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Posts Tagged “Caregiver Phoenix”

Take a Deep Breath and Ensure Healthy Lungs in Seniors with These Tips

Healthy Lungs

Help the seniors you love maintain healthy lungs.

It’s Healthy Lung Month, and the Scottsdale respite care experts at Nightingale Homecare want to make sure older adults maintain healthy lungs throughout aging! As we grow older, changes to all of the organs that impact breathing – lungs, muscles, and bones – can cause decline in lung function. These additional aging-related lung changes can affect seniors:

  • A weakened diaphragm, which can make it harder to inhale and exhale when exercising
  • Less sensitivity to foreign particles that can enter the airways, which means seniors may not have the urge to cough, allowing these particles to damage the lungs
  • The bones in the ribcage are thinner and altered in shape, making it more difficult for the lungs to expand and contract
  • Alveoli (tiny air sacs in the lungs) may lose their shape
  • The immune system is weaker, making older adults more susceptible to infections that can lead to pneumonia

Changes such as these can lead to shortness of breath and fatigue; but there are a number of preventative measures that can be taken to protect the lungs:

  1. Quit smoking – or never start. Smoking causes significant damage to the lungs, and it’s crucial for older adults (and all of us!) to refrain from engaging in this dangerous habit. The American Lung Association offers help for those who want to quit.
  2. Stay active. Engage in regular physical activity to strengthen both the lungs and chest muscles. It’s also important to avoid spending too much time lying in bed, which causes fluids and mucous to settle in the lungs.
  3. Maintain a healthy weight. Carrying excess body fat causes strain on the diaphragm, making it more difficult for the lungs to fully expand.
  4. Get vaccinated. All seniors should receive an annual flu shot, and ensure they’re up to date on pneumonia vaccinations.
  5. Avoid air pollutants. Healthy lungs can quickly deteriorate into damaged ones by breathing secondhand smoke, chemicals, and outdoor air pollution.
  6. Get routine checkups. Even when a senior is in the best of health, annual doctor visits (or as often as recommended by the physician) are crucial to maintaining good health, and to catching conditions such as lung disease early.

Let Nightingale Homecare’s home health care team help keep the seniors you love healthy and well! We offer a full range of skilled nursing, professional non-medical, in-home therapy, and many other home health care services that can address current needs and proactively plan for any potential concerns in the years to come.

Call us at (602) 504-1555 and request a complimentary in-home consultation. One of our registered nurses will perform an assessment to determine how to help seniors maintain healthy lungs and an overall healthier quality of life, while continuing to live safely and comfortably at home.

The Role of the Caregiver in Fall Prevention

Fall Prevention

Learn how a caregiver can help with fall prevention for seniors.

According to the Centers for Disease Control and Prevention (CDC), “Each year, one in every three adults age 65 and older will fall. Falls can lead to moderate to severe injuries, such as hip fractures and head trauma and can even increase the risk of early death.” The good news is that falls can be prevented!

With Nightingale’s falls prevention program, Paces, each of our patients is screened for fall risk at the time of admission to care. If the risk is significant, our professional clinicians work together to develop a customized fall reduction plan that addresses all of the unique factors that contribute to that patient’s risk. The family caregiver also plays a significant role in ensuring that his or her loved one is safe at home.   

There are many factors that increase the risk of falling. The more of these risk factors a person has, the higher the chance that he or she will fall. This is why the professional home health Scottsdale providers at  Nightingale Homecare perform a very detailed fall risk evaluation of each patient. We want to uncover every risk factor, so that we can discuss the risk with each patient and his or her caregivers and create the most successful fall prevention plan.

Some of the Factors That Can Increase the Risk of Falling

  • Problems walking or moving around, regardless of the cause
  • Weakness
  • Balance problems
  • Vision problems
  • Sensory problems, including lack of sensation in the feet (neuropathy)
  • Medications that cause drowsiness, dizziness or low blood pressure
  • Urinary urgency or incontinence
  • Uncontrolled pain
  • Wearing certain types of shoes
  • Low blood pressure
  • Problems with thinking, problem solving or decision making
  • Improper use of walkers, canes or other assistive devices
  • Not having the house set up to allow safe activities of daily living; for example, having to reach too high or stoop too low for frequently used items
  • Having cluttered stairways and walkways, poorly lit rooms, unsecure carpets, damaged floors and other issues within and outside the home

Caregiver Observations: Your Loved One

The following is a list of observations to watch for in your loved one while you are caring for him or her.

  • State of Mind
    • Is your loved one confused, anxious or depressed?
    • Does your loved one make decisions that jeopardize his/her safety?
  • Vision and Hearing
    • Is your loved one using glasses and/or hearing aids consistently and appropriately?
  • Strength, Mobility and Balance
    • Does your loved one get up safely?
    • Does your loved one lean on furniture and walls while walking?
    • Does your loved one wear long robes or other clothing that could be tripped on?
    • Is your loved one wearing safe footwear?
    • Does your loved one get dizzy or light-headed when getting up?
    • Does your loved one have to hurry to get to the bathroom to avoid having an “accident”?
    • Does your loved one move too quickly?
    • Does your loved one reach for objects that are too low or too high or seem to lose his/her balance when reaching?
    • Does your loved one have any new bruises, scrapes or skin tears?

Caregiver Observations: The Environment

Pay special attention to your loved one’s environment, and note the issues that may lead to a fall.

  • Is there enough light for your loved one to see effectively?
  • Is there anything on the floor your loved one could trip on?
    • Scatter rugs
    • Wires/electrical cords
    • Oxygen tubing
    • Furniture
    • Pets
    • Clutter
  • Are there uneven surfaces, loose tiles, torn carpet?
  • Is your loved one sitting on a firm chair that has arms?
  • Is your loved one using his/her walker/cane at all times and in a safe manner?
  • Does your loved one have frequently used items within reach in the kitchen, bedroom and bathroom?
  • Does your loved one have grab bars, non-skid bathmat and a shower/tub chair?

What to Do with Your Observations?

When you notice problems that will increase your loved one’s fall risk, there are things you can do immediately to help reduce the risk and keep your loved one safe in his or her home.

When problems are observed, take the following actions:

  • Notify your loved one’s physician about your concern
  • Remind your loved one to wear his/her glasses and hearing aids – make sure the glasses are clean and find out if the hearing aids work
  • Remind the person to do his/her exercises, and provide assistance
  • Remind the person to use assistive devices and show him/her how if reinforcement is needed (an occupational and physical therapist evaluation can help with this)
  • Remind your loved one about which footwear is safest and help him/her choose and apply the safest footwear
  • Remind your loved one of the risk for falling if clutter, cords or other trip hazards are visible; move these items out of the way
  • Remind your loved one that a sturdy chair with arms is safest for him/her to sit in; help the person select the safest chair available and make sure it is accessible
  • Consider an occupational therapist evaluation to determine any supplies that your loved one needs but does not have, such as incontinence products, non-skid slippers, non-skid bathmat, etc.
  • Report any changes in behavior, ability or status to your loved one’s physician immediately, including:
    • Eating habits
    • Changes in ability to move around
    • Increases in shortness of breath
    • Skin changes

At Nightingale Homecare, providers of the highest quality home health Scottsdale families trust, we’re always on hand to perform an in-home safety evaluation, to provide you with additional resources and recommendations to enhance safety, and to improve overall health and wellbeing with our personalized, professional home care services for seniors. Contact us at (602) 504-1555 any time to learn more!

More Than a Band-Aid: Why Senior Wound Healing Can be a Challenge

Scottsdale senior home care

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.

Is Your Loved One at Risk for Elder Abuse?

Sun City home health care

Learn the 7 main types of elder abuse and how to keep seniors safe.

Elder abuse is a serious issue that involves the abuse or neglect of people age 60 and older. The signs of abuse are often not recognized, leading to gross under-reporting of the problem. In fact, the limited research available suggests that only one in 14 cases of abuse are actually reported to the authorities. Sometimes the abuse is a continuation of existing dysfunctional family dynamics. More often, however, the abuse is a result of changes brought about by the stress of illness, dependency and need for increased care.

Adult children and spouses are the most frequent abusers of the elderly, followed by other family members. The National Center on Elder Abuse defines the following seven different types of elder abuse:

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Financial exploitation
  • Neglect
  • Abandonment
  • Self-neglect

Physical Abuse

Physical abuse involves the use of physical force that may result in bodily injury, physical pain, or impairment. Persons who have been physically abused may have bruises, welts, lacerations, rope marks, black eyes, wounds, cuts, or untreated injuries in different stages of healing. Dislocations, sprains, internal injuries, broken eyeglasses or frames, and medication overdosing or under-dosing can also be the result of physical abuse. The elder being physically abused is often withdrawn, anxious, depressed, and fearful around a family member or caregiver. A red flag that physical abuse may be occurring is a caregiver’s refusal to let the patient have visitors without the caregiver being present.

Sexual Abuse

Sexual abuse includes non-consensual sexual contact of any kind with another person. Bruising around the breasts or genital area, sexually transmitted diseases, vaginal or anal bleeding, and torn or bloody undergarments are signs of sexual abuse.

Emotional Abuse

Emotional or psychological abuse involves infliction of anguish, pain, or distress through verbal or non-verbal acts. Emotionally abused persons may appear agitated, upset, withdrawn, non-communicative, or unresponsive. Emotional abuse often accompanies other types of abuse. In the elderly, unusual behavior often attributed to dementia, such as sucking, biting, or rocking behavior, can also be signs of emotional or psychological abuse.

Financial Exploitation

Financial exploitation is a common form of abuse that occurs in the elderly and involves illegal or improper use of an elder’s funds, property, or assets. Financial abuse can include cashing an elder’s checks without permission; forging an elderly person’s signature; stealing money or possessions; coercing or deceiving the elder into signing a contract or will; or improperly using a power of attorney, guardianship, or conservatorship. Other indications of financial abuse include the disappearance of financial papers, checkbooks, and legal documents; a sudden change in banking habits or a change in banking locations; the withdrawal of large sums of money by a person who accompanies the elder; additional names added to an elder’s bank signature card; unauthorized use of an ATM or credit card; the unexplained transfer of assets to a family member or person outside the family; or the unexplained disappearance of funds or possessions.

Additionally, substandard care, even though financial resources are available, can be an indication of financial abuse. Exploitation may also occur in the form of fraud schemes by strangers.


Neglect is the most common type of elder abuse. Neglect may be intentional, such as withholding nourishment, or it may be unintentional, resulting from ignorance or from a genuine inability to provide care. Neglect can also take the form of failure to fulfill an obligation, such as failing to pay for necessary home care services or the failure of a caregiver to provide necessary care. Persons who have been neglected may appear dehydrated and malnourished, have untreated bedsores, lice, a flea infestation, a urine or fecal smell, be inadequately clothed, or live in hazardous, unsafe, or unsanitary conditions.


Abandonment is an extreme form of neglect that involves desertion of a person by an individual who has physical custody or by a person who has assumed responsibility for providing care to the individual. An example would be a caregiver who leaves a dependent elderly person alone for several days while traveling.


Self-neglect abuse primarily occurs in the elderly and includes behaviors or absence of behaviors that threaten a person’s health or safety. This definition does not apply to a mentally competent person who makes the voluntary decision to engage in behavior that threatens his or her safety and who understands the consequences of that decision. Self-neglect can include behaviors such as:

  • Hoarding
  • Failure to take essential medications or refusal to seek medical treatment for serious illness
  • Leaving a burning stove unattended
  • Poor hygiene
  • Not wearing suitable clothing for the weather
  • Poor living conditions or the inability to attend to housekeeping

Self-neglect accounts for the majority of elder abuse cases reported to adult protective services. Oftentimes, the problem is paired with declining health, isolation, Alzheimer’s disease or dementia, or drug and alcohol dependence. In some of these cases, self-neglecters will be connected to support systems within the community that can assist the person to continue living independently. Conditions like depression and malnutrition may be successfully treated through medical interventions. If the problems are severe enough, a guardian may be appointed or alternate living conditions arranged.

Risk Factors

A combination of individual, relationship, community, and societal factors contribute to the risk of becoming a victim or perpetrator of elder abuse. In many situations, the same risk factors may be shared by both the perpetrator and the victim.

In the elderly population, studies suggest that those at risk are most likely to be female, widowed, frail, cognitively impaired, and chronically ill. Social isolation and mental impairment, such as dementia or Alzheimer’s disease, are two factors that may make an older person more vulnerable to abuse. A history of domestic violence may also make a senior more susceptible to abuse. Particularly in the case of adult children, abusers often are dependent on their victims for financial assistance, housing, and other forms of support. Frequently, these individuals need this support because of personal problems, such as mental illness, alcohol or drug abuse, or other dysfunctional personality characteristics. The risk of elder abuse is particularly high when these adult children live with the elder.


Home care clinicians, such as the professional Sun City home health care staff at Nightingale Homecare, are in an ideal position to detect situations for potential abuse and to connect the patient and caregiver with community resources that may prevent escalation of the problem. Stressed caregivers can be put in contact with social organizations and support groups and connected with referrals for adult day care, delivered meals, and respite care. Providing resources for caregiving assistance can be a lifesaver. Clinicians should also teach family caregivers to recognize situations that cause increased stress, as well as appropriate ways to handle difficult patient behaviors like violence, combativeness, and verbal abuse. Identifying actions that can deflate stressful situations is critical to preventing abuse.

Reporting Abuse

Home health providers are mandated to report suspected abuse. Mandated reporters are required by law to report allegations of abuse to law enforcement and regulatory agencies. In most states, Adult Protective Services are the public agencies responsible for investigating reports of elder abuse and for providing victims and families with treatment and protective services. In most situations, the suspicion of abuse is grounds for reporting. Proof is generally not necessary, and the reporter has the option to remain anonymous. Even if a situation has already been investigated, circumstances that seem to be getting worse should continue to be reported and documented by the clinician. If the patient is in immediate danger or a life-threatening situation, it’s important to call 911 or the local emergency authorities.

A trusted home care team, like Nightingale Homecare, is instrumental in reducing the chance for elder abuse and neglect. Contact our Sun City home health care experts to learn how we can help a senior you love stay safe, healthy, and well, in the comfort of home.

Top Family Caregiver Responsibility: Managing Activities of Daily Living

senior care Phoenix, AZ

Family caregiver tips: learn the ins and outs of ADLs.

Activities of daily living, often termed ADLs, include the basic skills typically needed to manage the physical needs of a person. Providing assistance with the activities of daily living for someone in your care is one of the most important responsibilities you have as a family caregiver. It can be challenging, and you may feel awkward at times, but becoming informed on these vital tasks will help to make it easier.

The ability to perform ADLs is dependent on cognitive, motor and perceptual abilities. Assisting someone with their ADLs comes down to knowing how you can help. Understanding what your loved one’s level of function is in the following five areas of ADLs will help you determine what level of care or assistance you will be providing.


Grooming, bathing and hygiene are very personal activities. It will be important for you to provide as much privacy and independence as possible during these activities. Minimizing how physically exposed your loved one is during a task can help him or her feel more comfortable. You may wrap a towel around private parts and uncover only during cleaning.

A specific task may be done more quickly if you just do it yourself, but you should always try to let the person you are caring for perform the task whenever possible – although only if it is safe to do so. Your loved one may be able to take a bath independently and may just need your help to wash his or her back. Remember to take your lead from the person as to how much or how little to help.


Make certain your loved one has clean, dry clothing available to wear. Pick out a couple of clothing options and allow him or her to choose the desired outfit for the day, when possible. Make sure the choices you have selected are in good repair and weather-appropriate. Allowing your loved one to choose what to wear encourages independence and minimizes the hassle for your loved one of choosing between too many options.


If your loved one requires assistance with toileting, it can be an uncomfortable or embarrassing task for both of you. Try to be very matter-of-fact when talking about toileting and provide toileting assistance in the same way you would provide any other kind of help.

Your loved one may feel a big loss of privacy and independence. You can help to keep his or her dignity intact by allowing as much privacy as possible. For example, if the senior is able to use the toilet independently, help the senior to get settled, and then leave the room and wait outside the door until you are called back in to help.

Your loved one may require extra assistance in clean-up. Again, approach matter-of-factly and provide quick but thorough clean-up. As you spend more time with your loved one, it will become part of the regular routine, making it easier for both of you.

Keep a regular bathroom schedule to ensure there are no accidents. In between bathroom breaks, look for signs your loved one may need to use the restroom.


Keeping safety at the top of mind when you assist a loved one with transferring or ambulating is a priority. It may be necessary to use a gait belt, transfer board or Hoyer lift to help your loved one move from point A to point B. An assistive device, such as a walker, cane or wheelchair, may be necessary. You will need to be familiar with all of these devices in order to ensure the safety and well-being of your loved one. Keep in mind, your loved one’s tolerance level may change from day to day or hour to hour, so you will need to be prepared for the potential that your loved one may experience weakness in the middle of a transfer or while walking. Keep this in the back of your mind at all times so that you can safely assist your loved one to rest during the activity. Your loved one’s physical therapist can help create an exercise plan tailored to his or her physical limitations and strength in order to help regain or maintain mobility. 


Your loved one may have challenges with any or all of the tasks associated with eating: shopping, preparing, and eating food. As a caregiver, you will be responsible for ensuring all of these needs are managed and met. Check with your loved one’s physician regarding any dietary restrictions or considerations. It will be important to ensure your loved one receives the necessary food and fluids to maintain strength and nutrition. If you are ever uncertain about your loved one’s nutritional needs or if you are concerned about his or her nutrition and hydration status, speak with the physician about getting a dietician consultation.

If meeting all of your loved ones ADL needs seems overwhelming, never fear – Nightingale Homecare is here! We offer a wide range of highly personalized in-home care services for seniors, from meeting personal care needs, help with household tasks and running errands, and companionship, to specialized dementia care, skilled nursing care, and so much more. Contact us for the best senior care Phoenix, AZ and the surrounding area have to offer at (602) 504-1555.

Posted in Aging Issues, Family Caregivers on June 19th, 2019 · Comments Off on Top Family Caregiver Responsibility: Managing Activities of Daily Living