Supportive Care Bulletin
Helpful tips for family caregivers
Caring for an aging loved one often brings up big issues. Here is some guidance to help you on your journey.
Dressing your relative for incontinence
There are many undergarments designed to help with incontinence. They can’t prevent it, but they can help your loved one feel more comfortable with outings and retain their dignity despite the embarrassment of accidents.
Not all products are the same. Choose what’s right for the situation. For outings, aim for a garment that isn’t bulky. At nighttime, use a product that fights leakage and is easy to change in bed.
There are three basic categories of products created to absorb accidents.
- Pads or guards that are slipped into body-hugging regular underwear.
- Pull-on pants that closely resemble regular underwear.
- Briefs that open easily along the side yet gather at the leg for heavy-duty protection.
Your loved one may feel embarrassed by their incontinence and need for assistance. Use these strategies to help reduce emotional and physical discomfort:
- NEVER say “diaper.” Call them “modern briefs” or “new-fangled underwear,” or anything that steers clear of reference to infants. Make sure others do likewise.
- Use humor and a team perspective. It’s not the person that’s the problem, but a “misbehaving” bladder or bowel. For instance, you might say, “Looks like your bladder is going to give us a run for our money today, Mom!”
- Eliminate odors. The sense of smell declines with age, so your relative may not be aware of personal odor. Over-the-counter pills containing chlorophyllin copper reduce the odor of urine and feces. For sheets and clothing, add white vinegar or baking soda to the wash before the final cold-water rinse.
- Clean thoroughly to prevent skin breakdown. Use water, but not soap. Alcohol-free wet wipes are best. Air dry or use a soft cloth, not toilet paper. Then apply a moisture-barrier cream and/or cornstarch-type powder, not baby powder. A thorough cleaning is often difficult for elders to accomplish without assistance.
- Be prepared. Always carry cleanup supplies and extra disposable underwear and clean clothes. Have your relative use the toilet before leaving home.
What is a memory unit?
A condition that causes memory loss (dementia) is one of the most common reasons an elder can no longer live at home. Some assisted living facilities have “memory units.” So do some skilled nursing facilities.
Every aspect of a memory unit is geared to the needs of adults with dementia.
- More staff. Personalized attention is the heart of memory care. Familiarity is comforting to the person with dementia. This requires more staff per resident.
- Simplified environment. Fewer walls and shorter corridors are the norm. This way, residents can see where to go. They don’t have to remember. The decorations are usually homey. And clutter is kept to a minimum.
- Special activities. Cards or other strategy games are too hard for persons with dementia. Instead, these units focus on social and creative activities. For example, a story-telling circle or sing-along.
- Extra safety measures. Exit doors are typically equipped with alarms that signal if they are opened without a special code. Residents do not have kitchens or potentially dangerous objects in their apartments.
- Additional staff training. Employees are given lessons on how to work with people who have dementia. For instance, they may learn special techniques for calming an emotional outburst. Or how to recognize symptoms of pain in a person who is no longer able to speak.
Residents range from individuals with mild dementia to those in the late stages of the condition. A person with simple memory loss may need only verbal reminders to take their medications. At later stages, a resident may need help with dressing, bathing, and eating.
Monthly fees are higher for memory units than for basic assisted living. Note that Medicare does not cover these costs. That’s because dementia is not considered an acute medical problem.
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When parents need financial help
Many adult children are encountering the uncomfortable reality that their parents don’t have enough money. Perhaps they’ve simply outlived their savings. Or their medical expenses have grown beyond anything ever imagined.
Whatever the cause, it’s an issue that poses hard choices. How much should you support them? And what about your own needs? Your children’s? Here are some thoughts to consider.
- Seek professional help. Talk with an attorney or financial planner who specializes in elder issues to learn about strategies and special programs.
- Be honest about what you can do. On paper, living together may seem an obvious way to cut your parents’ expenses. Realistically, is your lifestyle compatible with their needs?
- Have a family meeting. No matter who lives where, make parental needs a family issue. Include your siblings via conference call, if necessary. Get help from a geriatric care manager if you are concerned about family tensions or simply want expert guidance.
- Forgive the past. It may be hard to stretch yourself to care for a parent who did a poor job of caring for you. To the best of your ability, focus on the present. You may find it empowering to “do the right thing.”
- Ensure sacrifices are shared. Spread the costs among all family members, including mom and dad. Watch out for emotional traps, such as hoping to make up for the past or hoping to earn words of love and recognition.
- Don’t be afraid to say “no.” Some parents will always want more, no matter what you give. Find a balance between your needs and theirs. If you are paying the bills, it’s appropriate that you also set some rules.
- Let reckless parents face consequences. If your parents’ free spending in the past limits their options now, you may all have to accept the natural outcome of their choices.
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