In Home Care Giving Beginning Tips – #1

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In Home Care Giving Tips starting from the beginning for spouse and family care givers  by Francy Dickinson

One day you are young and in a blink of the eye- you are a senior with health issues...Let's work to make the care giving path easier.

One day you are young and in a blink of the eye- you are a senior with health issues…Let’s work to make the care giving path easier.

Dear Francy: As I stand today…I can look back many years ago when I was first giving care to my elderly mother with many aging issues until she passed at 100. Then turned around and started caring for my husband, Georgie, who had Parkinson’s/ Alzheimer’s. After 15 years of in home care giving I learned a few things so I am going to share them. But I started this blog…because in the beginning…I was in a daze with no knowledge of the bumps in the road in home care. Now, I look back on it…I’m a CNA and have years of experience of daily living challenges and I know I can help you on your road. You will find a few years of index to review…I have done a lot of blogs to help you…always take a look and see if something I wrote a few years ago fits your needs. OK…so now I will begin at the beginning just for you !

CAN I REALLY GIVE CARE TO MY MOTHER? I AM NOT A NURSE!

Oh boy, this is a normal question and the answer is YES. You can take it a day at a time and if the path gets too hard you figure out how to get help or place your senior in a care facility. There are no rules…you have to work through the situation that matches, your own health and time limitations. There is no quilt over asking another family member to take over the care giving or finding a state Senior Care Worker that will find a good place for your mom in the months or years to come. Give it a try…and keep your spirits up..we all go through bad days…but the good days far out-weigh them.

WHERE TO START?

If you are going to put your senior in your own home…or keep them in their home. You start with a clean and safe place to house your senior. So that means that the lazy days of cleaning when you feel like it are gone. Now, just like in hospitals and care facilities – you have to think “CLEAN and SAFE”.

In Home care for the senior means you have to start at the front door and make a safe pathway through to the TV chair, the kitchen, the bedroom and the bathroom. All the rest of the house can be left alone…but the path that you and your senior will be taking all day and night has to be cleared away. If your senior is a bit of a hoarder…you do not throw away things…you go in and put things in boxes and place them in the back room or garage. Just know perfection is not required, but clear walk ways that are safe and will keep the senior from a fall…or allow the senior’s walker or wheelchair to get through doorways and from room to room – is required.

George carefully stepping down into our living room

George carefully stepping down into our living room

Look around…maybe the senior has been in a home for years…but the location of the comfortable TV chair that will be a lounger (maybe even an electric lounger) will be placed in a spot that is easy to see the TV and get up and down without any tables, chairs or throw rugs in sight. Watch your senior get up and down from this chair and move around. You can order and get great hand rails that can go on walls where the senior needs an extra boost to keep them steady. But NEVER let the senior do the TABLE TOP walk! That behavior is over…it is dangerous and the small side tables that are unsteady should be removed so the senior does not do this. Seniors must use their cane or walker in the house…no exceptions!

TV CHAIR-SIDE:

  • Have a good table with drawers next to their TV/Comfort chair. Make it work with a good lamp and the remote. Get a remote that will work and if it is confusing…then cover the remote with painter’s tape over the buttons you do not want them to push. ON-Off-Volume-Up n Down Channels is it…make it easy!
  • I get a nice size basket for the side-table and put all sorts of things in it that will keep the senior in their chair, not running around for small things. You will have a small scissors, nail files, pens, mirror, hand cream, small pad to write, lip gloss, telephone – etc. All within a basket that the senior can keep with their favorite things.
  • Then down by their feet…within range, but not where they will trip on it..get a small chill chest. This is where they fill it up with chilled water, Boost, sandwich or treats…so they do not have to move to eat or drink. This makes their day a little easier. They will get up and go to the bathroom, but not worry about eating. If they are not well, or tired…they only have to reach down and get a Boost, crackers, yogurt or water.
  • Add a heated throw, that is electric and will keep the senior warm, even in the summer months. Seniors in care, taking meds…get cold all the time. Add a small neck pillow so they can take a snooze ~ plus an eye shade so the lights don’t bother their nap. Now they are nice and snug in a rug!

KITCHEN UPDATE:

  • No money has to be spent here. Just streamline the kitchen so it’s easy to use from a walker (with a basket) or a cane. Remove things from the counter and keep only what they need. Clean the counters (senior eyes don’t see crumbs) and test that everything can be easily reached. Toaster, coffee maker, sweetener n mugs. Keep it easy!
  • Change the cupboards and put a set of things they need in the lowest and easiest cupboard to reach. Put a couple of glasses, mugs, plates, snack plates and bowls all together for them within an easy reach. Or use paper plates for snacks so they can clean up with no fuss.
  • Clean out the refrigerator and get rid of silly things that will never be used. Clean the shelves and only have things they really need. Yogurt, milk, mayo, and sandwich makings. Make their life easy…think about what they really use and eat now. Not what they cooked when they had family at home. Now there will be room for the pre made dinners that you bring to them…to heat in the microwave. Easy…remember its the key to care giving.
  • Put up a kitchen calendar so they know what is coming up and keep it active each time you visit. Have a place for notes or large phone numbers they may need. Move the table to a comfortable spot and remove un-needed chairs. Keep the kitchen easy and helpful…not cluttered. Yes, it will change the room…but life has now changed.

HALLWAY: Walking path needs to be clear

  • Walk the pathway the senior will use and repair any place that needs help. No scatter rugs…no holes in rugs…no boxes or shoes on the floor, just a clear walk way around the house.
  • Keep it Clear…Get a good plastic bin that you can keep mail and important papers in each day. Then once a week you can quickly go through the pile and pull out the bills and the important papers to address with your senior.

BEDROOM: Easy bed, side table, small chair for dressing and a dresser

  • Life has changed…no longer is the senior going to wear suits and ties to work or dresses to church. Yes keep one set…but remove old clothes and replace with comfortable new clothes that work around the house. Comfort, nice colors and ease is what we want for our senior. New underwear that goes on and off easy. A place for Depends and a throw away bin for used Depends. Get this room…cleared and cleaned.
  • Make sure the senior can reach the phone from bed. That the bedding is warm and easy to use, not heavy and layered deep with covers. Easy in and out of the bed is what will keep the senior safe. If the bed is not working…get the family to flip for a new mattress or get a hospital bed Rx from the doctor that can help the senior in getting up and down easily. New flannel sheets and pillows to keep senior warm and comfortable.
  • If the senior has to walk more than 3 feet to the bathroom…get them a commode for the night-time. That way they can just get up and go to the toilet easy and close…then during the day…they can walk to the bathroom. Think ahead..signs of helpful raised toilet seats and grab bars in the bathroom…are needed…and should not be ignored.
  • No slip on slippers…those are very dangerous. Get a full fitted slipper that has a good rubber sole so the senior can slip it on and walk safely in them.
  • Put small bottles of water by the bed and have them take a few crackers or a yogurt to bed with them at night. If they wake feeling weak…they can reach over and have a small treat to give them a boost. Only allow medications that can be easily taken without thought by the bed. Seniors can wake and think they have forgotten their meds and over medicate in the middle of the night. Be careful and think ahead.

BATHROOM:

George in his wheelchair we got a cart that would fit through our doorways

George in his wheelchair we got a cart that would fit through our doorways

Things are going to change in the bathroom.

  • The tub needs to have a good bath-bench, a hand-held shower head has to be installed and the toilet needs grab bars and easy to use toilet seats.
  • No scatter bath rugs now needed. You can have one hanging on the tub for bath day use only.
  • A large container of Bleach Wipes to clean the surfaces and the floors when there is any problem.
  • Baby wipes to clean the bottom if there is a loose stool problem and a good garbage can to hold the trash…you do not want to flush baby wipes.
  • I cleared the counter and put a basket there that contained the needed things for George’s care. Depends, bottom cream, wipes box, etc. This kept the area looking clean and I just refilled the basket to keep it all convenient.
  • Time for new towels. Most seniors have towels that are years and years old. Get them a couple of nice bath towels and new hand towels and wash clothes.
  • I used a nice hanging shoe holder for the back of the door in the bath. I filled it with the different creams, lotions, soaps and moisturizer that I used everyday. That kept bottles away from the walk way and the counter to keep the area  feeling clean. This room is going to be the hub of the senior’s care. Bath people will be coming in and problems with going to the bathroom always come – in care giving.
  • KEEP IT CLEAN..as clean as you can. You also want a box of gloves for you to wear while you give the senior personal care. I would also use the bleach wipes on the floor with my shoe to quickly clean up the floor on a daily…or weekly visit.

Basic arrangement of furniture, and ease of use items are easy to do once you get your mind thinking safety and clean. This first step can be a lot of sorting and cleaning, but it pays off with NO FALLS and NO BROKEN HIPS! You can care for a senior when they are able to be transferred and mobile. If the senior is not able to move around…you will be forced to have them in a care facility.

I would often sit down with my senior and remind them that the changes were for their safety. If they want to stay “at home” they have to change a few things to keep them there. You can not care for them, if they can not move … ask them to please work with me and together — we can make the house clean and easy as well as bright and cheerful. 

Not a bad start right? Nothing you can not do without a little help from a family member. Make the days that represent change easier by having someone come and sit with the senior as the cleaning takes place. Talking to the senior or playing cards and keeping their mind off of the CHANGE is the key to an easy transition to a clear and tidy surrounding. Vacuum,dusting and adding a small air filter makes the house smell fresh and clean. Airing out the room, changing lights to the new light bulbs and keeping it bright so the senior can see to move around…all these things will start your care giving on a good foundation. You can and you will do it. I trust in your own creativity and inner guidance to make it work.

I always want to remind you…that your time giving care to another…is a kind and loving thing to do. I thank you. francy

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Death, How To Cope When You Are The Caregiver

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Death and Dying issues to help caregivers by Francy Dickinson

Geo n francy oilMy Georgie has been gone for three months and I am adjusting to life again. I wanted to continue to share things with you. As you know, I began this blog to help myself and other spouse/caregivers with the issues that come up in daily care giving. I still want to be a voice in the wilderness for those that are giving their love, time, effort and attention to a loved one. Helping someone on their life’s journey is a very special and loving job…I hope you will find my words help you along the way. 

If you have been reading my blog over the years ~ you will remember I have always asked everyone to use hospice services when your senior is nearing death. You never have to be worried about it. The Hospice Services comes into your home and does an assessment of the senior and they share their ideas of how to help you. Their services are paid by a Medicare type of services…it then becomes a special Hospice Service expense and the medications and services are then no longer billed to you. So, financially, mentally and physically Hospice is the way to face the end of life issues with your loved one. It will help you overcome the worry and they will help you step by step…question after question.

That said; Georgie and I did not know he was at the point to call on Hospice. The doctors did not know what was wrong with George. He had a lot of tests and the diagnosis was not known. We had made another appointment for the next Tuesday to see the main doctor and talk to him about placing George in a care facility to review his health issues. In the mean time…we were home alone together. I was trying to understand how to use the oxygen, medications, catheter and take care of his physical needs. I was going on five days without real sleep and the situation was not good and we both knew it.  He was weakening by the minute and it was becoming very hard for me to do transfers and be strong enough to help him. We were ready for his “in hospital” care. I told George that after his stay at the care center I would be asking Hospice to come and help us and he understood that…but his end came before we could move through our plans.

Early on Saturday morning…George was taking his Albuterol breathing session. At the end of the session I went to remove the breathing mask and found he had passed. His eyes closed and he had stopped breathing. It was quiet and fast and I was heartbroken.

What I am going to talk about today is the process that followed. But once again, IF I had had the services of Hospice..all the following steps would have been taken care of for me. I would have been able to sit and be calmed by loving professionals and they would have taken over the different steps that come with a death while in their care. This is why I want you to NOT follow my lead…to avoid the sadness I had to walk through have the Hospice professionals by your side…caring for you and your loved one.

What to do when your spouse, or senior, passes and you are all alone:

  1. When George passed I went into shock. Lucky for me, I had my family and friends on my cell phone and I kept the phone close to me. I knew I was very tired and I had been afraid of my falling and needing help. So I was able to pull out my phone and call family and selected friends and our dear minister – to come and help me.
  2. Everyone arrived within minutes and each of them comforted me in their own way. They were not totally in the know…of what to do…but they worked together to decide on the immediate steps to take. I was in such shock, shaking and crying and just out of it…so they were gentle, loving and moved me through the process.
  3. We all knew we did not have to report the death the minute it happened. I had looked at the clock and knew he passed at 7:10AM but that was not really needed. I was just so struck with sorrow, I had no real knowledge of what was happening around me. That is why Hospice would have been so helpful…but my own support group did their best.
  4. Our minister asked everyone to come and circle around George and say a prayer and when we did that…each of us were then able to feel we had settled the tension and brought the love into a protective circle.
  5. If you have a faith that requires immediate burial, I suggest that you start today to make plans for the end of life. You will need to know the process and have numbers to call. In my situation, I knew that George wanted to be cremated, but we had no time frame to worry about. So we just took our time and did not call 911 until all the family members that wanted to view him, did so and at that time we made our call.
  6. Our local paramedics arrived and asked if they could inspect the body alone.So we cleared out of the room and they looked over things taking note that everything looked like a “natural death”. They wrote down the death and they made calls to the medical examiner and logged it in to the official book as a death with time and place written down. Then they alerted the police.
  7. A while later, the police arrived and they questioned all of us and asked questions about George’s health care and asked me to review the last couple of days. It was very hard for me to do this interview. I was still in shock and my mind was not able to connect properly with their questions. If I had had Hospice…that step would not have happened. Hospice is a legal service and the medical examiner takes their word for it. The police were very kind, but they had a job to do and they did it. Once again, they needed us to clear out and let them be with the body. When they were done…we were released to remove the body.
  8. We did not hurry…once again, we gathered together to say another prayer and wish George a loving passing. Then we called the mortuary services and they arrived to remove the body. I did not have to do anything personally. They simply enclosed the body and took it away. They were very kind and my family was very loving.
  9. My sister felt I needed to be taken home with her. I was still in shock and she wanted me to try to sleep and process the death away from the house.
  10. When I left my home, my friend and daughter-in-law cleared out the bedroom. They disposed of the sheets, pillows and medical things in the bedroom and master bathroom. They tried their best to clean the area so I could return to the house and not be upset. They did a loving job, that I am sure was very difficult for them.
  11. I returned to the house in two days. At that time, we had to go to the mortuary to review the details and pay for the services. They applied for the social security and veteran’s death benefit for me. So the basic paperwork was done.
  12. Now, this is where I will caution you. From that day forward, everyone I knew tried to help me. They gave me advice on social security, insurance, returning medical supplies, my own health, my mental health and so on. It was a constant barrage of information and suggestions to follow their opinions. This was the hardest time for me. I did not want to be rude…I listened and tried to understand what they were saying. But really, it became total overload.
  13. I will ask you to simply, sit and be quiet. Write down things and numbers and make your notes very complete…this is no time for shorthand. Then just take it easy. There is no time frame of getting services and help, insurance, social security and such done. Just do it on your own time.
  14. As usual…others try to take over and care for you. But you have to do it all on your own. It is best of you ask someone to drive you here or there. When we are upset the world does not need us behind the wheel of a car. But just write down a list of to do’s and slowly work through them.
  15. George and I had already talked through end of life issues. I knew he wanted no memorial and wanted a cremation. So, that made it easy for me. What does your loved one want? This is the time to talk and get it out in the open.
  16. The doctor had us fill out the no resuscitate papers and post them up on the kitchen door so the EMS could see them.  We talked about the issues of care at the end of life. So we were in place when his death happened. But what about you?  Do you have your end of life issues down on paper? Please do it for you and for your loved ones. Don’t make more work and worry for the loved ones left behind.

Lessons learned. I am still working on paperwork and details of my husbands death. I am still trying to learn to sleep and eat properly again after so many months of 24/7 care giving. It’s a hard road and I am walking it slowly, alone, but not afraid. I have support of friends, family and my small dogs. I am still working on my feelings of loss and I am still raw with my emotions. But I am taking care of myself now.

I gave care to my mother and my husband until their deaths. Now, its time for me to care for myself. Its hard to do…but I am trying day by day to form ideas of what my future is going to be. I so miss my Georgie’s smile and I can not imagine how I will live my whole life forward without him. But day by day…I learn and do.

I hope this helps you to prepare and take the fear out of a passing in your home. I cleared the house with love and blessed George on his way. I am sleeping soundly in our bedroom. I got new bedding, I brightened up the bathroom and I cleaned and cleared away the sadness of care giving in my surroundings. I now find my bedroom a place of comfort for me and I enjoy spending time there.

I will say…having my family and friends as well as my community of loving friends on Facebook, Twitter and through the group that follows my blog was totally positive and loving for me. I also had a #WritersThatChat group that continues to support me through the long grief process. I am a lucky girl to have had such a dear, as George, with me for over 30+ years. As I walk down my own path of life…I do not do it alone…I am surrounded with love.

Blessings on all that you do for your own loved one. francy

PS/ I find a little reminder of George is so healing for me. I blew up a picture of him and have it in my bedroom with a candle to light. I can have a good chat with him each day…kiss his picture and feel his love any time I am in need. Grief takes its own path…some move through it fast and strong…others have more up and down days. There are no rules for missing someone that you loved…but being ready for the hard time of passing helps.