Dealing with Noncompliant and Uncooperative Elderly Patients

There are many factors which can lead to an elderly person becoming noncompliant with their medication, or uncooperative with their care plan. As such, there are also many different ways a caregiver can deal with either problem. So what are some things that Encompass might tell a family caregiver if they’re struggling with an uncooperative elderly parent?

First off, the answer depends on the family caregiver’s personal relationship with the elderly person before there is a crisis. For example, sudden fits of crabbiness would raise alarm to an adult daughter who has had a lifelong happy and healthy relationship with her elderly mother. Conversely, changes in behavior would be less noticeable if the relationship between the mother and daughter has a long history of turbulence. Once the type of relationship is identified, the aim should then be to figure out why the elderly parent is being uncooperative.

Common reasons for elderly noncompliance

  • Side effects from medication–Side effects from medications can induce illness and older patients are especially sensitive to medication overdose complications, the New York Times notes.
  • Complicated medication regimen–It’s normal for an elderly person to be taking multiple medications several times a day. Understandably, this can get complicated, especially if your parent is disabled (poor eyesight, foggy memory, etc.). Keep an up to date list of your loved one’s prescriptions and go over it with a doctor or physician if there’s a notable change in health or behavior.
  • Unable or unwilling to change eating and exercise habits–For many medications to work properly, there must be a change in diet. Likewise, it’s very common for a doctor to recommend an increase in exercise to promote better health. Even so, lifelong habits are hard to change, especially when side effects from medication and physical limitation are at play.

Common reasons for an elderly parent’s uncooperative behavior

  • Unhappy with their situation–The ails of old age cause many people to lose their precious independence. This is a tough situation for many people to deal with. When facing the reality of a chronic illness, or lulling on the idea of being a burden on their families, many seniors become depressed or develop a negative outlook on life. Try talking openly and honestly with your loved one about their fears. Also, consider talking to the doctor about your his or her behavior as well.
  • Side effects from medication–As mentioned above, drugs can positively or negatively effect a person’s health, even leading to drastic changes in a person’s behavior.
  • Cognitive decline–Alzheimer’s disease and other forms of dementia slowly take away a person’s precious memories, leading to uncharacteristic behaviors and sudden outbursts. If possible, discuss what your parents’ expectations are regarding their care. This will help you act according to their wishes should a crises arise.

Many times, when elderly parents become uncooperative/noncompliant it means, You aren’t doing what I want you to do rather than them actually not wanting change to happen. In the end, the situation comes down to negotiation and letting the parent be a true partner in the decision-making process.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of geriatric care options and helps families maneuver through the challenges of the system. Get your free Cost Comparison guide by clicking here . Or contact us for a free consultation or just to say hello!

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Understanding Your Elderly Parent's Crabby Behavior

In a previous blog post, we discussed what to do when confronting an elderly parent’s uncooperative behavior. While it’s helpful to understand emotions that can lead to a caregiver developing a deep-rooted aversion to their aging parent’s crabbiness, it’s just as important to understand why an elderly person can become upset in the first place.

There are some people who have had a negative outlook on things most of their lives. Even so, many seniors’ behavior changes in the face of an injury, illness, or a negative reaction to medication.

Below are some common factors that can lead to a negative change in an elderly parent’s behavior:

Parent is frustrated with cognitive decline (Alzheimer’s or Dementia)

When a senior begins to lose their perceptive faculties and precious memories, life can be hard–especially if they’ve been independent their entire adult lives. Feelings of helplessness and depression can surface, dominating a person’s thought process in the face of  chronic cognitive decline.

What you can do

Acknowledge the situation for what it is (a difficult and disheartening reality) and exhibit patience and understanding. Know that your parent’s anger is often an expression of inner fears, even if one of the results is destructive behavior and insults directed at you. Offering companionship and an open ear can go a long way in helping your loved one avoid social isolation.

Related: 5 Steps for Handling an Aging Parent with Dementia

Physical impairment

Like cognitive decline, physical impairment that limits mobility and independence can be overwhelmingly frustrating to someone once active and athletic. Whether your loved one is at risk of falls, has trouble walking, or has simply grown frail in old age, routine tasks like cooking and cleaning may require assistance, making your loved one feel inadequate.

What you can do

No matter their age, parents generally don’t want to feel as if they’re a burden to their children. Speak with your elderly parents about the reality of their situation and your ability to assist them. From here, talk to a senior care professional to determine if home care needs to be brought in to help your loved one live more comfortably within the scope of their limited mobility.

Medication leads to change in personality

Sometimes taking a new medication can have adverse effects on the body. The chance of a negative reaction grows if your parent is prescribed multiple medications at once. These reactions could lead to a number of negative results, including a change in behavior.

What you can do

Keep an up to date list of your parent’s medication and make note of recent changes in behavior which may coincide with a new prescription. If a problem arises, go over the medications with your parent’s doctor or pharmacist, as an alternative with less harmful side effects may be available.

The pessimistic type

Some people have had a negative outlook on life for many years. In this case, an injury or illness is not going to lighten their mood any.

What you can do

Realize that pessimistic personalities seldom change. As a caregiver, acknowledge this and simply expect your loved one to be more irritable if he or she doesn’t feel well. If your parent’s negativity begins to affect your well being, remember to make time to de-stress–it will benefit both your and your loved one.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of geriatric care options and helps families maneuver through the challenges of the system. Get your free Cost Comparison guide by clicking here. Or contact us for a free consultation or just to say hello!

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Five Steps to Dealing With an Uncooperative Parent with Dementia

An elderly parent who constantly complains and criticizes may seem like a description of a sitcom character. But in reality, many older adults live with the stress of trying to care for their parent or parents who may be in a bad mood the majority of the time.

In an article on Psychology Today, Dr. Mark Goulston gives some advice on dealing with a cranky elderly parent. First off, it’s important not to feel any guilt or resentment about behavior that may be surfacing, and what’s more, children of aging parents must be proactive in addressing bad behavior directly.

Here are some key points from the article:

  • Many adult children–often in their 50s and 60s–are relieved to know they’re not alone in feeling that they are living under a cloud that will only leave when their parents pass away. “For them, there is no such thing as good news–not when their mother or father is chronically ailing or, worse, in good health but with a bitter or negative disposition,” Goulston writes.
  • When an older adult has the desire for their parent to die sooner rather than later, it naturally brings with it large amounts of guilt and stress. However, this doesn’t mean they don’t love them or really want them to die. Rather, it’s far more likely a desire for resolution to the unsettling feelings that are rooted in frustration and exhaustion caused by overseeing their parent’s care.
  • After an adult child comes to terms both intellectually and emotionally that they love their parents but resent their crabby behavior, they can become emboldened to stand up to them, which seemed impossible before.
  •  Goulston cites an example of a patient finally standing up to her elderly mother living in an assisted living facility. He describes what she said during the confrontation: “You’re my mother and I’m always going to love you, for as long as you live and beyond, but if you continue to act as negatively as you are, I’m not going to like you. And if I don’t like you, I’m going to visit you less often and shorten the amount of time I spend with you at each visit.”
  • Put in the above, frank terms, the elderly mother realized she had become a bully. And, not wanting to lose the companionship of her daughter, she began to change her behavior.

Coming to terms with an uncooperative parent’s behavior and ailing health is never an easy journey. But by being honest with yourself about your feelings, you will free yourself from any guilt and resentment you’ve built up, allowing you to enjoy what time with your parent or parents that you have left.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of geriatric care options and helps families maneuver through the challenges of the system. Get your free Cost Comparison guide by clicking here. Or contact us for a free consultation or just to say hello!

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“Physicians Choice Private Duty solves the challenges families face in caring for aging parents, with a focus on strategies that keep them in their homes. To learn more about our solutions, visit us today..”


Five Steps to Dealing With an Uncooperative Parent with Dementia

It’s no easy task caring for an elderly parent suffering from Alzheimer’s or dementia. Experienced family caregivers agree that one of the most common problems in dealing with a parent with Alzheimer’s or dementia is uncooperativeness. This comes in several forms, whether through disagreements about everyday tasks like eating, dressing and bathing, or even an elderly parent criticizing their children, regardless of provocation.

The lifestyle website Live Strong.com offers a five-step solution for dealing with a difficult elderly parent with dementia, adapted below.

Step 1–If possible, discuss your parents’ desires and expectations regarding their care before they develop dementia. This will help you act according to their wishes should a crises arise.

Step 2–Go over your parents’ finances to make sure the funds are available for their care needs. If they are financially unstable, take the necessary steps to apply for financial aid, or find other means to pay. Also, find out whether or not any legal arrangements have already been made. Any questions you might have can be answered by a senior care provider such as Physicians Choice Private Duty.

Step 3–Bring your parents along to family gatherings and other family duties, especially if they are living with you. LiveStrong notes that parents often become upset when they feel excluded from family outings–and who could blame them? You should also encourage your parents to contribute to their own care as much as their abilities allow. This will help them maintain self-respect when they’re asked to participate and perform tasks like chores.

Step 4–Perform a safety check of your parents’ home to help them maintain as much independence as possible. Remember, this will put less pressure on you. Many experts also suggest incorporating universal design into the home to make a living space comfortable and accessible to the entire family.

Step 5–Many seniors who are dependent on others end up being socially isolated, which leads to depression and even early death. To help alleviate this, invite friends and family to visit your parents on a regular basis.

What are some other ways that you recommend helping out with an uncooperative loved one with dementia? Let us know on Twitter or in the comments.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of geriatric care options and helps families maneuver through the challenges of the system. Get your free Cost Comparison guide by clicking here . Or contact us for a free consultation or just to say hello!

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How Seniors Can Prevent Fractures

In a previous post we discussed how regular exercise and proper medication management can help prevent seniors from falling. A new study published by Osteoporosis International backs this up, adding that older people at risk of bone fractures often make positive lifestyle changes to avoid them, including exercising, wearing proper footwear, and taking supplements.

Even so, falls are a leading cause of loss of senior independence. In many cases, falls result in bone fractures, leaving an elderly person debilitated for months. It’s even more discouraging to find that having such a fracture doubles a person’s risk of having another, according to Bio-Medicine.org. Fractures are a very real risk: Nearly half of all women and one in five men over 50 will suffer from a fracture after falling from standing height or lower. Hip fractures in particular leave many people living in long-term care facilities or even result in death, according to Dr. Joanna Sale, a clinical epidemiologist at St. Michael’s Hospital and lead author of the study.

In the study, participants over the age of 65 were asked about their perceived fracture risk, what recommendations they received about bone health, their results of recent bone density tests, and whether or not they made any lifestyle changes since their last fracture.

Some takeaways from the study:

  • Nearly all participants understood that they had low bone mass and were at risk of a having a future fracture. Even so, many were still confused about the significance of bone density.
  • Many felt that they had little control over their fracture risk. Still, all in this group were taking steps to manage their fracture risk, including using handrails or wearing proper shoes.
  • Nearly all said they were considering or were already taking prescribed medications for their bone health. Most said they either were or were considering exercising more, eating more healthily, taking supplements, and/or using walking aids.

The participants in the study were fortunate enough to be in the Osteoporosis Exemplary Care Program at St. Michael’s, which included a coordinator who educates and follows up with patients. Many others aren’t so lucky. By helping your loved one become educated about the real risks that come about with falls and fractures, he or she will be better able to take positive action to reduce fracture risk, enabling a longer, happier, and more independent life.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of geriatric care options and helps families maneuver through the challenges of the system. Get your free Cost Comparison guide by clicking here . Or contact us for a free consultation or just to say hello!

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having-trouble-with-your-home-health-care-provider

Many people consider falling to be an inevitable byproduct of old age. It’s easy to see why: studies show that a third of people over the age of 65 fall each year. Falling can lead to seniors developing a fear of walking, as those prone to falls can develop a deep-rooted fear of falling again. In previous posts, we shared ways that home health care professionals can determine if a senior is at risk of falling, and a checklist that caregivers can use for preventing falls in the home. Today, we’ll focuse on some things an elderly person can do to reduce their risk of falling in the first place. Taking these measures in order to reduce falls (and the length physical rehabilitation process that follows) if absoulutely essential if you have an aging loved one.

Below are some tips on avoiding falls, adapted from learnnottofall.com, a service of Phillips Lifeline.

Strength and balance

Those at risk (or afraid of) falling tend to become less active. In truth, the less active a person is, the more likely it is that he or she will fall due a lack of strength and balance. That’s why healthcare professionals recommend that seniors have a regular exercise routine, even if it’s just one step at a time.

Exercise can improve a senior’s:

  • Strength and stamina, promoting heart, lung and cardiovascular health.
  • Balance, which can diminish over time if not continuously worked on.
  • Gait and strength of walking.
  • Reflexes, by increasing responsiveness to obstacles or other potential dangers in their path.

Know your medications

While medications can help seniors stay well, they can also sometimes have side effects that make seniors prone to falls. This is especially true in the case of those taking several medications daily.

Things to consider when linking medications to fall risks:

  • Drugs may have side effects that make a person feel dizzy or confused.
  • Multiple drugs may interact, producing side effects that lead to falls.
  • Following the doctor’s orders may be difficult for some seniors, as their medication schedule is too complicated or they are suffering from side effects.

Falls are a leading cause of loss of elderly independence. Being aware of the factors that put someone at risk of falling are key to fall prevention. In the end, simple solutions like regular exercise and proper medication management can help your loved one live a more comfortable and healthy life–completely free from a fear of falling.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of geriatric care options and helps families maneuver through the challenges of the system. Get your free Cost Comparison guide by clicking here. Or contact us for a free consultation or just to say hello!

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having-trouble-with-your-home-health-care-provider

Our last post looked at ways to ensure that you and your aging loved one stay satisfied with a home health care provider. Today we’ll examine the flip side of the coin–what to do if a problem should arise.

One scenario that can lead to problems with health care providers is alleged theft by a home health care worker. As the Minnesota Board of Aging notes, many cases of valuables “gone missing” are actually the result of that item being moved, or a loved one forgetting where that item was placed.

If you suspect that a worker has taken money, credit cards or other valuables, call the police as soon as you can confirm that the item is missing–just as you would call the police if a burglary occurred. If the worker is an agency employee, contact the agency immediately as well. It’s worth noting the most agencies require a thorough background check before hiring an employee. This may not be the case with a self-employed worker. While the vast majority of workers do not steal, it’s always best to keep any money or other valuables locked up in a secure area.

Maintaining regular contact with your loved one’s case supervisor is a good way to ensure that problems are handled in an efficient manner, and in most cases involving agencies, case supervisors are the first ones you should go to with any issues. At Physicians Choice Private Duty, we always encourage clients to maintain contact and let us know how things are going–whether that means they’re good, bad or indifferent. We are commited to positive quality control and stand behind our promise of providing the best service possible to all of our clients.

Remember: good communication between you, your loved one and the home health care worker–and the case supervisor if you use an agency–should quickly alleviate the vast majority of any discrepancies. Whether you’re dealing with alleged theft, or are uncomfortable with a worker, your case supervisor should be able to help you with any issues.

If you’re currently working with a self-employed home health care worker, consider switching over to an agency. Most agencies already have policies in place in case problems arise. Additionally, agencies are required to investigate, and attempt to resolve, any grievances or complaints.

With an individual self-employed worker, this isn’t always the case, and you’ll have to resolve the issue directly with the self-employed worker. That’s why it’s absolutely essential to address how problems will be dealt with before they ever happen.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of geriatric care options and helps families maneuver through the challenges of the system. Get your free Cost Comparison guide by clicking here . Or contact us for a free consultation or just to say hello!

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“Physicians Choice Private Duty solves the problems families face in finding home health care providers they can trust. Providers who will focus on strategies that keep parents in their homes. To learn more about our health care services, visit http://www.encompass-home-health-care.com.”


things-to-consider-when-hiring-home-health-care

Many home health companies provide staff at their own convenience, not at the convenience of the patient and his or her family. That’s why we believe that a family first must decide what they need, and then must find a company able and willing to accommodate them, because after all, what good does home health care do if the family’s needs aren’t met?

Today, we’ll expand on an earlier post in hopes of giving you a better idea of what to look out for when seeking a home health care service provider.

The below info is adapted from the Minnesota Board of Aging. And as a side note–Minnesota ranks No. 1 in the U.S. in terms of senior health, with Iowa and Nebraska not far behind.

Here are a few key points to ensure that you stay satisfied with your home health care service provider:

  • Have realistic expectations.When it comes to home health care workers performing their daily tasks, being flexible as a family is important. For example, if a loved one’s morning routine changes regularly, it’s best to inform each new employee of your preferences to ensure transparecy. Keep in mind that arrival times may differ from day to day–health care workers often have busy schedules and arriving at the exact same time every day may not be possible.
  • Reschedule provided services. Personal scheduling conflicts are inevitable every now and then when working with a home health care worker. As such, it’s important to inform the provider or agency as soon as possible if things are changing, so that alternative servies can be provided or schedules can be changed. Have someone on backup who can call your loved one’s provider in case you’re tied up, and make sure they’re verified with the company so they can be your contact in the event of an emergency.
  • Know who to contact. Most agencies use a case manager–a person who is responsible for implementing and monitoring the client’s service agreement, and troubleshooting if a conflict occurs. Make sure you know who the case manager is, and be ready to contact him or her directly if you decide that there are any changes you would like to make to your health care services. Talking to other staff members instead of directly contacting who’s in charge can lead to confusion or misenterpretaion.
  • Have an emergency plan. Agency employees are instructed to call their office or 911 when they observe a client having a medical emergency. Hospice employees are given specific instructions on how to handle emergencies. A self-employed home care worker may not know your preferences in the event of an emergency, so be sure to map out a plan so that you’re prepared in case the unexpected happens.
  • Plan out liability. Agencies usually have insurance to cover the repair or replacement of an item accidentally broken by an employee. If such an incident occurs, inform the case manager as soon as possible. In most cases, though, you’ll need to resolve the incident together with the worker involved. In that case, writing out a section about broken items in your initial contract could be an important point.

Home health care can be a stressful affair, but keeping up on the listed points is a good way to ensure that you stay satisfied with your loved one’s home health care provider. Planning for emergencies and knowing what to expect is key to satisfaction on both ends of the bargain.

What are some other ways to ensure satisfaction with your home health care provider? Let us know on Twitter or in the comments.

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of geriatric care options and helps families maneuver through the challenges of the system. Get your free Cost Comparison guide by clicking here . Or contact us for a free consultation or just to say hello!

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“Physicians Choice Private Duty solves the problems families face in finding home health care providers they can trust. Providers who will focus on strategies that keep parents in their homes. To learn more about our health care services, visit http://www.encompass-home-health-care.com.”


things-to-consider-when-hiring-home-health-care

There are many aspects of home health care that families overlook when choosing a care plan for their loved one, like the care schedule needed for a home health care provider, or the specific needs of the senior involved.

Encompass has seen this time and again firsthand. We once had a family who needed coverage early in the morning–from 6:15-10:30 a.m.–but no other home care company would touch them because it is hard to find workers that want those hours. Other home care companies asked the family to change their hours or be more flexible with the times, a difficult solution for someone on a fixed schedule. Encompass was able to find a home health care worker to fill the early shift because we understand that, in reality, it isn’t always an option for a family to change their schedules on the drop of dime–especially when careers and other obligations may be affected.

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senior-health-5-signs-of-elderly-hearing-loss-omaha

Hearing loss is a common condition affecting older adults. According to the National Institute of Health (NIH), around 36 million (or 17 percent) of American adults admit having some degree of diminished hearing. Hearing loss can be caused by a variety of factors, including noise, disease, medication, heredity, or simply aging.

An elderly person with hearing loss faces many difficulties in his or her daily life, from not being able to hear and join in conversation with family and friends, to having trouble understanding a doctor’s advice. One study even links hearing loss with cognitive problems in the elderly, going so far as to suggest that it could even speed up the progression of dementia.

Five signs that indicate that an elderly person may be suffering from hearing loss can be seen below. If a senior exhibits one or more of the following symptoms, it may be time to consult a doctor:

  • Frequently ask you to repeat yourself, or speak clearly, slowly, and/or loudly in conversation
  • Have difficulty understanding words, especially in a crowd or a setting with background noise
  • Turn up the volume of the television or radio frequently
  • Uncharacteristically withdraw from conversations
  • Start avoiding social settings

The Mayo Clinic recommends seeing a doctor when one or more of the above signs of hearing loss begin interfering with your loved one’s quality of life. With 30 percent of adults 65-74 and 47 percent of adults over 75 having hearing impairment, knowing the signs and symptoms of hearing loss can help your elderly loved one live a happier and more fulfilling life after catching and treating hearing problems early on.

How have your addressed your loved one’s hearing loss? Let us know on Twitter or in the comments.

Related: The Senior Hearing Test You Can Do Yourself

Physicians Choice Private Duty currently serving Omaha, Eastern Nebraska and Western Iowa provides seniors and their families a complete understanding of geriatric care options and helps families maneuver through the challenges of the system. Get your free Cost Comparison guide by clicking here . Or contact us for a free consultation or just to say hello!

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“Physicians Choice Private Duty solves the challenges families face in caring for aging parents, with a focus on strategies that keep them in their homes. To learn more about our solutions, visit us today..”