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Recent Managing Daily Activities Advice

    What is the best way to get a large elderly person, who uses a walker, out of bed in the morning. She is 205 lbs and does not have bed rails. As a result, she often falls.
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    Laurel F. , Nurse and Care Manager answers:
    I would first consult her doctor to see if the falls are due to a treatable medical problem, and see if she is willing and eligible to have a medical bed. If not willing or eligible, there are products for attaching "hand hold" rails to the bed frame, or "transpoles" that are poles that mount to the floor, or ceiling and floor, for support. The bigger question is why is she falling--is it a strength or balance issue that might be treatable through better nutrition, hydration, exercise, physical therapy as is often the case. A geriatric care manager such as myself can assist in getting her to the doctor and asking the right questions.
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    Alan M. , Geriatric Care Manager answers:
    Might try using a hoyer lift Have a physical therapy consult on proper transferring techniques

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    I care for an 85 year old man who refuses to shave no matter what I do. He needs to be presentable because he has frequent social engagements. Any advice?
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    Anne J. , Elder Law Attorney answers:
    I would recommend that you discuss the issue with his doctor.

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    Showing signs of mental deteriation Physical pain and inability to do personal care adequately. How can I determine what her needs are and how I should be planning for her future?
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    Debbie S. , Geriatric Care Manager answers:
    Have a Professional geriatric care manager in your community do an assessment, and they can point you in the direction needed...

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    I am 78. I need transportation to doctor's appointments. My son works. He also doesn't realize that I need help getting to appointments. I don't want to ask him for help. I have always been independent and now I don't drive. I live in the country (Billings, Montana) so I don't have access to city transportation.
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    Sol L. , Elder Law Attorney answers:
    Two options: Check with the medical institution to see if it has a pickup service, and its range. If that doesn't help, check with the various home health care/companion services. I called Synergy Home Care just to check, and they do this for $18 per hour of employee time (travel plus waiting, if needed), plus $.55 per mile for both round trips - one to get you and bring you to town, and one to take you home. Hope this helps. Sol

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    My mom seems to need one of those scooters. Her ability is dramatically decreasing and she has fallen twice in the past two months. How do you know if a scooter is right to help her get around each day? And what is the right product?
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    Barbara P. , Geriatrician MD answers:
    Patient should be evaluated by physical therapist for appropriate assistive device. Scooters are very costly and very few diagnoses are covered by insurance. Scooter company advertisements are very misleading.
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    Debra D. , Geriatric Care Manager answers:
    You should have either a physiatrist or a physical therapist evaluate her before this. Emergency alert systems for people who live alone are really essential .
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    Mary Ellen S. , Geriatric Care Manager answers:
    A physical therapist is the best person to evaluate her, and suggest an appropriate one. Hopefully she wears a medical alert so that if she falls, she can press the button to get help quickly.

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    How do I find an occupational therapist to make home visit to assist in improvements to help aging parents perform activities of daily living?
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    Rachel F. , Occupational Therapist answers:
    In terms of finding an occupational therapist, I think a lot of it depends on whether or not the patient would qualify for insurance (or medicaid/medicare) to cover the care, or whether you would want to pay out of pocket.

    I work for an agency called Therapeutic Resources that sends me homecare cases for older adults, and I think they get the cases referred from the patients' doctors. Sometimes Medicare/caid wont cover OT unless the patient is technically "homebound." So a lot goes into it, especially if insurance will cover it. Also, you might want to look into homecare services in your area (I know Visiting Nurses Service is a big one in NY).
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    Rosario A. , Physical Therapist answers:
    There are many different companies that offer both occupational and physical therapy in your home. If you are looking for more ADL training such as dressing and grooming then occupational therapy would be beneficial.

    If you are looking for more gait training, strengthening and balance training then physical therapy would be a good fit.

    When it comes to finding these companies you can look under home care services. There should be a list of certified home care agencies and also private companies. Another key factor to consider is the issue of insurance to cover the care, which is another discussion in and of itself.

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    We have always known that my elderly father had a bunch of allergies. My sister is allergic to latex and I suspect that my father is now developing/showing an allergy to latex.

    I have been checking in on him pretty regularly in a local nursing home and have recently noticed some rashes on his body. Because he is allergic to mango, avocados and strawberries, I surmise that the rashes might be the latex gloves some of the nurses wear when they touch him?

    Is wearing gloves a normal thing to do in a residential facility?
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    Anne R. , Geriatric Care Manager answers:
    There are gloves that are made without latex that you should buy for the staff that cares for your loved one. You can purchase them in a pharmacy.
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    Denise D. , Geriatric Care Manager answers:
    Yes, wearing gloves is required when doing personal care. If you think your father may be allergic to latex, tell the facility and request that non latex gloves are placed in his room to use. Most facilities have these available as staff frequently has latex allergies as well that require them to wear them. If this does not solve the problem, you may want to investigate what kind of detergent, lotions, powders etc that they are using for your dad. Facility laundry soaps are often very strong and he could easily develop an allergy to lotions or powders that they are using on him frequently.

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