Pressure sores in the sacral region are especially concerning. This is the region of the body where the spine meets the top of the rear end. This condition can be caused or aggravated by several things. Here is a list of causes/reasons for these sores: a) Prolonged sitting. b)Incontinence and soiled briefs. c)Decrease in hygeine and perineal care.
To remember first and foremost, encourage toileting and/or repositioning every 2 hours. This will force the body to move about. 2nd, encourage fluids for hydrated skin. 3rd, change brief and shower daily, and last but not least, get a good barrier cream such as +Lantiseptic.
Sunday, October 13, 2013
Saturday, July 6, 2013
Hearing Loss or Slowed Processing?
Family and friends often recognize when a change occurs with their loved one, but sometimes are unsure what they are noticing. One way to decipher if there is a hearing problem or a slowed processing problem is to get in front of your loved one a speak clearly where they can see your mouth and be close enough to hopefully hear you. If they can give you an quick response when they can see what you are saying and hear you, then you are dealing with a hearing loss. If they seem to be able to hear but take a while to respond (more than 30 seconds), then a neurologist should be consulted and testing done. Also, many hearing aide retailers will give free preliminary hearing tests to advise if a trip to the audiologist is needed.
Monday, May 27, 2013
Evacuation and Emergency Plans
With all of the fiascos in the news as of late, I am reminded of the importance of disaster planning for the elderly and disabled. The recent explosion in West, Texas that devastated that little town left me in complete awe of their emergency response team. Those wonderful folks were successful in evacuating an entire nursing home before it burned to the ground, among everything else they had going on. Just within the past week we have had a devastating tornado go through Oklahoma and floods now occurring in San Antonio. It is important to be sure your loved one has an emergency plan in place, even if they are living in a facility. If they are in a facility, have the management go over what the protocol is for each state of emergency. It is always best to keep important documents and family heirlooms in a safe deposit box if it is possible, but if that is not possible, I would advise investing in a coded fire safe box. Also, in this box it is important that you keep a list of all current doctors, medications, and pertinent medical information, especially documents such as a living will, DNR, or power of attorney.
If your elderly loved one lives alone, please check all smoke and carbon minoxide alarms monthly. Ensure that there is always more than one usable exit to the outside and that there are no trip hazards or fall risks in the pathway. If your loved one is having difficulty with mobility and is still living at home, please be sure that a wheelchair could get out the door and away from the house. You may need to look into a wheelchair ramp. Many companies such as +Allumed and other mobility companies have removable handicap ramps that do not have to remain a permanent fixture to the home. Make sure your loved one has easy access to a phone, hopefully with large lighted buttons, so during an emergency they can see to dial. It may seem like overkill on a normal day, but in a smoky dark room it can be the difference between life and death.
If your elderly loved one lives alone, please check all smoke and carbon minoxide alarms monthly. Ensure that there is always more than one usable exit to the outside and that there are no trip hazards or fall risks in the pathway. If your loved one is having difficulty with mobility and is still living at home, please be sure that a wheelchair could get out the door and away from the house. You may need to look into a wheelchair ramp. Many companies such as +Allumed and other mobility companies have removable handicap ramps that do not have to remain a permanent fixture to the home. Make sure your loved one has easy access to a phone, hopefully with large lighted buttons, so during an emergency they can see to dial. It may seem like overkill on a normal day, but in a smoky dark room it can be the difference between life and death.
Saturday, May 25, 2013
Aging Couples and Independent Living Options
One of the problems that may be encountered with aging couples is the decline of one spouse. As an aging spouse begins to take on the role of caregiver for the ailing spouse, caregiving can become overwhelming. We have discussed many options, but I would like to touch on Independent Living centers today. The independent living option is more for the sanity and success of the caregiving spouse. A community I have worked with in +Cedar Park, TX is +Lakeline Oaks, a subsidiary of the +Steve Mueller Lifestyle Resort Communities. In this community residents have individual apartments with internal hallways, weekly maid service, three cooked meals served in the facility dining hall, planned daily activities, a privately contracted home health agency such as +Capitol Home Health on site, bank on site, gym, theater, privately contracted personal care services (such as my employer +ComForcare Home Care of Austin) available, bus transportation, and a doctor that provide weekly visits to the facility and has an office on site. With all of these listed ammenities, the caregiver is relieved of much of the stress and isolation that occurs with caring for an ailing spouse. Meals and meal planning are taken care of, basic housekeeping, having to get the spouse to appointments in town frequently, and the ability for both spouses to socialize is critically important. In these type of facilities, the caregiving spouse is surrounded by a tightly knit community and support network. As I have addressed in previous posts, isolation and depression for caregivers can be crippling and cause significant decline for the "well" spouse.
Wednesday, April 24, 2013
Signs an Elderly Loved One May Need More Help
Here are a few things to look for that may indicate your loved one may need a caregiver or new living arrangement.
1. Changes in grooming habits. Hair frequently unkempt, wearing the same clothes day after day, body odor.
2. Abnormal financial issues such as unpaid bills, bounced checks, overspending, or abnormal charitable gifts he or she cannot afford.
3. Confining him or herself to a certain section of the house. If he or she seems to avoid the kitchen or everything seems clustered into one area.
4. Decrease in mobility, avoidance of stairs, frequent falls, unexplained bruising that looks like it is from a fall.
1. Changes in grooming habits. Hair frequently unkempt, wearing the same clothes day after day, body odor.
2. Abnormal financial issues such as unpaid bills, bounced checks, overspending, or abnormal charitable gifts he or she cannot afford.
3. Confining him or herself to a certain section of the house. If he or she seems to avoid the kitchen or everything seems clustered into one area.
4. Decrease in mobility, avoidance of stairs, frequent falls, unexplained bruising that looks like it is from a fall.
Wednesday, April 17, 2013
Recognizing Grief and Loss
As I sit here tonight, it has been a tough week for the nation. We had the bombing in Boston. Tonight in Texas, an entire town was evacuated due to a fertilizer plant fire, which has been catastrophic for the elderly and disabled there, and children have been harmed and died from senseless cruelty. Today, many of us are likely to be feeling a sense of loss and bewilderment. However, if I might call attention to that feeling for one moment I think you will understand why.
It is vitally important that once someone receives a diagnosis of a health crisis or deterioration that they be allowed to be angry. Naturally, it is important to also remind them not to lash out at their support system. That said, anger is an important stage for grief. Imagine your sense of loss over the above issues, and then imagine that you are slapped in the face by your own body every morning you try to get up and carry on because a health condition is stealing your abilities and your independence. How did you feel when you passed that 30 mark and then snowballed to 40, 50, and 60 years old? Some days the sense of a lost youth creep in. Our loved ones with chronic illness and health problems have to try to make peace with loss every day, and sometimes many times a day. It is good to acknowledge the sense of loss and give that emotion a name. That way your loved one can verbalize that it is not the caregiver they are mad at as much as it is the illness and be relieved from a feeling of guilt.
It is vitally important that once someone receives a diagnosis of a health crisis or deterioration that they be allowed to be angry. Naturally, it is important to also remind them not to lash out at their support system. That said, anger is an important stage for grief. Imagine your sense of loss over the above issues, and then imagine that you are slapped in the face by your own body every morning you try to get up and carry on because a health condition is stealing your abilities and your independence. How did you feel when you passed that 30 mark and then snowballed to 40, 50, and 60 years old? Some days the sense of a lost youth creep in. Our loved ones with chronic illness and health problems have to try to make peace with loss every day, and sometimes many times a day. It is good to acknowledge the sense of loss and give that emotion a name. That way your loved one can verbalize that it is not the caregiver they are mad at as much as it is the illness and be relieved from a feeling of guilt.
Thursday, April 4, 2013
Vision Changes and Dementia
One of the unfortunate frequent occurrences with Alzheimer's and dementia is declining peripheral vision. While those with macular degeneration are familiar with losing straight vision and keeping the peripheral vision, with dementia it is the opposite. As time progresses a "tunnel vision" effect begins to occur and a straightforward gaze is frequent. Perception and depth begin to change and while putting the words to what is occurring or knowing what to do as these changes occur can be difficult, it is important to be aware of them. Simple changes can make a big difference. First, do not walk up behind or from the side of someone with these vision changes. It can be frightening and he or she may be easily startled. Do your best to get directly in front of of the person and softly approach. When feeding, be sure to bring the food up directly in front of him or her so that they are prompted by the visual field that food is coming to their mouth. If you are sitting next to the person and bring the food in on the fork from the side, he or she might never see the food coming towards the mouth and may struggle with the spatial awareness as well. When at that point of care, every bite can make a difference in caloric intake.
These perceptual changes are also why persons with dementia may react strongly to color and boundary changes in the flooring and environment. They lose spatial awareness, but are capable of seeing that there are changes in color, etc. in front of them. This may cause confusion and you may experience watching them try to take a step up, as on a stair, with changes from hard flooring to carpet, etc. Working with an occupational and physical therapist during these changes can be very helpful as a therapist can develop a specialized program for your loved one to help maintain skills or prompt responses for necessary tasks. Fully utilize home health care for such needs with agencies such as +Amedisys+, that have fully staffed nursing and therapy care that can come directly to the home and help work within your loved one's practical environment and daily needs.
These perceptual changes are also why persons with dementia may react strongly to color and boundary changes in the flooring and environment. They lose spatial awareness, but are capable of seeing that there are changes in color, etc. in front of them. This may cause confusion and you may experience watching them try to take a step up, as on a stair, with changes from hard flooring to carpet, etc. Working with an occupational and physical therapist during these changes can be very helpful as a therapist can develop a specialized program for your loved one to help maintain skills or prompt responses for necessary tasks. Fully utilize home health care for such needs with agencies such as +Amedisys+, that have fully staffed nursing and therapy care that can come directly to the home and help work within your loved one's practical environment and daily needs.
Tuesday, February 26, 2013
Neurological illness and bilateral activities
When faced with neurological illness, it is important to understand that there are some activities that can delay symptoms and help maintain functioning longer. Any activity that utilizes bilateral body movement can help delay deterioration. Playing cards, turning pages of a book, crocheting and handwork, and peeling vegetables are just a few simple activities that involve bilateral movement. Often as we age, we begin to acquire gadgets and gizmos that seem to make life much easier. However, in reality, performing some of these small tasks actually helps our brain function and works out the brain, so to speak, so that the two hemispheres of the brain communicate better. Hand tools in the kitchen (such as vegetable peelers), reading the actual paper or a real book, or even the old fashion rolling of a skein of yarn, are crucial to maintaining brain function.
It is also important to incorporate gross motor bilateral movement. Stretching the arms across the body, kicking the feet across (even if sitting down), bouncing a balloon in the air, and manipulating objects so that your loved one has to reach across the body to pick them up are all great tactics for involving gross motor bilateral movement. Marching in place and climbing stairs are also great activities for this important brain maintenance. These are great exercises for your loved one with neurological illness, but also for you to do with them for your own health.
It is also important to incorporate gross motor bilateral movement. Stretching the arms across the body, kicking the feet across (even if sitting down), bouncing a balloon in the air, and manipulating objects so that your loved one has to reach across the body to pick them up are all great tactics for involving gross motor bilateral movement. Marching in place and climbing stairs are also great activities for this important brain maintenance. These are great exercises for your loved one with neurological illness, but also for you to do with them for your own health.
Wednesday, February 13, 2013
Love for the Caregiver
In addition to the challenges I face daily as a family caregiver of disabled children, it has also been the misfortune of my children and I to be preyed upon by some of the worst types of human being that walk the earth. I tell you this because I want you, dear reader, to know that we have witnessed the worst of the worst. Knowing this side of life, I am forever thankful to God for putting me in the caregiving profession. It is through my job with +Comforcare Home Care of Austin that God has allowed me to also witness the best of humanity. I have a kind and good man, Jeff Henderson, as a boss. He truly has a heart for the people in the personal care business, employees and clients. I have seen the beautiful interaction between spouses as one cares for the ill spouse. Ladies, I am in no way trying to underscore your valiance and faithfulness, but I want to take a moment to give some respect to those male caregivers. God has put these men into my path so that I can know that good men exist. He has allowed me to see the best of them. Since I have been a caregiver professionally, I have seen a couple married 10 years and she had Alzheimer's for 7 of those 10 years. He still came faithfully every day to sit with his wife and care for her. In fact, I have seen that scenario more than once. It is a beautiful thing as a woman to know that there are men out there that fall in love with and cherish a woman in her senior years, instead of replicating a dysfunctional pattern portrayed through the media of men only chasing after young women in their child bearing years. To see a man at his wife's side during illness and you assume they have been married most of their lives, then find out they have been married 10 years or less, gives pause to the depth of the human soul. Then to also see a loving husband who devotes his life to his wife, in love and gratitude for the woman she is to him, blesses my heart in the sweetest way possible. I want to speak specifically today to the husbands caring for a wife with dementia, some days she may not remember your name and you may feel sad, but rest assured that a woman will always know her sweetheart in the depths of her spirit. She has a recognition in her heart of that one special guy who took the time to cherish her, endure with her, study her, and devote himself to her. Whether or not she remembers your name today is not what is important. What matters is that you are an imprint on her heart and a comfort to her spirit. Be blessed my dear friends and I thank you for giving me the privilege of a glimpse into your love story.
Tuesday, January 22, 2013
Medication Errors
I apologize for my long absence. My son went on a study drug named +Sutent December 7, 2012. We had to make a long trip to Indianapolis right after Thanksgiving and then he started the study drug after returning. Sam went on home bound because of the excessive fatigue and the difficulty maintaining a school schedule. At the same time my employer, +Comforcare Home Care , was working to find another caregiver to work opposite me with my clients. So, life got crazy and I slipped in the frequency of my posts.
One topic I want to address is the topic of medication management and medication errors. Even the most loving and attentive of caregivers, family or professional, can easily make errors in this department. Recently, while talking with a client's family, I was reminded for myself as well the importance of updated medication information. In a place of prominence, for us it is the refrigerator, a list of current medications should be kept. This way if there is ever an emergency there is a quick and accessible list for medical personnel. One of the family caregivers I work with keeps a list in his wallet, which I thought was a great idea as well.
The use of pill organizers can be a double edged sword. For those with loved ones with dementia or cognitive impairment, even pill organizers should be kept in a locked box. This way there is no possibility of your loved one forgetting what day it is and taking the next days medications. Also, if there are small children that come into the home, there is always the danger of a child getting into medications. For those without such challenges, pill organizers can be extremely helpful.
If I am at work (I am also a professional caregiver), I set alarms on my phone for when I need to get someone their medications. I have my kids set alarms on their phones for their medication times, which is helpful when I cannot be there. I also end up calling to remind them as well. It is important to be aware of warnings of side effects or drug interactions for each medication, and if need be to post that information with your medication list. For instance, with my son, he cannot have anything grapefruit and he cannot have nsaids, such as +Advil, while on the medication. This is important and vital information for yourself, your loved one, but also to have handy for other caregivers or medical personnel.
One topic I want to address is the topic of medication management and medication errors. Even the most loving and attentive of caregivers, family or professional, can easily make errors in this department. Recently, while talking with a client's family, I was reminded for myself as well the importance of updated medication information. In a place of prominence, for us it is the refrigerator, a list of current medications should be kept. This way if there is ever an emergency there is a quick and accessible list for medical personnel. One of the family caregivers I work with keeps a list in his wallet, which I thought was a great idea as well.
The use of pill organizers can be a double edged sword. For those with loved ones with dementia or cognitive impairment, even pill organizers should be kept in a locked box. This way there is no possibility of your loved one forgetting what day it is and taking the next days medications. Also, if there are small children that come into the home, there is always the danger of a child getting into medications. For those without such challenges, pill organizers can be extremely helpful.
If I am at work (I am also a professional caregiver), I set alarms on my phone for when I need to get someone their medications. I have my kids set alarms on their phones for their medication times, which is helpful when I cannot be there. I also end up calling to remind them as well. It is important to be aware of warnings of side effects or drug interactions for each medication, and if need be to post that information with your medication list. For instance, with my son, he cannot have anything grapefruit and he cannot have nsaids, such as +Advil, while on the medication. This is important and vital information for yourself, your loved one, but also to have handy for other caregivers or medical personnel.
Subscribe to:
Comments (Atom)