Elders need care, but you needn’t stress over them! Here's how to maintain a balance

By Saliha Nasline

Mary Vineetha hardly gets a break. Her days are a tightly packed set of chores, having to look after her 75-year-old mother during the better part of the day and later rushing off to her call-centre job. She often declines invites to professional and social events because of her mother’s needs.

The situation isn’t unique to Vineetha. Those caring for elders at home often feel overwhelmed and alone. Having to juggle between work and personal choices is a challenge. But there’s a lot that can be done to make the lives of caregivers and elders better. First of all, ensure that the older person’s needs are met, in terms of nutrition, medication, hygiene and special needs, if any. Have a healthy line of communication always.

It is important to be equipped in geriatric care because the number of elderly is going to increase in a big way in the years to come. According to Dr RK Singal, director of internal medicine at BLK Super Speciality Hospital in New Delhi, the number of people aged 65 or older is projected to grow to nearly 1.5 billion in 2050 from 524 million in 2010, with most of the increase in developing countries.

CHOOSE A SUITABLE ROUTINE

The elderly like consistency and routine, so giving them meals and snacks at the same time every day really helps, says Dr Aashish Chaudhry, orthopaedic surgeon and MD of Aakash Healthcare, New Delhi.

“An elderly person requires a schedule of healthy activities for the day. Maintaining a health diary is a good practice with which noting symptoms, home diagnostics, advice received and updating a doctor become easy,” says Dr Ravi Modali, a health and wellness consultant at CallHealth, a home healthcare service in Hyderabad.

NUTRITION AND MEDICATION

“Proper nutrition and timely medication are important for elderly people to avoid preventable health adversities in life,” adds Modali.

Dr Girish Chandra, senior consultant, psychiatry, Aster CMI Hospital, Bengaluru, says: “The elderly have a variety of healthcare needs which get complicated with age. Medication regimes have to be clearly understood by the elderly and the people caring for them. A chart which names each medication and indication in a language they understand should be prepared and followed strictly. They can use several aids like a dosage box or set reminders on their phones to ensure compliance. Regular review of the medication with doctors is of utmost importance so that polypharmacy is reduced.”

He adds that a well-planned diet relevant to their medical condition needs to be followed. Weekly meal planning which incorporates all necessary nutrients is the best way. “In some older people, nutritional deficiencies can be addressed with supplements,” according to Chandra.

To help the elderly stay on track with a healthy eating plan, Singal has some tips. “Do not let them skip meals. Select high-fibre foods like whole-grain breads, cereals, beans, vegetables and fruits. These may help lower risk for chronic diseases such as coronary heart disease and type 2 diabetes. Give plenty of water. Feeling less thirsty as one gets older is a common phenomenon, but the body still needs water to stay healthy.

Water-based fluids like caffeine-free tea and coffee, soup and low-fat or skimmed milk are good options.”

KNOW WHAT IS GOOD FOR THEM

Generally, diet practices that can be adopted for elderly people include fresh, fibre-rich and low-fat food. Water intake of two to three litres per day cleanses the blood and maintains kidney function efficiency, Modali says.

According to Chaudhry, challenges facing the elderly include loss of appetite and ailments such as diabetes, coronary heart disease, hypertension, etc. Dietary changes affect risk factor levels at all times and may have an even greater impact in older people.



“Relatively modest reduction in saturated fat and salt intake, increasing consumption of fruits and vegetables by one or two servings daily help regular bowel movement. To keep bones healthy, ensure at least three servings of low-fat dairy foods enriched with calcium and vitamin D. Keeping an eye on meal portion size helps maintain ideal body weight,” he adds.

KEEP FITNESS IN MIND

Healthy eating and regular physical activity are keys to good health even in old age. Some physical exercise is very important for the elderly to retain their mobility for as long as possible. If they are not used to doing it, “encourage them to begin with just 10 minutes of walk three times a week. Slowly increasing the length of time is a must,” says Singal. The carer should make sure that the elderly exercise for at least 150 minutes every week, says Modali.

MAKE THEIR LIVES COMFORTABLE

Older people may face special physical and mental health challenges that need to be recognised. For example: “Wearing dentures may affect eating and swallowing. Offering food that is easy to chew and providing food that is cooked soft are important,” says Chaudhry. Pay attention to their vision and deal with any changes as a priority. Regular eye examinations are a must.

Dr L Sreenivasamurthy, medical director, Nightingales Home Health Services, says: “Use a lot of natural light during the day by keeping shades and curtains open for better visibility. One should keep the house, pathways, doorways and staircases lit in the night. Replace lever-style door handles with round door knobs. Install low shelves in cabinets that can be pulled down and drawers that close on their own. Have a bathing seat or a bench that is adjustable with a hand-held shower instead a fixed shower. The floors in the house can be carpeted to reduce shock in case of a fall.”

There are times when caregivers feel burdened, exhausted and hopeless.

It is very important to share the responsibility either with family members or others without feeling guilty. Delegating duties among members of the family will not only help to share the load, but also inculcate a sense of involvement. This will not only ease the burden on caregivers but also make the elderly feel wanted, says Aster’s Chandra. Where this is not possible, paid caregiving should be sought, he adds.

GET PROFESSIONAL HELP IF NEEDED

Chaudhry says: “One should get some help when elders in the house wet their beds, are troubled with bed sores, have Alzheimer’s, dentition loss, bad eyesight and hearing loss. Help is also needed when an elder has chronic medical diseases such as asthma, diabetes, osteoporosis, heart ailments, stroke, etc.”

Call for help when anything abnormal is noted. If the patient has temperature, loose stools or black coloured stools, breathlessness, no or less urine output or constipation, medical attention is needed, says Nightingale's Sreenivasamurthy.

Modali adds: “Involve cost-effective solutions like subscribing to chronic care programmes, medical attendant services, periodic health and well-being checks, home-based nursing and treatment plans, and facilitation services in hospitals.”

CULTIVATE PATIENCE

Physical exhaustion is a key reason for losing patience. Some things to keep in mind for keeping your cool are:

- Getting enough sleep

- Eating enough and, importantly, consumption of nourishing healthy foods

- Drinking enough water

- Taking breaks

- Having fun and a good laugh every now and then

- Finding connections outside the caregiving situation

WORK-CARE BALANCE

Caregivers have a difficult task of balancing their personal and work lives. “Not every business is suited for a virtual workforce, so don’t compromise on your productivity if they need you to arrive at work in person. However, employers can give their staff the option to work remotely when in emergency,” BLK’s Singal says.

There could also be a financial burden, including loss of salary due to losing time at work. In addition to lost time at job, lower productivity could influence your ability to climb the career ladder. So, taking help is of utmost importance.

PREVENT CAREGIVER BURNOUT

According to Uthista Thota, a psychologist at YourDost.com, “As a caregiver, you should think of getting help when you find yourself showing signs of ‘caregiver burnout.’ Caregiver burnout is used to describe the physical and mental exhaustion that can develop among caregivers, and is often developed when caregivers try to do more than they can to help their loved one.”

Caring for a loved one can often be a long-term challenge, changing the family dynamics, adding financial pressure and creating additional workload around the house.

As a result, caregiver burnout can be a real danger.

“If you find yourself lacking energy, feeling exhausted, having less enthusiasm and energy than before, even after sleeping, you are neglecting your own needs. Stress and burnout affect our immune systems, causing colds and headaches.

The truth is that once these effects begin taking place, you’re no longer in a fit condition to care for another person,” Thota says.

TAKE CARE OF YOURSELF

Caregivers should maintain their mental and physical health, take breaks regularly and ensure they participate in leisure activities. “It is important that caretakers look after themselves, eat a balanced diet and exercise regularly.

Providing care is rewarding only when it is done without much stress on oneself. Often, in caring for the elderly, what we note is that caretakers completely take over the tasks so the elderly start becoming dependent on them. A good care model is when independence is promoted and nurtured to improve the confidence of the elderly as well.

Caring for someone with physical disabilities, who find it difficult to cope with activities of daily living, has to be thought out in a slightly different manner,” Chandra says. Also, when a caregiver starts feeling hopeless, it’s important to try and spring out of it.

“Embrace your caregiving choice, focus on the positive reasons behind that choice, focus on the things you can control, celebrate small victories, talk to a supportive family member or friend,” advises Thota from YourDost.