Category Archives: Caregiving

The Hospital Visit Scale

Dear Readers:

Because of my many  trips to the hospital to visit family member or other loved ones,  I started to think about my variety of stress levels I experienced upon making an entry  or upon departing the hospital. One (1 ) being least stressful of visits, five (5) being most. My perspective is from being the primary caregiver of the hospitalized patient. General visitors are likely to be less stressed, except when they have first time entry into specialized units such as Burn Centers, Cancer Units, Pediatric NIC units.

 

I created The Hospital Visit Scale by Terry Prince 2016© to help visualize this.

 

hospital-visit-scale-v1

 

 

I am calling myself a Covert Hidden Hero. Covert because end stage caretakers of military disabled veterans are not necessarily the ones at the onset of a military disability.  From 2002 to 2013,  I served as my father’s primary caregiver. My father was a WWII veteran who lost his leg at age 20  (as well as hearing ability in one ear) in military service in 1944 from a V2Rocket while in Belgium.  He was British and in the RAF and deemed 80 percent disabled but was able to live a full life (marrying, pursuing a career in aerospace engineering, having 3 children, sailing and motorcycling). However in his late 70’s  his medical care became much more complex when his meniscus in his only “real” leg tore and he had to have surgery. In his later years he had stage 4 kidney disease with dialysis for 2 years (likely caused by high use of over- the- counter pain medication for his osteoarthritis in his remaining leg and normal use of prescription medicine when he had phantom pains in his missing leg), neuropathy, steroid induced type II diabetes and heart issues. My father in his last 4 years of life had an annual average of 2 major hospital visits (all exceeding 1 week), with follow on transitional care in rehabilitation facilities and follow on skilled nursing either in home or in a facility.  He had at least 12 doctors or specialist services  (primary PPO Doctor, Cardiologist, Neurologist, Nephrologist(kidney)  Pulmonary, Orthopedist, eye doctor, audiologist, dermatologist, US Veteran System Primary Doctor, Sleep Apnea Specialist, Wound Care Clinician, Anticoagulation Clinic)  as well as many revolving hospitalists each time he was hospitalized.  

Having experienced hospitalization exceeding 10 months of a loved one in many ways, in many different times and hospital settings, I feel confident that this scale reflects most of the instances of hospitalization. But I am open to suggestions, any thoughts out there?

 

 

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Cleaning Distinctions – Let’s Make Them!

One of the difficulties we face as we age is seeing and smelling the dust, dirt and general debris. Sensory decline in older adults increases clutter potential. 

Make a distinction between light housekeeping and general housekeeping and deep cleaning services. Make a push for twice a year deep cleaning to your older or physically challenged clients.

For someone who is aging, especially those who are unfamiliar with housekeeping services, they may think “light housekeeping’ is good enough. But it really isn’t.  Light housekeeping services which are often provided as part of in- home care provider contracts, are just that. Light! Contracted Caregivers don’t seek to do more than is in their required contract. They may in fact be discouraged due to liability limits to do more.

Deep cleaning which involves lifting or moving the heavy furniture (to vacuum the carpet or floor below), dusting the heating or air vents and baseboards, is a household chore that needs to be done at least semi- annually.

Another area to observe for deep cleaning is the computer desk and  television corner. Older PC’s and TV monitors are notorious dust bunny attractors. Fans and air vent areas need to be checked and cleaned for dust build up.

Cleaning out the refrigerator is also a deep cleaning chore. In fact this is not an easy service to find help for. Deep cleaning a refrigerator can take an hours worth of time.  Light housecleaning services do not offer or desire to provide this helpful service.  Often this is because they don’t want to get into a battle with the homeowner about good food and bad. Reaching into the back or bottom of a refrigerator is not an easy job. Many refrigerators have various parts that need removal for deep cleaning and putting them back together is often a puzzle.

In-home servce intake providers (often LCSW) or professional organizers need to start serving as educators. At the onset of client work state firmly that a household will need to get some additional cleaning services in order to keep the house clean and safe, not only for the client but for the contracted caregivers.

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Sensory Decline Increases Clutter

The senses of smell, taste, vision, hearing and touch are taken for granted by many. However,  as one ages,  some sensory decline may occur. I recently gave a presentation in which I discussed sensory decline and it’s effect on clutter and disorganization in relationship to the aging client.

Smell and Taste

  • Doesn’t smell rotting food/trash
  • Doesn’t smell mildew or dirty laundry
  • Unsure if perishable food is “good”

Thirty percent of American’s over the age of 70 have experienced some form of problem with their sense of smell.  Problems with taste, although less common, often appear in older adults.

Vision

  • Doesn’t see expiration dates on products clearly
  • Doesn’t see “spills” around toilet or kitchen sink
  • Mail processing takes longer due to changes in vision
  • Doesn’t see dirt or dust

Approximately one in three adults over age 65 have vision reducing eye disease.

Hearing

  • Doesn’t hear sounds of  invasive pests in attic or basement
  • Doesn’t hear dripping pipe or faucet
  • Doesn’t hear warning beep of household appliance or timers

One third of adults between ages 65 – 75 have some form of hearing loss.

Touch

  • Unsure if item is too hot
  • Hard to pick up small objects or physically sort small objects
  • Increased incidences of  cuts or scratches because client does not initially feel sharp edges, chipped dishware, or broken items on floor

Keeping The Clutter- Hoarding Scale in mind, these issues are especially important to explore when working with aging Level II – Level V residential client homes.

PS – check out my presentation on Seven Types of Residential Households

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The Three Losses in Five Years Syndrome

Over the past 10 years, I have come across a subset of individuals who begin a sudden onset of chronic disorganization. These are individuals who are serving as family caretakers who have experienced at least three significant losses in their life over the span of 5 years. This subset has usually served as primary caretaker for either parent(s), spouse or sibling(s). Many of them also serve as the executor of one or more of these estates. Many of these individuals seem to take about 7 to 12 years after the final loss to come to terms with this in their life.

What I would like to see is a more active approach to treating this, more on the onset prevention than as an after effect treatment.

It would be beneficial to have physicians and their staffs work to identify caretakers who are already at two losses in five years, and encourage them to get additional support through grief counseling, caretaker support group participation and for those financially able, consider the services of a skilled professional organizer. A skilled professional organizer can do wonders to help the “primary caretaker client ” in terms of time management, goal setting, project planning and management. Many professional organizers can help establish bill paying and document management systems to handle the growing paperwork that complex and long-term medical conditions usually entail as well as documents for estates probate. A professional organizer can help the client simplify his or her life and environment as well as serve as a body double for difficult and often procrastinated tasks.

While a professional organizers services are not inexpensive, they are a valuable tool that may help the primary caretaker live a more vibrant and fulfilling life while and after experiencing heavy losses in their life.

The Three Losses in 5 Years are primarily death losses. For some, however, one of those losses can be the loss of a pet, divorce or significant job loss.

I believe more research and education is needed in this area. Let’s hope that this syndrome can be more clearly understood and helpful strategies for success developed and promoted to the general public.

 

This is a best of post

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Curator Vs. Caretaker

Are you a caretaker or curator of your special materials? I am talking about your private or personal family collections. What is the difference you ask?

When we first inherit or start to collect material we may be just caretaking. And that is Okay. Curating before we are ready can be a big mistake.

Do you let the special material sit in the box and wait to deal with it later? If this is the case, then you are a caretaker.  Or do you sort, label, arrange or classify and make some sort of arrangement of the material?  Curators do that.

Good caretakers pack and store material carefully, in safe spaces free free from harm. Inquisitive little children or pets,  pests or rodents can be an issue. Water or humidity or excessive heat or even excessive temperature changes within a short period of time can be a safety factor. Bright lighting or direct sunlight can also be damaging to your collection.

Are you ready to go from caretaking to curating your collection? The time has to be right. Maybe you are too tired of caretaking the collection so perhaps the time is right to pass the collection along to someone else to curate. After all not all caretakers have to curate.

Wise curators are deliberate with their plan. They think it out before they proceed. They seek advise if they need it. They don’t have to go it alone. Books, associations, organizations and solo practitioners are out there to provide assistance and advice to the curator. Remember seek help and guidance and think it through.

 

Books 

An Ounce of Preservation – A Guide to the Care of Papers and Photographs by Craig A. Tuttle

How to Archive Family Keepsakes: Learn How to Preserve Family Photos, Memorabilia and Genealogy Records by Denise May Levenick

How to Organize Inherited Items: A Step-by-Step Guide for Dealing with Boxes of your Parent’s Stuff by Denise May Levenick 

Saving Stuff: How to Care for and Preserve Your Collectibles, Heirlooms, and Other Prized Possessions by Don Williams, Louisa Jaggar

The Unofficial Family Archivist: A Guide to Creating and Maintaining Family Papers, Photographs, and Memorabilia by Melissa Mannon 

Consultants

Terri Blanchette   http://timesorters.com

 

Website/Blogs

The ArmChair Genealogist  written by Lynn Palermo*     lynn@thearmchairgenealogist.com

The Family Curator written by Denise May Levenick

Family History Secrets written by Wendy Percival. This British site is more about writing and creating – but done in an interesting way.

The Practical Archivist written by Sally Jacobs

 

 

If you enjoyed this you might also enjoy an article I wrote about ephemera many year’s back called Don’t Throw That Away!

 

* This blog was inspired by a post a few months ago by Lynn Palermo regarding curating and creating. If you read my last blog post and book review you would know I am showing my work. Denise May Levenick’s book, How to Organize Inherited Items: A Step-by-Step Guide for Dealing with Boxes of your Parent’s Stuff, also uses the three concepts of Curator, Creator and Caretaker.

 

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Renew and Refresh

I have been thinking about words that describe and encompass positive end stage turning points in change and transition. Renew and Refresh are two words that come to mind.

Renew is to be restored to a former state; become new or as if new again.

Refresh means make fresh again; reinvigorate or cheer (a person, the mind, spirits, etc. ).

Definitions from dictionary.com

Have you experienced either of these when clearing or phasing out of a transitional phase? Comments and thoughts welcome.

 

 

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Moving Forward

Hi, I am back. I’ve been on a sort of sabbatical the last six months due to extreme care-taking, settling an estate and dealing with the loss of a loved one.

It is great to be back and getting into the swing of things. While on my sabbatical I have managed to keep up my reading and researching. This year my reading goal is 75 books. For fun, I recently went to a 3-D Printing Workshop and found the process interesting and I definitely believe the availability and cost reduction of 3D Printers will start changing how we manufacture many things.

Professional I just re-certified in my profession getting my CPO-CD  and Master Trainer status renewal from the ICD for another three years. I also completed my ICF coaching credential audit for full membership.

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