer.   I originally began looking for small items that would help mom continue to do things she always did - like can openers or door handles. As she aged we needed more specialized items like hand holds for tubs or chairs for a bathtub.   You'll find this and more  in this catalog.   I can't recommend it enough.  If nothing else you'll see what's out there and you can take it to your local pharmacy to see what they can help you find.

Note:  The link below is repaired after a kind reader let me know I used the wrong URL.  ;)

On line, you'll find them at this Gold Violin site or  www.goldviolin.com
There's also a toll free number if you wish to order a catalog:  877-648-8400
Where can i find products for my elderly arthritic mom?  where can i find products for arthritis? where can i find products for aging in place? where can i find bathtub aides? where can i find bathtub safety products? where can i find bathroom safety products 

Pop wants to get hitched? Shacking up is easier!

I spoke with a flabbergasted friend last week and I've debated whether or not to blog about it.   My need to point out the variety of scenarios and possibilities for our elders and offer some practical advice won out.... so here it is:

My friends widowed father, age 82, wants to marry a woman he met through his church.   I encouraged her to support him. Provided his finances are in order; his needs will be met without monetary penalty  and with an iron clad Power of Attorney for medical care.   It's a good situation for both of them, they are of similar ethnic heritage so they like the same foods, have the same memories of growing up in the US with immigrant parents - it's all similar history.    They want to move in to an apartment in an assisted living center in the town where each raised their kids, went to church, have doctors and mutual friends.   Another important factor - both are comfortable financially and don't have any dependents that need to inherit their money. They've also downsized and both have few "heirlooms" to argue over.   It's just a great situation and each will be happy.  I've heard other, far less happy scenarios (and, you know you're going to hear about it now...)

My sister in law suffered a great deal of hurt after her grand father remarried and died soon after.  
"Grandpa" was actually the second husband of Grandma; he'd been married before but had no children.  He married Grandma when the daughter was a young woman.  He was a good husband and when a step-grand daughter came along, he wished to be called "Grandpa".    Grandma and Grandpa each brought their own houses, furniture, funds and mementoes into the marriage.  Among the four of them, they had an understanding that all of the things each (Grandma and Grandpa) brought to the marriage would go to their respective family should anything happen.  Some years later Grandma passed away suddenly.  Grandpa was lonely afterward and step-daughter didn't want to take anything from the home for fear of upsetting him.  Just three months passed and one day Daughter got a call from Grandpa's neighbor - he was married!   Daughter went to investigate and learned that it was true, Grandpa married a woman he met at his "club" and she had already moved into the house.   Daughter wanted to gather some of her mothers things only to see that many had been tossed out and the new wife refused to let her take antique furniture, photos of her family - nothing.   This began a very contentious and mean spirited exchange of visits, calls and even a couple of calls to police!  In the end, the Daughter and Grand Daughter got nothing and it was crushing for them.   They wanted the mementos from their mom, grand father and great grand parents that were with the step-grandpa.  After the shock of loosing Grandma, they left things to help him feel a sense of continuity and family and now his lonely heart was more important.  He died a few months later - no will, nothing written down and the "new" wife got it all - Grandma's house, Grandma's furniture, dishes, even the doilies.   Legally, there was nothing the Daughter or Grand Daughter could do. Grandma died with no will so everything went to Grandpa. When Grandpa died with no will it all went to his spouse. 

Now if Grand Pa had just shacked up with the new woman, they would have legal recourse.  ...  That is what I would propose to an elder if they wished to share their life with some one rather than be all alone.   There are all kinds of things to consider when elders marry:

• In most states a spouse can be forced to provide some kind of support for necessities - no matter how long the marriage.  
• The legal act of marriage can also tie up funds if a spouse incurs debt after saying "i do".  Debt, funds and property acquired before the marriage are not likely to be considered community property but it all depends on the state. 
• Should one spouse need state assistance, the state can put a lien on a home even though s/he only spent a short time there and didn't contribute to the upkeep - it all depends on state law.
• Widows pensions might also stop if a woman is remarried, to retain income, stay single!
• The contents of a house are generally considered the property of the home owner unless it's a high dollar item like artwork, jewelry.  
• Elders should give away heirlooms SOON or specifically call out distribution in a will.  Even if the remaining spouse remarries, the original heirs will have a legal standing to obtain things if it's written down.
  

I've also seen wonderful examples where families are co-operative, where grandma or grandpa WANTS to downsize and passes along heirlooms to be enjoyed while they are alive.   It seems that the painful examples are those we remember most.   I am by no means an attorney or legal expert but I do know that isolation ane loneliness are strong motivators.  If you love your elder, help them to feel less lonely, encourage them to be honest. If they want to share their lives, help them do it in a way that feels best for them and maintains relationships with their kids and grand kids.  Also try to form a friendship with the new "significant other"; they probably need some love and support too.  

Don't expect to get your gifts back...

A friend recently had a several falling out with her sister over a gift one had given their mother. The mother had this vase for years then when downsizing gave it to the other sister. The "giver" was upset because she always expected to get the vase back. I've discussed this situation with other friends and it seems to be an issue over and over, one family to the next. A child give something to a parent expecting to get it back 'someday' 'when Mom loves' or dies. Within my own family, my brother claims many of the things in my mothers home, and says "because I paid for it" - which may or may not be true. The rest of us have households with enough stuff, so if he wants it, he can have it. It's not worth arguing over.

My friend's situation above, however, resulted in hurt feelings, not necessarily anger. The giver was upset that her mother gave away "her" vase and upset with her sister for taking it when she knew the giver wanted it back. The giver felt betrayed by both her mother and her sister. What to do in cases like this is difficult. One must understand WHY mom gave the vase to the other sister. Did the sister ask for the vase? Did mom forget that the giver wanted it back? Did the giver clearly tell Mom that she wanted the vase back some day? In this case, I know the Mom and I'm sure she just forgot about the arrangement to return the vase but I could see where Mom could resent such an expectation. In the end, the sisters talked without involving Mom and sister two gave the vase to the giver. I could imagine, though, that this type of thing could escalate into one of those situations that triggers an argument, grudges and the breakdown of a relationship.

If it were me, I'd tell my daughter that if she wanted the vase, she should buy one for herself and I'd wonder why she gave it to me in the first place. It is obsurd to present a gift to someone and then expect it back. It's a GIFT not a LOAN. There are all kinds of complicated scenarios that could arise and each is just one more chance for hurt feelings, disappointment and confusion. It's best to just avoid that completely.

When we give a gift, we must live with the outcome of that action. Once the gift is presented, it becomes the property of the recipient and is theirs to do with as they please. I would hope that people could be genuinely open and act from a loving place. If you like and appreciate a gift, say so and use it with pleasure. If you are presented with a gift but it's the wrong size/color/texture/smell/style/etc. then gently speak up and let the giver exchange or return it. When it comes to your parents, don't complicate their lives, especially if they are elderly. Give them things that they will use and enjoy. Don't give them something because you want it for yourself at some point you just risk hurt and disappointment if it's broken or damaged, or also desired by a sibling.

Signs your parent needs "adjustment"

Two main objectives to keeping your Elders at home are enabling them to do as much for themselves as possible and ensuring their safety. Often they will make minor adjustments for themselves to help get things done but we kids and grand kids we also need to OBSERVE and ACT to enable their day to day activities and be safe.

Be patient and prepare to do things like this often or RE-do them often. I see things during every visit that I can change for Mom to help her do things more easily. As she grows weaker, we often address the same problem again and again. When she began to have trouble doing laundry, we got front loading washer & dryer. Six months later stairs were becoming difficult and were impossible with an arm load of clothes, so we did a minor remodel and moved the new machines from basement to the kitchen. Three months after that we had to install a shelf to create storage for the laundry soap and softener at arm height so she didn't have to reach up or bend down to get at it. Within a few more months, she could barely lift wet items from the washer to dryer but she kept at it one garment at a time. She wanted to do it for herself so we enabled that through a lot of work and effort on our part. Remember if you care about your parent, Aunt, uncle or friend, you will help them to help themselves.

Here's a list of things that we did at Mom's that enabled her to do for herself and be safe. Be sure to read later posts with aging in place tags for more ideas:

• Opening cans of food :
  moderate difficulty: get an electric can opener
  more difficultly: buy foods with flip top lids
• Soda cans or bottles: Get Open Sesame - a multi-tool for cans and bottles. It works on flip top soda cans, twist off caps and has a magnet for storage on the fridge.
  
• Opening jars:
  moderate difficulty: use rubber gloves, one to hold the jar and one to grip the top
  more difficulty: use under the counter mounted devices; these grip the lid while the user turns the jar, using rubber gloves to grip the jar is best. I don't have a specific name or source for these; I've found them in catalogs, dollar stores - I saw them in all kinds of places when I didn't mean to buy one and ordered one online when we did need it.
  
• Stairs: often going down is more dangerous than going up - my Mom seemed to have equilibrium problems when looking DOWN and decending at the same time. Ensure that railings are tight and strong enough to hold up under a lot of use and a lot of weight. Can you install railings on BOTH sides of the stairway? Consider a ramp for short rises like from the back door to the yard. The most sure fire safe thing: get your Elder on one level - eating, relaxing, sleeping, bathroom and laundry. There are also more spendy solutions like the lift chairs that ride up and down on a railing; I've seen this only once and it was quite an expensive solution. I'd prefer to sacrifice a formal dining room or living room to get my Mom on one floor.
  
• Medications and pills: This is one of the touchier issues with elderly folks. Often Elders underestimate the importance of keeping up with medications for a variety of reasons. This is another key issue to consider whether an Elder can no longer live alone.
  
  moderate difficulty: make a schedule by time and put it on the fridge, get a pill box labeled by days of the week or even morning, noon and evening. Fill it for them weekly.
  more difficulty: Call them with a reminder or hire an aid to visit regularily and remind them to take their meds. Sometimes aides cannot give meds due to liability but they can check the pill box and the schedule and "help your Elder remember" with gentle words. This person should also report back to the family if the Elder refuses, the pills in the box don't coincide with the schedule or other issues crop up

That's all for now, look for more installments as time permits.

Decline, like growth, happens in spurts

I find myself talking with the PARENTS of my friends more and more these days; they are dealing with the same parental situations as me. I was born when my parents were in their early 40's, they soon had grand kids near my age. Most of my friends parents are active, healthy and have done a lot for themselves. They are often shocked at things their parents do or can no longer do for themselves. I am not. At an early age, I saw and helped my parents with my very elderly grand parents.

Over the past year one thing has come up again and again from family to family - grandma or grandpa changes a lot during the 3, 6 or 12 months since the last visit. It seems that, like little kids who have growth spurts, elders decline in spurts as well. Within 6 months my Mom went from preparing simple meals like soup and a sandwich to being unable to open a can of soup with a conventional can opener. (We got an electric can opener but after another 6 months she was too weak to lift a 14 ounce can.) Her grip went from knuckle crunching to slight, like that of a six year old. Two years prior this, stairs suddenly became a huge problem. She feared going down stairs and going up she would take one step at a time putting both feet on a stair before tackling the next one. Our solution was to put in a ramp to the yard; we moved all of her living to one level of the house the year before.

My Mom's decline demonstrates the need to OBSERVE and ACT. If you are trying to keep your Elder in their home, look for ways to help them do as much as possible given their limits. Prepare to make adjustments often and make sure they are safe. Here's a minor example but one thta means a lot to Mom: She likes a cold Pepsi every afternoon. When I saw her pry open the top of the aluminum soda can a butcher knife I found some plastic gizmo's that fit over the tab and enable the user to lift it to open the can.

Often as our Elders age eating becomes a problem and is something that family must watch closely. Elders will TELL you they are eating well but often they are not. They compromise and eat what is at waist level - donuts, sandwiches for example. They forget how long left overs sit in the fridge and eat spoiled food. Mom's inability to make a meal for herself was a primary factor in our decision to move her to Assisted Living. I dropped by at lunch time to visit and Mom said, "It would be nice to have some warm soup." Translated this means, she can't prepare it for herself and she'd like me to make some lunch for her. It was rare that I visited Mom on a weekday and I suspected she was growing weaker. I told her we'd make it together so handed her a can and the electric opener while I got a pan and some sandwich fixings. I watched her struggle to get the can in the opener for a few minutes. Soon I blamed the opener as to clunky to help her save face. I fixed lunch and we had a nice visit. I left convinced it was time to move her.

Don't wait too long to move your parent

I fear we waited too long to move Mom. We worked hard for several years to keep her at home, until her arthritis made her too weak to do even the most basic things and she neglected to take her medication. We thought we did the honorable thing, working together to keep her at home. But, in the long run, it may have been a mistake.

At this point she is so weakened and crippled by arthritis, especially in one knee, that she can not walk from her room to public areas of the assisted living facility. She is unable to walk, unassisted to meet other residents and refuses to learn her way around. She is isolated and lonely. She feels more alone than ever before in her life and there is nothing we can do about it. We try to visit often, the care givers offer to help her walk but she is unwilling to call them.

This morning I visited Mom and she asked to go home again. I had a pretty bad migraine headache and was quite frustrated after hearing this daily for a week. She has also begun to accuse the aides of intentionally doing the opposite of what she asks which is NOT at all like my mother. I knelt on the floor then sat back on my heels in front of her recliner and broke into tears. Mom apologized and said "I'm sorry to be such a burden..." I told her that it's not a burden but that she must realize that she has severe limitations now and that we just can't take care of her at home. She craves conversation with people she's known for years; the problem is that many of them are dead. Those still living are demented or too deaf to communicate. She wants to share memories and laugh with people who shared her experiences but it is impossible.

Making her totally content is impossible so we must be thankful for moments when we can make her laugh or smile. It's hard for us - the family - to accept that we can't make every moment happy. At least we are going through it together and we're able to help her enjoy things SOME of the time...

Why not just move your mom to YOUR new town....

I live 2000 miles from my Mom and travel to see her about every 6 weeks. UGH! It's a scheduling and financial burden but I feel it's best for her. I can't tell you how many times well meaning friends suggested that I move mom closer to me and even implied that I'm a rotten daughter because I didn't do it! Needless to say, those folks are OFF the friends list.... Some friends can't understand why I travel so far so often to see my Mom. Here's my reason for leaving Mom in her home town:

Consider my Mom's condition: 88.5 years old, stiff and weakened from arthritis, and lived in the same house for 63 years. She retained friendships through school and church from the age of 12. She does not have the time to make new, deep friendships and experiences. She is NOT terribly forgetful or demented; she doesn't sleep the whole day away. She remains curious and intellectually aware. I live more than 6 states away from my home town where Mom still lives. It's a different geography, climate and a totally different type of people; they are not welcoming to strangers. Making connections is important to my Mom, it gives her a sense of "rooted-ness"; she could never make those connections if I move her to an ALF where I currently live.

Here's an example of the type of connections I mean: the maintenance supervisor at her ALF is the grandson of my Grandma's friend and neighbor, Mom met him years ago as a teenager. Another resident is the widow of a long-time neighbor and just recently two members of Mom's church congregation moved into her ALF. THESE are important connections that help her feel secure. These connections give her a sense of community within the ALF and thus help make it HOME. She'd never find these if I were to move her 2000 miles away. It's easier for me to travel to see HER rather than force her to live without this sense of connectedness. It's a relief to write about this here; those same snide people who made me feel like a rotten daughter would not take the time to listen to these good reasons. When it's their turn to fill this role, I hope I forget their attitudes and can offer some kind support and wise advice that benefits their parents .

Forcing Mom to settle in...

It's been several days since I was able to leave comments here; I was just too busy. Since my last post, I got Mom settled, talked her down after another distraught day; cleaned her house for my brother; made banking arrangements and bought many things she needs in her little apartment.

Mom's been in the assisted living facility for 11 days now and she sounds a bit better on the phone. We left her on Friday morning to spend time with some cousins and return to my home in Indiana for 2-3 weeks. It was very difficult to say good bye and leave her in the hands of others but it was necessary for her sake and mine. She must adjust and get acquainted and I need to get my own affairs back on track.

I need to get some paying work done and - most important of all - spend some quality time with my husband, Dan. He has been so loving and supportive; I could not have done this without him. I'd been at Mom's for two weeks trying to get things arranged when he arrived from Indiana. He spent three weeks there with me, organizing, fixing things at Moms, lifting new TVs, hanging pictures, moving furniture and mowing. He shopped with me and told me I was doing the right thing. When I feel the most guilty, he tells me it's necessary. "You would not allow a four year old to remain in an unsafe situation; this is very similar. Your mom is not able to be realistic so you must do it for her..." Intellectually I know this but he verbalizes it when others won't. He doesn't want to say anything harsh but knows just when I need to hear it.

As for Mom, her own phone seems to help a lot. She's placed a couple of calls and I've called Mom daily since it was turned on. She also began working with a physical therapist which gets her moving and gives her some company. Mom told me about a woman, Edith, who speaks to her at meals. Edith says hello but doesn't come early or stay late to chat. I hope Mom will invite her to her room for coffee and cookies or to sit in the sunshine; it could be just what both of them need! I just can't imagine just sitting there waiting for the next meal without trying to find something that makes me feel alive! I pray that Mom finds some motivation to get engaged and that she can pull some of these other residents along with her.

More safety tips for elderly parents at home

Ah - a few minutes to myself in the afternoon sunshine... So I'll take the time to write a few more things that we've done to make Mom's home safer:

Turn down the water heater: Mom's skin is quite thin and so seems more sensitive to hot, cold, pressure and even rough surfaces. To prevent burns we turned down the hot water heater to 100 degrees. It seems cool to me but she's quite comfortable in the shower; the tub is not an option any longer since she can't get out of it.

Drawers and drawer pulls: We replaced the drawer pulls on Mom's cabinets and bedroom furniture so it's easier for her to open the drawers with swollen bent fingers.

Use easy glide drawers, automatic closing drawers or drawer stops: Innovations in cabinetry make for safer kitchens. See your local home improvement store for these gadgets that make for easier opening and closing.

Sort through drawers and remove heavy items and clutter: Remove heavy clutter and, if possible, move the most used things to the front of drawers. This prevents a situation where a heavy drawer is pulled out to far and falls onto the floor or worse yet, an arthritic foot.

Use rubber shower pads in the shower and out: We got a couple of rubber shower mats - the kind with the little suction cups on the back - and installed one inside the shower stall and on the floor where Mom walks most. This helps her get traction getting into and out of the shower. The mat we found - at KMart - has a sort of beveled edge so that it gradually rises from the floor, suction cups ensure it won't slip.

Use rubber shower pad between a bed and commode or potty chair: The same rubber shower mat mentioned prevents falls when Mom gets up during the night. Placed on the slick hardwood floor right where she steps out of bed to turn and use a commode.

Replace buttons with snaps or velcro: Mom can no longer slip buttons into button holes, arthritis has robbed her fine motor skills. I stitched all the button holes closed, applied large snaps to the garments then stitched the buttons OVER the top of the old button hole so it appears as thought she's wearing her usual button front blouses. Your local one-stop fabric & sewing shop should have tools that help apply snaps so you can save time stitching things together.

Making a safe home for mom

As my mom gets more frail due to osteoporosis and arthritis I've tried to make her home safer to reduce the chance of falls, bumps, bruises and minor mishaps. Her situation is complicated because she uses a walker due to a bum knee, is blind in one eye and has become gradually weaker. As she's aged we make adjustments to enable her to continue to do things for herself; often these are not attractive alterations but it's more important to make her home safe. We hope to help maintain her independence, dignity, self-worth and to help her feel that an aging body is not robbing her of self-control.

These ideas below are in NO WAY meant to be professional full-proof measures but are just a few things we did at my mothers home as adjustments to help her. To avoid getting sued, I suppose I MUST say: Try these things at your own risk. Consider your own knowledge on use of tools and hardware before trying to do it yourself. Don't attempt something you are not familiar with; it's better to pay a professional to do it right the first time rather than have incur more expense and disruption later.

Here is a list of things that my family and I have done around Mom's home:

Remove area rugs. This prevents tripping over folds and eliminates one more thing to clean. Even if the rug remains flat, it can be a trip hazard. Old folks often can't lift their legs high when they walk, they tend to shuffle. That small 1/2" rise is enough to catch a toe or heel and cause a fall.

Be sure cabinet doors close: Open cabinet doors are right at eye or knee level, if they hang open it's one more thing to bump into. Sharp or pointed edges can crack or break a bone if someone falls against it. We installed magnetized gizmo's to hold the doors closed. As mom got older the magnets were too strong and she didn't have strength to open the door so I applied tape to the magnets to weaken their hold; it was enough to keep the door closed yet Mom could still pull it open.

Stabilize appliances: Mom once lost her balance as she pulled the fridge door open; the whole thing began to tip over. Luckily my nephew was there and big enough to catch her with one arm and push the fridge back with the other (he's a 6'5" hunk with strong arms and back). We solved this problem by nailing a 2X4 board across the front of the fridge; my husband drove very long screws through the board and into the toe kick of the cabinets. We painted it to match the cabinetry so it's not ugly. Since many refridgerators are deeper than cabinets this might not work in all situations. Other options we considered were a metal bracket that attached to the side or top of the fridge and then to a stud in the wall or even a strap around the top of the fridge and attached to the wall. The 2X4 was the "least ugly" of these solutions and most acceptable to Mom.

Check other appliances for stability: Wiggle other appliances to judge their stability. Consider the stove or dryer - anything where your elder could hang one, lean or fall on the open door. Front loading washers are not as big a worry since their weight is mainly on the bottom of the appliance which makes it more stable.

Get appliances on the living level: Mom's washer / dryer was in her basement and the stairs were a huge worry for us especially if she tried to carry anything. We converted a linen closet to a laundry closet and moved these up stairs.

Secure other furniture to walls with brackets: cook cases, china cupboards, curio cabinets - anything that might be top heavy and fall over when used as a hand hold. All it takes is a small "L" bracket and a couple of screws. Or, move heavy objects from upper shelves to the bottom shelves.

Get a taller toilet: Often our elders have a hard time getting up from low seats. Given that, the bathroom poses a huge problem. They are alone, exposed and it's often in tight quarters. A taller toilet enables them to more easily raise up from a seated position, installation of a grab bar to pull with their arms can help even further. Other options like a "riser" - a plastic toilet shaped device that fits over the toilet - are possible but these are hard to clean which creates another set of issues. Don't get a toilet that's too tall or they can't get on it in the first place.

Bathroom hand holds: Install grab bars near the toilet, shower or tub. If you notice that they hold on to a towel rod to walk across the bathroom, ensure that it is securely fastened to a stud in the wall; don't trust the little 1/2" screws that come with the towel bars. After we noticed that the towel bar was loose, we replaced it with a real grab bar; it does double duty for towels and to steady Mom.

That's it for now - I have many other tricks and I'll share those as time permits.