Making Your Home Safe

Safety is paramount in caring for your loved one. Many times the way our home is arranged is not really accessible or safe for someone who may be disabled or limited in their mobility. I recommend that you contact an Occupational Therapist to come out and evaluate your home. You can find an Occupational Therapist by contacting your hospital or rehabilitation center. You may also find them listed in the yellow pages. Their job is to help you make your home as safe as possible. They may even make suggestions as to structural changes which may be necessary for wheelchair accomodation. Perhaps you will need a ramp or will need to have doorways enlarged.

One of the typical changes will be a raised toilet seat with a grab bar beside it and grab bars in the bathtub and shower area. You may need a bath chair or bench in the shower that extends outside of the shower so they can transfer from a wheelchair and then slide over to be inside the shower. There will need to be organizers on the stool or bench that can hold soap, a wash cloth and shampoo. You will also need to make certain that there is a non-skid mat in the bath/shower as well as to step on when they get out. There are brushes that you can buy with long handles that allow your loved one to reach their feet or back.

Special attention needs to be given to the loved one's bedroom, their bathroom, any hallway they may need to use and any other room where they may spend a portion of their day. The kitchen may, or may not be, a place where they will spend time. If they are ambulatory, will they need handrails to get from one room to another? Or will they need to use a walker? A cane? Are there scatter rugs? They will need to be removed! Does furniture need to be rearranged for easier access? Do you have an intercom or baby monitor so you can hear them if they need you?

Hallways, bedrooms and bathrooms will all need nightlights. If they need to get up during the night, bright lights can disorient someone who has just woken up.

Make sure there are operational smoke alarms outside the bedroom and an accessible fire extinquisher.

Is there a cordless phone near both their bed and chair where they may spend a portion of the day? This is necessary if they will spend any time alone. Phones need to be programmed with emergency numbers, and yours, and have adaptive equipment if they are hard of hearing or large numbers if they have vision problems. Another necessity would be a medical or home alert necklace or bracelet. This would be a necessity if they wil be alone during the day.

On their bedstand they will need the phone (you can shut the ringer off in their room), a flashlight, and a bell to contact you if they can't yell for assistance. If they have emphysema, COPD, or asthma they may also need to have a breathing machine, or oxygen.

You will need to make certain that all obstacles are out of their way. That will include rugs and thresholds that may inhibit a walker, wheelchair or shuffling feet. And speaking of shuffling feet--do know what they are putting on their feet? NO SCUFFIES! Sneakers are best and they come with velcro tabs to close them.

The bathroom is the room where most accidents happen. If you have a tile or stone floor a fall there would certainly mean a broken bone or even a hip. You may want to have the bathroom fitted with a remant carpet piece. A slippery floor is not a good mix with a fragile person with mobility issues.

Consider the following do they need to have a hospital bed that lowers and raises? Or do they need rails to prevent falling? What about a beside commode?

A body pillow (cylindrical pillows that are about 3 to 4 feet long) can make them more comfortable. If they sleep on their side it goes between their knees and will help keep their spine in alignment. If they sleep on their back it goes under their knees which takes the stress off their lower back.

Kitchens--many people who need care are no longer active in the kitchen but if this is a big part of their identity it would be good to help set up the kitchen for their use. Coffee pot on the counter, a few dishes that they can use on the counter. If they have some memory loss there are locks you can get (and I strongly recommend) for the stove, cabinets that contain chemicals, and you can remove the knobs from the burners.

Take as many precautions as you can and your life will be easier in the long run.

Assessing the Costs of Caregiving

The average amount of time spent being a caregiver is five years. Unless you are aware of a terminal illness that may cause a death prior to that time you should figure your costs for a five year plan.

Will you need to take off work in order to provide care? Can you afford to do this? You will likely need to be available to take your loved one to medical appointments--which can be frequent. Do they need someone to be with them all day, or can they be independent while you are working?,

Does your community have an Adult Day Program? The typical costs are $40 a day. Does it provide transportation or is that your responsibility? Is there an active Senior Center in their community that they could spend some time each day?

What about meals? Will you make the meals for them? If you work will you leave a prepared meal? Do you have Meals on Wheels delivery available? These are on a sliding scale fee and frankly, I find them neither nutritious nor appetizing. Typically they are very high in sodium with a high tomato sauce content which can be irritating to a sensitive stomach to add all that acid. Can you afford to hire a personal chef who would cook 10 meals a week and leave them in their freezer?

Can you contact a local agency to do home care during the day? Or can you afford a private hire? In any case, you want to make certain that not only do you do a careful search but also a background investigation before you bring someone into your home to work with your loved one.

If you make the decision to keep your loved one at home, you will need to find a resource for a break. You will need a vacation time during the year. Will you have the support of other family members while you go away? Is there a nursing facility that has a respite care program that would be able to accomodate them for a week or so?

The average cost of a nursing home care is $50,000 a year--and that's without special services. The majority of the population still do not have long term care insurance so is this an amount you could afford? Because this is a long-term commitment, planning for the future is key. Take into account your loved one's financial resources, what opportunities there are in your community, and your emotional health.

In a great plan, you would have had this discussion with your loved one long before they need your help. You'll know what they want, be able to talk about what if you are unable to do that and what options they'd like. I also think it's a good idea to have them put it in writing so you can refer back to it with them if need be. With careful planning, being a caregiver can not only be doable but also rewarding for both of you.