Month: February 2023

Learning to accept help is hard.

Posted on February 23, 2023 by Pat - Caregiver

I have started this freaking blog, three times. I can’t seem to get going with it. Why? Because my mind is racing and I don’t want to deal with the emotional “stuff” that I am going to have to deal with. How can I tell you to learn to accept help when I have had trouble accepting help? Maybe, I can use some of my experiences so you don’t have to be as stressed as I was. Our own thoughts, feelings, and stressors keep us from accepting help much less asking for help. Look at us in our Superman power pose. We can handle all. We can do all. And we truly can until the needs of our loved one takes up so much time and energy that we have nothing left to give. This happens about 18 months to two years in the helping process. February 22, 2023 When I can help someone, I do. I don’t think a thing about helping them nor do I keep track or a “tab”, if you will. I am sure there are many people out there who are the same way. Just as I am sure that there are people that do keep score. Find the people who do not keep score and are willing and able to help each other out when needed. We can’t do it all. We do need help. We need a written list. It doesn’t have to be things for your loved one, it can be things for you or the house. Things that others can do for you to help ease the stress. What would help you? It is often hard to think about what would help us when we are put on the spot with an offer of help.

Caregivers Refuse to Ask For Help

Too often we think all the help needs to be for our loved one or we should not ask for help because we are the caregiver. Nope, wrong again. What could someone do for you to free up time for you to get your paying job done? What could someone do for you so that you can spend more quality time with your loved one? I want you to think and consider all of the things that do not require you personally to handle. There are quite a few, aren’t there? Write them down on a piece of paper and place them on the refrigerator. Think of it as delegating certain tasks so that you can be fresh, rested, and in a better frame of mind to help your loved one. Let’s face it, if you don’t take care of your health and your needs too, you will become ill and you can be in worse physical health than the person you are caring for…then who will take care of your loved one?

Let them pick what they want to help you with

Let them pick what they want to do from your list. Most of us have things that we can do and will do and we also have things we hate to do. Don’t expect someone to do something that they hate doing. Since you aren’t making them or expecting them to do something that they hate…you don’t have to feel guilty about asking for some help. People who express the desire to help really do want to provide care for you so that you are able to provide personal care and a great quality of care. Be open to accepting support from others. Our own personal barriers get in the way of asking for help or accepting help. Most of the time it is the negative head trash talk that gets in our way.

Examples of barriers that caregivers have in accepting or asking for help:

- Do you feel selfish if you take care of your own wants and needs?

- Do you feel like a failure if you have to ask for help?

- Do you feel that you have to prove something? (being worthy, loving, caring)

- Do you feel responsible? Are you truly responsible or is that a false narrative?

- Do you find yourself saying, “If I don’t do it, no one else will do it?”

- Do you find yourself saying,” Family takes care of family?”

- Do you keep hearing the promise that you made, playing over and over in your mind?

- Do you have the inability to let go of control?

- Do you have guilt over leaving your loved one for a short time?

- Do you have trouble feeling that no one else can “do it right?”

Reframe and Look for Solutions

Reframe the way that you view things. Look for solutions to the problems. The problems are things that get in your way of sleep, rest, physical activity, alone time, and being in the best frame of mind and shape that you can be in to provide the best care for your loved one. What are some solutions that will remedy these things? One of the best things to remember is to use “I” statements. As in, “I need…” “I want …” Do not say, “You need to…” No hinting allowed. No one can read your mind. If someone asks you what they can do, don’t even think that you are a burden. You aren’t. You are important to them and they want to help you. Don’t rob someone of a blessing when they want to do something to help. Caregiving is hard. Being a caregiver is hard. Caregiving is sometimes a burden. Don’t misunderstand…the person is not a burden. I want you to be able to recognize that caregiver burnout is real and it can happen to anyone. You do need help and you do need to rest. Admit what you cannot do. Admit what you can no longer do. The struggle is the fight inside your own mind. When you accept things that you cannot do, you allow your brain to look for other solutions. Pat

Who is messing with your routine?

Posted on February 16, 2023 by Pat - Caregiver, Husband caregivers, Parkinnson's disease

Mess with a person’s daily routine and find out what happens…

How do you feel when someone messes with your routine? Aggravated, pissed off, out of sorts, or off your game for the rest of the day. Very few folks can let it roll off their backs and move on without any negative feelings.

We are all creatures of our own habits. From what we do first thing in the morning to how we get dressed. Our habits are so ingrained in us that we don’t have to waste our precious brain energy to think about what to do. We just “do.” Everything goes off without a hitch, UNTIL…

February 15, 2023

Daily Routines

We need help getting dressed and our helper does things the way that they do them for themselves. Unfortunately, it is not how we do things for ourselves. Talk about trouble and aggravation and a few dammits are thrown in for good measure. We may be dressed but we are all out of sorts and are not happy. Routines can really help people with dementia.

Do this experiment

Try this and you will see what I mean. Stand up and relax with your arms by your side. Cross your arms over your chest. Look down and see which arm is on top. Left over Right or Right over Left. Now, relax them back down to your sides and do it the opposite way. Some of you can’t do it without a struggle. Some of you can do it but it sure feels strange.

Put on your jacket the “normal” way for you. Left arm in first or Right arm in first. Take it off and put it on again using the opposite arm. How does that make you feel? Kind of out of sorts? Now you are aware of how it feels to you. Now you can imagine how it feels to your caree too. You may have wondered why they were not helping you more and it seemed to be more of a struggle than it should have been. Now, you know. You weren’t doing things the way that they have always done them for themselves. You were throwing their routine off and their brain was having to figure out what in the hell was going on and how to compensate all the while their brain was screaming inside because you were doing it wrong!

Understand that people with dementia and, really all of us, have a daily routine

My goal is to get you to understand that we all have our own ways that feel right and good to us. It is comfortable, safe, and secure for us. When we feel comfortable, safe, and secure we are much more agreeable, and our attitude is much better. It is the little things that matter.

Some of you may be thinking, “I just want to get it done.” I understand that feeling. If you want to get it done more easily and with much less stress, then do it their way and you will be done in less time and have a better day.

Freebie for you

I have a document named “My Way.” It is about 12 pages, and it lists things that almost all of us do each day plus some things that we like to do, watch or listen to. It will be helpful to you and your loved one to let each other know what and how you like to do “things.” Send me an email with My Way in the Subject line and I will email you a copy. pat@EmpoweringHealthOptions.com

Husband Caregivers, Shower your Wives…learning how to do it better

Posted on February 8, 2023 by Pat - #alzheimers, #caregiver, #caregivers, #dementia, #information, #multiplesclerosis, #parkinsons, Caregiver Information, husband caregiver

Tips on how to be more helpful when assisting your loved one to bathe or shower. These are things that you need to think about when becoming a spousal caregiver. Understanding your own feelings and beliefs in this personal issue. Understanding your loved one’s feelings, wants and beliefs in this most personal area. It is difficult to ask for help with personal hygiene chores when you can no longer do your own self-care. February 8, 2023 You two have been through a lot. You are a team, usually. You are both independent and self-sufficient. Then, things change and you are no longer self-sufficient. You have become a care recipient. You need help because of a stroke. You need help because of cancer. You need help because of Parkinson’s disease. You need help because of Alzheimer’s disease or other dementia. No matter the reason, your wife needs help with one of the most intimate parts of her life. It could be a temporary help because of surgery, We don’t think about it much, but we each how our own ways of doing things. We have our own patterns and our own order of doing things. Most partners do not know their significant other’s daily routine. When you are the helper, you must be aware that your loved one has their own way of doing things. They have their own schedule and order in which to do things.

Learn Each Other’s Routine

Try this experiment. Each of you writes down exactly what you do from when you wake up to when you go to sleep that evening. I mean everything with the time of day noted. We won’t get into the getting dressed procedure. I know, some of you have this puzzled look on your face. We all have our preferred way of getting dressed and we have very specific ways we do things. For example, I place my left arm first, whether it is my shirt or jacket. It is automatic for me; if I even try to do it with my right arm first, I can’t do it easily AND I am out of sorts mentally. Now, the next day write down your partner’s daily routine with times noted. Do this from what you have observed or what you assume they do. You will probably get the big things right, but probably not all of the little things. Find a time to go over the information. Make it a date night. Talk about it and see how close you are to knowing each other’s routine. What are the similarities? What are the differences? This is a big-picture type of exercise. We all have our own routines. When you are the helper or caregiver, it is best for the caree (your loved one) to be as comfortable and safe as possible. In order for that to happen, you need to know their routine and their times. We automatically do things in our routine and we don’t realize that others have other routines. Doing their routine becomes doubly important when your loved one has Alzheimer’s disease or another type of dementia.

Men don’t automatically know how to care for female anatomy

Guess what? Female anatomy is different from male anatomy. We don’t automatically know how to help the other person with bathing. We don’t automatically know how to wash and clean some private areas effectively. We don’t automatically know what to lotion and what to powder. Sometimes, we don’t know what we don’t know until we get in the big middle of it. That can be very stressful. Caregiving is hard and you want to provide the best personal care possible. What follows are the supplies needed and the how-to tips to help you help your wife.

Bathroom

- Grab bars installed properly and permanently. Place one above the water turn-on area, too.

- Non-slip grips on bottom of tub

- Portable heater to warm up the room

- Shower seat or shower chair for tub

- Tub rail grab bar

- Hand-held shower head with 5–7-foot hose length

- Remove trip hazard rugs

Shower Supplies

- 4 Towels

- 2 Washcloths

- 2 Hand towels

- Pouf for bodywash – may have a handle

- Bar soap – gentle or sensitive skin type for washing privates and underarms

- Bodywash -for washing other body areas

- Shampoo

- Conditioner – apply on hair and immediately rinse off

- Lotion

- Facial moisturizer

- Deodorant

- Barrier cream or protectant – if needed

- Powder or Talc – if needed

- Gloves – nitrile seems to be the best

- Pump supplies are easier to use

- Cotton terry robe will help in the drying off stage, too.

- Always have them sit on the toilet to pee first before getting into the tub. Warm water brings on the urge to pee and if it happens in the tub, no big deal move on.

- Let the water run for 1 -2 minutes and check the temperature on the inside of your wrist before putting any water on them.

- You may want to place a hand towel on the shower seat for warmth or comfort

- Encourage them to wash everything that they can wash – promotes dignity and independence

- Use a gait belt – get trained in how to use one first

- As the helper, you need to remain calm and relaxed. It will be slower than you anticipate. If your approach is more of a loving gesture and a desire for them to feel good, it will go a lot smoother.

- If you have the attitude of getting in, getting it done, and getting out…it is probably time to hire this job out.

- Use the gloves – it helps to separate intimate touch from helping with a need

- Use a hand towel over their lap to promote privacy and dignity while they are seated on the shower seat

Order of Washing -Be Gentle

1. Wash the face and neck first and dry the face

1. Have them place a washcloth over their eyes while you wash their hair and condition it. Ask them to tip their head back. Scalp massages feel really good.

1. Dry the hair with a hand towel

1. If they can, have them hold the shower handle

1. If they can wash themselves, then you soap up the washcloth or pouf

1. Wash their back in a circular motion all the way down to the buttocks

1. Wash the arms and underarms next

1. Wash the front torso and under the breasts – wash skin folds well, too

1. Rinse them off really well

1. Place a towel over the top half of the body and pat dry a little (helps keep them warm)

1. Wash the legs and have them lift up one at a time or gently lift them up. If they can stand then have them stand.

1. Wash the feet and in between the toes (while they are sitting)

1. Tell them it is time to wash private parts. Offer them the option to wash their own private parts, even if you need to help some.

1. Use a clean washcloth and clean the vulvar area – use a different clean area of the washcloth for each swipe

1. Clean from clean to dirty = front (vaginal area) to back (anal area)

1. Separate the labia with one hand and clean gently with a downward motion to the perineum area (area between vagina and anus)

1. Separate buttocks and clean from bottom to top area

1. Rinse very well

1. Talking throughout the bathing process and telling them what you are doing or will be doing next seems to help everyone calm down

1. Use a towel to pat dry and dry well

1. Areas that need extra care to be dry – vulvar area, anal area, underboob area, all skin folds and in between toes

1. Gently get them out of the tub. Dry them off again or place a terry cloth robe on them to help with that. They can either stand or sit on the commode (lid down and with a towel placed on the lit) while you lotion them, powder them, and put on deodorant. Dry and style the hair. ** Note, some want to dry and style their hair before applying lotion and anything else. Some brush their teeth either before getting into the shower or right after getting out and drying off. Ask what they want to do. **

1. Apply barrier or skin protectants to areas needed (usually incontinent folks need this)

1. Never lotion between toes (want to prevent fungal or other infections)

1. Places to put powder or talc – underboobs (skin under the breasts, and torso area where they touch), skin folds (anywhere there is skin-on-skin contact that does not get a lot of air circulation)

1. Do not put anything in or right around vagina (it is self-cleaning)

1. Help them into their clean clothes

1. They may need a nap after a bath, it is hard work

Getting clean makes all of us feel better. Change the sheets on the bed on a bath day. Some bathe every day and some bathe 2 or 3 times a week. That is fine. Find what works best for your loved one and you. It is also fine if you hire a shower aide to come into your home to help with bathing your loved one. You will still have to do the daily cleansing needed which includes face, underarms, underboobs, skinfolds, feet, in between toes, vulva area and anal area. This is sometimes referred to as a sponge bath.

Products to Consider:

Soaps/Body Washes

CeraVe Body Wash for Dry Skin

Kiehl’s Grapefruit Bath & Shower Liquid Body Cleanser

Aveeno Restorative Skin Therapy Sulfate-Free Body Wash

Dial Clean + Gentle Body Wash, Aloe

Neutrogena Hydro Boost Fragrance-Free Hydrating Body Gel Cream

Olay Moisture Ribbons Plus

Dove Beauty Sensitive Skin Body Wash

Dove Body Wash for Dry Skin

La Roche-Posay Lipikar Wash AP+ Body & Face Wash

Lotions/Moisturizers

CeraVe Moisturizing Cream

Cetaphil Restoring Lotion

Eucerin Daily Hydration Lotion

Vaseline® Intensive Care™ Advanced Repair

Lubriderm Daily Moisture Lotion Shea + Enriching Cocoa Butter

Gold Bond Healing Lotion

La Roche-Posay Lipikar Balm AP+ Intense Repair Moisturizing Body & Face Cream

NIVEA Essentially Enriched Body Lotion

Facial Moisturizers

CeraVe AM Facial Moisturizing Lotion

La Roche-Posay Toleriane Double Repair Face Moisturizer UV SPF 30

Aveeno Positively Radiant Daily Moisturizer SPF 30

Cetaphil Daily Facial Moisturizer SPF 35

Unscented Neutrogena Hydro Boost Water Gel Face Moisturizer with Hyaluronic Acid

Aveeno Calm and Restore Oat Gel Moisturizer Unscented

Cetaphil Gentle Clear Moisturizer

Neutrogena Oil-Free Daily Sensitive Skin Face Moisturizer

Eucerin Redness Relief Day Lotion Broad Spectrum Sunscreen

Best Body Lotions for Men

Nivea Men Maximum Hydration 3 in 1 Nourishing Lotion

Aveeno Daily Moisturizing Body Lotion

CeraVe Daily Moisturizing Lotion

Dr. Jart+ Ceramidin Body Lotion

Vaseline Intensive Care Lotion

Jack Black Cool Moisture Body Lotion

Dove Shea Butter Lotion

Men Facial Moisturizers

Neutrogena Hydro Boost Face Moisturizer

Kiehl’s Ultra Facial Moisturizing Cream with Squalane

La Roche-Posay Toleriane Ultra Soothing Repair Moisturizer

Bulldog Mens Skincare and Grooming Original Face Moisturizer

Jack Black Double-Duty Face Moisturizer SPF 20

Cetaphil Fragrance Free Daily Facial Moisturizer

Skin Care Products for Incontinence – Barriers and Protectants

BAZA Clear Skin Protectant Ointment

Sween 24 Superior Moisturizing Skin Protectant Cream

Calmoseptine Ointment

3M Cavilon Durable Barrier Cream

Boudreaux’s Butt Paste Rash Cream, Original

Incontinence Cleansers

PeriFresh No-Rinse Perineal Cleanser

Aloe Vesta Skin Cleansing Foam

Theraworx Protect Advanced Hygiene & Barrier System

Toileting Information for husband caregivers

Posted on February 1, 2023 by Pat - #alzheimers, #caregiver, #information, husband caregiver

Dementia, Surgery, or other Health Problems Require Toileting Help

Personal hygiene care is probably one of the most needed guides that no one ever talks about. It is up close and personal. Dignity is important. Good information on the differences in needs of women versus men is needed for guidance and “how-to-do.” Let’s face it…we really only know what we need and how we do things. Someone else has no idea what you need and want. If you are helping someone of the opposite sex, some things that may be going through your mind include…

- How do I do this hygienically?

- Am I too rough?

- Am I wiping the right way?

- Am I helping with their dignity or do I just want to “get it done?”

- I hate this part.

- I want to do this right.

- I want to help them, but I have no idea if I am doing it right

February 1, 2023 The anatomical differences. The personal “wants” differences. The “how I do it” types of things may be different for each of us. Personal hygiene is definitely one area where very open and honest information is communicated for understanding. Never assume that you know best. Ask how you can best help them.

Tough Conversations, But Necessary Conversations

These are tough conversations but they don’t have to be awful. Maybe addressing it as a clinical need will help both of you to begin the conversation. Is it time to use adult undergarments that help with urinary or bowel incontinence? If she has hemorrhoids, how to best wipe and lessen the chance of discomfort or pain? Do any cleansers or ointments need to be applied after peeing or pooping? Do they prefer to be patted dry or wiped? After pooping, do they pat dry or wipe? Do they use a wet wipe? There are so many things to discuss. If you are used to being in each other’s space when bathing or toileting then you will have a leg up on everyone else. If you are used to being in private when you bathe or toilet, then you will have a little more “getting used to each other” in that situation. Maybe you can pee in front of each other, but pooping is a private situation for you. That is cool, make sure your loved one is seated on the toilet comfortably, and leave the room until you are called back. Try things and see what is more comfortable for both of you. Have gloves(nitrile) easily accessible in the bathroom and wear them. Wearing gloves seems to help each other to feel more comfortable with wiping.

Items to have on hand:

- Nitrile gloves

- Disposable white washcloths

- Pump sanitizer

- Personal cleansing wipes (Be careful, some of these cause a lot of irritation.)

- Barrier cream, if needed (Calmoseptine, A&D Ointment, Boudreaux’s Butt Paste, etc.)

Niceties or Aids to help:

- EasyWipe Toileting Aid

- Butt Scrubber Multi-Purpose Toilet Aid

- Bottom Buddy Toilet Aid

- Bottom Wiper Self Wipe Long Reach Wiper – for larger or obese people

- Squatty potty

Cleaning with tissue paper

1. Grab more than one sheet of soft tissue paper. 4-6 squares & roll over the hand to make a roll ( I know, some people wad toilet paper.)

1. Wipe from front to back. You are cleaning the vulva area and not the vagina. The vagina is self-cleaning. Some people use toilet paper to pat the area dry and that is fine.

1. Make sure the area is completely dry.

1. Be gentle

It’s important that you wipe front to back, as wiping the opposite way — back to front — can spread bacteria. After pooping, you will still need to wipe the vulva area as we pee when we poop. Prepare toilet tissue as before and you will wipe from front to back from the perineal area to past the anus. Yes, you may pat the area until it is clean. Place a little pressure on the area to clean it. Be gentle, do not wipe hard or aggressively. You may need to use a moist wipe and then pat dry. Wiping too much or too hard will cause anal itching and that will be maddening. 2 -4 wipes should be good. Note: The perineum is the area between the vagina and the anus.

Note: Sometimes wet wipes irritate the vulva or anal area. If it does, use warm water and a washcloth to clean the areas and then pat dry.

**Wash your hands after dealing with any bodily fluids, secretions, or stool.** If you have wiped and still feel like you need to wipe more….it may be because of one of the following … Dr. Sameer Islam

Feeling like you may need to wipe more may be due to one of these

1. Hemorrhoids (hangs on to feces)

1. Pelvic Floor Dysfunction (muscles are too tight)

1. Weak Rectum Muscles (leakage & soiling issues)

1. Foods can Weaken Muscles (Spicy foods, Greasy foods, Coffee)

1. Wiping Wrong

Tips to fix the problems

1. Fix your hemorrhoids

1. Get a bidet

1. Increase your fiber- slowly and drink your water to stay well hydrated

1. Pelvic Floor Therapy – see a physical therapist for too tight or too loose pelvic floor

1. Wipe correctly – front to back

Dr. Sameer Islam YouTube videos