What can I do to make my home safe?Safety is the first consideration in planning for the arrival of an older person to your home. Most medical conditions increase the risk of falling. Falls can lead to fractures and head injuries which worsen the condition of the elderly person. The risk of falling can be a result of weakness due to stroke or other neurological problems, certain medications which lead to dizziness and vision problems which make moving about the house very difficult.
These problems can be solved by taking the following precautions
- Removing slippery rugs.
- Installing handrails near bathrooms and bedrooms.
- A shower or tub chair which will prevent a weak or unsteady person from having to stand in the shower, or get up from a sitting position in the tub.
- If the house is multi–storied, it is advisable to have the entire living space of the elderly person on a single floor which will ensure that the elderly person does not have to climb stairs too often.
- If this is not possible then additional railings can be installed to enable the elderly person to hold the railing with both arms as they go up and down the stairs.
- Another option for multi–storied houses is to install a stair–glide, which is a motorized chair that rides up and down a rail attached to the stairwell. These chairs have their own safety features, including safety belts, seats that swivel, and back–up power.
- If the elderly person has to use a wheelchair, navigating through the house becomes very difficult. The doorways have to be wide enough to fit the chair. Barricades have to be put up at stair landings to prevent accidental falls. Other adjustments will have to be made in the design of the house to make it accessible by a wheelchair.
What can a physical therapist or occupational therapist do to help?Physical therapy
A Physical Therapist can often be referred to, to check the physical condition of the elderly person. The therapist normally checks the patient’s walking abilities, how difficult it is for the patient to get out of bed or do other activities like getting up from a chair, picking up objects like pillows form the floor, etc. The general physical strength of the patient is evaluated and accordingly exercises are suggested. These exercises can be performed at home or the patient may have to visit the doctor to perform certain exercises which may need use of special equipment. Normally, the doctor and the physical therapist work together to ensure proper and effective exercises which will HELP in improving the patient’s health faster.
A home visit from a physical therapist can be extremely helpful. A physical therapist can evaluate your living space and can make recommendations on how best to make it safer and easier for an older person to negotiate. When I do home therapy prescribed by a doctor, I usually schedule visits 2 to 3 times a week to do strengthening exercises, practice transfers in and out of bed, and exercise to improve balance and coordination.
Occupational therapy evaluates the elderly person’s ability to manage everyday activities, like getting dressed, bathing, grooming, and preparing meals. Certain medical problems like arthritis, paralysis, etc. can prevent the patient from performing tasks like buttoning shirts, tying shoelaces which we tend to take for granted. Occupational therapy is useful to provide alternative ways of doing these tasks by using simple devices. A long-handled grasper, for example, can be used to pull on socks that one can’t reach. Occupational therapists also suggest home safety measures to make the home a safer place.
How important are physical exercises?It is very important for the elderly person to remain active in whichever way possible. Even for bedridden patients it is important to have some degree of physical activity. Ask the doctor to suggest an exercise schedule to ensure that the exercises are performed at the right time and in the right quantity. It is important that the patient does not strain himself/herself by performing more exercises than he/she is capable of.
Most people who are unable to get out of bed have difficulty moving around in the bed as well. Changing positions can be difficult, and lying in one position for too long can lead to pressure sores and ulcers. Turning them or helping them turn onto their back or side every two hours can help prevent pressure-related problems. Other simple exercises like bending and straightening the arm at the elbow, moving the limb gently through it’s normal movement, etc. prevents the muscles from becoming stiff. A typical, full body range of motion regimen, starts with the shoulders and works toward the feet, moving each joint in turn. It is important that these exercises are performed in the presence of a trained therapist, nurse or doctor initially. Once the family members get accustomed with the ability of the patient to perform the exercises, presence of a therapist is not essential. These exercises should be performed carefully and slowly and it must be ensured that the patient does not strain himself/herself, while performing these exercises.
For mobile patients, walking is the most beneficial exercise. It helps in increasing circulation, maintaining strength of the bone structure, etc. It is very easy to perform this exercise with the help of a walking stick and other aids. Walking can be done within the premises of the house, or in some nearby parks depending on the physical condition of the elderly person. This simple task can give the person both a daily dose of exercise and a sense of accomplishment.
What are the types of walking aids available?Certain physical disabilities can make walking a very difficult or even an impossible task. To overcome these obstacles doctors recommend various walking aids to their patients.
Some of the common walking aids are
A walker is useful for patients with a severe balance problem. An arm rest and other accessories can be used with a walker for additional protection and support. If walking for long distances is difficult, use of a wheelchair can be considered.
Canes are of two types. Single Point Canes are useful for patients with a slight balance problem. On the other hand Quad Canes, with four feet, provide more support and stability for patients than Single Point Canes. Handles for these canes are available in a variety of forms and shapes to suit the needs of the patient. Special handles called ‘Ortho–Ease’ are molded according to the patient’s grip and this makes the use of cane more comfortable.
Who can I turn to for support?You should not feel alone when it comes to thinking about what’s best for your loved one. Whether you have a question about where to install a grab bar, what kind of exercise is safe, or which kind of walking aid is appropriate for a given disability, there are people who can help. If your family member’s doctor does not have experience with the special needs of older persons, ask for a referral to a local geriatrician or gerontologist. These doctors have special training and interest in the medical, physical and emotional needs of older persons.
Also ask for a referral to the local or state home health service. If your family member is coming to live with you after a hospitalization, speak to the hospital social worker about visiting nurses and home care services. Although services vary greatly from region to region, many are able to provide home nursing, in–home attendants and home physical therapy. A good social worker will work with the visiting nurse service to determine the amount of help you need based on the physical limitations or medical needs of your loved one.