Elder care: Caring for Your Aging Relatives
By: Dr. Peggy Malone
On this week’s episode of my television show ‘Living Well’, I chatted with Wendy Francis from the Alzheimer’s Society of Elgin and St. Thomas. I also talked to local health care provider Nancy Whittingham who has had some personal challenges that have inspired her to be a groundbreaker in the field of elder care in St. Thomas and Elgin County and beyond.
Both of these women shared some amazing information that will help you to make better decisions, offer better support and take care of your aging relatives and loved ones and yourself through the aging process.
There was such amazing content from this episode that I split it into two parts. In Monday’s post I shared Wendy’s great information on Alzheimer’s Disease and Senile Dementia and today we will cover Nancy’s information on eldercare.
Nancy Whittingham was inspired by her own personal journey to advocate for the elderly and their families as they age and potentially transfer their care to an elder care facility.
How did you become interested in the area of elder care?
Through my healthcare clinical practice, working with clients as they transitioned to long-term care facilities and then personally with my mom in 2007-09. Eldercare happens at home, in hospital, retirement and nursing homes.
How has your personal experience shaped your view of elder care?
I’ve been studying and involved with various aspects of natural health for over 25 years. That interest was initiated because of my mom’s experience using an integrative medical approach to address her long-standing rheumatoid arthritis condition.
I’m an advocate of an integrative medical model and my family advocated for that for our mom when she lived in a nursing home at the end of her life. When she entered the nursing home, she was taking almost no pharmaceutical drugs. This is important because recent Health Canada estimates reported that 70+ % of Canadians use natural health products as part of their healthcare options.
It is important to have other options available other than pharmaceuticals because there are serious issues with the elderly and drugs. Some of these are: overmedication; prescribing cascades/polypharmacy where one drug causes a side effect and then another drug is given to address the side effect and then it can just keep continuing; medications aren’t tested for safety and efficacy for seniors; no clinical trials for drugs are done on seniors due to ethical and other issues; there are high occurrences of adverse drug reactions (A.D.R.) with as many as 3,300 Canadians over 65 dying each year due to A.D.R. and seniors account for approximately 40% of prescription drug use in Canada; the elderly have declining function of various organs such as their kidneys and liver and so their bodies can’t process & eliminate a drug as efficiently, many drugs react differently in their bodies but this is not always considered in the type and or amount of the drug given.
There is a list called the Beer’s List that is comprised by a panel of geriatric experts and it is a list of 48 medications or classes of medications that should be avoided for the elderly because the risks outweigh the benefits. This was developed due to the shortage of geriatric specialists so that it would be a guideline for M.D.’s in general practice, but unfortunately, not all are aware of it or use it as a reference when prescribing for their elderly patients. This list can be found online.
In your opinion, what are a few important aspects of elder care that someone needs to be aware of?
Most important is to have conversations with family members before the need for eldercare arises. Know what your loved one wants regarding their care.
It’s essential to have Power of Attorney (POA) status established for both personal care and finances. Have this in place in advance and before your loved one is unable or unfit to make decisions in either of these regards.
It’s important for clear, honest and respectful communication with the entire team including family members, caregivers, medical staff, nursing staff and personal support workers. Discuss issues so there can be clear communication strategies and consensus if possible and this is crucial to have especially before a crisis occurs.
Be an advocate, especially when someone is in a long-term care facility and particularly if you are the Substitute Decision Maker (SDM). You need to be present as much as possible in order to know what is going on and to provide loving support for your family member.
Informed consent for medications!!!!! That means the doctor or nurse must give all information about the drug, test or procedure being recommended. This includes describing what the benefits, side effects, and reason for the requested medical intervention are so that the patient and /or family member(s) can make an informed choice as to whether or not to give consent to proceed.
Know that you/your family can’t do it all, that you’ll need the help of the whole family if possible. Even if some don’t live in the same city they can be consulted by phone, participate in decision-making and can offer emotional support. Also use the help friends, professional caregivers, and respite care where 4 weeks per year are available either spread out or taken all at once.
This usually is a highly emotional journey with a loved one as they age, especially if there is high cognitive decline/dementia. Take care to have healthy avenues to process your emotions.
What are some proactive strategies that would be helpful for an individual or a family that will be dealing with elder care in the near future?
– As mentioned above, know what your family member wants.
- – Be aware of your family member’s financial status so that you are aware of all possible options for care.
- – Do research, talk with friends and colleagues for their advice/suggestions especially if they have been through this experience.
- – Contact the Community Care Access Centre (C.C.A.C) in your area as they are the gateway for the process of getting into a long-term care facility.
- – Investigate, go and visit some nursing homes that you are potentially interested in putting on your list. You get to choose 3 options to put on your application with C.C.A.C. Ask around re: staff reputations, the medical staff’s philosophy especially if you want to use an integrative medical approach as some are not supportive of this. Each nursing home has an annual review done by the Ministry of Health, Long-Term Care and this report is made available to the public by each nursing home if requested. My suggestion is that staff reputation and attitude is more important that the bells & whistles of a beautiful location because they are involved with the daily living and personal care of residents.
- – There is usually a long wait list to get into a nursing home. Once you are in the CCAC system, you could get a phone call at any time informing you that a bed is available in one of your 3 choices of nursing homes. Your family usually have only a few hours to make a decision to take the bed and if declined, you go to the bottom of the list.
- – Look into the private nursing care that is available in your area to help with care at home. There are many private companies that exist and this is a growing area due to the increased demand, especially with the aging population.
- – Be aware of the Nursing Home Act, and the Resident’s Bill of Rights. These are available online and the latter is usually posted in clear view in a nursing home.
- – Most importantly and this dovetails with the Roger’s show, Living Well. Anyone has the potential to live a long time…….Are you ready???? Are you focussed on preventative wellness from a physical, emotional, mental and spiritual perspective?? This may be more relevant now as the baby boomers start turning 65 this year (2011). Some have termed it the “grey tsunami”. If more people enter their elder years in better overall health, that could mean less strain on the healthcare system and a greater chance of living longer in an independent and healthy way.
From your experience, could you share the differences of elder care at home vs. a long-term care facility?
It depends on many factors of when a long-term care facility is an option. These may include the status of the person’s physical and mental health, financial abilities, and family members available for eldercare at home.
The biggest change once in a nursing home is that it’s an institutional setting and there are rules and regulations that must be followed by staff due to this. It is often a huge, stressful change for all but especially for the elderly person leaving their home and moving into a strange setting with new people. The resident loses some control over their daily life just due to the nature of the setting ( ie: prescribed mealtimes, bathing times, lack of privacy, noise, suddenly living with a group of strangers, and realizing this move is more than likely where you will be living out the last part of your life). Statistics show that over ½ of those living in a long-term care facility have dementia.
A long-term care facility can give more balance to caregivers/family members and often is a necessity due to the declining physical/mental state of their loved one.
Often there is a change in family doctor when one is moved into a nursing home. If possible, it is wise to keep your family doctor if they are willing to see their patient in a nursing home as it helps with continuity of care.
In my opinion, it is the best scenario to keep a loved one in their home or living with a family member as long as possible.
What would you suggest as helpful resources and sources of information?
- – Friends, colleagues, professionals in eldercare and those who have had experience with this life journey
- – Research on the internet
- – Community Care Access Centre (C.C.A.C.)
- – Ministry of Health, Long-Term Care, & Compliance
- – Advocacy Centre for the Elderly
- – Seniors Healthy Aging Resource Environment Society (SHARES)\
- – Alzheimer’s Society of Elgin-St. Thomas
- – St. Thomas Elgin General Hospital – List of Home Service Providers
- – Private, Professional Homecare Companies
Know that as you are navigating the sometimes challenging world of caring for your aging relatives, you are not alone. There are many resources that can help to make the transition much easier.
Dr. Peggy Malone is a Chiropractor and an Athlete who helps other athletes to overcome injury and get back to their sport. Her weekly Television Series 'Living Well" inspires people from all walks of life to take control of their health to be as happy and as healthy as they can be.
A former varsity Basketball and Rugby player, she has since entered the world of endurance athletics where she has completed 2 Ironman Triathlons, 3 Marathons, several Half Marathons and many other Triathlons, Road Races and Off-Road Adventure races of varying distances.
Her own athletic endeavors and injuries have given her valuable insight into working with athletes in her practice for both the care of injuries as well as for the improvement of athletic performance.
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