Ask The Doctor: December 2021
Caregivers come to our home to help with my wife, who has dementia. Because we don’t always have the same person, I am constantly having to educate them about her needs. Do you have any tips for best doing this?
Consistency in caregivers is important, but not always possible. The home care industry can be a bit of a revolving door. Having a strategy and system for educating agencies and caregivers can indeed help you provide more consistent care, even if the caregivers aren’t always the same. Prepare a “tip sheet” to guide your conversations, and give the tip sheet to the provider. Keep the information short, just a couple of pages. You could start with a short biography to introduce your wife. Include pertinent information such as birthplace, her age, siblings, and if there are children and grandchildren. Mention accomplishments that she is proud of. For example, she may have been an actress or an excellent pastry maker. This information is fodder for conversations, which can be very useful when you want to divert her attention away from something that’s frustrating her or if she’s stuck in a loop (e.g., sorting the same pieces of mail over and over). Bullet point other relevant information into categories such as medications/medical conditions, challenges (e.g., knee osteoarthritis, hearing impairments/hearing aids), meals (e.g., favorite foods, mealtimes), household chores (e.g., instructions for laundry, cleaning). Finally, provide some details about the memory loss. The disease trajectory is unique for everyone, but there are common experiences. People with early-stage dementia have difficulty absorbing new information. They may frequently lose or misplace objects, and have difficulty with shopping, cooking, and keeping appointments. Memory worsens in middle-stage dementia, but people still remember their birthdate and can still brush their teeth, dress, and shower – but they may need prompts to do so. At this stage they may confuse names of family members or friends, their judgement declines, and they frequently repeat themselves. At the severe dementia stage, people may still recognize close family and friends but will not be able to verbalize names. They will need help with most activities of daily living. There are ways to compassionately deal with all these stages. UCLA has excellent videos covering common caregiver challenges. Produced in a problem/solution format, they are very useful for anyone involved in caring for a person with dementia. Find them at this web address: https://tinyurl.com/UCLAcaregiverTips.
I have a long-lingering cold and have some leftover antibiotics. Is it OK to take them?
Taking leftover medications is never a good idea. Colds and flu are caused by viruses, and antibiotics do not work against viruses. They work against bacteria. Taking antibiotics when they are not indicated encourages bacteria to mutate. That can lead to antibiotic resistance, leaving you at risk for more severe illness. Each year drug-resistant bacteria (also called superbugs) infect more than 2 million people in America and kill at least 23,000, according to the Centers for Disease Control and Prevention. Commonly prescribed broad-spectrum antibiotics destroy a wide variety of bacteria in your body, including some of the “good” bacteria that help you digest food, fight infection, and stay healthy. Bacteria that are tough enough to survive the drug have a chance to grow and quickly multiply. These drug-resistant strains may even spread to other people. It also could leave you at risk for infection from Clostridium difficile, a bacterium that can lead to diarrhea and life-threatening illness. A recent study showed that many older adults are unclear about antibiotic useage. About 40% of people surveyed said they’d expect their doctor to prescribe antibiotics for a lingering cold or flu. About 30% thought antibiotics would speed recovery. It won’t. What can help is getting plenty of rest, drinking lots of fluids, using a cool mist vaporizer, and drinking herbal tea with honey. If symptoms don’t improve after 10 days, or worsen, see your doctor.
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