Preventing Repetitive Stress Injuries- Work Ergonomics

November 14th, 2012 by admin

Over the years, technology has become such an integral part of our lives. We can easily spend a few hours on the computer doing work, searching on the internet, and/or socializing with family/ friends through social networks.  As we spend more and more time at the computer, we become more susceptible to neck, back, wrist, and hand injuries.  “According to the U.S. Bureau of Labor Statistics, nearly two-thirds of all occupational illnesses reported, were caused by exposure to repeated trauma to workers’ upper body (the wrist, elbow or shoulder).”   As a result, many of these individuals require rehabilitative services in order to remediate or alleviate the symptoms of these repetitive stress injuries.  Some common repetitive stress injuries are carpal tunnel syndrome, tenosynovitis, and tendinitis. Work Ergonomics is the study of how people interact with their physical environment while at work in order to minimize injuries. The use of workplace ergonomics can help reduce the incidence of repetitive stress injuries at work. Here are a few tips to consider when setting up your computer workspace:

  •  Computer Monitor- Try to make sure that the monitor is at eye level or just below it
  • Good Posture- Try to maintain the head and neck in-line with the torso
  • Maintain shoulders relaxed while typing (avoid hiking up your shoulders- it will increase the tension around your shoulders, neck, and back)
  • Keep your elbows close to your body and supported (you can rest your elbows on the chair’s armrest for support)
  • Keep your lower back supported (you can use a pillow or a backrest for lumbar support)
  • While typing your wrists and hands should be in-line with your forearms (you can use a wrist rest/ cushion to maintain the alignment)
  • Maintain adequate room between the keyboard and mouse while typing to maximize ease and comfort
  • Always maintain your feet flat on the floor; if this is not possible adjust the seat height or use a stool to prop your feet on

 The list above, listed a few simple ways to reduce the likelihood of incurring a repetitive stress injury. If you already have one, seeking therapeutic services can help you: strategize to prevent further injury as well as remediate and/ or alleviate the symptoms of them.

 By: Esther Gonzalez, M.S. OTR/L Bil TSHH

Senior Partner

Adapting Spaces, LLC.

egonzalez@adaptingspaces.com

888-956-0077

Caring for a senior during a natural disaster

October 29th, 2012 by admin

Dealing with the aftermath of a natural disaster like a tornado, flood, hurricane, or earthquake can be a very stressful situation.  Caring for a senior during and after a natural disaster can be even more daunting. A natural disaster can lead to loss of life and/ or property which can leave someone feeling empty, depressed and with an increased sense of vulnerability. This is why it is very important to be ready before disaster strikes so that you are prepared to face whatever the effects may be. Below are some ideas to help you and the senior you are caring for stay calm in the face of disaster.

Social Connections: When dealing with natural disasters, it is not uncommon to experience disruption of services that breach our social connections (i.e., family and friends). Therefore, it is important to connect with at least one person in your community- perhaps a next door neighbor.

Remain Informed: As part of your emergency kit, you should have included a battery operated radio with extra batteries. Make sure you remain informed about looming dangers and regular updates from emergency response agencies. Avoid listening to sensationalist news broadcasts or rumors and discourage the senior you are caring for to engage in this type of activity as well.

Try to Keep a Routine: Although, it may be easier said than done, it is important to try to maintain a routine. It will help you feel a little more organized. For instance, try to make sure that you and the senior you are caring for get enough food and sleep. If you are both under a medication regime, make sure to take your medication and provide medications to the senior at the regular times.

Stay Active: It is very easy to feel hopeless and helpless when there has been a loss of life and/or property due to a natural disaster. Therefore, it is important to avoid getting into a funk by staying active within your community. Invite the senior you are caring for to help you with light chores around the house if possible. This is one way to stay physically active. Another way is to volunteer to help others that have been affected within your community.  They will probably return the favor and help you out as well. Remaining active will help you and the senior you are caring for keep your minds occupied.

Additional Resources:

Evacuation Centers http://www.google.org/crisismap/2012-sandy-nyc

Report Storm damage http://www.nyc.gov/html/oem/html/nycsevereweather/damage_form.shtml

Red Cross NYC http://www.nyredcross.org/

By

Miller Calberto, M.S, OTR/L, CAPS

Senior Partner

Adapting Spaces, LLC

mcalbertotr@adaptingspaces.com

1888-956-0077

Paying it Forward

October 15th, 2012 by admin

Living at home with a disability can be quite challenging.  Many people with low income struggle because they can not afford to make their homes safer and more accessible.  As a result, they live day to day as best as they can and try to manage with their current situation.  In an effort to help out individuals with physical disabilities and/ or seniors in the community, a non-for-profit organization named Rebuilding Together was started.  This organization believes that “everyone deserves to live in a safe and healthy home” (www.rebuildingtogether.org).  Hence their mission is to assist low income home owners with home repairs, accessibility modifications, and energy efficient upgrades.  These modifications are done at no cost to the home owner since they work alongside volunteers and are helped by various corporate partners.  Rebuilding Together has been helping low income homeowners for over 30 years and has grown exponentially operating over 200 independent sites throughout the United States. 

 As part of a “paying it forward” effort, Adapting Spaces, decided to partner up with Rebuilding Together NYC to help out with a home accessibility project.  This project lead by Rebuilding Together, needed skilled experts in the field to volunteer their services to perform home assessments in order to determine the needs of their clients.  Therefore, Adapting Spaces decided to help by performing these assessments.  While working on this project, I had the opportunity to work with two families that were in need of home repairs and accessibility modifications.  One of the families shared their story with me and it really touched my heart.  I was deeply saddened to hear of their hardships.  This family had to face the daunting challenge of seeing their disabled family member confined to one room for over a year.  He had no way of accessing the other rooms in the house or the outside world because he could not walk.  While there, I also found out that this adolescent suffering from physical impairments, had a broken wheelchair and was not receiving any therapy services at home.  As a therapist, this was disconcerting and I was compelled to help out this family beyond performing the home assessment.  After leaving their home, I wrote a detailed report to Rebuilding Together with specific recommendations for accessibility modifications.  I also contacted another organization, with the family’s permission, to work on getting a new wheelchair and therapy services for the adolescent.  The family was very appreciative of my efforts in assisting them beyond the Rebuilding Together process.  Now, the adolescent has a new wheelchair and is receiving therapy at home.  He is starting to walk and is participating in various activities of daily living with the help of occupational and physical therapy.      

As an Occupational Therapist, I have the opportunity to work with and help many people suffering from various conditions.  I believe that it is important to help out those that are in need.  This experience has been personally and professionally rewarding in that it has made me more conscious of the fact that it only takes one good deed to effect a greater change in someone’s life.  I wanted to “pay it forward” by volunteering my services to Rebuilding Together’s cause.  In doing that, I was able to help out and make a huge difference in the life of this adolescent.  Being able to “pay it forward” has made my contribution that much more meaningful and purposeful.  “Pay it forward”, you never know whose life you can change.

By: Esther Gonzalez M.S. OTR/L Bil TSHH

Adapting Spaces, LLC

egonzalez@adaptingspaces.com

1888-956-0077

FALLS PREVENTION

September 24th, 2012 by admin

Fall prevention is an enormous topic that, as an Occupational Therapist, I get asked about all the time.  No one wants to or anticipates falling in their home, but it happens.  People always want to know how to not fall while at home.  If you work in healthcare in any way, you are aware of the prevalence of falls across the country.  Being able to advise clients and family members in proper home modifications is vital.  Keep in mind that you cannot prevent falls all together, but with the proper home modifications you can prevent falls as much as possible. 

According to The National Safety Council and Centers for Disease Control (CDC) in 2007, more than 21,700 Americans died as a result of falls; more than 7.9 million people were injured by a fall; and over 1.8 million older adults that had a fall-related injury resulted in an emergency room visit.  Falls are the leading cause of injury-related deaths among older adults 73 and older and the second leading cause of death from ages 60-72 (http://www.nsc.org/safety_home/Resources/Pages/Falls.aspx).”  In addition, a new CDC study published in the Morbidity and Mortality Weekly Report (MMWR), “ an estimated 234,000 people ages 15 and older were treated in U.S. emergency departments (ED) in 2008 for injuries that occurred in bathrooms.  Four out of 5 of these injuries were caused by falls” (http://www.cdc.gov/Features/Fallrisks/).

When I recommend home modifications, I do my best to keep it simple and save costs as much as possible.  This is usually a very overwhelming time for the people I am working with and by sticking to a few basic principles and recommendations I feel that I am generally able to accomplish what I need.  Here are my basic recommendations to decrease the risk of falls and increase safety throughout the home:

1)      To enter the home, be sure that there are handrails on both sides of the stairs.  Ideally, there should be a landing so that the door can swing open all the way to allow for easy entry.  Also be sure to provide/have proper assistance just in case.

2)      Upon entering the home one of the first things I look at is the type of flooring used.  I look for smooth transitions between rooms.  This allows for easy maneuverability of wheels (either on a walker or wheelchair) and reduces a trip hazard of having to step over a threshold.

3)      There should be no throw rugs.  If there are throw rugs that cannot be parted with, use of a non-skid mat under the rug is essential to reduce the possibility of wrinkling and sliding.  Another common suggestion is to tape the edges of the throw rug down to avoid the edge rolling up or getting caught.  Of course always use extra caution when rolling over the edges (of rugs/ thresholds) to avoid a trip hazard.

4)      Keep walkways free of clutter to avoid the need to step over or move things with your feet or equipment while ambulating.  Most standard/basic walkers are ~18” wide so keep this in mind for clearance.  This can be especially difficult in smaller homes with narrow halls and doorways.  If this is the case for you, do the best you can and if possible ask for or get assistance. 

5)      In the bathroom install a grab bar in the shower to assist with standing tasks.  In the instance of a tub/shower combo use a tub transfer bench for easier and safer transfers.   In the instance of a shower stall use a shower chair.  In either case I always err on the side of caution in the case that balance could be an issue.   This way there is a place to sit if needed in a pinch.   Non-skid matting or stickers on the floor can be used to decrease slippage on wet tile.  For ease of toilet transfers, at the very least use a raised toilet seat either with armrests attached or a grab bar on the wall depending on the space available. 

6)      If there are stairs present in/out of the home be sure to use contrast as a marker for the edge of each step.  This can be done simply with electric tape or paint.  People with visual impairments can have difficulty judging where the edge of the step is without contrast.   

7)      In the kitchen be sure that commonly used items are kept within easy reach.  This means to use the bottom shelf of the upper cabinets and the top shelf of lower cabinets as much as possible.   One other tip I love to give is to keep dishes used daily in the dish rack.  This way they are literally within arm’s reach at a moment’s notice.

8)      In the bedroom, as in the kitchen, use top drawers or the easy to reach middle portion of the closet to make clothes retrieval easier.  This way there will be minimal bending and over- reaching for needed items.  Be sure to keep bed linens off the floor to avoid getting feet/walker caught and tangled causing a trip hazard.  

9)      Lighting is key!  Be sure that lighting is kept natural whenever possible.  Avoid glare off shiny objects such as the television or floor.   To achieve this you may only need to change your bulbs to a different wattage or change the position of a lamp to provide less direct light. 

I always remind clients that safety is key!  Each person and each home is different, but with the right foundation you can easily build or change these recommendations to suit your needs. 

Contributed by

Elizabeth R.K. Tomoso, OTR
Occupational Therapist
Independent Life Solutions
(808)280-5176
etomoso@yahoo.com

BRINGING THE PATIENT WITH A STROKE BACK HOME

August 14th, 2012 by admin

As an occupational therapist, I often work with clients that have suffered a stroke.  The effects of a stroke, otherwise known as a cerebrovascular accident, can manifest in a number of ways.  It can range from slight weakness of the muscles to total paralysis of one side of the body.  The side of the body that is affected is the one opposite to the area of the brain that was injured.  This blog post will focus on those individuals who have completely lost use of one side of their body. 

In the past, rehabilitation facilities had therapists’ assess the client’s home prior to discharge.  This was done in order to make the discharge as efficient and effective as possible.  However, due to the overwhelming emphasis on work productivity, budget cuts, and cutting back on staff more and more rehab centers have abandoned this practice. Clients suffering from a stroke are being sent home with just the basic skills they have learned while at the rehab centers.

Individuals with a hemiparesis (paralysis of one side of the body) can present with many difficulties.  One of the areas mainly affected is the ability to perform Basic Activities of Daily Living (BADL’s).  This includes: bathing, grooming, feeding, dressing, and toileting.  They can also present with poor coordination, diminished sensation, speech difficulties, problems with swallowing, and cognitive impairments.  As a result, we will explore some ways to help these clients live more comfortable while at home.

To begin, it is important to assess the environment and remove anything that would hinder the performance of a daily routine.  This can be done by adapting the environment to include things that would make the setting more user-friendly.  For instance, two of the main areas that need to be looked at when assessing the environment are the bathroom and bedroom.  Sometimes remodeling is not an option; therefore, it is necessary to adapt the existing space.  Occupational therapists with their vast knowledge of assistive technology can help in selecting the right assistive devices and durable medical equipment to facilitate this task.

Currently, there are a number of items on the market that occupational therapists can recommend to assist in performing activities of daily living.  We often suggest that all self-care items be placed in an easy to access area.  It is also important to make sure that there is good lighting and ventilation in these areas.  In the bathroom, water temperature should be regulated to avoid getting burned.  When it comes to dressing, utilizing one- handed techniques has proven to be just as beneficial as using assistive devices to complete the task.  One- handed techniques allow the client with a stroke to use their unaffected side to aide in performing various tasks.  Consult with an occupational therapist to learn more about one- handed techniques.  In the meantime items such as elastic shoelaces, pants with a velcro fastener, and shirts with snaps or larger buttons can facilitate dressing activities.  As a rule of thumb, it is important that the individual performing the activity be seated on a firm surface with both feet placed on the floor to provide ideal support and optimal posture.

Mealtime is another difficult task to perform after a stroke.  It requires stabilizing the plate; gathering and/or placing food onto a spoon/fork; and stabilizing food while cutting. In order to help the individual successfully perform the task, it may be necessary to use assistive devices.  As a rule of thumb, during mealtime an upright sitting posture is essential.  It not only facilitates the activity, but also decreases the likelihood of aspiration (choking).  Thus, it is necessary to ensure that dining chairs provide proper support to maintain a good posture and that the table be at a comfortable height for the individual.  Currently, there is a vast amount of assistive devices that can help individuals with a stroke become more independent during mealtime.  Some frequently used items are a scoop dish/ plate, ergo plate, and rocker knife.  These items can help turn this experience from a frustrating one into a rewarding one.

Suffering from a stroke can be a life changing experience.  Even more so for those individuals with complete paralysis of one side of the body.  Hospitals and rehab facility programs are designed to make life after a stroke easier.  However, when the client goes home it tends to be a different story.  A combination of one- handed techniques coupled with assistive devices can help the client with a stroke live at home more comfortable and independent.  An occupational therapist can assist in training and selecting appropriate assistive devices. 

 By

Miller Calberto, MS, OTR/L, CAPS
Senior partner
Adapting Spaces, LLC
mcalbertotr@adaptingspaces.com
1888-956-0077

Edited by Ester Gonzalez, MS, OTR/L, Bil TSHH 

Baby Boomers Increasing as Caregivers

July 9th, 2012 by admin

Approximately 43.5 million adult children over the age of 50 – America’s baby boomer generation – are caring for their aging loved ones, reports the Family Caregiver Alliance. Many of these boomers are squeezed between facing their own health needs and the need to still work and actively provide the best care for their parents and other loved ones. About 10,000 U.S. baby boomers reach age 65 every day, and as people live longer, this generation may be the first to care equally as long for parents as for children.

A 2011 AARP Public Policy Institute study found that in 2009 the average caregiver was a 49-year-old woman who worked outside the home while investing nearly 20 hours per week in unpaid care for her mother. A MetLife study revealed that the total estimated aggregate lost wages, pension and Social Security benefits of adult caregivers of parents is nearly $3 trillion. But the toll on the new normal of boomers as caregivers is more than financial. Countless boomers are just not prepared for the physical and emotional impact of assisting their older loved ones.

“Family caregiving is becoming more and more commonplace for baby boomers,” said Walter Ochoa, President, Right at Home Brooklyn. “Some loved ones need more personal day-to-day care, while others only need occasional help living independently. The key is finding the right resources to match the needs of both loved one and caregiver.” Right at Home is a leading provider of in-home companion and personal care to senior citizens and other adults.

The best time to plan for care needs of parents and older loved ones is before the person’s health or living situation reaches a crisis mode. Here are suggestions for assisting with personal care and/or financial resources:

  • Talk together as a family about long-term care and a senior’s preferences and goals.
  • Consider modifying the loved one’s home with handrails, chairlifts, etc. instead of moving him or her into a care facility.
  • Discuss finances and insurance needs openly, referring to an elder law attorney, financial planner or other geriatric care support when needed.
  • To ease the load of caregiving, consider home care companies like Right at Home, which can provide everything from transportation and homemaking to hygiene care and skilled nursing.
  • Be sure the senior has an advance care directive, which includes a durable power of attorney that gives someone legal authority to make financial decisions on behalf of the senior. A health care proxy also is needed to allow someone to make medical treatment decisions for the loved one, and a living will details plans for end-of-life care.

 Because boomers are the “sandwich generation,” faced with the challenges of elder/parent care and helping their own children, caregiver professionals advise the boomers pay special attention to their own health and energy reserves. A MetLife 2010 study on working caregivers found that among female caregivers 50 years and older, 20 percent reported signs of depression. Boomer caregivers who simultaneously juggle work and raising adolescent children or young grandchildren encounter an increased risk for chronic illness, decreased emotional health and the abuse of alcohol, tobacco and other drugs. To keep a healthy balance in life, caregivers are encouraged to:

  • Get adequate sleep.
  • Eat nutrient-rich foods and drink extra water.
  • Make room for exercise several times a week.
  • Keep up-to-date on your own medical and dental appointments.

 Caregiving can be both a rewarding personal experience and a stressful demand. Boomers who plan ahead and talk through care options with their loved ones will be better prepared when a slowed stage of life comes knocking. Knowing a senior is safeguarded and content in his or her physical surroundings is truly a gift to any caregiver, especially those approaching their own mature years.

Right at Home of Brooklyn provides services, support and resources to older adults and offers a list of the “Top 10 Things to Discuss With Your Parents” to help boomers and caregivers of any age better assess the needs of their aging loved ones. Visit rightathome.net under About You for these helpful discussion topics.

About Right at Home of Brooklyn

The Brooklyn office of Right at Home is a locally owned and operated franchise office of Right at Home, Inc., serving the communities of New York City. For more information, contact Right at Home of Brooklyn at www.rah-nyc.com , 347-554-8400 or by email at wochoa@rah-nyc.com

Wounded Soldiers Regaining their Independence

May 30th, 2012 by admin

Memorial Day is a day of remembrance!  This is the day that we honor all of the brave soldiers that lost their lives in war and those that continue to sacrifice themselves for our country.  Many of these men and women not only lost their partners and close friends to war, but some have experienced other personal loses as well.  Daily, countless soldiers are injured and have to cope with living the rest of their lives with a physical disability such as an amputation or severe burns.  Others have to face the devastating effects of a traumatic brain injury.  Whatever effect the war may have had on them, they are now forced to face life with a different perspective.  What was once automatic and relatively easy has now become a challenge.  These life altering experiences make it difficult for soldiers returning home to resume their lives with the same level of ease and independence.  As a result, they often require rehabilitative services to increase their level of functioning and regain their lost independence.  

 Since World War I, occupational therapists have helped injured soldiers to heal mentally and physically. They have trained soldiers with disabilities to regain skills they need in order to function on a daily basis, as depicted on the TIME Magazine’s article “America’s Next War”. As occupational therapists, our goal is to help individuals with disabilities become more independent in performing day to day activities.  These may include activities that are meaningful and/ or purposeful such as bathing, dressing, grooming, moving around the home independently, preparing a meal, or returning to work after an injury.  As well as, those activities considered enjoyable such as leisure ones. Home modification is an emerging area of practice in the field of occupational therapy and one that is helping soldiers with disabilities adjust to civilian life.  Occupational therapists are uniquely positioned to provide this specialized service thanks to their in-depth knowledge of human function, task analysis, and the effect of the physical environment on human capabilities.   An adaptation or modification can consist of something as simple as installing a grab bar in the bathroom for support; lowering kitchen cabinets for those who are in a wheelchair; or installing a chair lift for accessibility purposes.  Through the implementation of home modifications, injured soldiers can regain their independence and engage in those activities that are important to them.  As occupational therapists, it is rewarding to know that we are able to provide such a unique service to those soldiers who have so graciously given so much. 

By

Esther Gonzalez, M.S. OTR/L Bil TSHH
Adapting Spaces, LLC
egonzalez@adaptingspaces.com
1888-956-0077

Autism: Making “Sense” of the World

May 9th, 2012 by admin

Every day, thousands of people are affected by Autism.  Autism is a disorder that can affect an individual’s ability to interact with others and engage in their environment.  Many children with Autism have difficulty perceiving and interpreting sensory input around them.  From the moment we wake up until we go to sleep, we receive information through our senses.  The way our brain makes sense of this information effects the way we respond to certain experiences.  If we perceive something to be harmful, we avoid it.  If we perceive it as being enjoyable, we are more likely to engage in it.  For children with Autism, this can be a big problem.  This inability to make sense of their world interferes with their ability to interact with others and engage in their environment appropriately.  As a result, they may exhibit adverse behaviors such as tantrums, outbursts, avoidance, and ultimately seclusion.  This can limit the opportunities the family has to bond with their child.  There is a way to help these children cope with these environmental stressors and decrease the occurrences of these adverse reactions.  Modifying one’s home to include a “sensory room” is one effective way.  The sensory room is tailored to the individuals needs and can be used to relieve and/or help the person cope with these involuntary responses to certain stimuli.  It contains various stations with specific sensory equipment and activities that are “less threatening” to the child.  The room is inviting and relaxing; it helps soothe and calm the person.  Some examples of things found in a sensory room are: bean bags; fiber optic/ led lights; bubble tubes; vibration/ massage chairs; ball pit; swing; sensory stations with various textures; calming wall colors; music station; and child- friendly padded floors and/ or walls.  We as Occupational Therapists specialize in and are knowledgeable in this area.  We evaluate the child and their living environment; as well as, provide helpful suggestions to keep your child safe and independent while at home.  Adapting the environment to include a sensory room would give you and your child the opportunity to bond more and enable your child to interact more freely in his environment. 

 April was National Autism Awareness month.  In light of that, we decided to take the opportunity to educate the public on how home modifications can be used to help make your home more user- friendly for your autistic child by including a sensory room.  If you have any questions about how to cope with the adverse effects of sensory processing or modifying your home to include a sensory room, feel free to give us a call.

By 

Esther Gonzalez, M.S. OTR/L Bil TSHH
Adapting Spaces, LLC
egonzalez@adaptingspaces.com
1888-956-0077

Dementia Care: Dealing with Mood Swings and Behavioral Outbursts

April 23rd, 2012 by admin

One of the most detrimental effects of dementia related conditions are mood swings and other behavioral changes. Dementia is not a single condition, but a non-specific illness diagnosed based on a set of signs and symptoms. Depending on the areas of the brain that are affected by this condition, the individual may display memory, cognitive, motor,  perceptual and information processing deficits.  An individual with dementia may perceive and process environmental information in a distorted manner which can bring about erratic behavior. For instance, they may have a heightened sense of smell and perceive smells as too strong and irritating.  Here are some helpful tips to make your home more comfortable and enjoyable for an individual with dementia.

Lighting:

It is very important to keep all areas of the house well lit since bright lights that can cause glare and poorly lit areas can create shadows and may be misperceived.

  • Use combination lighting and wall mounted light fixtures.

Noise:

Attempting to regulate noise levels in New York City, may be a challenge but it can be accomplished. Loud and constant noise is very irritating, especially to someone with dementia.

  • Seal crevices and cracks around baseboards, windows and doors to reduce sound levels.

Air quality:

Strong smells are very irritating and increased humidity may increase the potential for mold formation which can become a health hazard.

  • Eliminate or control the source of air pollution, garbage, pets, perishable foods.
  • Keep windows open when weather permits.

Temperature:

Keep home warm during the winter months and cool during the summer months.

  • Make sure the thermostat is working properly and is set at a comfortable temperature.
  • Make sure air conditioners are in working condition.
  • Install a temperature sensor  

I hope that these tips are helpful. If you would like to learn more ways on how to modify your home in order to reduce or manage mood swings and behavioral outburst in people with dementia, please give us a call at 1-888-956-0077.

By

Miller Calberto, MS, OTR/L, CAPS
Senior partner
Adapting Spaces, LLC
mcalbertotr@adaptingspaces.com
1888-956-0077

23 simple adaptations to help people with dementia stay at home.

March 26th, 2012 by admin

According to the Alzheimer’s Association, 70 percent of people with dementia and related conditions are currently living at home.  New York City is a place where due to its overpopulation and vertical construction style, caring for a loved one with dementia can be a real challenge. There are ways to improve the living space to make the client with dementia more comfortable and safer at home.

Wandering

Against popular belief, wandering is good for people with dementia and should not be prevented or limited.  It keeps them active and can help prevent other issues such as constipation. Wandering can be done in a safe way inside the home by taking simple steps. Assuming that all the rooms are on the same floor, as is often the case in New York City apartments.

  1. Walkways should be clear of any clutter and furniture. It is also important to keep in mind not to completely change the familiar look of the living space.
  2.  The doors for the rooms that you wish to keep the client from going into should be closed at all times.
  3. Doors should not be so obvious in appearance and their colors should blend in with that of walls.
  4. Make sure to place a chair near the rooms or in the hallway, so that the client can take frequent breaks.
  5. Minimize the use of mirrors around the home as this can make the client confused.
  6. It is ideal to install a passive alarm system that will quietly monitor the client’s routine around the house or apartment and will alert you if something changes.  The Grand Care system can do this for you.
  7. In the event that the client makes it out of the house, make sure to have a plan B. This plan should include having recent pictures of the client that shows what clothes he/she is wearing and a list of places the client frequently goes to.

 

Hygiene and Self-care

  1. As a rule of thumb, it is very important to try to simplify daily activities. By assisting the client in performing these activities you are encouraging them to become more independent.
  2. The pathway from the bedroom to the bathroom should be clear of any clutter or items that the client can trip over.
  3. Place reminders that illustrate where the bathroom is located.
  4. It is also important that the toilet and faucet are user-friendly. Toilet should be at a comfortable height and faucet should clearly display hot and cold water.
  5. Make sure to install a cold/hot water mixing valve to maintain water temperature consistent.
  6. Try to provide the client with comfortable clothes that will be easy for him/ her to put on and take off.
  7.  Another helpful hint is to take out a few outfits and give them to the client to choose.  Limiting the choice will make it easier for the client and/or caregiver to decide on what to wear. If the client is still able to make this decision on their own it is important to encourage them to do so.

 

Mealtime and Medications

  1. It is important to maintain a routine that will serve as a consistent reminder that it is mealtime.
  2. As the condition progresses, avoid providing the client with forks. Instead give them a spoon for safety purposes.
  3. Set up for mealtime by placing items in the same location all of the time. For example, if you use a tray place the food, beverages, and utensils in the same spot every time.
  4. Avoid having decorative items that look like food around the house.
  5. Proper seating and positioning is also critical during mealtime to avoid aspiration (food going down the windpipe into the lungs).
  6. Always make sure that the client has swallowed all of their food and/or medication as dementia clients tend to pocket food and medication which may lead to other medical issues.
  7. It is also important that dementia clients take their medications consistently. A pillbox is always helpful in this situation. Simply make sure that you choose a specific location within the client’s reach. 
  8. Set reminders that will help the client remember to take their medication. 
  9. Make sure to establish a system that will ensure that the client actually takes them. The Grand Care system can also help you with that.

These are very simple and very specific ideas that can be implemented in order to keep dementia patients comfortable and safer at home and avoid unnecessary and premature institutionalization. Next time we will continue with another set of great ideas to improve the dementia clients’ quality of life while at home.

By

Miller Calberto, MS, OTR/L, CAPS
Senior partner
Adapting Spaces, LLC
mcalbertotr@adaptingspaces.com
1888-956-0077