Wednesday, August 19, 2009

The Dangers of Dehydration

Dehydration can be a deadly threat to seniors. My mother, Elizabeth, was hospitalized because of dehydration. The Drs and hospital were unable to save her. She returned to the care facility were she had been staying and received hospice care for the last week of her life. I still grieve because I question what else I should have, could have done to have had a different outcome.
Preventing dehydration is key to better health for seniors. Janet Mentes PhD, APRN, BC in the American Journal of Nursing – June 2006, talks about why hydration matters:
Fluid balance, the state in which fluid intake equals output, is essential to health, regardless of a person's age. In older adults, adequate fluid consumption has been associated with fewer falls, lower rates of constipation, and lower rates of laxative use, as well as better rehabilitation outcomes in orthopedic patients and reduced risk of bladder cancer in men. 3-5 Drinking five or more 8-oz. glasses of water (but not other liquids) per day has been associated with lower rates of fatal coronary heart disease in middle-age and older adults than drinking two or fewer glasses. 6 And in one study, drinking 16 oz. of room-temperature water before a meal resulted in significantly lower rates of postprandial orthostatic hypotension in older adults who had autonomic failure. 7

There are a number of factors that contribute to dehydration in seniors. As we age our thirst mechanism becomes blunted we do not always realize that we need water. A second factor has to do with the changes to our body make up. From the age of puberty to the age of 39 - 60% of our body weight is fluid. After the age of 60 years old are men’s body fluid drops to 52% and women’s body fluid drops to 46%. Another factor is the loss of muscle as we age. Muscle cells contain more fluid than fat cells. Medication can also interfere with fluid balance.

Alexcia Hawkes in her blog article The Importance of Hydration in Old Age writes about the importance of drinking enough water. I find it amazing that dehydration contributes to falls, constipation as well as incontinence, and can increase confusion.

Nancy Hearn writes about 12 Symptoms of Dehydration. I didn’t know that cartilage in joints are made of fluid and that dehydration adds to joint problems.
Staying hydrated helps keep us healthy and functioning. Here’s to enjoying more H20 in our daily life and those we love.

Thursday, August 13, 2009

It's Time for a Bath

My mother used to love her bath's then AD set in and taking a bath or shower became war. I learned from a friend whose own mother had AD that many people who suffer from Alzheimer's develop a fear of water. Bath time became a huge struggle. My sweet loving mother would yell at me and accuse me of trying to kill her. It traumatized all of us including my two dogs who were pups at the time.

Someone suggested a bath chair that was a little better. What I didn't know was how to effectively use it. When I hired a new caregiver Jeanie showed me a much safer way of giving mom a bath.

1. Put the bath chair so the back is closest to the faucet.
2. Have mom sit down on the edge of the seat. Scooting back so well centered.
3. Then pick up her legs. Swiveling them into the bathtub.

She remained seated and safe during the procedure.

When my siblings and I were little kids and Mom gave us a bath she would hand us a dry washcloth to put over our eyes when she went to wash our hair. So that's what I did with her. It seemed when the water got into her face and eyes she became more frightened. I also made sure the bathroom was very warm, because she would chill so easily.

I learned that bathtub transfer benches are a great bath safety accessory that makes using tub/showers safer. Two of the legs sit on the outside of the tub. This allows for the user to sit on the edge of the transfer bench and swing their legs over then slide over the tub. This alleviates the need to step into the tub. Hand held showers are the ideal companion item for the transfer bench. Also called transfer tub seats, transfer tub benches, shower bench, or transfer tub seats.

I bought the hand held shower at Walmart and installed it myself with just a few tools. The bath/shower chair that we used had a back and was available through a local medical supply store. Some pharmacies also carry them.

I wish that I had been aware of how to safely use the bath chair earlier.

Sunday, August 2, 2009

Hand-over-hand technique

While reading blogs I came upon The Dementia Caregivers Toolbox. I used to put my hand over Mom's hand when I tried to feed her during the late stage of AD. I never new there was a name for this or why it worked. I am sure many people do this instinctively. It is very reassuring when you get validated unexpectedly.

I encourage you go to the Dementia Caregivers Tool box and read the full article. What a great site. Here is a sliver of the article.

The concept of the "hand-over-hand" technique is beyond simple and can be used by anyone to assist a person with dementia in many tasks. How does it work?

You, as the caregiver, put your hand over the hand of the person who has dementia and gently guide them to the activity at hand. If the task is walking, you would put your hand over their hand and slowly lead them down the hall, maybe clasping both your hands around their hand. If the task is stirring the cookie batter, you would put your hand over their hand and "show" them the motion used to stir and do it with them. You can use this strategy for helping people get in and out of chairs, brushing teeth, turning on televisions, combing their hair, you name it.