CareAcademy Blog

Senior Care Home Safety Tips to Prevent Falls

As a family caregiver or professional senior care provider, you need to know about how to make any environment safe for the person in your care.

Preventing Falls is a Big Part of Senior Care

Take a look at the environmental safety tip-list we’ve put together for every room in your house. Here’s all the ways we recommend senior care givers prevent falls around a home.

Living Room Safety Tips

Problem areas for falls in this living room include:
  • cords that run across the floor
  • slippery hardwood floors or tiles
  • carpet edges, throws, or rugs that are not secured to the floor
  • sofa or chair that is at an improper height
Prevent falls in the living room
  • Remove clutter, and rearrange furniture to have a clear walking path.
  • Keep mops, brooms, sponges, or other cleanup tools accessible within reach to wipe messes from the floor
  • Either remove throw rugs completely, or tack them down to ensure they don’t slip.
  • If the coffee table is too low, remove it. A coffee table should be at a comfortable height to use while sitting on a chair or sofa.
  • Make sure couches are not too low and enables them to access transfer pole to assist with sitting and standing.
  • Make sure that items the patient commonly uses (the phone, eyeglasses, remote control) or within reach when you leave.
  • Sofas should have armrests to support the individual while standing up.
  • Proper height of a sofa or chair means that the older adult can sit on the edge with both feet resting comfortably on the floor. A sofa or chair that is too high or too low can result in a fall when an elder is either trying to get down on the chair or trying to get up.

Senior Care Professional’s Safety Tips for Steps and Staircases

Even though the bathroom is the most common place for falling in the home, the stairs are the most common place for serious injury from a fall. Several areas on these stairs are common risk factors in most homes:
  • Lack of handrails
  • Low or lack of lighting
  • Poor carpeting, hanging edges
Prevent Falls on the Steps or a Staircase
  • Install handrails on both sides of the stairwell. Handrails should be round to ensure good grip. Rails should extend beyond the last step to help the older adult recognize they are on solid ground.
  • Remove any stair runner rugs
  • Fix broken steps or coverings.
  • Convince the older adult to move their bedroom to a room on the first floor.  This minimizes the threat of suffering a fall by– for instance – walking up or down a flight of stairs in the dark, or even using stairs while exhausted and barely awake

Senior Care Truths & Myths About Preventing Falls

Here are a few practices that do not effectively prevent falls and may, in some cases, increase the risk:
  • Wearing socks that do not have a grip or shoes with no tread.  Instead, make sure the older adult is wearing proper shoes, even in the house. Shoes should fit well and have some non-slip tread on the bottom. Older adults should avoid going barefoot in the house, wearing shoes with a heel, or wearing slippers. Shoes that tie or have velcro to close stay on snugly and are ideal.
  • Wearing bifocals while on stairs.  This can also cause problems because bifocals can impair the eye’s ability to judge depth and detect obstacles. We recommend most older adults use single-lensed glasses while on stairs.
  • Hip protectors are hard plastic shields or soft foam pads usually fitted in pockets in specially designed underwear to provide padding on the hips. Hip protectors probably reduce the risk of hip fractures in older people living in nursing homes, but unfortunately have not been shown to reduce hip fractures in older people that live at home.

Additional Locations for Falls

Quality senior care also involves attending to two additional locations in the home where falls frequently occur:
  • Transitional Areas:  Fall injuries occur frequently at the edge where the carpet meets the floor. These so-called “transitional areas” are often at different heights or textures and may pose a problem for the rubber tips of canes or crutches.  Transitional areas also frequently occur in areas where there is a difference in lighting.
  • Car:  It is actually very common for older adults to fall when getting out of a car.  Why?  Well, car seats are usually soft, cushy and low to the ground. This can make it hard for an older adult to get up from sitting in one. If this is the case, they should see a physical therapist.  Occupational therapists can help to assess other physical issues that can impede someone from using their car.
 

Professional senior care involves making every space safe for the adult you care for. Check out the CareAcademy online class for preventing falls in older adults.

 
Madhuri ReddySenior Care Home Safety Tips to Prevent Falls
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Senior Citizens & Emergency Situations: What To Do

Professional caregivers to senior citizens often need help understanding when and how to get assistance. In particular, when should you refer to a registered nurse? Or when do you call 911?

How to Handle Emergency Situations in Caregiving for Senior Citizens

It is always good to be prepared to handle an emergency situation. Even if you never need to use that knowledge.

How to Report an Emergency by Calling 911

If the older adult you care for suffers an emergency such as fall and is unable to get up on their own, it is better to call 911 right away, rather than moving them. The person may have a broken hip, for example, and moving injured senior citizens may cause them more harm. 911 is for emergencies only. If you are ever unsure if something is an emergency, it is better to call and let the 911 operator decide. Any physical or behavioral condition that comes on suddenly within 24 hours in an older adult is a medical emergency, and should be evaluated in an emergency room. Symptoms in older adults are often very nonspecific.

Examples of emergency situations for senior citizens, when you may want to call 911:

  • Trouble breathing
  • Chest pain
  • Heart attack
  • Sudden slurred speech
  • Unresponsive/unconscious
  • Severe allergic reaction with trouble breathing and/or dizziness
  • Sudden confusion or disorientation
  • Heat stroke
  • Stroke
  • Sudden blindness
  • Uncontrolled nosebleed
  • Vomiting blood
  • Sudden weakness
  • Bleeding that will not stop
  • Bleeding with weakness
  • Broken bones
  • Serious burns

What to Do If You Call 911

Do not move the older adult unless the person is in danger. Moving a person that is injured can seriously worsen their injury, such as if they’re experiencing paralysis.  You can place a blanket on the person and try to keep them as warm as possible, if that seems appropriate. Landline phones allow the dispatcher to “know” where you are calling from even if you cannot speak – for example, if you feel unsafe. Just dial 911 and leave the phone off the hook. Do not hang up.

Once you call 911, what do you do?

  • Let the operator speak mostly and do not interrupt
  • Follow all instructions
  • Be ready to answer the following questions:
    • What is your location?
    • Is the person awake?
    • Is the person breathing?
    • Is there an injury?
    • Is the person in a dangerous spot or position where further injury could occur?
    • Has the person experienced a recent major medical event?
    • Does the person have a chronic medical condition?

To save critical time after calling 911:

  • Put animals in another room
  • Turn on lights
  • Ensure that the house number can be seen easily
  • Unlock and open the front door
  • Clear a path to the older adult, both indoors and outdoors, and leave room for the ambulance in the driveway if possible.
Remember: remain as calm as possible during the situation. Handling an emergency situation with care and quick, calm action is the best way to help.

Senior Citizens & Non-Emergencies – What Should You Do?

Inform Someone Immediately in Non-Emergencies

If you are a non-medical care provider or family member caring for your elderly relative, there is always help available when you need it for non-emergency medical and health situations. If you notice any significant changes in the adult’s behavior that indicates a medical emergency or abuse situation, inform someone immediately. If you are a family caregiver, you need to call your loved one’s healthcare provider. If you are a professional caregiver, you need to call your supervisor. It is always better to report something than to risk endangering the person or yourself by not reporting it.

Seek Out Medical Care in Non-Emergencies

Some injuries don’t warrant an ambulance but require professional medical care, because they may lead to complications if not treated. Get same-day medical treatment from the older adult’s health care provider or walk-in clinic if:
  • The person has hit his or her head. Older adults are at higher risk for bleeding between the brain and the skull after a head trauma. A CT scan of the head is therefore wise after any head injury. This is critical and requires immediate medical attention if there’s also a worsening headache, nausea, vomiting, or a change in mental status or neurological abilities.
  • There’s been a cut that might require stitches or additional attention.
  • The person reports significant pain in any bones or joints, which could be signs of a broken bone or bleeding in a joint.
  • The person is no longer able to walk (but could before the fall).
  • The person has less mental or physical function than before the fall (for example, is more confused than usual or has a reduced range of motion).

Preparation Makes Handling Emergencies with Senior Citizens Easy

To make handing any emergency efficient, keep some critical information posted on the refrigerator at all times:
  • The senior citizen’s medical history
  • Emergency numbers, including doctor’s phone number(s), family members and close friends/neighbors
  • Your street address, apartment number, and closest cross street.
  • A call-back number to give emergency personnel and others who may have additional questions
 

Professional caregivers keep senior citizens safe and healthy everyday. Become certified in a CareAcademy online eldercare course.

 
Madhuri ReddySenior Citizens & Emergency Situations: What To Do
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How to Make Your Home Safer for Seniors

If you need to make a place safer for seniors that you care for, follow these general guidelines for safety precautions and eliminating risks.

Potential Risks for Seniors in the Bathroom

The bathroom is the most hazardous room in the home for falls!  Most bathrooms tend to have:
  • Wet & slippery tub surface
  • Lack of support handles/grab bars in the tub or near the toilet
  • Slippery towels or rugs on floor
  • A low toilet, which makes it difficult for an older person to sit down and get up

Making the Bathroom Safer for Seniors:

  • Ensure that the toilet is at a proper height. When an older adult is sitting on toilet, it should feel comfortable. They may need a toilet riser placed if the toilet is too low.
  • Grab bars may need to be placed for assistance into/out of the tub and when using the toilet.
  • Use non-slip mats, and decals in the shower to prevent falls.
  • A shower chair and transfer bench may be really beneficial.
  • Encourage elders not to hurry to the bathroom, especially at night, as this can increase the chances of a fall. For men who urinate frequently at night, consider offering a urinal near the bedside to avoid frequent bathroom trips.
  • Encourage the use of a night light. Ensure proper lighting between the bedroom and bathroom.

Potential Risks for Seniors in the Kitchen

Notice the following risky areas that are also common in many kitchens. Remember – we are talking about someone who may be a little off balance to begin with. But it’s simple to make any kitchen safer for seniors. Look for:
  • Shelving that is too high to reach or too low to bend over
  • Slippery floors
  • Unstable stools/chairs
  • Unsecured rugs

Making the Kitchen Safer for Seniors:

  • If mats are used in the kitchen, ensure that they are non-slip
  • Keep mops, brooms, sponges, or other cleanup tools within reach to wipe messes, so no unnecessary reaching has to take place and so any wet areas can be cleaned up quickly
  • Never use chairs with wheels in the kitchen. And always ensure the chairs have arms.
  • Make sure the kitchen table and chairs are sturdy, stable, and not too high or low.
  • Make sure shelves are between shoulder and waist height.
  • Encourage elders to ask for help when things are out of reach.

Common Hazards for Seniors in the Bedroom

Even bedrooms can have some problem areas. For example:
  • Poor lighting
  • Clutter
  • High bed
  • Walking aids, telephone or other necessary items (eg. glasses) that are out-of-reach

Making the Bedroom Safer for Senior Citizens:

In any bedroom, check a few simple things to make sure that the room is safe for adults of all ages.
  • Make sure no loose cords are laying across the floor.
  • Keep the area neat and free from clothes on the floor.
  • Encourage the use of night lights. Lighting is very important all over the house. (Imagine a sleepy older adult walking around in the middle of the night – they are more likely to fall if they can’t see well.)
  • Check for proper bed height. When sitting on the edge of the bed, both feet should be on the floor.
  • Ensure the nightstand is within arm’s reach.
  • Ensure walking aids such as canes and walkers are within reach of the bed.
  • Make sure that items the person commonly uses (the phone, eyeglasses, remote control) are placed within their reach when you leave.

Safety Risks for Seniors in a House’s Hallway

In a hallway, issues that can lead to falls include:
  • Poor lighting
  • Clutter
  • Cords that run across the floor
  • Carpet edges, throws, or rugs that are not secured to the floor
  • Obstacles such as lamps or furniture

Making the Hallway Safer for Elderly Adults:

  • Ensure lighting is proper and high wattage.
  • Rearrange any furniture so that it is not in the walking path for an elder.
  • Make sure no loose cords are laying across the floor
  • Secure throw rugs or carpets, either by nailing them down or using non-slip backing underneath the rug.
  • Consider installing handrails for balancing
 

Eldercare professionals are responsible for keeping environments safer for seniors. Find out more with online eldercare classes from CareAcademy.

 
Madhuri ReddyHow to Make Your Home Safer for Seniors
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Helping Older Adults with Car Travel

The lack of access to usable transportation options is a major reason why many older adults cannot live in their own communities or travel with dignity and independence. There are innovations in technology and transportation that are helping elderly adults with car travel.   For caregivers, there are many potential difficulties with assisting an older adult with transportation, such as managing physical disabilities, dealing with a wheelchair or other device, and cognitive issues such as agitation. These are things that can be learned to manage if you have the right skills and knowledge and are prepared. Professional caregivers of older adults should always promote a safe and positive experience for both the passenger and driver or companion.

Here are our suggestions for caregivers who are helping elderly adults with car travel.

Consider Transportation Options for Older Adults

If the older adult is no longer able to drive, the options include:
  1. Family, friends and caregivers driving the older adult. This is of course the most convenient option for the older adult, and can be a valuable area where care professionals are helping elderly adults.
  2. Public transportation. These are fixed routes but available at a low cost. They can be very challenging for older adults, because they may not be wheelchair accessible, and there may be some distance to walk to the desired location from the transit stop.
  3. Personal transportation. These are door to door transportation programs, oven available through state programs and non profits. There is usually a fee, but some offer deep discounts for seniors. These transportation options vary between communities. For more information about helping elderly adults with door-to-door ride share programs in your community, go onto eldercare.gov for more details.

Assisting an Older Adult With Getting Into or Out of a Vehicle

Whenever you are helping an older adult into the car, transferring them from a wheelchair to a car, or assisting with a mobility device such as a wheelchair or walker, it is important to use proper body mechanics.

Basics of Helping a Senior In/Out of a Car:

  • Check the surrounding area for possible slip or trip risks
  • Wear appropriate non-slip footwear, which are safer for both you and the older adult
  • Stand with feet about shoulder width apart.
  • Keep your head and body as upright as possible.
  • Lower your hips to the height of the older adult by bending your knees and hips rather than your back.
  • Carry weight as close to your center of gravity as possible.
  • Get close to the older adult. Bear weight on your forearms rather than your hands.
  • Lift with your legs, not just your back.
  • When lifting, do not rotate your spine. Shift the position of your feet to turn (pivot).
  • Push or pull an object instead of lifting whenever you can.
  • Know your limits

Basics of Wheelchair Transfers.

When transferring, positioning, and helping elderly adults get from a wheelchair to a car:
  • Have the older adult you are helping wear a gait belt during transfers, if one is available. A gait belt is a safety device used for moving a person from one place to another. The belt may be used to help hold up a person while she walks and decreases the chance of injury of a helper hurting her back while transferring a passenger.
  • Open the car door and move the car seat back to make more room
  • Stand with your back to the inside of the car door and pull the wheelchair toward you between the car door and seat.
  • Talk the older adult through the transfer process step by step, so that he or she can assist if possible.
  • Hold on to the gait belt and help them to a standing position.
  • Use your legs to pull up for strength.
  • Have the older adult lean forward and push themselves up from the arms of the wheelchair  Discourage them from  pulling on the car door to stand because it is not stable.
  • Carefully pivot yourself and the older adult so that his or her backside is toward the inside of the car.
  • Help them sit on the seat with their legs still out of the car. Be careful that their head clears the door frame while they are sitting down.
  • Help them move their legs into the car once they are sitting and have been given a moment to gain their  balance. Use a swivel cushion to swing the legs while in a sitting position on the car seat. If you don’t have a swivel cushion, place a towel on a heavy duty plastic bag on your cloth seat or directly on your leather seat. Then, help the older adult sit on the towel-covered seat. Next, go to the other side of the car and pull the towel toward you. The plastic bag makes it easier to slide the person further into the car. Finally, pivot his or her legs into the footwell of the car.
  • Assist with the seat belt, and close the door before going to your own seat.
Helping elderly adults with mobility and transportation is important. Car travel is a part of daily life for most people, including older adults. As a professional caregiver, you can be prepared for any situation.  

Find out more about CareAcademy’s online courses for eldercare professionals.

Madhuri ReddyHelping Older Adults with Car Travel
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Personal Safety & Managing Aggressive Behavior

  Caregivers need to learn about keeping themselves and the older adult safe while in their care. In today’s blog,  we will discuss personal safety  and what to do when managing aggressive behavior from an upset adult.  

Managing Aggressive Behavior

  You may be involved in situations where the older adult, particularly if they have cognitive impairment, becomes verbally abusive or combative.  These can be very difficult and stressful situations for you and the older adult. Here are three key tips on how you can manage these situations:

1 – Don’t use force.

It can often backfire. Physical restraints should not be used indiscriminately.

2 – Stay calm, quiet, and rational.

If you allow the person to verbally express their anger, the possibility of physical violence can be avoided many times. Try and remember that the person who is acting aggressively is not doing so to harm you. They are trying to protect themselves. Don’t give them another reason to feel threatened. Act calmly and composed, even if you don’t feel that way. Never shout or yell or try to grab or hold the older adult. This will only escalate the situation.

3 – Take personal safety precautions.

When an older adult is out of control, your primary concern when managing aggressive behavior is safety. Remember, violent behavior is usually not planned and may not be under their control. To help make sure that everyone is safe, you should:
    • Get something such as a table between you and the aggressive older adult.
    • Try to get any potential weapons out of reach.
    • Call for extra help if you need it.
 

Specific tips on how to alert someone about what has happened.  

If you are a family caregiver, be sure to tell the older adult’s health care provider once the situation has been handled. If you are a professional caregiver, tell your supervisor. If you feel threatened in the moment, call 911.  

Personal safety and managing aggressive behavior can be vital as an eldercare professional. Learn how to be prepared for any emergency. Register for an online course.

   
Madhuri ReddyPersonal Safety & Managing Aggressive Behavior
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Senior Abuse: What Signs to Look For

1 in 10 seniors are abused – so chances are you as a caregiver have met at least one.

As a Geriatrician (an MD that has special training in the care of people over the age of 65 years), senior abuse is something that I am sorry to say I have seen more than once. The victims are by definition a vulnerable population, who in some cases lack decision-making ability due to Alzheimer’s or other dementia, and/or have put their trust in someone who takes advantage.

In children, we may be more on alert to the signs of abuse – bruises that shouldn’t be there, strange behavior – but when we see the same in a senior, we are more likely to think of medical issues – they probably fell, they are just confused. Seniors with Alzheimer’s or other dementia are at the highest risk of being abused. It important for a caregiver to have a high degree of suspicion when you see certain important signs, so you can call the proper authorities in a timely way.

As a caregiver, you can help a vulnerable person just by knowing what to look for. As they say – if you see something, say something. Call your state’s Elder Abuse Hotline immediately.

Do you know exactly what Senior Abuse (also called Elder Abuse) looks like? What should you, as a family member, friend or caregiver be on the lookout for?

There have been numerous attempts to define senior abuse, which has sadly been documented for thousands of years. Over the last 10 years, though, there have been several improvements in medical research on senior abuse that have taught the medical community quite a lot. For example, financial exploitation has been noted recently to be practically an epidemic in our society.

In long-term care (otherwise known as nursing homes), studies have shown abuse of older residents by other residents. In fact, this is more common than physical abuse by the nursing home staff caregivers.

There are 5 main types of senior abuse (elder abuse):

  1. Physical abuse – carried out with the intention to cause bodily injury. The signs a caregiver should look out for: You might notice bruises, use of restraints, burns, multiple injuries in various stages of healing.
  2. Psychological or verbal abuse – carried out with the intention of causing emotional injury. The signs a caregiver should look out for: You might notice  a caregiver/family member yelling, threatening or signs of intimidation such as preventing the older person from seeing someone they wish to see.
  3. Sexual abuse – nonconsensual sexual contact. Commonly, a resident in a long-term care facility with dementia may in fact assault another resident who may or not have dementia. The signs a caregiver should look out for: This is hard to notice unless you care or know the person intimately, but signs of sexual abuse are similar in older adults as they are in younger adults.
  4. Financial exploitation – misappropriation of an older adult’s property or money. The signs a caregiver should look out for: You may notice weight loss without a medical cause, firing of home care by the abuser, inability to pay for medicine.
  5. Neglect – the failure of a caregiver to meet the dependent older adult’s needs. The signs a caregiver should look out for: You may notice malnutrition, poor hygiene, pressure ulcers, confusion. Neglect may be intentional or unintentional.

Of course, sometimes it is the primary caregiver themselves who are abusing a senior. If you are a caregiver feeling overwhelmed, you need help . Providing care for a senior, particularly one that has Alzheimer’s or other dementia, is immensely difficult and you can’t do it alone. Call someone and tell them you need help – for example, your doctor, or the senior’s doctor. You can also check the Alzheimer’s Association and AARP websites for other caregiver resources and supports. Most importantly, do not suffer it alone. It is important to know that as a concerned caregiver, you play an important role in identifying a senior who is or has been abused. So keep a look out for the signs.

We’d love to hear any comments you have so far. Do you know or suspect any seniors that have been abused?

 

Reference:

Lachs MS, Pillemer KA; Elder Abuse, N Engl J Med, 373;20 November 12, 2015
Madhuri ReddySenior Abuse: What Signs to Look For
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Older Women Are Feminism’s New Mentors

I know that an assisted living facility would not look as the cradle of feminism or the women’s liberation movement. Usually, these facilities are sprinkled with a few older women and men in rapid decline, some others who still are feisty and engaged, and others between these two categories. Most of the time, these places are covered with the veil of home-away-from home, and a hectic pace of activities and things that need to be done. One day, in the swirl of this rapid tempo, I met Laura. Laura was a 75 year-old woman, with a nice southern accent, who was diagnosed with mild cognitive impairment, high risk for falls, and incontinence, and who has been at the residential care facility for almost two years. In the middle of the lobby, Laura, with a very firm voice, was ordering one of the employees, to look for her cat that has been lost for most of the day. Trying to be helpful, I approached Laura and introduced myself and offered her to help with her cat search. After few actions addressed to find the cat, I invited Laura for a tea. Never would I have thought that what was about to unfold was going to be quite so interesting and thought provoking.  After telling Laura that she seemed that one of the very spirited older women in the facility, she commented that “Once a fighter, always a fighter…” Curious about the meaning of her statement, I asked her what fights she has fought and then, a rather unusual conversation started that was to stir some ideas in my mind about feminism. When asked about her week and what the highlights of the week were, Laura’s face beamed and she said that she looked forward to meeting with a couple of interns and volunteers coming to the facility to work on some activities. Laura was not to keen to what these younger people’s agendas actually were, yet she was very appreciative of the fact of them listening to her stories. She said in a eloquent way, “They really want to know, to learn from the past and my experiences. They ask, I answer. They want to hear about struggles and conquests of older women.” Although Laura was not exactly the “older version” that I had in my mind of a feminist, her stories of the battles for civil rights, equality, and women’s rights in the late 1960s and 1970s, resonated to my knowledge and first hand-experience of feminism. Her tale made me think of what is next for aging women, in a world that does not take well aging. A world that is plagued with ageism and sexism.  She was presenting a shift of the feminist paradigm from liberation to mentoring, and she opened a door into meaningful opportunities for these ”aging women” into their later years.

From Crone to Mentor: A New Role for Older Women in Later Years

Seldom do we question how the women’s movement has affected women of age, those women who took what they learned as activists in the civil-rights movement and applied it to rampant sexism. That phase of the women’s movement spawned two generations of equal rights, abortion rights, lesbian and gay rights, anti-ageism, and AIDS activists; a devoted, beleaguered army of caretakers of abused women and children in the shelter movement; and labor groups such as the CLUW and Women in the Trades. To name only a few “special-interest” groups. Elderly women today face different challenges, some triggering deep, personal questions—namely, what is their role as they age? Reproduction is no longer a goal; nor is raising children. If they had a career, it is in the past, or nearly so. Other traditional caregiver roles—parenting the grandchildren, caring for a husband or other family members—are still available, but this new identity may be difficult to bear. The “aging” woman, with her dry skin and wrinkled body, is no longer regarded as pretty, sexy, vital, or accomplished; she is in her “dimmed time.” Jean Shinoda Bolen has said that “In a youth-oriented patriarchy, especially, to become an older woman is to become invisible: a nonentity.”
What’s the future for this woman? What role should older women play in our society? What, if anything, is the role of feminists, activist women?
As Laura expressed when talking about “the highlight of her week,” perhaps we could create that new role where these fighters pass the baton; build a bridge to new generations of feminists, our sisters who still have a long road ahead of fighting for equality and identity. We need to find a way from which all generations of advocates of feminism can gain a way to replace the schism between “generations” with an understanding of scales. This will require a deep understanding of difference and especially, in this case, the marker of age as that difference. Younger generations are interested in how growing old has affected the perspective of older women who’ve struggled for decades with language-embedded sexism and rampant ageism in our culture.

Ageing Feminists – Who Are We Now?

Within the baby-boomer crowd, we find three different “generations”—those born in the mid-1940s, the mid-1950s, and the early 1960s. All three find themselves lost in the battlefield. Members of the first generation, especially, often discouraged by the meager results of the equal-rights “victory,” have difficulty empowering themselves and their sisters. Weary of trying to raise others’ awareness, seeing their self-esteem slip away, they can’t help questioning, yet again, who they are. Battling their own dependency issues, they now consider retirement—and what do they see? Living 20, 30, 40 years on the edges of society, without an audience interested in their experiences, knowledge or wisdom.

Mentors, Sages, Baton-Carriers

Following Laura’s first impressions, I have interviewed hundreds of older women who have stressed the importance of becoming mentors, sages, to help younger women meet their needs. One of them has said, “It’s not about me as an individual, anymore … I’ve done whatever I can to express my individuality, develop my personal self, now I want to contribute to the well-being of my daughters … and the Earth.” Others have remarked that the aging phase is a prime time to reinvent ourselves, to use the still-formidable energy of our mature years with compassion and wisdom. There is, after all, a difference between growing old and growing into an elder.
To become an elder takes work and a willingness to struggle continuously for awareness.
This struggle for awareness demands a relentless engagement with life and its constantly emerging challenges.

The Depth of Older Women’s Wisdom

Women need to understand that along with a left-brain linear intelligence, they also possess a deeper intelligence, more creative and respectful of life. Some call it intuition, but it is really a kind of an emotional intelligence, a spiritual force allowing those who have it to deal with both the quotidian and the divine. Imagine a world in which the wisdom and power of aging Goddesses guides us through our next challenges, with the shared goal of building a global village that is tolerant, nonviolent, and life affirming. It is time for all older women to tap into their wisdom, and guide people on a journey of healing and transformation. We need this for ourselves, and for the planet. It is time to nourish the soul, to mentor our daughters and sisters, and, at last, to regard our aging selves in a celebratory light.  

Develop your skills as an eldercare professional. CareAcademy online class to for effective inter-generational communication.

 
Doris BersingOlder Women Are Feminism’s New Mentors
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Medical Care Conversations: Listening Before Talking

Talking in Elder Medical Care

What is really being said?

When my elderly mother-in-law was in her final days, I was with my husband Joseph through much of his vigil.  Her doctor had communicated clearly the gravity of her situation although, as Joe was an emotional train wreck, he didn’t “hear” a lot of what was said.  I translated for him, gingerly converting into real words what the medical care terms indicated. As Joe’s mother’s neurological system collapsed, she experienced seizures.  To the nurse practitioner Joe desperately pleaded, “Seizures are treatable, right?” “Yes” she answered with a much-too-bubbly voice for the dire circumstances.  “Most seizures can be managed.”  She didn’t expand on the exception to this case, a dying woman in full organ failure. That’s all Joe heard:  His mother was having seizures; seizures can be managed, so manage them! I was annoyed.  If the NP had really “listened” to my husband’s anguished plea about medical care, she would have realized that he was grasping to save his dying mother.  Her seizures couldn’t be “managed,” and the nurse should have elaborated and calmed him. My mother-in-law passed away two days later.  It was almost a year before my husband and I revisited the medical explanation for her seizures. Joe was more than miffed, feeling very mislead, as I elaborated on what the nurse practitioner glossed over.  

Listening in Elder Medical Care

What is really being asked?

I certainly understand how fear, grief, shock etc. can twist words and create an illusion of mistruths. At a minimum, any eldercare or medical care professional interacting with families should remember these points:
  • Be accurate with the information you provide but more importantly, listen to don’t just hear what the family is really saying.
  • Be careful not to layer on your personal biases.
  • Know your audience!  Don’t dazzle them with medical jargon they can’t absorb.  Use simple terminology and examples.
Dialoging with families of loved ones with dementia requires a unique skill set, in part because their orientation/behavior fluctuates between lucid/appropriate and confused/goofy.

Answer a family’s question with a question so you can better answer their questions.

Don’t laugh; it’s a legitimate approach.  The point of which is – in order to really understand what the family wants to know,  what their concerns are, what’s important to them – you have to ask carefully-worded but probing questions. “When can my mother go home?”  On the surface it appears to be a straightforward question about necessary medical care.  And it is, if it’s asked in behalf of an otherwise stable person who is perhaps post appendectomy. However, if the parent has experienced a compromising stroke, major surgery, or has Alzheimer’s, “going home” is a far-from-simple question.  Then, it’s on you to gently probe.
  • Is the family in complete denial?
  • Are they confused as to the severity of their parent’s (or other elderly relative’s) needs?
  • Are they expecting a recovery that’s unlikely or unreasonable?
  • Do they think they can manage their loved ones exhaustive needs on their own?
With tasteful inquiries, you uncover the layers of their concerns; fear and misunderstanding are likely underlying factors in the family’s questions.  Your medical care expertise balanced with professional courtesy will provide the basis for meaningful dialogue with families in crisis.  

Want to learn more about how to help family members understand medical care?

Learn more in CareAcademy’s online class in Being an Eldercare Professional.

 
Elaine PereiraMedical Care Conversations: Listening Before Talking
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Top Infection Control Tips for Eldercare

This is part in our series on professional infection control in eldercare. In today’s blog, we discuss decontamination prevention and procedures, including barrier precautions, the appropriate disposal of contaminated materials and equipment, and preparing soiled linens for laundry.

Barrier Precautions

The need for protective gloves, gowns, and masks.

Often throughout your day, you will need to use personal protective equipment such as protective gloves, gowns, and masks to assist you with infection control & prevention. Wearing gloves Gloves allow you to create a barrier between you and the germs.  So, let’s discuss tips for wearing gloves.  First, you should wear single, disposable gloves when:
  • touching blood or body fluids
  • you or the the care recipient has broken areas of skin
  • you are assisting with personal care, such as cleaning stool or urine
  • you are handling soiled clothing or linens
  • the older adult has an indwelling device that you are helping to care for, such as a tracheostomy, central line, or indwelling urinary catheter
  • the older adult’s hands, clothes and home environment are not generally clean
  • cleaning the bathroom
Remove gloves prior to touching non-contaminated objects. Remove gloves promptly after use and wash hands thoroughly. Do not reuse or wash gloves for any reason! Before putting on gloves, wash your hands, then make sure the gloves do not have any tears or holes. Taking off gloves tips for easy infection control
  • Use gloved [right] hand to hold the [left] glove, near the wrist. Do not touch bare skin.
  • Peel the left glove off from the wrist. It should now be inside out.
  • Balled up the left glove in their right hand. Left it inside out
  • Put two fingers of their left hand inside the right glove. Did not touch the outside of the glove with their bare hand.
  • Peeled the right glove off from the wrist. It should now be inside out, over the left glove.
  • Threw away the gloves in the proper place.
  • Wash hands
Appropriate disposal of contaminated materials and equipment Syringes or needles are called “sharps” and need to be disposed properly:
  • Do not touch sharps with your bare hands. Use gloves and if possible, use a tool to pick them up
  • Sharps containers can be purchased from a pharmacy or healthcare provider and should be used to dispose of sharps
  • Fill the sharps container to approximately ¾ full, use heavy duty tape to secure the lid, and throw away with regular trash
  • Keep out of reach of children and pets
  • Always wash your hands after handling any medical sharps
Handling other wastes
  • Body wastes such as urine need to be flushed down the toilet
  • Soiled incontinence pads or disposable gloves need to be placed in plastic bags, tied and taken out to trash Immediately so that they do not create odors or grow bacteria in the home
  • Mop water needs to be flushed down the toilet or thrown outside – never put it down the kitchen sink

Properly Caring For and Decontaminating Equipment

Make sure that you don’t reuse equipment that is only meant for single-use, and ensure you dispose of it as per the directions. Properly clean reusable equipment. Clean and disinfect surfaces that are likely to be contaminated with microorganisms, including those that are close to the older adult (e.g., bed rails, overbed tables) and frequently-touched surfaces (e.g., door knobs, surfaces in and around toilets) frequently.

Cleaning the Environment

  • Wear gloves
  • Mop up any spills with paper towels or other absorbent material
  • You can use either a bleach solution (1 part household bleach and 10 parts water) or an Environmental Protection Agency approved disinfectant (eg. accelerated hydrogen peroxide) and wash the area well. If you are a professional caregiver, you agency may have specific guidelines about what to use.
  • The amount of time needed for the bleach to work is the amount of time it takes the surface to air dry after you have washed it with the bleach solution
  • Bleach solution needs to be put into a spray bottle, labeled, and a fresh supply made every 24 hours
  • Dispose of gloves, soiled towels and other waste in sealed double plastic bag

Preparing soiled linens for laundry

If you have linens that are soiled with body fluids, such as feces, urine, vomit, you should take the following steps to ensure infection control:
    • put on gloves before handling soiled linens and carry at arms’ length (not against your clothing)
    • put linens in a plastic bag, NOT on the floor, and take them to the bathroom
    • rinse the large solids out in the toilet and place the soiled linens back in the plastic bag
    • launder immediately, using bleach if linens are white. If the sheets are colored, make sure they are dried completely in the dryer (the heat is as effective as bleach in killing the bacteria). Hanging clothes out on a clothesline will also kill the bacteria.
 

To become certified in professional sanitation and environmental infection control in eldercare, check out the CareAcademy class!

Madhuri ReddyTop Infection Control Tips for Eldercare
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Handwashing Tips to Prevent Infection

Handwashing Tips to Help You Prevent Infection from Spreading

This is part of a series about maintaining a clean and healthy environment in eldercare (but it’s great advice for anybody!) In today’s article, we will discuss infectious diseases spread by skin, and how you can use handwashing as an effective infection control procedure.

Infectious diseases spread by skin

Some germs live on the skin. These include head lice and scabies. What are they?  Well, head lice are parasitic insects that live on a person’s scalp and hide in their hair.  Scabies is a contagious skin disease caused by a type of small bug called an itch mite.  People in group settings such as nursing homes are very likely to get these diseases, especially scabies.   So in order to keep scabies from spreading, oftentimes all affected family members need to be treated at once, even if they’re not feeling itchy at the time.  Their symptoms could appear much later if not treated, and they could also spread the disease to someone else!

Tips to Prevent Infection

Here are some additional tips you can use to prevent infection in the event that you come in contact with an infectious disease:
  • Keep yourself healthy
  • Keep up to date on Immunizations
  • Cover your mouth when coughing or sneezing
  • Stay home and rest when you are too ill to give someone else care.  That is very important since illness can affect your ability to do your job on top of being very likely to spread disease

Infection Control Procedures

Hand Hygiene

Hand hygiene (which includes handwashing and cleaning hands with antiseptic cleansers) plays a critical role in the spread of infectious diseases, even in an older adult’s own home. In fact, the most common way that infections are spread are by our hands! The reasons that most people claim that they don’t wash their hands regularly include:
  • causes dryness and irritation
  • sinks are not located in an easy space to get to
  • lack of soap or towels
  • simply too busy, or not not enough time
  • needs of the older adult are much more of a priority
  • belief that there is a low risk of catching an infection from the older adult
You should know that these are NOT good excuses!  Most germs are very easy to pass on.  By avoiding proper infection control, you are risking the safety of the older adult.

Proper Handwashing Technique

What should you use to clean your hands?
  • When hands are visibly dirty, contaminated or soiled, wash with soap and warm water. Either plain soap or antimicrobial soap work well.
  • If hands are not visibly soiled, use an alcohol based handrub for routinely decontaminating hands. Application is key – LET IT DRY! There is a “kill time” that refers to disinfectants – this is the time needed for the product to make contact with the surface being cleaned and remain wet. It is dependent on the microorganisms and also the manufacturer. Often handrubs may cause dry skin – it’s helpful to have moisturizer available, especially in the winter.
When should you wash your hands?
  • Before and after contact with the older adult’s skin, particularly if there are broken areas of skin
  • After contact with body fluids or excretions, wounds or wound dressings (whether or not gloves are worn)
  • After assisting the older adult with toileting or changing incontinence products
  • After you go to the restroom
  • Before preparing food
  • After wiping nose, sneezing or touching your face
  • When hands are visibly soiled
It may be necessary to perform hand hygiene between tasks and procedures on the same older adult to prevent cross-contamination of different body sites.

How do you properly clean your hands?

To correctly use a hand rub, you should:
  • apply it to the palm of one hand, rub hands together covering all surfaces until dry
  • the amount varies by manufacturer, but it is usually about 1 tablespoon (??)
For proper handwashing you should:
  • Get soap and towel before beginning; roll up sleeves
  • Take off your jewelry
  • Stand back from the sink
  • Clothes and hands should not touch the sink.
  • Turn on the water with a towel
  • Water should be warm but not hot
  • Wet hands. Fingertips point down.
  • Put liquid soap on hands and wrists.
  • Rub hands, fingers, and wrists. Rubbing helps loosen bacteria and dirt. Also, make sure to clean between fingers.
  • Rub hands under the water for at least 30 seconds (Sing “Happy Birthday” twice )
  • Dry hands with a clean towel. Do not shake water off hands.
  • Turn off the water with the towel
  • Don’t touch the sink, faucet, surfaces or doorknobs with hands after washing. This will re-contaminate your clean hands.
  • Put the towel in the hamper or laundry for cleaning
For Fingernail Hygiene
  • Keep fingernails short (¼ inch or shorter)
  • Artificial nails should not be worn when taking care of older adults

 Additional Tips to Keep Hands Clean

  • keep a pocket-sized container of alcohol-based handrub on you
  • place alcohol-based handrubs in the older adult’s bedroom and bathroom
  • remember that alcohol is flammable so store these handrubs away from high temperatures or flames
There are several important things you can do when taking care of other people in order to help prevent infection from spreading – handwashing is easy and essential.  

Become certified as a professional eldercare provider. CareAcadey offers a specialized class in how to Maintain a Clean and Healthy Environment.

Madhuri ReddyHandwashing Tips to Prevent Infection
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