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Caregiver Skills

Keeping the family loved one safe is one of the primary tasks of a family caregiver. Safety techniques to mitigate falls and to identify and correct hazards in the bedroom, bathroom and kitchen are common skills needed. Basic caregiver skills are needed to help the care recipient with ADLs (Activities of Daily Living) such as: transfer skills, nutrition, bathing/dressing, mobility, toileting and feeding/nutrition. Other skills needed may include: caring for skin, infection control, taking/recording vital signs, observing/reporting changes in health condition, managing medications, managing doctor appointments and caring for equipment such as wheelchairs and walkers.
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Basic Caregiver Skills

Fall Mitigation & Home Safety

Common types of safety incidents in the home of concern to caregivers are: falls, burns, and medication errors. These safety incidents are typically the result of an unsafe act or an unsafe condition. Some tips to help mitigate falls and home safety incidents:
  • Assist with transfers to bed, toilet, and vehicle.
  • Wipe up all spills immediately.
  • Make sure bath water is not too hot.
  • Assist with all cooking.
  • Pick up towels and clothing from the floor.
  • Remove area rugs.
  • Use pre-filled medication boxes or cards.
  • Use non-skid footwear.
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Bathing & Dressing

Be patient when bathing and create a safe environment. There are four types of bathing: shower, tub bath, partial bath (aka sponge bath) and bed bath. Partial baths can be given in between shower or tub baths. Bed baths are used when the loved one is unable to get a shower or tub bath and the entire body is washed. A few tips include:
  • Gather all supplies before going into bathroom.
  • Don't rush the bath.
  • Dry bathroom floor.
  • Remove items such as towels, clothing and other items from bathroom floor.
  • Use grab bars, either a tub seat or bench and a detachable shower hose.
  • Use a rubber mat in tub and a bath mat on the floor.
  • Use warm and low flow water.
  • Clean from a clean area of the body to a dirty part.
  • Clean under all folds of skin.
  • Bath time is a good time for hair, nail and foot care.
  • Use pull on clothing and simple fastners such as velcro or elastic bands.
  • Use low cut and non-slip shoes.
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Feeding & Nutrition

  • Feeding and nutrition requires planning and creating habits. When preparing meals there are several planning considerations including: special diets, individual likes and dislikes, nutriational values, budget, health concerns, and illness. Feeding may require establishing a few new habits. a few nutrition and feeding tips include:
  • Plan meals weekly before shopping.
  • Learn to read food container labels.
  • Aim for recipes that include fruit, veggies and whole grains and lean meats as allowed by special diets.
  • Include adequate liquids.
  • Eat with your loved one.
  • Offer just a few foods at at ime.
  • Watch for choking, chewing and/or swallowing hazards and prepare appropriate foods such as soft, liquid or small size prortions.
  • offer smaller and more frequent meals
  • Avoid constipation with plenty of liquids and fiber.
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Toileting & Incontinence

Some Seniors will need partial or complete assistance with toileting and/or incontinence. Incontinence is the inability to control urine or bowel elimination activities. Assistance may be needed to amulate to toilet and in transferring to an from the toilet. Safe transfer techniques need to be learned. Establishing a regular bathroom schedule may help to mitigate "accidents". A few tips may include:
  • During the toileting activity check for skin breakdown, change incontinence pads or adult diapers, and change bed lines.
  • Use easy to remove clothing.
  • Encourage hydration, exercise and fiber to reduce constipation.
  • Monitor urine color for signs o f illness.
  • Common urine related diseases include: urinary incontinence, Urinary Tract Infection (UTI) and kidney stones.
  • UTIs don't always cause symptoms but may come with signs such as: burning feeling when urinating, urinatine ofter,cloudy urine, redish colored urine, strong smelling urine, pelvic pain in women, mental changes or confusion and low-grade fever.
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Caring for Equipment

In addition to the equipment needed to measure vital signs such as a thermometer and blood pressure monitors, larger pieces of equipment such as canes, wheelchairs, rollators and scooters may be needed. Equipment needs to be kept clean and safe to use. A few tips for caring for the equipment include:
  • Wipe down surfaces with a damp cloth.
  • Replace cane tip if worn.
  • Check brakes and tighten if needed.
  • Check for worn tires.
  • Check for worn seats and backs on wheelchairs and rollators.
  • Inspect equipment regularly for signs of wear or damage.
  • Check for loose screws.
  • Professional service may be needed for motorized scooter. Keep clean, check tire pressure regularly.
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Transfer Skills

Skills to transfer a loved one from one location to another such as transferring to a wheelchair, toilet or car may be needed as a family caregiver. Learning to use gravity, leveraging and body position will be helpful. Helpful tips include:
  • Lock furniture or equipment wheels, such as wheelchairs, before transferring.
  • Person being transferred should we wearing non-slip footwear.
  • View this YouTube video on Transfer Skills from Family Caregiver Alliance: https://www.youtube.com/watch?v=oB0uPouIcXo
  • Helpful equipment might include a gait/transfer belt or mechanical lift.
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Taking & Recording Vital Signs

Measurement of certain "Vital Signs" such as temperature, blood pressure, heart rate, respiration rate, blood oxygen, pain level, blood glucose and weight are indicators of general body health. Recording these "vital signs" can identify trends in general health. Typical "vital signs" include:
  • Temperature.
  • Blood Pressure.
  • Heart Rate.
  • Respiration Rate.
  • Blood Oxygen.
  • Blood Glucose.
  • Weight
  • Pain Level
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Skin Care

The integumentary system, aka skin, is the largest organ of the human body! Hair and nails are also part of this system. The skin protects the body against many threats such as infection, abrasions, chemical assaults, viruses, and dehydration to name just a few. Normal changes with age include thinner, drier and more fragile skin. Protective fatty tissue is lost. If your loved one has mobility issues, check regularly for bed sore and reposition them on a regular basis while in bed or in a wheelchair. A few skin care tips include:
  • Baths are best time to observe skin. Check forredness, blisters, small cuts or dry patches.
  • If incontinent, perineal care is needed with each episode.
  • If incontinent,keep skin dry using bed pads.
  • If disposable underwear is used, monitor for leaks and incontinence.
  • Change clothing if sweaty.
  • Moisturize dry skin. Don't use lotionn between toes.
  • Hydration is important to healthy skin.
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Infection Control

The most common causes of infectious diseases are viruses, bacteria, fungi and parasites. Common infections in Seniors are pneumonia, influenza, skin infections and Urinary Tract Infections (UTIs). Be on the look out for signs of infections such as: fever & chills, confusion, loss of appetite, aches, nausea/vomiting. With skin infections there may be pain and redness. Two modes of transmission of infectious diseases are through the air and on surfaces. Hands are a very commone mode of transmission. A few tips to mitigate infections are:
  • Wash hands.
  • Wear PPE (Personal Protective Equipment) such a gloves.
  • Avoid sharing towels, wash clothes,& eating & drinking utensils.
  • Clean and sanitize equipment & surfaces.
  • Practice respiratory hygiene/cough etiquette,
  • Teach other caregivers the basics of infection control.
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Managing Medications and Medical Care

  • Three keys to medication management are: Right Dose, Right Medicine, and Right Time. There are three primary type of medication containers: pill bottles, pill boxes and bingo cards/blister packs. A few tips include:
  • Know Doctor's name, diagnosis and potential adverse reactions for each medication.
  • Try to use just one pharmacy for filling all medications. Get to know the pharmacist to coordinate all medications.
  • Work with doctor to have medications taken as few times per day as possible.
A key to good medical care management is communications. Establish a commnications network with all healthcare teams. A few tips include:
  • Prepare in advance for medical appointments.
  • Keep track of appointments and let love one know in advance of the scheduled appointment.
  • Arrange for transportation.
  • Let other family caregivers know about appointment.
  • Before appointment: get legal authority such as advance directives and Power of Attorney for Health Care so you can communicate with healthcare team. Prepare list of current medications and past medical histories including doctor's names. Take insurance cards and photo identification. Prepare a list of questions for doctor.
  • During appointment: let loved one answer as many questions as possible and include them in discussion with health care team. Start with most important questions and take notes of doctor's responses. Ask about any diagnosis, treatment, tests and new medications.
  • After appointment: with loved one's permission, get access to their electronic medical records, find community resources to deal with diagnosis, ask about availability of a social worker, and pickup any new medications from pharmacy.
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Observing & Reporting Changes in Health Conditions

Observing & reporting changes in health conditions of a Senior ASAP is necessary to keep them safe and mitigage serious outcomes. It is important to know the Senior to know when there are deviations in the baseline. Know the Senior's diagnosis. The baseline may include physical, cognitive, behavioral and functional measurements. A few observation and reporting tips include:
  • Observations may include your eyes, nose, ears and touch.
  • Regular measurement recording of vital signs and pain levels are helpful.
  • Know the signs of illnesses in older adults.
  • Take complaints, especially reports of pain, seriously.
  • Consider medication changes, changes in diet intake and diagnosis when observing and reporting changes.
  • Unusually agressive behavior and marked gain or loss of weight are additional signs of a change in health condition.
  • Develop a reporting plan ahead of time. People and groups to consider in the reporting plan may include other family/caregivers, rescue squads, and health care teams.
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Mobility

Human mobility is the ability to move from one position to another. Seniors have a decrease in their mobility capabilities. A decrease in mobility among senior may be due to but not limited to: age, arthritis, obesity, pain, dementia, medications, inactivity and injury. Determing the cause of the mobility issues is important in determining what aid and/or assistance is needed. When a caregiver helps someone safely, the risk of falls is reduced.
  • Physical caring assistance may include helping with activities in-bed, out of bed, clothing & shoes, balance & posture, pain & discomfort and communications.
  • Mobility aids may include: transfer belts, walkers, scooters, canes and wheelchairs.
  • When providing mobility assistance both physical or with an aid, clear the path to the destination, firmly plant your legs and conside the loved one's pain level.
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