Frequent Issues with Aging & Solutions in Home Healthcare

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[Harrison] Good morning, Ms. Joan.

[Joan] Good morning, Harrison.

[Harrison] So, this morning I want to talk about the consistent themes that seem to pop up all the time with these regular issues and how to potentially avoid them: the common challenges that residents or clients face that seem to be recurring, how can we prevent those?

It could be UTIs, falls, lack of hydration. There are a number of things that happen, but what are some of the most common things that you see happen over and over again with our aging loved ones? And what are some steps that we can take to proactively prevent those things from happening?

What to Expect with Normal Aging

[Joan] Okay, one thing that I always want to start with is to know what is normal aging and also what is normal for your loved one. We know things like all the senses decline with age. So the eyesight, the hearing, the so on. Does your mother, father, aunt, whatever it is, have they had an exam to determine do they need a hearing aid? So many old people avoid hearing aids because that’s a sign of old age.

And we know for a fact that if people go for a long time needing hearing aids, they lose permanently that part of their senses. So making sure that they, they have an exam. Do they need glasses? Those things. The muscle loss can contribute to falls, but 1 thing I see with a lot of older people that families can look at is fall risk.

Fall Risk & Factors

1st of all, how stable are they? I see a lot of older people that we’re we’re these big scuffies slippers and they’re very unsafe. We can slide out of them and fall. Area rugs! Get rid of the area rugs. Those are the number one places where people fall, even in the bathrooms where they have those rugs.

Just looking at what is safe so that can reduce falls. Looking at furniture placement, pieces of furniture, even though they’ve been there for the last 60 years, that might impede somebody getting to and from a room safely. And keeping in mind that if they have some dementia, 1 of the things I always teach about people with dementia is they lose peripheral vision.

And so if you were to go like this, this is how they see. So you can say, why did mom hit that table when she’s just walking across the room? It’s because she doesn’t get that that table is in the way. So looking very carefully at how is the room laid out? How safe is it? Have you removed any obstacles that could become a fall risk?

How stable is your relative? Do they need a cane or a walker? If they do, will they use it? It’s no good to lock it in the corner and then they fall because they haven’t gone. But how can you work with them to understand that it is a precaution to use that rather than say, oh, “I don’t want anybody to see me with this this walker or this cane.

Hydration & UTIs for Elderly People

Um, Hydration is so important. UTIs – the primary source of UTIs is dehydration. And a lot of older people simply don’t like to drink water. They deny that they don’t like to drink. I had a neighbor, next door neighbor actually, who collapsed and fell and it turned out she had, among other things, some dehydration.

And her husband said, “That’s crazy, she has a bottle of water in her hand all the time”. Yeah, but she doesn’t drink it. She carries it around, doesn’t drink it. In a lot of the communities that I’ve worked in, assisted living or skilled or whatever, we try to put like cucumber water hydration stations so obvious that people will drink it.

Sometimes the staff will kid people at breakfast, “no you can’t have your coffee until you drink this glass of water first”, even though they can’t, they can’t legally do that. But just making sure that people have hydration.

Social Interaction & Context for Seniors

Social context. One of the major factors of health and wellness is social context.

That’s one of the real issues for people. And I’m sure you see that a lot. If they no longer can drive and they don’t have people that can take them to things and they don’t have some friendly next door neighbors who drop in, How do they get that socialization? And how do they have a feeling of being needed and having some friends?

Can you do it on zoom? Can you get them? Can you set up a time with if they know how to use it that with some friends that they can talk so that they can socialize with people, even if they’ve always been somewhat of a loner still just having social contacts is really important. I remember my mother in law, when she got very old, she said, one of the hardest things of getting old is losing your friends and the more friends she would lose, the harder that was. And then how do you make new friends? Particularly if you’re restricted from getting out, if you’ve always gone to church and suddenly you can’t get to church. There are some churches now that are reaching out and providing car transportation for people to get to them, having a friendly neighbor, pick them up and take them to, to that, or if there’s a local adult day program, where you can go at least once a week to, to socialize with people.

Medication Management for Seniors

Medication is so problematic. I have a 96 year old friend that has one of these Monday, Tuesday, Wednesday, Thursday. And she, for a long time, been really good at making sure she had it, but she went through a period of where she had a UTI, got a little confused, got a little, and so she would just empty the pills out and put them back in and she wasn’t taking anything the way she should and by the time her family realized it, she had to go to the hospital.

So what are some things that your loved one can take? Can you fill up fill the pills up and when you go to visit, can you just look and make sure that there if there’s supposed to be two in that Monday slot? Are there still two in that Monday slot? And if not, then you need to have either you or if you have an agency like yours take over the medication management because that’s one of the biggest things that can throw somebody so far off and they literally can die if they don’t take them properly. But luckily, there are a lot of these little tools that you can use as long as your family member will allow you to set them up, or if they can do it themselves, but then follow through and take it.

And if they know that they always have a blue pill, but suddenly they don’t seem to have any more blue pills. What happened to them? How do you help them realize that they need to get some help.

Osteoporosis & Muscle Mass Loss

One of the things that happens, people lose muscle mass. If they have things like osteoporosis, for example, we don’t know sometimes whether they fall and break a hip or the hip fractures automatically.

So that’s one of the issues with older people to make sure: have they been checked for osteoporosis? How stable are they? And that’s another reason why you want to make sure if they really need that walker or that cane, that they’re using it and they’re not going to trip over a table. But if they do have very weak, porous bones, then that’s another reason to be extra, extra cautious of how they move around and what kind of safety measures you put nearby.

Now, how one of the biggest times people fall is going to the bathroom. And especially if they have urgency, which a lot of people, as they get older do, they have to go and they have to go now and the bathroom is not right next door. So, sometimes you have to resort if they really literally can’t at 2 o’clock in the morning. Safely get from their bed to the commode. Are they willing to put up with having a bedside commode just for the night so that they are safe and can get to the bathroom without falling?

Bathroom Falls

Because that’s probably the number 1 way. People fall. Safety in the bathroom is hard. Surfaces are hard. The floor is usually tile. There’s corners on the sink. They don’t have safety rails in their tub or shower area, and you can’t afford to have somebody come in and put them in. They do make stuff that you can buy at Home Depot and Home Goods that are Rails or bars that you can actually attach pretty safely into a shower stall so that somebody can more easily get in and out or put it next to the toilet, so that when they get up off the toilet, put in an elevated toilet seat. So they don’t have to go down so far. You can buy all those things just. You know, over the counter, and there are safety measures for people.

Food and Mold

So, just as a family member, knowing what’s normal for your mom or dad, seeing where they are, looking at the house from a real safety standpoint, take a walk through look around look in the refrigerator.

What’s in there has it been there and it’s moldy. Is there nothing in there? Sometimes you don’t even think about that. And then all of a sudden you realize that what they can’t even eat or shouldn’t eat what’s in there. So, making sure that you’ve checked all of those kinds of a, what we call activities of daily living the things that people need to do every day.

And certainly when your Atlanta home care agency comes in, they do that assessment. They check all those things out. And that’s one of the safety things for a family member to know that there’s somebody else there. If I can’t get over to mom’s house, or I live out of state, who’s checking that stuff out? Because mom may not realize that she hasn’t been to the grocery store or that the cottage cheese has been there for a month and she just didn’t feel right. Just checking all of those things that people need to function from a day to day basis.

[Harrison] Well, it can be super helpful for an agency like ours to help the family monitor those changes. The family knows their loved one the best.

And for us, we want to come in and understand what that baseline is. What’s normal? And then also keep the family posted as things change, because you’re right. So much of the common problems have really easy solutions. It’s just a matter of staying intentional and staying engaged. So thank you so much for all this detail and these tips.

I think this will be really helpful. So thank you so much, Ms. Joan.

[Joan] You’re welcome. You take care. Bye!