Dr Rahuls Elder Care
Tender Loving Care in Elderly
As people age, new concerns arise. It becomes more difficult to communicate with patients and discuss their needs in a constructive manner. The anger, sadness, confusion, and fear that comes as individuals lose their physical and mental capacity often comes across in aggressive speech or behaviors. Then, there are those who suffer from mental and physical illnesses, which makes the situation considerably worse.
Their behavior may be understandable based on their condition, but it doesn’t make it any easier to handle. Your elderly patients will require some special consideration. As a healthcare worker, it’s your job to figure out ways to cope. As you try to determine the best strategies for managing elderly behaviors, here are some dos and don’ts to follow.
Elderly and hearing loss
You’d be frustrated too if everyone around you was talking and laughing, but you couldn’t hear a darn thing! That’s the reality for many elderly people with hearing loss. They may seem to be irritable, when in fact they’re simply frustrated because they can’t hear what you’re saying. Some ideas when dealing with hearing loss:
Get their attention. Put your hand gently on their shoulder, or speak their name to get their attention, before you give important information.
Reduce background noise. Turn off the music or television. When in restaurants and social gatherings, sit away from crowded areas.
Speak clearly. People with hearing loss hate mumbling. Face the person and enunciate clearly. Speak at a speed slightly slower than normal (but not too slow).
Speak loudly. Speak a little more loudly than normal, but don’t shout.Repeat yourself. People with hearing loss may compensate by nodding as though they understand, when in fact they didn’t hear you.
Have good lighting. Facial expressions and body language can be seen more clearly in well-lit areas.
Understand common elder diagnoses
It might not be appropriate for you to ask people about their medical conditions. Asking a combative patient if they have Alzheimer’s disease would not be a good start, especially if the answer is no. But understanding some common ailments and symptoms can offer insight into what your elder patient may be dealing with.
The most common ailments our elderly patients experience include:
Heart conditions. This includes hypertension, congestive heart failure, high blood pressure, and coronary artery disease. Side effects include fatigue and lack of physical strength.
Dementia. In addition to memory loss, dementia patients experience paranoia, aggression, agitation, and lack of self-care.
Delirium. Symptoms include shaking, a shortened attention span, and extreme mood swings.
Depression. Depression is very common among the elderly. Sadness, irritability, fatigue, and feelings of worthlessness are all symptoms.
Communicating with Elderly Patients
1. Exercise Patience and Compassion
It goes without saying that patience and compassion are often needed when dealing with the elderly. Physical challenges, slow movement, forgetfulness, neediness, and apathy are just some of the behaviors you might encounter. Sometimes it’s easy to lose patience and become frustrated. One might even be tempted to give up and walk away.
During these moments, it’s very helpful to put yourself in the senior’s shoes, even for just a moment. Consider the elders you’re dealing with, and complete the sentence: “It must not be easy…,” or “It must be hard….” For example:
“She’s being so apathetic. It must not be easy to live without her friends around.”
“He does everything so slowly. It must be hard to deal with arthritis every day.”
Having empathy for the elder is an effective way to generate more patience and compassion. If, despite your best efforts, your patience still runs thin, take a time out from the elder if possible. Come back when you’re in a calmer state of mind.
2. Ask Instead of Order
As mentioned in an earlier section, one of the core needs of many seniors is to feel relevant and respected. You can help validate these needs by frequently asking instead of ordering when communicating with the elder. For example:
Instead of: “You’re having soup for lunch today.”
Say: “Would you like to have some soup for lunch?” or
“We’re having soup for lunch today, okay?”
Better yet, offer options: “Would you like to have soup or salad for lunch today?”
Asking questions offers the senior a greater sense of respect and regard. Offering options gives her or him a greater sense of control of the immediate environment.
With less cognizant and physically able seniors, ask and follow up without necessarily waiting for an answer. Let them feel they’re part of the decision making process, and have a degree of control over some aspects of their lives
3. Ask Instead of Assume
Similarly, ask questions instead of making assumptions when it comes to your actions in relations to the elder. For example, instead of turning the lights off in the senior’s room without asking, say “I’m going to turn off the lights for you, okay?” If the senior protests, let her have her way if it’s harmless, or explain why it’s important for you to do what you need to do (in most cases for the sake of senior’s health and well-being).
4. Use “I” instead of “You” Language
We know from the study of effective communication that people (including many elders) generally don’t respond well when they feel like they’re constantly being ordered what to do. Such “bossy” language is often manifested in the use of “you” statements, followed by a directive. For example:
“You must exercise today!”
“You have to take your medicine!”
“You should to air out your room!”
“You need to finish your soup!”
“You better not miss the doctor’s appointment!”
When people feel like they’re being bossed around on a regular basis, they’re more likely going to respond with what psychologists call the “Three F’s – Fight, Flight, and Freeze”, leading to behavioral problems such as argument, avoidance, or stonewalling.
Instead, use statements which begin with “I,” “It,” “We,” “Let’s,” and “This,” to convey messages. For example:
“I will help you exercise today.”
“It’s important to take your medicine.”
“We need to get some fresh air into the room.”
“Let’s finish your soup, okay?”
“This doctor’s appointment is very important.”
These types of statements compel the elder to be more open to what you have to say, encourage listening, and reduce the possibility of Fight, Flight, or Freeze responses.
5. Offer Choices Whenever Possible
Many elders desire to maintain a sense of independence. This may be especially important when seniors feel their physical and cognitive limitations, but still desire ways to maintain some level of local control in their lives.
Whenever possible and appropriate, offer an elder choices when interacting with her or him. This can be something as simple as asking whether the senior would like to have choice A or choice B for lunch. Having the ability to exercise
Age deserves respect
Our elders have all lived through times of incredible change, including wars and new technologies unimaginable 75 years ago. They’ve seen friends and loved ones born and die, and they may be struggling to find peace within themselves. We have a responsibility to maintain a high standard of respect for our elders and for the rich experiences of their lives.
Dr Rahul’s Elder Care comes with more than 10 years of experience in geriatric medicine. The highly skilled team specialises in elder care achieved through comprehensive approach and holistic attitude. Apart from regular geriatric clinic, the team specialises in Memory and dementia care, Pain and Palliative care, Transitional Care and Chronic Disease Management.