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Within the next ten years, the number of people and families with elderly relatives to care for is likely to exponentially increase, with the old in some Western populations actually likely to outnumber the young by the early 2020s. This means that more and more families will have to make long-term plans to care for a relative into old age. The added pressure of a rising elderly population will manifest itself in more money needed for public and social care provision.

In order to both save money and (more importantly) provide a more comfortable and enjoyable experience for our elderly loved ones who are in need of social care, it’s going to be necessary to make more provisions for our older friends and relatives to be cared for in their home.

There are a number of different types of accessibility alterations which may be required if your elderly loved one suddenly has difficulty getting around the house. These include:

• Help accessing a home (e.g. ramps or hand rails when approaching the front door).
• Help getting around a home (e.g. ramps, stair lifts, more grab rails and handles for getting up and down stairs/ in and out of rooms.)
• Help with mobility in the kitchen and bathroom.
• Help with visibility/poor vision in the home
• Alarm/warning systems in the event of an accident or fall.

These are the main types of obstacles which an elderly relative may face as they deal with the difficult challenges and lifestyle alterations caused by decreased mobility in old age. Below are 5 of the most useful tips which could make all the difference, and hopefully ensure that your elderly friend or family member lives a much happier and fulfilled life.

1. Move the essentials downstairs

Moving all the essential facilities in your house to the ground floor can be the simplest way to improve overall access and ease any potential mobility issues which an elderly loved one may face. If there’s a way of suitably renovating the house so that there’s access to a bedroom, dining area and living quarters on the ground floor, then this will minimize the risk of any trips, falls, emergencies or accidents.

The decision to move all the major facilities/core rooms in a home to one floor may form part of a wider conversation about whether an elderly relative may wish to downsize to a bungalow, or a house with easier accessibility built in to the design.

2. Make bathrooms easier to use

Bathing and washing are the most private and essential of daily rituals, and a person’s ability to bathe and wash safely and easily is arguably central to their sense of dignity and self-esteem. This means that accessibility improvements to a bathroom are arguably some of the most urgent alterations you can/should be making to a home.

Helpful structural changes to a bathroom include:
• Level access/walk in showers, ensuring that an elderly person doesn’t have any immediate trip hazards, and minimising the risk of falls as they get in or out of the bath/shower.
• Handrails mounted to the walls, should an elderly relative require help getting up off the toilet.
• Removing any other extraneous trip hazards, such as bath mats or even ripping up tiled surfaces which may inadvertently mean a person could slip or trip when the surface becomes wet.

3. Stair/wheel chair lifts

These can be an essential addition to any household and are once again an invaluable tool for minimising trips and falls. If your elderly friend or loved one is adamant that they don’t want to make too many major changes to their day-to-day lifestyle and want to keep their room layout broadly the same, then a chair lift can be a great way to maintain both continuity and guarantee safety. Installation and maintenance are increasingly simple.

4. Replacing household accessories

By this, we mean replace everyday household accessories which control the day-to-day operation of the house. These include light switches and door handles. Switching your existing light switches to touch lights or dimmer switches can give an elderly relative an opportunity to take advantage of more subtle lighting states, which is especially useful if they are partially sighted/having difficulty seeing in darker rooms. Likewise, replacing any door knobs with lever handles is an easy way to ensure that your elderly relative can enjoy easier mobility when moving between rooms.

Likewise, re-arranging kitchen drawers and storage to make it more easily accessible is another straightforward way of improving accessibility and minimizing risk.

5. Installing a personal alarm system

This may be a source of understandable reluctance for someone who may be having to confront problems with mobility. After all, conceding that you need some of kind of emergency back-up system can, in turn, feel like an admission of vulnerability, and preparing for a worst-case scenario that none of us want to think about as we get older.

Nevertheless, installing a personal alarm system in the event of any serious accident or fall is a vital last line of defense in ensuring that your elderly relative or loved one is safe and secure in their own home.

A number of telecare systems allow a homeowner to alert a carer or member of the emergency services should they find themselves falling victim to a trip, fall or major accident.

Encore Care Homes offer care homes across the south of England. Their private homes offer palliative care, short-term respite care, long-term residential, and nursing care.

https://encorecarehomes.co.uk

And the Oscar Goes to…
Watching the Oscars can be quite entertaining. Imagine the vision, creativity, and artistry that it takes for scores of people to come together to make a film that captivates the country by bringing a story to life! The coveted gold statue represents the pinnacle of one’s profession, a universally recognizable prize that causes a seasoned actor to forget his acceptance speech or lose her gracefulness while tripping over a ridiculously expensive gown. It made me wonder: What if there were Oscars awarded to the people who influenced healthcare? Here are some suggestions for the most deserving:

Best Picture: an award for radiologists viewing the film of a cancer-free survivor

Actor/Actress in a Leading Role: the oncologists who don’t let their patients see them cry after having to give a terminal diagnosis

Actor/Actress in a Supporting Role: the nurse who provides comfort to the parents of a dying child

Best Adapted Screenplay: the rehabilitation team members who help survivors find new life again after stroke

Cinematography: for persons who capture the inspiring moments of the Special Olympics
Costume design: the prosthetists, orthotists, and biomechanical engineers who create both function and beauty to clothe persons needing artificial limbs

Directing: the heads of national organizations that lead the way in research and education in a specialty area

Best Makeup: the funeral home directors who help make our loved ones look their best for the final goodbye

Best Visual Effects: the burn specialists and plastic surgeons who reconstruct the facial features of a firefighter or war veteran after severe burns

Best Sound Mixing: the audiologists and manufacturers of hearing devices that help us to listen and attend to the sounds around us

Best Film Editing: the skilled surgeons who remove the bad parts and recreate our inward parts so that our life picture is the best it can be
Best Original Song: the one sung by the double lung transplant survivors, like Charity Tillman-Dick, and made possible by the lung transplant team

I wish that we gave such awards to the people who make a real difference in the lives of so many. There are hundreds of unsung heroes of healthcare who influence our world but go unnoticed. When you come across one, won’t you tell them how much they are valued and appreciated? They may never win an Oscar, but without them we couldn’t shine.

Background

This type of cancer occurs mainly in older adults, with an average age at diagnosis of 73 years, with 9 out of 10 cases of bladder cancer diagnosed in persons over age 55. The American Cancer Society (ACS)(2012) reported that over 73,000 cases were diagnosed in 2012 and that this diagnosis rate has been relatively stable over the last 20 years. Men are three times as likely to get cancer of the bladder as women (American Foundation for Urologic Disease, 2008) and the incidence increases with age.

Risk Factors

Risk factors include chronic bladder irritation and cigarette smoking, the latter contributing to over half of cases. Male gender and age are also risk factors.

Warning signs

The classic symptom of bladder cancer is painless hematuria (blood in the urine). Older adults may attribute the bleeding to hemorrhoids or other causes and feel that because there is no pain, it must not be serious.

Diagnosis

Assessment begins with a thorough history and physical. Diagnosis may involve several tests including an intravenous pyelogram (IVP), urinalysis, and cystoscopy (in which the physician visualizes the bladder structures through a flexible fiber-optic scope). This is a highly treatable type of cancer when caught early. In fact, the ACS (2012a ) estimates that there were more than 500,000 survivors of this cancer in 2012.

Treatment

Once diagnosed, treatment depends on the invasiveness of the cancer. Treatments for bladder cancer include surgery, radiation therapy, immunotherapy, and chemotherapy (ACS, 2012). Specifically, a transurethral resection (TUR) may involve burning superficial lesions through a scope. Bladder cancer may be slow to spread, and less invasive treatments may continue for years before the cancer becomes invasive or metastatic, if ever. Certainly chemotherapy, radiation, and immune (biological) therapy are other treatment options, depending on the extent of the cancer.

Immune/biological therapy includes Bacillus Calmette-Guérin (BCG) wash, an immune stimulant that triggers the body to inhibit tumor growth. BCG treatment can also be done after TUR to inhibit cancer cells from re-growing. Treatments are administered by a physician directly into the bladder through a catheter for 2 hours once per week for 6 or more weeks (Mayo Clinic, 2012a). The patient may be asked to lay on his/her stomach, back, and or sides throughout the procedure. The patient should drink plenty of fluids after the procedure and be sure to empty the bladder frequently. In addition, because the BCG contains live bacteria, the patient should be taught that any urine passed in the first six 6 hours after treatment needs to be treated with bleach: One cup of undiluted bleach should be placed into the toilet with the urine and allowed to sit for 15 minutes before flushing (Mayo Clinic, 2012a).

If the cancer begins to invade the bladder muscle, then removal of the bladder (cystectomy) is indicated to prevent the cancer from spreading. Additional diagnostic tests will be performed if this is suspected, including CT scan or MRI. Chemotherapy and/or radiation may be used in combination with surgery. When the cancerous bladder is removed, the person will have a urostomy, a stoma from which urine drains into a collection bag on the outside of the body, much like a colostomy does. Bleeding and infection are two major complications after surgery, regardless of type, whether a TUR or cystectomy is performed. Significant education of the patient related to intake/output, ostomy care, appliances, and the like is also indicated.

Adapted from Mauk, K. L., Hanson, P., & Hain, D. (2014). Review of the management of common illnesses, diseases, or health conditions. In K. L.
Mauk’s (Ed.) Gerontological Nursing: Competencies for Care. Sudbury, MA: Jones and Bartlett Publishers. Used with permission.

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Caregiver neglect is a form of abuse that may not be intentional, but still can have long-lasting effects on a person. Like abuse, neglect can cause a plethora of physical problems, especially if the person is not receiving necessary medical attention. Neglect also can create emotional and psychological issues, changing the way they view themselves and others around them. Some of the more surprising ways caregiver neglect could cause harm include:

1. Self Neglect or Harm

When a caregiver fails to care for a person properly, persons who need assistance may begin neglecting themselves. TheNationalAdultProtectiveServicesAssociation defines self-neglect as “an adult’s inability, due to physical or mental impairment or diminished capacity, to perform essential self-care….” If no one is assisting in daily tasks, this could mean living in unclean quarters, compulsive hoarding, poor personal hygiene or wearing unsanitary clothing.

Self-neglect also could include not caring for themselves physically, like refusing to take medications or poorly managing prescriptions. Some cases of self-neglect include failing to eat or eating poorly where they do not receive the proper nutrition. Signs of this type of self-neglect could include lack of adequate food in the home, dehydration or malnutrition.

2. Lack of Trust for Others and Emotional Stress

Neglect from a caregiver, especially a family member, can lead to severe distrust, anxiety and isolation. The elderly person could become disconnected from others. If an elderly person who already suffers from mental health issues is neglected, the lack of trust and other psychological damage could be much worse.

The emotional and psychological abuse that can develop could cause an immediate impact on a person’s mental state, and it can develop into long-term physical and emotional problems. Victims of neglect have had significantly higher levels of psychological distress and lower perceived self-efficacy than older adults who have not been victimized, according to theNationalCenteronElderAbuse.

3. Financial Strain and Irresponsibility

If a caregiver is responsible for managing a person’s finances but neglects those duties, this could lead to months or even years of financial strain. For example, if the caregiver neglects to pay the person’s rent or mortgage in a timely manner, he or she could be without a home. If the utilities are not paid, the person could be forced to temporarily live without power. If the caregiver fails to pay for home care services or medication, it also could be damaging.

4. Wrongful or Accidental Death

Accidental or wrongful death can be caused by some of the most extreme types of neglect, as well as abandonment. If a person is unable to feed themselves, get the medical help they need or maintain a safe and clean home, it could have a tragic ending. Additionally, unexplained injuries and accidents can happen in nursing homes when patients are neglected or when people who live at home are neglected. If these injuries aren’t treated, they could lead to death. Neglect is also often a precursor to emotional and physical abuse.

About the Author

Sarah Blanchard is the marketing manager for Winburn Bequette and Odom Law Firm, two personal injury and nursinghomeabuselawfirms dedicated to representing victims of nursing home abuse in Arkansas. Connect with her on GooglePlus andYouTube.