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Meal preparation and Consultant Dietitian Services

Homecare Together offer help with Meal preparation, when you are finding this difficult yourself. A good diet is even more important as we age and Homecare Together can also help with menu planning and shopping. Our carers understand the type of food you like to eat and we prepare a nutritional support plan for every client. This includes everything you like to eat and also your dislikes and/or special dietary requirements. Homecare Together use the services of a Consultant Dietitian who can advise you at home and also help with meal planning. She can visit you at home or our carers can bring you to her clinic. At Homecare Together we pride ourselves on a bespoke service, which fits around you. So for further advice please call us on 01-534-7674.IMG_0324

 

Convalescence care after orthopaedic surgery

Convalescence care after orthopaedic surgery – how can Homecare Together help?

As we age, many people suffer significant issues, with bones and joints.

The main joints that can give us problems are our hips and knees. The main issues which cause these problems are osteoarthritis, rheumatoid arthritis or an injury such as a fall. Most hip replacements happen between the ages of 60 and 80 years of age.

Having orthopaedic surgery to replace a hip or knee should help to:

Relieve pain, improve function, improve mobility and in turn improve your quality of life.

Recovery

After a hip replacement:

For the first four to six weeks you will need a walking aid which is usually crutches. You may also require an exercise programme designed to you regain and improve the use of your new hip. Most people can get back to full normal activity within two to three months but it can take up to a year to feel the full benefit.

After a knee replacement:

For the initial period you will have a walking aid, which may be a walking frame or crutches. You will need to follow an exercise plan given to you by your Physiotherapist and this will reduce the risk of complications, such as knee stiffness. It might take a few months to get fully back to normal.

Homecare Together Convalescence Packages

Most people will require a period of convalescence after any orthopaedic surgery. Homecare Together can organise convalescence in the comfort of your own home. Our carers can help with all your activities of daily living, including personal care, but also shopping and preparing meals. We can help with any activities you might find difficult, especially during the time when you are using crutches. Our Physiotherapy partners, will liaise with your hospital team and assess you once you get home. They can visit as often as necessary, to get your exercise plan started at home and get you fully back on your feet. Our care staff can assist you with this programme. For more information about this service, contact us before your surgery and we will put your plan in place. The recovery post operatively, is just as important as the surgery itself, so planning ahead will help achieve the best results.

 

“Empty nesters should downsize?”

There has been a lot in the news this week, about encouraging older people to downsize their homes, to relieve the housing shortage. I see many problems with taking this stance. Firstly the negative labelling of the older person, so a “bed blocker” becomes an “empty nester”. Incentivising the older person, maybe with a grant, seems to me to be throwing money at an issue which has many more problems, on so many levels. Are the Government again looking for a short term solution,  from one social group, to a long term problem? Government policy makers, must take responsibility, for not addressing the crisis which remains in the construction industry, where it just does not pay to build new homes. Getting the rental market right, with regulation, might encourage more confidence and security in this area. As an older person I might be happy to rent, if I knew I had rent controls and security. Investment in social housing needs to also be addressed, if we are ever going to relieve an ever growing housing shortage.

In reality, there are many children unable to leave home or if they do, they end up returning to the family home, to enable them to save for a home of their own. Older people, are frequently using their savings and pensions, to get their children onto the housing ladder. It might be more accurate to call it a housing ledge, as climbing seems totally unrealistic these days.

Social isolation, which could result from older people relocating, seems to me, to be a much bigger problem. The cost savings to the Government, by family and informal carers taking up the slack, free of charge in many cases, of elderly care, would also have to be taken into account. When the older person has made their home in an area, with family and friends nearby, is it realistic to expect them to move out of the area? Restrictive planning laws mean, that many mature areas of the larger cities, have little availability of smaller housing units available. Why are we not looking at sheltered local villages, for the elderly, with on-site amenities like shops and leisure/health facilities?

The answers are not simple or cheap, but they can be found, with effective strategy and policy and the will, from the Government, to look after our older people. Homecare Together will advocate for the elderly whenever we can and we offer a useful resource, of free information in your area.

 

Dementia Tips

Tips about Dementia

If any of these are a concern for you or a loved one, seek medical review from your GP or Consultant

Warning signs of Dementia

  1. Asking the same question over and over again
  2. Repeating the same story word for word again and again
  3. Forgetting how to carry out activities that used to be done regularly and with ease
  4. Losing the ability to carry out simple operation such as paying the bills
  5. Getting lost in familiar surroundings or misplacing household objects
  6. Neglecting personal care (showering)
  7. Relying on someone else to answer questions or to make decisions that used to be handled easily

 

 

Symptoms of Dementia

  1. Memory loss
  2. Language and Communication problems
  3. General confusion disorientation as to time and place.
  4. Difficulty with abstract thinking/ lapses in judgement
  5. Difficulty performing familiar activities
  6. Misplacing objects
  7. Behaviour and personality changes
  8. Sudden mood swings
  9. Loss of initiative/apathy

There are also other idiosyncratic signs and symptoms, so never ignore any worries you may have. Speak to a medical professional.

Sleep disturbance and dementia

Sleep Issues and sundowning in dementia

People with Alzheimer’s and dementia may have problems sleeping

They may also have an increase in behavioural problems that begin at dusk and last into the night. This is known as “sundowning”.

Causes

Night time restlessness doesn’t last forever. It typically peaks in the middle stages, and then diminishes as the disease progresses. Scientists don’t completely understand why sleep disturbances occur with Alzheimer’s disease and dementia. As with changes in memory and behaviour, sleep changes somehow result from the impact of dementia on the brain.

Some studies indicate as many as 20 percent of persons with Alzheimer’s will experience increased confusion, anxiety and agitation beginning late in the day. Others may experience changes in their sleep schedule and restlessness during the night. This disruption in the body’s sleep-wake cycle can lead to more behavioural problems.

Factors that may contribute to sundowning and sleep disturbances include:

End-of-day exhaustion (both mental and physical)

An upset in the “internal body clock,” causing a biological mix-up between day and night

Reduced lighting and increased shadows causing people with Alzheimer’s to misinterpret what they see, and become confused and afraid

Reactions to nonverbal cues of frustration from caregivers who are exhausted from their day

Disorientation due to the inability to separate dreams from reality when sleeping

Less need for sleep, which is common among older adults

Talk to a Doctor

Discuss sleep disturbances with the doctor to help identify causes and possible solutions. Physical ailments, such as urinary tract infections or incontinence problems, restless leg syndrome or sleep apnoea (an abnormal breathing pattern in which people briefly stop breathing many times a night) can cause or worsen sleep problems. For sleep issues due primarily to Alzheimer’s disease, most experts encourage the use of non-drug measures, rather than medication. In some cases when non-drug approaches fail, medication may be prescribed for agitation during the late afternoon and evening hours. Work with the doctor to learn both the risks and benefits of medication before making a decision.

 Strategies for coping with sundowning

 If the person is awake and disturbed:

Approach him or her in a calm manner.

Find out if there is something he or she needs.

Gently remind him or her of the time.

Avoid arguing.

Offer reassurance that everything is all right.

Don’t use physical restraint. If the person needs to pace, allow this to

continue, under your supervision.

Keep the home well-lit in the evening. Adequate lighting may reduce the agitation that occurs when surroundings are dark or unfamiliar.

Make a comfortable and safe sleep environment. The person’s sleeping area should be at a comfortable temperature. Provide nightlights and other ways to keep the person safe, such as appropriate door and window locks. Door sensors and motion detectors can be used to alert family members when a person is wandering, as can personal safety systems using the latest in technology.

Maintain a schedule. As much as possible, encourage the person with dementia to adhere to a regular routine of meals, waking up and going to bed. This will allow for more restful sleep at night. Carers at night should also wear pyjamas if appropriate, so that the person with dementia understands that it is night time.

Avoid stimulants and big dinners. Avoid nicotine and alcohol, and restrict sweets and caffeine consumption to the morning hours. Have a large meal at lunch and keep the evening meal simple.

Plan more active days. A person who rests most of the day is likely to be awake at night. Discourage afternoon napping and plan more challenging activities such as doctor appointments, trips and bathing in the morning or early afternoon. Encourage regular daily exercise, but no later than four hours before bedtime

Try to identify triggers. Limit environmental distractions particularly during the evening hours (TV, children arriving, chores, loud music, etc.).

Be mindful of your own mental and physical exhaustion. If you are feeling stressed by the late afternoon, the person may pick up on it and become agitated or confused. Try to get plenty of rest at night so you have more energy during the day.

Share your experience with others.

There are many supports out there for family carers. For more advice on support groups and organised activities to help you please contact Homecare Together 01-534-7674.

Tips for Dressing with Dementia

Dressing with Dementia some tips

Dressing is a very personal choice. This activity is usually private and we make our own decisions about what we wear. As Dementia progresses we may need more help with many activities, dressing being one of them. As a carer we should enable the person with Dementia to make their own choices for as long as they can and offer assistance sensitively. Here are some tips to make dressing with Dementia a positive experience for them and you.

Choice: Wherever possible ask the person what they would like to wear. This maintains dignity, but try to limit the amount of choices, so maybe choosing between two options, to reduce confusion.

Independence: Once chosen lay the clothes out on a non- patterned background, in the order the person will put them on, so starting with underwear and ending with a cardigan or jumper. Check items are not inside out and that buttons and zips are open. If the person is confused break the instructions down into small steps. Using gestures may help too. If mistakes are made, try to turn it into a joke or tactfully find a way to both laugh about it. Placing clear labels on drawers where things are kept or store whole outfits together. If using labels you can use pictures and words to help the person identify what is in the drawer.

Comfort: Have the room warm and ensure lighting levels are suitable. People with dementia often have difficulty distinguishing clearly colours and light and shade in a badly lit room. Have a suitable chair nearby if the person has problems with balance. Ask the person if they would like to go to the toilet before they get dressed. Try to use the persons existing preference with their routine wherever possible. Several thin layers are preferable, so that they can remove them when needed themselves. Remember they may not be able to tell you if they are hot or cold, so observe for any signs of discomfort.

Shop together: Try to shop together for clothes. Shop in familiar places that the person knows and where if possible the staff, know them. If a shop is too busy or too big it may be overwhelming. Check sizes as they may have gained or lost weight. You can also shop on line, which means they can try the clothes at home without any stress. Look for easy care clothes which can be machine washed. The person may reject new clothes because they don’t recognise them as theirs. It can be better to buy more than one of items that they like, to avoid this issue.

Acceptance of unusual choices: Accept their choices so long as it is not doing any harm. This is better than having a confrontation. If for example the person wants to wear a hat in bed, let them if it is not harming them. If their choices could cause harm, like falling over a long dress for example, you may consider putting away these clothes.

Making dressing a positive experience: Homecare does have advantages because we can allow enough time for the person to process information and so maintaining independence. Use the time while dressing together, to chat about interesting topics. If the person is resistant to help, try to leave them for a while and then try again.

Self- worth and grooming: Remember if the person is used to wearing perfume or jewellery they may like to continue to do so. Photographs are a good way to remind the person how they like to look. They may like assistance to go to the hairdresser or you might arrange for one to visit the home. Practical tips can also include, wearing clothes that are easy to take on and off. Easy fastenings, including Velcro can be useful. Shoes with laces can be challenging, so Velcro fastenings are better. The person should not wear slippers for prolonged periods, as they may not offer enough support for the feet. For ladies a front opening bra can be easier for them to manage themselves. For men boxer shorts are usually easier to manage than y fronts. Remember the way a person dresses can help them remember what they are doing. For example if they are dressed for work they might think they are going to work. Similarly wearing night wear during the day may make them think it is night time. Carers can also dress in nightwear if looking after the person at night, to help them identify the time of day. At Homecare Together, we do wear uniforms, but not when looking after people with Dementia, as it can provide an unnecessary barrier between the client and their carer. Homecare Together can offer advice on many issues associated with ageing, so get in touch for more help or assistance.

 

Dementia and Exercise

Dementia and exercise 

At this time of year we are looking for ways to get our health back on track and increase our wellbeing levels. This is also a great time to look at some Homecare Assistance from Homecare Together, to help your loved one with Dementia to take more exercise.

Leading a physically active life can have significant benefits in the wellbeing of people with dementia. Exercise is good for both physical and mental health and may improve the quality of life for people at all stages of the disease. Physical activities can be defined, as activities which increase our heart rate and encourage deeper breathing. This can include everyday activities like walking, gardening and dancing or more formal group activities like exercise classes. This blog post explains why people with dementia, will benefit from exercise and the type of exercise appropriate, at the different stages of the disease. Exercise may bring benefits to people with dementia.

These include:

Improving the health of the heart and blood vessels of people with dementia.

Reducing the risk of some types of cancer including colon and breast and reducing the risk of diabetes and stroke.

Improving physical fitness increasing muscle strength which can help the individual to stay stronger and more independent for longer.

Improving the ability to dress and wash independently as they are more flexible and fit.

Helping our bones to stay strong and reducing the effects of osteoporosis.

Improving cognition recent studies have shown regular exercise may help reduce mental decline and help memory.

Improving sleep patterns.

Proving social interaction and reducing isolation.

Improving strength and balance so in turn reducing the falls risk.

Improving confidence self- esteem and balance.

Before you start

Check with your health care professional that what you are planning to do is safe and suitable for you or get an advocate to do so. Always consider the personal choices and preferences of the person with dementia, who may have always participated in exercise so may prefer one type over another. Others may have never participated in any exercise, so the starting point should be considered.

Exercises in the early or middle stages of dementia

Ball games, seated exercise classes, tai chi, dance, indoor bowls or swimming. Many of these can be accessed through local community centres at a low cost. Gardening and house work are also everyday activities that the person with dementia can incorporate into their everyday lives, these are also activities which that can help maintain independence. Encouraging normal activity for as long as possible should be encouraged.

30 mins of daily exercise for at least five days per week is recommended by the Department of Health and this could be a reasonable level achievable in the early stages of dementia.

 

 

Seated exercises

These are easily done while sitting in a dining or armchair

Marching while seated

Turning the upper body from side to side

Raising the heels and toes

Raising the arms toward the ceiling

Raising the opposite arm and leg

Bending the legs

Clapping under the legs

Bicycling the legs

Making circles with the arms

Practising moving from sitting to standing

Suggested exercise in the later stages of dementia (these should only be undertaken if safe to do so)

When getting up or going to bed shuffle along the edge of the bed, in the sitting position from one end of the bed to the other. This helps to exercise the muscles needed to stand up from a chair.

Balance in a standing position. This can be done holding a support if necessary. This helps balance and posture and can form of daily activities for example, when showering or doing the washing up.

Sit unsupported for a few minutes each day. This exercise helps to strengthen the stomach muscles used to support posture. This should always be supervised especially if there is risk of falling.

Lie as flat as possible on the bed for 20-30 mins each day to reduce the gap between the curve of the back and the mattress. This allows for a good stretch strengthens abdominal muscles and gives the neck muscles a chance to relax.

Stand up and move regularly

When is exercise not appropriate?

It is important to only exercise as much as your physical condition allows. If the person feels unwell or suffers pain while taking part in exercise or after increasing activity levels, they should stop and seek medical advice. Bear in mind that the person with dementia may not have the verbal skills to communicate an issue, so a trusted companion or carer should look for signs of distress or discomfort.

Source: Fact Sheet 529lp Alzheimer’s Society UK April 2015

 

Happy Christmas from Homecare Together

Homecare Together would like to wish all our clients and their families a very happy Christmas! Many of our clients will have family around for the Christmas period and it can be a great time of year, to reconnect with old friends too! Christmas can also be a very lonely and sad time for older people and people that live alone. We would urge anyone who has elderly or isolated neighbours, to check on them over the Christmas period, just to make sure they have at least one visitor. They may also need a little help, with collecting shopping and fuel. We would like to thank all the clients who have joined us over the last year and hope to continue to provide a quality, local care service, in 2016.

We helped our client adopt a cat for companionship

Homecare Together know, how important pets are to our clients. In some homes, where the older person lives alone, their pet is their constant companion. Pets offer companionship and company, which can help to reduce loneliness and isolation. Pet ownership, can also encourage positive social interaction and general wellbeing, through exercise and outdoor activities. Homecare Together carers, can assist you with looking after domestic pets, in your own home. We recently helped a client of ours to adopt a cat. Our carers organised the process and even installed the cat flap! This has enhanced the life of our client and research shows us that pet ownership, can reduce stress and blood pressure too. The  physical benefits of pet ownership are well documented. We have also seen pet ownership, have huge benefits for our clients with dementia. The comfort and familiarity of a pet, can help us to communicate positively, with the person with dementia. We can also see a common interest in animals, can help build the relationship between the client and carer, which is so important to Homecare Together. Our companionship service, offers the client flexibility and can be used on an ad-hoc basis too!

Dementia Matters this Christmas at St Josephs Shankill

In the run up to Christmas many organisations are looking for volunteers and are organising Christmas get togethers! St Josephs Shankill, is a centre that looks after people with Dementia, both in a Day Care and residential setting. They are refurbishing their home at present, to  facilitate the Butterfly model of dementia care. We had the pleasure of visiting their home recently and could see first hand the great work they are doing. There are so few dedicated dementia centres, like St Josephs, so Homecare Together would like to support them in any way we can. They are looking for volunteers for the collections over Christmas and are selling tickets for a fundraising Christmas lunch. So to find out more click on their link:

St Josephs Volunteer information

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