How to Prevent Theft by Caregivers Part 2

How to Prevent Theft by Caregivers Part 2

 

 Read Part 1 Here

 

 

 

 

 

 

 

Don’t Use Cash

 

If your hired caregiver is responsible for running errands or buying groceries, don’t give them cash. Instead, use prepaid debit cards or gift cards along with asking for receipts for all purchases.

 

That way, all purchases can be tracked and verified. Plus, if the hired caregiver steals those cards, they’re only getting a limited amount.

 

Though the vast majority of senior caregivers are reputable and honest, occasionally someone comes along who takes advantage of an elderly client.

 

According to Sally Hurme, coordinator of AARP’s Financial Protection Outreach & Service, there are at least 5 million financial abuse victims each year in the U.S., and only one in 25 of them are reported to authorities.

 

Hurme cites many reasons why elder financial abuse is a “particularly pernicious crime.”

 

“Studies point to specific cracks in victims’ defenses against exploitation: trust, financial niavete, cognitive impairments, social isolation, dependency, fear, and embarrassment.”

 

Hurme goes on to explain that elder financial abuse is unique because “there is a very real chance that the victim has no idea that she has been … victimized. The victim may have no awareness that anything is amiss with his finances.”

 

There are many ways of combating and preventing financial abuse of elders, one of which is using a reputable caregiving agency. Many of these agencies not only screen their employees, but also do background checks to ensure the safety and security of their elderly clients.

 

Some such agencies have also begun a gift card program. Gift cards are a convenient and easily accessible solution to preventing certain financial abuses. Agencies issue the gift card to the caregiver, who can then buy groceries and other essentials for their clients. Since the gift card is purchased through a bank, the agency can track purchases online and know when transactions take place. All risk, which is limited to the amount of money put into the gift card, is borne entirely by the agency. The caregiver never needs to use the senior’s cash or credit cards as all purchases must be made using the gift card. Receipts are kept and purchases are then billed to the client with their regular invoice.

 

Though financial abuse of elders is a reality, measures can be taken to minimize the damages and the possibility of elderly clients being victimized.

 

As Hurme points out, “Even though there are no broken bones, the effect is devastating financially and emotionally.”

 

Being aware, taking steps to prevent theft, and utilizing reputable In-Home Care Agencies are the first defenses against elder financial abuse.

 

 

 

Watch for Over Attachment

 

Hired caregivers who are planning to steal might start out by creating an unusually close relationship with your senior. Through this tight bond, they may be able to get your older adult to voluntarily give them money, valuables, or extravagant gifts like cars!

 

That’s not to say that you should be suspicious a little suspicious and look into things, especially if you see any of the signs outlined below.

 

An heirloom bracelet goes missing, electronic gadgets can’t be found, a wallet or bank account seems to be bleeding cash. Talk to anyone who’s hired someone to help care for an older loved one, and theft is almost always a major worry. Bringing a paid caregiver into the home — whether through an agency or privately — can come as welcome relief to all, but it can also feel like a risky decision. Stories abound about vulnerable people who’ve been taken advantage of.

 

The solution? Be careful, proactive, and alert. Here, some of the key warning signs that a caregiver is on the take.

 

Receipts that don’t add up

If grocery shopping and other errands are among a caregiver’s responsibilities, it’s pretty easy for “mix-ups” to occur. You might notice items listed on a receipt that seem out of character for your loved one, or certain supplies that seem to run out — and be replaced — with surprising frequency. If the caregiver takes your loved one out to shop or dine, you may notice purchases from stores that he or she doesn’t typically frequent or restaurant meals that are out of your family’s typical price range.

Why it’s worth worrying about:

A few dollars here, five dollars there may not seem worth making a fuss over. After all, caregivers aren’t usually well paid, so is it worth rocking the boat over a little bit of paycheck padding?

Yes, says Carolyn Rosenblatt, author of The Boomer’s Guide to Aging Parents. “You may see $6.50 for a lipstick, knowing Grandma doesn’t wear lipstick, but if you let it slide you’re sending a signal that no one’s minding the store.” Typically, these first purchases are tests, Rosenblatt says. “The caregiver is saying, ‘Let’s see if I can get away with it.’ If you don’t respond by confronting her, you’re saying, ‘Yes, you can.'”

 

What to do:

For starters, avoid cash. Supply the caregiver with debit gift cards preloaded with a limited balance. This way, if fraud is occurring, you can limit the amount of liability your family is exposed to. Also, use online banking to monitor card transactions, so you can see how much is being spent at each store. Ask the caregiver to supply receipts for each shopping trip, and keep an eye out for any purchase that seems unnecessary or for quantities that seem overlarge.

If you find yourself hesitating over a questionable purchase in case it’s an honest mistake, bring it up in that spirit, keeping it light and nonconfrontational. Explain that you noticed a purchase that didn’t seem to be something intended for your family member, and you’d like to keep those kinds of purchases separate in the future so it’s easy for you to keep track.

 

Phone Use and Friendships

 

Frequent cell phone use on the job

Texting or taking calls on the job is discourteous and distracting — but it could also be a sign of something more serious.

 

Why it’s worth worrying about:

While there are legitimate reasons a caregiver may need to make an occasional call, if someone’s on the phone all the time, it’s a signal that some outside relationship or network of relationships is more important than caregiving. It may even be that some outsider is calling the shots, says Rosenblatt.

 

What to do:

If you — or the agency you’re working with — haven’t already done so, run a thorough background check on the person you’ve hired. While some agencies do an in-depth background check on all employees, including requiring drug testing, others are much less thorough. It’s important to make sure good research was done, says Rosenblatt, because all too often records of crimes committed in other states or counties may not come up during a simple records search in your area.

Next, make sure you’ve securely protected your family member’s finances from potential fraud. The best way to do this is by having your family member sign a durable power of attorney for finances, which authorizes you or another trusted person to oversee financial transactions. A power of attorney is just a piece of paper, though, unless it’s recognized by the financial institutions that handle your loved one’s money. The safest strategy is to inform the banks and other financial institutions that you’re the proper legal agent for your loved one’s finances and that no one else is authorized to act. To do this, you’ll probably be asked to show a copy of the power of attorney document and may need to fill out additional forms.

 

 

Cultivating a Personal Connection

 

For many older adults, a caregiver quickly becomes a trusted friend, often the only person they see from day to day. With such consistent and intimate contact, close bonds are common. But keep your eyes open for anything that seems to step over the boundaries of professionalism. Watch and listen for signs that your loved one is becoming emotionally involved with or dependent on his or her caregiver, such as talking about the caregiver all the time or seeming to consider that relationship more important than friendships or family ties.

 

Why it’s worth worrying about:

Typically, thieves planning a scam will gradually “prime the pump,” seducing an elderly target with greater and greater shows of affection until he or she becomes emotionally dependent on the caregiver. “It can start very subtly: touches on the arm, little gifts, shows of affection,” says caregiving author Carolyn Rosenblatt. Hugs, compliments, and attention become stepping stones to building a connection that’s overly intimate. Some concerned family members have found themselves in situations in which their loved ones bought their caregivers cars or gave other expensive gifts, paid their rent, or “loaned” them money that was never repaid.

 

What to do:

Prevention is worth a pound of cure, experts say. Loneliness and isolation leave many older adults susceptible to all manner of exploitation, from relatively small expenditures to outright fraud and identity theft. To protect your loved one, you’ll want to act on two fronts.

First, the psychological: Think about your loved one’s day-to-day interactions. Does he have opportunities for companionship other than his caregiver’s visits? Can you find a day program or other activity for him to attend, or are there others who might visit from time to time to liven up his routine?

Next, the practical: Focus on safeguarding against his caregiver gaining access to his finances. Experts recommend setting up online banking for checking, credit cards, and any other accounts, so you can monitor all activity in real time. (Most transactions post within a few days.)

If you check credit card records and discover charges that you or your loved one didn’t authorize, act quickly to protect yourselves from identity theft, says Caring.com legal expert Barbara Kate Repa. Close the account and immediately alert the company holding the account that you believe it’s been used without your authorization. Then alert one of the three major consumer credit reporting agencies and request a fraud alert. If your loved one hasn’t already signed a durable power of attorney for finances so someone trusted has authorization to access financial accounts, encourage him or her to do it now.

 

Manipulation and Missing Work

 

Bids for sympathy

Personal tales of woe are a common danger sign. If your loved one begins expressing worry and concern for a situation his caregiver has told him about, that’s your cue to get involved — and quickly. “A sister with cancer who can’t afford medical care, a child who needs dental work, a family member in another country who’s being persecuted and desperately needs to come to the U.S. — these are the kinds of scenarios we hear all the time,” says caregiving author Carolyn Rosenblatt. “The next thing you know, your loved one’s writing checks and that money’s gone.”

 

Why it’s worth worrying about:

The caregiver relationship is a professional service. If it becomes personal enough for your loved one to become involved in the caregiver’s private life, the caregiver has clearly crossed a line. Best-case scenario: The caregiver is manipulating your family member. Worst-case scenario: An outright fraud is in progress.

 

What to do:

Act quickly. You may hesitate to question your loved one’s judgment, but the caregiver, if he or she is a practiced scammer, will be counting on that. Call a family meeting and discuss the situation with all family members, including siblings who don’t live nearby. Make sure everyone is on the same page, so you don’t end up in the all-too-common situation in which family members are divided against one another or undermine one another. As many of you as possible should talk to your parent or other loved one together, explaining how concerned you are and why you need to take steps to protect him or her.

If the caregiver was hired through an agency, it’s a good idea to alert the agency to your concerns and ask them to double-check the records of the searches performed and make certain this caregiver hasn’t been accused or convicted of exploitation or fraud in the past. If the caregiver was hired independently and a thorough background check was not performed at the time, now would be the time to do some digging.

Depending on how your loved one reacts, you may wish to terminate the caregiver’s employment or set up a more careful monitoring situation in which you limit access to funds. If possible, consult a family lawyer to make sure all possible legal protections are in place, says Caring.com legal expert Barbara Kate Repa. If your loved one’s judgment appears to be seriously impaired and you’re not able to convince him or her to grant you power of attorney, you may need to consider trying to obtain legal guardianship, also called conservatorship.

 

Missing Work on Mondays

 

Some days your loved one’s caregiver seems responsible and reliable; other days — particularly Mondays or the first day back after time off — he or she goes AWOL.

 

Why it’s worth worrying about:

“This is a classic sign of alcoholism or substance abuse; people go on a bender over the weekend and then can’t make it into work on Mondays,” says caregiving author Carolyn Rosenblatt. “Unfortunately, alcoholism and chemical dependency often go hand in hand, and they frequently lead people to steal to meet their need for drugs.”

 

What to do:

Be on the alert for other signs of alcohol and substance abuse. Check the liquor cabinet and make a note of liquid levels in each bottle; you might even taste the contents to see if they’ve been watered down. Go through bathroom and kitchen cabinets and empty them of any prescription and over-the-counter medicines that might tempt an abuser. For prescriptions in current use, count the pills so you can check if doses go missing. Hide medications in a safe place or — if your loved one doesn’t need them right now — take them home with you. Keep prescription receipts and labels in a safe place, so the caregiver can’t call in refills without your knowledge.

If your caregiver was hired through an agency, report all unexplained absences and discuss the situation with the agency. If the caregiver has a history of this type of behavior with previous clients, the agency should be proactive about assigning you a new caregiver. If the caregiver was hired independently, have a frank discussion and set boundaries. Explain that you require 24 hours advance notice if he or she has to miss work, and another unplanned absence is going to be grounds for dismissal. Then stand firm. The caregiver will almost certainly use illness as the excuse and protest that illnesses come on suddenly, but don’t get sucked into that debate.

While this is happening, take all necessary precautions to protect your loved one’s cash and financial records, since a caregiver with a drinking or drug problem is a risk and a disgruntled former caregiver can be a threat.

 

By using common sense and due diligence, you can both reduce the risk of caregiver theft and minimize it’s scope.  Always pay attention and trust your feelings.

 

 

Thoughts, questions, tips?  Feel free to comment below.

 

 

Suggested Security Camera System:

Arlo Security System – 4 Wire-Free HD Cameras, Indoor/Outdoor, Night Vision

 

 

 

 

 

 

 

 

 

 

 

 

 

Recommended Reading: 

How to Care for Aging Parents (3rd Edition);  A One-Stop Resource for All Your Medical, Financial, Housing, and Emotional Issues

by Virginia Morris

 

 

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How to Prevent Theft by Caregivers

How to Prevent Theft by Caregivers Part 1

 

 

 

 

One of the most common worries about hiring in-home help is that the caregiver could take advantage of your older adult. Even though the relationship between a hired caregiver and the family should be based on trust, it’s smart to take steps to prevent theft or fraud.

 

 

 

Prepare Your House First

 

Protect your senior from theft or fraud by removing or taking inventory of valuables, not keeping cash around, and watching bank and credit card statements carefully.

 

Keep an inventory of valuables in the home. Compile a list and take pictures to document your parent’s valuables, put them under lock and key, or remove them from the home.

 

Don’t forget about hidden jewelry or valuables, and think about removing any valuable memorabilia displayed in the house. There’s no need to put temptation in front of anyone.

 

 

 

Don’t invite petty theft. Your parent should keep only a small amount of cash at home. Don’t leave money in obvious places, such as the nightstand next to the bed. Make sure your loved one keeps any checkbook, ATM and credit cards, and computer passwords in a secure place.

 

 

 

Pay Attention

 

After spending some time with the hired caregiver, pay attention to how you feel about them in your gut. Most people work hard to make a great impression at the start of a new job. But later, you might start to see a different personality show through.

 

Arlo Security System – 4 Wire-Free HD Cameras, Indoor/Outdoor, Night Vision

If you start to feel uneasy, trust your gut and talk with their agency. If it’s a private hire, you might want to investigate for theft and (secretly) observe them carefully for a while.

 

If they continue to make you feel suspicious or uneasy, look for a new caregiver.

 

 

 

 

 

 

 

 

 

Do Your Homework

 

 

Whether using a home care agency or hiring an independent caregiver, it’s important to do your research to make sure that you’re getting a reliable person.

 

Of course, no one knows better than me that this isn’t a foolproof method — but due diligence is still required on your part.

 

Home care agencies are responsible for fingerprinting and screening to make sure potential aides don’t have criminal records or other complaints against them.

 

When selecting a home care agency, ask how they screen potential caregivers, how many theft accusations they’ve had in the past and how they’ve handled them. Will they replace stolen items?

 

Amy Nelson, founder and CEO of Accurate Home Care in Otsego, Minn., says that her agency reports theft accusations to the authorities and cooperates however possible. The caregiver is suspended until the investigation is over. If found guilty of theft, the caregiver is fired and reported to the Department of Human Services.

 

After you’ve picked an agency, it’s still wise to interview caregivers they assign to the job. If you don’t feel comfortable — at any time that the person is working for you — tell the agency that this person is not the right match for you.

 

When hiring an aide without going through an agency, spend the time and money to check them out, advises Lisa A. Lieberman, a licensed clinical social worker, family counselor and author of A ‘Stranger’ Among Us: Hiring In-Home Support for a Child with Autism Spectrum Disorders or Other Neurological Differences.

 

She stresses checking references, especially ones from previous employers, and scheduling a face-to-face interview before making a decision.

 

A criminal background check is one way to make sure that applicants are who they say they are. For example, SentryLink will conduct a background check on an individual and send the results via email for around $20.

 

Unfortunately, these precautions aren’t enough to guarantee you won’t get ripped off. Detective Mike Cruce of the Oro Valley, Ariz., police department, who solved the case of my missing laptop, warned that just because the prospective caregiver doesn’t have a criminal record doesn’t mean that you still can’t be victimized by them.

Just ask my caregiver, who had no criminal record when she stole my laptop.

 

 

 

 

Trust Your Instincts

 

 

Most people try to make a good first impression, so keep in mind that caregivers need to earn your trust and maintain it by being reliable over time. If you develop an uneasy feeling about a caregiver and aren’t quite sure they can be trusted, you could be right.

 

 

 

Everyone in the household should be comfortable with the caregiver. If you live alone, ask visiting family members and friends for their opinions of the caregiver and how she/he interacts with you.

 

In my case, my caregiver the laptop thief was shy but likable at the beginning — but after a few weekends with her, I began to wonder if I could trust her. It wasn’t one particular thing she did but a strange feeling that entered the room along with her. I began to secretly look after my wallet. She started showing up late, or not coming at all, and her excuses were hard to believe.

 

At that time, I should have called the agency and requested another caregiver. But I figured I was stuck with her, because the agency had been having trouble finding a caregiver to work in my part of town. This is a very real issue for people with disabilities nationwide; many people accept personal care attendants who are abusive because there is no one else to fill the gap.

 

Next time, I will make any uneasy feelings known to the agency.

 

 

 

Don’t Be So Darn Nice

 

The trick is to be comfortable with the caregiver, but not too comfortable, says Nelson. The same goes for caregivers: They need to feel comfortable in your home, but not so comfortable that personal boundaries are crossed. For instance, most agencies have rules against caregivers accepting loaned money, whether it’s solicited or not. Even if you don’t use an agency, it’s always wise not to let caregivers borrow money or important items.  

 

When James Kelley, who has facioscapulohumeral muscular dystrophy (FSHD), loaned one of his caregivers his very expensive leather-bound King James Master Study Bible, he never imagined he’d have a problem getting it back, because “who’s going to steal a Bible?”

 

The caregiver in this case asked to borrow his Bible for a couple of days, but after weeks went by and she still hadn’t returned it, Kelley, 44, confronted her. She assured him that she would bring it back. After a month passed and still no Bible, he called the home health agency, which contacted the caregiver — but she still didn’t bring it back.

 

That’s when Kelley, who lives in Cincinnati, Ohio, contacted his case manager, who advised him to call the police and file a report. He felt strange about filing a report over a Bible, but the detective assured him that, “If you don’t get some of these people when they’re taking small amounts, then they continue to push the envelope and see what else they can get away with.”

 

Kelley eventually got his Bible back after the detective told his caregiver that Kelley would press charges against her if she didn’t return it. The detective warned that she didn’t want it on her record, especially since she’s a health care worker.

 

Kelley ended up asking the caregiver not to come back.

 

Even trustworthy caregivers can forget they borrowed something. Consider this scenario: You lend your paid caregiver a book and, for practical reasons, keys to your house, but then due to everyday circumstances — a move, a career change, etc. — the caregiver stops working with you before the items are returned.

 

 

 

Caregivers and House Keys

 

In the case of the house keys, the best way to prevent that scenario is to never give the caregiver a permanent set. Instead, buy a key lockbox, like those used by real estate agents, and hang it on your front door handle with a key or keys inside.

 

 

Master Lock 5400D Select Access Key Storage Box with Set-Your-Own Combination Lock, 13/32-Diameter Shackle, 1-Pack

 

When a caregiver arrives at your home for work, he or she just punches in the code to the lockbox (like this Master Lock Select Access Key Storage Box pictured above) and retrieves the key — and then returns it to the lockbox after opening the door. The lockbox code is easily changed, meaning you don’t need to change your locks every time you change caregivers.

 

 

 

Protect Your Stuff

 

Detective Cruce says it’s especially important for those with multiple caregivers, or with a “revolving door” of caregivers who are new each time, to secure their valuables. Having multiple caregivers definitely complicates theft investigations, making it difficult to pinpoint who’s responsible for missing items.

 

When she started using a home care agency in 2006 due to her amyotrophic lateral sclerosis (ALS), Fern Cohen, of Rego Park, N.Y., was sent different caregivers every day. When her brand-new digital camera was stolen, the agency wouldn’t do anything because she couldn’t prove who stole it, even though Cohen knew who was working the day she found it missing.

 

“[The revolving door] was my main reason for switching from agency care to self-directed care,” says Cohen, 58. She now has a handpicked staff of four trustworthy caregivers.

 

(Self-directed care means that people with disabilities have decision-making authority over certain services, and take direct responsibility in managing their services, including personal care aides. Self-directed services may not be available in every state and may vary from state to state. Check with your state’s Medicaid program or your personal insurance for more details.)

 

After the digital camera incident, Cohen also realized she could take measures herself to avoid enabling theft in her home. So to safeguard her valuables — from otherwise trusted eyes as well as the hands of strangers — she bought a safe.

 

But theft is not limited to physical possessions. Be sure to monitor bank accounts and credit card charges and look for anything unusual. Staying aware of your financial situation and transactions may help detect a theft. Also, hide important documents and consider storing duplicate copies in a safe place with family members or friends.

 

For example, Kelley learned the hard way that it’s wise to always request a receipt when the caregiver returns from shopping for you. He gave one of his caregivers his food stamp card to go to the store for him one afternoon, and she didn’t bring back a receipt.

 

“It was a red flag when she didn’t bring back a receipt, so I waited until she left and went back over to the store with my food stamp card, and I told them that I needed them to run an audit on the card,” Kelley says.

 

Within a few days, the store provided an itemized computer printout that showed his caregiver had purchased $10 worth of items for herself.

 

Even if people take the precautions mentioned here, some may find it comforting to also monitor caregivers with nanny cams or webcams. This option can be very expensive and time-consuming, so research this technology and its associated costs before deciding if it’s right for you. (Also, consult an attorney, or familiarize yourself with state laws governing video surveillance and speech before recording anything.)

 

 

 

 

Break the Cycle

 

As for my stolen work laptop, I didn’t even know it was missing until I received a phone call from the support coordinator at the agency where my caregiver worked asking: “Are you missing a laptop computer?”

 

I went to check under my bed (not a good hiding spot), all the while thinking, “If it’s missing, she stole it.”

 

My support coordinator said that the whereabouts of my laptop were still unknown but that my caregiver’s ride had called the agency and reported that she had bragged about stealing it from beneath my bed. My support coordinator also told me that my caregiver had quit the day before.

 

I decided to press charges against my caregiver thief because I didn’t want this happening to anyone else. Later, I heard from the prosecutor that she had similar charges before, which were dropped by the client. The fact that she already had a second chance and blew it made me feel a little better about pressing charges.

 

A few days later, Detective Cruce returned my work laptop after convincing my now former caregiver that the judge would go much easier on her if she relinquished it.

 

“Theft is not uncommon for people who are vulnerable,” says Cruce, adding that every state has laws to help protect people who are vulnerable to abuse due to their age or disability. “Theft from a vulnerable adult is a crime by itself,” he continues. “So not only do you get charged with theft, but you also get charged with theft from a vulnerable adult; therefore, the consequences could be doubled.”

 

As of this writing, my former caregiver had received a $25 fine and was sentenced to 36 months of probation, during which she’s not allowed to have any contact with me. Theft from a vulnerable adult will appear on her record.

 

 

 

Be Prepared — Just in Case

 

It’s impossible to avoid getting ripped off. It happens to everyone, but it’s even more upsetting when you have a disability and you’re paying and relying on the culprit to help you live more independently. People with disabilities face the additional difficulty of having to get rid of a vital caregiver often without having another qualified person to instantly replace him or her.  

 

We love our caregivers. They are, literally, the reason we can get out of bed every morning. Most of them are dedicated to their caregiving jobs and are totally trustworthy.

 

But it’s smart to be prepared in case one of them decides to pull a fast one.   

 

 

 

Minimizing Stranger Danger

 

Allowing a “stranger,” even a professional caregiver with good references, into your home can be a scary proposition. But deciding when and how to work with outside caregivers is far less daunting if you assess your options and perform due diligence to evaluate candidates for the position.

Lisa A. Lieberman’s A ‘Stranger’ Among Us: Hiring In-Home Support for a Child with Autism Spectrum Disorders or Other Neurological Differences offers readers, especially parents, tips on how to do just that.

Lieberman, of Oswego, Ore., is a licensed clinical social worker and family counselor as well as an author and speaker.

 

 

 

Read:  How to Prevent Theft by Caregivers Part 2

 

 

 

Thoughts, questions, tips?  Feel free to comment below.

 

 

Recommended Reading: 

How to Care for Aging Parents (3rd Edition)A One-Stop Resource for All Your Medical, Financial, Housing, and Emotional Issues

by Virginia Morris

 

 

 

 

 

Please help others by sharing this post. Share on Google+Tweet about this on TwitterShare on LinkedInDigg thisPin on Pinterest

Have You Heard of Weighted Blanket Therapy?

Have You Heard of Weighted Blanket Therapy?

 

 

 

 

 

 

 

The drug-free therapeutic blanket known as weighted blankets have become the at-home treatment for insomnia, anxiety, autism spectrum disorders (ASD), attention-deficit hyperactive disorders (ADHD), Restless Leg Syndrome (RLS), Asperger’s and sensory disorders.

 

 

 

 

 

 

 

Many seniors, adults, teenagers and children face psychiatric issues that cause insomnia and severe anxiety. Patients with autism and other psychiatric disorders also face extreme anxiousness and the inability to induce calmness within themselves without the use of sedatives or drugs.

 

The combination of behavioral aberrations, and the lack of sleep among these people, have been known to lead to loss of productivity in their daily lives, irrational emotional behavior and out – of – character actions. It isn’t just the problem of not being able to keep their emotions under control, but the issue of lashing out aggressively due to psychological dysfunctions.

 

The root causes of such behavioral issues are anxiety and insomnia, which is usually treated with pharmacological (drugs) and psychological (therapy) methods. However, now with a breakthrough in the study of sleep medicine and psychiatric disorders, we know that the trick to soothing consternation and inducing sleep is much simpler than once thought.

 

The drug-free therapeutic blanket known as weighted blankets have become the at-home treatment for insomnia, anxiety, autism spectrum disorders (ASD), attention-deficit hyperactive disorders (ADHD), Restless Leg Syndrome (RLS), Asperger’s and sensory disorders.

 

 

Weighted blankets use deep pressure touch simulation (DPTS) to relax the body and make the patient feel safe, guarded and secure, which calms their unease and helps their body go to sleep. The sensory compression methodology facilitates a positive change with the comfort the blanket brings to its user. The weight of the blanket stimulates the receptors on your body which then activates the neurotransmitters in your brain to bring a sense of happiness to the person.

 

 

 

The Poly plastic (Polypropylene) pellets that have been used to fill the compartments of the blanket provide the weightage of the blanket. A quality weighted blanket is quilted, made of either cotton or fleece and weighs about 10% of the user’s body. Using the proper blanket according to the size and the weight of the user will give the optimum calming results.

 

This blanket has shown to be very effective in calming hyperactive children during bedtime, anxious patients in therapy and even adults undergoing chemotherapy. It has also proven to be efficacious in calming people down during anxiety inducing situations.

 

 

Studies Prove the Benefits of Weighted Blankets

 

– A 2008 study showed that weighted blankets are beneficial for anxiety. The study used a 30 lb. blankets on adults. In total, 63% reported a decrease in anxiety, and 78% found it calming.

– A 2015 study used 30 pound blanket on adults during an inpatient mental health hospitalization. 60% of them reported significant decrease in anxiety after use.

– Research on DPTS started as early as the 1950s. One article from 1992 found great benefits of this therapy for patients with autism. It reduces self-harming behaviors in autistic children, as well as produced better sleep. It also relaxes the muscles.

One adult autistic patient has stated, “I need heavy blankets on me to sleep well, or else my muscles won’t calm down.” 

– Weighted blanket were also found to be very calming for babies.

 

 

Therapeutic Benefits of Weighted Blankets

 

 

 

 

1. Weighted Blankets Promote Sleep

 

Insomnia is a sleep disorder that causes habitual sleeplessness. The lack of sleep leads to the over exhaustion of the human body and hampers the psychological well-being of the person. When a person is not able to function well, both physically and mentally, their social well being is affected and they begin to lose productivity in their lives. This leads to depression and other behavioral problems.

An easy solution to this problem is the weighted blanket. The pressure of the weighted blanket reaches deep within the body of the user to provide a comfortable environment for a person to fall asleep in. The sense of being swaddled and the physical connection that the user feels with the blanket makes them feel warm and safe. This helps their mind be at ease and they can be able to relax their body. The state of tranquility will help clear their mind and ensure a good night’s sleep.

According to the ‘Positive effects of a weighted blanket on insomnia’ by the Journal of Sleep Medicine and Disorders 2015 of the SciMed Central, the weighted blankets had improved the sleep quality of people with severe insomnia.

 

 

2. Weighted Blankets Imitate a Warm Hug

 

Research shows that hugs can actually make a person feel at ease. Hugging a person releases the hormone Oxytocin into the blood stream. This chemical reduces your blood pressure, calms your heart rate and provides and overall feeling of relaxation.

Although the blanket does not provide a human connection, your body may perceive the warmth and security the imitation that a hug provides. Both the hug and the blanket use a gentle yet firm pressure that goes deep within the person’s body tissues. This gives the user a sense of repose and allows your body to relax.

 

 

3. Weighted Blankets Provide a Sense of Security

 

Being covered by a weighted and warm blanket will ensure the feeling of calmness in the user. The ‘blanket therapy’ stimulates the receptors present throughout our body, which lessens a person’s discomfort. Once the user feels more comfortable in the blanket, they begin to feel secure as their body begins to relax. The body can only relax when your mind is soothed and your heart rate is calmed. This change in the body will ensure that both your body and mind believes that you are secure and safe.

 

 

4. Weighted Blankets Increase the Production of Serotonin

 

Serotonin is a chemical messenger, also known as a neurotransmitter that your brain and intestines produce for the smooth functioning of your nervous system, which includes the brain and the nerves. This hormone is secreted to promote happiness and the mood of the people. Known as the ‘happy hormone’, this chemical does not only affect a person’s mood but it affects their behavior. The lack of serotonin in the body leads to depression, insomnia and anxiety. That is why the sensory stimulating weighted blankets increase the production of serotonin in the body. The hormone relaxes your body and makes you feel calmer. That sense of calmness leads to pacifying one’s anxiety, which results to inducing sleep in the user.

 

 

5. Weighted Blankets Increase the Production of Melatonin

 

Melatonin, also known as the ‘sleep hormone’ is a chemical that affects a person’s sleep. The hormone is produced with the production of serotonin, as well as the pineal gland in the brain. This chemical is known to ease insomnia and induce sleep, which is possible through the therapeutic benefits of the weighted blankets that provide a gentle yet firm pressure on your body by stimulating your receptors.

 

 

 

6. Weighted Blankets Calm Patients with Autism Spectrum Disorder

 

Autism spectrum disorder includes Asperger’s, Autism, Rhett Syndrome and other unspecified Pervasive Development Disorders. Such disorders include behavioral problems that do not necessarily bode well with the norms of society. The patients suffering from such disorders feel aggression and irritation due to the inability to express or convey their thoughts clearly. Such slow cognitive development makes the patient unable to process information quickly and the change in their surroundings.

 

Patients with such disorders are not able to communicate properly, so they use erratic speech, repetitive actions and turbulent behaviors. During a frustrated outburst, the patient’s heart rate increases, their breath becomes shallow and their blood pressure rises – which further increases their irritability.

 

When the patient is going through such tempestuous emotions and tantrums, it is best to drape the weighted blanket around them or have them lay down with the blanket covering them. This will make them feel more relaxed and comfortable. Once they are no longer acting in a hysterical manner, they will be able to think with a clearer mind and a calmer body. Although communicating with their caretakers might still be difficult, there will at least be an opportunity for the patient to gather more patience and attempt to convey their thoughts in a more serene manner.

 

 

7. Weighted Blankets Help Overcome the Oversensitivity to Touch

 

Some psychiatric disorders make people oversensitive to touch. Patients with Autism Spectrum Disorders usually face such discomfort with the touch of other people but this can be overcome by introducing the weight of the blanket regularly to the affected patient.

 

The pressure of the blanket provides a similar feeling of human touch at a larger scale without actual connection – which can be a stepping stone in helping patients overcome their fear of touch.

 

During the 1990s, a squeeze machine was used to help patients overcome their oversensitivity to touch. Today, with the inception of the ‘therapy blankets’, patients can use the more accessible and less controversial mechanism to help people become more at ease with touch.

 

 

8. Weighted Blankets Pacify Obsessive Compulsive Disorder

 

Obsessive Compulsive Disorder or OCD drives a person to think repetitively about a certain incident or an object. Such thoughts constantly play across a person’s mind and lead them to neglect their duties and their personal lives. The patient becomes anxious about a particular event and conducts a certain action over and over again. Their thoughts are occupied and their bodies refuse to break out of an obsessive reverie.

A very effective way to ease an OCD patient’s anxiety, and to treat the inability to calm them down from a mind consuming thought is to use a weighted blanket. This blanket allows the patient to feel safe and secure without worrying about the numerous issues that may be present in their lives. The blanket provides a warm environment for the user by helping to relive stress and allow their mind to release the captivating thoughts.

 

 

9. Weighted Blankets Mimic a Massage

 

Draping the weighted blanket over the user’s body distributes pressure evenly throughout their body. This has similar effects of a deep tissue massage. The pressure of the blanket goes deep within your tissues while you use it to fall asleep. A massage is supposed to help our body and mind relax – which can be easily done at home by using a weighted blanket. The physical factor of a massage might provide it’s own intimate yet soothing aspect, but the weighted blanket is proven to give you similar results to an actual massage in the long run.

 

 

10. Weighted Blankets Improve Cognitive Function

 

Taking a look at the overall therapeutic benefits of weighted blankets, we can see that it relieves stress, reduces tension, induces sleep, calms your mind and relaxes your body. These components are very important if you want to live a healthy and happy life.

 

Raised blood pressure, anxiety and lack of sleep are truly killers of productivity and normal behavior. Sleeping with the weighted blanket promotes the users overall well-being by ensuring that they tackle their daily issues with a clear head and a well-rested body.

 

With a clear mind, a person’s cognitive functions are improved. They are able to perform efficiently and effectively without being burdened by psychological issues and behavioral changes.

 

 

 

Weighted blankets can potentially solve sleep issues, panic attacks, anxiety related disorders, lack of concentration and even aggressive behavioral problems that affect the smooth proceedings of one’s daily life.

Successful results of the weighted blanket  can be had without the high costs of therapy sessions, drugs and sedatives that are traditionally used to pacify more tremulous patients. I recommend giving this effective and inexpensive blanket a try.

 

 

 

 

 

 

 

How to Use a Weighted Blanket

 

The blanket can be used at night, during naps, or used casually quick calming effect. Studies have used it for as little as 10 minutes and up to 2 hours, but it can stay on as long as you would like. It is the most beneficial to have your whole body covered, but do do not place the blanket on top of the head or face as it can create a suffocating sensation.

 

 

Choosing Your Weighted Blanket’s Weight

 

Use the formula 10% of your weight plus one pound. For example, a 160 lb person should  choose a 16 or 18 lb weighted blanket.

 

 

 

Thoughts, questions, tips?  Feel free to comment below.

 

 

 

 

You may also be interested in:

Melatonin Helps Sundowning and Other Sleep Disorders

Gifts for Nursing Home Residents

Practical Shoes for the Elderly

Top Pillows to Relieve Neck Pain

Why You Should Use an Infrared Sauna (Often!)

Preparing For Your Elderly Parent to Move In

About Me

Create Your Own Blog

 

 

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Electric Blanket Buying Guide

 

 

Electric Blanket Buying Guide

 

 

 

 

Features to Look For in Your New Electric Blanket

 

 

 

Heated bedding of all types should meet current Underwriters Laboratories electric bedding safety standards.

It’s also important to read and follow manufacturer guidelines. Special care should be taken — or use avoided altogether — when selecting heated bedding for infants, the elderly, and those that are otherwise less sensitive to heat.

Pet owners are advised to consider low-voltage heated bedding, or a mattress pad that’s under the rest of the bedding so that it can’t be chewed on by a four-footed companion.

 

 

 

Durable, Machine-Washable Electric Blanket Materials

 

Some electric blanket manufacturers specify hand-washing only; however, trying to wrangle a large, wet blanket can be difficult — and it can be hard to rinse it thoroughly as well.

Machine-washable blankets are much easier to clean. When you do wash it, it shouldn’t pill, shed or bleed color. Always be sure to detach the power cords before cleaning.

 

 

 

Easy-to-Use Electric Blanket Temperature Controls

 

Because you might want to adjust the temperature in the middle of the night, you want the controls to be intuitive and within reach.

Many electric blankets and other heated bedding use digital controls, but others use analog dials. User ratings don’t seem to be influenced by the style of the controller, but we see some comments that in some instances, the dial can be easy to jostle. A few electric bedding products offer wireless controls.

 

 

 

 

Range of Electric Blanket Heat Settings, Including Preheating

 

To get the most use out of your electric blanket, throw, or mattress pad, you’ll want to be able to choose settings appropriate for everything from a cool summer evening to a winter blizzard.

Many electric bedding models offer 10 settings, though some, including our top-rated heated throw blanket, offer fewer without receiving very much negative user feedback over that.

 

 

 

Electric Blanket Automatic Shut-Off

 

An automatic shut off allows you to fall asleep safely with the blanket still on.

 

 

 

Electric Blanket Dual Control Options

 

Many couples sleep “differently” with one partner preferring a hotter or colder environment. Dual controls, which are usually found on queen-sized and larger blankets, allow each person to adjust the heat on his or her side of the bed. Some heated bedding take things a bit further by allowing adjustment of individual zones (such as the feet) for either user.

 

 

 

Things to Know Before You Choose an Electric Blanket

 

How often will you use your electric blanket?

If you live in a cold climate or often are cold in the evenings, you may want to outfit your bed with a reliable heated mattress pad. On the other hand, if you will only use the product a few weeks or months per year, a blanket may be more practical.

 

 

Measure your bed and electrical outlet.

Electric blankets and mattress pads are sold in normal bed sizes, such as twin, full, queen and king, but it’s best to be sure.

Most electric blankets have power cords that attach at the foot of the bed, with controls that stretch up to the head of the bed. If the cords aren’t long enough to reach a power outlet, you may need to rearrange your furniture. Most manufactures recommend that, for safety, extension cords not be used.

 

 

Do you have pets that sleep in bed with you?

Heated bedding can pose a hazard to pets if a claw or tooth exposes one of the heating elements. If you do sleep with a pet, experts suggest a low-voltage bedding option to minimize the risk of electric shock. In addition, a heated mattress pad is less likely to become a chew toy than a blanket that sits atop the bed.

 

 

Heated bedding won’t last a lifetime.

Judging from user reviews, all types and brands of heated bedding suffer from so-so durability — with the controls and heated wiring both being trouble spots.

While it’s never a bad idea to buy a model with a good warranty and then keep all packaging, receipts and other documentation of your purchase, user feedback indicates that warranty limitations and the hassle of returning the bedding to the maker lead most to just toss a blanket or mattress pad that has failed and buy a new one.

If durability is a top concern, electric mattress pads seem to enjoy a somewhat better track record according to experts and in user reviews.

 

 

 

What’s in a name?

Most heated bedding sold in the U.S. is made by one of three companies. Perfect Fit industries makes bedding under its own name as well as the Soft Heat, Select Comfort and Chattam & Wells brands. Sunbeam also manufactures the Slumber Rest, Therapedic and Imperial lines. Biddeford Mills makes Cannon, Sealy and Delightful Nights electric bedding.

While color choices, and materials and features (including the style of controller) may vary between brands and models, all heated bedding made by the same manufacturer will use the same core technology and should perform similarly.

 

 

Thoughts, questions, tips?  Feel free to comment below.

 

 

 

 

 

 

You may also be interested in:

Electric Blankets – Reviewing the Best

Electric Blankets – Comfort and Energy Savings

Space Heaters Buyer’s Guide and Reviews

Adjustable Beds – Benefits and Reviews

Top Pillows to Relieve Neck Pain

Top 10 Massage Chairs Reviews

 

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Minimize Your Senior’s Falling Risk Now!

Minimize Your Senior’s Falling Risk Now!

 

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Falls are the leading cause of death, injury and hospital admissions among the elderly population. In fact, one out of every three seniors falls every year.

 

 

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Last year alone, more than 1.6 million seniors were treated in emergency rooms for fall-related injuries, but you can drastically reduce the chances of this happening to your loved one.

 

 

Why are Seniors at a High Risk of Falling?

 

Several factors contribute to the fact that seniors fall so much more frequently than younger people:

 

 

Lack of Physical Activity
Failure to exercise regularly results in poor muscle tone, decreased bone mass, loss of balance, and reduced flexibility.

 

 

Impaired Vision


This includes age-related vision diseases, as well as not wearing glasses that have been prescribed. 

Further reading: Help For Low Vision

 

 

Medications


Sedatives, anti-depressants, and anti-psychotic drugs, plus taking multiple medications are all implicated in increasing risk of falling.

 

 

Diseases


Health conditions such as Parkinson’s disease, Alzheimer’s disease and arthritis cause weakness in the extremities, poor grip strength, balance disorders and cognitive impairment.

 

 

Surgeries


Hip replacements and other surgeries leave an elderly person weak, in pain and discomfort and less mobile than they were before the surgery.

 

 

Environmental Hazards


One third of all falls in the elderly population involve hazards at home. Factors include: poor lighting, loose carpets and lack of safety equipment.

However, falls are not an inevitable part of growing older. Many falls can be prevented, by making the home safer and using products that help keep seniors more stable and less likely to fall.

 

 

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Preventing Falls in an Elderly Person’s Home

 

(Don’t Procrastinate – Follow These Tips Today!)

 

 

 

 

Caregivers can do several things to make the home safer for their senior mom or dad, and avoid those emergency room visits.

 

  • Install safety bars, grab bars or handrails in the shower or bath.

 

 

 

  • Install at least one stairway handrail that extends beyond the first and last steps.

 

  • Make sure stairs are sturdy with strong hand railings.

 

 

  • Make sure rugs, including those on stairs, are tacked to the floor.

 

  • Remove loose throw rugs.

 

  • Avoid clutter. Remove any furniture that is not needed. All remaining furniture should be stable and without sharp corners, to minimize the effects of a fall.

 

  • Change the location of furniture, so that your elderly parent can hold on to something as they move around the house.

 

  • Do not have electrical cords trailing across the floor. Have additional base plugs installed so long cords are not necessary.

 

  • Have your parent wear non-slip shoes or slippers, rather than walking around in stocking feet.

 

I like these slip resistant self adhesive shoe sole pads, which work on men or women’s shoes or slippers.

 

 

 

  • Keep frequently used items in easy-to-reach cabinets.

 

  • Keep the water heater thermostat set at 120 degrees F, or lower, to avoid scalding and burns.

 

  • Wipe up spills and remove broken glass immediately.

 

  • Use a grasping tool to get at out-of-reach items, rather than a chair or stepladder.

 

 

 

 

 

Tools and Equipment to Increase Safety

 

 

Monitors and Sensor Pads

 

 

Sensors work well for the bed, chair, or toilet. The pads electronically detect the absence of pressure, which in turn sends an electronic signal to the monitor setting off an alarm.

Used on a bed, the pressure pads can be under or on top of the mattress. They are very thin, so they do not disturb sleeping and are plugged into the monitor via a telephone type line. Chair and toilet sensors work in the same way.

 

 

 

 

There are also pad monitors, like this Floor Pressure Sensor Mat, that detect and sound an alarm if a person steps on the pad (detects pressure).

This type of pad can be used beside the bed, in a hallway or in front of a chair while the person is seated.

 

 

 

 

 

 

 

 

Fall Mats

 

 

 

Fall mats are used in areas where a person could be injured from a fall on a hard floor such as the side of a bed, by a toilet or in front of a chair.

They are cushioned floor mats of various sizes 1-inch or 2-inches thick with beveled edges. They cushion the fall and prevent injuries.

 

 

 

 

 

 

Grab Bars

 

Grab bars provide extra stability and assistance during transfers. They are typically installed in areas where a senior may need something to hold on to for added balance. Bathrooms are a common location for grab bars, since they can help seniors sit down and get up from the toilet and enter and exit the bathtub or shower safely.

 

Further reading and examples:

All About Grab Bars and Hand Rails for Safety

 

 

 

Use a Shower Chair and/or Transfer Bench

 

 

 

When getting in and out of the tub, transfer benches provide stability and help the caregiver get the elderly seniors in and out of the tub safely, without injuring the elderly person or the caregiver.

 

 

 

 

 

 

 

 

 

When getting in and out of the tub, transfer benches provide stability and help the caregiver get the elderly seniors in and out of the tub safely, without injuring the elderly person or the caregiver.

 

Further reading:

Shower Chair and Bath Bench Buying Guide

 

 

 

 

Anti-Slip Mats

 

Install anti-slip mats on the bath tub or shower floor. The hard rubber material prevents the elderly person from slipping and provides stability.

 

 This Gorilla Grip Bath and Shower Mat features excellent gripping and fits any size bathtub.

 

You can also throw in your washing machine!  Wash on cold with gentle detergent (no bleach), and air dry.

 

 

Note that while the Gorilla Grip mat features hundreds of suction cups, textured and tiled floors do not allow for the suction cup to properly adhere to your surface, so this mat is recommend for smooth surfaces only. 

 

 

 

 

 

For showers, I recommend this Jobar Fast-Drying Bath/Shower Rug. 

It adheres really well to tile and textured shower flooring, and customers have washed it successfully in the washing machine.

 

 

 

 

 

 

 

 

 

Canes and Walkers

 

 

 

Canes and walkers help seniors feel steady on their feet. Make sure the mobility device you choose is the correct height for your elderly parent, and has rubber tip or other traction on the bottom, for safety.

Further reading:

How to Choose the Right Walking Cane

Choosing the Right Medical Walker

 

 

 

 

 

 

 

Socks, Shoes and Slippers

 

 

 

Wearing properly fitted, low-heeled, non-slip footwear for walking and transferring provides traction and is much safer than going barefoot or wearing normal socks.

 

 

 

 

 

 

 

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Many socks and shoes are available with non-skid treads on the bottom to reduce slipping accidents. These Unisex Hospital and Homecare Socks pictured above are a good choice.  You also can find a wide variety of non-slip socks on Amazon.

 

For more safe shoe and slipper tips, read:  

Practical Shoes for the Elderly

Shoes and Slippers for Swollen Feet

 

 

 

 

 

 

Lift Slings and Patient Body Lifts

 

 

 

 

Lift slings are used in conjunction with several caregivers or a body lift to move an elderly person who is unable to move themselves from bed to a wheelchair or chair.

 

 

 

 

 

 

 

There are 3 common reasons that caregivers may need a lift: if the elderly parent is too heavy to be transferred without assistance; to prevent injury to the caregiver; and to prevent the elderly person from injury or falling. 

 

Further Reading:

Patient Lifts and Slings for Safety and Comfort

 

 

 

 

 

 

 

 

 

Recommended Reading:

How to Care for Aging Parents by Virginia Morris, 3rd Edition

 

 

How to Care for Aging Parents, a One-Stop Resource for All Your Medical, Financial Housing, and Emotional Issues, is considered “the bible of eldercare”.  It is a clear, comforting source of advice for those who care for an elderly parent, relative, or friend.

This book is in it’s third edition, and fully updated with the most recent medical findings and recommendations. 

Read reviews.

 

 

 

 

Thoughts, questions, tips?  Feel free to comment below.

 

 

 

 

 

 

You may also be interested in:

The Right Lighting Prevents Falls

Shoes and Slippers for Swollen Feet

Practical Shoes for the Elderly

All About Grab Bars and Hand Rails for Safety

Install a Power Lift Toilet Seat for a Safer Bathroom

Shower Chair and Bath Bench Buying Guide

How to Buy an Elevated Toilet Seat

Should You Install Bed Rails?

Patient Lifts and Slings for Safety and Comfort

Caregivers Can Reduce the Risks from Heavy Lifting

Choosing the Right Medical Walker

How to Choose the Right Walking Cane

Help For Low Vision

Stop Alzheimer’s Wandering

Preparing For Your Hip Replacement Surgery

Studies Prove Blackcurrant Seed Oil Helps Arthritis

10 Simply Fabulous Arthritis Aids

About Me

Create Your Own Blog

 

 

 

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Important Tips For Stroke Patient Caregivers

Important Tips For Stroke Patient Caregivers

 

 

 

 

Life for the Jack Meadows family changed forever in December 1989 when this husband and father suffered a stroke. The massive incident in his brain left him with no use of his right side.

 

Months of rehabilitation restored strength and balance but could not return him independence in daily routines of self-care. He has a strong left arm and weak left leg to provide limited mobility. In addition, frustrating his life even greater is the lack of communication. He definitely has cognitive processes as is evident when following conversations and watching television quiz shows. But, thoughts have difficulty connecting to words and words in the brain do not translate to speech. 

His family has chosen to assist him at home. While visiting nurses and aides have contributed valuable services over the years, the major day-to day attention to his needs has been and continues to be given by his wife. A son, daughter and a few good friends frequently assist.

We (his family) have learned tremendous lessons about the skills our stroke patient has retained or developed. We have also acquired extensive knowledge and mastered many competencies in our twenty-four hour a day, seven days a week responsibility.

Over the years Mr. Meadows has required services in several hospitals and many doctors’ offices. Our experience has been that doctors and nurses do not know readily how to meet his needs. We can only surmise that they learned about stroke patients and other handicapped individuals in their schooling and on-the-job training but have not had the amount of direct experience as when a family provides care at home.

Our intention is to share the wisdom we have attained and to contribute to the quality of care accorded to all persons with physical restrictions.

 

 

Communication With a Stroke Patient

 

 

First, be sure you have the full attention of your patient.

 

While eye contact is important the individual who has had a stroke may look you square in the eyes but not have focus on the conversation.

Position yourself in front of your patient and tune out all other sights and sounds in the room. Turn down the volume of the television, radio and block the talk of any other people in the area. Make contact by touching the hand, chin or cheek, an area not affected by the stroke. Sometimes our family member is helped by directing him to look at the speaker. Saying, “look at my face,” does not offend him and gains his concentration. Use a normal volume and speak clearly.

Express one idea at a time in simple terms and repeat if needed to assure yourself that the two of you understood each other. For example, “do you want coffee?” and then follow up with “coffee?” More complex thoughts can also be conveyed in this manner. Ask, “were you on Omaha Beach?”… “Omaha Beach?”… “you were there during World War II?”

 

 

Hand gestures can assist with clarification.

 

Both the care giver and the stroke patient can benefit. Ask your client to point to what he wants or needs. He will develop a repertoire of pointing for such daily items as the television remote, newspaper, eyeglasses, radio, drapes, an uncomfortable foot or arm or headache. When going through complicated maneuvers such as using the mechanical lift to get in and out of bed the patient can work in coordination with the attendant. Instruct him to place his hand on the release lever of the lift and push in. Point to the lever or guide his hand to the lever. Demonstrate a pushing motion at the same time as saying, “push.”

 

 

Recommended: Pictures and Words Communication Flip Chart

 

 

At times when communication is not working, give it a rest.

 

Take time out and try again later. Sometimes the family or friend has exhausted the twenty questions and both parties are becoming frustrated. Tell the patient, “we will think about it,” or “we can try again later.”

 

 

 

Daily Care and Activities for Stroke  Patients

 

Have the person who had a stroke do as much routine self care as possible.

 

This may seem very little with one good arm but we have discovered many surprising tasks that our husband and father can do well. Every task he found he could do for himself raised his pride and confidence.

 

 

He can operate a television remote, secure a towel around his neck before eating, use a spoon to eat most anything, pick up food morsels he has dropped, use a cordless razor to shave and put a cassette in a tape player.

 

His more complicated skills include leafing through a magazine or newspaper, folding towels from the laundry and using the overhead bar to slide himself up in bed.

 

 

 

 

 

 

Vary the day but follow a routine.

 

This piece of advice may seem contradictory but really is no different for the person who lives with a stroke than the family around him. To make the most of the day a schedule provides security and comfort for both the stroke client and the caregiver.

For instance, a schedule of getting dressed in the morning, eating breakfast, moving into a comfortable chair and watching favorite television programs gives the patient peace of mind. He also can feel he has some control over his day as he watches the clock knowing certain activities will occur at specific times.

Additionally, within the day, activities could be varied so that the person who can not move himself does stay in one place, one position for such a length of time that the body and mind become numb. Thus, the assistant must move the client from the bed to the wheel chair to the easy chair and so forth several times in the course of the ordinary day. Staying in one place for hours at a time is neither comfortable physically or mentally.

 

 

The Routine

 

The routine for our stroke patient includes sitting in a recliner in the morning to watch television, moving to the wheel chair and into the kitchen for lunch, return to the bed after lunch for a nap or listening to music. In the afternoon he moves to the recliner again and enjoys watching children coming from school or birds dining at the feeder. Again he moves to the wheelchair and the kitchen for his supper. In the evening he may sit in the recliner again or sit in bed to watch television, read the newspaper or listen to the radio.

 

 

Recommended: Easy Comfort Lift Chair Recliner

 

 

 

 

 

A mechanical ‘lift’ (such as one manufactured by Hoyer) is a necessity. With practice it is easy to use and makes possible the mobility of a person weighing over two hundred pounds by the helper who is five feet tall.

 

A lift could be available in every wing of a nursing home, rehabilitation center, doctor’s office and hospital department. The lift seldom breaks down and takes wear and tear over the years.

 

Every care giver should learn to use this invaluable tool.

 

 

 

Use the stroke patient’s good side.

 

Place a tray or table where the mobile hand can easily reach. Items the patient wants at his access include tissues, cup, spoon, pills and cough drops. The television remote or the nurse call button must be on the side where the patient can handle them. 

 

 

Recommended: Carex Overbed Table

 

 

Carex Overbed Table

 

 

 

 

Be prepared for normal body functions at all times.

 

If the stroke patient uses a bedpan or underpads, a supply could be kept at the bedside. The patient can’t wait until a nurse or aide walks down the hall and back with the needed items. The same is true for saliva and nasal mucus. Tissues kept at the patient’s hand usually prevent a mess and embarrassment.

 

 

Stroke Patient Needs and Wants

 

 

Find those special traits that each person maintained in spite of the stroke or developed afterward.

For example, our patient can read a clock and point out directions when riding in the car. We also discovered that he can sing and his words are correct for the song and intelligible. At times he will try to sing a word that when spoken is not making sense to his listeners.

 

 

The member of the family who has had a stroke can be involved in everyday decisions.

This is accomplished by offering choices. The easy tasks such as what to have for dinner can be accommodated by asking, “what do you want, chicken or fish?” More difficult choices can also work in this manner. “What should we give our granddaughter for a wedding gift, money or a clock?”

 

 

Be patient and willing to try innovative approaches.

One great frustration is learning to eat with one hand, the opposite of the dominant hand. Our patient required many trials before being able to get more food in his mouth than on the tablecloth but eventually his persistence won.

 

 

In the process we found that a flat dinner plate did not work well. When a pie plate with sides was substituted he could scoop food into a spoon instead of pushing it over the edge.

He occasionally requires assistance with cutting food and picking up the last morsels. The person who sits to his right can assist by using his or her fork to push the food onto the spoon. This method allows him to master cleaning up well liked but difficult foods such as peas.

 

 

 

 

 

Special ‘treats’ rouse the spirits of everybody involved with the stroke patient.

We can’t take for granted the common events such as going for a ride in the car or giving a biscuit to the dog. The stroke patient who has difficulty getting around thrives on getting a change of scenery or visiting places he used to frequent. For our patient going past the plant where he worked for thirty-five years boosts his mood for days at a time. Other special treats include visits from friends and cards from school children. 

 

 

Include the stroke patient in as many events as possible.

Although he may not communicate easily, including him in conversations is good for his positive mental outlook. Moving him around is a difficult task for the family but one which must be undertaken to maintain his emotional well-being. For our patient the trip to his granddaughter’s wedding and reception was a huge undertaking but one worth the effort when the joy was shared by all. Other times to include him are more easily accomplished. For example, we arrange gifts for him to give at Christmas and birthdays. He participates in the selection and wrapping. 

Living with the stroke patient at home is not for every family. One member of the family needs to become the driving force behind the effort. In the Meadows family that person is the patient’s wife. Medications must be closely monitored. Services of doctors, nurses, aides and therapists must be scheduled. Doctors, hospital and pharmacy bills and Medicare and insurance payments are accurately watched and recorded. 

Overall, our family experience has been rewarding. The little triumphs from day to day far outweigh the effort and frustrations. Taking time, being composed and possessing boundless energy are necessary but not easy. Employing innovative thinking and maintaining focus on the solution to daily obstacles to the patient’s comfort and happiness is a challenge to family, friends and caregivers. 

 

Based on an article by Nancy Meadows

 

 

Recommended Reading:  Stronger After Stroke Your Roadmap to Recovery, Second Ed.

by Peter G. Levine

 

Stronger After Stroke puts the power of recovery in the reader’s hands by providing simple-to-follow instructions for reaching the highest possible level of recovery. Basic concepts covered include repetition of task-specific practice, proper scheduling of practice, setting goals and measuring recovery.

Sections new to the second edition cover the latest research from neuroscience, treatments for recovering sensation as well as recovery strategies for the young stroke survivor. Also included is a breakdown of the phases of recovery and how these phases can provide structure to efforts towards recovery.

 

 

 

Stronger After Stroke promotes:

  • Repetition of task-specific movements
  • Proper scheduling of practice
  • Challenges at each stage of recovery
  • Setting goals and recognizing when they have been achieved

The second edition is completely revised throughout incorporating feedback from readers and the latest research data. Peter has written a new chapter on “recovery core concepts” that defines the stages of recovery and explains how these stages can structure efforts toward recovery. There is also a new Question and Answer section culled from the talks Peter regularly gives on the subject.

Read reviews.

 

 

Thoughts, questions, tips?  Feel free to comment below.

 

 

 

 

 

 

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Planning a Family Meeting to Discuss Caregiving

 

Planning a Family Meeting to Discuss Caregiving

 

 

 

When taking care of an elderly parent or another relative, family members need to work cooperatively. The more people participating in care, the less alone a caregiver feels in his/her role. Books and articles about caregiving often mention the family meeting as a way to facilitate this process.

 

But how does one go about having such a meeting?

 

 

Each family is different. In some families, only a husband/wife and their children are considered “family.” In other families, aunts, uncles, cousins, current and ex-in laws and close friends may be included in the definition of family. When planning a family meeting, it is important to include everyone who is or will be part of the caregiving team, and this may include a family friend, neighbor or paid caregiver.

 

 

 

It is also sometimes helpful to engage the help of an outside facilitator, such as a social worker or minister to help the family communicate about difficult subjects during the meeting. (This is discussed in more detail below.)

 

A decision must also be made about whether or not to include the ill family member in the meeting. Family members usually do not want to be excluded from family events and their preferences for care must be considered. However, if someone has dementia or another condition where he/she might misunderstand the purpose of the meeting, it might be appropriate to hold at least the first meeting without him/her present. Also, other family members may need to share with each other thoughts or feelings that would be painful for the ill person to hear. Consider holding one meeting to focus on those matters, and holding a second meeting with the ill person present.

 

Communication is the key to working successfully with a group of people. If it’s difficult for some family members to travel to the location of the meeting, technology can help: a conference call or the use of a speaker phone can make it easier for them to participate. A videotape or an audiotape of the meeting can also be sent out to all family members who are unable to attend. With the use of email, even those who are not nearby can also be kept up to date on how things are going.

 

Prior to a meeting, you’ll find it helpful to prepare an agenda. Someone in the family will generally introduce the idea of a meeting and arrange the date and location. That person can also create an agenda for the meeting and send it out to all the family members ahead of time. Family members can then share their ideas and suggest other items to include.

 

 

 

An agenda might include topics such as:

 

 

  • The latest report from the physician
  • Sharing of feelings about the illness/caregiving

 

Fears: 

  • About death and dying 
  • About being overwhelmed 
  • About what will happen to family members after the death 

 

 

  • Sadness, confusion, anger, guilt, shame 
  • What does the person who is ill want and need? 

 

 

Daily caregiving needs:

 

  • Should the sick person move in with us? 
  • Does she/he need to be in an assisted living facility or nursing home? 
  • How much time does each family member have to visit? 
  • Other ways each person can help? What other help might be available? 

 

 

 

http://www.navigatepanc.com/wp-content/uploads/2015/09/iStock_000044814800_Medium-01.jpg

 

Financial concerns:

 

  • How much will it cost? 
  • How much work can family members afford to miss? 
  • What financial help might be available from outside? 
  • Who will make decisions (e.g., financial, medical, hiring a caregiver, etc.) and how will they be made? 

 

 

  • What support role does each person want to play? 
  • What sort of support does the primary caregiver need? 
  • Need for respite (a break from caregiving)
  • Help with meals, shopping, cleaning, laundry, etc. 
  • Emotional support by telephone or email 
  • Help with chores—i.e., taking the care recipient to doctor’s appointments 
  • How will the caregiving and support needs change as the illness progresses? 
  • Problem Solving 
  • List of tasks that need doing 
  • Summary of meeting and schedule for next meeting 
  • Written summary of what each person has agreed to 
  • Email or telephone tree for regular updates

 

It will probably be difficult to cover all these issues in one meeting, so additional meetings will be helpful. Each ensuing meeting should have a clear time table and a definite beginning and ending time. Be sure to stick to the time table; if meetings get to be too long, fatigue sets in, minds will wander, and people may resist coming to future meetings.

 

As with all high-level negotiations, deciding where to hold the meeting is as potentially controversial as the meeting itself. Whether you hold it in an office, a restaurant or someone’s home, keep in mind that you want a setting that the majority of the participants will find comfortable and convenient and that presents as few distractions as possible (e.g. noise, small children who need attention, etc.).

 

 

A successful family meeting gives everyone a chance to be heard. All feelings are appropriate and need to be expressed and acknowledged. People will be more willing to talk about their feelings regarding the situation if they feel safe. For example, the brother who is never present may reveal that he is unable to stand seeing someone sick, and the sister who is doing all the work may not realize how she pushes others away when they offer to help. Another sibling may be having marital problems which he or she has not yet shared with the family, and yet another sibling might be worried about losing a job. Each person needs to balance his/her own fears, concern, love and desire to help with available time, strengths, weaknesses and hopes.

 

Until the depth and breadth of the issues concerning the ill family member are explored, it is important to not try to solve the problems. Recording the problems in a list as they are shared, however, will be useful during the problem-solving portion of the meeting.

 

 

It is important for each family member to learn to use “I” messages, as well to say “I need…” rather than “You should…” Even when disagreeing, try to find the part of what is said that you can agree with. The goal of the meeting is to work as a team in caring for the person who is ill, even if there is conflict among family members in other areas.

 

At the conclusion of the meeting, make sure everyone has a clear understanding of the issues and considerations discussed. When the solutions to issues have been established, make sure that each person understands what he/she has agreed to do.

 

The most important thing for family members to remember is that the meeting is not a one-time event. Family meetings need to take place regularly. It is helpful to schedule them at a given time, perhaps at the same time each month. However, if this is not possible, they at least need to take place when the caregiving situation or other situations in family members lives change. Holding regular meetings puts less pressure on family members to get everything resolved in just one meeting, and allows more time for processing of information and decision-making. When a family member is unable to attend a meeting, keep in touch with them by phone, mail or email.

 

Families come with history: a history of how each person relates to the others, a history of what role each person has played and currently plays within the family, a history of how each person feels toward the person who is sick, and a history of how each person deals with illness and adversity. And in each family there are rules about what can and cannot be said, what emotions are okay and not okay to express. These factors can make family meetings difficult. This is why a third party facilitator can be helpful.

 

Family members play roles based on position in the family, relationship to the person who is ill, special talents, etc. The person who is the caregiver may be different from the one who handles the money, who may be different from the person who is the information gatherer, who is different from the one who is the decision maker or the one who has some medical background. One person might play several roles. Also, often someone is the “blamer,” and someone else the “blamed.” One person may try to make peace, and another may try to sabotage the process. There will be secrets, old family rivalries, guilt, unequal burdens, differing investments, values and interests. Some will worry about past promises and about someone else not pulling his/her own weight. Everyone will need attention, power, love, control, and appreciation. It can help to acknowledge that there is probably no fair distribution of work and trying to make it even will fail.

 

A narrow focus for each meeting can help alleviate some of the pitfalls. Still, you will have to deal with some of the difficult issues when they get in the way of cooperation. Remember that you can’t resolve long-standing family issues with one such meeting. The task is not to “fix” the family, but rather to have everyone on the same team, as much as possible, in caring for someone who is ill.

 

If alcohol will detract from the main focus of the meeting or will lead to conflict, it is better not to offer it. However, each family has different ways of communicating, and in some families a drink may make everyone more comfortable and more able to talk. In any case, over-consumption should be avoided.

 

 

Consensus

 

http://opengov.newschallenge.org/open/open-government/submission/consensus-based-governance/gallery/consensus.jpg/

 

Not all the issues inherent in caregiving and decision-making can be solved; sometimes it is important to accept approximations of a good solution. Try to work toward consensus building. Change happens slowly, but when families meet regularly, the seeds that are planted can grow into more productive solutions. Often things do not change until there is a crisis, but the work that has been done during the family meeting will make decision-making easier when the crisis does come. Agreements can be made on a time-limited basis to see if the agreed-upon action will work. Future meetings can be used to evaluate these trials and revise them as necessary.

 

Respecting each person’s individuality and situation helps to create an atmosphere of acceptance and allows for creative solutions to problems. For example, Carol finds it difficult to be around sick people, so when her brother got lung cancer, she knew she couldn’t take care of him. However, she was more than willing to make the pastas of their native Italy and take them to him to comfort him during his illness. Jesse lives a thousand miles away, but can get time off from work to be with her mother while her brother and his family take a vacation. When Ed’s mother had surgery, Ed arranged to take care of his father with Alzheimer’s, while his sister worked full time and helped with the expenses. Gina takes her parents to medical appointments while her sister makes sure they get their medicines properly every night.

 

 

Compromise

 

http://peoplemastery.com/wp-content/uploads/Compromise.jpg

 

In order for these solutions to work, people have to learn to compromise. By being open to alternatives, you might get part—although maybe not all—of what you want or need. We often hold out for only one solution to a problem, we don’t consider other possibilities that could assist us. Asking for help is one of the hardest things to do. Learning to graciously receive help offered can also be a struggle, not only for the person who is sick, but also for the person who is the primary caregiver. Being appreciative is the best reward you can give someone who is trying to help you, even if the type of help he/she is offering isn’t exactly what you wanted. When you make someone feel good about helping, he/she will want to help again. “Thank you” will take you a long way in working together. In creating the caregiving team, think about how each person should be acknowledged.

 

 

Put it in writing:

 

 

A written agreement capturing the decisions and agreements made at the end of the meeting can be a helpful reminder for family members. Distributing a calendar with different days marked with responsibilities and commitments can also help each person honor the agreements made.

 

Although family meetings can be powerful and effective ways to connect and work with family members, they cannot magically solve all the problems of caring for an ill family member. When families have trouble working together or coming to agreements or when the family is divided on a big issue, it often helps to invite a neutral outside facilitator to attend. Sometimes a crisis precipitates the need for a meeting—perhaps someone is in the hospital and major life and death decisions need to be made. Time can be of the essence. Whatever work you have done together earlier will help you at these times of extreme stress.

 

Social workers from local caregiver organizations (such as Caregiver Resource Centers in California), as well as ministers, private case managers, social workers in home health or hospice, physicians, discharge planners in hospitals and nursing homes can help facilitate a family meeting or refer you to someone who can. Psychotherapists in private practice are trained in family counseling. If you find yourself in a difficult position, you might also want to see a psychotherapist privately. Don’t forget the support you can find with friends, colleagues and support groups. Sharing experiences with other caregivers can help ease the feelings and frustrations often involved in being a caregiver.

 

Sources:

Share the Care, Cappy Capossela, Sheila Warnock, Simon and Schuster, 1995.

I’ll Take Care of You, Joseph Ilardo, Carole Rothman, New Harbinger Publications, Inc., 1999.

Taking Care of Aging Family Members, Wendy Lustbader, Nancy Hooyman, The Free Press, 1994.

The Caregiver Helpbook, Vicki Schmall, Marilyn Cleland, Marilynn Sturdevant, Legacy Health System, 2000.

How to Care for Aging Parents, Virginia Morris, Workman Publishing, 1996.

 

 

Recommended:

How to Care for Aging Parents – A One-Stop Resource for All Your Medical, Financial, Housing and Emotional Issues

 

How to Care for Aging Parents, 3rd Edition: A One-Stop Resource for All Your Medical, Financial, Housing, and Emotional Issues by [Morris, Virginia]

 

 

 

Also Very Helpful:

The Caregiver’s Toolbox – Checklists, Forms, Resources, Mobile Apps and Straight Talk to Help You Provide Compassionate Care

 

The Caregiver's Toolbox: Checklists, Forms, Resources, Mobile Apps, and Straight Talk to Help You Provide Compassionate Care by [Hartley, Carolyn P., Wong, Peter]

 

 

 

 

 

 

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Washing Your Senior’s Hair in Bed: Step-by-Step Instructions

 

How to Wash Your Senior’s Hair in Bed

Step-by-Step Instructions

 

 

 

 

 

 

When they’re not able to get into the shower or bath, it can seem impossible to keep their hair and scalp clean. No-rinse shampoos, dry shampoo, or wiping with wet cloths are helpful, but aren’t quite as good as a thorough hair washing.

 

A real wash with water and regular shampoo will make your senior feel more comfortable and keeps their scalp healthier.

 

Most of us have experienced (at least second-hand) the issues that arise when someone is sick and in bed for an extended period of time. The hair gets limp and often oily, matted with sweat and will tend to begin to smell after a few days.

 

 

Short Term Solutions

 

The short-term solution is the use of a “dry shampoo” or a “no-rinse” shampoo. These are typically similar in purpose, but are intended for differing hair types.

 

 
Dry shampoo is typically packaged as an aerosol spray that contains an oil-absorbing ingredient that can be brushed out of the hair once it has done its job.

It’s typically used with those who have oily hair or straight-to-wavy hair types.

You simply spray the powdery spray onto the hair at the scalp, let it dry (meaning allow the fast-drying propellant to evaporate) and use a natural-bristle brush to brush out the residue.

Before the creation of specific products for this purpose, many people would use talcum powder or corn starch in small amounts to produce the same effects.

 

 

 

 

 

No-rinse shampoos are liquid based, and usually come in a foaming formulation that is applied liberally to the hair and allowed to dry on their own without rinsing.

They often contain alcohol or other quick-drying ingredients as well as including leave-in conditioners to soften the hair and make it more manageable. These are used more with individuals with wavy-to-curly hair types and those whose hair tends to be dry or fly-away.

When my mom was in the hospital, the nurse used a No Rinse Shampoo Cap to wash Mom’s hair.  She just warmed the cap briefly in the microwave, put it on, and massaged Mom’s hair through the cap. Then she towel dried Mom’s hair a little, and let it air dry.  I was surprised to see what a good job it did at getting her hair and scalp clean.  This is a great option for a fast, no mess wash. 

 

 

Long Term Solution – A Thorough Cleansing

 

While dry and no-rinse shampoos are great for the short-term, after a while, they seem less effective as the hair begins to develop build-up. When this happens, you want to be able to give the hair a thorough cleansing. To do this, you need to look at the process a little differently than you might normally consider it.

 

 

What You’ll Need

 

Johnson's Baby Shampoo, Calming Lavender, 20 Ounce

 

  • Garbage bags and/or a few towels to line the bed and keep it dry
  • Washcloths
  • Towels
  • Bucket of warm water
  • Cup for scooping water
  • Empty bucket to drain dirty water

 

 

Follow These 12 Steps

 

1.   Lay out all your supplies so you know you have everything you’ll need

2.   Line the bed to keep it from getting wet

3.   Fill one bucket with warm water

4.   Gently place your senior’s head into the inflatable basin

5.   Make sure the basin is set up to drain into the empty bucket

6.   Scoop warm water from the full bucket to wet their hair

7.   Use a small amount of shampoo; using too much will make it difficult to rinse out

8.   Scoop warm water to rinse hair completely

9.   If hair is very dirty, shampoo and rinse again

10. When hair is clean, gently remove your senior’s head from the basin

11.  Wrap their head in a dry towel to keep them warm and comfortable

12.  Make sure the basin is fully drained – you might need to tip it over into the bathtub

 

 

This video shows how to wash a bed bound person’s hair using an inflatable shampoo basin:

 

 

 

 

The DMI Basin is easy to inflate and stores easily and compactly when not in use. It has a convenient tube attached so you can drain the water into a large basin or the sink if it’s nearby. The bed shampooer is constructed of heavy duty vinyl for durability and is easy to clean. It even has a little built-in pillow for the head.

 

 

 

DMI Deluxe Inflatable Bed Shampooer Basin, White

 

 

 

The basin is extra deep and constructed of easy-to-clean heavy duty vinyl, and includes a 40″ drain tube.  It measures 24 x 20 x 8 inches.  Read the reviews.

 

 

 

 

Some Nice Extras for Comfort

 

  • Plugging ears with cotton balls to keep water from getting in
  • Lining the neck opening with a small towel to protect from scratchy plastic seams
  • Giving them a washcloth to hold on their face if they’re concerned that you might get water in their eyes
  • Using a soothing lavender-scented shampoo for a relaxing experience

 

 

It can be challenging, but it’s definitely doable.  The most important things to remember are to have everything you need in easy reach before you begin, and to do what you can to make the experience both relaxing and pleasant for both of you.

 

Please share your tips with washing a bed-bound person’s hair in bed.

 

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Dental Care in the Elderly Helps Prevent Heart Attacks and Stroke

 

Dental Care in the Elderly Helps Prevent Heart Attacks and Stroke

 

 

 

 

Due to advances in medicine and an increase in prolonged life expectancy, the number of older people will continue to increase worldwide. It is essential that all older adults practice and maintain good oral hygiene due to the high correlation between oral health and general health.

 

 

In fact, a report from The Netherlands adds to the evidence tying chronic gum disease to heart disease and stroke.

In a study published in the Journal of Epidemiology and Community Health, of more than 60,000 dental patients, those with periodontitis were twice as likely to have had a heart attack, stroke or severe chest pain.

 

Previous studies have linked periodontitis and atherosclerotic cardiovascular disease, but this is the first to investigate the link in a group of people this large, the researchers say.

 

At the Academic Centre for Dentistry Amsterdam, investigators reviewed the medical records of 60,174 patients age 35 and older.

 

About 4 percent of patients with periodontitis had atherosclerotic cardiovascular disease, compared to 2 percent without periodontitis, the researchers found.

 

Even after taking other risk factors for cardiovascular disease into account, such as hypertension, high cholesterol, diabetes and smoking, those with periodontal disease were still 59 percent more likely to have a history of heart problems, according to a report in the Journal of Epidemiology and Community Health, August 8.

 

“It’s clear that periodontitis is associated with chronic inflammation, so it makes sense biologically that if you have a heavy infection in your mouth, you also have a level of inflammation that will contribute to heart conditions,” said Panos Papapanou of Columbia University in New York, who has studied the association between gum disease and heart disease but wasn’t involved in the current study.

 

The research team suggests that gum disease develops first and may promote heart disease through chronic infection and bacteria in the circulatory system.

 

Dr. Bruno Loos, the senior author of the new report, said by email that “plausible mechanisms to explain the relationship” may include a common genetic background for the way the body handles inflammation, oral bacteria and immune responses.

 

Still, this kind of observational study can’t prove that gum disease causes heart problems.

 

“The association . . . does not provide proof (of causation), even when the results from our study corroborate findings from previous similar research,” study coauthor Geert van der Heijden said by email.

 

Papapanou said that while the new findings are from patients with a relatively high socioeconomic status, “we’re repeatedly seeing the same conclusion.”

 

“It seems all over the globe we have to consider this relationship,” Loos said.

 

Dr. Frank Scannapieco, chairman of the Department of Oral Biology at the University at Buffalo in New York, who wasn’t involved with the study, told Reuters Health that while the association of periodontitis and coronary disease is “robust,” the strength of the link is “moderate compared to traditional risk factors such as hypertension.”

 

Papapanou advises: “Take care of your oral health for oral health itself. If you know there’s a positive association between oral health and other diseases, would you ignore it? I wouldn’t.”

 

 

What You Can Do

 

Maintaining good oral health is not only vital to your systemic health—it can keep you smiling well into retirement. Brushing at least twice a day with fluoridated toothpaste and a soft-bristle brush is as important as ever. Flossing is very important, too—it helps to remove plaque from between teeth and below the gumline that your toothbrush cannot reach.

 

As you age, you may be more likely to develop gingivitis. Gingivitis is caused by the bacteria found in plaque that attack the gums. Symptoms of gingivitis include red, swollen gums and bleeding when you brush. If you have these symptoms, see a dentist.

 

Gingivitis can lead to periodontal disease if problems persist. In the worst cases, bacteria form in pockets between the teeth and gums, weakening the bone and causing the gums to recede, pulling back from teeth. This can lead to tooth loss if left untreated.

 

As you age, changes in salivary flow and content may further lead to gingivitis, as well as cavities. Because approximately 80 percent of all American adults suffer from some form of gingivitis, it’s important to see your dentist twice a year for regular cleanings and checkups. If regular oral care is too difficult for you (see below), your dentist can provide alternatives to aid in brushing and flossing.

 

 

 

Certain dental products are designed to make dental care less painful for people who have arthritis. It is sometimes recommended that people with arthritis try securing their toothbrush to a wider object, such as a ruler, to ease arthritic hand pain while brushing. Electric toothbrushes also can help by doing some of the work for you. Ask your dentist for other suggestions.

Try these Radius brushes – their ergonomic handles are great for arthritis and other muscular disabilities, as well as for aid in home care.

 

 

Oral cancer is one of the most common cancers, with roughly 35,000 new cases reported annually in the United States. Oral cancer most often occurs in people who are older than age 40. Oral cancer can form in any part of the mouth or throat. If not diagnosed and treated in its early stages, oral cancer can spread, leading to chronic pain, loss of function, irreparable facial and oral disfigurement following surgery, and even death. Oral cancer has one of the lowest five-year survival rates of all cancers; this is primarily due to late diagnosis.

 

See a dentist immediately if you notice any of the following: red or white patches on your gums or tongue, a sore that fails to heal within two weeks, bleeding in your mouth, loose teeth, problems or pain swallowing, or a lump in your neck. Your dentist should perform a head and neck exam to screen for oral cancer during routine checkups.

 

 

As you age, you may develop dry mouth. Dry mouth (xerostomia) happens when salivary glands fail to work due to disease, certain medications, or cancer treatment. The condition can make it hard to eat, swallow, taste, and speak. Drinking lots of water and avoiding sweets, tobacco, alcohol, and caffeine are some ways to fight dry mouth. Your dentist also can prescribe medications to ease the symptoms of severe dry mouth.

Try Biotene Dry Mouth Oral Rinse

Studies have shown that maintaining a healthy mouth may keep your body healthier and help you to avoid diabetes, heart disease, and stroke. Older patients who are planning to enter a nursing home should inquire about on-site dental care. People who do not have teeth still need to visit the dentist regularly, since many aspects of oral health, such as adjusting dentures and oral cancer screenings, can be handled during routine dental visits. The best way to achieve good oral health is to visit your dentist at least twice a year.

 

 

Advice for Caregivers

 

Today, many older adults are keeping their natural teeth longer than in the past. This is a good thing, but medical conditions can create a risk of serious dental problems. Also, elderly people may be dealing with serious illnesses, mobility issues or mental health conditions that make it even harder for them to take care of their teeth. If our parents are in assisted living or nursing homes, oral hygiene may get overlooked.

 

Potential Dental Problems

According to the American Dental Association (ADA), as our parents age, they are increasingly at risk for periodontal (gum) disease, especially if they are not able to keep up with good oral hygiene practices. This disease is often painless; but when left untreated, teeth can become loose and eventually lost. Also, diabetes increases the risk of infection and can worsen gum problems. In fact, a recent study by the ADA concluded that diabetes was connected with one in five cases of total tooth loss.

Older adults are often taking many medications that have dry mouth as a side effect, or they may have a medical condition that has dry mouth as a symptom. Without saliva to balance acids in the mouth, tooth decay becomes a potential problem along with painful mouth infections, such as oral thrush.

It’s not just our parents who are aging; their dental work is as well. Fillings, crowns, dentures and partial dentures sometimes become worn out and need to be replaced just when it becomes hard for them to get to a dentist.

Another serious risk for older adults is oral cancer, especially if they are or were smokers. According to the ADA, the average age when oral cancer is diagnosed is 62. Dentists always do cancer screenings during routine examinations because early detection saves lives.

 

How Caregivers Can Help

Just as our parents did for us, we can remind our parents to brush and floss daily. If they wear dentures, they also need them to be cleaned every day. With all the risks to their oral health, get them to a dentist regularly, and take a list of their medications along. If your Mom or Dad has arthritis or another disability that makes it difficult for them to brush or floss, ask their dentist to recommend some modifications to make the task easier.

If dry mouth is an issue for your parents, you can discuss the side effects of their medications with their physician. You want to help them get relief. Over-the-counter oral moisturizers, alcohol-free mouthwashes and sugar-free gum and lozenges can help. Make sure they are using fluoride toothpaste. Encourage them to drink plenty of water and to avoid drinking acidic fruit juices and carbonated sodas.

Keeping on top of your parents dental care is challenging when they are in a nursing facility. Having to deal with so many other health care needs, caregivers often don’t rank dental hygiene as a top concern. You may have to communicate specific oral hygiene needs to the staff. Also, be mindful of your parents’ eating habits. If necessary, get input from the nursing staff. If they are not eating as much as usual, they could be experiencing dental pain or dealing with an ill-fitting denture.

It may feel like a strange role reversal, but now it’s our turn to do for our parents what they did for us. Their quality of life depends on good dental health, and we must ensure that their dental needs are met for as long as they are with us.

 

Here are some suggestions to help you help your elderly parent maintain
their dental health

 

1.  Be proactive:  if your parent is dependent on you to  take them to dental appointments there is no better time than now to do it than now to get things back into good health and set a dental checkup instead of waiting for something to hurt.

  

2.    If you have a parent at home with you or in a long term care facility brushing 2 to 3 times a day would go a long way to reducing cavities and promoting better gum health.

 

3.    Use of a daily fluoride mouthwash or high fluoride content toothpaste can also help reduce cavities.  Speak to your dentist about these products.

Try ACT Sensitive for an alcohol-free, non-burning flouride mouthwash option.

 

 

 

4.    A chlorhexidine mouthwash can help reduce cavities and gum disease in patients that are not able to brush effectively.

 

5.  You could also be trained to brush for your parent if they are unable to do so themselves.

 

6.   An electric toothbrush can also be helpful in getting the teeth cleaner.

 

7.   If they are okay with gum chewing, chewing a piece of sugarless, xylitol containing gum for five to twenty minutes after a meal or snack out can help reduce cavities.

 

Good dental health is something that many take for granted.  Being able to eat whatever we want, to speak without fear of a loose denture falling out or being too self conscious to smile due to cavities or missing teeth is a hardship faced by many older adults. 

Poor dental health can result in health problems.  For example, if you have missing teeth or loose teeth you may out of necessity choose softer foods to eat ,  which tend to be more more processed, with little or no fiber;  a  diet low in fiber  can lead to a greater incidence of colon cancer.

I hope this article has shed a little light on a common issue of dental health in the aging adult.  Remember that by being proactive, you can help prevent not only dental issues, but other, potentially life-threatening complications.

 

You may also be interested in:

A Guide to Getting Dentures

Caring For Your Dentures

Preparing For Your Elderly Parent to Move In

Easy Home Improvements for Mobility Issues

Caregivers Must Prepare for Emergencies

About Me

Create Your Own Blog

 

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Dementia Toileting Tips For Caregivers

Dementia Toileting Tips For Caregivers

 

 

 

Someone with dementia is more likely to have accidents, problems with the toilet or incontinence than a person of the same age without dementia.

There are many reasons.

 

 

Causes of accidents and problems can include:

 

  • not being able to react quickly enough to the sensation of needing to use the toilet
  • failure to get to the toilet in time, sometimes due to mobility problems caused by other conditions such as arthritis

 

 

 

 

 

 

 

 

 

 

 

 

Pictures & Words Communication Flip-Chart for stroke, ALS, dementia, Alzheimer’s, expressive aphasia, Lou Gehrig’s Disease, speech impaired talking disability patients at home/hospital

 

 

  • inability to find, recognize, or use the toilet; if someone becomes confused about their surroundings, they may urinate in an inappropriate place (such as a wastepaper basket) because they have mistaken it for a toilet
  • not understanding a prompt from someone to use the toilet
  • not managing the personal activities of toileting, such as undoing clothing and personal hygiene
  • not letting others help with toileting – perhaps because of embarrassment or not understanding the offer of help
  • not making any attempt to find the toilet – this could be due to lack of motivation or depression, or because the person is distracted
  • embarrassment after an accident, which the person unsuccessfully tries to deal with. Wet or soiled clothes or feces may be put out of sight (for example, wrapped up and put at the back of a drawer) to be dealt with later, but then forgotten.
  • In some people incontinence develops because the nerve pathways that tell the brain that the bladder or bowel is full, and also control emptying, are damaged. However, this is an uncommon cause of toilet problems and incontinence in people with dementia. It typically occurs only when dementia is more advanced.

 

 

Tips for Caregivers: The Importance of a Healthy Bladder and Bowels

 

Keeping the urinary tract and bowels healthy is a good first step to preventing toilet problems and incontinence.

 

It can be helpful if caregivers can work with the person with dementia to ensure the following:

 

  • The person should drink six to eight glasses of fluids each day – more if they have hard stools. Cutting down fluids or not drinking them for long periods of time (for example to avoid the need to urinate at night) can cause urinary tract infections and constipation.

 

  • They should eat a balanced diet with at least five daily portions of fruit and vegetables, and enough fiber to ensure a regular bowel movement.

 

  • The person should keep as mobile as they can. If they are able, walking every day helps with bowel movements.

 

  • Ensure a regular time, and allow enough time on the toilet, to empty bowels. There are biological reasons why trying to go a few minutes after a meal works – many people favor going after breakfast.

 

  • If a health professional has suggested the person might have an overactive bladder, they will also advise replacing drinks which irritate the bladder (eg tea, coffee, cola or alcohol) with water, herbal teas, squash and fruit drinks.

 

  • Women with mild dementia and urinary stress incontinence sometimes learn pelvic floor exercises, with the support of specialist continence nurses or physiotherapists. These exercises can cure stress incontinence caused by weakness of the pelvic floor muscles due to childbirth or aging.

 

 

Constipation

 

Equate - Fiber Powder, Clear Soluble, 125 Servings, 16.7 oz (Compare to Benefiber)

Laxatives are widely available over the counter for people with constipation. However, they should not be used for long without seeking advice from a GP or pharmacist, as the symptoms may mask another condition. 

 

Suggestion:  Equate Fiber Powder – Clear, Soluble (this product isn’t fancy, but it’s effective and gentle, as well as inexpensive).

 

If constipation is the cause of fecal incontinence, caregivers can learn to massage the person’s abdomen to relieve the blockage. Specialist continence nurses can train carers in this technique, though it requires co-operation and is not to everyone’s liking.

 

 

 

Tips for Caregivers: Helping to Reduce Accidents

 

 

Help with using the toilet at home

 

The following ideas may help someone to find, recognize and use the toilet more easily:

 

  • Help the person identify where the toilet is. A sign on the door, including both words and a picture, may help. It will need to be clearly visible, so place it within the person’s line of vision and make sure the sign is bright so it’s easy to see. Help the person know when the toilet is vacant; leaving the toilet door open when not in use makes this obvious. Check the placement of mirrors in the bathroom. The person with dementia may confuse their reflection for someone else already in the room, and not go because they believe the toilet is occupied.

 

  • Help the person make their way easily to the toilet. Move any awkwardly placed furniture or prop ajar any doors that are hard to open. The room and the route to the toilet should be well lit, especially at night. Movement sensor lights in the bedroom and bathroom can help at night.

 

 

 

These decorative night lights are great for added safety in your bedroom, bathroom or hallway; they detect motion up to 25 feet within a 100-degree-wide zone, and will auto shut-off after 90 seconds.  Their light sensor prevents the light from turning off during daylight hours or when you have the lights turned on.

 

 

 

 

  • Make using the toilet easier for people with mobility problems. Aids such as handrails and a raised toilet seat may help. Occupational therapists can give free advice on these, or you can ask someone at a local independent living shop.

 

For more help, see

 

  • Help the person identify and use the toilet. A contrasting color (eg black seat on a white base) can make it easier to see. Some men who have poor mobility or balance, or who can no longer direct their penis when urinating, may find it easier to sit rather than stand.

 

  • Help the person undo, remove and replace clothing easily. Trousers with an elasticated waist (tracksuit bottoms) are often easier than zips. Some people find Velcro™ fastenings easier to use than zippers or buttons.

 

Shop for

 

  • If getting to the toilet becomes too difficult because of mobility problems, an aid such as a commode may be useful. Using this will require the person to recognize the commode, be willing to use it, and find it an acceptable piece of furniture.  commodes and other aids can be very helpful.

 

  • The person should have privacy in the toilet, but make sure they don’t have difficulty managing locks. Some people with dementia struggle with this. To avoid the person locking themselves in, disable locks or ensure you can open them quickly from the outside.

 

 

 

Out and About

 

There are several ways to make traveling or being outside easier for the person with dementia. Being more confident and able to cope with accidents is important, because toilet problems can lead to giving up activities or becoming isolated.

 

  • Plan in advance. Find out where accessible toilets are.

 

  • Go prepared. Fit a light pad (the kind that attaches to underwear) and carry spare clothing and pads, as well as a bag for soiled items.

 

For more help, see

 

 

Remembering to Use the Toilet

 

  • Giving regular reminders about using the toilet is a common approach to help with accidents. For someone with urinary incontinence, the caregiver asks regularly (every 2-4 hours) whether the person needs the toilet. The person is given encouragement and assistance with using the toilet if they ask for help. It is important to check that the person has used the toilet, and not forgotten or become distracted. There is evidence that, over time, this can help some people reduce the number of accidents.
  • Prompting needs to be done sensitively, to avoid patronizing or annoying the person with dementia. Watch discreetly for signs that the person wants to go to the toilet, even if they cannot communicate this directly. These signs may include fidgeting, pacing, getting up and down, or pulling at their clothes.

 

 

Scheduling Toilet Use

 

  • For someone who is regularly wet it may be better to develop a timetable to offer help or reminders for going to the toilet, for example when they wake up, before each meal, at morning and afternoon coffee or tea, and before bed.
  • For fecal incontinence, it is often possible to re-establish continence by going to the toilet at a set time each day and helping the person stay long enough to have a bowel movement.

 

 

Night Time

 

Many older people wake during the night to urinate. A person with dementia may wake disorientated and unable to act quickly enough to find (or get to) the toilet. Ideas that might help include:

 

  • light motion sensors and/or night lights in the bedroom, passage ways and bathroom

For more help, see

 


 

 

Suggestion: as you can see, I am a big fan of night lights; these small, inexpensive items make a huge difference in your home’s safety!  

These automatic LED night lights are small, low-maintenance, and bright.  They will turn on automatically in low light and remain on until morning light.  This way, you “set it and forget it.” 

 

 

 

 

 

 

 

 

 

 

 

  • a urinal bottle (designed for men and women) or commode next to the bed at night.  Many people don’t realize these products exist, but they can be really helpful, especially for nighttime toileting.

 

 

 

 

  • not having drinks for two hours before going to bed, but remember that the person should still drink enough during the day to avoid becoming dehydrated.

 

 

For more help, see:

 

 

 

Dealing With an Accident

 

Hygiene is a very personal issue. From a young age, people are trained to control urges to go to the toilet, so having problems or being incontinent can make a person feel like they are losing control. This can affect their sense of dignity and self-esteem. Many people find it very hard to accept that they need help from someone else in such an intimate area of their life, even (or sometimes, especially) if the help is from someone very close to them.

Every individual will react differently to the experience of incontinence. Some people find it very upsetting, while others find it easier to accept. Approaching the problem with understanding, matter-of-factness and humor can help to improve the situation for all concerned.

 

If someone has an accident, it is important for carers and friends to:

 

  • remember that it’s not the person’s fault
  • try to overcome any embarrassment or distaste they may feel
  • avoid being angry or appearing upset.

 

This may not always be easy. If as a caregiver, you find feelings about incontinence difficult to handle, it is a good idea to talk things through with a health professional. This could be the GP, a community nurse or a continence adviser (a nurse with specialist training in management of incontinence). It is important to try not to let dealing with incontinence get in the way of your relationship with the person you are caring for.

 

 

For more help, see

 

 

 

Ensuring Good Personal Hygiene

 

Incontinence can lead to skin irritation and a general feeling of discomfort. After an accident, it is important to act quickly to make sure the person feels comfortable again and to ensure good hygiene.

 

  • If someone has become wet or soiled, they should wash afterwards with mild soap and warm water, and dry carefully before putting on clean clothes and fresh pads, with assistance if necessary.

 

  • Soiled clothes, reusable pads or bedding should be washed immediately, or soaked in an airtight container until they are washed.

 

  • Used pads should be stored in an appropriate container and disposed of as soon as possible.

 

  • Moist toilet tissues may be suitable for minor accidents, but be aware that some can cause an irritating rash.

 

 

Professional Support

 

It can be hard to seek professional help for incontinence. Many people do so only at a point of crisis, as it may feel like a loss of dignity for the person with dementia. Some may see incontinence as inevitable, but for many people with dementia, given the right advice and patience, accidents and incontinence can be managed or sometimes even cured

The GP should be the first port of call. The doctor should review the symptoms and any underlying medical conditions (urinary tract infection or constipation), diet or medications that might be causing the problems. The doctor may do an internal examination of the bowel.

If this assessment is unable to resolve things, ask to have the person referred to a continence adviser. You may have to be persistent here you may have to push to see someone who understands incontinence in people with dementia. There may be a wait for these services.

The continence adviser will assess the problems and how they are affecting quality of life for the person and any carer. It is common to be asked to keep a chart of toilet habits.

After a thorough assessment the continence adviser will write up a continence care plan tailored to the individual. The plan should include things that the person with dementia and any caregiver can do to help. It should also describe the support that professionals should provide, as well as follow-up and next steps.

The goal – agreed with the person with dementia and carer – should be to cure toilet problems or incontinence wherever possible. In many cases, identifying and addressing practical issues, changing medications or making simple changes to lifestyle (diet, fluids, exercise) are sufficient to achieve this.

In a few cases referral to further specialists such as a geriatrician or urologist will be needed. For some people, advice will focus not on cure but on containing the incontinence as comfortably as possible using aids.

 

 

Incontinence Aids

 

It may be that everything has been tried and toilet problems and incontinence persist. In this case, use of aids can help ensure greater comfort and protect clothing, furniture and bedding. The main aids are:

  • Incontinence pads and pull-up pants. These can be worn day and night, or during the night only, to draw fluids away from the skin. It is important to find the right type and absorbency for the individual: they should be comfortable without chafing or leaking. They should be changed as often as necessary.
  • Male continence sheath. This is a silicone condom which drains into a bag attached to the leg. It may be especially helpful when worn at night.
  • Waterproof mattress protector. This is often used in combination with an absorbent bed pad. The protector should not come into contact with the skin, as it may cause chafing and soreness. You can also buy special protective duvet covers and pillowcases.

 

 

For more help, see:

 

 

 

You may also be interested in:

 

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