Showering and the Elderly

As people age, the bathroom goes from being the bathroom to the scariest place in the house.  Most bathrooms are somewhat confined for space, can be hazardous because of slick flooring, but bath rugs can be equally hazardous if you have a foot shuffler that doesn't pick up his or her feet.  Due to thinning skin, baths feel like a raging inferno or the arctic sea and it is hard to get the water temperature comfortable.  Also, the lighting in the shower/bath area is usually dim in most bathrooms.  So, it is not a shock that many elderly persons begin to avoid getting showers or they greatly protest doing so.

First, keep your loved one in a routine of getting showered or bathed. If you give in to much to the protesting, it actually gets worse instead of better.  Not only can this effect their overall health and hygiene, but if they get out of the routine they will sometimes become combative when you have the "enough is enough" point and require them to bathe.  There are some ways to make it less traumatic.  First, make sure there is good lighting and adequate grab bars.  Many medical supply stores will carry grab bars, but you are likely to find the same thing at +The Home Depot a lot cheaper.  Those with dementia, low vision, and aphasia (difficulty understanding), in particular are already terrified and confused.  Don't add making them feel like they are being shoved naked into a dark hole part of their experience.  You have to try to see it from their point of view.  If they need bathing assistance, do it quickly, with compassion, and go in head to toe fashion.  They do not enjoy being in there as we do, so don't drag it out.  Utilize bath aides, such as shower seats and removable shower heads that the spray can be adjusted.  It is terrifying to many elderly to have water running directly over them (such as with a stationary shower head) and they develop a fear of drowning.  There is a great website called +Allegro Medical that you can get any number of adaptive aides and medical supplies and save yourself tons of money.  I know from experience that they are the cheapest and best that I have seen for all things medical.  (Great for incontinence supplies as well.)

Also, make sure the shower area is heated.  If you don't have a heater in the bathroom (lots of houses don't anymore), get a little heater to turn on while they are in there.  It truly does help.  A large towel is great for keeping them warm, but when it comes to drying off another person, hand towels actually work better.  If you or a caregiver are assisting with the shower, always use that time to do a body assessment for bruising, sores, etc.  That does not mean you suspect abuse, just that skin breakdown and integrity are so crucial and bruising and sores can occur without the most loving of caregivers ever knowing it.  Last, I would encourage some type of reward for the resistant bather.  Time the shower where they can have an afternoon snack, a favorite magazine, or just anything enjoyable to them that can be done afterwards so that it doesn't seem so bad.

Avoiding Bedsores

As our bodies age, the skin begins to thin at the surface.  This explains why the elderly can bruise easily and are also frequently cold.  It is important as your loved one declines in mobility that you be aware of ways to avoid bed sores and contractures.  One thing that may seem silly, is to never go to bed with the sheets tucked in at the bottom of the bed.  A tucked in top sheet can cause toes to contract, which can cause further mobility issues.  It is also important to let your loved one move as much as is feasible.

Bed sores and contractures occur when the body sits or lays in one position for too long without movement or blood flow.  Simply by having your loved one shift their seating, stand up for a minute, walk about the room, repositioned with pillows during sleep. etc. you can help to avoid bedsores and contractures.  If you see persistent reddening in an area, most frequently noticed at the sacral area of the spine, it is important to begin to apply barrier cream and keep your loved one off of the area receiving too much pressure. A bedsore can turn necrotic (septic or deadly) in a hurry if left unattended.  So try to assess or have your caregiver assess your loved one's body on a regular basis, such as with toileting or changing clothes.

When confronting issues of incontinence care with the added difficulty of decreased mobility, special care should be given to the sacral area.  This area is often affected by urine at night and then when pressure is added from sitting or laying in bed, infectious sores can develop in a hurry.  I recommend using a barrier cream such as +Boudreaux's Butt Paste to try to prevent redness and skin breakdown.

I am going to post a link today, as this will have a lot of encouragement and ideas on this site.  Here you go: www.facebook.com/ComforcareAustin and it is my place of employment. Love these folks!

Importance of Respite Care

It is imperative for caregivers, employed and financially compensated, to take respite care.  Even if it is just 2 to 4 hours a week, this time away from the care giving responsibilities can be a tremendous asset in fighting caregiver fatigue and depression.  For those with loved ones at home with issues such as dementia, this respite time can be crucial, even if all it is utilized for is to be able to sleep for several solid hours in a week.  Caregivers often suffer from severe sleep deprivation and will decline quickly in their own health if their own needs cannot be met.  So much time and energy is consumed by care giving, that many caregivers begin to see a marked decline in their own health occur from the stress involved with the job.  Some common medical problems that begin to arise are: weight gain, especially fat in the front belly, or as some term it, the "deep apple fat."  This is a dangerous form of weight gain in that it indicates a higher tendency towards heart disease and diabetes.  This type of weight gain occurs because of the increase in stress hormones in the body and how the body gets signals to store fat.  Sleep deprivation is another serious medical problem that may arise for a care giver.  If you have a loved one with dementia or that is a serious fall risk, you find yourself bolting up in the night and listening for every little sound.  This lack of deep sleep can be very detrimental to mental functioning and outlook.  High blood pressure is always a concern, as is diabetes, depression, anxiety, and bowel problems.  Even if the only respite one can get is to soak in a relaxing tub with a favorite scented bubble bath from +Bath and Body Works, the rejuvenation time can work wonders. Caregiver and compassion fatigue is not an issue to dismiss or take lightly.

"Non-Medical" Services

It is important to know that your first line of health care is ironically referred to as "non-medical" services.  Companies such as the one I work for, +Comforcare Home Care  Senior Services of Austin, will provide professionals to help toilet, shower, dress, feed, exercise, and groom your loved one.  Caregivers can also assist with household needs, such as cleaning, cooking, shopping, etc.  Many family members mistakenly think they can handle all of these aspects on their own, but end up being worn down by the stress of caring for someone's daily personal needs.  This is especially true for dementia patients, as night time hours can be exhausting for the family caregiver, and then trying to also care for all of their loved ones daily needs during the day can cause a speedy burn out.  A professional caregiver can assist with daily body assessments to prevent wound issues, daily blood pressure monitoring, medication reminders, and a wide range of services that will be needed well before a nurse, doctor, or facility enter the picture.