Senior friendly railway stations

At Old is Gold Store, wherever we go, we make it a habit to look at all public places such as railway stations, resorts, hotels and restaurants through the eyes of a senior citizen so that we can highlight all the senior friendly places to our customers.  Given our record in India, we can safely state that it is easier to document and list all senior/disabled friendly places (a very short list) than enumerate all the places which are not senior friendly (a very long list indeed).

Recently, on a trip to Varkala in Kerala, we were pleasantly surprised to find the railway station had ramps for entry to the station, ramps for entry to the canteen, free stretcher and wheelchair service and an easily accessible and readily available wheelchair at the station.

I could not spot the toilet though in the short time that we were there, so I cannot state whether the toilets were senior safe.  Also we did not find an elevator to help people cross over to the other track (we had to climb a flight of stairs to get on to the over-bridge and climb down on the other side).  Nevertheless, we appreciate the builders of Varkala station and hope that more public places take the cue from Varkala.

If you have noticed places that have taken special care to make all areas accessible, please write to us at involve@oldisgoldstore.com with photos.

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Most of our elderly parents live in denial

protecting elderlyMost of our parents, even though they have become older and have lost some of their balance, still believe that they are completely capable of living unaided.  Genuine inability to notice the gradual deterioration of faculties along with not wanting to “burden” their children with their difficulties plus pride leads to this deadly state of denial.  And sometimes as children, we are also lulled into a false sense of belief that all is well, especially when we are living away from them – until there is some unfortunate accident that leads us to re-look at the situation with new eyes.

A few incidents involving our customers can help illustrate this problem as well as enable you to identify such situations and take necessary measures to ensure that your parents lead a safe and secure life.

I will narrate below one such incident involving one of my favorite customers.  An elderly lady, she walked into our showroom one bright sunny day to take a look at what we had on offer.  “Saw your advertisement and was curious to know what you have for us oldies…”, she said with an impish grin.  I showed her the different products we had and she clucked at each of them as though to say, “maybe for other older people… I don’t need these now”.  Finally we came to the walking sticks section and she picked up one of them, checked the price, paused a bit, chuckled and said, “I might be needing this one of these days”.  She then put the stick down and added “just not yet” and left the shop.

She came again a couple of days later saying she was just passing by and wanted to drop in and say hello.  I noticed a slight stutter in her steps and her hand against the wall, but pretended that I hadn’t noticed anything.  Her eyes wandered around the shop and I caught her glancing at the walking sticks.  “Not for another six months at least”, she half muttered to herself. She then shook her head, made small talk with me and went away.

A week later she was back.  This time she said “I keep coming to your shop and going away empty handed.  The least I can do by way of encouragement is to buy something. This time I am determined to buy something from your shop just to show you that I appreciate what you are doing and for all the times you have patiently listened to my chatter”.  Then she looked around and said, “what can I get for Rs. 500?” and then she looked at one of the walking sticks she had spied during her previous visits.  She grabbed at one and pretended to be surprised that it was priced exactly at Rs. 500.  “Humph, might as well buy this then, even though God know I don’t need it now.  I only rarely feel dizzy when walking anyway” she said and bought the stick.  She unwrapped it then and there and declared, “Now that I have bought it, I may as well use it whether I need it or not”!  Now, every time she visits us, she has her trusted walking stick firmly in her hand.

It took this tough lady 3 visits to convince herself to buy a walking stick, something she needed quite desperately.  Most of our customers are like that when they come by themselves – reluctant to accept that they are no longer as sprightly as before.  Some times, one of their children or a younger relative accompanies them and in that case there is usually a lot of argument before the young person says “I will buy this now.  You can use it when you want”.  Invariable, whatever they buy gets used from that day forwards.

When you are living away from your parents, it is usually not possible to find out exactly how they are getting on.  You end up going by their word, which is not always as objective as we would like it to be.  So remember, you need to be a lot more proactive when it comes to ensuring that your parents have all the protection and safe guards they need to lead an accident-free and safe live.

Limited Mobility and flying

If you are flying domestic or international, and have mobility issues, it is important that you understand what facilities your selected airline carrier provides. Different Indian airlines seem to provide different levels of service and some charge for the services while others provide this for free. Also different airlines have different rules regarding powered wheelchairs and the kind of batteries they use.

Here are the links to the relevant pages for the different airlines in India for your ready reference.

1. Air India.
2. Jet Airways.
3. Spice Jet.
4. Indigo.
5. Kingfisher.
6. Go Air.

Have a safe flight.

Foot care for diabetics

Over 60% of diabetics suffer from some form of nerve damage.  This is called diabetic neuropathy. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness-loss of feeling-in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs.

People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.

The most common type of diabetic neuropathy is peripheral neuropathy, which essentially affects hands, arms, legs, feet and toes.  In many cases people lose sensation in these area and hence injuries to these parts of the body, especially feet and toes go unnoticed, leading to infections which could eventually result in amputation, septicemia and even death.

The importance of foot care for diabetics cannot be stressed enough.  Here are some precautions to take:

1. Inspect your foot daily (Visual surveillance of extremities(VSE))
2. Wash foot in lukewarm water
3. Use correct footwear
4. Do not walk bare foot
5. Do not walk with ulcer in the foot
6. Get periodic foot exams
7. Do not sit with legs crossed
8. Do not trim corns and calluses
9. Do not apply heating and cooling pads on legs
10. Cut nails carefully

In addition, there is whole range of special footwear available today that can keep your foot safe and free of infection.  We have already covered some of the silver yarn based socks.  You can read more about them here.

So what do you look for in footwear (shoes or sandals), if you are a diabetic?  The diagram below gives you a quick overview of some the important features necessary in prophylactic footwear:

Click here to buy prophylactic footwear specially designed for diabetics and people with arthritis.

Travelers Thrombosis – Precautions and prevention

Anti-Embolism StockingsFor many decades now and especially since the beginning of the IT boom, Indians have been settling down in all parts of the world, for business, work or other purposes.  The one thing common to all the Indian diaspora is their strong ties with their homeland, especially to their friends and relatives living in India.  This has resulted in a lot of travel back and forth making Indians among the largest populations of frequent long distance travelers.

Most families travel once a year to their home land and in turn parents who reside in India travel abroad to spend time with their children and grand children on a regular basis.  This article is specifically for the elderly who travel by air to be with their family and shows how some simple precautions can reduce the chances of Deep Vein Thrombosis(DVT).

The elderly who travel long distances by air are at high-risk of what is being called Travelers Thrombosis.  In medical terms this is known as Deep Vein Thrombosis (DVT) and  Pulmonary Embolism sometimes collectively called Venous Thromboembolism.  DVT is a common medical condition in the population. The disease process in DVT occurs because of blood clotting, most frequently in the large veins of the calves. Sometimes these clots break free and travel up the veins through the heart to lodge in the arteries of the lungs. This related condition is known as pulmonary embolism (PE), and it may cause sharp chest pain or breathlessness. PE may be life-threatening if the embolus (circulating clot) is large.

Causes for DVT can be both acquired and inherited.  The Inherited ones could be due to deficiency of one or more of Antithrombin, Protein C, or Protein S.  Additionally people with blood groups other than O are also at slightly elevated risks.

The acquired causes include:
1.  Old age.  [Most of our parents]
2.  Major surgery or orthopedic surgery [Many of our parents go through knee replacement surgeries.  This is one major cause for DVT].
3. Cancers, especially pancreatic.
4.  Immobilization, sitting in one position for long hours, and travel, especially by air. Bed-ridden patients also are at high-risk.
5.  Hormonal replacement therapy.

There are several other causes which are not limited to older people.  Please refer wikipedia for more details.

DVT can be quite painful and even life-threatening.  Here are some precautions you can take when traveling by air:

1.  Drink plenty of non-alcoholic fluids.  Ideally water, fruit juices, and isotonic drinks.
2. Regularly massage your calves and mobilize/rotate your ankles
3. Wear comfortable, loose clothing that does not restrict blood flow.  Light cotton wear is ideal.  Saris and salwars are fine. Avoid tight jeans.
4. Move around during transit breaks.  Avoid moving around in the cabin during the flight as you risk injuries due to turbulence.
5.  Be vigilant for the symptoms of DVT, in particular pain in the calves, during and for up to a month after long flights. If symptoms occur, seek medical advice without delay.

Finally, there are stockings called Anti-embolism stockings that apply about 15 -20 mm Hg of pressure at the ankle and reduced pressure as they go up the leg. These stockings help in preventing DVT.  They come in various sizes and in two models – Above knee, and below knee. At Rs. 800 to Rs. 1200 a pair, they are a steal when you consider how much pain and suffering they may actually save you from.

It is important to choose the right size and type for them to be effective.  Too loose and they will not have the desired effect and if they are too tight, they may become like a tourniquet and restrict blood flow.  Similarly some people find the thigh-length stockings uncomfortable and just end up rolling it down till their knees.  These people are better off buying the below-knee model at the outset.

Before measuring, please ensure that there is no edema (swelling due to fluid collection), deformity of the leg, arteriosclerosis and skin conditions such as dermatitis.  You can take measurements while lying down or standing up.  There are basically 3 measurements you need to take – thigh circumference(g), calf circumference(c) and ankle circumference(b).  Then compare these against the size chart provided by the manufacturer to choose the one closest to your requirements.

If you are a senior citizen and are traveling by air, don’t leave home without it.  You can buy your Anti-DVT stockings here.

Don’t wait for your first break – get Anti-slip mats

October 20th was the World Osteoporosis day.  Their slogan is “Stop at one.  Make your first break the last”.   According to some studies, 1 in 5 older people die within a year of their first fracture and 1 in 3 become dependent on others within a year of their first fracture. Since many older people are prone to Osteoporosis, with regular checkups, improved diet, calcium supplements, and care, even the first fall and fracture can be avoided.

One of the most common causes for a fracture we come across among older people is a fall in the bathroom.  This is not very surprising give that Indian bathrooms are perennially wet and slippery.  However, with a little effort this can be changed.   Reviewed below is a product that is fairly inexpensive and easy to install, clean and maintain and will probably give the elders at home several years of independent living.

Anti-slip mats

Called a snake mat or an anti-slip mat, this is a mat that is commonly used in public wet areas such as around swimming pools and is extremely good at keeping the surface dry while letting the water drain away.  The mat comes in rolls 15 mtrs in length and about 4 ft wide, but can be cut to fit most bathrooms.  The material is heavy enough so it does not curl up and trip anyone and light enough to be easily lifted and rolled up for cleaning.  Cleaning the mat is also fairly simple – just spraying water through a nozzle with some pressure should do.  Click here to buy.

Keeping yourself and your home safe

Opened the newspaper today and there was yet another news item about another elderly couple robbed at home.  The stories are disturbingly similar.  Two youngsters knock on the door, one of the elderly (living alone or with an elderly spouse) opens the door, the youngsters barge in, pull the gold chain from the lady’s neck, grab whatever else they can, injure one or both of them and run away.

For the young thugs it is probably the easiest way to make money.  The elderly are easy targets, the police are stretched too thin to follow up on every such crime, and the victims are shaken, tired and too distraught to take any further action.

If you are a senior citizen reading this or have elderly parents living alone (or with you but alone through out the day when you are in office), here are a few tips that can help you and your parents remain safe when at home.

1.  Have a grill door fixed outside your main door.  Keep it locked all the time.

A good grill door would cost you Rs 15000 to Rs. 20000.  It is a one-time investment and worth its weight in gold.  A lot of visitors come by who need not enter your home.  These people can be dealt with from within the safety of your house.  If you need to sign documents or if they request for water to drink, you can handle it all through the gaps in the grill door.  This ensures that for the thugs to reach you, they need to do extra work and spend more time – which dramatically increases the risks they have to take and gives you more time to holler for help.  So they usually leave to find easier targets.  Remember to keep the keys away from reach of outsiders so the thugs are not able to reach in and snatch your keys.  A key holder nailed on the inside of your main door well out of arms length from the outside is an ideal place to keep the grill door key.  That way, if you need to let a friend or relative in, you don’t have to walk far to get the keys.

2.  Avoid keeping valuables and cash at home.

These are the things that attract the thug in the first place.  If you ensure that there are no valuables at home and make sure this fact is known, you immediately become far less appealing to the thieves.  Set aside your sentiments and get rid of that thick gold chain around your neck, the gold bangles around your wrist, and the glittering diamond ear studs.   Replace them with simple jewelry that look clearly inexpensive (but elegant, of course).

Don’t keep cash lying around or in plain sight.  You might ask, “Who can be so stupid as to have cash lying around the house?”, but you would be surprised to know how many people make this mistake! Start using credit cards, get an ATM card and withdraw only as much as your require, keep an account with your neighbourhood kirana shop and pharmacy and settle bills on a monthly basis or have a cheque  book ready.  And if you need to pay other bills, do it online through net banking.  You definitely should not need more than a couple of thousand rupees in cash with you at any given point of time.

3.  Don’t let strangers in.

Another cardinal rule and if you have put the grill door, quite easy to implement.  In India, every household gets a lot of uninvited visitors every day.  Courier agents, grocery delivery, vegetable man, the gas delivery person, the EB meter reader, the used paper collector, the census guy, the person selling encyclopaedias or peddling hundreds of other things from snake oil to eatables, the list goes on and on.

Most of these guys do not have to come into the house.  Deal with them through the grill door and be done with it.  It is not ill-mannered or discourteous no matter what was taught to you when you were young.  Times have changed, and you should too.

If it is somebody you have to let in, (the gas delivery man, the electrician or the plumber you called), check their credentials and only then let them in.  Stay with them and keep a close watch until they leave, and make sure you lock the grill door in their presence when they leave. And while they are in the house, make sure you keep all the money and valuables hidden.  Don’t let them enter areas where they have no business.

4.  Keep all important numbers and a mobile phone handy.

Make a list of all important numbers, print them in bold face, big fonts and stick them prominently in every room.  That way, if you fall down, feel sick or need to make a call quickly for some other reason, all the data and tools you need are right there within reach.

Some of the important numbers to maintain are those of your  Doctor, the nearest ambulance service, pharmacy, food caterer (if you regularly get food from outside), your nurse/nursing assistant, your physiotherapist, children, relatives, friends and neighbours.  Put all these numbers on speed dial on your mobile phone.  A mobile phone with a pre-paid card costs nearly next to nothing these days.  There are even a few senior friendly phone models available in  the market today with big buttons and displays that make it a breeze to use a mobile.

5.  Keep the other unwanted visitor out – the mosquito

Of all the unwanted, uninvited visitors to your home, none is more dangerous than the diminutive mosquito. Not only can they make your life miserable by biting you all the time, they can also cause malaria, dengue and other serious diseases, some of which can be life threatening for the elderly.    You need to mosquito-proof your home.  Mosquito meshes are available and you can fix these on all your doors and windows and when you sleep, you can use one of the large number of easy to use mosquito nets that are available in the market today.

The points listed above are a few simple ways in which to make your life much safer and they neither cost you too much not force you the dramatically change your lifestyle or the way you live.  Let not the next news item about robbery be about you.

Here’s wishing you a secure and safe life.

Making your bathroom senior friendly and safe

If you have perused a copy of house beautiful or homes and gardens or some such magazine, you would have seen photos of wonderfully spacious, carpeted, dry and glistening bathrooms.

Unfortunately Indian bathrooms are a completely different matter.  Most of them are small and ill-lit, have narrow doorways, have the slipperiest tiles on the floors and walls and are almost always wet.

No surprise then that most of the accidents that happen at home happen in the bathroom, especially where senior citizens are involved.

However, with a few changes and some precaution, your bathroom can be made safe (though they will never look like the picture above) and usable. The changes we are recommending here are cost effective and do not require any major remodeling or masonry work.

1.  Remove the latch/lock on the inside of the bathroom.  

Most Indian bathrooms have a strong latch on the inside that ensures that nobody can gain access to the bathroom from outside when the bathroom is already occupied.  With elderly people in the house, it is very likely that sooner or later, the person inside may not be able to open the door by themselves and will need assistance from outside.  In such cases, the only option is to breakdown the door and this means that any help that can be rendered will be delayed.

One easy way to circumvent this problem is to remove the latch on the inside and replace it with a typical aircraft toilet door vacant/engaged type of door latch.  This allows people to quickly enter the bathroom if required as well as ensures that people know when a bathroom is occupied.  This will cost very little and could save a life next time an elderly family member has a dizzy spell or falls down in the bathroom.

2.  Use anti-slip mats where necessary.

Indian toilets and bathrooms are always wet and this is an indisputable fact.  On top of that most bathrooms have tiled floors that make the bathroom floor cold and slippery all the time.  One simple way to ensure people do not slip and fall is to cover the wet areas with an anti-slip mat.  These mats are similar to those used around swimming pools and so are designed to keep the top dry while allowing water to flow freely through the gaps.

A simple device that ensures that you don’t have to lay a new floor for your bathroom, something that can not only prove costly but will also put your bathroom out of commission for a week or so.

The mats are in-expensive (at about Rs. 170 per sqft), are easy to remove and clean and extremely durable.  The mats stop people from slipping even when there are minor/major oil spills or talcum powder spills (both of which are deadly when combined with water on any hard flooring).

3.  Convert Indian toilets into western toilets.

They say that sitting on your haunches is the fastest and best way to evacuate your bowels and personally, I quite agree.  However, as people get older, it gets more and more difficult to go on ones haunches and the western commode become more appealing.  However, breaking the Indian toilet and replacing it with a western one can be a costly and time consuming process.  While the best course of action is to bite the bullet and make the change, if budget and time are constrained, there are multiple other options in the form of Indian to western converters.

Option A:  A simple converter that can be placed on top of the existing Indian commode.  Not the most elegant solution, but an effective stop gap arrangement.  Could cost as little as Rs. 900.

Option B:  A height adjustable powder coated or chrome plated western commode with pail that is clean and effective and easy to wash and maintain.  Several variants are available and cost anywhere between Rs. 1500 to Rs. 4000.  You can buy it here.

4.   Install grab bars and railings.

The next issue faced by senior people is support when sitting or getting up from the toilet seat.  Many times, the walls around the toilet are tiles and smooth offering no assistance to the elderly by way of something to hold on to.  At other times, the walls themselves are too far away from the closet to be of any assistance.  Many western closets are also very low making it very difficult for people with weak knees when sitting down and getting up.  There are a few simple devices that can make life easy under such circumstances.

A.  A toilet raiser.  This is a small hard-plastic device that sits on top of the commode and increases the overall height of the commode by 8cm to 13cm.  It can be easily removed and washed after use or completely removed when not in use.  Such a toilet raiser will put you back by about Rs. 1500 – much cheaper than ripping out the low commode and replacing it with a taller one!  Click here to buy.

B.  Grab bars.  These are stainless steel bars that you can affix to the walls around the toilet bowl.  When installed at the right height, they can provide additional support allowing people to use their hands and upper torso to take the weight off their knees when getting up or sitting down.  Would cost you between Rs. 500 to Rs. 1500 to install a pair of grab bars.  Click here to buy.

C. Toilet safety railings. In some bathrooms, the walls may be too far away from the toilet bowl and hence having grab bars conveniently placed may not be an option.  Under such circumstances, the best option is to go for a toilet safety railing. It requires no wall and can be fixed to the toilet bowl itself with just a couple of screws (the provision for such screws is already available on most of the common toilet bowls to accommodate the toilet lid.  So you can easily fix these railings yourself without having to call a plumber or a carpenter.  Will cost you about Rs. 2500 – Rs. 3000.

5. Install a health faucet.

Many Indian bathrooms have a tap close to the floor with a tiny bucket to assist in washing oneself. To use this, a person has to bend down and straighten many times in the process of washing oneself.  A health faucet is a good option that makes the cleaning process efficient, thorough and easy.  A health faucet is a tube connected to a tap at one end with a hand-held nozzle at the other end.  The nozzle can be pressed to release water and it can also be used to regulate the pressure of the water jet.  Will cost about Rs. 500 – Rs. 1500 to buy one.

6. Get a shower chair and a hand shower installed.

Having a bath, especially with hot water can be tiring for the elderly.  A shower chair and a hand shower can allow people to have a leisurely bath while seated. The shower chair shown here is a very light weight hard plastic and aluminium chair that is easy to carry and wash.  Its shape also provides access to different parts of the body so bathing a patient also becomes easy.  The chair is also height adjustable and costs about Rs. 2000.