After twenty years of working passionately in the field of dementia and aging in the non-profit sector, new Wellness Director Dr. Michal Herz selected Assured Allies, a fast-moving insurtech company, as one of the best ways to instantiate a global pilot project for successful aging.

One month on the job as Wellness Director, is it too early to describe your vision for your role at Assured Allies?

It’s an emerging role. My main role is to look at the current Age Assured program — which helps older adults with long-term care insurance to age successfully in their homes for a longer period of time before they require institutional care — and pull together existing learnings so that, from a vision point of view, we can take the product forward. It’s a good moment to come on board because the company already has a stable product clinically and technologically as well as a team of professionals forward-facing with our members. We are still learning a lot and the growing number of insurance carriers who have contracted with us —  with a combined total of 20,000 policyholders — will allow us to draw more and more powerful inferences that enable us to scale in a very smart way.

Given your background in academia and the non-profit sector, your arrival here seems like an especial validation of what I’ve heard many say, that they chose Assured Allies because the company’s business model is aligned with its mission to do real good in the world. 

I have been in the field of aging my whole career, celebrating 20 years this December. Nineteen of those years I worked in the non-profit sector across a variety of roles, from academic research to project management to policy work. Assured Allies is the first time that I’ve seen a business combine the speed, funding, and technological abilities of a for-profit with the systematic and altruistic thinking of a non-profit. The combination is fascinating. I was tired of big organizations that move slowly. 

I also think there’s a unique opportunity for Assured Allies, which operates mainly in the United States, to be a kind of catalyst for other countries, or a global pilot project. 

How so?

I spent a lot of my career in the U.K., Israel, and at the World Health Organization (WHO), and the philosophy — how we perceive human rights, caregiving, and healthcare — is very different in the United States. The private sector plays a much bigger role than in other countries. As a for-profit start-up, we can move quickly and take calculated risks on a smaller scale than a government can. And it’s a blessing that private insurance carriers in the United States have the money to see if our model of long-term care policyholder engagement and non-medical intervention works. And ultimately there’s no reason why a government wouldn’t decide to adopt our service — they’re aspiring to do the same things. It’s what everybody all over the world is saying they want, and research globally supports the idea that aging in place is the best option for individuals and society. 

What makes you confident that Assured Allies will succeed at finding a way to help people age in a healthier way and to finance longevity that can be adopted by governments around the world?

The field of elder care is often not very data driven, and Assured Allies is very data driven. The fact that it has invested considerable resources in its proprietary predictive analytics  — that apply both to optimizing human-based care and improving actuarial forecasting — is key to its success. 

Also, learning here is very open-ended and valued. Data is not only numbers. Qualitative data, transcripts, thematic analysis — talking to people and getting the broader picture —  is part of the data as well. Data without context alone can be misleading; it’s how you connect the dots. Anyone who has worked clinically, knows that a lot of the knowledge gleaned from working with patients in healthcare doesn’t manage to get through research publishing to be classified as official data. But it is still really important.

I am looking forward to studying the ample qualitative data we have accumulated so far, listening to transcripts; interviewing the Age Assured Allies [professional aging experts] about their subjective impressions; maybe shadowing home visits to observe our members in the context of their homes and families. A deep dive that can reveal some new types of data that we may want to use in the future. For example, we may know when a claim has been activated but what is the story before that, in the months leading up to that claim? “A fall” for example is often a lagging indicator, not a prime cause of decline.

Do you think as a society we are in denial about aging?

Yes, as a culture we avoid and push away deterioration and death, and the denial costs us. For example, the vast majority of people want to die in their own beds, but in high income countries most die in the ambulance or in the hospital. Between point A and point B, we’re getting something wrong. Data from Israel shows that health expenses in the last three weeks of life are equivalent to all health expenses up to that point. In effect, in many cases we might be using resources incorrectly. People often reflect on how painful the last days of a family member’s life are with an over medicalised approach to end of life. To be clear, I’m not saying we should withhold care; I’m asking that we get better at making late-in-life decisions. In the U.K. caregiving facilities get rated by how many residents achieve a good death. Part of their job is to help people to plan for their death and be ready for it, to think ahead about pain management, infection control and communicating with relatives, decide if and when they want a DNR, or do-not-resuscitate order. Facilitating those timely conversations in advance provides people with so much dignity and comfort versus knee jerk reactions in a crisis that they have little control over.

How can Assured Allies help?

What we can do is use our expertise and experience and predictive analytics to help older adults and caregivers map the situation, plan ahead, and then try and finetune so that our members age successfully in place and enjoy the highest quality of life for as long as possible. I’m excited about how I can combine my 20 years of experience in the field with Assured Allies’ predictive analytics to create solutions for people that are backed by large datasets and yet also customized for their particular situation.

Observing how our Age Assured members thrive when they stay connected to friends and family, Senior Ally Angelina Portuense has put together the following 2021 holiday gift list to support year-round interaction, intellectual stimulation and engagement for older adults and their families.  Happy Holidays!

Grandpad: For a second year in a row, the Grandpad, a tablet designed for older adults, continues to be a hit. The tablet and corresponding subscription service allows users to videochat with loved ones and to send photos, videos, and voice emails. The tablet also comes preloaded with customized music and popular games. 

Customized Photo Album or Calendar: This gift requires more effort on the part of the giver to select photos, write captions, and customize, but the gift becomes that much more meaningful to the recipient. Every time your mother or father-in-law flips the calendar page up for a new month, he or she will remember special family times and feel connected. Online retailers like Shutterfly make creating the perfect custom calendar or photo album easy. Walmart and Walgreens Pharmacy also offer in-store kiosks that do the same.

Amazon Echo: Amazon’s Echo and Echo Show provide hours upon hours of stimulation and connection. The cylindrical Amazon Echo sits on a tabletop and uses artificial intelligence or AI to run a voice-controlled virtual assistant, Alexa. You can ask Alexa to play music, check the weather, turn off any wifi-controlled light or adjust a smart thermostat. The Echo Show adds a display screen to facilitate video chatting, web browsing, and more. 

Audible.com Subscription: For those who enjoy getting swept up in a good book, consider a subscription to Audible, an audiobook service from Amazon. A huge library of books, podcasts and guided wellness is accessed easily through an internet browser or Audible app on a smartphone or tablet. 

Online Education: “Inspire the person who inspires you” by giving the gift of online classes through platforms such MasterClass or GetSetUp. MasterClass is an all-you-can-learn subscription platform (starting at $15/month) featuring classes by artists, leaders and celebrities.   Take a cooking class with Gordon Ramsey or work on your singing with Christina Aguilera. GetSetUp is a social and educational buffet of online classes by and for older adults with strong offerings in computer literacy, fitness, personal finance, aging in place, art and more.  

Quality Time Coupon: A coupon for the gift of your time together — a dinner date, show, or nice walk around the neighborhood followed by tea and homemade cookies — is a great way to show someone you care. You can get really creative with this one! If you’re feeling ambitious, put together a homemade coupon book for a whole year of outings. 

GoGo Grandparent Gift Certificate: GoGo Grandparent connects seniors to ride sharing services like Lyft and grocery and meal delivery options. By gifting a GoGo Grandparent gift certificate, you are giving someone the gift of mobility and independence, and the chance to attend an in-real-life event like a local class or museum exhibit.

Angelina Portuense, B.S.
Angelina is a case manager who has been working in the elder care field for over 6 years. Her passion for working with older adults started in her teenage years when she became a family caregiver.

Caregiving is stressful. And the upcoming holiday season can add even more stress. Here are some tips to remind all hardworking caregivers to take care of yourselves, too. Reducing stress will not only improve your own health but enable you to be a better caretaker for all those in your circle of care.

  1. Accept help. Caregivers balance a lot in their day-to-day lives, and the holiday season is often a busy time of year with lots of items on the to-do list. Covid-19 continues to make life more difficult, and this may also mean that help for caregivers may look different. Maybe a friend or family member can arrange to have groceries or prepared meals delivered to the caregiver or person being cared for. Have a family member or friend go for a socially distanced walk or have a socially distanced visit with the person being cared for to give the caregiver a break.
  2. Get connected. Caregivers often feel alone in their role, and the holidays can be an especially challenging time for them. Covid-19 continues to make many feel more lonely, with restrictions on gatherings and canceled activities. Happily, many caregiver support services have become virtual, including caregiver support groups and other community programming for caregivers. Check out this list from Care.com of virtual support groups. You may also want to contact your local Council on Aging or Area Agency on Aging to find out what virtual support programs are available in your community.
  3. Seek social support. Family and friends provide important emotional support to caregivers. Even if your travel or gatherings continue to be constrained by Covid-19, do make sure you check in with extended family members to share your feelings and updates on how your caregiving is going. Do you need more help? What kind of help? You don’t have to have all the answers to reach out for additional support.
  4. Plan ahead. Now more than ever we see how uncertain the future can be. Planning ahead can really help to reduce anxiety. What will happen if the caregiver gets sick? What will happen if the person you are caring for gets sick? What happens if other care providers, such as an adult day program or respite, become modified or unavailable? Put a plan together for any of these questions now so that you are prepared later.
  5. Celebrate the holidays a little differently. Caregiving during the holidays can be difficult because of the physical and/or cognitive limitations of the person receiving care. Maybe they are easily overstimulated or have a hard time getting around. This year, take the opportunity to celebrate the holidays in a new, and simpler, way, focusing on what is most meaningful to you and your family. Is travel too difficult or risky? The pandemic has revealed that Zoom holidays can still be deeply meaningful, easier on the caregivers (less cooking, traveling, etc.) and on the person receiving care. Take advantage of some of the new holiday activities in your community, like drive-through light displays, or watching holiday concerts or movies on TV.  
  6. Fill your tank. Caregivers are constantly giving themselves to others, especially during the holiday season. “All that giving can leave you running on empty,” cautions AARP. Find ways to “fill your tank,” like getting lots of sleep, exercising, and enjoying holiday traditions like decorating the house, baking, or listening to holiday music. Put that “me time” on your calendar and enjoy it — you deserve it! 

You are not alone!
We hope these tips have been helpful, and we want to remind you that you are not alone, even though it might feel like it sometimes. Many caregivers have a hard time asking for help and may end up feeling depressed and isolated. During the ongoing global pandemic, even those of us who are not caregivers are feeling this way, so it’s even more important for caregivers to seek support. The theme of this year’s National Family Caregivers Month is “caregiving around the clock,” acknowledging the reality that caregivers never truly get a break from caregiving. For additional caregiving resources, check out Mental Health Americathe Caregiver Action NetworkThe Family Caregiver AllianceAARP, and the National Institute on Aging.

As Vice President of Research & Development at Assured Allies, Gilad Braunschvig thrives at the challenging intersection between clinical research, data science, actuarial science, and product development. On a two-week trip to the company headquarters in Boston from the Tel Aviv, Israel office, Gilad sat down to chat about what drives him as a leader, why he chose to work at Assured Allies, and why the predictive analytics and digital underwriting that his teams are developing have the potential to revolutionize both the insurance industry and the ability of people to age successfully.

What attracted you to Assured Allies?

The mission. It’s trendy today to say you want to do good, but I believe Assured Allies is sincere in its mission to help older adults age successfully and that its business model reflects this. This mission is so important. Most of us have parents and grandparents. Like many, I have a place in my heart for older people. They are so easily forgotten, invisible. Especially in the tech industries — it’s not so cool to take care of older people. That’s part of why there’s such a big void in that space, a void that we are helping to fill.

Gilan Braunschvig

You are at the crossroads of data science, clinical research, and product development at Assured Allies. How does the data science piece do good in the world?

Our proprietary predictive analytics allow us as a company to do several beneficial things. First of all, we can take a specific candidate or policyholder and, based on population-wide clinical data and their individual information, say something smart about them. If a person turns out to have a greater risk for decline or fall in the future, for example, we can suggest things that they can do now to try and prevent that.

Secondly, we use data science models to optimize the actuarial science of insurance companies, which frees up capital to do good things. For example, because we can more precisely quantify and predict risk, we assist insurance companies in creating new products and bringing them to market, allowing more people the opportunity to be covered by long-term care insurance. It’s a win-win. More people can get better coverage, and insurance companies can better manage capital because they can more accurately calculate risk. 

You are also leading the research and engineering behind Assured Allies’ new digital underwriting offering. Why are insurance carriers so excited about this?

Digital underwriting is revolutionary for the insurance industry in many ways. First of all, it reduces friction for new members.  Traditional underwriting involves elective medical processes like blood tests that take time and effort to complete, especially in COVID times. By contrast, digital underwriting involves a simple video-recorded series of physical and cognitive tests that can be done in the comfort of your home. It reduces the days and weeks-long timeframe of traditional underwriting to a mere 30 minutes.

Secondly, digital underwriting for long-term care insurance unlocks new possibilities for more accurate assessment of risk. Standard underwriting is based on a list of disease-related questions derived from old models. It does not really quantify the functional level, both cognitive and physical, of the individual. The diseases are considered to be proxies for that, but while they are reasonable proxies for mortality, they are not for disability. Some of it is because so much has changed in how people age with these diseases and how we treat them. By testing for cognitive and physical function with scientifically validated tools, we produce a more precise actuarial risk level for each candidate.

Last but not least, we’ll learn which parts of digital underwriting are more or less significant and adjust the weighting accordingly. Our models will only get better using this online feedback loop.

Can you compare and contrast your existing program, Age Assured™, which helps older adults who already have long-term care insurance age in place, with the new products in development?

In Age Assured, we are trying to mitigate risks that are right around the corner for older people. But in the newer programs we are developing, we are trying to incentivize intervention far upstream of risks that are 10, 20, 30 years away. There are a lot of things people can do to reduce the risks of aging early on to enjoy both a longer and a healthier lifespan. It’s very exciting. 

You were nominated as one of your company’s top leaders for #NationalBossDay. It can be a difficult leap for top engineers to have the people skills to lead a team successfully. How did you do it?

I was interested in learning how to be a good manager at my first job at XtremIO Dell-EMC, where I led small teams of a few people all the way up to a team of 30 engineers. I sought out leadership positions whenever possible after that both as a tech person and as a manager. It was partly for career considerations but also because my own best work happens when I have a strong team around me. 

There is an art and a craft to being a good leader. People are most efficient and productive when they feel relaxed and in a safe place, and getting them there can be a very subtle and personalized process. “Personalization” is a buzzword in tech but we also need to personalize the work experience for employees, which can be pretty hard. You need a quick and deep understanding of where that person is at each moment. You have to think strategically about how you are communicating as a manager and what you are asking them to do, exactly. 

Can you unpack that last idea a little bit?

Sure. In software engineering there are different ways to solve any problem; there’s no one right answer. My job is to communicate clearly what the problem is, make sure that everyone has the tools to make the right decisions, and then trust my team to come up with the solution. Then I need to get out of the way. Otherwise I’m a blocker for everything.

When you’re not working, what else do you like to do?

I love being a dad and have two amazing girls 8 and 9 years old. I am a fan of my home town soccer team, Hapoel Jerusalem. I also work out a lot. I run more than 75 KM (50 miles) a week and am currently training for a marathon.

Smart devices can help older adults stay safe and engaged while living independently. Family and caregivers can have peace of mind, knowing that an older relative has taken their medications thanks to a notification from a smart pillbox, or seeing who comes to the front door thanks to a smart doorbell.

Too often, however, smart devices introduced into the homes of older adults don’t go according to plan. Either they never engage with the technology, don’t receive adequate support in learning how to use it, are afraid to break it, or, worst case, view it as a nuisance or even a menace. 

The following tips are to help caregivers be successful so that when they do spend the time and money to install a smart device in the home of an elder, it makes a positive difference for all concerned. 

Assess smart home readiness

The digital divide varies wildly. Is your mother-in-law open-minded and familiar about new technology or defensive and dismissive? If they are already using a smartphone, tablet, smart TV, or smart speaker, they can download apps to control and/or voice-activate a range of smart home devices. If they aren’t using a smart device at all or only within a very narrow range of function, then installing other smart devices in the home is going to involve a steep learning curve. If they rely exclusively on landlines and cable TV, consider standalone smart plugs, doorbells and lights that operate with both a traditional (manual) and a smart interface.

Tech hurdles

High speed internet is required for most smart devices, but 22 million older Americans still lack access. If this is a problem, try AgingConnected.org, a non-profit that matches seniors with affordable internet options by zipcode. Best Buy also has dedicated resources to help seniors get online.

Beyond broadband access, the top three barriers to tech entry cited by a 2021 survey of over 2,300 older adults are cost, complexity, and security. Before purchase, try to calculate the complete cost, which may include not only the sticker price of the device but installation/home configuration and subscription fees. Next consider ease-of-use versus complexity. Configuring and customizing a new device, which often pops out of its packaging with no manual, and learning how to use basic features are challenging steps for everyone. including older adults. Plan ahead for adequate time and support for caregivers and receivers to achieve competency. If memory issues are a problem, consider a posted “cheat sheet.” And be sensitive to the fact that many older adults have privacy concerns when it comes to sharing personal information. And many don’t like monitoring devices — they feel like they’re being watched. If they have concerns, how can you help address them?

What’s in it for them?  

Many older adults reject a smart device not because of a digital divide or other barrier-to-entry but because they just don’t see a need for it. Seniors “learn new tech skills when that tech has value to them,” writes Joelle Renstrom in Slate. It’s easy for caregivers to get excited by the latest smart device and dream about all of the ways it can make life easier. But think about it from your care receiver’s perspective. What’s in it for them? How will it improve their day-to-day life? Are there any features to play up such as gamification? Can they customize it to match their favorite color scheme, music, or voice? Does it open the door to communicating more often with a favorite grandchild? 

Also, consider their real needs and tackle what’s most important first. Installing smart lighting in the dark bedroom hallway to prevent falls, for example, might be a higher priority than a smart doorbell if your grandmother lives in a relatively secure, gated community with neighbors who watch out for each other. 

Discuss together first, then decide 

This may seem obvious, but it’s tempting to bypass this step, especially when considering a smart device as a gift. Surprise! Your loved one may not tell you that the wifi-enabled digital photo frame you got for their birthday went dark a day after you set it up, or got moved behind a large plant. If an older adult is not on board with your gift in advance, this sort of tech fail is a distinct possibility. 

There is no replacement for you

Smart devices can help keep an older person safe and provide back-up and relief for caregivers, but should never be seen as a replacement for a caregiver’s human touch and care. A monitoring device, for example, still requires a person to take note and make decisions if a dangerous situation occurs. Says Wendy A. Rogers, PhD, in a recent American Psychological Association article about optimizing tech for older adults, “I can’t emphasize enough that technology’s purpose is not to do away with human support, but rather to enhance what is possible.”

Bigger smart screens

Older adults generally prefer larger screens to smaller ones and are one of the most likely demographics to upgrade to a Smart TV, but many don’t know about its videoconferencing ability. So this might be something to explore together. Seeing family faces on a 30” smart TV in “gallery” mode on Zoom versus one-at-a-time on a small smartphone screen could make a world of difference. 

What about Age Tech? 

Age Tech, or devices designed exclusively for people 65+ like the Jitterbug smartphone with its larger buttons and the simplified Grandpad tablet, might be a helpful way to introduce some older adults to smart tech. But David Stewart of Ageist warns that it’s better to “just make a good product and forget about age targeting” because “to equate age with a handicap is to ghettoize a huge group of highly capable people.” The 80- and 90-year-olds that Stewart observed in a pilot study who were given free Apple watches loved them, using them to count daily steps and view text messages. “There was also a noticeable embrace of a device they perceived as being of-the-moment and very cool.” 

Age-specific products that are one-off solutions and/or which carry a stigma (i.e. older adults are prone to fall) are trending down. From 2011 to 2021, according to LInkAge’s 2021 technology study of older adults ages 55-100, use of medical alarm pendants fell precipitously from 35% to fewer than 10%, and key fob panic buttons usage fell by 10% in the two-year period from 2019-2021 alone. Some of this plummet might be due to all-in-one solutions like the Apple Watch, which can detect hard falls and dials 911 if you’ve been immobile for one minute. 

Widen your tech support circle 

Caregivers can sometimes be reluctant to introduce new tech out of fear of being “on call” for endless technological difficulties. To avoid burnout, try not to be the only person on tech support duty. If the product comes with technical support (and the support has a good reputation, is not another layer of frustration), make sure that the phone number or email address is readily available, maybe added to the cheat sheet. 

If you have an older child or teenager in your family or community, consider asking them to pitch in for tech 101 support. Young people love being the authority on a subject that comes naturally to them, and solving tech issues can be a great intergenerational bonding experience. Organizations like Teeniors.com also offer trained teen tutorials on zoom for older adults for an hourly fee. 

Smart devices will continue to improve the ability of all of us to age independently in our homes of choice. Because we’re at the early stages of this age-tech evolution, the going can be a bit uneven. Being aware of any perceived or real tech hurdles you and your care receiver face before adding a smart home device — and discussing them together — will lay the groundwork for success. We wish you and yours the best of luck in your smart-home endeavours!

The pandemic is causing people to feel more stressed, grief, anxiety, and worry. According to the Centers for Disease Control and Prevention, these are very natural responses to this difficult situation. While there are ways to manage these negative emotions, not everyone is equipped to handle them effectively. There are times when getting professional help is the best course of action. And the elderly are particularly vulnerable to both the virus and the bouts of mental health.

The effects of COVID-19 on mental health

For seniors, there has been a lot of fear and anxiety during the COVID-19 crisis. This is the age group that’s been hit the worst – they’re getting the sickest and they comprise a sizeable percentage of those who passed away from the virus.

It’s especially difficult for seniors to maintain relationships and links to people outside of their homes. Most socializing now occurs online, so they’re at an obvious disadvantage. Most of them aren’t technologically savvy. A recent study found that the pandemic has taken a severe toll on seniors’ mental health. Due to social distancing measures and stay-at-home protocols, 17% of seniors 65 and older feel isolated, while 26% have higher risks of early death due to loneliness.

Moreover, the pandemic’s mental health impacts have even stretched to family caregivers who look after seniors. Caregivers carry the psychological burden of keeping their senior loved ones healthy and safe, even before the pandemic. Add in the stress and anxiety over contracting the virus, possible financial struggles, and the inability to access much-needed health services, caregiving is proving to be a much harder task than it already was to start with.

How telemedicine helps

Telemedicine gives seniors access to mental health professionals, easing the strain on both the seniors’ and caregivers’ mental stress. However, while telehealth does connect more senior patients to psychiatrists, there’s still a shortage of these specialists to contend with. Fortunately, telehealth gives patients the option to obtain care from different types of mental health professionals, such as mental health nurses.

Plus, telehealth also gave rise to the widespread adoption of online healthcare learning. This strategy helps produce more graduates, addressing the shortages in specialized care. Nowadays, nurses can take online RN to BSN programs to upskill and advance their careers. Through these programs, nurses can earn specializations in sought-after tracks including mental health nursing. The Commission on Collegiate Nursing Education deems these online programs just as valid as traditional ones. This makes them great options for practicing nurses who want to advance their careers without taking time away from work due to the lessons being taught purely online. As these mental health nurses are trained specifically in psychotherapy and psychopharmacology, they’re fully equipped to handle telemedicine sessions for mental health. Telemedicine opens up lines of communication to alternative mental health professionals like these advanced-practice nurses.

Guiding seniors through telemedicine sessions

Caregivers are responsible for helping seniors through the telemedicine process. While the virtual calls can be set up by caregivers, seniors who can perform the task for themselves should be encouraged to do so. But when explaining technology to them, it’s important to break down the process step-by-step using simple language.

Start with explaining the value of mental health telemedicine before walking them through a practice session. It would also benefit seniors to have written instructions clearly outlined. After running through a session, have them repeat the process until they get comfortable with it. Remember to be patient and give them encouragement. Even care teams are struggling with the transition to telemedicine, so it’s even tougher for the senior demographic. They have to learn new technologies on top of adjusting to a new medium of care.

The pandemic may have exacerbated mental health issues in the elderly and their caregivers, but it also made telemedicine more commonplace. Having this type of access to much-needed mental health assistance could make all the difference between suffering mental distress and thriving. 

Photo credit: Pexels.com

Each year 36 million older adults fall, and falls are the leading cause of injury and fatal injuries in adults 65 or older. Several factors put you at increased risk for falling as you age, but one often overlooked aspect is hazards in your home. At Assured Allies, we are passionate about helping people age with dignity, choice, and independence in the place they call home. Thus, it is important that you know what to look for and how to make your home the safest place it can be. This blog series will take you step by step through different areas of your home and highlight ways you can make your home a safer place for you to age independently. 

The first spotlight in this series is the entrance to your home. Access to your home is one of the most critical areas to consider when looking at ways to make or keep your home safer. Areas to consider: 

  • Path to Main Entrance 

The path to the entrance of your home should be clear of cracks, loose bricks, debris, and/or landscaping, and it should be at least 36 inches wide to accommodate assistive mobility devices such as wheelchairs and walkers. 

  • Threshold:

It’s best to have at least one no-step entrance into your home. Your threshold should be a maximum of a half-inch high. Where possible, install no-step thresholds or threshold ramps.

  • Stairs

If you do need to navigate stairs to enter your home, install sturdy handrails on both sides. Ensure the depth of the stairs is deep enough to fit your whole foot and the stairway’s width is wide enough for assistive mobility devices. 

  • Ramp/Lift

If stairs become too difficult to manage, you might want to consider having a ramp or lift installed. Be sure to work with a professional and check with your town/city to ensure you don’t need any building permits. 

  • Doorway

The width of your doorway to your home should measure at least 32 inches wide. However, doorways that measure 36 inches are the most ideal. Hire a professional to widen your doorways or to install swing clear hinges to make your doorway wider.

  • Lighting

Make sure you have good lighting throughout the pathway to your entrance and at your entrance door. Motion sensor lights can be beneficial to ensure that lights are always on when you need them.

  • Surface

Slick surfaces increase your risk of falling. Install tread, anti-slip paint, or grip tape to stairs and entryway pathways to make these surfaces safer. If you live in an area prone to ice and snow, be sure to have your pathways cleared and use salt to help de-ice your entrance and pathways.

  • Other Things to Consider

Ensure that door hardware such as locks, handles, and peepholes are easy for you to use and placed in accessible places. Have a covered landing at your doorway to provide a surface that is flat and protected from the elements, and add a stool or table on the covered landing to give you an area to place items.

We always recommend you work with qualified professionals when making any modifications or changes to your home. Ensure that all work done to your home is done by an experienced and licensed contractor. Additionally, occupational therapists (OTs) can help evaluate your home and identify modifications and changes specific to your needs. When possible we recommend working with a Certified Aging in Place Specialist (CAPS) professional. These individuals are usually contractors, OT’s or other professionals who are specifically trained to assess homes and make recommendations/modifications for aging in place.  

Stay safe and stay healthy.


If you want more information about COVID-19 testing you can visit the FDA’s webpage on COVID-19 testing basics.

Don’t forget to follow Assured Allies on MediumFacebookTwitter, and LinkedIn!

Katelynn Dornbusch, OTD, OTR/L
Katelynn is a registered occupational therapist. She graduated from Washington University School of Medicine in St. Louis with her doctorate in occupational therapy in 2018. As an Ally with Assured Allies, she is working directly with members to help them remain independent and meet their goals as they age.

As the year 2020 comes to a close, most of you may be feeling relieved but perhaps also a little stressed. Holiday times ⏤ even during a typical year (which 2020 certainly was anything but!) can feel overwhelming and exhausting. For some, it may bring about feelings of loneliness and sadness. You are not alone. 

Especially in a year where we had to deal with a pandemic, you deserve a break! Here are some simple nutrition and health tips that may help everyone have a holiday season that’s not only less stressful, but enjoyable and memorable. 

Tip #1: Get enough vitamin D from sunshine and mushrooms for a strong immune system

Vitamin D works with calcium, phosphorus, and other minerals in your body to keep your bones strong but also supports a well functioning immune system. During this winter season ⏤ particularly when we are dealing with COVID-19, having a strong immune system is vital.  

So why mushrooms? A recent study has found that zapping mushrooms, from the humble white button mushrooms to other wild or ‘newer’ varieties like maitake or shiitake with a little UV light increases their vitamin D content. You can find these mushrooms with labels that indicate that it’s been treated with UV light but if you don’t see them around, exposing mushrooms (even store bought ones) in sunshine increases their vitamin D level. About 15 minutes in the sun, preferably with the gills up will do the trick. While you’re at it – get some sunshine on your skin too. Sunshine is the best way to boost your vitamin D level. However, since it’s winter, you can also get more of this important vitamin through mushrooms or other foods like fortified plant-based milk, fatty fish, and fortified cereals. Supplements are also ok and may be necessary, but ask your doctor or dietitian to check your current vitamin D level to determine the right amount you should take.  

Tip #2: Add some spice to your meals to release those “feel-good” chemicals 

Spicy foods release endorphins – the chemical produced naturally by our nervous system. It helps us to cope with pain or stress and hence, it’s often called the “feel-good” chemical. Studies show that when capsaicin, found in hot peppers, binds to pain receptors on our nerves, the brain releases endorphins. Capsaicin is associated with antioxidant and anti-inflammatory effects as well. Those who eat chili peppers may have a 26% less risk of death from heart disease and are 23% less likely to die of cancer compared to those who do not eat the hot stuff. So add some kick to your recipes to cook up some heart-healthy dishes that will boost your mood and protect you and your loved ones health.   

Tip #4: Drink and be merry with…water and tea! 

Sure a little red wine may help with your mood and health (especially when you enjoy a glass with your loved ones) but today, we’re referring to drinking enough fluid, like water. During the winter season, you may tend to drink less water because you may not feel hot, sweaty, or thirsty. But no matter the season, your body needs hydration to function at its best. Water helps lubricate our joints, keep our blood clean, carry nutrients to the cells, and help regulate our body temperature. 

If you have trouble drinking enough water during the colder seasons, try some warm water with lemon slices. Hot beverages like tea – from ginger, rooibos, mint, green, black, and other delicious herbal types work well too. Just try not to add sugar and limit the amount of coffee, alcohol, and other sugar sweetened beverages or fruit juice so that you can feel your best (and leave a little room for a few scrumptious holiday desserts!). 

Tip #5: Keep moving to keep the joy flowing 

When it’s cold and perhaps even snowy out, it feels more challenging to get out and about. But movement is key to our health and happiness. In addition, engaging in playful or physical activities can help improve our mindset, lower stress, and increase social bonds, which can all add up to a more fulfilling and enjoyable holiday season. 

Find what works for you. Make it enjoyable but keep it simple ⏤ do you have any neighbors that might want to take a walk around the block with you? If you don’t have a dog, why not volunteer to walk your neighbor’s dog that may need some exercise? If you’re gathering as a family (of course, in a socially-distanced manner) why not play some outdoor games on the patio like bean bag toss, horseshoes, ring toss…to name a few. Or just moving around the house such as cleaning, going up and down the stairs, using some hand weights or stretch bands, taking a movement break during TV commercials … it all adds up. 


Holiday season is time for unwinding, relaxing, recharging, and yes, indulging a little. With a few health tricks up your sleeve like the ones we shared with you here today, we hope that your winter and holiday season will be filled with joy, health, and connection. May your 2020 end on a happy and enjoyable note! 

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Sahra Pak, MS, RD, CPT, DipACLM
Sahra is a registered dietitian with a focus on plant-based nutrition, lifestyle medicine, public health, and mindfulness. Her personal mission is to work toward increasing equity, wellness, and happiness for all, by contributing to work that promotes the health of both people and the planet.

Over the past month, COVID-19 cases and hospitalizations in the United States have hit a record high. To stay safe during this time it is essential to know the symptoms of COVID-19, follow CDC recommendations, and to get tested if you are symptomatic or exposed to the virus. However, with all the advances in science and various types of testing it can get confusing to understand the rapidly evolving information about COVID-19 testing.  We hope this article will help you better understand COVID-19 testing. 

Antibody tests 

When it comes to COVID-19 testing, two main categories of tests exist: antibody tests and diagnostic tests. Antibody tests can determine if you have developed antibodies which means you may have been infected with the COVID-19 virus in the past. However, antibody tests cannot tell you if you have an active case of COVID-19. Your doctor can help decide if an antibody test is right for you. An antibody test might be recommended if you had symptoms of COVID-19 in the past and you were not able to get tested, or if you have symptoms of COVID-19 and other types of tests are coming back negative. If you want more information about antibody tests you can read this article on antibody testing from John Hopkins Medicine. 

Diagnostic tests 

Healthcare professionals most often use diagnostic tests to diagnose people with an active case of COVID-19. Fortunately, these tests can now be administered in a number of ways. While many tests are administered by healthcare professionals at a clinic or testing site, some diagnostic tests can now be done at home. Samples are most often taken from a patient’s nose or throat area, but some tests can now use samples of saliva. Results from diagnostic tests can be delivered in minutes (rapid point of care tests), or may take days or even weeks depending on how fast they can be processed in a lab. Rapid point of care tests, often simply referred to as `rapid tests”, have the capability of analyzing patient samples in a clinic or at a doctor’s office. For this reason, results from rapid tests may be available for patients within minutes. Other diagnostic tests that are not rapid tests, send samples to a lab where they are analyzed. Analyzing results in a lab requires increased time and results may not be available for days or weeks. 

One important thing to know, is that diagnostic tests are considered either molecular tests or antigen tests. Antigen tests, sometimes called rapid antigen tests, tend to deliver results more quickly, but are more likely to miss an active case of COVID-19. For this reason, if you are exhibiting symptoms of COVID-19 and receive a negative antigen test your doctor might recommend that you also get a molecular test to ensure that you do not have an active case of COVID-19. 

What to do?

Most importantly if you think you might have COVID-19 or have symptoms of COVID-19 it is important to contact your healthcare provider, local pharmacy, or local health department to find out about testing in your area. You should also make sure you isolate yourself from exposing others until you have confirmed test results.


If you want more information about COVID-19 testing you can visit the FDA’s webpage on COVID-19 testing basics.

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Katelynn Dornbusch, OTD, OTR/L
Katelynn is a registered occupational therapist. She graduated from Washington University School of Medicine in St. Louis with her doctorate in occupational therapy in 2018. As an Ally with Assured Allies, she is working directly with members to help them remain independent and meet their goals as they age.

The holidays are quickly approaching and that means it is time to start thinking about who and what you want to buy for those closest to you. It can be especially hard trying to find the “perfect gift” for an older adult. 

With the Pandemic continuing to disrupt life as we know it, older adults have been considered the most vulnerable and thus have been required to take precautions to remain safe. As a result of the precautions, older adults have been faced with the loss of socialization and stimulation. To help offset this loss, gifting user-friendly technology that can help users stay engaged and get connected could mean a world of difference. We have put together a list of tech gifts that are simple and enjoyable to utilize. So don’t fret, the gift recipient does not need to be tech-savvy!  

  1. First on our list is the Grandpad, a tablet designed specifically for older adults. This subscription service includes a tablet pre-loaded with the user’s preferences and contacts. It allows users to connect with loved ones through a simple video chat platform, send videos, photos, or voice emails through the easy to use large text applications. In addition, there is customized music and popular games to ensure the user has plenty of opportunities to stay engaged.  
  1. Great Call, a company whose focus is on providing older adults with health and safety products, has developed cell phones specifically for them. The Jitterbug Smart2 is a top pick this year, with features including a large 5.5” screen, voice typing text, a clear-named list based menu, and a long-lasting battery life. It also has mobile internet access and the ability to video chat with loved ones. In addition to being a cell phone, consumers can turn their phone into a personal safety device at an additional cost, by choosing a Lively Health & Safety Package upon purchase. This device currently has a 4.1 out of 5-star review. 
  1. For the older adults in your life who enjoy reading books, but have difficulty doing so, Amazon’s Kindle is an ideal gift. The Amazon Kindle has a few versions with different price points. We recommend the new Kindle Oasis. This model is waterproof, has an adjustable warm light, a side space with page turn buttons, and the ability to adjust the size of the text. Also, for individuals who have eyesight impairments, the kindle can be paired with Bluetooth headphones and be used aside Audible so that listening to books is just a click and connection away. 
  1. Oftentimes when we think about wearable technology, we think of watches that can accept phone calls, read text messages and overall simplify our lives. A smartwatch that can monitor an individual’s heart rate, provide personalized health metric information and notify emergency responders if it detects a sudden fall or an irregular heartbeat are all features incorporated in the Apple Watch Series 6
  1. We know vacations and plans to travel have been canceled or rescheduled due to COVID-19. However, it does not necessarily mean that eye-opening experiences we would normally see upon traveling need to be missed out on. Virtual reality headsets are allowing older adults to experience the world from the comfort of their homes. MyndVR has created an in-home virtual reality package where older adults have access to the largest library of senior-friendly virtual reality content through the use of a headset and corresponding tablet. The tablet, with a high definition screen and simple user interface for easy navigation, is used to pick the video of choice while the lightweight ultra high definition display headset provides the viewer with the ultimate visual experience. Chose from a trip to a country you have never visited or take dive with dolphins.

We hope found some ideas in our suggestions. Do let us know what you end up getting for the older adult in your life, and what they thought of the gift. Happy holidays!

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Angelina Portuense, B.S.
Angelina is a case manager who has been working in the elder care field for over 6 years. Her passion for working with older adults started in her teenage years when she became a family caregiver.