Learn more about the importance of hydration for seniors.

The importance of hydration for seniors cannot be overstressed. In an older loved one, dehydration can occur rapidly and be life-threatening. Many older people often are not as quick to feel thirst as younger people are, so they may not be drinking enough fluids to begin with. This, combined with health concerns that might cause your loved one to reduce her fluid intake, puts the older person at high risk for dehydration.

When you are caring for an elder loved one, offer a drink of water every time you interact with him or her, and make sure she always has fresh water within reach. However, be aware that even when offered water, many older people will say, “I’m not thirsty” or, “I’ve already had too much to drink today.” You may need to be persistent in encouraging your loved one to regularly drink water.

Fluid Balance

Fluid balance occurs when the amount of fluids a person takes in equals the amount of fluids the person loses. Each day, we lose fluid in the form of urine, sweat, bowel movements and breath vapor. To maintain a state of fluid balance, we must take in enough fluid each day to equal, or balance, these losses. When fluid balance is not maintained, your loved one may develop either dehydration (too little fluid in the body) or edema (too muc  h fluid in the body).

Dehydration

Dehydration can result from conditions such as vomiting, diarrhea, fever or severe blood loss. A very common cause of dehydration, however, is simply not drinking enough fluids. Many elderly people have conditions that put them at risk for becoming dehydrated. For example, a person who has problems with mobility or other disabilities may have a difficult time getting up to get a drink. Your loved one may also cut back on fluids because she is trying to reduce the number of times she needs to get up and go to the bathroom, or she is afraid that she will not be able to make it to the bathroom in time. Some seniors who are incontinent may also reduce their fluid intake because they think this will lower their risk for having an episode of incontinence. However, it is important to know that decreasing fluid intake does not decrease incontinence, nor does it decrease trips to the bathroom. In fact, the opposite may be true. As the urine becomes more concentrated, it irritates the bladder and may increase the urge to urinate, resulting in the need to urinate more frequently.

As your loved one’s caregiver, you will play an important role in helping to ensure that she takes in enough fluids. Here are some tips to encourage fluids:

• Frequently offer fluids that your loved one likes at the temperature she prefers.
• Encourage her to drink plenty of fluids with each meal.
• Frequently provide your loved one with a pitcher of clean, fresh water. Encourage her to drink each time you enter the room.
• Be sure she has a clean drinking glass or cup within easy reach. Refill the glass if she cannot do it. A drinking straw or a plastic water bottle with a screw-on lid and a straw may make it easier for some people to drink independently.
• If she frequently refuses beverages, offer fluid-rich foods instead, such as ice cream, popsicles, gelatin or fruit.

If your loved one becomes dehydrated, her physician may give an order to “encourage fluids” or “push fluids.” This means that she should be urged to drink as much fluid as possible. Encourage her to drink each time you enter the room and again on your way out. Keep a record of the amount of fluid your loved one drinks and record the total for the day on the flow sheet for her physician and for your reference.

Be on the Lookout! 

Dehydration is a serious condition. If you suspect that your loved one is dehydrated, contact her physician immediately. Signs and symptoms of dehydration include the following:

• Confusion
• Poor skin turgor (the skin does not return to its normal shape when gently squeezed or pinched)
• Passing of small amounts of dark-colored urine
• Constipation
• Drowsiness
• Very dry skin or chapped lips
• Elevated temperature

Edema

Edema, or the state of retaining too much water, can result from medical conditions (such as chronic heart failure or kidney disease) that make it hard for the body to rid itself of excess water. Your loved one’s physician may place restrictions on the amount of fluid she is allowed to have each day.

When you are caring for a loved one and fluid restrictions are in place, the physician will tell you how much fluid she is allowed to have over the course of the day. Offer small amounts of fluid at regular intervals. This will help to prevent your loved one from becoming too thirsty.

Measuring and Recording Fluid Intake

When orders to encourage or restrict fluids are in place, you will need to measure and record your loved one’s fluid intake. A person’s fluid intake includes all of the liquids she drinks, as well as foods that are primarily liquid (such as soups) or that are liquid at body temperature (such as ice cream or popsicles).

Although in everyday life fluids are usually measured in ounces (oz), in health care, fluids are measured and recorded in milliliters (ml) or cubic centimeters (cc). A milliliter (ml) is equal to a cubic centimeter (cc). One ounce equals 30 milliliters or 30 cubic centimeters.

With prepackaged items, printed information on the container indicates how much it holds. For example, a small prepackaged milk container contains 8 ounces, or 240 ml (remember, there are 30 ml in an ounce). In other cases, you will need to determine how much fluid the container holds. When you are caring for your loved one and need to measure fluid intake, you can determine the amount of fluid your cups, glasses and bowls hold by filling them with water and then pouring the water into a measuring cup.

To measure and record fluid intake, observe how much fluid your loved one consumes at each meal and in between meals. For example, if she had 8 oz (240 ml) of milk, 4 oz (120 ml) of coffee and 12 oz (360 ml) of soup with lunch, you would record her fluid intake at lunch time as 720 ml. Then, if she had another 8 oz (240 ml) of tea in between lunch and dinner, you would record her fluid intake as 240 ml.

Sometimes your loved one may not consume all of the fluid in the container. In this case, estimate how much of the total was consumed. For example, if she only drank about half of her coffee at lunch, you would estimate the amount to be 2 oz (60 ml) instead of the full 4 oz (120 ml).

Remember the Importance of Hydration for Seniors – Nightingale Homecare Can Help!

As the top providers of elderly care Scottsdale and the surrounding area offer, our home health care team is always here to provide the resources you need to help older loved ones remain hydrated and healthy. Contact us at (602) 504-1555 for a free in-home consultation to learn more about our professional in-home care services  and the importance of hydration for seniors.

Learn tips to reposition bed-bound seniors safely and correctly.

As providers of the most trust home care Paradise Valley and the surrounding area has to offer, we know working with bed-bound seniors and chair-bound seniors requires much care and attention, and one of the most critical components is repositioning. The primary purpose of repositioning is to improve circulation to the skin and other organs, relieving pressure and preventing skin breakdown. Repositioning also helps in providing comfort to your loved one and ensures movement of the joints and muscles. Although many bed-bound patients often resist turning and will tell you they just want to be left alone, turning will improve comfort over the course of the day and night, and will also give you opportunity to inspect the skin.

Your Loved One’s Individual Repositioning Schedule

Although the current accepted “guideline for care” is to reposition your loved one every two hours, there is much more involved in finding the right solution for your individual loved one. The frequency of turns/repositioning should be individualized to your loved one based on such factors as:

• Tissue tolerance
• General medical condition
• Level of activity and mobility
• Overall treatment objectives
• Comfort
• Skin condition

To test your loved one’s “tissue tolerance” you must observe and document the time it takes the skin to redden over bony prominences (hips, ankles, shoulders). You must gradually increase the amount of time the person is left in the same position until redness is detected. Once the threshold has been established, you must set the turn frequency to 30 minutes less than the time interval, with no more than 2-hour intervals maximum. Repositioning a chair-bound loved one should occur even more frequently.

In addition to determining tissue tolerance and the frequency of repositioning, you will need to move your loved one using proper techniques. Keep these points in mind when repositioning:

• Make sure the pressure is relieved or redistributed.
• Avoid positioning over bony prominences that redden easily.
• Do not drag or pull your loved one while repositioning, which can damage the skin.
• Alternate between the back, right side and left side on the schedule determined for your loved one, but at least every two hours.

Necessary Equipment for Your Bed/Chair-Bound Loved One

Depending upon your loved one’s condition and activity orders, the use of equipment can make all the difference for a person who is bed/chair-bound. You should talk to your loved one’s physician and health care team about necessary equipment to aid your loved one in repositioning and preventing skin breakdown and other complications.

Some equipment to consider:

• A hospital bed with bedrails
• A trapeze, if your loved one has upper body strength to help reposition
• A Hoyer lift
• Drawsheets and bedpads
• Slide sheets
• Wedges and pillows
• Low air-loss mattress
• Wheelchair cushion
• Geri-chair
• Heel and elbow protectors
• Contracture rolls

Always Use a Drawsheet!

Using a drawsheet under your loved one makes it much easier to position the person, and also reduces the possibility of your loved one developing a skin injury/breakdown. If you don’t have one, you can make one by folding a twin-sided top sheet in half. To place the sheet correctly under your loved one, follow these steps:

• If your loved one has a hospital bed, raise the bed to a level that reduces the strain on your back, and make the bed flat.
• Roll your loved one to one side and place the half rolled up sheet on top of the fitted bottom sheet so that the top and bottom of the drawsheet go across the bed (perpendicular to the bed). Position the drawsheet so that it will be between the person’s head and knees.
• Roll your loved one onto the sheet and unroll the sheet out flat under the person.
• Tuck in the drawsheet tightly on both sides. Smooth out any wrinkles to reduce possible skin irritation.

Basic Repositioning Rules for a Bed/Chair-Bound Person

• Never lift more than you can manage.
• Get help when needed.
• Explain to your loved one the steps involved, and how the person can help.
• Raise the bed to safe working height and ensure that brakes are applied.
• Never lift your loved one.
• Never pull the person by the arms.
• Never attempt to pull your loved one without a drawsheet; the risk of giving your loved one a skin injury or injuring yourself is very high without one!

Moving Your Loved One Up in Bed

There are several methods for moving a person up in bed. If your loved one has some upper body strength or is able to use his/her bent legs to push up in bed, this can be helpful. Aids such as trapeze bars, side rails and “slide sheets” can be useful tools when you are moving your loved one without additional help. The goal to moving your loved one up in bed is to not lift, but pull the person up in bed using a drawsheet. Do not slide your loved one up in bed without a drawsheet, as you can create friction or shear skin injury. These are instructions for using a drawsheet and two-person assist for moving a person up in bed:

• Lay your loved one on his or her back; place the pillow at the head of the bed and against the headboard.
• Stand between the shoulders and hips of your loved one, with your feet shoulder-width apart. Weight will be shifted from back foot to front foot.
• Fan-fold the drawsheet toward your loved one and grab the drawsheet at the person’s upper back and hips.
• Ask your loved one to tilt his/her head toward the chest to protect the neck, and to fold the arms across the chest, bending knees to assist with the movement. Let your loved one know when the move will happen.
• Tighten your gluteal and abdominal muscles, bend slightly at your knees, and keep your back straight and neutral.
• On the count of three, gently slide (not lift) your loved one up the bed, shifting your weight from the back foot to the front, keeping your back straight with your knees slightly bent.
• You may need to do this more than once to get your loved one in the right position.
• Replace the pillow under the person’s head, and position the person in bed.
• If your loved one is going to remain on his/her back, raise the foot of the bed enough to bend the knees. In addition, you can place a pillow under the knees to prop the person up to prevent sliding down in bed. This will help reduce friction and shear skin injury as well.

Turning and Positioning Your Loved One in Bed

Repositioning bed-bound seniors is easier to accomplish with help. If you don’t have help, it can be done but will require more steps to accomplish. Here are the steps to repositioning a person in bed without help from experienced providers of home care Paradise Valley families depend on.

• Move the person to the center of the bed so the person is not at risk of rolling out of the bed.
• Ask your loved one to look towards you. Position the arm nearest you stretched toward you and the arm farthest from you across his/her chest.
• Position a pillow next to the person on the opposite side of the bed.
• Reach over the person and grab the drawsheet on the opposite side, gently pulling the drawsheet toward you.
• Gently pull the person’s hip and shoulder towards you with the drawsheet as you place the pillow under the drawsheet to prevent your loved one from rolling back.
• Go around the other side and get your hands, palms up, under the person’s hips to pull him/her back into position.
• Position the pillow or a foam wedge under the drawsheet at the person’s back. Push the pillow close against the back to help prop the person on his/her side.
• Make sure the arm under your loved one is pulled out from under him/her, resting more on the shoulders for comfort.
• Make sure your loved one‘s ankles, knees, and elbows are not resting on top of each other to prevent skin problems.
• Make sure his/her head and neck are in line with the spine, not stretched forward, back, or to the side.
• Place a pillow under the top arm of your loved one.
• Place another pillow or a specially designed foam leg wedge between the person’s knees. This extra bit of support will add comfort by keeping the spine in alignment and by easing pressure on the bony areas of the knees and ankles.
• Return the bed to a comfortable position with the side rails up. Check with your loved one to make sure he/she is comfortable.

Repositioning Your Seated Loved One

Repositioning chair-bound persons is just part of the care to prevent the development of skin problems, and each person will present different needs. Seated people need to be repositioned more frequently than bed-bound people. Instruct your chair-bound loved one to shift his/her weight every 15 minutes. If your loved one is unable to reposition, you will need to physically move him/her at least every hour. To do this, you will need to use a drawsheet or sling under your loved one’s buttocks and hips to gently pull from side to side. In addition, your loved one who is chair-bound should always use a pressure redistribution cushion, which will distribute the weight of the body without impeding function or increasing the risk of skin damage.

Other factors, such as your loved one’s nutrition, medical condition, skin condition, and tissue tolerance will also determine repositioning needs. Ask your loved one’s health care team what their recommendations are for repositioning. Use of a Hoyer lift, geri-chair and a seated positioning system may be necessary for your loved one who is unable to reposition independently in a chair.

To ensure your loved one is safe from injury – as well as yourself! – call on Nightingale Homecare, providers of the most trusted home care Paradise Valley and the surrounding area have to offer. We can assist with a full range of both skilled and non-medical services for seniors in the home, based on each person’s individual needs. Call us at (602) 504-1555 to learn more.

Learn everything you need to know to protect seniors from shingles.

Back in the day, getting chickenpox as a child was a rite of passage. Parents would often even throw “chickenpox parties” – inviting the neighborhood kids over when one was contagious with the disease! The thinking was that since everyone was going to catch it anyway, why not get it over with?

Thankfully, we now have effective vaccines that allow for the prevention of chickenpox. But for those who were stricken with the disease at some point, the lingering effects can manifest later in life as shingles – a condition that can lead to significant pain and discomfort that can last for weeks. There are also a number of serious complications that can arise in older adults who develop shingles, including:

• Blindness
• Infection
• Neuralgia (nerve pain)
• Hearing loss
• Encephalitis
• Facial paralysis
• And more

Although contagious, it’s important to note that it is the chickenpox virus that will be passed on from the person infected with shingles – not shingles itself.

Shingles typically displays as a rash of blisters that wrap around one side or the other of the upper body, with pain, burning, tingling, or numbness, sensitivity when touched, itching, and sometimes fatigue, headache, fever, and light sensitivity.

Additional risk factors, over and above being a senior, include taking certain prescription medications (prolonged use of steroids, for instance, as well as medications taken to ensure transplanted organs are not rejected), diseases such as HIV/AIDS and cancer, and any other condition or treatment that leads to a weakened immune system.

There is a silver lining in all of this, however! Two types of shingles vaccines are available and recommended for everyone age 60 and older: Zostavax and Shingrix. Talk with a doctor to determine which is right for your senior loved one, but the basic differences include:

• Zostavax: A live vaccine that provides protection for five years, given as a single injection.
• Shingrix: Often preferred over Zostavax, Shingrix is a nonliving vaccine that provides protection beyond the five-year mark. Shingrix requires two injections given six months apart.

Although neither vaccine provides 100% protection, the risk of contracting the disease is reduced, and if a vaccinated senior does develop shingles, it’s typically less severe and of a shorter duration, with fewer complications.

For more information about shingles or any other concerns of aging, contact the Scottsdale senior home care experts at Nightingale Homecare. Our nursing team is always on hand to help provide the resources seniors and their families need to optimize health and wellbeing, and our customized in-home care services ensure that older adults are living life to the fullest, each and every day.

Contact us at (602) 504-1555 to learn more or to schedule a complimentary in-home consultation and discover a better quality of life for a senior you love!

Senior wound healing is often difficult for older adults.

Remember as a child scraping your knee on the playground, when all it took was a hug from mom and a band-aid to have you back up on your feet, good as new? A senior wound, however, achieving complete healing is often a much more complicated process, for a variety of reasons, including:

• Less skin elasticity. The natural process of reduced elasticity in the skin as we grow older makes it harder for skin to heal – in fact, the U.S. National Library of Medicine estimates that senior wound healing can take up to four times as long in comparison to younger people.
• Longer inflammatory response time. Our blood vessels expand when a wound occurs, so that white blood cells and nutrients can more quickly reach the wound area. Yet this inflammatory response is markedly slower in the elderly.
• Diabetic effects. Those with diabetes (and over 11 million seniors in the U.S. are diabetics) often experience problems with hardened arteries and narrowed blood vessels, both of which can contribute to delayed wound healing. Additionally, neuropathy can inhibit a diabetic from sensing the pain of a wound, enabling it to worsen.

Interestingly, there is one key factor that helps older adults experience enhanced wound healing: regular exercise. Ohio State University conducted a recent study among healthy seniors between the ages of 55 and 77 in which some engaged in regular physical activity, while the others did not. A small puncture wound was then given to each senior, and the healing process was monitored. Those who had participated in the exercise program healed a full ten days faster than those who did not.

At Nightingale Homecare, our Scottsdale senior home care experts are proficient in senior wound healing, and offer a specialized wound and ostomy care program to provide better management and faster healing of wounds, ostomies, and other skin problems such as:

• Surgical wounds
• Bed sores
• Diabetic, arterial, or venous stasis ulcers
• Colostomies
• Urostomies
• Fistulas
• Incontinence skin concerns
• And more

We are familiar with the best products for specific types of wounds, and incorporate additional measures to expedite healing, such as ensuring seniors are receiving proper nutrition and hydration, relieving pressure, and preventing infection.

Contact Nightingale Homecare any time for more tips and resources related to effective wound healing for seniors, or to arrange for a free in-home consultation with one of our Scottsdale senior home care professionals to find out how we can help your loved one more heal more quickly and get back to enjoying life! You can reach us at (602) 504-1555.

Learn everything you need to know about taking vital signs at home from Nightingale Homecare.

If you are a caregiver for a loved one who has a medical condition that requires monitoring, chances are his or her physician has asked you to keep an eye on a measurement or two in order to detect a change in condition. Learning to monitor vital signs is a necessity for caregivers of people with chronic conditions.

Checking vital signs is an important skill to learn, because it tells us how the person’s body is functioning, helping us to monitor current conditions and alerting us to changes in health status. It can also give us clues to possible medical conditions that have yet to be diagnosed. The four main vital signs that are measured to give us an overview of your loved one’s health status are:

• Body temperature
• Heart rate (pulse)
• Respiration rate
• Blood pressure

The Scottsdale senior home care team at Nightingale Homecare shares the following instructions on how to correctly monitor vital signs:

Body Temperature

No individual has the exact same temperature reading throughout the day, as body temperature naturally fluctuates. Normal body temperature measured orally ranges from 97.6 to 99.6 degrees Fahrenheit (36.4 to 37.5 degrees Celsius) for a healthy adult. Of course, normal temperature variation depends on recent activity, food and fluid intake, time of day, etc.

Body temperature may be abnormal due to fever (high temperature) or hypothermia (low temperature). According to the American Academy of Family Physicians, a fever is indicated when body temperature rises one degree or more over the normal temperature of 98.6 degrees Fahrenheit. Hypothermia is defined as a drop in body temperature below 95 degrees Fahrenheit.

There are four different ways to measure body temperature:

Orally: At Nightingale, we ask that our caregivers and clinicians use a digital thermometer to measure oral temperature over glass thermometers due to safety reasons. If you do not have this piece of equipment to monitor your loved one’s temperature, you should make the investment; they are inexpensive and reliable.

Rectally: If your loved one’s doctor asks you to take a rectal temperature, you should use a digital thermometer over a glass thermometer for safety reasons. Rectal temperatures tend to be 0.5 to 0.7 degrees F higher than when taken by mouth.

Axillary: Temperatures can be taken under the arm using a digital thermometer. Temperatures taken by this route tend to be 0.3 to 0.4 degrees F lower than those temperatures taken by mouth.

By ear: A special thermometer can quickly measure the temperature of the ear drum, which reflects the body’s core temperature (the temperature of the internal organs). An ear temperature is between 0.5 -1.0 degrees F higher than an oral temperature.

By skin: A special thermometer can quickly measure the temperature of the skin on the forehead. A skin temperature is between 0.5 -1.0 degrees F lower than an oral temperature.

Taking Body Temperature Using a Digital Thermometer:

• Wash your hands.
• Cover thermometer mouth tip with a clean plastic shield.
• Press button to set the thermometer.
• Place the thermometer under the tongue and instruct your loved one to close his or her lips around the probe.
• Wait several minutes and remove thermometer when beeping indicates the reading is complete.
• If you are taking a record for your loved one’s physician, write down the temperature, including the date, time and method used as follows: “O” for oral, “R” for rectal, “E” for ear, “A” for axillary.
• Remove the plastic shield.
• Clean and sterilize the thermometer following manufacturer’s instructions, or with an alcohol prep pad wiping from the top to the tip.

Note: Oral thermometers are not indicated for some individuals, such as those with a history of seizures, or people unable to close their mouth fully. Digital thermometers can be used to take an axillary temperature by being placed under the armpit, against dry skin, and following the instructions noted above.

Pulse Rate 

Pulse rate, also called heart rate, indicates the number of times the heart beats per minute. As the heart pushes blood through the arteries, the arteries expand and contract with the flow of the blood. Taking a pulse not only measures the heart rate, but also can give us information on the strength and rhythm of the heart.

Normal pulse for healthy adults ranges from 60 to 100 beats per minute. The pulse rate may fluctuate and increase with exercise, illness, room temperature, injury, and emotions. It is not uncommon for athletes, who do a lot of cardiovascular conditioning, to have a heart rate of nearly 40 beats per minute and experience no problems.

Taking a Pulse Rate:

• Wash your hands.
• Make sure that your loved one is at rest before you begin.
• The easiest place to find a pulse to measure is at the radial artery found on the inside of the wrist at the base of the thumb. Alternatively, you can find the pulse on the inside of the elbow (brachial artery), or neck (carotid artery).
• Note: If you use the neck, be sure not to press too hard, and never press on the pulses on both sides of the lower neck at the same time to prevent blocking blood flow to the brain.
• Use your first and second fingertips (never the thumb, because it has a pulse and will interfere with an accurate assessment of your loved one’s heart rate) to press firmly but gently on the wrist (or otherwise) until you feel a pulse
• With an analog clock or watch, wait until the second hand is on the 12 to begin counting.
• Begin counting the beats of the pulse
• Count pulse for 60 seconds until the second hand returns to the 12. Or, you may also count for 15 seconds and multiply by 4 to calculate beats per minute. Note: The physician may request for you to take the loved one’s heart rate for a full minute, if he/she has an irregular heart rate.
• When counting, do not watch the clock continuously, but concentrate on the beats of the pulse.
• If your loved one’s physician asks for a record, write down the heart rate, including the date, time, and if you notice any irregularities.

Respiratory Rate

Respiration rate, also referred to as breathing rate, is the number of breaths taken over a minute. This measurement is always taken when the person is at rest and involves how many times the chest rises per minute.  One respiration count is equal to the chest rising (inhaling) and falling (exhaling) once. The normal range for an adult is 12 to 20 respirations per minute.  Factors like age, fever, agitation, activity, illness and sleeping can alter breathing and therefore the respiratory rate.  When a person is acutely ill, respiratory rate fluctuations and patterns are monitored as a warning sign for further decline.  

Taking Respiratory Rate:

• You can keep your fingers on the radial pulse after you have stopped counting pulse rate, and use the next minute to count the person’s respiratory rate.
• With an analog clock or watch, wait until the second hand is on the 12 to begin counting.
• Count breaths (inhale + exhale = 1 respiration) for one minute. You may also count for 15 seconds and multiply by 4 to calculate breaths per minute.
• If your loved one’s doctor wants a record, write down respiration rate, noting any observations (such as irregularity, increased effort or wheezing). 

Blood Pressure

Blood pressure is the force of the blood pushing against the artery walls during contraction and relaxation of the heart. Each time the heart beats, it pushes blood into the arteries, resulting in the highest (top) number of pressure reading. This is called “systolic.” The bottom number, lowest reading or “diastolic” is when the heart is totally relaxed before the next beat. The blood pressure measurement is recorded in millimeters of mercury or mm Hg and written as systolic/diastolic.

A blood pressure reading identifies how effectively the oxygenating blood is moving through the blood vessels of the circulatory system. In healthy adults, the systolic pressure should be less than 130 and the diastolic pressure should be less than 85. High pressure is called hypertension and low pressure is called hypotension.   Many health conditions can affect blood pressure. Cardiac patients, and those afflicted with hypertension, are instructed to monitor their blood pressure, as it can directly lead to life-altering conditions like heart attack, heart failure and stroke.

At Nightingale, all of our staff use manual or android cuffs, as electronic blood pressure machines can be unreliable and false readings could lead to devastating consequences for your loved one. You will need to have a stethoscope, blood pressure cuff with inflatable balloon (sphygmomanometer) with a numbered pressure gauge called a digital monitor or aneroid monitor.

Before you measure your loved one’s blood pressure:

The American Heart Association recommends the following guidelines for home blood pressure monitoring:

• Have your loved one refrain from smoking or drinking coffee for 30 minutes before taking blood pressure.
• Have your loved one go to the bathroom before the test.
• Your loved one should relax for 5 minutes before taking the measurement.

Taking Blood Pressure 

• Have your loved one sit with the back supported (he or she shouldn’t sit on a couch or soft chair). Your loved one’s feet should be on the floor and uncrossed.
• Wash your hands.
• Place your loved one’s arm on a solid flat surface (like a table) with the upper part of the arm at heart level.
• Place fingers on the underside of the elbow to locate the pulse (called the brachial pulse).
• Wrap and fasten the deflated cuff snugly around the upper arm at least one inch above where you felt the strong and steady brachial pulse.
• Position the stethoscope diaphragm directly over the brachial pulse and insert the earpieces.
• Turn the knob on the air pump clockwise to close the valve.
• Pump air, inflating the arm cuff until the dial pointer reaches 170.
• Gently turn the knob on the air pump counter-clockwise to open the valve and deflate the cuff.
• As the dial pointer falls, watch the number and listen for a thumping sound.
• Note the number shown where the first thump is heard (systolic pressure).
• Note the number shown where the last thump is heard (diastolic pressure).
• Deflate and remove cuff.

• If your loved one’s doctor asked you to take multiple readings during one sitting, take the readings one minute apart and record all the results.
• It is best to take blood pressure at the same time every day.
• If your loved one’s doctor asks for a record, write down the date, time, and blood pressure reading.
• When blood pressure reaches a systolic (top number) of 180 or higher OR diastolic (bottom number) of 110 or higher, this could require emergency medical treatment, so call your loved one’s doctor for further instruction. 

Properly monitoring vital signs can be a challenge, which is why we recommend letting Nightingale Homecare’s professional home health care staff take care of it for you! Our Scottsdale senior home care team is highly skilled in a wide range of both medical and non-medical home care services, ensuring that older adults live their safest and healthiest lives possible, in the comfort and familiarity of home. Contact us at (602) 504-1555 to learn more and to find out if our services are available in your area.