Help With Elderly Parents http://www.helpwithelderlyparents.com Giving Caregivers Information They Can Trust Mon, 11 Jun 2012 01:01:46 +0000 en-US hourly 1 http://wordpress.org/?v=3.4.1 12 Do’s and Don’t's For Doctor’s Visits http://www.helpwithelderlyparents.com/mdoffice/?utm_source=rss&utm_medium=rss&utm_campaign=mdoffice http://www.helpwithelderlyparents.com/mdoffice/#comments Tue, 29 May 2012 15:50:31 +0000 Suzanne http://www.helpwithelderlyparents.com/?p=579 [...]]]> Elderly Parents and Their Doctor: How to have a more effective visit:

1. Leave your cell phone in your vehicle. You do not need it in the doctor’s office. The people in the waiting room do not want to hear your conversation. And please do not be one of those people who will answer their phone while the nurse is getting your blood pressure or the doctor is trying to talk with you and/or your parent.

2. Write down your question’s and concern’s ahead of time. Do not rely on your memory. Do not be afraid to ask your questions even if the doctor seems to be in a hurry. You might also ask the nurse some questions. If he or she can not answer them, they will tell you to ask the doctor but chances are they can answer some of them.

3. Tell the nurse and the doctor all the concerns you have at the start of the visit. (Again, write them down.) Different symptoms may be related or not. By knowing all your problems the doctor can prioritize.

4. If your doctor ask you how you are doing the proper response is not, “You tell me.” No one knows how you feel but you. It is up to you to tell the doctor how you feel. In the case of a parent who can’t communicate, it is up to you to tell the doctor how they are doing. You are with them every day, you notice any changes.

5. Describe your symptoms clearly using descriptive words even if you think it sounds weird. How long have you or your parent had this symptom? How severe is it? Does it interfere with your ability to eat, sleep, work, or perform any normal activities?

6. If you have expectations, state them up front also. Sometimes you may be right on target, other times you may need some education.

7. Tell the truth. If your elderly parent drinks two six-packs of beer every night, or uses illegal drugs, these are a few of the health risks their doctor needs to know about. If do not feel you can trust their doctor with this information, find a doctor you do trust.

8. Bring all medications and supplements, or a list of them, to each doctor visit. Bring the ones actually being taken and remember those that are only as needed (or prn in medspeak). If the doctor prescribed a medication and you stopped giving it, let him know. (Actually, you should have called him first to before stopping the medicine). For instance if you stopped taking potassium because it was burning your stomach, the doctor may need to change you blood pressure medication.

9. Make sure you doctor knows every doctor your parent is seeing. This enables them to share test results and treatment plans, prevents duplicate or conflicting medication prescriptions as well as duplicate tests.

10. Bring a record of your parent’s medical history and any medical records you may have such as test results or images from scans or x-rays. (I don’t get copies of all my mother’s labs and tests unless something is really weird. But if we are going to a specialist, even though her doctor’s office will fax the information, I get a copy.)

11. Don’t be afraid to disagree with your doctor. If they are recommending a medication and you do not want to take it, tell him and tell him why. If the medication is too expensive there maybe less expensive alternatives. If you think your parent needs to see a specialist, say so.

12. Do what the doctor tells you to do, take the medication he tells you to take! There is nothing more frustrating than the person who keeps coming to the doctor with numerous complaints but will not take their medication because they do not like to take pills. Why are you wasting their time and your money?

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Memorial Day Tribute to Granny http://www.helpwithelderlyparents.com/memorial-day-tribute-to-granny/?utm_source=rss&utm_medium=rss&utm_campaign=memorial-day-tribute-to-granny http://www.helpwithelderlyparents.com/memorial-day-tribute-to-granny/#comments Mon, 28 May 2012 17:05:10 +0000 Suzanne http://www.helpwithelderlyparents.com/?p=577 [...]]]> I sat on the front porch yesterday as the sun was going down and the trees cast long shadows on the ground. There was a breeze blowing the leaves creating a rustle as if someone were passing through. The birds were chirping, heralding the ending of the day as the crickets and frogs joined in.

There was contentment in moment as I felt you sitting beside me once again. We were back on that Georgia mountain you loved so well, sitting on the front porch watching the firefly’s come out as the Bob White’s called out and sad sound of the whip-poor-will answered back.

Your eyes were twinkling as you told a story as only you could, with your unique expressions that were always so descriptive. Memories of conversations and dulcimer playing arise, happier times, when life was simpler.

Memorial day is a day we set aside to remember those who have given their lives for our country. This year, I can not help but remember those who, like you, stayed home and made sure they had a country to come home to.

You raised two daughters while Grandaddy served in the Navy during WWII. Your stories of how you and your sister Sybil got by made it sound more like an adventure than a struggle. Then again, you almost always found a silver lining and turned it into gold.

Ever the lady, you got courtesy and respect wherever you went. Your warmth and genuine interest in people gained you many friends. Sadly you outlived all your siblings and friends, making your last few years lonelier than they should have been.

But you kept going, kept finding a reason to get up every morning. You always had something you wanted to do around the house or something new to make or a new recipe to try. You never gave up. Death had to sneak up on you in your sleep because that was the only way to catch you.

I thought it might get easier after the funeral, that the pain of loss would ease a bit. But at odd moments memories kept surfacing. I could get nothing done.

I gave up and went outside, called by memories I could not stop. I sat down in the rocking chair and within moments I knew you were there. You drew me down the path of memories then we returned to the present and I finally understood.

I could be with you again anytime, for you would be with me on any porch I ever sit on. And if I listen closely, I can hear you laughing as you tell another story.

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Elderly Parents Not Eating? http://www.helpwithelderlyparents.com/noteating/?utm_source=rss&utm_medium=rss&utm_campaign=noteating http://www.helpwithelderlyparents.com/noteating/#comments Fri, 25 May 2012 10:00:13 +0000 Suzanne http://www.helpwithelderlyparents.com/?p=494 [...]]]> “Nothing has any taste anymore. Not even ice cream, if you can believe that!” Granny is 92 years old and that is also what she weighs, which is not enough. My granny and I share a love of ice cream, especially Blue Bell Homemade Vanilla! So when she told me yesterday that not even ice cream had any taste, I knew things were serious!

Like many people as they age, my grandmother is losing her sense of taste. For some, the sense of smell also declines decreasing their ability to taste. Granny also has macular degeneration, which is slowly causing her to go blind, so she has a hard time even seeing her food. Living alone, she often feels like cooking is too much effort, especially a few weeks ago when she was temporarily using a walker.

Having given up driving over the last year, she still has not adjusted to having to ask others to take her to the store or go for her. Many of our elders also have dental problems that make eating difficult, dementia which causes them to forget to eat, and depression which can lower the appetite. I have had more than one elderly person tell me they could afford medications or food but not both.

What can a caregiver do when their parents are not eating enough?

Make sure they have food. Actually look in the pantry, refrigerator and freezer. Many elderly parents are too proud to tell their children they do not have enough money for food. Or they do not want to bother you, so if you do not ask them if they need anything from the store, they will just do without.

If they live alone, are they able to cook? There might be assistive devices that they can use to make cooking easier, such as a walker with a seat so they can sit down as needed. If cooking is still too hard for them, it might be time to look into Meals On Wheels in your community. Also, when you cook, make extra and take to them.

Socializing while eating is a large part of the American culture and many of our senior citizens are missing this interaction. They are eating meals in front of the television, the local news keeping them company for their meal. Call your elderly parent and ask them what they had for lunch or supper. It reinforces the need to eat without nagging, serves as a reminder to eat and anticipating you are asking when you call may actually motivate them to eat. So try to have a meal with them as often as you can.

Also, have a medical evaluation. There could be a medical reason your parent is not eating. It could be depression or a digestion problem. There are also medications available that help to stimulate the appetite.

Those are the easy problems to fix. The lack of taste is a bit harder. Here are a few suggestions:

Serving

Put less food on the plate. A large amount of food can be overwhelming to someone who already is not really hungry.

Serve only one or two foods. Fewer choices may be less intimidating.

Make the food as attractive as possible. Even when she is eating alone my granny puts out a placemat, cloth napkin and coaster on her dining room table. “There’s no sense in losing your civility,” she quipped when I teased her about it.

Serve small snacks between meals such as cheese and fruit, crackers and peanut butter, or half a sandwich on a small attractive plate.

If using replacement shakes put them in a glass rather than serve them from the bottle or can.

Specifically adapted utensils, plates, mats and cups may make self-feeding easier and promote greater intake.

Flavor

Add extra herbs and spices to enhance the flavor.

Ask them what foods that can taste. In the same conversation where she complained about not eating, granny mentioned that she hoped my aunt would bring her some desert from the church function she was at and mentioned making a pitcher of sweet tea. Ah, ha! She still tastes sugar. My grandma had more of a taste for salt. Using sweeteners such as Fructevia sprinkled lightly on foods might enhance the tastes. Instead of regular salt, try using small amounts of Sea Salt which tends to have a stronger taste.

Timing

Allow plenty of time to eat. Lingering at the table, talking and snacking may increase intake.

What is traditionally the time they eat the biggest meal? For my grandma it was lunch, with granny it is supper. Plan the main meal at their traditional time.

Have afternoon tea and a snack

Food

Let them eat what they want. Seriously. You have to start somewhere. Certainly if they have dietary restrictions you may have to limit some of their choices but you can talk with a dietician to help you. Or ask their doctor about bending the restrictions a little.

Serve their favorite foods

Nutritional shakes such as Boost, Ensure or Glucerna for diabetics can be used as meal replacement or between meal snacks.

Adding Nutrition to Shakes

If your elderly parent needs more calories and nutrition you can supplement commercial shakes by adding an extra scoop or two of protein powder and mixing it in the blender with ice cream and syrup or honey.

Add fruit and frozen yogurt to commercial shakes, along with protein powder.

Add different flavored extracts to enhance the taste.

Peanut butter or other nut butters can be added to shakes.

Powdered milk added to shakes will increase calories and protein without increasing fat.

For added carbohydrates add some Polycose Powder to shakes and foods such as mashed potatoes, cottage cheese, yogurt, oatmeal, cereals and soups. It is tasteless and odorless.

And finally, do not nag. Gentle reminders are okay but avoid making mealtimes into a fight-time.

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Elderly and Antibiotics http://www.helpwithelderlyparents.com/antibiotics/?utm_source=rss&utm_medium=rss&utm_campaign=antibiotics http://www.helpwithelderlyparents.com/antibiotics/#comments Thu, 24 May 2012 10:00:41 +0000 Suzanne http://www.helpwithelderlyparents.com/?p=422 [...]]]> Elderly are more susceptible to infections than most people and as a result often end up on antibiotics. While all medications have the potential to cause reactions, antibiotics seem to be the culprits more often than most.

The trouble is we do not know how you will react until you take the medication. While the list of possible side effects for all antibiotics are often long, there are five that are most commonly seen: nausea, vomiting, diarrhea, rash, and secondary yeast infection.

The problem for your elderly parents is they are more susceptible to yeast infections than younger people. Prevent the yeast infection by eating yogurt or drinking buttermilk every day or taking probiotics works sometimes. If that does not work, there are over the counter preparations ladies can try. Read the package instructions and follow them. If those do not work, have the doctor prescribe Diflucan. Usually, but not always, one pill will take care of the problem. So if you know that Sulfa gives mama a bad yeast infection go ahead and ask the doctor to order something for her. Or she may choose to order a different antibiotic.

But what about your father? He can get a yeast infection too. Yeast infections can occur in your mouth and are quite painful. When yeast infections occur in the mouth it usually called thrush. Thrush is associated with babies but people who wear dentures, are on long-term steroid therapy or have a weakened immune system have a harder time fighting it off. There are prescription medications available to relieve the discomfort and treat the yeast.

If your parent experiences any of the other common side effects, nausea, vomiting and diarrhea, depending on the severity and the antibiotic, the physician may decide to treat the symptoms and continue the antibiotic. Always check with your doctor before stopping a medication unless the reaction is severe.

If your parent has any trouble breathing or starts to swell, especially in the face, give them some Benadryl if they can swallow and call 911. They could be going into anaphylactic shock and every second counts.

While a reaction can occur at any time, usually the chances are greatest after the second dose of medication. Stay nearby for the first hour after giving a new medication for the first couple of doses.

Please do not ever give your elderly parent leftover antibiotics unless their doctor has given you instructions that it is okay because of a chronic, ongoing infection. Some medications and antibiotics do not play well together. Antibiotics are often specific to what classification or type of organism they treat. Cultures are done to determine what exactly will kill off the bacteria. Giving a person an antibiotic that is not strong enough to kill the infectious organism can lead to a more virulent drug-resistant strain.

Some antibiotics have to be monitored via blood work to ensure they are at therapeutic levels without being toxic. These types of antibiotics are usually given IV and can often be given at home. IV antibiotics get into the blood stream immediately and go to work faster. IV antibiotics are much stronger than those taken orally. They also have side effects and because of the speed with which those side effects can hit, make sure you know which ones to look for before the nurse hangs the antibiotic so that you know what to watch for.

Remember to check with the pharmacist about what to do if you miss a dose. This is more important with antibiotics than some other medications. And ensure your elderly parent takes all of the antibiotic until gone. Just because they feel better does not mean they are well. If you parent is started on an antibiotic and you do not see improvement within 48 hours, let you healthcare provider know.

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Infection Control Part 5 – Caring for Elderly Parents with Infections http://www.helpwithelderlyparents.com/infection5/?utm_source=rss&utm_medium=rss&utm_campaign=infection5 http://www.helpwithelderlyparents.com/infection5/#comments Wed, 23 May 2012 10:00:23 +0000 Suzanne http://www.helpwithelderlyparents.com/?p=486 [...]]]> If your elderly parent has a communicable disease whether it is a cold or HIV, there are standard precautions you should take to prevent the transmission of the illness to others, including yourself.

Caring for Someone with an Infection

It is also important to protect yourself from getting an infection from the person for whom you are providing care. Washing your hands is always the number one thing you can do but consider the following also:

Clean equipment by rinsing in cool water to remove any particles (warm water may cause particles to stick to the equipment). Then wash with hot, soapy water, rinse well, and dry thoroughly. If you are dealing with a very virulent infection, you may want to rinse with cool water, spray with a ten percent bleach-water solution and allow it to sit for a couple of minutes before washing in hot soapy water. Boiling for “sterilization” is usually unnecessary.

Urinary drainage bags a.k.a. catheter bags ideally should be left connected to the catheter to prevent contamination. However, during the day mobile people often switch to a smaller leg bag that can be hidden under a skirt or pants leg. Leg bags and the larger night bags can be cleansed with soap and water. Rinse with a tablespoon of vinegar in a cup of water to help keep down oder and infections. Allow to air dry.

Dispose of body wastes down the toilet being careful to avoid splashing. Wash linens and clothes soiled with body waste separate from other laundry.

If the parent you are caring for receives medications from a multi-dose syringe such as an insulin pen, it is best to have the person receiving the medication remove the needle from the pen if possible to protect yourself. With a standard syringe and needle, never remove, bend, break or recap the needle after use.

In healthcare settings sharp objects such as syringes with needles are disposed of in biohazard containers and the containers are incinerated according to strict guidelines. Small versions of these biohazard containers are available in most pharmacy’s but should never be thrown out with your home trash. If you elect to use these, you will need to find out where you can drop them off for disposal. Your pharmacist, physician, hospital or local home healthcare agency can direct you where to take them.

If you are caring for someone with an infection that can be transmitted by blood such as HIV or hepatitis B, consider having any used needles disposed of as a medical facility would.

For most homes people can use any rigid, puncture-proof receptacle with a small opening, such as a bleach bottle, will do and is acceptable practice. Place a small amount of bleach in the bottle, drop the syringe, with needle intact into the bottle. When full replace the cap and tape it well with a strong tape. I always reminded my patients that things fall off garbage trucks all the time and the last thing you want is a child getting into a bottle full of used needles. Never use bottles, glass or plastic, that can be returned to the store.

When someone in the home is receiving wound care the soiled bandages should be placed in a bag which is then tied up and placed in another bag for disposal. If the bandages are dripping wet, talk with your healthcare provider about using a more absorbent dressing. If there is a chance of a blood-born infection, soiled bandages might need to be burned. Discuss this with your healthcare provider.

Clothes and bedding should be laundered separately in hot, soapy water with a ten percent bleach solution added to the detergent.

Do not share thermometers, razors, razor blades, toothbrushes, douche or enema equipment.

Do not share eating and drinking utensils. Clean them after use with hot soapy water. Using a dishwasher is good.

When flushing a toilet germs are sprayed into the air, even with the lid down. Toothbrushes should be covered or placed in the medicine cabinet or in a drawer.

Faucets in bathrooms and kitchens should be cleaned daily with a disinfectant.

Obviously the best way to prevent infection is through cleanliness. The foundation of it all is good hand washing.

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Infection Control Part 4 – What if you get sick? http://www.helpwithelderlyparents.com/infection4/?utm_source=rss&utm_medium=rss&utm_campaign=infection4 http://www.helpwithelderlyparents.com/infection4/#comments Tue, 22 May 2012 10:00:50 +0000 Suzanne http://www.helpwithelderlyparents.com/?p=484 [...]]]> Unfortunately it happens. We all get sick from time to time. The best thing to do is have someone else take over the
care of your parent if possible and for you to stay away from your elderly parent.

If you must provide care there are some precautions you should take. Always wash your hands prior to giving any care or before handing them anything. As an extra precaution where disposable gloves but remember, gloves do not take the place of hand washing. And in this case sanitizer will not take the place of soap and water. If there is a risk of your illness being airborne you should wear a mask when you are within three feet of your elderly parent. I know masks are uncomfortable but for the elderly a cold can be pneumonia and possibly death.

You will also want to wipe down any surfaces you touch such as doorknobs, telephones, handles of appliances, and faucets with either a commercial disinfectant cleaner or a ten percent bleach-water solution you mix yourself. Bleach is an easy and cheap disinfectant and is actually more effective at killing germs when diluted than straight out of the bottle. (Who knew?) It is also a corrosive and will eat through stainless steel so wipe surfaces off with water after spraying.

The chlorine in bleach degrades rapidly when exposed to light and should be discarded after twenty-four hours. Mix it in an opaque bottle to prevent light from entering. Bleach expires. Bleach begins degrading after six months and looses twenty percent of effectiveness each year. Never, ever, ever mix bleach and ammonia. This combination forms a poisonous gas that can kill you! Never add bleach to commercial disinfectants because of possibly dangerous chemical reactions.

Do not put off seeking medical assistance for yourself if you are ill. Delaying treatment can cause a prolonged recovery time or lead to a more serious illness. If you are a full-time caregiver chances are your stress level is high and your immune system is not quite up to par. Take care of yourself. Get plenty of rest.

If you suspect your parent is coming down with an infection do not delay getting them to the doctor. As mentioned before, elderly often have compromised immune systems making it harder for them to recover from even minor illnesses.

Tomorrow we will look at what to do if your parent has a contagious illness.

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Infection Control Part 3 – Stopping the Spread http://www.helpwithelderlyparents.com/infection3/?utm_source=rss&utm_medium=rss&utm_campaign=infection3 http://www.helpwithelderlyparents.com/infection3/#comments Mon, 21 May 2012 10:00:32 +0000 Suzanne http://www.helpwithelderlyparents.com/?p=479 [...]]]> Yesterday we looked at some methods to break the chain of infection. Today we continue that discussion.

Get a pneumonia vaccination and a yearly flu vaccination. A tetanus shot every ten years is also recommended. Always complete antibiotic therapy unless instructed otherwise by your parent’s health care provider.

For someone with a productive cough, have them spit the mucus into a tissue and have a receptacle nearby for disposal. For a dry cough or sneeze, cover your mouth and nose with the bend of your arm, rather than your hand.

Good oral care is extremely important in the prevention of respiratory infections. Studies have found that people who get aspiration pneumonia are more likely to get it from inhaled saliva than from inhaled food. Your mouth meets all of the first 5 links in the chain of infection especially if there is plaque build-up. It is warm, dark and moist in there, a germs idea of paradise!

Unfortunately, mouth care is the most neglected area for those who cannot do it themselves. If the person is not able to brush their own teeth, using toothettes, lemon-glycerin swabs and finger toothbrushes are easy to use. Mouth care is so important that I have written a whole article on it here.

If you are providing care for a parent who has had a heart valve replacement they may need antibiotic therapy started before a procedure or dental treatment is done. Be sure to ask their physician or dentist.

If your parent has tubes of any kind, follow your health care provider’s instructions on cleaning and care. Care of IV’s, PICC lines, tracheotomy tubes, and other invasive devices are beyond the scope of this blog. Please consult a health care professional for instruction and advice on caring for them.

Urinary catheters are a major source of urinary tract infections. Avoid them if possible. If an indwelling catheter is in place you can reduce the risk of infection by daily cleaning with soap and water, avoid over manipulation of the tubing, keep the bag below the level of the bladder or clamp the tubing if the bag must be raised such as for turning. It is better to use a closed system where the bag stays attached to the catheter as opposed to switching to a leg bag during the day. Adequate hydration will help keep the bladder flushed. (If an elderly person starts becoming confused, weaker, or falls, check for a urinary tract infection).

Gastric feeding tube sites should be cleaned daily with soap and water. Avoid over manipulation as it may irritate the gastric lining.

While the incidence of homecare personnel bringing infection into your home is low, here are some insider tips to lower the risk:

Show them where they can wash their hands as soon as they arrive.

Ask to be one of the first patients they see that day. However, if your loved one has an infection, they should be seen later in the day to lower the risk of spreading it to other home bound patients.

If they sound like they are sick or have sick children, ask them to reschedule or send someone else.

Only in the last few years has the tracking of homecare acquired infections begun. In the home setting the patient may have an increase in host factors such as chronic illness, immunosuppression, advanced age. The goal is still to protect the patient.

What happens when you fail to break the chain and infection occurs? That will be the subject of tomorrow’s post.

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Infection Control Part 2 – Breaking the Chain of Infection http://www.helpwithelderlyparents.com/infection2/?utm_source=rss&utm_medium=rss&utm_campaign=infection2 http://www.helpwithelderlyparents.com/infection2/#comments Sun, 20 May 2012 10:00:04 +0000 Suzanne http://www.helpwithelderlyparents.com/?p=475 [...]]]> Yesterday you learned about what makes up the chain of infection: an infectious agent, a reservoir, a portal of exit, a mode of transmission, a portal of entry and a susceptible host. And you know that an interruption in any area can stop the infection from spreading. Today we will look at what you can do to stop the spread of potentially lethal germs.

Steps caregivers can take to break the chain:

Lower your elderly parent’s risk for coming into contact with microorganisms by avoiding people who are obviously sick with colds, influenza, pneumonia, etc. Ask a person not to visit if they think they might be sick or if they have been around someone who is sick. This seems obvious but even nurses and doctors go to work sick and they know better! Do not be afraid to ask someone to come another day when they are not sick. Most people will understand.

Wash your hands before and after giving care, preparing meals, toileting, coughing, sneezing, etc. Have visitors wash their hands, especially if they are professional healthcare providers. Keep liquid soap and paper towels at the sinks in the kitchen and bathroom. You can read more about the importance of hand washing here.

Put hand sanitizer everywhere: the kitchen, living room, bedrooms, and in your vehicle. Hand sanitizer does not kill all germs, especially MRSA (Methicillin-resistant Staphylococcus aureus), and you should wash with soap and water when available. When using hand sanitizer rub your hands together vigorously until dry. It is the friction as well as the alcohol in the hand sanitizer that kills the germs.

Pardon me while I step briefly off topic. Recently there have been news reports of kids drinking hand sanitizer to get drunk. This might lead you to concern about having hand sanitizer around especially if your elderly parent has some confusion or dementia. I was surprised to learn that hand sanitizers contain ethyl alcohol as opposed to isopropyl or rubbing alcohol. So in theory, someone could get drunk off of the ethyl alcohol but it would not be by accident. That stuff is nasty and it would take more than one bottle to get drunk. So the likely hood of teenagers or kids drinking hand sanitizer to get drunk is extremely low.

I have worked with both the developmentally delayed and the mentally ill and have had both drink hand sanitizers without any adverse reaction. Now they did not drink more than a bottle and I am sure if they had the results could have been different. But unless your parent is an alcoholic, the chances of them willingly drinking enough hand sanitizer to get drunk are slim. I would not let this slight threat stop me from using hand sanitizer to prevent the much larger risk of infection. If they do drink hand sanitizer call poison control, 1-800-222-1222, and follow their instructions.

Back to our chain breaking.

Practice good skin care, hygiene, and protection from injury. Pad the siderails on beds; cover any areas on wheelchairs that might cause injury. Treat skin tears and wounds by cleaning and keeping them covered. Use insect repellent when outside and treat bug bites promptly to relieve itchiness and prevent scratching. Keep your own nails short and smooth to avoid skin tears and scratches.

Encourage good nutrition, especially protein intake as this promotes healing of wounds. Fruits and vegetables are also important in maintaining health. Keep the home at a comfortable temperature. Ensure adequate ventilation to avoid moisture buildup and stale air, especially if you are in a newer, energy efficient home or are using kerosene heater.

More tomorrow…..

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Infection Control Part 1 – The Chain of Infection http://www.helpwithelderlyparents.com/infection1/?utm_source=rss&utm_medium=rss&utm_campaign=infection1 http://www.helpwithelderlyparents.com/infection1/#comments Sat, 19 May 2012 10:00:11 +0000 Suzanne http://www.helpwithelderlyparents.com/?p=470 [...]]]> The elderly are at higher risk for infections due to several factors including decline in the function of their immune system, poor nutrition, lack of activity, as well as medications and other illnesses that inhibit their ability to fight off infections. The best defense is a good offense and that starts with realizing what you are up against.

Drug resistant bacteria, swine flu, avian flu, e-coli, flesh-eating bacteria, West Nile Virus, it seems like we have a new bug to fear every month. And so-called “super bugs” that were once the purview of hospitals are now being acquired in the community setting. These are bad enough in a healthy adult but they are often deadly for our elderly parents.

As hospital stays are shortened, more procedures and surgeries being done on an outpatient basis, the need for good infection control guidelines in the home and community is becoming increasingly more important. To complicate matters even more, home care has gone high-tech with tracheotomies, ventilators, dialysis, intravenous medications and other invasive procedures. Our population is living longer and with chronic illnesses that require the skilled care of nurses, therapists and aides in the home to educate and assist with care.

With the lack of 24 hour professional monitoring, it is up to the family and/or caregivers to be the first line of defense in the prevention of infection as well as the recognition of the early signs and symptoms. Something as simple as a cold can be deadly to someone with chronic breathing problems such as COPD. A small scratch in the elderly can rapidly become septic requiring emergency treatment. (Sepsis is a bacterial infection spread throughout the body and is more commonly called blood poisoning). Good infection control cannot be over-emphasized.

The Chain of Infection

Infection requires a chain of six steps to occur and a break in the chain lessens the likelihood of infection occurring. Those six steps are an infectious agent, a reservoir, a portal of exit, a mode of transmission, a portal of entry, and a susceptible host.

1. Infectious agent: a microorganism, usually bacteria, virus or fungus, or the more common term, germ. The virulence or strength of the germ is determined by its ability to invade and multiply in normal, healthy individuals. While an organism may not be virulent for a healthy individual, in a compromised person such as the elderly it becomes pathogenic (causes illness).

2. Reservoir: There must be a favorable environment for growth and replication. This is the source of the infection such as a sick person, a contaminated object or a carrier species (insect, rodent, animal).

3. Portal of Exit: This is the route the infectious agent takes out of the reservoir such as through the nose, mouth, sexual organs, feces and through blood.

4. Mode of Transmission: This is how it moves from reservoir to host. Contact or touching an infected person such as kissing, sexual intercourse, and shaking hands, or an infected object such as shopping cart handles, phones, computer mouse and door handles. Droplet transmission through sneezing, coughing, and being spit on. Things routinely taken into the body such as air, food and liquids. Insects, rodents and animals don’t actually cause disease, they merely transfer it to us via biting, blood and feces.

5. Portal of Entry: This is how the infection enters the body such as through the mucous membranes of the nose or mouth and through a cut or injury to the skin.

6. Susceptible Host: Someone who is at risk. This includes those who are lowered immunity, fatigued, stressed, anemic, not immunized, poor nutritional status and those with underlying disease.

Tomorrow, we’ll look at breaking the chain, the first step in prevention.

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Conjunctivitis http://www.helpwithelderlyparents.com/conjunctivitis/?utm_source=rss&utm_medium=rss&utm_campaign=conjunctivitis http://www.helpwithelderlyparents.com/conjunctivitis/#comments Fri, 18 May 2012 10:00:01 +0000 Suzanne http://www.helpwithelderlyparents.com/?p=490 [...]]]> Conjunctivitis also known as Pink Eye, is caused by any number of things including bacteria, viruses, allergies and irritating agents that cause the covering of the eyeball known as the conjunctiva to become red. The eyes look blood-shot and may or may not itch. The eyelids may be stuck together in the morning due to tearing or drainage. Warm compresses to clean the eyes and ocular decongestants are the treatment of choice. A doctor may need to treat the underlying cause.

Conjunctivitis is an extremely contagious eye infection that should be treated promptly by antibiotics. Because it is so contagious extra care should be taken to avoid spreading of infectious organisms.

  • Wash your hands before and after touching near the eye or the eye it’s self.
  • Wear gloves to apply medication for others and then wash your hands. Gloves are never a substitute for hand washing, especially when dealing with eye infections.
  • Use medication exactly as ordered and for as long as ordered.
  • Instruct your parent to not rub their eye.
  • Use a single tissue or damp cotton ball to gently wipe drainage from each eye. Start at the inside corner and sweep outward then discard immediately. Never use the same tissue or cotton ball on both eyes to avoid cross-contamination. Wash your hands.
  • Warm or cool compresses, whichever feels better, will help to decrease discomfort and can be used several times a day. Keep cloths separate from other laundry and wash in hot water. Wash your hands.
  • Wash pillowcases in hot water and change them at least daily, more often if you see drainage. Once the infection is cleared up, wash all the bed linens. Wash your hands after handling linens.
  • Towels, face cloths, handkerchiefs or any other material that comes in the contact with the face should be kept separate from other clothing and washed in hot soapy water. Wash your hands after handling.
  • No swimming, no contact lenses and no eye makeup until your eyes have been clear for at least two days.
  • Discard any eye makeup, especially mascara and eyeliner, that might have become contaminated.

It is a bit of extra work but worth the effort to prevent the spread of this painful infection.

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