Welcome to the RU-vid channel of Certified Senior Home Safety Specialists, Esther Kane and Robin Schiltz.
Together, we have more than three decades of combined experience in healthcare (Esther as an Occupational Therapist and Robin as a senior care Dental Hygienist) and as caretakers of our own elderly parents.
This channel is for seniors and caregivers of elderly parents and senior loved ones.
Visit our website at seniorsafetyadvice.com for in-depth articles to help you and the senior loved ones in your life.
Some of the key topics that Senior Safety Advice covers include: • senior life hacks and demos • reviews of products for seniors • safety tips for aging in place • home modifications to increase safety • helping seniors navigate technology • other useful information for seniors and caregivers
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Hospice totally prepared us for everything during my husband's last 6 months of life. They came to tend to him 3 times a week, once from the nurse and twice from the LNA to bathe him in bed. He had a catheter and they occasionally changed that. No IV fluids because that is not good for an actively dying patient. The only respite we could get in Vermont was if he went to a hospital for a week, where he never would have received the care needed that we provided at home. Hospice provided all his supplies (depends, chucks, catheter bags, cleaning syringes, a bedside table) we got our own hoyer lift and wheelchair. I believe he got better care from our hospice than from his primary and hospital stays. We were trained to use the morphine and only used that the last week of life. I'm not a trained nurse but could do everything they did for him. The oncall nurse came out in the middle of the night when he died and we helped prepare the body and said goodbye when the sun came up.
I am sorry for the loss of your mother. I'm responding as an experienced visiting hospice registered nurse, and the author of articles at Compassion Crossing .info that help caregivers and families understand hospice and palliative care. 1. I appreciate that you are doing this series. Still, if I may tweak something you stated, you stated, "They will not recommend a treatment plan," and then referred to your mother about how you were used to the providers telling you what to do next regarding treatment. The order a doctor writes to the hospice agency to make an admission is an evaluation and treatment order ("eval and treat" for short). The evaluation is when the hospice registered nurse comes onsite to determine if the patient is terminal. The hospice medical director is then called to confirm the RN's findings and receive permission to admit the patient. The treatment is hospice, where the plan of care is to provide comfort care through what life remains. Every nursing visit should include a discussion of what to expect next as part of the natural dying process and how to manage symptoms with either medications or non-pharmacological means. 2. Hospice is a federal program, and Medicare regulations do not vary from state to state concerning hospice. I cannot stress this misconception enough because I run into it in various social media forums, where people will state that the rules vary by state; they do not! Again, this is a federal-run program where CMS makes the rules without regard to the source of payment (whether pro-bono to private insurance or state Medicaid to Medicare itself). As part of 2, the family does not have to obtain recertification as this is part of the CMS rules. The hospice agency will arrange for this. If the patient no longer qualifies, they will be discharged for failure to decline. 3. There is an entirely false statement that going onto hospice means you are agreeing to stop all other types of healthcare (stated around the 5:40 mark or shortly after that). A) You could have obtained a 3rd party prescription for the insulin (I know this for an outright fact, being a hospice registered nurse and knowing Medicare regulations), and your insurance (not hospice) would have provided a level of coverage for the insulin just as if your mother was not on hospice. B) When discussing medications provided by (covered by) hospice, these are medications directly related to the terminal illness and specific comfort medications. Just because a given medication is not covered by hospice does not automatically mean it cannot be obtained, given, etc. It just comes down to who is paying/providing the medication. C) Recommendations to stop or change medications are just recommendations. I recommend that they be followed by the patient, power of attorney, or family if no POA is in charge. 4) Medicare requires that hospice staff not be the primary caregiver. Therefore, hospice doesn't come out and give medications, call with medication reminders, or so on. 5) Hospice is a generic word like "hospital." There might be two to dozens of hospice agencies in any geographic area. While all of them must obey CMS rules (see #2-this is not a state-by-state situation), how they apply them can vary by agency (not state, but by agency). Some agencies would have had more frequent visits for your mother. For instance, I've worked for several agencies where cancer patients are seen twice to thrice per week at minimum and during daily visits in the last two weeks. 6) Around the 9:25 mark, hospice is always covered by Medicare, Medicaid, and private insurance. Hospice is a service and not a location. This is another myth -- hospice is not a location. So, when referring to the coverage in this area, you are talking about two (2) separate things. The cost of hospice (a service) and the location (hospital, nursing home, etc.). Insurance covers the hospice service but may or may not cover the location(s) for which the hospice is being provided; the location is often a completely different organization than the hospice provider. 7) Thank you, thank you, thank you for recommending interviewing several hospice agencies! 8) Shortly after 11:35, you talk about coverage for IV fluids. A level of dehydration in the body toward death is not only natural but necessary to prevent lingering through the dying process. IV fluids in the last month or so of life are extremely dangerous in terms of causing immense suffering. Good intentions can cause significant harm, and giving IV fluids to someone whose heart and kidneys are shutting down risks fluid overload, heart failure, and other issues that can hasten death (if they occur) or cause lingering through the active dying phase where families then become tormented asking, "how long will they suffer like this?" I am sorry for the loss of your mother and do appreciate that you are putting out these videos.
Oh thank you! I guess it means you are going through this scenario! I lived it as well so I empathize with you and I do want you to know that you can get through it. Take care.
Well, yes and no. They are marketed as flushable but they really are not so be very careful with those. I worked for several plumbers for many years and they all told me that these wipes that claim to be flushable do not disintegrate. So, eventually, they end up clogging your pipes so be very careful with these - I would use them sparingly.
So nice to hear you point out the marketing angle on appropriate hygiene. Like adding rinse and repeat on the shampoo instructions when really, once is enough. They really sold extreme hygiene - and are still selling it, hard. I'm 72 and have scheduled myself for once per week, but if i do gardening I always shower when i come in because reasons...
Yeah, it's quite amazing how marketing affects our decisions and then generation after generation, it just becomes part of the norm. Reminds me of the story of a husband who always saw his wife cut the ends of a roast before she baked it. He asked her why did she do that and she said that's how she was taught, her mother always did that. So, later the wife asked her mother why does she cut the ends of the roast before baking and the mother said, because it otherwise would not fit in the pan! It's so easy to just do what we've always done without questioning.
Thank you so much!!!! The word "community" terrifies me as well 55+ stuff--I like the kids running around my neighborhood, young families living in my old apt building. It keeps me young babysitting for neighbors.
Oh of course! I understand. It is wonderful, really, to see so many different types housing for older adults. No matter where you live, these are all communities, they just have different amenities. Different strokes for different folks as they say. I also love the idea of integrating nursing homes with child care centers. They've been doing that in Europe (Denmark I think) for years and the concept is finally hitting the USA (we're so far behind!). www.theatlantic.com/education/archive/2016/01/the-preschool-inside-a-nursing-home/424827/
❤thank you. I so needed to hear these words. I'm struggling to find my last living relative a place to live her last 6 months safely and free from pain. She is in hospital right now and they are looking to move her next week. Your words about guilt, relief, mixed emotions really hit home. I feel so guilty that I am physically, mentally, emotionally unable to take care of her. Pray I find a good facility.
Oh thank you for the kind words and you are welcome. I'm sorry you are in this position but I am glad that my experience (both professional and personal) may help you. It's difficult to accept that we may simply not be equipped to care for a loved one but truth is, it may actually be better for the loved one. I do hope you find a good facility - there are some out there!
I am in my late sixties, I have stopped showering every day since retiring, I am fully healthy, I walk most days, I don’t emit bad smells, I campaigned heavily for my elderly father not being showered any more frequently than every 3 days when round 90. He could even go longer than that. I myself am able to go several days & do so especially in winter. Frequent showering is overrated & unnecessary. Younger bodies have different needs. Let elderly people make their own choices! Of course support them in sensible ways & any ways required. Having a shower or bath regularly is a fitness activity & is useful from that perspective, it’s up the person’s daily activities they participate in, if that is a reason then they should do it, in my opinion.
I agree with you, it is very important to allow everyone to make their own decisions, as long as they are cognitively able to. The problem comes when someone has a cognitive issue such as dementia. Someone with illnesses that affect their reasoning and judgment need help and it's those folks that can be helped with the tips in this video. Otherwise, it's certainly up to each person to make their own decisions on how they care for themselves.
Very good video. Lots to consider. My Mom hated to bathe and her smell was gone from age and smoking. It was not a good situation! I typically shower and wash my hair twice a week. My friends think that's weird 😂!!
Oh, I get it! I worked with so many of my patients when I did home health who had a significant odor! But their sense of smell had declined so they didn't notice it. But yes, it's not an easy situation. Hey, I wash my hair once a week (I do take 3 or more showers a week though - depending on what I do). A hairdresser once told me years ago that all we needed was once a week and I've been doing that ever since. I have to say, my hair is thicker than most at my age so maybe there's something to that.
I become disoriented in the shower. On a good day, I can get into the bathtub, but am more comfortable washing at the sink. I lived in the wilderness when I was younger & it's possible to do a thorough job ! There's also the energy factor to consider !
Oh yes, the energy factor is an issue, for sure! And one that I think is overlooked in most cases. When my mom-in-law was in her 90's she had to take a nap after she showered. It was exhausting for her. Lived in the wilderness?!!! Wow. I bet you have some stories to tell.
In a care home there's the lack of privacy, no assurance that a shower wont be interrupted by someone wandering in to the room. There might also be a subconcious fear due to association with being cold that puts off elders that have no tolerance of being cold.
Time management is the big obstacle. Something that I would anticipate takes no more than an hour, turns into 3 hours because of whatever they got into. Next thing I know my to do list and the wife's list is way over due. I then get that overwhelming feeling of how did I get so far behind? Only to wake up and experience the same process over and over again. Don't care if you got ur oxygen mask on or off. Just clean up this mess now caregiver before it gets even worst. No rescue helicopter available.
Yeah, well - it's true that there is no such thing as a "to do list" when you are caring for someone with dementia. Very much like not being able to stick to a to do list when you are caring for a small child. The trick is to learn to let go of that control otherwise it does, as you say, become overwhelming. There is always the option (if possible) to get some respite help or placement in a memory unit. I know that it's a very difficult decision and emotionally charged but sometimes that's the best option for everyone. Take care.
Exhaustion is not behavioral. I have on my right side a damaged knee and an issue with mobility in my right shoulder. It is hard to bend down even on a shower chair to wash that leg. It is also hard to clean my back with the shoulder issue. You are making a lot of excuses that seem to imply elders are "crazy", lazy and don't care. That is not true.
Hmm, I am sorry that you took my information as "excuses" - that's absolutely not what I meant at all. Having physical problems is not an excuse, having cognitive problems is also not an excuse. These are issues to be dealt with and hopefully there are tools and help that can make the process of showering / bathing easier.
I bought a spray hose/nozzle that reaches from sink faucet to toilet with a diverter that acts as a bidet with hot & cold water mix so temp is always comfortable...purchased from Amazon and installed it myself. You may want to stress the importance of cleanliness to avoid a UTI that in the elderly can mimic mental confusion, anger, dementia etc. Often misdiagnosed in the elderly.
Oh absolutely - you are so right. And thank you so much for sharing your story and tip. Here's a link to a bidet sprayer that connects to the water pipe (not sure what it's called) for the toilet. It may not be exactly what this reader mentioned but it's a great idea! amzn.to/3WbyZM5
@SeniorSafetyAdvice looking forward to your next podcast 😀 I'm 71 and am just starting to acknowledge my physical limitations as well as my mental and emotional health since they all interconnect. Of course, it should go without saying, get square with God first and foremost.
I used to be an aide and often wondered why seniors dont like to shower! Now Im older, I can see its hard with bad knees, aches and pains etc. Its not for not wanting to stay clean.
Absolutely!! There are so many factors involved that it's difficult for anyone who isn't experiencing them to comprehend. Physical factors are just one thing, but if there are cognitive factors, that's even more complicated. Thank you so much for sharing and I do hope you can get some relief from those aches and pains!
SOLD! x2 Best Pxword book for seniors I've seen after hours of research and the only one that I found that had detailed info (this video) This will be a gift to my wife but really all my family. It will be stored in my fireproof safe. Thank you!
Dad has a no slip walk in shower with heated bench. There are 4 grab bars. Where he sits on the bench there is a hand held shower wand with built in grab bar. There is a heater in the bathroom and heated flooring and the shower has it's own light. Still, he refuses to take a shower for 10 days at a time. I have to ask over and over. He's not uncomfortable or afraid. He feels secure. I ASKED HIM. No. He'd rather watch tennis all day.
Oh, well, he certainly has absolutely everything that he would need to make him extremely comfortable in the shower. Sometimes, there's just no reasoning. So sorry!!
"Getting " another person to do what you want is selfish. The best way to get anyone to do something is make the action itself desirable to them - and not as a reward. If the action has a high enough value and they need help to do it they, will try to do it without help and only accept help if they understand the difficulty and the risks of doing it without assistance. Love requires recognition and acceptance of the rights of another person and respecting them. When a mentally competent adult refuses to do something they have a reason that is valid to them. If you're not willing to devote the effort that's necessary to understand that reason and address it with supportive and remedial action, but attempt to force or coerce them into agreeing, they will resist more strongly. Objectively, showers are not necessary for hygiene. They are a modern invention for people who are in a hurry. Sectional sponge baths are used in senior care facilities.
All of this is true for someone without cognitive disabilities. But, this video is mostly meant for adults with dementia, Alzheimer's or other diseases that cause cognitive impairment. Truthfully, the cognitive impairment or mental illness are pretty much the only reason anyone would refuse to shower for weeks or months. At least that has been my experience.
My grandmother was in her early nineties when she refused to wash. She’d previously been fastidious about bathing daily. This turned to a daily sponge bath and massage with moisuriser and ice gel linament worked into her sore muscles and joints, which she thoroughly enjoyed . Eventually her dementia progressed and she believed she” had a very very very very good wash this morning”. It made me smile. Fortunately she didn’t get smelly, and was willing, usually, to change into clean clothes and let me brush her hair and clean her dentures. We would chat and laugh so she was pretty compliant with me.
I buy personal wipes that can be flushed down the toilet. I'm 75 and bathing is so very difficult. The worst part is getting my legs up and over the tub edge, then finally out again. From getting out supplies until I towel dry my hair and dress, and back in my wheelchair it takes me over 2 hrs. It is exhausting! Wish I had a walk in shower!
Thank you so much for sharing. Wouldn't a bathtub bench work for you? That may be easier to get your legs in and out of the tub. Of course, sponge baths may work very well for you too. Be careful with the "flushable wipes". They aren't really flushable. I worked for many years with plumbers on their Internet Marketing and all of them said that eventually, these wipes do end up clogging up the pipes and then it's a very costly process to clean them out. So, it might be better to just toss them in the garbage can and empty that every day or two. I do understand about the process being exhausting, that's why I emphasize in the beginning of this video that it's not really medically necessary to take a bath or shower every single day! Also, you may want to check with your local Area Agencies on Aging to see if there are any services in your area that can help you to pay for a shower installation, if that's something you can do in your home.
Thank you for doing this video. You have explained everything I needed to know sooner than I did. It will make life so much easier than it has been xxx
Oh, you are welcome and thank you for the comment. If you are going to be caring for someone with dementia, make sure to join a support group as soon as you can. You will learn so much from others that have and are going through it.
Just seeing this video about bathing and seniors. 72 , fell recently injuring knee. I was searching how to safely getting in the tub and saw this. I have never been a shower or bath everyday person. Growing up in the 50s and 60s everyone bathed on Sat before church on Sunday. I grew up in a very hit humid state but still it was no a common practice to bath everyday. Plus I am not fond of being wet as I have always been very thin. I get cold easily. Getting older has posed more issues with fear of falling and it is very tiring. I still have relatively long hair so washing and drying it takes a lit of time. I don't do much but light house keeping, watch tv so don't get dirty. You did say something that hit home. My family doesn't bug me about bathing as I do get in once or twice a week. Sponge off in between but you mentioned losing control. It hit home. I am a control freak and growing old has taken so much. I do feel angry at times. Scared too. I hope caregivers back off their senior parents or spouse and let them keep making personal choices.
Oh I understand and I thank you so much for sharing! Yes, control is big, big, big! And if you are a control freak as you say, that makes getting older only more difficult. If you can find a way to let go of some of that control, maybe speaking to a counselor can help? I know, it sounds silly to do something like that at 72 or older even but it's never too late to learn. And frankly, you will actually be taking control of your emotions instead of letting them control you. But I get it - losing control is change and change is hard, especially when you're older. I do think most family caregivers do let their older parents and relatives do their own thing. But if someone has dementia or Alzheimer's or some other cognitive impairment, they'll go weeks and more without a bath or shower and that is not good. That's who this video is really for. We did make a video about getting in and out of the tub - maybe they can help. ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-zJyEES_KMUQ.html ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-SLR1IXxObLI.html
Well, let's look at a situation that is fairly common. Woman with Dementia: "I need to get my purse because my mother is waiting for me to take her to the grocery store." Her mother has been dead for over 20 years. Caregiver: "No, you don't need your purse, your mother has been dead for 20 years." Woman with Dementia: "Oh no, she's not dead. You are wrong. How can you say that?" Now, the woman with dementia is upset, crying perhaps in a state of a bit of trauma finding out that her mother is dead. She won't remember this conversation, she will just be traumatized by it for the moment and it can also be emotionally traumatizing for the caregiver as well. Now, if you applied therapeutic fibbing and instead of following the conversation above, it could go as follows. Woman with Dementia: "I need to get my purse because my mother is waiting for me to take her to the grocery store." Caregiver: "Oh, I think we have some time to do that, your mother actually called and said she would be late. So why don't we go for a walk in the meantime?" Woman with Dementia: "Oh, that sounds fine, let's do that." By re-directing the person with dementia they can now continue with their day in a more pleasant manner without any screaming or crying, etc. I do think that God would greatly approve of the empathy and kindness that you would be giving to that person suffering from dementia.
@@reneerandallbassett6032 God don't understand lies, he will not go bk on his word. He said thou shall not lie, a lier will not inherit the kingdom. This is not 2 change anyone and no disrespect. I say this with love.
Oh, I talk to myself all the time! But, I do talk to my friends too. I find sometimes that I talk myself out of whatever I was thinking of doing simply by talking it over with others. Have an awesome day and thanks for your comment!!
I'm 77 and have only ever showered/bathed weekly unless I'm dirty, as you say, from gardening or doing a deep house cleaning. However, I do take a washcloth and wash the nasty bits every day, change my underpants and incontinence pad after I wash. I have a step-in shower with hand grip bars and a slip proof floor. I imagine with my knees getting bad I'll need a bench, but so far so good.
Wow, sounds like you are doing all the right things. It's so refreshing to hear that and I applaud you! I would say to get a bench because I'm of the mindset of implementing safety before something happens. Only because I spent so many years caring for older adults who had a silly little accident that could have been prevented if they had just added a grab bar or bench or removed a rug. Why wait? I think the whole point of aging in place is to make the "place" as safe as possible so that you can age in place for as long as possible and as independently as possible.
Thanks. Broken humerus a week ago today and can verify all you have said. Meeting surgeon tomorrow about a repair. May do the surgery knowing the pain will go back to day 1, but knowing I have made it through week 1 means I know I can do it again if needed. It does get better by the day, you will celebrate the extra inch of movement you have, and sleep gets easier.
This is BS for idiots! I was both a PT in nursing homes, caregiver for elderly parent and now…Senior, living with my children! NO ONE is going to tell me when to bathe! I KNOW MY SKIN, and it’s changes due to autoimmune diseases! Mind your own business and just provide safety equipment!
Well, again, as I've said several times already - this video is REALLY for caregivers who are caring for seniors with dementia or other neurological issues that are affecting their cognition. So, unless you have those issues, then this video really isn't for you. But thanks for watching.
I looked after a friend's mother who has dementia and she doesn't even know when she needs to releive herself, or when she's thirsty or hungry. She's like a baby who never learns. All these were shockers for me!
Yes, it's a regression for some older adults. If you haven't seen it before it can be shocking and difficult to accept. I worked with so many older adults with cognitive decline - I feel like I've seen all stages and all mannerisms emerge from these diseases. Your friend is lucky to have you.
Then you'd need to either call emergency services/911 or get a neighbor/friend/family member to come over to help the person up. If the person falls frequently, you might consider purchasing a lifting cushion to have on hand. Here's a link to the device on Amazon: amzn.to/3hZtCfq
Growing up in the 1960s, people typically took a bath once a week. The idea of showering daily is ridiculous. It wastes water and body care products, it dries your skin and your hair. Using a basin of water to wash your face, underarms and private parts is much easier to achieve. As a 69yo, I don't have the energy to deal with getting the cat box out of the shower, vacuuming up the cat litter, getting fresh clothing, showering, wiping the water off the shower walls and floor when I'm finished, then dressing and moving the cat box back into the shower. I monitor myself for body odors and wash myself as necessary. I spend most of my days alone at home with my cat. He never objects, so get over it.
You are absolutely correct about bathing habits in the 60's and earlier too. Your approach of using a basin for targeted cleaning of essential areas is a practical solution, especially for those with limited energy or mobility. It's true that daily showers aren't necessary for everyone, particularly for those who aren't very active or don't sweat much. And the fact that you live alone with your cat certainly makes it much easier and more convenient but for older adults who live with others it may be a different story. We also all have to remember that our senses tend to dull as we age. So, we may not see, hear or smell as well as we used to and since those senses tend to dull gradually, it's difficult to tell sometimes. But sounds like you're doing all the right things for yourself. Take care.
Same we just bathed once a week. In the summer mom made sure we came in and washed our hands and if we were running around barefoot we had to wash our feet before we got to bed. Now if I have dirty feet and I’m too tired to wash them, I just put socks on when I go to bed so I don’t get the sheets dirty. 😂
I have had a fall, and taking showers is frightening ( fx hip) I have a helper who comes twice a week just to be here as I climb into the shower. Modesty is maintained as well as possible as she prepares the water temp and clean towels . I also have Life Alert as I live alone. Your article q most helpful and thank you for caring.. We are still valuable but for a bit of frailties c age.. Course we're still adorable and talented.
These are not safe, please install real grab bars that are permanently mounted. When you have a real emergency and it needs to support your full weight it will be able to. Don’t gamble with your safety.
I agree and I state that in this video. Suction grab bars are okay for anyone who only needs a handle without putting any weight on it. Otherwise, you are absolutely correct. It's much more important to have the permanent grab bars installed properly and of course, to choose ones that can hold your weight. Thank you so much for your comment.
THIS WAS A LIFESAVER! My mom scoots herself off her bed onto a mattress that I leave next to her bed then onto the floor. When I’m alone I have had to leave her until I could get help. My mom cannot walk so I modified by using her commode chair on its lowest setting. I was happy that we could get her on her knees then she put one leg forward and pushed herself onto the commode. I was then able to transfer her yo her wheelchair. I cannot thank you both enough for this video.
Yes, HOA in some of these communities. That can be a good thing or a bad thing. I've lived in some that had condo commandos and others that were much better. I've learned to ask about the HOA to several homeowners before I buy a home.
Very good advice,thank you! I can not stress the importance of having a good financial planner. They offer so many resources for safely growing your wealth (whatever that may be) and many plans for your long-term care. So critical. There are programs for long-term care where if you don't end up using it, your investment is returned, but only a good financial advisor can direct on these programs. I wish to age in place, therefore building my strength and health is very important to me and have a trainer to get me on that path. Please don't live for just today. it's a massive mistake.
Very wise words! I agree, you have to spend time preparing for your old age. If you don't, it may be more of a struggle than it needs to be. And exercise and building strength has as much of an impact as the financial aspect. Thank for sharing your tips!
I've taken so many deep breaths I feel hyperventilating at times. Mother went back to her residence. I have difficulty calling her mother because she made it Abundantly clear that she wanted nothing to do with my sister, myself. Stating she tolerated our handicapped brother. She ask I honor her wishes and never check on her or even come to her funeral. The story is long and her decisions put my husband & I in dire straights so to speak. Financially and yes probably emotionally. She left the home we purchased for all of us, at her request and troublesome Financially, after her last abuse of shoving me over a low pine chest injuring my chin. She did this while my back was turned. She was evaluated by several Dr's and found to be of right mind, which hurts more because in my mind. She did this knowingly. Her current situation leaves her alone at her home. Why do I still worry. Why can't I just move on 😢
