We often hear these phrases; “Why do they behave like kids? They are so stubborn like children!”  As our parents grow older, we play the dual roles of being parents to our children and caregivers to our parents. Is caring for our parents the same as caring for our children?

Having experienced both roles, I can say categorically that it is completely different caring for our parents.  Children require us to walk the talk. We as parents need to guide them through tough choices, be supportive through tough situations and help them navigate through life. Until they grow up and become independent, we support them through the phases of childhood, teenage years and adulthood. We can see them bloom and grow into strong, independent adults.

Our parents have been there and done that with us. In their twilight years, they face a different future. They see themselves becoming weaker. It takes longer to walk the stairs. They require more visits to the doctors, more medicines, and different diets. They find it so difficult to ask for help. A walking stick is a symbol of their growing old and is often resented.

The biggest difference in caring for our parents as compared to caring for our children is our attitude. We are used to looking at our parents for help, guidance and support.  They were so strong, could carry us on their shoulders and were there in our universe forever. And now, to see them grey, weak and ill often moves us to anger and frustration. We are not ready for them to become old. But it creeps up on them and on us. And one day, we find ourselves changing diapers, giving them medicines, taking them to the doctors, making special food. We feel panicked when dementia, Alzheimer’s, or just old age diminishes their physical and mental capabilities until they don’t resemble the parents we know.

Acceptance

It is acceptance that changes the way we care for our parents – acceptance of their old age, their infirmities, their helplessness, and their need for independence. Once we accept, we can move past our feelings. The anger and frustration dies away replaced by empathy and love. It becomes easier to give your Dad a bath without being embarrassed.

Parents in their twilight years face the prospect of illness, loss of independence and death. We need to create an environment where they feel safe, well cared for and inclusive. We need to treat them with dignity, help them face their illnesses and fears.

Seniors falling and injuring themselves is every caregiver’s nightmare. Many older adults want to be independent as long as possible, yet they are at risk of falling. Balance exercises is essentially for seniors who want to retain their independence.

We found a free 12 minute video by Physical Therapists Bob Schrupp and Brad Heineck that helps seniors improve their balance with 10 useful balance exercises for seniors to do at home.

If your older adult practice these simple exercises at home, they can increase balance and reduce fall risk. This is important to seniors because falls can lead to several complication, including hospitalisation.

This product from Karma is extremely light-weight and highly durable. This ultra-light transport chair weighs only – 9.2kg can take up to 100Kg weight and provides a more stable ride. Can move in very narrow space and allows easy storage and transport.

AVAILABLE AT OLD IS GOLD STORE

Doorways

• The safest way to operate the wheelchair is on level floors that are free of obstacles. Whenever possible use a ramp to enter or exit a facility. Keeping your hands on the push rims will allow you to maintain maximum balance. Do not try to force yourself over an obstruction by propulsion and never use the sides of a doorway to pull yourself through a passageway.

Negotiating Inclines

• Never turn on a hill due to the danger of tipping.
• When assisting, go straight up a slope. If user needs to go down midway, walk backwards until user is on level ground. (See Figures 2.2 and 2.3.)
• Do not drive up to 7 degrees of incline to avoid danger. When negotiating inclines, don’t propel up to 3 degrees of incline.
• Avoid stopping on an incline, it can potentially cause you to lose control of the wheelchair.
• Do not use the brakes to slow down or stop the wheelchair, this could cause it to seize up, causing you to lose control or fall out of the wheelchair.
• Whenever possible, utilize help from an assistant/attendant while negotiating inclines.

Figure 2.2

Figure2.3

Kerbs

• Whenever possible get help from an assistant/attendant (if you have assistance make sure that your chair is equipped with push handles)
• Avoid hard impacts when descending a kerb. A hard impact could adversely affect the wheelchair.
• Never try to scale or descend kerbs that exceed a normal height.
• Always take care when climbing kerbs or turning on slopes and never move in reverse without an assistant.

Stairs

• Always use two or more assistants. Tilt the wheelchair to its point of equilibrium. One assistant (at the back) holds the wheelchair up against the first step, gripping the handles firmly to lift. The second assistant, holding firmly a fixed part of the front frame, lifts the wheelchair above the stairs and holds it while the first attendant places one foot on the following step and repeat the operation (See below Figure)
• Never go down the steps forwards.
• Never use an escalator for transport, use an elevator.

Streets

• Always use extreme caution when crossing streets. Reflective tape on the wheelchair and/or your clothing will make you more visible to drivers.
• Please comply with traffic safety code.
• Avoid potholes and rough terrain that might cause the casters to become stuck. (See Figure 2.4)

Figure 2.4

General

• Always make sure BOTH brakes are applied before getting in or out of the wheelchair.
• Never stand on the footplates when getting in or out of the wheelchair.
• Never carry more than one passenger. KARMA wheelchairs are limited to one user.
• Use caution to assure your clothing doesn’t get tangled with the wheels.
• When the user is operating the wheelchair using the push rim, please push the wheelchair gently. DO NOT apply a sudden huge force on the push rim. It could cause the chair to tip over. Please refer to the figure below for the best grip points for using the push rim.

Upholstery

• When cleaning the upholstery, use warm water and a mild soap.
• Upholstery cleaner/foam can also be used, but avoid other cleaning solvents.
• Do be far away of flame, it might injury user and damage the wheelchair.

Anti-tippers

• Please strongly consider purchasing anti-tippers and always use them to avoid personal injury. The distance between anti-tipper and wheels is at least 5cm; the height to floor doesn’t exceed 5 cm.

 Maximum User Weight Limit

• Loads exceeding maximum capacity can damage your wheelchair and cause malfunctions yielding a safety hazard.

Avoid General Misuse

• Any vehicle can cause injury if misused and with reasonable care and your safety will be ensured.
• Your wheelchair will give years of safe use if used sensibly and be aware that careless use endangers your own safety as well as that of user.
  • Do not let children stand or play on the wheelchair. (See Figure 2.5)

Figure 2.5

Festive season is just around the corner and it’s time to figure out what you should gift your parents this year.  The question is what do you get your parents who already have everything?

Elderly parents don’t need or want gifts to put on their shelves or coffee tables…just adds to the clutter. Nor do they want a kitchen aid, clothes or shopping coupons. Parents usually claim they have everything they need, but that’s not entirely true because when it comes to their safety and comfort, they tend to take it lightly.

We’ve come up with 7 Diwali gift ideas for parents who have everything that will not only put a smile on their faces but also ensure their safety and comfort.

#1 COMODITA Prima Special Rollator Walker with exclusive 16 inch wide, ultra-comfortable orthopedic seat.

This rollator is a walker with a seat for elders who require balance support as well as a place to sit down comfortably anywhere.  Especially useful when going for walks in safe places like malls and gated communities. The modern design and sturdy construction of the Comodita Prima Special Rolling Walker make it one of the safest walkers on the market. The exclusive 16″ wide orthopedic seat makes it ultra-comfortable, ideal for users that enjoy resting between walks. –   BUY NOW!

#2 MOBILITA Walking Stick/Tripod With Swivel Base

Height adjustable, high-grade aluminium walking stick with tripod base and L-shaped handle. The base also swivels ensuring that the base is firmly placed on the ground irrespective of the angle of pressure or angle of the surface. Provides superior grip and comfort. For regular use, for people with minor balance issues and weak legs.   BUY NOW!

#3 MOBILITA Raised Toilet Seat with Lid

A typical western closet is about 16″ in height.  This is very low for many seniors and those with recent knee surgery. So, they find it very difficult to sit down and get up from the toilet seat.

The toilet raiser is a easy to install device that can provide additional height.  Besides, this is made of good grade plastic. Also, the raiser comes with a lid and simple clamps to hold it firmly in place.  Easy to clean, extremely hygienic and comfortable. Comes in 3 heights (2”, 4”, 6”) and fits most western closets. BUY NOW!

#4 MOBILITA Extra-Wide Comfortable and Adjustable Backrest

This is an adjustable backrest to put on the bed so that the person reclining can sit up at various angles.  This can help people with reflux, breathing difficulties or for people to have good back support while reading, working, watching TV or eating in bed.   BUY NOW!

#5 Squatty Potty Style Stool for Western Commode – Height Adjustable

This is a wonderful stool to enable those using a western closet to sit at the right angle for easiest evacuation.  Also, this is a well manufactured product with two pieces, one fitting on top of the other to provide two heights, namely 7″ and 9″.

It is very similar to the award-winning squatty potty.     BUY NOW!

#6 Swivel Seat for Car

Do you or your elderly relatives find it difficult to get off the car seat?  This unique cushion swivels 360 degrees to make it easy to get in and out of any car. The foam cushion sits on a turntable base so you can swivel sideways to get in or out of the seat without straining your back or hips. Lightweight and portable.  BUY NOW!

#7 Anti-Slip Safety Mat for Wet Areas Standard Size (2.5ft X 1.5ft)

The bathroom is one of the most accident-prone areas in the house. Especially in India where most bathrooms and toilets are perennially wet. This anti-slip mat is similar to the mats used around swimming pools to help wet areas stay slip-free.

Besides, there are large gaps to allow free flow of water, the anti-slip mat remains dry on the top ensuring dramatic reduction in the possibility of slipping.

Available in standard size of 2.5 ft x 1.5 ft.  BUY NOW!

There are many constraints commonly voiced by NRIs when they are discussing ways to take care of their ageing parents back in India, especially after some medical event has made their parents less independent than before. Many of these constraints do not take into consideration ground realities and what is best for their parents.  This article lists some of these contraints raised in order to highlight the fact that it is important for the NRIs to understand that the situation has changed and they and their parents need to adapt to the new circumstances.

1.  My parents don’t want to leave the house/area they are currently living in.

This is one of the commonest requests.  “My parents have always been independent and capable of looking after themselves.  However, since my father had his operation/ has become bedridden, things have become very difficult for them to manage on their own.  However, they don’t want to move out of their house“.

If one or both of your ageing parents are living in an independent house or even an apartment and are no longer capable of managing their daily living activities, and there is no one else to help them, then you should have all options on the table, including the possibility of moving into a care centre (if available).

2.  We don’t want a full-time live-in person as it will impact their privacy. Is it not enough for someone to come only for the morning/night?

Having someone around 24 x 7 is absolutely essential if your parents’ capacity to look after themselves is diminished.  If you have someone during the day and no one at night, what happens if your mother needs to go to the bathroom in the middle of the night?  Or has breathing difficulties?  Or requires water to drink? Or has some other medical emergency?

If you have someone at night but not during the day, who will help them bathe, eat, and perform other daily living activities.

3.  We don’t mind having 2 shifts one coming in the morning and one coming in at night, but they should bring their own food and not use our bathrooms.

If you have two people working round the clock, then you are talking about two 12-hour shifts.  So let us say, one comes in and stays from 8 AM to 8 PM, and the other comes in at 8 PM to 8 AM next morning. It is going to be extremely difficult for them not to have at least one meal and some coffee/tea during their 12-hour period. Or use the rest room for that matter.  Would you work under such conditions?  And even if somebody is willing to, do you think they will be able to give the kind of care you expect for your parents?

4.  Not understanding recovery periods.

“My mother broke her hip and has had her operation.  I am here to look after her.  I am sure she will be back on her feet in a month and I can go back.  Nothing needs to change“.

Yeah! Right!
As people get older,  recovery takes longer.  And even after they recover, they are unlikely to get back to their old independent self. At least not in the majority of the cases.  Face the facts. Things have changed.  You have to deal with it.

5. My parents only eat what they have cooked.

Well, if they are no longer able to cook, then they have no other option but to hire a cook or order food from outside. Can you think of any other option?

Well, we aren’t here to dismiss your constraints and worries.  You are far away from your parents and neither party can move in with the other.  These are ground realities.  Everyone knows you as an NRI would find it extremely difficult if not impossible to uproot yourself from home, family and career to come back to India to look after your parents.  Just don’t let that guilt stop you from making other hard decisions.  Put your foot down where you need to, and make the changes that you have to. If it costs you more, well, just figure out a way of taking care of it.  The well-being of your ageing parents is still your responsibility.

Every week we get calls from around the world asking us the same question. “Can you recommend someone who would look after our ageing parents back in India?”.

Unfortunately, in most cases the short answer is “no”.

While India may be the head quarters of outsourced services for the software and back-office industries, we are as yet unable to find high-quality service providers for looking after ageing parents.

This is not just because there are so few such home health care agencies ready to take on such a role, but is also because of the myriad constraints that the NRIs and their parents put on the potential service providers.

Ideally what you are looking for is a continuing care facility or a multi-level care facility such as those found in the west which provide all the services necessary to an ageing resident, whatever be their physical and mental condition, now and in the future.

Such establishments are rare in India, at this point in time, though a few are coming up in various parts of the country.

Realistically though, for now your best option is to find an immediate family member or a close relative to look after your parents and arrange for a home healthcare service provider to assist the family member/relative in the care giving process.

Options

If an immediate family member or close relative is not available, look out further for a relative, who because of financial reasons, would be willing to stay with your parents and look after them for a monthly salary. This would be a win-win situation for both parties as it gives you a dependable and trustworthy resource to be your representative at home while providing this relative with boarding, lodging and a certain amount of financial independence. Of course, it may not be fair to have them look after all aspects of caregiving (depending on the condition and needs of your parents). So, you can arrange for professional home care service provider to assist this person in the routine aspects of caregiving.

In the next article we will see what are the common constraints people face and how some of those could be tackled.