Recent Caregiver Blogs

Posted: 4/7/2022 7:38:12 PM

Telltale Signs that Patients Are Skipping their Medications

At present, there is a health problem so big, yet that remains unnoticed to many—nonadherence to prescribed medications. This is how bad the situation is: according to a review by the Annals of Internal Medicine, 20-30% of prescription medications are never filled and about 50% of medications are not taken as prescribed. What’s worse, this problem is responsible for approximately 125,000 deaths and 10% of all hospitalizations.

There are many reasons why patients do not take their medications as recommended. Some skip their meds on purpose, saying that the medications' side effects make them stop. Some experience difficulties such as swallowing problems. Other patients stop because they feel better and don’t think it’s necessary to continue. Some also think their medications are too costly, ineffective, or worse, making them sicker rather than better. Patients also miss doses due to confusion and simply forget.

Whatever their reasons, skipping medications can have serious and deadly consequences for patients. They are not receiving an important part of their treatment and, therefore, risk getting worse or suffering complications.

Caregivers are in a position to help, because they spend the most time with patients. Their careful observations can provide clues that a patient is not following their treatment as recommended.

Here are telltale signs that a patient has not been following their treatment plan:

1. The patient asks you to leave the room when it’s medication time.

Caregivers are not allowed to administer medications, they can only assist or remind a patient to follow their prescriptions. Patients can get away with skipping their meds by simply saying they took it when they didn’t.

2. Pill bottles don’t seem to empty.

You might notice a bottle that is supposed to be finished is still sitting on the medicine counter. You do not remember them refilling their medication and don’t notice any torn foil packs or empty bottles in the trash.

3. The patient’s symptoms come back or become worse.

One of the most significant signs that a patient has stopped taking medications is that their previous complaints have come back or they report feeling sicker after a little improvement.

4. The patient is often forgetful.

Memory problems can cause confusion in a patient, who will likely not remember to take their prescribed medications. Patients with dementia, such as Alzheimer’s disease, may be missing doses, which is also a sign they are advancing in the disease.

5. The patient says they feel better and don’t need pills any more.

Other patients may not hide it and will tell you that they stopped on purpose. Also, do not be surprised to find that they’ve been taking more “vitamins” or “supplements,” which they prefer over their prescriptions.

When you suspect a patient is not following their recommended treatment, you may directly ask the patient if that’s the case. Whether you believe they are telling the truth or not, you must discuss the matter with your supervisor or nurse so your patient can get the necessary help regarding the importance of sticking strictly to the treatment plan.

Medicines won’t work if a patient won’t take them. This is the hard truth. These consequences can be prevented if everyone, including the patient, tries their best to do their part.


Posted: 3/10/2022 2:50:07 PM

Medication Management, from Prescription to Refill

If you are a caregiver wishing to make your life easier by doing just one thing for a start, try medication management.

Medication management entails being knowledgeable about the patient’s medications and being organized enough so that the patient takes the medications in the right way, in the right amount, and at the right time. Being a champ at managing your patient's meds can save you a lot of time and can allow you to do other important things for yourself, and for your patient. Most importantly, it ensures that your patient gets the maximum benefits by preventing missed doses, and keeps them safe by preventing ‘double dosing.'

Be sure to follow these helpful tips:

Upon prescription:

Ask the doctor for any clarifications regarding the prescription, like the drug name and dosage if they are not legibly written.

Ask what the meds are for, and other details such as how much and when to give them.

Ask the physician what to do if certain adverse effects, such as severe allergic reactions, are noted.

Inform the physician of all the patient's medications including supplements and herbal medicines.

Upon obtaining medications from the pharmacy

Obtain all meds from the same pharmacy if possible. It helps the pharmacist determine the compatibility of the drugs.

Check to make sure that the prescription has the patient’s name on it. Double check for accuracy, ensure that what you get is the same as what is prescribed.

Getting organized

Make a comprehensive chart. Assign one column for each of the following details: generic name, brand name, what the medication is for, date when they were prescribed, date when to stop taking them, the doctor who prescribed it, the amount to take per dose, the time to take them or the frequency, the route (how to take them), and common side effects. Assign another column for important notes, such as if they are to be taken on an empty or full stomach, if they should not be crushed, or if certain activities, such as driving, should be avoided. If you can manage, take a picture of the bottle and the pill together, and include the pictures in your chart. Be sure to include supplements and herbal medicines that the patient is taking even without prescription.

Make a list. This time, list all medications that the patient needs to take at a certain time of day. The list is critical, especially when refilling the medication boxes, and when ensuring that you have the right pills at medication time.

Keep the chart handy and take it in with you to every visit to the doctor. The doctor needs to know all medications that the patient is taking, whether prescribed or not.

Obtain three pill boxes with different colors. Each pill box should have seven slots that are big enough to contain a day's medication.

Assign a color each for the morning, afternoon, and evening pills. If possible, make four sets of these pill boxes to allow you to organize the medications up to four weeks.

Update the chart and your list accordingly. Remove discontinued meds from the chart, and add new ones to the chart and the list as appropriate.

Set up alarms. Mobile devices allow multiple alarms to be set in a day. Even if you feel in control of your time, unexpected events can lead to missed doses.

Storing the medications

If you have young children living with you and your patient, or if your patient who has dementia is prone to double-dosing due to forgetfulness, keep medications out of reach in a locked cabinet.

If the patient with dementia is taking medications on their own, keep the color-coded pill boxes in separate locations. Sometimes, in their confusion, they reach for the wrong pill box even if they are color-coded for the right time of day.

Take note if there are medications that need to be stored in the refrigerator.

Make a habit of checking the expiration dates of medications. For those nearing expiration, it will help if you stick a note on the bottle with the expiration date written in big letters.

Refilling supplies

Medications that are to be taken for long-term are best purchased in bulk because they are cheaper. Consider mail order plans that can provide medications for up to 90 days to save you trips to the pharmacy. You may ask the patient’s insurance provider or pharmacy for this option.

Others

Make sure no one else is taking the medication other than the patient.

Keep the contact number of the hospital or the physician handy in case of emergencies related to taking medications.

Familiarize yourself with the medication and dosages. Read the labels carefully. Before giving the meds, it is best to double check everything, especially if there are new additions.

Keep a record of side effects and include details such as when they were noted.

Medication management may be overwhelming at first, but when done properly, it becomes your first ticket to a successful and less-stressed life as a caregiver.


Posted: 2/7/2022 5:28:57 PM

Maximizing Independence at Home for Clients with Early Stage Dementia

How important to you is your Independence? How important is it to be able to do what you want, when you want to? To most, it means having a full life instead of simply “existing.” Freedom is so important that countries fight wars to protect or take back their freedom, and to have what we now call “independence.”

Older people with dementia, whose activities are controlled and limited, also feel this way. They feel they need fight for the right to accomplish tasks on their own and to decide for themselves. They only want to live their lives the way they used to. They think, “Why not? A little forgetfulness does not make me an invalid.” Their age and experience are evidence of their successful decision-making over the years, which make them an “expert” in many different things. For clients, a “little forgetfulness” does not have to be enough reason to keep them in their homes or in facilities, feeling like children who would endanger themselves without proper supervision.

Caring for a client with early-stage dementia, who fights for their independence, can be a big challenge to caregivers because it often results in power struggles. The caregiver fears that, if they do not put some limitations to a client's freedom, the client's safety and health would be at stake. On the other hand, when a client cannot regain control, they can feel weak, frustrated, angry, and depressed. In both cases, the caregiver is faced with seeing through a difficult situation.

When a client with early-stage dementia demands their independence, caregivers are often left wondering how to best handle the situation. The only solution is to maintain balance by looking for a compromise, where caregiver and client can meet halfway. This solution is called maximizing independence.

What are some of the ways to maximize independence for clients with dementia, so that everyone is happy and confident that the client will be fine on their own at home? Here are some helpful tips for caregivers:

1. BE CLEAR ABOUT WHAT THE CLIENT CAN AND CANNOT DO ON THEIR OWN. If they can eat on their own but should not cook, have prepared meals ready to be warmed or have a service like Meals-on-Wheels deliver food. When caregivers know which activities clients can perform by themselves, it is easier to adapt the home and provide them with the necessary tools to safely live on their own.

2. INSTALL SAFETY FEATURES AT HOME AND REMOVE CLUTTER. Make sure that grab bars are installed in the bathroom and on the toilet, and any other place they are needed. Check if there is a need for a raised toilet seat or a bedside commode. Remove clutter, which can cause falls.

3. KEEP REMINDERS FOR THE CLIENT. Remind them of doctor’s appointments or of their medication times. Perhaps stop by for a hello after lunch to check if they’ve turned off the stove.

4. ORGANIZE AND SIMPLIFY THINGS. Confusion in clients with dementia worsens over time, so it really helps to have things at home organized and simplified. Organizing their one-week’s supply of medications, labeled and color-coded, will help those in early-stage dementia to know which medications are due. When choosing decor for the house, avoid designs that have too many complicated patterns and colors. For example, use only white plates and other dinnerware.

5. HAVE IMPORTANT CONTACT NUMBERS ON SPEED DIAL. Set number 1 on the phone pad to dial the person to contact during an emergency.

6. PRE-ARRANGE APPOINTMENT SCHEDULES AND TRANSPORATION. Some tasks may be too complicated for clients with early-stage dementia, such as appointment-setting and scheduling transportation. Caregivers can help in this regard.

7. MAKE ROOM FOR EXTRA TIME IF THEY LIVE WITH YOU. If they prefer to do things on their own and they will be safe while doing so, giving them enough time to finish a task will help build their confidence and self-esteem. As a caregiver, you will need to remember to have a lot of patience with them.

8. BREAK BIG ACTIVITIES INTO SMALL TASKS WHEN YOU ARE WORKING TOGETHER. If they become confused about setting the table, give step-by-step instructions on how to perform the task, such as “Put the placemat on the table, take two plates out of the dish rack, get two spoons and two forks…” This way, the client will feel good about accomplishing a task and still being able to be helpful.

As caregivers, your empathy toward a client who needs their independence must be the basis of your care. Clients with dementia are elders of our society who deserve your utmost respect, while ensuring their freedom to do the things they can for themselves, within the limits of their health and safety.


Posted: 1/12/2022 2:18:40 PM

Heroes Without Superpowers – Proper Body Mechanics Save the Day

Caregivers do a lot in a day. By “a lot,” we mean muscle work from the beginning of the shift to the end, including running, changing bedsheets, lifting heavy items, lifting patients and clients while transferring them from the bed to a chair, walking them to the bathroom and back…the list just grows.

They do all these to care for their patients, sometimes even skipping breaks and staying late. Caregivers are heroes in their own way, but since they are only human, all this lifting and turning takes a toll on their physical health.

Whether in a hospital, facility, or a client's home, the tasks and challenges for caregivers are very similar and often exactly the same, and the danger of back injury while doing these tasks is real!

This is where the use of proper body mechanics becomes crucial in preventing injuries, such as back strain and spine damages. There are many aspects to using proper body mechanics to help protect yourself from injury, but here are the most important that caregivers must always practice, regardless of the task:

1. Do a quick mental analysis of the task before you. Are you lifting a patient and transferring them to a chair? What should be done first? Where is the safest place to stand?

2. As you picture the task in your mind, do some arm and leg stretches and warm up your muscles.

3. If you are doing the heavy task with a patient, explain the steps of your approach to them. This technique is very useful, not only in keeping both caregiver and patient safe during the movement, but also in giving the patient the chance to help you while moving them.

4. Before lifting or transferring a patient, always keep your feet apart to ensure a wide and secure base of support. This technique helps keep your balance during the task.

5. Bend your knees and not your back. The heaviest force should come from the feet.

6. Stay as close as possible to the person or item to be moved because your body can best support a heavy load this way, with the force of the lift coming from the shoulders and the upper arms instead of just the lower arms.

7. Face your task so that it is directly in front of you. This approach prevents you from twisting or reaching out unnecessarily and hurting your back in the process.

8. Move as one unit so that, as you turn left, the whole body turns left and not just the upper body. This technique prevents twisting movements that can hurt the back or spine. The head and neck must also be kept aligned to prevent injuring your neck and shoulder muscles.

9. Your foot should go in the direction of your movement. This move keeps your knees and calf muscles from harm.

10. Hold on properly to the person or item to be lifted. If you fail to do this, the patient may fall and become injured, or your toes will feel how heavy the falling object really is!

11. When lifting, the force of the movement should come from the muscles of the entire arms and legs. These muscles can handle lifting better than the back muscles.

12. No sudden movements! Jerky movements can rip muscles and even fracture bones, so you must always keep this one rule in mind.

13. No lifting or turning more than you can handle. Be sure to ask for another person’s help if needed.

14. Use tools that will make your work easier. Turning sheets, mechanical or electric lifters, transfer belts, and gait belts will help keep you from injury, so do not hesitate to use them when you need them.

Being a caregiver is a rewarding job, but be careful to not let the work rob you of your own physical safety while on duty. Practicing proper body mechanics at all times is like putting on armor before battle, it protects you from unnecessary injury on the job.


Posted: 11/5/2021 9:15:47 AM

Rule Your Day: Great ADL Tips for Caregivers

Caregiving will not be complete without assisting the patient in performing activities of daily living (ADL). ADLs are basic self-care functions a patient needs to keep healthy. These activities are eating, bathing, toileting, dressing, walking, and moving around. For a caregiver, helping a patient with these tasks could be the most tiring and time-consuming thing the caregiver would have to do in a day.

Being new to caregiving should not overwhelm you and make you give up on one of the most important decisions of your life, to care for a human life, so consider these ADL tips to get you through your day in a breeze.

In general, follow these helpful tips:

- ENCOURAGE INDEPENDENCE AS MUCH AS POSSIBLE. Part of your role as a caregiver is to make your patient feel good about themselves and to prevent frustration, and nothing can do that better than letting them do things for themselves. So allow activities where they can be independent caring for themselves but within safe limits.

- ALLOW ENOUGH TIME FOR THE PATIENT TO PERFORM A TASK AND THEN YOU FINISH WHAT THE PATIENT COULD NOT DO. Patients are limited by their physical illness, so caregivers must give them enough time to finish their tasks to let them have a sense of accomplishment.

- HAVE A SCHEDULE AND A ROUTINE. Make a daily plan of activities and have a routine. This is especially helpful in caring for young children and those who are confused.

- KEEP THE PATIENT’S PREFERENCES IN MIND. Establishing a great relationship with your patient means respecting their needs and wants. Sometimes, something as simple as letting them use their favorite things or just playing their favorite music can make the day a lot easier for both of you.

- DIVIDE BIG TASKS IN TO SMALL ONES. This tip is particularly useful in dealing with patients who have dementia and have difficulty understanding and following instructions. So next time that you help them dress, instead of saying, “Put on your clothes” you can tell them to put their shirt on, slide their right arm then their left, and then button their shirt up. It will take more time for them to analyze how to perform big tasks than follow simple instructions.

- ANTICIPATE NEEDS AND GATHER ALL SUPPLIES AND EQUIPMENT BEFORE STARTING CARE. This technique will prevent you from going to and from the patient’s room and feeling exhausted from all the running.

WHEN FEEDING:

1. Serve hot foods hot and cold foods cold.
2. Cut foods into small bites.
3. Garnish their plate with a colorful food.
4. Choose lighter utensils.
5. Offer a sip of water every after a few bites.
6. Play their favorite music during meal time.

WHEN BATHING:

1. Use liquid soap and shampoo in a dispenser to prevent picking up the slippery bar soap.
2. For patients who are weak, keep a safe sturdy chair for them to sit on while in the shower.
3. Ensure that grab bars and anti-slip mats are installed.
4. For older patients, keep the bathroom warm and free of drafts.
5. For patients with decreased sensation, test the warmth of the bath water before the patient get in to the bath water.
6. Ask the patient to clean what he can reach and finish the rest of the bath for them.
7. Clean in between skin folds.

WHEN TOILETING:

1. Use raised toilet seats with arm rests for those patients who have difficulty getting up and down.
2. Teach the patient how to use a self-wipe toilet aid, an assistive device to help them reach and clean their private parts.

WHEN WALKING OR MOVING AROUND

1. For patients who are in bed most of the time, help them sit up and dangle their feet first for a few minutes before helping them to stand and walk. This prevents them from fainting.
2. Use a transfer belt or a lift to move weak patients from the bed to a chair or to another seat.

WHEN DRESSING:

1. For confused patients or those having difficulty with hand movements, let them use shirts that open in the front; Velcro fasteners are more preferable than buttons.
2. For patients with advanced dementia, limit the choice of clothes for each change to two choices.
3. For weak patients, comfortably loose pants with an elastic waistband are preferable because they are easier to put on and take off.

Helping patients perform activities of daily living is a challenging task. If it gets overwhelming for you as a new caregiver, keep in mind that your best teacher would be your own experience over time as well as your genuine concern for your patient. As you go through your daily work, you will gain more insight and knowledge on how to care for your patient, and this would ultimately help you develop a system that truly works.