Part 10: Practical Tips to Ease the Way (Section 2 of 2)

by
Shari (Zissie) Gitel
zissieg@walla.com

Now it’s time to discuss tips for keeping the patient well-dressed, fed, comfortable and occupied. Sounds easy, right? Well, with a little ingenuity and a lot of determination it isn’t all that hard. Let’s get started.

Fashion Design and Physical Education 101
If the patient is able to dress him/herself there are some nifty contraptions to aid the process. There is a device to help patients put on their socks without having to bend down to do it. Long shoehorns help with getting shoes to slide onto the feet. Avoid shoes with laces or buckles. Slip-ons or shoes with Velcro closures are the easiest to handle. Shirts, trousers and skirts without buttons or zippers speed up the dressing process. Simplicity is the name of the game, not haute couture.

In the event the patient is wheelchair-bound and sedentary or supine most of the day, you’ll need to protect the patient from pressure sores. Special pillows for chairs and air mattresses, which require electric pumps to keep them inflated, for beds help prevent these sores. There are many types of wheelchairs, some with reclining padded high backs and legs that can be raised to elevate the patient’s legs. Trays can be acquired to attach to the wheelchair. The patient should be encouraged to change positions several times during the day to prevent the same area of the body from receiving the bulk of his/her weight continuously. In hospitals, they place a folded flat sheet under the trunk of the patient’s body to help pull the patient up in bed or turn him/her over. This is a two-person job.

PREVENTING PRESSURE SORES IS A MUST!

Doorways in many homes do not accommodate the width of a wheelchair, walker or commode chair. Many homes do not have elevator access, or ramps. If your home falls under one of these categories, check with Lishkat HaBriyut to see how to qualify for altering your home to meet the patient’s needs. If you must carry a wheelchair-bound patient up or down stairs, it is easier to transfer him/her to a sturdy arm chair first. This greatly reduces the weight you will have to lift, as the wheelchair alone can weigh as much as 40 pounds or more. Again, this is not a one-person job.

Home Alone
If the patient is on his/her own for any portion of the day he/she may benefit from a long-handled reaching device—either to reach something on a high shelf or to pick something up off the floor. It is also worthwhile to bring in a professional to advise you on how to redesign rooms to make them patient-friendly. Cabinets, drawers, height of furniture—just about everything imaginable—come under this category. Eating and food preparation utensils can be purchased that make life easier for patients with manual dexterity problems. For patients who have difficulty swallowing thin liquids, there is a food thickener on the market that can be added to the liquids. For people who have difficulty getting food and drinks into their mouths spillage on clothes is a common occurrence. You may want to invest in disposable bibs for adults. If food preparation is a problem, many organizations and companies provide meal deliveries to the home, some of them subsidized according to the patient’s ability to pay.

Some other items you may want to have on hand, depending upon the patient’s condition are a blood pressure machine and inhalation machine. And let’s not forget one of the most important items: an alarm system for the patient to call for emergency help.

Patients with dementia should be taught to always put things back in their proper place: keys on a table by the door, glasses next to the bed, money in his/her wallet, etc. It takes a lot less time to spend an extra minute or two replacing the items in their proper location than spending several minutes or sometimes even hours trying to locate them. Carefully label items that the patient may have trouble identifying. Monitor the patient’s medications. There are medicine boxes of all types on the market for this purpose. Depending on the degree of the patient’s dementia, you may not want to give him/her access to medications at all.

WORDS TO LIVE BY: A PLACE FOR EVERYTHING AND EVERYTHING IN ITS PLACE!

Leisure activities should be encouraged to keep the mind and body sound. I have found that a discman/tape player with headphones (my daughter says I’ve dated myself and should really recommend an iPod) is a handy entertainment center. Whether it’s music, audio books, or lectures, the patient is bound to find something that will hold his/her interest. Large print books are available for the visually impaired. There are also many assistive devices to help the visually impaired enjoy the use of TVs and computers. Playing cards come with large numbers on them. If the patient can handle them, give him/her games to exercise the mind, such as Jumble puzzles, Sudoku, crosswords. These are readily available on the internet and can be printed in large type or enlarged on a copy machine to facilitate use by the patient.

Make sure the patient regularly exercises his/her body to the best of his/her ability. Keep those extremities limber and strong. Muscle atrophy is something you really want to avoid. You can purchase an elastic sash from your kupat cholim’s physical therapy department (at least that’s where we got ours). When the ends are tied together the sash, looped around the ankle and held in the patient’s hands, acts as an aid to the patient to raise his/her legs while sitting, thereby exercising the muscles. It can also be used in arm exercises, providing resistance as the patient stretches against it. Again, this is something you will want to discuss with the patient’s physical therapist.
Tricks of the Trade
For us, the caregivers, I also have some tips. Continue to breathe in and breathe out. This will keep us going for the short term. I found a little trick which works wonders for me, and I’m considering patenting it. Previously I mentioned how much benefit I received from reflexology. For those who are not familiar with reflexology, it involves the therapist pressing and massaging different areas of the foot which correspond to different areas on the body. After every session I felt extremely relaxed. One day I said to myself if my feet being relaxed makes my body relax, let me try an experiment. I am about to share my discovery with you. It’s something you can do any time day or night, and no one need even know you’re doing it. For me it provides instant relaxation. All it involves is wiggling your toes. Try it. When I wiggle my toes, my forehead relaxes and my back and shoulders are less tense. I hope it works for you, too. Another technique I have employed when I find myself clenching my jaws or grinding my teeth is repeating the letter “N” over and over. This relaxes the jaw and facial muscles. You may, however, want to practice some discretion in where you perform this particular exercise. Otherwise, people around you may decide you’re a good candidate for institutionalization! And do find time for yourself to get out and exercise to keep those endorphins flowing. Laugh as much as you can, because laughter is truly the best medicine.

This whole adventure in writing my blog itself has been therapeutic for me. I don’t know how helpful it has been for you (I sincerely hope it has been), but for me it just felt great to get a lot of things off my chest and transferred to paper. Perhaps writing down your frustrations and feelings can do the same for you.

Finally, I would like to thank the Yad Sarah organization for giving me this opportunity to enlighten the public on services for the disabled and elderly. Most of the assistive items and services I have mentioned in my articles are available through Yad Sarah. I strongly recommend you visit the Yad Sarah website (http://www.yadsarah.org/). If you live in Israel, I hope you take advantage of the many services Yad Sarah provides, visit the Guidance and Exhibition Center, volunteer for the organization or support it in any way you can. If you are among my readers from abroad, perhaps Yad Sarah can act as a model for a similar organization in your own community. Contact Yad Sarah to find out how their representatives can help you. Visit the headquarters in Jerusalem. You’ll enjoy a tour like no other you have ever experienced.

I hope you’ve enjoyed reading my blog as much as I have enjoyed writing it.

Shalom for now.

Guide to Services for the Aged and Disabled in Israel
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