Guidelines for Homecare for the Elderly

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.

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.

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.

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.

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 sore; 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.

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.

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.

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.

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.

Make sure you have a list of their medications, the name and number of their doctors. Also, have their medicare and other health insurance information available.

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 face mask and gloves. Paper gowns and goggles are also available if necessary.

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.

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.

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.

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.

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 12 years ago. She had a below the knee amputation and could not live alone. Unfortunately, she fell and broke her hip about 5 years ago and had rehabilitation, which was excellent.

Also, my husband had a stroke about 8 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.