Are You a Caregiver? | ||||||||
A caregiver is an unpaid relative or friend who cares for a person who is ill, frail or disabled. The "sandwich generation" is the term used for people who care for their aging parents while supporting their own children. You may not see yourself as a caregiver. You might think you are just taking care of a person who needs you. You might think you are just doing what any wife, husband, sibling, child or friend would do. Start thinking of yourself as a caregiver and you will see how important your job is. Becoming a caregiver is not always an easy or natural thing. You might feel forced or pressured into being a caregiver. You might have other demands, such as a young family or a busy job, or not be very close to the person you care for.1 It can also be a big change, and it might take time to get used to your new role. It is normal to feel confused and stressed when you are a caregiver. You might think it will help you cope if you ignore your own feelings and needs. This might work for a while, but it will be hard to keep doing this; ignoring your feelings could affect your health. When you are a caregiver, you have an important role, and you have to stay healthy to keep doing a good job. A caregiver needs to take care of him or herself.1
Facts
Many caregivers say they feel better prepared and less worried when they get information about the tasks they will be doing and the skills they need as a caregiver.6 The skills you need to become a caregiver are sometimes harder than you think. For example, driving an older adult to an appointment is not just about going for a drive - you might have to dress the person, transfer them into and out of a wheelchair, into the car and out of the car safely. Many caregivers learn the skills needed from health care providers.7 The following information will help you with the practical tasks that caregivers do. Tips
Emotional SupportYour loved one might feel afraid, sad, angry or lonely because of everything they are going through. They are often dealing with changes in their body, the way they look, their mental abilities, the roles they play in life and thinking about what might happen to them in the future. When you are helping someone deal with these feelings, it helps to show respect and kindness. Be patient and listen to your loved one; allow him or her to show you how they feel. You might not be able to fix their problems, but it can help if you listen to them. Tips
If you need help with your feelings or those of your loved one, ask for it. You can talk to another family member, a social worker, nurse, doctor, chaplain, or spiritual advisor. See Chapter 3: Caring for you...the Caregiver for more information on when and how to get help. Enjoying Time TogetherEnjoy time with your loved one. Share a morning joke or go for a walk outside. Pleasant activities will make you and your loved one feel better. Plan things to do that your loved one will like. Maybe you can watch an old movie together or find music that your loved one enjoys. Remember that fun activities can be simple. Even watching a sports game together (if the person likes sports) can make your loved one less lonely. Do not forget cards and board games are fun too! Ideas:Picnic lunch: A picnic gives you some quality time with your loved one. You can even have a picnic in your living room (or any other room) if your loved one cannot get out. Spread a picnic blanket out and decorate the area (perhaps with some flowers, photos etc.). You might want to play some relaxing music, like sounds of birds or water. Be creative:Painting, drawing and doing crafts are fun ways to get rid of stress and be creative. It will also help you and your loved one to feel more relaxed and you can laugh together. Relaxation exercises:Exercises that help you relax and meditation exercises are easy to do, and are great ways to get rid of stress. They help you sleep, make you more alert, and improve your mood and health. You can buy guided relaxation tapes or CDs and meditation music in many book and music stores. You can also find these things at the Ottawa Public Library. See Section 3: Caring for You...the Caregiver for relaxation exercises. Scrapbooking:Making a scrapbook is a fun way to spend time with your loved one. Let your loved one do as much as they can, and help if they ask. You can find everything you need at an art store, department store, or dollar store. You will also learn a lot about each other when looking at photos for the book. Read a book:You and your loved one can enjoy a book by reading aloud together. Visit your local public library and take advantage of the many books, audio books, and programs. Go to: Ottawa Public Library Caregiving is not all about work. Having fun is important - not just to reduce your stress but also to create a sense of self worth and belonging for your loved one. Give us your feedbackPlease share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at healthsante@ottawa.ca. References
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Helping Someone with Daily Physical Needs | ||||||||
Start with talking to your family Doctor. You may also contact your Community Care Access Center (CCAC) as they are a first step to the health system in your area. A CCAC care coordinator can help connect you to many services available in your home and/or help you move your loved one to a Long-Term Care home. Once you have a CCAC care coordinator, it is important to update your care coordinator as your situation changes for possible adjustments in your services. Visit CCAC for more information. Many caregivers provide practical care to their loved one. Practical care could be helping them take a bath or to get dressed. These tasks are easier to do if you have good information and know how to help. Bathing, showering and groomingBathing or showering is a private activity. Allow your loved one to do as much as they can on their own. Cover the person as much as possible so they feel less exposed. Wrap a towel around private body parts and clip it with a clothespin (or Velcro tabs), or use a long, plastic apron in the tub or shower for more privacy. Make bathing a comfortable and enjoyable part of the day. Keep the bathroom as warm as possible. Play music if your loved one finds it relaxing. (Remember to keep the music player or radio away from water). Use scented pot-pourri to make the bathroom area more inviting. Do not use bath oils; they make the bathtub slippery. Tips
Watch this video for more tips on bathing your loved one: Bed bathsYour loved one will need a bed bath if they cannot get to the bath or shower. To give a bed bath:
DressingMake sure your loved one has clothes that are easy to put on. Pants with zippers and buttons are hard to get on. Loose fitting pants with elastic waistbands are easier to pull up and down. Clothes with Velcro are easy to use. You can find these at specialty stores. If your loved one has an arm or leg that does not move very well, put it into the shirt or pants first. Include your loved one as much as possible when you are buying them clothes. Let them pick out the colours that they like. This will help them feel more in control of their life. Mouth careMake sure your loved one is cleaning their mouth and teeth. Help them if they cannot brush, rinse and floss by themselves. Make sure they brush their teeth twice a day and floss once a day. Also brush and rinse dentures twice a day. (Put a face cloth in the bottom of the sink when you are brushing dentures; they can slip out of your hand and break if you drop them). Store dentures in water, this will keep them from drying out or cracking. If they do not fit properly or hurt your loved one, talk to their health care provider. Watch this video for tips on mouth care Dental CareSee the resources at the end of this section for information about dental care. Foot careCheck your loved one's feet when you are bathing them or helping them get dressed. You need to check them every day if they have diabetes or circulation problems. Look for:
Tell your health care provider if you see an open sore that is red or swollen, or has pus or is painful. For more information, visit the Saint Elizabeth website 2 ToiletingIf your loved one needs help to go to the bathroom, give them as much privacy as possible. For example, you can help get them to the toilet then leave the room until they call you for help. Bedpans or bedside urinalsYou will need to use a bedpan or bedside urinal if your loved one cannot get out of bed. Ask your loved one to lie on their back with their knees bent. Next, get them to use their feet and legs to lift their buttocks off the bed so you can slide the bedpan under them. If their legs are too weak, have them roll onto their side so you can put the bedpan against their buttocks. Then get them to roll onto their back while you hold the bedpan in place. You can put baby powder on top of the bedpan so it does not stick to their skin. You have to clean the bedpan with hot water and soap, and rinse it out well every time you use it. You can rinse it with cold water and baking soda to keep it smelling better. TipsClean and dry your loved one's skin after they use the bedpan. Wet skin can cause painful bedsores. People get bedsores when they are always sitting or lying down. This constant pressure damages the tissue underneath the skin and causes sores. If you see red areas of the skin that do not go away, tell the health care provider. Incontinence pads (bed-pads)A person has incontinence when they cannot control their bladder or bowel. An incontinence pad is a plastic pad you put on the bed, under the person's buttocks. The pad protects the bed, and you can easily change it when it gets wet or dirty. Some pads can only be used once (these pads are "disposable pads") and are put in the garbage when they are wet or dirty. Put them in the garbage or outside right away. You can wash, dry and re-use reusable pads. Keep reusable pads in a tightly sealed container or plastic garbage bin until you wash them. Plastic bed coveringsYou can buy plastic bed covers (sometimes called mattress covers) at a department or linen store. This cover goes under the bed sheets to protect the mattress. Adult diapers or briefsAdult diapers and underpants with pockets to put liners in can help your loved one stay dry and more comfortable. The type of product you choose depends on the amount of body waste. It is very important to change the adult briefs or liners as soon as they are wet or dirty. TransferringYou might have to move, reposition or transfer your loved one when you are caring for them. To avoid hurting yourself and your loved one, it is important to do this properly. Watch these short caregiver videos for lifting and moving a person safely.3 Tips
Get help if you think you or your loved one might get hurt. Watch the short videos below on moving people safely.4
WalkingWalking can increase your loved one's appetite and make them feel better. To help your loved one walk, put your closest arm around the person's waist. Use your other arm to reach around in front of you and hold the person's hand or elbow for extra support and control. Ask them if the walking speed is okay. Move slowly because your loved one might be dizzy if they have been lying down for a long time. If your loved one falls down when you are transferring them or walking with them be sure not to hurt yourself. Make sure you:
Watch this short video on assisting someone from the floor5 for specific moving techniques. Turning in bedIf your loved one cannot move in bed, you need to turn them every couple of hours. This will prevent bedsores and make your loved one more comfortable. Moving a person in bed:6
Pain SupportYou might need to help your loved one deal with pain. They might have pain because of a disease or illness they have (cancer, arthritis pain or other) or from a treatment they are getting. You can treat most pain by making sure your loved one gets the right pain medication and takes it regularly as prescribed. Your loved one's health care provider is the best person to help them deal with pain and any side effects from the pain medication. For more information: Saint Elizabeth website how to deal with pain.7 Give us your feedbackPlease share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at healthsante@ottawa.ca. References
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Mealtimes and Eating | ||||||||
Meal planningYour loved one may have problems planning meals, shopping for groceries or making meals. You can help them plan meals ahead of time so they do not have to decide what to eat every day. Weekly plans make it easier to get the groceries you need. If your loved one has a treatment or surgery coming up, make and freeze meals for them. It is important for your loved one to eat a healthy diet that includes:
Canada's Food Guide can help you plan meals. You can find the guide on the Health Canada1 website. If you have more questions on healthy eating, visit Dietitians of Canada2 or talk to a dietitian. Time saversIf you do not have time to make meals, you can get them in the frozen food section of your grocery store. You can also get a volunteer or community service like 'Meals on Wheels' in your area to deliver hot, nutritious meals or packages of pre-frozen meals that you heat when you want. When friends and family members ask how they can help, ask them to make a meal! The following time and energy saving list has been adapted from Dietitians of Canada3:
Poor appetitesPeople usually do not eat as much when they are sick. If someone is in later stages of an illness such as cancer, he or she may experience "cachexia-anorexia". This is a serious problem of continued weight loss. Treatments, medications or other reasons that are connected to the illness are some of the causes for this illness. If your loved one is not hungry, there are ways to help:
Older adults with dementia have many challenges when eating meals. Information on topics such as food likes and dislikes and improving the atmosphere when they eat are helpful. For more information: Living with dementia - Meal time.4 Food safetyDo not forget how important it is to make sure that you make your loved one's food safely. Food poisoning can be a painful or very dangerous result of incorrect food handling. Tips:
Give us your feedbackPlease share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at healthsante@ottawa.ca. References
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Home Safety | ||||||||
Keeping your loved one safe is an important part of caregiving. You may need to make some changes to the home to keep your loved one safe. Tips:
Can you leave your loved one home alone?If your loved one lives with you, you have to decide if they can stay alone when you go out. Your loved one can stay home alone for a short time when they can:
Talk to your health care provider if you are not sure. Personal Emergency Response Systems (PERS)PERS allow your loved one to press a button when they need help. The button is on either a necklace or wristband that they can wear or it can be a small remote control or console on the counter. The console has two-way speakers so that your loved one can talk to the staff at a 24-hour response centre. Your loved one can ask them to call friends, neighbours or emergency services depending on what help they need. Your loved one can also use a special telephone that will dial out pre-programmed emergency phone numbers. Falls preventionOlder adults can fall while living alone or with you. They are more at risk if they:
To prevent falls
Bathroom safety
Medication safetyYour loved one will probably be taking medications. Make sure they take them properly. You can buy special pillboxes, called dosettes, with sections to organize all the medications for a day. Pharmacies can also make "blister packs" for your loved one. They have the name and time of each medication arranged in the right order for each day. In Ontario, the MedsCheck1 program lets you book a free yearly meeting with your pharmacist to review all of your medications. Be sure to include all over the counter medications as well as prescriptions in this review. Tips:
See Chapter 2: Finding your Way through the System for more suggestions about talking with health care providers. Give us your feedbackPlease share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at healthsante@ottawa.ca. References
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Supplies and Equipment | ||||||||
Your loved one may need supplies and equipment to keep them safe at home. Start with talking to your family Doctor or contacting your Community Care Access Centre (CCAC) for a care coordinator to complete an in-home assessment. Your care coordinator can refer you to professional services such as physical therapy or occupational therapy for aids and other equipment. Once you have a CCAC care coordinator, it is important to update your care coordinator as your situation changes for possible adjustments in your services. For more information: CCAC. You can also speak with community organizations about how to borrow, rent or buy specialty devices and products. Different names for these devices and products are:
You can call the Ontario Government Assistive Devices program (ADP)1 to get help with funding if your loved one has long-term physical disabilities. Your local health unit, Ottawa Public Health the March of Dimes Canada2 and the Canadian Red Cross3 may be able to help as well. Special SuppliesSome examples of special supplies and equipment that might help you and your loved one are: Grab bars or grip barsGrip bars help stop slips and falls. You can use them in the bathroom to help with support in the bathtub, shower, or toilet. You can also put them in hallways for support and safety when walking. Make sure the grab bars are securely installed. BedrailsBedrails help support a person when they get out of bed. They can be plastic or metal. Some bedrails have built-in pockets for magazines and books. Comfort aidsYou can find many things to make your loved one more comfortable. You can use bed pads made of sheep fleece or special cushions filled with foam to make their bed or chair softer. They are very good for people who are in bed or sit for long stretches of time. Shower heads and hand-held showersShowerheads and hoses that attach to the tub faucet help you and your loved one with hair washing, back washing and rinsing in the tub or shower. Basic showerheads do not cost very much. Bath or shower seats and transfer benchesYou can use seats and transfer benches to help your loved one get in and out of the tub. They are good for people who have problems stepping over the tub walls, or need to sit while bathing or showering. They also make it easier for your loved one to wash their feet or shave their legs. Bath and shower matsUse safety mats inside the bath or shower so your loved one does not slip or fall. You can buy safety mats that will cover most bathtubs from end to end. Bathing underclothesYou can help your loved one stay covered while bathing by using special kinds of underwear that cover a person's private areas while they are in the bath or shower. You can place a dry wrap over the wet underwear to allow the person to remove the wet underclothes in private. You can lift the dry outer garments easily when someone uses the toilet without showing their private parts. There are also long plastic aprons that the person can wear while bathing, or towels that stay wrapped around the person (with a clothes-pin, clip or Velcro tabs). Raised toilet seats and bedside toiletsYour loved one might have trouble getting up from the toilet. A raised toilet or raised toilet seat can help. There are different types of raised toilet seats, including seats with arms and lids and other special features. Plastic is more comfortable than stainless steel. You can also find different types of bedside toilets and bedpans. Adult diapers/underwearYour loved one might have bladder or bowel control problems. You can buy adult briefs or liners to help absorb any fluid that leaks from him or her. There are many different kinds of briefs. Some slip-on and look and feel like regular underwear. This can help a person keep their dignity and be more comfortable during day-to-day activities. Dressing aidsStocking aids will help a person pull up socks, without having to bend. There are also aids used for putting on pantyhose. Long shoehorns can help a person to put on a shoe without bending down. Clothing button and zipper aids allow people to dress themselves instead of relying on help. These aids make them feel more independent and they have more dignity. Button pulls and zipper pulls can help someone who has arthritis or problems with moving their fingers. Dressing sticks have different sized hooks on both ends to help with zippers and putting on clothing. They will help a person who has trouble moving their arms or only have use of one arm. Usually, dressing aids cost about $10 to $20. Mobility aidsSpecial chairs (chair lifts) and cushionsChair lifts are chairs that tilt forward to help someone get in and out of the chair. There are many chair lifts available, and they are often modern looking and comfortable. Chairs with power buttons can help lower and raise the person from a sitting position to a standing position and back down to a sitting position. You can also get special cushions to help a person sit and get up off a chair or sofa. For example, self-powered portable lifting cushions can help a person get into and out of any chair by lifting people up as they begin to push off the chair. Swivel cushions can help a person get in and out of car seats by turning in place, so the person does not have to turn him or herself. Stair glides are powered chairs installed on stairways to help a person go up and down stairs. Electric or manual wheelchairsWheelchairs are very expensive. You can buy used wheelchairs, borrow them from a community or health care program, or get financial help through a program like the Assistive Devices Program. Talk to your family doctor, government health office, or local community organizations and centres about these ideas. When you choose a wheelchair, you will need to think about the height and weight of the person you are caring for and their basic needs. Will the wheelchair be used only occasionally for short distances? Will you need a wheelchair for both indoors and outdoors? A qualified sales representative or occupational therapist can help you with your choice. Walking aidsThese devices can help people feel safer and more stable when they walk. It is recommended to have a professional help you choose the right walking aid for your loved one. For more information contact: CCAC. CanesCan have different features such as:
The size of the cane depends on the size of your loved one: Get them to stand up with their arms at their sides. Turn the cane upside down and put the handle on the floor. The bottom tip of the cane should be at the level of your loved one's wrist. This will be the right size of cane for your loved one. If you are unsure, an occupational therapist can help you find the right cane. WalkersMost walkers have wheels to allow your loved one to turn and move around easier. Some may have brakes, seats, baskets and can be folded for easier transportation. Mealtime aidsSpecial dishes: There are plates, bowls and other products made for people who have a hard time using every day dishes. For example, you can find plastic, circular rims that fit around any plate. These rims keep food on the plate while you push it onto your fork. Bedside tables and trays: You can find bedside tables and trays in many stores, not just places who sell assisted living supplies. Some of these tables have wheels and easily fold up. Bedside tables and trays allow your loved one to eat in bed and keep personal things such as tissues, books and crossword puzzles close by. Finding supplies and equipmentTo find the right supplies and equipment, talk to your health care provider. TipsPrivate insurance and government-funded programs may cover the cost of some supplies and equipment. See Resources at the end of this section for more ideas about places to rent or buy equipment. Caregiver SafetyIf you do not feel safe when caring for your loved one or do not have the support to give safe care, you may need to find another place for your loved one to live. They might have to:
These changes may be hard for your loved one. Tell them how you think these decisions will help them in the future. Caring for Someone Far AwayCaregiving can be a challenge when you live far away. You might be sharing the care with someone who lives closer to your loved one or you may be the only caregiver. You might even find it hard to visit because of the cost and time to travel. Living far from your loved one can make you feel sad or guilty because you think you cannot help them. Sometimes people will move closer to their loved one for a short time. This could work if you want to organize care for your loved one. Of course, this is not always possible. You can think about your loved one moving to where you live. This can work if your loved one will need care for a long time. It is important to talk about this and make a decision with your loved one. Sometimes a move can turn out to be a good decision. When your loved one lives far away, there are still many ways you can help. The resource, So Far Away: Twenty Questions and Answers about Long-Distance Caregiving (pdf version), offers information about caregiving from afar. It looks at topics such as complex family relationships, legal issues, housing options, and advance directives.4 Give us your feedbackPlease share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at healthsante@ottawa.ca. References
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Give us Your Feedback | ||||||||
Please share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short survey Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at healthsante@ottawa.ca. |
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Resources | ||||||||
MunicipalAlgonquin College, Dental Clinic (September to April) 613-727-4723 ext 7630 City of Ottawa, Employment and financial assistance for adults and older adults with low income Community Care Access Centre: provides care for an older adult in their own home, coordinates care in the community for the older adult, including specialized support services. They also provide information about long-term care options. Community and Social Service, Financial assistance for adults and older adults with a low income: 613-560-6000 Ottawa Dental Society, Dental Emergency Services: 613-523-4185 The Regional Geriatric Program of Eastern Ontario: a network of specialized geriatric services, from hospital to home. ProvincialOntario Ministry of Health and Long-Term Care, Assistive Devices Program Saint Elizabeth Health Resources - Topics include diabetes, older adult care, wound care and more. NationalCanadian National Institute for the Blind (CNIB) Canadian Red Cross, Health Equipment Load Program |
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