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shaving, caring for the skin, hair and mouth, and transferring (moving
from chairs, toilets or bed). During the course of our daily lives these
activities are taken for granted until weakness or a disability makes them
difficult to accomplish independently or safely. Providing assistance requires
knowledge, patience, skill and physical strength.
an older person may require strength, special equipment and skills. It
is advised that caregivers ask the elderly person's doctor and.or physical
therapist for special instructions on how to safely bathe the care-receiver.
and Shaving: Visits to a barber or hairdresser are very positive experiences.
Individuals who provide this service will often come to the home. Wetting
hair with alcohol or cream rinse helps to remove the snarls. Dry shampoos
are available if your family member is bed bound. People who are diabetic
or on medication to thin the blood (anti-coagulants, i.e., Coumadin) should
use an electric shaver to reduce the risk of cuts. It is much easier and
safer to shave another person with an electric razor.
- Keep skin
clean and dry, especially when people are having problems with bowel and
bladder control. When washing, use a mild soap, rinse well, and dry thoroughly.
- Keep bed
linens clean, dry and free of wrinkles. Disposable bed pads can be purchased
at a drug store and can keep sheets dry so that the caregiver does not
have to change sheets so often.
- Massage skin
gently using a light, circular motion. Change the position of older people
at least every two hours, particularly for those confined to a bed or wheelchair.
Encourage them to shift their weight between position changes to redistribute
pressure onto other areas.
good nutrition and adequate fluid intake. As a supplement to your family
member's diet, give a multi-vitamin every day to ensure proper nutrition.
Check with the physician as to the appropriate supplement.
- Use mattress
and chairs that are soft and form-fitting rather than rigid and hard. (Example:
egg crate mattress and sheep skin). This spreads the weight over a larger
skin area, decreasing the pressure under the bones.
movement or mild exercise; this helps stimulate circulation which is good
for the skin. Combing hair and helping with bathing and dressing are good
ways for frail people to get exercise and be more independent.
- Watch for
possible sources of pressure on anything that would interfere with good
circulation, such as tight shoes, elastic cuffed socks or tight undergarments.
- Bony prominences
are prone to skin breakdown. They are heels, feet, behind the knees, hips,
buttocks, sacrum, elbows and shoulder blades. A special air mattress may
be ordered by the doctor to prevent skin breakdown.
- Watch for
any redness or a break in the skin and report it immediately to the doctor
or nurse, and keep the care-receiver off the affected side.
- Safety features
in the bathroom, such as grab bars and raised toilet seats, make using
the bathroom safer.
- A commode
or urinal may be necessary when flexibility and distance to the bathroom
are a problem. They may be especially helpful at night.
- Lack of control
over bowel or bladder functions can be embarrassing and older people may
try to hide it from caregivers and professionals. Be sensitive to the older
person's feelings, and mention this to the doctor. Loss of bowel and bladder
control is not a part of normal aging and often can be controlled.
- For the care-receiver
with bowel and/or bladder problems it may help to take them to the bathroom
every 2 hours. Specialized programs exist to retrain a bladder and bowel
function. Check with your doctor or nurse for a program in your area.
or Irregularity: Many elderly become constipated due to medications and
inactivity. If your care-receiver is experiencing this problem the doctor
or nurse can suggest a stool softener. Other important factors are:
- Eat plenty
of fresh fruit, vegetables and foods high in fibers.
- Drink at
least 8 glasses of water a day.
- Avoid constipating
foods like cheese, rice, bananas, etc.
as much as is tolerated.
- Be sure your
doctor is aware of all the medications being taken.
be very time-consuming, especially if the older person must be fed. Encouraging
independent eating saves time for caregivers, and promotes the independence
and self-worth of the older person. Try to relax yourself and enjoy the
time spent with your care-receiver. Here are some suggestions for encouraging
- Check gums
for areas of redness. Dentures may not fit correctly and cause the family
member pain when chewing.
- Provide adaptive
equipment such as plate guards or special silverware with built-up handles.
These can be purchased from medical supply houses (listed under Hospital
Equipment and Supplies in the Yellow Pages). An occupational therapy evaluation
can recommend the best for each individual.
- Prepare finger
foods which may be easier to eat than those requiring utensils.
older people to use a straw, cups with 2 handles, or a glass with ribbed
surface for independent drinking.
- If the older
adult has limited vision, consistent place setting of food and utensils
helps to know where to find silverware, beverage, etc. Using the clock
method to locate food may be helpful; for example, Your meat is at 9 o'clock,
your potato is at 12 o'clock and your carrots are at 3 o'clock.
Treat older people who are being fed as adults, not children. Disciplining
poor eating habits should be avoided. When they lack interest in food,
try to learn the reason. For example, ask if they are thirsty or not feeling
well, or if the food in not appetizing on this occasion.
Moving people who cannot move safely by themselves requires skill, knowledge,
and some strength. For every type of disability, there is a specific technique
to use. Ask a doctor, therapist or attend caregiver training for specific
techniques. In all cases, remember:
- When lifting,
do not add your own weight to whatever you are lifting -- get close and
keep balance centered.
- Do not use
weak back muscles to lift - use your leg muscles because they are much
- Do not twist
when you are lifting - instead, change the position of your feet so that
you face the older person, keeping your spine straight.
- Balance is
vital - spread your feet to serve as a base for support.
- Your doctor
can refer you to a physical therapist who can teach you to transfer safely.
Rest and Sleep:
As we age, our sleep patterns change. The elderly require less sleep time.
It takes longer for them to fall asleep. Also, awakenings during the night
increase. Scheduled rest times are important. A few naps during the day
can refresh and revitalize the care-receiver. However, if you notice that
your care-receiver is sleeping for brief periods during the night, it could
indicate a problem. Notify your doctor and discuss your concerns.
Tips for Encouraging
- Allow the
care-receiver to do as much as possible; provide only as much help as needed.
When older people do all or part of their own personal care, it is a form
of exercise that will help maintain strength as well as promote independence.
No matter how small the activity (holding the soap, combing the front of
the hair, etc.) it is important that the person be able to participate.
- Adapt the
home to allow the care-receiver to do more things. Install equipment such
as grab rails in the bathroom, wheelchair-accessible sinks and mirrors,
bath bench for the shower or tub, and lights with switches that can be
- Seek the
aid of therapists or nurses to teach you how to perform personal care tasks
safely and effectively.
- Learn about
the care-receiver's disability and what you and others can do to help him/her
function as independently as possible. If the older person cannot perform
a certain activity, see if there is a part that can be done. For example,
one might be able to independently dress the upper body if sitting, but
require help dressing the lower body.
possible, include the care-receiver in making plans for his/her care. Take
suggestions and feelings into consideration and encourage involvement in
his/her own care. Sometimes, slowing the pace of an activity allows older
people to do more for themselves.
Be aware of
changes in the care-receiver's health and abilities. Your plans for care
will change as the care receiver changes.