Skilled Nursing Tips for Family Caregivers / Checking Vital Signs

Vital signs are the front line health metrics which help a care team assemble a picture of a patient’s current condition. Vitals typically measure temperature, pulse rate, and respiration rate, however, blood pressure levels are often also included.

Why is it helpful for a family caregiver to measure these key health indicators? In a time of concern (i.e. if your loved one is under the weather), checking their vitals helps you to gauge the severity of the situation from a health standpoint. If you’re wondering whether to take them to the E.R. or call their doctor, it can bring you peace of mind and help you make a clearer decision knowing that their blood pressure, temperature, and pulse are all normal and you’re not necessarily in crisis mode.

Checking vitals is often times what a nurse will do in the doctor’s office or hospital, however, it’s possible for any family caregiver to do it at home. Luckily, loads of technological medical devices are available at your pharmacy or online with which you can take accurate vitals readings digitally. Understanding the data you’re given, however, is a different matter.

Don’t miss this quick guide to checking and understanding vitals:

Temperature
Did you know that a normal body temperature may range anywhere from 97.8 to 99° F? 98.6° F is the average, however, your loved one may run a little colder or a little hotter than that. Knowing their baseline temperature will help you catch sudden spikes or drops that may require special attention.

Increases in body temperature, or fevers, are especially worth monitoring when they creep over 101° F. While a fever isn’t necessarily dangerous, high body temperatures may exacerbate symptoms of certain conditions like multiple sclerosis and dementia, especially if they are the result of an infection. If you are worried about a sudden fever, monitor your loved one’s temperature and record the readings every 1 to 3 hours; share this information with your loved one’s home health nurse and doctor.

Hypothermia, on the other hand, is a drop in body temperature below 95° F which typically results from exposure to the cold but can also be caused by low blood sugar, alcohol intoxication, and advanced age. A low body temperature coupled with hypothermic symptoms like shivering, increased heart rate, rapid breathing, and lack of coordination require immediate medical attention.

Respiration and Pulse Rates
Your loved one’s respiration rate, or the number of breaths they take in a minute, may range on average from 12 up to 20 breaths while at rest. Medical conditions and illnesses can affect how slow or how fast your loved one is breathing. Sudden changes in respiration rate should be monitored and reported to a medical care team.

Your pulse rate measures the number of times your heart beats in a minute; on average, pulse rates can range from 60 to 100 beats per minute. Pulse rate is typically measured with other helpful devices like a pulse oximeter or digital blood pressure monitor, however, you can easily measure pulse rate yourself with a couple fingers.

Gently place your forefinger and middle finger over the artery on the thumb side of your loved one’s wrist or on your loved one’s neck on either side of their windpipe. Set a timer for 60 seconds and then measure the number of thumps you feel with your fingers during that time. An exceedingly high pulse rate over 100 bpm is called tachycardia and may require immediate medical attention if it does not subside. The same goes for a pulse rate that is far lower thanyour loved one’s norm.

Blood Pressure
The clinical accuracy of blood pressure readings is a must in a good digital blood pressure monitor. Being able to quickly and clearly display an accurate reading, as well as record it and alert users to alarming readings, equips caregivers with health information they can rely on.

A normal blood pressure for a healthy individual is around 120/80 mmHg; it’s a measure of the force at which blood is being pumped through the circulatory system. Depending on your loved one’s condition, their baseline blood pressure may be higher or lower. Any unusual blood pressure reading that drops below 90/60 or jumps up above 140/90 could indicate that another underlying factor is at play, like an infection, and that your loved one should be monitored closely (and their doctor called).

Measure blood pressure regularly around the same time each day while your loved one is at rest, following the instructions that come with your digital monitor. Knowing what is a normal reading for your loved one will help you recognize potential warning signs sooner rather than later.

Caregiver Stress Relief Photo of the Week

Caregivers employed with senior care companies know the realities of caregiver stress. Caregiverlist invites all family caregivers and professional caregivers to take a moment for relaxation with our photo of the week and inspirational quote. This week's photo features one of a kind sunset with clouds,  for caregivers and nurse aides to relax. Thank you caregivers and certified nursing aides for caring for our seniors and please refer your friends to apply for part-time and full-time job positions on Caregiverlist.com and visit our career center for additional career tools.

Caregiver Stress Relief Photo Sunset

"The only source of knowledge is experience." 

Albert Einstein

Caregiver Support a Future Concern

I’m part of the Baby Boomer generation that provides family caregiving to an aging parent. As such, I and my siblings provide much of my mother’s long term services and support (LTSS) which allows her, at 80, to comfortably age in place, at home. I have three siblings to share in that care. In my old age, family care will be split between two children. As Americans age and their families shrink, there is concern for the future supply of relatively inexpensive family support for elderly individuals.

A recent report released by the AARP Public Policy Institute indicates a rapid decline of family caregivers within the next 20 years. The drop in the caregiver support ratio, or the number of family caregivers (adult children) available to care for their elderly parents, prompts a call for policy action to find new solutions to finance LTSS.

 According to the report, "The departure of the boomers from the peak caregiving years will mean that the population aged 45 to 64 is projected to increase by only 1 percent between 2010 and 2030, During the same period, the 80-plus population is projected to increase by a whopping 79 percent."

The shortage trend continues until 2050, when the population of parents to children is expected to balance again.

The call to action has been to federal and state Departments of Aging to provide more caregiver training and more affordable and quality nursing homes in order to fill the gap left by the decreasing number of family caregivers.

Right now, AARP projects these states to have the best and worst caregiver ratios in 2030:

Best:
District of Columbia: 6.4
Utah: 5.8
Alaska: 5.3
Illinois: 4.9
Georgia, New York and Texas: 4.8

Worst:
Arizona: 2.6
Florida and Hawaii: 2.9
New Mexico: 3.2
Iowa: 3.3
Maine, Nevada, Vermont and West Virginia: 3.4

How about you? Do you provide family caregiving to a senior loved one? With how many people do you share in that care? How many people will you have to care for you in your old age?

Family Caregiver Survey Participants Needed: Win a $50 Gift Card

The family caregiver role commands various roles: walking assistance, preparing meals, taking out garbage and more.  Every caregiver has different experiences depending on the senior’s needs.  Caregivers of older adult relatives—spouse, parent, sibling, partner, or other close person—may fill out a survey and be entered to win a $50 Wal-Mart gift card. Caregivers must also provide transportation for this person, such as going to medical appointments, buying groceries, going to church and so on.

The College of Nursing and Department of Gerontology of The University of Missouri—St. Louis seek to examine the impact of providing transportation for family caregivers through a new instrument that will measure this level of impact. Byrant Price, doctoral student, and Dr. Jean Bachman, faculty advisor, organized the study.

Caregivers who complete the survey do not receive any direct benefits, but participants will help Price and Dr. Bachman gain a better understanding of the experience of being a caregiver. Caregivers who participate may choose to be entered into a raffle to win a $50 gift card for completion of the survey of which ten (10) winners will be selected when the survey ends.  Participants can simply select "Yes" at the end of this survey and to provide their personal information for the raffle. 

Approximately 270-460 participants are being sought for this study so odds of winning the optional raffle are approximately 1 in 27-46. 

Caregivers seeking community can submit their stories on Caregiverlist.com. Share your story and read others for inspiration. 

 

 

Inside the Dementia Epidemic: Indie Award-Winning Author Shares Story About Caring for Mother

Martha Stettinius is the award-winning author of the book “Inside the Dementia Epidemic: A Daughter’s Memoir,” and until recently a “sandwich generation” caregiver for her mother, Judy, who had vascular dementia and probable Alzheimer’s disease. When Judy, 72, could no longer live alone in her remote lakeside cottage—when she stopped cooking and cleaning, lost a lot of weight, and was in danger of falling—Martha encouraged her to move into her home with her husband, Ben, and their two children. For 8 years, until Judy passed away late last year, Martha was her primary caregiver at home, in assisted living, a rehab center, a “memory care” facility, and a nursing home. Martha serves as a volunteer representative for the Caregiver Action Network (a national organization providing caregiver support and advocacy) and as an expert in dementia care for the website eCareDiary.

In this short excerpt from “Inside the Dementia Epidemic: A Daughter’s Memoir,” Martha writes about taking her mother to visit her old cottage, and learning that day to see dementia differently.

In late October, two and a half years since she moved in with us, I bring Mom along with me and Ben and the kids for an afternoon at the lake. I imagine that she will light up at the sight of the cottage, but as she sits outside with me in the front yard in the shade of an umbrella, and watches the waves, her expression is flat, muted, as if the yard is just a place like any other.
At first, I feel deflated, but within moments I realize something: It’s time for me to stop trying to bring my mother pleasure through what’s left of her memory. If she no longer recognizes the deep blue swell of her lake, if these pieces of her life no longer move her, then truly there’s nothing but the present moment—and other people.

I decide to take her out for a rowboat ride. I wonder if feeling the rowboat rock softly on the water will help my mother experience the joy in the lake she used to feel in her canoe, or when she watched the waves from her desk.
Ben helps me support Mom under her arms as she steps in. Mom sits in the middle of the wide seat along the back of the boat, Andrew [our 12-year-old] squeezes into the bow, and from the middle seat I row the three of us a hundred feet out into the lake. I keep my eyes on hers. She grips the edge of the seat, her back ramrod straight, her eyes wide but not scared. We bounce gently on the waves and Mom releases her hands from the seat to stretch her arms and clasp the sides of the boat. She smiles. When I tell her that she can lean against the high back wall of the boat, she scoots her bottom toward the wall and relaxes.

Back on shore, there’s a problem. We find that Ben has gone off to the store; Andrew and I have to pull up the heavy boat and get Grammy out on our own. I call Morgan [our 10-year-old] out of the house for her help. We hold Grammy’s hands and coach her to walk up the length of the boat from the back, which is still in the water, to the bow so we can help her step out onto the beach. She stands on the seat in the bow, too high to step down. I ask Andrew and Morgan to find a stool in the boathouse and they bicker about who should go. Andrew finds my garden stool, which has wheels, and I wedge it between my feet beside the boat and try to persuade Mom to step down on it.

“Don’t make me cry,” she says.

My heart flares for a moment with guilt, but she trusts me and her fear passes quickly. She holds my hands firmly as I ask Andrew to carry over one of the lawn chairs. Mom hesitates, then lifts one leg over the rail of the boat and steps onto the chair, brings her other leg over, pauses, then steps down to the garden stool and then onto the shale, where she tucks her slender shoulders into my arms. Such a production! I can’t believe I asked my mother, who just recovered from a pelvic fracture, to clamber in and out of a boat.

But I’m glad I did. In the boat Mom seemed to absorb it all—my attention as I held her eye and smiled at her, the breeze, the blue-green waves, the gentle push of the oars, the firmness of the boat’s floor under her Keds. When we passed our neighbors on their dock Mom had let go of the side of the boat to wave with a big smile.

Without memory, I think to myself, what’s left? Not destinations like going to the cottage—not the pleasure of their anticipation and repetition—but moments like these, of sense and touch, rhythm and movement, patience and reassurance.

"Inside the Dementia Epidemic: A Daughter's Memoir” is available through all major online book retailers as a paperback and e-book. Martha can be contacted through her website and blog, www.insidedementia.com, and on Facebook, Twitter, LinkedIn, and Google+.

 

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