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.
Let’s imagine that you have dementia. What would you miss? What would you forget about that you enjoy? We all forget the details of our lives and often take the little things we enjoy for granted. People living with dementia can rarely seek out enjoyable activities independently and often even forget what used to bring them pleasure. That is unless memory is triggered. Knowing that, how might you activate pleasure linked to past experiences?
One great resource is the small book titled, 14,000 Things to be Happy About by Barbara Ann Kipfer. She gives us hundreds of things that make us smile because they conjure up the sights, sounds, smells, and feel of what it’s like to experience them. Dairy farms, fresh flowers, the sound of tap dancing, a camping tent, finger painting, candy apples, the smell and color of fresh fruits, bubble gum, bridges, and puppies are a few examples. You can pick up her book at any bookstore or even thrift stores to prompt memories.
Or, along with elders, come up with your own “Happy Book”. Then think of ways to bring those experiences back again for people living in your community. For example, we put up a tent in the backyard at our community and had a campfire in a small charcoal grill. That changed the whole feel of the backyard; it became a campsite that one family had enjoyed on vacations. The stories shared around that fire were priceless and they would never have relived the time together without the simple trigger of a tent and campfire. From such stories you will find even more things that you can use another time to bring enjoyment to so many people.
I’m not a big fan of reality TV shows. The “supposedly” unscripted real-life situations to me are far from a virtual tour through life. That said, I do find myself entertained from time to time at the subject matter some creative person comes up with to actually create a show. Unbelievable…
I visited with a dear friend recently who has been caring for her sweet mother for many years. Once healthy and mobile, age and illness is slowly taking its toll Painful neuropathy, crippling arthritis and diminishing eyesight have teamed up to challenge her spirit and soul. My friend is tired and I often see glimpses of resentment, despite her deep love, respect and genuine concern for providing the care she deserves. This scenario could easily be a true reality tv show, however the ratings would struggle.