Folks

From Bwtm

This page is about Home support for an Elderly Couple.

Contents 1 Objective 2 Services Required 3 Desires 4 misc 5 Sources 6 Kidney Disease 7 Dementia 7.1 General 7.2 Occupational therapy for dementia 7.3 links 8 ref

Objective

1. Provide basic hygiene care and grooming for Mom. Bathing and dressing.
2. help with laundry. organize clothes in closets and tidy laundry area.
3. Light housekeeping. Change linens and bed making. Collect and dispose of trash and recycling.
4. Provide healthy breakfast for both. Help with meal prep and cleanup. Keep counters tidy. Check food supply.
5. Dispence medications from prepared cassettes for both.
6. Encourage hydration for Mom.
7. Provide safety for Mom to avoid falls or injuries. Walking assistance.
8. Provide respite to Dad.
9. Provide afternoon activity to promote regular sleep patterns.

Services Required

1. In home Aid service from 8:00am to 11:00am seven days a week.
   1. Primarily covers items 1-7 above.
2. Daily in home visit to dispense evening medications from cassette, 15 minutes. Encourage hydration for Mom.
3. Respite for Dad:
   1. Mom should be out of the apartment 3 days per week 2-3hours each time.
   2. Provide companionship. Promote group activities.
   3. Activities could be physical therapy. Combine hair appointment with lunch and walking. Others to be developed.

Desires

1. Have a writen plan. Provide consistent service day to day. Periodic review and revise if required.
2. Would like 2-3 Aids to consistently do the daily morning shift. Uniform style of dress. Prominent name tags.
3. Have a plan to deal with Mom's tantrums. see item 1.
   1. Phone contact to avoid "I will call the Police" threats.

misc

1. clear out clutter in kitchen cabinets.
2. note paper crafting with photos of roses.
3. Mom sometimes likes to cook but use of stove requires supervision.
4. organize collections and package in display boxes.

Sources

1. Fox Run Home Support Services
2. http://seniorshelpingseniors.com for respite care
3. https://www.homeinstead.com/
4. http://www.seniorhelpers.com/oaklandmi
5. http://www.assuredhospicecare.com/Home.html

Kidney Disease

1. Aranesp® is a prescription medicine used to treat a lower than normal number of red blood cells (anemia) caused by chronic kidney disease in patients on dialysis and not on dialysis. http://www.aranesp.com
2. Welcome to the ESA APPRISE Oncology Program https://www.esa-apprise.com/ESAAppriseUI/ESAAppriseUI/default.jsp
3. Blood tests. Kidney function tests look for the level of waste products, such as creatinine and urea, in your blood.
4. High blood pressure medications. People with kidney disease may experience worsening high blood pressure. Your doctor may recommend medications to lower your blood pressure — commonly angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers — and to preserve kidney function. High blood pressure medications can initially decrease kidney function and change electrolyte levels, so you may need frequent blood tests to monitor your condition. Your doctor will likely also recommend a water pill (diuretic) and a low-salt diet.
5. Medications to treat anemia. In certain situations, your doctor may recommend supplements of the hormone erythropoietin (uh-rith-roe-POI-uh-tin), sometimes with added iron. Erythropoietin supplements aid in production of more red blood cells, which may relieve fatigue and weakness associated with anemia.
6. Medications to relieve swelling. People with chronic kidney disease may retain fluids. This can lead to swelling in the legs, as well as high blood pressure. Medications called diuretics can help maintain the balance of fluids in your body.
7. Creatinine is a chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Approximately 2% of the body's creatine is converted to creatinine every day. Creatinine is transported through the bloodstream to the kidneys. The kidneys filter out most of the creatinine and dispose of it in the urine. Because the muscle mass in the body is relatively constant from day to day, the creatinine production normally remains essentially unchanged on a daily basis. http://www.medicinenet.com/creatinine_blood_test/article.htm
8. Blood urea nitrogen (BUN) level is another indicator of kidney function. Urea is also a metabolic byproduct which can build up if kidney function is impaired. The BUN-to-creatinine ratio generally provides more precise information about kidney function and its possible underlying cause compared with creatinine level alone. BUN also increases with dehydration.
9. Results of the blood urea nitrogen test are measured in milligrams per deciliter (mg/dL) in the United States and in millimoles per liter (mmol/L) internationally. In general, 7 to 20 mg/dL (2.5 to 7.1 mmol/L) is considered normal. But normal ranges may vary, depending on the reference range used by the lab, and your age. Ask your doctor to explain your results. Urea nitrogen levels tend to increase with age. Infants have lower levels than other people do, and the range in children varies. Generally, a high blood urea nitrogen level means your kidneys aren't working well. http://www.mayoclinic.org/tests-procedures/blood-urea-nitrogen/basics/results/prc-20020239
10. American Kidney Fund http://www.kidneyfund.org/are-you-at-risk/helpline/

Dementia

General

1. Rummaging and hiding things
2. http://www.helpguide.org/articles/alzheimers-dementia/alzheimers-behavior-management.htm
3. http://www.helpforalzheimersfamilies.com/dementia-support-network/hiding-misplacing-things-rummaging/
4. Caregiver’s Guide to Understanding Dementia Behaviors https://www.caregiver.org/caregivers-guide-understanding-dementia-behaviors

Occupational therapy for dementia

1. THERAPEUTIC INTERVENTIONS FOR PEOPLE WITH DEMENTIA – COGNITIVE SYMPTOMS AND MAINTENANCE OF FUNCTIONING http://www.ncbi.nlm.nih.gov/books/NBK55462/

1. Communication is key. Keep the following strategies in mind: http://rehabvisions.com/dementia-occupational-therapy-treatment-techniques/
   1. Present one idea at a time.
   2. Speak slowly and simply.
   3. Avoid asking questions.
   4. If you need to repeat something, repeat the message exactly as you said it the first time.
   5. Approach dementia patients from the front, never from behind.
   6. Use gestures or visual aids.
   7. Remember processing delays (ex: patient may take up to 90 seconds to process a simple verbal command).

links

https://www.caring.com

ref