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Maintaining Independence

I want to remember
By Regina D. Posvar LPN,RNA

Q: Dear Regina, My mom has had mild dementia for two years, maybe longer. Her doctor told her that she is just getting older and it is normal to forget as we age. This is more than just forgetting. She has always been independent and has been living in her home for 50 years. I don’t think she is in any danger right now but I wanted to know if you had any advice on helping her to stay safe in her own home, or when do you recommend her needing a caregiver or placing her in a home? I want to be prepared.

A: Your concern is validated. Helping your mom stay independent as long as possible will slow the progression of some types of dementia. Let me mention a few tips that can help. Take note of her home and her daily routine. You want to look at her environment and how she functions in it. You may need to adjust some things or add things to her home to make it easy for her to manoeuver and be safe. For example:
• Her shower or bathing area – does she need a bench to sit? or grab-bars to hold herself up? Does she need a tub? Does her shower have too high of a lip that she can potentially fall?
• Changing the knobs to handles makes it easier for her to open doors. (In later stages if you want to keep her from getting into a room that is not hers or filled with dangerous items then switch the handle to a knob and put a safety cover over it.)
• If you find she is confused in the kitchen then simplify it for her. (kitchen safety may need more attention as this may be the determining factor to having someone help her with meals. Make sure the help is involving her and not doing it for her).
• Give her a calendar with large print so she can follow along on her daily schedule.
• Label things if this will make it easier for her to remember and if she struggles with sequence then number them.
• If she struggles with putting on appropriate clothing she may just need them to be picked out by her and laid out in the sequence that she normally puts her clothes on.

She will need someone to supervise if the prep of these tasks are needed throughout the day. Some people can be started with just coming in early morning and preparing or at night and laying out the day for her so she can care for herself.

Have other family help with the evaluation of the home or have a professional do an assessment for safety and they can help with many suggestions to help her maintain safety and independence to the best of her abilities. Keep in mind that the assessment will involve family participation.

Placing her in a home is when she is no longer safe to live on her own and no one in the family is able to live with her or have her live with them. There are many reasons why family cannot have their older adult live with them. But having your loved one live in a group home for older adults does not relieve the family of responsibilities of caring. The family are still the primary caregiver and should always be. The care home is a partner and both parties should work together while involving the older adult in the plan of care. Most families I have worked with are strong advocates for their loved one but often adult homes will exclude the family caregiver is some areas of care. This should not be so. That system does not work and it puts too much strain on the professional caregivers in many aspects and just leads to poor care for the person needing care. Care homes should incorporate family participation as part of the care team.

Quote of the day from DailyCaring

There are four kinds of people in the world. Those who have been caregivers; those who currently are caregivers; those who will be caregivers; and those who will need caregivers.

— Rosalynn Carter
Send questions and stories to [email protected] or text 758-496-4509.

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