Once man, Twice a child

Tue, Aug 11th 2015, 11:49 AM

While the attention is often on the elderly relative who needs help because they’re getting on in age and have limitations, the caregivers who take care of them should also seek help to ensure that they too remain healthy, according to a general practitioner.

“We are noticing a lot of fractures in families, because as people get into declining state of health, invariably it ends up falling on just one member of the family to do most of the care, so I think some of the real heroes that we see in this country are the people who actually take the time to feed, bathe and turn, and who really take care of their parents,” said family medicine specialist Dr. Patrick Whitfield who practices out of Chesapeake Comprehensive Care, Alexander Street.

“It goes back to the adage — once a man, twice a child — you invariably almost go back to how you were when you were a baby, so the same things that people have to do for a baby, they have to do for the elderly. The unfortunate part is we are finding more and more that the stress and strain tends to end up on just one person because siblings and other relatives have other things to do, or have other commitments, so they can’t really help. The whole brunt falls on one person and that is very taxing to that person.”

Over the next 10 years, Dr. Whitfield said it is expected that the frequency of dementia will increase at least by 25 to 30 percent due to the baby boomer generation advancing into the elderly age group. With people living longer, he said 50 to 60 percent of people who attain their 80th birthday will have varying degrees of Alzheimer’s which is a fatal disease and for which there is no cure. It’s a disease h that see sufferers simply get worse and worse until they die. Until they die, someone will have to care for them.

In most instances, he said caregivers don’t have training in their role taking care of a relative with declining health, and that they simply learn as they go how to take care of elderly relatives with dementia and terminal cancers. But the doctor offered insights and tips in terms caregivers can engage to guard their own mental, physical and financial health as they care for aging relatives and make life easier for themselves.

The doctor says caregivers should ask questions, create a schedule, get organized, keep track of medications, simplify meals, make the home environment safe, ask for advice, recruit a team, encourage self care and prepare for emergencies and plan for the unexpected.

Ask questions

“Ask questions of your loved ones so you can give them the best care you can. Set aside a time to talk, find out how they’re feeling, or if there is anything they want you to do for them. Don’t argue and insist that your opinion is the best. Show that you heard what they’re saying by simply repeating what they said, so you can make them feel like they’re involved in their care.”

Dr. Whitfield said what happens in most instances is that caregivers decide what the elderly relative needs and what they don’t need and doesn’t sit down and talk with them and ask questions to find out exactly what their needs are.

Create a schedule

“You need to give some structure to your schedule — set time for meals, for personal care, for household chores, set sleep and wake times to ensure they get enough rest. Basically you organize a schedule rather than just letting it flow.”

Get organized

As paperwork can pile up, the doctor said caregivers should keep prescriptions in a safe place where they know to find them. He said creating a folder, whether it’s a physical folder or an electronic document with information for insurance, National Insurance number and doctor contacts is important. That folder should also have information on medical appointments.

“Get organized so you don’t have to be looking around for stuff. Keep information readily available.”

Keep track of medications

“Most older people take at least four or five different medications for different conditions — Alzheimer’s arthritis, blood pressure, diabetes, and if you don’t keep them in an orderly fashion you can get mixed up and cause mistakes. Go over the list of your relative’s medications with the doctor and pharmacist to make sure you have the correct dosage and how long they’re supposed to be on it for. Ensure that you store all their medications in one place so it’s easy access, and you don’t have to go all around the house to find the medications. And at least once every two to three months, make sure to throw away any expired medication.”

Simplify meals

When it comes to meals, Dr. Whitfield said planning ahead is important to caregivers. He said all grocery shopping should be done in one trip, and that they should try to cook a batch of meals and freeze them that can be thawed as needed. He said they could also seek help from family members and friends with preparing meals, and setting up a schedule for people who can’t help with daily care to supply those meals. Before any meals are prepared, the doctor said the caregiver should find out from the doctor whether the patient has any dietary restrictions.

Make the home safe

The doctor encourages the installation of grab bars and handrails in the bathroom. He says one of the most dangerous things that can happen is if an elderly person slips in the tub and can fracture their hip which could immobilize them for up to three-four months, which is high risk because the longer they’re immobilized, the more complications they can get.

“Because of their age, their bones get thinner, so it’s a lot easier for them to get fractures. If anything spills on the floor, clean it up right away and properly so they don’t slip; secure rugs with tape, pick up clutter off the floor, because when they’re walking and slip on something that could be a major issue.”

Ask for advice

Caregivers, especially those people in the caregiving role for the first time should ask for advice as they have a lot to learn.

“Ask for advice, specifically as it relates to bathing, and dressing, how you manage the bladder and bowel problems, how to lift safely so you don’t hurt your back and more importantly so you don’t hurt your relative’s back, and talk to someone about what needs to be done to adapt the home for safety.”

He said they could talk to someone who has had experience such as a caregiver, or the doctor about the care that would be needed. He said they could also need advice on how to make meals that the elderly can consume.

“If you’ve never done it before, you just can’t go into it and say you’re going to use common sense,” said Dr. Whitfield.

Recruit a team

For those persons finding the role of caregiver overwhelming, and not being able to handle it themselves, Dr. Whitfield encourages them to put together an on-call group of family members or friends who can step in and help with preparing meals and running errands whenever needed.

Encourage self-care

“One of the main things that happens to elderly people is loss of self-esteem. Nobody likes to feel totally dependent, and they need to have some degree of feeling of still having some degree of control,” he said. “What you try to do is encourage them to make decisions. If they can dress themselves, allow them to dress themselves. If they can use the toilet by themselves, then give them that opportunity. Let them choose what they can and cannot do.”

According to Dr. Whitfield, self-esteem and independence is the last thing that elderly people hold on to. He said if an elderly relative can do something, he encourages the caregiver to allow them to do it. He said to try to not totally make them dependent, because once somebody loses their self-esteem and their sense of independence that they can take them down the hill and they die sooner rather.

Prepare for emergencies/plan for the unexpected

According to the doctor caregivers should make it a point to speak with the relative’s doctor as to what symptoms they should look out for that would alert them to having to take the person to hospital, like chest pain, trouble breathing, dizziness and let the doctor explain what they should do. Next to the phone in you house, he said, should be a list of all emergency names and numbers — ambulance, doctor and family and friends. By engaging the tips, Dr. Whitfield said caregivers could retain their sanity, as he said it’s the lack of preparation that can cause them to feel like they are losing their sanity due to mental, physical and financial strain.

“You might have your own family to deal with, but in addition to that, if you’re constantly giving attention to your loved ones, it can be mentally draining. You may have situations where you have a person waking up in the middle of the night and constantly talking; they may have a lot of pain and scream out in the middle of the night; so you can go for very long periods of time without getting enough sleep, so you get headaches, fatigue and tiredness in the midst of your loved one suffering. In terms of the caregiver himself it can amount to an enormous toll mentally and physically. Then financially it can affect people because they’re not going to work, having to take time off because they can’t afford to hire a nurse or can’t find people who are going to stay home with their relative while they go to work. And then you have to be careful who you let into your house because you don’t know how they’re going to treat your loved one,” he said. “So fatigue, depression, headaches and lack of sleep is suffered by the caregiver and that could influence their blood pressure, so it’s very taxing on them.”

When caring for an elderly relative, the doctor said caregivers should also ensure that they speak to them about financial and legal issues, including a living will and financial status. And if the relative is lucid, he said they should be asked to locate documentation that includes their birth certificate, NIB card, property deeds and marriage certificates for safekeeping.

10 tips for caregivers-

Ask questions.

Create a schedule.

Get organized.

Keep track of medications.

Simplify meals.

Make home safe.

Ask for advice.

Recruit a team.

Encourage self-care.

Prepare for emergencies and plan for the unexpected.

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