Caring for My Aunt~An Update

health risks for elderly

It’s been over a year since my aunt came to live with my family. It’s taken nearly that long for her body to adjust to the change.

Although I expected her health to improve once it looked like she would survive the whole ordeal, I didn’t expect her to get as healthy as she is. She was extremely weak, confused and recovering from multiple infections, dehydration and years of sleep deprivation, malnutrition and mismanaging her medications.

There are a few factors that I believe have contributed to her overall wellness. In no particular order, I’ll list them below:

1. Adequate Sleep

None of us realized until we slept with a monitor overnight (in case she calls)  just how often my aunt woke up to go to the bathroom during the night (4-5 times). I think she was more worried about having an accident than she was likely to.

When she lived on her own, she was physically incapable of changing her bed linens and I believe she got herself up a few times a night as a precaution.

Her habit was to go to bed at 9:30 pm after she took her pills and wake up in time for Mass on EWTN at 8 am. We continued that when she came for the sake of continuity and routine but a better schedule has evolved.

Last summer, we didn’t think it was unusual that she fell asleep in her chair throughout the day even if people were visiting. She did that before she came all the time. Now I know why.

We figured out together that my aunt prefers to get ready for her day after Mass (9 am) because she can watch it from bed.  Most mornings, she sleeps through it.

Her caregivers come at 7:30 every night to help her get ready for bed rather than 9pm. Sometimes she falls asleep as early as 8:30 and often sleeps through the night (thank you, Jesus!). Like I said, this schedule has evolved through discovery. An outsider might think that she spends too much time in bed, but I know it’s been beneficial to her and to the whole situation.

There’s tons of research about the restorative benefits of sleep and I agree that it’s had a healing effect on my aunt. Unfortunately, her short-term memory hasn’t improved but because she’s rested, she doesn’t fall asleep during waking hours anymore so her interaction and engagement with people who come to visit has improved.

2. Elevating her feet

After a scary bout of swelling, leg ulcers and cellulitis last summer, her doctor recommended elevating her feet for 2 hours a day. Since the only way to do that is for her to get on her bed, she does that every afternoon. Sometimes she falls asleep but usually she just watches EWTN or prays the Rosary.

This practice really has prevented recurrence of any of the conditions that led to it, gives us both a much-needed respite and adds an anchor to her routine.

3. Nutrition

My aunt’s diet for the couple of years before she came here was a piece of cottage cheese toast twice a day with her medicines, a big glass of V-8 mixed with a gross amount of fiber powder twice a day and whatever her best friend could prepare for the two of them in her own compromised state of health and immobility.

Now that she’s here, my aunt eats about a cup of cereal with almond milk every day for breakfast and a cup of coffee. For lunch she enjoys a sandwich and a pickle. I say “enjoys” because she prefers not to deviate. She loves that sandwich. She likes a few peanut butter crackers when she gets up from her rest then has a regular dinner with the family which almost always includes a protein, a vegetable and a full salad.

My aunt has lost nearly 60 pounds on this casual but healthy plan since she came. She moves so much better, no longer suffers from chronic hip pain, does not struggle to walk or stand from a chair and is able to get in and out of bed without gasping for breath and getting winded.

I know first-hand this diet is so much better than the institutional foods she was eating in the nursing home. The food was gross (loaded with carbs, sodium and sauces) and they almost always offer a dessert (who could resist?) and soft drinks at every meal-yes, even breakfast.

4. Fresh air and sunshine nearly every day

My aunt NEVER went outside before she came to live with us. She preferred the comfort of air conditioning and she was terrified to fall.

I didn’t imagine that she would want to go on the porch but it turns out she spends the better part of her days there when the weather cooperates.

It’s a great part of her normal routine and gives all of us a little more room to spread out. Our house is small as it is for a family of 7 (including my aunt). Extra livable square footage is great. The porch is shaded but open so she can watch what’s going on in the neighborhood and in the back yard when the kids have friends over. It connects her to the outside world. That’s been a great thing.

5. Regular human touch and interaction

It’s not uncommon for older adults to become isolated and lonely. Despite efforts from her closest friends, when my aunt quit going to daily mass and became increasingly housebound due to her fear of falling, she was alone most of the time.

She didn’t seem discontent but she was becoming more desperate for visitors. As much for the help as for the company.

She requires care and assistance for all of her personal needs. The normal interaction during that process by people who she knows and physical touch has to contribute to her health.

According to some alarming research, social isolation is as deadly as smoking and about twice as risky to seniors as obesity. Studies show that loneliness impairs immune function and boosts inflammation. SCARY, isn’t it?

6. Prescription Management

Thinking back to the times that I would visit my aunt, I suspect that she was over-medicating by as much as 2X the prescribed dosage.

When she sorted her pills in the morning, she put her evening pills in a little tin. Then evening would come and out came the bag of medicine bottles again and she’d prepare her evening pills and put her morning pills in the little tin.

Wait a minute-didn’t she do that in the morning? Didn’t she already prepare he evening dose? Yes and Yes.

Now that I’m managing her prescriptions, it’s not unusual for her to ask whether she took her pills and she doesn’t believe me sometimes when I tell her she did. Her short-term memory doesn’t work.

The statistics for prescription mismanagement in the elderly are startling. According to the CDC,  there are nearly 700,000 ER visits each year for adverse drug events in patients over 65. An estimated 23% of nursing home admissions are due to the senior’s inability to manage their prescriptions on their own ( anyone?). 

No question my aunt would rather be living the life she remembers….active in the church, instructing adults in the faith, visiting shut-ins, helping the Daughters of Charity with their administrative work and playing the piano every week at a local restaurant near her former home. But since she can’t do those things any longer, we’re trying to keep her safe, secure, happy and healthy here.