When the caregiver needs a caregiver – lessons it taught me.

Recently I took a fall and badly injured the knee I had replaced last fall.  Suddenly, I needed someone to do certain things for me.

It really puts it into perspective how the person we are taking care of feels.  Here are five items that I really never thought much about:

1.  PrivacyI had none.  I had to have someone help with bathing and for some reason that was very stressful for me.  We all have the same parts so what is the big deal?  It is a big deal.  Even though the person we are taking care of might be close family, they might still want privacy.  See what you can do to give them as much as possible.

2.  My schedule – Suddenly I had to do things when it was convenient for someone else.  Everyone was terrific about working with me but it was odd to have to have to have someone take out my dog, cook my meals, etc.  Being independent one day and then not the next was hard.  I will keep this in mind to see if people I am caring for would like things done on a different schedule if I can.

3.  Sleep – I hate to sleep on a schedule.  You get used to getting up and going to bed when you want but when others are helping, you adjust.   I couldn’t get up to get to the rest room so had to watch my drinking habits.  It was hard to move around to get comfortable also but I lived.  This will make me consider ways to make my “patients” more comfortable at night.  When mom was here, we put a baby monitor in her room so I could hear if she needed help in the night.

4.  Irritability – I try to be pleasant all the time but I found out that I can be a real crab when I am hurting.  I have had people tell me that the people they were caring for were real bitchy at time and now I definitely understand how that could be.  Mom never really complained but when she wanted to could be VERY stubborn.  She would just look at me with a gleam in her eye and say “NOPE”!  When she said that, there was no reasoning with her.

5.  Medication – I confess that I am not the best at taking my meds on a strict schedule.  I also take supplements like calcium and vitamins.  Due to outside help, these were looked at very carefully.  I felt like I was a little kids being spied on.  I realize that medications can all have interactions with foods, drinks and other meds but I was on top of that and having someone question it made me irritated.

Now, none of this is complaining.  People have to do what they have to do but it really opened my eyes to how what I was doing might make someone else feel.  It is easy to get in a habit and just do things without really thinking how the other person might feel.  Take time to see how what, how and when what you are doing might be interpreted by the person you are caring for.

Ask them if you could do things differently to help them.  Ask for suggestions but be prepared, you might get them.

 

Patience – A Much Needed Virtue

As we all know, being a caregiver can be very taxing.  It makes you draw on your strength, nurturing abilities and your patience.  Sometimes your patience is the hardest thing to maintain.

We have to remember that the people we are caring for might be in pain, embarrassed to have to have a caregiver, scared and/or mad at their bodies for breaking down.  They are not upset with us but the situation.

It is hard to have a loved one yell at you or refuse to cooperate with what you have to do in order to help them.  At times, they act like little children.  I particularly remember when Mom would get this look in her eye and just say “nope” when I tried to get her to take her pills or drink something.

There is no easy way to tell someone how to have patience.  What worked for me was to walk away and try later.  It did me no good to try to ask her to take it again or “force” her to do it.  Sometimes I was able to distract her and she would do it without realizing it.  Sometimes music will calm someone.

Sometimes you just need a break.  The next three posts will be about Respite Care.  It is a way to get away from the situation enough to come back refreshed and ready to begin again.

What do you do when your patience is at an end?  Please let us all know so that we might be able to try it when we really need it.

Always have a back up person in case you can’t be there to be a caregiver

This just sounds like common sense but too many times, one person feels like they are the only one capable or willing to take care of the loved one.

Recently, I was sick for over 3 weeks.  Had my mother still been with us, who would have been able to take care of her?  I would not have been able to be with her as I could have given her my chest congestion,cough and other symptoms.  Symptoms that are bad for you would be possibly fatal for someone with a compromised immune system.

It does not always have to be an illness.  It could be a family emergency that takes you away like another family member ill, having a baby or a death.  Also, sometimes it is job related.   Sometimes you just need to have a break.

If your loved one has family and friends around that could step in or if you would have had to hire someone if you have an emergency, it is important that you have enough information available for the “replacement” to do what you do on a daily basis.

If family and friends are not available, make sure you have a medical team (CNAs, CMAs, bath aides, nurses, etc) up to date with the necessary information.  You can find employees like this through your local health department, senior center, Area on Aging or your health professional.

This can be as simple as having a representative of their agency come out, visit with you and your loved one.

For example, you need to have the medication schedule written out with where and how the medications are bought.  What is a typical daily schedule?  Are there any food allergies?  Does food need to be prepared in a special way?  Where is any non medical equipment (special eating tools, bath aids, etc) that you use? Is there anything that brings out bad behaviors in your loved one?  What calms them?

What to you is automatic may not even occur to someone else.

This is why I think it is critical to have the binder that was discussed in a previous post.  It has the doctors involved with your loved one, medications, other treatments such as physical therapy or any other therapy, etc.  It also has a copy of all legal paperwork such as living will, DNR, etc.

A calender is also necessary for medical appointments that are coming up.

So bottom line, make sure everything in the binder is kept up to date.  It will give you peace of mind in case of emergency.

 

 

Dehydration – What to Watch For

Dehydration – It’s is easier than you think

I always thought that it would hard to get dehydrated.  After all, you get thirst, you drink, right?

Not so.  In fact, in elderly it is very easy.  It occurs when the body has lost too much fluid AND electrolytes (mineral compounds the body needs to keep the correct temperature and maintain the fight fluid balance.

In elderly, they may not want to have to run to the bathroom all the time or wake in the night to go to the bathroom so they limit their fluid intake.  Although it makes sense to them, it can be deadly.  Certain illnesses make elderly more sensitive to this.  For example, Parkinson’s can make it difficult for someone to swallow or hold a glass to drink from.

It can go on for a while without becoming serious but severe dehydration can  be fatal and is a common  reason of hospitalization of elderly.

Dehydration can be caused as a side effect of medications like diuretics or laxatives or illness  such as diarrhea, vomiting, heat stroke, high blood sugar (hyperglycemia) , infections or excessive exercise.

The most common signs of dehydration in the elderly are thirst (although some elderly have a decreased sense of thirst), confusion, irritability and poor skin elasticity.

It is difficult to detect dehydration until the condition is moderate or severe in nature.

Things to watch for:

(The following can also be signs of many other medical problems but it will give you an idea of what to look for)

  • Thirst – some people have a decreased thirst as they age
  • Dry mouth, dry tongue with thick saliva – can be heard sometimes when talking
  • Headaches
  • Difficulty passing urine or reduced amounts that are dark yellow
  • Dizziness that becomes worse on standing
  • Weakness
  • Sleepiness
  • Urinary tract infections
  • Dry, warm skin
  • Flushed face
  • Fever
  • Irritability
  • Malaise
  • Constipation – fluid is used to soften and move stools
  • Cramping in arms or legs

 

Possible Treatments for Mild Dehydration

  • Drinking lots of fluids – make sure there are fluids available wherever they sit and perhaps some on their bedstand.
  • Eat food and drink with sodium and potassium to restore electrolytes: broths or soups (contain sodium); fruit juice, soft fruits, vegetables (contains potassium); sports drinks like Gatorade that contain electrolytes

Caution – Be aware of any dietary restrictions when adding food or drink as certain medications can interact with certain foods/drinks.  Potassium  needs to be monitored  in certain people.

Signs to watch for in severe dehydration

  • Signs and symptoms of mild dehydration become worse
  • Confusion
  • Irritability
  • Lethargy
  • Poor skin elasticity
  • Decreased consciousness/ fainting
  • Lack urine output
  • Shrunken eyes
  • Moist, cool extremities (arms, legs, etc.)
  • Severe muscle contractions in the arms, legs, stomach, back
  • Rapid and faint pulse
  • Low blood pressure
  • Rapid breathing
  • Convulsions
  • Bloated stomach
  • Heart failure

Possible Treatments for Moderate to Severe Dehydration

  • Severe dehydration is a medical emergency and should be treated at the hospital
  • Replenishment of water and electrolytes through intravenous therapy or oral rehydration therapy (solution of salts and sugars taken by mouth; this treatment is most often for dehydration caused by excessive diarrhea)

Tips to Avoid Dehydration

  • Encourage them to drink appr. 6-8 glasses of fluid a day (Water is best).  Of course this depends on exercise and temperature.  If they are reluctant to drink a big glass, try several smaller glasses.
  • Check body weight regularly, fluctuations of 2-3 lbs per day may indicate irregular fluid intake
  • Avoid being in the hot sun for long periods and ensure extra hydration for longer exposure
  • Keep a water bottle on hand and  try to drink often
  • Broths or soups (contain sodium); fruit juice, soft fruits, vegetables (contains potassium) as part of general diet.
  • Make sure the glasses they use are appropriate for them.  Perhaps they need a straw or a cup with a lid to avoid spills.

Bottom line, dehydration can be serious but is usually easy to avoid.  It just takes being aware of liquid intake.

Do you have any tips on how to avoid dehydration in elderly?

Human Touch – As Important As Air?

That may sound a little dramatic to most people but if you stop to think of it, we all need the human touch.  Think back to a time when you were hurting, either physical or emotionally, and someone came along and either touched you on the shoulder or held your hand and things seemed to get better.

There have been many studies done on this with a good deal of articles written on it but I prefer to just tell you my thoughts on it.

Everyone likes to be touched in a friendly manner.  Babies are cuddled for a reason.  It helps to establish a sense of safety and peace.  In some hospitals, preemie babies are held by women hired to just do that…they rock the babies and cuddle with them.  It has been proven to help them.

Senior citizens or other people that require caregivers are just the same. I believe the need for touch increases when people age or are sick.  They need to feel a connection to the world.  They tend to receive the least amount of touching of any age group.  Seniors are most likely to live by themselves and have less physical contact with the outside world.  But, as people age, they tend to be more likely to need touch and be touched than younger people.

Having someone take their hand, stroke their arm, or rub their feet can make them feel loved and reassure them that they are valued and not alone.   Isolation can be swept away with a single stroke of the hand. It helps with other problems as well such as depression, feelings of isolation, lack of self-esteem, and anxiety. 

Bottom line, we need to be touching the people we are taking care of.  Below are several ways you can touch someone without it being obvious.

  1.  Put lotion on either the hands or the legs.  Mom had dry skin as she aged so I would just put lotion on every day or two.
  2. Holding hands.  When Mom was in bed, we would watch tv until she fell asleep.  I would just lightly hold her hand.
  3. Massage.  Although Mom never got a massage and I am not sure she would have, a massage is a safe way for someone to get the touch needed.  It can be as simple as a neck rub or as much as a full body massage.
  4. Brushing their hair.  Mom loved to have her hair brushed and I can remember as a child I did too.  One of the perks of going to get a haircut for women is the great shampoo that goes along with it.
  5. Just resting your hand on their shoulder or knee while in a seated position can be reassuring.

I really believe that touch is critical.  Seniors sometimes only have one or two people they see on a regular basis and in most cases, they are busy and do not have the time to spend quality time.

If you are a caregiver, please take the time to touch your loved one in some way every day.  It does both of you good.

Words from a 92 year old

I found this on the internet and had seen it many times but it makes a lot of sense.

The 92-year-old, petite, well-poised and proud lady, who is fully dressed each morning by eight o’clock, with her hair fashionably coifed and makeup perfectly applied, even though she is legally blind, moved to a nursing home today. Her husband of 70 years recently passed away, making the move necessary.

After many hours of waiting patiently in the lobby of the nursing home, she smiled sweetly when told her room was ready. As she maneuvered her walker to the elevator, I provided a visual description of her tiny room, including the eyelet sheets that had been hung on her window. “I love it,” she stated with the enthusiasm of an eight-year-old having just been presented with a new puppy.

“Mrs. Jones, you haven’t seen the room …. just wait.”

“That doesn’t have anything to do with it,” she replied. “Happiness is something you decide on ahead of time. Whether I like my room or not doesn’t depend on how the furniture is arranged, it’s how I arrange my mind. I already decided to love it. It’s a decision I make every morning when I wake up. I have a choice; I can spend the day in bed recounting the difficulty I have with the parts of my body that no longer work, or get out of bed and be thankful for the ones that do. Each day is a gift, and as long as my eyes open I’ll focus on the new day and all the happy memories I’ve stored away, just for this time in my life.”

She went on to explain, “Old age is like a bank account, you withdraw from what you’ve put in. So, my advice to you would be to deposit a lot of happiness in the bank account of memories Thank you for your part in filling my Memory bank. I am still depositing.”

And with a smile, she said: “Remember the five simple rules to be happy:

1. Free your heart from hatred.
2. Free your mind from worries.
3. Live simply.
4. Give more.
5. Expect less

Elderly in large family gatherings

Of course we all want to include our elderly whenever there is a family event.  They are the reason we are here?  But, sometimes large gatherings can be very stressful for elderly or people with disabilities.  Consider the following:

1.  Hearing – What to us may be normal noise can be very loud and confusing.  Mom preferred that we visit her one family at a time.  She said that all the noise and commotion made her nervous.  She loved us coming but handled it much better when there were only two or three of us.

2.  Children – Children like to play with things.  They can be loud and playful.  We accept this as kids being kids.  When the grandkids were jumping around near mom, she was afraid they would either fall on her or knock something into her.  Because she was fragile (without really looking it), this could have caused a major problem.  She was on a blood thinner and any cut or hard bump could have been serious.  She also was nervous when small kids came to her house because of her medication.  In order for it to be handy for her, we left it on the table as a reminder to take it but when grandkids came around, she was afraid they would get into it.

3.  Medication – Anyone who takes medication has to have it on a fairly regular schedule.  Make sure if you are having someone to your home to make sure they have their medication with them and that they remember to take it.  It is easy for them to forget with all the excitement.

4.  Bathrooms – Some elderly have problems with either incontinence or bowel problems.  Make sure that they are close to a bathroom and have supplies in case they are needed such as pullups.  We never traveled without some.  Of course you have to be discreet but that is easily done as long as you think it out ahead of time.

6.  Diet – Keep in mind that texture and taste has to be taken into consideration.  Chewing and swallowing is affected with alot of medical conditions.  Make sure plenty of fluids are available.  Spices should be kept to a minimum on some dishes so they can eat without having problems later.

7.  Transportation – Make sure that someone is going to pick them up and take them home.

8.  Length of stay – It is easy for elderly to tire out.  They may have a rest schedule at home.  Try to limit the time they are away from home or provide an area where they can lie down for awhile.

Although you have to take all these things into consideration, it is also important for our family members not to be forgotten.  If they don’t want to attend for whatever reason, maybe take a plate of food to them or drop in later just to say hi.  Loneliness can be very depressing and many seniors suffer from it.

November is Caregiver’s Month – Celebrate Yourself!

Following are some very interesting facts about caregivers in the United States.    Here are some very interesting facts about caregivers:

 

  • 39% of all adult Americans are caring for a loved one who is sick or disabled – up from 30% in 2010
  • Alzheimer’s is driving the numbers up.  15 million family caregivers are caring for 5 million loved ones with Alzheimer’s
  • It is NOT just elderly who need caregivers.  The number of special needs children is rising too.
  • Wounded veterans need care too.  As many as 1 million Americans are caring in their homes for service members from the Iraq and Afghanistan wars who are suffering from traumatic brain injury, post-traumatic stress disorder or other wounds and illnesses.
  • It’s not just the women doing the caregiving.  Men are now almost as likely to say they are family caregivers as women are (37% of men, 40% of women).  36% of younger Americans between 18 and 29 are family caregivers as well.
  • Family caregiving is serious work.  Almost half of family caregivers perform complex medical/nursing tasks for their loved one.
  • Family caregivers are the backbone of the Nation’s long-tern care system.  Family caregivers provide $450 BILLION worth of unpaid care each year.  That is more than total Medicaid funding and twice as much as homecare and nursing home services combined.

These facts are from the Caregiver Action Network – www.caregiveraction.org – 202-772-5050

You are a very vital part of your loved ones life.  Too many times, caregivers just do what needs to be done without thinking they are doing something special.  After all, these are our loved ones we take care of but YOU ARE SPECIAL and so is what you do.

Communicate with other family members – They need to know what is going on.

It is critical to communicate with the other family members.  They need to know what is going on too.  It is equally hard on them as they want to be able to help but many can’t due to circumstances – maybe they live somewhere else, health issues, jobs, family commitments, etc.  Just because they are not there does not mean they do not care.

I set up a Facebook group for my brothers, kids, nieces and nephews so that I could posts about the good and the bad.  Naturally I also phoned them but sometimes something came to me in the middle of the night or when they might be at work.  It was also hard to remember who I told what to so I was repeating myself.

Involve them in decisions.  It is not all on your shoulders.  It will make you all feel better if it is a shared mental task.

When my mother-in-law was dying, we took a notebook up and whomever was there at the time would write down what the doctors or nurses said or funny things Ann said.  We put down different feelings and then when the next person came in, they could just read down through it.  I still look at it from time to time.

Whatever works for you, communicate as a family.  This is a hard time for everyone and you all need each other.

Legal – Wills – We all need them.

Once again – I am not a lawyer.  This is my understanding.  Consult your attorney for clarification in your area.

We all should have these in place but if you are like me, you probably don’t.  Everyone should have a will especially when kids are involved. Then as life changes, we should always keep them updated.

My mother did not have a will.  She just assumed that everything would be divided between the four kids. So, we made an appointment and went to the lawyer.  For a reasonable amount of money she wrote out a basic will.  I thought we had it all covered with a few specific items going to my brothers that had meaning for them and the balance divided between all us kids equally.

The lawyer advised to change the beneficiaries on the life insurances to the estate of MOM.  But, mom didn’t tell me there were multiple life insurance policies.  I changed them on the two I knew about.  Now, we have found others so I may have messed up the funds without meaning to.  Also, her checking account and savings account were not set up right so they might revert to the person on the account with mom.  The lawyer has to talk to the bank and see exactly how they were set up.

It is very important to understand the differences between and, and/or, payable upon death, with rights of survivorship, etc so that you make sure everything is written they way the person wants. What did she actually mean to happen we will never know.

Bottom line, make sure you understand exactly how everything is titled (like vehicles and houses), know about all the life insurance policies and accounts (IRA, CDs, 401K, etc.) and how they are set up.  Have your lawyer go over exactly what will happen when your loved one passes so they understand it.  By doing this, you can make sure that their final wishes are carried out.