Care giving guide for first timers


Guide For First Timers

Caregiving is not easy but it’s probably one of the most complicated roles you’ll ever play but you do get the satisfaction of helping someone. Most caregivers experience mixed emotions as they have very little control over what happens and often experience feelings of resentment and frustration about the loss of privacy. This guide is aimed to help first time caregivers, it includes advice, resources and checklists. We hope this guide helps you get organized and make the process easier for both you and your loved one. Finally, remember: Just take it one step at a time.

Step – 1

Anticipate and Plan
When it comes to your parents or anyone close to you; plan a conversation. Don’t wait for a sudden illness or a critical diagnosis to take you by surprise. Plan caregiving at an early stage. Talk to your loved ones about their views and wishes, preferences and finances.

Step – 2

Group Resources
Don’t try to handle all the responsibilities of caregiving yourself. Talk to other family members, friends, and professional caregivers. Assign roles to whoever is willing to help, usually other family members and friends. It is also important to engage an unrelated mediator to manage disagreements and resolve any difficult issues.

Step – 3

Make a Plan
Sit with other members of your family and develop a short term and a long-term plan. This includes financial planning as well as determining role each of you play. Also, gather all medical records in one place as it will help you respond more quickly during an emergency. In case, you have to do everything yourself, consider engaging a part time caregiver.

Sometimes, hands-on caregiving tasks, such as bath or toileting can be uncomfortable. Check if any other member can help or consider hiring assistance.

Tasks that can be shared or delegated:

  • who will take care medical appointments
  • who will prepare meals
  • who will step in when the primary caregiver is away
  • who will keep tabs on all expenses

Set up an email or WhatsApp group to keep everyone up to date, this will help you stay organized and focused.

Step – 4

Care for Your Loved One
Choosing between your own career, children, spouse and taking care of a parent often becomes a challenge for caregivers. Source products that lighten the caregiver’s workload and help your loved one remain safe and independent.

Some products that you might consider:

Step – 5

Get Trained
As a primary caregiver, ask your doctor or medical assistant to train you on day to day procedures such as sugar level tests, nebulization or dressing a wound.

Step – 6

Stay organized
Caregiving can be a complex role but try to be organized with health records, filling prescription and storing all emergency numbers in phone and in a notebook as well. Also, check out sources for ambulances, medicines, doctors who make house calls, medical oxygen suppliers and hospitals near you.

Step – 7

Take care for yourself
Caregiving can be highly stressful. Add loss of sleep, poor eating habits and lack of exercise can affect your health indirectly. Always, take care of yourself first; engage in activities that you find relaxing. Remember, caregiving is a long haul and you’ll need to stay fit physically and mentally to care for others.

Finally, take care of your personal finances, paying for medical expenses, missing out work, passing up promotions, are all going to take a toll. Keep a record of all expenses and share it with others in your family.

Transitioning from the saree to the nightgown

Cocoon adaptive clothingMost elderly ladies, especially in South India, have worn nothing but sarees all their lives.  While the saree is an elegant dress, it is quite a handful to drape, even for a normal person.  But to have to drape it on another person, that too someone who is confined to their bed is not only tedious but also difficult to manage for multiple reasons.  Just imagine having to change the saree every time there is a diaper ‘accident’ and you will understand some of the problems faced in such situations.

One such story involves an 89-year-old lady. This lady had been very active until she fell and fractured her hip a few months ago.  One thing led to another and now she is confined to her bed, and dependent on her daughter for everything.  A feisty lady, the perceived loss of control of the household and having to depend on others made her very difficult to deal with.

One of the things she refused to compromise on, in the beginning, was the saree.  She insisted that she had to be in a saree all the time.  And not just any kind of saree but one of the starched and iron cotton ones that she was used to all her life.  The daughter tried gamely for a few days but was unable to take on the additional burden of changing her mother’s saree two or three times a day.

She then bought nightgowns from us, but her mother refused to even consider them, even after she was given a wide choice of designs to choose from.  Finally, the mother and daughter had a big showdown at which time, the daughter reduced the choices to grey hospital gowns and our special design Cocoon nightgowns.  The mother finally relented and decided to go with the nightgowns, for she abhorred the dowdy hospital gowns, which she felt made her look and feel even sicker than she actually was.  Needless to say, the mood in the house subsequently went downhill.

We came to hear about this story when the daughter, the primary caregiver came to buy some more of our specially designed back-open nightgowns for her mother.

With dark circles around her eyes, hunched shoulders and a resigned look, she appeared to be at the end of her tether.  On gentle probing, she confided that she felt that she had let her mother down as she could not even meet the simplest of her wishes.

Once she narrated her story, we took a leaf out of another customer’ story (similar beginning, but a different ending), and suggested the following:

  1. Have specific visiting hours for her mother during which time her friends and relatives can come and visit her.
  2. Get the mother dressed in a saree for the those visiting hours, so she can receive her visitors the way that she liked – prim and proper in a starched cotton saree.

A few weeks later, the daughter came back for a few more of our nightgowns.  She seemed to be in a much better mood and was happy to share with us that our suggestion had worked very well and both mother and daughter were very pleased with the arrangement.

“Now that my mother has got used to wearing nightgowns, she finds them very comfortable and elegant.  She has sent me here to get some more, with clear instructions to get pastel shades because that is what complements her complexion”, she said with a throaty laugh.

On our part, we are very happy to have contributed in making the life of another care recipient and that of the care giver just a little bit better.

What qualifies someone for hospice?



Hospice:  A home that provides care for the terminally ill.  Cancer patients in their last stages and others who have six months or less to live, benefit from moving into a hospice as the hospice is geared to take care of their needs and ensure comfort and care.

Palliative care:  Palliative care refers to treatment given not towards curing an illness, but towards keeping the patient comfortable and pain free.

Looking after a loved one who is terminally ill is one of the toughest assignments one can have.  Firstly, unless one is a nurse or a doctor, one is not fully qualified for the task at hand.  Secondly, if the loved one is suffering, watching them from close quarters can be really traumatic and both emotionally and physically draining.

Under such circumstances, opting for hospice care may be the best thing one can do, for oneself and for the patient.  A hospice is geared to look after the terminally ill and will be able to keep your loved one as comfortable as possible.  In addition, many times, they will have licenses to procure and prescribe pain killers such as morphine, that are not available to others.  On top of that, this will give you the opportunity to spend quality time with the loved one rather than constantly worrying whether one is doing enough for the loved one.

In India, there are quite a few charitable organizations that run palliative centres.  Most of these however cater to the poor and destitute. They do the best that they can but given that they are charity run and are invariably filled beyond capacity, they may not be suitable for those that are willing to pay for better quality services.

Searching on google for “hospice”, “palliative care”, “terminally ill care” and similar words along with the name of one’s city will give one a quick overview of the available options.

It is important to remember that considering the option of hospice care for a loved one is not an act of abandonment, a sign that one is relinquishing one’s responsibilities or dereliction of duty.

Under such circumstances, it may be the right thing to do for one’s loved one.

Enteral Feeding – An introduction

Enteral-Feeding32Sometimes, a bedridden person may not be able to ingest food through their mouth. This can be due to various reasons, from refusing to eat (in some cases of dementia) to inability to swallow due to being comatose, having neurological problems, having obstructions in the food canal or other similar problems.

Under such circumstances Doctors advice enteral feeding. Enteral feeding is defined as delivery of a nutritionally complete feed, containing protein, carbohydrate, fat, water, minerals and vitamins, directly into the stomach, duodenum or jejunum. Basically, what this means is that the doctors will insert a tube into the body and you will have to use that tube as the means to feed the patient. The food, in this case, would be a nutritionally complete meal replacement powder such as Ensure, Fresubin or some other brand.

The feeding tube can be inserted in a couple of different  ways. Given below is a brief layman’s understanding of them.

Nasogastric intubation
In this case, the doctor will insert a narrow bore tube, called a Ryles’ tube or a nasogastric tube, through one of the nostrils into the stomach or duodenum(which is the part of the small intestine just after the stomach). Whenever feeding is required, the desired quantity of the meal replacement solution (freshly prepared) can be injected into the tube slowly. Alternately a bag of the food can be attached to the tube and the food released slowly over an extended period. It is usually recommended that this method is used for no more than six weeks at a time, but if no other option is available, this can be used indefinitely subject to the patient not suffering any major discomfort.

This type of intubation is contra-indicated under some conditions such as

  • High risk of aspiration
  • Gastric stasis
  • Gastro-oesophageal reflux
  • Upper gastrointestinal stricture
  • Nasal injuries
  • Base of skull fractures

Percutaneous Endoscopic Gastrostomy
Percutaneous endoscopic gastrostomy (PEG) is an endoscopic medical procedure in which a tube (PEG tube) is passed into a patient’s stomach through the abdominal wall. In some cases, the tube is extended into the duodenum or the jejunum. This method for enteral feeding is indicated when such feeding is required for extended periods of time measured in years. To install the PEG tube, an invasive operation is required. In one popular method, an endoscope is inserted through the mouth or nostril into the stomach and a light flashed to identify the area where the incision needs to be made. Then an incision is made in the abdominal wall and the stomach and the tube inserted into the stomach. The stomach is then stapled or sutured to the inner abdominal wall at that point so that it does not move and dislodge the tube. The operation is relatively straight-forward and is conducted very often under local anesthesia nowadays.

Since an operation is required, this is not suitable for patients too weak to undergo operations under local or general anesthesia. In addition, this operation becomes difficult if the patient does not have the ability to swallow as that makes it difficult for the endoscope to be inserted.

PEG reduces dramatically the possibility of aspiration (food coming back up from the stomach) and reflux and is ideal in cases where the need for enteral feeding is for a prolonged period.

If your loved elder is unable to eat normally, do consult your doctor regarding enteral feeding.


Understanding and dealing with faecal incontinence

Any form of incontinence, though may not be fatal, can surely rob the life of the affected.

faecalIncFaecal Incontinence (FI) is basically lack of control over defecation leading to involuntary loss of some or all of the bowel contents. This is a symptom and not a diagnosis. There can be several underlying reasons for FI including recent anorectal surgery, damage during childbirth, weakened sphincter, Irritable Bowel Syndrome (IBS), Chrohn’s disease,  just diarrhea or neurological conditions such as Alzheimer’s and dementia. Luckily not too many people suffer from this. It is estimated that just over 2% of the adults suffer from faecal incontinence at some point in time and only 0.5 – 1% of adults experience regular FI.

While potential embarrassment is a major worry, there are more serious health concerns associated with FI over and above the underlying causes of the FI in the first place. As the skin around the anal region has prolonged contact with faecal matter, this can lead to maceration, which is the softening and whitening of the skin due to continues exposure to moisture. Additionally, because of the bacteria that flourish in the faecal matter, Urinary Tract Infections(UTI) become more common. Finally, especially in the case of bedridden people, bed sores (also called pressure ulcers) start forming rather frequently.

Use of adult diapers and their regular change can help mitigate some of the problems. Also regular cleansing and strict maintenance of hygiene can go a long way in reducing the chances of bed sore and related issues.

If you or your loved ones suffer from FI, do approach a Doctor at the earliest.

A note for those family members living with their elder parents or relatives: Many people suffering from FI are too embarrassed to discuss this problem and may be trying to quietly deal with the problems themselves. If you notice frequent and hurried visits to the toilet, reluctance to leave home, frequent washing of clothes, especially undergarments, stains on clothes and bed linen and smells associated with fecal matter, broach the subject with sensitivity and gently get them to allow you to take them to the Doctor.

Staying safe and allergy free this Diwali

8210-on-head_D_2Diwali is fast approaching. While this is a joyous festival, for many of our elders, this is a time of great trepidation.

After all, Diwali is inextricably entwined with fireworks, and this means heightened levels of pollution that can lead to breathing difficulties and chest infections. For people with weakened immunity, having asthma or chronic obstructive pulmonary disease (COPD), Diwali can be extremely taxing.

So here are a few things you can do to protect yourself and your dear ones from the pollution:

  1. Avoid going out
  2. If possible stay inside an air-conditioned room. Ensure that the air-conditioner’s inlet vent is in closed position, so that it does not suck in outside air but keeps the same room air circulating. Most air-conditioners have a setting for this.
  3. Wear a mask. A N95 approved particulate respirator mask that covers the nose and mouth should do the trick. All the toxic particles released by bursting firecrackers will be blocked by this mask ensuring that none of it enters your lungs.
  4. If you suffer from asthma or bronchitis, make sure you have your inhalers and medication ready and with you at all times.
  5. If noise is an issue, get earplugs. Disposable soft earplugs that are gentle on the ears are available.
  6. If you wear hearing aids, this may be a good time to remove them or switch them off. [At least when you are at home and in a safe environment].
  7. Take all your regular medicines without fail.
  8. Drink plenty of fluids
  9. Encourage family, especially children, to reduce quantum of purchase of fireworks
  10. Call your doctor immediately if:
  • You have shortness of breath or wheezing that is rapidly getting worse.
  • You are coughing more deeply or more frequently, especially if you notice an increase in mucus (sputum) or a change in the color of the mucus you cough up.
  • You cough up blood.
  • You have increased swelling in your legs or abdomen.
  • You have a high fever (over 100 degrees).
  • You feel severe chest pain.
  • You develop flu symptoms.
  • You notice that your medicine is not working as well as it had been.
  • You use oxygen at home and feel like you need more. Use only the amount
  • recommended by your doctor. In some people with COPD, too much oxygen can
  • be dangerous.

Here’s wishing you a happy and healthy Diwali!  To buy the mask please visit our site.

5 steps to Happy Feet

A lot of senior citizens who come to our store complain of pain in their feet. While there could be several reasons for their pain, and it is best to approach the doctor for proper guidance and cure, one way to reduce foot pain is to increase blood circulation to your feet.

Age and certain chronic conditions such as diabetes can reduce the blood flowing to the extremities. This results in reduced oxygen and nutrient supply to the cells and this can result in pain.

Here are 5 things you can do to reduce pain in your feet:

jwalker1. Walk.
This may sound like weird advice for somebody already suffering from feet ache. However, a moderate amount of walking can significantly improve blood circulation which in turn can reduce pain in the feet.


2. Keep your legs warm.
In winter months, it can get chill in the night and as you know cold can affect blood circulation. Keep your feet warm by covering them with a blanket or using a heating pad or a hot pack/hot water bottle.

Oppo_3971 vissco_heatingpad

3. Don’t cross your legs.
Many of us tend to cross our legs while sitting. Crossing legs also affects the blood flow to our feet. Sit down with both legs to the ground (do not leave them dangling) or even better, rest them on a footstool.


4. Massage your legs.
There is nothing as soothing and relaxing as a nice massage. Have a younger one give you a proper massage. Alternately get one of the foot massagers available in the market and indulge yourself once in a while.


5. Reduce weight (if you are over-weight)
Obviously the more heavy you are, the more work your feet have to do. Reducing your weight can go a long way in reducing feet pain.

Here is wishing you “Happy Feet”.


Facilitating grooming services

Barber_shavingAt Old is Gold Store, we are constantly looking for ways to help senior citizens and their caregivers.

One big complaint we have been hearing from many of the seniors unable to leave home was their inability to get a haircut or shave at home.  Last week, we took the first step of solving this problem by identifying a dependable local barber, running him through a short senior sensitization session and scheduling appointments for him.  He has started his work today and completed his morning appointments successfully.

This senior grooming service provider is available for house calls in and around Adyar on all Tuesdays.

You can fix an appointment by calling us at 044 244 66 244.

If any of you know of any dependable, clean and hygienic barbers in your area, let us know so that we can enlist their services and help them and senior citizens in their area.  Thanks


Life-life balance

life-balance-elephant1People are fond of talking about work-life balance. Basically what this phrase means is that one’s life should not be all work and there must be time allocated for self, family, friends and recreation and hobby,  so that there is a good balance in one’s life.

For people who are looking after elderly loved ones at home (whom we call “family caregivers”), we have a similar phrase – it’s called life-life balance.

Many of the family caregivers we meet have pretty much completely given their lives to looking after their elder ones, usually their parents. We know a Doctor who has given up practice to look after her mother, a man who has taken long leave from his government job (on loss of pay) to look after his ailing and aged father, a lady looking after her husband who has got Alzheimer’s and her mother-in-law who is really old, the list goes on…

What is common to all these people is that they no longer seem to have a life of their own. Their day (and night) revolves around the people they are caring for and everything they do is rearranged to ensure that the routine for these people is not upset. This kind of life can be extremely stressful and many of them are depressed, and have lost interest in all the things that gave their life a good balance.

If you are family caregiver, falling into such a rut is very easy, and before you know it, you life would have become completely uni-dimensional.  To avoid getting caught do the following:

1. List down things that you love doing. This could include work, hobbies, general activities, fitness routines, friends, etc.

2. Build a support structure that will let you provide time for most of these activities. Have helpers come in to relieve you, talk to your friends, relatives, siblings to give you regular breaks – any which way, ensure you always have some “me” time.

3. Don’t let the condition of those under your care get to you. More importantly don’t feel guilty. Most family caregivers have not received a single day’s formal training in looking after the elderly and consequently most feel inadequate and ill-equipped to handle the different situations that arise. When you are feeling that way, tell yourself you are providing the best support that you possibly can.

4. Get proper rest. Getting up 3-5 times every night can be extremely enervating. Even if you believe that you are used to it, it can still impair your judgement considerably. So do not compromise on the rest and sleep that you need. Find ways to avoid having to get up in the night. Diapers can help a lot here or have a night nurse so you can be fresh to face each new day.

5. Remember, you are duty bound to look after yourself as well as your loved ones. Besides, only when you are fit can you do a good job of providing support to the cared ones.

Life-Life balance is all about making sure you don’t short-change yourself. Get up and go get a life!

This is an article in the series – “The Elephant in the Room”.
The elephant in the room” (TEITR) series is meant to highlight many facts and realities about the life of senior citizens in India that most of us tend to ignore/avoid.

Silver and its anti-bacterial properties.

how-silver-ions-workYou would be surprised to know that silver and silver compounds have a toxic effect on various bacteria, viruses, algae and fungi. While heavy metals such as mercury and lead have similar properties, the advantage with silver is that it is not toxic to human beings unlike lead and mercury. Below are some of the ways in which the medical industry has been using silver and silver compounds:

Several topical creams and gels have silver in them and help in speeding up the healing process for burns and cuts.

Hospitals are impregnating their upholstry, bed linen and even carpets in an effort to increase the sterility of their premises.

Silver is commonly used in catherers as they are very effective in reducing bacteria, especially for adults having short-term catheterizations in hospitals.

Because Silver inhibits the growth of bacteria and fungi on clothing, it is being used in clothing such as socks to reduce odors and the risk of bacterial and fungal infections. It is incorporated into clothing or shoes either by integrating silver nanoparticles into the polymer from which yarns are made or by coating yarns with silver. When it is used as a yarn, even washing has only minimal detrimental effect on its anti-bacterial efficacy leading to long lasting effectiveness. These socks are especially useful for people with diabetes who are prone to infections that can lead to further complications.

Silver yarn socks are now available in India. They are quite inexpensive and very comfortable to wear and can protect you from infection. To know more go here.