Caregiver by Design

I work with people in pain almost every day and have discovered that there is no benefit to discounting the pain, trying to tell someone that "pain is gain" or that they have to push through it.   Instead, acknowledging the pain, finding a new focal point of comfort, and teaching an allowance for movement through the pain with the focus of achieving even one degree of less pain after the mobility; is the approach that works time and again.  

Chances are that you are no stranger to pain or the effects that it has on your loved one.  You may have fallen into the cycle of allowing for stagnation and compensation because of your loved one's complaints of pain.  Then, noticed that they are doing less for themself, moving less, becoming weaker and ironically enough, developing more pain.   

In this episode, you can learn how to get mobility and activity through the limitations of pain by using assisted range of motion, and visualization, combined with breath work, and incorporation of the movement of the body around the source of pain.  

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

In this episode, you will learn how you can use effleurage to help someone's body prepare to move early in the morning, after being still for a long time, or to arouse the brain-to-muscle connection for those with neurological impairments. 

What is Effleurage massage? A french word defined as "to skim or to touch lightly"

I decided to share this topic with you after a rewarding experience I had this week as a clinician using this touch to help an individual who had been bed-bound, and very limited in her active, volitional movement very limited, to help her to participate in my therapy session.  This would be a missed opportunity by many providers because, to be honest, it just seems too simple.  Therapeutic touch and interventions with intention can have a profound impact and should not be overlooked.  This approach used with my patient increased her ability to roll in bed, increased her eye contact, and verbal communication.  What could this touch do to help the one you care for?  It only takes a minute and you can learn how to use it today.

An example of the sequence that you can use: effleurage massage (just a few sweeps), followed by assisted movement, then followed by active movement with purpose (such as rolling in bed).  Give the body the opportunity to work.  Be the facilitator of your care recipients potential. 
Benefits of the use of effleurage:

• increase arousal/stimulation
• increase awareness
• provide comfort
• decrease a stress response

Different approaches have different effects.  Fast, light, repetitive sweeping motions with the fingertips along the contour of the limb or face are stimulating while slow, heavier pressure with more of the palm of the hand is calming.   Know the needs of your care recipient.  Practice on your own skin (leg or opposite arm) to feel the effects. 

Using a skill like this is therapeutic and you have all that you need to be therapeutic versus ordinary.   Make a habit of looking for ways to interact with your loved one therapeutically every day and you will find that your caregiving burden lightens over time.  

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

Many caregivers feel stuck and experience the following according to https://www.whereyoulivematters.org/caregiver-burnout-caring-for-aging-parents/

• 55% of CG feel overwhelmed by the amount of care they provide
• 18hrs is the average amount of time spent providing care 
• 1 in 5 CG report physical strain due to CGing duties

Are these numbers your destiny? What areas can you take control over and how can you start making changes today that will help you to avoid falling into these statistics?  
The largest contributing factor to all of the above areas is the care recipient's level of independence and how much is required of the CG.  What can you do to increase your recipient's independence?   

1. recognize the areas that your care recipient is leaning on you too much for.  The areas where they have declined in the quality of movement.  Where are you seeing weakness, stiffness, pain?  
2. What can be done to make improvements in these areas? Developing their independence is a key to avoiding the "overwhelm by the amount of care" required
3.  Make a goal to decrease the number of hours spent providing care, again by increasing their independence in any way possible 
4. Pay attention to the risk factors associated with your physical injury or progressive strain placed on your body during CG duties and make adjustments that focus on decreasing those risks.

How do you transition?  Begin coaching your loved one to greater independence vs providing the "done for you" approach.  It is unconventional to consider using a "do it yourself" approach to your care recipient but I challenge you to give it a try.  This is the rehab approach that will make a difference in both of your lives.
Take a few minutes to watch this free training video i made for you  https://www.caregiverbydesign.com/freetraining 
You know you need more help and are ready to start.  This is for you. https://www.caregiverbydesign.com/coaching

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

Skin breakdown can have a life-threatening impact and it can sneak up on you and your loved one.  You can avoid it and you can also make quick changes to help promote the healing of this condition.   

Here is what happens: pressure applied to the surface tension of the skin diminishes blood flow to the skin and can have very negative results in as little as 1-2hrs.  A serious skin breakdown can develop into an open pressure sore within just one week.  An advancing open sore can become serious and lead to complications within 1 month.  Here are some examples of seriously negative complications from skin breakdown: 

• cellulitis
• bone and joint infection
• cancer
• sepsis

Risk factors associated with the development of skin breakdown: 

• Immobility or decline in mobility
• incontinence of urine and/or stool
• impaired sensation of skin
• poor nutrition
• poor blood flow

You can avoid the potential development of skin breakdown by making sure that your loved one can adjust their own position frequently and that they are not sitting on a hard surface for any period of time greater than an hour if they are at risk.   If they can't reposition their own body, take a close look at why and how to help them develop this skill.  (MORE on this to come, so stay tuned) .  
Use non skin shearing surfaces to help mobilize them if you have to do all the work. 
Use pressure-relieving cushions to help reduce the risk of pressure sores.  (low air loss mattresses, chair cushions that are air-filled or gel-filled) 

signs of skin breakdown in order

1. red skin that may be warm and your LO complains of itchy or burning sensation or pain
2. purple colored skin that is more painful or may have lost some of the sensation 
3. open area has developed and may be oozing

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

Pain is something that we all can relate to on some level.  Unfortunately, it is one of the most limiting factors for our seniors and for those facing chronic illness or progressive disease.   Did you know that the lack of joint mobility produced by getting up and moving around/walking or rolling in bed, increases a person's pain because of these factors?    

• fluid builds up around the joint when a joint is immobile 
• muscle atrophy can cause pain
• pain elicits fear which limits movement 

Intervention for pain is often a missed opportunity for the use of NONmedication/pharmaceutical options that work even better than the average go-to medication choice are discussed in this episode.    The elderly population and those with chronic illnesses are at a disadvantage when it comes to pain management because of how medications are prescribed.   What if you could ease their pain without adding another medication?  I have seen it work and I encourage you to experience it as a recipient first so that you can possibly deliver relief to your loved one in the same way.  

1. myofascial release
2. meditation
3. hypnosis

You can develop the skills to help your loved one with pain and see the relief they experience and then utilize their less painful state to increase their mobility.  Remember the less they move, the more they feel the pain.   So, don't be afraid to teach them how to move through some pain and to address the pain, validating it and attempting to find a solution for it, each and every time.  

• help with guided meditation @ the mindful movement: https://youtu.be/UWOwrPW5mqw
• pain management article sighted in this episode: https://www.practicalpainmanagement.com/treatments/pain-management-elderly
• breathing video : (min 2:30 for diaphragmatic breathing) https://youtu.be/V5gfoxdv9k8
• get direct help/work with me: https://www.caregiverbydesign.com/coaching
• use my therapy strategy at home: https://www.caregiverbydesign.com/freetraining

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

Episode 51
How can one person's fall destine them to nursing home placement while another suffers different injuries that could be seen as more limiting, yet they are able to return to their prior living situation?   I share the differences between the factors of recovery in this episode 

• chronic and progressive illness
• motivation factors
• support systems
• perspective 
• environmental factors

Have you ever wondered what OT is and how it's different from PT?  I have been an OT for 23 years and I still have to explain it to people.  I discuss how an OT approaches solving the challenge that someone who has fallen and can't use their arms or their legs for mobility or daily activity, and how you, the caregiver, have the same potential.  You just need to know where to start, what barriers to eliminate, and how to maximize potential at every point. 

Too often, caregivers limit TOO much of their loved one's opportunities and in so doing, they contribute to increased risk of weakness, balance disturbance, endurance limitations, fear of mobility, and more.    I share some tips with you here.   I know that caregivers can successfully master a DIY rehab approach at home and avoid the avoidable costs of hospital stays, nursing homes, rehab costs, and related costs of illness and injury.   

Wondering how to get more help?  Learn how to set a clear goal with your personal needs as the main vision.  Design your caregiving experience with intention.   I have a free training here that I know will help you TODAY:   https://www.caregiverbydesign.com/freetraining

When you are ready to jump-start your DIY rehab at home, join this coaching series: https://www.caregiverbydesign.com/coaching

Other media outlets where you can see me and interact: https://www.youtube.com/channel/UCkf3lSUFi2ER0_i33go5k2g
TikTok: https://www.tiktok.com/@thecaregiver
FB: https://www.facebook.com/caregiverbydesign
IG: https://www.instagram.com/caregive_bydesign

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

I don't know of anyone who actually wants to go to a nursing home or wants to have their loved one require that level of care, but it happens.  You have probably heard stories of people who fell, broke a hip, and then somehow never come home again.  You might wonder how one thing, like a fall, leads to such an undesirable outcome.  Well, I am going to tell you.   Then, I am going to tell you what can be done differently to avoid that outcome.  

Here are the major factors that lead to needing a higher level of care like a nursing home: 

1. lack of additional support coming into the home as needed
2. chronic illness/progressive illness or disease 
3. regression in mobility and strength
4. decline in endudrance
5. decline in appetite/food intake/nutrition
6. failing to eliminate the cause of the initial fall/injury 
7. complacency 
8. repeat injury 

All of the above tend to occur but it doesn't take all of them to cause the need for long-term care.   In this episode, I am sharing with you the story of someone who found themselves in this situation, and then I share what could have been done differently so that the long-term care option would not need to be considered. 

You can make a HUGE difference in preventing injury at home with your loved one by keeping them moving, active, engaged, and inspired.  If they have recently come home from rehab or the hospital, or completed home care therapy, you MUST keep it going.  Don't let them become complacent and definitely do NOT do too much for them.  If you do this, you are taking away opportunities for all the aspects that they need for further recovery:  mobility, activity, endurance, strength, cognitive challenge and more.    

If you are ready for learning a new perspective, my proven 5 step strategy to maximizing someone's quality of life and living your caregiving life without regrets please grab your free training here:  https://www.caregiverbydesign.com/freetraining

When you want a tailor-designed approach, a DIY rehab at-home approach, for your loved one, so that you can live a life of freedom and they do too, this is for you: https://www.caregiverbydesign.com/coaching.    You might be just right for this small group coaching series that will launch you into a life of coaching your loved one instead of caregiving all the time.  Get more information at the link and get on the wait list today. 

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

60% of caregivers assist with ADLs - we are going to talk about the area that tends to require the most support today.  LOWER BODY CARE
Contributing factors: 

•  Limited hip mobility
• Back pain
• Too round in front
• Arthritic fingers and hands
• Poor vision
• Immobile ankles
• Swollen legs
• Poor sensation of LE
• Paralysis

In most cases, every single one of these barriers can be worked around to allow for a person to be independent with dressing and washing lower extremities. 

First, look at a few important facts:  

1. Work from easiest to most challenging. For example it’s easier to pull loose pants than it is to put fitting pants on that have a button and zipper.       Underwear vs pull-ups    socks vs pantyhose       slide on shoes vs laced 
2. Location!   (where are they sitting) The height of the seated surface is very important.  Higher means more reaching but it might be easier to lift the leg to clear the floor for getting it over the foot, however, reaching the foot for a sock is much harder
3. If you can cross one ankle over the opposite knee you have much more opportunity for success
4. Process: step back and do more watching, directing and add assistance as needed. 

Remember that the more you do leads to you doing more.    If your LO can not assist more than lifting a leg while you put the sock on, then my goodness, work with that.  Don’t miss an opportunity to use what they have and advance that as much as possible.  

If they are limited because they are tight in a joint, take a minute to mobilize that area first.  Work on that area daily to make more progress.   How?     Get help here.   
https://www.caregiverbydesign.com/coaching
Free video training  "Start living a life without regrets!" https://www.caregiverbydesign.com

Lower extremity muscle activation is a critical part to overall health.  Don’t give up on this too soon.  Even if your LO has hemiplegia or LE paralysis, you have to maintain mobility of the joints to help you and them with basic mobility.    When you stop allowing your LO to use their lower body musculature to do basic ADLs, you are contributing to the overall decline of their lower extremity muscle strength and this leads to mobility limitations and overall health decline.   

Pick a day this week during your ADL routine, and look at the clock.  See how much time you are using to help with dressing and what part is taking the longest or is causing your body to work the most.   I would guess that it is with LB care.  Make a goal to shave some time off of this area by starting to involve your LO with it more so you can do something else while they work on it.    OR, by making the task easier for you to do by changing the location, position, and/or approach

Do you believe that it’s possible?   If you are saying no, I’ve tried everything;  I want to you pause and really allow yourself room and permission to see things differently. Need help getting started, go to : https://www.caregiverbydesign.com and watch the video

LEAVE A 5 STAR REVIEW FOR THE PODCAST HERE (subscribe and scroll to the bottom.  click on "leave a review" )  https://podcasts.ap

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

Let’s talk about the impact of illness or hospitalization on one’s health.  I see it happen firsthand as a therapist working in the hospital.  People lose their ability to walk and complete self-care with independence within a very short period of time, making it harder for them to go home without additional support.  Consider this: 

1. How at risk are you?  How about your partner, the one you care for?  We are moving less and getting out into nature less as we further develop our society.   Too many hours spent in front of various screens is just 1 example and cause.  RESEARCH article:
   https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2759840
   
   
2.  The objective of therapists like myself is to discharge the patient to a SAFE environment with adequate support.  Over the course of 1-2 weeks, I see patients move from a short-term rehab plan to a home plan when they are able to cooperate in strength, endurance, and self-care skill-building interventions with OT and PT.   When they can’t participate (due to medical instability) or they refuse to participate, we see the loss of potential for home discharge 

The same thing can happen at home with an illness or during home recovery from a hospital discharge, so do everything you can to keep your LO moving with the intention.  Look at what can happen to the body with immobility:
 https://www.frontiersin.org/articles/10.3389/fnut.2021.633987/full

Are you seeing this happen with your loved one, either at home or at the hospital, and feeling helpless?   Here is what you can do. 

•  keep them moving and doing as much as they can for themselves so they are always at a starting point of advantage.  
• Look at what your loved one can do easily.  Any mobility or activity that you see them do like:  sitting up at the side of the bed or without the support of the couch/chair.  Standing up without losing balance, walking, any daily task they do well - have them do that MORE or for longer periods of time than they are currently

The HOW: 

1. Start a simple movement and exercise program - do it at least once a day https://www.caregiverbydesign.com/seatedexercises (FREE DOWNLOAD VIDEO TO USE)
2. Use the right support items to maximize safe mobility and self-care:   walker, canes, adaptive tools, shower chairs, grab bars, toilet seats/ grab bars, etc CONSISTENTLY
3. Get out of the house, stay social, keep the mind engaged and this includes problem-solving through basic daily tasks.  

Let's get you and your partner living the life you actually want by sorting out what your vision for living is, what the boundaries are and how to build strength, mobility, and independence for you both.   https://www.caregiverbydesign.com/coaching Find out more at the link.  I will contact you when we are ready to start.  

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

Patients have been coming home from the hospital sicker, weaker, and with more complications than you might be prepared to manage at home for a few reasons and the burden on you might be bigger than you expected.  This is a global situation.  

What's going on out there?     

• Covid 19 has overburdened the global healthcare system by adding people requiring treatment to the normal flux of patients 
• Covid 19 has stressed the labor pool of healthcare workers who have to take time off due to exposure, and in some regions of the world, can not work unless they are vaccinated. 
• The lack of available beds in short-term rehab settings and long-term care/nursing homes makes discharging patients from the hospital to such a facility very prolonged.  So, if it is possible to send them home with the support of the caregiver vs staying additional weeks, waiting on placement to STR or LTC, a possibility, then it becomes the plan
• limited options for some patients (lack of any support at the home and no funds for most facilities) means that there are some patients that end up "boarding" in the hospital until a spot opens up at a facility. This can take weeks to months. 

What to pay attention to and what to ask about with the consideration of a "home too soon" situation : 

1. What are the caregiver's limitations (pain, mobility) and ability?   What is the caregiver's availability and willingness to help with everyday activities?
2.  medications: knowing what the new ones are.  What was added or discontinued?  Side effects of medications and interactions.  What to look for if the medication is not working correctly? 
3.  community support for you and your partner/LO for the ongoing medical situation that they are dealing with.    Community support for future planning and for financial support.  
4. Positioning and mobility:  safety.  How to assist them in a restorative way. 
5. Signs and symptoms of worsening health, flare-ups, reoccurrences.  How to avoid these and what to look for.  

You are a vital part of the healthcare system as a caregiver and you should be informed and supported.  That is what I am here for.   I have 2 offers to further help you. 
First:   a free video training  "Start living your life without REGRETS!".  start living a life with vision and a plan every day while you help your LO become stronger and more independent  https://www.caregiverbydesign.com

Join a limited group coaching opportunity to help make BIG impact with small changes that put your needs and vision in center focus.  This is geared especially for partners, spouses who are caregivers and want to develop a strong relationship through the present challenge. 
https://www.caregiverbydesign.com/coaching

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining