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
Wash the face and neck first and dry the face
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.
Dry the hair with a hand towel
If they can, have them hold the shower handle
If they can wash themselves, then you soap up the washcloth or pouf
Wash their back in a circular motion all the way down to the buttocks
Wash the arms and underarms next
Wash the front torso and under the breasts – wash skin folds well, too
Rinse them off really well
Place a towel over the top half of the body and pat dry a little (helps keep them warm)
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.
Wash the feet and in between the toes (while they are sitting)
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.
Use a clean washcloth and clean the vulvar area – use a different clean area of the washcloth for each swipe
Clean from clean to dirty = front (vaginal area) to back (anal area)
Separate the labia with one hand and clean gently with a downward motion to the perineum area (area between vagina and anus)
Separate buttocks and clean from bottom to top area
Rinse very well
Talking throughout the bathing process and telling them what you are doing or will be doing next seems to help everyone calm down
Use a towel to pat dry and dry well
Areas that need extra care to be dry – vulvar area, anal area, underboob area, all skin folds and in between toes
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. **
Apply barrier or skin protectants to areas needed (usually incontinent folks need this)
Never lotion between toes (want to prevent fungal or other infections)
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)
Do not put anything in or right around vagina (it is self-cleaning)
Help them into their clean clothes
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
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.)
Bottom Wiper Self Wipe Long Reach Wiper – for larger or obese people
Squatty potty
Cleaning with tissue paper
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.)
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.
Make sure the area is completely dry.
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
Hemorrhoids (hangs on to feces)
Pelvic Floor Dysfunction (muscles are too tight)
Weak Rectum Muscles (leakage & soiling issues)
Foods can Weaken Muscles (Spicy foods, Greasy foods, Coffee)
Wiping Wrong
Tips to fix the problems
Fix your hemorrhoids
Get a bidet
Increase your fiber- slowly and drink your water to stay well hydrated
Pelvic Floor Therapy – see a physical therapist for too tight or too loose pelvic floor
Maybe, it is because you don’t know your “why.” Your own personal “why” is what motivates you. You can say “I need to…” or “I should …” do X,Y, and Z. Yet, it never gets done. Is it because you don’t know where to start? Is it because you are not sure what to do or what is important? Is it because you don’t really see the benefit of doing “it?”
January 11, 2023
Simon Sinek, says to always start with your “WHY?” Why is it important? How will it help you or your loved one? How will it improve your life? How will it decrease your stress? Why do you do what you do?
The Stress-Buster Binder is for you, if you want an easy to use format.
Will a fill-in-the-blank PDF help you?
Would a fill-in-the-blank notebook be of benefit to you? Would a fillable pdf document be of benefit to you? For some of you, it is what you have been looking for. For others, it is something you didn’t know you needed but will be of tremendous help to you. What is in the world could it be? My shameless plug for my Stressbuster, Time Saving Important Documents Binder.
How will it help?
It is organized by topic. The pages are protected by sheet protectors, you fill it out and have the information at your fingertips. You know how it is, you go to a new doctor and you have to fill out a complete medical history. You cannot remember everything nor can you remember dates. With the grab-and-go binder, you fill it out ONCE and use the information forever. That decreases your stress level when you are asked for medical information that you don’t recall.
Topics Included:
A durable power of attorney Financial
Power of attorney for Health
HIPAA
Health Care Proxy
Financial Affairs
End-of-life decisions
Advance directive
Will
Things you may also need, that you didn’t-know you would need
Medical History
Online Accounts – passwords and security questions
And more…
Pre-printed Binder Kit (pages are in sheet protectors) Checklist
You also receive clean sheets to make copies. This is great for updating the records and for when you need to use medications given check-off sheets.
The complete binder kit is $249.00 and can be mailed anywhere in the contiguous 48 states for $17.00, as of this date 10/25/2023. Prices for printing and mailing may be updated as those prices increase. Yes, I am telling you to get the binder before the price increases.
Computer version Checklist
Fillable PDF file for family use $129.00
Fillable PDF file for single use $69.00
Pat
It may be disease-related or due to other reasons that can be addressed and fixed.
December 7, 2022
You notice that your mom has lost weight. Maybe, she was a larger woman who could lose a few pounds. She tells you that she is not hungry or doesn’t have much of an appetite. She does not appear to be underweight, so you don’t think too much about it.
Unintended Weight Loss
A couple of weeks later, you see her again and you notice a little more weight loss. The question to ask is, “Do you mean to lose weight?” Unintended weight loss can become a problem. She also appears weaker and more tired.
Ask more questions such as:
Is your mouth sore or is it hard to chew?
Is it hard to swallow?
Do you feel like you are choking when you swallow?
Have you lost your appetite?
Does your stomach hurt?
Do you have swelling or are you retaining fluid?
Can you only eat a little bit at a time?
If yes, to any of these, a visit to the primary care physician is in order.
Physical issues also contribute to malnutrition
Try to find a physical cause. Can they get to the store? Can they cook for themselves? What are they eating? Frozen dinners, soup, cheese, and crackers? Are they drinking enough fluids?
They may be eating, but it may not be enough for their nutritional needs. There is usually an imbalance of protein, fat, carbs, and calories that the body needs every day.
What else can cause malnutrition?
It could be their medications. It could also be dementia or depression. Chronic disease also decreases appetite.
Common chronic diseases that affect (usually decrease) appetite:
Common things that may decrease appetite that is usually self-limiting or can be more easily treated at home.
Cold/Flu
Dehydration – when we don’t get enough fluids we feel sick
Stress
GERD – acid reflux
Sadness
Grief
Problems caused by malnutrition:
Increased risk of hospitalization.
Increased risk of death.
It weakens the immune system, making them more susceptible to “getting” an infection.
It causes muscle weakness and bone loss which can lead to an increase in falls and fractures.
It slows wound healing.
It decreases heart muscle mass.
It causes poor respiratory function.
It increases anxiety.
It increases self-neglect. (Poor hygiene, Unkempt appearance, Neglecting to clean the house, Hoarding, Not wearing suitable clothing for the weather, Messy hair, Dirty nails, Unusual odors, etc.)
FYI
**An obese person can still be malnourished.**
**It isn’t always diagnosed in a hospital setting or a physician’s office without information from the patient or family members.**
If you suspect your loved one is malnourished, you may have to be a more vocal advocate to get it checked out. It is perfectly okay for you to speak up and keep speaking up until you have been listened to and someone does a malnutrition lab workup.
A Registered Dietician (RD) can be of tremendous help.
Pat
It isn’t just a severe headache. Info for those that don’t know.
March 23, 2022
Migraines not only affect the person that has them, it also affects their loved ones. Everyone’s emotional health and well-being are affected. Irritation, negative feelings and sometimes anger shows up. That is normal. The problems arise when we don’t deal with the irritation, negative feelings and anger appropriately.
Look, the person that has migraines does not want to have them. They are sometimes debilitating and their quality-of-life sucks. Remember, it is not just a severe headache, it is a brain disorder. I have been on both sides of this issue. I have only had three debilitating migraines in my life. I also have had many migraines that were annoyances and I have had some that you cannot think clearly for hours. When you can’t think clearly, it takes about four times as long to work on a project than it normally does. Sometimes, you can push through and sometimes you can’t. Sometimes, medications work and sometimes they don’t.
Triggers
I know what most of my triggers are and I can do a pre-emptive strike with over-the-counter and prescription meds when I feel the familiar pain beginning. I call it, the cocktail. I usually only have to take the cocktail once and the pain decreases to where I can function almost normally. The great thing about the cocktail, I use less medication overall. My migraines are acute. If they were chronic, then I would have to take preventative measures all of the time. Preventative measures include prescription medications, supplements, massage, running, walking, stretching, etc. As you can see, there are many things that may help with preventative measures. You have to find the group of things that will work for you. We will talk more about treatments and prevention next time.
I am thankful that I do not have chronic migraines. For those that do, I can empathize with you. I can also empathize with your family. It is hard on the family when you have plans and then a debilitating migraine flares-up. The plans go out the window or the one that is having the migraine flare-up is left at home. It sucks.
If someone is having a severe migraine, they probably should not be left alone. They should be watched. Why? Because they usually cannot get liquids or crackers safely on their own. A person that is having a severe migraine may be having neurological deficit problems and they could even have a stroke. If a person gets to status migrainosus (severe pain, lasting 3 days or more) they can have a stroke. They usually need to be in the hospital at this stage with a neurologist monitoring their condition.
As you can see, migraine is not just a bad headache. It takes the whole family working together to help get a handle on calming down migraine. Learning and understanding what a migraine disorder is and the ways in which each of you can help makes it much less stressful on all involved.
Eating nutritionally better, regular exercise, staying hydrated, learning more effective ways to deal with stress will help all involved. Help lighten the load at home for the one that has migraines. Be supportive. Ask how you can help them. Don’t be an ass. This is hard when you have been dealing with migraines for a while. During an attack is not the time to go through all the preventive measures “they should be doing.” Learning their own preventive measures takes time.
For those that have migraine flare-ups. Are you actively doing anything to try and find ways to decrease your attacks? Are you open to trying two or three things for 3 months to see if they help? Some of you have hurt for so long, that you don’t feel like you have the energy to find things that help. Maybe, you need help in getting plans of action that are unique to you and your needs.
**Shameless plug – I help with these types of plans. – Shameless plug over.**
If you have given up, I hope that you reconsider. Will you be open to the possibility that you can be helped? That you can get better and feel better? Yes, it will take time and effort on your part. You deserve to have fun and a good quality of life. If you are looking for an end to all the flare-ups and pain, that is not realistic, at this point in time. A decrease in migraine days and a decrease in the severity of pain is possible.
I encourage you to share this with others. Especially those that do not understand what happens during a migraine attack. My goal for this article is to help others better understand what a person that has migraines goes through.
Headache Types – Migraine, Non-migraine and Mixed
There are many types of headaches, about 150 different types. First, we have to figure out if the headache is a primary headache or a secondary headache. A primary headache has no known underlying cause. A secondary headache is the result of another condition. The other conditions are things like, inflammation, bacterial or viral infections, a trauma to the head or neck, sinusitis, etc.
Examples of the most common primary headaches:
Cluster headache
Migraine (with and without aura)
Tension headache (medically known as tension-type headache)
Trigeminal autonomic cephalalgia (TAC), including cluster headache and paroxysmal hemicrania
Silent migraine
Basilar migraine
Abdominal
Ocular
Vestibular
Status Migrainosus – ongoing pain lasting for more than 3 days
Examples of the most common secondary headaches related to another medical condition:
Disease of blood vessels in the brain
Head injury
High blood pressure (hypertension)
Infection
Medication overuse
Sinus congestion
Trauma
Tumor
Hangover
Menstrual
Exertional
There is a mixed type of headache, a migraine and a tension type headache that happen at the same time. Some call it a mixed tension migraine.
A migraine can occur in four different phases. Not everyone will experience every phase.
Premonitory phase – also known as the prodrome phase
Non-painful symptoms that may occur a few hours of a few days Before the headache arrives.
Unexplained mood changes
Food cravings
Neck stiffness
Increased yawning
Diarrhea or Constipation
Increased sensitivity to light, sound, or smells
Aura phase – sensory disturbances that may occur before or during an attack
Visual auras may occur in one or both eyes
flashing lights
zig-zagging lines
blurred vision
blind spots that expand over time
Sensory auras cause numbness or tingling that starts in the arm and radiates to the face.
Motor auras cause problems in the person’s ability to think clearly and communicate verbally.
slurred or jumbled speech
difficulty understanding what others say
difficulty writing words or sentences
having trouble thinking clearly
Headache phase – pain ranges from mild to sever (not everyone will have a headache, but they may have all of the other symptoms such as nausea, vomiting, off balance, etc.
Postdrome phase – happens after the headache subsides and lasting a few hours to a few days
exhaustion
confusion
generally feeling like crap
Migraine Triggers:
lack of sleep or jet lag
hunger or dehydration
foods
additives
alcohol
caffeine
medication overuse
smells
lights and sounds
weather
female hormones
physical activity
stress
Unusual signs and symptoms of migraine:
Body chills
Phantom smells
Brain fog
Insomnia
Stuffy or Runny nose
Watery eyes
Your skin or hair hurts – Allodynia – pain from things that do not normally hurt
Hiccups
Ringing in your ears
Double vision
Trouble hearing or understanding what others are saying
Sparks of light in vision
The Complete Headache Chart
Type
Symptoms
Precipitating Factors
Treatment
Prevention
Hangover Headaches
Migraine‐like symptoms of throbbing pain and nausea not localized to one side.
Alcohol, which causes dilation and irritation of the blood vessels of the brain and surrounding tissue.
Liquids (including broth). Consumption of fructose (honey, tomato juice are good sources) to help burn alcohol.
Drink alcohol only in moderation.
Caffeine‐ Withdrawal Headaches
Throbbing headache caused by rebound dilation of the blood vessels, occurring multiple days after consumption of large quantities of caffeine.
Caffeine.
In extreme cases, treat by terminating caffeine consumption.
Avoiding excess use of caffeine.
Exertion Headaches
Generalized head pain of short duration (minutes to 1 hour) during or following physical exertion (running, jumping, or sexual intercourse), or passive exertion (sneezing, coughing, moving one’s bowels, etc.).
10% caused by organic diseases (aneurysms, tumors, or bloodvessel malformation). 90% are related to migraine or cluster headaches.
Cause must be accurately determined. Most commonly treated with aspirin, indomethacin, or propranolol. Extensive testing is necessary to determine the headache cause. Surgery to correct organic disease is occasionally indicated.
Alternative forms of exercise. Avoid jarring exercises.
Post‐TraumaticHeadaches
Localized or generalized pain, can mimic migraine or tension‐type headache symptoms. Headaches usually occur on daily basis and are frequently resistant to treatment.
Pain can occur after relatively minor traumas. Cause of pain is often difficult to diagnose.
Possible treatment by use of antiinflammatory drugs, propranolol, or biofeedback.
Standard precautions against trauma.
Hunger Headaches
Pain strikes just before mealtime. Caused by muscle tension, low blood sugar, and rebound dilation of the blood vessels, oversleeping or missing a meal.
Strenuous dieting or skipping meals.
Regular, nourishing meals containing adequate protein and complex carbohydrates.
Same as treatment.
Temporomandibul ar Joint (TMJ) Headaches
A muscle‐contraction type of pain, sometimes accompanied by a painful “clicking” sound on opening the jaw. Infrequent cause of headache.
Caused by malocclusion (poor bite), stress, and jaw clenching.
Relaxation, biofeedback, use of bite plate. In extreme cases, correction of malocclusion.
Same as treatment.
Tic DouloureuxHeadaches
Short, jab like pain in trigger areas found in the face around the mouth or jaw. Frequency and longevity of pain varies. Relatively rare disease of the neural impulses; more common in women after age 55.
Cause unknown. Pain from chewing, cold air, touching face. If under age 55, may result from neurological disease, such as MS.
Anticonvulsants and muscle relaxants. Neurosurgery.
None.
Fever Headaches
Generalized head pain that develops with fever. Caused by swelling of the blood vessels of the head.
Caused by infection.
Aspirin, acetaminophen, NSAIDs, antibiotics.
None.
Arthritis Headaches
Pain at the back of head or neck. Intensifies on movement. Caused by inflammation of the blood vessels of the head or bony changes in the structures of the neck.
Cause of pain is unknown.
Anti‐inflammatory drugs, muscle relaxants.
None.
Eyestrain Headaches
Usually frontal, bilateral pain, directly related to eyestrain. Rare cause of headache.
A boring, burning, or jabbing pain caused by inflammation of the temporal arteries. Pain, often around ear, on chewing. Weight loss, eyesight problems. Rarely affects people under 50.
Cause is unknown. May be due to immune disorder.
Steroids after diagnosis. Confirmed by biopsy.
None.
Tumor Headache
Pain progressively worsens, projectile vomiting, possible visual disturbances speech or personality changes; problems with equilibrium, gait, or coordination; seizures. Extremely rare condition.
Cause of tumor is usually unknown.
If discovered early, treat with surgery or newer radiological methods.
None.
Tension‐Type Headaches
Dull, non‐throbbing pain, frequently bilateral, associated with tightness of scalp or neck. Degree of severity remains constant.
Emotional stress. Hidden depression.
Rest, aspirin, acetaminophen, ibuprofen, naproxen sodium, combinations of analgesics with caffeine, ice packs, muscle relaxants. Antidepressants if appropriate, biofeedback, psychotherapy. If necessary, temporary use of stronger prescription analgesics.
Avoidance of stress. Use of biofeedback, relaxation techniques or antidepressant medication.
Migraine without Aura
Severe, one‐sided throbbing pain, often accompanied by nausea, vomiting, cold hands, sensitivity to sound and light.
Certain foods, the Pill or menopausal hormones, excessive hunger, changes in altitude, weather, lights, excessive smoking, and emotional stress. Hereditary component.
Ice packs; isometheptene mucate, combination products containing caffeine, ergotamine, DHE injectable and nasal spray, 5‐HT agonists; analgesics or medications, which constrict the blood vessels. For prolonged attacks steroids may be helpful.
Biofeedback, betablockers (propranolol, timolol), anti‐convulsant (divalproex sodium). Calcium blockers and NSAIDs may prevent or treat migraine headaches.
Migraine with Aura
Similar to migraine without aura, except warning symptoms develop. May include visual disturbances, numbness in arm or leg. Warning symptoms subside within one‐half hour, followed by severe pain.
Same as migraine without aura.
At earliest onset of symptoms, treat using biofeedback, ergotamine, dihydroergotamine or a 5‐HT agonist. Once pain has begun, treatment is identical to migraine without aura.
Prevent with same techniques as migraine without aura.
Cluster Headaches
Excruciating pain in vicinity of eye. Tearing of eye, nose congestion, flushing of face. Pain frequently develops during sleep and may last for several hours. Attacks occur every day for weeks/month, then disappear for up to a year. 80% of cluster patients are male, most ages 20‐50.
Alcoholic beverages, excessive smoking.
Oxygen, ergotamine, sumatriptan or intranasal application of local anesthetic agent.
Use of steroids, ergotamine, calcium channel blockers and lithium.
Menstrual Headaches
Migraine‐type pain that occurs shortly before, during, or immediately after menstruation or at mid‐cycle (at time of ovulation).
Variances in estrogen levels.
Same treatment as migraine.
Small doses of vasoconstrictors and/or anti‐inflammatory drugs before and during menstrual period may prevent headaches. Hysterectomy does not cure menstrual headaches.
Hypertension Headaches
Generalized or “hairband” type pain, most severe in the morning. Diminishes throughout day.
Severe hypertension: over 200 systolic and 110 diastolic.
Treat with appropriate blood pressure medication.
To prevent, keep blood pressure under control.
Aneurysm
Symptoms may mimic frequent migraine or cluster headaches, caused by balloon‐like weakness or bulge in blood‐vessel wall. May rupture (stroke) or allow blood to leak slowly resulting in a sudden, unbearable headache, double vision, rigid neck. Individual rapidly becomes unconscious.
Congenital tendency. Extreme hypertension.
If aneurysm is discovered early, treat with surgery.
To prevent, keep blood pressure under control.
Sinus Headaches
Gnawing pain over nasal area, often increasing in severity throughout day. Caused by acute infection, usually with fever, producing blockage of sinus ducts and preventing normal drainage. Sinus headaches are rare. Migraine and cluster headaches are often misdiagnosed as sinus in origin.
Infection, nasal polyps, anatomical deformities, such as a deviated septum, that block the sinus ducts.
Treat with antibiotics, decongestants, surgical drainage if necessary.
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.
