She cares for her husband who has Alzheimer’s. She’s been caring for him for six years. Recently, he’s been asking repetitive questions. “He usually asks these questions when we are eating and sitting together,” she writes. “Maybe this is the only way he knows how to communicate with me. When I try to redirect, it only lasts about a minute and he will start again. I haven’t had this happen as much before; now he just keeps asking the same question until we finish eating or I tell him he can go to bed.”

So, how do you manage repetitive questions? Please share your suggestions and ideas in our comments section.

Resources

Resources for Managing Dementia’s Difficult Behaviors

Tips to Manage Difficult Behavior

I can remember managing her incontinence like it was yesterday. Incontinence has a way of staying with you. She wore Depends during the day, which she hated. The dressing-for-the-day ritual included her throwing the Depends against the wall and stating, “I hate that thing.”

Getting her to wear the Depends was nothing compared to changing the Depends. I remember one unfortunate episode when she began disrobing because of an incontinence episode that, unfortunately, was still occurring. As she walked across the bathroom and left, well, a trail of incontinence, I followed behind with paper towels and wash cloth.

Evie was a very proud woman. But, the Depends and incontinence humbled her. It humbled me, as well.

Managing the incontinence is not for the faint of heart or for those with the sensitive stomach. It’s kinda smelly, pretty gross and awfully embarrassing.

It’s also not something that you can really speak about. So, you go about your day, doing what needs to be done. Today, let’s talk about it.

So, tell us: How do you deal with your caree’s incontinence?

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Becky offered prevention tips, including good hand-washing techniques. Nancy shared ideas to manage those tough days when your caree just doesn’t feel well, including creating a back-up plan so others can step in to help so you can work or attend to other responsibilities.

A few important tips:

–With older adults, a temperature (or lack of a temperature) is not a good indicator of an illness’s severity. Contact a health care provider if your caree’s temperature is above 99 degrees;

–Older adults are more fragile; their condition can change quickly. It’s important to closely monitor your caree.

When you first notice that your caree is not feeling well, observe and note your caree’s condition, including temperature, color of urine (a dark color can indicate dehydration), skin and mucus membrane. With the information at hand, contact your caree’s physician for further instructions.

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My mother-in-law has entered a stage where she won’t swallow her food. Usually she eats well in the mornings but by lunch and supper she can’t swallow no matter what food we offer.

Does anyone have any suggestions? Wondering how long this can last before it causes serious problems. She was just in the hospital with a UTI and dehydration and constipation. No matter how hard we have tried to avoid the 3 problems, they happened anyway.

• The first video, Tips for Making a Hospital to Home Transition, provides insights and expert guidance on important issues caregivers need to plan for, and manage, when bringing a caree back home from the hospital. It offers advice on maintaining effective dialogues with health care providers, preparing the home for new equipment needs, planning for additional expenses, and more.

• The second video highlights a detailed checklist, Planning for your Discharge Guide, which CMS developed to help you as plan to care for your caree at home.

Visit the Ask Medicare web site at www.medicare.gov/caregivers for additional resources and information.

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Donna W., one of bloggers, sent the two photos, below, of a Caregiving Étagère, the hub of her mom’s room for her supplies and care. She also sent a photo of the communication board she created for the respite caregivers to use while she was away on a trip in December.

So… what’s in your caregiving closet? We’d love to see!

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The purpose of your caregiving closet is to organize personal care items that you use daily, regularly and/or may need at some point in the future. If you and you caree live in separate households, you may want to create two closets–one for each household.

While the initial set-up may take time, you’ll find that having an organized closet that has just what you need, when you need it, is a life-saver. The closet also will come in handy when you take a break; your back-up will be able to step in more easily because the necessarily supplies are organized and handy.

So, here’s the list of products and supplies for your Caregiving Closet:

Over the Counter Medications
Acetaminophen – chewable tablet, liquid and suppository
Anti-inflammatory (ibuprofen/naproxen sodium)
Antibiotic ointment
Stool softener
Gastrointestinal medication (client preference or diagnosis driven)
Antihistamine
Anti-diarrheal
Weekly pill reminder box

Diabetic supplies
Glucose tablets
Blood sugar monitor and supplies
Extra insulin and syringes

Oxygen supplies
Extra portable oxygen tank

First Aid supplies
Instant hot/cold packs
Band-Aids
4X4 gauze pads
Tape
Kerlix
Ace wraps
Normal saline rinse
Sling with safety pins
Scissors/tweezers
Sun screen
Insect repellent
Lip balm
Body lotion
Hat/umbrella
Digital scale
Digital thermometer
Automated blood pressure system

Incontinence supplies
Washable bed protectors
Briefs
Perineal care wipes
Protective/barrier cream/ointment

Emergency supplies
Flashlight with extra batteries
Battery powered radio
Blankets
Change of clothes
Extra 2 day supply of prescription medication
Bottled water/Gatorade
Snacks like protein bars/nutritional drink supplement

Safety preparation
Medical Alert system (pendant)
Phone programmed with 911
Emergency numbers placed by phone
Hand held shower head
Shower chair
Non-skid mat for shower/tub
Toilet frame/riser
Grab bars
Soap on a rope
Double sided tape to secure throw rugs

Cognitive safety preparation
Door, bed, chair alarms
Special door locks
Lock up – medication, alcohol, cleaning supplies, guns, etc.
Alzheimer’s safe return system
Alerting police of senior situation

Vial of Life (Ready Reference card)
Medication list
Allergies
Physician list/phone numbers
Diagnoses
Contacts/phone numbers

To ease in re-stocking, hang a list of the products and supplies in your closet on the closet door. And, for your convenience you can download the list of supplies and products to save and print.

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Chirag lives in Chicago, so I met him for dinner about a month ago. I was able to see the technology used in his product—a personal emergency response system that detects falls. The product is light-weight, unassuming and easy-to-wear. What’s most exciting to me is young people developing technology to create better quality-of-life for older adults and their family caregivers. It’s exciting because they provide cross-over into industries (such as consumer electronics) that brings awareness and information to individuals (i.e., family caregivers) who need the products but may be unaware of the availability. (You’ll hear my excitement on the show; you can listen via the player at the end of the post.)

More than 90 percent of the products on display at the AAHSA Idea House are on the market today. Product highlights include:

• A medication dispenser that automatically organizes, reminds, dispenses and monitors an individual’s medication use. The technology enables pharmacies to be notified when refills are needed.
• Electronic distribution of medical records to doctors, family members and caregivers on an ongoing basis. The distribution enables timely responses to the data, thereby improving an individual’s health outcomes and reducing health care costs over time.
• Automatic personal emergency response systems, including fall detection that monitor a person’s events and notify emergency medical services and caregivers immediately when needed.
• A security system that replaces the traditional peephole with an LCD screen to make it easier for people in wheelchairs or other needs to see who’s at their door.
• Hybrid Assistive Limb (HAL), a wearable robotic suit that is designed to multiply a person’s strength by reading bio-electric signals a person generates. The suit uses those signals to guide the movement of robotic limbs strapped to a person’s arms and legs. With HAL’s help, many stroke patients may be able to walk and nurses have extra strength to move individuals who need assistance.
• Height-adjustable kitchen and bath appliances designed to meet different users’ needs.
• A Passive Sleep Monitoring System that monitors a person’s sleep quality, breathing and heart rate as he/she lays on the mattress and enables caregivers to detect sleep-related markers of disease, like urinary tract infections and depression, earlier.

Because technology will become more and more important in your caregiving role, the following resources can help you stay up-to-date:

The Daily Wrinkle: Jill Gilbert of Gilbert Guide gives us a video reviews of aging products and innovators.

Aging in Place Technology Watch: Laurie M. Orlov blogs about and analyzes technology trends.

Microsoft Health Tech Today: Bill Crounse hosts this monthly video covering developments in health care technology.

And, Chicago’s PBS station featured a segment on the Idea House; take a tour:

You can listen to the show via the player below. Some highlights:

1. Keep a journal about your care recipient’s care needs, including how often they use the bathroom.

2. A change in your care recipient’s toileting could indicate a problem. Call your doctor if your previously-regular care recipient goes 24 hours without a bowel movement.

3. Visit this website for more information: www.aboutincontinence.org/

Our show closed with tips from Jeannie on which products to use to manage incontinence. I hope you find the show helpful; please feel free to share your questions and stories in our comment section.

Image via Wikipedia

by Gary Hirsch, adviser to online incontinence care products provider SecurePersonalCare.com. The following article, Go Green & Save Money on Adult Diapers in One Simple Step, originally appeared on Gilbert Guide and is re-printed courtesy of Gilbert Guide, Inc. Copyright © 2009, Gilbert Guide, Inc.

The economy isn’t the only thing that could use a boost: so could your diaper. Past topics in this column have discussed reducing your carbon footprint with adult diapers and ways to try incontinence products before you buy. But did you know you can save money and reduce your consumption of adult incontinence products by making one simple change?

Adult Diaper Doublers
In this post, I want to discuss the benefits and uses of booster pads, which are commonly referred to as “diaper doublers.” In a nutshell, a booster is an absorbent rectangular pad that is constructed without a plastic barrier so that liquid can easily pass through it. Often it is wrapped or covered in the same type of non-woven material that is used as cover material for the diaper.

The absorbent material is usually a blend of fluff pulp (same as in the diaper) and may have some polyaculate or superabsorbent polymers mixed in with the fluff—it is that absorbent stuff in the middle that really can help make a difference in both the performance of your incontinence product, and thereby your rate of consumption and the amount of money you spend on incontinence care overall.

These booster pads come in different lengths and widths sized to fit comfortably within the diaper or undergarment. When purchasing, check for the words “maxi” or “extra-length” and the accompanying sizing description to better understand how they’ll work with the product you currently use. It can be difficult to find boosters in some retail or mass-market stores. Your best bet for finding diaper doublers is an online store, preferably one which offers a sample so you can try before you buy.

Diaper Boosters Stretch Your Dollar
Everyone’s talking about economics these days, and as I mentioned earlier, using boosters can be a very cost-effective way to manage incontinence, since they can often help you cut down on the number of diapers you use by providing extra absorbency for urge and stress incontinence.

Additionally, using a booster pad at night can help extend the total absorbent capacity and comfort of the wearer depending on the individual level of incontinence. I have found for most store-bought diapers, including brands from Tena and Kimberly Clark as well as private-label brands, that a booster inside their diapers and protective underwear (e.g., Pull Ups) can greatly improve the longevity of the product and reduce cost. A good booster is far less expensive than double diapering (putting one diaper on top of another while cutting holes in the plastic of the diaper on top), not to mention much more comfortable, with less bulk.

Booster pads are available from Secure Personal Care and other sites that offer Attends Health Care products. Look for a category named “booster” or “diaper doublers.”

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