When elderly people spend time in a hospital, they often leave more disabled than when they got there. That’s pretty stunning considering the condition they may be in when admitted. Some of the most common reasons for hospitalization are injuries from a fall, pneumonia, infection, cardiovascular disease and dehydration. Treatment of the acute condition frequently doesn’t include special care needed to prevent rapid, and sometimes irreversible, physical and mental deterioration. Weakness from bedrest, weight loss, adverse drug reactions, delirium, and hospital-acquired infection are all too common. At a time with people 65 and older make up the fastest-growing segment of our population, our hospitals should take notice. Fortunately, some are. Special services such as the Acute Care for Elders (ACE) unit exist, but in only small number of our 5000+ hospitals in the U.S. What’s different about this specialized care? There’s a greater emphasis on maintaining mobility and preventing functional decline, cognitive assessment, a communal dining room to encourage better nutrition and social interaction, early discharge planning, and staff with training in geriatrics play key roles. I’m glad to see that hospitals are addressing this pressing issue, but wonder if it’s enough to prepare for the sheer number of us baby boomers beginning to need this kind of care.
Does your local hospital highlight special care for older patients?
What happens when an eldercare professional becomes a family caregiver? This situation hit home when my husband had a cycling accident and fractured his hip. I was surprised by my reaction to suddenly becoming his care partner, juggling the role of home nurse, personal care attendant, meal provider, and problem solver of getting around in our two-story house. Somewhere in the mix I was also moral support and empathizer. The first week centered on creating a new routine, helping with pain management and personal care. Oh, and wound dressing changes. I quickly was reminded why I never became a nurse, calling a nurse-friend in a panic because the dressing from the hospital was stuck to the wound and I was sickened by pulling it off! If I’m perfectly honest, I felt angered at times by this turn of events that intruded our lives- I didn’t have time for this! It didn’t help seeing my active husband now using a walker- making him “old” to my eyes, bringing up fear about what’s to come as we age.
Now four weeks later I’m a bit more philosophical and I wonder about the interplay of personal and professional roles for those of us with years of experience in eldercare services. As an occupational therapist and dementia care educator I’d like to think I know something about managing home care. But I acknowledge that when it’s personal it’s a totally different dynamic. The boundaries become fuzzy and my emotions make it hard to be as objective as I would be in a professional role.
Luckily our situation is temporary. I know so many people for whom caregiving is endured for years, like my nurse friend who recently lost her husband to dementia and cancer. She cared for him at home for five years. We all will be eldercare partners at some point. I guess we have to suite up, show up, do the best we can, and allow others to help us out along the way.
What is it about skilled touch that decreases distress for those living with dementia that can lead to behavioral symptoms? Common responses include decreased aches and pains; sensory stimulation resulting in increased body awareness; relaxation; aids sleep; decreased feelings of loneliness; uplifted mood.
The following is an excerpt from The Physiological and Psychological Effects of Slow-stroke Back Massage and Hand Massage on Relaxation in Older People (2010) Melodee Harris and Kathy C Richards, Journal of Clinical Nursing, 19, 917–926
“In recent years, the nursing profession used technology and pharmacology to relieve conditions such as pain, anxiety and insomnia that were once treated with massage. However, interest in massage has grown with the move to more holistic nursing. This review examines the physiological and psychological effects of slow-stroke back massage and hand massage on relaxation in older people and identifies effective protocols for massage in older people.
Outcomes on psychological indicators are consistent with strong physiological indicators for slow-stroke back massage on relaxation in older people. Statistically significant results and improvements for physiological and psychological indicators are associated with decreasing agitation and promoting relaxation using hand massage in older people. Stronger correlations were found between slow-stroke back massage and psychological responses in older people. The effects of massage for reducing anxiety and increasing relaxation were recurring themes suggesting that slow stroke back massage reduces psychological stress. The studies on hand massage reported a consistent reduction in verbal aggression and non-aggressive behaviour in persons with dementia.”
Hand massage and slow-stroke back massage are a part of the Compassionate Touch® program. Care-partners of all kinds can learn to use touch in a focused way to increase quality of life for those living with dementia.