Caregivers and professionals often focus on “large picture” issues such as housing and increasing dementia. Other issues often end up with lower priority due to a lack of time or knowledge, or burnout. Yet these are the ones that often bring on those larger picture issues or distort what is really going on.
It is important to note that if a loved one has a moderate to advanced dementia, they may not be able to tell you that they are having symptoms or problems. Caregivers need to be proactive.
Four of the concerns you always need to keep in mind are:
- Foot Care
- Oral/Dental Care and Hygiene
- Medication and Medication Review.
This newsletter focusses on the first two. We will cover the second two in upcoming newsletters.
1. Foot care:
Three out of four older people develop foot problems as they age. What starts as something simple and treatable can, if left unchecked, end up in mobility problems,falls, amputation, institutionalization and even death.On the flip side, proper attention to one’s feet can help to avoid these problems. It can also help to alleviate symptoms of diabetes, arthritis, and circulation problems.
The best way to address minor foot conditions is to have regular foot assessment and care before they become big problems.A foot care professional is either a podiatrist or a Registered Nurse who has specialized in foot care. Assessment and treatment should include close examination of the feet. It should also include an examination of socks and shoes for possible aggravation points to the feet and to make adjustments if possible.
The best foot care is done on a preventative basis. Regular exams should occur every six weeks to three months, depending on the condition of feet and other issues such as medical diagnoses.
Do not wait until a loved one has pain or something is obviously wrong. By then, the problem may have become more serious and require more aggressive treatment than might otherwise have been necessary. If leaving the home is difficult, home visits are available through the Nurses who specialize in foot care.
2. Oral/Dental Care and Hygiene:
Research shows a connection between poor oral health and diabetes,respiratory diseases, and possibly heart disease. Advancing age puts people at risk for oral problems and for decreasing sense of taste. Xerostomia (dry mouth) occurs when the glands that produce saliva become impaired from disease, medications or cancer treatment. Poor oral health can also cause pain and discomfort.
Due to frailty, dementia, or other problems, cancers, gum disease, or cavities may go undetected until there are acute symptoms, such as pain or infection. As noted above, a person may not be able to verbalize that they are having pain. This puts the onus on caregivers to provide oral care or make sure it is provided.
If there is a problem or pain in the mouth, and someone cannot tell you, they may exhibit agitation or hostility or they may stop eating. These behaviours are often misinterpreted by caregivers at home and and even by staff in facilities.
As people age, their jaw can change and their gums can shrink, making them susceptible to infections, and gum disease and lead to poorly fitting dentures.Even if someone has a complete set of dentures,or even no dentures or natural teeth, they should continue to be seen by a dental hygienist or dentist.
If cost is a factor when considering dental care, there are often low cost clinics available through hospitals and universities. If a dental visit, or any outing causes agitation or anxiety in a loved one, a small amount of medication may be appropriate.
Diamond Geriatrics Care Managers will co-ordinate care for your loved one or client. We will make sure that care is provided on a regular basis, and concerns are followed up on. We do in depth assessments and monitoring, to lessen the possibility that problems occur, and if they do, they are taken care of as soon as possible.
Tips to Insure Care
- Keep a calendar going with all medical appointments.
- Maintain an up to date list of medical professionals and their contact information so none are left out.
- Schedule regular appointments for foot and dental care for a year.
- Seek out professionals who will come to the house if someone cannot go out.
- Caregivers should develop regular routines for helping with oral and foot care so that their loved one is accustomed to the process.
- Wait for guidance if you are unsure about how to clip toenails or provide foot care.
- Foot and facial massages are great ways to help a loved one relax if they display anxiety or other behaviour when foot or oral care is provided.
- If a loved one displays behaviour which you do not understand and they cannot explain, remember the cause might be related to feet, oral health,or other unidentified problems.