Guidelines for Homecare for the Elderly
Making the Decision
Choosing to provide home care for a loved one is a monumental, life altering decision, and there are particular guidelines that will help you do the job effectively and still keep your stress level down. Over 25 million people care for an ill or elderly loved one in their homes. Exactly what is a caregiver? Ultimately, being a caregiver for a disabled, elderly family member requires a great deal of planning, some basic healthcare skills, knowledge about eating and hydration, plus knowledge of emergency care. Before you make the decision to become a caregiver you can consider assisted living facilities, nursing homes and home healthcare services.
Your home may need to be modified to make it accessible and usable for your loved one. There are financial considerations and you are probably going to need some assistance with personal care for your loved one; so you may need someone to do some housekeeping for you. If you have other family members who can help, whether it's preparing a meal, helping you with cleaning or filling your car with gas, it will make a big difference in your stress level. Communicating with your loved one to share your feelings and reassure them you will support them is important. Caring for a loved one in your home can be very rewarding but it certainly adds a great deal of stress to your life, so it is important to focus on your needs, as well as, those of your loved one.
Gentle Care
Shower Chair
Bathroom Grab Bar
Long Handled Shower Head
Safety the Number 1 Consideration
Most homes are not designed for people who have mobility problems; doors may be too narrow, hallways may also be too narrow, and there certainly has to be an evaluation of the bathroom. Sometimes structural changes to the home can be made without too much cost but often the caregiver must become very creative in finding ways to meet the needs of the patient. There are many accessories you can put in a bathroom at a reasonable price that will help to prevent falls.
If you are caring for someone in a wheelchair or using a walker eliminate all throw rugs, as they are just asking for an accident to happen. Keep all clutter off the floor and all areas where the patient is living. If your loved one still wants to drive this can sometimes be a problem if they no longer drive safely. If the parent is unreasonable you may have to talk to their insurance company or find some way for their license to be revoked.
The most common accidents that happen in homes are falls, burns, poisoning, cuts and choking. Bathing is another problem. If the patient is bedridden, they will need to be bathed and given very good skincare, which means using lotions to massage their backs and any bony prominences, so they don't develop bedsores. These patients also must be turned at least every two hours if they are unable to do so on their own. If the patient can use a wheelchair or walker you can purchase bath chairs so they can sit in the shower plus a long shower handle will help them bathe more easily. It is important to let the patient be as self-sufficient as possibly and just add assistance as necessary.
Special Considerations for Alzheimer or Dementia Patient
If you are caring for patient with Alzheimer's or dementia the task is a little bit more difficult, as they may not remember any instructions you suggest, and they also forget how to use household appliances. In addition, they can get lost very easily if they wander out of the house. These patients become easily confused, suspicious or fearful. As their disease progresses they will start having trouble with balance and will eventually depend on a walker or wheelchair to get around. It will be necessary to install locks on all the doors, preferably deadbolts either very high or low, so they cannot be opened easily. It is not difficult to put childproof locks or doorknobs on cabinets or drawers, which are storage areas for knives, or other items that might be dangerous for the patient.
You may have to go to court to obtain legal rights to become your parent's legal guardian.
Responsibility for Medications
Another important area is monitoring their medications. More than 2 million Americans experience adverse drug reactions from prescription medications each year. It is important to understand the patient's medical diagnoses and the purpose for the various medications. The best thing to do is set the medication up in a weekly pillbox to make sure the right medications are being taken at the correct time.
Pill Box
Be Aware of Normal and Abnormal Signs of Aging
The skin is the largest organ of the body and aging makes the skin become drier and more fragile, which is why good skincare is so important.
In the muscular skeletal system there may be problems with the weakness and poor balance. If this is the case, insist on them using a walker or a cane. Too often falls cause fractures in the elderly, and they do not heal quickly.
Memory retention lessens with regard to the nervous system, and the elderly will quite often remember a great deal of their younger years but may not be able to remember what happened this morning.
The circulatory system isn't functioning as well either and the first noticeable place is often in the legs and feet. Check the feet for any growths, such as corns or other sores, then check the legs. Blood clots can form in the legs if the patient is inactive. If you see a red area in the leg that's warm to the touch a trip to the doctor would be in order to rule out a blood clot. Quite often the patient's feet will be cold due to poor circulation. Keep the feet covered and you can also also use socks to keep them warm.
Normal respirations are 16 to 20 per minute; however, an older person may normally breathe more rapidly, particularly if they have any lung disease. Assess the patient for any dramatic changes. Are they breathing much more rapidly or shallow and slow? Changes in breathing are important to note, and if the changes are dramatic the physician should be notified. Of course, if they are in distress, call 911.
The urinary system and the bowels can also be a problem as women and men both can often develop incontinence. It can be very helpful to keep the bedside commode close to the bed and keep a urinal for men because they may not be able to make it to the bathroom. If they are wet is important that they are cleaned up promptly because this will cause the skin to break down over a period of time. Sometimes diapers must be used if the incontinence is continua,l and remember this is often humiliating for your loved one.
If your loved one is a heart patient, nitroglycerin should be close to the bed. If they report chest discomfort sit them up and give them a nitroglycerin for under their tongue. If they report chest discomfort and you notice they are sweating and breathing very hard, then it is time to call 911. Give them an aspirin to chew and another nitroglycerin. It is easy to learn CPR, which could save their life. However, if they have written notarized, documentation such as a living will, you need to be aware of their wishes.
Quite often your loved one may be suffering from more than one disease, which makes care more difficult. For instance, arthritis can be very painful. If they have hypertension (high blood pressure) it should be monitored and, of course, their medication needs to be given regularly.
Prevent Infection in your Home
We all want to maintain a clean and healthy environment in our homes but it is especially important if you're dealing with the critically ill elderly person. These patients are typically more susceptible to infection. The most important way to prevent infection in any home is hand washing. If you have been out somewhere, wash your hands immediately when you get home and wash them before you give care to your loved one. If someone is sick, running a fever or coughing, they should stay away from the patient, or if you must give care to the patient, wear a facemask and gloves. Paper gowns and goggles are also available if necessary.
Providing Proper Nutrition
Elderly people quite often lose their appetite; so if you know of some foods they are particularly fond of, try to fix them more often. Use fresh vegetables and fresh fruits is much as possible, but remember they also need protein. As we grow older we gradually lose our taste buds and the taste buds for sweets last the longest. That doesn't mean you feed your loved ones candy all the time, but they might enjoy a some strawberry preserves on their toast. You may have to cut the food in small pieces so they can still feed themselves. Sometimes food has to be puréed if there are no dentures or their teeth are in very poor condition.
Good Grooming
In addition to bathing, it is important to comb or brush the hair, provide fingernail and foot care, assist with oral care as necessary, which includes denture care, flossing teeth and assist the patient with shaving. If you are caring for an unconscious or semi-conscious patient it is important to perform oral care. Again, you want them to be as independent as possible but sometimes they need help and won't ask, so it's up to the caregiver to make sure all the patient's needs are met.
Keep Your Sense of Humor
Knowledge is knowing a tomato is a fruit. Wisdom is not putting it in a fruit salad.
Caffeine is proof that God loves us and wants us to pay attention.
I'm a pessimistic optimist. I expect the worst - that way things can only get better.
How to Make the Bathroom Safer for Your Elderly Parent
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Get Energized
Caregivers must be energized. Being a caregiver can be very stressful, and it's so important to have a life of your own as well.
Here are a few tips to get energized:
- Think about your own life and your goals. Focusing on things that are important to you can re-energize you.
- Stop and count your blessings. It is healthy to take note of the good things in your life and the people you love and who love you. If you are having trouble with depression, try keeping a gratitude journal and take time each day for meditation or prayer.
- It is important to get enough sleep, eat healthy and get some exercise each day to manage your stress. Research has proven that both exercise and adequate sleep can reduce your stress level.
- Learn to accept the things you cannot change. Obviously this can be difficult, but if you can put your focus on the things you can control and not dwell on those things that you can't you will be happier and have less stress. Put your energy into things that make you happy.
- Surround yourself with loving, positive friends. Your body and brain will respond in a physical way that produces natural chemicals, which will make you happier
- Keep your sense of humor and laugh every day. Research shows us that happy and optimistic people are healthier, recover more quickly from illness, have fewer health complications and live longer. Call a friend that you enjoy talking to or rent a comedy movie that you will enjoy. Reading a lighthearted book is also a good escape.
Summary
Caring for an elderly person that you love is rewarding, but it certainly changes your lifestyle. It is a decision you should make carefully. When we have a major change in life it takes time for us to adapt and to establish a new routine that works well for everyone concerned. I have been caring for my mother since we built an addition on our home 5 1/2 years ago. She had a below the knee amputation and could not live alone. Unfortunately, she fell and broke her hip about a month ago and is in rehabilitation at this time. Also, my husband had a stroke about 5 years ago, but he is able to walk with a cane and is somewhat self sufficient. We have make this living arrangement work without any controversy, so I know it can be done. It isn't what I would have chosen for any of our lives but we accept life on its terms.
The lesson I've learned has been to take better care of myself. If you don't take care of yourself, then you are putting your health at risk. Look at the big picture, find little shortcuts that make your day easier and don't pack too much activity into one day.
More Items for the Disabled
The deluxe folding bedside commode by Drive Medical is designed to meet your needs. The frame can be configured to be used as a bedside commode, toilet safety frame, elevated toilet seat or over your existing toilet. The tool free removable back makes configuring the commode easy for any application.
Comments
This was a comprehensive hub with many tips and much useful information, especially about things the caregiver needs to do to take care of his/herself. Your own experience as a nurse and also caretaker for your mother shines through in what you've written. As you stated, not everyone can handle the stress of taking care of loved ones who are disabled, but those who are highly motivated, who educate themselves, reach out for community support and take care of their own health and needs can find caregiving rewarding even though it is still very challenging. Am voting this hub up, useful, beautiful, awesome and interesting.
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Happyboomernurse, Thank you so much for your comments. The degree of disability has a big impact on whether caring for the patient is feasible for you. Also, I have the support of my husband, which is very helpful even though he is in poor health since his stroke. Love concurs many hurtles.
I totally agree. The degree of disability can be the final determining factor and it's important not to judge those who are unable to care for a loved one no matter how much they may want to.
And love itself conquers many hurtles that would seem otherwise unsurmountable.
I've learned over the past ten years that this can be one of the hardest things in the world to do. Thanks so much for outlining the important things to consider here! I hope your guide proves to be helpful for a lot of people- and considering the growing number of aging folks who have chosen to remain in their homes, I imagine it will!
Your article is a must read for families who are or will be caring for their elderly loved ones. I had this experience with my Mother. It is so important for them to be able to stay in their own homes if possible. You have many needed items listed. Thank you for sharing this.
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Happyboomernurse, I agree its important not to judge because not everyone can provide the care necessary. I appreciate the comments.
Simonne, It is difficult. Many things can arise that you didn't count on. You are right about the large number of elderly people and many people have to make this decision. I hope my hub helps others. I appreciate your comments.
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always exploring, I am glad you enjoyed the hub and appreciate your comments.
Pamela99, You are a source of encouragement and enlightenment and I admire you in your role as caregiver to your Mom and husband. It is truly important to take care of yourself, too. I've recently had to take this seriously as I was neglecting my medical needs being just too burned out on medical appointments, follow-up visits, blood work, ER trips, surgeries etc for my "girls". You are right about having a support system in place to allow for a mini respite.
All the best to you.
Peg
Pamela you have done a good job as usual. Thanks for the tips, I know that many persons will appreciate the information as many of us have no idea what to do such a situation arrives.
Great subject, Pamela and know that you speak from experience.....you are a great daughter and a wonderful person! Voted up - super info!
Caring for elderly is very challenging and you are definitely qualified to write on this subject. Love your quotes--humor is so important. Rated up.
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Peg, I am glad you are now taking care of yourself. Thank you so much for your comments.
Cardisa, It can be a very difficult sometimes to know how handle all the problems when you are put in this position. I appreciate your comments.
Audry, I appreciate your very nice comments.
Anginwu, I agree that humor is important. Thank you for your comments.
I have had years and years experience in the professional position caring for elderly people, and little did I know it would help me be immediately adjusted to the care I am offering to my parents now as they have become older. I would have to say being more patient with the elderly goes a long way.
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CMCastro, I think being patient really is a necessity if you're going to have a good relationship and meet their needs as well as yours. I appreciate your comments.
Told you - great subject~! Congrats on making it into the Fab 14....and best of luck to ya~!
Excellent hub, voted up, useful, and awesome. Congrats on making the fan favs this week. I coordinated 24 hour care for my mom in her last few months of life and took one shift myself, which is all I could do with a full-time business to run by day. You have a lot of practical things things that would have helped me if I'd had access to this hub back then. Even so, the times I spent caring for her became special memories and they developed our relationship.
Great starting guide to get the care going in the right direction!
Just stopping by again to congratulate you on making it to this week's fab 14 in the Fave contest and to wish you good luck.
"Outstanding Hub" everyone should take the time to read this informative article. Your insights are spot on, thanks for taking the time to share your wisdom.
I wish the best for you and your family.
Best wishes. Mike
Very good hub. With all the baby boomers becoming older this is in the near future for many today.
Excellent hub on the elderly. I to am from the boomer generation. Fortunately I am healthy, but I know that can change on a dime. It's important to understand the elderly, we are not just disposable. We contributed to shaping this world and now it's our time to be rewarded with good care, rest and respect. Thank you for this wonderful share.
Hi Pam,
I thoroughly enjoyed your very helpful article and as you know, my 93 year old mother will probably at some point in the near future, need some kind of help at home. Good luck with your mom and I'm glad you're able to help others with your excellent information about caring at home for the elderly.
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Audry, I appreciate the comments and good luck to you also.
WannaB Writer, I'm finding that caring for my mother has drawn us closer together also. Thanks so much for your comments.
Mrs. Dee, I appreciate your comments.
HappyBoomernurse, Thank you for stopping by. It's much appreciated.
Mike, I very much appreciate your comments.
Hanna, That is so true and nursing homes are very expensive, plus they don't always get quality care. I appreciate your comments.
saddlerider, I agree completely with your comments. We still have something to contribute to our families and society. Thank you so much for your comment.
Diana, I very much appreciate your comments and I know your situation may change with your mother also. Thanks for stopping by.
This is a very useful and impressive page Pamela. My own father is very elderly and has some of the problems described here, so I know how difficult it can be for anyone to cope in these circumstances. I'm sure for anyone learning to deal with this kind of problem, your advice would be helpful. Even the mere fact that a page like this is published will allow some carer-relatives to realise they are not going through this alone, so it's a really worthwhile page.
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Greensleeves Hubs, Thank you so much for your comments and I hope it does help some people who are just getting to this stage.
Wonderful hub. Great ideas to help the elderly. God Bless You Precious Heart.
Excellent hub Pamela
I'm currently having to deal with the care taking of my father. It's hard or him to let go of his world and home and enter mine but he understands sooner rather than later is better as his health issues progress. This hub has given me some direction and Guideline in how to better help him. Thanks for sharing your expertise and knowledge on this subject. Rated up!
What a superb hub, Pam. I voted it up/useful/intersting. You've taken care to have a thorough list of important information and hit the highlights of consideration for alzheimer/dementia patients as well.
Great job-congratulations on your nomination.
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stars, Thank you so much for your very sweet comment as I really appreciate it.
Bail Up!, I'm so glad this hub has helped you since you're taking your father into your home. Thanks for your comments.
Denise, I'm glad you like the hub and I very much appreciate your comments.
Great info--- and a nicely done hub, Pamela !!!!!!!!!!
great hub and good luck in the contest
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Carolina, I appreciate your comments very much.
annmackiemiller, Thank you for your comments and I am very hopeful about the contest.
As a professional caregiver, I can say for sure this is great information and advice, particularly about how to remain optimistic. I think compassion is the key. But also having compassion for one's self and knowing when to take a good time out away. Having relief caregivers in the wings is so important! Thanks for this great hub!
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mega,I certainly agree that taking care of yourself as a caregiver is very important as I can tell I'm getting burned out. Thank you so much for your comments.
I just hope I never need a caregiver Pam, but I know I probably will. Oh well...
Great Hub.
The Frog
Excellent hub - voted up!
Thanks for all the information. Very helpful as we may all need some kind of help down the road to aging.
Excellent information. All would have helped me through long term care and burial of parents.
Now, kids gone, doubtful they'll be back. Last place I want to see is a nursing home ... maybe a Peterbilt.
Doubt it'll rain money to pay any bills when I head for a wheel chair and hospital bed in one half of a shared room with another resident playing their TV at full blast because they're deaf. Make it quick and cheap.
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Frog Prince, I hope I don't need a caregiver either and I guess no one wants to lose their independence. I want to wake up dead! Thanks for your comment.
realhousewife, Thanks so much for your comment.
pat potts, It is good information to know, just in case. I appreciate your comment.
Prairie Wind, I have no desire to be in a nursing home either for some of the reasons you listed. If we are lucky we will maintain on our own until the end. Thanks for your comments.
Well written, Pamela. I've not had to care for elderly parents (who've both been gone a while now), but a fair bit of what you discuss here does apply to my wife--and I swore before I was ever married the FIRST time that no wife of mine was going to a nursing home, ever.
We always have to smile at the weekly pill container recommendations (yours and others), though. Pam has to take so many meds, it would require a dump truck.
Instead, what we're doing (at least for now) is to use my old steel toolbox from my OTR trucking days. The key meds are in there (anything that would be a real problem if either missed or taken "double" by accident). It's locked, and I carry the key on my belt.
Late at night (I'm always up then; she's not.) I count out ONE day's worth of meds into ONE bottle, place it on the stand beside here "main easy chair", and that's that. In the evening, she hands off the empty bottle back to me, and...repeat the cycle.
Voted Up and Several.
I took care of my grandmother when she got out of the hospital several times and spent the first year out of high school with her back in '76. It was a very memorable time. I cooked, cleaned and made sure she got her meds correctly. I also helped my great-aunt get her ready for baths. My great-aunt was a nurse and came out to my grandmothers several times a week for that. My grandmother didn't feel comfortable with me bathing her. I am now using those experiences with my husband. It does seem a lot harder, probably because I am older and wearing out also.
This is very thorough written well good job!
Way to go Pam! You amaze me.
Pamela,
As a nurse and a daughter who loved both parents to pieces (and wish she could again), this article is just superb in every way. Voted UP and UABI and I wish you luck in the contest... an inspirational subject worthy of a win, mar.
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Ghost, It sounds like take good care of Pam. I know that isn't always easy. I appreciate your comments.
Becky, .You really started care taking very young and I imagine you are getting worn out. I have been doing it so long myself that I'm feeling a little worn out also. I appreciate your comments.
Naomi, Thank you so much for your comments.
Joanne, Thank you so much, I appreciate your comments.
Post-menopause, I know that must've been tough and I'm hoping this hub will help people before they get into that position. I appreciate your comments.
Mar, I understand what you're saying is I still miss my father and being a nurse just help with the caretaking role. My mother is 87 and I just read losing her. Thanks so much for your comment and for your good wishes about the contest.
Excellent hub! My sister and I went through all of this with our Mom, who passed on just a little over a year ago. Caring for someone you love is an honor and burden rolled into one. If you are in the middle of this process right now, try to cherish the good moments, because all too soon, they will be gone. I wish everyday that I had just one more day to help my Mom eat her food, change into her PJs or just give her a hug. Very helpful and important hub.
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JLPeterson, Your comment is very meaningful to me and I appreciate it so much. I certainly dread the day when my mother won't be here any longer. Thank you for your comments.
An excellent hub. extensive and informative, very well written
Voted up
Great Hub Pamela! My sister is going through this now for our mother. I feel bad that I'm 2000 miles away and I'm not able to help. I know that she is going through a lot and is doing a great job with her. It's been a good learning experience for her teenage children as well.
Outstanding hub on Homecare for the elderly! Off to vote in the Tug-of-war on FaceBook!
Good luck Pam!
K9
Great Hub. We are going thought that right now with my father.
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Rosemay, Thank you very much for your comments.
lisabeaman, So many people are going through this right now and as the baby boomers get older it will become even more common which is why thought writing this hub was so important. I appreciate your comments.
K9eystrokes, I appreciate your comments and thank you so much for your vote.
pftsusan, I know quite well how that changes life in your home as there are good things and some things are tough. Thank you so much for your comments.
Brilliant Pamela
A great hub and voted up for sure.
Take care
Eiddwen.
An absolutely brilliantly written hub, Pamela. Thank you.
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Eiddwen, Thank you so much for your comments.
Hello, I appreciate your comments very much.
Pamela: Very informative Hub. I am going through this with my Mom now, and your hub gives great tips.
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Pino Krisio, We are in the same boat. I'm glad the hub was helpful and I appreciate your comments.
Amazing hub Pamela, good luck for the contest :-)
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Cloverleaf, I very much appreciate your comment. Thanks for the good luck wish.
Great Hub! I really respect your knowledge in this area.
I would appreciate it if you would give your thoughts on family caregiver aggrangements. Have you seem many people use them? Please refer to;
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wiseoldaccountant, I'm glad you found my hub useful. I appreciate your comments. I am obviously a caregiver for my mother and I only personally know of a couple of other families in this position. The arrangements would depend on several things, such as the health and mobility of the parent, what changes you might have to make physically to your home to accommodate the patient and what changes will be necessary in your typically daily living routine. I hope I've answered your question.
Pamela99 Found your hub informative and thought provoking. We definitely have to take precaution in ensuring the safety as well as convenience of our aging parents. There are many items on the floor that an elderly person can stumble upon can cause them to fall. Falls are a great concern for older folks.
Also, in the shower, we should ensure that the heater will not exceed a certain level. There are instances when elderly folks get burned, because they are unable to remove themselves from harm's way in a short time.
The pill box idea is a no brainer. You have to have it. Thank you. It does not need to be purchased from specialty stores. You may be surprised to find these medication organizers at your local dollar store. We bought ours there. It helps our aging parents stay on top of their medications. You would be surprised how organized they can be when we provide them with the products that can simplify and ease their difficulties. That was really insightful. Thank you. Voted UP!
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jeyaramd,My mother uses a medicine box as do I and it really does help keep your medication organized. Thank you for all your helpful comments. You have some good suggests that help keep the elderly safe.
The pill containers are good so that you can keep track of what they are taking. In most cases, they won't. And in some cases, they over medicate or under medicate themselves. More often than not our elderly are dealing with Dementia.
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pftsusan, That is a big problem for many seniors and so sad. I am so fortunate my mother has no sign of dementia and she'll we 87 in a couple of weeks. Thanks so much for your comments.
God Bless her Pamela. And you've been blessed too.
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pftsusan, I believe that and thank you. God Bless you also.
I am so happy to discover this hub. As a baby boomer who has one parent with Alzheimer's and one debilitated by a stroke, I'm always looking for ideas on how to keep them safe and entertained. After working in healthcare for over 30 years, I still feel inadequately prepared for this chapter in life. Thank you so much for writing about this issue affecting so many of us.
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IRC, You certainly have your hands full. I hope you can get some additional help for your sake too. It is quite a challenge to care for one parent, let alone two. I wish you the best and appreciate your comments.
Thank you Pamela99. We are fine. I have an awesome brother and neice and between us, we manage fine. We are blessed. I just read the other message you sent me and wow! We are living parallel lives in different places. I hope we will be friends. We all need someone who simply - understands. You take care of YOU too!
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Linda, I would like to be friends also. We do need someone who understands and most people really don't if they haven't had the experience. You take care of you also. Thanks.
Then, we are friends in the journey. :-)
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I agree. We are friends and may be able to help each other in the more difficult times.
73