At My Fingertips

The day caregiving got easier

admin — Tue, 12 Jul 2011 19:21:31 +0000


I remember the day that caregiving became dramatically easier. It wasn’t at the beginning of my caregiving journey with Dad. Initially, getting Dad to adopt my caregiving solutions was difficult to say the least. You see, Dad was an electrical engineer. And anyone who lives with an engineer knows that this isn’t just a vocational choice – it is an integral part of the way he approaches the world. Dad was rational, systematic, and always sought the easiest and best way to accomplish a task. My mistakes As his caregiver, I thought the best way to solve problems for him was to do what he did – think through the problem. Do some research if necessary. Find what appeared to be the best solution. Then just tell Dad how best to accomplish the task. After all, that is the engineering thing to do. If you have been the caregiver of someone who is not suffering from dementia, you probably already spotted my mistakes. I was trying to solve problems for Dad. Plus, I was telling Dad what to do. Caregivers often say how they have assumed the role of parent in their relationship with their aging parents. In a sense that’s true. We have to look out for their safety, health, wellbeing, comfort, and, at times, the most basic of needs, much as a parent does for a child. With our parents, though, we aren’t dealing with children who have no life experience to guide their choices. Parents and older adults have decades of experience making choices for others and certainly for themselves. The break through So how did caregiving become easier for me? One day, instead of telling Dad that he had to wear his elastic stockings, I asked him. Much to my surprise, I learned that the stocking were so tight they caused him a great deal of pain. And the pain came not only when wearing the stockings, but also when the stocking were removed. You see even though Dad was lying down after his stocking were removed, fluid moving back into his legs was extremely painful. We agreed to talk with his doctors about the pain. One doctor recommended elastic bandages instead of stockings – a solution that worked well for him for years. Another doctor suggested raising his legs for half an hour after we removed the bandages. This allowed the fluid to move back into his legs more slowly and practically eliminated the pain. The lesson I also learned an important lesson. I no longer told Dad what to do. I asked. We discussed his needs and solutions. I offered choices. I learned to accept his decisions. The power of choice People most often see choice as making a decision between something that is good and something that is bad. For caregivers and their loved ones, choice is rarely that clear. As caregivers, as much as we would like to offer choices that physically and emotionally feel good, the choices we offer must be based in reality. And in reality there are often no good choices – just choices between solutions that are equally unwelcome. For the care receiver, though, the simple act of choosing can make the unwelcome tolerable. They have the dignity of making the decisions on what affects their lives. Choice also makes caregiving a partnership. While the caregiver’s responsibility is not lessened, it allows the ultimate responsibility to rest with the care receiver, as it should. As long as an adult can function cognitively, he or she has the right to make the choices for their own welfare. As caregivers, we have the obligation to respect those choices even if we would not choose them for ourselves. I highly recommend partnering with your loved one. Offer choices. Enjoy the reduced resistance, improved relationship, understanding, and mutual respect your collaborative efforts bring. It can go a long way toward making caregiving easier. Have you experienced the power of choice in caregiving?

I remember the day that caregiving became dramatically easier. It wasn’t at the beginning of my caregiving journey with Dad. Initially, getting Dad to adopt my caregiving solutions was difficult to say the least. You see, Dad was an electrical engineer. And anyone who lives with an engineer knows that this isn’t just a vocational choice – it is an integral part of the way he approaches the world. Dad was rational, systematic, and always sought the easiest and best way to accomplish a task.

My mistakes
As his caregiver, I thought the best way to solve problems for him was to do what he did – think through the problem. Do some research if necessary. Find what appeared to be the best solution. Then just tell Dad how best to accomplish the task. After all, that is the engineering thing to do.

If you have been the caregiver of someone who is not suffering from dementia, you probably already spotted my mistakes. I was trying to solve problems for Dad. Plus, I was telling Dad what to do.

Caregivers often say how they have assumed the role of parent in their relationship with their aging parents. In a sense that’s true. We have to look out for their safety, health, wellbeing, comfort, and, at times, the most basic of needs, much as a parent does for a child. With our parents, though, we aren’t dealing with children who have no life experience to guide their choices. Parents and older adults have decades of experience making choices for others and certainly for themselves.

The break through
So how did caregiving become easier for me? One day, instead of telling Dad that he had to wear his elastic stockings, I asked him. Much to my surprise, I learned that the stocking were so tight they caused him a great deal of pain. And the pain came not only when wearing the stockings, but also when the stocking were removed. You see even though Dad was lying down after his stocking were removed, fluid moving back into his legs was extremely painful. We agreed to talk with his doctors about the pain. One doctor recommended elastic bandages instead of stockings – a solution that worked well for him for years. Another doctor suggested raising his legs for half an hour after we removed the bandages. This allowed the fluid to move back into his legs more slowly and practically eliminated the pain.

The lesson
I also learned an important lesson. I no longer told Dad what to do. I asked. We discussed his needs and solutions. I offered choices. I learned to accept his decisions.

The power of choice
People most often see choice as making a decision between something that is good and something that is bad. For caregivers and their loved ones, choice is rarely that clear. As caregivers, as much as we would like to offer choices that physically and emotionally feel good, the choices we offer must be based in reality. And in reality there are often no good choices – just choices between solutions that are equally unwelcome. For the care receiver, though, the simple act of choosing can make the unwelcome tolerable. They have the dignity of making the decisions on what affects their lives.

Choice also makes caregiving a partnership. While the caregiver’s responsibility is not lessened, it allows the ultimate responsibility to rest with the care receiver, as it should. As long as an adult can function cognitively, he or she has the right to make the choices for their own welfare. As caregivers, we have the obligation to respect those choices even if we would not choose them for ourselves.

I highly recommend partnering with your loved one. Offer choices. Enjoy the reduced resistance, improved relationship, understanding, and mutual respect your collaborative efforts bring. It can go a long way toward making caregiving easier.

Have you experienced the power of choice in caregiving?

Medication dos and don’ts

admin — Sun, 03 Jul 2011 16:30:35 +0000


Managing medications was one of my greater challenges when taking care of Dad. Between prescriptions, over the counter drugs, and vitamins, he took 25 different medications a day. Watching his nurses, who trained in medication management, struggle to ensure that he received each dose of medication correctly throughout the day, made me realize that medication management is a challenge we all face, family caregiver and professional alike. Medication safety is a major concern for caregivers. While medications can help keep your loved one healthy, they also can cause serious problems. When your loved one takes a number of medications, there is a greater chance that the drugs will interact negatively with each other. There also is a greater risk of forgetting to take medications, taking them at the wrong time, or taking too much or too little. If your loved one is aged 65 and older, they are more prone to taking medications incorrectly. Additionally, they are more likely to use multiple medications. They may also have more difficulty handling medications and understanding instructions due to declining vision, hearing, and memory. A number of dos and don’ts can help you to get a handle on medication management for your loved one. Medication Dos DO make sure that all your loved one’s doctors know about all of you loved one’s medications. An easy way to accomplish this is to keep an up to date medication list in your personal health record. Then make a copy of the list and give it to each of your doctors. In addition to prescriptions, include any over the counter drugs, vitamins, supplements, and herbs. DO make sure that your loved one takes each medication exactly as it has been prescribed. You need to know the purpose of each medication; the amount to take and how often to take it; the best time to take it; whether to take it with or without food; and any storage requirements. It’s also helpful to know potential side effects and what to do if they occur. DO read the precaution stickers on the label and follow their instructions. Ask your pharmacist to explain the precautions, as well as for tips about using the medicine. DO let doctors know immediately about any side effects such as upset stomach, diarrhea, difficulty urinating, constipation, forgetfulness, skin irritation, dizziness, etc. that your loved one experiences, especially after starting any new medication. DO try to use the same pharmacy to fill all the prescriptions so that they can help you keep track of everything your loved one is taking. DO talk to your loved one’s doctor or pharmacist before adding over the counter medication, vitamins, and supplements to avoid an interaction with another drug your loved one is taking. DO keep all medications out of the reach of children. Five Medication Don’ts: DON’T change your medication dose or schedule without talking with your doctor. DON’T use medication prescribed for someone else. DON’T crush or break pills unless your loved one’s doctor instructs you to do so. DON’T use medication that has passed its expiration date. DON’T store your loved one’s medications in locations that are either too hot or too cold. For example, the bathroom cabinet may not be the best place for your medication. You will find more help on managing medications in Medicines and You: A Guide for Older Adults, which is available from eldercare.gov. For information on personal health records see my earlier post on the Benefits of a Personal Health Record. Have you discovered other dos and don’ts for managing medications?

Managing medications was one of my greater challenges when taking care of Dad. Between prescriptions, over the counter drugs, and vitamins, he took 25 different medications a day. Watching his nurses, who trained in medication management, struggle to ensure that he received each dose of medication correctly throughout the day, made me realize that medication management is a challenge we all face, family caregiver and professional alike.

Medication safety is a major concern for caregivers. While medications can help keep your loved one healthy, they also can cause serious problems. When your loved one takes a number of medications, there is a greater chance that the drugs will interact negatively with each other. There also is a greater risk of forgetting to take medications, taking them at the wrong time, or taking too much or too little.

If your loved one is aged 65 and older, they are more prone to taking medications incorrectly. Additionally, they are more likely to use multiple medications. They may also have more difficulty handling medications and understanding instructions due to declining vision, hearing, and memory.

A number of dos and don’ts can help you to get a handle on medication management for your loved one.

Medication Dos

DO make sure that all your loved one’s doctors know about all of you loved one’s medications. An easy way to accomplish this is to keep an up to date medication list in your personal health record. Then make a copy of the list and give it to each of your doctors. In addition to prescriptions, include any over the counter drugs, vitamins, supplements, and herbs.
DO make sure that your loved one takes each medication exactly as it has been prescribed. You need to know the purpose of each medication; the amount to take and how often to take it; the best time to take it; whether to take it with or without food; and any storage requirements. It’s also helpful to know potential side effects and what to do if they occur.
DO read the precaution stickers on the label and follow their instructions. Ask your pharmacist to explain the precautions, as well as for tips about using the medicine.
DO let doctors know immediately about any side effects such as upset stomach, diarrhea, difficulty urinating, constipation, forgetfulness, skin irritation, dizziness, etc. that your loved one experiences, especially after starting any new medication.
DO try to use the same pharmacy to fill all the prescriptions so that they can help you keep track of everything your loved one is taking.
DO talk to your loved one’s doctor or pharmacist before adding over the counter medication, vitamins, and supplements to avoid an interaction with another drug your loved one is taking.
DO keep all medications out of the reach of children.

Five Medication Don’ts:

DON’T change your medication dose or schedule without talking with your doctor.
DON’T use medication prescribed for someone else.
DON’T crush or break pills unless your loved one’s doctor instructs you to do so.
DON’T use medication that has passed its expiration date.
DON’T store your loved one’s medications in locations that are either too hot or too cold. For example, the bathroom cabinet may not be the best place for your medication.

You will find more help on managing medications in Medicines and You: A Guide for Older Adults, which is available from eldercare.gov.

For information on personal health records see my earlier post on the Benefits of a Personal Health Record.

Have you discovered other dos and don’ts for managing medications?

Benefits of a Personal Health Record

admin — Sun, 26 Jun 2011 21:48:04 +0000


After Dad suffered a series of medical problems, I dropped abruptly into the role of providing accurate information to healthcare providers. Those were scary times with major decisions to make. Unfortunately, I knew very little about Dad’s health issues, medical insurance, and doctors. I scrambled for information through crisis after crisis until I made up my mind to put Dad’s health information into one place – his Personal Health Record. What is a Personal Health Record? A Personal Health Record (PHR) is a system you create to manage health information for you or your loved one. A PHR can be a paper based system or you can use a computer based digital system. The paper method is low cost, reliable, and accessible without the need for a computer or any other hardware. A digital system is easy to update. You can carry your PHR with you on a USB drive and print out copies for healthcare providers. What information should be in a PHR? To have the information you need for a variety of medical circumstances your PHR should have the following information: Personal information – name, address, phone, email, social security number Insurance and provider information – include phone numbers and addresses Information for emergency contacts Current Conditions – condition, date diagnosed, treating doctor Current Medications – name of the medication, dose, frequency Pertinent Test Results – test, date, results, purpose, measurer Allergies Immunization history Surgical History Current Health Risks and Family History Information on medical devices – especially implantable devices such as a pacemaker Living will and organ donor instructions One of the main reasons people hesitate to create a personal health record is that they think it’s too time consuming. Starting slowly with basic personal and insurance information, and a medication list, will help almost immediately with each doctor visit or during an emergency. Then gradually add additional information as healthcare providers request it. Soon, you will have the information you need and will start seeing the benefits of all your hard work. Benefits of a PHR You will find your PHR helps you in many ways: Save time – finding the information you need in one place Know that important information is not forgotten Increase your sense of control over health Promote better health management by using a systematic approach to healthcare Avoid duplicate tests Support timely, appropriate preventive services Ease the transition when changing or consulting a new doctor Provide current and accurate information for doctors and the medical team so that their decisions are based on current information Verify the accuracy of information in provider records Support continuity of care across time and providers Improve communication so that it is easier to ask questions, to set up appointments, to request refills and referrals, and to report problems. Support understanding and appropriate use of medications Reduce adverse drug interactions and allergic reactions Have information to manage long distance caregiving Provide emergency information quickly and accurately Creating a PHR You can create a PHR yourself and store your information in a three-ring notebook. You might find it easier to create your lists on your computer in a word processing program like Microsoft Word. There are also a number of PHR systems available for purchase. To see the PHR I created for my Dad, visit http://www.atmyfingertips.us.com/ How have you benefited from your PHR?

After Dad suffered a series of medical problems, I dropped abruptly into the role of providing accurate information to healthcare providers. Those were scary times with major decisions to make. Unfortunately, I knew very little about Dad’s health issues, medical insurance, and doctors. I scrambled for information through crisis after crisis until I made up my mind to put Dad’s health information into one place – his Personal Health Record.

What is a Personal Health Record?
A Personal Health Record (PHR) is a system you create to manage health information for you or your loved one. A PHR can be a paper based system or you can use a computer based digital system. The paper method is low cost, reliable, and accessible without the need for a computer or any other hardware. A digital system is easy to update. You can carry your PHR with you on a USB drive and print out copies for healthcare providers.

What information should be in a PHR?
To have the information you need for a variety of medical circumstances your PHR should have the following information:

Personal information – name, address, phone, email, social security number
Insurance and provider information – include phone numbers and addresses
Information for emergency contacts
Current Conditions – condition, date diagnosed, treating doctor
Current Medications – name of the medication, dose, frequency
Pertinent Test Results – test, date, results, purpose, measurer
Allergies
Immunization history
Surgical History
Current Health Risks and Family History
Information on medical devices – especially implantable devices such as a pacemaker
Living will and organ donor instructions

One of the main reasons people hesitate to create a personal health record is that they think it’s too time consuming. Starting slowly with basic personal and insurance information, and a medication list, will help almost immediately with each doctor visit or during an emergency. Then gradually add additional information as healthcare providers request it. Soon, you will have the information you need and will start seeing the benefits of all your hard work.

Benefits of a PHR

You will find your PHR helps you in many ways:

Save time – finding the information you need in one place
Know that important information is not forgotten
Increase your sense of control over health
Promote better health management by using a systematic approach to healthcare
Avoid duplicate tests
Support timely, appropriate preventive services
Ease the transition when changing or consulting a new doctor
Provide current and accurate information for doctors and the medical team so that their decisions are based on current information
Verify the accuracy of information in provider records
Support continuity of care across time and providers
Improve communication so that it is easier to ask questions, to set up appointments, to request refills and referrals, and to report problems.
Support understanding and appropriate use of medications
Reduce adverse drug interactions and allergic reactions
Have information to manage long distance caregiving
Provide emergency information quickly and accurately

Creating a PHR
You can create a PHR yourself and store your information in a three-ring notebook. You might find it easier to create your lists on your computer in a word processing program like Microsoft Word. There are also a number of PHR systems available for purchase.

To see the PHR I created for my Dad, visit http://www.atmyfingertips.us.com/

How have you benefited from your PHR?

Creating memories for Father’s Day and every day

admin — Sat, 18 Jun 2011 21:51:23 +0000

This Father’s Day will be bittersweet for us. It is the first one without Dad. We are fortunate, though. You see Dad and my sister decided to make a series of recordings. My sister asked questions and Dad supplied the answers. They only recorded three sessions, but Dad’s personality and his presence come through so clearly. Listening to these recordings brings him back. It is like having him here talking with us today.

Question and answer recordings are great projects for your loved one. Reminiscing serves many purposes, especially for older people. This simple activity is low stress and can be done in short periods should your loved one tire quickly. They truly enjoy and appreciate the interest in their life.

This is a terrific project for grandchildren. The grandchild learns about life in an entirely different era. It opens up their horizons and their imaginations. And the grandparent can impart life lessons and instill a sense of legacy. Both the interviewer and your loved one become closer with a better understanding and appreciation for each other. The grandchild may also have the computer skills to save the file, put it in different formats, and even create playlists, CDs, or DVDs.

Recording sessions can provide respite time for you. I was grateful for the time my sister spent on this project with my Dad. It was a rare opportunity to do something for myself.

When starting the project, don’t try to capture everything at once. Creating legacy information is a wonderful goal. But sometimes setting expectations too high or trying to make it perfect gets in the way of actually creating the project. This should be fun and relaxing for your loved one. The information you obtain and the conversations themselves are what’s important.

Simple question and answer recording with your loved one are easy to make. You will need a device to record the interview. Finding a device may be easy since many devices have recording capability these days. Dedicated recorders are small, compact, and inexpensive. To record successfully, you need to ensure that the microphone on the recording device is near the person who is speaking. Once you have your recording, you will need to transfer the recording to your computer. And you will want to make the recording available for others to listen to. A family member or friend may be able to do this for you. Don’t be afraid to ask. The person you ask may be thrilled to be able to help out and become a facilitator for this special project.

If you would like more information, the website Family Oral History using Digital Tools can help get you started.

Happy Father’s Day, Dad. We miss you.