The Key to Hassle-Free Home Care

When a family member is hospitalised, more often than not we are so focussed on their recovery that we do not give much thought to what happens when they are discharged. Yet, the way the transition is handled - whether the patient is to go home, to a community hospital or a nursing home - is critical to their health and well-being. Most studies point to an overwhelming number of elderly patients who prefer to recuperate in the comfort of their own homes. Home care or home-based care allows them to get better at home surrounded by their loved ones; staying in their own homes gives them a sense of comfort and normalcy. The familiar environment often makes them feel secure and happy and this in turn will aid in their recovery and contribute to an overall better quality of life. While home care is an attractive option for the elderly with its many benefits, it is not without its challenges. Here’s a look at the 3 key challenges that the average family will face when opting for home-based care.

Non-Accommodating Setting

Most homes are usually not equipped to meet the accessibility needs of the sick/frail elderly who may struggle with mobility issues. Hence, it would be necessary to modify homes to make them as safe and hazard free as possible. This helps to prevent life threatening falls, increases accessibility within the home and allows for greater independence. Modifications can be simple, in the form of installing bed rails, ramps, grab bars, slip resistant treatment to floors, foldable shower seats etc or complex like widening doorways or building an extra room on the ground floor (for those living in multi-storey houses). However, for some homes, the structural constraints of existing living space may not allow for major modifications.

While there is a plethora of internet-based information on the topic of home modifications, a lot of information may exist in a fragmented fashion to the elderly and their caregivers. This will likely cause further confusion as they do not know how to go about initiating the process of home modification. The current practice is to engage the service of an Occupational Therapist who will assess your home and recommend the correct actions to remove hazards and install the required safety fittings. Thereafter, you will have to source for your own private contractor to do the necessary retrofit; there is no one-stop service which helps to assess, recommend, source for and then oversee the entire modification process.

Oddly, the biggest challenge to making these safety modifications for the sick/frail elderly is not the lack of product or knowledge to implement these installations. The biggest challenge lies in convincing the elderly that these non-invasive installations are useful and important to their continued independence and well-being. These modifications not only improve quality of life for the elderly, but that of their caregivers as well. Even if affordability is not an issue, some elderly can be quite stubborn and insist, for example, on their ability to climb the stairs on their own, claiming there is no need to build an extra room on the ground floor to relocate them.

While we are on the topic of non-accommodating settings, let us take a more in-depth look at how we can prevent falls at home. It has been found that most falls among seniors (69.7%) happen at home due to clutter or hazards such as slippery floors and loose cords. Hence, it is of utmost importance that fall prevention starts with creating a safe living space. This doesn’t have to involve a complete house remodel; you can make your home safe from falls with just a few basic changes.

Firstly, clean up clutter on the floor to maintain a clear walking path. Secondly, remove loose carpets and slippery throw rugs; if there is a need for mats, use those with non- slip backings, coil and tape loose electrical cords against the walls to prevent tripping over them. Thirdly, install grab bars on walls and non-skid tapes on floors in the bathrooms and shower areas, and handrails along stairways and hallways for extra support. Next, make sure entrances, stairways and rooms are brightly lit. Lastly, avoid wearing loose clothing; opt for better fitting and properly hemmed clothing so as to reduce the tendency of stepping and tripping over clothing or thread dragging on the ground.

Caregiver Deficiencies

As life expectancy increases, family caregiving for an elder parent, spouse or relative with frailty, dementia or other chronic health problems can last for five to ten years or well beyond. It is therefore easy for family caregivers to become burnt out or struggle with the emotional implications of caring for a family member. The physical demands of caregiving can also take a toll on health. This is especially so if caregivers are ill-equipped to perform certain tasks such as changing feeding tube, catheter care or tracheostomy care that are usually performed by a professional nurse. And when caregivers feel they cannot properly care for their charge, they may feel a sense of helplessness and frustration. Moreover, if the caregiver has no support from other family members, feelings of animosity may begin to fester for family members who are not helping out.

Over and above advanced nursing skills, many caregivers be it family members or foreign domestic workers - often lack confidence even in the basic caregiving skills needed to assist in the activities of daily living. Caregivers also often find themselves with less personal time and time for other family members. They end up having to sacrifice things they enjoy like hobbies or vacations or they have trouble balancing work schedules around caregiving. Eventually, when caregiving takes them away from their paying job, they will also start to feel the financial strain. Caregivers are often at high risk for depression as their caregiving duties take up so much of their time that they no longer maintain social connections outside of home i.e. they become isolated socially. Many caregivers feel ashamed to ask for help from others and perceive asking for some assistance as a sign of weakness. Even if they want to ask for help, they may not know where to start and who to approach.

Lack of sleep is another challenge for caregivers. They may not get enough rest as they need to be alert all the time, even during the night, lest their care recipients need the washroom or a cup of water. Sleep deprivation can take a further toll on the caregivers who are already feeling the strain of burnout. In Singapore’s aging society, we will also be faced with the problem of ageing caregivers. Coupled with an increasing life expectancy and a decreasing birth rate, the dependency ratio will be almost 1:1 by 2050 i.e. one adult supporting one elderly. Ageing caregivers have their own health concerns, such as chronic conditions like hypertension and diabetes, and have to worry about their own future medical needs. They may also have less strength to help their charges in daily activities such as transferring them from beds to wheelchairs.

Difficulties in making choices on caregiving equipment and Supplies

To the layman, sourcing for the right medical equipment or supplies can be quite a daunting task. More often than not, we do not realise there are actually many products and equipment in the market that can help to make patients’ care at home more comfortable and improve their quality of life while at the same time easing some of the burden caregivers may face. The wide range of products available from different companies in the market makes it difficult to comprehensively compare the cost and qualities of the supplies we need before we decide what to buy. Making a well-informed decision about the products that we need is very crucial as using inadequate or improper medical equipment can seriously endanger the health and well-being of the sick/frail elderly.

Conclusions

It can be stressful for families to start sourcing for help when an illness kicks in and current services catering to home - based care are too fragmented. Families in need of help will also have difficulties navigating and making choices.There is a need for a one-stop information portal on the various services out there and this is where AB HomeCare comes in to fill the gap. Made up of medical professionals, AB HomeCare puts itself in the shoes of caregivers to provide one stop integrated solutions to the 3 key challenges so as to ensure a hassle-free discharge from hospital to home, followed by care at home.

Source: PRIME Aug-Sept 2018 Issue

Article re-posted with permission from Prime Magazine Singapore