Friday, October 12, 2012

Determing the Level of Care Needed

What are ADLs?
One of the most important ways of determining the Level of Care you need for a loved one is the number of ADLs they need assistance with along with the amount of assistance needed.

ADLs are Activities of Daily Living
They include the basic levels of self care; ambulation, feeding, dressing, bowel and bladder management (toileting), transfers (bed, toilet, wheelchair) and hygiene/grooming.

How Much Assistance is Needed?
Your loved one may be able to walk, but needs to use a walker, and must have help going up or down stairs. He can feed himself, but needs help preparing meals and cleaning up. He can dress himself if someone helps select his clothing and assists him with his socks and shoes. He can get undressed by himself. He needs help with bathing as he can't get in and out of the tub alone. He is able to use the toilet, but occasionally has accidents if he waits too long to go. Reminders would help.

Many private care, non-medical service agencies offer a wake-up and /or good-night care from a CNA (certified nursing assistant) or HHA(home health aide). wake-up careis comprised of a visit in the morning to help clients get ready for the day including grooming and hygiene which could include bathing if desired and dressing. The aide can prepare and serve a morning meal, and perhaps make a sandwich to be eaten at lunch.

The good-night care would be for bathing or bedtime care. Perhaps it could be scheduled to include meal prep for dinner or an evening snack. Or it can be schedule later in the  evening  and the aide can then tuck the patient in bed and make sure lights are out and the house is closed up and locked for the night.

Medication reminders can be given, but the medications have to be prepared in a med box, or the client able to dispense on his own from the prescription bottles. Only licensed nurses (RNs or LPNs)  can dispense medications. Medications can be set up in a med box and labeled by family members. Med boxes are available for once a day dispensing or with multiple sections for several doses a day.

If your loved one needs assistance with IADLs (Instrumental ADLs) such as housework, meal preparation, shopping, managing money, using the telephone, or using transportation you may need to hire care for more hours/day or days/week. Other IADLs can include safety and caring for pets or others such as a spouse. These issues can require even more care.

Make a list of tasks that are essential for someone else to help your loved one with, and those which you can assist with, and discuss with the caregiving agency.

Tips for Hiring
My best advise is to make sure you're hiring from a licensed and bonded agency. Not all agencies are created equal and not all are required to be licensed by your state. Licensed agencies are overseen and required to adhere to state requirements and standards of care for hiring and supervision to ensure safe, quality caregiving. Unlicensed agencies are not overseen to ensure that they adhere to standards of care. Some may provide excellent care, but if they don't there's no one to answer to. A licensed agency will have experienced nurses and personnel to assist you with selecting the type of care needed; where as the unlicensed agency may be run by a lay person with no caregiving experience.

If you hire privately, be sure to check references and have them demonstrate how they will assist your loved one with ADLs before hiring. You should observe any caregiver in the care they provide to ensure they meet your expectations.

Additional reading...
You Won't Know What You Don't Know
Aids to Help Keep Aging Family Safe


Tuesday, September 11, 2012

Never Forget

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Thursday, August 9, 2012

You Won't Know What You Don't Know...

At the risk of sounding too much like Yogi Berra (famous catcher for the Yankees), when it comes to caring for aging parents and loved ones, you won't know what you don't know until you know it.

We learned very quickly when we had children that they don't come with an instruction book. Parenting is about winging it most of the time, and sharing your successes and failures with your peers.

In the same way, aging loved ones don't come with instructions either. And many of the predicaments can be much more difficult to maneuver. In many ways it becomes even more important  to network with friends, family, co-workers, etc. to learn what they know that once they didn't know they needed to know either.


This is just one of the reasons I wrote the book The Everything Guide to Caring for Aging Parents; to share my experiences from both sides of the fence. As a home health and hospice nurse for over 30 years, I think I've seen and helped families cope with almost every scenario. And as a daughter/daughter-in-law with aging parents, I have lived through many of these experiences myself.  I hope you find it helpful!


Friday, July 27, 2012

Yogic Meditation Reduces Caregiver's Depression and Risks

Researchers at UCLA recently noted that caregivers caring for elderly with Alzheimer's dementia can improve their cognitive function and lower their own depression and mental and physical health risks and issues through a specific yogic meditation called Kirtan Kriya. 

By practicing this meditation researchers "found that meditation from yoga can help lower depression in caregivers, and may also improve their cognitive functioning. The researchers even found that the meditation was associated with a decrease in cellular aging from stress."

Wednesday, July 4, 2012

Happy 4th!

Wishing everyone a happy safe and sane 4th of JULY as America celebrates another birthday!


Thursday, June 14, 2012

Aids to Help Keep Aging Family Safe and Active

There are a multitude of items available on the market to assist aging people remain as independent and safe as possible. One of the better inventions is the rolling walker with the seat. Sometimes I want to borrow my mom's if I'm going to be somewhere where I need to stand for a long period of time. 

Be aware though that it's not a device to lean back and take a nap. Mom slid right out and on to the floor when she decided to just lean back and relax. Wasn't hurt, but surprised her.

Some of the other great tools include an "Economy Aluminum Shaft Reacher" for grabbing things from high spots, or picking up the newspaper off the ground. "Sock and Stocking Aid with Cord Loop" is great for putting on socks when the body just won't bend like it used to.

Raised toilet seats, commode chairs, bathtub benches, grab bars, gait belts, over bed tables,  hoyer lifts, overbed trapeze bars, hospital beds, tab alarms, wheel chairs, and a large variety of incontinence supplies (diapers, pullups, chux) etc. are widely available to help with the safety and Activities of Daily Living (ADLs) for our aging family and friends.


It may not be an App, but if there's a need, there's a device to help keep your loved ones active and safe.



Find a Hearing Specialist near you for your loved ones with Healthy Hearing.


Thursday, April 26, 2012

More Information About End of Life Decisions

Learn more about speaking with your loved ones about comfort care and end of life decisions...