Posted by Lauren Batalka on Mon, Feb 21, 2011
Once your parent is back at home after suffering a hip fracture, her comfort, safety, and mobility become top priorities. She'll need changes in her environment so she can feed and dress herself and get around the house. That's where an occupational therapist (OT) can help. This professional is trained to look at home environments and suggest changes that will make it easier to function.
The OT will develop a plan based on the layout of your parent's home and her doctor's recommendations (the doctor will determine how much weight, if any, your parent can bear on the injured side, for example). Below are questions to ask your parent's occupational therapist.
1. What sort of devices will my parent need to help her get dressed?
If your parent can't bend, she'll need to learn how to use adaptive devices like a dressing stick. She can use this long dowel with a hook on the end to help her put on underwear, pants, and socks. Long shoehorns are especially useful for getting into shoes without having to bend. (Your parent will probably want to invest in a pair of slip-on shoes with nonslip soles.)
2. Will any of the surfaces my parent sits on need to be raised?
Your parent's occupational therapist may recommend that she sit in seats that are firm and raised. If your parent has a favorite chair that's too low, he might suggest placing a firm cushion on top of it or boosting it with cone-shaped furniture raisers. If the chair doesn't have arms, the therapist may suggest switching to one that does, so that your parent can get up more easily. He may also recommend purchasing an elevated toilet seat.
3. Will my parent be able to bathe herself?
Because your parent won't be able to bend, the occupational therapist may recommend a bath chair for the shower. He can show her how to position herself while using a long-handled sponge to wash her feet and legs. The OT should also show your parent the proper way to get in and out of the shower stall or bath. (Grab bars will make it easier.) If safety mats aren't already in place, he'll likely recommend peel-and-stick safety mats for the tub or shower to prevent slipping.
4. Can my parent carry things around the house?
Your parent will have restrictions on how much weight she can carry. Since she may be using a walker, she'll need to use some alternatives for lifting and carrying objects. Check medical supply companies to find walkers that have attached baskets for transporting lightweight items around the house.
5. Is cooking off limits?
Many kitchen tasks require lifting or bending -- moving pots and pans, leaning over the counter to chop or stir. The occupational therapist can show your mother how to push pots and pans along the counter instead of lifting them. He may also suggest that she sit on a high stool to chop vegetables.
6. What's the best way for my parent to get in and out of bed?
7. Is it safe to use a walker in the house?
To ensure that your parent will be able to move through the house easily and safely, the OT will check the lighting to make sure it's bright enough and remove hazards such as throw rugs, clutter, and electric cords. He can also show your mother how to position the walker in front of cabinets and closets before opening them and how to carry food.
8. How can I make things easier for my parent in her home?
Your parent will be temporarily unable to do many tasks that are usually second nature, particularly those that require reaching and bending. The occupational therapist can recommend ways to arrange items around the house so that your parent can reach them without injuring her hip. Ask the OT to show you how to make sure your mother is moving properly so you can remind her if necessary.
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Posted by Lauren Batalka on Fri, Feb 18, 2011
How can I talk to my loved one about incontinence?
Realize it's normal to feel uncomfortable. There are some discussions between close relatives, especially a parent and child, that many of us would rather avoid: Talking to your own children about sex is probably not something many parents can glide through without some discomfort. Equally difficult, or perhaps even more so, is broaching the subject of incontinence with the very person who used to change your diapers when you were an infant.
Whether or not the person you're caring for has memory problems or dementia, the topic of incontinence is challenging. "Society has programmed us to view bodily functions as dirty and private, and when you're dealing with a parent, having such a discussion isn't a natural thing to do," says Carol Jones, a family consultant with the Mountain Caregiver Resource Center in Mount Shasta, California.
Avoid denying there's a problem. When talking to adult children who are caregivers, Jones found that they often have such a hard time dealing with incontinence that they pretend it's not happening. "Sometimes the biggest problem is that the caregiver is embarrassed and feels the need to cover up the accidents, even denying that the person is incontinent."
Don't assume the person is trying to punish you. Another pitfall, particularly if the person has dementia, is the misperception that he's having accidents "on purpose," as a way of gaining control, according to Jones, yet that's rarely the case.
Communicate about the problem. To overcome these emotional obstacles, Jones recommends tackling the topic head on. "The best way to do it is to speak frankly and say, 'We're in this together. I know this is embarrassing for you, and it's hard to depend on someone else for bodily functions, but I want to work on this with you to make it easier.'" Of course, if the person you're caring for has dementia or Alzheimer's, you may need to use a different approach.
Take him to the doctor. First, if the person you're caring for hasn't seen the doctor, he should make an appointment or you should make one for him. Incontinence isn't a normal part of aging; it could be a sign of, say, a urinary tract infection. Medications could also be the cause, or accidents could be a sign of another medical problem, such as an enlarged prostate in a man.
If the person has already seen his doctor and medical treatment hasn't solved his incontinence, you can try a number of things to make it less of a problem.
Make sure there's nothing to slow him down when he needs to urinate. One impediment to getting to the toilet on time could be the clothes he's wearing. Jones used to run an adult daycare center, and a big obstacle to reaching the toilet was the men's pants: "I live in cowboy country, and men would come in with button-front jeans, and by the time they got to the bathroom, there's no way they weren't going to wet themselves." An easy solution is to make sure your father wears pants with a large zipper fly or an elastic waistband.
Another option is to check with your local medical supply store to inquire about installing handrails and grab bars to make it easier for him to get to the toilet, or look into buying a bedside commode or urinal for him to use at night.
Help set up a toilet schedule. If the doctor hasn't told you how to set up a toilet schedule, it's easy enough to do. It tends to work best with stress incontinence (this is a result of weak pelvic floor muscles, and is often triggered by sneezing, laughing, coughing, or lifting; it's more common in women) and urge incontinence (when a person has a strong urge to urinate and leaks urine before reaching the toilet). Urge incontinence often occurs in people who have diabetes, stroke, dementia, or Parkinson's disease.
Try keeping a diary or have him log the times when he urinates for a period of two or three days. Once you've figured out when he typically needs to relieve himself, set up a schedule so that he heads to the toilet before he'd typically need to go.
Watch the fluids before bed. Of course, how much fluid he drinks will affect how often he needs to urinate. People often assume that withholding fluids will help incontinence. However, barring a medical directive from the doctor, your parent should drink fluids throughout the day to avoid dehydration and cut down on fluids in the evening so he doesn't need to go as often at night.
Consider other possible triggers. What the person drinks and eats can affect incontinence. Anything with caffeine, for example, may irritate the bladder and should be reduced or eliminated. "Coffee, colas, and chocolate will cause your parent to have to go much more often, as will alcohol -- though I'm not talking about an occasional glass of wine," says Jones. Spicy foods, carbonated beverages, and foods with high acidity like tomatoes, peppers, and citrus are also bladder irritants and are best avoided. "If he has orange juice in the morning, try switching to apple juice," suggests Jones.
Learn about incontinence products. Long gone are the days when wearers of incontinence products felt as though they were carrying around a log in their pants; today there are plenty of comfortable products to choose from. There are briefs of different sizes and shapes, male and female briefs, some that look like a classic diaper, and some that appear no different from underwear. A variety of cleansers, moisturizers, and skin barriers can protect your parent's skin against developing sores.
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Posted by Frank Esterle on Mon, Feb 14, 2011
Caring for yourself while caring for others is an important — and often neglected task. So this Valentine’s Day, save a little love for yourself by following these crucial steps to heart health
The American Heart Association tells us that heart disease is the number one killer of women – twice as many women die from stroke or cardiovascular disease than all cancers combined, including breast cancer. To raise awareness, the AHA promotes its “Go Red for Women” campaign, launching this month.
And, while all women must pay attention to maintaining their heart health, studies show that caregivers have twice the risk of developing a chronic illness such as heart disease, based in part on the prolonged stress they encounter during their caregiving journey.
Unfortunately, the challenges that caregivers face when they take on the role of caring for a loved one can prohibit or prevent them from finding the time to care for themselves. This is the big red flag we have to wave this month to help caregivers find the time to avoid the minefields that blow up their own self-care plan.
For instance, a study from the National Alliance for Caregiving on caregivers whose health has declined since they started caring for a loved one shows:
- Stress is a caregiver’s #1 issue and 91 percent report also suffering from depression
- 72 percent of these caregivers neglect their own doctor and dental appointments
- 10 percent adopt or resume bad behaviors such as smoking and they misuse alcohol or prescription drugs to cope
- 87 percent report getting less than eight hours of sleep a night and have less energy
- Almost four out of 10 said they have had weight loss or gain
Here are the five AHA tips for women aged 50 and over to review when it comes to keeping your heart healthy:
- Know your family history. You have a greater risk if a parent or grandparent had heart disease. In fact, a new study released this month shows that a mother’s stroke history can help predict her daughter’s risk of heart attack or stroke.
- Don’t smoke and avoid secondhand smoke.
- Drink in moderation. While alcohol adds calories to your diet that can cause weight gain and your blood pressure can increase if you drink too much, four-fluid ounces of red wine a day can be all right according to some physicians.
- Eat a heart healthy diet – lots of fruits, vegetables, omega-3 fatty acids such as salmon or trout and fiber-rich whole grains. Also, stick to less than 1,500 mg of sodium a day and avoid sugar-sweetened beverages.
- Know your numbers. Do you know what your good and bad cholesterol numbers are and what they should be? How about your Body Mass Index (BMI)? Are you getting at least 30 minutes of cardio exercise a day? Do you have a waist measurement of 35 inches or less? If you do not know your numbers, find out today and then check the Weight Control Information Network, maintained by the U.S. Department of Health and Human Services and the National Institutes of Health, to find out what these numbers mean and how to maintain healthy scores.
Doing all the right things is hard enough for the average woman, but when you are caring for a loved one, it becomes an even more daunting task. When I have spoken to caregivers, they say to me, “Give me a break – literally! How can I find time to exercise or get more sleep? I don’t even have time to take a shower and I eat standing up in the kitchen because I have no time.”
Yes, it is hard. This is where the love comes in. Caregivers are giving love to their loved one, leaving precious little time to love themselves. So, if you have a mother, spouse, sister, friend, neighbor or co-worker who is a caregiver – what kind of Valentine’s wish can you send their way this year? Three ideas:
- Give respite: Give the caregiver you know a break so they can take a walk, get to a yoga class, take a nap, etc. Healthy heart help: Bring the caregiver in your life some heart healthy groceries – all cut up or in ready-to-eat freezer bags or snack bags. Make it easy for them to stay on track with good nutrition.
- Have a laugh: The power of humor is scientifically proven. Having a good laugh at least once a day releases endorphins that enhance mood and have even been show to boost immune systems. Call the caregiver you know and have a good chuckle.
Sometimes it’s hard to find that balance between self-care and caregiving. But, by taking care of your heart health, you will ensure you continue to be the heart of your family. And, as a friend to a caregiver, warm their heart this month with an act of kindness and support. It will do both your hearts some good.
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To learn more about respite for caregivers, click HERE.
Posted by Frank Esterle on Mon, Feb 07, 2011
Daughters who provide most of the care for ailing parents suffer more from cardiovascular stress than wives looking after ill husbands, a new study says.
Researchers at the Stanford University School of Medicine say that compared with wives, daughters caring for a relative with dementia in their own homes experienced measurably greater increases in heart rate and blood pressure during interactions with the ailing relative.
No such differences between wives and daughters turned up during moments when the relative was absent. Lead study author Abby King, an assistant professor of health research, told a meeting of the Society of Behavioral Medicine in New Orleans that the study provided the "first evidence of differential physiologic effects of caregiving in the natural environment for daughters versus wives."
"Our data suggest that from a physical health standpoint, daughters are a very important group to look at, and they may in fact be facing more difficult challenges that translate into actual effects on their cardiovascular system," King says. Daughters may carry a heavier burden as caregivers because they tend to be younger, with independent lives and may not have bargained for life as a caretaker.
In the United States today, about 75 percent of older caregivers are women, said King, who described them as "the life net between their loved ones and institutionalization." The study involved 81 women between the ages of 50 and 85 caring at home for a parent or spouse with dementia resulting from Alzheimer's disease, Parkinson's disease or stroke.
Some 57 percent of the women were wives caring for husbands. The rest were daughters looking after a mother or father. Read more.
Do you need a break from caring for a loved one? Click here to learn about our respite program.
Posted by Lauren Batalka on Fri, Feb 04, 2011
Everyone gets a bit anxious in the winter. Short, dark winter days and loads of snow make winter a time of isolation and decreased activity. There are some things caregivers can do to help our elderly or ailing relatives get through winter reasonabbly active and mentally healthy.
Safety and Health: Winter can be a scary time for elderly people who fear slipping on ice or wonder whether they'll be able to pay the heating bills. There are a few things that caregivers can do to help alleviate these sources of anxiety.
Keep drives and walkways shoveled and free of ice. You can hire someone to clear driveways and walks for your loved one, but many communities offer free driveway-plowing services to senior citizens. Call city hall to find out if this service is available.
Find out about heating bill assistance. If getting bills paid is a worry, contact your local Area Agency on Aging to find out if your loved one is eligible for an energy assistance program.
Change furnace filters. For maximum efficiency, this may need to be done as often as once a month. As caregiver, you are in the best position to handle or oversee this chore.
Socializing: When it's cold and dark, it's easy to get isolated. Before your loved ones begin feeling lonely, think about how you can help them connect with others during the cold winter months. When it's safe to venture out, be sure your loved one can get out and about.
Keep up social commitments if possible. Continue to arrange rides to church, the senior center, or to other activities.
Don't forget group meals. Many communities have group meals for seniors. There might be a senior center in town, or the hot meals might be served at a community center. Bingo, cards, blood pressure checks, and the opportunity to visit with others can provide a needed break in a seemingly long day.
Prepare and share a meal. You might like to enjoy a quiet meal together. Or if a neighbor offers to bring a casserole, suggest she stay and have a meal with your loved one.
Entertainment at home: Sometimes, it'll just be too unpleasant to get out. Or maybe your loved one is homebound by a physical or mental disability. There are still some things that caregivers can do to brighten those long months.
Buy and fill a birdfeeder. You can find birdfeeders that attach directly to a window, so your loved one can easily see the ongoing show the cardinals and chickadees provide.
Offer to pick up and return books and videos. Your local public library may even have a delivery service for homebound people.
Send a letter. Even long-distance caregivers can bring some light into a dark day. Make a point to send a note or letter, especially in the winter. Yes, an old-fashioned letter in this age of electronic communication means a lot to the elderly.
Watch for signs of depression: Though elderly people are not at a particularly high risk for Seasonal Affective Disorder, a mood disorder caused by changes in daylight, they often face an increased risk of depression due to life changes, medication, and illness, according to the National Institute for Health's Medline website. During winter, when stress levels and isolation increase, be sure to watch for persistent sadness, discouragement, reduced energy, and sleep problems.
Many elderly are unwilling to admit being depressed for fear of being seen as weak or unstable. You might want to try this approach: address the issue by naming the symptom ("You need to see a doctor about your sleeping problem") rather than naming the illness ("I think you are depressed").
And be sure to take care of yourself, too. Keep in mind the tip from the National Family Caregiver Association: "Remember to be good to yourself. Love, honor, and value yourself. You are doing a very hard job and you deserve some quality time for yourself." This winter, be sure to think of ways to keep yourself safe, healthy, connected with others, and entertained, too.
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