Help, Dad Fell Twice this Week

Featured

Tips to help elders/seniors from falling – by francy Dickinson

George was an avid golfer, skier, ran and played tennis. Is there memory in those muscles still?

My dear Georgie was an avid golfer and skier. He ran, cycled and played tennis. Is there memory in those muscles still? Alzheimer’s and Parkinson’s is robbing him of his mobility, how I am fighting to keep him moving.

 Dear Francy: Dad fell twice this week alone. He has a bruise on his upper thigh and his ribs are sore. I took him in to the doctor to check it out after the second fall, but this is so frightening. His Parkinson’s is just turning his legs into jelly. What can we do to keep him safe? 

I am right there with you. My Georgie is falling all the time and I worry so about a broken hip. How do you keep someone that is aging and losing their strength from taking tumbles? Well there are things you can do to lessen the problem. So, lets go through the list together and see what pertains to us and if we can use the ideas to keep our guys standing and walking safely.

  1. Start with clearing space. No matter where you live…look over the pattern that the senior is using to go to the bathroom, the kitchen, the bedroom and back to their favorite chair. Is there obstructions? Remove throw rugs, extra furniture and any clutter. Keep the area clean and clear…so the cane, walker or wheelchair is easy to use. If you have to re-arrange furniture so the senior is safer…do it. Life does not have to be pretty…it just has to work for the senior.
  2. Take note of the time of day that the senior takes their falls. If it’s at night they may need a better path to the bathroom or a portable commode. These commodes are easy to use and you tell the senior it’s just for night-time. Set it up right by the bed so there is only a couple of steps and then put in a good night light so the commode can be seen and used. When I had mom, I would use the commode by the bed at night and then take out the bucket, clean it and move the commode part over the toilet during the day. This provided handles for the senior to use when getting up and down off the toilet.
  3. “Table top walking” is a favorite with women. They do not want to break down and use that cane. So they move through their home by grabbing onto a chair back, a table top and counter. This is so dangerous and you simply have to draw a line and refuse to allow the senior to keep this habit. Get them a cane or a walker. The rule is a cane is for pain. Used for recovery from an operation, a break, or a arthritis type of continual pain. The walker is for steady and support-always get a walker with a seat, so the senior can rest if they feel weak. The wheelchair comes when the falls are simply so often that you can not depend on the senior to be safe alone. Physical Therapy should be ordered and they will review your senior and help them make the choice of what is right for them. If it is a walker or wheelchair, you will have to go through the living area and prepare space for the senior to move. Doors may have to be taken off hinges, kitchen areas cleared and a basket to carry food and drinks has to be added to the walker or wheelchair for convenience.
  4. Exercise. Physical Therapy can be the key to success to getting any senior walking stronger again. After stroke care, Parkinson’s, severe arthritis – it all has a lot of recovery to keep the body in movement and the PT will give special exercises to help the senior regain strength. I found it surprising that doing the exercises even three times a week made a big change for George.
  5. Recovery. Mom was a girl that had a series of tiny strokes. She was in her nineties
    Mother on the go in her wheelchair at 98 with our dear Kathy who helped me with care giving

    Mother on the go in her wheelchair at 98 with our dear Kathy who helped me with care giving

    and each TIA took away her muscle abilities. I told her in order for her to remain with me, in my home…she simply had to be mobile. I could not lift or transfer her all day with my bad back. So she was such a trooper. Each time she lost her balance and could not walk…she would pull her self up and use her walker inch by inch. With me following her with the wheelchair in case her legs gave out. She recovered over and over again. I know; first hand…that muscles do have memory and you can recover it with patience and continued practice. But there is always a line in the sand when wheelchairs have to be used and transfer help from a care giver is the only way a weak body is able to keep safe.

  6. Eating to stay fit. Protein is really important to re-build your muscles. Add a protein drink to the senior’s morning exercise routine. It will help give them a boost. Go over their food and make sure they have plenty of small ziplocks filled with treats. Carrots, celery, peanut butter on crackers, a cookie, fruit slices etc. Keep them handy so the senior can munch and crunch every few hours. If they are living alone, you will call them for a short reminder for pills and snacks – four times a day…this will keep their energy up. Often seniors forget to eat and drink..they lose their energy and that reflects in their ability to safely walk. My trick is that they keep a cooler by their TV chair and it is filled each morning with drinks, food, treats and the senior then does not have to go anywhere for their daily food. This is perfect when a senior is checked in the morning and evening by a care giver or family member.
  7. Rules: setting rules is no joke. You set rules for children when they are growing…so you need to set rules for seniors. They may break them…but they need to know they are there. George is not allowed to walk without his cane or walker. I spend my day finding a cane in one room and bringing it back to him and keeping the walker close. But his dementia does not help him remember. So, its my job to keep his tools of support around him close, so he uses them. George can not overload his hands…I now transport anything he needs in a basket so he walks with hands free and balance in check.
  8. Medications can be a big problem with falls. Talk to the doctor about his falls and tell him they are worrying you. Ask if he can review the prescription list and see if any of the medications could make the senior dizzy, tired or forgetful. So when you are giving the senior their morning pills – you can adjust their routine to allow them to rest for a while after they take their meds. Make sure the senior is sleeping in their bed at night and resting their brain and body. Many elders sleep in their chairs and nap all day. This confuses the body and does not help the senior stay strong.
  9. Talk to your senior. Just sit down and tell them your concerns. “Dad, I want you to live with us. But if you fall and break your hip – you will have to have more care in a facility. This is why we are all trying to keep you safe. I know that the walker is not fun, I know you don’t like to be bothered with me hovering. But I am doing this to keep you safe and at home (or with us).” When seniors hear your concern, when they understand your fuss is in love – they take note of their own care. Life gets easier. I often ask George; “What do you think we can do to fix this?” And through his dementia he usually has a come back. Some times its funny…sometimes its way to hopeful…but he feels involved in the conversation. A senior’s personal honor has to be kept in place for them to work with you on solving problems.
  10. NO SHAME _ NO BLAME I work very hard to deal with emergencies, not yell about them. Even though I get mad and exasperated when my Georgie does something silly and causes a big issue of a fall. I take the moment new. I use a calming voice. i tell him to relax and just stay still till he can catch his breath. I inspect his body and make sure he is in one piece. I ask him about pain level. (1-10) I keep him still untill he can recover his mind and review his own body. When I feel it is safe I assist him in getting up again, using a straight chair. I bring the chair to the site of the fall. I get George turned around and on his hands and knees. Then he puts his hands on the straight chair’s seat and I assist him to slowly stand. If he is dead weight and not thinking straight – I do not try to move him alone. I call for help. I have a neighbor that comes over and if he did not respond to my call – I would call 911 and ask for assistance with a fall. The EMS (fire fighters) come and get him up and into a chair or bed. They check him out and would then help me transfer him to ER in my car or by ambulance if it was needed. I force myself to stay calm and thinking.
  11. After a fall: I have George drink water while he sits calmly in his chair. I turn off the TV and put on music to help him relax. I bring him something that has sugar, like a cookie and make him tea. I sit with him and we talk about something totally unrelated. That allows his mind to rest back into place. The shock of a fall is hard for anyone. Letting the senior absorb the shock and relax again…then rest for a while before they go to the bathroom (or back to their day activity) is best. I always cover George with a light throw when he is in his chair…keeping him warm, rested, fed and calmed with music and talk…brings life back to him. I save my fears and upset for another room…away from him. Often the fall worries me – more than George. So I try to calm myself down with a little tea and maybe a walk around the yard or a chat with a friend on the phone. It’s OK to cry out frustrations, but its not OK to do it in front of the senior. They will feel nothing but guilt over your upset.
  12. Pain. If the fall causes bruising or pain. Its best to make a call to the doctor’s office and ask to talk to the nurse. Tell her what you have done and what the senior complaints have been. They will tell you what to look for that would require the senior to come into the office. The rule I live by…is the ER and doctor’s office are there for real emergencies and I take that seriously. Just like a new mother…it takes experience to tell when a baby is in need of rest and love or a trip to the doctor. So it goes for seniors in care.

Just the fact that you care about your dad and his falls..tells me that you are a kind person there to help your dad through his elder challenges.

George is now waiting for his PT appointment to get a wheelchair. I am concerned what that will mean to our household routine. Will he not want to even try to walk or exercise when he gets in that chair? Will his dementia and Parkinson’s really start to take a dive when he is no longer moving on his own? I worry about change…

I know what it takes to give care on a full time basis. Its lonely. I thank you for your love and kindness to your father. I hope these ideas have helped. Blessings, francy

Routine gives Alzheimer’s n Elders Good Home Care

Featured

George’s Routine -Daily exercise with me ;O

Ideas to give Elders and Dementia/Alzheimer’s seniors good care with routines..by francy Dickinson

Dear Francy; Dad moved in two months ago and stays in bed all day. What can I do to get him up and out? 

Good Care Secret? ROUTINE

Many people lose their routines when they retire or suffer a loss of a spouse or a health change. It is a normal for them to react…they just cope. So, if you are unable to get them professional care…then YOU have to be the care giver with the mostest….and that means YOU return the senior to ‘a routine’. You might remember back to when you were raising or helping others raise their children…children respond to life so much stronger with a routine in place….well…this is just like that…the more you pre-program the day with activities that are repeated…the more secure the senior feels and the more they respond in kind.

I say this with love…because it means that YOUR own life is changed…you, have to live for another and it is very challenging…trust me — I live it. But here are the rules:

RULES FOR DAILY ROUTINE:

  1. You will do the routine for two days and then take a break. So we have two days on and one day off. That off day means you can sleep in or do your own morning routine. 
  2. You will have an up attitude, even when you are down, sick or tired. That is what it means when you ‘give care’ You are giving not taking.
  3. You will think through a routine and write it down and then make it your own.

FRANCY’S ROUTINE WITH GEORGE:

George hates to get up in the morning. So I do not pressure that…I allow him to rest. He has Alzheimer’s and Parkinson’s so there are loads of issues for him. But what to remember is that everyday…is a new day in his mind…so it has to be a new day in my mind too.

I bring him breakfast and tell him that he has to get up in 1/2 hour and then I take note of the time. I either rest, or go and get things done in the house while he is eating and then return at the set time for him to get up. I make sure he has taken his meds then I get him up and bring him into the bathroom. Usually, he has already gone to the toilet…so I begin with him sitting on his bath bench facing out into the bathroom – or facing me standing right next to him. It is a good height and easy for him to get up and down from this sitting position.

I start him by asking him to remove his upper clothes and as he does that I go and get his clean clothes for the day. I always put out an under shirt and a thermo-shirt and then a flannel shirt or nice sweat shirt (sometimes with an added vest.) <Why so much? Seniors often have a problem with feeling cold and to keep the house temp in order…I layer his clothing>

Once he is undressed on top: I then get warm water and give him a wash cloth and he does his personal wash up, then deodorant  Twice a week we do a bath; the other days it is this procedure instead. <Many elders become worried about water and a bath is hard to get them to do…so this is a short clean, if the problem with the bath continues, then hire a bath person to come once a week and you do the clean up ea day in-between>

Then I help him dress with his undershirt, his thermo-shirt and have him stay seated.(I do not add the rest of the tops until he is done with all of his clean up and ready to exit the bathroom) Still in his sitting position: I then have him do his leg exercises that keep his calves strong. <This exercise keeps the falling down to a min. The calves are the point that helps us stay up and balanced> He will sit and lift one leg out straight and then do flex and point of his foot for a 20 count. Keeping the leg out and straight the whole time. Then we change to the other leg. I do the flex and point with a slow (one-and two- and three…so the point is on the number and the flex is on the and count– up to 20) You can do this a round of one or two…depending on how strong the legs are and if they have fallen within the last month. If so, repeat the 20 count routine on both sides.

He stays in a sitting position and we take off his socks. I let him do it and he bends down and then takes off his pajamas and his Depends…he then cleans up with a fresh wash cloth, just like we did with his torso and then sits back down. I make sure his feet are done and I help him with this so he can be steady. I then apply a moisturizer for his legs and feet and he has to rub it in. It will require him to bend over; so I stay close and hold his shoulders so he does not fall while he rubs in the moisturizer all over his lower leg & feet. If there is fungus on his toes we do the drops at this time. The skin there gets very flaky and we want it healthy, clean and moist. <This is when you notice if there are any sore spots or red spots. If so you talk to the doctor right away by phone and get guidance  Any sores on legs or feet are serious and hard to heal…get help —fast>

I then (while in a sitting position) have him put on his new Depends to the knees and add his sweatpants to his knees and then he stands and we pull them up. He sits down and we add his socks and slippers. He then gets up and goes to the sink and I have him do his shaving on his own. Then I remind him of his mouthwash, his floss and then he sits back down to do his Sonicare. Now you may or may not have a Sonicare…but I feel they have saved our teeth. They are an investment, but they do such a good job when you are unable to move your arms well to do your teeth. <Obviously if using false teeth you would have them soaking while you did the body clean and rinse and put the teeth in fresh and ready to go. You never brush false teeth they are made of material that is to be cleaned with a Polident-type of soaking once a day to keep the mouth fresh and you would  have your senior rinse their mouth with mouthwash before the teeth are put in again.>

Now he is back standing at the sink:  I have him use a wash cloth and get it very warm water and let George go over his face. Then I use a sugar scrub…it is designed for the face. Or you can use a cleanser for the face with beads in it to remove the dead skin on the face and leave it looking fresh and healthy. George moves and scrubs the scub all over his face up into his brow and hairline and his eye brows. Then he takes the hot wet wash cloth and cleans it off the scrub…rinsing and cleaning until the scrub is gone. Then he puts on Oil of Olay. <Any moisturizer is good, this one is easy for a guy to use and It is designed as a nice face moisturizer and it goes all over the skin of the face and ears and chin. it has SPF in it so the sun will be kept away from delicate facial skin and ears.  Now he is clean and ready to leave the bathroom.

I remove all his clothing that has to be washed and put it in the closet in a large clothes hamper and do a load twice a week of his clothes alone. < It is “SO-OOO” important to keep the bathroom and clothes clean, the bed linens and towels clean too! The ability to have bed sores and infections in small cuts and scraps are very high – when a person is older and their body is not as healthy as it used to be. Clean everything…be a freak…or hire it done. Its your choice.>

George then goes out to the living room. Where I have a straight back chair. I put a small pillow on the chair for his comfort and he sits down. From here he does his exercises. He will first do a stand – squat – stand and slowly sit. This is an exercise that allows his thighs and bum to learn how to sit and stand from a chair, again. I use the term stand as (solider with his straight arms down to his side – I say squat and he does and I move my arms to the front so he remembers that he has to balance his body with his arms. Then I say solider again and he goes into the straight standing position with his arms straight down to his side and then I use my voice “Slowly down” for him to sit in a slow motion….then it is repeated for at least 10 times. If we do this 4 times a week…his body responds well…if we do it less…he forgets the routine and his muscles get weak again. That is when he begins to fall and it goes down from there…

I have learned that his routine is really ‘my routine’ and the more we are able to stick to it..the better his body and muscles respond.  

From there I do arm exercises and I will do a little video for you to use if you like. I will add it in to this blog when I get it done.

After we are through I help him back into his chair and have him do 3 really deep breaths to load up his brain with oxygen. Breathing-in with the nose and out with the mouth. The is the beginning of his day…from here he rests and we do what ever our day holds. But I do this as often as I can. YES…it is a pain — NO he is not always nice to me while we do it — YES I have to push him each time — NO he does not remember the exercises or the toilet routine —YES it does make a difference in the quality of his day forward.

It’s a routine that takes about 1 hour and 30 minutes because he is slow. But it sets the tone for a full day of healthy, happier emotions and the attention makes him feel wanted and I always give him a full cheer-leading routine as he is going through is paces.

I know you can do it. It would be done like this at a professional care facility…so I think doing it at home makes the ability of the senior to stay in good health and strong all the longer. I feel that Alzheimer’s is going to take over George…but we can hold it off by keeping him fit and clean and happy in his day

Blessings on all that you do each day for your senior. Francy