A short introduction and then deeper into subject of making changes in your home and work environment. I have 30 + year history of providing and coordinating care for various elderly relatives. In my practice, I specialized as a consultant pharmacist. It has given me a front row seat to the changes in our medical care, how families and individuals cope with functionality changes in their lives, the various levels of community support, social safety net changes in the states and the caregivers.
I believe that good medical care is important. BUT, an individual’s quality, participation and enjoyment of life is more dependent on the attitude of the individual, living environment and social network surrounding them (including pooties and woozels). Medical interventions such as drugs, surgeries, therapy, nutritional/herbal supplements are a double-edged sword. The can be of great benefit or the proverbial stick on the camels back that causes everything to collapse.
Making changes to ones environment to accommodate a physical or mental challenges tend to be viewed from polarity of two perspectives and we shift back and forth along that spectrum. First, it is giving in to the situation to alter a home to accommodate life changes and it is a sign of weakness or lack of competence. Second, our total environment and personal interactions should be altered to accommodate life changes. My first experience into these different approaches was at two different great-grandmothers houses.
Great-grandma M kept her house in perfect order and the lawn extended straight to the street. When we visited as small children it was our parents responsibility to keep us from touching or damaging the crystal figurines on the coffee table, sit quiet for a multi-course meal and not run into the street. She was rigid in her approach to life. The only time I remember her being overjoyed at seeing two little girls and didn’t say “quiet your too noisy” as we giggled was at the nursing home.
Great-grandma L had a nice house, lawn and vegetable garden. When we were too energetic, we could play outside in the fenced yard. When she could no longer run the wringer washer on her own, Mom would come over and help. Later Mom would just pick up the laundry, bring vegetables from our garden and Great-grandma had toys and games for us to play inside with her. After her last heart attack, a woman was hired by the state of Oregon for assistance, which allowed her to live at own home for the remainder of her life.
Below the fold I am going to list accommodations, I have seen used for different issues to either help the individual or the caregivers (we do not want them exhausted). I encourage you to share your experiences or challenges in the comments. (Occupational therapists, caregivers and individuals who have made changes please give us your input).
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My first reaction for any functional or mental issue is to review all medications, supplements and medical treatments to evaluate if they could be contributing to the problem. If none is found a medical work-up to identify a change in a known diagnosis or a new medical issue. Those steps are beyond the scope of this article, but something to keep in mind.
Balance/Walking
Falls are a concern and one of the primary reasons individuals have to make major changes in their lives. Prevention is easier than recovery and proper movement decreases wear and tear on joints and muscles. Canes are obvious solution, but it is easy to be embarrassed, and common objections are “I am not that old” or “disabled”.
When going on a car trip keep a cane, walker or wheelchair in the trunk. For the bus or an airplane a folding cane in the purse will work. The desire to visit the next shop, see all the exhibits in the museum or have lunch out is great motivation.
When at the grocery store grab a cart in the parking lot and use it to walk into the store. At home use a wheeled office chair. Give a gift of a walking stick or fancy cane. Ice and snow a problem use a ski pole. My Dad was the hardest – "I not wandering around like a dottery old fool outside”. I finally convinced him if he used a shovel the neighbors would just think he was after thistles or changing the flood irrigation.
Grab rails in the bathroom or by a floor level change. I have seen heavy furniture pieces at entries of sunken living rooms and offices instead of a grab bar.
Offer your arm to steady someone as they step up/down a curb or stairs or are walking over rough ground. If your grab them they are more likely to fall.
Exercise
My favorite balance and strengthening exercises to recommend are Tia Chi, Qi Gong and a program called Sit and Be Fit.
Diet
Diet is one of the cornerstones of health. It can be a method to effect medical conditions such as diabetes or a heart condition, avoid allergies for flare ups or prevent a change in residence due to malnutrition.
It can also become a hobby to replace an active outdoor lifestyle. A lot of kitchen equipment can be considered power tools.
Hearing Loss
Gradual hearing loss can be very isolating and the lack of appropriate responses has more than once been interpreted as dementia. Hearing loss often happens in the higher frequencies first – so this is primarily to women watch the tone of your voice and try deepening it. Go from soprano to baritone.
A clue someone has hearing loss is they talk loud. Face a person directly when speaking and do not turn your head, it adjusts your volume based on the direction of the sound.
TV too loud, try a wireless headset. My Grandmother loved hers and it allowed her to keep watching TV when she moved to an assisted living facility.
Doorbell linked to a flashing light bulb. Using a pet to identify sounds – check out Dogs for the Deaf.
Noise Sensitivity
Some individuals find noise or loud sounds cause problems with increased perception of pain, agitation, anxiety or decreased ability to concentrate. Keep some background sound going –music TV. Use ear plugs or noise reduction headsets.
Entertaining
Instead of cooking a complete meal and serving: consider a theme potluck, cater all or part, go to a restaurant or have a boardgame night with snacks.
Gardening
Reduce the size of the garden, change from a formal to English countryside and then to container gardening. For an extreme change take up Bonsai or appreciate silk flowers arranging.
Housework
Change the carpet out for laminate flooring. Decrease the dusting by clearing the clutter and moving nick-knacks behind the glass doors of a hutch. Hire a house cleaner.
Increase motivation to use limited energy for cleaning the house by inviting company over for a visit or a meal.
Moving
There are times a total life change is required. It might be simply down sizing to reduce house and lawn work. Or, in my case moving to a larger house so there was space for my parents, no stairs and close enough to town they could call a taxi.
I have been fortunate each time I moved someone to a care facility or different level of care they were able improve their health or slow the progression of their medical issues. Then 1 to 4 years later another shift. It was done with a lot of consultation with persons involved (extended family), soliciting their input and keeping them informed. Even with Alzheimer’s or dementia there are steps that can be taken to ease a transition.
An important consideration for residence choices is an abusive personality or history, whether in the person needing assistance, a family member or involved friend. For example, a residential facility was the only good option for my Grandmother due to her controlling personality, coupled with constant complaints and criticisms of an aunt. There was then the emotional and physical energy to make frequent visits, regular excursions, monitor care and deal with my aunt. I have seen multiple instances where the caregiver or the caregiving family was physically and emotionally exhausted, literally dropped someone off at a facility and never visiting again.
Try respite care if you are becoming irritable or tired.
Employment
The obvious changes we tend to look at are changing to part-time employment, home office or early retirement for stress reduction or the time to take care of another. Several of the ideas mentioned above can be used in the work environment. It is important to keep in mind the positives of employment; a sense of purpose, distraction, enjoyment and economic security.
Some individuals have been able to successfully create a business to meet their special needs or a family member.
Continued Discussion
Imagination, willingness to try new methods, ability to try again after failure and maintain a social network seem to be the common theme of individuals who adjust to the changes in life that are thrown at them. There are a lot of issues I did not touch in this article, stamina, physical strength, pain, mental changes, memory loss and dementia to name a few. Do not be shy about mentioning them in the comment section with ideas or challenges you are facing.