Because We Care

Introduction

1. Hands-On Caregiving
2. Tips on Safety
3. Meals
4. Caring for Your Home
5. Exercise
6. Clothing
7. Entertainment, Entertaining and Travel

Some things that can bring about positive changes for the better include:

• Standing back and taking a look at your situation--what is working well and what isn’t--and finding ways to make changes for the better
• Establishing routines that effectively meet your care receiver's needs
• Improving your physical surroundings
• Physical, speech and occupational therapy and/or exercise
• Assistive devices, which range from special eating utensils to specially equipped telephones, that increase independence and safety
• Improved nutrition
• Carefully monitoring medications and their interactions
• Intellectual stimulation
• Social interaction
• Spiritual renewal
• Employing home and/or health care personnel who demonstrate that they really do care and who will work to foster independence
• Finding ways to economize on your work load
• Filling each day with activities to which you can both look forward

Hands-On Caregiving

If your older relative or friend needs considerable help, a well-planned routine can make the more demanding parts of your caregiving day go more smoothly, take less time and help to ensure that your care receiver does not develop problems which could be prevented.

• Make a list of all the things you need for morning and bedtime routines, buy several of these items, and have them close at hand, such as bathing items, medications, and clothing. This saves time and keeps you from having to search or leave the room for them when you are helping your older family member. If you use items in several different places, have duplicate items stored in these rooms, such as the bathroom and bedroom.
  
• If possible, have someone help you with the morning and bedtime routines, if your older relative needs a lot of assistance, since getting up and going to bed often are the most challenging times of the day.
  
• Practice good oral hygiene that includes tooth brushing, denture cleaning, and cleaning around the gums, preferably after every meal. Good oral hygiene helps to prevent tooth decay, tooth loss and gum diseases, as well as secondary infections that can result from poor dental care. Persons with disabilities or medical problems may need special care in addition to daily hygiene routines.
  
• If your older family member is disabled, has poor eyesight or cognitive impairments, you may need to remind them about personal hygiene and/or assist them. If your care receiver is incontinent, it is especially important to ensure that he or she is clean at all times, to use protective (barrier) creams, and to change incontinence aids and clothing as often as needed. Poor hygiene can result in diaper rash and blistering of the skin. Poor hygiene also can contribute to the development of decubitus ulcers (pressure sores) and other problems that cause pain, discomfort and serious, even life-threatening infections. In older women, tight fitting clothing and diapers can lead to yeast infections.

There are new commercial products* that make incontinence much less of a problem than it once was because they keep clothes and bed linens clean and dry. You also can discuss ways in which your care receiver’s incontinence may be corrected with your health care provider, including exercises and surgical procedures.

For those web links that have an asterisk*, click on the highlighted search word which will take you to the Abledata web site; then type in the same search word(s) on the Abledata key word search site to gain access to the information you want.

• Older persons with limited movement should be turned in bed on a regular basis to prevent pressure sores. Correct bedding, such as sheepskin or egg carton bed coverings and/or an air mattress, helps to prevent pressure sores. It is important to move older persons with disabilities at least once an hour, even if it just to reposition them, to do range of motion exercises, and to have them sit in various chairs that offer sufficient support.
  
• Make lists of:
  • Morning and bed time routines
  • Medical personnel with their area of expertise, addresses and telephone numbers
  • Home health agencies
  • Other people who can help or fill in, if you need additional help
  • Lawyers and financial advisors
  • Where needed items are kept, such as thermometers and blood pressure monitors
  • Medications, when they are to be taken, and where they are stored
  • Exercise schedules and directions
  • Emergency contacts in addition to 911

These lists and other needed information can be put into a clearly marked notebook and kept where others can easily find them in your older relative’s room. This book should be complete enough so that someone filling in for you will know exactly what is needed and what to do.

Tips on Safety

Quick, easy, and readily available ways to communicate with others that can help in an emergency are a must for you and your older family member or friend. You can get:

• A cordless speaker phone with memory so that you can simply hit one button in an emergency and get help without compromising the safety of your care receiver.
• A cellular phone, if you and your care receiver travel.
• A signal system* which will summon help with the push of a button, if you leave your care receiver alone, at times.
• A specially equipped telephone* with speed dialing, a large digital display for easy reading, and ring and voice enhancer, if your care receiver has hearing problems.
• An intercom, * that will alert you if your care receiver is having problems when you are in another room.
• Smoke detectors on each floor, which should be periodically checked to ensure that they are operating properly.

If your family member is disabled, you will want to ensure that he or she:

• Has a clear path through each room, that there are no rugs or raised room dividers to trip over, and no slippery floors. You can carpet the bathroom with all weather carpeting to help prevent falls. This can be pulled up in sections, if it is wet.
• Uses a cane or walker, if needed.
• Is secure in his or her wheel chair. If your older relative is weak a tray that attaches to the wheel chair can prevent falls and gives your care receiver a place for drinks, magazines, etc. It is important to ensure that the wheels are securely locked when doing transfers, or if the older person’s chair is on an incline.
• Cannot fall out of bed. If the bed does not
  have guardrails, you can place the wheel chair or other guards next to the bed, and position your older relative in the middle of the bed so that she or he can turn over without fear of falling.

Meals

As people age, they sometimes experience problems with chewing and swallowing, but there are ways to minimize these problems. The need for certain nutrients in older person’s diets may also change.

Avoid foods that are high in:

• Saturated fats
  
• Salts, chemical preservatives and additives
  
• Sugar and calories that do not enhance nutrition, but may add to excessive weight gain

There are numerous ways to obtain pre-prepared and easy to prepare meals that are nutritious time savers.

For older people who are homebound, meal times can be pleasant social events, when you can be together and talk. If your relative or friend is confined to bed, you can sit and talk while he or she eats and bring a tray in for yourself. There are a host of eating utensils* and accessories that make eating easier for persons with disabilities.

Caring for Your Home

• Use an attractive plastic tablecloth or place mats that are easy to clean and an attractive towel, apron or other covering for your care receiver’s clothes, if there is a tendency to spill food. Be sure that it is large and long enough to cover their laps and fold it inward before taking it off to avoid spillage on the floor. Consider having a vase of flowers (even if they are artificial) on the table or next to the bed, if your older relative is confined to bed, and open the curtains and let the sun shine in.
  
• Use light-weight, plastic easy-grip glasses, or cups with handles. If there is a lot of spillage, try a drink holder with a lid and plastic straw insert.
  
• If clothes are wrinkled, you can put them in the dryer with a wet towel or sponge on a warm setting. This often saves a lot of time ironing.
  
• If your care receiver is incontinent, you can:
  • use washable or disposable pads on the bed above the sheet
  • rubberized sheets underneath the bed sheet
  • a stain and water resistant mattress pad
    
• If the mattress does become soiled, it will need to be thoroughly cleaned and aired after being sprayed with a safe (always read the label) antibacterial cleaning agent. You can ask your doctor or pharmacist for recommendations.
  
• You can use water-resistant pads or heavy towels on the wheelchair or furniture that your care receiver uses. If you travel, keep pads in the car for use on the car seat and when visiting other places.
  
• When buying towel sets, you may want to purchase extra wash cloths since these are used more frequently and wear out faster. Thermal blankets also are useful because they are warm, lightweight, and easy to wash.
  

Exercise

In consultation with your care receiver’s physician and physical therapist, you can plan a routine of exercises. Exercises even for bed and wheelchair-bound older persons help to improve:

• circulation
• lung and heart function
• posture
• mental alertness
• help to prevent:
  • diabetes
  • pressure sores
  • osteoporosis
  • heart disease
  • stroke

If appropriate, encourage your relative to do a little more physical activity each week. Vary the exercises and challenge them to do better. Exercise with them. If they are confined to a bed or wheelchair, try to get them to exercise at least five minutes every hour, and again, regularly change their position to prevent pressure sores.

Clothing

Regardless of our age or physical condition, we want to look and feel our best. Today’s clothing* options make that a much easier goal to reach. When buying clothing, consider the following:

• Clothing that is washable and wrinkle-free saves on dry cleaning bills and ironing time.
  
• Slacks and skirts that have elasticized waistbands or tie waistbands are easier to get on and off and are more comfortable.
  
• Clothing with snaps or zippers and some that button down the front are easier to manipulate.
  
• Shoes that will not slip off easily, and have a non-skid tread.
  
• Interchangeable and color coordinated clothing. e.g. slacks and tops that can go with several others.

Entertainment, Entertaining and Travel

Boredom can sap our intellect and spirit, but you can change this by creating activities that you and your care receiver look forward to and by sharing these with others. There are many activities that frail and disabled older people can enjoy. You can:

• Check the TV listings and choose your favorite programs to watch each day rather than having the TV going nonstop.
  
• Get large print and talking books from the library and read together.
  
• Check for special events that are low-cost or free. Invite a friend or family member to join you, preferably one who can drive or help you if your care receiver has a disability.
  
• Go out to lunch or the early-bird specials at restaurants.
  
• Visit an art-hobby store and see what is available in the way of arts or crafts projects that you and your care receiver can enjoy.
  
• Invite family or friends over for dinner or lunch. If you have limited funds to entertain or do not have time to prepare food have them over for dessert or snacks, ask each of them to bring something, or to chip in on a carryout meal.
  
• Plan day trips to local places of interest. Again invite a friend or family member to join you.
  
• If you can afford to do so, go on a vacation. You can share the adventure and expense with other family members or friends. Many places offer senior discounts. Make sure that they can accommodate your needs, especially if your care receiver is disabled. Large hotel and motel chains now go out of their way to help, if you make your needs known to them. In addition, there are companies and organizations that plan trips for persons with limitations in their mobility. Many travel books have special sections on accommodations, travel, and activities for those with limited mobility.
  
• If you have the room, invite friends or family members to come and stay with you for awhile in your home.
  
• Check colleges, religious organizations, and community centers for free courses and other activities.
  
• Visit museums, galleries, botanical and zoological parks or a petting zoo.
  
• If appropriate, get a pet. Your local shelter or humane society has many nice pets available for adoption.
  
• Get a computer with Internet access so that you can e-mail friends, join in chat rooms, learn about things that are of interest to you, and enjoy computer games.
  
• Ask your local Area Agency on Aging about friendly visitor, volunteer, and telephone reassurance programs.
  
• Many fraternal, religious, and social organizations have activities specifically for older people. This can be a great way to extend your circle of friends and supportive network.

Additional Resources and Reading Lists

This NAIC Internet Notes site on Exercise and Fitness lists a host of web sites that feature information about exercise and how to do them as well as organizations in the field.

Go to the NAIC Internet Notes on Nutrition and Food Safety and view the Consumer Sites for guides to healthy food choices.

The NAIC Internet Notes on Prescription Drug web sites has sections on Geriatric Pharmacy and Drug Use and Name and Prescription Drugs.

AgeNet’s Home Safety Checklist can help to ensure your care receiver’s safety.

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