Archive for March, 2012
Posted on March 30, 2012 - by Nurse Virginia
DEALING WITH DIFFICULT PHYSICAL BEHAVIORS
ACT – Do not over react – a physically aggressive or combative elder is a frightened elder. Remain Calm- The elder has usually shown signs of aggression before they have started to strike out.
- Be alert – the care giver knows their elder. Look for signs of restlessness, agitation.
- Be prepared Size up the situation and have help ready to assist if a combative incident occurres.
- Know the elder Know the elder’s body language – red face, shaking fists, refusing to respond to re-direction, calling out, raised voice etc.
- Initiate “rescue” intervention one caregiver starts the activity of daily living (ADL) if opposition is met, whether in the form of verbal or physical anxiety or aggression, a second caregiver arrives on the scene. The second caregiver is the “rescuer” and sends the first caregiver away – making the elder feel as though they have been rescued.
- Speak in positive tones acknowledge that the elder is upset “You look upset” “You look frightened, everything is fine now” “I’m sorry your upset”
- Stand to the side of the elder do not stand in front of the elder that can be perceived as being confrontational.
- Show concern for the situation/without anger KEEP YOUR HANDS ATYOUR SIDE and don’t make large gestures with your hands.
- Be ready to use objects – grabbing a pillow to protect against a swinging cane or to place between angry elders.
IF TWO ELDERS ARE INVOLVED IN COMBATIVE BEHAVIOR Do not raise your voice – during a violent episode things can escalate with increased noise in the environment. Identify which elder will be easiest to re-direct and attempt to move that elder away from the other aggressive elder. Or initiate a hold technique on the more aggressive elder.
THE HOLD TECHNIQUE is when a care giver reaches their arms around an elder’s mid-section from the back, over their arms, and holds them. While another caregiver comes to the front to reassure the elder. It is very important to provide that reassurance.
TAKE A DEEP BREATH – RECOGNIZE THAT CONFRONTATIONS ARE DIFFICULT FOR EVERYONE
EVEN THE CONFUSED ELDER
Virginia Garberding R.N.
Director of Education – The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on March 22, 2012 - by Nurse Virginia
22 – BATHING CONSIDERATIONS FOR THE ELDER WITH ALZHEIMER’S DISEASE
- Depression could cause the elder to lose interest in personal hygiene.
- Physical illness could also cause the elder to lose interest in personal hygiene.
- If the Hypothalamus region of the brain (the body’s internal thermostat regulator) is damaged from Alzheimer’s disease, this could cause a changed sense of perception of hot and cold water temperature.
- Brain damage could also cause a different sensation of water.
- Older skin tends to be dry and sensitive, daily cleaning of private areas and under skin folds is recommended instead of frequent baths.
- Poor lighting and poor eyesight could play a role in not wanting to bathe.
- Lack of privacy. Be as nonchalant as possible. Take an almost businesslike tone, discussing bathing as if it is a necessary medical procedure rather than a personal experience.
- Room temperature too cold.
- Water to hot or cold.
- Fear of falling.
- Fear of water or of being hurt by it.
- A disruption in the daily routine of the elder.
- Unfamiliar caregivers.
- The reason for taking a bath is forgotten. Because the elder doesn’t remember what bathing is for they don’t have the patience to endure the lack of modesty or being cold.
- Humiliation of being reminded to take a bath.
- Agitated before starting the bath.
- Feeling of being rushed by the caregiver.
- Feeling embarrassed about being naked.
- Fatigue
- Fear of hair washing and water on face.
- Elder waiting too long while caregiver prepares bath.
- Fear of water/soap
Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on March 12, 2012 - by Nurse Virginia
WHEN THE “SICK” SPOUSE JUST DOESN’T LOOK SICK – THE JOB OF BEING A CAREGIVER IS SO HARD – WHY DO PEOPLE DO IT?
(PART II)
This is a problem I have heard many people share, when their loved one just doesn’t look sick.
Book excerpt from: Because You Care – Spiritual Encouragement for Caregivers
From Twila
“Steve doesn’t look sick,” my friend said. “I expected him to, you know-“
“It’s a progressive disease and-“
“But that’s the way it is with everybody,” he said and shrugged. “We’re all progressing toward the end. Everybody is terminal. We all die eventually, and then we go to be with Jesus.”
“But his muscles atrophy-“I tried to explain, but I don’t think he heard the words. His harsh tone made it clear he wasn’t really interested in Steve.
The conversation left me bewildered. It wasn’t the first time, I’m sure it won’t be the last that I didn’t know how to react to insensitive remarks. Just because my husband doesn’t look disabled doesn’t mean he hasn’t fallen multiple times or that he doesn’t struggle when he climbs the stairs.
Most people assume that seriously people look wan, haggard, and listless, carry oxygen around with them, or sit in wheelchairs. Some diseases attack from within, and it takes a long time before it shows outwardly. Even though Steve looks healthy, his disease is incurable and crippling.
When people ask Steve how he feels, he usually says, “I’m doing all right.”
I know differently because I live with him. One day he dropped a jar of spaghetti sauce in the grocery store. I pushed the cart into another aisle while store personnel cleaned up the splattered mess. I was embarrassed by the situation and embarrassed for my husband. He doesn’t look sick, I thought, so people don’t know that he dropped the jar because he has no strength to grip it. For days I felt guilty for running away.
One day as I cried out to God for answers and understanding I read Proverbs 3:5-6: Trust in the Lord with all your heart; do not depend on your own understanding. Seek his will in all you do, and he will show you which path to take.”
I’d read those verses many times, but that day I had an insightful moment. The words “Do not depend on your own understanding” became real to me. I sensed God had whispered that I didn’t have to know everything-that I wasn’t supposed to know everything. I needed only to trust.
Those simple, often-quoted words from Proverbs gave me great comfort. I frequently encountered things I don’t understand about Steve’s progressive illness. I don’t comprehend why God doesn’t answer my prayers for my husband to get better. Why is there no medication or treatment for his disease?
End of Book Excerpt – Because You Care is published by Harvest House Publishers, Eugene Oregon
Virginia Garberding R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on March 7, 2012 - by Nurse Virginia
THE JOB OF BEING A CAREGIVER IS SO HARD – WHY DO PEOPLE DO IT?
(PART I)
Others may call you brave. That is the opening sentence of Cecil Murphey’s new book Because You Care – Spiritual Encouragement for Caregivers written with his assistant Twila Belk.
Book Excerpt:
They’ll use words like noble or sacrificial. They’ll admire and applaud you because you’ve offered to make yourself available to someone who needs a long-term caregiver.
“I couldn’t do what you’re doing for him,” a friend says.
You listen to the words your friend speaks, and you like hearing the compliments. Yet as you listen and smile, you don’t see yourself as exceptional. You’re doing the right thing for someone you love, and that gives you peace. You also know the reason you’ve devoted your energies to another person.
You can express that reason in a single sentence: “I do it because I care.” You might say it’s because you love the person, or you may do it because of a strong sense of commitment to God and to your loved one. Regardless of how you express yourself, you’re determined to give yourself as fully as you can.
Some days you may not feel like loving anyone. You get tired, lose your temper, or think of things you didn’t accomplish. During the worst times, you wish the situation would change. And in those dark moments, you’ve probably prayed, Dear Lord, please take this burden from me.
The situation probably won’t change for a long time-perhaps years. It’s not the kind of life you would have imagined. You probably envisioned living out your years in blissful peace. Caring for your loved one wasn’t part of your dream, but this is the life you have. Despite the moments of sadness, perhaps even regret, your answer remains the same: “I care.”
End of excerpt
Not only is this book beautiful to just page through with photography from Betty Fletcher, but it contains the wisdom of the caregiver. Both Twila and Cec are direct caregivers for their spouse, and the insight they have, offers support to all who wear the caregivers hat.
Virginia Garberding R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on March 6, 2012 - by Nurse Virginia
TAKING CARE OF THE ELDERLY PARENT LIKE THE NURSING HOME DOES WITHOUT RESTRAINTS
Lily was 89 and the last thing her family wanted was a call from the nursing home saying Lily had just had a fall. And so, bending to pressure from the daughter, the nursing home reluctantly put a belt restraint on Lily’s wheelchair to keep her in the chair.
Many years ago it was common to see every elderly person not only in a wheelchair but many with a restraint tied around their waist to keep them in that chair. Now before you can tie a person to a wheelchair, you must have tried other alternatives. These alternatives focus on the need of the elderly person.
Is the person anxious and just wants to keep going all the time? Develop a regular routine of walking, having snacks and meals, rest periods or naps, creative activities as well as regular exercise.
The confused elder who keeps trying to walk when forgets he needs assistance could need a consistent routine. I recently heard from a daughter who was the caregiver for her father, who has Alzheimer’s disease, for part of the year and then he goes to live with her sister for the rest of the year. Each time he moved he had to relearn the environment. However if the father’s routine was kept in both homes the adjustment would be smooth.
If the elder has weakness in their legs the nursing home would have the person seen by a physical therapist. The therapist would create a specific program of exercises for the elder to build strength. The elder living at home can still have their physician write an order for therapy as well. Many therapy companies now offer home visits under Medicare.
Having a change of seating helps a lot with a confused elder who is unaware that they now need assistance to walk. Alternate between stuffed chairs and hard surfaces, the problem arises when the elder is asked to just sit in the same wheelchair all day. I wouldn’t like that too much myself.
Virginia Garberding R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
- Help your elder find comfort, relevance and respect no matter how frail he or she is.
Find out why the quality of life depends so much on the family no matter who the direct caregiver may be.
Find out how to have a meaningful visit with your parent when they have dementia.
Testimonial:
Katherine from Wisconsin said "I bought a book for each of my three children because this is what I want them to know if I ever need to be taken care of."
www.pleasegettoknowme.com
