Your parents recently moved into a retirement home and you were relieved they’d now have three proper meals per day. With your mother’s progressing dementia, she hadn’t been cooking for quite some time.
There’s only one problem.
Your mom has been bringing her purse to the dining room where she stashes extra food! She takes it back to their room and hides the food and you’ve been finding it in various states of science-experiment decay!
What is happening?
In the past, this might have been called “hoarding”. But “hoarding” has a negative connotation and is quite different than what is happening for your mom. A more suitable term might be “collecting”.
Her new behaviour is not unusual and it makes sense when you consider what is happening in her brain.
The drive or instinct to gather is a hard-wired human instinct. Humans have been hunters and gatherers for millennia. We have the instinct to gather food beyond what we immediately need to prepare for future hunger.
In modern society, most of us are blessed enough that we don’t have to worry about our next meal. With 24/7 grocery stores, we have access to food at any time. But for your mother who has dementia, that option is not as viable.
First of all, she likely grew up in an era where stores were not open 24/7. Secondly, she may feel particularly vulnerable that she has no way of accessing food at any given time—she likely cannot drive, she likely wouldn’t know how to get to the closest grocery store, she might not even have access to money to purchase food. Her instinct to gather food that is available actually makes perfectly good sense. She is gathering food because she doesn’t know where her next meal is coming from.
“But wait!” you say. “She has three full meals daily with access to a coffee bar that has muffins and cookies and fruit—she’s never left hungry. Of course, she knows where her next meal is coming from!”
Your response is perfectly logical. Remember, though, that her brain’s ability to be logical is diminished. If she has dementia, she may not remember yesterday clearly enough to remember that she did, indeed, receive three full meals. She can’t use yesterday’s experience to reassure herself that she will likely receive three meals today.
From her perspective, she is suddenly in this new place that doesn’t yet feel familiar.
There is no kitchen that she can see. She doesn’t recall the delicious dinner she had last night. No wonder she is concerned about where her next meal is coming from! On top of all that, one of the deeper portions of her brain—the Amygdala—continues to send out hunger-gathering instincts for self-preservation.
Instead of considering her behaviour to be “hoarding” and problematic, understand that she is doing her best to provide for herself and meet her most basic human needs.
Did you know that vision loss is not a part of normal aging? Normal aging might include changes in your vision, but the loss of vision altogether is not a normal part of aging. Normal aging includes changes to the body that all people will experience, provided they live long enough. Changes to hair—such as hair loss, or hair turning white/gray—is a normal part of aging. Everyone’s hair will eventually turn colour and become thinner if they live long enough. Macular degeneration, by contrast, is not a normal part of aging because it is not inevitable that someone will eventually experience macular degeneration.
Age-related Macular Degeneration (AMD) is the leading cause of vision loss for people over age 50. It affects 15% of people over age 50; it affects 30% of those over age 75. AMD is a serious condition because it can severely impair someone’s sight as it progresses.
The macula is an area of the eye that is responsible for detail vision. It is the bull’s-eye of the retina, and it is what allows people to read. The macula is essential for the detail vision necessary for reading; the rest of the retina cannot read; only the macula can read. If the macula is severely impaired, the ability to read will disappear; larger or stronger glasses won’t solve the problem as only the macula can provide the detail necessary for reading.
There are two types of macular degeneration—dry and wet.
Dry AMD is much more common, accounting for 85% of all AMD cases. Its impact is less severe because those with dry AMD typically only lose 10-20% of their vision. Wet AMD is less common, but its impacts are more severe. Only 15% of those with AMD experience the wet version, but they will typically lose 80-90% of their vision and become legally blind.
Dry AMD always precedes wet AMD. Sometimes people ignore symptoms and by the time they see an ophthalmologist, the dry AMD has become wet and is much more severe. With dry AMD, the peripheral vision is maintained and will not be lost. The visual detail provided by the macula is what may be affected. Reading will become difficult, but most people will not become blind as a result of dry AMD alone. In fact, only 5% of people with dry AMD will progress to vision that measures as legally blind, and that typically requires 10 years of progression. Dry AMD typically progresses quite slowly.
What are the risk factors for AMD?
Heredity — almost half of all AMD cases are genetic. It isn’t as simple as having a specific gene; it is a series of genes that are responsible for AMD.
Smoking — increases risk by 3-4 times the rate of a non-smoker. Smoking also increases the risk of wet AMD. Combine the hereditary risk with smoking, and the risk rises to 34%!
Age — while you cannot control the risk factor of age, you can control sun exposure. AMD is the wearing out of the macula. Overexposure to the sun can expedite this process.
Nutrition —maintaining excellent nutrition is important for eye health. Once diagnosed with AMD, patients are advised to eat a nutrient-rich diet that is high in vitamins, minerals and antioxidants (or supplement as needed). When patients follow this regimen, there is a 25% reduction in vision loss.
Wet AMD — if someone has wet AMD in one eye, they have a 50% risk of also developing AMD in the other eye.
Those with AMD are well aware of vision changes and how that impacts detail activities such as reading or needlework. What people underestimate is how AMD can impact practical elements of day-to-day living and increase risk in other areas of life.
Older adults with vision loss have:
Twice as much difficulty with day-to-day living compared to their peers
Twice the risk of falling
Three times the risk of depression (often linked to the loss of reading ability, a key enjoyment activity for many people)
Four times the risk of a hip fracture
Vision loss affects more than just vision!With increased risk of falls, fractures, depression, and difficulty with daily living, someone’s life could be severely impacted.
How do you prevent AMD?
Regular eye exams are crucial to ensure that AMD or any other vision concerns are detected early and treated in the most effective ways possible. Of Canadians who do not wear glasses, 50% have not had their eyes checked in the past 5 years, if ever! Even if someone does not wear glasses, they should still visit an optometrist occasionally to check eye health.
If you know a senior with vision loss who is at risk of falls, fractures, depression or having trouble with daily tasks, we can help!
What does exceptional dementia care have in common with an Improv Drama 101 Class?
In both cases you should never say “no”. Instead you say “yes and...”
Drama workshops will have participants interact in a group. One person starts the conversation and activity. It’s up to the next person to carry it on and not let the dialogue or action fall flat. If in doubt, you respond with “yes and...”
If the first drama participant says “did you see that dog run past?” and the second participant responds with “no” it completely shuts down the improv drama. Instead, the second participant is supposed to respond “yes and I think he was chasing a cat.” This creates an opportunity to keep the conversation going. The first participant now has something to build on. “Oh really? I hope it wasn’t my cat he was chasing.” Now the second participant can build on that “Oh you have cat? What type?” and the conversation continues.
Believe it or not, this skill set is highly useful in advanced dementia care. Those two simple words can open up an entire world of dialogue, just as though it were an improv class.
When someone has advanced dementia, their brain operates differently than your brain. Someone with dementia cannot match your thinking, but if you try to understand what they are perceiving, you have the chance to tap into their world just a little bit.
When your mother with advanced dementia declares “I got married last weekend you know.” You might be tempted to respond with the facts: “No mom. You got married 61 years ago and you haven’t been to a wedding in years.” You are factually correct, but you have also lost the opportunity to have a great conversation. Your mother might even become agitated trying to get you to understand her perspective.
The conversation will be far more effective when you use the drama concept of “yes and.”
Instead, when your mother says “I got married last weekend you know,” you might reply: “yes, and I’ll bet you were a beautiful bride.” Instead of focusing on the facts on when the wedding took place, you’re answering in a way that promotes conversation. Your mother might just sigh wistfully and say “I think I was…” If she’s enjoying this reminiscing, go with it: “yes, and did you wear a veil? What did it look like?” guide your mother down memory lane, and if the memories are embellished, that’s okay too!
However your mother remembers a happy moment is hers to have; facts are less critical than feelings. The “yes and” concept can be applied in many situations and it’s not limited to just “yes and…” It’s the concept that counts. In many cases, asking questions can be very helpful to better understand the reality that your loved one is living in that moment.
When your mother asks “Who are the children that are playing in the yard?” and you look out the window and don’t see anyone and say “No one is there Mom. I don’t see anyone,” the conversation ends and you lose the opportunity to see her reality at that moment. In this case, more questions might work better than “yes and.”
You might respond: “Oh, what are the children playing?” and see where it takes you. It gives the chance to have a conversation that matches your mother’s world and reality. She may reply: “I think they’re playing hopscotch.” Again, a question might be helpful: “Is that right….do you recall how to play hopscotch? I haven’t played in years! Want to try?” The next thing you know, you’re having a discussion about hopscotch or something else from a walk down memory lane. It’s a precious moment that would have been lost without the improv-style interaction.
When you’re interacting with someone who has advanced dementia and they may be trying to communicate something to you that doesn’t match your reality, or that doesn’t align with your recollection of an event, pause and use the “yes and…” strategy to explore your loved one’s memory. What matters most at that moment? Is it correcting the “facts” of a story, or sharing a moment of connecting emotionally and gaining a glimpse into your loved one’s reality?
Family caregiving includes a broad scope of activities. It is not only hands-on personal care, though that can certainly be part of family caregiving. Also included are activities like driving to doctor’s appointments, running errands, cleaning the house, doing laundry, cooking meals, sorting the mail, paying bills, setting up appointments, etc. A primary family caregiver may not be doing all of these activities, but they may oversee the completion of these tasks and arrange to have assistance in these areas.
Family caregiving can also happen from a distance when family members are spread out across a province, or even across the continent. Although the caregiver is not physically present all of the time, they feel the primary responsibility for the care of their loved one, and so they are the advocate and spend many hours on the phone or on email arranging help across the country.
The role of the family caregiver can be incredibly exhausting and sometimes rather lonely. People often do not know where to turn for assistance and attempt to manage everything on their own.
Often, this may not be a realistic goal as the care of their loved one may be too demanding for any individual to take on single-handedly, and so to preserve the health and mental wellness of everyone involved, it may be best to enlist the help of others—be it other family and friends, the LHIN, or a private agency. To advocate for the health and wellness of family caregivers (who are often too busy advocating for their loved one to speak for themselves!), we at Warm Embrace Elder Care have provided a Family Caregiver Bill of Rights.
FAMILY CAREGIVER BILL OF RIGHTS: I HAVE THE RIGHT…
To take care of myself. This is not an act of selfishness. It will give me the capability of taking better care of my loved one.
To seek help from others even though my relatives may object. I recognize the limits of my own endurance and strength.
To maintain facets of my own life that do not include the person I care for, just as I would if he or she were healthy. I know that I do everything that I reasonably can for this person, and I have the right to do some things just for myself.
To get angry, be depressed, and express other difficult feelings occasionally.
To reject any attempts by my loved one (either conscious or unconscious) to manipulate me through guilt, and/or depression.
To receive consideration, affection, forgiveness, and acceptance for what I do from my loved one, for as long as I offer these qualities in return.
To take pride in what I am accomplishing and to applaud the courage it has sometimes taken to meet the needs of my loved one.
To protect my individuality and my right to make a life for myself that will sustain me in the time when my loved one no longer needs my full-time help.
To expect and demand that as new strides are made in finding resources to aid physically and mentally impaired persons in our country, similar strides will be made towards aiding and supporting Caregivers.
When you think of family caregiving which words come to mind?
What creates the difference between the first column experience and the second column? How can family caregiving be both frustrating but joyful, a burden and a blessing?
Here are 4 survival tips to take your family caregiving experience away from the first column and into the second column.
1. Take care of yourself
It may sound trite, but self-care is crucial. If you don’t care for yourself, you’ll have nothing left over to give to anyone else. You need to allow yourself time to refuel. How you re-energize will be unique to you; there is no right or wrong answer. Maybe you exercise, or enjoy dinner out, or attend a rock concert, or read a book, or travel. It doesn’t matter what you choose to do; it matters that you take time for yourself and prioritize your own self-care.
2. Allow yourself to be “off-duty”
It is not reasonable to expect yourself—or anyone else for that matter—to work or be on-call 24/7. And yet, when in the midst of family caregiving, people often hold themselves to an unrealistic standard of doing it all, all of the time. You need time when you are not “on-call”.
This includes elderly spouses who have assumed the caregiver role and who live together. It can be tough for the caregiving partner to feel “off-duty” when they are at home together with their partner who requires care. Respite care is critical to help both halves of a couple remain healthy—both physically and mentally.
Feeling “off-duty” also applies to family members who are receiving constant phone calls from their elderly loved one. They need time when they can turn off the ringer and not field any phone calls—a timeframe when they are “off-duty” from repeated calls.
3. Enlist support before a crisis emerges
All too often people will say: “Dad won’t accept help from anyone else, so I have no choice!” Then a crisis occurs and it is Dad who has no choice—he must accept help from another source because you, the family caregiver, are now experiencing your own health issue related to burn out. Sure enough, Dad does accept the help, although it might have been a smoother introduction to care had it not been a crisis situation.
It will be a kinder transition for your father to accept outside support in a graduated care plan, rather than abruptly. With advance notice and the luxury of time, caregivers can be selected to match your father’s personality and preferences. In a crisis situation, you might have no choice but to get a caregiver—any caregiver—in place the same day. A more ideal match could have been made with advance planning.
Best of all, your burnout can be prevented in the first place! It is far easier to prevent burnout by providing support early on than it is to recover after burnout has occurred.
4. Protect Family Roles and Relationships
Caregiving can upset the long-ingrained roles and family dynamics. A husband who is suddenly thrust into the position of caring for his wife may feel ill-equipped for the role of the family caregiver. He doesn’t feel like a husband. . . he feels like a caregiver. And she doesn’t feel like a wife. . . she feels like a patient. Their interaction as husband and wife has been interrupted and they begin to interact as patient and caregiver, which may start to stress their marriage.
It is important that key family roles and relationships are preserved. That couple needs to continue to feel like a married couple. A parent and child need to preserve their mother-son relationship. It may be best to let certain elements be provided by a professional caregiver so the family relationships can remain intact.
Family caregivers are SO important to the health and well-being of their loved ones. It is crucial that their health and sanity is protected. If the family caregiver burns out, then there are two people requiring care!
The only way to survive family caregiving and find the positive is to take care of yourself, have time that you are “off-duty”, get help in place before it’s too late, and aim to protect family roles and relationships for as long as possible.
4 Reasons to Get Elders Out of the Hospital Quickly!
Your mom just had surgery and you thought she’d be in the hospital for weeks, but she’s being discharged today! You may feel as though your mother is being pushed out of the hospital door just to make space for the next patient, but there’s a lot more to it than that.
Here are four reasons why you don’t want an elderly relative to remain in hospital any longer than necessary:
1. Bedrest is TERRIBLE!
When someone is sick or recovering after surgery, it is tempting to pamper them while they remain in bed all day long, but that is actually the worst thing for recovery. For every day of bed rest, the frail elderly lose approximately 5% of their mobility. After only a week of bedrest, they could be down by 35% of their mobility—and they may not have started with 100% prior to surgery. Getting up and out of bed is crucial to retain mobility and strength. Encouraging someone to get up periodically throughout the day will prevent the 5% mobility loss that comes with complete bedrest.
2. Hospitals make you sick!
The risk of contracting an additional illness while in hospital increases the longer you remain in hospital. Those with weakened immune systems are most likely to contract superbugs such as MRSA or C-difficile which are antibiotic resistant.
These illnesses can cause severe diarrhea which often leads to dehydration, which increases the risk of delirium—the next item on the list.
3. Delirium, Dementia or Despair?
Delirium is a state of confusion that can be mistaken for a sudden case of Alzheimer’s Disease. It is NOT a form of dementia, but it can mimic dementia. The frail elderly are at high risk of developing delirium in the hospital.
Here are some of the risk factors:
Medication changes—their regular medication routine may be changed to help with diagnosis
Interrupted sleep—injections in the middle of the night, a nurse checking in, etc.
Day/night reversal—orientation to time of day becomes difficult when lights are on all night and circadian rhythm is interrupted.
Lack of social interaction—while nurses and doctors may conduct a test or provide care, they cannot remain at a patient’s bedside for hours at a time. The loneliness and sense of isolation can cause the elderly to despair. With a sense of time interrupted, someone may believe they have been abandoned for days.
4. Get back on the john!
If an elderly person is at risk of falling or they need assistance, they won’t be permitted to toilet independently. They can press the buzzer to request help, but hospital staff may not be immediately available. In many cases, it is easier to catheterize a patient to ensure that they are not attempting to get out of bed and risk falling on their way to the bathroom.
The longer someone is catheterized, the greater the risk that they will become incontinent. The catheter holds open the muscles that usually contract to block the bladder. Those muscles will essentially become lazy. The catheter might be removed, but the muscles may have lost their ability to retract and no longer be able to contract sufficiently to contain urine.
Losing the ability to hold one’s bladder has enormous ramifications. Beyond the increased care needs, someone’s confidence and quality of life can be negatively impacted by incontinence.
The hospital is the right spot for someone who is acutely ill or injured, but it’s a terrible place to recover! Returning home as soon as possible will prevent these four risks of a prolonged hospital stay. We can help your loved one remain healthy and well!
Inclusion is a hot topic and a very important one for our elderly population. It emphasizes the importance of inviting the active participation of all citizens, including our elderly population, into our social fabric.
The Canadian Network for the Prevention of Elder Abuse (CNPEA) has reported that:
Being socially isolated is a common affliction among older adults. More than 30% of Canadian seniors are at risk of becoming socially isolated.
Isolation and loneliness are as bad for your health as smoking 15 cigarettes a day.
And, social isolation can put seniors at increased risk for elder abuse.
Inviting the elderly population into social spaces is the first step, the second next step is creating an age-friendly community.
What exactly is an age-friendly community?
Being age-friendly means that there are no barriers to accessing services in the community, regardless of age or ability. A city that is designed to include and be accessible for its elderly residents is automatically factoring in the needs of its younger population.
For example, if a community is accessible for someone using a walker or wheelchair, it is also accessible to a parent pushing a stroller. The examples that we think of quickly are usually about physical accommodation such as ramps, wider doorways, longer crosswalk signals, etc. These accessibility features are certainly important, but a truly age-friendly community is about far more than just physical accessibility.
Dr. John Lewis, professor at the University of Waterloo, points out that currently, one-quarter of Waterloo Region’s population is age 55 plus. That number is only going to increase in the next few decades. It is not acceptable that there are ageist prejudices towards 1/4 of our population! If we want to have a community that is inclusive to all members, it needs to be designed to suit those who are age 55 and older.
Age-friendly communities are about inclusion and a sense of belonging. It is about receiving the respect and dignity that all citizens deserve, regardless of ability or age.
Often, these issues relate directly to coping with ageism. Ageism is the stereotyping of and prejudices against someone because of their age. It might include automatically treating someone in a certain way, just because they appear to be a senior.
For example, assuming someone is hard of hearing because they have gray hair is an ageist stereotype. Another example is the way that professionals often speak about a senior to their family members, as though the senior is not even in the room! The conversation should be directed to the relevant person, regardless of age.
In addition to physical challenges, some people experience cognitive changes. These people deserve the same level of respect and inclusion as all other members of society. Brenda Hounam, dementia advocate and spokesperson, highly advises communicating about dementia itself. Rather than hiding her challenges with dementia, she has decided to be very public and make others aware of her disease.
Hounam suggests that people “open the doors for communication—just ask”. She feels that it is much better to ask for clarification and to communicate clearly with someone who has dementia; do not just make assumptions. She asks that people do more than just listen; she wants people to truly hear and validate what she is saying. Hounam’s overarching message is that “we are all unique, and we all have something to contribute until the last breath.”
Being inclusive and respectful of all citizens—regardless of age, ability, or illness—better allows us to fully acknowledge and appreciate the contributions of all members of society.
Driving is a very personal issue that involves strong emotions. For many seniors, driving is a privilege they’ve had for decades, and their personal sense of identity and independence is often linked to their ability to drive. When driving seems so second nature, it can be difficult for people to remember that driving is truly a privilege, not a right.
So, when is it time to give up the privilege of driving?
Oftentimes, the person who is suffering from dementia is the least aware that anything is wrong. They may not notice that their reaction time has changed, or that their judgment is off. The family are often the first ones to be concerned about driving, and rightfully so, as research shows that someone with dementia is eight times more likely to be in an accident than the average population.
Some warning signs to watch for if you have an elderly who is driving with dementia:
Damage to the car
Difficulty navigating familiar routes
Simple errands taking hours longer than necessary with no explanation
Mixing up the gas and brake pedals
Missing stop signs or traffic lights
Problems with lane changes and merging
Passenger input is required
Family refuse to get into the car
Consider the “grandchild question”: do you feel comfortable allowing the grandchildren to ride with their grandparent behind the wheel? If your answer is no, there are likely significant concerns about your loved ones’ driving ability.
If you are concerned about your loved ones’ driving, you need to speak to their doctor. It is ideal to attend a doctor’s visit with your loved one; you may also write letters to inform the doctor of the changes your loved one is experiencing.
The family doctor is required to notify the Ministry of Transportation, and it is the MTO who will revoke the licence (not the family doctor). After being notified by the family doctor, the MTO will send a letter directly to your loved one (not to the family doctor). The letter will state whether they may continue to drive, they need an assessment, more medical evidence is required, or the licence is revoked.
What happens when their licence is revoked?
If the licence is revoked, it is HIGHLY advised that your loved one’s car be removed from the property. Someone with dementia may no longer remember that they are not allowed to drive. Disabling the vehicle is an option, though it is remarkable how handy and mechanically-minded many seniors from that generation can be, so the simple options of unplugging the spark plugs or draining the battery may be insufficient. The most ideal solution is to have the vehicle removed from the property altogether to ensure that your loved one is safe, and to ensure that others are safe as well.
It is important to understand how devastating the loss of a licence can be for many seniors. It can result in loss of independence, reduced social interaction, loneliness, lowered self-esteem, depression, and increased stress on family and friends. For all of these reasons, family doctors do not just send letters to the MTO easily; they must have concrete evidence of imminent safety concerns. To minimize the negative impact of losing a licence, family and friends can assist by providing alternate means of transportation and socialization.
There are volunteer driving services that can be accessed through your local community centres or the Alzheimer’s Society. Taxi companies are often able to offer discounts to “frequent riders”. If your loved one drives less than 4000—5000km per year, then it is cheaper to take a taxi everywhere than it is to maintain the car. From a purely economic standpoint, driving may simply be too expensive compared to alternate options! Appealing to your loved one’s financial sense may be more effective than having them agree that their driving is no longer safe.
In the world of homecare, terms like ‘minimum’, ‘maximum’, and ‘eligibility’ frequently arise.
When arranging publicly-funded homecare through the LHIN, the first concern will be eligibility—is your loved one eligible for LHIN homecare? If they are, the next question will be “for how much homecare?” Publicly-funded homecare is all about eligibility and maximums—the maximum amount of service that can be provided based on eligibility.
Privatehomecare is exactly the opposite. There are no eligibility criteria, and there is no maximum amount of service. We gladly provide as much service as a client needs or wants. In fact, to ensure that clients truly are well-served, we have minimum service provisions rather than maximums.
Why do we have minimum service provisions?
Here at Warm Embrace Elder Care, we have service minimums as a way of ensuring that we always provide service in line with our philosophy of care. Here are a few important ways that minimum service provisions contribute to the fulfillment of our mission and our philosophy of care:
Our philosophy of care is about promoting abilities and never doing for a client what he or she can manage independently. It takes significantly longer to support someone in doing a task slowly, at their ability level, than having caregivers just rush through a task on a client’s behalf. What is best for the client though? If caregivers always just do the task because it’s faster, eventually, the client will lose the ability to manage that task independently. Promoting abilities—even though it may take much longer and requires more support—is better for clients, so we allow enough time to support independence and not just do tasks ourselves.
Part of dignified care is ensuring that we match each client’s individual pace. Being rushed through your daily routine, especially with something as intimate as personal care, can feel very dehumanizing. Our clients deserve the dignity of taking time and lingering over their personal routines and not being rushed by an artificial deadline imposed by a one-hour visit.
Companionship is an essential element of our service. Our clients and caregivers establish a special bond, and this bond is developed by sharing quality time together. If caregivers simply rush in the door hurrying to complete a specified task in less than an hour and rush back out the door, it is difficult for rapport to develop. Slowing down and getting to know each other as human beings first, before jumping into tasks or personal care, puts the focus where it should be—on the people first and not on the tasks alone.
When a caregiver is paired with your loved one, that caregiver is prepared to assist in numerous ways. Caregivers are able to help with numerous tasks in the time they are present—they might do some laundry, wash dishes, make dinner, help your loved one to shower and get dressed, and then run errands. The benefit of this model is that you don’t need a separate person for each task—you don’t need a driver who only does errands, and someone else who only assists with personal care, and someone else who only does laundry, etc. It’s a more comprehensive approach where all the different elements of daily life can be seamlessly woven together—the same as you weave numerous elements throughout your day. Because we’re aiming to assist with so many different elements of daily living it takes more than an hour or two to effectively assist with each.
Living and serving by our mission and our philosophy of care is what makes our service exceptional. Minimum service is the first step to abiding by our mission. Beyond the minimum, the sky is the limit! Clients don’t need to worry about exceeding the maximum or being capped at a certain level. Instead of feeling limited by caps, maximums or restraints, clients can know that we’ll be there to assist as needed.
Do you know a senior who has suffered a serious fall? Likely you do, since approximately 30% of seniors who live in the community suffer a fall each year. The consequences of a fall can be quite serious—injury, hospitalization, even death from complications.
Did you know that falls are the cause of 90% of all hip fractures, 50% of all injury-relatedhospitalizations in seniors, and the 5th leading cause of death in the elderly?! These numbers also double when a senior has dementia. So, it is extremely vital in keeping seniors strong and steady on their feet.
Why do seniors fall in the first place?
“Falling isn’t as much about slips and trips. It’s about the failure to recover. Slips and trips happen at all ages” (Dr. George Fernie). There are various external factors at play that contribute to slips and trips; such as:
Poor footwear (e.g. slippers)
While some falls can be attributed to tripping—such as tripping over floor mats, pets or curbs—other falls seem mysterious. The person will report that they just went down and we're not sure why. In many of those mysterious cases, the fall is due to internal factors such as:
Visual and hearing deficits
Neuropathy (abnormal sensory feedback)
Low blood pressure
Pain and foot drop
Weakness and tightness
Slowed reflexes and balance disorders
What can we do to prevent falls?
1. Get rid of all the external factors that cause slips and trips!
Ensure that your living space has no loose carpets or rugs, the lighting is bright for increased visibility, all chairs are sturdy with armrests, everything needed is on the main floor (no stairs), and that proper footwear is worn in the house.
2. Improve balance and stability!
“She says she wants to keep living in her home. We say it starts by keeping her on her feet” (American Academy of Orthopedic Surgeons). The number one key to fall prevention is staying active! Physical activity has shown to mitigate the deathly consequences of falls – just walking, gardening or housework is enough for an elderly loved one.
However, when your elderly loved one refuses to do regular exercise the best option is to increase their base of support.
To remain balanced, there must be a stable base of support—the wider the base of support the more stable it becomes. The base of support is the invisible box that can be drawn around your feet when you are standing. Added to this is our centre of mass—which is approximately where our belly button is located.
When someone’s centre of mass is in the middle of their base of support, they are perfectly balanced. When their centre of mass begins to reach the outer edge of their base of support, they are more prone to falling.
For example, a ballerina narrows her base of support to be only one square inch when she is en pointe. Her balance is quite precarious because her base of support has been reduced. The only way that she remains upright is by perfectly hovering her centre of mass over her base of support. She is constantly adjusting to ensure that her centre of mass doesn't sway too far aware from her base of support.
In contrast, a football player crouches low and spreads his feet wide so that he has a wider base of support than he normally would. He may even put one hand to the ground adding a third point of contact and expanding his base of support further. He has a stable base of support, and his centre of mass is positioned in the middle of his base.
In the case of a frail senior, their feet may ache or have bunions, causing that person to only walk on the edges of their feet, which reduces their base of support and their balance. Instead of using the full surface of their foot, they have reduced their base of support more like a ballerina. As well, the senior’s posture may be more forward-leaning, pushing the centre of mass to the outer edge of the base of support, causing instability. A senior will not likely be crouching down to touch the ground for support, the way a football player does.
The best way to create a strong base of support is to use a walker. The four wheels of the walker expand someone’s base and provide the necessary support. Much like a football player, a well-balanced senior using a walker is less likely to fall than a senior who is precariously balancing on sore feet. If their posture is forward leaning then the walker extends the base of support ensuring that the centre of mass remains in the middle of the base of support.
Encourage the seniors in your life to carefully assess their centre of mass and base of support to ensure that they are as safely balanced as possible. Every fall that is prevented is a great success and ensures a longer and healthier life for that senior!