Discover how to help seniors stay independent and safe.
It’s a common struggle among family caregivers: deciding when to step in and help, and when to step back and allow an older loved one to accomplish as much as possible independently. It requires a delicate balancing act. On the one hand, we need to ensure safety is never compromised; yet on the other hand, we never want to do anything to damage a senior’s self-worth and self-esteem.
So the question becomes, how can we help seniors stay independent, while ensuring safety? The Sun City home health care experts at Nightingale Homecare have several key recommendations:
Remember: You’re a team! Changing the mindset from working for a senior to working with a senior can make a world of difference in your approach. Talk with the older adult in an open and honest way about the challenges and concerns he or she is facing, and how you can best provide needed support. Naturally, these needs will change over time; and when cognitive issues come into play, communication strategies will need to be modified as well. But we all appreciate being asked for our input, and to know that value is placed on our feelings.
Allow time before jumping in to help seniors. It may seem more efficient to take care of tasks yourself, but doing so may be at the expense of your loved one’s self-image. Instead, factor in plenty of extra time for tasks, allowing the senior ample opportunities to tackle them independently whenever possible.
Focus on the senior’s strengths. If certain tasks prove to be too challenging for your loved one, shift the focus to those he or she is able to manage more easily. For instance, if preparing an entire meal is too difficult, ask the senior to manage creating her special dessert recipe while you work on the main course.
Remind the senior that helpful workarounds are a positive. A senior may balk at the idea of using a walker or wheelchair initially, or in having grab bars installed in the bathroom. And many times older adults are resistant to the idea of needing someone to help with everyday activities that they’ve been managing their entire lives. Providing a reminder that assistance and home modifications are empowering, allowing the senior to accomplish more independently and to remain in the comfort of home throughout aging, can be beneficial.
At Nightingale Homecare, it’s our mission to deliver the highest quality in-home care help for seniors with the respect and dignity that allow for maximum independence and autonomy at all times. Never coming in and taking over, we work together with seniors and their families to develop a plan of care that addresses all needs – including those for personal freedom. Contact our Sun City home health care team at (602) 504-1555 to request a free in-home consultation and discover how we can improve life for a senior you love.
Discover the 5 stages of Parkinson’s disease and the changes that may occur in each from the Phoenix senior care team at Nightingale Homecare.
According to the Parkinson’s Foundation, the number of Americans diagnosed with Parkinson’s disease is predicted to cross the one million mark by next year – impacting more than those with MS, muscular dystrophy, and Lou Gehrig’s disease combined. In fact, there are already more than ten million people with the disease worldwide.
As such, it’s likely that most of us either already are or will be closely acquainted with someone managing the disease; so it’s important for all of us to better understand how the disease progresses, and what changes might be encountered in each stage. Our Phoenix senior care team has the information you need:
In the beginning stage of Parkinson’s disease, patients typically begin to experience mild tremors on one side of the body, as well as barely perceptible changes to posture, ambulation, and/or facial expressions.
As the disease begins to progress to Stage 2, tremors may become apparent on both sides of the body, along with rigidity and more noticeable changes to posture and ambulation. During this phase, patients can usually still manage daily life independently, although with a bit more difficulty.
Balance and coordination issues are common in this stage, leading to slowed movements and increased risk of falls. Activities of daily living (ADLs) such as getting dressed and eating may require a little assistance – or may simply take more time to complete independently.
In the fourth stage of the disease, there is a markedly greater level of impairment, and many daily tasks will require assistance, including help with walking and other forms of movement.
In the fifth and final stage of Parkinson’s disease, many patients will need a wheelchair for mobility, as impairment of motor skills advances and there is increased difficulty with standing, walking, and managing daily activities. Hallucinations are also common in this stage.
If you or a senior loved one is managing the effects of Parkinson’s disease, our Phoenix senior care team is on hand to help with personalized services adapted to meet needs both now and as the disease progresses in the future.
Our Journeys Parkinson’s and Movement Disorder program is staffed by BIG and LOUD certified therapists with specialized expertise in improving quality of life for those challenged by movement difficulties such as those experienced in Parkinson’s disease.
Our BIG program utilizes a proven exercise approach in which patients learn techniques to make bigger movements that lead to more normalized movement patterns; and
Our LOUD program helps patients improve quality and volume of speech, leading to more confident and effective conversation abilities and socialization.
We also work with Parkinson’s patients to improve swallowing, facial muscle control, balance, fine motor skills, fall prevention, and much more.
Overcome the challenges of getting proper nutrition with dementia with these tips.
Alzheimer’s and dementia often present numerous eating challenges. Regular, nutritious meals are important to maintain, as poor nutrition and eating habits can aggravate confusion and lead to physical decline. These tips will help you understand what causes eating challenges in your loved one with Alzheimer’s/dementia, and how you can encourage good nutrition in each stage of the disease.
In the early stages of Alzheimer’s/dementia, your loved one may forget to eat and lose the skill needed to plan for and prepare nutritious meals. As the disease progresses, your loved one may experience a diminished sense of smell and taste, which can cause a loss of interest in eating. Your loved one may also lose the ability to effectively use utensils necessary to eat. Agitation and distraction may affect mealtime greatly, so it will be important to plan for a distraction-free and consistent mealtime. In the later stages of the disease, your loved one will experience difficulty chewing and swallowing, which will challenge your ability to ensure proper nutrition.
Tips to Improve Nutrition
Maintain familiar routines.
Don’t rush mealtime.
Don’t worry about messes!
Offer favorite foods and drinks.
Check food temperature before offering.
Offer vegetables, fruits, whole grains and lean proteins.
Cut down on refined sugars, high saturated fats, high salt and cholesterol.
Provide foods that are calorie-dense and dementia-friendly: peanut butter sandwiches, milkshakes with added protein supplement, pudding cups, ice cream, pureed fruit and sweetened yogurt.
Keep distractions to a minimum; use a soothing voice and turn off the TV and cell phones. Calming music may be helpful.
Be sure your loved one is in a seated position at 90 degrees to prevent choking.
Serve meals on bright, solid-colored dishes. A color contrast between the tableware or placemat and the dinnerware serves as a visual cue for self-feeding.
Your loved one may need assistance at meals to increase caloric intake. If she says that she does not want to eat more, allow her to rest, and then try to get her to eat more with your assistance.
Be mindful of textures that she is most responsive to.
Place a beverage directly in front of your loved one, not off to the side.
Be sure dentures are in place for all meals and secure with denture adhesive if necessary. If your loved one is refusing to wear his or her dentures, it may be dental issues or it may be necessary to modify the diet.
Bowls are easier than plates. Spoons are easier than forks.
Bowls with suction cups are helpful.
Use straws or lidded cups for liquids.
Offer one or two types of food at a time, in small portions.
Offer three meals and snacks, or smaller meals throughout the day.
Provide the major caloric meal early in the day.
Add butter, syrup and dipping sauces to increase calories.
Offer foods that are easy to chew and swallow. Avoid popcorn, nuts, raw vegetables and other foods that are difficult to chew.
Remind your loved one to thoroughly chew and swallow carefully throughout the meal.
Cut food into bite-sized portions. Finger foods are even easier: pieces of fruit, cheese, crackers and other snacks.
Eating your meal with your loved one often improves intake.
Your loved one’s physician may add supplements if weight loss and nutrition are a problem. You may consider adding an instant breakfast drink mixed with ice cream.
Staying hydrated can be one of the bigger challenges in your loved one with Alzheimer’s/dementia. Offering small cups of water and fluids throughout the day is very important. Be sure adequate amounts of liquids are consumed at meals. Generally, your loved one may not request something to drink—you need to provide it to her. A health shake between meals may be a way to hydrate her as well as provide added calories. Offer other foods with high water content, such as fruit, soups and smoothies. It may be necessary to offer fluids every two hours to maintain hydration.
Watching for signs of dehydration will be imperative in maintaining your loved one’s overall health:
Weight loss of two pounds or more in a 24-hour period
Dizziness or headaches
Inability to sweat or produce tears
Rapid heart rate
Low blood pressure
Staying Alert for Swallowing Difficulty
“Dysphagia,” or difficulty swallowing, often occurs in the late stages of Alzheimer’s disease when the patient loses the gag reflex and has decreased levels of consciousness. Ensure that your loved one is sitting up straight with her head slightly forward when eating. At the end of every meal, be sure and check your loved one’s mouth to ensure that all food has been chewed and swallowed. Aspiration pneumonia is a leading cause of death in those with Alzheimer’s, so it is critical you watch for the signs of dysphagia and refer to a speech therapist when you notice these signs:
Coughing or choking at meals
Wet vocal quality during or after meals
Decrease in the amount of food eaten
Increasing time and effort spent at mealtime
Food, liquids or saliva leaking out of the mouth
‘Cheeking,’ or holding foods in the mouth instead of swallowing them
Spitting out food
Difficulty swallowing medications
Unexplained weight loss
Eating too fast, or cramming food into the mouth
Extended chewing before swallowing
Clearing throat frequently during a meal
Combating Swallowing Challenges
Using all of the techniques mentioned above will help combat swallowing challenges in your loved one. In the later stages, offering pureed foods and a soft diet will help aid in swallowing. Using a commercial thickener like “Thick-It” in thin liquids may also be recommended for your loved one with swallowing challenges. Thickened liquids won’t trickle down the throat as readily as thin liquids and are less likely to cause coughing, choking and aspiration. Your loved one’s physician, speech therapist or nurse will recommend the thickness necessary, depending upon the patient’s ability to chew and swallow. If your loved one is on thickened liquids, then ALL liquids provided must be thickened to the recommended consistency.
The clinician will recommend the minimal level of thickness needed for swallowing safety. As with anything, there are benefits to these thickening agents, but there are also risks. These preparations don’t work for everyone, and in some cases, they can lead to dehydration. They may also reduce the effectiveness of medications when taken together with the thickening agent.
Things to be Alert to When Feeding Your Loved One
In the later stages of the disease, it may become necessary for you to feed your loved one in order to maintain safety and nutrition. When it comes to this, be sure to follow the above pointers on eating and maintain a relaxed, comfortable environment, sticking to a routine. It will be very important for you to take your time with feeding, to avoid choking and agitation. Never rush your loved one when it comes to feeding.
Follow these additional pointers to ensure feeding success!
Be sure that the last bite has been swallowed before the next is provided.
Give only small bites of food on a spoon.
You may need to be prepared to give the next bite after your loved one swallows the last bite, to maintain her interest in eating.
If your loved one has difficulty opening her mouth for food entry, you may brush a spoon against the lips, to aid in opening her mouth.
You may gently brush her cheeks and neck to encourage swallowing.
Place food well into the mouth to assist with chewing.
Frequent cueing may be necessary, i.e.: “Open your mouth, chew the food, and now swallow.”
Alternating liquids with solids may assist with swallowing each bite.
Check for pocketing. Food must be cleared before adding the next bite.
For those living with Parkinson’s disease, many challenges present throughout the day. The symptoms of Parkinson’s (tremors, stiffness, balance problems and slow movement) tend to worsen over time, making all activities of daily living more difficult. Ongoing evaluations performed by your loved one’s physician, nurses and occupational and physical therapists are necessary in order to maximize independence and improve safety.
The Scottsdale home care team at Nightingale Homecare offers tips and information on assistive devices below that may lessen the frustrations and safety issues that often accompany this disease.
Unsteadiness, poor balance and shuffling gait are hallmarks of Parkinson’s disease and produce many challenges with walking safely. In the early stages of Parkinson’s, a straight cane is often helpful. These often work better than a quad cane or tripod cane for those with Parkinson’s. Proper fit is essential as the height of the cane will need to support proper posture. Once your loved one has progressed to a walker, four-wheeled walkers offer more stability than walkers that need to be lifted. In late-stage Parkinson’s, a wheelchair or electric scooter may be necessary.
Probably one of the more frustrating and isolating activities those with Parkinson’s suffer is that of eating. There are several remarkable breakthroughs to make eating easier for people with tremors. The utensils have larger, weighted handles that make gripping easier. There are also utensils that are self-stabilizing and self-leveling and designed to counteract tremors by up to 70%. Many people with Parkinson’s also find it helpful to use travel cups with the lid and straw attached as well as plates with scooped edges to avoid accidents.
A few adaptations can help remove the frustrations that someone with Parkinson’s may experience in dressing him/herself. These devices include:
Magnetic buttons, with buttons on the outside that close with magnets on the inside.
Zipper pulls which are attached rings to the tiny handles on zippers that make them easy to zip up and down.
Weighted button aides with a large grip handle with a loop on the other end. You simply thread the loop through the eyelet, hook the loop around the button, then pull the button through the eyelet.
Shoes with Velcro or elastic shoelaces are much easier to put on and off than shoes with regular shoelaces.
Your loved-one’s occupational therapist can help make specific recommendations for the bathroom, but devices that make the bathroom safer and more manageable for those with Parkinson’s disease include:
Bars or handrails added to tubs/showers and toilet areas
Non-skid bathmats or decals on the tub floor
Tub chairs or benches
Raised toilet seats
Electric toothbrushes and razors
The fine motor skills lost with Parkinson’s can make holding a writing instrument difficult. There are many writing devices that are easier to grip. Other writing utensils are designed to improve shaky penmanship.
Improve balance and prevent falls with these tips from our Scottsdale home care experts.
From adulthood onward, all of life can seem like a balancing act. We balance work, family, friends, community, etc. But then there comes a time later in life when, for the sake of our safety and independence, we have to consider our actual balance. As we age, our bodies naturally change, and there are many things that can affect a senior’s balance, including:
Exercise is an essential part of a healthy lifestyle, and research shows that following a regular exercise routine can help older adults build muscle tone that can improve balance and reduce the risk of falling. Consider working the following types of exercise into your daily routine:
Strength and resistance training
Adjust your diet
Generally, eating a well-balanced diet and avoiding alcohol in excess is key for a healthy lifestyle. However, some seniors may need to make adjustments to their diets in order to get the nutrition needed to improve balance. For example, seniors who have low levels of vitamin D are at an increased risk of having balance problems, falling down, and breaking bones.
Additionally, if the senior has a condition like Meniere’s disease that affects the inner ear, his or her doctor may suggest dietary changes such as:
Avoiding caffeine as caffeine may make symptoms like tinnitus worse
Eating six small meals daily rather than three large ones
Reducing daily salt intake to less than 1,500 mg, to reduce fluid retention
Avoiding monosodium glutamate (MSG), as it may cause fluid retention
Use corrective devices as needed
Often, poor balance is caused by physical changes in the body, such as reduced vision, hearing or mobility. Hearing aids and prescription eyeglasses can help reduce symptoms of dizziness and disequilibrium, and seniors should get treatment for cataracts, glaucoma, and macular degeneration if needed.
Also, walking aids, such as canes, walkers, and wheelchairs, can help seniors live safely and independently when they are properly used.
If a dizzy spell occurs…
It may not always be possible to prevent a dizzy spell, even if you take all the precautions listed above. In order to prevent loss of balance when feeling dizzy, follow these steps:
Sit or lie down as soon as you feel dizzy
Move slowly and try not to change the position of your head
Rest as much as you can and don’t try to go back to your regular activities before you are ready
Avoid exposure to things that may cause sinus congestion
Try to manage your stress and anxiety levels
At Nightingale Homecare, we strive to help seniors stay safe, happy, and healthy in the comfort of home by offering a full range of Scottsdale home care services that can allow them to live the lives they want. To help ensure the home is a safe place, we are always happy to provide a home safety assessment and make recommendations on how to reduce the risk of falls in the home. Additionally, our Paces Fall Prevention Program incorporates the expertise of our professional therapists, dieticians, social workers, home health aides and others to provide a well-rounded fall prevention plan that can be implemented to enhance safety even further.