Recent Caregiver Blogs

Posted: 11/25/2019 2:39:22 PM

Caregiver Lessons: Behavior Changes in Clients and What They Could Mean

While on the job, caregivers will care for clients with many different health conditions, and as caregivers they will be the ones spending the most time with their clients. Caregivers are the eyes of the healthcare team, and are able to see and observe client behaviors that physicians and nurses may miss.

A sudden change in a client's behavior could mean a worsening of their condition or a sign of a negative experience that has happened to them recently. In any case, the caregiver must be alert to their client’s behavior to prevent them from being harmed.

Below are some behaviors that may be observed suddenly in clients, and what these changes could mean:

1. A depressed client who is in their first week of medications for depression suddenly feels energized, and acts as if they need to do something or go somewhere else.

Clients who are taking medications for depression may feel stronger and more energetic before they feel happier. This difference between the improvement of energy and the improvement of mood means that, if they are thinking about committing suicide, they will have the strength to carry out their plan of self-harm.

If this behavior is observed, caregivers must discuss the matter immediately with the supervisor and then closely supervise the client during this time.

2. A client with Alzheimer’s disease starts to walk around aimlessly, forgetting where they are going and why. They become irritable and report seeing things that are not there.

During the early stages of dementia, clients might forget information more than people without dementia. Clients with early-stage dementia will begin to have worsening forgetfulness, such that they get lost in their own homes or neighborhood, or they show personality changes and frequent mood swings. This signals that they have moved to the advanced stage of the disease.

The caregiver must expect that their client will become more dependent and need closer supervision.

3. A client with a disability suddenly appears fearful, refuses to be touched or bathed, shows inappropriate affection, or has recent nightmares.

Clients who are disabled, or those who are incapable of expressing and protecting themselves, are prone to physical and sexual abuse. Abusers get away with it because they can take advantage of a client's helpless situation.

When caregivers notice these changes in their client’s behavior, they should discuss it immediately with their supervisor. This is because there are procedures that must be followed when dealing with cases of abuse.

4. A person who recently had a stroke becomes very quiet and unaware of their environment, or they may start neglecting one side of their body.

Caring for a client who has had a stroke can be challenging. Other than being weak, they may start showing apathy, where they seem unconcerned about their environment, appearing to be motionless and staring at the wall.

Caregivers must understand that apathy may or may not be a sign of depression in stroke clients. They must give the client more encouragement and involve them in simple activities.

Some stroke clients may also start leaving the food untouched on the left side of their plates or clean only the right side of their body. These behaviors are signs of neglect, wherein they completely and unconsciously ignore one side of their body or things that are on that side, oftentimes their left.

Both of these changes in behavior are a result of damage on one side of the client’s brain. It can also mean that their recovery may be a lot harder than stroke clients who do not show these behaviors.

Caregivers can help these clients be more aware of their environment as well as their self. They can talk to them from the neglected side of their body and help them scan for things in every direction.

Although changes in client behavior often have significant meanings, caregivers must understand that these behaviors may not always be caused by the reasons above. However, when these responses are observed, it is best to discuss them immediately with the supervisor, who can provide proper guidance and help.


Posted: 11/18/2019 6:58:51 PM

Winter is Coming: Help Your Elderly Clients and Loved Ones Stay Warm

“Winter is coming.” This phrase has been popularized by the TV series Game of Thrones, and it warns of the cold season when the villains of the story, the White Walkers, destroy lives and villages.

Having older people under your care can feel the same. While winter can be beautiful and nostalgic, the extreme cold can negatively affect elderly clients in many ways. The most serious consequence of exposure to cold is hypothermia, wherein the body temperature drops so low it causes injury to the body, or even death. Here is a simple refresher of why older people need to be protected from low temperatures:

1. The elderly can have more difficulty feeling the heat or cold in the environment. They might be freezing but are not aware of it.

2. Their body cannot properly control body temperature, so during winter the body cannot readily get warm.

3. The elderly with chronic diseases and those taking certain medications tend to be more affected by a cold environment.

4. Many elderly people are malnourished or dehydrated, and they can easily become sick because of the cold.

5. If they are inactive at home, they may not be dressed properly when they go outdoors.

6. Older people who have dementia may be more confused and wander, or walk aimlessly out of their home.

The dangers of winter for the elderly population are very real, so caregivers must prepare early and make sure that their clients are safe and have everything they need during harsh, colder months. Following are some helpful tips for caring for elderly people during winter:

1. Keep them indoors as much as possible.

2. Maintain a comfortable room temperature at 68-75° Fahrenheit (20-24° Celsius).

3. Close all windows and doors to avoid drafts.

4. Dress clients warmly in layers, while making sure that they can still move around comfortably.

5. In the morning, upon waking, they may need additional layers of clothing, as the body easily feels cold after a night’s rest.

6. At night, dress clients warmly and provide a warm blanket for them to use. Put socks on them, too.

7. Maintain proper nutrition and hydration. Soups and warm drinks can help keep clients warm.

8. Ensure that heaters have been checked recently and are working properly to prevent carbon monoxide poisoning, which can lead to death. Carbon monoxide is an odorless, poisonous gas that comes from burning fuel in engines, furnaces, and heaters.

9. When it is necessary to go outdoors, help clients put on a warm coat, wool clothes and socks, gloves, a hat, scarves, and ear muffs. If the cold is extreme, cover all exposed skin and use a scarf to cover their face.

10. Keep them actively moving, because being active keeps the body warmer.

11. Discourage them from consuming alcohol or drinks that have caffeine, because these drinks decrease circulation in the hands and feet.

12. If an elderly client appears cold, confused, has bluish fingers, and is less responsive, seek medical assistance immediately.

Hypothermia is a very dangerous consequence of exposure to low temperatures. The elderly population is especially at risk for hypothermia. When caregivers provide care during cold months, they must consistently work with the healthcare team to ensure that an older client is kept safe and warm.


Posted: 11/11/2019 2:28:53 PM

A Family Caregiver’s Guide to Transitioning Their Loved One from Home to a Facility

Being a family caregiver is a work of extreme dedication and sacrifice, and deciding to pass on your loved one’s care to another is a heart-wrenching, guilt-loaded decision that you sometimes have to make for their own sake.

But the decision to move is just a small part of the story. Actually taking them to a facility and living those first days and weeks after the transition takes the most of the adjustments from both the caregiver and the family member.

Trusting your loved one's care to a nursing home is never easy. Your loved one may be resentful of the idea in the first place, so allow yourself some bad times in the early phase. How will you manage during this nerve-racking experience?

First, you have to know what to expect.

Transitioning your loved one to a facility is a lot of work, so you may need someone else’s help on the first day. You have to carry all necessary documents and medical information that the facility may require.

Take your loved one’s personal belongings and some things that they are fond of, such as a family picture or a photo album.
Your loved one will most likely be uncomfortable in their new environment so accept their negative feelings as part of the adjustment period.

When you go home, there will be a mixed feeling of guilt, relief, and worry. You may expect to have a good night’s sleep only to find yourself worrying if your loved one is doing fine in their new home.

Your first visit will be emotional. You have missed your loved one, but you know that they are in good hands. You listen to their stories. Expect complaints as part of the stories but just keep on listening. This is an important part of transitioning because you must keep communication intact.

Also, expect that they may insist on going back home. Be ready to explain why they have to stay. Be prepared to offer a comforting hug, and provide reassurance that you will see to their welfare even if they are in the facility. Always end the visit with a positive emotion, so think of short walks or some coffee time before you go.

By the end of two weeks, you would have become familiar with their routine, as well as the staff in the nursing home. Now the idea of your loved one staying somewhere else is not as blurry as the first day. You begin to calm down your worries because as you think of them within the day, you’ll have an idea of what loved one is doing.

The second consideration when transitioning your loved one is to make them feel at home in their new environment.

Ask the staff if you can recreate the feel and comfort of your home by redecorating or redesigning their room if at all possible. Do not forget to bring them the things they need for their hobbies, and most importantly, their favorite music.

Lastly, expect to have care plan meetings with the staff.

Care plan meetings will summarize your loved one's experience in their new home as well as the goals that will improve their health. Your loved one will sit with you during some of the portions of the meeting because they are the most important participant of the team discussion.

The care team will discuss activities and treatments, including medications. Your loved one’s concerns will also be a topic. Be prepared to answer their questions as well as asking some questions yourself.

Transitioning your loved one to a nursing home is beginning a new chapter in your life as a family caregiver. The best that you can do after the move is to take care of yourself, continue cooperating with the healthcare team, and plan for frequent memorable visits.


Posted: 11/4/2019 2:43:03 PM

Seeing Nothing: Caring for the Visually Impaired

To most people, waking up each morning means seeing everything around you again; your family, the view outside your window, your pet, or just about any familiar object in your room. But there are those who could not open their eyes like this. Their ‘I woke up like this’ moment has taken a totally different meaning because they are blind or visually impaired. To some people with poor vision, there is no light even in the morning, only nothingness, much like the ‘back of your mind.' To some, it is like seeing through an eternal haze or a small hole.
Vision is something a lot of us take for granted. Imagine having to do everything with your eyes closed… A fun game maybe if done in a minute or so, but to experience this as an ordeal every day, blindness or poor vision could be a big pit of depression to fall into.

Caregivers must care for visually impaired patients with empathy and keep in mind the following great tips to let them go about their day feeling safe and accomplished.

1. KEEP THE PATIENT SAFE

Safety is a priority. For those who are just recently struggling with poor vision or blindness, it is frustrating to be unable to see the world as they used to. It is important to stay with them and support them in all their needs.

Remove clutter and anything that might get in their way around the house. Never keep a door ajar. Either close or completely open it or else they may bump into the edge of the door. If they rely on good lighting to adequately see, ensure that their surroundings are brightly lit. When rearranging furniture, inform the patient first and then indicate the new location of all the things that were moved.

If you are to walk with them, stay on their side while letting their hand hold your upper arm. If the path is narrow, inform the patient beforehand and step forward so that they automatically walk behind you.

If there is an immediate danger, say ‘stop!' rather than ‘watch out'. Always fully describe the patient's path, especially if there is a sudden need to step up, down, or to the side.

When it comes to being independent in activities of daily living, arrange their medications preferably in different containers, or in rectangular pillboxes with compartments. Read the expiration dates of medicines to them. While eating, if there is any hot soup, tell them the location of the hot soup using the clock-hand placement as a guide. Remind them that the soup is very hot. Also, do not fill their glasses up to the brim to prevent them from spilling their drink.

If they are walking with a guide dog, the dog must not be distracted. It should not be petted, fed, or interacted with. The animal is trained to lead, so it is good to just stay on the side and let the dog guide the patient.

Be the person’s shopping buddy by reading the label or tag for them, and helping them make choices in their purchases.

2. SHOW RESPECT

The right approach to helping a patient with vision problems is to greet them using their name and to identify yourself as a caregiver. Before entering their room, knock on the door and let them know that you wish to enter.

Do not assume that the blind or all those with poor vision would need help, so always ask them if they need assistance. If they do not accept your help, do not feel bad about it. Saying 'no' to your offer is just a sign that they are very independent and capable of doing things on their own.

When it is time to leave or stop the conversation, say that you need to go so that the conversation can be completed. When you need to ask something, address the patient directly and not their companion.

Caregivers must exercise patience when helping the visually impaired because it may take longer for them to do things.

3. BE THEIR EYES AND THEIR GUIDE

If something is going on, explain and describe what is happening. If the patient is eating, describe their food to them and tell which food is on what part of the plate. Use the placement of the hands of the clock to describe the arrangement of the food on the plate or the table.

If they want to be seated on a chair, let them hold the back of the chair, so they will know how to seat themselves.

Do not feel awkward using ordinary language to guide them as long as you are clear and specific. Of course, this also means not pointing at something and saying, ‘over there’ at the same time.

Always use the patient as the reference when referring to directions such as ‘left' and ‘right.’ When you are facing the patient ‘Take a step to the left,' means that they need to step to their left, not yours. Always anticipate the path and tell them to either step up or down or to keep their head low as appropriate.

4. ACCOMPANY THEM IN THEIR EYE CHECK UPS AND PROVIDE LOW VISION AIDS AND ASSISTIVE DEVICES IF NEEDED

A patient's vision may need to be checked regularly. A caregiver can help them by accompanying them to the vision center and then bringing all their medication records and other necessary documents. If vision aids are prescribed, the caregiver must ensure that they are available for the patient to use. They may need a white cane to help them walk, so the caregiver must provide them with one.

Caring for the blind or those with low vision may be challenging at first. But in due time after a lot of patience, the patient and the caregiver would be able to develop their own tempo of doing things so that both feel less stressed and more fulfilled. The most important role of the caregiver is to let the patient appreciate and experience the world through them.


Posted: 10/28/2019 2:29:34 PM

How to Be One Step Ahead at Preventing Falls

One in every four older Americans fall each year. Because of falls, one older adult dies every 19 minutes, so that about 27,000 deaths occur due to this accident each year, making falls the leading cause of death in this age group. It costs a total of $31 billion to cover the expenses for these injuries, and because the aging population is expected to grow in the coming years, these numbers are likely to double, too.

Due to fear of falling, many older adults choose to avoid social interactions and other important activities. As a result, they feel depressed, helpless, and isolated. Caregivers who are constantly with their patients must be aware of the danger of falls and must do everything to prevent injury because this is one of the best ways to preserve the patient's independence and maintain their health.

What can caregivers do to prevent falls in older patients? Here are some great tips to keep in mind:

1. OBSERVE THE PATIENT’S CONDITION FOR ANY SIGNS OF WEAKNESS OF LOSS OF BALANCE. A patient who is weak or has difficulty walking will hold on to walls or furniture for support. They will also stand or walk with a wobble. Knowing their level of weakness can help the caregiver decide the extent of independence the patient can have or the amount of supervision needed.

2. MAKE SURE THE PATIENT RECEIVES A REGULAR EYE CHECK UP AND THAT EYEWEAR IS ALWAYS AVAILABLE TO THEM WHEN NEEDED.
Older people usually have poor vision due to aging and other causes such as diabetes and cataracts. When the patient cannot see clearly, they fall because they lose their balance and do not see the hazards in their surroundings that could cause them to trip.

3. ALWAYS MAKE SURE THAT A CALL BELL OR CALL LIGHT IS NEAR. An elderly patient who has difficulty moving must always have a call bell or a call light to signal that they need help when moving or transferring.

4. CHECK THEIR REQUIREMENTS FOR A PORTABLE TOILET OR URINAL. Incontinence is one of the reasons why older people fall. A patient who is incontinent will hurry to reach the toilet in time, and in doing so, may fall.

5. TEACH PATIENTS TRANSFER TECHNIQUES. Patients who are still independent in moving around must be taught how to move about safely, especially when getting off the bed or using the wheelchair. As a general rule, let the patient get up from the bed slowly and have them dangle their feet by the side before getting off the bed. The wheels of the wheelchair should also be locked before transferring to it.

6. REMOVE CLUTTER AND OTHER HAZARDS. The caregiver must check the home or surroundings for things that can cause falls in the elderly such as items that block paths or items that are scattered on the floor. Examples of these hazards are throw rugs and things that can get in the way such as footstools, and loose electrical cords.

7. ENSURE ADEQUATE LIGHTING. Poor vision and inadequate lighting is a perfect recipe for falls in the older person. So keep outdoor pathways and indoor hallways brightly lit.

8. INSTALL GRAB BARS IN THE SHOWER. Grab bars provide support that a patient can hold on to while standing, sitting, or keeping themselves balanced. Caregivers must check if grab bars are installed in the shower and the toilet.

9. CHOOSE A RESIDENCE WITHOUT STAIRS IF AT ALL POSSIBLE. Climbing up and down stairs is a struggle for older people. The best home for patients would be a one-story house without stairs.

10. REVIEW THE PATIENT’S MEDICATIONS. Older patients usually take several medications. The caregiver must know if any medications cause dizziness, blurry vision, or have any side effects that can affect the patient's movement and balance.

11. IF THE PATIENT NEEDS TO REMAIN IN BED, ADJUST THE BED FOR SAFETY. To do this, lower the bed to its lowest position, raise the side rails, and lock the wheels of the bed.

Falls can take away an older person's life. Caregivers must take extra care in preventing falls at all costs. Making sure that an elderly person or patient is kept safe as they move, walk, or transfer is one of the best ways of showing that you care.