Caregiving

Understanding and coping with challenges of being a caregiver.

Drawbacks of Bed Rest

Posted by on Sep 8, 2010 in Caregiving, Health Care Team and System | 0 comments

Sometimes acute injury or illness leaves a senior bedridden but too much bed rest can have negative health effects. For the older adult, bed rest or chair rest, even for a few days, can cause deconditioning; that is changes in muscle strength and muscle bulk that can result in dependence and  impairment in balance.  Muscle strength is important to perform daily activities.  For example, strength in the quadriceps (thigh muscle) is necessary to rise from a chair, independently. Loss of strength in the muscles of the ankle joint may result in falls. Deconditioning can result in a loss of independence that lasts long after the acute problem has been treated. How does deconditioning begin? The human body is designed for movement. It is also subject to the forces of gravity, so  that each move we make to stand and walk is a move against gravity.  When we are at rest, gravity doesn’t have its usual effect. Without this force to pull against, muscles and  bones get weaker. This weakness can lead to loss of muscle mass, muscle shortening, changes in the joints, changes in cognitive abilities, and reduced circulation. Keeping moving, even small steps or little stretches can make a big difference to recovery. How can you help? If you have a senior who is in hospital or a long-term care home, ask for a physiotherapist who can work with them to prevent deconditioning.  Many hospitals have programs designed to help.  Some even bring specialized equipment like a half-barrel or sling to help a senior in bed gently work their muscles. You can also ask the nursing staff to show you how to help the older adult do the exercises safely. As a family member, you can provide essential support and encouragement. If an exercise program is not offered or you have a senior who is at home and on bed rest, simple range of motion exercises can be done while lying in bed.  Start at the shoulders and work through all the joints of the body gently moving the limb through its normal range of movement.  These movements should be gentle and not cause strain or pain.   1. Make circles with the arms and straighten and bend the elbow.  Rotate the wrists. Open the hand and then make a fist. 2. To help hips remain loose, lift the leg and move it away from the body, then return it to rest. 3. Bend and straighten the knee. If the person is able, bring the knee toward the chest and then return the leg to rest on the bed. 4. Rotate the foot in a full circle. Reverse the direction. 5. Even sitting up in bed a few times can help the muscles, since multiple muscle groups are required to move from a lying to a seated position.  Sometimes we feel a person is safer lying quietly in a bed, and when bed rest is required it can be just what the doctor ordered.  However, we should change our view that bed rest means complete rest.  It should include working the muscles and bones that were designed to be in motion. Vol. 3, No. 23 © ElderWise Inc. 2007. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise Inc., Canada’s go-to place for “age-smart” planning. Visit us at www.elderwise.ca and subscribe to our FREE bi-weekly...

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Hearing Loss? Take Action!

Posted by on Sep 8, 2010 in Caregiving, Health Signals | 0 comments

 It is estimated that 33% of those who are aged 65-74 have some hearing loss: 45% of those 75 – 84 years of age, and more than 60% of people over 85. Hearing is important to the quality of everyday living. Taking part in a conversation, receiving directions and information, and enjoying entertainment and recreation are affected when hearing is lost.  Hearing impairment can cause us to become isolated and withdrawn: to feel “stupid” or embarrassed in everyday situations – or to become depressed.  With gradual hearing loss, the person may not be aware of the changes: others might notice first. The flip side is that with a hearing aid you can reduce the nerve deterioration that usually results from untreated hearing loss.  Ironically, the number one reason those who need a hearing aid avoid getting one is that they think the hearing aid will make them look old, frail, or “dumb”.  The opposite is true!  Wearing a hearing aid can make you more alert, interactive, and involved. How can you encourage someone to get a hearing test? Some people are intimidated by the thought of having a hearing test.  Understanding the process of a hearing test may help.   How can you help someone who’s afraid of the test results? Some people avoid getting tested because they fear the results will confirm they have hearing loss.  But knowledge is power.  Having the test means being able to find help or the tools needed to improve the quality of hearing.  Just because you get a hearing test does not mean you have to get a hearing aid. It’s the first step to figuring out what you need and what could improve your quality of life if you need it. How can you help someone who has hearing loss? Speak slowly, clearly, facing the person, without putting your hands over your mouth Lower your voice, without speaking louder.  Reduce background noise/distraction. There are tools to help people with hearing loss, for example, an amplifier for the telephone and headsets for television.  You can find out more about these devices from an audiologist. Seek reliable testing. Find a qualified professional. Visit a qualified Audiologist or Hearing Instrument Practitioner. Audiologists have a masters or doctorate degree in hearing sciences. Hearing aid practitioners have a two-year College diploma and, in most cases, significant experience with hearing loss and hearing aids. Both are regulated, and both will be able to help determine your current hearing sensitivity and whether you need amplification. Additional Resources: The Canadian Hearing Society http:/?chs.ca   Hearing loss is not harmless.  It can lead to depression, anxiety, and social isolation.    Vol.3, No.10 © ElderWise Inc. 2007. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise Inc.,  Canada‘s go-to place for “age-smart” planning. Visit us at www.elderwise.ca and subscribe to our FREE bi-weekly...

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Home Care for Canada’s Elderly

Posted by on Sep 8, 2010 in Caregiving, Health Care Team and System | 0 comments

What is Home Care? Home care helps elderly people remain in their own homes, helps reduce hospital admissions, and may allow earlier discharge from hospitals. Home care is appropriate if you need help from registered nurses, physiotherapists, occupational therapists, and social workers, or if you need personal care provided by home health aides.   Who provides Home Care? Both public and private sectors offer home and community care services.  Public services are funded and managed by the local health authority. Eligibility depends on a professional’s assessment of your specific needs, your existing supports, and local community resources. Many people are surprised when they learn that public funding for home care is available for limited hours and only for very specific types of support.  That’s where private home care providers can help, with a variety of services, from personal care to visiting and companionship, from housekeeping to help with transportation.  Some are non-profit organizations; others are businesses. Expect variety in types of services offered, staff qualifications, and costs.  Seniors who want to stay in their home often mix different types of services, both public and private. When home care is no longer a viable option, you need to understand higher levels of care available for the elderly. Care homes, including assisted living and long term care, exist to serve different levels of care. Further reading: Long Term Care Planning Long Term Care Terminology  Understanding “Assisted Living” Vol.3, No.11 © ElderWise Inc. 2007-2011. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise Publishing, a division of ElderWise Inc. We provide clear, concise and practical direction to Canadians with aging parents. Visit us at http://elderwise.memwebs.com/ and subscribe to our FREE e-newsletter.      ...

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Services for Aging Parents at a Distance

Posted by on Sep 8, 2010 in Caregiving, Health Care Team and System, Planning | 0 comments

You and your aging parents are cities or provinces apart. Your dad has early dementia and lives at home with your mom. You’ve agreed as a family that your elderly parents need help at home. Mom agrees – now where do you look?  First, know what type of service you want and the terminology to use when searching.  Adult day care programs are offered in the community to provide social activities and health or medical care.  The individual might attend one to five days a week.  Home care or community care programs are offered to help people remain in their own homes, reduce admission to hospital or long-term care, and to allow earlier discharge from hospital. These services are offered through public and private agencies. Public programs are managed by local health authorities and vary across the provinces. Private services are offered by for-profit agencies and fees/services vary across the specific agency.  Respite care is temporary support, given to provide relief to the family.  If Mom is taking care of Dad at home and needs a break, you will want to find respite, or relief services.  Generally, these programs are offered by the local health authority or through voluntary or private companies.  Start your search with terms like “home health care” in your parents’ city/town, as well as “seniors services” by province or municipality.  Vol. 3, No. 9, © ElderWise Inc. 2007-2013.  You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise. Canada’ go-to place for “age-smart” planning. Visit us at http://elderwise.memwebs.com/ and subscribe to our FREE e-newsletter....

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Long Distance Caregiving

Posted by on Sep 7, 2010 in Caregiving | 0 comments

Many families are faced with the unique issues of long distance caregiving. The ordinary challenges of helping and caring for aging parents can multiply when you live thousands of miles away or even overseas. Val moved to Canada from England 16 years ago. She became a daughter whose parents lived “across the pond.”  Having made many trips to Britain, Val shared with us some tips that she has learned over the years. Here are the biggest challenges she experienced: Understanding what is going on – and encouraging family at home to be open and honest about the current situation. Getting family to realize that keeping secrets may not be a kindness. It is so important to let those who are away know what is going on. You have to live with consequences of your actions and inaction: e.g., do I get on a plane immediately or wait and see what happens? Communicating well is essential. The value of a local contact – either family or neighbours or good friends. You need to be specific about how they can be helpful to you.  Here are more suggestions from Val: Long-distance caregivers often feel guilty. Guilt wastes time and energy, and doesn’t help anyone. Try these ideas for taking action instead: 1. Help each other. Your friend or family member may not tell you about health issues or challenges because they don’t want to worry you. Explain that you’ll worry more if they’re not honest with you. Reassure them that your aim is not to interfere, but to support them the best way you can. Ask for their ideas on how you can help. 2. Get the facts. You may ask someone living nearby to contact you when they feel the senior has a health or safety issue. Ask questions to determine exactly what is happening.  “Your mom’s memory’s gone”, is an alarming message. If it turns out that Mom wrote a reminder to feed the cat, you can then explore the reasons behind the change in behaviour. Contact ElderWise, health care organizations or seniors’ associations for advice. 3. Trust your local contact. Their concerns are usually genuine. If Dad seemed his usual self while you were visiting over the holidays, you may feel the person who lives nearby is exaggerating in their updates. This may not be the case – in particular, those with dementia will often appear more capable when visitors are around. 4. Don’t jump to conclusions. If your loved one complains about neglect, remember that people with Alzheimer’s disease have little short-term memory. They may forget they ate lunch, had a visitor, or went on an outing. If the senior has in-home care, or lives in a long term care home, try to build rapport with one or two staff members and ask when it’s best to get in touch for an update. Check the facts with caregivers before complaining! 5. Understand the reasons behind a decision. You may have concerns regarding a decision that affects the elderly person. Before you react, check why this decision was made. Those involved in day-to-day caregiving know the current situation, and usually have the senior’s best interests at heart. They will appreciate it if you reinforce any messages they’ve been giving. When Uncle Joe complains that he’s not allowed to drive his car, there’s probably a very good reason! Don’t talk him into finding the keys and going out anyway. Building trust and good relations with staff at the care home, or whoever is in a caregiving role, is key to ensuring your peace of mind as well as good care for your aging parent. Vol. 5, No. 2 © Val Carter and ElderWise Publishing...

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Action for Common Aging Concerns

Posted by on Sep 7, 2010 in Caregiving, Health Signals, Planning | 0 comments

In previous newsletters, we showed how you can approach sensitive topics during holiday visits with aging parents. During the visit you may have noticed new areas of concern, or old problems that are calling for action. Now, you may feel anxiety or uncertainty about what to do next. Taking that first step, no matter how small, creates momentum towards positive change. Here are some first steps for common concerns: 1. Health Changes in physical or mental health are usually at the root of all other challenges facing your aging parents.  Many factors combine to keep seniors healthy. Among the most important are good medical care, proper exercise and nutrition, and a sense of purpose and belonging. A good first step is to become more informed about your parent’s health. Educate yourself about normal aging, and learn more about their chronic health conditions. With your parents’ permission, talk with their family doctor about your concerns. 2. Hygiene Personal care may slip when a senior’s eyesight, physical energy, or state of mind are affected. First, gently point out some physical evidence (e.g., stained clothing) and share your concern. Encourage your parent to get a physical check-up and/or an eye exam.  3. Housekeeping Loss of strength or mobility can make household chores more difficult. Start a conversation about getting more help – either from other family members, or by hiring someone. Some seniors are reluctant to ask for help or to invite “strangers” into their homes. Suggest that help with household duties may mean that your parents stay in their own home a little longer. 4. Hazards Safety hazards at home increase when health and strength start to fail. Here are some simple adaptations that make life safer: rearrange cupboards to easily reach things, install grab bars in the bathroom, remove loose scatter rugs, and add brighter lighting, especially over stairways. You can also look into personal emergency response systems. Worn on the wrist or as a pendant, they enable your parent to call for emergency help when they cannot reach a telephone. Initiating some of these changes may require a “community” effort. That can mean recruiting help from other family members, friends, neighbours and/or getting outside help – private or public. In larger towns and cities, families can call on their local seniors’ resource centre for more information on support programs. In rural areas, churches and other members of the community traditionally step up to help neighbours. Concerned families can also ask for an assessment of the senior by their local health authority, to see whether their family member (who must consent to the assessment) qualifies for public assistance. Vol. 5, No. 1 © ElderWise Publishing 2009. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise, Canada’s go-to place for “age-smart” planning. Visit us at http://elderwise.memwebs.com/ and subscribe to our FREE...

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