Archives for Barbara

Smartwatches for seniors

The makers of smartwatches are now designing products for older adults. And they just may have come up with an acceptable alternative to the standard “I’ve fallen and I can’t get up” pendant. Perhaps you’ve tried to get your loved one to wear a personal emergency response system (PERS) pendant—only to hear, “No. I don’t like it.” Many older adults consider the pendants ugly and stigmatizing.

The new smartwatches offer advantages:

  • Unlike home-based emergency response systems, they work anywhere there is a cell signal.
  • They are easy and natural to wear.
  • GPS features enable using the watch as a locator device for persons with dementia.
  • They can do dual duty as fitness trackers, measuring heart rate, number of steps, etc.
  • They send and receive text messages. Some even handle phone calls.
  • Apps are available for things like setting a timer for pill reminders, or scheduling appointments. Soon even EKGs for heart monitoring.
  • They tell time!

On the downside:

  • Will your loved one use all these features? Or will the apps just be confusing? The options are likely too much for those with memory problems.
  • How useful is the watch in an emergency? Screens are small and several steps may be required. Practice may be necessary ahead of time.
  • So far, the automatic fall detection apps still have a few bugs to work out.
  • Not all smartwatches offer a companion service for 24/7 connection to a trained professional who can triage the need for help.
  • Those with hearing loss may have difficulty hearing a respondent if the device isn’t held close to the ear.
  • While smartwatches are definitely more stylish, they are still big. They seem to appeal more to men than to women.
  • These devices need to be regularly charged.

Meeting resistance to a PERS device?
Many family members find their loved one simply won’t wear the device. A smartwatch may be the solution, but they aren’t for everyone. As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice can help you determine the best ways to protect your relative in the case of a fall. Give us a call at 1-800-897-3052, toll-free.

Researching treatments online

For those facing a serious—or even incurable—condition, the Internet can seem to be the last refuge of hope. But how can you distinguish a trustworthy website from that of a huckster? “Follow the money” is an important key for deciding if a website is truly unbiased. Start by asking yourself who, what, and why.

Who: Whose site is it? 
Websites cost money to create. Who is paying? Check the “About Us” page. If the source of money is not obvious, use “Contact Us” to ask, “Who are you and how do you get your funding?” Keep that funding in mind as a possible source of bias.

What: What kind of information is provided?

  • Is it a research-based news article? Does it cite research done in university or government studies? Is there mention of “randomized clinical trials”? These are the gold standard of science.
  • Is it a blog? Is it one person’s opinion, or are other sources included? What are the author’s credentials? Are they reliable?
  • Is it a forum (or “chat room”)? Anyone can speak in a forum. Chat rooms offer a wealth of practical tips for day-to-day coping with side effects. But they are not reliable sources for evaluating the success rate of treatments.
  • Is it really just a sales piece? Does it make claims about a treatment sold by the sponsor? If so, review multiple sources and look for promises that are backed by credible research as described above.

Why: Does the website identify its purpose? 
Government and university websites typically have a mission to educate. The websites of nonprofit organizations usually weave education with advocacy. A for-profit company is not automatically suspect. Many generously share their expertise through educational articles. Simply use caution if they ask for your personal information or if the talk turns to specific treatments that they themselves sell.

Confused about where to turn?
As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice can help you determine your confidence level in the various options you are considering. Give us a call at 1-800-897-3052, toll-free.

Age-friendly kitchen

Aging creates so many “new normals.” Even routine activities such as cooking may become challenging for your loved one. Balance issues can make reaching, bending, or lifting a problem. Arthritis often makes it difficult to maneuver pans and tools, turn on a faucet, or twist off lids. Extreme fatigue may sap overall motivation. And problems with memory increase the risk of a kitchen fire.

Consider these revisions to create an age-friendly kitchen.

  • Stoves. Choose a stove with continuous grates (for gas) or a flat surface so that pots can be moved off the burner without lifting. And look for stove controls that face the front so your loved one is not reaching over hot pots to change settings. If memory is a concern, add an automatic stove shut-off sensor. (If there is no movement around the stove for 15 minutes or so, the device shuts off all burners.)
  • Microwaves. Countertop rather than overhead placement makes access safe and easy.
  • Sinks and faucets. Install a single-handle faucet to make it easier for those with arthritis. You might even consider a faucet with sensors at its base to turn the water on and off. If possible, position a sink with a hose sprayer near the cooking area so a pot can be filled in place on the stove with no need for lifting.
  • Cabinets. Place frequently used items and heavy items within comfortable reach to reduce bending. Install lazy susans and pullout shelving for easier access. Use “loop” pulls or long “D-shaped” handles rather than knobs for cabinet doors.
  • Countertops. Include lighting under cabinets to compensate for shadows cast by overhead fixtures. Create countertops at several heights with knee space underneath to permit use as a seated workstation if need be.
  • Freezer/refrigerator. Look for a side-by-side model rather than top-and-bottom. Include pullout drawers and shelves to minimize reaching and bending.

Does a remodel seem in order?
If the person you care for wants to continue living independently, a kitchen remodel might be a wise choice. As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice have seen that sometimes even simple changes or rearrangements can make a world of difference. If you follow principles of “universal design,” the layout will be easier for everyone, not just a person with physical challenges. Give us a call at 1-800-897-3052, toll-free to discuss a home assessment.

Setting Limits Nicely

Many of us were raised to believe that the only polite or kind answer is “yes.” But as Dr. Christine Carter, a UC Berkeley researcher, notes, “If you find yourself saying ‘yes’ when you mean ‘no,’ it’s a recipe for overwhelm and exhaustion.” Not to mention resentment, burnout, and ill health!

Ironically, research shows that the busier we are, the more we tend to say “yes.” Saying “yes” makes us feel generous. The consequences—becoming stressed and overburdened by the commitment—are down the road. We’d rather overlook those realities than feel stingy or selfish right now by setting limits and saying “no.”

According to Dr. Carter, there are three steps to saying “no” gracefully:

  • Rehearse saying “no.” There is a process. First, avoid comparing your need to the other person’s. Then, train yourself to think through how you will feel when the day of reckoning comes. Recall the last time you overextended yourself and ended up sick. Or ended up too tired to do something you were looking forward to. Finally, practice a few phrases that you can readily use, no extra thinking required.
  • Be truthful, but vague. Having a response you feel confident in makes it more likely that you will use it. You don’t have to justify yourself. (Too much detail and the requester will start problem solving to help you find the time!) A simple “I wish I could, but that doesn’t work for me at this time” is an effective standby. Or if you would genuinely like to help, “I can’t do ‘X’ next Thursday, but I could do ‘Y’ the week after that.”
  • Make your decision final. If the person pushes you, repeat the same phrase. This way you signal that you aren’t going to change your mind. If they insist, then be honest about how their pressure makes you feel: uncomfortable, perhaps even hurt or angry.

Do you have trouble saying “no”?
We can help! As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice see many well-meaning family members burn out because they don’t know how to set limits and ask for help, especially with their loved one. Give us a call at 1-800-897-3052, toll-free. We can help you say “yes” to those things you truly want to do and give you options for those things you’d rather not.

Conserving Energy

People with congestive heart failure (CHF) often tire easily, especially if they exert themselves. In CHF, the heart is swollen with fluids and cannot beat efficiently. The body’s cells then become hungry for oxygen. If your loved one has CHF, you witness this in his or her fatigue, shortness of breath, and frequent naps.

Even with CHF, however, your relative needs to be physically active. Physical activity helps the heart muscle gain strength. It improves circulation. It helps with weight control, and, oddly, with reducing fatigue. Exercise also helps with depression, which is common in CHF.

Pacing is the key
Talk with the doctor about optimal forms of physical activity. Initially, walking, swimming, or biking may be recommended. As CHF progresses, simple tasks, such as taking a shower or cooking a meal, may qualify as exercise. Ask the doctor for a prescription to work with a cardiac rehab team to create an activity plan tailored to your loved one’s needs.

Conserving energy
Think of personal energy as a tank of gas. With CHF, your relative has a small tank and needs to be “fuel efficient.” Conserving energy when doing chores leaves more “in the tank” for doing things that bring joy and meaning.

  • Alternate periods of activity with periods of rest. Divide large chores into smaller tasks throughout the day or across the week.
  • Avoid rushing. It wastes energy.
  • Work smarter. Minimize trips up or down stairs. Cook large quantities of food and freeze for heating later. Instead of towel drying, slip on a terry cloth bathrobe after bathing.
  • Get help for mundane tasks. Have groceries and prescriptions delivered.
  • Create workstations that permit cooking, grooming, dressing, bathing while seated.
  • Use a cart or walker with a basket for carrying things from place to place.
  • Avoid bending or reaching. Use extenders.

Looking for ways to ease fatigue?
Give us a call at 1-800-897-3052, toll-free. As the Iowa City, Muscatine and Cedar Rapids experts in aging well, we at Iowa City Hospice understand that quality of life is based on how much time your loved one can spend doing things he or she truly enjoys. Let us help you identify ways to conserve on chores so your relative can go full throttle on pleasant activities.

Embarrassing Behaviors

What do you do when sweet Mom starts cursing angrily? When straitlaced Dad makes off-color remarks?

In persons with dementia, these behaviors are not on purpose. They are caused by the brain changes of the disease. If you can’t find humor in the situation, draw on your patience. Believe it or not, your relative is doing his or her best.

Consider these strategies to reduce or discourage outbursts:

  • Stay calm. Your relative is likely frightened or uncomfortable. Try to respond with curiosity. See if you can figure out why they are behaving as they are.
  • Identify (and avoid) common triggers. Angry lashing out is often a sign of too much to handle. Look for patterns. Do they occur when you are in a rush? When there is a lot to do? Try slowing down. And keep instructions simple, one step at a time.
  • Simplify the situation. If Mom is acting out, perhaps it’s the environment. Lots of people? Too much noise or stimulation? Do what you can to go to a place that is quiet, calm, and uncluttered.
  • Go along when you can. If Mom thinks her babies need her at home or Dad wants to go to work, it’s harmless. No need to argue. Trying to persuade your loved one that he or she is wrong will only result in anger and mistrust of you.
  • Redirect attention. When embarrassing behaviors occur, try focusing your relative’s attention on something else: “Dad, look! They’ve got chocolate cream pie today.” Or, “Mom, I almost forgot to tell you….”

Check with the doctor
If these behaviors are new, perhaps dementia is at the source, or there is a problem with hearing or vision. Unexpected outbursts in people known to have dementia can also be caused by pain. An undiagnosed bladder infection is a common culprit.

Problem behaviors draining your energy?
It’s hard to care for a person with dementia! Especially when they behave in ways that are embarrassing. We at Iowa City Hospice have a lot of experience with this uncomfortable side of memory loss conditions. As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we can help you identify triggers and develop distraction techniques to reduce these problem behaviors. Give us a call at 1-800-897-3052, toll-free.

Bathing and Dementia

Bathing brings many discomforts. Bathrooms can feel cold and drafty when a person is wet. And running water can be noisy. Nudity makes bathing very intimate, which can be distressing when a modest person needs help and may not recognize the helper. 

Plus, bathing is a complicated process with many steps in a specific order. People with dementia may become confused and frustrated. They also may forget about the purpose of cleanliness.

Here are some tips to ease bath time:

  • Guard the senses. Sometimes people with dementia are hypersensitive. Heat the bathroom ahead of time. Be gentle and avoid scrubbing. Check the water for temperature—too hot?—and the water pressure from the shower—too hard?
  • Promote independence. Encourage your loved one to do things themselves. If you do need to take over, tell them what you are going to do before you do it. And give them a role so they can participate, such as holding the soap.
  • Preserve modesty. Even if you are helping a spouse, have a towel at the ready for undressing and dressing.
  • Maintain a routine. Most families notice that certain times of day are better than others. Bathing at the same time each day may make it easier.

Sponge baths work just as well.
In terms of hygiene, all that’s needed is a twice a week wash, and even that can be just the highlights: armpits, folds of skin (under the breast, on the belly), groin, genitals, feet. Remember to keep the rest of the body covered with warm towels to minimize any chill.

Get creative

  • Try singing together. Or play music or old radio shows for distraction.
  • Consider using bath wipes. Warm by putting an open package in the microwave for 10 seconds.
  • Call it “spa time.” Use no-rinse soap on moist, warm midsize towels and massage in gently. Wipe off with warm, moist washcloths.

Tired of the bathroom battlefield?
As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice have developed many strategies and insights that can help you make bath time more pleasant. Make a vote for peace in the household and give us a call at 1-800-897-3052, toll-free.

What does it mean to be “community-based”?

Iowa City Hospice is a community-based organization. We were founded about 40 years ago by neighbors and community members who saw a need for local services to bring dignity and comfort to end of life care. By 1983, we had a board of directors and trained volunteers, all community members working together toward a heartfelt goal.

Since our founding, our community has expanded to include all of Johnson County and the counties that touch it. Our staff live in the community they serve. We are your neighbors and friends. This is our home: We know these places, we know these facilities, and we know these people. This is a wonderful place to be, and a wonderful place to serve.

Our formation, our foundation, and our success would not be possible without the support of our community.  We have been sustained for four decades through generous donations of time, of expertise, of money, and of spirit.

We strive to repay that generosity by keeping our community foremost in all of our goals:

  • We answer to local, volunteer board members who give freely of their time and talent – not a compensated corporate board in distant headquarters.
  • Our mission is “to provide compassionate care for anyone in our community affected by serious advanced illness and end of life conditions.” That’s anyone in our community, whether or not they can pay for services.
  • Since Iowa City Hospice is a 501(c)3 not-for-profit organization, every dollar we receive goes back into our community, through compassionate patient care,  enhanced services, staff salaries, volunteer training and more.

Iowa City Hospice is homegrown, brought forth from the community to serve the community. Some of our original volunteers are with us still, and we cherish their continued support. We cherish your continued support.

If you’re new to the Iowa City area, or new to hospice services, welcome to our community. If you’ve been around awhile, thank you for welcoming us.