Organizing home care

kkl1943

Hi everybody! I have learned much from this forum (thanks!), but now I face a new problem and need your kind advice again. My DW (82) has late-stage dementia. So far, I have been able to take full care of her (besides a bit of respite care from an aide), but all my current arrangements depend on my wife's ability to walk short distances between her bed, chair, and bathroom, leaning heavily on my arm. Now she is losing this ability: her knees start bending, and I cannot carry her over because of my bad lower back. (I am also 82 after all.) How do I organize her/our everyday life (especially her toiletting and showering) when she cannot walk at all any longer? I particular, what special furniture/equipment should I get? Thanks in advance!

cdgbdr

Please have her physician order a home health or hospice referral for her. They will help you with all of this.

Michele P

It’s time for in home care. She is at high risk for a fall. You can’t do this by yourself anymore.

kkl1943

https://alzconnected.org/discussion/comment/253199#Comment_253199

Thank you, but right now I am looking for more specific advice. (Before home care help starts, I want to have an independent opinion on its best organization.)

towhee

You are absolutely right, you cannot keep supporting her the way you are doing because if she falls you are going to go down with her. I will tell you what I have seen done with my LO, but you do need to call your doctor and request a home visit by an occupational/physical therapist to see what you need. The doctor will probably give you the name of a company, which often provides other services as well. Medicare will pay for some equipment, but only with a doctors order. Also, what equipment you can use depends on the physical setup of the house, how wide the doors are etc.

I am going to put this in order of strength/difficulty.

LO using walker with person assisting using wide gait belt (Person has some strength but balance is off)

LO walking with walker with person behind them with wheelchair in case legs give out

LO standing from bed, holding bedrail/handhold, making quarter turn, sitting in wheelchair. Goes to toilet, stands, holds grab bar, quarter turn, continues holding onto grab bar, lets other person assist with clothing, sits. Reverse to return to bed. (The shorter the turning radius the better, so a quarter turn is better than a half turn if possible.

LO uses a sit to stand lift from bed to bathroom (LO has trouble turning or trouble standing, but can still bear some weight)

LO uses a more complicated sit to stand lift, (more difficult to stand but still has some body control)

LO uses Hoyer lift

You have to have a certain amount of room to use a lot of these lifts, and you have to be trained, and what Medicare will pay for is iffy. Thes lifts can cost thousands of dollars. Probably what the occupational therapist will recommend is a wheelchair and grab bars. You have to train on how to use a wheelchair so that setting the brakes when necessary becomes automatic. If she is going to spend any time in it she needs a good cushion and the chair needs to fit her and be the right height for her to get in and out of. The grab bars also need to be placed at the right height and anchored properly. Any respite care workers you get should also have training on the proper way to use the setup you will have.

For showering, it depends on your shower setup, but some combination of grab bars and bath benches. We had to take the shower doors off and use a long bath bench where my LO could sit on the bench outside of the shower and then slide over into it, as they were afraid to step over the 5-inch-high edge.

I hope this helps.

kkl1943

https://alzconnected.org/discussion/comment/253247#Comment_253247

Thank you so very much for your advice!

jfkoc

Best to plan ahead. If you go down then you are faced with placement or 24/7 help.

There are all sorts of help aids out there for you but in the name of looking ahead I agree that an evaluation needs to be done. Then what ever is needed is prescribed and paid for by insurance.

You really need professional advice…for example I have 2 rollators and they serve 2 purposes. One is lightweight and stays in the car. The other is much more stable and used at my home.

You will need advice on exactly where to install grab bars as well as how they must be installed.

A professional will tell you the whys and the whats. Until they can get to you do a google to see what kind of aids are available. It is a mine field to be crossed carefully.

kkl1943

https://alzconnected.org/discussion/comment/253275#Comment_253275

Thank you very much for your advice!