Client Education

Care Planning

Some Scenarios, Some Solutions

By: Vivian Fransen, Special to AccentCare

In many situations, there's the right way and the wrong way to solve them. But not when it comes to the concerns often faced by seniors and their loved ones. Ask 10 people for their solutions about the same issue, and you'll get 10 different answers.

The following examples show the creative thinking behind three such issues.

Situation A: Lillian, an 85-year-old woman who has lived alone in Maryland all her life, now finds it too difficult to go up and down the stairs of her Cape Cod home. Her doctor confirms that the problem can be addressed by having knee surgery, which will require a brief stay in the hospital and live-in assistance and physical therapy for several weeks following surgery. Lillian prefers to avoid this surgery (including the expense and major disruption to her life). "If only the bathroom in this house was on the first floor, not the second floor, I could get along just fine," she said.

Caregiver Solution: After carefully assessing the lifestyle requirements of Lillian and discussing her medical condition with Lillian's physician (including confirmation that Lillian's health insurance provider will cover most of the medical costs of this surgery), Lillian and her caregiver decide to arrange for a carpenter and plumber to install a first-floor bathroom, which allows Lillian to avoid climbing stairs on a daily basis. When she does need to go upstairs, she makes sure someone is close by in the house to assist her. For Lillian, the cost of this renovation is preferable to undergoing knee surgery at this time.

Situation B: David, a 76-year-old man who lives alone and was recently prescribed a low-dosage anti-depressant by his family doctor, has dropped a great deal of weight over the past few months and reports periods of confusion about taking his medication. To help David's physician determine whether a medication change is needed, David's son (who lives an hour from his father) needs reassurance that David is taking one pill every morning after breakfast.

Caregiver Solution: As a temporary measure until other arrangements can be made, David's son insists that his father call him at his work number every morning (including weekends) after he has taken his medication to leave the message on the answering machine, "Good morning. This is Pop. Just took my pill." If David's son does not receive a message by 10 a.m., he calls his father. If there is no answer, David knows that his son will assume something is wrong with his father. His son will then call David's neighbor to check on him or, if the neighbor is not available, the rescue squad. (David will do anything in his power to avoid a visit from his neighbor or rescue squad unless it's an emergency.)

It was soon discovered the confusion was partly due to David's forgetting to eat meals and dehydration due to very little fluid intake.

Situation C: Emily, a 76-year-old woman who lives with her adult son and experiences bouts of memory loss, frequently receives telephone calls from her three daughters who live several hundred miles away. She is having increasing difficulty trying to figure out which daughter lives where and who is calling. The first 10 minutes of each conversation is spent helping Emily understand who is calling her.

Caregiver Solution: A photograph of each daughter doing a different activity is placed next to Emily's telephone. When each daughter calls, she identifies which photo is hers. For example, "I'm Alice, your daughter who likes to play the piano."

Or "I'm Cindy, your daughter with the little black dog." Or "I'm Peggy, your daughter with the twin boys." After seeing the usefulness of these photos, the daughters chipped in to buy a telephone with one-touch number memory dialing for Emily that has big buttons to hold these photos. Now, when Emily wants to call a specific daughter, she simply pushes the button with the photo of that daughter on it.

Vivian E. Fransen is a communications specialist working with health-care organizations and educational institutions and writing for New Jersey-based newspapers and magazines.