Waiting for God

Defining Community of Care

A community of care is the group of people who take part in caring for a dependent senior.  It includes family and friends who get groceries, help pay bills, oversee medicine and medical procedures as well as paid resources such as personal support workers (PSW).  It is generally the responsibility of one or two persons to coordinate across several parties to ensure the dependent senior’s care needs are met.

Role of alternate decision maker

In many places, it is the Power of Attorney (or Mandate in Quebec) who is responsible for ensuring the needs of a dependent senior are met.  Powers of attorney have the legal right to make decisions for finances and personal care.  Most of the care needs fall on that person.

It would be nice if all families were built on a spirit of support, sadly many family members are absent when they are needed the most.  They live too far, they are too busy to take on more responsibility, or there is a family issue that prevents them from taking part.  Getting as much help as possible from family and friends can greatly reduce the cost of care, as good care is expensive.  SeniorSynCare can help with this.  Click here to sign up.

 

Senior dependent needs and available resources to fill them  

There are several tasks that some seniors can no longer do for themselves.  Below is a list that highlights needs and who can offer the service (See Matrix).  This list also shows the numerous roles that must be coordinated.  SeniorSynCare can help with that.  Click here to sign up.

Who does what?  Scroll down for an overview of the needs.

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    • Sleep
        • Personal Support Workers
        • Family members
        • Companions
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    • Nutrition
        • Dietician
        • Mouth and throat specialist for swallowing
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    • Medical
        • Palliative Nurse
        • Family doctor
Physical Activity and Mobility

This is usually the largest challenge for dependent seniors.  The aging process has removed much of their tactile capabilities, and the body is not as flexible as it once was.

Physical activity is still important as you transition to death. The ease at which one can be transported to and from medical appointments is quite dependent on the ease at which one can move their bodies. Click here for an overview of recommended exercise for dependant seniors. 

Assisted living facilities can be helpful for people with limited mobility.  The more limited the mobility the larger the need for many daily tasks such as bathing, eating, using the toilet, etc.

Consider the following as potential additions to the community of care

    • Personal Support Workers help with personal hygiene, exercise, and general mobility
        • Additional support is often required in assisted living facilities.
        • These services are tax deductible in some jurisdictions
    • Occupational therapists can evaluate a person’s individual mobility needs and make recommendations to improve daily quality of life.
        • Check to see if you can get one covered by health insurance or a government program
      •  

As we age, our requirements for exercise change.  That does not make exercise less important.  It is imperative for seniors to remain as active as possible WITHOUT overexerting oneself.    Exercise increases the length of time one can stay independent allowing mobility for things we take for granted when we are younger.    Before starting any fitness regime, it is good to check with your physician to determine any potential limitations.

Mental Stimulation and Human Connection

Like our bodies, our minds require stimulation to stay fit. Mental stimulation has a positive impact on overall health and well-being. Click here for information on the aging brain.

There are many ways to stimulate the mind and improve cognitive skills.  Individual needs and interests vary, and improvement is dependent on several factors.  However, there are several ways that one can keep the mind occupied.

    • Keep dependent seniors stay connected with family and friends
        • The best way to stay mentally agile and healthy is to engage in conversation it is also essential for mental health
        • Email, texting and video conferencing is excellent if they are comfortable with the technology, otherwise it should be avoided as it causes more stress than comfort
    • Listen to music with them
        • Music helps with cognition and can help with memory recall (if listening to a song with emotional significance).
        • Purposefully listening to music lyrics and processing them helps the mind stay active
    • Engage dependent seniors in recall testing activities
        • Play memory games together
        • Talk about current affairs, or ask them to recall events and share them with you
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    • Do puzzles and play board games when you are together if possible.

Consider additional support through companions.  Companions can be either paid or volunteer positions.  These people can come for a few hours per week to visit and engage in social activities, like the ones above, together.

Sleep

A good night’s sleep is important to maintain a high quality of life.  This is true even as we approach the end of life.  Aches, pains, memory, lucidity, and general mood are enhanced when the body and mind are well rested.

Personal support workers can help put your senior to bed.  If a senior does not get up in the night, this is a safe way to end the day as no additional support will be needed.  If the senior lives with a family member, the family member can put the senior to sleep.

 

One of the signs of the body shutting down in an increase in the amount of sleep.

Seniors often do not sleep well and wake up throughout the night.  If a dependent senior has dementia and is prone to wondering, this can be problematic, and may mean that the person will need assisted living or to be supervised 24-7.

For those who do wake up, make sure their environment is safe.

Tips include: 

    • Reducing hazards
      • Remove trip hazards, such as area rugs, cords, small furniture
      • Walkers may also pose a hazard depending on person’s lucidity at night

 

    • Keep a phone by the bed
      • Some seniors have a button (such as LifeLine), but they do not always think to use it

 

    • Keep lights handy
      • Lights with motion sensors in the hallway and bathroom
      • Voice activated lights if comfortable with technology
  •  
    • If necessary, get a commode (make sure it is not a trip hazard)
     

The following may be helpful to keep dependent seniors asleep through the night.

    • Avoid naps during the day, particularly in the late afternoon or evening
     
    • Avoid sleep disturbing substances within 4 hours of bedtime:
      • Alcohol (some people have a high tolerance to alcohol and it does not affect their sleep negatively – this is particularly true for those to have consumed alcohol regularly throughout their lives)
      • Tobacco
      • Caffeine
      • Large meals (note that light snacks may be helpful to keep your blood sugar consistent throughout the night)
       
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    • Consistent and regular bedtime routine
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    • Going to bed and waking up at the same time everyday
     
    • Doing relaxing activities before bed (such as reading, stretching, meditation, taking a bath, etc.
     

Exercise

    • People who exercise experience superior sleep (longer, deeper and easier to attain)
      • Do not exercise within 3 hours of bedtime
       

Reduce distractions

    • Eliminate televisions, cellphones, tablets and bright lights
     
    • Keep your room dark, quiet and cool
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Click here for more information related to sleep in the elderly.
Nutrition

Eating right is just as important as you grow old as it is when you grow up.  You are what you eat.   What we eat not only touches are taste buds, but also our digestive tracks (absorption, digestion, and eventual excretion).  Seniors tend to have more trouble with their digestion leading to inadequate nutrition intake, which can lead to deficiency related diseases.  We need fewer calories, but more nutrients.

A dietician can assess the types of food that would be best for the dependent senior.  Whereas a mouth and throat specialist can assess their ability to chew and swallow.

Genes express differently as we age affecting how our systems absorb food. The older we get, the less stomach acid we produce and this can lead to poor absorption of key nutrients (B12, iron, calcium and magnesium).

Almost all dependent seniors have the following issues with food:

    • Trouble with digestion and absorption of food
    • Lower intake of nutrient rich foods due to oral health, inability to chew, mouth dryness and decreased appetite.

Studies show that many seniors decrease their intake of healthy foods, such as fruits and vegetables and increase their intake of carbohydrates and sweets.  This causes a diet that is low in antioxidants, which can increase the aging process. 

 

Food must be enjoyable and cost effective.  Sharing meals with friends and families can be a great support and increase the positive association with eating.  It is also good to experiment with different foods and food groups.  Diversity of food choices leads to a healthy diet, but they must be easy to chew and swallow.  As we get older our swallowing reflexes decline.
 
Consulting a dietician might be a good idea to make sure that the intake of food is not only healthy, but easy to chew and swallow.  
 

Click here for the necessary nutrients, and which foods provide them.

For more information go to:

https://behavioralnutrition.org/aging-and-nutrition/

https://www.healthline.com/nutrition/nutritional-needs-and-aging#You-May-Benefit-From-More-Fiber

https://health.gov/news/202107/nutrition-we-age-healthy-eating-dietary-guidelines

Medical

At end of life most medical interactions are to enhance quality of life.  Needles, change bandages, assess overall health metrics like blood pressure and oxygen levels.   A general practitioner or a family doctor will be part of the process of assessing what small treatments will improve quality of life, such as antibiotics for pneumonia.

Make sure you have a good relationship with your dependent senior’s family doctor and that you have access to their medical files.  This will help if there are frequent trips to the hospital, and also if there are regular treatments at the doctor’s office.

As seniors lose mobility, it gets more and more difficult to get them to appointments without assistance.  If their lucidity is fading, they will also need to attend these appointments with an alternative decision maker.

Check with your health insurance to see if a palliative nurse is covered.  Many make house calls, and can be a great link between you and the health care system.  They will work with the family doctor for proactive care that will minimize physical discomfort through the last years of life.

Emotional/Spiritual

Dependent seniors are emotionally fragile.  They are more sensitive to issues of life after death and the meaning of a life well lived.  They have much wisdom to share with us if we are willing to slow down and listen.

As we near death, we tend to look toward what comes after death.  Death doulas and spiritual leaders can work with the community of care and act as a bridge between the senior and their network of friends and family.

Click here to get more information on the spiritual needs of those nearing end of life.