Pressure Ulcer Prevention

Pressure ulcers (otherwise known as bedsores or decubitus ulcers) usually occur where there are bony prominences or where soft tissue is compressed between bone and a surface. I would say a hard surface, but the surface doesn't have to be very hard, just constant.

When people are in bed much of the time, pressure ulcers can form at the tailbone, on the heels, on the hip bones, along the spine, and even on the elbows. When people sit a lot, pressure ulcers are often formed where those bones are that hurt when you sit too long. They are called "ischial tuberosities."

For prevention when in bed, it is good to have at least a thick (at least 4" thick) foam overlay on the mattress. Then it is also good to make sure the person doesn't lay in the same position too long. In the hospital or nursing home, turning every 2 hours is the rule of thumb for people who can't turn themselves, but that usually isn't very realistic at home. That is why the thick foam is important, or maybe even an alternating air mattress.

When in bed, heels are especially prone to pressure ulcers, but they can be prevented by keeping pillows under the legs, so the heels are not on the bed, or by using special foam boots that can be found at medical supply stores.

When sitting, it is again important not to stay in the same position too long. People even get pressure ulcers sitting in recliners! Encourage them to move around in the chair, if they can, or help them to do so. Also, encourage them to get up and walk, if they can.

People who spend long periods of time in a wheelchair should have a special cushion to distribute the pressure. Those can also be obtained at a medical supply store. But, even with a cushion, people should change position often.

Don't use donut cushions. They cut off circulation and create more risk for pressure ulcers.

Don't sit on pillows. They are not soft when compressed.

Encourage water drinking to keep skin well hydrated.

If a pressure ulcer starts, do everything to REMOVE THE PRESSURE until it heals. After all, they are caused by pressure, so the cause has to be removed for healing to take place.

Remember, preventing pressure ulcers is a lot less work than getting them healed after they occur!

I am here.
Sue Ellen

Caregiver Needs

If you are a caregiver, it is easy to focus on how you have to be strong to meet the needs of the person you care for, and to forget about YOUR needs. Remember, if you don't take care of your needs, you won't be a good caregiver for long. You will burn out.

So, what needs do you have?

Well, maybe you have the need to vent. A caregiver support group can give you a place to do that, where others will really understand what you are talking about. Lood at www.caregiver.org to find a support group near you.

You also have the need to take care of your own health, emotional and physical. If you are having symptoms, like headaches, backaches, or stomach pain, don't ignore them. Have them checked out. If you think you can't take the time, that is all the more reason to TAKE THE TIME.

Eat a healthy diet with lots of fresh fruits and vegetables -- at least 5 servings a day. Nine is better!

Make time to exercise. It reduces stress and keeps depression away (If you think you don't have time to exercise, check this out)

Set limits. Say no, when necessary, to friends, family, and to the person you care for.

Don't become isolated from friends, family, and activities that you have enjoyed. If you need to, put the word out that you need someone to stay with the person you care for a couple of hours a week, or twice a week. You really need to participate in the rest of life to stay healthy and care well.

I am here,
Sue Ellen

Getting Help

Have you been thinking about hiring a home health aid to help out with the person you care for? Maybe you have struggled with making this decision. Maybe you have even felt guilty for not being able to do it all yourself. It is easy for me to just say you shouldn't feel that way, but the fact is, if you do get help and are then able to get away regularly, or rest, or just have some time alone, you will be a better caregiver in the long run.

I suggest that you find your helper by using an agency. They screen employees, and they are there for you if you have questions or concerns. You can tell them what your needs are, and what you are looking for in a caregiver. If any problems come up, the agency is there to deal with them (and, by the way, mention problems as soon as they arise. They are easier to deal with early on.)

Once you have a caregiver, and you are comfortable that they know how things are done around your house, enjoy your time!

I am here.
Sue Ellen

Reminiscing to Enhance Lives

Have you ever stopped to consider the wealth of wisdom and knowledge stored up in the elderly? When you think about it, there are years and years worth of already-invented wheels (as in Why reinvent the wheel?) out there for us to learn from, and by appreciating that and finding ways to draw out that wisdom, we can even give the elderly in our lives a meaningful activity to share in. That activity is reminiscing.

Recent research has identified several very healthful aspects of reminiscing. First, reminiscing allows us to recall previous life situations and re-experience them. This helps us to integrate our life in the past with our current life. Second, it helps us to make meaning out of our previous life experience. If we are unable to find meaning in our life, we are unable to develop any new insights or benefits from our experiences. Third, reminiscing can strengthen our self-esteem and reduce feelings of isolation. As we share our remembering with others, we can develop a powerful sense of ourselves as survivors. The sharing of our life story with another person reemphasizes our interdependence with other people and it validates our lives in a social context. The philosopher/theologian Kierkegaard remarked, "Life can only be understood backwards; but it must be lived forwards." Reminiscing is a useful companion to our lives in the past, our lives today, and our lives in the future.

There are several different ways that you can benefit from this gift of reminiscence. You can consider remembering your own life story, retelling someone else's story (e.g. your children) or listening to another person's story. Whether you are the story-teller or the audience for another's story, you can reap the blessings of this life-giving gift.

In order to tell your story or the story of another, you only need to follow three simple steps:

• Remember it
• Record it (in writing, audio, or video)
• Relate it to another person

If you are going to help another person in their reminiscing, these suggestions might be helpful:

• Consider looking at pictures, letters, other remembrances to stimulate the flow of memories
• Listen attentively and thoughtfully
• Offer encouragement and support to the person reminiscing
• Encourage the person to share not only experiences, but more importantly, their feelings.
• Assist in recording the reminiscing, so that it can be used in the future.

I am here,

Sue Ellen

Keeping Up With the Jonses? No, just keeping up!

I find that when I am a caregiver, home all day, busy with meeting needs that can't be scheduled, it is hard to keep house. For some reason, the more I am home, the more mess I make! I guess that is because I am home, using the house. It was that way with homeschooling too. When other people were at work and school all day, we were home all day, using the house and making messes every time we turned around.

So, what can we do? The best, most realistic help I have found is the Fly Lady. She calls herself that, because she teaches fly fishing, but that isn't what her web site is about. It is all about keeping up with the house in a realistic, easy, non-stressful way. You can access her site at: www.flylady.com

At the Fly Lady site, there is lots of information, but she breaks things down into simple terms and simple activities. To me, she has been a great blessing. I hope she is the same for you.

I am here.
Sue Ellen

Caregiver Online Help

Here is a great source of medical information, and it is free! (If you really want to pay for it, see the link for the Merck Manual Home Edition on the right). This is the Merck Manual, and it is available online. You CAN buy it if you really want to, but here is a link where you can get the information FREE http://www.merck.com/mmhe/index.html Just look at the list on the left side of the page, and there you will see a list of health topics. There is lots of info there. And, if you want more in-depth information, look at the line on the top of the page and mouse over "manuals." There you will see the Merck Manual of Geriatrics, among others, and the information is free online.

Hope this helps.

I am here.
Sue

What Caregivers need this blog?

Accountants, marketing executives, mid-level managers, real estate agents, teachers, computer programmers, truck drivers, salespeople, mechanics, welders, journalists, editors, secretaries, loggers, college professors -- anyone who always knew nursing wasn't for them, but now needs to know what nurses know. This caregiving blog is for you! You know who you are.

If you are lurking about in the blogosphere after work, or during lunch hour, to see what you could find about arthritis, congestive heart failure, Alzheimer's disease, cancer, lung disease, diabetes, or how to get your elderly parents to stop smoking and eating fat, this caregiving blog is for you! You are in the early stages of caring for your aging parents who still live at home and care for themselves, but things are changing. They visit the doctor more than the grandkids. You wonder about their safety behind the wheel (not to mention, the other people on the road). And what about all those pills they take? How do they keep track of them? In short, you worry.

Or maybe you were looking around because Mom moved in with you a few years after Dad died, and you just wanted to get away for a while. She's taking a nap and the teenagers are at school. This is your chance to sit down, have a cup, and take some time for yourself.

Then there are those of you who desperately, and perhaps suddenly, need to know the nuts and bolts of caring for a disabled, maybe even bed ridden elderly parent or other loved one. You are overwhelmed.

I am here to help. I have many years of home health experience where I helped people in these same situations every day. That's why I know you can do it if you have the right information. I have seen people go from clueless to competent on a regular basis. If you are feeling overwhelmed (or even just whelmed), this caregiving blog is for you.

I am here.
Sue Ellen