Caregiver FAQs: Caregiver & Elderly Support, Hygiene & Health Help

The 3 Cs of caregiving are compassion, communication, and commitment.^1,2

Compassion means caring with empathy, respect, and dignity in mind. When you're compassionate, you naturally think about how you'd want to be treated and give that same care to your loved one.

For instance, if someone were to give you a bath, you would want privacy and some control. Compassion allows you to consider it for your loved ones without hesitation.

Communication is necessary for caregiving as it allows your loved ones to be involved in their care. It allows them to let you know their preferences, creating a safe space and easier care.

For example, your loved ones will prefer to follow a senior hygiene plan created with them, not for them.

Commitment keeps compassion and communication flowing. It means showing up even when you would rather stay home wrapped up in bed. It's hard, but showing up daily builds your resilience.

The 3Rs aim to improve the emotional side of your care; they are^3,4

• Respect: Understanding that your loved ones have their own emotional needs and strengths. Acknowledging this shows them respect and lets them know you see them.
• Reflect: When you're busy, it’s easy to care for your loved one based on routines or assumptions. Reflection is a break in that cycle. It involves actively taking a pause to understand your loved one's point of view and modifying your care.
• Respond: It involves taking the verbal and nonverbal cues learned from respect and reflecting to meet their present needs.

Caregiving often creates a space where you give all you have for someone and forget yourself.5 This space is caregiver burnout, and it could lead to physical and emotional exhaustion.⁵

If you find yourself going through the following, it’s time to find support:⁵

• Withdrawing from your friends and family
• Feeling hopeless and helpless
• Sleeping too little or too much
• Losing weight or gaining weight
• Finding it hard to focus
• Visiting the hospital frequently for one illness or the other

While you may feel like you don't need anyone, taking care of yourself can help you better care for your loved ones. ⁵ So, take a break with respite care. These services allow you to take days to weeks off to refresh and get back to feeling more like yourself.⁵

Leaving behind independence to rely on others can be challenging and may lead to feelings of denial. So, getting your loved ones to accept help could be a challenge.

Here are some communication strategies to break those walls:⁶

• Calm them down or make sure they are calm before accepting help.
• If their first language isn't English, try communicating in their first language.
• Pay attention to what they are saying and be present in conversation.
• Use terms of endearment to keep them softened.
• Be honest and open; use terms like “we” and “us”.
• Watch your body language; make sure it mirrors empathy, not pity.
• Talk to them with respect and empathy.
• Don't judge them for not wanting help.
• Ask questions to understand why they do not want help. Let your questions allow them to express themselves but remain respectful.
• Be positive about the outcome; being negative can put them on the defense throughout the conversation.

When they agree to accept help, involve them in the process. Start with small steps, like allowing them to pick who cares for them.

Here are some basic ways you could make your loved one's home safer:

• Remove tripping hazards like loose floorboards, rugs, and extension cords.
• Move furniture that blocks pathways to ensure clear walking areas.
• Ensure good lighting throughout the home, especially in hallways and staircases.
• Make the bathroom safer by installing grab bars, using nonslip mats, and adding shower chairs if needed.
• Use assistive devices like walkers or canes in living spaces to improve mobility.

• Be patient no matter the situation; don't be in a rush.
• Be prepared for any situation; think ahead. For example, pack an incontinence care bag when going out.
• Avoid being disrespectful; treat them like you would treat yourself.
• Celebrate their wins.
• Show empathy, not pity.
• Be kind; don't be cruel.
• Don't be dismissive; listen actively.
• Promote their independence; let them contribute to their care.
• Create a self-care routine for yourself. Remember, if you burn out, you can't give your best.
• Know when you need help and ask for it.

Here are some common challenges that you may face as a caregiver:^{7, 8}

• Time management: Caregiving is a full-time job that takes up most of your time. It often leaves you feeling isolated from your friends and family.
• Emotional strain: Caring for someone 24/7 can affect your mental health, leading to conditions that affect your overall well-being, like anxiety and depression.
• Financial strain: Most people who step into the role unprepared often have to quit their jobs or reduce their hours to focus on caregiving, leading to financial stress.
• Lack of support: Caregiving can often leave you feeling like you have no one. Fortunately, there are many resources to support you, like community services, respite care, and support groups.

Caregiving could affect your physical and mental health in the following ways:⁷

• Physical demands: Caring for others involves lifting, changes in sleep patterns, and posture issues, which can lead to headaches, body pains, and stomach issues.
• Mental demands: Caregiving comes with stress, anxiety, and depression. It could affect your ability to focus, as well as your appetite.

Physical and mental strain are symptoms of caregiver stress.⁷ Self-care could be an effective way to help you continue doing what you love.⁸ It involves prioritizing yourself and finding help when needed.⁸

Your loved ones could be experiencing incontinence because of the following reasons:⁹

• Certain foods and drinks like alcohol, caffeine, and spicy food
• Conditions like urinary tract infections, constipation, and prostate cancer
• Aging
• Certain medications like high blood pressure, sedatives, muscle relaxants, or even large doses of vitamin C

If you notice your loved ones are having frequent bathroom accidents, see a doctor.

Several products could help with incontinence in older people; they include¹⁰

• Bed sheet protectors could help absorb moisture while your loved ones sleep. You can also use them on chairs or recliners.
• Incontinence pads could help with light leaks but not for bowel incontinence.
• Incontinence underwear could help with mild to moderate leaks. It could help support active and mostly independent older adults

While choosing an option for your loved one, it is important to ask yourself questions like:¹⁰

• How absorbent are they?
• How mobile are your loved ones?
• How easy are they to use?
• What's your budget? Should you go for disposable or washable items?
• Are they discreet and comfortable?

The following are incontinence care tips that could help when accidents happen¹¹

• Put on gloves for both your safety and theirs.
• Clean your loved ones immediately to prevent odors.
• Clean with mild soap and water.
• After rinsing thoroughly, make sure to pat dry the necessary areas.
• If you are using soap-free cleansers, make sure it doesn't cause irritation or dryness.
• Remember to moisturize. You can use barrier creams to protect the skin.
• Reassure them and take them through the process.

Here are some travel-friendly tips for incontinence:¹²

• Avoid their triggers, like coffee or spicy food.
• Schedule regular bathroom breaks.
• Practice urge suppression if recommended by their doctor: a technique where you help them use the toilet only after they squeeze the muscles they use to pee for 5 seconds.
• Choose clothing that is easy to remove.
• Pack dark clothing to help hide leaks.
• Have a care kit ready for accidents. It could contain clothes and incontinence pads.

There are several ways you could support your loved ones with bowel incontinence; they include:¹³

• Track their food or drinks; help them note their triggers.
• Help them avoid those triggers. Also, avoid food like coffee, caffeine, and beans; they worsen bowel incontinence.
• Make sure their meals are fiber-rich and hydrating.
• You could try bowel training or kegel exercises with the help of a specialist.
• See your healthcare provider to learn the best options for your loved ones, whether lifestyle changes, surgery, or medication.
• Use support products like barrier creams, pads, moist towelettes, and disposable undergarments.

Sometimes, your loved ones might not agree to a routine like bathing or showering. Here are some tips to help them with personal hygiene when they refuse:

• Have a talk about why they don't want to shower; be open to their reasons.
• Make the bathroom comfortable: a clean, well-lit, and warm bathroom could be inviting.
• You can also ask your loved ones what would make them feel more relaxed.
• Offer alternatives like sponge baths or self-cleaning.

If they still refuse or hygiene becomes a health concern, consider seeking help from a caregiver or doctor.

Here's a list of warning signs to let you know your loved one's health is approaching a decline:¹⁴

• Loss of interest in things they previously enjoyed.
• A sudden shift in their moods.
• Increased forgetfulness.
• Poor appetite and weight loss.
• Bruises, burns, and cuts they can't explain; it could be because of falls.
• Poor hygiene.
• Suddenly falling sick more often.
• Poor decision making such as not taking essential medicine.
• Reduced mobility.

You shouldn't ignore these signs. Instead, document them and let a doctor know about them.

As your loved ones age, so do their bodies. Their bodies experience changes not just physically but on a cellular level.¹⁵ These changes build over time, leading to serious health concerns.¹⁵ Here are some common ones:¹⁵

• Chronic health conditions: Chronic Obstructive Pulmonary Disease (COPD) and diabetes
• Muscle and bone weakening: Osteoarthritis and frailty
• Mental health condition: Depression
• Poor nutrition

One issue often leads to another. For example, bone weakness can lead to a fall, which can cause more time in bed, leading to more muscle loss or depression. That’s why spotting and managing these changes early makes a big difference.

For many of us, forgetfulness will come naturally as we age .16 When it starts affecting everyday life, it could be a sign of something more serious, like dementia.¹⁶

Here are a few signs that may point to dementia:¹⁶

• Making poor decisions repeatedly
• Missing bills or appointments often
• Getting confused about dates, places, or time
• Repeating the same questions multiple times
• Losing things and not being able to retrace steps

Dementia is not the only cause of increased forgetfulness.¹⁶ So, if you notice any of these changes in your loved one, speaking with a doctor early on is a good idea.

Watching your loved ones' health decline is never easy. You watch them move from independence to total dependence. Regardless, here are ways to support them as their health declines.

• Spend time with them; make them feel loved.
• Adjust your care routine to meet their current health needs.
• Don't limit yourself to what you know; ask your doctor for medical advice.
• Seek community and professional support.

Your loved ones, like you, have the right to refuse treatment. You could try to persuade them, but you can't force them. The following are ways you could help them feel more comfortable with the idea:

• Bring a trusted family member into the conversation.
• Hear them out: put your emotions aside and listen.
• Reassure them: They may associate hospitals with new problems, drugs, or being weak.
• Use incentives to help them feel excited about going. For instance, you could say, “If we see the doctor, I will take you to your [insert their favorite place] afterward.” Make sure to follow through on incentives.
• Schedule appointments on different days. Too many appointments at once could be tiring and demoralizing.

A reduced appetite is common in older adults.¹⁷ Still, sudden or drastic changes can be a sign of something more serious, like chronic conditions, acute infections, and even depression.¹⁷ So, when you notice these changes, speak to a doctor.

• Give them regular sips of water to help with a dry mouth.
• Avoid hard foods; opt for soft-boiled or liquid if they have a dry mouth.
• Make sure their dentures fit and are comfortable.
• Add their favorite spices or flavors if they can't smell or taste as much.
• Make mealtime a mini buffet; include varieties of their favorite foods.

Watching your loved ones go through the end-of-life stage is inevitably going to be difficult. The best thing you can do is provide them with physical and emotional support, whether through yourself, palliative, or hospice care, to ease their passing.¹⁸ Here are signs that your loved ones need end-of-life support:¹⁸

• Eating and drinking less
• Sleeping more and staying awake less
• Withdrawing from the present and reliving more about the past through stories
• Showing signs of depression or anxiety
• Experiencing illusions or hallucinations or delusions
• Breathing that becomes slow or shallow
• Losing consciousness

While you can't stop aging, you could help slow down some of its effects.¹⁹ Here are a few ways to support your loved one's quality of life:¹⁹

• Keep their diet healthy: For example, less sodium and more unsaturated fats.
• Help them get regular exercise within their abilities, like taking a walk.
• Help them get enough sleep, about 7 to 9 hours each night.
• Help them stay social: encourage groups, regular conversations, and visits.
• Keep up with medical checkups to help catch problems early and get treatment on time.
• Ask your doctor about medications to help your loved ones.

As you help improve your loved one's quality of life, remember to stay realistic about their health and focus on what comforts them.

f you're experiencing caregiving stress, asking for help is a good idea. You may need help if you're:^7,8

• More anxious than usual
• Having difficulty falling asleep
• More tired than usual
• Missing your medical appointments
• Feeling hopeless
• More irritated

There are several options to help. They include:⁸

• Part-time caregivers, like adult daycare programs
• Full-time support: senior centers and in-home care
• Respite care

There are several caregiver support options available. You could begin your search by contacting your loved one's hospital or local agency on aging. They may connect you to a social worker or care coordinator.

You could also explore the following programs:

• Local council services like Eldercare can help you find services for your loved ones.
• Caregiver support groups like the Family Caregivers Alliance could help you with online support.
• Respite grants like the ARCH National Respite Network could help you find respite care and resources.
• Charities like Meals on Wheels could help with nutrition for your loved ones.
• Helplines like the NAMI HelpLine for your mental health.

Balancing caregiving with work and other responsibilities can be tough, but these implementing some of tips can help:

• Time management: Creating a week-long schedule with time allocated to specific tasks can help you stay on track. Make your schedule flexible, as emergencies could happen.
• Talk to your employer: Depending on your job policies, you could change shifts, adjust your hours, or go hybrid to meet your caregiving needs.
• Share the care: Share the responsibility with someone else. It could be a professional, a family member, or community services like adult day care. The important thing is to ask for help.
• Practice self-care: While prioritizing your loved ones' health, prioritize yours. Know your physical and emotional limits to prevent you from overexerting yourself.