Maintaining general hygiene and daily routines become increasingly difficult with the growing of age. In 2016, upwards of 12 million senior Americans had some level of need, and among those, 6.3 million had a high need because they had limitations in two or more ADLs or were severely cognitively impaired and required help. By 2050, the number of people who need assistance due to a high need is projected to reach 15 million.
Unfortunately, it is sometimes extremely difficult to convince the senior to accept outside help as they feel it will compromise their dignity, self-esteem, and privacy. That’s why it is necessary to keep in mind that elders are still capable of making decisions regarding their personal care. This guide will help you to understand various aspects of adult care and help make your loved ones feel more comfortable, safe and happy during the transition.
Senior Care Tips:
Senior individuals need assistance to go through daily activities such as preparing and eating meals, bathing, laundry, shopping, and more. However, they also need companionship, support, and special care depending on their health condition. Here are important things every personal adult caregiver needs to remember.
1. Bathing and Personal Hygiene:
“If you want others to be happy, practice compassion. If you want to be happy, practice compassion.” – Dalai Lama
One of the most challenging aspects of senior care is bathing and hygiene. Requiring bathing and hygiene assistance is not only physically strenuous but also emotionally challenging, as elders usually feel embarrassed that a complete stranger has to give them a bath.
❖ Create a Bathing Schedule
One of the first things you will need to figure out is a bathing schedule for the elder. Depending on their health condition, they may not need a daily shower. Most adults, in fact, need a sponge bath daily and require a full bath only 2-3 times a week. Make sure to pick up the timing and the type of bath that suits their needs.
❖ Natural Conversation Is the Key
You must keep in mind that bathing isn’t going to be the most pleasant experience for most elders. So, try to keep the environment as friendly and comfortable as possible. Try to strike up a natural conversation to relax the elder.
❖ Keep the Bath Ready
Make sure to keep the bath ready before undressing and bringing the elder into the bathroom. It will not only help minimize anxiety but also protect them from the cold.
❖ Maintain the Dignity
Maintain the elder’s dignity during a bath. Keep their towel or clothing ready and put it on as soon as they come out of the tub or shower. If you are giving a bed bath, make sure to uncover just the part of the body that is being cleaned.
❖ Use the Correct Continence Aids
Some seniors have difficulty in controlling their bladder or bowel functions. You should use the right continence devices and change or clean them regularly to avoid the potential risk of infection. Consult your elder’s general physician (GP) to see if they have any special toileting needs.
❖ General Personal Hygiene
General personal hygiene includes skin care, mouth care, hair care, and shaving. Keeping the skin clean and dry is extremely important, as most seniors are susceptible to bedsores and skin infections, especially those having physical limitations.
Keep their teeth clean. Brush at least once a day. Keep hair short as it is easy to maintain. You may have to wash the hair in a sink or using a dry shampoo. For shaving, use an electric shaver as it is safe and comfortable. Try to keep the elder in a sitting position while shaving and use dentures to avoid injuries.
❖ Take Proper Safety Precautions
When it comes to bathing, a fall risk is your number one safety concern. Nearly one-third of the elders over the age of 65 fall each year. So, make sure the grab bars are installed, the floor is not wet or slippery, the bathroom is warm, and the water temperature is suitable.
❖ Allow as Much Self-Care as Possible
Allow the senior to maintain as much of their self-care as possible. It will provide them with a sense of self-independence. So, when taking a bath, allow them to wash easily accessible areas such as legs, feet, and hands.
❖ Be Patient
Last, but not the least. Always, be patient. In elderly care, particularly dementia or Alzheimer’s care, you may have to explain why and what are you doing again and again. So, don’t stress out. Try to keep a positive attitude irrespective of how difficult the circumstances may seem.
2. Safety Supervision:
“To care for those who once cared for us is one of the highest honors.” – Tia Walker, The Inspired Caregiver: Finding Joy While Caring for Those You Love
The risk of accidental fall injuries increases with the growing age. Loss of bone density, the decline of nervous coordination, and weak eyesight often lead to fatal slip and falls.
➔ Falls account for 25% of all hospital admissions,
➔ And 40% of all nursing home admissions,
➔ 40% of those admitted do not return to independent living,
➔ 25% die within a year.
Unfortunately, most incidents never get reported.
Even a seemingly harmless tripping incident can lend a deathblow to the senior’s self-confidence.
Keeping the surrounding clean and tidy is the easiest way to prevent slip and falls. Avoid leaving items on the staircase, passage or floor. Keep these areas clean.
❖ Eliminate Tripping Hazards
Furniture, cables, wires, loose carpet, unsecured throw rugs, and floorboards that stick up are the common tripping hazards. You should push the furniture, cables, and wires against the walls to prevent accidents. Use double-sided rug tape or non-slip pads to secure throw rugs and carpets firmly to the floor. Fix the wooden floor or replace it if necessary.
❖ Avoid Stairs
Seniors are most likely to fall when using the stairs. If possible senior should avoid using stairs. If it’s not possible to live on one level, try to limit the trips you take up and down the stairs.
❖ Install Grab Bars and Handrails
Safety devices such as grab bars and handrails make it easier for the elderly to move around in the different sections of the house. Provide a handrail along staircases passages, hallways, and even bedroom walls, and grab bars in the bathroom and toilet. You may also need to consider replacing entrance steps with a ramp, especially if the elder is wheelchair bound.
❖ Keep The House Well-Lit
Inadequate lighting can almost certainly lead to accidents, as aging affects the sense of sight. All the areas of the house, especially stairways and narrow hallways require adequate lighting.
❖ Maintain Pavements and Driveways
Shovel the ice and snow on the pavements, backyard, and driveways regularly during the winter. Keep these areas free of debris.
❖ Make the Floor Non-Slippery
Wet floors often lead to slips and falls. So, keep the floors in different sections of the house dry and tidy. Make sure to clean the bathtub regularly as well.
❖ Keep Assistance Devices Accessible
Providing the elderly with the right walking aids such as walkers and canes for safe mobility at home is crucial. Make sure the device is a perfect fit for their mobility requirements, as poorly fit aids can increase the risk of falling; also put it in an easy-to-reach place.
❖ Monitor Medications Regularly
Most seniors use multiple medications. Hence, they may experience various side effects such as dizziness and nausea which may lead to loss of balance. You should review the prescription each time the elder gets a new one. Be sure to consult the general physician about safer alternatives to the medications with extreme side effects.
3. Assistance with Ambulation:
“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.” – Leo Buscaglia
Mobility is one of the most critical aspects of an elder’s sense of self-independence and confidence. Usually, ambulating involves helping elders get in and out of the bed and assisting them to walk or move around in a wheelchair. However, you will need to learn proper transfer skills first.
Never lift the elder with your back. Always use your legs to do the heavy lifting.
If the senior is too heavy, ask for help. Your safety is as important as theirs.
If possible, explain what you are about to do. Try to make them an active participant in the transfer process, at least mentally.
❖ Moving the Elder from Bed to Chair
When moving the senior from the bed to the wheelchair, position the chair close to the bed such that elder’s stronger side is closer to the chair. Be sure to lock the brakes. Make sure the elder is comfortable before moving them to the wheelchair.
Whenever possible, you should use a gait belt to transfer elders from the bed into the chair and vice versa. Made from leather, this simple device provides better support and grip during the transfer, reducing the risk of injury to both the senior and personal care provider.
You can also use a mechanical lift to transfer bedridden seniors. When using a mechanical lift, understand the safety steps involved. You should also have an assistant with you.
❖ Assisting Older Adults with Walking
When you are helping a senior with walking, place yourself on their weaker side. You can also use a gait belt, walker or walking cane to help the elder. Encourage the adult to be as self-independent as possible. Don’t forget to use proper footwear.
❖ Helping Older Adults after a Fall
Sometimes, you may have to assist an elder after a fall. You can help them stand up if there is no visible injury. In case of injury, however, get medical help first. Don’t attempt to move the elder by yourself.
4. Light Housekeeping:
“Offering care means being a companion, not a superior. It doesn’t matter whether the person we are caring for is experiencing cancer, the flu, dementia, or grief.” – Judy Cornish, The Dementia Handbook: How to Provide Dementia Care at Home
Regular housekeeping is required to keep the elder’s home comfortable and safe. However, as part of a homecare service, it will restrict to only light housekeeping chores. Usually, it involves keeping the section of the house clean that the senior uses. It may include the following activities.
It may include cleaning the dishes after meals, sweeping and mopping floors, cleaning kitchen countertops and appliances, running the dishwasher, organizing kitchen items, and taking out the trash.
It comprises cleaning the tub, shower, sink, toilet, and counters with a disinfectant, organizing bathroom cabinets, linens, and towels, arranging the medicine cabinet, and emptying trash.
❖ General Maintenance
General maintenance of other sections of the house includes dusting, vacuuming carpets and rugs, light gardening such as watering plants, cleaning inner windows and mirrors, and organizing clutter.
❖ Essential Errands
You have to do grocery shopping. Prepare meals, serve, and clean up after meals as well. Other essential errands include helping with laundry and ironing and changing bed linens. In addition, you may also have to assist with specific tasks depending on the elder’s medical condition.
5. Meal Preparation:
“It is not how much you do, but how much love you put in the doing.” – Mother Teresa
Most seniors need help with preparing and serving nutritious meals due to physical limitations. The declines of taste and smell along with difficulty in chewing the food often diminish the desire to eat. That’s why, preparing and serving healthy and tasty meals to the elderly is easier said than done.
❖ Consult the General Physician
The first thing you need to do is consult the elder’s general physician to understand their specific nutritional needs. Sometimes, doctors may provide you with a weekly meal plan. You might also need to exclude certain foods depending on the medication. For example, levothyroxine, a drug commonly prescribed for hypothyroidism, interacts poorly with grapefruit. It is better to avoid grapefruit and grapefruit products if the senior is taking levothyroxine.
❖ Plan and Cook Meals Together
One of the easiest ways to encourage the elders to cook and eat healthily is to make them a part of the daily meal preparations. You can plan as well as cook the meals together. You can also take your client grocery shopping if their health permits.
❖ Cook Extra Meals for the Freezer
More often than not, a typical recipe comprises cooking a meal for two. Preparing meals for just one person every day may not be feasible physically and economically. So, you may have to cook extra meals for the freezer. Keep plenty of containers handy to store the leftovers in the refrigerator or freezer. Put the days, dates, and timings on the containers.
❖ Use Only Healthy Snacks
Make sure the snacks are healthy and easily accessible. Keep fruits, cheese, and other healthy snacks on the kitchen table or anywhere the elder can easily reach.
❖ Provide Creative Meal Choices
The diminished taste and smell often obliterates the desire to eat meals. So, to pique their interest in the food, try to be creative by experimenting with flavors and colors. Make sure each meal looks as good as it tastes. Avoid repeating the same meal twice in a week if possible.
6. Shopping and Running Errands:
“Care is state in which something does matter. It is the source of human tenderness.” – Rollo May, psychologist.
As a caregiver, you may also have to run errands and do the grocery shopping. Physical limitations often make it difficult for elders to drive around, to pick up their favorite takeout, medications or dry cleaning.
❖ Keep Them Involved
For an elder living alone, a simple trip to the nearby post office once every month can make a big social difference. If the senior wants to participate when running daily errands, especially for grocery or personal shopping, make sure to take them with you. It will help enhance the sense of connection with the community as well as independence.
❖ Running Daily Errands
In most situations, especially managing bedridden elders, you will have to run the daily errands alone. It will involve running to the pharmacy, post office, dry cleaning agency, nursery, and even a local discount store.
❖ Grocery Shopping
You may have to help make the grocery lists, drive the elderly to and from the grocery store, and assist during the shopping. If the elder is incapacitated or sick, you may have to do the grocery shopping alone.
7. Medication Reminder:
“Although the days are busy and the workload is always growing, there are still those special moments when someone says or does something and you know you’ve made a difference in someone’s life. That’s why I became a nurse.” – Diane McKenty
Most elders above the age of 65 need to take several different medicines regularly. However, memory impairment and sensory decline can make it almost impossible for elders to maintain the complex medication cycle. Medicines can act as a double-edged sword, causing more harm than good, especially when they are not consumed judiciously. Keeping track of medication is one of the primary responsibilities of a personal caretaker.
❖ Consult the Elder’s Doctor and Pharmacist
Talk to your elder’s doctor as well as the pharmacist to know everything about the medication. You must know how a particular drug works, what the potential side effects are, and how to recognize those. You can also ask if there is an alternative to it if the medication is not available. Most importantly, you should ask what the purpose of the prescribed medication is.
❖ Stick to the Prescription
Make sure that the elder takes the medication according to the prescription, without fail. Use a pill box with labels for each day of the week to organize the medications. It also comes with several rows to keep track of multiple medications taken within a day. However, you should make sure the pillbox is filled correctly.
❖ Follow Handling Instructions Diligently
Make it a point to read the handling instructions carefully. Sometimes, the medication may need to be administered in a specific manner or stored at a particular temperature. For example, you may have to inject a proper dosage of insulin using a syringe.
In case of doubt, call the pharmacist or the doctor, immediately. Store all medications in a designated and secure location, especially if you are looking after someone with cognitive or memory issues. Usually, medicines need to be stored in a cool and dry area.
❖ Provide Medication Details at Every Appointment
Chances are, as a personal caretaker, you will have to accompany the senior to the scheduled doctor’s visits. You should bring all of the elder’s medicines and supplements along to get them reviewed by the doctor. Every time the doctor prescribes a new medication, they would like to ensure that the new supplements can produce no harmful side-effects.
❖ Report Side-Effects Immediately
Even if it’s a mild reaction or side effect, you need to report it immediately to the concerned doctor. Ask the family members to provide a contact number in case of such emergencies. Also, try to fill the prescriptions at the same pharmacy. The pharmacist can readily check the drugs for possible hazardous interactions.
8. Exercise or Range of Motion:
“There are only four kinds of people in the world. Those who have been caregivers. Those who are currently caregivers. Those who will be caregivers and those who will need a caregiver.” – Rosalyn Carter
The importance of exercise increases with the growing age. Unfortunately, most elders are reluctant to take up any exercise owing to their physical limitations. However, this is no excuse to avoid exercise, as it is critical for the elder’s mobility and independence. You should encourage the senior to pick up a fitness regime.
❖ Types of Exercise
Usually, you can incorporate four different types of exercises including endurance training, strength training, stretching, and balance activities. While endurance training focuses on developing blood circulation and breathing, strength exercise helps reduce age-related muscle loss. Stretching exercise helps improve joint movement. Balance exercise improves balance and reduces the risk of falls. However, clarify the fitness routine with the concerned doctor or physical therapist first.
● Endurance Exercise:
➢ Brisk walking or walking
➢ Water aerobics
➢ Mowing the lawn
➢ Chair Aerobics
● Strength Exercise:
➢ Weight training
➢ Sit to stand
➢ Chair dips
➢ Wall press
● Balance Exercise:
❖ Safety Comes First
When it comes to elder’s exercising, safety is the chief concern. So, start slowly and build up the routine gradually. Be sure that the senior stretches, both before and after the exercise as it can reduce the risk of injuries. If required, use suitable safety gear for protection, during a workout.
Take their physical condition into account. Don’t go overboard with the fitness regime. If the elder feels exhausted or off balance, stop immediately. For someone with a bad hip, just walking around the house for a few minutes is more than enough.
❖ Range of Motion Exercises
The Range Of Motion (ROM) exercises can improve joint function. Hence, they are considered suitable for the elderly. Active exercise is performed by the elder, while the personal caregiver has to perform the passive exercise. First, you must understand the basics of joint movement, such as the difference between outward rotation (external) and inward rotation (internal), as well as how to support and position the joints during the exercise.
Usually, you should support the upper and lower sides of the working joint. Consult a physical therapist or your elder’s doctor to know the different types, durations, and sequences of passive exercises. Remember, over-extending joint movements can cause pain and discomfort.
9. After Surgery Care:
“No matter what the relationship was between the parent and child, whatever it was, this is going to be extremely challenging because it is not logical. There’s no way to deal with it rationally or directly. You don’t reason it out. What I’ve said to so many people is: we always must lead with our love.” – Dr. Stephen Hoag
Though age is no barrier to undergoing surgery, recover from one becomes increasingly challenging with age. Previous injuries, ailments, and declining health can delay the recovery process for weeks. In other words, after surgery care is an arduous process for both the elder and their caregiver.
❖ Prepare Well in Advance
In general, preparation for the surgery involves, providing wholesome nutrition to the elder, performing exercises, and providing counseling. All these efforts aim to prepare the elder mentally and physically for the operation. So, you may also have to address their concerns in this regard.
❖ Understand the Surgical Procedure
You must understand the surgical procedure to ensure better post-surgery care. Schedule a preoperative meeting with the physician to discuss dietary restrictions, lab tests and diagnostic, and the potential complications associated with the procedure. Make sure to carry a medication record with you, during the visit. You may also have to complete a few home safety and modification tasks depending on the surgery before the elder returns home.
❖ Rehabilitation Post-Surgery
After a successful surgery, people often tend to fall back into a daily routine, which often leads to post-surgical complications. As a caregiver, it is your primary responsibility to stick to the doctor’s instructions during the aftercare period.
Make sure to monitor the elder’s physical and mental activity during this period, to prevent complications. Follow the medication schedule judiciously. Don’t let the elder stretch beyond their limits during the recovery period. Keep an eye on their sleep schedule as well. In case of doubt, contact the concerned doctor immediately.
❖ Coordinate with the Family Members
You have to coordinate with the family members and doctors to develop a comprehensive aftercare schedule. Work together with the doctors to create nutrient-rich meals, dressing wounds, maintaining personal hygiene, and overall aftercare. Sometimes, you may have to work with a physical therapist or another certified medical professional for a quicker recovery.
10. End of Life Care:
“Caregiving leaves its mark on us. No matter what we do to prepare ourselves the hole left behind looms large.” – Dale L. Baker, More Than I Could Ever Know: How I Survived Caregiving
End-of-life care is one of the most challenging circumstances to navigate for a caregiver. However, at this stage, the role of a caregiver is more critical than ever. Not having this conversation can lead to a lot of complications. It usually involves discussing things such as, how the elder wants to spend their final days, ask them if they want to continue with the treatment or medication, and is there a new treatment or medication they would like to try.
The best time to bring up the end-of-care topic is when your loved one is relatively fit both physically as well as mentally. So, don’t wait until the last minute. For example, Charles Ornstein, a health-care reporter, could make the right decision when his mother went into the coma. As his family had already discussed his mother’s end-of-life wishes, they decided to disconnect the ventilator after taking a second medical opinion. His mother passed away peacefully with her husband, son, and daughter by her side just the way she had wished. The matter was resolved without any further legal and medical complications.
It is better to take the elder’s lead in this regard. Listen carefully to them in case they would like to talk about their end-of-life preferences.
You should forward their wishes to the concerned health care professionals and legal advisors.
Asking typical end-of-life questions is a great place to start the conversation. Dr. Atul Gawande, a practicing general surgeon and a professor at Harvard, recommends asking following five questions.
➔ What is your understanding of where you are and of your illness?
➔ What are your fears or worries about the future?
➔ What are your goals and priorities?
➔ What outcomes are unacceptable to you? What are you willing to sacrifice and not?
➔ What would a good day look like?
In the coming years, the demand for elderly care is likely to go up as the number of seniors in the US continues to rise. Though adult care can be a rewarding experience, more often than not, caregivers have to face stubborn behavior as most seniors aren’t willing to ask for help.
So, when it comes to elder care, you need to handle the situation with a gentle touch. Contrary to the popular belief, it involves going well beyond just assisting with personal hygiene and nutrition. Hopefully, these 10 tips will help you provide comprehensive care to help them lead a healthier and happier life. What about you? Share your caregiving experience in the comments section below.