Friday, 4 May 2018

*** BLOG ON HOLD ***


Don't worry, I haven't disappeared forever
 -  I'll be back soon.....PROMISE !!!

***In the meantime, please visit me on 'the Twitter'
Lots of goodies going on there!







Love Dollie
xxx

Friday, 6 April 2018

The Cat in the Hat on Ageing

Getting Old, Sam-I-Am?



Here we have a cute little ditty by every family's favourite author, Dr Seuss.

Although probably not totally appropriate for the kidlees, I think it perfectly sums up how most of us feel about this annoying (yet inevitable) process of ageing.

The terror that our body parts, one by one, will slowly grind to a halt, the wrinkles will take over and hip-hip-horray... we have officially become ELDERLY.

Short and sweet but told in that uniquely wacka-doodle Dr Seuss style that we know and love... it offers a nice slap in the face as we realise that one day, we will be old too.

I especially love the defiant twist at the end meant to bring it all into context, allow us to believe it's not all doom and gloom - AND hopefully make us snort out loud!




Getting old SUCKS!


And further more...


I wish I could not get old in a House,
I wish I would not get old with a Mouse

I'm not getting old in a tatty grey Coat,

And Im not getting old riding shot-gun on a Goat

I do not like getting old Here or There,

I will not be getting old ANY-BLOODY-WHERE!




Cheers
Dollie






Sunday, 11 March 2018

Dementia Diagnosis for Aunty Win

A Letter to the Fam



I recieved this email from my cousin Rochelle recently.

Thought I'd share it here on my blog (because I can), and also to emphasise how shitty and random this heartltess Dementia biaaaatch is.

Aunt Winnie taught me that girls don't have to aspire to be receptionists or "mere note-takers" or run round after others... "unless you want to, then that's just fine".

Instead, if  you've got the gumption (her favourite word) - you can make a great career doing something you love and find a nice boy "wearing not-too-tight slacks" to make a good enough life together.

It has eventuated that I have done both.

Aunt 'Winnie-the-Poo' - YOU ROCK!

(I will/do miss her so much).


Older adults in their younger days

Aunty Win - back in her prime 



To my dear family,
I've been back from overseas for amost 2 weeks and there have been a few changes with Mum (our Winnie), so thought I'd send a group email update so you all know where that's at.
Unfortunately, and as predicted by most of us, her mental health has declined significantly.  
I took her to her GP and she completed a MoCA test (half hour competency testing), where the results were not flash:  ie: 10 out of 30 is bad.
Poor mum scored 2...(TWO!)  Is that even a number???
Thank the Lord she defiantly remembered where she was from, although truthfully, I think she must have fluked the second point by just sheer good luck!
We also discussed her anxiety levels and turns out, they've put Mum on a little 'upper' to assist with her mood.  Arthur is great with mum and loves her to bits which I could cry with relief about cos he's such a caring wonderful man.  
Obviously, as a retired school teacher,  he revels in the role of directing and correcting!  (Plus the Citalopram will be doing it's job - keeping Mum ticking along and happy to stay back after class with another special Arthur 'detention' !!!)
In the meantime, the Geriatritions will without doubt, assess Mum for 'Care-Home' level care, and I assume officially diagnose her with Dementia. This should happen soon.  Hopefully, while I am still in the country - although I may be called up any day now so not sure what we do then... 
Thankfully, in this hip hop zippity do da modern day and age (haha as she used to say!), most stuff can be sorted online and organised via email etc.  And legally, I dont need to go to the lawyers- which is just perfect.
The best thing is that the staff at the Respite home where Mum is now are all on the same page as I am.  And they have been concerned with her deterioration for a while - the head nurses have an amazing rapport with her, plus they've kept me fully up to speed on Mum. 
I am just SO impressed with the set-up there!
Win gets to stay in her current apartment WITH Arthur - and the Care Team actually comes to her! This includes 3 showers a week, getting dressed daily and undressed, breakfast, lunch and dinner, dispensing medications, clothes washing, housekeeping etc.
At the moment, Mum is just having shower and dressing assistance (extra $100 a week).  Once the new level of care comes through, we will apply for a subsidy as their combined total assets is less than $119k.
This new level of care will be paid from Dad's deceased estate account (ie: $23k -  and then the good old government takes over...PHEW).

Elderly losing happy memories

Our happiest (and silliest) days... 


I did have Mum come stay with me by herself last week (and my girls too, much to their horror), for a night recently. She spent the WHOLE time thinking Arthur would be coming to pick her up at any second - watching out the window, pacing up and down etc. 
I could tell she really would have preferred to go back 'home' to Arthur; we had to phone him a few times during the night when the panic set in. 
You should have seen it the next day, though, when they re-united.  I just about died... they had the biggest SNOG I've seen in ages....in front of all the staff...everyone...THEY DIDN'T CARE!!!
(I think I was actually JEALOUS!)
Mum's just fine where she is and like I said, Arthur loves her to bits. So as weird as all this is, Winnie's definitely safe and cared for. She actually does realise her memory is bad (kind of), but quickly seems to forget she had that flash of realisation and so we just move on.
She happily accepts shower assistance, and for her own dignity and personal presentation, I'm terribly thankful for that.  Physically, Win looks and IS well.
Dont know what else to say but I really hope this email doesn't cause any concern for you guys.  I really feel she is in the right place and I think we should all feel blessed that she married Arthur last year - as crazy as that seemed at the time.... WHO IS THIS MAN WITH THE GIANT MOUSTACH WHO IS IN LOVE WITH OUR WINNIE? 
Because it certainly takes the load off me - not that I'm complaining...
It's just hard, you know?
Anyway, I hope all is well with you guys - sorry if I've rambled on but I wanted to put you in the picture seeing as you are her family,,, the people who love her the most. 
God, does she even remember?  
You know what...I really don't know any more.  Today for example,  she called me Geraldine.  As in Aunty Gerry, her twin, who died when they were in their 20's.  And I can tell when she looks at me that she's not Mum anymore.  I hate that the most about this disease.
Anyway, I'm waiting for confirmation of my next placement abroad - not sure when or where that might be but I'm loving my Oncology nursing and the fabulous people involved in the industry so that makes it all worthwhile (as well as being the best distraction from the Win & Arthur !)
Will keep you all updated as the rest of the saga of our our gorgeous Mum/sister/Aunty's life unfolds. 

Love you guys,
Rochelle
PS: please, dont worry about mum.  She is fine, really.
PPS: we must all get together in the SAME room one day.  Life's too short. - I could end up losing my mind, just like Mum.  ARRRGGGHHHH!

Dementia in old people

Winnie when she was wee! 



Friday, 9 March 2018

A Carer's Tips for Assisting Seniors at Shower Time

The Washing of Little Old Ladies Bottoms!

<<<CAUTION - this post contains nudity and wrinkly moist skin which may be considered distasteful and (hopefully) offensive>>>


It's interesting the reaction I get when I tell people that part of my role as a careworker is assisting older adults to shower.  More often than not, their response is to recoil in horror and say:

"Ewwww...you mean you wash OLD LADIES' BOTTOMS?!"

To which I've found there is no perfect answer because...  1.They aren't really listening (they're still too caught up thinking about ALL THE NAKED OLD PEOPLE); and... 2. Sometimes you actually DO have to wash old ladies' bottoms which in those instances, makes it quite accurate.

Instead, I just nod my head and laugh along because it's easier that way.  And anyway, I don't have to justify what I do (or to whom I do it to) because I'm smug in the knowledge that they'll understand one day soon enough.

When it's one of their own nearest and dearest whose health starts to decline and then out of nowhere... BAM!  Mum or dad has tripped on a rolling pin or thrown themselves down the back steps, revealing they are aren't coping as well as everyone thought they were.  

An emergency family meeting is called and a decision has to be made that if their Beloved is to continue living alone in their own home, then personal hygiene issues (or lack thereof) would need to be addressed.

Indeed, it's a sad slap of reality when normal daily bathing practices, ones our aged parents have managed beautifully and without fuss their entire lives - can no longer be safely achieved.

In lieu of that, I have compiled a few useful notes (from a careworker's perspective), on the intricacies involved in helping a frail elder at shower time.

NOTE:  Regardless of whether the responsibility has landed on YOU as the designated caregiver of your vulnerable relative, or instead a paid carer has been summoned from an outside service provider - the fundamentals of this most necessary process are exactly the same.

Assisting elderly people to shower
OLD PEEPS = SLIPPERY WHEN WET!



1.   GETTING ORGANISED  

 - It's All About SAFETY
As professionally trained carers there is what's called a Duty of Care obligation to keep your client safe at all times.  You’ll find this phrase bandied around quite a lot in Aged-Care circles but it’s there to hopefully prevent negligence and to protect the rights of your client - and ultimately, you.

And although it can be complex to understand, basically it means that if you don’t follow the procedures and policies set by your employer, you could end up being taken to court and losing your job if something terrible happens.

What with every bathroom being so different and every elderly client being such an individual, with their own specific circumstances and needs (not to mention their random quirks and peculiarities), carers have quite the responsibility to stay aware and to adapt to each situation as efficiently as they can, while at the same time trying to maintain ultimate client contentment.

In other words – DON’T LET THEM FALL!



Showering your elderly client
Water, water every where... 
IT'S DANGEROUS STUFF!



 - COMMUNICATION
Always TALK to your client.  

And then LISTEN to what they tell you.  

If you as their personal carer, open up the lines of communication and show yourself to be friendly and approachable (as well as gushing with confidence galore), you’ll find they will relax and trust you to take good care of them.

Showers can be scary and susceptible places so the last thing you need is a wobbly naked pensioner to feel frightened in their own bathroom.  So get chatting, relieve the awkwardness and ask them what they like and what they don’t like.  Are they going out today? Isn't the weather dreadful lately?  

(Weather discussions never fail in breaking the ice with elderly people and are an ideal ploy for moving things onto a more casual and sociable footing).

Also, talk to your client’s spouse or live-in relative (if there is one), as they will offer valuable information about your clients condition and may have hints or suggestions that will keep everyone satisfied and therefore make your job that much easier.

Theoretically, if your elderly client still lives at home then they should be quite capable of doing a lot of the effort themselves.  Showering however, can be hard work to those who are delicate, may have just come home from a stint in hospital, undergone recent surgery or be returning to normal life after an injury of some sort ie: a fall.  

Your job is to assist them by encouraging independence, offering plenty of support and to just guide them as is necessary. 





 - The All Important... CARE PLAN
But before you trundle your dear old lovely off to the perils of the bathroom – you must first read the Care-Plan!  

It is absolutely crucial to familiarise yourself with any health concerns or medical issues your client has BEFORE you attempt to shower them.  And the Care Plan contains the important paperwork that holds all the juicy info you could ever need – and then some!  

Not only will reading the CP dictate how you treat your client, but it will also offer insight on how much and what kind of assistance you will need to provide for them.

For example, if your elderly client has had a stroke they will likely not have full use of one side of their body.  Consequently, this means you need to alter the way you dress and undress them.  If you hadn't read the notes in the CP you would not have known this and off you would charge... headlong into an embarrassing and potentially dangerous situation that leaves your client feeling anxious and upset.

It’s important to note too, that even though you've assisted Mrs Jones with her shower every Tuesday for the last two years, you would still need to regularly check that the notes in the Care Plan have not since been updated, say, by the visiting District Nurse or an official assessment officer from somewhere.

A change in the client’s health status is something a personal carer needs to be aware of and usually the client won’t think to tell you - so you need to be all over it, baby! 


Towels for your elderly clients shower
The Leaning TOWELS of Pisa?



 - Be Professional
Be friendly and chipper by all means, but be confident in your own abilities as well (even if you are not).  It must be hard enough having some stranger standing in your bathroom seeing you starkers at the best of times… so imagine how frightening it would be to have a carer who is hesitant and unsure of procedure coming at you with latex gloves on… EEEK!

Again, in my experience, just talking to your client is the best way to relieve any awkwardness and it shows that you understand and are considerate of their feelings (ie: you care).

Offer them the respect and dignity you would hope for if it was YOU getting the once-over.

And don’t worry, they will soon let you know if you are rubbing their back too hard or they have soap in an orifice!



 - Sort out CLOTHING
As part of a personal carer’s shower preparation, you need to confirm if fresh clothes are already laid out or set aside somewhere.

Will they be getting undressed/dressed in the bedroom or in the bathroom?

Perhaps by the heater in the kitchen?

Make sure you clarify beforehand so there is no unnecessary time-wasting or leaving your client to wait and get all cold and cranky while you faff round finding bra and underpants somewhere in the bedroom dresser… third drawer down… on the right... next to the bed, I think she said…OH MY GOD... WHERE???

Not good enough - get organised first!




 - Bathroom Set Up
Again, I stress the importance in ensuring everything is ready BEFORE you escort your client into the bathroom for their shower.

And it's the little things that make all the difference.

Such as:  Is there a heater or an extractor fan?  Is it on?  Do they want it on?

Perhaps they don’t.  So always ask before you go cranking it up and causing your client to fret about power bills or that the house might catch fire.

Remember you’re dealing with people who have lived a lot longer than you and they may well have experienced a tragic incident like their house burning down or a bomb being dropped on them in the war or similar catastrophic event from ye Olden Dayes.

You just never ever know their background reading… so resist being bossy and taking over their entire bathroom routine, no matter how silly or unnecessary their requests might seem to you.

And trust me, never be tempted to judge your client because ultimately, it will reflect in the way you treat them.

And that's just not caring at all, is it.


Elderly people dont like to waste electricity

Now THAT'S a fan! 



 - Safety Equipment
Make sure your client uses the Hand Rails AT ALL TIMES.  

Now is not the time for them to be a hero and to try and impress by showing off how fit and youthful they still are and that they don’t need rails thank you very much. 

Pride goeth before a FALL and all that.

Also, make sure the essential Rubber Mat is placed correctly and FIRMLY inside on the shower floor for your elder to stand on (and maybe one in front of the shower door as well, if there's a sparey.  

Blimey, line them up the entire length of the house if you have them!

Rubber Mats are a fabulous invention and everyone, not just the old peeps, should be using them when it comes to shower time.  After all, they provide the ideal non-slip surface which is paramount to anyone intent on remaining upright in a tiled bathroom.

Also, ensure the area is clear of any potential tripping hazards like towels on the floor, bathroom scales, random slippers and the like.

And for heaven's sake... make sure Rexy, the over-excited Jack Russell, hasn't followed you in for a look, too!  

Nosey pets hate to miss out on all the fun - but stand firm.  Take no nonsense and shut any wayward four-legged friends securely in another room.

WOOF!!! (Sorry, Rexy)


Keeping pets out of the way

Rexy is NOT sexy at shower time!


Get all the facecloths, brushes, loofahs etc that you will need so they are handy when required. And check if your client intends to wash their HAIR today and if so, put shampoo and conditioner paraphernalia within easy reach.

Some seniors, usually the laaadies, like to instead pop on a shower cap  - especially if they've just had their hair done (blue rinse, anyone?).  Or maybe just to keep from having to deal with wet hair after the ordeal of their shower ie: more hard work.

Another more pertinent reason for a client to don a shower cap, is to protect expensive Hearing Aids from getting wet.  Thankfully, you'll find that most elders will opt to remove these BEFORE they get into the shower (due mainly to the terror of shelling out more big bucks if they have to buy new ones!).

Make sure you place these teeny tiny little contraptions somewhere secure when they are taken out, or you'll be in deep dark trouble with your ticked-off client, make no mistake!

You will however, have the odd shower-ee who is prepared to take the risk of leaving their hearing aids in during shower time.  Being able to hear and chat away with YOU, their carer, can be too good an opportunity to miss for some lonely conversation-starved pensioners!

Whatever your client's preference, this will have no doubt been ascertained during your in-depth discussions with them in the prep stages.

Do they use a stool or a chair in the bathroom to sit and get undressed on?

This is quite common although it depends on their needs ie: how frail and dependent your client is.  Some older adults are still quite nimble and can peel away their robe, flick off their slippers and cartwheel into the shower before you've even hung up the towel!

Others may need a lot of assistance and a guiding arm on their back or arm is just about compulsory, even if it is just a peace of mind thing - for YOU more than anything.  Better to be annoyingly over-protective than to coast along and not pay enough attention to the proceedings.  

There's just too much water and slippery surfaces to dare risk it!

Because ultimately, a fall in the shower (and the resulting injuries) can mean the difference between an elder staying in their own home or having to move into a care home.  And they know it.

Do they use a shower chair when they shower?  Hopefully, YES! 

These light and nifty contraptions can be transferred into the shower stall when required and then easily whipped out into the back room and out of the way when not.  Trust me, a shower seat can save a heck of a lot of stress and eliminate the massive potential for unexpected mischief.

There are also fold-out shower seats that attach permanently to the inside shower wall.
As shown:


Shower seats for old people

Flip-up shower seats - fun for all the family 


Either device means your elderly client can safely perch while you operate taps, hoses and the lathering of soap etc, without having to worry that they'll perform any unplanned party tricks (like slipping over and breaking their hip for one).

One last thing, showering an older person is also about keeping your client warm and toasty at all times.  Most elders detest being cold and, as they are usually without a lot of meat on their bones, rest assured they will feel any (or all) potential draughts at shower time.  

And I can guarantee you they will not hesitate in telling you so.  Not just the shower door - but the door to the bathroom, hall and lounge room as well.

Were you born in a tent?

SHUT THE DAM DOOR!




 - Protective Clothing... FOR YOU
I’d like to think that most councils, agencies or service providers dealing in Aged-care do the proper thing and provide ample protective clothing for carers who undertake shower assistance duties.

The most obvious of these being disposable plastic or latex gloves which offer infection control to prevent against any nasties being transferred between either of you.  

Gloves are therefore, one of the most essential items in any personal carer's kit bag and for obvious reasons we go through squillions of them.

As the saying goes:  If it's not on - IT'S NOT ON!



Protect yourself by gloving up
Glove Up!




 - OFF WE GO!
When it’s finally time to escort your client to their shower, if they have a wheeled walker or walking stick, then let them use it all the way up to the chair in the bathroom.  Once they are sitting down or holding onto a safety rail, you can then place it out in the hallway so it’s not under your feet during the shower process.

By the way, when I say RAIL - I do not mean towel rail.  

Towel rails are, by nature, loose and unstable and offer zero support to somebody who might lunge to grab at it with their entire body weight behind them.  I am always reprimanding my clients whenever they start to reach for a towel rail…

“No, Mrs Brown!  Trust me, that flimsy towel rail won’t save you in an emergency!”

And then I waggle the flimsy towel rail up and down to prove my point and they glare at me like I am a big meanie.

You have to laugh, which thankfully most of the time - we do.

Actually laughter, as we all know, can be a life saver in a lot of sticky situations – and it’s a pearler at shower time.

And you will find that if you keep the atmosphere cheerful and encouraging (perhaps throw in the odd compliment too)… then things will flow a lot smoother and you will have your squeaky clean senior dressed and relaxing with a nice hot cuppa in their hand before they can say “Oh dear, I seem to have misplaced the soap!”



Dignity in showering elderly people

Is it all a cover-up?






2. NUDE UP!

 - Undressing 
OK so you've got the shower scene all set up magnificently and your client is poised in the bathroom ready for the next stage – getting undressed.  

You may find though, that some of your more fit and nimble clients will have already undressed and are ‘robed-up’ waiting for you.  Either they are still quite independent and need minimal assistance (except maybe a bit of your reassurance) – or their spouse, the primary caregiver, got them prepped for you.

If not, then it’s up to you to get things rolling.

Chat to your client and see which end they like to start with.  Most older people like to peel off their top half layers first so they can stay sitting down for as long as possible.

(Exhausting work for some, this shower business).

That way, standing up for removal of the bottom layers (pants, underwear, stockings etc) can be synonymous with the effort required for stepping into the shower recess as well. Do it all-in-one-swing-kind-of-thing so there’s less exertion and therefore, less unnecessary pain or uncomfy-ness for a nervous pensioner. 

Depending on their circumstance and health status, you’ll need to modify the method of undressing of your client accordingly.  You would already have read their Care Plan so you would know if there are any sensitive areas to be aware of or inhibiting factors where your full attention is required.

Again I mention the unfortunate stroke victim who could have one side of their body not functioning at full capacity and therefore a technique adjustment will be required by you. 

They may have a pesky arthritic shoulder that has literally ceased and so lifting an arm above their head is near impossible now.

Or maybe there is a bandage from recent surgery or perhaps a catheter or colostomy bag you need to work around.   Don’t rush the process - just be guided by your client’s abilities.

And if they want to take their own clothes off - THEN LET THEM!

In fact that’s a good thing because it shows they are still coping and can contribute to some of their own personal hygiene regimes which also gives a feeling of having control.  

Whatever the situation, it’s all about keeping your client safe and knowing they can trust you when they feel they need to.

Once the top layers are removed (and placed somewhere strategically to NOT be tripped over later), it’s time to get lower garments off.  

A useful trick, once the client is standing up (preferably holding a rail), is to pull skirts or trousers down, stockings down, underpants down – then have the client sit back down again so you can slide all the ‘bottoms’ over and off their feet in one go.

That means less up-and-down for a weary retiree rather than torturing them one clothing item at a time. 

Shower assistance for older adults

DOH!

And remember (especially for the 'girls') that it’s always thoughtful to have a towel or robe handy to drape around her once she’s naked.  Just nice to keep a hint of dignity during the process so she's not left feeling completely exposed like some sort of exotic pole-dancer about to shake her GROOVE THANG in the spotlight.

Use your ‘carer’s initiative’ to gauge what type of person your client is – some older adults are painfully modest and worry dreadfully about being looked at, even by you.

Others fling it all off without flinching and are possibly more concerned that you've got the water temperature right than to care about somebody looking at them with no clothes on.  

And anyway, a lot of these old dears have spent so much time in hospitals or at medical specialists where they've been prodded and probed in all directions, that they are now immune to the concept of ‘feeling nude’ at all.





 - Check WATER TEMP

Hand-Held Hose - OR - Fixed Shower Head?
There really is no contest – the hand-held jobbie wins hands-down every time (pardon the pun).  

As opposed to the fixed shower head where water gushes from high above, creating an out of control situation for both you and your client.  And it doesn't matter how clever you are, you’ll never be able to direct the torrent of water at a suitable angle that keeps your client wet – and you dry.

And of course, you would NEVER let them plunge full force into a stream of water until you've first adjusted the temperature to the correct setting.  A bit like a child's bath - you'd never plonk your baby into bathwater you hadn't felt with your elbow first; it's the same deal for a mature-ager.

Remember, water temps can fluctuate throughout the showering process depending on the age of the house - or if it’s one of those annoying antique hot water systems that’s got pipes so old, it's older than your client!  

So be prepared to fiddle with it as you go – and if your client starts to shriek, that's a definite sign that something has gone awry.


Check water temperature for your elderly client

Don't send your client Psycho
...with water that's too HOT!



Oh, and here's a trick that goes down well... squirt the water nozzle on the shower seat by for at least half a minute before your client sits their bum down.  You'll earn massive amounts of brownie points for this, I can guarantee it.

Now it really looks like you care!




3. SCRUB UP!

 - Let's Get CLEAN
The amount of assistance you need to actually provide an elderly peep at shower time depends obviously, on their personal needs and how physically capable your client still is.  

I’ve had showering shifts where I end up parked on the stool in the bathroom, chatting away through the shower door while they do their thing and I sit there feeling completely superfluous - like some sort of Peeping Tom! 

Always wise to keep the offer open though, and let them know you're there by throwing in the odd  “Are you alright in there, Mrs Smith?”  


Clearly they are able to manage – perhaps they may have had a small accident recently or some surgery and are just a little nervous to be showering alone.  But that’s a good thing because independence and confidence will hopefully be regained in a matter of time.

On the other side of the soap-dish, however, are the seniors who need a dam whole lotta help!  

These are the most concerning kind of shower assistance shifts because quite honestly – there’s potentially SO much that can go wrong.  It’s up to you as a trained and caring professional to put your skills into practice and to keep yourself focused.  


Now is not the time for short-cuts and rushing procedure just so you can squeeze in your lunch break!

Make sure you do your job by the book and cover your own butt (as opposed to theirs).  Even if your impatient elder does get snippy with you for taking so long to set up the bathroom or that you’re fluffing round with boring old rubber mats and towel placement. 

Not only do you have to escort an exceptionally frail elder into the shower recess, but you find you will more than likely have to stay for the duration, ie: actually in the shower with them... DOOR OPEN. 

Don’t forget though, if you feel your client is not managing well and you are concerned that their condition has deteriorated, then you should most definitely report your observations and/or thoughts to the higher powers that be. 

As a general rule, most shower assistance scenarios fall somewhere between the two extremes and the stages of showering another person are usually in a 'top to bottom' order - pretty much the same as how you most likely shower yourself.  

Commonsense, anyone?  

In this order as follows:
  • Face is first (some laaadies may have separate ‘face only’ washcloths)
  • Torso, Chest/Boobs, Underarm, Arms, Hands, Fingers
  • Back
  • Front Bottom 
  • Legs & Bums (handy if they stand up for you at this stage)
  • Tootsies!

Depending if today is hair-washing day or not, most elderly clients like to get that done either a firm FIRST or a firm LAST – you will have already discussed this and slotted it in accordingly.  

Basically, you should be guided by your elder, keep the chit-chat going and for gawd sake SMILE.  I wouldn’t want a frowning, angry-faced carer touching my privates – would you? 

Speaking of ‘privates’ … a special mention at this juncture, to the washing of an adult person’s groinal areas.  

Remember, the people you are assisting are not in a care home (yet); therefore they should still be perfectly capable of washing their OWN bottoms…although you may have to soap up the washcloth for them first.  

Thankfully, most will attend to their 'special' regions themselves.  Elderly men especially, can feel quite modest and shy at shower time, and you’ll find most are more than able to wash their own willies with minimal fuss and no discussion (or eye contact!) required.  




Showering with old people

And then there's Dick... 

All silliness aside, assisting an older adult to shower (especially if they become your regular client) can be an ideal time for noticing any changes to their physical appearance – meaning observations that might indicate something is awry with their health.  

Things like bruises or strange marks on the skin, pain, or maybe their mobility is more restricted or strained than usual.  


Ask them about it (tactfully)... but more importantly ALWAYS REPORT IT.  


Other things you can note are general maintenance stuff like overgrown toenails that need trimming, hair that needs cutting, or anything else out of the norm that just doesn't sit right.  Always listen to your ‘little voice’ and pass your thoughts on to your employer if it bothers you.

There's the horrendous story about a carer who’s client had confided in her that she’d bumped her head after a slight tumble earlier that day.  


"But I'm perfectly fine now and there's nothing to worry about, so pleeeeease don’t tell my daughter as she will only make a fuss.”  


Desperate seniors don’t like to look like they are struggling so are loathe to tell family members for fear of being labelled as ‘not coping’. 

Anyhoo, the carer in the story chose not to pass the information on and sadly, the client ended up dying of a brain aneurysm a week later.  Many meetings were held, the family sued in all directions and the careworker, understandably, lost her job.  Just a crappy and unnecessary set of circumstances on all fronts.  

Moral of the story:  cover yourself and report EVERYTHING.

But back to the showering at hand….

Last but not least, when you’ve finished thoroughly cleansing your client, it is most important to ensure you have washed all the SOAP from their body.  

If you didn’t know already, residue soap on older skin can easily cause a rash or nasty irritation… which can lead onto infection… which can lead on to your beloved doing a stint in hospital on strong medication and all because of a little bit of forgotten soap under the rim.

That's why a hand-held shower hose is so, well... HANDY.  It gives the client something to hold onto and be in charge of and also they can be washing off the soap lather thoroughly as they go.


Rub-a-Dub-DUB!



Elderly at shower time
A shower-er's best mate!!







4.  DRY UP!

 - Towelling Off
After strategically manoeuvring your client out of their shower (or at least being in the proximity as they haul themselves out, remember: safety safety SAFETY) - it’s now time to dry off.  

And of course you have all the towels strategically ready to wrap round your client’s shoulders as they wobble towards you – perhaps one for wet hair if it was washed, as well as the main one for their bod. 



Important to get elderly people dry after shower time

Just towelin' around?

A good idea, while they are still standing (yes, holding onto a handrail) is to rub dry your client’s back and then travel all the way down drying their posterior and backs of legs as well.  

Basically, it's a good idea to try and catch them before they crash land onto the bathroom chair with the sheer exhaustion of it all!  

Then, once sitting, you can conceivably hand over a towel for your client to dry their own face, neck, upper body and arms (and front bums about now, too). Try and encourage as much independence as you can - although in my experience, this is where a lot of older people run out of steam and are left with very little energy to do much at all (except to sigh and look forward to lunch). 

Therefore, it’s up to you to finish off and check for any parts that may still be MOIST (eww there's that word). 


Bearing in mind that even just slightly moist-ish - is still MOIST.

I make a point to re-dry areas such as the armpits, beneath a woman’s breasts (sometimes a man’s...) and other skin folds around the groin and torso just to be sure, to be sure.  You’ll find your client will appreciate such diligence because they know how essential it is to get completely dry.


And NOT moist.

Important to understand that creases left with the slightest of moisture can mean nasty micro-organisms are allowed to breed and when that happens, there is a massive possibility of it developing into….please no... oh, don’t let it be so –  - - INFECTION!  

And being that older adults generally, are already compromised when it comes to immunity, the last thing they need is for gluggy wet forgotten epidermal areas to end up all stinky and horrid and oooozy.


For then we're ALL in trouble!





 - Getting TOEY?
A special mention at this point - to TOES.  

Toes are usually the last point of attack when it comes to drying your client - so always make it count!  


A grand idea is to crouch right down to toe-vicinity and use the edge of the towel to zig-zag back and forth in between each toe (in a hack-saw motion) and then do it over again if you still aren't happy with having got all the moisty bits. 

Ensuring tootsies are completely dry is imperative - because of course if toes or feet are out of action, then your client is out of action.  


And once an elderly adult is immobile – it’s a dam hard road for them to get back to full strength again… and sadly, some never come right.  


Keep elderly clients' toes dry

Keep those tootsies dry, Dry, DRY!



 - Get DRESSED UP!
Before you start dragging clothes onto your squeaky clean shower-ee, you need to be aware if there are any other minor personal care grooming rituals that your client undergoes before dressing. 

A good time to have a chat about this would be after you've slipped on the underwear component of their dress and they're poised ready for the next stage.  This is obviously for modesty’s sake and so your client is not left feeling ill at ease with being naked and exposed to all and sundry.  


Note too, that this would be the ideal moment to slip in any incontinence pads or special adult diaper pants into your client’s knickers.  As disdainful as it seems, you WILL get used to seeing these delightful devices - although you can tell by how much your client complains that they GODDAM NEVER WILL!  


Do you blame them?

But back to the grooming ritual section of our quest.  
Things such as: 

- the dispersal of talcum powder to potentially wet skin

- the application of moisturiser to potentially dry skin
- a dainty squirt of body spray or slick roll of deodorant
- the donning of compression stockings (used to aid with common circulation issues)

Once all the pre-lim stuff is sorted you can then launch into operation ‘Clothes On’ with hopefully a minimum of fuss as you approach your big finale.  

A point to consider during all of this process is to be mindful of the delicateness of the skin older people are burdened with and how easily it will bruise (or even tear, eeek!).  Especially from getting snagged on clothing, zippers or worse still – your finger nails.  


So slow and steady wins the race; don’t rush and unless your client is clearly struggling, allow them to do as much as they can - ON THEIR OWN.  


Oh, and don’t forget to slide any weak or dicky limbs into sleeves or pant legs first so you aren't left battling with a floppy elbow joint or gammy leg that just won’t bend where you need it to.  


Talk to your client as you go – they usually have the routine down pat, so don’t try and be a self-appointed smarty-pants.  


Instead, follow their lead. 


Elderly people have extremely thin skin

The SKIN, 
That elderly are IN,
Is THIN!



 - Final Grooming Bits
Ok, so your elderly client is now fully clad in their outfit du jour - you are now left with only a couple of tail-end bits n bobs to wrap things up. 

These might include:   
  • Hearing Aids re-inserted
  • Hair brushed/combed
  • Blow-drying of wet hair
  • Shaving assistance
  • Teeth or denture cleaning
  • Make-up application (ooo la la!)

Thankfully, you will find most elders can handle these fiddly extras themselves and usually prefer to attend to them once you have departed.  Always important to encourage as much independance as possible so your client can feel they still have some say over their own grooming processes. 

“I‘m not in a nursing home yet, honeybunch!”

Managing to still take pride in one's appearance, as trivial as it sounds, does wonders for a senior's self-esteem by boosting confidence, restoring  dignity and more importantly - let's them know they are absolutely worth it!




Helping elderly clients apply makeup

Pucker Up?




 - Pack-Up, PISS OFF!
Once you've chaperoned your spruced-up charge to the security of their favourite armchair, it is usually expected that the carer then complete their duty with a quick tidy-up of the bathroom to ensure your client stays out of trouble once you have gone.  

This would involve the likes of:

  • Disposal of wet towels and soiled clothing
  • Rubber mats hung up to drip dry
  • Mopping up of ALL excess water from bathroom floor surfaces 
  • Check the heater is off
  • Ditto for the fan
Hooray you made it!  

Isn't it comforting to know how all of us, regardless of our age or our ability, feel so much better after a nice hot shower.



Cheers

Dollie