Caregivers of older adults can face many challenges. For some, a primary challenge is safely providing personal care to an older adult with limited strength or balance. For others, the primary challenge is balancing the time demands of caregiving, work, hobbies, and other responsibilities. Fortunately, there are tips and strategies to follow that may help address some of these challenges. In this article, specific tips for providing personal care will be provided along with strategies for practicing proper self care.
Personal Care Skills
Bathing & Showering
Helping an older adult bathe or shower is a worrisome task because getting in and out of a tub or walking on a wet floor can present a fall risk. Generally, installing grab bars and using an adjustable bath chair can make the process easier. Additionally, placing a non-slip mat on the floor of the tub or shower can help prevent slipping.
Before beginning, always gather any needed supplies such as soap and towels. Then, before the older adult steps in, make sure the water temperature is comfortable to avoid any chance the older adult will suddenly move when they feel the water and possibly lose their balance. Once the older adult is under the water, you can gently assist them in testing the temperature further.
When helping the older adult clean themselves, be sure to remain calm and avoid sudden movements that could startle the older adult. Depending on the older adult’s physical and cognitive limitations, it is best to minimize how much you help as this will give the older adult a positive sense of independence. Similarly, giving the older adult choices during the process can also foster a sense of control. When you do provide assistance, it can be helpful to give verbal warnings of what will happen next. For example, you may tell the older adult that if they lean against the wall and lift their left leg slightly, you will be able to clean the sole of their left foot. After bathing or showering, try to pat the skin dry rather than rubbing and apply lotion to keep skin soft and free of sores.
Getting dressed requires balance, strength, and coordination. Many older adults view getting dressed as a key aspect of their independence. A few challenges that arise when getting dressed include reaching for clothes, pulling on zippers, and fastening buttons. Check out the following video from AARP that provides tips for addressing the aforementioned challenges.
Helping an older adult maintain an adequate diet can be very stressful for caregivers. With age, appetite naturally diminishes. However, getting enough protein and calories is crucial for maintaining strength. If the older adult does not seem to be eating enough, consider the potential causes, such as having no appetite, forgetting to eat, having trouble opening containers, and having problems chewing. If a cause is identified, it can be helpful to consult a health professional for advice. For example, a physician may be aware that a certain medication can diminish appetite.
To help improve an older adult’s diet, it can be helpful to stock the fridge or pantry with good sources of protein and whole grains. Keeping these foods readily accessible will make it easier for the older adult to comply with diet recommendations. If chewing is difficult for the older adult, making smoothies with fruits, vegetables, and nut butters is a good option. An older adult’s diet may also improve if mealtime is a social event, as older adults tend to eat more when they are not eating alone.
Caregivers should do their best not to argue with older adults about eating, and instead use simple encouragement such as calling daily at lunchtime to remind them it’s mealtime. Lastly, it can help to bring the older adult along when grocery shopping so they can choose the foods they prefer and possibly be taught how to read labels if nutrition is a concern. If preparing meals is a challenge, it can be helpful to have meals delivered. Prominent companies offering this service include GoPuff, Instacart, Walmart, and Amazon.
Whether moving an older adult from bed to chair, from chair to bed, from commode to chair, or from sitting to standing, the key things to keep in mind are the same. First, try to practice good lifting mechanics to avoid injury. Good lift mechanics involves keeping your feet hip width apart with one foot ahead of the other and knees bent. The back should be straight with chest high and head up. When lifting upwards, the knees should remain bent and focus should be on using the leg muscles rather than back muscles.
Second, transfers should follow consistent steps each time. Before beginning, it is best practice to wash your hands and make sure the older adult knows where they will be moved. If transferring in or out of bed, first bring any utilized mobility aid such as a wheelchair, walker, or cane close to the bed. Position the device so it is on the older adult’s stronger side. For each transfer, ask the older adult to push up on the count of three and guide them to where they’re going. It is safest to use a gait belt or pants when lifting the older adult, as pulling on an older adult’s arms can cause injury. If using a mechanical lift, be sure a therapist or device representative demonstrates how it should be used before trying yourself.
Older adults and caregivers typically spend a great deal of time together and experience mutual stress and hardship. This shared experience can foster strong connection and appreciation. However, the stress and uncomfortable aspects of the relationship can also lead to conflict, anger, and even feelings of resentment.
For older adults, it can be emotionally challenging to ask for help and feel vulnerable. The natural process of aging can make an older person feel frustrated about what they can no longer accomplish independently, embarrassed by their needs, and anxious about worsening health conditions. Caregivers must recognize that an older adult’s presentation of anger may stem from those hard feelings of dependence and fragility, rather than annoyance with the caregiver themselves. Caregivers should make an effort to not take outbursts personally, think about why the older adult was upset, and encourage the older adult to talk about their negative emotions. Before having serious conversations, check that both individuals are feeling calm and have the time to comfortably discuss important issues.
No matter the current situation, it is important not to spend all time together focusing on tasks and problems. Instead, some time should be set aside for enjoyable activities like watching a movie or taking a walk.
Self Care Skills
A common notion is that people can only help others if they also take care of themselves. This is especially true for caregivers taking care of older adults. Caregivers who take time for themselves are less likely to feel overly stressed, less likely to get sick, and less likely to experience burnout. It is important to recognize that self care is not selfish, and can come in many different forms. Here is s short list of examples of purposeful self care:
Taking a warm bath
Getting a massage
Going for a jog
Calling a friend
Setting Healthy Limits
One essential part of self care as a caregiver is setting specific healthy limits. Setting these limits entails deciding exactly what time, skills, expectations, and preferences you have as a caregiver. It is very common for caregivers to be the type of person who always puts others first and blames themselves when issues arise. Caregivers must decide and communicate their limitations in order to avoid becoming overworked.
Consider all your obligations, including work and family, and try to write down how much time you have to commit to each. Then consider the tasks and responsibilities that fall under each obligation and take note of those you don’t believe fit your skills and preferences. Consider delegating these tasks to family members, friends, or hired help. Try to make a schedule of your obligations that you can share with the older adult and your family so they understand and abide by your limits.
Balancing Time Demands
Setting healthy limits is the first step in balancing the demands on a caregiver’s time. The next step is being purposeful with how you handle new tasks and responsibilities. It is important to not immediately agree to take on new tasks. Instead, find out and consider exactly what the new task involves. Reference your written healthy limits schedule. It is completely fine to give an honest explanation for why you cannot take on the new task. Alternatively, consider strategies such as agreeing to take on the task for a set amount of time or sharing half the load with someone else. If the task is unavoidable, it may be time to seek help.
Asking for Help
Help can come from family members, friends, neighbors, or paid help. Do not be afraid to approach these people for an honest discussion of what you need and what they may be able to provide regularly or just once in a while. If considering hiring help, check out the Hiring Help Guide for more information. As the team of individuals helping the older adult grows, it is important to decide how information will be shared. Information may be shared:
Over the phone
Over video calls
Through group text messages
On a shared calendar
Asking for help does not always entail seeking assistance in taking care of the older adult. Asking for help can also be seeking out mental health professionals who can guide you through the social and emotional challenges of being a dedicated caregiver. Counselors, psychiatrists, and support groups are all great options for caregivers experiencing stress, anxiety, or depression.
Caregivers of older adults typically have many responsibilities pulling them in different directions. This can be mentally and physically stressful. Those caring for older adults are prone to stress because they are commonly worried about the older adult’s health, spending less time with friends and family, and feeling unsure of how to address certain challenges. It is important to notice the warning signs of stress. Signs of stress include:
Having trouble sleeping
Unintentional weight changes
Getting sick more often than usual
Having frequent headaches
Struggling to concentrate
Losing patience more quickly than usual
As a caregiver, it is important to celebrate small successes, take a break if feeling overwhelmed, and set realistic goals. However, each individual may have a different set of activities that help them relax. Caregivers should make an effort to schedule their personal stress relieving activities, whether it be a daily walk, a monthly massage, or occasional yoga. Other examples of healthy activities are:
Listening to music
Joining a support group
One form of seeking help is utilizing the services of a respite care provider. Respite care providers offer short-term relief to caregivers by providing supervised care to older adults for an afternoon, a few days, or even weeks. Providers may provide services in the older adult’s home, at a healthcare facility, or at an adult day care center. Adult day care is a form of respite where older adults can participate in social activities, meals, and recreation during the day.
These services are typically not covered by insurance though, so it is important to consider the costs of each service.
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