Lift Chairs: Making Use Of Technology In Taking Care Of The Elderly

We all grow old. No one can deny that. No matter how much money you have, how good you have been, how much people respect you, the fact remains that we grow old.

No one can bargain for one more second of time or of youth. Sure, certain advancements in technology have allowed people to minimize the ravages of time, but they all realize, sooner or later, that every battle we fight against time will loose.

This does not stop the fighting spirit of humanity, however. We continually face adversity and yet we go on fighting. Some of us have faced their darkest enemies and emerged triumphant. For we are human, and we never choose to go quietly.

We make use of our different technologies in order to make our lives a bit easier. If we cannot win the battle against time, at least we can delay its effects.

The lift chair is a perfect example of one such innovation. With the lift chair, an elderly person can rise from seating without the need for assistance from others.

We take pride in our little accomplishments of independence. Whether it is building a skyscraper, or getting up every morning, we feel that our little accomplishments make us the persons that we are.

The lift chair does do many things for the elderly other than let them stand on their own. Lift chairs give elderly people a sense of independence. Imagine how it would feel like to be on the prime of your life one day and be unable to rise from your chair the next.

Lift chairs give the elderly the sense that they control their lives. Each human appreciates the need for control. Think about it: when have you felt your darkest despair? The answer would be when you felt helpless and unable to do anything about a problem, right?

What are the different factors you need to consider in getting a lift chair?

Well, in order to get an effective lift chair, you'll need to take into consideration the physique of the person who will use it.

This includes the weight and the height of the person who will use it. In taking this into consideration, you can make sure that the lift chair will be able to support the person effectively.

You can also be sure that no mishaps will happen because of the lift chair.

You also need to consider the specific features you want built-in to your lift chair. Some lift chairs offer you a massage function and still some offer heat therapy. This is to further care for the one using the lift chair. These features assure comfort and relief for the elderly.

The intended use of the lift chair should also be considered. Some lift chairs recline fully and may be used as beds, while others are merely for sitting and only recline a bit.

There are also a variety of designs to choose from. Take the design into consideration as sometimes visual stimuli can affect the relaxation of the person using it.

The location of the controls, the adaptability of the lift chair to the user should also be taken into consideration.

And, of course, you need to keep within your budget. You need to find a good quality wheelchair within the range of your intended price. After all, you don't want to waste money, right?


by: Jeanette Pollock

Care Tips for Chronic Wounds: Pressure Ulcers

Three months ago, Mrs J, 79, had a cerebrovascular accident (CVA) that left her unable to move. When she was discharged home, her skin was intact. Now she has been readmitted to the hospital with an unstageable sacral pressure ulcer (PrU).

On discharge from the first hospitalization, Mrs J's daughter bought a pressure-reducing mattress for her mother's bed; however, she did not obtain a chair cushion. In the last few weeks, Mrs J has spent most of the day sitting in a chair without pressure relief. Because the daughter was focusing on postCVA care and exercise, she failed to recognize the early signs of skin breakdown. When she did notice the wound, she attempted to pad it with gauze dressings from the local pharmacy. She then noticed an odor coming from her mother's wound, which prompted her to call her mother's health care provider; this led to the present hospital admission.

PATIENT EVALUATION

Designing a clinical pathway for PrU management begins with a comprehensive assessment of the patient and the wound. First, perform a risk assessment to determine the patient's PrU risk. Although numerous risk assessment tools are available, the Braden Scale (http://www.bradenscale.com) is the one most commonly used in the United States. Depending on the facility's standards, risk assessment may be done on each admission, readmission, or level of care change. The information gathered in the risk assessment will help in determining the optimum pressure-relieving device.

Other assessment tools, such as nutritional assessments, may be used in conjunction with the PrU risk assessment tool to develop a comprehensive plan of care. In addition, determine if the patient tried to treat the PrU at home, indicating which topical interventions have and have not been effective for the patient.
Mrs J's PrU is unstageable: Its depth is indeterminate because the wound is covered with a moist eschar and marginal slough. The eschar seems to have pulled away from the wound's edge between 6 and 8 o'clock; the wound margins also appear detached from the wound bed in this area, indicating tunneling.

Because of the adherent eschar, it is impossible to assess whether the wound margins are intact around the remaining perimeter. The wound has a pungent odor and purulent drainage. The periwound skin is reddened and warm, which may indicate a wound infection (see Infection: A Complication). Mrs J denies pain at the wound site, and she does not have an elevated temperature. The wound, but not the necrotic tissue, is cultured. No other areas of skin breakdown are apparent.
After completing the patient and wound assessment (see Advice on Documentation), a plan of care that is customized to the patient's needs can be created. In Mrs J's case, the health care provider schedules surgical wound debridement in the operating room. Debriding the devitalized tissue will allow the underlying healthy tissue to regenerate.

INTERVENTIONS

Debridement has revealed a Stage III PrU (see Staging Pressure Ulcers). The wound's odor and the redness of the periwound skin have dissipated; there's no evidence of a wound infection. In addition, the wound culture shows no signs of infection.

Tunneling is noted around the wound, with moderate serosanguineous drainage. The base of the wound is filled with healthy red granulation tissue. An alginate rope is loosely packed into the tunneled areas, and an alginate pad is fluffed into the wound base. The alginate will absorb up to 20 times its weight; therefore, it can be changed just once daily. The alginate is covered with a dry dressing and secured with a retention tape that is chosen for its gentleness to the periwound skin.Topical wound management should be reevaluated with each dressing change.

Because of the wound's severity and Mrs J's immobility, a low-air-loss (pressure-reducing) specialty bed is ordered for pressure relief. Mrs J is permitted to sit in a chair only for meals; the rest of the time she must remain in bed to keep pressure off her wound. A clinician from the hospital's rehabilitation service evaluates Mrs J for a seating device, and a dietitian assesses her nutritional status.
General advice for managing a PrU, regardless of stage, includes the following:

* Use normal saline solution or an appropriate cleansing agent to clean the PrU.

* Apply a topical prescriptive treatment or dressing that will maintain a moist healing environment based on the exudate amount or tissue type.

* Do not use drying treatments, such as heat lamps or antacids.

* Place the patient on an appropriate pressure-relieving device to keep pressure off the wound.

* Change the patient's position as needed, at least every 2 hours while the patient is in bed and every 15 minutes while he or she is sitting in a chair.

* Complete a comprehensive nutritional assessment, screening the patient for nutritional deficiencies.

Patient education should include the importance of regular skin assessments and the significance of reddened areas of skin. Provide printed educational material on skin assessment that the patient can refer to at home. In addition, discuss the use of pressure-relieving devices, turning and positioning, and nutritional screenings. Finally, arrange for home health care follow-up visits.

by Hess, Cathy Thomas

An Independent Lady

When I read the article by Jonathon Hardcastle-Caring for the Elderly, it clearly reminded me of my mother Willie M. Stevenson. She was a very Independent Lady but having a terrible fall at the age of 81 was shocking.

Mother’s life was totally changed with one horrifying accident she lost her independence. Mom’s accident left her dependent on our entire family, friends and a staff of nurses, therapist and doctors. We were all needed to care for her twenty four hours a day for fifteen months.

Mother wanted to stay home instead of living in a facility. For the family this was very challenging. That’s why Jonathon’s article (Caring for the Elderly) was so appealing to me, especially when it came to the difficult task of hiring nurses that stayed with her around the clock. Nurses needed for medical care and companionship.

by: B. Stevenson

Caring for the Elderly

Caring for the elderly is one of the most challenging and rewarding jobs in nursing. Demanding a great deal of tact and care, looking after elderly patients is a trying and testing job, although it is one of the most necessary and most sought after positions in modern times. Elderly patients require care for a number of reasons, and these each carry their own complexities and challenges which must be met by the carer.

For some elderly patients, care is a round the clock affair, and this means you also have to be dedicated to patient's well being. On top of that, patients require genuine attention, which extends beyond the hours of the job. A carer for the elderly must be a genuinely caring person, willing to commit to a career in people. At times it can be a demoralising and depressing job, but at the end of the day, the difference good care can make to quality of life is substantial.

Amongst other things, elderly patients need human company and companionship, and a good carer should have the ability to listen and interact on many different levels. It is a good idea to come with plenty anecdotes, and a good knowledge of current affairs to keep your patients amused whilst you provide them with essential care to improve the quality of their lives. Additionally, it requires patience. Elderly patients can, at times, be set in their ways, and can find it hard to accept help and treatment from someone younger than themselves. However, it is essential to remember that the patients are people too, with their own opinions and dignity. In nursing the elderly, it is a case of striking a balance between offering care and assistance and understanding the mindset of the patient, and this is arguably one of the most difficult things about the job.

Caring for the elderly is not a job for everyone, but it is a job that many would find appealing. Working with the elderly can be very rewarding, and the loyalty and respect you can expect in return for your help is heart-warming. Furthermore, many patients will adopt you and care for you as their own, creating a uniquely bonded two-way relationship. It is this relationship which makes caring a job that is worth far more than any wage, and is something which can provide the real sense of job satisfaction which can't be found anywhere.

By: Jonathon Hardcastle

Caregiving - Families Don't Always Play Fair

In our busy world, caregiving can become a complicated task especially when multiple family members are involved. Who will take responsibility for what tasks? Often the majority of the work is delegated to the family member who has the most available time. Caregivers placed in this position feel that this is not always fair and that their brothers, sisters, or other family members take advantage of them. This resentment creeps into family relationships.

The individual with the majority of the caregiving burden burns out and their health may fail. Statistics report that caregiver stress is at an all time high resulting in physical and emotional declines. Exhausted caregivers are taken to task by family members for not doing more. Or the caregivers themselves feel guilty that they are not doing enough to care for their older adult. Many times this is a no win situation unless other family members will commit to providing support through time or money.

Signs of caregiver exhaustion can be seen in the older adult through poor general appearance or hygiene, poor nutrition, dehydration, lack of socialization or missed medical appointments. At times the primary caregiver is so exhausted that they do not notice weight loss or other changes in the older adult that may be seen by other family members who express concern. It is at this point that family disagreements may occur about the best care for the older adult. Some family members may recommend facility placement or in home care because they feel the primary caregiver is unable to provide the best care.

In this situation a compromise is usually the best course of action for the older adult and the entire family. The primary caregiver may feel unappreciated or victimized because other family members feel he or she is not providing the best care. While neither side may want to be seen as giving in it may be in the best interests of the older adult to compromise. Outside evaluations from physicians or case managers may also prove helpful in deciding on the best course of action. Many older adults would prefer to remain at home if the cost of care is not prohibitive or if the care necessary does not exceed what can be provided. Many times a trained personal care provider can provide the majority of care when skilled nursing is not needed.

Families should know that there are many options available for assistance so that any one family member need not be overwhelmed. These include not only in home care, but day care, family counseling and other services.

By: Pamela Dombrowski-Wilson

The Accident

At the age of 81 my mother had an accident breaking her neck and causing injury to her spine. My mother was in good health for a woman of her age and doctors determined that she could survive an operation, without becoming paralyzed. The surgery was a great success and within two day she was gaining the use of her hands and feelings were returning in verious parts of her body.

Everything went great until her insurance company got into the act. Mother had insurance from her job through Kaiser Permanente who had taken control of her Medicare. She also had insurance with United Health Care through my father's retirement benefits. She lived near Cedars-Sinai Medical Center, where she was taken by paramedics. The operation was performed there. Mother received excellent care from great doctors and medical staff. She stayed in ICU for only one day, doctors felt she would be walking again within six months.

The nightmare started, Kaiser Permanete wanted their patient at their hospital. They refused to pay for Cedars-Sinai's services and took my mother in the middle of the night to one of their facilities. Within a week she had a stage four decubitus ucler. Our fanily's hands were tied, we could not get her away from Kaiser because they controlled her medicare. We had to wait three months until the end of the year to disenroll her from Kaiser, all the time her health was declining. Are HMO's taking advantage of our aging loved ones?