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Getting out of bed can present risks, especially when attempted too quickly. I suggest to our residents/clients that when rising from bed and standing, do so slowly. Getting up too fast can cause your blood pressure to drop. That can make you feel wobbly. Also, it is wise not take a step for 5 seconds, or until you are sure you have your balance. I also recommend positioning furniture to allow for open walkways. And it is important to remove any electrical cords or throw rugs that might be in the way. This is especially critical for those who shuffle their feet when they walk.

When mobility and balance become issues, the simple task of taking a bath or shower can become risky for seniors. The ideal solution to this problem includes eliminating having to lift legs to enter a conventional tub. So stall showers are preferred. Adding a chair in the shower can lower risk even more. When a conventional bathtub is the only choice, using a chair is often a must. And I recommend practicing how to use the chair. It’s important to sit before lifting a leg to enter or exit the tub – sit and swivel. In addition to decreasing risk, these suggestions can add to the independence of someone in your care and help them to maintain more of their personal dignity.

Our elders want to be heard and respected for what they have to say. So I believe it is important to take the time to have two-way conversations. Sometimes I have to get things started, but often our residents want to talk about their past, their family and about current events. The question “What do you think about…?” can get things started and demonstrates that I am interested in what they have to say. Exchanges such as this build self-esteem. Questions about the person’s past can bring back fond memories and utilize long-term memory. And for me, I learn so much and am so grateful that our residents share their hard earned wisdom, fabulous stories and valuable experiences with me. One caveat. Stay away for topics that cause the person to get upset or angry.

To improve the day of a person who is frail, we have found it is beneficial to focus on their strengths. For example, assess which of their five senses (sight, taste, hearing, touch, smell) are functioning best. If it is smell, I may bring flowers, bake cookies or open the window for fresh air. Then I would bring their attention to their strength so they take advantage and enjoy that strength…and just as important, put what ails them in the background for a bit. Also, we choose to do a activities a frail person can enjoy and succeed at. For example, if they like the mental challenge of doing a crossword puzzle, but have poor vision and/or shaking hands, we may sit with them, read the clues and fill in the grid. And we may even provide a magnifying glass so they can get a sense for how they are doing. Making such adjustments can add fulfillment to the lives of those who are frail.

When caring for a senior with kidney disease, medical professionals say it is important to keep blood pressure down. So I monitor blood pressure and quickly inform doctors of change. I also make sure I use low-salt alternatives when preparing meals. To compensate I add more flavor to recipes with fresh spices. These can include cilantro, garlic, ginger, onion, rosemary and sage. Keeping weight down is tied into better blood pressure, too. So I make walks and chair exercises part of the daily routine. And I am constantly on the lookout for signs of the kidneys failing. Symptoms include reduced quantity of urine, lower extremity swelling, feeling tired and weak, confusion and forgetfulness.

For more symptoms, here is a list from the Mayo Clinic.

Some people tend to worry and live with a high level of anxiety. I strive to alleviate their nervousness. Communication is key. For some residents, I write notes on issues that worry them. When they want to know at what time they will be taking their medication or when an activity is starting, they just read (and reread) their note. And I understand a resident may be nervous about participating in an activity, even when it is something they have had an interest in. It’s important to make the transition to the activity (and it’s group of people) pleasant and keep the person in their comfort zone. Tell them ahead of time who they will be seeing, show them pictures/videos, build their confidence and address their fears.