Split Safety & Wellness Responsibilities for Aging Parents
Julie Fries, RN, In Home Care
Every family member has a special talent. You might be the handyman (or woman); some of us have a gift for interior decorating, while others are really good at wrangling schedules and paperwork into perfectly organized files arranged by date. As our parents age, it’s time to step up and split up some very important duties to help keep them safe and healthy at home. Show how you care for your parents—and for one another—by sharing family responsibilities:
For the Handyman/Home Depot Shopper:
Install a grab handle between the storm door and the exterior door to help an older person boost up and over the threshold of his or her house. Buy several nightlights and plug them in all along the route to your person’s bathroom. (A while ago, maybe one would suffice, but aging people need a better lit pathway.) Find a shower seat with a notch to hold a handheld shower nozzle so your parents don’t have to reach up and wrestle with an unwieldy hose connected to the showerhead. Install a high-rise toilet seat so it’s easier and safer for mom and dad to sit down and get up.
For the Interior Decorator/Efficiency Expert:
Work with your parents to rearrange often-used items so they are more accessible. However, remember to make these changes as a team. Rearranging personal items can cause anxiety if your parents can’t find something you put in a “better” place. The goal is to store food, dishes, clothing, and other everyday items within easy reach and prevent a fall that might come from standing on a stool or chair.
Walk through the house with an eye toward trip hazards. Remove area rugs from all but the most essential places, like entry doors, and safely move electrical cords out of walkways.
Arrange furniture to allow plenty of room to walk freely and remove items that tend to collect on stairs or in hallways, especially those things that are halfway to their destinations, like piles of papers (that can be recycled), garbage bags (on their way out to the trash can), or laundry baskets (on their way to or from the laundry room). Is there a better system for these things, like a new location for the garbage and recycling, or a hamper-on-wheels for laundry?
For the Organizer Extraordinaire:
If you like to bring order and predictability to the world, then you will be almost giddy when you discover how easy it is to have your parents’ prescriptions safely organized in bubble packs and set to auto-refill.
Set an appointment for an Options & Solutions visit from Valley VNA nurses, and bring your questions and a notebook. We come to your parents’ ho
use for a 60-90 minute appointment to talk about helpful services that are available when the time is right. Learn about new ideas together, and give your parents time to think about when and if they might like to use them, including: Meals-on-Wheels hot meal deliveries; foot care clinics that include a foot soak, nail trim, filing, and foot massage; blood pressure clinics; flu shot clinics; Health Chats, a health talk presented by a nurse; cleaning services through the VNA’s Home Maids division, and in-home respite care for caregivers.
Together, we can all do our share. Not only will it lighten your load, everyone has a chance to share their own special kind of love. To learn more about any of these services, or to schedule a no-cost Options and Solutions visit, call (920) 727-5555 or visit www.valleyvna.org.
In-Home Care Nurses Help Families Solve Problems, Keep Spirits Up
By Colleen Harvot, Valley VNA Senior Care Director of In-Home Care
I help lead a team that provides in-home care to seniors throughout east central Wisconsin. Julie Fries, RN, and Andrea Hilgers, LPN, our degreed nurses, are the first point-of-contact with all of our in-home care clients. They make the initial visit to meet the family and complete an in-home initial assessment of a client’s needs. Once a relationship is established, we assign caregivers to make regular home visits. However, our nurses remain in constant contact with our staff members and are friendly and willing resources to the families we serve.
Here are some of the questions we get from our families, and a bit of the advice we offer when family members are perplexed about their loved one’s needs or behaviors. It’s invaluable to have nurses on your in-home care team!
Why is this happening?
As people age, their behaviors change in ways that spouses and other family members may not understand. A typically calm and serene person may become anxious or agitated in the midst of cognitive decline because customary routines suddenly become confusing or scary. A person who has always loved to cook may abandon her kitchen entirely. We help explain why these changes are happening and encourage family members to remain open to their person’s need for change. We coach families on how to dampen anxiety and redirect a person’s attention to new engaging activity that better fits their interests and abilities. Family members who accompany their loved ones with Alzheimer’s and dementia will lower stress levels when they “go along for the ride” for a mixed-up conversation or perceived alternate reality. As long as everyone is safe, arguing with a person in this situation will only cause sadness and anxiety—for everyone. We counsel people to embrace change as a fact of life and love anyway.
Do you think I should call the doctor?
In-home care can be provided to any family who requests it, whether they have a doctor’s order or not. A senior keeps his or her own doctor and family members remain the main point of contact for all health-related appointments and activities. However, our nurses are able to contact your doctor if we see something that needs attention. For instance, a senior who contracts a urinary tract infection will have symptoms that our on-site caregivers will recognize. We can report these symptoms to your doctor or suggest that a family member call to discuss the symptoms and probable diagnosis. Many families appreciate “another set of eyes and expertise” in having in-home care nurses on their team.
What do I do about that?
It’s completely understandable that a spouse or child of a senior will get overwhelmed or exasperated when they realize they need help with more aspects of physical, social, or housekeeping tasks. Whenever we hear “Now what do I do about that?” we can usually help find an answer! We make referrals to foot care clinics, where foot care nurses can help soak, file, and trim a senior’s feet. We can arrange for drivers to help with appointments, errands, and shopping. A person can be brought in to help with meal preparation, light housework, and cleaning. We connect families to Meals on Wheels deliveries to access convenient nutritious food and a daily visit from a volunteer. We help arrange for respite care for an evening out, a lunch date, or even a vacation for the primary family caregivers. We take pride in helping families solve problems so they can keep their spirits up.
“We sit in the house all day. We need to get out or see more people.”
Caregiving can be lonely for everyone involved. Lack of mobility or appropriate activities for changing bodies and minds can feed isolation. Our nurses know about activities for our client families at every stage of life, and they are all designed to bring joy and peace. We can connect families to Lyrics and Laughter, a music appreciation class for seniors and their caregivers held at Valley VNA, or arrange for life enrichment activities to become part of our in-home care (think playing cards, building a birdhouse, decorating cookies, or looking at books about WWII). The Therapeutic Home Touch program is designed for men and women in the final stages of Alzheimer’s or dementia, many of whom crave a soothing environment. Specially trained caregivers use music, aromatherapy, and massage to reduce agitation—and these effects linger for hours afterwards. That’s a gift for every member of the family!
Julie and Andrea are in constant contact with our caregivers, clients and families. This extra layer of expertise ensures quality care and helps us help families as they strive to do right by the people they love. That should lift your spirits.
By Colleen Harvot, Director of In-Home Care
Family caregivers to seniors are people who step up and help their loved ones life safer, happier, and healthier lives. Their roles vary from accompanying aging parents to their doctors’ appointments, visiting them regularly for socializing and wellness checks, daily phone calls, all the way to around-the-clock physical caregiving, including dressing, feeding, toileting, and socialization. Those of us who are parents can remember the sense of responsibility we had when our children were young, then away at college, and now out on their own. The situations change, but thoughts and anxieties still linger in our hearts and minds every day. This is aptly called the mental load or emotional load that a caregiver does to keep family members safe, happy, and validated.
Caregiving can be very rewarding because we have chosen to live our values by caring for a person who is vulnerable and in need of an advocate. At the same time, there are many aspects of caregiving that can be exhausting. It takes hours of time each week, almost always unpaid, and worries about the future do not miraculously evaporate when our heads hit the pillow. We also ruminate on the past and remember days when we were all younger and more energetic. We tell ourselves to be grateful for what we have while grieving happier or easier times of the past. If we remain open to them, we can discover genuine joy in moments of humor, a compliment, or a “thank you.” Consider these ideas to help acknowledge the caregivers in your life:
- See them. Caregivers to seniors are some of the most invisible, yet completely indispensable, people in our families and communities. Do you know a young mother who keeps an eye on her elderly next-door neighbor, and perhaps brings over an occasional hot meal or shovels the walk? She’s a caregiver – despite her daytime job and family’s schedules and demands. Has your mom taken on more responsibilities for your dad now that she has to remind him to take his pills? Perhaps she does a lot more of the driving, too, and feels a little sad about losing her gentleman chauffeur. She is a caregiver. If your brother has a more flexible schedule and goes to doctors’ appointments with your parents, he is a caregiver (and a notetaker and follow-up appointment-maker). There is a mental load associated with each of these jobs. A caregiver is always asking “What if?” or “What next?” Many caregivers will say it’s not the work that’s dispiriting, it’s feeling unseen. Think about the caregivers in your life. Take a few minutes to write an e-mail, send a text, or put a card in the mail that says, “I see what you are doing. You are not invisible to me. I am grateful for you.”
- Be patient. Allow planning time. This is especially true for full-time caregivers to aging parents or spouses. Caregivers who attend to the daily needs of dressing, toileting, feeding, and supervision (especially in the case of Alzheimer’s, dementia, or mobility concerns) cannot respond to a lunchtime invitation proffered at 10 a.m. the same day. They first need to arrange for coverage while they are gone. Caregivers’ friends may call two or three times with an invitation, but then they get frustrated when the caregiver can never accept. If they stop calling, isolation seeps in and threatens the well-being of both the caregiver and care receiver. Commit to inviting your caregiving friends whenever your group has an outing. Try to afford them ample time to make plans. Do not give up on caregiving friends when they most need your support.
- Make arrangements for respite care, even if your family doesn’t choose to use it. Respite care is when a professional caregiver comes into a person’s home while their primary caregiver is away for a relatively short period of time, anywhere from a couple of hours to a couple of weeks. Respite care requires an initial evaluation of the care receiver’s needs, including a visit from a nurse to record essential health information. A thoughtful gift for a caregiver is to set up this initial no-charge visit in advance. If a caregiver wants to schedule a getaway, or even convalesce from his or her own illness or surgery, the plans are in place to have helpers at the ready. It’s a great stress relief for a caregiver who feels constantly “on the job.”
During the holiday season, let’s all make a special effort to validate the caregivers in our lives. The most important gifts don’t cost a dime, but they are golden.
Pat Bowen is a Sunday Eucharistic Minister Volunteer to Valley VNA Residents
Pat Bowen was raised in a devout Catholic family near Poughkeepsie, New York, and her experience with Catholicism led her to join a convent, the Dominicans of Newburgh (now the Dominican Sisters of Hope), after high school. There she studied and discerned her future vocation for two and a half years, progressing through three of the seven steps toward her final vows. After prayerful consideration she decided she would continue her desire to teach outside of the convent. However, her time in religious formation afforded her the opportunity to “bring up any question and ask anything about Catholicism,” and the result is a more steadfast faith in God that remains a very important part of her daily life.
As a young teacher nearly 40 years ago, Pat met her would-be husband Chuck, a printing-industry estimator, on a fortuitous camping trip with mutual friends. Together they raised three boys, now grown: Mark, Kevin, and Paul; a fine artist, brewmaster, and middle school technology teacher, respectively. After 15 years in New York they relocated to Wisconsin where Pat resumed her vocation as a preschool and elementary teacher in the now-named St. Mary Catholic Schools. She retired five years ago and is happy to have the time to enjoy her first granddaughter, Karalyn, 17 months, who lives in Oshkosh with her parents, Mark and Karissa Bowen.
Pat volunteers at Valley VNA and 15 years ago got involved with a ministry that beautifully shares her devotion to her Catholic faith and her love for nurturing people at all stages of life. She is a Eucharistic minister (a distributor of Holy Communion) to residents at Valley VNA on Sundays during the community’s televised Mass. Her Sundays start out with 7:30 Mass at St. Margaret Mary Parish in Neenah where she picks up the consecrated hosts for the typical number of Valley VNA residents she serves. She arrives in time to give Communion to residents within their televised Mass and often stays after to visit with others individually. “I explain to people I am there to share Holy Communion, and their eyes just light up!” Pat said. “Even if they are confused about other things, they understand what I am offering them and thank me. It gives me such joy—it makes my day.”
The best Sundays are when Pat arrives at Valley VNA and sees so many people at Mass, she has to literally “break bread” to serve them all. “One day there was a resident with her daughter, son-in-law, and five grandchildren. I know that lady was so happy to have her family at church with her. On a big day, I bring communion to 30 or 35 people, and for part of the year I split Sunday duties with another couple, Jenny and Dennis Bauer.” The result is up to two hours of visiting, shared prayers, laughs, and affection at Valley VNA—all inspired by the love of God and His people.
Individual Service Plans
By Pat Hoogevoorst, RN, Clinical Services Director at Valley VNA Senior Care
All residents who move into Valley VNA Senior Care Assisted Living have a comprehensive assessment prior their move date. These assessments are conducted by one of the registered nurses from the Valley VNA clinical team. The purpose of the assessment is to establish the needs and abilities of the person so an Individual Service Plan (ISP) can be developed. The ISP is the guide the staff will use to provide appropriate care for our new resident.
The assessment will cover many areas including physical health, medications, presence of pain and intensity, the need for nursing procedures, and mental and emotional health. We look at behavioral patterns, a person’s capacity for self-care and personal care such as dressing and toileting, and risk factors for falls, choking or elopement (wandering off). Social needs, decision-making, nutritional needs, and preferences for certain daily routines are all recorded. We also consider outside services that may be required to properly address all of the person’s needs.
The assessments are completed in person with the resident and his or her family member or Power of Attorney for Health Care (POA). Some information is gathered from past health histories or recent doctors’ visits, medication lists, discharge summaries, family caregivers, or third party providers like home care or hospice caregivers. Other portions of the assessment are completed during the meeting.
The ISP clearly details care needs in all areas, when they are to be completed, who is responsible for the care, and the desired goal for the resident. The assessments also help the Valley VNA team recommend the most appropriate court, or section of our residence, where the person can be happiest, most comfortable, and safe.
ISPs are fluid documents; as a resident’s needs change, so does the ISP. Assessments are reviewed at least 30 days after move-in, after any significant changes in a resident’s status, and every year. We include the resident and his or her family member or POA whenever we update the ISP because it is an excellent opportunity to keep the lines of communication open between all parties. Our goal is to create an in-depth person-centered ISP that helps each resident age with grace and dignity.
My Life as Volunteer Rickshaw Pilot
By Sue Ruthven
The staff at Valley VNA started talking about raising money to purchase bike rickshaws about two years ago. Right away, my husband Paul and I knew we would be members of the first corps of volunteer pedal-pushers, technically known in the Cycling Without Age rickshaw program as “pilots.” The two of us love the outdoors and do a lot of biking. Most importantly, we knew my mom Marion, a resident of Valley VNA, would love us to take her on rickshaw rides.
This is the first full season of rickshaws here in Neenah because the specially-ordered bikes arrived on a ship from Denmark just as the weather got cool last fall. I went through about three hours of training this spring and generally sign up to take residents around town one or two times a week through an online portal that allows me to choose times that work for me. My mom is naturally my favorite passenger, but I sign up for other ride slots and meet lots of other very appreciative residents, too.
VNA pilots have access to a garage at Valley VNA, and we arrive a few minutes ahead of our bike ride time to bring one of the two rickshaws up to the front doors. There, we press an alert button that announces we are ready, and a VNA staff member accompanies our passenger outside to help him or her get settled in. The rickshaw is a two-seater, and even guests are invited to join us (after signing a pesky waiver in advance of the ride, of course). I have yet to bring a young person and an old person on a ride together, but I can only imagine their simultaneous giggles, each of them feeling the same breeze and sunshine, but participating in the ride through entirely different lenses of life experience.
My friend recently asked me what my mom thinks of her rickshaw rides, and I said, “I think my mom is picturing herself riding with her sisters on a bike down a dirt country road, crickets chirping in the meadow.” She was a hardworking farm girl for whom the song of redwing blackbirds still conjures memories of roadside cattails and fence posts. She loves to be outdoors!
The amazing people of Neenah are so fascinated and friendly when it comes to VNA rickshaws. We are a bit of a wide load, so I used to worry about frustrating drivers when I had to take a full lane. That fear is entirely unfounded; in fact, drivers willingly slow down and even roll down their windows and wave. Young and old faces light up when they see us coming. Rides out to Kimberly Point inevitably involve one or two stops as curious people flag us down to ask questions about our three-wheeled contraption (with a sly power assist, should your legs get fatigued). I like to stop at Rocket Park so my passengers can watch the kids play, then on to the fountain, where I will park just close enough to feel the mist brush our faces. It’s all so invigorating and life-giving.
One of my recent passengers was a little confused about my role as a rickshaw pilot and encouraged me to stop at the desk after our ride to get paid. She was very happy for me to have the chance to earn some extra pocket money, but I assured her that I was happy to volunteer! In truth, I am paid back in joy. I talk to fascinating Valley VNA residents, interact with people in our beautiful community, and help some very special seniors experience warm summer sunshine again, just like when they were younger. It’s true what they say—you really never forget how to ride a bike.