Very often, family caregivers realize they need help to take good care of their elderly loved one and with the rest of their responsibilities at work and at home.  Nevertheless, it is not easy to leave someone you love in the hands of a stranger, because you never know if they will care as much as you do.

Here we give you 10 questions you should ask the homecare provider you are considering hiring, to ensure they will offer the best care and human quality possible:

1.How long has (company name) been in business?
The longer a home care provider has been active, the easier it will be to check their references and reputation through the Better Business Bureau, with local senior and healthcare service providers, at church, and talking to friends and family.

Good providers show higher staff retention rates, and so, their caregivers are more experienced and better trained.

2.Can you share with me information about your services and fees?
Besides helping you compare services and fees, the quality of the materials they give you will offer hints as to the attention the company pays to the details of its business.  Remember to ask for references too.

3.How do you choose your caregivers?
The best providers employ caregivers who have enough experience and training but also a gift to serve and care for others.  There is no gain in having a very experienced person if he or she is not compassionate and loving.

An agency must check and interview the candidates for criminal and other background information, for personality evaluations, interviews, and reference checks.

The provider must offer training for the caregivers who pass the screening process, and should ask them to follow a training plan to continue developing their skills.

4.Are the caregivers bonded and insured?
A serious provider will have coverage to protect your loved one and your family.  They should carry professional and general liability insurance; they must bond their employees and cover them with workers’ compensation.

5.How are the caregivers supervised?
The provider must perform regular quality assurance calls and visits to ensure their caregivers are offering the best care possible.  To be more certain, they should be thoroughly supervised by a certified company representative.

6.Will you do a home evaluation before starting the services?
This is vital because in this way, the provider can pinpoint the needs at home, and tell you if they can take care of them satisfactorily or if you have to make the adjustments.  For example, your loved one may need a low air loss mattress system, bars installed in the bathroom, areas free of clutter, etc.  You and, if possible, your loved one, must check all of these along with the provider.

7.Will you supply a written care plan from the beginning?
Having everything in writing prevents misunderstandings, and it will serve you as a guide when you have questions.  It has to be done with your input and based on your needs, and it must allow for flexibility to make adjustments as your loved one’s needs change.

8.What happens if I don’t like the caregiver assigned to me?
If there is no chemistry, the provider must assign a different caregiver for the sake of everyone involved.

9.How do you handle emergencies?
The caregiver has to have a procedure to follow in case of an emergency, for example, if the lights go out, if there’s a snowstorm, or a natural disaster.  The provider must offer 24/7 phone service for emergencies.

10.    What’s the procedure when dealing with problems?
You should have clarity about how and who you have to contact in case you have a doubt, a concern, an issue, a request or a complaint.

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The 40-70 rule emerged as a guide to help families talk to their senior loved ones about how they will be taken care of as they age and become more dependent, and about what both parties feel, think, and expect of their lives during this stage.

It is meant to be a way to improve the communication gap that may exist between adult children and their senior parents.  The condition of aging commonly shocks family caregivers profoundly, because of the many difficult situations that come up during this phase of life.

Sometimes it can be very hard to talk to your dad about him crashing the car against a pole, or to ask your mom if she is taking all her medications as the doctor prescribed, or to find the way to tell your parents that they need more help at home.  This is challenging even for families where communication is open and trusting, and in many cases what happens is that people decide to not say anything at all, leaving many situations unresolved.

Adult children have to learn to talk to their senior parents sooner than later, before a serious crisis is just around the corner or has already taken place, and this is what the 40-70 rule is all about.  It helps families with senior loved ones deal with sensitive topics and difficult conversations right on time.

Basically, the rule is that if you are 40 and your parents are 70, you have to start talking about certain senior matters.  This rule is based on the fact that 1/3 of adults in the United States have problems talking to their parents because of the prolongation of the parent-son role.  Yes, many parents continue to have a very controlling relationship with their children, even after they become adults, making certain conversations quite difficult.

Do not wait until your aging parent is partially or totally bedridden, cannot understand you, or requires the help of a bariatric mattress to prevent bed sores; because sadly, this happens too often, and you end up regretting not having had the opportunity to discuss their wishes and expectations with them.

Get more information about the 40-70 rule; read this booklet, and get the help you and your senior loved one need.

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Bedridden patients, whether confined to bed for an indefinite period as they recuperate from injury or surgery, or if they are going to be bedridden for the long term, need specialized care and equipment to provide comfort and maintain good  health.  Fortunately, many of these specialized necessities are available for patients who are being cared for at home, and can be prescribed by physicians to make the job of caregivers much easier to manage.  Some of the most essential items for care are described below:

.Hospital Beds
The hospital bed is probably the most necessary of all equipment as it is where the patient spends most of their time.  Beds range from manually operated to full electric Adjustments can be made easily to help the caregiver provide the patient with the utmost comfort.  These beds are also on wheels which makes it much easier to place them in the most convenient locations.  The bed itself consists of a metal frame with head and foot boards and metal springs.  Side rails can be installed as an extra safety precaution where necessary.

.Special Mattresses
One of the biggest health risks to the bedridden patient is the development of pressure sores.  These painful ailments can be prevented by the regular use of a low air loss mattress or a pressure relief air mattress.  By gradually inflating and deflating, these special mattresses can gently turn the patient throughout the course of the day thus relieving pressure points that can develop into skin wounds.

.Over bed Tables
These tables that are fully adjustable and move easily on castors are a must have for both patient and caregiver aid.  They are invaluable for feeding, bathing and putting the items that the patient may need throughout the day within easy reach.   Some styles even offer a tilt option for the patient who likes, and is able to do various activities such as writing letters, doing puzzles or reading.

.Patient Lifts
One of the most difficult chores for the caregiver of a bedridden patient is lifting them out of bed for personal care or therapy, or transferring them to a chair for a change of scenery.  Patient lifts can make this job much less physically draining for both the caregiver and the patient.  Like hospital beds, theses lifts come in varying degrees of automation.

.Wheel Chair
Providing an opportunity to get out of bed and enjoy a change of scenery is very important to the health and well being of any patient.  A wheel chair provides a means for patients to get outside, move to a community room for socializing, or sit up to a dining table to enjoy a comfortable meal time.  The feeling of independence that a wheel chair can provide is very vital to every patient’s sense of self-esteem and dignity.

When searching for information about the equipment you need for your situation, be sure to inquire about the availability of used equipment and rentals.  Both are usually available and can really help to stretch your care giving budget.

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Caring for a bedridden patient in your home can be challenging and time consuming even with some of the best conveniences that are available such as adjustable beds that make it easier to make the patient more comfortable, and an alternating pressure mattress that works wonders to prevent bedsores. Even the most caring and compassionate person can still benefit from a little help now and then.  Your doctor or health care practitioner should be able to help you contact a home care agency in your area.  Home care agencies generally provide several different kinds of services based on the individual’s needs.  Depending on the patient, you may request one or a combination of these services.  Some of the most commonly used services are detailed here:

Personal Care
Personal care is often one of the most difficult aspects of caring for any elderly or bedridden patient. Maintaining a sense of dignity is often difficult and patients can become very demoralized and embarrassed.  Having a home care aide perform some of these tasks can make the situation take on more of a professional rather than personal nature, thus alleviating the stress on both patient and caregiver.  If the patient suffers from incontinence, needs help dressing and bathing, a home care aide for personal care can be a real life saver.

Nutritional Care
Proper nutrition is vital to the health of every patient and a dietician or nutritionist will help the caregiver design healthy menus that are personalized to the patient’s dietary needs.

Physical Therapy
Bedridden patients often require physical therapy to keep muscles and joints moving and functional.  They will also instruct caregivers in the use of special equipment that may be used to promote a patients physical health.

Nursing Care
A registered nurse can work closely with the doctor of an in home patient to ensure that his/her health status is monitored and that proper treatment stays on course.  A nurse can monitor IV treatments, give injections, dispense medications and dress wounds.  Nurses can be invaluable for the home caregiver for both their medical expertise and their emotional support.

Occupational therapy
An occupational therapist will work with individuals and access their capabilities to complete tasks.  They will then make suggestions as to how to improve those processes, and help to implement those new techniques.

Speech therapy
In cases where speech impairment exists, a speech therapist can come into the home to work on speech improvements as well as to help develop alternate methods of communication.

Homemaker service
A homemaker will help with light daily chores such as doing dishes, tidying, vacuuming, laundry or preparing meals.  Duties can be determined on an individual basis between the caregiver and the homemaker aide.

Volunteers
Volunteers from the community often work with home care agencies to provide companionship, transportation to and from appointments and help with daily activities like shopping, correspondence and getting outside.  

Pet Therapy
Somewhat new to the home care service industry, pet therapy is proving itself to be a real winner!  Many patients who have been pet owners through their lives find the visit from a furry friend to be very calming and enjoyable.
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If you’re taking on the responsibility of caring for an elderly parent in your home, you’ll want to know the best ways to prepare for their arrival. These nine essential rules will help you get ready for new role:

1.Get informed

.Just as you organize and take care of your own financial, health and legal files, it’s important you have access to the same information belonging to your elderly parent. If possible, try and collect information and actual records of the following (some of which you may need to help access special services and healthcare for your parent):
.Social security number
.Healthcare insurance details. Is your parent receiving Medicare? If so, do you have detailed information regarding the benefits of this service? You will need to copy the back and front of all their health insurance cards and policies.
.Details of other healthcare providers, e.g, dentist, pharmacy, optometrist.
.A list of all the medications your parent is taking, dosage amounts and instructions for taking them. Take this information with you to every medical appointment.
.Copies of past medical records, including date and results of recent medical tests e.g, x-rays, MRIs, CT scans

Do you know if your parent has made any of the following – a will, durable power of attorney for finances, durable power of attorney for healthcare, a living will? Some of these will help you take care of and make decisions for your elderly parent if their health condition deteriorates to a point where they are unable to represent themselves. If not, you might want to arrange to help your parent prepare these legal documents. When necessary, consult a lawyer specializing in elderly law. If some of these documents have already been drawn up, make sure you have access to the records and are aware of their content.

Make sure you are aware of your loved one’s financial matters. Do they have bank accounts? Do they receive regular income from social security, pension programs or through other channels? Do they own any assets, property or real estate? How much is their home worth? Do they have any other investments, stocks or IRAs? If possible, talk to your elderly parent about how they might wish you to help manage or arrange their financial matters.

2. Do your research
If your loved one has particular medical conditions, make sure you are well informed about what they are. Talk to their physicians and take the time to obtain reading matter from the library or book stores. Being informed will help you provide the best possible care for your elderly parent and will also make your task easier since you will gain valuable advice. You may even find supporting services that will help you with their care.

3.Call a family meeting
Your elderly parent might be living with you but that doesn’t always mean the full responsibility of their care should fall on your shoulders. Call a family meeting involving all those who are interested in the care of your parent. Express any desires for additional help you have and how your family members can be involved. Talk about important decisions that have to be made regarding your parent and try to get input that will be useful. Allow everyone to have a chance to express their feelings and wishes.

4. Know your community resources
Gather information about your community’s local services. They may include senior centers and adult day centers. Or you might find useful meal delivery and transportation support services, as well as home health agencies. Also, contact your local social services department to discover other services you might benefit from. There is valuable information you can access via the internet including support groups and forums for elderly caregivers. Don’t be afraid to ask your friends and family for advice too – those who have experience in taking care of an elderly loved-one might have a wealth of information to share with you, too.

5. Look out for these symptoms
Many people believe that incontinence, signs of confusion, depression, or loss of sight, hearing or memory, are symptoms to be expected in the elderly. However, many fail to realize that these are often treatable conditions and could be side effects of prescription drugs. If you notice any of these symptoms in your elderly parent, take them to their physician. Failure to report them could lead to unnecessary functional decline in your loved one.

6. Hire a care manager
This is another resource you might find to be a great help. These professionals are trained to assess your loved-one’s particular needs and make recommendations about services which could benefit them. They will help you make the most of community resources and will also hire and manage paid caregivers on your behalf. Visit the website for the National Association of Professional Geriatric Care Managers (www.caremanager.org) to help you locate a care manager near you.

7. Consult your elderly parent as much as possible
If your elderly parent is in a healthy state of mind, it is vital that you talk to and consult them about every aspect of their care – after all, much of your responsibility will be to make sure they are comfortable and happy with their environment, daily routine and how they are being cared for. Gain as much input from them as possible about their needs, wishes and preferences. In all aspects, involve them in decision-making as much as possible. This will help them maintain control of their affairs and will make for a better patient – caregiver relationship.

8. Take care of yourself
Despite all your good intentions, if you don’t take care good care of yourself, you may be of little emotional and practical help to your elderly parent. If you feel you are becoming over-tired and stressed because of your new responsibilities, don’t be afraid to ask for help and support from other family members and friends, or even community services, who will allow you to take a break when needed. Make time for yourself – to relax and for your own interests so that you don’t feel like your entire life has been taken over by your role as a caregiver. In addition, make sure you don’t neglect your own meals and healthcare as you look after these needs for your elderly parent.
Acknowledge any feelings you have related to your parent’s need for care – sadness, frustration, anxiousness about their future. Write your feelings down in a journal or enlist a listening ear if it helps. Bottling up emotions instead of confronting them can cause additional emotional stress. Take good care of yourself and your role as a caregiver will stay manageable.

9. Purchase or hire good equipment
There are lots of tools and devices available for purchase today that can make life for your elderly loved-one (and you!) easier and more comfortable. Consider if both you and your parent might benefit from equipment such as wheelchairs and wheelchair ramps, eating or dressing aids, walkers or rollators, bathroom and toileting aids, physical therapy accessories and incontinence aids. Since the elderly are more susceptible to bed sores, consider investing in a pressure mattress or alternating pressure mattress that will help prevent these uncomfortable and serious wounds. Research the variety of elderly-aids on offer to help you give your precious loved-one the best care possible.

If you liked this article, tell all your friends about it. They’ll thank you for it. If you have a blog or website, you can link to it or even post it to your own site (don’t forget to mention http://www.volkner.com as the original source).

Living with pressure sores is never an enjoyable experience. If you are at risk of developing them, or you are taking care of someone who might be at risk, get informed about pressure sores to avoid developing these unpleasant injuries.
This guide will tell you the best ways to prevent and care for pressure sores.

What are pressure sores and what causes them?

Pressure sores are also described as bed sores, pressure ulcers or decubitus ulcers. They are formed when constant pressure on part of the skin causes the blood vessels feeding that part to shut down. At first, this causes a red or dark patch on the skin. As further pressure is applied, the skin continues to deteriorate, breaking down to form blisters and dead skin, and then going on to affect underlying tissues, bones and joints.

Pressure sores can appear on any part of the body, but will usually develop on parts most susceptible to pressure when sitting or lying down, e.g., the lower back, buttocks, shoulders, hips, heels, knees and ankles.

In general, people who are bed-bound or in wheelchairs are particularly susceptible to developing bed pressure sores. Other factors that increase the likelihood of developing these sores include old age, immobility, incontinence, malnutrition and dehydration, diseases that slow healing, mental disorders that result in a lack of awareness about the body’s condition and the taking of certain medications such as sedatives.

How will I know if I have a pressure sore?
There are four stages of severity in the development of a pressure sore.
-  Initially, you may find it appears as a red area of skin (or a darker area of skin than normal on darker skins). It is a mark that doesn’t disappear after a few hours and may also feel tender. Sometimes, the initial appearance of a pressure sore may appear like a bruise – purple in color and painful to touch.
- The second stage may include a partial loss of skin that may appear as a blister, shallow crater or abrasion.
- The third stage of severity involves a full skin loss which extends to the underlying skin tissue.
- The last stage involves a total skin loss and the sore extends to the underlying tissue, muscle and bone.

How do I treat existing sores?
Properly caring for your existing pressure sore is the best way to promote healing and prevent it from becoming more severe. You might be caring for your pressure sores yourself or have a caregiver who cares for them, but it is always best to be informed about the process. Here are four main steps that need to be followed:

1. Pressure relief
Continuing to place pressure on an existing pressure sore will aggravate the sore and prevent it from healing. Instead, it is essential to relieve the area from any form of pressure. If possible invest in a pressure-reliving mattress or pressure relieving aids such as cushions to help you.

2. Cleaning
Pressure sores will heal well if they are kept clean and it will also ensure the prevention of infection. This means they should be free of dead tissue, have excess fluid drained away from the sore and should also be clear of any other debris. A healthcare professional should show you how to clean or rinse the sore and also how to wipe away any loose material. The right equipment and methods should be used too. If too much force is used, it can aggravate the sore or if not enough force is used, the wound may not be cleansed properly.

3. Removing dead tissue
Dead tissue which is present in the pressure sore can lead to infection and prevent the sore from healing. Your healthcare professional will usually carry out the process of removing the dead tissue. Since it may be painful, a pain-reliever may be taken beforehand. Procedures that may be used can range from simply rinsing the sore to applying enzyme medications to dissolve the dead tissue. In rare cases, surgery to remove deeply embedded dead tissue may be required.

4. Dressings
It is important to choose the right dressings to care for your pressure sores. Speak to your healthcare professional about the different types available. You will require different types depending on the type that will best aid healing, how often the dressing needs to be changed and whether or not the sore is infected.  Dressings are normally required to keep the sore moist and the surrounding skin dry.

What else should I know?
When cleaning your sores, it is a good time to check for signs that it is healing well. Ideally, you should see signs of a sore healing within 2 to 4 weeks. This includes seeing a decrease in the size and depth of a sore and a decrease in drainage.
Also, you should look out for any signs that the sore has become infected as the infection can spread to the underlying tissues, bones and even to the rest of the body. Signs of infection include having think green or yellow drainage, a foul odor, redness, warmth or tenderness surrounding the sore and swelling. Watch out for signs of fever, chills, weakness, confusion, difficulty concentrating and rapid heart beat that can indicate the infection might have spread throughout the body. If you are concerned and experience any of these symptoms, contact your healthcare provider immediately.

To manage the pain that pressure sores cause, changing your body position is often a factor that helps. In addition, some patients may choose toe an over-the-counter pain reliever or ask their doctor for a prescription.

How can I avoid developing pressure sores?

There are many ways to prevent pressure sores from occurring. Try to incorporate the following tips into your daily routine:

-    Examine yourself very carefully ever day for any signs of sores developing. Recognizing you have a sore developing at an early stage will help you take care of it and prevent it from becoming more severe.
-    Eat a nutritious and balanced diet, with extra protein to help keep your skin tissue healthy. A good diet will ensure your body has what it needs to heal itself well and cope with infection.
-    Use barrier creams or protective creams to protect areas that are susceptible to becoming moist.
-    Protect vulnerable areas of your body from pressure, fiction and moisture. If you are in a wheelchair or undertaking bed rest, it is essential that you change your body position every two hours (or it is recommended that those sitting down change positions every hour). Your caregiver or physician can give you guidance on which positions are best to use.
-    Keep you skin clean, dry and well-moisturized. Moisturize your skin thoroughly after washing as skin can be weakened when it dries out. Avoid using talcum powder which depletes the skin’s natural oils.
-    Make sure any existing sores are cleaned, dressed and bandaged properly.
-    Drink at least 2 liters of fluid a day.
-    Make sure there are no wrinkles or crumbs on your bed sheets or chair.
-    Go to great lengths to avoid rubbing areas of your skin that could get sore. This includes avoiding dragging your heels or elbows when moving around in bed.
-    Invest in pressure-relieving aids such as pillows, sheepskins and foam pads. The best investment patients can make to prevent pressures sores is buying a good pressure mattress. These mattresses are designed to relieve any pressure that is exerted on a patient when lying down. Some designs even help reposition the patient’s weight every few minutes, meaning there is no need to continually reposition them. Pressure-relieving mattresses are one of the best tools used to prevent the development of pressure sores.

If you liked this article, tell all your friends about it. They’ll thank you for it. If you have a blog or website, you can link to it or even post it to your own site (don’t forget to mention www.volkner.com as the original source).