November 9, 2015

Of course, those who care for demented elderly patients will know there is no such thing as a quick tip. Everything you do must be tailored to the patient. But I thought I would give it a try. Sort of a chronicle of my day in caring for mom and overcoming the challenges she poses.

1. Never feed your patient anything your dog should not eat!

My mother does not like dogs. She never has. But she is quick to use my Val.

Here, let me give him my food. He looks hungry.

No mom, Valentino has his own food.

If she says it once, she will try it an indefinite amount of times, no matter how hard you protest. The simple solution is never to leave her alone with the dog while she is eating. Allow me to raise an even more serious alarm: Never give mom anything that is poisonous to the dog. I avoid giving her dark chocolate, raisins, grapes, or chicken or turkey with bones. If I do give her a small amount of these things, I am sure never to leave her alone.

2. Keep disinfectant on hand in every room!

This is very important. You don’t want to have to run to another room to get a wipe or a spray. Mom was wiping her placemat—I assure you it was clean—with her napkin, which she had moistened with spittle. The mats are clear plastic imprinted with pictures of animals. Occasionally some of the dye splatters in the process of making the mats. Mom unfailingly tries to remove the dye with her spittle and her napkin. The mats are actually new and replaced the last mat, which was one of a set from Pimpernel. Quite lovely. But wherever she wore down the design with her incessant rubbing, she filled it in with ink or pencil. We could no longer bear the desecration; so we pitched the mat—sigh!—and replaced it with something simpler and easier to clean.

3. Keep napkins and tissues out of reach!

Mom is a napkin and tissue hoarder. I am led to believe that many elderly are—hoarders, that is. (Add pens and pencils and lip gloss to her hoarding habits.) Back to the paper: Wherever mom sees a napkin or tissue, she claims it. She runs through a roll of toilet paper every 2 to 3 days. You will often see her rolling the paper in her hand until she has a satisfactorily large wad to stuff into her pocket. In fact, enough with which to polish a car! Each day, we assiduously empty her bed and chairs and pockets of the napkins and tissues she collected the day before. When she stayed at a lovely assisted-living residence nearby for a few days, they presented us with an entire hamper full of tissues and napkins she had spirited away.

Keeping her stash to a minimum is important, not just a matter of aesthetics or housekeeping. The paper wads often find their way into her diaper and down the toilet. As this is an old house, my drains are not able to take a steady diet of mom’s paper goods. If your parent hoards paper goods, keep a drain cleaner and the number of Roto Rooter on hand!

4. Keep rubber gloves on hand for rinsing soiled clothing!

Rubber gloves should be kept in addition to the surgical gloves, which are a must for all toileting and showering. I keep rubber gloves in the basement sink, where we pile her soiled clothing. I first wash everything out in the sink while wearing my heavy-duty gloves. Next step is the Lysol wash. All of her clothing goes through two washes: first in Lysol Concentrate and detergent, then in detergent to rid the clothing of the smell of the Lysol. Great product, and it isn’t destructive to the material. My water bill may be sky high, but her clothing is clean.

5. Be sure lighting is sufficient!

I keep night lights on all over the place to be sure mom can see when she navigates her way to the toilet at night. I need not remind any readers how dangerous a fall can be for elderly patients. By the way, my electric bill is also out of sight! So it goes.

6. Remove all area rugs!

Years ago, I wrote a primer on caring for patients with osteoporosis. Area rugs were among the objects that constituted a serious falling hazard. They are especially dangerous for people who are not steady on their feet and who are wielding walkers. Our prettiest Oriental carpets and their mats now languish in corners or the basement. But at least they are not subject to spills or other soiling.

7. Use sippy cups!

Mom was forever spilling her drinks, as the glasses she used became too heavy for her. So now we use sippy cups. She seems to enjoy drinking from the particolored cups. And we have eliminated the danger of having her (and Valentino) walking over shattered glass. The sippy cups also serve another useful purpose. I recently poured some juice for mom in a narrow glass. I was on hand to supervise. But she protested that it was too much to drink. So I poured everything into the sippy cup. Mom drank it down without a complaint.

8. Hide the hairbrush!

This might not be a problem with elderly men, but it is for elderly women with thinning hair who are particular about cleaning the brushes. When mom brushes her hair, she pulls the stray strands off the brush and washes them down the bathroom sink. Again: drain cleaner and Roto Rooter!

9. Lock the doors!

This entails more than your normal door locks. Fortunately, mom is short, so I employ a chain lock high up on the doors, where she cannot reach. The door I am most concerned about is the basement door. Although she has never tried it, there is always a first time. Unfortunately, mom can open all the other doors and we cannot use combination bolts for our own safety in case of fire. But, I am a very light sleeper, which makes my nights extremely difficult. (I can hear Val padding on my bedroom carpet, let alone mom banging her walker on the way to the bathroom and then slamming the bathroom door.) But when I do sleep, I rest assured that mom cannot reach the chains. However, I am reminded of the time Ann found mom on a chair, while trying to reach candy she had hidden on top of a cabinet. Ann nearly had a heart attack. Fortunately, the chairs here are too heavy unwieldy for her to move. And the kitchen stools are curved saddle benches that cannot be used for climbing.

10. Keep a chalkboard or a slate handy!

Mom asks the same questions over and over and over and over—ad infinitum! Continually answering her becomes an annoyance and a distraction. So to prevent going hoarse and going mad, we keep a slate nearby with the answers on it. When she starts to fugue again, we merely show her the slate. Mom will usually read the answer aloud and then say, Oh. And sometimes, she just asks the same question again, forgetting that she has read the answer. Just shake your head and slowly walk away. Maybe that’s the time to go down the basement to do another load of laundry.