IT'S RAINING AGAIN AND THE DOGS HAVE TO GO OUT

I’ve never seen such rain as the winter I was in Portland with Wayne.  Nineteen ninety-six was one year that Portland was plagued with flooding and mud slides.  What a mess.  By the time I went home, I had webs between my toes.  When spring came, the rain continued but the beautiful flowers began to bloom and the city became lovely, with flowers everywhere.  Maybe it was worth all the rain to see such beauty.  I missed the tulips that were springing up in my front yard in Hermiston.  I was eager to get home to our house, where we could get things back to normal again.  At least I hoped it would be normal again.

     It’s a good thing I carry two umbrellas around in the car.  We don’t need umbrellas in the Eastern side of the state.  Eastern Oregon doesn’t get much rain, we have mostly sunshine year round.  As I looked out at the rain, I realized how lucky we were to be in a nice apartment and together.  I was alone for so long that even all the problems seemed better than being alone.

     I lost myself in my writing, and for a change of pace, I would bake cookies and give them to all the neighbors and the hospital staff.  I love to make cookies and it helped to calm me when things got really bad.  The smell of the cookies baking seemed to help Wayne too.  He would remark on how good it smelled.

     We did have a problem with the dogs during the rainy times---they didn’t want to go out in the rain to do their business.  You should have see Mother in her slippers and robe, holding an umbrella over the dog, while she got wet, just so he would do his business.  It was a funny sight, but she would do anything for her little poodle.

     You should have seen me trying to hold an umbrella over Wayne while pushing the wheelchair up the hill to the hospital.  I tried to have him hold it but he would drop it every time.  So, we both just got wet.  I will say one good thing about all that moisture, though.  My skin stayed dewy fresh all the while we were in Portland.  It was so smooth and soft, it was almost worth the rain.

     Our dog Maynard died while we were in Portland.  One morning he woke up but he couldn’t stand; his back had given out on him.  He was a miniature dachshund, and that breed seems to have problems with their backs as they get older.  It happened to our other dog last year, as well.  It was a sad day when I had to have him put down.  I cried all the way home from the vet.  I missed him so much!

     Pets are wonderful companions to the elderly.  They give their owners unconditional love, and caring for a pet gives the older person a reason to stay well.  The simple act of petting a cat or dog can actually lower a patient’s blood pressure.  Sounds crazy, but it works.

     If your patient is agitated, give him the dog or cat and let him stroke the animal---you will see a marked difference immediately.  Researchers have given animals to mentally challenged patients and observed the calming affect that the love of an animal brings to the patient.  A patient rocking or banging on the table will suddenly become quiet when handed an animal to love.  Amazing!  Very good therapy.

     There are volunteer groups that bring animals to nursing homes so the residents can spend time with their favorite animal, since they are unable to keep one on the premises.  The residents really look forward to the visits.  You can see the big smiles that appear when they know it is visiting day for the animals.  The anticipation perks them up, their energy level rises and they are far happier.  When you place a kitten or puppy in the lap of the elderly person, they cuddle the animal like a baby and the animal responds with lots of licking and cuddling.  After the animals have gone, the patients glow with love for days and look forward to the next visit.

     Older people take better care of themselves when they have a pet to care for.  They know that their dog or cat depends on them for everything.  Studies have shown that pet owners live longer and are happier people with someone to love.  I know that my mother was much happier with her little dog to care for.

         THOUGHT FOR THE DAY

Happiness is something that comes from within.  It is 

our choice to be sad or happy each day.

Happy is always better

     

KEEP YOUR LOVED ONE BUSY

Keeping your patient alert and involved can make the difference between whether the patient is healthy or depressed.  Research proves that if we give the elderly challenging intellectual activities it will slow the death of brain cells and help them stay in good mental health through their seventies and eighties.  Busy hands are happy hands, as Mother used to say.

     There are so many projects that can deep the intellectual stimulation going.  Listening to books on tape or taking night classes in an interesting subject will help.  There are book clubs that keep their members challenged by discussions of new books on the market.  Genealogy is a fascinating subject, and tracing the lineage of one’s family history is quite a challenge.  Volunteering time to a political campaign definitely can keep a person very busy and challenged.

     Does your patient love to dance?  There are dances at the senior citizens club and trips to other clubs for dancing.  If they love to work in the garden, that is a wonderful pastime.  Working out at a gym and swimming are great exercise and good relaxation techniques.  If your loved one has always been an outdoors person, a fishing trip would be a great way of getting exercise and having a good time.

     There is so much to do in the community that you shouldn’t have trouble finding something that will challenge your patient or loved one.  The main thing is stay as active as possible.  Staying busy will help your loved one stay positive and healthy.  When the time comes when they are not able to be active anymore, then they can find projects to do at home.

     People who are well groomed have a more positive outlook on their condition.  It is important for a woman to have an easy hairstyle and for a man to be shaved and neatly groomed each day.  Whatever clothing your patient prefers, from jogging outfits to comfortable sports clothing, it is their choice of how they should dress.  Just beware of letting them stay in a bathrobe all day.  This is the prelude to depression.

     Help them to stay happy, stay healthy, and stay busy.  You will find that your patient is much more satisfied with life if they are busy.

     

MORE COMMUNICATIONS

     Memories can be sparked by pictures, as well.  Get out the old picture album and ask about a few of the pictures, then sit back and enjoy the stories.  They love telling them and you may find out things about your loved one that you didn’t know.  If you have a tape recorder, this is the time to bring it out.  You could record their past adventures for posterity and make them happy by remembering old times.  There is nothing quite like reminiscing.  Memories that have been locked away can be brought out to be enjoyed again.

     If your patient enjoys playing cards or assembling a picture puzzle, this can fill many hours, and if the children pitch in to help, it makes a wonderful time for young and old alike.  Even a game of Go Fish with the grandchildren will bring a smile to the face of your patient.

     It doesn’t take much to please your loved one.  They just need to feel they are part of the family and not someone to shut in a room and forget.

     If my mother-in-law had been able to pursue an outside interest, she would have been happier.  

     As her condition became worse, she needed more help than we could give her.  We placed her in a local nursing home, close to us, where she spent her last eight months.  She was reduced to skin and bones at the end, because it took too much energy to eat.  She would try, but she couldn’t get enough oxygen and her energy level was extremely low.  She lapsed into a coma and died with her son holding her hand.  She was finally free from pain.

     The caregiver requires contract with others outside the house as much as the mother or father she is caring for.  Communication with friends, with other caregivers, with new people, is the leavening necessary to keep the human spirit rising.  Close confinement with those whose care is your responsibility, without refreshing breaks, inevitably leads to smoldering resentment and anger.  

     

THE LAST OF COMMUNICATION

     Handicrafts are a way of filling the time of your patient.  If your loved one is good with the crochet hook or knitting needles, they can make wonderful Christmas gifts for the family.  A gift made especially for you is a gift that will be treasured long after your loved one is gone.

     Crafts and crossword puzzles are a good way of keeping busy and exercising the mind as well.  It is important to keep the mind active.  Anyone can do crafts, even if they are confined to bed.  There are tables that are made just for that purpose.  They have wheels, so you can push them anywhere, and they are cut out to fit under the bed and over the lap of the patient, just like the ones used in hospitals.  They are so handy for crafts and writing letters or reading.  Of course, when you are encouraging your loved one to do a craft project.  It is nice if you pitch in and help, or at least work alongside them.  No one likes to do things alone.

     My mother used to crochet lap robes for the nursing home.  She enjoyed making them and the residents enjoyed receiving them.  I would take them to the home and the residents who were able would write, would than send notes to Mom.  She was so pleased to receive them and it made her work a little faster on more of them.  She knew that it meant a lot to receive a gift, even from a stranger.  Many of the nursing home residents outlive their families and have no one.  Mom made enough lap robes for all the residents of the assisted living home and was working on finishing up the nursing home.  She felt useful, even when she couldn’t get out anymore.  It meant a lot to her to stay busy and productive.

     If your loved one is mobile, they might like to try volunteering at the local hospital.  They can work in the gift ship, greet visitors, read to patients, or bring books and magazines to the patients.

     Wouldn’t it be good for your loved one to talk with an old friend, someone that hasn’t been heard from in years?  Talk to your loved one about her friends and get the name of one, then call that person and give her the phone number.  It may take a little time to find the person, but it will brighten your her day and keep a smile on her face for some time to come.  There is nothing like a phone call from an old friend to bring back happy memories.

     Let the person know when he or she will have visitors.  This will allow your loved one the pleasure of anticipation.  Looking forward to a visitor is not only wonderful, but it gives the patient the opportunity to spruce up the room and to put on their best dress too.  If you set up a schedule of visitors, it will also allow you to set the time and length of each visit.  It makes it easier on you and your loved one.

     

Continuation of Communication

We all need friends, someone that we can talk with, someone with whom we can share our innermost thoughts.  You and I see our friends daily, but when a shut-in is cut off from their friends, it makes life rather lonely and meaningless.  It can lead to depression and self-pity.  Encourage family and friends to visit on a regular basis and you will see a marked difference in the attitude of your patient.

     Cards and letters are good, but it’s important to stay in touch with the outside world.  This can be accomplished by taking the patient out to lunch, to the senior citizen center, to church, shopping or to some community function.  If they can’ walk that far, use a wheelchair.  Even a trip to the grocery store can lift the spirits of a shut-in.

     If they are mobile, encourage them to take part in community activities.  Volunteering part of their time can help them stay in touch.  It may also lead to a larger circle of friends.  Feeling useful is the key to staying happy.  We can’t make our loved ones happy---that comes from within---but  we can help them on the road to happiness by keeping them busy.

     A good way to keep in touch and enjoy is through community functions:  craft shows, art exhibits, plays, concerts, and sales.  Everyone loves to go to a sale, even when they don’t need anything.  If your patient enjoys yard sales, it will excite them to spend a day visiting the local ones.

     The senior citizen center in your town is a wonderful place to look for things to do.  They will have a daily activity list.  Seniors at the center keep busy with trips, volunteering, Meals on Wheels, and just visiting with housebound seniors.  They have buses that will pick seniors up and take them to the center for lunch or any of their functions.  They have volunteers that will take seniors to the doctor, to the dentist, or shopping.  One need never feel alone when the senior citizen center is full of friendly people waiting to help.  A special event on the center calendar is dancing.  Center members visit with neighboring senior centers, for dances, potlucks, or shows.  Some even take trips to Reno or Las Vegas to have a weekend of shows and gambling.  A senior need never be housebound unless they are too ill to go out.  The other seniors at the center will keep them busy, as busy as they went to be.

     

COMMUNICATIONS

COMMUNCATION

     Mail is an important link to the outside world for a shut-in.  Letters mean a lot to someone who is housebound.  If you’ve ever been hospitalized or ill, remember how important cards were to you.  Imagine how small the world seems if you were shut in the house with no one to talk to but your family and you seldom saw anyone else.  Pretty lonesome.  That’s when cards and calls from family and friends are really important.

     With this in mind, I called some of my mother-in-law’s relatives, asking that they send cards or letters on a regular basis.  When the mail began to arrive, she perked up like she had won a million dollars.  I realized how lonely she really was.

     We went to work each day and had the opportunity to see and talk with other people, but she saw very few people.  Some of her friends came by to see her, but it wasn’t long before they stopped.

     My mother and father lived next door by now, and Mom would come over each day for coffee, to spend a little time crocheting and talking with my mother-in-law.  It was great for both of them, since they enjoyed each other’s company.  Our parents had been friends for a long time, even before Wayne and I met.  When my mother started coming over every day, his mother became much easier to handle.  She had something to look forward to.  It is a little thing, having a visitor, but when you are lonely and ill it means the world to you.  It is a link to the outside world, a world that you don’t get to see except through the window.

CONTINUATION OF CHAPTER ON EATING

   If your patient can’t come to the dinner table and must eat in bed from a tray, be sure to brighten up the tray with a pretty place mat or a flower in a small vase.  Bright colors help to cheer the patient and soft music can also soothe them and make mealtime more pleasant.

     If they don’t eat much at mealtime, provide some nutritious snacks such as fruit, cheese, raw vegetables, juices, or just bread and butter, to help supply needed nutrition.  Sometimes smaller meals are more suitable for a poor appetite.  Four or five small portions each day will be handled better than three large ones.  A large portion is overwhelming to a person who doesn’t feel well and it’s also hard to gauge how much they’ve eaten.  Most likely their doctor will want to know how much the patient eats, in case there needs to be supplemental feeding.  If you do need supplements, there are many canned supplements on the market.

     Remember that if the patient had a small appetite before their illness, you can’t expect them to have a large appetite now.  They may be accustomed to only a cup of coffee in the morning.  If you feed them a big breakfast, you will be wasting a lot of food.  You can try adding a little more each day until they eat a more balanced meal.  But it takes time...don’t hurry.

     If the patient cannot chew easily, be sure to cut their food into bite-sized pieces.  If the patient is low on energy, you may have to serve soft foods for awhile.  If you need to thicken everything for easy swallowing, use gelatin to thicken cold drinks and potato flakes for hot foods.

     Sometimes the patient has a problem swallowing, or dysphagia.  This condition can cause all sorts of eating problems.  There are two types of dysphagia.

     Paralytic dysphagia results from damage to the lower motor system originating in the brain stem.  The swallowing reflex may be diminished or absent and the muscles for swallowing paralyzed, which leads to the high risk of aspiration.  Aspiration refers to breathing in food and drink.  People that have difficulty swallowing are at high risk of aspiration and consequent choking.

     The other type of dysphagia is pseudobulbar dysphagia.  This is a result of damage to the intellectual centers of the brain and the upper motor systems of the brain.  In this condition, the swallowing reflex is not paralyzed, but the supporting muscles may be weak or uncoordinated, which also can lead to aspiration.

     If the patient can swallow liquids, there are supplements available that can increase their caloric intake.  Ask their doctor about specific supplements before you use them.  He may have other methods of treating the condition.  He might also suggest diet restrictions.

     If your patient needs to increase their fluid intake and calories, mix a can of supplement with fruit, ice cream, or yogurt, then blend it for a delicious milkshake.  You can substitute frozen cola, fruit ice, popsicles, or slushy drinks for different flavors.  But, whatever products and foods you use, clear them with their doctor first.

     Keep track of how much food is eaten and how much liquid the patient drinks.  The doctor will ask, so keep good records.

         

REMEMBER

                  

                                            Watch for a poor appetite.

                                            Join the patient at mealtimes.

                                            Keep an antacid on hand for heartburn.

                                            Serve a balanced diet.

                                            Watch for trouble swallowing

                                            Keep good records for the doctor.

                                            Serve nutritious snacks in between meals.

FOR THE CAREGIVER

    

     Give someone a hug each day.  Personal contact makes us feel warm and comfortable.