Getting Up After a Fall

Dignity Care - What to do after a fall

No one ever intends to fall.  I hear it from my clients all the time: “I’m careful” or “I’m not going to fall” even though I think they are really trying to tell me that they are worried about falling.  However, that level of fear doesn’t always translate into taking specific measures to avoid a fall or learning what they can do to prevent falling.  Without proper prevention and safety measures, falls happen. When people fall, the response is usually, “It was an accident, I won’t fall again.”

One of my clients is the poster child for this attitude.  She has fallen multiple times, but isn’t able to relate any of her falls to the other times she has fallen.  While we’re working on that end of things, in the meantime we needed some tips on getting up after falls.

My favorite find is this video on how to get up.  The main point is to be creative about what you have within reach or crawling distance to be able to get yourself (or someone else) up off the floor. Also, make sure to evaluate yourself for possible injuries, pain, range of motion issues, and/or bleeding before trying to get up. Another thing they discuss is the importance of lifeline devices such as Life Alert. If help is immediately available at the push of a button, you won’t even need to worry about how to get up with possible injuries or finding a way to get help.

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Dignity of Risk and Caring for an Elder

Dignity Care - Dignity-of-Risk

Growing old should not mean that you lose control of your daily life and all the decisions that go along with it. Yet too often that is exactly what happens. If you are a caregiver, have you ever heard yourself saying, “you NEED to use your walker, because you might fall”, “you need to drink that water”, “let me carry that for you or you might drop it”, and/or “don’t do that, you might fall”?

Even though the person has lived with and managed their risks all their adult life, suddenly everyone else is telling them what they can and can’t do. However, this is based on what? Safety? For what end, hanging around waiting to die?

There is a wonderful concept called “The Dignity of Risk”, which acknowledges that life experiences come with risk. It explains that we must respect a person’s self-determination and right to allow them to make their own choices about which experiences are worth a risk.

the dignity of risk

I understand that there is an issue of safety here. I’m not saying ignore the risks. However, I’d like to see risks balanced more thoughtfully against the person’s preferences for how they want to live their days and what they do or do not want to do. They’ve been making decisions all their life about what they choose to do, what they want to try, what they want to eat, etc. They weighed the risks of eating fast food, of skiing, of taking a new job, and/or buying lottery tickets. They deserve our respect and support in continuing to make their choices.

As caregivers, I’d encourage us to allow the elders we work with, or are related to, to live their lives as independently and freely as possible. Listen to their priorities and concerns. Help them think through their decisions. Yes, there is that pesky risk factor, but how does it weigh against the dignity of their life and the loss of life experiences? They have the right to choose their risks. Let’s support them in that.

Home Care Addresses Social Isolation Worries

Dignity Care - Home Care Addresses Social Isolation Worries

A recent Harvard School of Public Health study published in The American Journal of Public Health suggests that “strong social ties, through friends, family and community groups can preserve our brain health as we age and that social isolation may be an important risk factor for cognitive decline in the elderly.” The study also indicated that those elderly engaged in many social contacts had the slowest rate of memory decline.

home care social isolation

For elderly persons living alone, maintaining that social contact becomes extremely difficult.  Remaining in one’s home always seems like a wonderful goal but it can bring unintended consequences, the most common one being isolation.  The less able one is to get out and around (or drive), the more they stay at home, alone and out of touch, the fewer activities they are involved in, and the more they withdraw into themselves.  This hastens decline, both physically and mentally, which keeps them home even more – a vicious downward spiral.

Using in-home care services is one way to introduce people into their daily lives, and offer the possibility of connections and relationships.  Our caregivers often establish strong bonds with their clients, bonds that enrich both of their lives.  Although the caregiver starts out as a support and helper for the client, it is not unusual for the relationship to evolve into one where the caregiver is learning from the life stories of the client, where they both share laughs or worries about life, where the client can offer advice and wisdom.  The social contact becomes as important as the caregiving tasks that are getting completed.  The hours the caregivers spends in the house bring energy, connection, the outside world.  Caregivers help ward off the social isolation and the decline that comes with it.

 

Caregivers Forced to Choose Between Caring for a Loved One and a Job

Dignity Care

At least 42 percent of U.S. workers have been caregivers for aging loved ones in the last five years. In fact, most family caregivers work full or part-time while caring for their parent, spouse, aunt, uncle, or other loved one.

jugging your job and caring for a loved one

The majority (68 percent) of family caregivers report making work accommodations because of caregiving duties including: arriving late/leaving early or taking time off, cutting back on work hours, changing jobs or stopping work entirely.

If this is you, you understand the challenge of juggling work and caregiving.  You’ll want to know that AARP is fighting for workplace flexibility, like family leave or paid or unpaid sick leave, to support family caregivers as they balance work and caregiving responsibilities.  AARP is pushing for legislation that would:

  • Let employees use their existing sick time to help care for a family member; or
  • Give employees a few hours of unpaid time each year to help care for their loved ones; or
  • Allow employees unpaid leave to take their loved ones to the doctor, in the same way 15 states allow employees to take unpaid time off to attend parent-teacher conferences and school events.

Video from AARP –

 

Embarrassing Things People With Dementia Say

Dignity Care - Embarrassing Things People With Dementia Say

Many people with dementia lose their social filters and no longer understand what is or is not appropriate to say in public. They do not say embarrassing things intentionally but have indeed lost the lens they used to live with. You may have encountered situations like these: Person with Dementia upon hearing someone speaking a different language: “Speak English!” or they may use a racial slur to describe them.

I have seen and heard many elders using racial references that were, to say the least, disrespectful. It doesn’t necessarily mean the people are racist. Many of our elders grew up in much less diverse communities than we have today. They have simply lost whatever inhibitions they may have had. When they see someone of another ethnicity, they blurt out labels that they heard as youths, embarrassing everyone involved.

How to respond: One of my clients used to make these remarks frequently. He also had travelled a lot. I would apologize calmly to the person and then begin talking about what language I thought they might be speaking and what country they might be from, asking my client if he had ever been there on his travels. This could lead him into a conversation about travel. If the person, he was making the remark about was on staff at the nursing home I’d include them in the conversation.

Person with Dementia, generally a man pinches a woman or otherwise acts out sexually: “Nice butt!”

Stay calm and realize that this behavior is caused by the disease. Dementia has stripped your dad of his inhibitions and he really can’t help it. Try not to overreact from embarrassment.

How to respond: Calmly say, “That’s inappropriate, Dad,” or something to indicate that the action is not acceptable. It won’t help to scold, however. Apologize to the person affected and then if possible, move your dad away. Explain to the person that dad has Alzheimer’s and his actions are the result of the disease. If you can’t defuse the situation by moving him away, just allow the affected person to handle it. If it happens to a professional caregiver, they are trained to handle these situations.

When these and other uncomfortable situations occur, we are embarrassed for ourselves and for the person our elder once was. Learning that we aren’t alone in enduring this public embarrassment helps, Talk with other caregivers, either in person or online, for perspective and the chance to laugh about these situations. When we share our stories with people who understand, our pain and embarrassment doesn’t take on a life of its own. Try a caregiver forum, such as the one at AgingCare.com

aging care forum

Medication Tips For Seniors – Caregiver Information

Dignity Care - Medication Tips For Seniors - Caregiver Information

Did you know that nearly one-third of the population has difficulty swallowing pills? Most people don’t swallow pills correctly. This often results in gagging, choking, and vomiting, which usually results in people not taking their medications at all, or not taking the recommended dosage, which then results in a need for later additional medical care.

If you are caring for a senior who has trouble swallowing their pills, here are some medication tips and some good news. Researchers have found new techniques that make pill-popping easier, even for large pills.

German researchers recently tested two methods of swallowing pills and found that 80% of the time these methods worked better than the normal way of taking a pill. The first is the “pop-bottle method,” and it makes tablets go down with ease. The second is the “lean-forward technique,” which sends capsules straight down the throat. Both have been rigorously tested by 151 volunteers who swallowed numerous dummy pills for the sake of science. And now they are being shared with the world via their publication in the Annals of Family Medicine.

Read about each method so you can try it yourself or have the senior you are caring for try it. Just may make life a little easier for you both.

When Caring For The Dementia Patient Is Hard On The Caregiver

Dignity Care - When Caring For The Dementia Patient Is Hard On The Caregiver

When you are caring for someone with dementia, you need support.  It isn’t something you can do alone without getting burned out quickly.  There are other caregivers out there in similar situations who can share tips and ideas with you to make your days more manageable. There are local support groups as well as online blogs and forums.  In fact, there are so many online options you can get lost in them and never get away from the computer screen.  Pick a few that seem to work for you and stick with them.  When I have a question about a specific problem, I usually go to the Alzheimer’s Association.  For example, I get asked frequently how to deal with the constant questions from a person living with dementia?  Here’s an entry from a site full of ideas, The Alzheimer’s Reading Room.

Alzheimer's Reading Room

The author who shared her suggestions for dealing with those constant questions has her own blog about living with dementia, Dementia By Day.  She is the coordinator of a memory care home and shares her stories and successes and observations.  Her blog is great for caregivers or family members who are new to the world of dementia.  One of her reminders to all of us caring for someone with dementia, which is my favorite, is “It’s never about the outcome when someone has dementia—it’s all about the process.”

Michele

Choosing Care Wisely – the conversation between provider and patient

Dignity Care - Choosing Care Wisely - the conversation between provider and patient

Choosing Wisely® aims to promote conversations between providers and patients by helping patients choose care that is:

  • Supported by evidence
  • Not duplicative of other tests or procedures already received
  • Free from harm
  • Truly necessary

choosing wiselyAn initiative of the ABIM Foundation, Choosing Wisely is working to spark conversations between providers and patients to ensure the right care is delivered at the right time. Participating organizations have created lists of “Things Providers and Patients Should Question” which include evidence-based recommendations that should be discussed to help make wise decisions about the most appropriate care based on a patients’ individual situation.

Take a look at the list of questions the American Geriatrics Society put together for older adults vising their physician.

Help With Home Care Costs For Veterans

Dignity Care - Help With Home Care Costs For Veterans

SALUTE TO THE PAST

There is a little known benefit providing help and support for eldercare costs. Veterans and their survivors may be eligible for monetary payments called the “VA Aid & Attendance Pension Benefit.” These benefits are paid out to the recipients each month to cover the costs of assistance with daily activities (cooking, cleaning, bathing, dressing, personal hygiene, etc.), Home Care Costs for Veterans. Very few people who qualify for this benefit even know about it. It is often overlooked by families of veterans and surviving spouses who need additional money for their care.  The benefit is available to honorably discharged veterans who served during a war period.

Many families are deterred from applying because the process is long and complicated. It may be worth getting some professional help. There are financial planners and consultants who specialize in veterans’ benefits and can help you understand the process. They are prohibited from charging you to actually fill out the application but can charge for information and advice. Be sure to ask upfront about how their fees since they usually say they will help you apply “for free”. Despite the added confusion of whether it is truly a free service, getting help with the application process is the best way to go

Alzheimer’s Caregiving – Rummaging Behavior

Dignity Care - Alzheimer’s Caregiving – Rummaging Behavior

Rummaging and hoarding are common behaviors associated with Alzheimer’s disease.  Although these actions may seem random and meaningless to the frustrated caregiver, rummaging actually serves a purpose in the middle stages of dementia. You won’t be able to stop the behavior but understanding what’s behind it may make it easier for you to cope with it.

I found a great description of what is happening on the blog The Dementia Queen.

Senior Hoarding and Rummaging

“In the middle stages, rummaging is largely a coping mechanism for language deficits and the need to be repetitive.  Once speech and comprehension skills decline, a person in the middle stages has to find another way to interact with the environment.  Using her hands to explore the world is simply a function of survival- if she can’t tell you that she is hungry, then she will just start searching for food herself.  Repetitive actions, such as pacing and saying the same word or phrase over and over again, is usually a behavior used by the person to relieve anxiety and search for reassurance.

It is also the case that people with Alzheimer’s in the moderate stage need to have meaning in their lives. They need to do something other than sit. They need to have control over something – because throughout their lives, they engaged in meaningful action to one or another degree and had some control over what they did or didn’t do.”

There are many websites with tips on how to approach caregiving for someone with dementia. HelpGuide.org is one of them.

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Why Is Staying Hydrated So Difficult For Seniors?

Dignity Care - Why Is Staying Hydrated So Difficult For Seniors

Hot summer days are a good time for everyone to be thinking about staying hydrated. For older adults the topic of hydration is a year-round discussion that never goes away. It’s a serious issue for most seniors but doesn’t get resolved because it needs to be addressed every day and can’t be solved with a pill.

Seniors have a very high risk for dehydration, which is one of the most frequent causes of hospitalization after the age 65. They have a greater risk of dehydration for many reasons, including the facts that as we age, our kidneys become less efficient at conserving fluids, our sense of thirst weakens, and we are less able to adjust to changes in temperature. Some medications like diuretics, sedatives, and laxatives can also cause increased fluid loss.

Dehydration can cause temporary symptoms that mimic symptoms of Alzheimer’s. If dementia-like symptoms seem to appear suddenly, it could be dehydration which is easily curable.

Seniors and HydrationSymptoms of dehydration range from minor to severe and include:  persistent fatigue, muscle weakness, headaches, dizziness, nausea, forgetfulness, confusion, lethargy, increased heart rate, sunken eyes, dry mouth, dark colored urine.  Urine should be clear to pale yellow. I tell my clients that if their urine is darker than pale yellow, they should head straight to the kitchen from the bathroom and drink a full glass of water.  Keeping a glass of water beside you all day to sip on rarely results in someone drinking enough fluids.  It’s more effective to drink the entire glass, even if it’s a small glass.  Seniors can’t rely on their sense of thirst to tell them when to drink water.  Scheduling a glass at each meal and/or after a bathroom visit, making sure to drink the full glass, is the best way to make sure you’ve gotten your full daily amount.

 

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Get Creative About Home Safety Features

Dignity Care - Getting Creative Safety in the Home-2

Making a home safe for a senior is an important element of responsible caregiving, but many of us balk at having to change the way our house looks to accommodate new safety needs. Gradually though, designers are beginning to realize that just because you are losing some agility or vision doesn’t mean you are also losing your aesthetic sense.

Rock Wall GripsI was at a seminar listening to an architect talk about ways she incorporates interesting elements into her safety designs. One of her creative ideas is to use rock-climbing holds in some of the places you’d want to add a grab bar. They come in all sorts of shapes, materials, and colors, and can be added here and there to provide a convenient handhold as you move through the house.

Another creative solution is using LED tape to highlight critical areas like doorways or hallways so that someone can more easily find the bathroom in the middle of the night. The LED lights are just enough to act as a nightlight or to prevent the shadows that can distort surfaces.

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Exercising Seniors Hold Alzheimer’s At Bay

Dignity Care - Exercising Seniors Hold Alzheimer’s At Bay

You have another excellent reason to get out and exercise. This time you are holding Alzheimer’s at bay. Research studies with seniors have looked at the impact of exercise on brain function or on its effects on slowing the progress of dementia. A recent study at the Cleveland Clinic looked at the actual physiology of the brain and found that the brains of people who exercise do not atrophy even if they are at high risk for Alzheimer’s.

As many as 1 in 4 of us can carry a specific gene – ApoE4 – that triples the risk of developing Alzheimer’s. Those are pretty bad odds, but the Cleveland Clinic followed people with this gene and found that those who exercised regularly showed no shrinkage of their hippocampus. In other words, even though they are at high risk for Alzheimer’s disease their brains looked just like the brains of people at much lower risk for the disease.

This link to an article about the study gives you more specifics about the extent of exercising you need to do to keep that gene under control.

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Casey Kasem’s Caregiving Fiasco – Prepare with End of Life Planning

Dignity Care - Casey Kasems Caregiving Fiasco - Prepare with End of Life Planning

The bizarre family feud over who should take care of Casey Kasem and make decisions about his care was played out publicly and legally for several years until his death this month. His 3 children from a first marriage and his second wife fought vehemently in both the media and the courts over who should be able to make decisions, who was able to visit him, who was ultimately responsible for his care. His wife went as far as secretly moving him out of California and not letting the rest of his family know where he was.

Most families, even if they disagree about care for a parent, won’t go to such extremes as Kasem’s family. But family conflict is common and we can use Casey Kasem as a reminder that it’s worth taking the time to talk to the people around you about what’s important for you at the end of your life, or even in your later years.

Families need to talk and to understand what their parents want to have happen or not happen. Everyone involved should be part of this conversation so there is less chance down the road of someone disagreeing about what he thought Mom would want. Talk now when there is no crisis pressuring a decision. The Conversation Project in Boulder County offers an easy-to-use guide to get your family talking about how they want the end of their lives to look.

Here is a brief video explaining the Conversation Project and end of life planning –

Spouses Provide Complex Care At Home

Dignity Care - Spouses Provide Complex Care At Home

Spouses taking care of one another during illness seems a natural part of an intimate relationship. However, the reality is that spouses are assuming the caregiving responsibility over long periods of time and with little or no help from professionals or other family members.

If you compare spouses to adult children taking care of a parent at home, you might say that the spouse is better off as a caregiver. This is because they have fewer competing responsibilities than caregivers who may also have young children or teenagers at home, plus a full-time job. However, this apparent advantage is offset by financial issues, health problems, and other limitations. Plus, not to forget the stresses of constant caregiving.

Additionally, add to that the fact that family caregivers are expected to do tasks that in the past were done in a hospital or nursing home. In this era of complicated medication regimens, wound care, and procedures associated with complex chronic conditions, caregiving is a challenge that no one should have to face alone.

Home care agencies like Dignity Care, licensed as a Class A agency with registered nurses, are a perfect support for family caregivers who need just a little (or a lot) of extra help and expertise.

AARP’s Public Policy Institute has produced a collection of studies and reports on family caregivers that are well worth a read.

Traveling With Dementia

Dignity Care - Traveling With Dementia

Having dementia doesn’t mean any more vacations or travels or trips.  It just means you may have to plan more carefully ahead of time to ensure the comfort and safety of everyone in your group.

traveling with dementia

I was accompanying a client with dementia on a weekend trip and thought I was prepared for every possible situation – until we got to security at the airport.  Our wheelchair escort had been ready for us at the airport door, zipped us onto the elevators, zipped us past the long line at security, zipped us up to the checkpoint.  It all seemed too easy to be t

rue.  Things fell apart when the escort zipped my client through one security checkpoint and left me to go through another, where as luck would have it I was pulled aside for an additional scan.  My client was 50 feet away beginning to get agitated and I discovered that trying to explain to the TSA agent while she was doing the extra scanning was the wrong time to be talking.  She wanted me to stand still and be quiet.  Fortunately, I had nothing hidden on me and it didn’t take long before I was able to rescue my client from his agitation.

That was the one possible situation I hadn’t planned for.  My takeaway lesson was not so much that I should have anticipated this possibility but more that I should have found ways to slow things down to a manageable speed.  Even in the rush at security, I should have slowed our zippy escort and taken the minute to explain to the agents our situation.  A few minutes of their time would have done wonders for us all.

Our trip turned out well and our airport experience on the way home was smooth, in large part because of lessons learned.  And my constant reminder to myself to think ahead and exude calmness.

If you’re considering a vacation, weigh the pros and cons of the trip before you decide to go.  Even though it sounds like a great idea at first, it may be too much for the person with dementia and a fun vacation could become a long disaster.

Take the time to think through all the details and plan for all sorts of contingencies.  The extra effort upfront pays off when your trip goes smoothly with no hiccups.  Here’s a great Travel Tip Sheet from the Alzheimer’s Association.  In addition to being the beginning of vacation season, June is Alzheimer’s and Brain Awareness Month.

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Act FAST For A Stroke

Dignity Care - Stroke Reactions

Act FAST For a Stroke!  Stroke is an emergency and a brain attack. Learn how to act FAST and call 911 at the first sign of stroke.

Recognizing stroke symptoms can be easy if you remember to think FAST. Use FAST to remember the warning signs:

F= Face            Ask the person to smile. Does one side of the face droop?

A= Arms           Ask the person to raise both arms. Does one arm drift downward?

S= Speech        Ask the person to repeat a simple phrase. Does the speech sound slurred or strange?

T= Time            If you observe any of these signs, it’s time to call 911

May is Stroke Awareness Month.  The National Stroke Association has easy ways for you to learn more about stroke before it happens to you or someone else.

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In Home Care Helps Seniors with Depression

Dignity Care - In Home Care Helps Seniors with Depression

Too many seniors grapple with isolation and depression, but these are not a normal parts of growing older. They are treatable medical illnesses, much like heart disease or diabetes. Depression is a serious illness affecting approximately 15 out of every 100 adults over age 65 in the United States.

Seniors experiencing feelings of depression and isolation have a higher risk of hospital admissions, as well as a higher risk for being scammed. Not to mention it makes for a miserable life.

So what can you do? Helping seniors stay healthy means more than ensuring they get good physical care. Individuals living alone miss out on the stimulation of interactions with others on a regular basis. Our caregivers serve that dual purpose of providing physical care and social connection. We enjoy our clients, building a relationship with them, and sharing the highs and lows of their days. Caregivers can laugh with their clients and be an empathetic ear. We make sure our clients are getting out of the house and attending events and activities that interest them.

Hiring a caregiver to help out, even for a couple of hours each week, brings conversation and spark along with the physical help. Caregivers are a good antidote for depression

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Care for a Senior Can Cause Stress for the Caregiver

Dignity Care - When Caring For The Dementia Patient Is Hard On The Caregiver

Family caregivers need to worry about themselves as much as the person they are caring for. Caring for yourself is part of being a good caregiver for another. In a study published in the Journal of the Royal Society of Medicine, “Quality of life: impact of chronic illness on the partner,” the authors stated: “… the most striking research finding is a tendency for the caregiver’s quality of life to be worse than that of the patient.”

What can you do?

Be on the alert for that Super Caregiver mentality that has you thinking you’re not an adequate caregiver unless you’re giving 100% of your attention and unless you’re sure never to have more fun than he or she is having.

Read more of the article and the 6 tips the author gives for caregivers.

Bringing Seniors the Quality Care They Deserve

Dignity Care - Bringing Seniors the Quality Care They Deserve

We all realize that September 2013 will long be remembered by those in Boulder County and other communities along the Front Range.  I, along with everyone at Dignity Care, wish all those who have had to deal with this huge upheaval in their lives, the courage and the strength to put the pieces of their lives back together, one step at a time.

For many of our senior citizens in Boulder County, the flood has greatly affected/changed their lives.  Add to that the confusion about Medicare, Medicaid, Obama Care, and the recent chaos of our government, many seniors are feeling lost and in need of assistance. So, as Healthcare Professionals we must help our senior citizens deal with all the changes and educate them as to where help is available to them. Our county provides many senior resources that can really make a difference in their lives.

In the past few years, we are pleased to say, Dignity Care has experienced a tremendous growth spurt. Dignity Care owner,  Mary Kirk and Dignity Care Director, Ruth Rowse, RN have gained the confidence of the senior community in Boulder County through their model of Case Management and heartfelt caregiving. We have appreciated this trust.  We strive every day to bring quality care to those we serve to the highest possible levels.

We always feel honored to be of service to our clients. Along with our basic homecare services, Dignity Care also has Registered Nurses and Geriatric Case Managers that can help seniors in many ways – from something as simple as Medication Administration to the complexities of crisis intervention.

Let’s all keep working to provide our seniors with the wonderful care they deserve.

Dignity Care

Resources for Caregivers

Dignity Care - Resources for Caregivers

Family caregivers need to worry about themselves as much as the person they are caring for. Caring for yourself is part of being a good caregiver for another. In a study published in the Journal of the Royal Society of Medicine, “Quality of life: impact of chronic illness on the partner,” the authors stated: “… the most striking research finding is a tendency for the caregiver’s quality of life to be worse than that of the patient.”

What can you do?

Be on the alert for that Super Caregiver mentality that has you thinking you’re not an adequate caregiver unless you’re giving 100% of your attention to them and making sure that you’re never to have more fun than he or she is having.