Let's Talk Eldercare...grab a cup of java, pen and ipad
Updated: Feb 23, 2019
Caring for your elderly parent or spouse brings about changes in the family dynamics. Some are great by bringing generations together, while others are trying bringing on frustration. Here we will discuss many topics that arise relating to Eldercare but let's not to debate the issues of caregiving but reason together and help each other strategize a resolution...a community of people with a plan. Feel free to leave a comment.
My Parent Treats Me Like A Child!
Many of us who have taken care of an aging parent know all to well of the treatment of the adult child is less than admirable in some cases. Our parents don't listen to our suggestions, tend to ignore our warnings and sometimes flat out tell us "No, I am not going to 'so-in-so' and you can't tell me what to do because I'm your mother/father!"
Well, that fact is that they are the parent and they feel they don't have to listen to you. But take a moment and think about it and put yourself in their shoes. Would you want your child to tell you what to do? You are using an authoritative voice when you speak to them. Yes, the slightest intonation in your voice can cause them to frown and give the "parent look."
Also take into consideration that they feel weak and vulnerable now. They spent all those decades caring for you and being their for you and now the role has reversed...now they will try to hold on to the last thread of dignity and authority over you by acting aloof and stubborn. Let's not forget the physical and mental changes they are experiencing-- they may be reverting back in time when you were a child. As the brain ages, old memories return to them of their youth and also memories regarding you as their child. In their mind's eye they see you as a child even though you are an adult. Or they may be regressing back to a time of their youth and remembering someone from their past who wasn't kind toward them and you remind them of that person.
Go with the flow. Choose your battles carefully or choose not to go to war at all. If it's not life threatening; let it go and revisit it at a more quiet and peaceful time when tension has reduced to a lull. You will be surprised as to why they treated you that way and you may even get an apology or at least a variation of one.
Housing Options for the Elderly
All of us over the age of 40 years will have to think about our parents or spouse as they age. We need to consider where will they go when they get to a point of needing assistance. There are several options for placing your parent or spouse:
1. Aging in Place. This is where they remain in their own home with medical services provided in their home. This also includes those adult children who have taken their parent(s) into their own home to care for them. Aging in place is the most cost effective. Your typical monthly expenses are already recognized and affordable since it is their home or yours. The only added expense would be a caregiver or sitter if you are continuing to work outside the home.
2. Senior Apartments also known as Independent Living Facilities. These are apartments that are designed exclusively for those over the age of 65. Very similar to your typical apartment but have physical modification on the premises for the safety and use for senior such as ramps and larger bathrooms. Some have planned activities, medical space in the main office lobby but no caregiver assistance unless you purchase it on your own. Price ranges from $900 and up just like any other apartment.
3. Group Homes. These are not as well known but very similar to ALF yet less costly. These are homes which have been converted into housing which several seniors live together. They may range from generally supervised for those who are more independent to 24 hour supervision due to the residents being more dependent in their care. I would say this is the "hidden gem" most people are unaware of. They are converted homes so they have a "home like" feel which the resident will be quite comfortable with. You have a choice of double occupancy and private room in most cases. Meals are planned, activities and medical appointments may be provided. Health professional are hired through an agency on an "as needed" basis. The Group Home would range from $1K to 3K depending on the need of your parent, which state you reside and the demand for them.
4. Assisted Living Facilities (ALF). These are large housing facilities that provide meals, social activities, general medical services and 24 hour supervision. . Meals, activities, outings are planned. In most facilities, additional charges (i.e. help with washing clothes and bathing assistance) can be added and accumulated over time if you are not careful. Various paraprofessionals come to visit the resident of the facility on a regular basis. Assisted living facility price ranges are broad, from about $3K to $10K and above
5. Nursing Homes which we all are very familiar with have the continual 24 hour nursing care and other paraprofessional OT, PT, ST, PA available on site during the day due to the residents requiring medical and physical assistance on a daily basis, planned and supervised meals according dietary or physical limitations and restriction. Activities are planned throughout the day if they choose to participate. Average cost is approximately 5K/month.
6. Long Term Memory Care facilities for those with Alzheimer or Dementia. These require 24 hour care, supervision and monitoring along with safety precaution of added fencing, locking and security doors and door alarms to prevent the resident from wandering off. As this is the most expensive.
Many decisions need to be made regarding your parent or spouse. Such questions to consider are: Should they stay in their home or move in with you? Do they need to downsize and move into a more manageable place such as an apartment or group home? Should you consider an assisted living facility or a nursing home or is your only choice is a Memory Care facility because of mental decline? Spend a considerable amount of time thinking this through and discussing with your parent or spouse before it is needed.
Getting Things in Order
Both you and your aging parent/spouse or disabled individual will need to sit down and look at the following areas before finalizing a place to live.
Look at their personal finances in managing the home or if the new location is affordable. If they plan to stay at home, look at the monthly bills and expenses. Don’t forget those that come in semi annually and annually such as auto insurance, homeowners insurance and property taxes. Have some money saved for daily necessities such as toiletries, undergarments, travel, entertainment.
In some facilities the monies such as social security, disability and other paid out benefits follow the patient. So if you plan to have your parent or spouse to live in a federal or state funded facility, all monies go to that facility along with the possibility of all of their property dispersed unless they sign it over to you or one of the children. Even this must be done at least two even in some cases years in advance before moving in a state/federally recognized facility. If it is discovered you withheld any of this money, you just may find yourself in court for not allocating funds designed to support your spouse or parent.
Other facilities such as Assisted Living Facilities and Residential Group Homes will only want you to pay a monthly fee but your are able to keep all you parent’s or spouse’s property. Review the different types of facilities and do your research into each.
Medical needs such as getting to and scheduling medical appointments, the need for an additional caregiver, managing medications and vital signs recording will need to be done in order to note any change in condition.
The need for additional supplemental medical insurance coverage should be considered to defray the 20% which Medicare does not cover. This may not be an issue initially when you consider bills under $10,000 but when the medical expenses reaches the hundred of thousands, this will become a major expense for the entire family.
Having a Living Will and a reliable person to be power of attorney to follow the parent’s wishes will lessen the possibility of conflict amongst the siblings and other family members. Some family are not ready to discuss this topic so choosing the right individual to obey your parent’s or spouse’s final wishes will be important.
This is also true for the funeral arrangements which will also need to be discussed with your parent or spouse. Will it be a casket or cremation; purchase of a plot or a donation of the body to science?
And finally the Will needs to be shared in writing and in a conversation with those family members who will need to be involved and everything done as order upon expiration of the parent or spouse in a manner in which they want the property to be distributed. Some states you can register the Will with the county in which you live as a secondary precautionary measure in order to prevent anyone from making changes to the will. No matter where they choose to live, these topics need to be explored in depth.
Prevent the Spread of Infections
Many lay people never seriously considered microorganism around them daily...on their skin, on surfaces and in a simple cough or a sneeze. If you are healthy and have a great immune system, you may rarely get sick from these microorganism but the elderly have a weaker immune system and everyone working with and around them need to take precautions to keep them healthy. Also several microorganisms have developed a resistance to antibiotics now so this also needs to be taken into consideration.
One simple way to prevent spread of infection is to wash your hands. Lathering up your hands for at least 15 to 20 seconds BEFORE and AFTER working with your elderly parent or spouse will reduce the chance of infection for the BOTH of you and any family members who live within the home. Make sure you rinse the soap down the drain, dry your hands well using disposable paper towel and use that same paper towel to turn off the faucets or you will re-contaminate your hands again.
Using disinfectant gels and sprays may work but then again the bacteria or virus will or have developed a resistance to it so it’s nonfunctional against them. Try bleach/water (1:10) or hydrogen peroxide or white vinegar to disinfect in the home. Some people are now using essential oils like tea tree, lavender and oregano blend but you must know how to use them so do your research into their uses. While doing this, wear gloves and with that said…
Gloves will also protect you and your elderly parent or spouse from infection. Wear them while cleaning their room and equipment as mentioned, while working with your elderly parent, removing soiled bedding/diapers, and if you or they are sick. Put those gloves on JUST AS YOU enter their room if they are restricted to a bedroom and take them off BEFORE you leave their room.
You can also wear a mask if there is a possibility of body fluids can become airborne such as coughing and sneezing. So keep a larger trash can in their room that accommodate throw away items and dispose of them outside in a sealed trash can. Wash your hands AGAIN after you finish this process also. Doing a weekly thorough cleaning will help reduce the chance of infection or the spread of an infection.
Don’t allow other who are sick to come in contact with your elderly parent or spouse. This includes children and teens because they are unaware how quickly infections can spread. If your parent or spouse gets ill, you will bear the brunt of the recovery process and going to additional doctors appointment for the new illness. Always practice good hygiene in every scenario in your home.
Spotting An Elderly Person in Need
Many people rarely know how to spot a senior citizen who is in need of daily sustenance such as food, shelter, clothing and toiletries. Because I work in home health, I am privileged to spot the obvious needs of the elderly over time. Most elderly will not let you know of their needs because of pride or embarrassment. Others feel you want something from them in return so they never feel safe to ask for help or assistance.
Here are some signs of an elderly person in need:
They tell you they haven’t eaten breakfast and it’s past 12:00 noon. You would have to be around them on a regular basis to spot this one. If you visit them often and they tell you the same thing every time, then most likely they don’t have enough food. Most elderly are not hungry but those who are without food will tell you they ate a slice of bread with white gravy (which is nothing more than flour, oil and water) or they will eat later.
In the grocery store line, they only have a handful of items. They only bought what they could afford. Most likely it will be can goods or pre- packaged dinners but never fresh or frozen items.
They walk around looking at the price of the items over and over again... they are trying to decide if they should purchase or can afford the item.
They count out their change to get an item then remove that same item if it goes over their budget. This is the elderly person that people in line complain about holding up the checkout not realizing the elderly have to be careful to buy only what they can afford. They still have medication to pay for and utility bills coming in so they don’t want those items cut off on them.
Unkempt Body. Signs such as uncombed hair, body odor and unbrushed teeth, urine and bowel movement odors. You have to be close enough to see and smell for this. This could be a sign of lack of cleaning products, diapers, hygiene products but also a decline in mental ability to be aware of their needs.
What Can You Do?
There are a few things you can do to assist them without losing their dignity.
Give them a gift card to a bargain grocery store or thrift store even if it’s just $10 dollars. Going to these places allows them to buy more and get a senior discount.
Pick up the grocery tab for them or pay for the item they couldn’t afford to purchase. Don’t let them talk you out of it because they are not used to anyone caring enough to do such a bold act.
If you know them, drop off a bag of toiletries or cleaning products at their door. Pick up shampoo, deodorant, soap, lotion or laundry detergent, dishwashing liquid and all purpose cleaner etc at a dollar store. It’ll cost you about $7 plus gas.
Take them to a senior event were they are giving away food and other items. Some nonprofits have such events annually or monthly. If they can drive, notify them of upcoming events they can attend and get free services, food and gifts.
Take them out to lunch or dinner. Surprise them with a free meal but nothing spicy that will make them sick; their digestive system will suffer.
Pay a utility bill for them. You can call the local water or power company and give their address and let them know you want to pay their utility bill this month. These utility companies will allow you to do this.
Pay to get their hair done, a pedicure or a massage. This would a special treat for them since they may not be able to afford it.
Pay for a cleaning service to clean their home. Just a basic cleaning or deep clean but be there to supervise so items are not stolen from them.
Other Sugar Alternative for the Elderly
Let's talk about sugar substitutes. Most people use artificial sweeteners found in products such as Splenda and Sweet n Low when their diet restrict the use of regular sugars. There are a couple of natural sweeteners to choose from. Let's look at them...
Xylitol and Swerve which is derived from fruits and vegetables and looks just like sugar granules measures out like regular sugar and taste like it too. These two can be used to make jams, jellies, cakes and pies. Stevia is from the stevia plant leaves and is super, super sweet with a slight bitter bite at the end but companies are improving the taste. It comes in liquid, powder, granules and fruit and chocolate flavored to make hot and cold drinks. With stevia liquid form, you only need a few drops so put in three or four drops in your drink and taste if you need more.
Another alternative would be coconut sugar which has a more robust earthy flavor which most people are not accustom to; it's definitely an acquired taste. And one other option is honey but it can be expensive due to the bee population dying off and little research has been done on the use of honey in the diabetic person’s diet so do your investigation on using honey.
Agave is an option but it affects glycemic level of diabetics individuals so is may not be a wise choice. So pick the sugar alternative best suited for you, your parent or spouse.
For those individuals who need to restrict the amount of salt there are good alternative to table salt which have health benefits you are unaware of. A good substitute to try is Bragg's Amino Acid All Purpose Seasoning. It is derived from non GMO soybeans, doesn't contain any wheat and is gluten free. It contains many (16 to be exact) amino acids needed for normal bodily function.
Sea salt is another good salt substitute which doesn't raise the blood pressure, provide your body with trace minerals and has a more pungent saltiness in comparison to table salt so you use less. You can choose from Himalayan, black, smoked, grey, kosher sea salt to suit your palate.
And the third choice for a salt substitute is lemon juice. Use it instead of salt. An added plus with lemons is that it adds vitamins to your meals, you can use the peeling as a zest on foods, drinks and desserts. And finally some people prefer the use of Apple Cider Vinegar as a salt substitute for its nutritional benefits and the flavor in comparison to salt.
Always check the labels of food you purchase for both the salt and sugar content. I once was drinking what I thought to be a organic nutritional drink only to look at the back label and found that drink had over 400 mg of salt in it! Take this into account when you buy prepackaged foods or buy meals at restaurants. At the end of a day you may have surpassed your daily allowance unknowingly. To reduce your cravings for salt and sugar, try eliminating your use of both sugar and salt for a week or two weeks and you will realize your need for either of them will have reduced significantly.
As with all new things always be aware that you may have an allergic or any reaction so consult your treating physician before using these substitutions.
Water Needs of the Elderly
Water is the universal solvent for all living things; nothing can survive without it. Many elderly try to drink teas, sodas or juices to replace water but it is impossible. Water hydrates every cell in the body, help flush the kidneys and add water to the large intestine to prevent constipation. If you are sick; drink water...if you are hungry; drink water...if you are fatigued or dizzy; drink water. Do you get my point?
Water is also important to drink while taking their medications; even some medication for high blood pressure require drinking water. To test for dehydration in your parent or spouse, gently pinch the skin of the back of their hand or center of their chest and hold for about three seconds and release quickly. If the skin does not return to it's normal state within one second, then they are dehydrated and need to drink water.
Most elderly don't like drinking it because they have to go to the bathroom more often the normal. But if they start drinking water on a regular basis at least two 16 oz bottles daily, the urge frequency will subside over time. Then begin to add a cup at a time as the body becomes acclimated to the amount ingested.
In addition to frequent urination, the elderly complain about wetting themselves or that they use up too many disposable pads and that can become costly. Well, there are reusable pads out there you can purchase now. They are considered sanitary pads but can be used as incontinent pads. The outer cover is made of PUL, a water resistive fabric while the interior is made of microfiber material against a flannel material. Better yet, you can make them yourself; about 20 pads at a fraction of the cost of just five store bought reusable pad. If you can sew a basic straight or zigzag line, you can make your own pads, you control how thick or thin you want them, if you want a snap or Velcro closure and they are washable which saves you money. They are far more comfortable and hold less odor than the disposable ones. Try to make a week's worth even if they are just for backup in case of an emergency. So make sure your parent or spouse gets the amount of water to stay hydrated and the body to function properly.
Impress upon your spouse/parent or disabled person you are caring for the importance of water to health.
Every BODY has an odor. As you go through different phase of development while growing up from childhood through teen years then aging and until death, body odor changes. Odor is normal and natural but is the number one complaint by caregivers. As the person ages, their sense of smell diminishes significantly so they are unaware of the odor. This odor also increases due to medications being taken, dehydration and slowing of the digestive system.The elderly loss of control of the bowel and bladder results in dribbling in their clothes, on the furniture and on the floor.
There are several ways to reduce this problem.
Use a combination of baking soda and cornstarch as a powered deodorant. After a bath and fully drying the body, lightly dust under the arms, under the breast, and the genitalia. Just remember a little goes a long way.
Place a plastic barrier on the mattress along with mattress pad atop of that and finally the moisture barrier bed pads in order that urine and feces does not penetrate to the mattress and cause damage due to the odor.
Change diapers and undergarment along with the sheets often. Today you have access to disposable and reusable diapers and incontinence pads. Have a combination of both just in case of an emergency situation where you may not be able to get disposables.
Buy perfumed lotions instead of spray perfumes. This allows you to have the entire body smelling good from head to toe.
Put down carpet deodorizer on the carpet and allow to stay for several weeks especially on accidental spills of urine and BM. The baking soda will absorb and hold the odor over time.
In the bedside commode add water to the bottom of the bucket with a little vinegar or baking soda. This will make it easier to clean as well as reduce the odor.
Place a plastic carpet runner under the bedside commode for easy cleanup if any spills occur.
Use a plug-in air freshener near the room but remember having one directly in the room can be overpowering for some people. Or use a diffuser in the home with natural essential oils to get the added medicinal benefits from the oils.
Breath odor can be reduce by removing bad teeth first. Bacteria under the teeth can be very strong plus it is a health hazard to anyone who has bad teeth in their mouth. Use a baking soda based toothpaste or dip the brittles in baking soda to stop morning breath in its tracks.
Buying Liquid Chlorophyll is a good internal deodorizer. This is extracted from dark leafy green plants and has mint flavor. You can purchase at your local health food store and mix in water that your parent or spouse drinks.
Put an air purifier near the intake vent in the home. This will disperse the clean air smell throughout the entire home and reduce or totally eliminate the use of synthetic air fresheners.
Nail Care Of The Elderly
People never think twice about nail care. Some just bite their nails off, others just quickly cut them down with a set of nail clipper and while others go to the nail spa and get their nail trimmed and polished. Both fingernails and toenails need to kept clean and should be cut short and filed down because of the bacteria and grime they collect underneath them. This bacteria could be ingested, passed on to other body parts and to other members in the family. Wearing false nails also trap bacteria, dirt and grim between the false nail and the natural nail. That is why the medical field does not allow treating staff to wear false nails.
For the elderly this is one of the most neglected body part for hygiene and care. They become thick, twisted and out of control causing foot problems of wearing shoes, putting on socks and walking. Because the elderly usually have thicker nails, soaking their feet or hands in warm water with epsom salts for 15-20 minutes will soften the nails so they can be easily cut down.
If they are bedridden, wrap warm, moist towels around their feet and tie it in place with a couple of plastic bags and allow to stay for 20 minutes or until the nail softens. If that doesn’t work, put a thick layer of warm lotion on the nails and wrap in plastic for 10 to 20 minutes. You can take a soft bristle brush and gently exfoliate the dead skin from the hands and feet while they soak.
When clipping the nails, remove a little at a time while holding the skin back at the tip of the toes or fingers to prevent it from getting snipped. Removing the cuticles should NOT be done but remain on the nail bed because it is the body’s way of preventing bacteria from getting under the skin. Dry thoroughly and add a thin moisture barrier of oil based salve on the hands and feet making sure you focus on the skin around the nails. Giving a quick hand or foot massage would be greatly appreciated at this time. You can even buy a extra tube of lip balm reserved specifically to moisturize the skin around the nails to prevent cracking and peeling. Don't share nail equipment of your parent or spouse with others in the family and clean after each use.
NOTE: Those with diabetes will have to have their nails done by a podiatrist only. Some will come to your home so call around to see if they do home visit for those who have limited mobility or are bedridden.
How Do I Wash My Parent's Hair?
Some of you will have those parents or a spouse restricted to a bed or can’t get into a shower. So this means you will have to use alternative forms of washing the hair. Here are a few quick tips before you begin:
1. Do one section at a time. Divide the hair into four section and work in a pattern that will be easy for you to maneuver. 2. Work at a level which you do not have to bend over them during the process. This will prevent you from becoming fatigued or injured. Make sure your parent or spouse is in a comfortable position as well. 3. Gather all the necessary tools before you begin. Have extra towels on hand. 4. Maintain the hair throughout the week. Keep it short, braided or pulled back in a ponytail holder to prevent the build up of tangles and knotting.
Here are some choices you have in caring for the hair of your elderly parent or spouse restricted to the bed:
Dry Shampoos and Conditioners. These come in a powder or spray forms and come in a variety of price ranges from $5 up to $28. Another form of "shampooing" is using dry baking soda to absorbed the oils and neutralize hair odor and then brush out thoroughly.
Hand Towel with Foam Shampoos. Another form of washing the hair is using hand towel. Spray the hair with warm water then take a wet warm hand towel and apply a foam soap on it to wash the hair. Use another towel to wash out the soap then dry with a third towel.
Cold Wash. Here you only use a conditioner to “wash” the hair. Perform it as you would the hand towel method, wash out with a plain water towel and towel dry.
No Rinse Shampoo Cap. These have been available in the medical field for some time. The shampoo is within the cap so all you have to do is put the cap on and massage the hair and finally hand dry the hair without rinsing… no water needed.
Check out reviews online and try them out yourself to see which type of shampoo best suit your and their needs.
You’re Getting a Caregiver or Sitter or Companion...Here are the Options
You realize you need help in caring for your parent or spouse or you need time to get away for some “me time.” just a couple of hours or a weekend. Let’s look at those you can call on to help be a caregiver, sitter or companion for you when you need it. Let's define the three to make the distinction.
Caregiver or Homecare Aides are trained to care for the physical needs of a patient. Some are trained in caring for a specific group of individuals while others are general in their caregiving skills. A Sitter only supervises the person and assisting with basic tasks of answering the phone, getting an out-of-reach item, adjusting the bed or feeding. A Companion is one who comes to spend time with a person for socialization, conversation or activities such a reading, crafts, etc; no physical involvement with the disabled person.
Family members are a good place to start when looking for a caregiver, sitter or companion. They know your parent or spouse, know what to expect and know what needs to be done. This is true for that family member who spends time with you; those that don’t visit nor call...let’s be honest; don’t chose them. They really don’t want to be bothered so asking them will be futile. And asking a teenager is not a wise choice unless you KNOW without a doubt he/she is very responsible. Now asking a teen to sit for a couple of hours or act as a companion may not be an issue since you have everything set up, arranged, diaper changed, meal prepared etc. but be aware the most drugs stolen from the elderly would first be a family member and most likely a teen. They can sell it or use it. I remember a commercial on TV while in the Midwest where the grandson helps his grandmother open her pill bottle and he takes some for himself before giving her the bottle back. Just be aware.
Hired caregivers from non-medical homecare companies is a popular option these days. They are screened and some are trained in certain specialties. Let these companies know what you desire and what is expected from the caregiver so you can have a good fit for you and the one you are caring for. You don’t want one coming over to help you and don’t have the skill to deal with your parent or spouse. Try to stay with the same individual each time you have them come to help you in order that you don’t have retrain each new caregiver that comes to your home. Always have two or three in mind that you can choose from just in case one or the other is not available.
If you hire a private caregiver of your choosing, make sure you have a contractual agreement between you and they, especially if you plan to have them to live with you. There has been instances were either the “employer” took advantage of the caregiver or the caregiver who move in and wants to stay indefinitely. So, you see how important a contract would be needed in such cases. Still again keep your important items in a locked safe place when you are not home and monitor those medications for theft.
Adult Day Cares are also available for several hours a day. These are utilized by adult children who continue to work and need someone to care for their parent or disabled person during working hours only. Much like a child daycare, activities, meals and undergarment changes are performed.
Respite Care is another option for longer time length such as a week or a month. Residential Group Homes, Assisted Living Facilities and Nursing Homes provide this option. Also some individuals who have spare rooms and experience with working with the elderly or disabled will house them in their private home for you. But you have to find these generous, caring people by asking around.
At Caring for Family Consulting we come out and give you and one additional person hands on training in direct care of your parent or spouse. Sessions are two to four hours long and packed with valuable information and is adapted for you depending on your need and prior experience in working with your family member. Respite is also available in some cases.
The Need for CPR and First Aid Training
All parents with children should be taking a CPR/First Aid Coursebut also those caring for their parent, spouse or the disabled should too. Until a choking event occurs or your elderly parent or spouse passes out in front of you or your family member experiences a major accident within the home, many never consider taking a CPR or a First Aid course. CPR courses will cover basic rescue breathing techniques and how to use a defibrillator if the situation calls for one. First Aid trains you as the caregiver to handle basic emergency situation until help arrives.
Most cities offer these classes free or at a minimal cost. Though you may not remember all the details of the rescue procedure, knowing SOMETHING is better than NOTHING. Waiting for an ambulance to show up and not having this basic knowledge will cost your parent or spouse time without oxygen, blood loss or an added injury when you could have begun the basic steps to prevent further damage to their bodies.
Having a good first aid kit is also advisable. Make sure it contain items such as large and small bandages and gauze, antibiotic creams or spray and ACE bandages, ice pack, hand sanitizer, gloves and masks at your home; placed in a red tackle box with a large cross on the it to identify it as such. For CPR, having a disposable face mask for the survival breathing would be advisable. Also have a blood pressure cuff and a thermometer available and be familiar on how to use them. Make sure all of these items can be quickly located in case of an emergency.
Lacking the of knowledge in CPR and First Aid will result in increase anxiety, stress upon you, demand of your time and an additional medical visit due to this new injury. Learn both CPR and First Aid...it’s better to be safe than sorry and regretful.
Urinary Tract Infection are common amongst the elderly...a very chronic problem which leads for frequent visits to the doctor. As a caregiver, you should look for early signs of this menacing illness.
There are reasons why the elderly succumb to so many UTIs.
Weaker immune system. As they age, their immune system is not as efficient as it used to be.
Muscle of the pelvic floor are weaker resulting in the inability to empty out the bladder completely. This results in bacterial growth which will migrate to the bladder and kidneys if not monitored.
Holding the urine due to the fact they don’t want to go to the bathroom.
Wearing undergarments that are already soiled. Because disposable incontinence pads are costly and the elderly don’t want to waste their money on buying more pads.
Resistive bacteria. Yes, let me admit that there is a generation of bacteria that have developed a resistance to the current antibiotics. This is not unknown to the medical community, it has been occurring for the past three decades. Quite often new antibiotics must be developed and the price goes up with it.
As a caregiver, observe your parent or spouse and look for these signs.
Burning sensation during urination
Frequent urge to urinate with little urine passed
Cloudy, bloody or strong smelling urine
Complaints of low back pain or abdominal pressure
Confusion, agitation or hallucinations
Frequent falling or dizziness
Not drinking enough water
Not going to the bathroom as they should be
Take them to their doctor for a proper diagnosis and follow the prescribed instruction until all medications have been used up. Not using the complete dosage results in the bacteria developing a resistance to the medication and another visit to the doctor.
Some things you can do as the caregiver to prevent the return of the UTI are:
Have your parent or spouse go to the bathroom frequently and sit there until the bladder totally empties out. Never allow them to hold their urine; the bacteria needs to be removed from the body.
Have them or you wipe them front to back to prevent the spread of the bacteria. Keep the area clean by using disposable wipes.
Have the wear breathable fabric undergarment when possible to prevent moisture and warmth which bacteria loves.
Drink plenty of water to flush the urinary system and eat balanced meals.
Garlic, Garlic, Garlic! Garlic is one of the most potent antibacterial, antifungal, antimicrobial food around and it tastes great.
Drink pure 100% Cranberry Juice which is very bitter but beneficial to reducing bacteria growth. Avoid coffee, alcohol and soft drinks during the infection.
Do pelvic floor exercises to tone up those muscles. Using the step stool placed under the feet during toilet use (known as StepnGo or Squatty Potty) helps the body fully empty out the bowel and bladder.
Use a long hose shower head to bath and rinse the perineal area thoroughly. Don’t forget the dry well to remove any form of moisture which bacteria can grow.
Use these techniques to reduce the “frequency” of going to the doctor for UTIs.
The Elderly On Tight Budgets
Some elderly will succumb to being on a very tight budget. Either they can’t go past the “fixed" income bracket, loss of spouse supplemental benefits or a financial disaster of some type. These individuals will have to learn to adapt by stretching their funds beyond what they think is possible...you know the proverbial “Squeezing blood out of a turnip?”
Over the decades, my mother and patients I treated taught me skills that I implement in my personal life in some form or fashion. Here are just a few that the elderly can begin to incorporate in their lives to save as much as they can:
Products are easy to get at any dollar store but when begin to analyze the cost per ounce, you can do much better with simple items such as these:
1. Bleach. It is a great disinfectant for those situation where you might find yourself or your spouse sick. Keep a small bottle on reserve for such a situation.
2. Vinegar. There are over 50 uses for vinegar. It is also a cheap disinfectant, insect killer, window cleaner, deodorizer, degreaser, laundry booster, skin care product, digestive aid and more.
3. Borax. I am surprised at the power of this mineral used to clean clothes, floors, general all purpose cleaner, degreaser and carpet cleaner etc.
4. Washing Soda. This is an ‘ole time favorite’ that almost went obsolete but you can find it more and more. Much like borax, it cleans almost anything.
5. Baking Soda. Another long term generational favorite that can knock out all types of odors in your house and on your body, helps with digestive issues, toothpaste substitute and a scrubbing cleanser.
6. Laundry Bar Soaps. These are also handy when you want to do laundry by hand for just a few items you have worn. Don't forget the old wash board!
Senior on a budget really have to watch their electric, water and gas; especially during peak winter and summer months. To reduce the cost of these utility bills consider the following:
Plastic Sheeting. Put this on all the windows with a small push tacks at each corner and along the sides of each window for the winter months. You can buy a big roll of this at your hardware store and when winter is over, fold it up and use it year after year. If you have some thick fabric laying around or a quilt, put that on top of the plastic to reduce drafts.
Fans. Whether it be a box fan or a ceiling fan, these turned on correctly according to the season can help reduce utility cost.
Water Heater Temperature. Turn this down to 115 to 120 degrees depending on the season. You can even wrap them with a water heater wrap or blanket to conserve the water temperature.
Curtains/Blinds. Opening curtain or blinds in the winter to allow heat in the home for solar gain and closing them in the summer keeps the heat out.
Fabric Sunscreen or Window Tint. These can be pricey but worth the investment. They have a dual purpose; they reduce the sun’s heat and UV rays from coming into the home while preventing people from looking into your home during the day. The fabric can also be folded up and stored for next year while the tint is permanently adhered to the windows.
Insulation. Insulation on the floor can be done putting a layer of foam under tile or simply laying wall to wall carpet. Put at least 12” of high quality insulation in the attic for the weather you may experience in your region. Foam tubing on pipes will prevent them from freezing and bursting.
Caulking. Buying several of tubes of caulking can cover window sills (inside and out), light switches, plug outlets and holes under the sink.
Personal Care Products
Making your own healthcare products will save you money at the cash register.
Shampoos. Diluting shampoos with water can stretch it twice as long and can be used for a body or hand wash.
Scrungees/Body Scrubbers. Using these items to wash your body with couple of small squirt of liquid soap brings about a ton of lather to bathe with and make it last up to six months or longer.
Baking Soda. Use as a deodorant or toothpaste or breath odor or any body odor. Use it as a body exfoliant to remove dead skin along with the body scrubber with a little soap added.
Lotion and Oil Blend. Combining these two together can moisturize the skin deeply without becoming overly oily. Use oils you already have at home and add it to lotion that best suits you. Try putting this lotion blend on at night so it has plenty of time to absorb into the skin.
These products are very cost effective and can be used individually or in combination to help save TONS of money and last forever while staying well within your budget.
Grab that Bag and Let’s Go!
Today’s earthquakes, tornadoes, fires, tsunami, cyclones, snow storms, flooding, even water disappearing from rivers, lakes and oceans is happening all over the globe. With that many natural disasters occurring, everyone should be ready to move in a moment’s notice, especially the elderly and the disabled. Having a bag ready and waiting will be crucial if you have to leave your home.
The Bag--your choices in bags run from a backpacks, baby bags, duffel bags, shoulder bags, laundry bags, or rolling suitcases. Make sure it sturdy, able to withstand rough treatment and easy to clean. It should be large enough to hold basic necessities you use on a daily basis. EVERYONE should have their own bags just in case of separation.
The Bag’s Content--items such as trial sized deodorant, shampoo, toothpaste/toothbrush, bar and liquid soap, lotion/oil, comb/brush, flattened roll of toilet paper, wipes etc. Two sets of clothing, underwear, socks, face towel and hand towel should also be stored in the bag with the concept of “ one to wear; one to wash.” For the elderly or disabled, plenty of disposable and reusable undergarments, wipes and at least two month’s worth of medication/creams should be in their bag or additional bag used to store these items.
Having a jacket, foldable raincoat, umbrella, hat and gloves along with a good pair of shoes would also be ideal. Don’t forget bottles of water tucked in the outside pockets for each bag. Having a personal first aid kit and a lighter in each bag would a plus for those simple medical events. Keep an empty tuna can and metal eating utensils, along with one MREs (Meals Ready to Eat) at the bottom of each bag just in case. Add bags of dehydrated or freeze dried fruit or vegetable along with beef jerky and throw in a hand full of hard candy for comfort food. Have a list of family contacts, medication, physicians and alternate housing address (i.e. hotel, relative’s home) and the meet up location should also be in the bag.
Messenger Bag--some people have never heard of these bags. They range from small pocket size to shoulder size. They should be considered for keeping legal papers (i.e. SS, DL, house deed, car title, marriage/divorce papers, birth/death certificates etc.) along with having all this same information on a flash drive located in a separate location. Don't forget the cell phone!
Bag Location--the bag should be placed where it can be easily accessed such as the corner of a room, in an armoire or hanging in the closet. Don’t place where it can’t be reach or too heavy to maneuver. If possible have everyone grab a small lap/bed throw on the way out. This will come in handy if it get chilly or just to sit on.
5-Gallon Food Bucket--having extra food and water wouldn’t hurt either. Quick to eat energy bars, fruit leathers, easy open vegetable cans, thin pastas such as vermicelli, cans of tuna, soup bowls and additional varieties of jerky and dehydrated fruit and veggies are good choices. Add a lighter, candle, additional eating utensils and a can opener. Keep those tuna cans to eat out of. Have bottled water in the bucket to prepare these foods and to drink. Don’t forget to purchase the Gamma lid to be placed on the bucket. This lid provides an airtight seal so no moisture can enter it.
Rehearsal-- Occasionally perform a trial run, drill or discussion to make such everyone understand what is expected of them, do they have enough supplies for the amount of days and to see if the procedure goes smoothly.
These are just a few things to have prepared before disaster strikes.
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Basic Equipment Needs for the Aging Parent, Spouse or Disabled
You have decided to bring your parent or spouse home to stay with you but you have no idea what equipment you need when they get there. Here are some basic but necessary pieces of equipment you should have for them.
The Wheelchair and/or Walker:
These two items Medicare pays up to 80% of the cost. But if your parent or spouse doesn’t need a wheelchair to get around because they are able to walk, Medicare won’t just give a wheelchair to you. These two items are suggested/prescribed by the PT (Physical Therapist), OT ( Occupational Therapist) and MD (Medical Doctor). They are difficult to get without being of “medical necessity” which means they “need” it to ambulate or maneuver when they get into the home or to make medical visits. Wheelchairs come in a variety of styles, sizes and weight but the elderly get the standard metal wheelchair in most cases. Walkers have a variety of foot option such as two or four wheeled, weight bearing stop gliders and the standard legs. If you can’t get one prescribed then your local thrift store or medical supply or go on website that has items for sell may be an option. Most likely you will find one or both of these types of equipment for resale locally so don’t hesitate to look on app such as Letgo or 5 mile if you are on a budget.
Hospital Bed and Bedding
The bed is usually rented from Medicare but if you know that this will be long term need for your parent or spouse then spend some time looking for one at those places mentioned above. Some charities and church organizations will let you use one at low or no cost if you contact them while they have them in stock. These beds come powered where you can use the remote to adjust the bed’s height, head and foot of the bed; semi-powered, where the only the head and foot of the bed can adjusted with the remote or manual where hand cranks are located at the foot of the bed in order to adjust the bed.
Mattress Egg Crate will be needed if your parent or spouse is restricted to bed. These help relief pressure areas on the body. Long Twin Sheets are needed since hospital beds are longer than your standard twin bed. Mattress Pads and Covers will be needed to keep the bed from getting soiled. They come in disposables and reusable types. Extra Blankets/Throws will need to be reserved to due the fact older people tend to get cold very easily.
Bedside Commode or Raised Toilet Seats
These are also prescribed by your medical professional. There are many variations of these commodes so make sure you get the right advise on the one they will need. Don’t forget to put a night light in the area which this commode will be placed in order to prevent the chance of falling during the night. If you will be using wipes on a regular basis, try to order by the case instead by the package to save money.
Shower Chair, Tub Bench and Other Miscellaneous Items
Since your parent or spouse will not be getting into the tub, a chair or bench will be needed. These also are dependent on the need of your parent or spouse so get an accurate evaluation at the hospital of what chair or bench is needed before they come home. Grab Bars or Stabilizing Bars are used to maintain their balance while moving in and out of the tub or shower. Grab Bars are secured into the wall and used to pull up on while the Stabilizing Bars have a suction cup and both ends which is used strictly for balancing body weight while moving in the bathroom area. Bath Mats are needed inside and outside the tub/shower area to prevent slip and falls. Make sure the mats have a rough surface on them so the feet won’t slide during movement.
Blood Pressure Cuff and Thermometer
While treating patients, I have seen so many of them without these two devices. Having each of these item will help you monitor your parent or spouse health status and any changes that might be occurring. Choose one that is easy to read for both you and your parent or spouse. Allow them to learn how to take and record their readings by providing a notebook and pencil. But you know, “there's an app for that” you can place on your phone or their. Be careful not to download a “gag” app which is used only for fun and jokes...yes really.
Diapers, Undergarment and Incontinence Pads
Make sure you have plenty stored up in their closet and bathroom. Find which one is best for them to use and which is best for you also if you are going to be the one putting them on and taking them off. This is another item which comes in assorted styles so find the one that best fit the need.
Lubrication and Wipes for cleaning the perineal areas thoroughly and to prevent skin breakdown. Extra Towels are necessary to have on hand because you use a lot more than you think.
Rubber bottom Shoes and Socks
This one is overlooked and should not be ignored. Having these on their feet will prevent falls and slips. Make sure they are of good quality and not too tight on their feet or calves that they hurt, cut off circulation and easy to put on and take off. TED Hose are the exception to this because they are required to be tight to prevent blood clots and reduce swelling.
Having these items ready BEFORE your parent or spouse comes home will make your caregiving much easier and stress free when all things are in place before they come to stay.
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Best Places to Buy Groceries for the Elderly
There are many grocery stores to shop but I have had seniors tell me which ones are more convenient for them. Factors such as price, location, space to use their walker or wheelchair, helpful associates, parking and variety were the main points brought out by the elderly which affected their preferred store. The following stores are their favorite choice along with a couple of suggestions of alternative places to shop for groceries:
Walmart’s Neighborhood Markets. The plus for this store according to the elderly is that fewer people shop there during the day (a mini Walmart) which makes it easier for them. The variety of items was also commented on such as buying undergarments and the pharmacy on site.
Aldi Food Market. Many seniors love this one because of it simplicity and having the basic food staples they want. But they also mentioned how this stores occasionally have medical equipment to take home and the gluten free section for their baked goods and pastas. Size of the aisle and the quieter environment was also important to them. Let’s not forget price with some seniors being on a fixed budget, Aldi gives them more bang for their buck and fresh tasting produce and increase in organic items availability.
Food Lion. This one is located in only specific states but has improved itself. Larger signage, more variety and fresh fruit and vegetable ready-to-eat hot and cold meals and a gluten free items makes it popular with seniors along with the helpful staff. Store is organized well to prevent fatigue while shopping.
WinCo Foods. Locations are in the Northeastern and Southwestern states and is employee-owned. It is situated similarly to a warehouse/grocery store feel with deep discounts on all items. It also has a bulk items section of spices, nuts, dehydrated fruits, grains, candies and coffee that can compete with the best of health food stores. They even have packaged meals for survival situations! One drawback is that they do not accept credit cards.
Food Banks. Seniors fail to realize they can go to the food bank and get food if they need to. Some Food Banks have collaborated with local churches to provide a bag full of fresh produce for about $7 per bag. They bring out a huge semi truck once a month to the church or senior center and hand out the bags of produce. If you want more bags, you have to wait until everyone is served then you can pick up more at that same price.
Community Gardens. More churches with open spaces, senior apartment complexes and neighborhoods with a vacant lot are putting in garden beds so people in the area can rent annually and grow their own fruits and vegetables. Some gardens are basic with only beds, while others house chickens, rabbits and bees. Others are designed more elaborately with pergolas/gazebos, hanging lighting and park benches so small venues can be held there.
Meat and Fish Markets. These stores specialize and sell mostly meats and/or fish. Not all locations have these types of stores. Here they can buy meats, chicken, sausages, bacon and their by product such as cheeses, milk, eggs, tallow and fat for cooking. Some fish markets have a large variety of fish, shrimp, clams, crabs etc. and they can choose between frozen or fresh, have it cut and cleaned, even have it fried while you wait.
These grocery stores are the chosen option by senior or available for seniors to help them save money on food.
Oils and Fats...You Mean We Need Them?
The topics on fats and oils have been an ongoing controversy for decades. Your body needs fat for growth and development, store for times when food is limited, transport certain vitamins such as A, D, K, and E in the blood to be utilized by the body, necessary for nerve and brain electrical conduction and assist in hormone production. Having the right fats is essential to survival for all living creatures.
Let's look at the saturated, unsaturated and hydrogenated fats. Saturated fats are mostly from animal in origin or derived from their by products such as found in meats and dairy products. Coconut is the exception to this rule. For centuries and even some cultures today eat fat raw, fried and cooked with no physical ill effects as long as no chemical additive, added hormones and antibiotic were not used in these animals.
Unsaturated are from vegetables, nuts and seeds which the body utilizes quite readily. These two are naturally occurring and accepted by the body for energy and use by the body’s systems.
Hydrogenated, on the other hand, is changed by heat and/or chemically altered for a longer shelf life; not for your health. They are found in processed foods, fast foods and store bought baked goods. It has been found that it causes inflammation that affect the heart, diabetes and the immune system disorders.
Choose fats such as olive, grapeseed, avocado, coconut, animal fat etc, that are healthy. Keep them in the refrigerated and/or add a Vitamin E capsule to it to prevent it from becoming rancid too quickly.
Dental Care Affect the Elderly’s Health
Couple of decades ago the medical field came to the realization that lack of dental care affects the health of the individual. Certain diseases such as diabetes increase dental problems which in turn affects health. Infected gums can result in multiple forms of heart diseases if left untreated. It has been recently suggested that certain types of fillings begin to affect the immune system over time due to the direct exposure of tissue in the mouth.
Because some elderly can’t afford the cost of dental care, most go untreated. In addition to affecting health, bad teeth causes breath odors, difficulty chewing and eating causing weight loss and irritability due to pain. These in combination causes a cascading effect of not eating proper foods, teeth getting worse and increased poor health.
Look for these Signs of Dental Problems:
Bleeding, swollen, red or tender gums
Continual bad breath despite brushing
Loose teeth or gums receding from the tooth
Change in teeth position and color over time
Poor fitting dentures or bridges
Ways to prevent these dental problems for the elderly is to get regular check ups. This will help identify problems before they get worse. Brushing the teeth, flossing and oil pulling will reduce bacteria growth and removal of bad teeth will prevent spread of infection. If the situation is dire and a number of teeth need to be removed and denture purchased but unaffordable for the elderly, do some research of reduced cost facilities that provide dental care. This can be a dental school, low cost dental facility or just have teeth removed in a systematic way by removing a couple of the teeth at a time every six months while on a discounted dental program. Trying to keep teeth that are full of bacteria increases the chance of illness or even death in the elderly. So have their teeth checked on a regular basis.
Personal and Home Security Systems
Today there are a plethora of monitoring systems out there to choose from for both personal and home surveillance. Some are so small that no one would realize they are being observed. Get on online a found out what out there because things are being updated and invented every year.
For personal application, where you would need to monitor your elderly parent or disabled person, you can use bed alarms to know when your loved one has gotten out of bed, a wheelchair seat alarm which notifies you of them getting out of the chair, pull “call” alarms so they can notify you when they need you or using basic baby monitors and be placed near your bed and your aging parent's bed will notify you of activity in the room. Today, these monitors can be synced with your smartphone so you can observe activity in their bedroom.
For the home, door alarms will let you know if anyone and entered or exited the home. These alarms are great for those parents or spouse may have the tendency to wander off. Having a video monitor of some form inside and outside your home would be ideal especially if you have people coming into your home on a regular basis to care for your elderly loved ones or monitor where your parent or spouse is located at the moment. These also can be connected to your smartphone so you can observe at anytime...anywhere.
Having a “Sign In and Sign Out” Booklet will also help you gauge who is coming to your home and who isn’t showing up. Most people are not use to this but it will give you a general idea of the traffic flow in your home. Keep this located at the entry so it’s visible to all visitors and they won’t forget to sign it.
All types of monitoring, both personal and home are essential for the protection of your family member and your property so have one in place.
Coming Holidays...Coming Family...Coming Conservation
The winter months ring in Thanksgiving and Christmas holidays for most. It is a time for three generations of family to come together, cook their favorite holiday meals and lounge around and relax in each other’s company. But these two holidays of the year are the only time you can get family to come together. I suggest schedule a time where you discuss what your plans are upon your death, share the living will, the will, choose your power of attorney and let everyone know your advanced directive if you are in a coma or pass away and need the funeral plans completed.
There will be a few who do not want to discuss this now-- not during the holidays! But what other time do you have when they all come together? THIS is the only time you have and make it clear for them and that they understand that you want things to run smoothly, what you expect from them and how to proceed. Doing this when ALL of the immediate family is together is like having a house full of witnesses for your instructions. No one will ever be able to make any changes to your plans unless 100% of the family agrees to change it and that is highly unlikely to happen. Discuss with them the things they would like to have to pass on to the next generation, share moments of endearment with them, and get constructive ideas from them.
Do this several times until you get them to understand what you are doing , what you want done and why. Finalize everything with a complete workup of your wills, directives in writing from an attorney and registered with the county to prevent anyone from changing anything. IF you’re REAL lucky to have a family who is in full agreement with your plan with no foreseeable conflict amongst the family members then just a notarized copy of all your instructions given to each family member of your plans may be suffice. I hate to be curt but the latter RARELY happens. You may need to spend six months to a year to plan this out and making sure you have all your bases covered but it will be worth it in the end.
Sooo... Where is That in the House?
Whether your elderly parent or disabled one lives alone, lives with you or in a group home, there are things and areas of the home they should be aware of and how to use them in case of an emergency. Make sure you and they are aware of the following items or location of devices needed in case of an emergency situation:
Main Water Shut Off -- This will need to be shut off during repairs or natural disaster.
Gas Line Shut Off -- knowing where this is located will help the repair person quickly turn it off if need be.
Water Shut off under the Sinks, Toilets and Wash Machine -- just in case a situation where these items begin to flood or hose bursts.
Fire Extinguishers/Alarms -- in case of a fire, there should be a couple in different locations throughout the home and know how to use them.
Breaker Box Location -- know for electrical problems, repairs or emergencies which require it to be turned off.
Alternative Exits -- if they need to get out of the home, some other ways other than the doors should be provided. Window exits should be made available with teaching them how to remove any locks and how to open these windows to exit the home.
Alarm System Disable -- in case it begins to go off for no apparent reason.
Emergency Backpack -- when they have to leave in hurry for whatever reason.
Personal and Medical Information -- they should have quick access of their own information to provide to any treating healthcare professionals along with work and home/cell phone numbers of family, relatives, caregiver, Fire Dept and Police Dept will come in handy.
Portable Alarms -- such as bed alarms and call alarms for their personal safety.
For their safety and the safety of those in the home, occasionally review these locations of these items and have them practice using them for those situations where they may be alone or need to direct someone to locate them.
“I Wear A Catheter and I Don’t Get Infections.”
One female patient made this statement to me in a “matter of fact” manner. In my experience, many patients both males and females wearing a catheter get multiple infections while using them; especially females. They end up taking multiple rounds of antibiotics to try to clear it up with the infection returning again and again. But this woman made me realize this can easily be avoided with good hygiene in the perineal area...VERY good hygiene.
She explained that she first starts off with super clean hands and a clean surface to which to work from. She would lay down and place a clean towel (whether cloth, pad or paper towels) underneath herself and clean the area with approximately four to five disposable wipes. The technique of wiping the area gently and then folding the used portion of the towel inward to make sure she doesn’t wipe with the dirty used portion of the towel. She cleans around the urethra, clitoris, vulva, around the vagina and finally the labia thoroughly. She then would clean with a new wipe the perineum and anus in a direction AWAY from the vagina then finally wiping down the tube with another clean wipe. She stated she does this several times a day; not once or twice but SEVERAL times a day.
She stated she uses the long hose shower head to rinse but she still does a good washing of the area with a very mild soap or a vinegar/water combination in a spray bottle prior to the shower rinsing technique followed by good drying of the perineal area to the point of laying down on her back to air dry the area under the ceiling fan if necessary. But as she said, you can’t get in the shower several times a day so that is why you need the wipes to do it by manually throughout the day. She told me she buys wipes by the case; not the packages which a good idea for saving time and money.
For males who are utilizing catheterization, this cleanliness of washing hands thoroughly and working on a clean, sanitized surface should also be done whether it be internal or external catheters to prevent the growth of bacteria and the spread of infection.
So, from the mouth of a female patient who wears a catheter...this infection is completely avoidable if done right.
Low Cost Exercise Equipment
As you and you parent or spouse stay at home, the two of you may find yourselves becoming lazy. Not because you two are not trying but the demands of going to medical appointments, meal planning, bathing and dressing, has overtaken your lives to the point you don’t want to exercise. But here are some quick, easy forms of exercise that is entertaining and fun.
Wii Video Game can be played by you, friends, your elderly parent or disable individual. These were used in the medical setting in the 90s and new variation of them are now used in rehab facilities. The elderly have a slight difficulty getting used to releasing the button on the remote but it doesn’t take long before they get accustomed to it. Used the balance board to improve their lower body strength, balance and coordination which reduces the risk of fall.
Exercise Video or DVDs. You can find these on the internet, at the library or purchase them. Choose a few of different levels of experience for you and your aging parent or disabled person as they process in strength and endurance.
Water Bottles or Bags of Beans. Using various sizes of unused water bottles or bag/cans of beans to provide resistance for arm exercises especially for the elderly. Double up the bag of beans in order to prevent the original bag from bursting during use.
Old Belt or Gait Belt. These belts have multipurpose uses and one of those uses is for stretches. Loop the belt around your wrist, elbow, thigh or foot to improve flexibility but be gentle as you hold for several seconds or you will cause injury.
Various Sized Balls. Balls of all sizes, densities and weights make great exercise equipment. Small ones for grip strengthening, catching or massaging the body and large ones for reaching, throwing for arm and leg strengthening and for the trunk and abdominal muscle for strength and balance.
Exercise Bands/Tubing. These can be purchased at most retail stores at a low cost. Buy a pack with three or more types of resistance so as you and your parent improve in strength, you can change band resistance.
Putty. Buy theraputty online or the old fashion silly putty for finger, wrist even for foot strengthening. Add marbles, beans or pennies for dexterity and pinch.
Bean Bags & Rope. Make about 10 bean bags of different weights for a competitive toss game using rope as the boundary line or score points. Do it sitting or standing or both!
Thrift Store Buys. Stop by your near by thrift store and you'll be surprise the amount of exercise equipment you can purchase for under $10.
These are just a few quick, inexpensive ways to stay fit without going overboard in cost. Have fun solo, together or as a team! Drink plenty of water during these activities too!
“They told me I Can’t Take Him Home because of Alzheimer's”
I recently had patient tell me that his father was in a nursing home for rehab after a hip fracture. He told me that the nurse at this facility had told him that his father had Alzheimer and was unable to go home even after the treating physician was discharging him from the nursing home. The nurse refused to allow him to take his father home and he was outraged. This diagnosis was news to him. Sure, at 85 years old anybody would have some memory loss but not Alzheimer...not all of a sudden developing this diagnosis.
These are some facts all caregivers should look into after their elderly parent or disabled had been released from a medical facility which has an effect on their memory:
A Change in their Medications From What They Originally were Using at Home Giving new prescriptions to new patients usually occurs during any hospital or nursing home stay. Get a list of these medications and review the side effect online or better yet go to your pharmacist to learn about them. The new drugs or the combination thereof will have a great effect on memory. When they are discharged from these facilities always go back to the original treating physician and review what is needed and what is not.
Your Elderly Parent Received Anesthesia for Surgery.
Some elderly take longer to recover from the anesthesia after the surgery taking several weeks or months to get back to normal. But some never seem to recover quite as well from it especially those with previous diagnosis of heart disease, Parkinson and Alzheimer have the most difficulty.
New Environment Moving to a different facility causes confusion. They are bombarded with new staff, thousand of questions, new medications, different room which to sleep and awakened throughout the night.
Loss of Interaction with Family, Friends, Pets, Neighbors. Having daily contact with significant people and pets in their lives keep your parent or spouse active and alert while isolation brings about hopelessness, despair and decrease in mental stimulation.
Dehydration. Most elderly won’t drink the amount of water they need to flush the kidney or hydrate the colon to rid the body of medication laced waste.
Do a complete checklist of the topics discussed above before accepting a comment of having Alzheimer unless it has been received from a physician who has had them tested for it.
Note: It is illegal to keep a person against his/her wishes. This may fall in the lines of kidnapping, elder restraint against his/her will...just so you know.
What is Elderly Learned Helplessness?
In my blog “Eldercare Trickery and Caregiver Tips”, I briefly discuss the process of Learned Helplessness. I first learned of this term with my psychology degree. But as I worked in the medical field in OT and PT, I had realized after observing the family dynamics that the family members were creating this form of co-dependence that rewarded this behavior. Learned Helplessness, by our definition, is when the caregivers, who are caring for the individual who is ill or injured, conditions the person who is ill into believing they are unable to care for themselves or that the ill person gets positive reward for being sick.
A good example of this is when an ill or injured person who is unable to do for themselves, the caregivers do everything for them from bathing, dressing and feeding. But as this person gets better, the caregiver continues to do everything for them. Another example was told to me by one of my patients. She said that being in the hospital was a “Mother’s Paradise.” She went on to explain that while in the hospital a woman has nothing to do; food is cooked and brought to them then taken away with no dishes to wash, medication is given to them by a nurse, an aide comes help them bathe, make their bed and clean up their room, etc. She stated, “What’s not to like about that?” Only after she explained this to me did I realized this gave them positive reinforcement to NOT get well.
Be aware during caregiving that you don't do too much for the one you are caring for. Allow them to do as much as they are physically able, especially those things they have been doing since childhood like washing their face/hands, brushing teething, feeding themselves, dressing, etc. These skills are ingrained in them from their toddlerhood so these are stored in their long term memory.
As they improve be sure to wean them off from being dependent upon you by doing less and less for them overtime. Gradually let them do more for themselves while you stay a safe distance away so they can do it on their own. This will build up their confidence and the desire to be independent. There will be a few who will stubbornly refuse to get better but gently encourage them to try and reward the effort. Again, very gradually have them do more for themselves while still giving positive accolades. Before you know it (and before they know it), they are independent again.
Using Oxygen in the Home
Some of you will find that your aging parent or spouse will need oxygen. This is needed to survive and maintain good oxygen level to prevent exhaustion, overwork the heart or damage the brain. Special care needs to be considered with the use of oxygen in the home.
Here are some precautions:
1. Keep any form of flames away from oxygen. It is a flammable gas so be careful around open flames, heaters, fireplaces and cigarettes.
2. Make sure oxygen level remains at the prescribed level unless instructed otherwise. During strenuous exercise during therapy or walking it may need to be turned up but that is for a short period of time.
3. Make sure small children do not come in and play with the knob settings or unplug the unit.. They can be very curious so make sure you keep an eye on them the entire time they are in the room. Also make sure they don’t put it on their own face and nostrils. This become a choking or over oxygenation situation to a child.
4. Keep the condenser water level maintained and change when needed. This will keep the nose and lung moisturized with humidity correctly.
5. Change the tubing when needed and check for kinks in the line to make sure air is flowing properly.
6. Have empty oxygen tanks marked and removed by the providing company. But also has a several of tanks on reserve just in case of an emergency situation.
7.Make sure the tubing is long enough so your parent or spouse can maneuver in their room and bathroom. A colored tube is more visible to see on the floor while walking thereby preventing falls.
8. Keep a small fan in their room due to the amount of equipment in the room or the humidity buildup in their after a shower.
9. Have semi annual or annual preventive maintenance done on all the equipment.
Use special care when having oxygen use in your home and make sure every visitor is aware of these precautions.
Tiny Houses Built For Seniors and Disabled...What a Novel Idea!
I have looked at tiny homes for quite some time. I saw how efficient they could be for a single person, college student or someone trying to move away from the mega mansion concept. As I watched the tiny home movement grow, I wondered if this would be a great alternative for senior or disabled person as they age. Manufacturers of these tiny homes focused on them as retirement home but never adapted them for those who were wheelchair bound or required a walker/rollator to maneuver around in the home. The bedroom were usually in lofts, bathroom were tiny and a large oven and fridge were placed in them, which in my opinion, defeated the purpose of economy.
But finally, some tiny home developers are making these homes for those are physically challenged, requiring wider doorways, lowered counter space and light switches and ease of access drawers and extra storage space for needed equipment and roll-in showers. This can be an additional form of housing that can be placed in the backyard of caregiver adult children which allows the home to be hooked up to existing utilities of the caregiver’s home. This type of housing will provide the senior or disabled person the independence and freedom of space while providing general supervision of the disabled by the caregiver.
Pricing for these tiny homes can be high if you begin to add extra custom amenities such as built in fireplaces, special lighting, and added windows. But if kept simple by removing the full size oven and adding two burner stove top or only a microwave, a small refrigerator instead of a full size one, remove the queen bed and put in a hospital/twin bed, the cost would be far less than what you would pay for assisted living or senior apartments on a monthly basis. Plus you can keep a closer eye on them literally through the back window.
This would be a good housing option for your elderly parent or disabled person. Check into them and discover if this would work well for you and your aging parent...providing the freedom, privacy and security you both want and desire.