Sputum From a Client With Lung Cancer

How to handle sputum from a client with lung cancer who also has pneumonia.  She has declined treatment with antibiotics since she is approaching her final days.  I have given the caregiver gloves, masks, gowns, hand sanitizer and antimicrobial Wet Ones.  We would like to be careful but don’t want to be over the top.  Pneumonia is contagious but to what degree from aerosol droplets?  When should she where gloves and masks?  Should the client be asked to wear these since she is bringing up diseased sputum?  How do you dispose of the sputum?  How to you clean her mouth afterwards etc.

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Antibiotics for delirium?

Many elderly people (especially those with dementia) cannot reliably report classic UTI symptoms (such as itching, urinary burning, frequency or inability). A normal urinalysis (or even just an over-the-counter urine dipstick) can be very helpful in diagnosing or ruling out a UTI. Delirium can also be caused by dehydration, drug interactions, drug overdoses and hypothermia. The good news is that UTI-based delirium is highly

treatable with antibiotics. If an elderly person in your care displays sudden symptoms of delirium such as acute agitation, be sure to ask your doctor to check for a UTI—and check often. Left untreated, a UTI can lead to serious illness and death. On the other hand, if it is treated as dementia and not as a UTI, unnecessary medication may be administered, leading to added complications.

The caregiver advantage

Employing a consistent, regular caregiver can go a long way in helping to recognize the sudden behavioral changes that signal a UTI or other health problem. Furthermore, by providing careful toileting and bathing assistance, a caregiver can assure a more hygienic condition for elderly clients, greatly lowering their risk of contracting a UTI.

The myth of accidental falls

Falls and their consequences are the leading cause of death in people 65 years and older. For people 85 and older, it’s estimated that one in five falls results in death.

The accident myth

Until recently, most falls have been blamed on a single cause—precipitated by either a medical event or an “accident” related to the environment. Today, researchers know that falls are rarely the result of an isolated event. Rather, falls are complex events caused by the interaction of both internal and external factors.

Most falls represent the end result of a series of independent and often small risks. Individually, such risks pose no harm. Young and able-bodied people can manage avoiding many daily mishaps so naturally, they never even realize it. Eventually though, age, disability or compromised health not only creates its own risks, it can make it impossible to deal with even the simplest environmental risks.

Often, a fall “happens” (meaning, factors set it in motion) long before the victim encounters the event. As relatives and caregivers, it becomes our responsibility to recognize and correct those factors—both physiological and environmental— and break the chain of risk, before a fall occurs. Prevention is no accident.

Tips for caring for people with Alzheimer’s Disease

Caring for someone who suffers from Alzheimer’s Disease can be a complex, unpredictable and stressful task. While there are no tried-and-true approaches that will work 100% of the time, here are a few suggestions that have helped other
caregivers manage clients with Alzheimer’s.
Bathing
• Plan the bath or shower for the time of day when the person is most calm. Be consistent and try to develop a predictable routine.
• Draw the bath ahead of time and have everything ready before you bring them in.
• Make the temperature of the room and the water as ideal and comfortable as possible.
• Be gentle and respect that they may find bathing scary. Remain patient and calm.
• Never leave them alone in the bath or shower. Use safety items like non-slip mats.
Dressing
• Try to have them get dressed a the same time each day. Develop a routine.
• Encourage them to dress themselves as much as possible. Do not rush them.
• Keep the selection of outfits limited. If the person has a favorite outfit, suggest to their loved one to buy several identical sets.
• Arrange clothes in the order they’re put on.
• Choose clothing that is easy to put on and take off, with elastic or velcro instead of buttons or zippers that can be frustrating.
Eating
• Maintain familiar mealtime routines, but adapt to the person’s changing needs. Try serving small portions or several meals throughout the day.

Communicating with older adults

Here are a few tips for improving your communication with the seniors you care for, even as their own skills begin to deteriorate.

• Treat the person as a mature adult. Avoid speaking in a condescending, child-like or belittling way, which creates tension and resentment.
• Speak at a medium volume unless asked to speak up. Yelling right away can seem demeaning.
• Listen actively to understand. Ask questions to clarify, add positive interjections, or summarize their words. Give them an opportunity to correct you.
• Maintain eye contact, but don’t stare.
• Observe their nonverbal cues and control your own, especially those indicating frustration, boredom or anger.
• Use touch to offer encouragement and support, however, only according to each person’s individual comfort level.
• Smile!

Helping seniors take their medicine

Researchers have found that getting older adults to take their medicine is a difficult task—even in those with life-threatening conditions. One study estimated that seniors only take half of the doses of the prescription medications they administer themselves. “Few people take all of their medications and many do not bother to take any,” said Dr. R. Brian Haynes.

There are many potential reasons why seniors might not bother (or be able) to take their medications. These include dementia, mental illnesses, depression or confusion. Plus, many conditions, such as diabetes, have very complex drug regimens.

Some seniors are stubborn against taking medicines, believing they are unnecessary. This can be especially true for medications that affect conditions that are relatively asymptomatic, like hypertension or hypothyroidism. Worse yet are drugs that are essential but come with unpleasant side effects. Finally, some seniors may adopt a state of mind in which they abandon hope that they will recover, and thus view taking medications as pointless.

How can caregivers remedy the situation?

Since up to half of seniors are unable or unwilling to follow a prescribed medication regimen, the only sure solution is continual monitoring of medications by a caregiver. Caregivers

are often more effective than families at medication reminders, since seniors tend to view

them as more authoritative than relatives. Plus, tasked with this duty, caregivers are more reliable at following through, since they keep daily records and are less susceptible to distractions or complacency.

 

The attention caregivers can bring to monitoring medications can also save lives by helping to avoid accidental dangerous interactions between multiple medications. Drug interactions are a serious concern for seniors. Almost 40 percent of all drug reactions reported each year involve people over 60. Caregivers can also be excellent at noticing and reporting any side effects a senior may be experiencing—including dizziness, constipation, nausea, sleep changes, diarrhea, incontinence, mood changes, or a rash—after he or she takes a drug.

Monitoring is critical

Why do so many seniors skip their meds?

New CPR recommendation: just push hard and fast

Mouth-to-mouth no longer recommended for bystanders trying to save lives

Chest compressions alone, or Hands-Only Cardiopulmonary Resuscitation (CPR), can save lives and can be used to help an adult who suddenly collapses, according to a new American Heart Association scientific statement. Bystanders who witness the sudden collapse of an adult should activate the emergency medical services

(EMS) system and provide high-quality chest compressions by pushing hard and fast in the middle of the victim’s chest, with minimal interruptions, according to the new guidelines.

Helping seniors get the essential sleep they need

Like younger people, older adults require seven to nine hours of sleep per night. Seniors, however, are more prone to sleep disorders. In fact, one out of every two seniors suffers from sleep deprivation.“The biggest myth is that sleeping poorly is just part of getting old. Actually, seniors are falling asleep during the day because they aren't getting enough quality sleep at night,” says Dr. Sonia Ancoli-Israel.

People age 70 and older who sleep five hours or less per night are more likely to experience falls than those who sleep more than seven to eight hours per night. When seniors don’t get the sleep they need at night, daytime drowsiness impairs their ability to perform normal activities such as driving increasing the risk of accidents.

Aging itself doesn’t cause sleep deprivation. Rather, ailments associated with aging—such as arthritis, physical disabilities, respiratory problems and depression—are likely to blame. Seniors’ sleep  cycles can also be disrupted by physical inactivity during the day, depression, anxiety and stress. Also, some prescription medicines taken by seniors may rob them of sleep. Naps are not the answer to daytime drowsiness. Trying to catch up by napping during the day creates a sleep/wake cycle that interferes with normal sleep patterns.

Many sleep problems can be overcome simply by helping seniors stick to a regular sleep schedule, getting up and going to bed at the same time daily. Sleep and aging experts agree that the two most critical factors for getting a good night’s sleep are what a person does during the day and his or her sleep environment.

1. Keep seniors active during the day.

2. Avoid consumption of caffeine and alcohol.

Consuming coffee, tea, chocolate, sodas or alcohol in the evening can interfere with nighttime sleep, especially in older people. Ending the ritual of a “night cap” will make the night more restful. Avoiding liquids before bedtime also reduces the need to use the bathroom at night.

3. Improve the sleeping environment.

A good sleep  environment is one that is quiet, dark and on the cool side. Lumpy, sagging or worn mattresses may also be part of the problem.

4. Seniors should sleep separately from restless partners.

separate room can help both partners sleep better. Some causes of insomnia may be due to medications or due to depression or medical conditions that are treatable with medications. Therefore, if sleep problems persist, it pays to seek a doctor’s advice.People who share a bed with partners who are restless, snore, or have an illness are likely to be sleep-deprived. When necessary, moving to aSeniors should maintain a moderate level of exercise or activity during daytime, especially outdoors. People who get natural daylight sleep better at night.

Sleep deprivation can be deadly

Age old solutions for sleep loss

Why seniors are losing sleep

York Region Seniors Community

"According to the Statistics Canada 2006 Census, there are 91,920 seniors (those aged 65 and older) living in York Region. Seniors represent 10% of the Region’s population, which is a lower percentage than Ontario and Canada (about 14% each). Among urban municipalities, York Region has one of the fastest growing seniors populations. It is expected that by 2031 the number of seniors living in York Region will increase to 303,517, or 20% of the population. The anticipated increase is largely due to the high proportion of baby-boomers in York Region. All of Statistics Canada’s 2006 Census information is currently not available. However, the 2001 Census indicates what to expect when the complete 2006 information becomes available." ~ Source: Statistics Canada 2001 and 2006

How live-in care works

A live-in caregiver stays in the home 24 hours a day, and is available to assist morning, noon and night. If we provide live-in care for 7 days a week, we assign a primary caregiver and a back-up caregiver to the job. The primary caregiver provides care for 4-5 days a week, and the back-up caregiver takes over for the remainder of the week.

All live-in caregivers must maintain a separate, permanent residence. They are permitted to reside on the client's premises only during their assigned days and nights, and they must leave the client's premises with their belongings on their days off. They are strictly forbidden from using the client's property, such as phone, television or car, for their own, personal use. Live-in caregivers must also respect the company policy on visitors: none are allowed while providing live-in care




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