Supportive Care Bulletin
Helpful tips for family caregivers
December 2011/January 2012
Communication is central to so much in family caregiving. This month we highlight both talking and listening. We also offer you Part 2 of our series about urinary tract infections and how to prevent them.
- Listening: The other half of the conversation
- Talking with children about serious illness
- Urinary tract infections: prevention tips
Listening: The other half of the conversation
Good communication requires both speaking and listening. Oddly enough, if you make a specific effort to listen, it can open doors. Once “heard,” the other person may be more willing to hear your point of view.
Deep listening is more difficult than it sounds. It’s not passive. It requires concentration. It also takes humility and empathy. Here are some tips:
Consider the setting
- Schedule your talk at an unhurried time.
- Turn off the TV, music, and cell phone.
- Make sure the seating and room temperature are comfortable.
Observe yourself. Are you
- distracted by physical needs or strong emotions? If you are hungry, upset, or tired, you won’t be able to concentrate on what the other person is saying. Consider talking after a meal or in the morning when you’ve had a chance to rest.
- bored? If you “already know what is going to be said,” it’s probably best to push your internal reset button. Be open to the possibility that things might not be completely as you expect them to be.
- unable to concentrate? If you find your mind wandering, try mentally repeating their words. It will help you focus and fully take in what the speaker means.
- preparing your replies? If you find you are concentrating on your response, try listening attentively and then waiting one full second after the speaker finishes before you begin talking. After completely hearing what was said, you can thoughtfully compose your reply.
Show empathy. Often the best way to get something is to give it yourself.
- Nod and encourage. “Yes,” “uh huh,” smiles, and open body language cue the speaker that you are interested and paying attention.
- Ask questions. “Could you tell me more?” or “An example would help me understand better.”
- Check in and repeat back. “I’m understanding that what you’d like most is . . .” or “So, you are feeling frustrated that . . .” Paraphrasing can ease defensiveness in the speaker, making him or her more open to hearing what you have to say.
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Talking with children about serious illness
Children are like sponges. They soak up whatever is around them.
In a household dealing with serious illness, they’ll pick up on others’ sadness or anxiety.
If no one has explained the situation, they’ll make up their own ideas about what’s going on. As a result, they may feel unnecessarily scared and alone.
Instead of trying to “protect” a child from potentially upsetting news, experts recommend honest talk geared to the individual child. Such talk helps the child
- learn about normal emotions and how to cope
- trust the adults around them
- feel that they’re an integral part of the family
Having the conversation
- Ask questions. Ask the child what they’ve noticed. And what they’ve been feeling. Let them know no question is wrong.
- State the facts. Address their concerns and be honest. Children are concrete thinkers. A simple gloss over, such as “Grandpa is going for a long sleep” instead of “Grandpa has died,” can backfire into a fear of sleep.
- Consider their perspective. Children are self-focused. Reassure them they are not the cause of an illness or death.
- Prepare them for what to expect. Think very concretely about what the child will be witnessing soon. For instance, you may want to talk about symptoms. Or the new people coming to the house to help. Or that family members may be sad, but it’s not about the child.
- Be careful about overload. Let the child dictate the pace at which you give new information. Keep it simple, and respond to the concerns they bring up. Encourage them to ask you about anything that confuses them. You don’t have to cover everything in one talk.
Withdrawn or overactive behaviors may reflect a child’s emotional overwhelm. As much as possible, try to maintain a normal routine, including quality one-on-one time.
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Urinary tract infections: prevention tips
Although seniors, and especially women, are at high risk of urinary tract infections (UTIs), a lot can be done to prevent this often painful condition.
Help your loved one make these strategies into habits:
- Drink plenty of water. A minimum of six 8-ounce glasses per day. This helps flush bacteria out of the urinary system.
- Urinate frequently, or about every 2 to 3 hours. Try to completely empty the bladder each time. This helps prevent bacteria from settling in the bladder and multiplying.
- Wipe from front to back. This is always a good idea, but is essential after a bowel movement. Most UTIs are caused by E. coli bacteria from the intestines. Wiping from front to back helps ensure bacteria from the anus are not brought forward to the urethra. The front-to-back rule is particularly important for women, because the anus and urethra are so close together on the female body.
- Wear cotton underwear. Avoid nylon panties and tightly fitting pants in general. The idea is to keep the genital area dry and allow airflow. A warm, moist environment promotes growth of bacteria.
- Change soiled incontinence products (pads or underwear) regularly. This is particularly important with incontinence of the bowel.
- Urinate after sex. Also wash and urinate before sex. Use of feminine hygiene sprays and douches is not encouraged. They tend to irritate the urethra.
- Take showers instead of baths. This allows for better cleansing of the genital area.
There is also some evidence that cranberry products can help prevent repeat UTIs. In this case, the strategy is to drink unsweetened cranberry juice. Or take vitamin C or cranberry in capsule form. Both increase the acidity of urine. Check with the doctor first! These are preventive strategies and are not to be used to treat an existing infection.
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