Wednesday, 16 October 2019

Care Partner Wednesday--Anxious To Powerful With Assistive Devices






Do you remember the bundle buggy?

A cart sitting on four wheels with a handle at the top. Used for shopping trips, usually pulled by an older person.

The bundle buggy received a facelift several years ago. It's now called a "trolley dolly" or a foldable shopping cart, or perhaps a "rolling bag cart." No longer just a metal frame, the outside is wrapped in funky colours of fabric. And the person pulling it? It could be male or female, often quite young, a city dweller who travels by public transit or perhaps an Uber. Yes, the bundle buggy definitely had an upgrade.

Except in my mind, it's still a bundle buggy, still for old ladies, and I refuse to use one...for now. It's a thing with me.

I'll probably be the same way about a walker.

Assistive devices have been around since the first caveman picked up a stick to help him manoeuvre uneven ground. Recent technology has improved them to such a degree that you may not be aware of what's available. They all maintain the same goal--to assist with independence, comfort, and safety as your needs change.

As our population ages and technology improves, this industry explodes with new options.

Mobility--Canes, Walkers, Wheelchairs

I'm not a big fan of canes, for many reasons.

  1. Someone who gets a walker or wheelchair is normally assessed by a qualified occupational therapist (unless it's passed down from Great Aunt Harriet, which is not a good idea.) However, a cane can be picked up at any drug store (or passed down from Great Aunt Harriet) and is not necessarily what is needed, the right height or safe.
  2. I have seen many canes with an absent or worn down rubber grip on the bottom. This renders it slippery and unsafe.
  3. If someone is not properly assessed for a cane, they don't know if that's the device they need. Many people who wobble on an unsteady gait and need a walker are still using their cane long after they should.
  4. I have also seen canes used as weapons in the hands of someone with dementia.
If you are going to get a cane, get a professional assessment and check in regularly to understand if your needs have changed.

Walkers and wheelchairs also need professional occupational therapist assessments. If you live in Ontario, this can be done through the government agency LHIN (formerly CCAC. ) A warning, though--this route can take a long time. A private OT can speed the process up tremendously.

Ontario also has a program to which you can apply for funding. Called ADP (assistive devices program) this pays a percentage of the cost. An OT would fill out the paperwork.

Wherever you live, check what financial help is available for assistive devices. Any defraying of cost can be significant.

Walkers provide stability and those with seats supply a place to rest. They can also be attached with a basket or satchel to hold items.

Wheelchairs are for those who can't walk, or can only walk with help. Transport wheelchairs fold and can be put in the trunk of a car or easily stored away. However, they aren't comfortable to sit in except for a short time. 

All parts of the body need to be measured for a wheelchair to fit correctly. Height, weight and other special needs will be considered by the OT as they assess the right kind of wheelchair. If the person is at all able to self-propel, a lighter chair with this kind of capability is available.

I shared my feelings on canes, so here is my non-professional input about wheelchairs. I think all wheelchairs for elders should have the capability to tilt. This means that through a simple mechanism in the back, the whole chair tips back, giving the person the ability to rest in their chair. Tilting also changes position, which is valuable for skin integrity when people can't shift around themselves. Even if it isn't needed at the time of purchase,  funding is only available every five years, and the chances of needs changing before that time are great. Get a tilt chair. (Sermon over.)

Bathrooms--grab bars, seats, shower chairs, special tubs, hand-held hoses


Bathrooms can be hazardous, but a few simple changes can make them more accessible and safer. Get a professional to install grab bars, as they will be able to find studs to ensure the bars are safe and able to bear the necessary weight. Raised toilet seats can be installed on regular seats to make getting up and down easier. Some have special arms on each side of the toilet can also make it possible to maintain independence while using the facilities.


Shower chairs are padded, waterproof chairs on locking wheels. Someone with limited mobility can be wheeled in the chair into an accessible shower and cleaned with a hand-held sprayer. Drying, even dressing can be accomplished on the same chair.

We've all seen the pictures of step-in tubs where you sit down and close the door. The tub fills with water and you enjoy a safe, whirlpool experience. Although an expensive option, this is a comfortable alternative for some.

Technology

This area is exploding with opportunities. Alexa sits on your counter, and not only plays your favourite music and trivia games with you but calls for help if you fall. Hearing aids are smaller and more efficient, and I've even heard about a tiny tracker that attaches to your device (or anything) and can find it for you if lost, through an app on your phone. Do you have any idea how many hearing aids would benefit from this? A bracelet alerts others when a wanderer attempts to leave the building. The possibilities are endless.

The challenge is to view all these as aides, devices to keep you as independent as possible, and not the trappings of aging. If that's an issue for you, I hear you. Let's support each other as we move into independent elderhood.

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CarePartner Wednesday--Anxious To Powerful With Assistive Devices

Wednesday, 9 October 2019

Care Partner Wednesday--Empower Your Later Years with Awesome Decisions Now



Margaret liked her stuff. She wasn't the least bit materialistic, but her sentimentality made it impossible to part with anything which had the slightest story attached to it. In her house, whole rooms were devoted to boxes of old pictures, which she planned to sort through someday, her mother's teacups, her deceased sister's treasures and furniture with a history. She loved to walk among it, touching this box and that chair and remembering.

When she had to leave her house, it took months to decide what she could part with, and in the end, the answer was, "not much." Her apartment in her retirement home was crammed to the ceiling with boxes and stacks of precious items. Even her bathroom cupboards were packed. She sat looking at it all and wondered what to do.

Then she fell. Twice. Her family sat her down and had a serious talk with her about moving to long-term care where she would get the care she needed and staff would be around to monitor her. "But what about all my things?" Her son leaned across the table, looked in her eyes and said, "Mom, what do you think will happen to all this when you die?" His words startled her, but she knew the answer. No one in her family cared about any of the items in the boxes. 

So this time, with her daughter's help, she relentlessly discarded. Or so she thought. She exhausted herself deciding, and her dreams were full of insecurity as she questioned herself. Once she discarded an item she could never get it back so each choice she made felt momentous.

She moved into one room. After moving, a small pathway down the middle remained for her to walk, and at least 25 boxes sat outside the door. Her daughter's red face dripped with sweat, and Margaret sat on the bed and cried. What should she do?

Planning for independence later in life starts many years earlier.

I learned this lesson when I became a widow at 53. My husband liked his stuff and collected many items. His stockpile of DVDs was epic. He filled countless binders with newspaper clippings. and kept every church bulletin. He loved books, all things musical--the list went on. It fell to me to decide what to keep, what to sell, what the children might like and what to throw out. It was a huge job which I attacked in layers. As I packed and sorted and tossed and made decisions, I thought to myself, "I never want my children to have to do this for me."

Clear the Clutter
Look around your home. Check out the cupboards, the drawers, the closets, the storage rooms. What do you have which you never use? Are there boxes and bins you haven't opened for years? 

Start with one room. Give yourself as much time as you need, but keep at it. When you think you are done, give it a few days and go back and see if there's anything else you can get rid of. Reward yourself if you find something. Then move on to the next room.

Margaret let her possessions possess her. They became so big that they affected her quality of life as she aged. Don't let that happen to you.

Look After You
Medical events happen, and some aren't preventable. As you age, your body doesn't function as well as it did in your twenties. That's not rocket science. But each day, determine to live the healthiest life you can. Make nutritious food choices, limit your portions, exercise and get enough sleep.
Participate in activities and pursue relationships which give you purpose and fulfil you. Life doesn't come with guarantees, but give yourself the best chance when you pursue physical, emotional and mental fitness.

Check Your Home
Falls bring disaster. We'll talk more about that next week. Check for any tripping hazards such as electrical cords or rugs. Scatter rugs should be removed as they have great potential to lift and cause a tumble.
Have someone install grab bars in your bathroom to make getting in and out of the tub easier. 
Look into what technology has to offer in terms of monitoring, so if you do fall you can quickly get help.

Ask For Help
Don't be stubborn. I'm preaching to myself here. If a task is becoming too difficult for you, ask for help. No one gives out awards for doing your housework into your eighties or lugging bags of groceries when it hurts your back. 

Independence is a process. Start today for a better, more independent life tomorrow.


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Care Partner Wednesday--EmpowerYour Later Years With Awesome Decisions Now

Wednesday, 2 October 2019

Care Partner Wednesday--The Good, The Bad and the Ugly of Independence



Independence. Toddlers throw tantrums for it, teenagers get drunk asserting it, we all crave it. We want to do what we want to do when we want to do it. We'll stay within the law (mostly) and societal boundaries (for the most part) but we crave the ability to make our own choices and decisions.

And that's a good thing.

Right?

It's no secret that as we age, our independence is threatened by our bodies. We don't see or hear as well, some of us don't move as easily, and sometimes our judgement is as impaired as our joints. We need help, and as much as it urks us to admit it, we can't do some of the things we did even ten years ago. Or we can, but the cost is high.

How do elders find their way?

Independence--The Good
The key to independence for elders is to find new pathways to former pleasures. Here are some examples:

Problem: You loved the independence of driving yourself everywhere. There's nothing like just hopping in the car (well, maybe more like hobbling than hopping, but you got there eventually) and going where you wanted to. You even gave other people rides. But lately, you realize your sight isn't as good and your reactions are slower. You're kind of dreading next year when you have to take your driver's test again.

Solution:You take cabs. It seems like a lot of money, but when you add up gas, the cost of your car and insurance, you're ahead. Or, you impress the heck out of your grandchildren by learning to take Uber. You still have your independence, your stress levels are going down and it works out cheaper in the long run.

Problem:You love to garden, but your back protests after a few minutes of weeding. Pruning, even light digging is okay, but weeding sends your back into spasm.

Solution: Hire a neighbourhood kid to weed your garden and save yourself for the fun stuff like planting and picking.

Problem: You love big family dinners, but last year the shopping, planning and cooking for Thanksgiving almost killed you. You have always been the host and you are loath to give it up, but you know the time has come.

Solution: Approach your family, telling them you'd still like to be hostess, but the work of preparing the meal is too much for you. Accept however they want to do it--divvy up the tasks, or have someone take on the job or even (gasp) order in. You do the little fun things you always enjoyed like folding the napkins fancy and making place holders.

Independence--The Bad
When is independence bad? When it's time to change, to find a creative solution, to look for new pathways, and you don't.

  • When you drive that car, even though you know you've had a few close calls because you can't bear to give it up. 
  • When you need a day to recover from doing the housework, but you don't get help because you love to hear your friends say, "And she does all her own housework--at her age."
  • When you keep working long past retirement age, even though every day is a struggle and your doctor has recommended you stop.
  • When you're using the furniture to get around the house, holding on to chairs and couches for balance, but you won't get a walker because they're for old people.
The difference between the good and the bad is often a matter of timing. And wisdom. The ability to recognize when things need to change and the wisdom to make those changes and find the pathways to new solutions--that's the good. The bad is not doing it.

Independence--The Ugly
The bad quickly slips into the ugly when the consequences of poor choices rush to meet us. 
  • A car accident that was your fault
  • a fall resulting in a hip fracture because you were trying to vacuum and tripped over the cord.
  • a heart attack because you kept pushing yourself to go to work when you no longer needed to.
The ugly has far-reaching consequences, but most importantly, it can affect your quality of life.


Before the bad becomes the ugly, why not make some wise choices and look for some new and creative ways to live your best, most independent life?