Doll Therapy with Dignity for Loved Ones Living with Dementia

pexels-photo-272056Babydolls.  Traditionally, a toy for little girls to play with, hold, and take comfort in has become a popular therapy tool for some individuals living with Dementia. Although this device should not be used for everyone, a baby doll does bring great comfort to those who have had an affinity to caring in their earlier years.

One particular memory care unit I worked on had a whole nursery set up in a quiet room at the end of the hall fixed with two cribs, a diaper bag, and a rocking chair.  These Items, of course, you would not ordinarily expect to see when the average resident was age 92. And yet, two women, in particular, would frequently come in throughout the day to lay the baby doll down for a nap, sing him a lullaby, or like any good mother would show him off to all the other staff and residents.

Sweet and endearing as it may seem the site of an older adult holding a baby doll and “pretending” that it is real can be alarming.  I’ve had several family members come up to me over the years questioning the practice partly out of concern for the persons well-being and partly because a women holding a baby doll is a visible reminder of dementia.

Dolls with Dignity

While caring for someone living with Dementia and Alzheimer’s we have a duty to uphold their dignity.  Dignity is so important that the Right to Dignity is an actual federal mandate in nursing homes. This right is particularly important while using Doll therapy. Like most treatments in Dementia care, while addressing or interacting with the individual and the baby doll, we must always treat the doll as if it were a real baby. And never correct the way in which the individual cares for the baby doll.

It is not uncommon for someone to swaddle and swoon over the doll in one moment only to drop them on the floor (by accident) the next.  They may leave the baby doll lying around, spill food on the doll, or even hold them upside down by the foot.  But this doesn’t mean that WE can do this.  Even if we think that the person isn’t watching we should always hold and treat the baby doll as if it were an actual baby.  Otherwise, they will probably perceive us as negligent, and they won’t be afraid to tell us this either.

 

Alzheimer's care doll therapy
Image Source NPR: Doll Therapy May Help Calm People With Dementia, But It Has Critics

 

There are several common questions people want to ask when they see doll therapy in use, but these questions are often the ones that we should avoid. For instance, we shouldn’t ask what the baby’s name is, how old the baby is, or who the father is.  Most likely they won’t be able to tell you and realizing that they have forgotten such important information can be quite upsetting. Instead, statements like “oh look at those cheeks” or singing a lullaby, are more engaging and empowering ways to enhance the therapeutic nature of baby dolls and will make the individual feel secure and even a bit prideful in that moment.

We don’t have to be ashamed or embarrassed by doll therapy.  It brings great joy and comfort to care for a baby in this stage of their life and your support enhances their quality of life.

 

Does this Mean I should Buy Mom a Baby Doll?

No. As mentioned above, doll therapy is not for everyone, but if you notice that your loved one is feeling a bit more anxious laying a swaddled baby out where they can find them is a good way to see if they are interested.  Even placing the swaddled baby in their arms to see if they attach to them is okay. However, it should not be a forced process, and if uninterested you will surely know.  But, if their face lights up and a big smile appears you will know you’ve just given them a great gift of comfort.

The Use of Robotics in Long-term care Facilities: A Step Into the Future?

 

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Robot and Frank (Click for Movie Trailor)

The use of robotics and other AI Technology in Long Term Care is a highly debated topic, and there are fair arguments both for and against. Their use, however, seeks to solve a  grave concern in the field.  The number of adults 65+ by 2050 is expected to rise to 88 million. At such large numbers, resources are essential to the ability to provide and care for our older populations.

The greatest resource is the caregivers themselves, and currently, there is a significant shortage in the United States. Recruitment of employees is hampered by negative stereotypes of nursing homes and the often deeply emotional realities of caring for someone at the end of their life.

The most common reason people choose to work in long-term care is that they had a good relationship with an older adult (commonly a grandparent) at some point in their lives. The lack of senior caregivers will become a national endemic if the issue is not addressed.

There are several different types of robotics for senior care, but the most commonly used are robotic caregivers, social robots, and teleconferencing robots.  Their use has grown increasingly more popular over the years and can now be found in Japan, throughout Europe, and the US.  As the number of older adults increases, their use could be the solution we are looking for.  But can a robot actually replace the human connection and socialization we as humans need?

The Pros and Cons of Robotics in LTC

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Robotic Caregivers

Designed and developed in Japan, the Robobear is a transfer and lift machine for people who have difficulties getting up and moving on their own.  Traditionally, this is a job for Certified Nursing Assistants who assist in lifting and transferring individuals from the bed to their wheelchair or from the wheelchair to the bathroom.

Nowadays, there are Hoyer lifts and sit to stand lifts which help take some of the strenuous burdens off of the caregiver, but they are still in the room and able to talk or calm a resident during the transfer process.

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The Robobear (as pictured above) is designed to make this process a bit less scary and jarring for seniors. However, the idea that a cute smiling bear is more inviting and more receptive to seniors is a bit unfounded, but it does offer a friendly alternative to the more sterile machine options on the market today. In their use, we should keep in mind the potential for confusion they may cause our residents with dementia or Alzheimer’s.

Prototypes of humanoid robots are still being developed.  And one day we may find that robots that look like humans could replace our caregiving staff.  Although this still seems like an idea of science fiction, Carebots are already developed and on the market and their use is specifically targeted to assist the elderly.

Social Robots

Social robots are developed to simulate real pets.  Most common are dog and cat robots as seen in the video below.  The company Hasbro’s found that their children’s toys were being used by a growing number of seniors and decided to create a line especially for older adults living in nursing homes.

 

These “pets” act and respond just as a real cat or dog would.  The cats will purr and vibrate while being pet and meow in response to being held.  Since pets aren’t allowed in many long-term care settings, this type of companionship is a welcome replacement.  And especially for those living with Dementia or Alzheimer’s can offer a sense of comfort and purpose.

Hasbro is not the first to unroll a line of robotic pet companions.  Japan has a line that was established in 2003, which was purposefully designed as a therapeutic intervention for seniors.  Unfortunately, this line is a bit pricey and not as easily obtained whereas Hasbro’s Lifelike pets are much more reasonable at about $100.00.

Robotic Conferencing

The Cruciferous Vegetable Amplification episode of the Big Bang Theory parodies the idea of sending a virtual self out into the world through video conferencing. Funny or extreme as the concept of this was, this type of technology is available and for the medical field has great potential to allow physicians to be two places at once.

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Image Source: CBS Network

One such technology is the GiraffPlus, already on the market and providing In-Home help care to the elderly throughout Europe.  The GiraffPlus is a vacuum cleaner, monitoring system, environment evaluator, and a telehealth conduit for seniors living in their home.

As the number of older adults remain in their home, these types of technologies make aging in place a sustainable living option even as care needs change. Alternatively, however, does the lack of a personal visit to the doctors or the now “traditional” form of health care offer something more than a teleconference can offer? Particularly to a more vulnerable population for isolation.

Can a robot console the way a human can?

Seven million Americans over the age of 65 suffer from depression. This number will continue to increase over the next several years, but without enough caregivers, it’s hard to care for the emotional and physical needs of our older adults.

And as many movie and TV representations show us, although some robotics are advanced with many capabilities true human connection is not one of them. Although robotics have become increasingly popular throughout Europe, Japan, and the US one French non-profit the Society of Saint-Vincent-De-Paul
 created a short clip that portrays the ill-effects this lack of human console can have on an individual.

 

The Future of Long Term Care

Technology has been incorporated in nearly every field so it is no surprise that we would find a way to advance our caregiving methods. Personally, I am still on the fence when it comes to robotics specifically and maybe only sold on the cute toy kittens and a bit weary of a giant smiling bear capable of lifting a person.

As a field, we still have an opportunity to invest in real live humans to fulfill our caregiving needs.  In an earlier post, Addressing Our Caregiver Shortage through Intergenerational Programs: Introducing our Youth to Seniors Living in Long-Term Care I discuss the importance of intergenerational interventions now so that our youth will grow up wanting to care for their elders.

I would love to know what you think about the use of robotics in Long Term Care?  Is it cool, weird, innovative?  Leave your thoughts in the comment section below!!

A Year in the Upside to Aging

designers don't actually solve problems.they work through them.

A year ago I came up with the wild idea of starting a blog. As if six years of writing research papers and projects wasn’t already enough to last a lifetime.  But, I wanted to take these important conversations occurring in the field of aging and bring them to the people who were living through them every day.

Over the past year, I’ve connected with so many inspiring people working and living with Dementia or Alzheimer’s.  I’ve been humbled by the sheer enormity of the community affected by these diagnoses. And the unique and innovative ways they continue to bring awareness and support to the cause.

I was honored to write and collaborate with Sixty and Me, whose mission is to empower women to embrace and thrive in their sixties and beyond.

I joined the ranks of AlzAuthors, a community built from shared experiences and understanding of the ups and downs of Alzheimer’s. Whose great authors share personal stories and resources in hopes to help others with similar experiences.

And sat down with Meg LaPorte whose new series Age in America is sharing the stories and perspectives of residents living in nursing homes.  Whose mission is to reframe perceptions of aging in America with oral histories, storytelling, and images that illustrate the positivity, diversity, and value of being older.

I am thankful for the support I’ve received over the past year and motivated to continue to share the upsides to aging.  I’m excited to announce the launch of my new website is coming soon and will continue to share exciting projects in store for the year ahead.

When I started my career in activities, I had training…lots of it! My relationships with those living with Dementia and Alzheimer’s was built on fun and laughter, not sadness or confusion.  And for that, I will always be grateful because it has given me an alternative understanding and awareness of the needs of our older adults that I hope to share with all of you.

For nostalgia sake here is my very first post 4 meaningful ways to spend time with a loved one living with Dementia

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4 meaningful ways to spend time with a loved one living with Dementia

Spending time with a parent or loved one living with dementia can be a worrying experience.  “What should I say?” “What can I do?” or “What if they don’t know who I am?” are all completely normal questions you may ask yourself. Not to mention, if you weren’t that close before their diagnosis, the task of getting to know them now might feel overwhelming. Fortunately, with a little preparation and patience, you will find there are many ways to engage and even have fun with your loved ones.

Below are just a few ideas to get you started!

  1. Music will almost always awaken the soul.

Create a special playlist with all of your loved one’s favorite songs and listen to them together. If you don’t know all of their favorite songs here are a few Patriotic songs and other popular sing-along songs they might enjoy:
Alexander’s Ragtime Band
• America
• America the Beautiful
Bicycle Built for Two
• For Me and My Gal
• Give My Regards to Broadway
Hail! Hail! The Gang’s All Here
• Home on the Range
• I Love You Truly

And don’t be shy, it is okay to tap your toes and sing along. They may be sitting in a wheelchair, but that doesn’t always mean they can’t tap their toes and swing those arms like the best of them!

Watch as Henry’s caregivers reawaken his soul with some of his favorite songs (An excerpt from the documentary – Alive Inside):

  1. Go outside – Don’t forget to bring the snacks and something to read!

Whether your loved one is living at home or at a nursing facility the chances for them to spend time outside are often limited.  Take this opportunity to get some fresh air and Vitamin D.

It might be nice to just sit outside and enjoy the peace and quiet, but bringing a long a pack of snacks and water makes the whole trip feel more like a picnic.  And if the quiet gets to be too much bringing along reading material and reading aloud to your loved one provides a meaningful and engaging experience for you both!  I always like to bring short stories from Chicken Soup for the Soul or articles from whatever magazine or newspaper I have on hand.

Safety and Comfort first: If it is sunny bring a hat and sunblock to protect them from the sun…and don’t forget their sweater! That cool breeze might feel heavenly to us, but it could make your loved one feel extremely cold and uncomfortable.

3. ZZZ… It is okay if they fall asleep!

It is important to note that it is okay if your loved one dozes off while you are with them. This doesn’t  mean you are boring them or that they want you to leave. There are some reasons why they may be feeling sleepy…Whatever the case try not to take it personally! Your presence is making them feel less alone and more secure even if they aren’t able to express it. Stay there and hold their hand while they nap or make them a card while you wait for them to wake back up.

4. Take notes and Keep track!

It might be helpful to take a notebook with you every time you visit your loved one. The entries can be as brief or as detailed as you would like. But, a good starting point for your entries is the date, the time, the activity, and a note of your loved one’s mood (i.e., mom was smiling as we listened to her favorite songs or mom dozed off as we read from the paper).

At first, this might seem a bit much but after a month or so you should begin to see patterns in your loved one’s routine.  For instance, when tracking, you may find that during your afternoon visits mom is always sleeping or is hard to engage in conversation, but when you visit in the mornings, she is wide awake and smiling. Once you’ve noticed the pattern, you may decide that morning are a better time to visit. And the same goes with identifying what activities they would prefer to do…are they always awake and smiling while listening to music?  Then finding ways to incorporate music in your visits will help them feel more engaged!

As adults, we are always being told to live in the moment. And when we are with our parent or loved one who has dementia this sentiment couldn’t be truer.  As caregivers, you are often the unsung hero’s for our aging population and will spend most of your time focusing on the medical care your loved one receives.  But you also deserve to be able to spend time with your loved one and to get to know them during this new phase of their lives.

This is NOT an Anti-Aging Book: A Closer Look at Cameron Diaz’s The Longevity Book

 

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Image Source: Our Body Book

The other day my husband and I were in the car on our way to dinner when an expose of Cameron Diaz’s book The Longevity Book came onto the radio.  We hit the interview about mid-way through so I missed the author’s name, but as I sat there listening to this woman so confidently and eloquently call out our society on its anti-aging culture I audibly questioned who she could be? A new voice from AARP? Or maybe, an expert representative from the National Institute of Health?

After ten years in the field, I’ve become so accustomed to the leading experts address the topic of aging that the very thought a Hollywood Actress would so boldly discuss the positive of aging was probably my last guest. Which undoubtedly calls into question my social relationship with Hollywood and the parallels to youth that we so desperately hold.

An open and honest depiction of the real beauty and privilege it is to experience the aging process.

It was refreshing to hear that a woman who for so long has been a symbol of youth and beauty describe her fear of turning forty. In her book, she describes experiencing this time publicly.  In interviews, questions became more frequently around her age rather than her craft.  And she realized that no one cared about the biological effects that she was physically experiencing, but merely what would happen to her career now that she no longer looked twenty-five.

Although these questions are a bit shallow, arguably they stem from our collective fear of aging.  And without practice in real aging dialog, our society’s questioning of the maturing process to someone who is experiencing it (at least in the way our youth drove society understands aging) the questions may seem a bit crass and inappropriate.

But rather than hiding behind a perfectly manicured face or becoming a spokeswoman for the latest anti-aging product Cameron Diaz wrote a book.  A book to guide women to a better understanding of the next phase in their life. An open and honest depiction of the real beauty and privilege it is to experience the aging process. And to combat the somewhat silly notion that the awkward and uncomfortable state of our youth should somehow remain our ever present.

The book goes on to explain both the biological and social effects of aging has on women and offers a new and refreshing dialog on aging within popular culture. Stated in Chapter One, the book’s mission is to be used as a tool to reshape an already well-established dialog on what it means to grow older. A guidebook to what is to be expected during the natural progression of life and to offer a scientific understanding to a woman’s cellular body.

 

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Image Source: Our Body Book

 

It was Cameron Diaz’s journey that compelled her to write The Longevity Book, and she is just one of the many influencers speaking out against stereotypes on aging, but one of the few outside of the world of the aging services.

Changing the Way, we Discuss Anything Aging

Although every woman’s experience to aging is unique, we all have a shared involvement in the process. Unlike ever before, both men and women can live a healthy and active life well into their nineties even our centurions have expressed happy later years.

As I mentioned in my last post, Meg LaPorte the Founder of Age in America, a Collection of Stories Designed to Challenge Aging Stereotypes, when asked about their age and life more than likely older adults share the happy life they have led. They express thankfulness for the path they have taken to get to where they are today.

The Longevity Book is a surprisingly pleasant and easy read that is perfect to add to your summer reading list. It offers great tips on how to openly discuss our unique experience, which is so critical to our own perceptions of self-worth. And teaches us that when we change the way we talk about the aging experience, we begin to help others find the beauty in theirs.

Meg LaPorte the Founder of Age in America, a Collection of Stories Designed to Challenge Aging Stereotypes

17992364_205406703283763_1150171843449567255_nAmerica is built on stories.  The collection and dissemination of oral history have long been a way to preserve the past and, for the generations who came before us, a way to pass on traditions and family legacies.

For older adults, in particular, these stories are built from the memories of their life and the nostalgia for days past. Even the most mundane of the everyday events are looked back on with fondness.

Today, much like the stories being shared, the aging process occurs behind closed doors.  Rarely discussed and often avoided, as many people choose to refuse the aging process rather than embrace it.

Age in America offers alternative narratives and challenges long-held assumptions about what it means to be old by, as their motto suggests, chronicling lives, challenging stereotypes, and changing perceptions — one story at a time.

The founder, author, and creative director of Age in America is Meg LaPorte. She cites that she is influenced by close colleagues and leading experts in the field Dean Judah Ronch, P.h.D of the UMBC Erickson School of Aging. And Bill Thomas, MD an author, entrepreneur, and physician whose wide-ranging work explores the terrain of human aging (ChangingAging, About).

Meg received her Graduate degree from the school and is currently writing for Dr. Bill Thomas’s blog ChangingAging.org.

First Stop…Age in America, Baltimore!

Inspired by the Human’s of New York series, Meg found a beautiful way to bring the stories of aging America out of the confines of the nursing home and share them with the rest of the world. She admits that although she had periodic moments of doubts,  the “candor that the residents express is amazing” and their excitement and receptiveness for the series drives her love and desire to share this important work forward.

She believes that by demonstrating that we are all essentially the same–human and interesting and imperfect–we can shatter the stereotypes of aging and help to eliminate discrimination of people based on how old they are.

Still relatively new, this project is evolving. With such a strong network foundation and support, Meg foresees that this project will continue to unfold and grow in a variety of directions.

In just a few months Meg has introduced her readers to a number of people living in and around Baltimore city.  From lost love to second chances, the residents Meg has interviewed do not pine for their youth, but proudly describe the path they’ve taken that has led them to the person they are today.

Nancy, 82

“…But I won’t let that get to me. I’m very blessed.” -Nancy

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To read Nancy’s story visit Age in America

Meet Nancy, 82, from Arbutus, MD.  She has volunteered her whole life and lives by values taught to her by her mother at a very young age.  Despite having a recent surgery and blindness in one eye, Nancy continues to volunteer at her local senior center every day. She says, “I just live down the street, and I used to walk it, but I can’t judge steps and curbs anymore so I can’t go outside. But I won’t let that get to me. I’m very blessed. I do all the things I can do.”

Robert, 83

“…I lived in West Virginia every summer on my grandparents’ farm. Those are my best memories.” -Robert

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To read Robert’s story visit Age in America

Meet Robert, age 83.  Robert worked for the B&O Railroad in Baltimore City for over 30 years.  Born and raised in Baltimore he reflects on his youth “I would get on the streetcar and go to Baltimore as a young kid, go to the movies, come home late on the streetcar and I never had any problems.”

Robert’s and Nancy’s stories highlight the importance of Meg’s work, which connects stories to faces and brings a new presence to their local communities. With their respective reintroductions to the reader and to the community, Meg’s project weaves together past and present narratives into a larger and familiar story that we can all identify with.

The Future is Age in America

Age in America’s vision is to create a society where ageism does not exist and where aging is not feared but revered. And their mission is to reframe perceptions of aging in America with oral histories, storytelling, and images that illustrate the positivity, diversity, and value of being older.

Over the next year, Meg will be conducting interviews in cities across the country.  With a set list of questions, she hopes to capture the stories of our nation’s past from the people who lived through it.

If you would like to be interviewed for the project or you would like to host the project in your community, please contact Age in America via email: malaporte@me.com.

 

Meg LaPorte

 

Meg LaPorte is a journalist specializing in aging issues. She served as managing editor of Provider magazine for nine years and holds a master’s degree in Management of Aging Services from the University of Maryland Baltimore County.

Jackie, 68

I had the exciting opportunity to sit down with Meg LaPorte about her latest project Age in America. Age in America’s mission is to reframe perceptions of aging in America with oral histories, storytelling, and images that illustrate the positivity, diversity, and value of being older.

Stay tuned for a closer behind the scenes look at the next greatest human interest series since Humans of New York!

Until then here is Age in America’s first spotlight Jackie, age 68, from Baltimore City.

Age In America

“My mother and father wanted the best for me. My father worked at Bethlehem Steel [at Sparrow’s Point]. He was a good provider. We also had a grocery story. My mother had me in piano lessons and I did piano recitals. I even went to Peabody Preparatory but I didn’t stick with it. That’s one regret I have, but I became a teenager and I wanted to be with my friends rather than in the house practicing. My childhood was full of exciting things to do. I was spoiled. My father pretty much gave me whatever I wanted. Even when I was 18 or 19, my dad would be with his friends down at the laundromat and I would be in the car and he would flag me down and he would take me to fill the car up with gas. When I think about it, I think ‘you were spoiled…

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Urinary Tract Infections Strike at Any Age… Keep an Eye Out for These 6 Signs.

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First posted on Sixty and Me on May 9, 2017.

Urinary Tract Infections (UTIs) are not an ideal topic for conversation. They are a painful nuisance that accounts for 8.1 million people visiting their primary care physician each year.

However, the severity of symptoms that can occur in an older adult makes it a necessary conversation topic.

UTIs can occur for anyone at any age but are most common in women and older adults. As we get older, however, the symptoms of a UTI will change. If you’ve had one in your life, you know that they can be both painful and uncomfortable. However, aside from the general irritation, and although rare, you may outwardly show changes in your cognition.

UTIs Often Mistaken for Early Stages of Dementia or Alzheimer’s

UTIs in the elderly are often mistaken for the early stages of dementia or Alzheimer’s, according to National Institutes of Health (NIH), because symptoms include confusion or delirium-like state, agitation, and hallucinations. Some may exhibit other behavioral changes, poor motor skills or dizziness, or even fall.

These symptoms may manifest themselves in different ways that often risk the dignity of the infected older adult. It is not uncommon for seniors to do out of the ordinary things such as curse at or threaten to harm their caregivers as well as remove articles of clothing in public.

Unfortunately, when an older adult starts “acting out” or demonstrating “aggressive behavior” the first diagnosis given by health care professionals is a complication due to dementia or Alzheimer’s rather than looking at the behavior as a symptom of an UTI.

These types of drastic personality changes are common, but because the symptoms are so closely associated with dementia, it is often interpreted as just another reminder of our loved one’s cognitive decline.

How to Reduce the Risk of a UTI

UTIs are caused by bacteria in the bladder. People with incontinence or who have difficulty getting up and going to the bathroom on their own are more at risk for UTIs because of the close contact the adult briefs have with their skin.

Here are some suggestions for reducing the risk of UTI. First, drink plenty of fluids (2 to 4 quarts each day) and drink cranberry juice or use cranberry tablets. However, avoid caffeine and alcohol because these irritate the bladder. It may be helpful to set a timer to remind on the use of the bathroom.

For women, do not use douches or other feminine hygiene products and always wipe from front to back. Also, wear cotton-cloth underwear, and change briefs frequently, at least once a day. You can read more suggestions here.

3 Ways to Track and Prevent UTIs

Talk to a Doctor

Left untreated, UTIs can severely compromise the immune systems of older adults. A UTI can be determined with a simple urine test, so asking a doctor to perform a urine test when we notice a sudden change in behavior is a great way to prevent prolonged discomfort and worsening of symptoms for our loved ones.

Take Notes

Family caregivers should always keep notes of their loved one’s medical conditions and behavior even when a UTI is not suspected. Charting this day to day is helpful in managing care, and also allows us to document trends we may not pay too much attention to in the moment. Click here for documentation resources.

Stay Hydrated

Dehydration in older adults is common and is a leading cause of developing an UTI. Drinks like Gatorade and apple juice are popular options to keeping our loved ones hydrated.

Like mentioned above, drinking cranberry juice is a popular home remedy for treating UTIs. This sweet juice is also a more enticing drink to offer our loved ones who just don’t seem to drink enough water. Read more on how cranberry juice fights urinary tract infections here.

Caregiving that Enhances Dignity

UTIs in older adults will cause our parent or loved one to act in all types of ways that may compromise their dignity. As a family caregiver, it is shocking and even hurtful when our loved one becomes angry and threatens us. But taking these types of reactions personally can be detrimental to the quality of care we provide as we may become more cautious or saddened by their new behavior.

As we stop and consider these behaviors as symptoms rather than natural progressions to a disease process we may begin to reframe the way we provide care. Catching these types of changes at the onset of an infection will better allow us to get them the medical treatment they need, but also stops the worsening of these often-uncharacteristic behaviors.