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  ARCHIVE OF ARTICLES  
   
  MEDICAL CARE AT HOME  
  Seniors who live independently can experience changes in their healthcare needs, even overnight. Home healthcare services provide necessary supplementary assistance by assigning trained and certified home healthcare aides to assist at-home seniors. Whether the situation is temporary, such as after surgery, or in cases involving the chronically ill, home healthcare aides work in concert with the seniors’ doctors, nurses, physical and occupational therapists, and other healthcare workers to ensure that they receive proper medical care. Those services may include assistance with bathing and toileting, and medication dispensing. Services can be scheduled for the days and times necessary, subject to the senior individual needs so that they receive timely caring and compassionate assistance.

P.S. Coordinated medical at-home care benefits at-home seniors.
 
     
  IS IT TIME YET?
  When might it be the appropriate time to bring someone in to provide home care for a senior? Perhaps the at-home senior has issues with forgetfulness and there is a concern over his or her physical safety. Family and friends may not be available during the hours when the senior needs assistance. Keep in mind that home care may be implemented over a period of time, starting with simple household duties and developing into more extensive services when the individual needs of the senior change. If home care is something that you have considered, contact a home care provider to schedule an initial confidential meeting to discuss your needs and learn about the range of services offered.

P.S. People who view home care assistance as a convenience generally handle it better than those who view outside help as a necessity.  
     
  GRANNY PODS  

As the number of senior citizens increases, so does the need for providing them with care and assistance with daily activities. Earlier generations cared for senior family members in multi-generational households. Now more seniors are opting to live independently, but their medical conditions often interfere with their desires to age in place. Granny pods, or pre-fabricated backyard cottages, are gaining popularity. These pre-equipped medical structures are specifically designed for senior living. Many have cushioned floors, medical monitoring systems, web cams, and handicap bathroom facilities. A granny pod installed in the yard of a family member provides proximity to loved ones and independent living space. The customized medical systems help family and caregivers provide appropriate care.

P.S. When area zoning laws permit, a granny pod can be installed and hooked up to the property owner’s utilities. January 5, 2016


 
     
  ANALYZING NEEDS  

Once a family member realizes that some caregiving assistance is necessary in the home to care for a loved one, it is time to analyze the tasks and hours when this help will provide the maximum benefit. Listing daily caregiving needs and the times that they are done is helpful. Usually caregiving tasks of bathing, dressing, and breakfast are accomplished in the morning. Lunch and afternoon activities take place midday, and dinner, toileting, and bedtime rituals are done at night. If full-time caregiving service is not affordable, then a careful review of the task list can help in determining what hours of professional caregiving will provide the most relief in the family’s daily schedule. Engage a caregiver for those hours.

P.S. About 70 percent of people over the age of 65 will require some caregiving assistance at some time during their lives.


 
     
ASSIGNING POWER

A durable power of attorney is an important document for a senior in good health to create. This document assigns legal powers to a trusted family member or friend to act as the senior’s agent when the senior becomes either mentally or physically incapacitated. The powers assigned should be thoroughly discussed in advance and can be limited to the area of healthcare needs. A durable power of attorney remains in force during disability. This document can be changed or revoked as long as the senior remains competent. If the senior has an accident or stroke, the agent immediately has the authority to make medical care decisions and to hire any professional caregivers that the senior may require.

P.S. A durable power of attorney is especially useful when assets are modest and too limited to require the added legal expenses associated with trusts and guardianships.

REALITY CHECK

Although the human body undergoes many physical changes during the senior years, one thing that usually remains unchanged is the feeling of being younger and more vital than one really is. A bad fall, chronic disease, or other ailment can bring about the unwelcome realization that totally independent living is no longer possible. Loved ones need to recognize when outside help is required and openly discuss caregiving options with the senior. Many reputable agencies have qualified caregivers who can aid the senior client in the routines of daily living. Consider the self-care tasks that the senior needs assistance in doing. Then talk to an agency to determine whether caregivers are needed on a part-time or full-time basis.

P.S. The more effort that is spent in screening and hiring the appropriate caregivers, the more successful the caregiving experience is apt to be.

SOLVING PROBLEMS
Most but not all care-giving experiences are positive. Griping to a friend or family member about a careless or chronically late caregiver will not solve the problem. It is important to be proactive and speak honestly with the caregiver about any concerns as soon as possible. Try to remain positive and suggest ways in which any issues can be resolved. Give the caregiver an opportunity to modify his or her behavior, and watch carefully to see if the situation improves. If problems persist, do not hesitate to contact the agency to find another caregiver who may be better able to meet household expectations. An unhappy senior client, employer, or caregiver can result in a frustrating experience for all parties involved.

P.S. Being a good advocate for a senior loved one can lead to resolution of problems before the issues become worse.

PARENTS AND CHILDREN

Caring for an aging or ill senior parent can be an exhausting experience. Becoming the sole caregiver disrupts the parent/child relationship and replaces it with parent/nurse. Although there are benefits to feeling supportive, there are also downsides to this changed relationship. By taking on what is essentially a second full-time job, other areas of personal life suffer. Some people experience inattentiveness at work and/or sleeplessness at night. At some point, it usually becomes necessary to seek professional caregivers to help with the daily caregiving tasks. Seeking outside assistance should not feel like a dereliction of duty. This decision is really an acknowledgement that others are qualified to provide care and a step towards the restoration of the parent/child relationship.

P.S. Family caregivers need to set aside personal time during the day to take a walk or coffee break.

HOME CARE

Seniors are often sent home from hospitals after joint replacements or other surgical procedures before healing is complete. Since these patients still require medical treatment, doctors usually prescribe home care. Skilled medical professionals like nurses and physical therapists come to patients’ homes and change dressings, administer intravenous pain killers, and help with physical rehabilitation. This type of care is intended to be on a short-term basis and is used to help patients go from hospital care to being able to care for themselves independently. Home care visits usually last for 30 minutes to an hour and may be scheduled once or twice a week or more frequently if needed. Healthcare agencies can supply qualified personnel to meet senior clients’ needs.

P.S. Most insurance plans require prior authorization for home care and may limit the number of visits within a certain time period.

CARING FOR MS PATIENTS

Multiple Sclerosis (MS) is a disease that attacks the central nervous system and often results in numbness, lack of muscle control, fatigue, and blurred vision. There are several forms of the disease, and most of them include periods of remission followed by an increase in debilitating symptoms. As the disease progresses, functional abilities of senior clients can change rapidly within a short period of time. Seniors with severe MS are often faced with the need for in-home caregivers to help them with tasks of daily living. Caregivers need to be especially observant of small day-to-day changes in their senior clients as these changes may signal the onset of worsening symptoms and a need for additional caregiving services.

P.S. Both caregivers and patients with multiple sclerosis (MS) can benefit from a support network of people who are experiencing similar issues. The National MS Society can provide support suggestions.

TO MOVE OR NOT TO MOVE

Children who do not live near their elderly parents may find it difficult to manage senior in-home care for them from afar. Sometimes children opt to move the seniors from their familiar surroundings to live nearer to their own homes. Although relocating can provide the children with better opportunities for overseeing home healthcare needs, it comes with certain risks. Seniors often respond to dramatic changes in surroundings by becoming anxious or depressed. These feelings can result in unhealthy changes in blood pressure or blood sugar levels as a result of increased stress. Diabetes and pain management can become more difficult. Before uprooting parents, children may want to discuss alternative options with caregiving agencies and their senior parents.

P.S. When stressed, the brain releases hormones that have been linked to health problems like heart disease and high blood pressure.

TAKING A BREAK

There are different cultural norms related to caring for aging parents. In some cultures, children welcome aging parents into their households and provide daily care for them as needed. In other cultures, parents live in their own homes as long as possible, relying on children to help them with activities of daily living. When children are the only caregivers, they often find juggling work, family, and caregiving tasks overwhelming. Many healthcare agencies offer respite care to give exhausted family caregivers a break from their caregiving responsibilities. With respite care, the agency provides qualified personnel to give temporary care to senior clients on a one-time or regularly scheduled basis, and weary caregivers get time to relax.

P.S. Respite care may help family caregivers cope with caregiving for a longer period of time before other arrangements need to be made.

FILLING IN THE BLANKS

Communication between caregivers and senior clients is extremely important. Hearing loss associated with normal aging can create misunderstandings as well as angry feelings. Friends, family members, and caregivers in the home need to be sure that the senior completely understands directions. People with hearing loss are often quite adept at pretending to hear what is said to them. They may use facial expressions, body language, and lip reading skills to make sense of the verbal content that was not actually heard. When caregivers notice a change in comprehension or cooperation, they may suggest that hearing tests be performed on the senior client. Tests may indicate that hearing aids can be effective in making daily communication easier.

P.S. Caregivers can help their seniors learn to wear and care for their hearing instruments.

SOURCES OF CARE

One of the most frequent reasons given for not using a particular senior caregiving service is lack of awareness that the service is offered. When senior loved ones are no longer able to care for themselves adequately, caregiving options need to be explored. Ask doctors and friends about the services available in the local area. Some community and government agencies offer senior programs as do certain religious organizations. Internet sites about caregiving for the elderly may list services that are being offered publicly. Browse web sites for private companies that provide qualified caregivers for in-home caregiving. Knowing how to locate appropriate caregiving options can make a significant difference in the level of care loved ones receive.

P.S. Most recipients of senior healthcare services turn to family, friends, and professional agencies to provide needed assistance.

EXTRA HELP

Certified home health caregivers are usually required to care for senior clients who are chronically ill, suffering from dementia, or seriously disabled. Their duties may include extra help with activities of daily living: toileting, bathing, dressing, and other personal needs. Some of these caregivers may also prepare meals, feed senior clients, and do light housekeeping tasks. Their duties are associated with the senior client’s needs only and do not extend to other members of the household. In some states, certified home health caregivers are able to change bandages, check catheters, monitor intravenous lines, and administer medications with the supervision of a nurse or doctor. Most certified home health aides work for caregiving agencies and must be hired through the agency.

P.S. Fees for certified home health caregivers vary from state to state and are based on their experience and training.

SAFETY FIRST

Caregivers working with seniors who are “aging in place” need to identify any hazards in the house that could jeopardize the senior clients’ independence and well-being. The bathroom is often cited as an area that needs safety equipment such as grab bars, shower seats, and handicap toilets. The bedroom may not need special equipment, but caregivers should consider whether there are tripping hazards like scatter rugs, torn carpeting, and/or tangled electrical cords. Nighttime phone access can be critical, and a mobile or cell phone should be reachable without getting out of bed. Night lights or baseboard rope lighting can be installed to illuminate the way to bathroom facilities. Seemingly small changes can create safer environments for caregivers and their senior clients.

P.S. Cleaning out closets and getting rid of clutter may help seniors keep their belongings more organized.

PAVING THE WAY

Caregivers hired from an agency or from other sources need to be prepared for their specific caregiving duties within the particular household situation. A good way to ensure that caregiving tasks will be performed properly is to spend time with the caregiver before the job formally begins. Introduce the senior needing care to the caregiver. Describe the daily routines and the patient’s personal likes and dislikes. Be sure to provide, verbally and in writing, a list of all health conditions and emergency contacts to be used if a serious medical situation arises. Discuss mobility issues and how best to handle them. Inform caregivers of personal needs such as eyeglasses, hearing aids, and dentures. Proper preparation can improve caregiving success.

P.S. To learn more about caregiving costs and ways to pay for care, visit http://longtermcare.gov/costs-how-to-pay.

DOING HOMEWORK

When choosing long-term care providers for a loved one, it is important to understand that quality can vary from agency to agency and from caregiver to caregiver. The goal is to find the best provider to meet the senior client’s needs. Before hiring anyone, gather advertising materials, in person or on the Internet, from several sources. Check to make sure that the agencies are accredited and that their caregivers have had thorough background checks. Find out which agencies have the specific services that are needed and how much these services will cost. Choose an agency and interview prospective caregivers. Remember that care needs will be ongoing, so choose the caregiver that best meets the senior’s physical, emotional, and financial needs.

P.S. Medical coverage for in-home services varies. Be sure to check insurance plans to determine whether or not in-home services will be covered.

BLADDER ISSUES

Urinary incontinence is a common condition endured by many seniors. The loss of bladder control can affect a person’s dignity and may even lead to withdrawal from normal activities. There are many causes for urinary incontinence, and a trip to the doctor may help determine whether there is an underlying illness or physical abnormality that is causing the loss of control. Treatments can involve exercises, medications, dietary changes, and surgical intervention. Should treatments be unsuccessful, loved ones and caregivers need to be able to manage sanitary needs with minimal embarrassment. Extra attention should be paid to reducing tell-tale odors and stains so that the senior client is more self-confident and willing to participate in social situations.

P.S. Some medications such as diuretics, antihistamines, sedatives, and calcium channel blockers can make incontinence worse.

MEDICAL-ASSIST GADGETS

Most people are familiar with wheelchairs, walkers, bath stools, and hospital beds that help seniors with disabilities to live in their own homes. Medical supply stores, catalogs, and Internet sites have a wide selection of gadgets for specialized medical needs. There are doorbells that blink when they are ringing so that someone who is deaf can see that there is a visitor. Talking thermometers speak temperature readings aloud for those with impaired sight. Special silverware is available to fit the hands of arthritis and stroke patients. Medical alert buttons and remote patient monitoring devices keep loved ones and/or caregivers aware of emergency situations. Gadgets may not be necessary, but they might provide seniors with more independence and security.

P.S. Long-handled combs and brushes are available so that people with limited range of motion are able to groom themselves.

DRUG SAFETY

Vision issues and forgetfulness can interfere in seniors’ proper use of prescription medications. In-home caregivers are able to help senior clients manage their drugs more safely. Although not all caregivers are certified to dispense medications, most can help by prompting seniors to take medicines at scheduled times. Caregivers can stress the importance of keeping medications in their original containers so that drugs can be easily identified by name, color, shape, and size. If senior clients are unsure about dosage or frequency of use, caregivers can have them check dispensing information on the labels of the original containers. Caregivers may also suggest that senior clients speak to medical professionals before adding any non-prescription drugs or supplements to their regimens.

P.S. When pill boxes are used to dispense daily pills, be sure that boxes are stored out of the reach of children. Pill boxes do not have safety lids.

POSITIVELY GOOD

When one is injured or physically impaired, negative thoughts can fill the mind. Individuals dwell on all the things that can no longer be done independently. Caregivers in the home try to divert negative thoughts by making positive observations such as, “You can walk farther today than you did yesterday!” No matter what the situation is, the caregiver will try to give it a positive spin. By talking and acting in positive ways about activities and procedures, caregivers help their senior clients adjust better to their present situations. Fortunately, it is difficult for the mind to concentrate on two things at once, so when positive words and phrases are used, negative ones are pushed aside.

P.S. New studies of brain imaging indicate that positive thinking interacts with sensory experiences of pain.

NUTRITIONAL VALUE

Medical studies have indicated that there is a strong relationship between good food choices early in life and better health during the senior years. Most ailments that keep seniors from enjoying active lifestyles are associated with poor nutrition. Diseases like diabetes, cancer, arthritis, osteoporosis, and stroke are more likely to develop when lifestyle choices did not include plenty of fresh fruits, vegetables, fibers, proteins, and healthy liquids. Avoiding processed foods that contain polyunsaturated fats, sugars, and large quantities of salt can reduce the risk or severity of many diseases. In-home caregivers who are involved in food preparation for their senior clients try to prepare healthy meals and snacks. Even when a disease already exists, proper nutrition may help lessen symptoms.

P.S. Exercise, balanced diets, no smoking, and time spent with family and friends can all help people remain active into their senior years.

PEACE OF MIND

A personal emergency response system (PERS) enables a senior living alone, or one who has caregivers in the house only a few hours a day, to get help in a crisis situation. Most systems have three components: a small, portable radio transmitter; a console or WiFi connection to a telephone line; and a 24-hour emergency response center that monitors incoming calls. The senior can wear the portable device on a pendant, wristband, or belt loop. By depressing a large button on the portable device, the senior can send an emergency signal for assistance to the call center. This type of system works well inside the home, but is only effective outdoors within a few feet of the house.

P.S. Personal emergency response systems can be purchased, rented, or leased, but Medicare, Medicaid, and most insurance companies do not pay for these devices.

RESISTANCE

Suggesting to aging seniors that they may need to hire caregivers to help them with activities of daily living may sometimes provoke angry responses. Many seniors react negatively because they associate care-giving with loss of independence. It is often difficult for them to cope with the feelings of inadequacy that develop as a result of being unable to bathe, dress, or feed themselves. Even when the need for assistance is urgent, seniors may still resist having caregivers in the home. Experienced caregivers understand the angry feelings of their senior clients and try to help them adjust gradually to accepting assistance from a non-family member. Cheerful words and compassionate care can usually overcome initial resistance.

P.S. If a senior client is particularly ornery, intervene on the caregiver’s behalf and thank the caregiver for putting up with the unpleasant behavior.

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